Is a filum terminale with a normal appearance really normal?

INTRODUCTION. Tethered spinal cord is defined as a condition in which the conus medullaris ends at a level below the L1-2 intervertebral space. The spinal cord is considered to be tethered when there is a thick filum terminale or low-lying conus medullaris. It has also been reported that a normal level of the conus medullaris and normal thickness of the filum terminale do not mean that there is no cord tethering. MATERIALS AND METHODS. In this investigation, we examined 21 fila terminalia; 5 of them were taken from cadavers, and these were used as a control group (group 1; n/n), 8 from patients with a normal appearance of the filum terminale but with clinical symptoms (incontinence) and pathologic results of a urodynamic study (group 2; n/ab), and 8 from patients with an abnormal appearance of the filum terminale and with clinical symptoms (group 3; ab/ab). Interestingly, we found that while fila terminalia in the control group were made up mainly of collagen fibers, more connective tissue with dense collagen fibers, some hyalinization and dilated capillaries were noticed in the fila from group 2. RESULTS. Our results suggest that these histological features may reflect a decreased elasticity within the filum terminale, resulting in a tethering effect on the lower conus in otherwise normal physiological conditions. CONCLUSION. These findings lead us to reconsider sectioning of the filum terminale in incontinent patients with normal results in radiological studies, whose condition is called "nonneurogenic neurogenic bladder."     

Behçet's disease: diagnostic and prognostic aspects of neurological involvement

This study was conducted to describe clinical and prognostic aspects of neurological involvement in Behçet's disease (BD). Patients referred for neurological evaluation fulfilled the criteria of the International Study Group for Behçet's Disease. We analyzed disability and survival by the Kaplan-Meier method, using Kurtzke's Extended Disability Status Scale (modified for BD) and the prognostic effect of demographic and clinical factors by Cox regression analysis. We studied 164 patients; of the 107 diagnostic neuroimaging studies: 72.1% showed parenchymal involvement, 11.7% venous sinus thrombosis (VST) and the others were normal. CSF studies were performed in 47 patients; all with inflammatory CSF findings (n=18) had parenchymal involvement. An isolated increase in pressure was compatible with either VST or normal imaging. The final diagnoses were VST (12.2%), neuro-Behçet's syndrome (NBS) (75.6%), isolated optic neuritis (0.6%), psycho-Behçet's syndrome (0.6%), and indefinite (11%). VST and NBS were never diagnosed together. Ten years from onset of BD 45.1% (all NBS) reached a disability level of EDSS 6 or higher, and 95.7±2.1% of the patients were still alive. Having accompanying cerebellar symptoms at onset or a progressive course is unfavorable. Onset with headache or a diagnosis of VST is favorable. Two major neurological diagnoses in BD are NBS and VST. These are distinct in clinical, radiological, and prognostic aspects, hence suggesting a difference in pathogenesis.     

Determination of some heavy metals in food and environmental samples by flame atomic absorption spectrometry after coprecipitation

A novel preconcentration procedure based coprecipitation of Cu(II), Co(II), Cd(II), Ni(II), Mn(II), Fe(III) and Pb(II) on thulium hydroxide precipitate has been presented prior to flame atomic absorption spectrometric determination of them in environmental samples. The analytical parameters that influenced the quantitative coprecipitation of analytes including amount of thulium, pH, duration time, etc. were investigated. The effects of alkali, earth alkali, and some transition metals on the recoveries were also studied. Under the optimized conditions, the detection limits (3 sigma, N = 10) for the analytes were in the range of 0.1-1.6 μg/L, respectively. The validation of the presented coprecipitation method was checked by the analysis of certified reference materials (TMDA 54.4 fortified lake water and HR-1 Humber river sediment). The proposed coprecipitation method has been successfully applied for the determination of traces of copper, cobalt, cadmium, nickel, manganese, iron and lead in food and environmental samples.     

Antagonism of TIM-1 blocks the development of disease in a humanized mouse model of allergic asthma

Studies in mice and humans have revealed that the T cell, immunoglobulin, mucin (TIM) genes are associated with several atopic diseases. TIM-1 is a type I membrane protein that is expressed on T cells upon stimulation and has been shown to modulate their activation. In addition to a recently described interaction with dendritic cells, TIM-1 has also been identified as a phosphatidylserine recognition molecule, and several protein ligands have been proposed. Our understanding of its activity is complicated by the possibility that TIM-1 possesses multiple and diverse binding partners. In order to delineate the function of TIM-1, we generated monoclonal antibodies directed to a cleft formed within the IgV domain of TIM-1. We have shown here that antibodies that bind to this defined cleft antagonize TIM-1 binding to specific ligands and cells. Notably, these antibodies exhibited therapeutic activity in a humanized SCID model of experimental asthma, ameliorating inflammation, and airway hyperresponsiveness. Further experiments demonstrated that the effects of the TIM-1–specific antibodies were mediated via suppression of Th2 cell proliferation and cytokine production. These results demonstrate that modulation of the TIM-1 pathway can critically influence activated T cells in a humanized disease model, suggesting that TIM-1 antagonists may provide potent therapeutic benefit in asthma and other immune-mediated disorders.     

Utilization of membrane filtration for preconcentration and determination of Cu(II) and Pb(II) in food,water and geological samples by atomic absorption spectrometry

A method for separation–preconcentration of Cu(II) and Pb(III) ions by membrane filtration has been presented. The analyte ions were collected on acetate membrane filter as their 1-2-pyridylazo 2-naphthol (PAN) complexes. The analytes were determined by flame atomic absorption spectrometry. The analytical parameters including pH, eluent type, sample volume, amount of PAN, etc. were examined in order to gain quantitative recoveries of analyte ions. The effects of foreign ions on the recoveries of analyte ions were also investigated. The detection limits by three sigma were found to be 1.2 and 3.5 μg L⁻¹ for Cu(II) and Pb(II), respectively. The preconcentration factor was 60 for Cu(II) and 20 for Pb(II). The validation of the presented procedure was checked by the analysis of certified reference materials. The optimized method was successfully applied to food, water and geological samples with good results.     

Intrasellar epidermoid cyst presenting as pituitary apoplexy

We herein present a patient with intrasellar epidermoid cyst presenting as pituitary apoplexy, who was operated upon with a trans-sphenoidal approach. The clinical presentation, radiological and histological differential diagnosis and type of surgical intervention for intrasellar epidermoid cysts are discussed.