High-dose infliximab prophylaxis in endotoxin-induced uveitis.

PURPOSE: The aim of this study to analyze the preventive effect of high-dose infliximab in endotoxin-induced uveitis (EIU) in rabbits. METHODS: An experimental study was conducted on 64 rabbits. Salmonella typhimurium lipopolysaccharide endotoxin was intravitreally injected. Infliximab was intravenously (i.v.) injected 24 h before the intravitreal injection (20 mg/kg). The animals were randomly assigned to five groups: group A, saline intravitreal injection; group B, Infliximab i.v. group C, infliximab + saline; group D, intravitreal endotoxin and group E, infliximab i.v. + intravitreal endotoxin. With two masked observers, a microscopic examination of aqueous humor (cells, tumor necrosis factor [TNF] alpha) and aqueous protein level were performed 24 h after an endotoxin injection and 48 h after an infliximab infusion. RESULTS: Infliximab treatment, at a dose of 20 mg/kg, significantly improved all the parameters. Inflammatory cell infiltration was significantly reduced in the iris, ciliary body, and anterior chamber (U Mann-Whitney test, P = 0.01). Associated with a lower level of TNF-alpha and protein exudate in aqueous humor (U Mann-Whitney test, P = 0.01). CONCLUSIONS: Infliximab, at a dose of 20 mg/kg, is effective in the prophylaxis of the EIU.     

Blood Flow Increase by Cervical Spinal Cord Stimulation in Middle Cerebral and Common Carotid Arteries

The effect of spinal cord stimulation (SCS) on cerebral blood flow (CBF) has, in the past, been evaluated by semiquantitative techniques, but has not been used to treat CBF diseases. The aim of this study was to assess the effect of cervical SCS on regional blood flow by both semiquantitative and quantitative methods. Thirty‐five patients with cervical SCS‐implanted devices were enrolled. The following parameters were measured before and after cervical SCS: systolic and diastolic velocity (cm/s) in the middle cerebral artery (MCA) by transcranial Doppler (TCD) and volume blood flow quantification (ml/min) in the common carotid artery (CCA) by color Doppler. During cervical SCS there was a significant and bilateral increase in systolic (21%) and diastolic (26%) velocity in the MCA and in CCA blood flow (50%). We conclude that cervical SCS increases blood flow in the middle cerebral artery and common carotid artery. The consistent increase supports the potential usefulness of cervical SCS as an adjuvant treatment for cerebral blood flow diseases.     

Lymphoepithelioma-like carcinoma of the skin: A light-microscopic and immunohistochemical study

Cutaneous carcinoma histopathologically resembling nasopharyngeal carcinoma has been termed lymphoepithelioma-like carcinoma of the skin. We present an additional example of this rare cutaneous neoplasm that was located on the left temple of an 83-year-old woman. Serology for Epstein-Barr virus was negative, and exploration of the nasopharyngeal region disclosed no abnormalities. Histopathologically, the neoplasm consisted of a relatively well-circumscribed, dermal-hypodermal nodule composed of irregular aggregates of epithelial cells with vesicular nuclei, some of them in mitosis, and scant cytoplasm. A dense lymphocytic infiltrate was present within the neoplastic aggregates, obscuring the epithelial component, and at scanning magnification, the lesion closely resembled cutaneous lymphoma or pseudolymphoma. There was local sebaceous differentiation. Immunohistochemistry showed positivity in the epithelial component for AE1/AE3 and AEB-903 cytokeratins and negativity for 8–18 cylokeratins. The inflammatory infiltrate was positive for leukocyte common antigen, UCHL-1, L-26, Leu-22, and OPD-4 in variable proportions. Scattered cells within this inflammatory infiltrate were also positive for S-100 protein, vimentin, HAM-56, and MAC-387. In situ hybridization investigations for the presence of Epstein-Barr virus genomic DNA yielded negative results. Lymphoepithelioma-like carcinoma of the skin is a distinct cutaneous neoplasm of unknown histogenesis, although some foci of adnexal differentiation have been found in some specimens. The possibility of cutaneous metastasis from occult nasopharyngeal carcinoma should be ruled out.
Requena L, Sánchez Yus E, Jiménez E, Roo E. Lymphoepithelioma-like carcinoma of the skin: A light-microscopic and immunohistochemical study.     

Interventional computed tomography

Due to the development and refinement of computed tomography (CT), sonography, and interventional techniques, the field of interventional radiology has seen tremendous growth in recent years. In particular, the precise anatomic detail provided by CT and sonography has allowed percutaneous biopsies and abscess drainages to be performed safely and effectively. Percutaneous biopsies are now becoming the most common interventional radiographic procedures in many institutions. The usual indications for a biopsy are to determine the etiology of a mass, neoplasm, or inflammation, and to determine whether masses in known oncologic patients represent scarring or residual viable tumor. Accuracy rates for most percutaneous CT-directed biopsies are well over 90%, and the complication rate is very low. CT-directed percutaneous abscess drainages are also safe and effective and, in most cases, will be preferable to surgical drainage. The initial indications for percutaneous drainage (single, unilocular fluid collections) have been greatly expanded to include multiloculated collections, interloop abscesses, periappendiceal abscesses, and even percutaneous cholecystotomies. Biopsy and drainage procedures, together with their accuracy rates, indications and complications, are reviewed in this monograph.     

Estimating neuron dendritic length in 3D from total vertical projections and from vertical slices

The recently developed method of total vertical projections is illustrated to estimate the total dendritic length of a human Substantia Nigra neuron. Next, the length of the different orders of dendritic branches, and the mean segment length for each order - commonly regarded as important parameters in neuron physiology - are also estimated. Finally, it is shown how to estimate the mean dendritic length in a population of neurons from vertical slices of arbitrary and unknown thickness. Being unbiased and highly efficient, the proposed methods offer interesting alternatives to current procedures used for the metric analysis of neuron arborizations.     

Seizures with Onset in the Sensorimotor Face Area: Clinical Patterns and Results of Surgical Treatment in 20 Patients

Summary: It is not generally appreciated that intractable seizures involving the face area are amenable to surgical treatment. Twenty patients with onset of sensorimotor seizures in the face area of the pre- and postcentral gyri have been studied and surgically treated since 1948. Seizures started in the face, tongue, or throat, followed by diverse patterns depending on spread of seizure activity. Two patients had epilepsia partialis continua; 6 had either tonic or atonic drop attacks. All patients had pre- and postcentral face area resections, 12 in the dominant hemisphere. In addition, 3 had more extensive postcentral removal, 7 had temporal lobe, and 4 had small separate or contiguous frontal or parietal resection. Because the seizures were not sufficiently reduced by the first operation, 6 required reoperation; 4 of these patients had residual epileptiform activity on electrocorticogram (ECoG) after the first resection. Three patients had new neurologic signs that did not return to the preoperative level, but in 2 of them the deficit related mainly to higher resection in the central area. All but 2 of these 20 patients had at least moderate seizure reduction. Corticectomy can be performed for treatment of seizures arising in the lower central area and usually does not lead to significant permanent neurologic deficit.     

Stimulation of tumor growthin vitro andin vivo by suramin on the VX2 model

Suramin is an antitrypanosomal compound with confirmed efficacy against several human malignancies. It is generally assumed that its mechanism of action includes the interaction with different growth factors, unlike most of the anticancer drugs. Its anticancer activity has not been testedin vivo against squamous cell carcinoma. The purpose of this study was to assess the efficacy and toxicity of suraminin vivo andin vitro on the VX2 tumor model at therapeutic monitored plasma concentrations. We determined the pharmacokinetics of suramin in rabbits, and modelized its administration in order to obtain plasma concentrations between 150 and 300 μg/ml throughout the treatment course of 3 weeks. Under these conditions, antitumor effects of suramin were evaluatedin vivo by comparing liver tumor involvement in suramin-treated and control rabbits. Liver involvement was quantified by image analysis andin vitro effects were also determined at the same concentrations.In vivo, suramin promoted liver tumor growth significantly (p<0.05), compared to untreated controls.In vitro, suramin significantly stimulated tumor cell growth at concentrations above 200 μg/ml (p<0.01). Suramin may have stimulatory effects on tumor growth in squamous cell carcinoma at relevant plasma drug concentrations. Caution should be taken in further trials in patients with squamous cell carcinomas.