Oxfendazole Treatment of Sheep with Naturally Acquired Hydatid Disease

A blinded, randomized placebo-controlled trial assessed the efficacy and safety of oxfendazole for the treatment of ovine hydatid disease. Cyst fertility and parasite viability were measured following daily, weekly, and monthly treatment schedules with 30 mg of oxfendazole per kg of body weight. The 12-week trial was conducted in 215 adult sheep in the central Peruvian Andes and was masked for both treatment group and scheduling. In this trial oxfendazole significantly reduced protoscolex viability relative to controls in all treatment groups. In the daily, weekly, and monthly groups, 100, 97, and 78% of sheep, respectively, were either cured or improved following treatment, compared to 35% cured or improved animals in the control group. However, daily dosing at 30 mg of oxfendazole per kg proved highly toxic to sheep, resulting in a 24% death rate in the daily group as compared to a 4 to 6% mortality rate in all other groups. If found safe in humans, oxfendazole may prove to be a useful and inexpensive treatment for cestode infections in humans. This study suggests that a staggered dosing regimen of oxfendazole, and possibly other benzimidazoles, may be as efficacious as daily treatment regimens for hydatidosis while decreasing both the cost and adverse effects associated with daily dosing.     

Predicting tumor metastasis in patients with oral cancer by means of the proliferation marker Ki67.

Recent developments of a Ki67 antibody to recombinant parts of the Ki67 nuclear antigen have provided a marker for tumor proliferation. In the present study, biopsy specimens were obtained from 20 patents with squamous cell carcinoma of the oral cavity at various sites, who also received a regional neck dissection. The patients' mean age was 61 years. Normal mucosa obtained from the surgical materials of 10 patients with a non-tumor condition was also examined as a control. The expression of Ki67 was examined immunohistochemically and the labeling index (LI) assessed in the biopsy specimens. The patients were divided into two groups; patient who already had a regional lymph node metastasis at the time of tumor resection and patient without any metastasis. All of the oral carcinoma and normal mucosa specimens were positive for Ki67, while the magnitude of staining showed a wide variation. The median LI of the patients with metastasis and without metastasis was 37.63 +/- 8.30 and 20.40 +/- 4.22 respectively, while the normal mucosa control was 7.62 +/- 1.70. The results of this study suggest that an immunohistochemical examination of the biopsy materials for the Ki67 antigen and assessed LI index should prove useful for the prediction of lymph node metastasis.     

Sjögren Syndrome and Spinal Cord Stimulation: A Case Report

Sjögren syndrome is a chronic autoimmune disease. This disease mainly involves salivary and lacrimal glands, although it may also involve the musculoskeletal, respiratory, gastrointestinal, renal, hepato‐biliary, hematological, neurological, vascular, or both systems. Small vessel disease may appear in up to 30% of the cases. We present a case report of a 62‐year‐old female diagnosed with Sjögren syndrome. Systemic associated manifestations of her disease included interstiticial vessel vasculitis with a necrotic, sharp, and painful ulceration in her left heel. Because of refractory pain to common analgesic medical therapies (paracetamol, metamizol, and tramadol), she was referred to our pain unit for evaluation and treatment prior to limb amputation. In our pain unit, a percutaneous posterior spinal cord stimulator (SCS) was placed. SCS clinically reduced her pain by 90% and helped to improve her quality of life and significantly reduced her intake of analgesics. We conclude spinal cord stimulation may be a good alternative to conservative therapies in patients with vasculitis of Sjögren syndrome.     

Early embryonic brain development in rats requires the trophic influence of cerebrospinal fluid

Cerebrospinal fluid has shown itself to be an essential brain component during development. This is particularly evident at the earliest stages of development where a lot of research, performed mainly in chick embryos, supports the evidence that cerebrospinal fluid is involved in different mechanisms controlling brain growth and morphogenesis, by exerting a trophic effect on neuroepithelial precursor cells (NPC) involved in controlling the behaviour of these cells. Despite it being known that cerebrospinal fluid in mammals is directly involved in corticogenesis at fetal stages, the influence of cerebrospinal fluid on the activity of NPC at the earliest stages of brain development has not been demonstrated. Here, using “in vitro” organotypic cultures of rat embryo brain neuroepithelium in order to expose NPC to or deprive them of cerebrospinal fluid, we show that the neuroepithelium needs the trophic influence of cerebrospinal fluid to undergo normal rates of cell survival, replication and neurogenesis, suggesting that NPC are not self-sufficient to induce their normal activity. This data shows that cerebrospinal fluid is an essential component in chick and rat early brain development, suggesting that its influence could be constant in higher vertebrates.     

A variant of calcifying epithelial odontogenic tumor with Langerhans cells

A variant of calcifying epithelial odontogenic tumor (CEOT) with Langerhans cells is reported. Compared to a typical CEOT, the tumor islands of this case were thin and composed of a small number of polyhedral epithelial cells. Almost no calcification of homogeneous eosinophilic materials was observed. In addition, clear cells which structurally corresponded to Langerhans cell were intermingled in the epithelial islands. These cells stain positively for S-100 protein, lysozome, MT 1, LN-3 and OKT 6 antibodies, but not for keratin antibody. Electronmicroscopic examination revealed the rod-shaped and racket-shaped structures called Birbeck's granules in the cytoplasm of these clear cells. Our observations indicate a variant case of CEOT with Langerhans cells in tumor nests.     

Risk factors for acute renal failure in trauma patients

Abstract Objective: To elucidate the risk factors for the development of acute renal failure (ARF) in severe trauma. Design: Prospective observational study. Setting: A general intensive care unit (ICU) of a university hospital. Patients: A cohort of 153 consecutive trauma patients admitted to the ICU over a period of 30 months. Results: Forty-eight (31 %) patients developed ARF. They were older than the 105 patients without ARF (p = 0.002), had a higher Injury Severity Score (ISS) (p < 0.001), higher mortality (p < 0.001), a more compromised neurological condition (p = 0.007), and their arterial pressure at study entry was lower (p = 0.0015). In the univariate analysis, the risk of ARF increased by age, ISS > 17, the presence of hemoperitoneum, shock, hypotension, or bone fractures, rhabdomyolysis with creatine phosphokinase (CPK) > 10 000 IU/l, presence of acute lung injury requiring mechanical ventilation, and Glasgow Coma Score < 10. Sepsis and use of nephrotoxic agents were not associated with an increased risk of ARF. In the logistic model, the need for mechanical ventilation with a positive end-expiratory pressure > 6 cm H₂O, rhabdomyolysis with CPK > 10 000 IU/l, and hemoperitoneum were the three conditions most strongly associated with ARF. Conclusions: The identified risk factors for post-traumatic acute renal failure may help the provision of future strategies. Received: 22 September 1997 Accepted: 14 May 1998     

The efficacy of combined use of 1 alpha-hydroxyvitamin D3 with calcium supplements in the treatment of osteoporosis

Synthetic analogue of active vitamin D metabolite, 1 alpha (OH) D3, has been widely used in the treatment of osteoporosis. However, the most effective method of treatment is yet to be established. Importance of calcium supplement to improve the calcium metabolism in osteoporosis is also reported by many authors. We have studied the combined effects of 1 alpha (OH)D3 with calcium supplement in preventing progressive decrease of bone mass in patients with osteoporosis. Sixty-six cases of postmenopausal and senile osteoporosis were divided into two groups: one treated with calcium alone 1,000 mg a day and the other treated with calcium 1,000 mg and 1 alpha (OH)D3 0.5 microgram a day, and both groups were followed for 24 months. Bone mass was evaluated by microdensitometry of the roentgenograms of the second metacarpal bone. The results revealed that the combined use of 1 alpha (OH)D3 with calcium has a significantly more favorable effect than the use of calcium alone in preventing bone loss. Therefore, 1 alpha (OH)D3 with calcium is useful in the treatment of osteoporosis. The conclusion would be further confirmed with longer term study and a more accurate method of measuring bone mass.