Posterior reversible encephalopathy syndrome caused by hypertensive encephalopathy and acute uremia

Introduction  

The posterior reversible encephalopathy syndrome (PRES) is a recently proposed cliniconeuroradiological entity. The most common causes of PRES are hypertensive encephalopathy, eclampsia, cyclosporin A neurotoxicity, and the uremic encephalopathy. On magnetic resonance imaging (MRI) studies, edema has been reported in a relatively symmetrical pattern, typically in the subcortical white matter and occasionally in the cortex of the posterior circulation area of the cerebrum.     

Effects of intrathecal administration of FK506 after sciatic nerve crush injury

Although various administration routes of FK506 have been published, intrathecal administration of FK506 has not previously been reported in the literature. A daily dose of 0.05 mg/kg of FK506 was given (a small dose compared with those reported in the available literature). The authors used this small dose to obtain lower immunosuppression and neurotoxicity, and a higher axonal regeneration rate. A total number of 40 female Wistar rats were used and randomly divided into four groups: control, sham, FK506-treated, and vehicle-treated. Sciatic nerve regeneration was evaluated by walking track analysis, an electrostimulation test, and light microscopic evaluation. There was a statistically significant difference ( P < 0.05) between FK506-treated and vehicle-treated groups at the end of 6 weeks according to both the walking track analysis and the electrostimulation test. Comparing the stimulus thresholds of the sham and FK506-treated group, no significant difference ( P > 0.05) was observed. Evaluation of the data revealed that FK506 had a beneficial effect on sciatic nerve regeneration.     

Plasma cell dyscrasia with kappa light-chain crystals in proximal tubular cells: a histological, immunofluorescent, and ultrastructural study

This is a case report of a 56-year-old man with plasma cell dyscrasia who presented with proximal tubulopathy manifested as kappa light-chain crystal deposition in the proximal convoluted tubular cells. This was associated with mild cellular damage. The crystals were seen as negative images with the hematoxylin-eosin and periodic acid-Schiff (PAS) stains. They were identified as kappa light-chains by immunofluorescent imaging and confirmed by immunoelectron microscopy. Ultrastructurally, the crystals appear to be located within lysosomes. No deposits of light-chains were seen elsewhere in the kidney biopsy.     

Treatment of acute myocardial infarction in pregnancy with coronary artery balloon angioplasty and stenting: use of tirofiban and clopidogrel

Acute myocardial infarction (AMI) in pregnancy is rare and has a high mortality rate of 37-50%. The most important risk factors are advanced maternal age, hypertension and diabetes mellitus. Although thrombolytic therapy, percutaneous transluminal coronary angioplasty (PTCA) and coronary artery by-pass grafting can be performed, primary PTCA and antiplatelet agents have recently improved prognosis. We here present a case of AMI in a 43 year old woman in the 20th week of pregnancy treated successfully with aspirin, clopidogrel and intracoronary stenting without any complications.     

Interferon-gamma gene+874T-A polymorphism is associated with tuberculosis and gamma interferon response

Interferon-gamma is the most important cytokine in resistance to mycobacterial diseases and common variants of interferon-gamma gene could be related to tuberculosis susceptibility. We tested the hypothesis that the interferon-gamma+874T-A polymorphism is associated with tuberculosis disease, and affects the interferon-gamma response. We determined by pyrosequencing the distribution of the interferon-gamma+874T-A polymorphism in a Turkish population of 319 patients with pulmonary tuberculosis, 42 children with severe forms of tuberculosis and 115 healthy donors. We also analysed whether any correlation exists between this polymorphism and interferon-gamma response to Mycobacterium tuberculosis antigens by ELISPOT in 58 pulmonary tuberculosis cases, and the results were analysed according to the genotypes. We found that the minor allele (T) frequency was significantly lower in patients with pulmonary tuberculosis when compared to controls (P=0.024, OR=0.7), a similarly significant decrease in the frequency of TT genotype was observed in patients with pulmonary tuberculosis, compared to the control group (P=0.02, OR=0.49). IFN-gamma responses to PPD antigen in TT genotype was found to be significantly higher than the AA group (P>0.001). Non-parametric correlation analysis of ELISPOT data showed significant reverse correlation in PPD, CFP10 and ESAT6 values and IFN-gamma +874 genotypes. These results show that the IFN-gamma +874T-A polymorphism is related to the IFN-gamma response and the magnitude of the response decreases during transition from TT- to TA and to AA genotypes. Our data suggest that similar to various Caucasian populations, in a Turkish population the IFN-gamma+874 T-A polymorphism is also associated with tuberculosis disease and affects the magnitude of the IFN-gamma response.