Tuberculosis of the posterior vertebral arch. Apropos of 2 cases

Spinal tuberculosis involving vertebral arc occurred in two patients. The first case had a single lesion presenting as a pseudo-tumoral feature. The second one had plurifocal tuberculosis peripheral and spinal one. The needle biopsy permitted the diagnosis in the two cases. Computed tomography showed the vertebral arch lesions with details and contiguous corporeal involvement. Clinical and radiological improvement was obtained after medical treatment.     

Investigation of natural radioactivity levels in water around Kadugli, Sudan.

Surface water from Miri Lake and groundwater from around Kadugli (West-Central Sudan) obtained by means of hand-pumps was analysed for (238)U, (226)Ra, (222)Rn, and (232)Th activity concentrations. The surface water showed very low levels of radionuclide concentrations: <1.0-7.5, 8.5-16.5, <1.6, and <0.1-0.39mBqL(-1) for (238)U, (226)Ra, (222)Rn, and (232)Th, respectively. Groundwater revealed a significant amount of natural radioactivity (16.1-1720, 7.7-14.3, 3000-139,000, <0.1-39mBqL(-1)) respectively. The overall annual effective dose was below the WHO reference dose level of 0.1mSvyr(-1) except in one groundwater sample with an associated dose of 0.7mSvyr(-1).     

Prolonged disease-free survival in pediatric non-Hodgkin's lymphoma using ifosfamide-containing combination chemotherapy.

Pediatric non-Hodgkin's lymphoma (NHL) constitutes 16 per cent of pediatric malignancies reported to the National Cancer Institute (NCI) in Cairo. The adopted treatment for these cases was, from 1982 to July 1985, a modified St Jude's regimen consisting of: vincristine, cyclophosphamide, adriamycin, prednisone and intrathecal methotrexate for the first 6 weeks for induction, followed by cranial irradiation for cranial prophylaxis. Patients in remission received maintenance therapy for 18 months. Of 32 patients complete remission (CR) was achieved in 24 patients (75 per cent); partial remission (PR) in one patient (3 per cent); five patients showed no response (15 per cent) while two patients died during the induction phase. At 60+ months follow-up, 60 per cent of cases are still alive, disease-free, and overall survival is 66 per cent. A new protocol was adopted in 1985, consisting of alternating cycles: A and B, for 4-8 cycles. Cycle A: cyclophosphamide, high dose ara-C, adriamycin, and vincristine. Cycle B: ifosfamide, methotrexate, VP 16, with intrathecal methotrexate. The response in 39 cases is: CR in 31 cases (82 per cent); PR in four cases (10 per cent); no response in three cases (8 per cent). At 60+ months, the disease-free survival is 60 per cent, and overall survival 80 per cent. This new protocol has the advantage of: short duration of therapy and so better patient compliance, no maintenance therapy or cranial irradiation with its sequelae in the future. Moreover, it has a better overall survival.     

VEGF and mRNA VEGF expression in CSF from Behçet's disease with neurological involvement

Vascular endothelial growth factor (VEGF) stimulates angiogenesis, but is also pro-inflammatory and plays an important role in the development of neurological disease, where it can have both attenuating and exacerbating effects. Several studies have indicated that VEGF-A (VEGF) may play a role in the pathogenesis of neurological inflammatory diseases.To assess the role of VEGF in patients with Behçet's disease with neurological involvement, VEGF was measured in the cerebrospinal fluid (CSF) of 32 patients compared to a group of 12 patients with noninflammatory neurological diseases (NIND) and 14 patients with multiple sclerosis (MS). We have also studied the expression of mRNA-VEGF (VEGF-A) in CSF and in peripheral blood mononuclear cells.The mean VEGF_CSF was significantly increased in neuro-BD and MS patients compared to NIND patients. There was an association between neuro-BD-VEGF_CSF, and leukocyte count. A significant correlation was also observed between neuro-BD-VEGF_CSF and CSF_%CD4 cells. As a measure of the integrity of the blood-brain barrier Q_albumin was found correlated to VEGF_CSF. VEGF mRNA was significantly increased in neuro-BD patients compared to NIND patients.These results indicate that, VEGF may be associated with the increased percentages of CD4 cell subpopulation. The role of VEGF is within the inflammatory cascade in the mediation of blood-brain barrier disruption and not specific to Behçet's.     

Large artery involvement in Beh?et's disease

Ten (2.2%) of 450 patients with Beh?et's disease seen over a 10 year period had arterial manifestations. This was demonstrated by occlusion of radial and superficial femoral arteries in 3, aneurysm of subclavian, innominate, common and external iliac arteries and abdominal aorta in 4, both occlusion and aneurysm of pulmonary, external iliac and renal arteries in 3. All patients were male except one. Their ages ranged from 24-36 years with a mean age of 30 +/- 5 years.     

Hyperphosphatasemia related to three intestinal alkaline phosphatase isoforms: biochemical study

An unexplained hyperphosphatasemia was noted in a healthy 47-year-old woman. The electrophoretic pattern on agarose gel with and without wheat germ lectin of the serum of this patient showed the presence of three isoforms which have been characterised as being of intestinal origin: their biochemical (neuraminidase, phenylalanine) and thermodenaturation properties are similar to those of intestinal tissue extract. The pI and pH optima of these isoforms agree with an intestinal origin. Our results suggest the existence of different allelozymes of intestinal alkaline phosphatase.     

Differential diagnostic use of interleukin patterns in patients being monitored after transplantation

BACKGROUND AND AIM: We investigated how far the determination of selected interleukins in bodily fluids of patients who had received kidney allografts can help to confirm the diagnosis of complications after transplantations. MATERIALS AND METHODS: Levels of soluble interleukin-2-receptor, interleukin 6 and interleukin 8 were determined in serum and urine of 79 patients. According to the type of diagnosis obtained with histological, serological and microbiological methods and to the clinical course, the groups "stable graft function without complication", "allograft rejection", "cytomegalovirus infection", "systemic extrarenal bacterial infection", "urinary tract infection" and "pyelonephritis" were created. RESULTS AND CONCLUSIONS: The activation of the immune system in different ways depending on the trigger substance (alloantigen, virus, bacterium) and the possibility to differentiate systemic and local processes cause typical patterns of interleukin levels in serum and urine in conjunction with the above mentioned complications after kidney transplantation. Cytomegalovirus infections and systemic extrarenal bacterial infections differ from rejection by the unchanged urine interleukins IL 6 and IL 8, the local urinary tract infections differ from rejection by the unchanged serum interleukins. Acute pyelonephritis differs from rejection by the significantly higher serum IL 6 level. During our daily clinical work, the practical interleukin determinations were proven to be an important tool for early and differential diagnosis of complications after kidney transplantation.