Posterior reversible encephalopathy induced by intravenous immunoglobulin.

Sir, Intravenous immunoglobulin (IvIg) is commonly used in nephrologyunits for the treatment of auto-immune diseases, antibody-mediatedrenal allograft rejection and immune deficiencies. Minor adverseeffects, such as myalgia, headache, shiver, nausea, vomitingor fever occur in <20% of patients. Major reactions includingrenal failure, thromboembolism, aseptic meningitis and anaphylaxisare less common. Whereas osmotic nephropathy resulting frommaltose and saccharose toxicity is well-known to nephrologists,posterior reversible encephalopathy syndrome (PRES) is a rareand potentially severe adverse event of IvIg therapy. A 42-year-old man was admitted     

Pregnancy impact on uterosacral ligament and pelvic muscles using a 3D numerical and finite element model: preliminary results

Introduction and hypothesis

We studied the geometry of and changes in structures that play an important role in stabilizing the pelvic system during pregnancy using a numerical system at different gestational ages and postpartum.

Methods

We developed a parturient numerical model to assess pelvic structures at different gestational stages (16, 32, and 38 weeks) and postpartum (2 months and 1 year) using magnetic resonance imaging (MRI). Organs, muscles, and ligaments were segmented to generate a 3D model of the pelvis. We studied changes in the length of uterosacral ligaments (USL) and thickness of the puborectal portion of the levator ani muscle (LAM) during and after pregnancy. We used this model to perform finite element (FE) simulation and analyze deformations of these structures under stress from the increase in uterine weight.

Results

Analysis reveals an increase in the length of US ligaments at 16, 32, and 38 weeks. Two months after delivery, it decreases without returning to the length at 16 weeks of pregnancy. Similar changes were observed for the puborectal portion of the LAM. Variations observed in these structures are not equivalent to other anatomical structures of pelvic suspension. FE simulation with increased uterus weight does not lead to those findings.

Conclusion

This analysis brings new elements and a new focus for discussion relating to changes in pelvic balance of parturient women that are not simply linked to the increase in uterine volume.

     

Ultrasonic signs of pneumothorax: Preliminary work

Ultrasonography is considered to have limited application in respiratory diseases because air reflects sound waves. Twenty-four patients with radiologically confirmed pneumothorax and 100 healthy subjects underwent sonography. In all normal subjects, the hyperechoic pulmonary interface showed respiratory motions termed the “gliding sign” with some comet-tail artifacts. Sonographic signs were shown in all pneumothoraces: disappearance of the gliding sign and no comet tails. The extent of collapse cannot be evaluated, but it is possible to determine its area in partial pneumothorax (N = 5). The follow-up (N = 8) showed the reappearance of the gliding sign. Ultrasonography may be helpful in diagnosing pneumothorax in certain cases. © 1993 John Wiley & Sons, Inc.     

Metabolic activity in the brain of juvenile and adult rats with a neonatal ventral hippocampal lesion

Longitudinal studies on patients for schizophrenia suggest that functional brain perturbations precede the onset of symptoms. Rats with a neonatal ventral hippocampal lesion (NVHL) are considered as a heuristic neurodevelopmental model of schizophrenia. We characterized basal metabolic changes observed in NVHL rats before and after the age when known behavioral alterations have been reported. Male pups were lesioned with ibotenic acid at postnatal day 7 (PD7). We measured local cerebral metabolic rates for glucose (LCMRglc) by the quantitative autoradiographic [¹⁴C]2‐deoxyglucose technique at pre‐ (PD21) and postpubertal (PD42) ages when NVHL rats do not express abnormal dopamine related behaviors, and at adulthood (PD70). We observed a widespread increase in LCMRglcs in PD21 NVHL indicative of an ongoing intense reorganization of the brain while at PD42, increases were less extended. At PD70, changes in glucose metabolism were restricted to specific systems, such as the auditory system, the cerebellum, the serotonergic median raphe, and median septum. These data show in a heuristic animal model of schizophrenia that functional metabolic changes within the brain could precede the onset of dopamine‐related behavioral alterations and lead to a distinct ensemble of functional changes in adulthood in systems that may be relevant to schizophrenia. © 2009 Wiley‐Liss, Inc.     

Mediastinal tuberculosis in an adult patient with cystic fibrosis

Tuberculosis (TB) is rarely observed in cystic fibrosis (CF) patients. We report the first case of mediastinal TB, associated with leg pain and skin rash, in an adult patient with CF, and discuss factors suggestive of TB in the course of CF.     

Hyperbranched PEGmethacrylate linear pDMAEMA block copolymer as an efficient non-viral gene delivery vector

A unique hyperbranched polymeric system with a linear poly-2-dimethylaminoethyl methacrylate (pDMAEMA) block and a hyperbranched polyethylene glycol methyl ether methacrylate (PEGMEMA) and ethylene dimethacrylate (EGDMA) block was designed and synthesized via deactivation enhanced atom transfer radical polymerisation (DE-ATRP) for efficient gene delivery. Using this unique structure, with a linear pDMAEMA block, which efficiently binds to plasmid DNA (pDNA) and hyperbranched polyethylene glycol (PEG) based block as a protective shell, we were able to maintain high transfection levels without sacrificing cellular viability even at high doses. The transfection capability and cytotoxicity of the polymers over a range of pDNA concentration were analysed and the results were compared to commercially available transfection vectors such as polyethylene imine (branched PEI, 25 kDa), partially degraded poly(amido amine)dendrimer (dPAMAM; commercial name: SuperFect(?)) in fibroblasts and adipose tissue derived stem cells (ADSCs).     

Leg muscle vibration modulates bodily self-consciousness: integration of proprioceptive, visual, and tactile signals

Behavioral studies have used visuo-tactile conflicts between a participant's body and a visually presented fake or virtual body to investigate the importance of bodily perception for self-consciousness (bodily self-consciousness). Illusory self-identification with a fake body and changes in tactile processing--modulation of visuo-tactile cross-modal congruency effects (CCEs)--were reported in previous findings. Although proprioceptive signals are deemed important for bodily self-consciousness, their contribution to the representation of the full body has not been studied. Here we investigated whether and how self-identification and tactile processing (CCE magnitude) could be modified by altering proprioceptive signals with 80-Hz vibrations at the legs. Participants made elevation judgments of tactile cues (while ignoring nearby lights) during synchronous and asynchronous stroking of a seen fake body. We found that proprioceptive signals during vibrations altered the magnitude of self-identification and mislocalization of touch (CCE) in a synchrony-dependent fashion: we observed an increase of self-identification and CCE magnitude during asynchronous stroking. In a second control experiment we studied whether proprioceptive signals per se, or those from the lower limbs in particular, were essential for these changes. We applied vibrations at the upper limbs (which provide no information about the position of the participant's body in space) and in this case observed no modulation of bodily self-consciousness or tactile perception. These data link proprioceptive signals from the legs that are conveyed through the dorsal column-medial lemniscal pathway to bodily self-consciousness. We discuss their integration with bodily signals from vision and touch for full-body representations.