Hypoxia activates endothelial cells by the action of reactive oxygen species generated in part by cyclooxygenases (COX) production enhancing leukocyte transmigration. We investigated the effect of specific COX inhibition on the function of endothelial cells exposed to hypoxia. Mouse immortalized endothelial cells were subjected to 30 min of oxygen deprivation by gas exchange. Acridine orange/ethidium bromide dyes and lactate dehydrogenase activity were used to monitor cell viability. The mRNA of COX-1 and -2 was amplified and semi-quantified before and after hypoxia in cells treated or not with indomethacin, a non-selective COX inhibitor. Expression of RANTES (regulated upon activation, normal T cell expressed and secreted) protein and the protective role of heme oxygenase-1 (HO-1) were also investigated by PCR. Gas exchange decreased partial oxygen pressure (PaO2) by 45.12 ± 5.85% (from 162 ± 10 to 73 ± 7.4 mmHg). Thirty minutes of hypoxia decreased cell viability and enhanced lactate dehydrogenase levels compared to control (73.1 ± 2.7 vs 91.2 ± 0.9%, P < 0.02; 35.96 ± 11.64 vs 22.19 ± 9.65%, P = 0.002, respectively). COX-2 and HO-1 mRNA were up-regulated after hypoxia. Indomethacin (300 µM) decreased COX-2, HO-1, hypoxia-inducible factor-1alpha and RANTES mRNA and increased cell viability after hypoxia. We conclude that blockade of COX up-regulation can ameliorate endothelial injury, resulting in reduced production of chemokines.

Há controvérsias sobre a existência de uma epilepsia parcial benigna parietal distinta da epilepsia com pontas rolândicas. Estudamos 164 crianças com epilepsia e focos restritos às regiões centrais, temporais médias e parietais, sendo excluídas as que apresentavam elementos indicativos de lesão cerebral. Foram analisados a idade dos pacientes, a idade de início, o tipo e o número das crises, antecedentes familiares para epilepsia e a reatividade à percussão dos pés e mãos ao EEC As pontas foram de localização central e/ou temporal média (PCT) em 111 casos (temporal média em 56, centrotemporal em 29, central em 26) e parietal (PP) em 53 casos. A idade dos pacientes e idade de início das crises predominaram na faixa até 6 anos de idade no grupo com PP e acima dos 6 anos no grupo com PCT. As crises orofaríngeas e motoras da face corresponderam a 44,1% das crianças com PCT e, apenas, a 16,9% daquelas com PP. Pontas evocadas por estímulos somatossensoriais, ao EEG, foram registradas em proporção mais elevada de casos com PP (39,5%) do que no grupo com PCT (3,5%). Nossos achados mostram que epilepsia, na ausência de sinais lesionais, em crianças com PP, é relativamente frequente e tanto a idade dos pacientes, idade de início e perfil das crises, quanto a reatividade do EEG à percussão de pés e mãos, mostram diferenças significativas em relação ao observado nas crianças com PCT.

There are controversies about the existence of a benign parietal epilepsy distinct from the benign partial epilepsy with centro-temporal spikes. We studied 164 children with no neurological or neuroradiological evidence of brain damage and with epilepsy and spikes restricted to the centro-temporal (CTS) or to the parietal regions (PS). The subject's age, age at onset and type of seizures and the presence of spikes evoked by consecutive taps applied to both hands and feet were compared between 111 patients with CTS and 53 patients with PS. Age of patients and age at onset of seizures predominated until 6 years in the PS group and after 6 years in the CTS group. The occurrence of oropharyngeal or facial motor seizures was statistically more frequent among the patients with CTS (44.1%) as opposed to PS group (16.9%). In 39.5% of the children with PS and only in 3.5% of those with CTS, the EEG showed high voltage potentials, similar to the habitual spikes in clinical EEG, evoked by the stimulation of one or both feet or hands. Our findings suggest that in neurologically normal children with epilepsy, the group with PS differs from those with CTS in the age, age at onset and type of seizures and EEG reactivity to percussion of hands and feet.

São raras as descrições na literatura de distúrbios dos movimentos como primeira manifestação da síndrome de imunodeficiência adquirida (SIDA). Relatamos o caso de um paciente com 54 anos que apresentou quadro de hemibalismo de instalação súbita e piora gradual. A tomografia computadorizada de crânio mostrou área de hipoatenuação com efeito de massa e impregnação de contraste na região talâmica e subtalâmica esquerda. A investigação levou ao diagnóstico de SIDA e de provável toxoplasmose cerebral. Os autores realçam o fato de que, nos distúrbios extrapiramidais, a SIDA deve ser uma possibilidade etiológica a ser investigada.

There are few descriptions of movement disorders as an initial presentation of acquired immunodeficiency syndrome (AIDS). The authors report the case of a 54-year-old man who presented with hemiballismus of gradual onset. The computed axial tomographic scan showed a deep seated enhancing lesion with mass effect. Investigation revealed AIDS and a probable toxoplasmosis. It is concluded that AIDS must be considered in the aetiological diagnosis of patients with movement disorders.