HSV encephalitis with normal initial CT scan - a case report with a review of the literature

Introduction. HSV-1 is the most common cause of viral encephalitis with a high mortality rate if left untreated and causes frequent diagnostic difficulties. It commonly involves the temporal, inferior frontal lobes and the limbic system. HSV can be differentiated by a combination of symptoms, laboratory tests and neuroimaging findings.Case report. A 29-year old female with HSV encephalitis, who, despite prevailing symptoms of altered mental status, had no abnormalities on initial CT head scan. Three MRI follow-up examinations revealed imaging findings with characteristic evolution. Despite CSF results being negative for HSV antibodies, the combination of symptoms, CSF analysis, and characteristic MRI findings were highly suggestive to diagnosing HSV encephalitis and to implement proper treatment.Discussion. In case of radiological changes in temporal lobe, the involvement of the Herpes simplex encephalitis (HSE) should always be considered. Although the laboratory tests happen to be inconclusive or even falsely negative, neuroimaging often helps to determine the diagnosis. Despite HSE being a severe neurological disorder, initial CT scans can be normal. MRI has become superior, especially at the early phase of the disease and is capable of determining the extensiveness of lesions

Morphological changes of the pancreas in course of acute pancreatitis during treatment with Ulinastatin

Acute pancreatitis is a severe clinical conditio that causes significant mortality in patients. Since we do not have at the moment effective causal treatment research on the use of pro tease inhibitors can produce tangible benefits. In view of the growing number of cases and high mortality in severe AP with one hand, and the lack of a usal treatment research efforts undertaken to search for effective drugs for this disease seem to have deep reasons. Aim of the study was to determine the histopathological changes in the pancreas in the treatment of acute pancreatitis with Ulinastatin. Material and methods. The study was conducted in male Wistar rats weighing 250-300 grams. 150 individuals were used for the experiment, 60 of them were treated with Ulinastatin. Experimental acute pancreatitis was induced by the model proposed by Aho and Henckel using sodium taurocholate. Ulinastatin dose numer depended on the duration of the experiment. For histopathological examination pancreatic fragments weighing approximately 1 g each were taken. Assessment and documentation of histopathological preparations were made by light microscopy. Results. Evaluation of the histological preparations of various time groups showed significantly improved results after application of Ulinastatin, depending on the duration of the inflammation and the number of doses of the drug. Conclusions. Application for the treatment of UTI leads to inhibition of the inflammatory process at the stage of pancreatic edema and in cases of severe necrotizing course limits the progression of the disease which gives grounds for its clinical use in humans