A case was presented of a 41-year-old male with progressive claudication and numbness in the lower extremities. A MRI showed swelling of the spinal cord with an intramedullary high signal intensity on a T2-weighted image. The patient was diagnosed with transverse myelitis and was started on intravenous steroids. However, there were no significant effects with the steroid treatment. An angiography showed a spinal dural arteriovenous fistula fed by a T11 radicular artery. An endovascular embolization was performed and the claudication and numbness were improved. We report a case of spinal dural arteriovenous fistula misdiagnosed as transverse myelitis.
Adult ; Angiography ; Arteries ; Central Nervous System Vascular Malformations* ; Humans ; Hypesthesia ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Myelitis, Transverse* ; Spinal Cord ; Steroids

This study was performed to examine the role of transglutaminase 2 (TG2) in ventilator-induced lung injury (VILI). C57BL/6 mice were divided into six experimental groups: 1) control group; 2) lipopolysaccharide (LPS) group; 3) lung protective ventilation (LPV) group; 4) VILI group; 5) VILI with cystamine, a TG2 inhibitor, pretreatment (Cyst+VILI) group; and 6) LPV with cystamine pretreatment (Cyst+LPV) group. Acute lung injury (ALI) score, TG2 activity and gene expression, inflammatory cytokines, and nuclear factor-kappaB (NF-kappaB) activity were measured. TG2 activity and gene expression were significantly increased in the VILI group (P < 0.05). Cystamine pretreatment significantly decreased TG2 activity and gene expression in the Cyst+VILI group (P < 0.05). Inflammatory cytokines were higher in the VILI group than in the LPS and LPV groups (P < 0.05), and significantly lower in the Cyst+VILI group than the VILI group (P < 0.05). NF-kappaB activity was increased in the VILI group compared with the LPS and LPV groups (P < 0.05), and significantly decreased in the Cyst+VILI group compared to the VILI group (P = 0.029). The ALI score of the Cyst+VILI group was lower than the VILI group, but the difference was not statistically significant (P = 0.105). These results suggest potential roles of TG2 in the pathogenesis of VILI.
Acute Lung Injury/pathology ; Animals ; Cystamine/therapeutic use ; Cytokines/analysis ; Enzyme Inhibitors/therapeutic use ; Enzyme-Linked Immunosorbent Assay ; GTP-Binding Proteins/*antagonists & inhibitors/genetics/metabolism ; Gene Expression ; Lipopolysaccharides/toxicity ; Male ; Mice ; Mice, Inbred C57BL ; NF-kappa B/metabolism ; Respiration, Artificial ; Transglutaminases/*antagonists & inhibitors/genetics/metabolism ; Ventilator-Induced Lung Injury/*enzymology/pathology/prevention & control