-Study of 22 patients with the severe form of neurocysticercosis treated with albendazole (ABZ) administered in 6 different schedules ranging from 15 to 30 mg/kg/day for 21 to 60 days. Dextrochloropheniramine and ketoprofen were the adjuvant drugs. Multiple symptoms were observed in 90.9% of patients. Intracranial hypertension was manifested in 90.9%. Hydrocephaly occurred in 86.4%. Evolution was satisfactory in 10 patients, 8 died and 4 had sequelae. Tomographic studies showed the appearance of an isolated IV th ventricle in 9 patients, after ventriculoperitoneal shunt, before ABZ treatment in 3 of them, during in 5 and after treatment in one. Median clinical follow-up duration was 10 months for the patients who died and 3-4 years for survivors. In 3 patients there was an increase in cyst size during the administration of the 15 mg/kg/day ABZ dose, which was not observed in any patient when the 30 mg/kg/day dose was used.KEY WORDS: cysticercosis, neurocysticercosis, severe forms, treatment, albendazole, dextrochloropheniramine, ketoprofen. Formas graves da neurocisticercose: tratamento com albendazolRESUMO -Estudo de 22 doentes, com a forma grave de neurocisticercose, tratados com albendazol (ABZ), administrado em 6 diferentes esquemas, que variaram de 15 a 30 mg/kg/dia, durante 21 a 60 dias. A dextroclorofeniramina e o cetoprofeno foram as drogas coadjuvantes. Múltiplos sintomas ocorreram em 20 doentes. Hipertensão intracraniana foi manifestação mais comum em 20. Hidrocefalia foi detectada em 19. A evolução foi satisfatória em 45,4%, faleceram 36,4% e 18,2% ficaram com sequelas. Na evolução tomográfica apareceu IV o ventrículo isolado em 40,9%, após derivação ventriculoperitoneal, em 3 deles antes do tratamento com ABZ, em 5 durante e, em um, após o tratamento. A mediana estatística do período de seguimento clínico foi 10 meses para aqueles que faleceram e 3-4 anos para os sobreviventes. Em 3 doentes houve aumento no tamanho dos cistos durante a dose de 15 mg/kg/dia de ABZ, não observado na vigência de 30 mg/kg/dia. PALAVRAS-CHAVE: cisticercose, neurocisticercose, formas graves, tratamento, albendazol, dextroclorofeniramina, cetoprofeno.

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We evaluated the use of albendazole in combination with dextrochloropheniramine for the treatment of neurocysticercosis. Forty patients were treated from September 1984 to December 1987; each was diagnosed on the basis of clinical, epidemiological, cerebrospinal fluid and tomographic data. Patients were divided into 3 groups according to the albendazole treatment schedule. Group I received 10-15 mg/kg albendazole daily; group II received 15-25 mg/kg/d; group III received 15-30 mg/kg/d. Each patient also received simultaneously 18 mg/d of dextrochloropheniramine. Clinical improvement was observed in 4 patients in group I (50.0%), 10 patients in group II (83.3%) and 18 patients in group III (94.7%). Three patients in group II, and one in group III, died. Group III patients showed a significant improvement in quality of life compared to the other 2 groups. Side effects were insignificant in all groups. The combination of albendazole and dextrochloropheniramine seems to be a promising treatment for neurocysticercosis, especially at the doses used for group III, i.e. 15 mg/kg/d of albendazole for 21 d followed by 20-30 mg/kg/d for 30 d after a one-week interval, in combination with 18 mg/d of dextrochloropheniramine.

-Natural killer (NK) cells play an important role in immune surveillance against tumors. The present work aimed to study the cytotoxic activity of NK cells and T cell subsets in peripheral blood of 13 patients with primary tumors in central nervous system (CNS). As controls 29 healthy subjects with the age range equivalent to the patients were studied. The methods employed were: a) determination of cytotoxic activity of NK cells towards K562 target cells, evaluated by single cell-assay; b) enumeration of CD3+ lymphocytes and their CD4+ and CD8+ subsets defined by monoclonal antibodies; c) the identification of tumors were done by histologic and immunochemistry studies. The results indicated that adults and children with tumor in CNS display reduced percentage of total T cells, helper/inducer subset and low helper/suppressor ratio. The cytotoxic activity of NK cells was decreased in patients with CNS tumors due mainly to a decrease in the proportion of targetbinding lymphocytes. These results suggest that cytotoxic activity of NK cells may be affected by the immunoregulatory disturbances observed in patients with primary tumors in CNS. KEY WORDS: brain tumors, NK cells, T cell subsets.Alterações imunológicas em pacientes com tumores primários no sistema nervoso central RESUMO -As células natural killer (NK) desempenham importante papel na vigilância imunológica contra tumores. O objetivo do presente trabalho foi estudar a atividade citotóxica de células NK e as subpopulações de células T no sangue periférico de 13 pacientes com tumores primários no sistema nervoso central (SNC). Como controle foram estudados 29 indivíduos saudáveis com faixa etária equivalente aos pacientes. Os métodos empregados foram: a) determinação da atividade citotóxica de células NK contra células alvo K562; b) quantificação de linfócitos CD3+ e subpopulações CD4+ e CD8+ por meio de anticorpos monoclonais; c) identificação dos tumores por análise histológica e imuno-histoquímica. Os resultados indicaram que adultos e crianças com tumores no SNC apresentam diminuição na percentagem de linfócitos T, da subpopulação de células T auxiliares e da relação células auxiliares/supressoras. A atividade citotóxica de células NK esteve deprimida em pacientes com tumores devido principalmente à diminuição da capacidade de formar conjugados com a célula alvo K562. Os resultados sugerem que a atividade de células NK pode ser afetada por distúrbios imunorregulatórios observados em pacientes com tumores primários no SNC. PALAVRAS-CHAVE: tumores cerebrais, células NK, subpopulações de células T.Most cancers result from interaction of genetic and environment factors; however, genetic factors by themselves explains only about 5% of all cancer. The others have been atributed to environmental factors, that may interact with genetic cancer susceptibility and individual response 1 .