Nutrition et fonction immunitaireNutrition and immune function

A deficiency of total energy or of one or more essential nutrients, including vitamins A, B₆, B₁₂, C, and E, folic acid, zinc, iron, copper, selenium, essential amino acids and essential fatty acids, will impair immune function and increase susceptibility of the host to infectious pathogens. This is most likely because these nutrients are involved in the molecular and cellular responses to challenge of the immune system. Providing these nutrients to deficient individuals restores immune function and improves resistance to infection. Thus, appropriate nutrition is required in order for the host to maintain adequate immune defences towards bacteria, viruses, fungi, parasites and tumour celîs. Although the intakes of several nutrients which result in greatest enhancement of immune function appear to be greater than recommended intakes, excess intake of certain nutrients also impairs immune responses. Some nutrients (e.g. glutamine, arginine) may become limiting in critical illness and there is mounting evidence that provision of these will aid patient recovery.     

Treatment of diabetic polyneuropathy with the neurotrophic peptide ORG 2766

The efficacy of the neurotrophic peptide ORG 2766 in diabetic patients with polyneuropathy was evaluated in a double-blind, placebo-controlled, multicentre trial. One hundred and twenty four patients were randomised in five groups to receive 0.1, 0.4, 2 or 5 mg ORG 2766 or placebo, once daily, administered subcutaneously 52 weeks. Thermal discrimination thresholds (TDT) and vibration perception thresholds (VPT), motor and sensory nerve conduction velocity, Hoffmann reflex, heart rate variation during deep breathing and heart rate response after standing up, neurological examination score and neuropathic symptom score were determined at baseline and after 17, 34 and 52 weeks of treatment. Of the nerve function indices studied, at week 52 the TDT_warmth of the hand in the ORG 2766 0.1, 0.4 and 5 mg groups and the TDT_cold of the foot in the ORG 2766 0.1 and 0.4 mg groups significantly improved compared with placebo. Further significant improvement as compared with placebo was observed in the paraesthesia score at week 34 and week 52 in the ORG 2766 2 mg group. Only at week 34 had both the heartbeat variation during deep breathing and the VPT of the foot in the ORG 2766 0.1 mg group improved significantly, compared with placebo. No further statistically significant differences were observed at time for the other measures. No adverse reactions were observed. The only recorded drug-induced side effect was pain at the injection site. Taking all measures of efficacy into account, the statistically significant results observed did not show consistency within each measure. Therefore, it is concluded that ORG 2766, in contrast to earlier reports, is not effective in treating diabetic polyneuropathy.     

Mutagenicity of benzo(a)pyrenyl-1-sulfate in the Ames test.

Comparison of the mutagenicity of nine isomeric benzo(a)pyrenyl [B(a)P] phenols conjugated with either sulfate or glucuronide was carried out using strain Salmonella typhimurium TA98. Of the nine conjugates tested, only B(a)P-1-sulfate was mutagenic. Accordingly, the mutagenicity of B(a)P-1-sulfate was compared with that of B(a)P and 1-hydroxybenzo(a)pyrene [B(a)P-1-OH] in the presence and absence of rat lung S9 and Aroclor-induced liver S9 with and without an NADPH-generating system. B(a)P-1-sulfate was slightly mutagenic, whereas B(a)P and the 1-hydroxy derivative were nonmutagenic when S9 fractions and NADPH were omitted. Addition of induced liver S9 with NADPH caused mutagenicity with B(a) -1-OH greater than B(a)P greater than B(a)P-1-sulfate. B(a)P-1-sulfate was the only mutagenic species when lung S9 was added. This mutagenicity did not require NADPH. Sodium sulfite, an inhibitor of arylsulfatase, decreased the mutagenicity of B(a)P-1-sulfate. These data suggest that a unique mutagenic species is generated from B(a)P-1-sulfate via arylsulfatase in rat lung.     

Widenings of the myelin lamellae in a typical Guillain–Barré syndrome

The so-called “widenings of the myelin lamellae” are thought to be specific ultrastructural features of peripheral nerve myelin in patients with peripheral neuropathy associated with a monoclonal dysglobulinemia of IgM type and antiglycolipid activity. We report here a case of Guillain–Barré syndrome with no evidence of serum monoclonal dysglobulinemia, presenting the typical widenings of the myelin lamellae in small-diameter myelinated fibers from a sural nerve biopsy. In view of the positive reaction with anti-C3d complement on direct immunofluorescence, an immunological mechanism may be involved in the widenings of the myelin lamellae. © 1994 John Wiley & Sons, Inc.     

Identifying incident cases of parkinsonism among veterans using a tertiary medical center.

To better understand the impact of incident Parkinson's disease (PD) on the Veteran's Health Administration (VHA) and to develop methods applicable to future epidemiological research, we performed a medical record review study at a tertiary referral VHA medical center. Searching the local data base, we identified 782 veterans with diagnostic codes for PD or secondary parkinsonism (SP) between 1998 and 2000. Based on structured medical record review, a movement disorders specialist confirmed diagnoses for incident parkinsonism cases. Among the 782, 191 incident parkinsonism cases were identified (100 PD, 75 SP, and 16 Parkinson's Plus). Incident PD cases were older at diagnosis (74.5 vs. 70.4 yr; P < 0.05) and more likely to be white (81% vs. 62; P < 0.07) than incident SP cases. Diagnostic codes were insufficient to distinguish between incident PD and SP (positive predictive value, 57% and 39%, respectively), and VHA sources failed to identify 21% of confirmed deaths among the incident PD cohort by November 2004. Although the large number of incident cases identified suggests PD is an important cause of disability among elderly VHA users, observed limitations of VHA sources for identifying incident PD cases and determining their vital status should be considered when designing future studies.     

潮汕地区健康青年H9、H6、H5亚型甲型流感病毒血清抗体调查

目的：调查潮汕地区健康青年中H9、H6、H5三种甲型流感病毒亚型的隐性感染情况，以期了解上述三种禽类甲型流感病毒亚型是否能够或已经从禽类直接或间接传染给人。方法：潮汕地区健康青年血清946份，通过HI实验进行抗体检测。结果：H9亚型抗体阳性率达37．2％；同时发现有三份血清存在H5抗体；未见H6亚型抗体的存在。结论：H9亚型在健康青年中的隐性感染率非常高；H5亚型抗体的存在也应值得注意。     

联合检测CEA、CA19-9在结直肠癌诊断中的应用

目的探讨用化学发光法检测CEA和CA19-9在结直肠癌诊断中应用价值。方法用化学发光法测定29例结直肠癌患者、46例良性疾病患者和20例健康人群血清CEA和CA19-9含量。结果癌变组CEA和CA19-9含量明显高于良性对照组和健康对照组,差异具有显著性(P<0.05),其中敏感性、特异性、有效性分别为65.5%、92.4%、84.2%和51.7%、95.4%和82.1%,联合检测的敏感性、特异性、有效性分别为82.8%、90.9%、88.4%。结论联合检测CEA和CA19-9有利于结直肠癌临床诊断,可提高其敏感性和有效性。     

Détermination de la tortuosité pour la détection des rétinopathies vasculaires sur les images d''angiographie rétinienne

Les rétinopathies vasculaires peuvent être accompagnées d'une modification de la forme des vaisseaux. Les patients atteints courent le risque de perdre la vue. Jusqu'ici, les méthodes utilisées par les ophthalmologistes pour analyser ces modifications sont qualitatives. Nous proposons une méthode nouvelle d'analyse de la tortuosité des vaisseaux de la rétine en vue d'élaborer par la suite un outil d'aide au diagnostic des rétinopathies vasculaires. La première étape de la méthode est une représentation symbolique de la structure vasculaire de la rétine. La deuxième étape appelée reconstitution 2D est la classification des entités vasculaires en gros vaisseaux (artères ou veines) et en petits vaisseaux (artérioles ou veinules) en utilisant la moyenne du diamèetre et du niveau de gris des segments de vaisseau comme paramètres discriminants. La dernière étape consiste à calculer l'excentricité des vaisseaux pour décrire leur tortuosité. Pour s'assurer de la capacité de l'excentricitéà décrire les petites modifications de forme, un second paramètre a été défini à titre comparatif. Les résultats obtenus permettent de quantifier les modifications de forme des vaisseaux.     

The surfaces of the parasitic nematodes Trichinella spiralis and Toxocara canis differ in the binding of post-C3 components of human complement by the alternative pathway

The binding of human complement components C3, C5 and C9 to the surface of the infective larvae of the nematode parasites Toxocara canis and Trichinella spiralis, by the alternative pathway, was examined by direct and indirect immunofluorescence on the intact parasites. This showed that although C3 bound to both nematodes, they differed markedly in the binding of C5 and C9; C5 bound only minimally to T. spiralis, and C9 binding to this parasite was barely detectable. In contrast, both early and late components bound to T. canis to a high density, comparable to, or in excess of, the binding of these components to the infective larvae of the trematode Schistosoma mansoni. The lack of binding of the post-C3 components to T. spiralis did not correlate with enhanced binding of the control protein, Factor H.     

多种肿瘤标志物联合检测肺癌的临床意义

目的 评价血清肿瘤标志物甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原50(CA50)、糖类抗原19—9(CA19—9)、铁蛋白(SF)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFlRA21—1)水平对肺癌诊断的临床价值。方法 测定72例肺癌患者和40例良性肺病患者的血清AFP、CEA、CA50、CA19—9、SF、NSE、CYFRA21—1水平，比较两组的差异。结果 肺癌组患者CEA、CA50、CA19—9、SF、NSE、CY—FRA21—1水平高于良性肺病组，AFP对肺癌的诊断价值不大。NSE CYF、RA21—1的联合检测具有良好的阳性和阴性预测值。六项联合检测的敏感性和准确性最高，但与两项联合检测的敏感性和准确性差异无统计学意义。结论 NSE CYFRA21—1的联合检测具有良好的临床应用前景。