Treatment of HTLV-I-associated myelopathy with high-dose intravenous gammaglobulin

Summary Fourteen patients with HTLV-1-associated myelopathy were treated with high-dose intravenous gammaglobulin (IVGG). Ten received 10 g/day of IVGG and 4 received 400 mg/kg of body-weight/day of IVGG for 5 consecutive days. Improvement of spastic paraparesis was observed in 10 within 7 days of the commencement of IVGG. The therapeutic effects were sustained for more than 3 weeks in some patients. There were no side effects. Analysis of factors of relevance to the clinical improvement with IVGG showed that the beneficial response was preferentially found in patients having a high CSF titre of anti-HTLV-I antibodies, a high CSF IgG level and a marked brain MRI abnormality.     

Differential diagnosis of HTLV-I-associated myelopathy and multiple sclerosis in Iranian patients

Summary Two Iranian patients with chronic progressive spastic paraparesis and urinary dysfunction were referred to our hospital with the presumptive diagnosis of multiple sclerosis (MS). Routine CSF analysis and magnetic resonance imaging of the two patients were only partially characteristic of MS. Testing for antibodies to human T-cell leukemia virus type I [HTLV-1] in serum using a radioimmune precipitation assay revealed antibodies to HTLV-I in both patients. The infection with HTLV-I was confirmed by polymerase chain reaction (PCR) and liquid hybridization analysis using primers to the tax/rex region and a corresponding probe, demonstrating proviral DNA in peripheral blood mononuclear cells of both patients. On the basis of these findings demonstrating the presence of proviral HTLV-1 DNA in the two Iranian patients, the initial diagnosis of MS was corrected to that of HTLV-I-associated myelopathy (HAM). In contrast, several patients with definite MS (nine from Germany, two from Iran) with a relapsing and remitting form of the disease were tested for HTLV-1 infection by enzyme-linked immunosorbent assay and PCR, which yielded negative results. However, the mother of one HAM patient was found to be infected with HTLV-I. To support an association between HTLV-I infection and CNS disease in the two HAM patients, we analyzed the production of specific IgG antibodies within the CNS based on a simple enzyme immunoassay for viral IgG antibodies in CSF and serum. In the two HAM patients there was significant intrathecal antibody production directed against HTLV-I, but this was not found in any of the samples from MS patients. These findings demonstrate an immune reaction to HTLV-I in the CNS of HAM patients, thus confirming the association of infection and CNS disease. The demonstration of intrathecal HTLV-I antibody production also proved useful for the differential diagnosis of MS or HAM, especially in patients from areas endemic for HTLV-I.Abbreviations DTPA diethylenetriaminepentaacetic acid - ELISA enzyme-linked immunosorbent assay - HAM HTLV-I-associated myelopathy - HTLV-I human T-cell leukemia virus type I - MRI magnetic resonance imaging - MS multiple sclerosis - PBMC peripheral blood mononuclear cells - PCR polymerase chain reaction - RIPA radioimmune precipitation assay - SDS sodium dodecyl sulfate - TSP tropical spastic paraparesis     

金银花颗粒在旋风分离器中的流场数值模拟分析

目的 针对金银花颗粒在旋风分离器中的运动行为过程进行研究,考察不同设计参数和操作工艺条件下,颗粒在设备内部的运动过程变化规律。方法 基于仿真模拟技术,考察受不同设备长径比、入口进气雷诺数、颗粒质量流量3个因素影响的金银花颗粒在分离器内的运动规律,并以金银花颗粒得粉率为验证指标参数,对模型可靠性进行了分析。结果 通过仿真模拟得到了各个不同工艺条件下的金银花颗粒运动轨迹分布,计算出了对应设备的颗粒得粉率。提出金银花颗粒分离的最佳工艺建议为设备长径比5∶1,入口进气雷诺数3.23×10⁴,颗粒质量流量80.1 mg/s,得到的金银花颗粒得粉率为96.30%。结论 为旋风分离器内金银花颗粒的有关研究提供指导,同时改善旋风分离器在控制和设计上的不足。     

Tropical neuropathies

This article reviews the more common peripheral neuropathies that are restricted to or occur with greater frequency in tropical or subtropical countries. Familiarity with them is desirable for all neurologists so that they can be recognized if they present in temperate countries. Once diagnosed they may require referral for specialist management at a centre for tropical diseases. Together, they constitute an important and variegated group of disorders. Received: 23 April 1997 Accepted: 24 April 1997     

Ultrasound in tropical pyomyositis

Tropical pyomyositis is an infection of muscles mainly presenting in black people, occurring in the trunk and limbs. At Hoima Hospital, Uganda, 58 patients (30 men and 28 women) with a mean age of 21 years have been investigated by ultrasound; a total of 81 lesions were present. Two different characteristic images were found; abscess was present in 65 cases while 16 patients showed a diffuse infiltration among the muscular fibers. These two different images correspond to the two stages of histologic and clinical progression described by other authors. Ultrasound is useful to demonstrate the progression of pyomyositis and to determine when and where to drain any abscess.     

Mercury from gold minings in the Pantanal of Pocone (Mato Grosso,Brazil)

The Pocone gold minings are situated in the Bento Gomes River Basin, at the border of the Pantanal of Mato Grosso. Gold-bearing quartz veins are removed from the subsoils, milled with water, centrifuged and the heavier fraction is subsequently mixed with mercury for gold separation. The gold mining activities caused a very intensive landscape change, threatening many environmental processes like sediment control and storage and recycling capacity of mercury. Cold Vapor Atomic Fluorescence System (CVAFS) was used to determinate total mercury in water, suspended material and sediments from Bento Gomes River, sampled monthly for 1 year. Apart from the fact that mercury concentrations are low in water and bottom sediments, they are slightly higher in relation to background levels measured in the area. The concentration in suspended material is also lower than other rivers with gold mining activities, but the floodplains of the Bento Gomes River act as mercury sinks. Therefore, the discharge of mercury into the Pantanal floodplain should be avoided, in spite of actual contamination of the system being very low.     

Mortality during heat waves in New York City July, 1972 and August and September, 1973.

Twelve phthalic acid esters, including those commonly used as plasticizers for biomedical devices, were subjected to various biological tests for acute, short-term, and chronic toxicity. Certain aspects of subtle toxicity were investigated as well as overt toxic manifestations. The acute ip LD₅₀ for these compounds in mice ranged from 3.22 to more than 100 g/kg. A comparison of acute LD₅₀ to chronic LD₅₀ reveals that most of these phthalates are 2–4 times more toxic chronically. However, the chronic toxicity of di-n-octyl phthalate was 21.74 times greater than its acute toxicity, while for di-2-ethylhexyl phthalate the chronic toxicity was 27.99 times greater. Most of these compounds produced a prolongation of pentobarbital sleeping time in mice pretreated with a phthalate ester.     

Antibody to HTLV-I in Indigenous Inhabitants of the Andes and Amazon Regions in Colombia

To explore the HTLV-I-carrying groups among the indigenous inhabitants in South America, a sero-epidemiological study on HTLV-I focusing on hinterland villages isolated from others in the Andes and Amazon regions was conducted. Five (2.9%) out of 171 subjects showed positive for HTLV-I antibody in the gelatin particle agglutination (PA) test. Two out of 5 positives with high antibody titer (≫× 1024) in the PA test also showed a positive immunofluorescence (IF) test and anti-HTLV-I-specific protein products, p19, p24, p28, gp46, and p53 in sera by the Western blotting (WB) test. One of three negatives in the IF test showed positive antibodies to p19 and p24 by the WB test. Finally, two were confirmed as HTLV-I carriers and one was suspected of being a carrier. All three are Paez Indians from the central Andes; 53- and 34-year-old women and a 35-year-old man. The results show that HTLV-1 carriers exist among isolated indigenous people in South America.