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Mircea Balasa Ellen Gelpi MJ Rey Jordi Vila Lluís Ramió‐Torrentà Ana Ma Quiles Granado Ricard Molina Latorre Hubert Lepidi Didier Raoult Albert Saiz 《Brain pathology (Zurich, Switzerland)》2014,24(3):230-238
Central nervous system Whipple's disease (CNS‐WD) with clinically isolated neurological involvement is a rare condition fatal without an early diagnosis. We aimed to present clinical and neuropathological features of three cases of pre‐ or post‐mortem polymerase chain reaction confirmed CNS‐WD with distinct clinical presentation, outcome and pathological findings. One patient had an acute onset with spinal and brainstem involvement and died without CNS‐WD diagnosis after 14 weeks. Neuropathology showed extensive inflammatory and necrotizing lesions with abundant foamy periodic‐acid‐Schiff (PAS)+ macrophages. The second patient had a subacute evolution with late CNS‐WD diagnosis and death occurring 18 months after onset despite antibiotic treatment. Brain examination showed inflammatory lesions in the brainstem, thalamus and cerebellum, and abundant foamy PAS+ macrophages. The third case was diagnosed within 4 weeks of onset and treated with an excellent response. He died after a disease‐free period of 24 months of unrelated causes. Neuropathology showed cystic residual lesions devoid of microorganisms without inflammatory reaction. CNS‐WD may have an acute or subacute course with variable response to treatment. Accordingly, subjacent lesions may be those of a severe acute necrotizing encephalitic process or subacute inflammatory lesions involving diencephalic, brainstem, cerebellar and spinal regions. Chronic, cavitary brain lesions may be sequelae of a successful treatment. Early diagnosis should allow appropriate treatment and improve prognosis. 相似文献
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Interleukin-4 (IL-4) has distinct hematopoietic activities, primarily as a costimulant with other cytokines to enhance colony formation of hematopoietic progenitors. We investigated the influence of IL-4 on stromal cell-supported long-term cultures (LTCs) of normal human bone marrow. Addition of IL-4 to LTCs of unseparated bone marrow or highly enriched CD34+ cells resulted in a significant increase of myeloid progenitors in the nonadherent, as well as in the stromal cell-adherent cell populations. In contrast, the total cell number was not influenced by IL-4, suggesting a selective effect on primitive progenitor cells. Cord blood cells or CD34+ bone marrow cells were incubated with stem cell factor (SCF) and/or IL-4 in stromal cell-free cultures. In these experiments, a twofold to fivefold increase of myeloid progenitor cells was observed in the presence of SCF and IL-4 as compared with SCF alone. Preincubation of the stromal cell cultures with IL-4 resulted in an enhanced adherence of CD34+ cells to the stromal layer. Secretion of hematopoietic growth factors produced by the stromal cells, such as granulocyte-macrophage colony-stimulating factor (G-CSF), and IL-1, was inhibited by IL-4. Thus, the increase of hematopoietic progenitors in LTCs, as observed in the presence of IL-4, can be at least partially explained by a costimulation of SCF and IL-4 on primitive progenitor cells and by an enhancement of hematopoietic cells to stroma. The downregulation of CSFs by IL-4 might prevent the expansion of the mature hematopoietic cell compartment. 相似文献
995.
Pelinck MJ; De Vos M; Dekens M; Van der Elst J; De Sutter P; Dhont M 《Human reproduction (Oxford, England)》1998,13(4):960-963
The aim of the present study was to investigate pregnancy rates ensuing
from transfer of embryos with multinucleated blastomeres. In our in- vitro
fertilization (IVF)/intracytoplasmic sperm injection (ICSI) programme, 1735
embryo transfers were performed from January 1, 1995 to August 31, 1996. In
136 of these transfers at least one embryo with one or more multinucleated
blastomeres was present per transfer (study group). For each of these 136
transfers, two matched controls with transfer of exclusively mononucleated
embryos were selected (control group). Matching was carried out according
to age, method of fertilization (IVF or ICSI), number of transferred
embryos and quality score of transferred embryos. In the study group, there
were eight transfers of exclusively multinucleated embryos from which one
pregnancy ensued and 128 transfers in which multinucleated and
mononucleated embryos were transferred together leading to 23 pregnancies.
The overall clinical pregnancy rate per transfer was 16.9% in the study
group versus 28.7% in the control group (P = 0.01). The ongoing pregnancy
rate per transfer was 13.2% in the study group versus 23.2% in the control
group (P = 0.03). The implantation rate per transferred embryo was 6.0% in
the study group versus 11.3% in the control group (P = 0.003). This study
shows that embryos with one or more multinucleated blastomeres have a
poorer implantation potential than embryos with mononucleated blastomeres.
Transfer of embryos with multinucleated blastomeres should hence only be
considered when insufficient numbers of embryos with only mononucleated
blastomeres are present.
相似文献
996.
Background: The aim of this study was to evaluate the clinical performance of G‐Bond all‐in‐one adhesive with Gradia Direct resin composite placed in non‐carious cervical lesions (NCCLs) over a five‐year period. Methods: Forty‐seven restorations were placed in NCCLs in 10 subjects (age 45–75 years) after written informed consent was obtained. Institutional ethical approval for the trial was obtained before recruitment. Restorations were placed according to the manufacturer’s instructions and using 50% phosphoric acid to etch uncut enamel margins. Patients were recalled annually for five years and restorations reviewed for presence and marginal staining. Photographic records were obtained prior to restoration, immediately after placement and at each recall. Results: At five years, 6 of the original 10 subjects were available for recall, meaning 27 restoration sites could be evaluated. All restorations remained intact apart for one partial failure at four years. This resulted in a cumulative retention rate of 97.5% of restorations at five years. Marginal staining occurred around seven restorations during the study. Staining tended to be isolated to a few patients. Conclusions: It was concluded that G‐Bond with Gradia Direct resin composite showed excellent results over the five years of the study. This material combination seems very suitable for the restoration of NCCLs. 相似文献
997.
Oral Diseases (2010) 16 , 482–487 Objectives: To determine somesthetic, olfactory, gustative and salivary abnormalities in patients with burning mouth syndrome (BMS), idiopathic trigeminal neuralgia (ITN) and trigeminal postherpetic neuralgia (PHN). Subjects and Methods: Twenty patients from each group (BMS, ITN, PHN) and 60 healthy controls were evaluated with a systematized quantitative approach of thermal (cold and warm), mechanical, pain, gustation, olfaction and salivary flow; data were analyzed with ANOVA, Tukey, Kruskal–Wallis and Dunn tests with a level of significance of 5%. Results: There were no salivary differences among the groups with matched ages; the cold perception was abnormal only at the mandibular branch of PHN (P = 0.001) and warm was abnormal in all trigeminal branches of PHN and BMS; mechanical sensitivity was altered at the mandibular branch of PHN and in all trigeminal branches of BMS. The salty, sweet and olfactory thresholds were higher in all studied groups; the sour threshold was lower and there were no differences of bitter. Conclusion: All groups showed abnormal thresholds of gustation and olfaction; somesthetic findings were discrete in ITN and more common in PHN and BMS; central mechanisms of balance of sensorial inputs might be underlying these observations. 相似文献
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