COLLAGEN DISTRIBUTION IN FOCAL AND SEGMENTAL GLOMERULOSCLEROSIS: AN IMMUNOFLUORESCENCE AND ULTRASTRUCTURAL IMMUNOGOLD STUDY

Focal and segmental glomerulosclerosis (FSGS) is a non-specific scarring process of the glomerulus, initially described in idiopathic nephrotic syndrome. The distribution of types I, III, IV, V, and VI collagen and of the α 1, α 3, α 4, α 5, and α6 chains of type IV collagen was studied by immunohistochemistry in sclerotic lesions of nine nephrotic children. Dual immunofluorescence and high-resolution immunogold labelling were used to determine the precise distribution of the antigens. No changes were detected in normal glomeruli of patients compared with controls. In FSGS, type IV collagen [α 1(IV)2 α2(IV)], and to a lesser degree type VI, accumulates in the two components of the lesion: the enlarged mesangial matrix and the material deposited between the pushed-out podocytes and the α 3– α 5(IV)-positive glomerular basement membrane. Staining for α6(IV) and types I, III, and V collagen was practically negative. These results suggest that the matrix components of the sclerotic lesion are produced solely by glomerular cells. Changes in the relative distribution of type IV collagen chains, characterized by the presence of collagen [α 1(IV)2 α2(IV)] in close contact with the podocytes, strongly suggest a switch in the podocyte programme of collagen synthesis.     

Invasive reperfusion study II. Multicentre European randomized trial of anistreplase vs streptokinase in acute myocardial infarction

IRS II (Invasive reperfusion study II) was a multicentre randomizedtrial comparing the efficacy of a 2–5-min 30 U anistreplaseintravenous injection with a 1 500 000 U 60-min streptokinase(SK) intravenous infusion in acute myocardial infarction. 116patients were randomized within 6 h of onset of symptoms. Earlycoronary patency was assessable in 107 patients by coronaryangiogram performed 102 min after thrombolytic treatment (range:30–297 min) in the anistreplase group and 93 min (range:22–330 min) in the SK group. The early coronary patencyrate was significantly higher in the anistreplase group thanin the SK group: respectively, 70% (38/54) and 51% (27/53),P<0.05. Fifty patients had assessable coronary angiogramsat 90 min and 24 h. The 24-h patency rate was 92.3% (24/26)in the anistreplase group vs 87.5% (21/24) in the SK group.No early reocclusion occurred in the anistreplase group vs 15.4%(2/13) in the SK group (NS). Fibrinogen fell to 13.2 ±19.8%on anistreplase vs 9.4 ±10.3% on SK (NS). Bleeding complicationsoccurred in 12% (7/58) of treated patients in the anistreplasegroup vs 20.7% (13/58) in the SK group (NS). Two cerebrovascularaccidents occurred after thrombolytic treatment with anistreplase(3.4%) vs one after SK (1.7%) (NS). Thus, anistreplase is moreeffective than intravenous SK and easier to administer.     

Bacteriocin production by Shigella sonnei isolated from faeces of children with acute diarrhoea

Sousa MÂB, Mendes EN, Apolônio ACM, Farias LM, Magalhães PP. Bacteriocin production by Shigella sonnei isolated from faeces of children with acute diarrhoea. APMIS 2010; 118: 125–35. Shigella is a common agent of diarrhoea, a worldwide major health problem. The bacterium produces bacteriocins; however, the role of these substances as a virulence factor is completely unknown. With the aim to search for colicin production by Shigella sonnei, to evaluate the influence of culture conditions on bacteriocin expression, and to characterize the substance partially, 16 S. sonnei strains isolated from children with diarrhoea were tested for antagonism against members of the intestinal microbiota or agents of diarrhoea. Nine strains exhibited isoantagonism and heteroantagonism against S. flexneri and diarrhoeagenic Escherichia coli. Autoantagonism and antagonism against the intestinal microbiota were not detected. Culture medium and incubation conditions influenced antagonism expression. Antagonism resulting from bacteriophages, low pH, fatty acids, hydrogen peroxide, and chloroform was excluded. The activity of the intracellular fraction obtained with 75% ammonium sulphate was preserved at pH 1.0–11.0, and was found to be reduced by organic solvents and affected by high temperatures and proteases. The antagonistic spectrum and the in vitro conditions for better antagonism expression suggest that the role of colicin in S. sonnei virulence, if any, would be expressed prior to infection, and may regulate population density of enteropathogens by helping in organism transmission.     

Transition to adulthood: validation of the Rotterdam Transition Profile for young adults with cerebral palsy and normal intelligence

The aim of this study was to investigate the validity of the Rotterdam Transition Profile (RTP) to describe the transition process from childhood to adulthood in young adults with cerebral palsy (CP). Participants were recruited from rehabilitation centres and hospital departments of rehabilitation. In total, 81 young adults (47 males, 34 females) with CP and normal intelligence participated (mean age 20y 5mo [SD 1y 4mo] range 18−22y; 95% spastic CP, 48% hemiplegia, 38% diplegia, 14% quadriplegia; 78% Gross Motor Function Classification System Level I, 83% Manual Ability Classification System Level I). The RTP and the Assessment of Life Habits questionnaire are used to measure transition and functioning in daily activities and participation. Almost all participants were in the transition process or had reached an independent adult lifestyle (ranging from 60−100%, housing 42%). Compared with able-bodied peers, young adults with CP lagged behind in their development in housing (25 vs 36%; p <0.05), employment (33 vs 49%; p <0.05), and intimate relationships (37 vs 76%; p <0.01). Associations were found between the phase of transition and age, parents' level of education, gross motor functioning, manual ability, level of education, and level of functioning in daily activities and participation. The RTP is a valid tool to gain more insight into the transition process, at the individual as well as at group level.