Antiphospholipid antibodies and pregnancy

The presence of antiphospholipid antibodies is associated with a clinical syndrome characterised by thrombocytopenia, arterial and venous thromboses and recurrent fetal loss. Among theses antibodies currently detectable in laboratory are the lupus anticoagulant and anticardiolipin antibody. The antigens for theses antibodies are phospholipid-binding-proteins (prothrombin and beta 2 glycoprotein I). The exact mechanism of action of antiphospholipid antibodies remains controversal. The pathogenis of pregnancy loss seems related to the increased incidence of placental infraction. In spite of the improvement in our knowledge on the pathogenic mechanisms of the antiphospholipid syndrome, the standard therapy is still based on anti-platelet or anticoagulant drugs, both for vascular and obstetrical problems. Larger prospective clinical studies are needed to validate therapeutic implications.     

Dysplasia epiphysealis capitis femoris: Meyer dysplasia

The clinical importance of dysplasia epiphysealis capitis femoris (Meyer dysplasia) is that it is easily mistaken for Legg-Calve-Perthes disease, leading to unnecessary diagnostic procedures and treatments. After a review of 578 children (619 hips) with Legg-Calve-Perthes disease, 17 children (27 hips) in whom both the clinical and radiologic pattern was obviously different could be found and a diagnosis of dysplasia epiphysealis capitis femoris was finally made. The mean age was 2.5 (range 1.9-3.6) years. There were 16 boys and 1 girl. Ten children had bilateral involvement (59%). The capital femoral epiphysis was delayed or was smaller in 26 hips, separated or cracked in 15, and cystic in 6. A normal bone structure was established in approximately 2 to 4 years. The final results assessed by the Mose and the Stulberg classification were good in all 27 hips. This study suggests guidelines for evaluating this rare condition based on the authors' findings and a review of the literature.     

Increased ipsilateral whole breast vascularity as measured by contrast-enhanced magnetic resonance imaging in patients with breast cancer

BACKGROUND: Tumor-induced neovessel formation identified by gadolinium-enhanced magnetic resonance imaging (MRI) is a commonly used marker for breast malignancy. The purpose of this study was to assess possible differences in whole-breast vascularity as measured by contrast-enhanced MRI in the ipsilateral and contralateral breasts of patients with unilateral breast malignancies. METHODS: Gadolinium-enhanced MRI of the breast using a Siemens 1.0-T scanner with dedicated breast coil was performed on 22 consecutive patients with histologically confirmed unilateral breast carcinoma. Whole-breast vascularity of the breast containing the carcinoma was estimated as increased, decreased, or similar compared with the contralateral unaffected breast. Breast vascularity was then correlated to clinical factors including tumor size, histology, multifocality, nodal involvement, and patient age and menopausal status. RESULTS: Twenty patients had infiltrating carcinomas, and 2 patients had ductal carcinoma in situ. Four were multifocal. Fifteen of 22 patients demonstrated clear evidence of increased whole-breast vascularity in the ipsilateral breast containing the primary breast cancer compared with the contralateral breast. Although there was no clear correlation between the presence of increased whole-breast vascularity in the cancer-bearing breast with tumor size, histology, grade, mammographic appearance, or patient age and menopausal status, increased vascularity was present in 3 of 4 patients with multifocal disease and in 4 of 5 patients with metastatic disease in the axillary nodes. CONCLUSIONS: Measurable increases in whole-breast vascularity can be identified by contrast-enhanced MRI and appear with increased frequency in the cancer-bearing breast. These findings suggest that factors other than tumor size and histology may influence development of macroscopic vessels during tumor progression and may be indicative of angiogenic tumor biology.     

Immunoglobulin G antibodies to herpes simplex type 1 virus detected by radioimmunoassay in serum and cerebrospinal fluid of patients with schizophrenia.

Serum and CSF specimens from 16 schizophrenic patients and 18 nonpsychiatric controls were tested by radioimmunoassay for immunoglobulin G antibody of capsid, envelope and excreted antigens of herpes simplex type 1 virus. There were no significant differences in the antibody levels between the schizophrenic patients and the controls. The etiological role of viruses and virus-like agents in schizophrenia and some methodological aspects are discussed.     

Jaccoud arthropathy and pyrophosphate arthropathy: a rare association

Jaccoud's arthropathy (JA) is a chronic deformity affecting hands and feet, which are voluntarily correctable by the patients. JA was usually reported in association with rheumatic fever and systemic lupus erythematosus. We describe an exceptional association between a pyrophosphate arthropathy and JA of the hands. It is a 48-year-old woman, having a 13 years history of polyarthritis involving shoulders, elbows, hips and knees, and 4 years after, a progressive unlar deviation of the fingers of the hands. Calcium pyrophosphate dihydrate crystals were identified in the synovial knee biopsy. Hands x-rays as RMI don't identify erosions and confirmed the JA.     

Interest in prolactin levels in galactorrhea

The action of prolactin (PRL) in supra-physiological levels on the ovaries or on the hypothalamic-pituitary axis for the release of gonadotropins leads to a reversible inhibition of the cyclic functioning of the pituitary gland and of the ovaries. The consequences are either the production of immature follicles marked by anovulatory or dysovulatory cycles, or the absence of follicle production marked by amenorrhea. Thus, prolactin plays a major role in the productive system by its lactotropic and antigonadotropic effects. Through this study we intend to try to determine the diagnostic value of the association of the cyclic dysfunctions with galactorrhea by measuring the prolactin levels in 2236 patients complaining of galactorrhea. Measurements of FSH and LH levels were also performed in 236 women among those consulting for infertility associated with galactorrhea. The results obtained showed that galactorrhea was associated with prolactenemia in only 17% of cases and of the ovaries was proportional to the prolactin in blood.     

Asymmetric activation of extracellular signal-regulated kinase 1/2 in rat vestibular nuclei by unilateral labyrinthectomy

The expression of phosphorylated extracellular signal-regulated kinase 1/2 (pERK 1/2) was evaluated in the vestibular nuclei (VN) of rats following unilateral labyrinthectomy (UL). Immunohistochemistry revealed a significant asymmetrical increase in pERK 1/2 expression in the VN, 5 min after UL, after which pERK 1/2 immunoreactivity decreased rapidly and was undetectable by 90 min after UL. These results suggest that unilateral deafferentation of the vestibular system triggers intracellular signal pathways that activate ERK 1/2 in the VN.