APOE genotype, plasma lipids, lipoproteins, and AD in community elderly.

BACKGROUND: Genetic variation at the APOE locus has a major influence on both plasma lipid levels and the risk of AD. The relationship between APOE genotype and plasma lipids may influence the risk of AD. OBJECTIVE: In a community-based study of white, African American, and Caribbean Hispanic elderly in New York City, we investigated the relationship between plasma lipids and AD as well as the possible influence of APOE genotype on this relationship. METHODS: Total plasma cholesterol (TC), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels were investigated in a cross-sectional study of nondemented elderly and patients with AD and in a prospective study of incident AD. Analyses included APOE genotype, gender, ethnicity, body mass index, and other potential confounders such as a history of hypertension, smoking, aspirin use, previous stroke, or ischemic heart disease. RESULTS: Compared with nondemented elderly, decreased TC level had a weak but significant inverse association with incident AD, independent of APOE genotype. No other lipoprotein fragment was associated with either prevalent or incident AD. CONCLUSION: Our results suggest that no consistent relationship exists between APOE genotype, plasma lipoproteins, and AD.     

The spectrum of neurologic disease associated with anti-GM1 antibodies

We compared anti-GM1 IgM antibody titers in patients with various neurologic diseases and in normal subjects. We found increased titers in patients with lower motor neuron disease, sensorimotor neuropathy, or motor neuropathy with or without multifocal conduction block. In patients with other diseases, titers are similar to those in normal individuals, suggesting that anti-GM1 antibody levels are not increased nonspecifically after neural injury or inflammatory diseases. Anti-GM1 antibodies in many of the patients occur as monoclonal gammopathies, predominantly of lambda light-chain type, but the antibodies are sometimes polyclonal with normal or increased serum IgM concentrations. Most of the anti-GM1 antibodies appear to react with the Gal(beta 1-3)GalNAc epitope which is shared with asialo-GM1 and GD1b, but in some patients the antibodies are more specific for GM1 and associated with motor neuropathy. Patients with motor or sensorimotor peripheral neuropathy or lower motor neuron disease should be tested for anti-GM1 antibodies or anti-Gal(beta 1-3)GalNAc antibodies, as therapeutic reduction in antibody concentrations was reported to result in clinical improvement in some patients.     

Usefulness of optical coherent reflectometry with guided radiofrequency energy to treat chronic total occlusions in peripheral arteries (the GRIP trial)

Optical coherent reflectometry, a forward-looking, fiberoptic-guided device was used in 72 patients to direct radiofrequency energy across the central intraluminal portion of 75 chronic total occlusions in peripheral arteries (iliac, femoral, and popliteal) that failed attempts with conventional guidewires. The system was successful in crossing 76% of the chronic total occlusions with no clinical perforations or distal embolizations, and complications consisted of a single dissection greater than or equal to grade C.     

Use of pre-existing ureterocutaneous anastomosis as conduit in renal allotransplantation.

This report details 2 patients with unusable bladders whose renal allografts were anastomosed to an existent end cutaneous ureterostomy. The literature on renal allotransplants into intestinal conduits is reviewed. Use of existent, mature end cutaneous ureterostomies is suggested as an alternative to an intestinal conduit in patients with unusable bladders who require renal allografts.     

Bacteria,parasitic agents and rotaviruses associated with acute diarrhoea in hospital in-patient Indonesian children

Faeces from children (aged from one month to 12 years) with acute diarrhoea admitted to hospital in Yogyakarta, Indonesia, from June 1978 to June 1979, were examined for the presence of enteric pathogens. One or more recognized enteropathogens were identified in 56% of children. Rotaviruses were identified in 38% of all children. Toxigenic coliforms (predominantly Escherichia coli) were isolated from 12% of children. Salmonella sp. (6%), Shigella sp. (4%) and enteropathogenic parasites (predominantly Trichuris trichiura) from 3 · 5% of children. Mixed infections with two or more enteric pathogens were found in 7 · 6% of children. The incidence rate of each pathogen was correlated with age of the child, socio-economic level of the family and duration of breast feeding. Toxigenic coliforms were equally common in all age groups from both well-to-do and poor families. Enteropathogenic parasites appeared in increasing frequency with age. They were more common in artificially fed children and in children from families of low socio-economic level. The occurrence of multiple infection with mixtures of enteric pathogens increased with increasing age. Mixtures of parasites and other enteric pathogens only occurred in children with acute diarrhoea. These results provide baseline data about the relative importance of different enteropathogens in Indonesian children.