Angiography‐negative primary central nervous system vasculitis in children: A newly recognized inflammatory central nervous system disease

Inflammatory central nervous system (CNS) diseases in childhood comprise a wide spectrum of heterogeneous conditions. We studied 4 children with primary CNS vasculitis in whom results of magnetic resonance imaging studies were abnormal but results of conventional angiography were normal. We determined that angiography‐negative, biopsy‐confirmed primary small‐vessel CNS vasculitis is a previously unrecognized distinct disease entity in children. The diagnosis must be considered in a child with a progressive, acquired diffuse or focal neurologic deficit, even if the results of conventional angiography are normal. A lesional brain biopsy is required to confirm the diagnosis. Use of immunosuppressive therapy plus aspirin leads to an excellent neurologic outcome.     

Narrowband Ultraviolet B Radiation for Lichen Planus: Long-term Follow-up of 192 Patients

BackgroundNarrowband UVB (NB UVB) has been suggested as an option for lichen planus control. However, the literature is lacking in reports of long-term results. OBJECTIVE: We sought to evaluate the long-term results of NB UVB therapy in lichen planus.MethodsThis was a prospective, retrospective analysis of patients with lichen planus treated with NB UVB at our institution since 2004. The clinical response and relapse rate were recorded according to age, sex, mouth involvement, skin phototype, number of treatments, and total radiation dose.ResultsOne hundred thirty-seven of 192 (71%) eligible patients had a major response (MR) and 102 (74%) patients had no recurrence after an average follow-up period of 58.7 months. MR was achieved in 66 percent and 75 percent of men and women, respectively (p=0.021) and 76 percent and 68 percent of patients with Fitzpatrick Skin Types I and II and Skin Types IV and V, respectively (p=0.017). Age at the onset of the disease, number of treatments, and total UVB dose had no effect on the MR rate. The disease-free periods were 131 and 101 months for male and female patients, respectively (p=0.06), and 128 and 103 months for patients 40 years or younger and older than 40 years of age, respectively (p=0.07).ConclusionBased on our results, female patients and patients with lighter skin phototypes appeared to have higher MR rates. However, female and older patients appear to be at increased risk of recurrence.     

In Vitro Synthesis of DNA Complementary to Purified Rabbit Globin mRNA

Several properties of the viral RNA-dependent DNA polymerases and of rabbit globin mRNA make it possible to consider synthesis of the globin gene in vitro. These enzymes copy an RNA template using a short sequence of complementary nucleotides as a primer. Furthermore, globin mRNA has a 3'-terminal sequence of adenylic acid residues that make it particularly suitable as a template, since oligo(dT) can be annealed to a specific site on the mRNA. This small primer could phase the DNA polymerase, possibly ensuring that replication is initiated from that end of the globin message. We have used this approach and find that purified mRNA is an efficient template for the polymerase enzyme. The reaction requires the RNA template and the four deoxyribonucleoside triphosphates, and it is markedly stimulated by the addition of oligo(dT). Consistent with the expectation that the oligo(dT) uniquely phases the polymerase at an adenine-rich region in the globin message, oligo(dG), oligo(dC), and oligo(dA) fail to serve as primers. The product has a density intermediate between that of DNA and RNA, and shifts to a lighter DNA density after treatment with base. Further, it is specifically complementary to globin mRNA and sediments slightly faster in an alkaline sucrose gradient than a DNA standard that has a molecular weight of 129,000. The data suggest that a major portion of the DNA product is a sequence of at least 500 bases, about 50 more than would be necessary to encode rabbit globin. The potential usefulness of this interesting product is discussed.     

Physiologic pigmentation of the oral mucosa in Israeli Jews of different ethnic origin

Abstract The prevalence of oral physiologic pigmentation in three ethnic groups of a total of 2465 Israeli Jews was determined, and the relationship of oral pigmentation to age and sex with in the groups was noted. Results showed the presence of oral pigmentation in 63.6% of the Eastern group, 54.8% of the Sephardic group, and 24.9% of the Ashkenazi group. No indication was found of sex predilection, and no significant trend was evident in the prevalence of pigmentation with relation to age. The leading site of pigmentation among the entire sample was the gingiva, and this finding did not vary with ethnicity.     

Radioimmunoassay of gentamicin in Micromonospora medium extracts.

Medium extracts of Micromonospora adversely affected a radioimmunoassay which was used for the measurement of gentamicin in the medium. An overestmation or an underestimation resulted, as judged by the addition of extracts to a gentamicin standard sample.     

A new cryptic virus belonging to the family Partitiviridae was found in watermelon co-infected with Melon necrotic spot virus

A novel virus was detected in watermelon plants (Citrullus lanatus Thunb.) infected with Melon necrotic spot virus (MNSV) using SOLiD next-generation sequence analysis. In addition to the expected MSNV genome, two double-stranded RNA (dsRNA) segments of 1,312 and 1,118 bp were also identified and sequenced from the purified virus preparations. These two dsRNA segments encode two putative partitivirus-related proteins, an RNA-dependent RNA polymerase (RdRP) and a capsid protein, which were sequenced. Genomic-sequence analysis and analysis of phylogenetic relationships indicate that these two dsRNAs together make up the genome of a novel Partitivirus. This virus was found to be closely related to the Pepper cryptic virus 1 and Raphanus sativus cryptic virus. It is suggested that this novel virus putatively named Citrullus lanatus cryptic virus be considered as a new member of the family Partitiviridae.     

Multiple intracranial mucoceles associated with phaeohyphomycosis of the paranasal sinuses

The purpose of this article is to alert clinicians to a new pathogenic fungus of the paranasal sinuses called Exserohilum rostratum. Exserohilum species are one of the etiologic agents of phaeohyphomycosis, a constellation of entities caused by dematiaceous fungi. This class of fungal sinus infection has emerged only in the past decade; it occurs primarily in immunocompetent individuals and produces a tenacious, progressive pansinusitis. To our knowledge, this study describes the first case of multiple intracranial mucoceles secondary to E rostratum. The diagnostic workup includes computed tomography and magnetic resonance imaging followed by direct microscopic examination of tissue biopsy specimens. A craniotomy followed by a bilateral external ethmoidectomy was necessary for complete extirpation of the infected mucoceles. Aggressive surgical management of this mycotic infection is described.     

Transtracheal/transesophageal stimulation of the recurrent laryngeal nerve

A new technique is described which allows stimulation of the recurrent laryngeal nerve (RLN) through intact tracheal and esophageal mucosa. In ten anesthetized dogs, the posterior-lateral tracheal wall and the anterior-lateral esophageal wall were stimulated by a 1 to 2 mA current with a probe placed just distal to the edge of the cricoid cartilage. The tracheal mucosa was approached through a tracheostomy stoma and the esophageal mucosa through the mouth. The resultant vocal cord motion was frequency dependent, with graded abduction occurring below 30 Hz and adduction above 40 Hz. By stimulating the posterior laryngeal mucosa proximal to the cricoid edge, the RLN branch to the posterior cricoarytenoid muscle was activated, causing ipsilateral vocal cord abduction independent of frequency. Monitoring of cardiopulmonary parameters demonstrated no alterations at these amperages. There were no mucosal abrasions noted. The transtracheal and transesophageal approaches to RLN stimulation appear promising as diagnostic techniques for evaluating vocal cord function during laryngoscopy and, possibly, as methods of glottic airway control.     

Biotransformation of monoterpenes by mentha cell lines: conversion of menthone to neomenthol

Following previous results, which indicated that cell lines derived from different MENTHA chemotypes were either capable or not capable to biotransform pulegone into isomenthone, we studied menthone biotransformation by IN VITRO cultured MENTHA cell lines. All the six cell lines did transform (-)-menthone into another monoterpene. The latter was identified by GLC, TLC and NMR techniques as (+)-neomenthol. None of these cell lines reduced (+)-isomenthoneto the corresponding alcohol. These results indicate a stereospecificity in respect to both precursor and product in this plant cell biotransformation system.