SEQUENCE TYPING CONFIRMS THAT CAMPYLOBACTER JEJUNI STRAINS ASSOCIATED WITH GUILLAIN-BARRÉ AND MILLER-FISHER SYNDROMES ARE OF DIVERSE GENETIC LINEAGE, SEROTYPE, AND FLAGELLA TYPE

To determine the involvement of the corticospinal tract in Guillain-Barré syndrome (GBS), we examined central motor conduction in patients with GBS-like symptoms and hyperreflexia using a magnetic stimulation technique. The subjects were 3 patients who exhibited ascending muscle weakness 2–4 weeks after preceding infections. Deep tendon reflexes were exaggerated in all four limbs of the 3 patients. The results of cerebrospinal fluid examinations revealed protein elevation without pleocytosis. The serum anti-GM(1) antibody titer was elevated in 2 patients. The results of nerve conduction study revealed axonal motor neuropathy and normal F-wave conduction. Central motor conduction time (CMCT) in patients with hyperreflexia was significantly delayed compared to that in patients with GBS and areflexia (p < 0.001), and the delayed CMCTs were significantly improved in the recovery periods (p < 0.001). Although hyperreflexia is a controversial symptom in patients with GBS, these findings indicate that there is functional corticospinal tract involvement in patients with a GBS variant.     

抗消化性溃疡病药物杂环甲醛缩氨(硫)脲和酰胺的合成和构效分析

呋喃唑酮是我国临床上发现并使用的抗消化道溃疡药物。为优化其活性,对呋喃唑酮分子中的硝基呋喃环和噁唑酮环进行了结构修饰和改造。合成的28个化合物的生物活性表明,用呋喃、噻吩、吡咯或甲基吡咯代替硝基呋喃环,用氮脲、氨硫脲和芳酰肼等结构片断替代噁唑酮环,均可引起活性和毒性的变化。构效关系分析表明,化合物的水溶解性和羰基的电荷密度是影响化合物活性的重要因素。     

维甲类化合物的研究 IV.双叔丁基苯类化合物的设计合成和构效关系

以３，５双叔丁基４羟基苯基为结构单元设计合成了取代的酰芳胺、芳酯和查尔酮类化合物，模拟全反式维甲酸的分子形状、长度和功能基的空间配置，并研究对细胞诱导分化的活性。结果表明分子一端的疏水性基团，另一端羧基的存在以及分子的共轭性，是呈现诱导分化活性的必要和充分的因素，缺少其中任何一个则失去活性，而且分子的构象、形状和基团的配置也起关键作用。芳酰胺类的Ｎ甲基化产物的稳定构象是两个芳环呈顺式排布，使分子成弯曲状，而不呈反式的伸展形式，以致与全反式维甲酸分子的伸展形状不同，这是它失去活性的原因。本工作发现化合物Ｎｏ４ｆ，４ｇ，７，１３，３２，３７和３８等具有显著的细胞诱导分化作用。     

红芪多糖RHG的分离纯化及化学结构

甘肃产的名贵中药材红芪( Hedysarum polybotrys Hard.-Maz)的根经热水提取,醇析、脱除蛋白质、DEAE-Sephadex A-25离子交换色谱及Sephadex G-75柱色谱分离得一水溶性多糖RHG。用电泳及凝胶过滤法鉴定为均一组分,系由单一葡萄糖残基构成。平均分子量1.4×10⁴。经甲基化、高碘酸钠氧化、Smith降解、NMR和IR分析以及KI-I₂反应证明其化学结构是以α-D-(1→4)葡萄糖为主链,并在 6-位氧上有短而少量分枝的葡聚糖。     

Bet v 1, the major birch pollen allergen, conjugated to crystalline bacterial cell surface proteins, expands allergen-specific T cells of the Th1/Th0 phenotype in vitro by induction of IL-12

Modulation of allergic immune responses by using adequate adjuvants is a promising concept for future immunotherapy of type I hypersensitivity. In the present study, recombinant Bet v 1 (rBet v 1, the major birch pollen allergen) was conjugated to cross-linked crystalline surface layer proteins (SL) derived from Gram-positive eubacteria. T cell lines (TCL) and clones (TCC) were established from peripheral blood of birch pollen-allergic patients. TCL and TCC were induced either using rBet v 1 alone or rBet v 1/SL conjugates (rBet v 1/SL) as initial antigen stimulus. Cytokine production after re- stimulation with rBet v 1 was investigated. TCL initiated with rBet v 1/SL showed significantly increased IFN-gamma production as compared to rBet v 1 -selected TCL. TCC were established from TCL of five patients. As expected, the majority of CD4+ TCC induced by rBet v 1 (55%) displayed a Th2-like pattern of cytokine production. However, only 21% of Bet v 1-specific TCC isolated from TCL established with the Bet v 1/SL revealed this phenotype. The majority of SL-specific TCC (80%) belonged to the Th1 phenotype. In cultures of peripheral blood mononuclear cells, both, SL and Bet v 1/SL (but not rBet v 1) stimulated the production of high levels of IL-12, a pivotal mediator of Th1 responses. Moreover, stimulation of rBet v 1-induced TCC with rBet v 1/SL led to an increased IFN-gamma production. This effect could be reversed by neutralizing anti-IL-12 mAb. Together these results indicate an adjuvant effect of SL mediated by IL-12. Our results indicate that bacterial components, such as SL, displaying adjuvant effects may be suitable for immunotherapeutical vaccines for type I allergy.      

Shoulder arthrography: comparison of morbidity after use of various contrast media

This prospective study compares immediate and delayed patient discomfort in 177 patients following shoulder arthrography using intraarticular combinations of metrizamide, meglumine/sodium diatrizoate, meglumine diatrizoate, lidocaine, epinephrine, and air. Patients receiving conventional ionic monomeric positive contrast media had a 60% (90/150) incidence of moderate or severe delayed exacerbation of their baseline symptoms; only 14% (3/21) of patients receiving metrizamide, a nonionic contrast medium, had similar levels of postprocedural discomfort. Morbidity was somewhat diminished with the use of double-contrast (45%, 34/75) rather than single-contrast (75%, 56/75) examinations, and with avoidance of sodium-containing contrast agents or epinephrine. Nonionic or monovalent polymeric contrast media, despite their present high cost, may be the agents of choice if single-contrast arthrography is performed in joints (such as the shoulder, hip, and temporomandibular) associated with a high incidence of post-procedural pain.     

Intestinal pseudo-obstruction syndrome in a child with myotonic dystrophy

Gastrointestinal symptoms in myotonic dystrophy are increasingly observed, but major intestinal movement disorders such as intestinal pseudo-obstruction appear to be an infrequent complication. We describe a 13-year-old boy who, after appendectomy, developed intestinal pseudo-obstruction syndrome as the first clinical manifestation of myotonic dystrophy. He developed several similar episodes thereafter, which responded to conservative measures. When a child with myotonic dystrophy presents with an ileus, the diagnosis of intestinal pseudo-obstruction should be considered and therapy should then be conservative.     

Participation of immune complexes in adenovirus infection

To determine the participation of immune complexes during adenovirus infection, we evaluated serum and necropsy specimens of patients with confirmed adenovirus infection of the lower respiratory tract. In lung and kidney from seven dead patients, immunofluorescence revealed the presence of hexon, immunoglobulins and complement. These patients had clinical manifestations of kidney dysfunction. In dead patients (3/3 in whom serum was available) neither anti-adenovirus antibodies nor adenovirus-specific immune complexes could be found in the final stage of the infection. However, two of these patients had anti-adenovirus antibodies and immune complexes in samples obtained early in the infection. Most patients (16/19) who survived the infection had circulating anti-adenovirus antibodies. Half also had immune complexes specific for adenovirus in some moment of the illness. This suggests that immune complexes arise during respiratory infection by adenovirus, probably contributing to its clinical picture.