Antiganglioside autoantibody profiles in Guillain-Barré syndrome

We established anti-ganglioside antibody profiles in GBS and studied the frequency, fine specificity and clinical correlate. IgG and IgM antibodies to 8 gangliosides were tested by immunodot-blot in 249 consecutive patients with Guillain-Barré syndrome with large variability in clinical expression, referred to our laboratory over a 8-year period. IgG and IgM anti-GM1 antibodies were measured by Elisa. Thin-layer chromatography overlayed by serum was used to control positivity. 89/249 GBS (36%) had characteristic anti-ganglioside antibody profile. Isotypes were, IgG (62%), IgG + IgM (26%) and IgM (12%). Antecedent infections were found in 62% of GBS included more frequently Campylobacter jejuni and cytomegalovirus. Various autoantibody profiles were described with an immunodominant ganglioside. We detected 6 characteristic anti-ganglioside profiles with fine specificity and immunodominant ganglioside corresponding to 6 immuno-clinical variants of GBS: 1) anti-GM1 and GD1b IgG and IgG > IgM in the acute motor axonal neuropathy after Campylobacter jejuni infection in 41 GBS; 2) anti-GD1a IgG in 6 severe motor axonal GBS after Campylobacter jejuni infection; 3) selectively anti-GQ1b IgG in 17 typical Miller Fisher syndrome with areflexia, ataxia and ophthalmoplegia; 4) anti- GT1b ganglioside and polysialogangliosides IgG (n = 9) in two separate cranial nerve variants, ophthalmoplegic SGB and lower cranial nerve variants depending upon the presenting deficit; 5) anti-GD1b IgG in 5 pure ataxic sensory GBS (4%); 6) anti-GM2 IgM in 11 severe GBS with antecedent CMV infection (8%). 34 GBS (14%) had low levels of anti-GM1 and GD1b IgM antibodies which are not disease specific and may simply represent part of the naturally occurring autoantibody population or a secondary response to disease. 126 GBS (50%) had no antibodies, predominantly in classical form. Associations between isotype, fine specificity and clinical presentation permit the definition of homogeneous immuno-clinical variants. Various autoantibody profiles with diagnostic and prognostic value are easy to perform by immunodot blot in acute peripheral neuropathies.     

Intra-mandibular salivary tumors. Apropos of 3 cases of malignant tumor

Three cases of intra-mandibular salivary tumors are presented. Two patients died (one with local recurrence, the other with metastasis). 69 cases have been reported in the literature. The lesions present as a progressive swelling of the mandible, with a frequent nervous involvement. The histologic diagnosis is difficult. Mucoepidermoid tumors are the more frequent (71%) but all salivary tumors can be found. An aggressive clinical behavior with local recurrences and/or metastasis (more than 30%) justify a radical treatment.     

Study of the innervation of the spinal ligaments at the lumbar level

The authors studied the innervation of the human lumbar spinal ligaments on cadaver or surgical specimens. In the ligaments annexed to the neural arch and in the posterior longitudinal ligament were found free-ending fibers and amyelinic perivascular fibers. In the anterior longitudinal ligament, coexisting with perivascular fibers were found encapsulated corpuscular formations on the ventrolateral aspect of the junction between the intervertebral disc and vertebral body. These findings comfort the role of the anterior longitudinal ligament in proprioception essential both in static and dynamic function of the spine.     

A systematic review of the anatomical findings of multiple gallbladders

Background

Multiple gallbladders (MG) are a rare malformation, with no clear data on its clinical impact, therapeutic indications or risk for malignancy.

Lofgren syndrome and peritoneal involvement by sarcoidosis: case report

OBJECTIVE: An unusual case of a patient with L?fgren syndrome peritoneal involvement by sarcoidosis. Patient and methods: A 36-year-old woman presented with L?fgren syndrome and an increase in liver enzyme levels. An abdominal CT scan showed multiple nodules on the peritoneum mimicking peritoneal carcinomatosis. Laparoscopy was conducted with biopsy of the peritoneal nodules. RESULTS: Biopsy specimens from the peritoneum, liver, and bronchi showed noncaseating granulomas, and the search for tuberculosis was negative. Clinical and biological features resolved within 6 months, without therapy with steroids, while a thoracic CT scan as well as an abdominal CT scan showed no change. CONCLUSION: To our knowledge, this is the first reported case of peritoneal sarcoidosis associated with L?fgren syndrome. A longer follow-up will, however, be required to assess the chronicity of the disease.     

Ocular sarcoidosis: when should labial salivary gland biopsy be performed?

Purpose

To assess the usefulness of a labial salivary gland biopsy (LSGB) in subsets of patients with uveitis.

Methods

A retrospective study of 115 consecutive patients with uveitis for whom a LSGB had been done because of suspected ocular sarcoidosis (n?=?86) or unexplained uveitis (n?=?29). Eighty-six patients had a suspicion of ocular sarcoidosis because of ocular features (n?=?67), an elevated angiotensin converting enzyme (ACE) (n?=?29), or because of CT findings (n?=?32) suggestive of sarcoidosis. The biopsy results were analyzed together with their ophthalmological features and the results of other relevant examinations, such as the serum levels of ACE and a chest radiography or a CT scan.

Results

Six of the 115 patients (5.2 %) with uveitis had sarcoid granulomas on the LSGB. At the end of the study, 32 patients had proven sarcoidois while 22 patients were considered as having either indeterminate or presumed sarcoidosis, according to the criteria of Abad et al. A raised ACE (p?=?0.016) and a compatible radiology (p?=?0.033) were related to a positive LSGB test, but not to the features of uveitis. Granulomas were only found in the LSGB of the patients with an elevated ACE or compatible CT scans.

Conclusions

In this study, the LSGB sensitivity (18.75 %) in the patients with proven sarcoidosis appears to be lower than in other reports. Our results suggest that this investigation is a possible method of tissue diagnosis in patients with raised ACE and/or CT scan pattern compatible with sarcoidosis, and should not be performed in patients with unexplained uveitis or because of their ophthalmological features.     

Differences in oxidative stress dependence between gastric adenocarcinoma subtypes

AIM:To investigate the extent of oxidative stress in pre-neoplastic and neoplastic gastric mucosa in relation totheir pathological criteria and histological subtypes.METHODS:A total of 104 gastric adenocarcinomas from98 patients(88 infiltrative and 16 intraepithelial tumors)were assessed immunohistochemically for expression ofiNOS and occurrence of nitrotyrosine(NTYR)-containingproteins and 8-hydroxy-2'-deoxyguanosine(8-OH-dG)-containing DNA,as markers of NO production anddamages to protein and DNA.RESULTS:Tumor cells staining for iNOS,NTYR and8-OH-dG were detected in 41%,62% and 50% ofinfiltrative carcinoma,respectively.The three markerswere shown for the first time in intraepithelial carcinoma.The expression of iNOS was significantly more frequentin tubular carcinoma(TC)compared to diffuse carcinoma(DC)(54% vs 18%;P=0.008)or in polymorphouscarcinoma(PolyC)(54% vs 21%;P=0.04).NTYRstaining was obviously more often found in TC thanthat in PolyC(72% vs 30%;P=0.03).There was atendency towards a higher rate of iNOS staining whendistant metastasis(pM)was present.In infiltrativeTC,the presence of oxidative stress markers was notsignificantly correlated with histological grade,density ofinflammation,the depth of infiltration(pT),lymph nodesdissemination(pN)and pathological stages(pTNM). CONCLUSION:The iNOS-oxidative pathway may playan important role in TC,but moderately in PolyC and DC.DNA oxidation and protein nitration occur in the threesubtypes.Based on the significant differences of NTYRlevels,TC and PolyC appear as two distinct subtypes.     

Differential effects of cooked beans and cooked lentils on protein metabolism in intestine and muscle in growing rats

AIMS: The effect of diets based on cooked beans or lentils on protein metabolism in intestines and muscles was studied in rats. METHOD: The cooked seeds were used as the unique protein source in balanced diets (containing 229 and 190 g of crude protein per kg dry matter) fed to young growing rats for 20 days. Their effects were compared with those of the control casein diet in pair-fed rats. Protein synthesis rates in small and large intestines and in gastrocnemius and soleus muscles were determined in vivo, in a fed state, by the flooding dose method, using 13C-valine. RESULTS: In the small and large intestine tissues of the legume fed groups, protein, RNA relative masses (mg.100 g BM(-1)) and protein synthesis rates (FSR and ASR) were higher than in the control rats (p < 0.05). In gastrocnemius and soleus muscles,protein and RNA contents (in mg) and protein synthesis rates were significantly (p < 0.05) lower in the legume-fed groups than in the control rats. CONCLUSION: The chronic intake of cooked legumes increased protein synthesis rates in intestinal tissues and decreased them in muscles. This effect was greater for beans than for lentils in the large intestine and in gastrocnemius muscle.