Facial nerve palsy produced by plasma cell granuloma

There are many causes for peripheral facial nerve palsy, such as an isolated phenomenon occurring in a healthy person (Bell's palsy), a manifestation of a systemic illness, or a component of a more widespread neurological disease. Plasma cell granuloma is the proliferation of polyclonal, nonneoplastic plasma cells. Several cases have been reported in the literature in which plasma cell granulomas have affected the brain, lungs, gastrointestinal tract, kidneys, salivary glands, and skin. We report a case of peripheral facial nerve palsy produced by a plasma cell granuloma that was confirmed by histological and immunohistochemical studies.

Cardiovascular parameters of heroin-withdrawn addicts treated with guanfacine

Blood pressure and heart rate were monitored in heroin addicts detoxified with guanfacine in an outpatient program. Retrospective analysis of the cardiovascular parameters from the addicts who failed this detoxification during the first 5 days of treatment (they consumed heroin within this period) showed that these patients experienced less hypotension and bradycardia when treated with the alpha 2-agonist than the group of successful patients. Therefore, the relapse to opiate use could be predicted, at least in some patients, by a minimal cardiovascular reaction to guanfacine. Opiate use was followed by significant increases in blood pressure and heart rate, as had happened in previous studies with clonidine-treated addicts. This finding further confirms a similarity between alpha 2-agonists adrenergic and opiates with regard to their cardiovascular effects.

Phenytoin reduces the contraction of recessive dystrophic epidermolysis bullosa fibroblast populated collagen gels

Recessive dystrophic epidermolysis bullosa (RDEB) is a group of genetic disorders in which blistering occurs below the basement membrane, in many cases resulting in extensive scar formation, contractures and mitten deformities. Our aim was to compare quantitatively the contraction forces generated by normal and RDEB fibroblats and to investigate the effect of Phenytoin (5,5-diphenyl-2,4-imidazolidinedione, sodium salt; PHT). PHT is an anticonvulsant agent, that causes fibrosis as a side effect. This study utilised conventional untethered fibroblast populated collagen lattice contraction and a quantitative force measurement instrument, the culture force monitor (CFM). The RDEB cell lines were hypercontractile, generating 2.5 times the force of normal fibroblasts, though they appeared morphologically normal. In untethered collagen gels PHT (20 micrograms/ml) significantly reduced contraction of both normal and RDEB fibroblasts over 7 days. Pre-treatment of RDEB cells for 5 days also produced a 40% reduction in contraction as measured in the CFM. One suggested mechanism of PHT action is through inhibition of matrix metalloproteinase activity, but the similar effects of PHT and Colchicine (an inhibitor of microtubule polymerisation) in the CFM, indicate that it may act on contraction through disruption of microfilaments and changes to cell shape. These findings show that isolated RDEB fibroblasts retain the hypercontractile features of many of the patient's lesion sites and imply that local application of PHT may have a therapeutic effect in controlling contraction.

Adhesion, invasion and intracellular replication of Salmonella typhimurium in a murine hepatocyte cell line. Effect of cytokines and LPS on antibacterial activity of hepatocytes

Elimination of pathogenic microorganisms in the liver may be an important effector mechanism in host defenses. In this paper we describe the adhesion, invasion and multiplication of Salmonella typhimurium in a murine embryonic hepatocyte cell line (ATCC TIB-73). Monolayers of hepatocytes treated with recombinant IFN gamma, IL1 beta, and LPS exhibit antibacterial activity against intracellular Salmonella. The dynamic of the infection process in stimulated vs unstimulated hepatocytes was determined by counting the number of survival bacteria in the cell monolayers at 4 and 28h after gentamicin was added to the infected cells. Salmonella typhimurium is able to adhere, invade and replicate inside the hepatocytes. The maximum number of cell-associated bacteria is approximately 15 bacteria per cell, whereas the invasive capacity of Salmonella is 0.003 bacteria per hepatocyte. Stimulated cultures display antibacterial activity compared to unstimulated controls. The antibacterial activity does not seem to be mediated by nitric oxide (NO) since inhibition of NO production by using NG-Monomethyl-L-Arginine did not revert the antibacterial activity. Also, high amounts of NO induced by adding L-Arginine to the cell cultures did not enhance hepatocyte antibacterial activity.

[Parasitic delirium in patient with multiorganic pathology: a complex situation]

Delusion of parasitosis is often observed in people who usually take psychoactive drugs. Moreover, it can be present in infectious diseases or tumours of the central nervous system, metabolic disorders, deficiency and states systemic disorders, such as Systemic Lupus Erythematosus (SLE). The neuropsychiatric manifestations in SLE patients are common and constitute one of the criteria for the classification of SLE. Presentation as an acute organic mental syndrome is a clinical emergency and it is usually required the admission in the hospital. We report a case of delusion of parasitosis in a middle age woman diagnosed of SLE several years before and with previous corticosteroid therapy, right temporal arachnoid cyst, chronic Lyme disease and hypothyroidism. We analyse the different role of each pathology and the clinical practice difficulties in the management of these disorders.

Conjugation between cloned human NK cells (H7.8) and K562/MOLT4 tumor cell systems: saturability, binding parameters, and population distribution of conjugates

Effector-target conjugation between cloned NK(H7.8)-K562 and NK(H7.8)-MOLT4 tumor cells has been studied from binding isotherms. Nonlinear and linear regression methods were used to calculate the maximum effector and target conjugate frequencies as well as the dissociation constant of the conjugates formed. The results obtained show there is an enhancement of the effector-target saturability and effector-target affinity in comparison with the values previously observed for polyclonal NK effector cells. Population distributions revealed that different types of conjugates were formed as the effector-to-target ratio was changed in the NK(H7.8)-K562 and NK(H7.8)-MOLT4 tumor cells. In both cases conjugates where one effector cell was bound to several target cells and conjugates with one target cell bound to several effector cells were found. At all values of R the prevailing conjugates were those with one effector cell bound to one target cell.

Differential expression of DNA topoisomerases in non-small cell lung cancer and normal lung

DNA topoisomerases are ubiquitous nuclear enzymes, and important targets of cancer chemotherapy. Expression of topoisomerase genes is often correlated with in vitro chemosensitivity. We investigated the expression of the topoisomerase genes in normal lung and non-small cell lung cancer. Expression of topoisomerase II-alpha, topoisomerase II-beta, and topoisomerase I genes has been assessed in tumor samples of 60 patients who underwent operation for a non-small cell lung carcinoma, by RNase protection assay, and by immunohistochemistry. The expression of topoisomerase II-alpha gene was either undetectable or very low in normal lung, while most NSCLC expressed readily quantifiable levels of this gene. No alteration of the topoisomerase II-alpha gene was found by Southern blotting in the NSCLC samples. In contrast to topoisomerase II-alpha, topoisomerase II-beta was expressed in most normal as well as in tumor tissue samples, at a similar level. The levels of expression of both topoisomerase II isoforms was lower than that of human lung cancer cell lines. The results of the topoisomerase II mRNA expression were confirmed by immunohistochemistry. Whereas topoisomerase II-alpha staining was mainly limited to the nucleus, staining with topoisomerase II-beta antibody was exclusively observed in nucleoli. Topoisomerase I was localized in the nuclei and expression was mainly limited to tumor cells. By RNase protection, topoisomerase I expression in NSCLC samples was in the range of that of human lung cancer cell lines. The expression of the topoisomerase genes did not seem to be coordinated. In tumor cells, there was a positive association between expression of topoisomerase II-alpha and Ki-67, a marker of cell proliferation, as assessed by immunohistochemistry, but not with topoisomerase II-beta or topoisomerase I. Clinical characteristics of the patients, and their survival did not appear to be correlated to the level of expression of any of the topoisomerase genes, although a trend towards a shorter survival was observed in patients whose tumors expressed relatively high topoisomerase II-alpha mRNA levels.

IN CONCLUSION

(1) the two isoforms of topoisomerase II are differentially expressed in normal lung and NSCLC cells; (2) higher topoisomerase II-alpha expression is associated with higher cell proliferation in NSCLC; (3) the expression of topoisomerase II-alpha and topoisomerase I, but not of topoisomerase II-beta, was higher in tumor cells compared to normal lung. Given the differential expression of topoisomerases in normal lung and tumors, research of more potent and specific topoisomerase inhibitors might prove beneficial in non-small cell lung cancer. Immunohistochemistry may be indicated in prospectively investigating the correlation between expression of topoisomerases and results of chemotherapy treatment.

Differential expression of the c-kit proto-oncogene in germ cell tumours

The c-kit proto-oncogene product and its ligand stem cell factor play an important role in haematopoiesis, spermatogenesis, and melanogenesis. Using an anti-c-kit antiserum raised against a synthetic peptide, we studied the immunohistochemical expression of the c-kit gene product in 60 germ cell tumours (GCTs) (53 testicular, 7 extragonadal), derived from primary GCTs in 45 cases and metastatic tumours in 15 cases. Twenty-eight out of 28 seminomas showed c-kit membranous staining in the majority of cells. A similar pattern of expression was seen in intratubular germ cell neoplasia. Nine out of 29 (32 per cent) non-seminomas displayed cytoplasmic, but not membranous, c-kit immunoreactivity in occasional cells. In three mixed GCTs, c-kit expression was limited to the seminoma component. In normal testis, c-kit expression was observed in some basal tubular cells, corresponding to undifferentiated spermatogonia. These results suggest a role for c-kit in the oncogenesis of GCT, where down-regulation of c-kit might be a critical step during progression from seminomas to non-seminomas. Immunohistochemical analysis of c-kit should be considered as a diagnostic aid for GCT and in particular may be helpful in the identification of certain extragonadal seminomas.

Ethanol intake, plasma catecholamine levels, and ST-segment changes without myocardial injury in rats with short-term ethanol consumption

The authors studied the effect of short-term ethanol consumption on the ST-segment and the association between ST-segment changes and the amount of daily ethanol intake and levels of plasma catecholamines. The study used 63 rats (control group n = 20, study group n = 43). The rats in the study group were exposed for 6 days to progressively larger doses of ethanol followed by 15 days of continuous exposure to ethanol. At baseline an electrocardiogram (ECG) was recorded, and on day 25 the ECG was repeated and plasma catecholamine levels were measured. The animals' hearts were removed and processed for histologic study. Repolarization abnormalities were observed in 68% of the ethanol-consuming rats. Two factors differentiated the subgroup of ethanol-consuming rats with ST-segment changes from the subgroup without ST-segment changes: amount of daily ethanol intake (0.0077 +/- 0.02 mL/g/d vs 0.0058 +/- 0.019 mL/g/d) and plasma epinephrine levels (3,881 +/- 733 pg/mL vs 1,478 +/- 406 pg/mL). No myocardial damage was detected. Our results suggest that in ethanol-consuming rats, high-volume daily ethanol intake and increased plasma catecholamines may mediate changes in the ST-segment.

Reversed metal replicas of freeze-dried proteins to be visualized with the scanning tunneling microscope

Scanning tunneling microscopy of metal-coated specimens has become a reliable technique that permits direct three-dimensional visualization of structural details at a level at which individual subunits in protein complexes or even single domains of proteins can be resolved. We describe in this paper a variation of the freeze-drying metal coating procedure that allows us to image with the STM the inner side of the metal replica, previously in contact with the protein molecules. We have tested this new approach with two different well characterized protein systems: freeze-dried two-dimensional crystals of bacteriophage phi 29 connector and the vesicle form of two-dimensional crystals of cytochrome oxidase from beef heart mitochondria. The images obtained have very good contrast and provide direct topographic information of the crystal surface, complementing structural information obtained previously with transmission electron microscopy. The resolution limit is imposed by the size (2-3 nm diameter) and corrugation of the metal grains used to prepare the replica and by the randomness of the metal shadowing.

Interleukin-7 rescues human activated T lymphocytes from apoptosis induced by glucocorticoesteroids and regulates bcl-2 and CD25 expression

We studied the ability of several interleukins to inhibit the cellular death of IL-2-dependent human T cells deprived of IL-2 testing viability, DNA integrity, and expression of bcl-2 gene product. Our in vitro results showed that the addition of IL-7, and in a far less efficient manner IL-4, augmented the viability of IL-2-dependent T-cell clones of different origin, specificity, and phenotype. Furthermore, IL-7 reduced the percentage of apoptotic T cells inhibiting DNA fragmentation. In addition, IL-7 but not IL-4 was consistently able to suppress the cell death of IL-2-dependent T cells triggered by DEX, a synthetic GC. The suppression of T-cell death triggered by IL-7 was not affected by the addition of anti-IL-2 antibody. Interestingly, IL-7 inhibited the downregulation of bcl-2 gene product expression that appeared on TCCs after IL-2 withdrawal and also shared with IL-2 the ability to induce the upregulation of CD25 antigen on activated T lymphocytes in the presence of DEX. These experiments establish a novel role for IL-7 in regulating viability and GC-induced apoptosis on activated human T cells and suggest that the maintenance of bcl-2 levels is a general mechanism by which interleukins preserve activated T cells from undergoing apoptosis.

Presence and isotype of anti-ganglioside antibodies in healthy persons, motor neuron disease, peripheral neuropathy, and other diseases of the nervous system

Antibodies of the IgM, IgG and IgA class against GM1, asialo-GM1, GD1b and GM2 gangliosides were determined in the sera of patients with motor neuron disease (MND), peripheral neuropathy, other neurological diseases (OND) and healthy individuals. Antibodies of the three immunoglobulin classes were present in healthy persons. MND patients did not differ from OND or controls in anti-GM1 titers of the three isotypes. In the group of peripheral neuropathy, no elevations of antibody titers were observed in patients with sensory or sensory-motor neuropathy; however, four out of 12 patients with the motor variety had very high levels of IgM or IgG antibodies. Two of these four patients also had increased titers of IgA antibodies, but no patients exhibited high titers restricted to this isotype.

[Current use of penicillin in community-acquired pneumococcal pneumonias]

BACKGROUND

A retrospective study was performed to know the clinical and microbiologic aspects of community-acquired pneumococcal pneumonia in adult patients admitted to a general hospital from 1990-1992.

METHODS AND RESULTS

The medical records of 55 patients, aged 20-86 years (man age: 58 year) were reviewed. Streptococcus pneumoniae was isolated from blood in 45 cases (81.8%), transparietal lung puncture in 5 (9.1%), pleural fluid 3 (5.5%) and protected specimen brushing (> 1,000 UFC/ml) in 2 (3.6%) Most isolated (80%) were sensitive to penicillin (CIM < 0.1 microgram/ml); intermediate (CIM > or = 0.1 microgram/ml) 9 (16.4%) and resistant (> 1 microgram/ml) 2 (3.6%). Underlying diseases were present in 39 (70.9%) cases. All patients received empiric treatment with one or more antibiotics effective against Streptococcus pneumoniae. Only in 2 of the 9 cases treated with erythromycin the microorganism was resistant to this drug. Eleven patients died (20%), 5 died before to the fifth day of admission. Mortality was influenced by involvement of 2 or more lobes and immunosuppression (p < 0.05).

CONCLUSIONS

This study suggests that 80% of the community-acquired pneumococcal pneumonia in a population with a high prevalence rate of disease requiring hospital admission are very sensitive in vitro to penicillin in contrast with its seldom clinical use in the authors environment. No microorganism presented with CIM above 2 micrograms/ml. Mortality was not due to inadequate therapy but rather to the severity of the underlying disease.

ICAM-3, the third LFA-1 counterreceptor, is a co-stimulatory molecule for both resting and activated T lymphocytes

Optimal activation of human T cells mediated by ligation of CD3/T cell receptor (TcR) complex requires co-stimulatory signals. These can be provided by the adhesive interaction between receptor molecules on T cells and their counter-receptors on antigen-presenting cells. Soluble ICAM-3, anti-ICAM-3 and anti-CD3 mAb were utilized to address the role of the ICAM-3/LFA-1 pathway in TcR/CD3-dependent or -independent T cell activation. Immunoaffinity-purified ICAM-3 co-immobilized with suboptimal concentrations of anti-CD3 monoclonal antibody (mAb) stimulated T lymphocytes as monitored by the expression of the lymphocyte activation antigens CD25 and CD69. The mechanism underlaying this activation appear to involve the interaction of ICAM-3 with a beta 2 integrin, likely to be LFA-1, since mAb to the CD18 chain completely inhibited T cell activation. Similar experiments demonstrated that anti-ICAM-3 mAb were able to co-stimulate both resting (cord blood) and activated (T cell clones) T lymphocytes. On the contrary, anti-ICAM-1 mAb were only co-stimulatory for CD25 expression on activated but not on resting T cells. In addition, we have found that some gamma delta T cell clones bearing the V delta 1 segment were activated by direct mAb engagement of ICAM-3 in the absence of TcR/CD3 occupancy. Furthermore, immobilized anti-ICAM-3 mAb also induced development of dendritic processes. In conclusion, our data suggest that ICAM-3 on the surface of both T cells and antigen-presenting cells plays an essential role in the initiation of the immune response.

A novel functional cell surface dimer (kp43) serves as accessory molecule for the activation of a subset of human gamma delta T cells

Kp43 is a cell surface molecule expressed by NK cells, gamma delta T lymphocytes, and a small subset of CD56+ alpha beta T cells. In the present study the distribution and function of Kp43 on gamma delta T cells is described. The expression of Kp43 on freshly isolated gamma delta T-cell populations derived from fetal and adult tissues was biased toward memory V gamma 2+/V delta 2+ T lymphocytes and appeared to be up-regulated after activation. Several gamma delta T-cell clones were derived from different sources. Adult V gamma 2+/V delta 2+ T-cell clones expressed the highest levels of Kp43, V delta 1 T-cell clones derived from periphery expressed moderate levels, whereas some thymus V delta 1 T cells and fetal gamma delta T-cell clones displayed low or undetectable levels of Kp43 molecule. Based on the effect of a specific mAb, this dimer appears to be fully functional as previously shown for NK cells. The stimulation of Kp43+ gamma delta T-cell clones with a combination of anti-CD3 and anti-Kp43 co-immobilized on a solid substratum enhanced both the expression of cell surface CD25 and the secretion of TNF-alpha. The restricted expression and functional activity of the Kp43 dimer suggests that it may play an important regulatory role in activation, selection, Ag recognition, and responsiveness of a subset of gamma delta T cells.

A novel functional cell surface dimer (kp43) serves as accessory molecule for the activation of a subset of human gamma delta T cells

Kp43 is a cell surface molecule expressed by NK cells, gamma delta T lymphocytes, and a small subset of CD56+ alpha beta T cells. In the present study the distribution and function of Kp43 on gamma delta T cells is described. The expression of Kp43 on freshly isolated gamma delta T-cell populations derived from fetal and adult tissues was biased toward memory V gamma 2+/V delta 2+ T lymphocytes and appeared to be up-regulated after activation. Several gamma delta T-cell clones were derived from different sources. Adult V gamma 2+/V delta 2+ T-cell clones expressed the highest levels of Kp43, V delta 1 T-cell clones derived from periphery expressed moderate levels, whereas some thymus V delta 1 T cells and fetal gamma delta T-cell clones displayed low or undetectable levels of Kp43 molecule. Based on the effect of a specific mAb, this dimer appears to be fully functional as previously shown for NK cells. The stimulation of Kp43+ gamma delta T-cell clones with a combination of anti-CD3 and anti-Kp43 co-immobilized on a solid substratum enhanced both the expression of cell surface CD25 and the secretion of TNF-alpha. The restricted expression and functional activity of the Kp43 dimer suggests that it may play an important regulatory role in activation, selection, Ag recognition, and responsiveness of a subset of gamma delta T cells.

Factitious systemic lupus erythematosus

We report the case of a 15-year-old girl who simulated a complex clinical picture including cutaneous lesions, fever, arthralgia, asthenia and oliguria. A diagnosis of probable systemic lupus erythematosus (SLE) was assumed by numerous specialists and steroid therapy instituted. Factitious SLE should be considered for differential diagnosis of SLE, especially when laboratory evidence for autoimmunity is not demonstrated.