ABSTRACT
Viliuisk encephalomyelitis (VE) is an endemic neurological disease in Northeastern Siberia and generally believed to be a chronic encephalomyelitis of unknown origin. We investigated 17 patients with a clinical diagnosis of VE within the Viliuiski region of Sakha (Yakutian) Republic to explore the core clinical syndrome of chronic VE and subsequently whether VE is caused by Borrelia burgdorferi infection. We found a chronic myelopathy as the core of the syndrome, often following an acute phase with a meningo-radiculo-neuropathy, suggestive of chronic neuroborreliosis. A search for inflammatory parameters in a larger cohort in blood (39 VE patients and 41 controls) and CSF samples (10 VE patients and 7 controls) excluded an ongoing chronic infection, but revealed evidence for an immunological scar or a chronic inflammatory ("autoimmune") response in the CSF. In addition, we detected signs of a previous exposure to Borrelia burgdorferi antigens in a subset of chronic VE patients with positive serological results using ELISA/immunoblot in 54/10% and 22/0% of VE patients and controls, respectively (p values of 0.003/0.034; Fisher's exact test). However, CSF analyses did not show a link between exposure or at least immunological reaction against Borrelia and the risk of suffering from VE. Our data provide the first evidence of the presence of Borrelia burgdorferi or similar pathogens in Northeastern Siberia, but do not support a causative role of these pathogens in the aetiopathogenesis of VE.
Subject(s)
Encephalomyelitis/physiopathology , Encephalomyelitis/virology , Lyme Disease/complications , Lyme Disease/epidemiology , Adult , Aged , Antigens, Bacterial/cerebrospinal fluid , Borrelia burgdorferi , Encephalomyelitis/cerebrospinal fluid , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunoblotting , Male , Middle Aged , SiberiaABSTRACT
"One-pot" substitution of the twenty hydrogen atoms in pentagonal dodecahedrane (C(20)H(20)) by OH, F, Cl, and Br atoms is explored. Electrophilic insertion of oxygen atoms with DMDO and TFMDO as oxidizing reagents ended, far off the desired C(20)(OH)(20), in complex polyol mixtures (up to C(20)H(10)(OH)(10) decols, a trace of C(20)H(OH)(19)?). Perfluorination was successful in a NaF matrix but (nearly pure) C(20)F(20) could be secured only in very low yield. "Brute-force" photochlorination (heat, light, pressure, time) provided a mixture of hydrogen-free, barely soluble C(20)Cl(16) dienes in high yield and C(20)Cl(20) as a trace component. Upon electron-impact ionization of the C(20)Cl(16) material sequential loss of the chlorine atoms was the major fragmentation pathway furnishing, however, only minor amounts of chlorine-free C(20) (+) ions. "Brute-force" photobrominations delivered an extremely complex mixture of polybromides with C(20)HBr(13) trienes as the highest masses. The MS spectra exhibited exclusive loss of the Br substituents ending in rather intense singly, doubly, and triply charged C(20)H(4-0) (+(2+)(3+)) ions. The insoluble approximately C(20)HBr(13) fraction (C(20)Br(14) trienes as highest masses) obtained along a modified bromination protocol, ultimately allowed the neat mass selection of C(20) (-) ions. The C(20)Cl(16) dienes and C(20)H(0-3)Br(14-12) tri-/tetraenes, in spite of their very high olefinic pyramidalization, proved resistant to oxygen and dimerization (polymerization) but added CH(2)N(2) smoothly. Dehalogenation of the respective cycloaddition products through electron-impact ionization resulted in C(22-24)H(4-8) (+(2+)) ions possibly constituting bis-/tris-/tetrakis-methano-C(20) fullerenes or partly hydrogenated C(22), C(23), and C(24) cages.