Relationship Between Neuromyelitis Optica Spectrum Disorder and Sjögren's Syndrome: Central Nervous System Extraglandular Disease or Unrelated, Co-Occurring Autoimmunity?

OBJECTIVE: Sjögren's syndrome (SS) patients may be affected by the neuromyelitis optica spectrum disorder (NMOSD), a severe demyelinating syndrome associated with anti-aquaporin 4 antibodies (anti-AQP-4 antibodies). The relationship between SS and NMOSD has been a sustained focus of investigation. Among SS patients, anti-AQP-4 antibodies have been detected exclusively in those with NMOSD. It has therefore been speculated that NMOSD is not a neurologic complication of SS. However, such studies evaluated small numbers of SS patients, often mixed with other inflammatory disorders. METHODS: We compared frequencies of anti-AQP-4 and SS-associated antibodies in 109 SS patients, including 11 with NMOSD, 8 with non-NMOSD demyelinating syndromes, and 90 without demyelinating syndromes. RESULTS: When assessed using a fluorescence-activated cell sorting (FACS) assay, anti-AQP-4 antibodies were seen exclusively in those SS patients with NMOSD (72.7%), but not in SS patients without NMOSD (P < 0.01). In contrast, anti-Ro 52, anti-Ro 60, and other autoantibodies were not more prevalent in SS patients with NMOSD versus those without. Anti-AQP-4 antibodies were detected more frequently among NMOSD patients by FACS assay than with a commercial immunohistochemical assay (72.7% versus 54.5%), despite assessment after a more prolonged period of immunosuppressive therapy (median 38 months versus 5 months; P < 0.01). CONCLUSION: The syndrome-specificity of anti-AQP-4 antibodies, along with an otherwise similar antibody profile in SS NMOSD patients, indicates that NMOSD is not a direct central nervous system manifestation of SS. Anti-AQP-4 antibodies can persist and be refractory to prolonged immunosuppressive therapy.

Intra-articular recurrence of benign chondroblastoma with articular involvement at initial presentation--a case report.

We report a case of chondroblastoma involving the upper tibial epiphysis, which had an unusually aggressive course, with articular involvement at initial presentation. Intra-articular and soft tissue recurrence occurred after treatment consisting of curettage and bone grafting. Although the incidence of local intraosseous recurrence of chondroblastoma is relatively high, intra-articular and soft tissue implantation is rare and is usually due to intra-articular spillage during surgery. Spontaneous articular involvement is rarely seen.

Biotechnology and research: promise and problems.

Biotechnology has expanded greatly during the last two decades. This expansion is due to worldwide investment in basic biomedical research. The new knowledge generated by this investment has led to a bounty of potential applications for improvement of health, which are being explored for commercial purposes by the biotechnology industry. Private investment is thus ever present in development of these biotechnological products. All these factors raise important questions, including increasing concerns about intellectual property and conflict of interest. As this expansion continues, the established processes of peer review should be strengthened.

Insulin signaling: lessons from the Drosophila tuberous sclerosis complex, a tumor suppressor.

The genes that encode the proteins composing the tuberous sclerosis complex (TSC) are tumor suppressors. Experiments in the model organism Drosophila melanogaster have provided insight into the identity of these genes and their functions in regulating cell size and proliferation. Montagne et al. describe the various genetic interactions that show TSC to be a regulator of the insulin signaling pathway and a regulator of progression through the cell cycle, which explains its effects on cell size and tissue and tumor growth.

Efficient diode pumping for q-switched yb:er:glass lasers.

A system of local rate equations combined with a ray-tracing technique is used for numerical analysis of energy storage within a Yb:Er:glass laser under diode pumping. It is shown that any pumping system could be characterized by relative pumping efficiency, which depends mainly on the pumping source parameters but only slightly on parameters of the Yb:Er:glass. Transverse pumping can ensure the storage efficiency close to the utmost value for the glass. Some simple and efficient pumping cavities are considered. A traditional end-pumping configuration with collimating lenses is considerably less efficient. Application of nonimaging optical elements such as a lens duct can effectively increase the efficiency.