Trigger factors of cutaneous lupus erythematosus: a review of current literature.

It is currently believed that autoimmune conditions are triggered and aggravated by a variety of environmental factors such as cigarette smoking, infections, ultraviolet light or chemicals, as well as certain medications and vaccines in genetically susceptible individuals. Recent scientific data have suggested a relevant role of these factors not only in systemic lupus erythematosus, but also in cutaneous lupus erythematosus (CLE). A variety of environmental factors have been proposed as initiators and exacerbators of this disease. In this review we focused on those with the most convincing evidence, emphasizing the role of drugs in CLE. Using a combined search strategy of the MEDLINE and CINAHL databases the following trigger factors and/or exacerbators of CLE have been identified and described: drugs, smoking, neoplasms, ultraviolet radiation and radiotherapy. In order to give a practical insight we emphasized the role of drugs from various groups and classes in CLE. We also aimed to present a short clinical profile of patients with lesions induced by various drug classes.

Treatment of cutaneous lupus erythematosus: current practice variations.

The treatment of cutaneous lupus erythematous (CLE) remains a challenge. Most of the therapeutic options used in CLE have not been tested in randomized controlled studies and to date no agent has been approved. Therefore, CLE treatment is mostly based on personal experience. To better characterize therapeutic habits among physicians treating CLE patients, a questionnaire-based study about various aspects of topical and systemic treatment for CLE has been performed. The questionnaire was distributed among CLE experts, mostly from Japan, the USA, and Europe. A total of 82 completed questionnaires were assessed. High-potent and potent corticosteroids as well as calcineurin inhibitors were the most often recommended topical treatment for all CLE subtypes. The most relevant factors for initiation of systemic therapy were severity of skin lesions, concomitant involvement of internal organs, CLE subtype and lack of response to topical therapies. Corticosteroids and antimalarials were considered as the most suitable and effective systemic drugs for CLE patients. However, significant differences were observed between various CLE subtypes and between different countries regarding the assessment of various topical and systemic treatment options. In conclusion, great variability of obtained answers underlines the need of development of CLE treatment guidelines suitable for different disease subtypes.

Lines of dense nanoparticle colloidal suspensions evaporating on a flat surface: formation of non-uniform dried deposits.

Line evaporation of dense nanoparticle suspensions is studied theoretically and experimentally. The 2-D lines are drawn by a pen-like nozzle continuously dispensing a commercially available concentrated organic suspension (50 wt%; 4.3 vol%) of 5 nm gold nanoparticles in toluene solvent. Such particle-containing lines show promise for industrial applications where circuits are inkjet-printed and heat-treated to dry off the organic solvent and sinter the nanoparticles, thus producing a continuous electrically conducting path. The employed nanosuspension displays spontaneous thickening upon contact with a solid surface in the ambient atmosphere, and thus does not dry according to the well-established coffee-stain forming mechanism applicable to dilute particle suspensions. In the present work, model lines ( approximately 1 mm width) are studied to elucidate the drying peculiarities of such nanoparticle slurries. These scaled-up lines allow detailed spatial measurements of their topography throughout their prolonged evaporation period, and make possible direct comparisons between experiment and theory. The results show the particle deposits formed by evaporative drying of these lines to be of non-uniform thickness with a dent in the middle of the lateral cross-section. Formation of this practically undesirable landscape is attributed to the highly non-uniform evaporative character of sessile or pendent liquid lines, which results in a non-uniform consolidation of the porous phase formed upon contact with the solid surface. The formulated description of the shape changing process, as done in the framework of the consolidation theory, yields predicted deposit speck shapes that compare favorably with the temporally resolved experimental data.

Immunofluorescent analysis of antibodies against neurons in the case of paraneoplastic syndrome.

The authors report clinical and neuropathological findings especially immunofluorescent detection of antineuronal antibodies in the case of paraneoplastic syndrome in course of the small-cell lung carcinoma. The clinical symptoms, observed in 48-year-old woman, covered bilateral pyramidal syndrome, cerebellar syndrome, myasthenic syndrome and impairment of the cranial nerves. Neuropathological investigation revealed paraneoplastic encephalopathy in the form of encephalitis. Immunofluorescent analysis showed brightly fluorescent neurons standing out against a dull background.

Atypical case of sporadic Creutzfeldt-Jakob disease (CJD) in a young adult.

The great concern exists that new variant of CJD (nvCJD) developed as a result of exposure to bovine spongiform encephalopathy (BSE)-infected meat products. Therefore, all cases of CJD in the young, as the one of ours are the matter of interest. The 21-year-old female developed a rapid progression of pyramidal, extrapyramidal and cerebellar signs, visual loss and psychiatric symptoms, leading to death in 16 weeks. The microscopic features were: a neuronal loss accentuated in cerebral cortex with extensive astroglia proliferation and spongiform changes. Immunohistochemical staining, revealed the presence of "synaptic" deposits of PrP in the cerebral cortex and in the cerebellum. No florid amyloid plaques were present. The case was diagnosed as a sporadic CJD, with some features of Heidenhein variant (visual symptoms) and corticostriatocerebellar category. The pathological findings excluded a nv CJD which is linked with BSE.

Free sterols in the rat white matter following experimental global ischemia.

The pattern of free sterols occurring in the cerebral white matter was studied in an experimental model of global ischemia that was induced in rats by means of the method described by KORPACHEV et al. (1982). Sterol isolation, separation and identification was accomplished by suitable extraction procedures followed by gas-chromatography-mass spectrometry of the purified sterol extracts. It has been shown that the percentage of lanosterol happened to decrease sharply following the ischemic state and other sterols, typically occurring in maturating brains and absent in the control brain specimens from adult rats, such as 4,4-dimethylcholesterol, 4,4-dimethylcholest-5,8,24-triene-3 beta-ol and 4,4,14-trimethylcholest-5,8-diene-3 beta-ol happened to appear. The appearance of these forms of free sterols in the postischemic brain is interpreted as a biochemical exponent of regeneration processes occurring in the white matter membranes following the injury suffered during the experimental heart arrest.

Myelin-oligodendroglia complex in rats subjected to experimental cardiac arrest.

In an experimental model of clinical death induced in rats using the method of Korpachev et al. (1982) the myelinoligodendroglia complex was evaluated using the morphometric method of investigation. The results documented acute oedema of oligodendroglia nuclei in the early period, and degenerative changes later on. The studies of myelinated fibers seem to testify some differences in sensitivity according to the axon and myelin diameter on the influence of ischemia. The later changes of myelinated nervous fibers in the postresuscitation syndrome seem to be the secondary effect of autoimmune dependent neuronal destruction, whereas the alterations of oligodendroglia only partially contribute to the myelin lesion.

Myelin lipids and proteins in experimental global ischemia.

The experiments were performed on white rats, in which clinical death was induced according to the method described by Korpatchev et al. (1982). After cardiac arrest and cessation of respiratory function lasting 5 minutes resuscitatory action was performed. The lipids and proteins of the cerebral myelin fraction were studied in animals sacrificed 1, 9 and 14 days after global ischemia. The obtained results lead to the following conclusions: 1. Myelin lipids in postreanimation syndrome are characterized by a marked increase in cholesteryl esters and a mild one of lysophosphatidylcholine content. 2. Myelin lipids in the predemyelinating period demonstrate a general pattern of reaction, notwithstanding to the character of the primary noxious agent. 3. After global ischemia a great fall of small basic protein in the myelin fraction and subsequently of SBP to LBP ratio occurred. 4. Various noxious agents affect different proteins of the myelin membranes and the resulting changes seem to be characteristic for various pathological processes.

Free sterols in senile human brain.

Autopsy material of 18 patients, who died between 66-86 years of age and of 4 ones, who died between 20 and 38 years of age was investigated. The white matter of frontal lobe, corpus callosum and cerebellum was studied using histological and biochemical methods. According to the results of neuropathological studies, the material of aged patients was divided into two subgroups: patients with vascular changes only and brains with senile atrophy of Alzheimer type. Chemical changes in all aging brain regions studied included higher proportion of desmosterol and differences in the pattern of cholesterol isomers. These findings are interpreted as suggesting some chemical transformations of cellular membranes in the cerebral white matter of the aging. The above mentioned changes were almost identical despite presence of the signs of Alzheimer's type senile atrophy, therefore it is not possible to explain their significance in developing of dementia process.

Analysis of heavy metals content in the brain with the use of electron paramagnetic resonance in a clinically unusual case of hepato-lenticular degeneration.

An analysis of heavy metals content in the brain of a clinically unusual case of hepatolenticular degeneration was performed with the use of paramagnetic resonance. The studies established a manyfold increase of copper content in the brain in the form of free ions, and, less significant, also in the form of copper multi-ion clusters. The content of iron in the studied brain was lower than in controls. These results confirmed significantly the neuropathological diagnosis of hepato-lenticular degeneration.

Electron paramagnetic resonance analysis of heavy metals in the aging human brain.

Electron paramagnetic studies of heavy metals were performed with the use of a Radiopan spectrometer on autopsy material of 5 aged patients (mean age 80.2 years) and 15 control patients (mean age 29 years). The obtained results lead to the following conclusions: 1. The aging brain is characterized by a tendency to decrease in concentration of isolated Cu2+ ions, and a marked decrease in concentration of Fe3+ ions as well as of free radicals, whereas the concentration of Cu2+ clusters is significantly increased. 2. The cases showing both arteriosclerotic and senile degenerative changes are characterized by higher concentrations of Cu2+ clusters than the brains with dominance of the arteriosclerotic process, whereas the concentrations of isolated Cu2+ and Fe3+ ions as well as that of free radicals do not differ between the two subgroups. 3. The diminished concentrations of Cu2+ and Fe3+ ions and free radicals observed in brains of old persons and concomitant with increased concentration of multi-ion aggregates (clusters), more marked in cases of senile atrophy of Alzheimer type, seem to result from some slow-down of metabolic processes in the aging brain.

Myelin lipids in ischemic stroke.

Slices of ischemic focus (infarct area) and of the contralateral frontal lobe were submitted to histological and biochemical studies. The obtained results indicate that in stroke cases the necrotic focus as well as contralateral brain hemisphere are characterized by a marked decrease of cholesterol and cerebrosides content and an increase of lysophosphatidylcholine and cholesterol esters in the myelin fraction. We conclude that ischemia as well as the degenerative aging process are both responsible for the abnormal lipid pattern in the myelin of the white matter in stroke cases. The long lasting hypoxia resulting from cerebral vessel atheromatosis contributes to biochemical changes in the myelin of the apparently healthy white matter of the contralateral hemisphere in brain infarction.

Blood vessel endothelia of the cerebral white matter of rats exposed to hypoxia. Karyometric and cytophotometric evaluation.

Hypoxic hypoxia is used as one of the models for examining the unfavourable effect of oxygen deficit on the nervous system. Since some morphological studies concerning the effect of hypoxia on the central nervous system have given consideration to perivascular lesion zones and glia alterations in the white matter, the present evaluation of the effect of hypoxia has been directed to vascular endothelia of the white matter. Examinations were conducted on adult rats of the Wistar strain which were exposed to acute hypoxia by being placed in a gas mixture containing 2% O2 or to moderate hypoxia - in a gas mixture containing 7% O2. Experimental animals were sacrificed 4 and 24 h after hypoxia and 14 and 60 d after hypoxia. The behaviour of vascular endothelia after hypoxia was evaluated by karyometric and cytophotometric methods. The measurements show an edema of endothelial nuclei in capillaries of the cerebral white matter of the rat in the first 24 h after hypoxia accompanied by nuclear chromatin index alterations proportional to the intensity of hypoxia. The measurements of endothelial nuclei 14 and 60 d after hypoxia show a development of a degenerative process in these nuclei, manifested by their decreasing size and by nuclear chromatin concentration in their central parts. The morphometric and cytophotometric examinations point to long-term alterations induced by hypoxic hypoxia.

[Chronic eosinophilic meningitis caused by cysticercosis cerebri]. / Encephalomeningitis chronica eosinophilica w przebiegu wagrzycy mózgu.

The authors describe a case of encephalomeningitis chronica eosinophilia in a 60-year-old woman. The etiology was not investigated clinically. The autoptic diagnosis was cerebral cysticercosis.

[Equilibrium disorders and ataxia as dominating symptoms in a case of Alzheimer's disease]. / Zaburzenia równowagi i niezbornosc jako dominujace objawy w przypadku choroby Alzheimera.

A case of a 66-year-old female woman with Alzheimer's disease (confirmed histologically) is reported. In the case cerebellar symptoms predominated without evidence of dementia. The patient died after duodenal haemorrhage.

Myelin lipids in aging human brain.

The studies were performed on autopsy material of 18 patients who died between the ages of 70-89 y, and of 5 patients who died between 23-44 ys of age. White matter of the frontal lobe and of oerebellum was submitted for histological and biochemical analysis. The neuropathological data provided a rationale for dividing the material into two subgroups: one including patients mainly with vascular changes in the brain, and the other consisting of patients with senile atrophy of the Alzheimer type. Chemical alterations noted both in frontal lobe and in cerebellum were an increase in lysophosphatidylcholine content and a marked decrease in myelin yield. Additionally, in cerebellum a decrease in sulphatide content was observed. The chemical results were almost identical in the two subgroups of patients, although they differ in neuropathological patterns of lesions. It is emphasized that the general decrease in myelin yield as well as some minor changes in myelin lipid pattern seem to be a sign of aging and are not connected with atrophy of the Alzheimer type.