5-Mycoloyl-beta-arabinofuranosyl-(1-->2)-5-mycoloyl-alpha-ar abinofuranosyl-(1-->1')-glycerol, an antigenic glycolipid from the Mycobacterium avium-intracellulare complex (MAC) was examined for its applicability to the serodiagnosis of MAC infection by ELISA. Serum IgM antibody titres against this glycolipid in healthy controls, pulmonary tuberculosis patients and sputum-MAC-culture-negative MAC patients were generally below the cut-off point (ELISA-negative), whereas most of the MAC-culture-positive MAC patient sera were ELISA-positive (93.5%) and their titres were often very high. Thus, high serum IgM titres against this glycolipid may be said to imply that the MAC disease is in an active phase.

Adult↗

PubMedDate not supplied

Aqueductal blood clot as a cause of acute hydrocephalus in subarachnoid hemorrhage.

We describe two patients with acute hydrocephalus, in whom CT scans did not show intraventricular hemorrhage unequivocally. Midline sagittal MR imaging revealed a blood clot plugging the aqueduct. MR imaging is useful for detecting sub-acute clots within the aqueduct and for differentiating them from other entities.

Caudate Nucleus↗

PubMedDate not supplied

Pleurisy in primary Sjögren's syndrome: T cell receptor beta-chain variable region gene bias and local autoantibody production in the pleural effusion.

Pleurisy with or without effusion has not been considered to be associated with primary Sjögren's syndrome (SS), but rather to represent a manifestation of the underlying disorder, usually rheumatoid arthritis in secondary SS. We describe a patient with primary SS who presented with pleural effusions (PE) as an initial manifestation. Serological studies of paired serum and PE specimens demonstrated the occurrence of local immune reactions in the pleura, including the production of rheumatoid factor and anti-SS-A antibody, the formation of immune complexes, and activation of complement. In addition, the analysis of T cell receptor beta-chain variable (V beta) regions in the PE revealed the overexpression of a number of V beta gene products, including V beta 2 and V beta 13 that have previously been shown to be over-represented in the salivary glands of patients with SS. Thus, our report not only calls for an awareness of pleurisy as an extraglandular manifestation of primary SS, but suggests that a common biased T cell response might play a critical role in the pathogenesis of the glandular as well as extraglandular manifestations.

Aged↗