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X linked agammaglobulinaemia and rheumatoid arthritis.

BACKGROUND: Much interest has been shown recently in the pathogenic role of B cells in rheumatoid arthritis (RA) owing to the marked clinical responses to anti-CD20 treatment in RA. CASE REPORT: A patient with X linked agammaglobulinaemia (XLA) presented with an erosive symmetric polyarthritis with histological features of RA, including formation of a destructive pannus. Furthermore, the patient developed subcutaneous nodules that were histologically indistinguishable from rheumatoid nodules. Surprisingly, lymphocytic infiltrates in both the synovium and nodule consisted almost exclusively of CD8+ T cells. DISCUSSION: Although some peculiar B cell subsets have been described in patients with XLA, no B cell subsets could be demonstrated in synovial tissue or the subcutaneous nodule. This case illustrates that classical RA can develop in the absence of mature B cells.

Agammaglobulinemia↗

The effects of various chemicals on the development of hyperplastic liver nodules in hepatectomized rats treated with N-nitrosodiethylamine or N-2-fluorenylacetamide.

The effects of various hepatocarcinogenic, non-hepatocarcinogenic and non-carcinogenic chemicals on the induction of hyperplastic liver nodules by N-nitrosodiethylamine (DEN) or N-2-fluorenylacetamide (2-FAA) as an initiator were studied in male Fischer 344 rats. Rats were injected intraperitoneally with 200 mg of DEN/kg body weight or were fed on basal diet containing 200 ppm of 2-FAA for 2 weeks, and then given various test chemicals starting from week 3. They were also partially hepatectomized in week 3. All animals were killed at the end of week 8 and examined histologically. For quantitative analysis, hyperplastic nodules in the liver were measured with a color video image processor, VIP-21C. The effect of various chemicals in rats treated with DEN or with 2-FAA were compared. The production of hyperplastic liver nodules was greatest in rats treated with strong hepatocarcinogens, and less in rats treated with weak hepatocarcinogens. Very few hyperplastic nodules were produced after treatment with non-hepatocarcinogens or noncarcinogens. Hyperplastic nodules were formed in rats treated with phenobarbital, which is a hepatopromoter. Saccharin, which is a urinary bladder promoter, did not enhance the production of hyperplastic nodules in the liver. These results indicate that many hepatocarcinogens enhance liver carcinogenesis. The classification of chemicals as liver carcinogens is discussed on the basis of the results.

2-Acetylaminofluorene↗

[Aluminum as an adjuvant in vaccines and post-vaccine reactions].

Aluminium compounds have been widely used as adjuvants in prophylactic and therapeutic vaccines. Adjuvants are able to stimulate the immune system in a nonspecific manner, i.e. high antibody level can be obtained with minimal dose of the antigen and with reduced number of inoculations. Adjuvants use has been mostly empirically determined by such factors as efficacy and safety. The mechanism of action of the aluminium adjuvants is not completely understood and is very complex. The basic factors of the mode of action: 1) the complex of antigen and aluminium gel is more immunogenic in structure than free antigen, 2) effect "depot"--The antigen stimulus last longer, 3) the production of local granulomas. Vaccines adsorbed onto aluminium salts are a more frequent cause of local post-vaccinal reactions than plain vaccines. 5-10% those vaccinated can develop a nodule lasting several weeks at the injection site. In some rare cases the nodules may become inflammatory and even turn into an aseptic abscess. The nodules persisting more than 6 weeks may indicate development of aluminium hypersensitivity. Finally aluminium adjuvant immunogens induce the production of IgE antibodies.

Adjuvants, Immunologic↗

[Diagnostic management of the thyroid nodule. National Agency for the Development of Medical Evaluation].

Several partners worked together to write the recommendations concerning the diagnostic management of thyroid nodules in accordance with the methodology developed by ANDEM for writing Recommendations for Clinical Practice. There are several reasons for these recommendations: earlier controversies are still debated, clinical practice is multidisciplinary and varied, diagnostic methods have changed but their diffusion has been variable, and finally, there are no formal recommendations for clinicians on this subject.

Female↗

Alterations of ornithine decarboxylase gene during the progression of rat liver carcinogenesis.

Liver nodules and carcinomas, developing in F344 rats initiated with diethylnitrosamine, exhibit high ornithine decarboxylase (ODC) activity and DNA synthesis. ODC-related RNAs of 1.8, 2.1 and 2.6 kb are produced by normal rat liver. Early preneoplastic nodules, developing 10 weeks after initiation, showed overproduction of 1.8 and 2.1 kb RNAs, while the 2.6 kb RNA was barely detectable. Rises in the 1.8, 2.1 and 2.6 kb RNAs occur in late nodules (30 weeks after initiation) and in carcinomas. The comparison of different tissues for relative increase in ODC activity, RNA levels and DNA synthesis showed that these parameters behaved in the same way: highest increases occurred in early nodules and carcinomas. These observations suggest that overexpression of ODC gene and alterations in regulatory mechanisms of ODC gene expression may be implicated in the progression of preneoplastic lesions to malignancy. Southern blot analysis of PstI DNA digests revealed the presence of ODC gene rearrangement in two carcinomas and in one late nodule. However, the role of this phenomenon in the progression of preneoplastic lesions is unclear, due to the possibility that ODC pseudogenes are involved instead of or in addition to ODC gene.

2-Acetylaminofluorene↗

Silver staining two types of meiotic nodules.

We have developed a reliable method for silver staining nodules on synaptonemal complexes (SCs) of tomato (Lycopersicon esculentum). This technique involves hypotonically bursting primary microsporocytes, fixing SC spreads with paraformaldehyde, and incubating the spreads at 40 degrees C in a 33% aqueous silver nitrate solution covered with nylon mesh. When tomato SCs were stained by this method, nodules were observed with the same distribution and frequency as nodules stained with uranyl acetate and lead citrate. Incubation in silver nitrate at higher temperatures caused the loss of some or all nodules. The pattern of loss suggests that two types of nodules coexist during late zygonema and early pachynema and that one type becomes the late nodules of mid-pachynema through early diplonema.

Meiosis↗

Expression of Rhizobium leguminosarum CFN42 genes for lipopolysaccharide in strains derived from different R. leguminosarum soil isolates.

Two mutant derivatives of Rhizobium leguminosarum ANU843 defective in lipopolysaccharide (LPS) were isolated. The LPS of both mutants lacked O antigen and some sugar residues of the LPS core oligosaccharides. Genetic regions previously cloned from another Rhizobium leguminosarum wild-type isolate, strain CFN42, were used to complement these mutants. One mutant was complemented to give LPS that was apparently identical to the LPS of strain ANU843 in antigenicity, electrophoretic mobility, and sugar composition. The other mutant was complemented by a second CFN42 lps genetic region. In this case the resulting LPS contained O-antigen sugars characteristic of donor strain CFN42 and reacted weakly with antiserum against CFN42 cells, but did not react detectably with antiserum against ANU843 cells. Therefore, one of the CFN42 lps genetic regions specifies a function that is conserved between the two R. leguminosarum wild-type isolates, whereas the other region, at least in part, specifies a strain-specific LPS structure. Transfer of these two genetic regions into wild-type strains derived from R. leguminosarum ANU843 and 128C53 gave results consistent with this conclusion. The mutants derived from strain ANU843 elicited incompletely developed clover nodules that exhibited low bacterial populations and very low nitrogenase activity. Both mutants elicited normally developed, nitrogen-fixing clover nodules when they carried CFN42 lps DNA that permitted synthesis of O-antigen-containing LPS, regardless of whether the O antigen was the one originally made by strain ANU843.

Carbohydrates↗

Expression and induction of cytochrome P450 isozymes in hyperplastic nodules of rat liver.

The change of cytochrome P450 (P450) isozymes in a early stage of hepatocarcinogenesis in male F344 rats has been studied. Liver microsomes were prepared from normal rats (group 1), rats treated with diethylnitrosamine (DEN) alone, which developed no hyperplastic nodules (group 2), and rats treated with DEN plus 2-acetylaminofluorene, which developed many hyperplastic nodules (group 3). The amount and activity of P450IA1 and P450IA2 expressed in the liver were analyzed by several immunological methods using monoclonal antibodies against the P450 isozymes and a mutagenicity test. In the group 2 and 3 rats, the total amount of P450 and the amount of P450IA2 were much smaller than those in the group 1 rats, and P450IA1 was detected only from the group 3 rats. As observed by immunohistochemistry, P450IA1 was prominent in hyperplastic nodules developed in the group 3 rats, and the distribution of P450IA1+ cells in individual nodules was heterogeneous. When the rats were treated with a P450 inducer, 3-methoxy-4-aminoazobenzene or 3-methylcholanthrene, both P450IA1 and P450IA2 were induced in all groups of rats; however, the induction rates of the P450 isozymes, especially that of P450IA2, in the group 3 rats were smaller than those in the group 1 and 2 rats. The present work demonstrated that P450IA1, which is responsible mainly for detoxication of aromatic amine carcinogens, increased in level along with the development of hyperplastic nodules, whereas P450IA2, which is responsible for mutagenic or carcinogenic activation of these carcinogens, decreased in its amount and inducibility.

2-Acetylaminofluorene↗

Effects of phosphorus and nitrogen on nodulation are seen already at the stage of early cortical cell divisions in Alnus incana.

BACKGROUND AND AIMS: The present work aimed to study early stages of nodulation in a chronological sequence and to study phosphorus and nitrogen effects on early stages of nodulation in Alnus incana infected by Frankia. A method was developed to quantify early nodulation stages in intact root systems in the root hair-infected actinorhizal plant A. incana. Plant tissue responses were followed every 2 d until 14 d after inoculation. Cortical cell divisions were already seen 2 d after inoculation with Frankia. Cortical cell division areas, prenodules, nodule primordia and emerging nodules were quantified as host responses to infection. METHODS: Seedlings were grown in pouches and received different levels of phosphorus and nitrogen. Four levels of phosphorus (from 0.03 to 1 mM P) and two levels of nitrogen (0.71 and 6.45 mM N) were used to study P and N effects on these early stages of nodule development. KEY RESULTS: P at a medium concentration (0.1 mM) stimulated cell divisions in the cortex and a number of prenodules, nodule primordia and emerging nodules as compared with higher or lower P levels. A high N level inhibited early cell divisions in the cortex, and this was particularly evident when the length of cell division areas and presence of the nodulation stages were related to root length. CONCLUSIONS: Extended cortical cell division areas were found that have not been previously shown in A. incana. The results show that effects of P and N are already expressed at the stage when the first cortical cell divisions are induced by Frankia.

Alnus↗

Primary nodular cutaneous amyloidosis--long-term follow-up and treatment.

A case of facial primary nodular cutaneous amyloidosis is reported. This illustrates: the striking appearance of this unusual condition; the investigations appropriate to establish the diagnosis and to exclude underlying systemic amyloidosis or a condition which might contribute to amyloidosis; and the difficulty of successful management. Initial investigation failed to reveal any evidence of systemic amyloidosis or an associated internal illness. Two amyloid nodules were excised, but 7 years later the patient developed further nodules on the adjacent facial skin and again sought dermatological advice. He was reinvestigated and again no underlying condition was found. A trial of cryotherapy was unsuccessful, but curettage and cautery produced a cosmetically acceptable result.

Adult↗

Tyrosine phosphorylation and subcellular localization of focal adhesion proteins during in vitro decidualization of human endometrial stromal cells.

Human endometrial stromal cells undergo in vitro decidualization when treated with progesterone and estrogen. Using this model, we previously reported specific changes in the c-Src kinase activity and tyrosine phosphorylation of several proteins during in vitro decidualization. Focal adhesion kinase (FAK) and paxillin are known to form a complex with c-Src at the focal contacts and to participate in the integrin-mediated signal transduction as c-Src substrates. We here examined the tyrosine phosphorylation and subcellular localization of the focal adhesion proteins in stromal cells isolated from human endometrium. We found, however, that the total levels of FAK and paxillin tyrosine phosphorylation were not markedly changed during decidualization or after steroid withdrawal. In our culture system numerous multicellular nodules were developed in cultures of decidualized stromal cells, within whose nodules the focal contacts were found to disappear. Moreover, disruption of the focal contacts was accompanied by disorganization of the actin-based cytoskeleton. These findings suggest that tyrosine phosphorylation of the endometrial paxillin and FAK is not tightly regulated by the kinase activity of c-Src during in vitro decidualization. The escape from regulation by c-Src may be in part due to the dissociation of the focal adhesion proteins/c-Src complex caused by the breakdown of the focal adhesion plaques as well as the loss of the actin-based cytoskeletal architecture.

CSK Tyrosine-Protein Kinase↗

[More recent aspects of treatment for hypothyroidism and goitre in children and adolescents (author's transl)].

According to more recent knowledge L-thyroxine alone is recommended for thyroid hormone replacement therapy, no longer the combination of L-thyroxine and triiodothyronin, since L-thyroxine is converted to triiodothyronine in the periphery of the body. Additional application of triiodothyronine causes unphysiological elevations of blood levels of triiodothyronine. When changing from the combined thyroid hormone therapy to treatment with L-thyroxine alone it is enough in most cases to replace the previous amount of L-thyroxine only; previous recommendations for the dosage of thyroid hormone were rather high. Average requirements of adults for L-thyroxine are around 170 mug per day. Children need about 90--100 mug per m2 body surface per day. -- When hypothyroidism is suspected in newborns or infants no protracted diagnostic procedures are justified with respect to brain development and its requirement of thyroid hormone during this period of life. Replacement therapy should be started within 1--2 days. The exact diagnosis can be established later, for instance during the third day of life when a temporary interuption of treatment for diagnostic purposes has no longer such negative effect on normal brain development. As long as physiological doses of L-thyroxine are used no side effects are to be expected for patients who later turn out to be euthyroid. -- Following exclusion of hyperthyroidism goitres in children and adolescents equally need thyroid hormone replacement therapy to reduce the size or prevent further enlargement or even the development of nodules within the gland. The dosage for this is about half to three quarters of the full replacement dose. The nature of thyroid nodules should be investigated, even surgically, since malignancies can develop in children and juveniles as well as in adults.

Adolescent↗