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.

The morphology and histochemistry of adult rats neurocytes after BCNU administration.

Studies were performed on adult rats of Wistar strain given four 7-days-spaced intraperitoneal doses of BCNU with single dose resembling to used in clinical practice. The animals were sacrificed at the seventh day after the last dose of the drug. Morphological alterations were evaluated in H + E or cresyl violet stained sections. In frozen microtome sections histoenzymatic reactions were performed to detect enzymatic activity of some phosphatases and esterases. Karyo- and cytophotometric measurements of pyramidal cell nuclei in frontal and parietal cortex and of motor neurons in trigeminal nerve nucleus were performed in sections subjected to Feulgen reaction, using automatic microscopic image analyzer "Morphoquant" (VEB Carl Zeiss, Jena). The performed studies showed that administration of multiple therapeutic doses of BCNU lead to primary injury of vascular wall as oedema and proliferation of endothelium and small perivascular haemorrhages. The cytostatic drug induced a decrease in NsE and AlkP enzymatic activities, increased activity of AChE, ChE, AcP and ATPase and topographically variable changes in intensity of TPPase enzymatic reaction. Several karyo- and cytophotometric alterations were observed also in neurocyte cell nuclei which became elongated and acquired a more round shape. This was associated with a decrease in relative DNA content, loosening of nuclear chromatin structure and with shifting chromatin lumps toward periphery of cell nuclei.

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.

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.

Effect of hyperthermia on morphology and histochemistry of spinal cord in the rat.

Studies were performed on mature Wistar strain rats, subjected to 43 degrees C environmental temperature for 4 h at a relative air humidity of 60-70%. Spinal cords of rats sacrificed 1, 24, 48, 72 h and one week after hyperthermia served as a material for the studies. Routinely stained preparations (H+E, Nissl) and enzymatic activity of some phosphatases and esterases was estimated as well in sections subjected to Feulgen reaction karyo- and cytophotometric measurements were performed on cell nuclei of anterior horns neurocytes, anterior columns oligodendrocytes and on anterior funicle astrocytes of the spinal cord lumbar segment. The hyperthermia resulted in rat spinal cords in several morphological and histochemical alterations. Signs of diffuse spinal cord lesion of vascular origin were present with degenerative alterations of neurocytes, oligodendroglia proliferation and astroglia hyperplasia. In histoenzymatic studies changes in enzymatic activity of NsE, AChE, ChE, AcP, ATPase and TPPase were noted. They were dependent upon the time which elapsed after hyperthermia. Karyo- and cytophotometric measurements demonstrated cell nuclei oedema in neurocytes, oligodendrocytes and astrocytes associated with a decrease in the relative DNA level and changes in density and concentration of nuclear chromatin. The observed morphological, histoenzymatic and cytophotometric changes were of a reversible type and majority of them vanished within a week after hyperthermia.

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.

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.

Effect of BCNU, administered to pregnant female rats, on morphology and histochemistry of brain neurocytes in the progeny.

For evaluation of neurotoxicity of 1,3-bis[2-chloroethyl]-1-nitrosourea (BCNU) effects of the compound were examined on histoenzymatic activity of some phosphatases and esterases and on karyometry and DNA cytophotometry in brain neurocytes of the progeny of mothers who had been given the drug during pregnancy. The studies were performed on young, 14 and 28 days old rats of Wistar strain originating from mothers given intraperitoneal BCNU injections on the 12th and 18th day of pregnancy. Material of the studies included neurocytes of frontal cortex, parietal cortex and of trigeminal nerve nucleus in which enzymatic activities of some phosphatases and esterases were estimated and which were subjected to karyometric and DNA cytophotometric measurements, using Morphoquant automated microscopic image analyzer (VEB Carl Zeiss, Jena). The experiments documented decreased nonspecific esterase and ATPase activities and increased activities of acetylcholinesterase, cholinesterase, alkaline phosphatase and acid phosphatase in neurocytes of experimental animals, as compared to control animals of the corresponding age. The changes were noted both in 14 and 28 days old animals. Changes in thiamine pyrophosphate phosphohydrolase (TTPase) enzymatic activity were of different type in dependence upon age of the animals (increased activity in 28 days old rats, decreased activity in 14 days old rats). In animals subjected to BCNU action in fetal life several karyo- and cytophotometric changes were noted also: circumference and area of cell nuclei cross-sections were decreased, cell nuclei became more round, relative DNA content of cell nuclei increased with parallel increases in compactness and concentration of nuclear chromatin. Karyometric changes showed similar character in both age groups while changes in DNA cytophotometry were more evident in 14 days old rats.

Blood vessel endothelia in rat brain following experimental administration of BCNU (carmustine): karyometric studies and cytophotometric studies on DNA.

Studies on the effect of BCNU (Carmustine), administered in 4 intraperitoneal injections of 7.5 mg each, on cell nuclei of blood vessel endothelia were performed on the parietal cortex and the thalamus of 20 adult rats of Wistar strain. Karyometric studies demonstrated increased circumference and cross-section area of cell nuclei in vascular endothelia following administration of the cytostatic drug. The nuclei acquired a more spheric shape and a decreased surface irregularity (decreased folding) of their cross-sections. Extinction of endothelial cell nuclei estimated following administration of BCNU showed also an increased content of DNA as well as a more compact and concentrated nuclear chromatin. The alterations noted in endothelial nuclei of thalamic blood vessels were more pronounced than those seen in the parietal cortex.

Karyometric, cytophotometric, and histoenzymatic studies on neuroglia of young rats subjected to CCNU (Lomustine) action.

Studies on the effects of CCNU on neuroglia cells of the central nervous system in young individuals were conducted on 19 Wistar strain rats, each given 2 mg doses of 0.25 CCNU in 7th and 12th d of life. Karyometric and cytophotometric studies proved that CCNU administered to young rats induced changes in oligodendroglia and astroglia of the central nervous system. The changes included significant increase in nuclei contour and in the area of nuclei cross-section in oligodendro- and astroglia cells, elongation of oligodendroglia nuclei and an augmented DNA content in the 2 neuroglia types. The observed karyometric and cytophotometric changes were more evident in oligodendroglia nuclei than in astroglia nuclei.

Histoenzymatic, karyometric, and DNA cytophotometric studies on rat neuroglia following administration of BCNU (carmustine).

BCNU is a nitrosourea derivative applied in anti-neoplastic therapy. As a result of conversion under in vivo-conditions, products of alkylating properties are formed which derrange DNA metabolism, and products of carbamylating activity which disturb protein metabolism. Studies on BCNU neurotoxicity were performed on 20 adult rats of Wistar strain which were given the compound intraperitoneally, in doses corresponding to those used for tumour treatment in humans. Material for estimating unfavorable effects of the drug on central nervous system involved brains, the sections of which were subjected to histoenzymatic reactions and stained according to FEULGEN for karyometric studies and DNA cytophotometry. Size and shape estimates for nuclei of the cells and their DNA content were obtained using Morphoquant automatic microscopic image analyzer (VEB Carl Zeiss, Jena) and compared to those of neuroglia of control animals, given no drug. Multiple intraperitoneal injections of BCNU induced distinct histoenzymatic, karyometric, and cytophotometric changes in oligodendroglia and astroglia. In oligodendroglia, lowered NsE and AcP activities and augmented TPPase activity were noted while in astroglia decreased activity of the former 2 enzymes was associated with an augmented ATPase activity. In karyometric studies, significant decrease in the size of astroglia and in DNA extinction was noted. No karyometric or cytophotometric alterations were noted in oligodendroglia nuclei. Results of the presented studies may indicate primary injury to vascular walls and secondary damage to neuroglia.

Histoenzymic investigation of the rat amygdala in the course of ontogenetic development.

A histoenzymic study of various dehydrogenases, phosphatases and of esterases was conducted in rat amygdala in the course of postfetal ontogenic development. The performed investigations have revealed a variable degree of activity of several enzymes in the course of postnatal maturation of the rat, corresponding to the gradually developing behavioural functions. The histochemical maturation of the amygdaloid system of the rat is completed at the age of between 17 and 40 days postnatal. The obtained evidence revealed considerable differences in AChE, ATP-ase and acP activity between the individual nuclei of the amygdala as well as some developmental variability of this differentiation.

Karyometric studies and quantitation of the DNA content in nerve and oligodendroglial cells after intraperitoneal administration of Vincristine.

Karyometric and cytophotometric investigations were conducted on nuclei of nerve cells of the Gyrus cinguli and on oligodendroglial nuclei of the corpus callosum following a 12-fold intraperitoneal injection of Vincristine into Wistar rats. The results of our investigations have shown a distinctly decreased content of DNA in neuronal nuclei of experimental rats along with a slightly increased content of DNA in glial cells. It is assumed that intraperitoneal administration of Vincristine does not inhibit the replication of DNA by oligodendroglial cells and that the observed reduction of DNA in neurocytes is the result of a disturbed turnover of DNA that is due to some damage of cytoplasmatic structures (rough endoplasmatic reticulum and microtubules) induced by the applied cytostatic compound.

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.

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.

[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.

[A case of primary multifocal glioblastoma multiforme of the brain]. / Przypadek pierwotnie wieloogniskowego glejaka wielopostaciowego mózgu.

A 60-year-old patient is described with two independently located foci of glioblastoma multiforme in both frontal lobes.

[A case of Moschkowitz syndrome (thrombotic thrombocytopenic purpura)]. / Przypadek zespolu Moschkowitza (zakrzepowej plamicy maloplytkowej).

A case of thrombotic thrombocytopenic purpura with unfavourable outcome is described in a 22-year-old female patient with prevailing signs of central nervous system damage.