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En este artículo se presenta, en base al análisis de los componentes del Decálogo de Barragán, los avances detectados de la última década y los principales desafíos que enfrenta el manejo costero integrado (MCI) en Uruguay. Tanto en Uruguay como en la región se han intensificado actividades con alta capacidad de impacto en zona costera (e.g. litoralización) lo que sumado a las tendencias regionales de la variabilidad y el Cambio Climático exige implementar acciones para modificar el uso dominante del espacio costero. En el período indicado se han mejorado las capacidades del país para abordar el manejo costero, tanto a nivel normativo como de políticas públicas, así como de integración de los niveles implicados, de articulación entre las instituciones competente y un mayor involucramiento de los actores sociales. Se aprobó una Directriz costera y se creó un Departamento de Gestión Costera y Marina en el Ministerio de Vivienda Ordenamiento Territorial y Medio Ambiente, a la vez que se incorporaron conceptos clave como el de componentes vulnerables. También se avanzó en el conocimiento científico, particularmente de índole interdisciplinaria, y se consolidó la formación terciaria con base conceptual en el MCI, así como en las instancias de capacitación a actores de la sociedad civil y de la gestión. Se evidencia una mayor concientización de la población en relación a estos temas y se han multiplicado las acciones de participación de la sociedad civil, si bien se requiere aún un importante esfuerzo para avanzar hacia un equilibrio entre desarrollo y conservación que cuente con la participación sustancial de los actores. A la vez, se constatan desafíos mayores como dar continuidad a las diversas iniciativas, y superar algunas incertidumbres propias de la Directriz sancionada. Un aspecto central sigue siendo la financiación adecuada de los programas y proyectos ya aprobados, y la mejora y ampliación de la capacitación de los actores. Finalmente, siguen siendo puntos débiles la puesta en práctica y diseminación de experiencias de MCI exitosas, principalmente de carácter local, así como lograr una mayor participación social en la toma de decisión.

Sheep are not only a major livestock species globally, they are also an important large animal model for biomedical research and have contributed to our understanding of the ontogeny and architecture of the mammalian immune system. In this study, we applied immunohistochemistry and multicolor immunofluorescence in fixed and paraffin-embedded lymph nodes to phenotype the key populations of antigen presenting cells, lymphocytes, and stromal cells that orchestrate the host adaptive immune response. We used an extensive panel of antibodies directed against markers associated with dendritic cells (MHC class II, CD83, and CD208), macrophages (CD11b, CD163, and CD169), stromal cells (CNA.42, S100, and CD83), and lymphocytes (CD3, Pax5, CD4, CD8). Using different methods of tissue fixation and antigen retrieval, we provide a detailed immunophenotyping of sheep lymph nodes including the identification of potential subpopulations of antigen presenting cells and stromal cells. By characterizing cells expressing combinations of these markers in the context of their morphology and location within the lymph node architecture, we provide valuable new tools to investigate the structure, activation, and regulation of the sheep immune system in health and disease.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) affects various components and segments of the peripheral nervous system differently, and thus there can be phenotypic heterogeneity. We report a 47-year-old woman with chronic sensory disturbances and proximal weakness limited to the legs. Motor and sensory nerve conduction studies were normal. Somatosensory evoked potentials and imaging indicated a demyelinating process involving the lumbosacral roots. The patient responded favorably to IVIg. Although she did not fulfill the diagnostic criteria for CIDP we believe this patient represents a restricted regional CIDP variant.

It has been difficult to replicate consistently the experimental model of axonal Guillain-Barré syndrome (GBS). We immunized rabbits with two lipo-oligosaccharides (LOS1 and LOS2) derived from the same C. jejuni strain and purified in a slightly different way. LOS1 did not contain proteins whereas several proteins were present in LOS2. In spite of a robust anti-GM1 antibody response in all animals the neuropathy developed only in rabbits immunized with LOS1. To explain this discrepancy we investigated fine specificity, affinity and ability to activate the complement of anti-GM1 antibodies. Only rabbits immunized with LOS1 showed monospecific high-affinity antibodies which activated more effectively the complement. Although it is not well understood how monospecific high-affinity antibodies are induced these are crucial for the induction of experimental axonal neuropathy. Only a strict adherence to the protocols demonstrated to be successful may guarantee the reproducibility and increase the confidence in the animal model as a reliable tool for the study of the human axonal GBS.

In the Schwann cells and neuronal plasma membranes the gangliosides are organized in clusters forming complexes of gangliosides in the microdomains termed lipid rafts. We investigated frequency, clinical correlates, fine specificity and pro-inflammatory properties of antibodies to ganglioside complexes (GSCs) in a Guillain Barré syndrome (GBS) population. In 63 patients with different GBS variants we performed an ELISA for antibodies to Campylobacter Jejuni ( C. jejuni), gangliosides and GSCs. We studied the fine specificity of antibodies to GSCs by immunoabsorption study and performed a complement activation assay. Twenty-seven percent of patients had antibodies to GSCs and 71% had antibodies either to single gangliosides or to GSCs. Patients with antibodies to GSCs had more frequent involvement of cranial nerves but did not present more frequent antecedent respiratory, gastrointestinal or C. jejuni infection, did not have a preferential demyelinating or primary axonal GBS variant and did not develop greater disability at six months. The absorption study showed in 2 sera that antibodies to the complex GD1a/GD1b did not react with the gangliosides forming the complex or other single gangliosides, suggesting that antibodies to GSCs are targeted to new conformational glycoepitopes different from the ones displayed by the single gangliosides. Antibody anti-GSCs activated the complement more frequently than antibodies to single gangliosides. Complement activation indicates that antibodies to GSCs have high avidity, pro-inflammatory properties and may exert a pathogenic role in GBS.

Il contributo affronta i principali profili problematici connessi all'adozione della Direttiva del Presidente del Consiglio dei Ministri del 22 aprile 2014, relativa alla declassificazione e al versamento straordinario di documenti presso l'Archivio centrale dello Stato

Three patients developed acute pure sensory ataxic neuropathy. Two of the three patients had a recent Campylobacter jejuni infection. Patient 1 had monospecific IgG anti-GD1b. Patients 2 and 3 had cross-reactive IgG anti-GQ1b and anti-GD1b and patient 2 also had IgG anti-GT1a. Motor nerve conduction studies were completely normal. Sensory conductions showed reduced amplitude or absent sensory nerve action potentials with normal or slightly slowed conduction velocities. In patient 2, serial electrophysiological studies showed reappearance and improvement of sensory nerve potential amplitudes in 4 weeks. All patients recovered completely in 2 months and sensory potential amplitudes normalized in 3-5 months. Our findings: (1) confirm the existence of a pure acute sensory ataxic neuropathy with cross-reactive IgG anti-GQ1b and anti-GD1b as a variant of Guillain-Barre syndrome; (2) expand the clinical presentation of Guillain-Barre syndrome after C. jejuni infection and suggest that molecular mimicry is at the basis of acute sensory ataxic neuropathy; and (3) indicate that, in acute sensory ataxic neuropathy with prompt recovery, the site of the lesion is not in the primary sensory neurons and the pathophysiological mechanism may be functional in nature.

We evaluated the efficacy and safety of rituximab in an open-label, uncontrolled study of 13 patients with polyneuropathy associated with antibodies to myelin-associated glycoprotein (MAG) and correlated the response to therapy with clinical and laboratory features. One year after rituximab therapy, anti-MAG immunoglobulin M (IgM) titers were significantly reduced. At that time, eight patients (62%) had improved in both the inflammatory neuropathy cause and treatment (INCAT) sensory sumscore and the Medical Research Council sumscore for muscle strength and seven of them also in the INCAT disability score. The improvement in the mean INCAT sensory sumscore was significant at 12 months and correlated with lower anti-MAG antibody at entry and at follow-up. This study suggests that rituximab may be efficacious in patients with anti-MAG associated neuropathy and particularly on sensory impairment and in those with moderately elevated antibody titers. These findings suggest that antibody reduction below a critical level may be necessary to achieve clinical improvement.

New Zealand white rabbits were immunized with a lipopolysaccharide (LPS) extracted from a Campylobacter jejuni HS:19 strain isolated from a GBS patient expressing GM1 and GD1a-like epitopes, Freund's adjuvant (group I) and Freund's adjuvant plus keyhole lympet hemocyanin (KLH) (group II). Both groups showed high titers of anti-LPS and anti-GM1 and lower titers of anti-GD1b and anti-GD1a antibodies. Weakness and axonal degeneration in sciatic nerves was detected in 1/11 of group I and 6/7 of group II. This model replicates, at least in part, the pathogenetic process hypothesized in the human axonal GBS with antiganglioside antibodies post C. jejuni infection and indicates that KLH plays an additional role in neuropathy induction.

Interferon-β (IFN-β) ameliorates disease course in a subset of patients with MS. The reasons for heterogeneity of clinical responses, however, are unclear. We assessed possible effects of IFN-β on the gene expression of the leukocyte adhesion molecules VLA-4 and LFA-1 during the first year of treatment of 50 patients with relapsing-remitting MS who showed differential clinical responses. We observed a significant reduction of VLA-4 (P=0.002) and LFA-1 (P=0.03) mRNA expression compared to baseline in first-year clinical responders (n=22). In contrast, first-year IFN-β non-responders (n=28) had unchanged levels of VLA-4 and LFA-1. In vitro treatment of PBMC with IFN-β indicated a direct effect on transcription of the integrins' genes. Transcriptional downmodulation of adhesion molecules during IFN-β treatment may contribute to its mode of action in MS. © 2004 Elsevier B.V. All rights reserved.

Objective: To report two patients with an acute exclusively motor neuropathy with conduction blocks.Methods: Serial electrophysiologic studies were carried out.Results: Two patients developed symmetric proximal and distal weakness without sensory abnormalities after enteritis. Tendon reflexes were normal in one patient and brisk in the other. One patient had high titer immunoglobulin G to GD1a and GM1, and the other to GD1b, GD1a, and GM1 and a recent Campylobacter jejuni infection. Electrophysiology showed early partial motor conduction block in intermediate and distal nerve segments, normal sensory conductions even across the sites of conduction block, and normal somatosensory evoked potentials. Conduction blocks resolved in 2 to 5 weeks without excessive temporal dispersion of proximal motor responses.Conclusions: Acute motor neuropathy with normal or brisk tendon reflexes, conduction block, and fast recovery appears to be a variant of Guillain–Barré syndrome. Conduction block may result from immune-mediated conduction failure at the nodes of Ranvier without demyelination.

The World Health Organization (WHO) recommends the direct fluorescent antibody test (DFA) for the detection of lyssaviruses such as rabies virus (RABV) in the central nervous system of suspect animals, and the rapid fluorescent focus inhibition test (RFFIT) to determine the titer of neutralizing antibodies in serum and cerebrospinal fluid (CSF). These tests can be performed with the use of fluorescent antibody conjugates produced from anti-RABV or anti-ribonucleoprotein polyclonal antibodies (PAbs), or from mixtures of monoclonal antibodies (MAbs). Described here is the production of an anti-ribonucleoprotein fluorescent antibody conjugate, obtained by the purification and conjugation of PAbs of animals, such as rabbits, immunized with viral ribonucleoprotein concentrated by cesium chloride (CsCl) gradient ultracentrifugation. This method makes it possible to obtain a fluorescent PAb conjugate with excellent specificity and sensitivity, besides a high titer.

One of the methods used for controlling cattle rabies in Brazil consists of vaccination. Sometimes, however, rabies occurs in cattle supposedly protected. Since rabies vaccine batches are officially controlled by tests performed on laboratory animals, it is questionable whether the minimal mandatory requirements really correspond to immunogenicity in the target species. We have analyzed the association among potencies of rabies vaccines tested by the NIH test, the contents and form (free-soluble or virus-attached) of rabies glycoprotein (G) in the vaccine batches, and the virus-neutralizing antibodies (VNA) titers elicited in cattle. No correlation was found between G contents in the vaccine batches and the NIH values, whatever the presentation of G. There was no correlation either between NIH values and VNA titers elicited in cattle. There was, however, a positive correlation (r = 0.8681; p = 0.0001) between the amounts of virion-attached G present in the vaccine batches and VNA elicited in cattle. This was not observed when the same analysis was performed with total-glycoprotein or free-soluble glycoprotein. The study demonstrated that NIH values can not predict the effect of the immunogen in cattle. On the other hand, the quantification of virus-attached rabies glycoprotein has a strong correlation with VNA elicited in cattle.

Background Rabies is a fatal zoonotic neglected disease that occurs in more than 150 countries, and kills more than 55.000 people every year. It is caused by an enveloped single stranded RNA virus that affects the central nervous system, through an infection initiated by the muscular nicotinic acetylcholine receptor, according to many authors. Alkaloids, such as acetylcholine, are widespread molecules in nature. They are present in numerous biological fluids, including the skin secretion of many amphibians, in which they act (together with proteins, peptides and steroids) as protection agents against predators and/or microorganisms. Among those amphibians that are rich in alkaloids, there is the genus Rhinella. Methods Bufotenine was isolated from Rhinela jimi skin secretion after a liquid-liquid partition (H2O:CH2Cl2) and reversed phase high-performance liquid chromatography analyses (RP-HPLC). Bufotenine was also extracted from seeds of Anadenanthera colubrina in acetone solution and purified by RP-HPLC, as well. Structural characterization was performed by mass spectrometry and nuclear magnetic resonance analyses. Cytotoxic tests of bufotenine were performed over baby hamster kidney (BHK-21) cells using MTT test. For the antiviral activity, Rabies virus strain Pasteur vaccine (PV) was used on fluorescence inhibition test and fluorescent foci inhibition test, with both simultaneous and time course treatment of the cells with the virus and bufotenine. Results In the present work we describe the effects of bufotenine, obtained either from toads or plants, that can inhibit the penetration of rabies virus in mammalian cells through an apparent competitive mechanism by the nicotinic acetylcholine receptor. Moreover, this inhibition was dose- and time-dependent, pointing out to a specific mechanism of action. Conclusions This work do not present or propose bufotenine as a drug for the treatment of rabies due to the hallucinogen and psychotropic effects of the molecule. However, continued studies in the elucidation of the antiviral mechanism of this molecule, may lead to the choice or development of a tryptamine analogue presenting potential clinical use. Electronic supplementary material The online version of this article (doi:10.1186/1678-9199-20-45) contains supplementary material, which is available to authorized users.

O Programa Nacional de Profilaxia da Raiva tem como objetivo manter níveis imunogênicos protetores nos animais vacinados, com títulos de anticorpos neutralizantes (AcN) ≥ 0,5UI/mL. O objetivo deste estudo foi avaliar, de acordo com a idade, raça e o período entre a aplicação da vacina e a colheita do sangue, a resposta imunológica de cães que receberam dose única de vacina antivírus da raiva de cultivo celular. Neste estudo foram analisadas 432 amostras recebidas no Instituto Pasteur de São Paulo no triênio 2009-2011. Os dados foram analisados e a avaliação de AcN para o vírus da raiva foi realizada por meio do teste rápido de inibição de focos fluorescentes (RFFIT). Do total das amostras analisadas, 21,76% não possuíam títulos protetores. Dentre essas, 67,02% das amostras eram de filhotes e quando considerado o intervalo entre a data de aplicação da vacina e a colheita do sangue, 60,63% amostras não atingiram a titulação nos seis primeiros meses. Concluiu-se a partir do estudo desta amostragem a necessidade de uma segunda dose de vacina em filhotes, pois estes ficam mais suscetíveis à infecção pelo vírus da raiva, o que aumentaria a possibilidade de uma resposta rápida e duradoura.

The susceptibility of the C6 rat glioma cell line (ATCC; CCL-107) to rabies virus was characterized. The kinetics of infection performed with a fixed and a wild strain (from an infected cow) of rabies virus was monitored by direct immunofluorescence. Fluorescent cytoplasmic bodies were readily observed by UV microscopy from 24 hours post-infection (hpi) onwards. The ability of C6 to produce rabies infective virion particles was confirmed by determining the viral titres present in the supernatants of infected cultures, by both BHK-21 cell infection and mice inoculation. C6 cells produced similar viral titres to those produced by BHK-21 for both strains used. In addition, the yield of rabies glycoprotein was assessed by ELISA. In general, BHK-21 and C6 cells infected either by PV or with the wild rabies strain produced similar amounts of rabies glycoprotein. At 96 hpi, however, when the glycoprotein production peaked, BHK-21 infected with the wild strain produced significantly higher amounts of glycoprotein than C6. Subsequently, the optimal conditions for isolation of wild rabies virus strains from C6 cells were established and these proved to be as sensitive as NA cells in detecting 10 wild rabies samples. Due to the high sensitivity exhibited, C6 rat glioma cells present a new and useful system for rabies virus investigation.

CD1 are MCH-like glycoproteins specialized in capturing and presenting glycolipid to T cells. Expression of CD1 molecules has been observed on endoneurial machrophages in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and vasculitis and polymorphisms of CID1A and CD1E genes have been associated with susceptibility to develop Guillain–Barre syndrome. In 46 patients with CIDP, in 13 patients with multifocal motor neuropathy and in 132 controls we genotyped exon 2 of CD1A and CD1E genes. We found no association between chronic dysimmune neuropathies, with or without anti-ganglioside antibodies, and polymorphisms of CD1A and CD1E genes.

Isolated pure motor involvement of the shoulder and arm muscles is extremely rare after stroke, and up to now has been documented by magnetic resonance imaging (MRI) in only one patient.1 The corticospinal system is known to exert a greater influence over distal than proximal upper limb muscles, and the mechanisms that induce better recovery from stroke of proximal muscles are debated. The contribution of ipsilateral corticospinal fibres from the unaffected hemisphere, or of corticoreticulospinal projections, has been hypothesised.2,3 A 65-year-old right-handed man awoke unable to abduct the right arm. Examination showed a strength of 0/5 (Medical Research Council scale) in the right deltoid, 2/5 in the biceps and 4/5 in the triceps. Strength in the remaining upper and lower limb muscles as well as the sensory examination were completely normal. Tendon jerks were normal except in the right biceps, where they were reduced. Electromyography showed no voluntary activity in the right deltoid muscle, and a reduced recruitment pattern with motor units of low firing frequency in the biceps brachii. A computed tomography scan showed a small hypodense lesion in the left precentral gyrus. Two months later, the patient was able to abduct the arm against gravity and the strength in the biceps was 4/5. Biceps tendon jerk was hyperactive. At 7 months, the patient was able to hold the right arm abducted against resistance (4+/5). Standard and functional magnetic resonance imaging (fMRI) was performed 2 months after stroke. fMRI was carried out using the blood oxygenation level-dependent contrast technique. To explore the cortical activity of the primary and secondary motor cortices, a self-paced finger-tapping task at a frequency of about 1 Hz was used. The experimental paradigm was a block design …

An improved methodology to prepare (S)2,3-O-cyclohexylideneglyceraldehyde is described. Starting from the commercially available (L)-cyclohexylidene protected ascorbic acid the enantiomerically pure aldehyde was synthesized in only two steps in 41% overall yield.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) affects various components and segments of the peripheral nervous system differently, and thus there can be phenotypic heterogeneity. We report a 47-year-old woman with chronic sensory disturbances and proximal weakness limited to the legs. Motor and sensory nerve conduction studies were normal. Somatosensory evoked potentials and imaging indicated a demyelinating process involving the lumbosacral roots. The patient responded favorably to IVIg. Although she did not fulfill the diagnostic criteria for CIDP we believe this patient represents a restricted regional CIDP variant.

Avaliou-se o efeito da suplementação de uma combinação homeopática sobre a contagem de células somáticas do leite (CCS), o teor sanguíneo de cortisol e a resposta de anticorpos neutralizantes antivírus da raiva de vacas leiteiras. Trinta e duas vacas Holandesas em lactação foram blocadas em pares e aleatoriamente alocadas a um de dois tratamentos por 63 dias, posterior a um período de padronização de 14 dias. A CCS mensurada no final da padronização ajustou os valores semanais de CCS no modelo de análise estatística. Os tratamentos foram: 150 gramas de uma combinação homeopática (Hypothalamus, 10-30; Colibacilinum, 10-30; Streptococus Beta Hemolyticum, 10-60; Streptococus Uberis, 10-60; Phytolacca, 10-60; Calcium Phosphoricum, 10-30; Natrum Muriaticum, 10-60; Urtica Urens, 10-30; Silicea Terra, 10-400) em veículo mineral, ou 150 gramas do mesmo veículo mineral (controle). A homeopatia tendeu a aumentar a CCS de 124 para 222 x1.000 células mL-1 (P=0,09) e a CCS linearizada (P=0,08). Não foram detectados efeitos de tratamento sobre a concentração sérica de cortisol após estresse induzido por aspiração percutânea do saco ventral do rúmen (P=0,59) ou sobre o título de anticorpos neutralizantes em resposta à vacinação antivírus da raiva (P=0,40). A suplementação com homeopatia tendeu a aumentar a CCS de vacas com baixa CCS. The effect of supplementing a homeopathic combination on milk somatic cell count (SCC), blood cortisol content and the antibody response to rabies vaccination of dairy cows was evaluated. Thirty-two lactating Holstein cows were paired blocked and randomly assigned to one of two treatments for 63 days, following a 14-day standardization period. The SCC measured at the end of standardization period adjusted weekly SCC values in the statistical analysis model. Treatments were: 150 grams of a homeopathic combination (Hypothalamus, 10-30; Colibacilinum, 10-30; Streptococcus Beta Hemolyticum, 10-60, Streptococcus Uberis, 10-60; Phytolacca, 10-60; Calcium Phosphoricum, 10-30; Natrum Muriaticum, 10-60; Urtica Urens, 10-30, Silicea Terra, 10-400) in mineral vehicle, or 150 grams of the same mineral vehicle (Control). Homeopathy tended to increase SCC from 124 to 222 x1,000 cells mL-1 (P=0.09) and linear SCC (P=0.08). There were no detectable treatment effects upon serum cortisol concentration following stress induced by percutaneous aspiration of the ventral rumen (P=0.59) and upon serum antibody title in response to rabies vaccination (P=0.40). The supplementation with homeopathy tented to increase the SCC of low SCC cows.

In the quest for susceptibility factors of inflammatory neuropathies, many genes implicated in the pathogenesis of autoimmune diseases have been investigated with negative or conflicting results. We studied, with a gene candidate approach, the CD1 system specialized in capturing and presenting glycolipids to antigen-specific T cells, and the SH2D2A gene encoding for a T-cell-specific adapter protein implicated in control of early T-cell activation. In Guillain-Barre syndrome, an initially positive association study with polymorphism of CD1A and CD1E genes was not confirmed. In chronic inflammatory demyelinating polyneuropathy, we did not find an association with CD1 genes, but we found an association with a homozygous genotype for a low repeat number of tandem GA in the SH2D2A gene. This genotype could result in defective control and elimination of autoreactive T cells. All the studies were performed on relatively small size populations. Confirmation in larger sized studies is required both for CD1 and SH2D2A genes. Considering the relative rarity of patients with inflammatory neuropathies, this can only be accomplished by international collaboration.

The laboratory tests recommended by the World Health Organization for detection of rabies virus and evaluation of specific antibodies are performed with fluorescent antibodies against the virus, the ribonucleoproteins (RNPs), or by monoclonal antibodies. In this study, we purified the rabies virus RNPs for the production of a conjugate presenting sensibility and specificity compatible with commercial reagents. The method employed for the purification of RNPs was ultracentrifugation in cesium chloride gradient, the obtained product being used for immunizing rabbits, from which the hyperimmune sera were collected. The serum used for conjugate production was the one presenting the highest titer (1/2,560) when tested by indirect immunofluorescence. The antibodies were purified by anion exchange chromatography (QAE‐Sephadex A‐50),conjugated to fluorescein isothiocyanateand separated by gel filtration (Sephadex G‐50). The resulting conjugate presented titers of 1/400 and 1/500 when assayed by direct immunofluorescence (DIF) and simplified fluorescence inhibition microtest, respectively. Sensibility and specificity tests were performed by DIF in 100 central nervous system samples of different animal species, presenting 100% matches when compared with the commercial reagent used as standard, independent of the conservation state of the samples. The quality reached by our conjugate will enable the standardization of this reagent for use by the laboratories performing diagnosis of rabies in Brazil, contributing to the intensification of the epidemiological vigilance and research on this disease. J. Clin. Lab. Anal. 23:7–13, 2009. © 2009 Wiley‐Liss, Inc.

A general procedure for fractional integration and structural breaks at unknown points in time is used, which allows for different orders of integration and deterministic components in each subsample. First, the procedure is extended to the non-linear case, and is showed by means of Monte Carlo experiments that it performs well in a non-linear environment. Second, it is applied to test for a single break in the unemployment rate in the US, the UK and Japan. The results shed some light on the empirical relevance of alternative unemployment theories for these countries. Specifically, a structuralist interpretation appears more appropriate for the US and Japan, whilst a hysteresis model accounts better for the UK experience (and also for the Japanese one in the second subsanple). These findings are interpreted in terms of structural instability in labour markets with different features.

Glial fibrillary acid protein (GFAP) is increased in serum and cerebrospinal fluid of patients with dementia, traumatic brain injury, stroke, and multiple sclerosis. To determine whether GFAP is increased in Guillain-Barre syndrome (GBS) we evaluated serum GFAP in 30 controls, 20 patients with acute inflammatory demyelinating neuropathy (AIDP), and 17 with primary axonal GBS. Serum GFAP levels were increased in axonal GBS (median, 0.74) compared with controls (median, 0.41; P < 0.0001) and AIDP (median, 0.58; P = 0.0015). GFAP levels correlated with Hughes grades (serum r = 0.74; P < 0.0001) 6 months after neuropathy onset. Applying the cutoff value in serum of 0.63 to the diagnosis of axonal GBS, we obtained a sensitivity of 76.5% and a specificity of 86%. Thus, serum GFAP levels may be used in GBS as a diagnostic marker of the axonal variant and to predict outcome.

The SH2D2A gene encodes a T-cell-specific adapter protein involved in the negative control of T-cell activation. The genotype GA13-16 homozygote of the SH2D2A gene promoter has been associated with the susceptibility to develop multiple sclerosis. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated neuropathy sharing several pathogenetic mechanisms with multiple sclerosis. We genotyped the SH2D2A promoter region in 105 controls and 48 patients with CIDP. We found a significant association between CIDP and the genotype GA13-16 homozygote (OR 3.167; p 0.013). We hypothesize that this genotype is associated with the susceptibility to develop CIDP and may be implicated in the persistence of the disease.

Three patients developed acute pure sensory ataxic neuropathy. Two of the three patients had a recent Campylobacter jejuni infection. Patient 1 had monospecific IgG anti-GD1b. Patients 2 and 3 had cross-reactive IgG anti-GQ1b and anti-GD1b and patient 2 also had IgG anti-GT1a. Motor nerve conduction studies were completely normal. Sensory conductions showed reduced amplitude or absent sensory nerve action potentials with normal or slightly slowed conduction velocities. In patient 2, serial electrophysiological studies showed reappearance and improvement of sensory nerve potential amplitudes in 4 weeks. All patients recovered completely in 2 months and sensory potential amplitudes normalized in 3-5 months. Our findings: (1) confirm the existence of a pure acute sensory ataxic neuropathy with cross-reactive IgG anti-GQ1b and anti-GD1b as a variant of Guillain-Barré syndrome; (2) expand the clinical presentation of Guillain-Barré syndrome after C. jejuni infection and suggest that molecular mimicry is at the basis of acute sensory ataxic neuropathy; and (3) indicate that, in acute sensory ataxic neuropathy with prompt recovery, the site of the lesion is not in the primary sensory neurons and the pathophysiological mechanism may be functional in nature.

CD1 is a small family comprising 5 MHC-like genes located on chromosome 1 and encoding glycoproteins termed CD1a, CD1b, CD1c, CD1d and CD1e. They are expressed mainly on the surface of dendritic cells, monocytes and some thymocytes and are specialized in presenting lipid antigens to T lymphocytes. The structure is similar to that of MHC class I molecules with 3 globular domains and the β2-microglobulin. It has been shown that all five human CD1 genes exhibit a limited number of polymorphisms in the alpha1 domain whose effects are still unknown. CD1e results to be the most polymorphic isoform with six CD1e alleles (01, 02 in exon 2 and 03, 04, 05, 06 in ex3) described to date. At this moment, few investigations on the allele frequencies of the CD1 genes have been reported and all additional information improves our knowledge on this new class of antigen-presenting molecules. In order to study possible allelic variations of exon 2 of human CD1a and CD1e genes, we analyzed, by a sensitive technique, the sequence-based typing (SBT), 114 DNA samples from unrelated healthy Italian individuals from the Abruzzo region. Our experimental findings indicate that the allele frequency distribution of both CD1a and CD1e genes is in accordance with that observed in other geographic areas and did not identify any new allele, thus confirming a very low polymorphism.

A patient with chronic hepatitis from hepatitis C virus (HCV) infection developed Lewis-Sumner syndrome (LSS). The neuropathy worsened after intravenous immunoglobulins, remitted after intravenous methylprednisolone, relapsed during interferon-alpha, but responded again to steroids continued for 68 weeks with clinical remission and without worsening of hepatitis. We are not aware of other reports of HCV infection and LSS. This association may be coincidental or related to a virus-triggered immune-mediated process. Although the coexistence of a dysimmune neuropathy with hepatitis makes problematic the choice of treatment, we emphasize that the patient's condition during treatment with steroids and the 46 following weeks without therapy has been excellent.

Ectopic mediastinal parathyroid adenomas may be cause of Primary Hyperparathyroidism (PH). The occurrence of these lesions is explainable on embryologic basis. We report the case of a 20-year-old patient with PH due to an ectopic mediastinal parathyroid adenoma located in the anterior mediastinum. After its accurate pre-operative localization, surgical resection through a cervical manubriotomy was performed. Serum calcium and parathyroid hormone (PTH) levels returned promptly within the normal range, no complications occurred and the patient was discharged in the 4th postoperative day. Different surgical approaches are discussed.

Following previous studies reporting microbiological diagnosis by flow cytometry, the possibility of using this method was examined to monitor infection of susceptible cell lines by a fixed rabies virus strain (Pasteur Virus strain-PV) or a wild rabies virus strain (WRS). Suspensions of BHK-21 and C6 cells were infected with viruses and a time course of virus infection was established. Sequentially, at several time points, infected and control uninfected cells were fixed, permeabilized, and stained with a rabies virus-specific antibody conjugate. This was achieved by resuspending cells in a solution containing p-formaldehyde in FACS lysis fluid, which allowed the detection of intracellular virus with flourescein-coupled antibodies by flow cytometry. A Becton Dickinson FACSCalibur flow cytometer was used to analyze the percentage of cells infected and the kinetics of the infection process was determined. As early as 12 h after inoculation with both rabies virus strains, significant levels (P0.01) of infection (from 4.7 to 7.1%) were detected by flow cytometry. The maximum level of infection was obtained at 48 h in C6 cells (88%) with both viruses. The advantages of this method for examination of intracellular virus infection are discussed.

The determination of the rabies neutralizing antibody (VNA) response after immunization against rabies is an acceptable index of the efficacy of a vaccine and a successful treatment. Several tests have been developed in attempt to improve the assessment of VNA, from mice inoculation to cell-culture fluorescence inhibition tests. All of them, however, present special difficulties in terms of reading or accuracy. The present study describes a neutralization test performed in cell-culture appraised by flow cytometry (FC). Serial dilutions of the serum samples were mixed in vitro with rabies virus before the addition of BHK-21 cells. After 24h-incubation, cells were released by trypsin treatment, fixed and permeabilized with a p-formaldehyde solution and stained with a rabies virus nucleocapsid protein-specific antibody conjugate. The percentage of virus infection inhibition caused by specific antibodies present in the serum were evaluated in a Beckton & Dickinson FACSCalibur® flow cytometer. A correlation curve between the IU/ml content and the percentage of infective inhibition was built with a reference serum and the VNA titers of serum samples were obtained by extrapolation. Titers obtained by FC and standard test showed an effective pairing results (p < 0.01), with a correlation coefficient (r) = 0.7. These results permit to envisage the FC as a suitable technique to evaluate VNA in sera from immunized animals and likely in human serum samples. Nevertheless, new studies comparing FC to gold-standard techniques are required for determining the FC values of Sensibility and Specificity . A titulação de anticorpos neutralizantes contra o vírus rábico (AcN) pós-imunização é um parâmetro aceito como indicador de eficácia da vacina e do sucesso do processo de imunização. Este estudo descreve um teste de neutralização realizado em cultura de células, analisado através da técnica de citometria de fluxo. Diluições seriadas de amostras de soro foram misturadas in vitro com vírus rábico e adicionados a células BHK-21. Após incubação de 24 h, as células foram individualizadas por tratamento com tripsina, fixadas e permeabilizadas com p-formaldeído e coradas com conjugado específico. A porcentagem de inibição da infecção viral causada pelos anticorpos específicos presentes nas amostras de soro foi determinada em citômetro de fluxo Beckton & Dickinson FACSCalibur® e comparada com um soro de referência internacional. Os títulos de AcN foram determinados por extrapolação. Os níveis de correlação (r) entre os títulos obtidos com CF e SFIMT foi de 0.7712 (p < 0,001), e entre CF e ELISA de 0,6702 (p < 0,001). Os resultados indicam que a CF pode ser utilizada na análise de títulos de anticorpos neutralizantes em amostras de soro, com a vantagem de ser um método automatizado. No entanto, devem ser realizados novos estudos, comparando a CF com as técnicas consideradas como padrão ouro, para que os valores reais de Sensibilidade e Especificidade sejam determinados.

Despite the absence of current official reports showing the number of cattle infected by rabies, it is estimated that nearly 30,000 bovines are lost each year in Brazil. In order to minimize the important economic losses, control of the disease is achieved by eliminating bat colonies and by herd vaccination. In this study, we compare the antibody response in cattle elicited by vaccination with an attenuated ERA vaccine (AEvac) and an inactivated-adjuvanted PV (IPVvac) vaccine. The antibody titers were appraised by cell-culture neutralization test and ELISA, and the percentage of seropositivity was ascertained for a period of 180 days. IPVvac elicited complete seropositivity rates from day 30 to day 150, and even on day 180, 87% of the sera showed virus-neutralizing antibody titers (VNA) higher than 0.5IU/ml. There were no significant differences between the VNA titers and seropositivity rates obtained with IPVvac in the two methods tested. AEvac, however, elicited significantly lower titers than those observed in the group receiving inactivated vaccine. In addition, the profiles of antirabies IgG antibodies, evaluated by ELISA, and VNA, appraised by cell-culture neutralization test, were slightly different, when both vaccines were compared.

The favourable properties, on which is based the successful history of the use of alumina in orthopaedic surgery, are due to the tough control made by manufacturers on the whole process from raw materials purity to the quality controls. The minimum requirements of a medical grade alumina are stated from 1981 in ISO 6474 standard. Nevertheless, due to the voluntary character of standards, and lack of national and international laws, it was possible in the past to introduce into the market materials with characteristics not in compliance with the standard ISO 6474. A THR implanted on a fifty years old patient was revised three years after implantation, due to the failure of the alumina ball head. To understand the causes of such an early failure, the fragments of the retrieved ball head were submitted to a series of non destructive and destructive controls. The results show that the poor quality of the design and manufacture of the implant was the origin of the failure.

Campylobacter jejuni (C. jejunj) infection is the most common antecedent in the axonal variant of Guillain-Barre syndrome (GBS). Antibodies against nerve gangliosides found in GBS patients recognize cross-reactive epitopes in the lipopolysaccharide (LPS) of C. jejuni. This led to the molecular mimicry hypothesis of GBS. We immunized eleven rabbits with a LPS extracted from HS:19 C. jejuni strain isolated from a patient with GBS and complete Freund's adjuvant (CFA)(group I). In a second experiment we immunized seven rabbits with LPS, CFA and keyhole limpet hemocyanin (KLH)(group II). All group I rabbits developed high titers of anti-LPS, anti-GM1, anti-GD1b antibodies and lower titers of anti-GD1a. One rabbit, 50 days after initial inoculation, showed tremor and weakness. All rabbits of group II developed high titres of antiganglioside antibodies and six animals showed weakness 59–113 days after initial inoculation. Two rabbits died. Pathology showed mild to moderate, tendentially grouped, axonal degeneration in sciatic nerves of four out of five animals. Control rabbits of group I (immunized with CFA only) did not develop antibodies, controls of group II (immunized with CFA + KLH) developed low titers of IgG anti-GM1. None developed neurological signs or showed axonal degeneration. C. jejuni LPS is a potent B-cell stimulator capable to induce a strong antiganglioside response in rabbits. However, to induce the neuropathy is crucial to employ KLH, a glycoprotein known to stimulate both humoral and cellular responses. This animal model reproduces the pathogenetic process hypothesized in axonal GBS with antiganglioside antibodies post C. jejuni infection.