Guillain-Barré syndrome: a century of progress

In 1916, Guillain, Barré and Strohl reported on two cases of acute flaccid paralysis with high cerebrospinal fluid protein levels and normal cell counts — novel findings that identified the disease we now know as Guillain–Barré syndrome (GBS). 100 years on, we have made great progress with the clinical and pathological characterization of GBS. Early clinicopathological and animal studies indicated that GBS was an immune-mediated demyelinating disorder, and that severe GBS could result in secondary axonal injury; the current treatments of plasma exchange and intravenous immunoglobulin, which were developed in the 1980s, are based on this premise. Subsequent work has, however, shown that primary axonal injury can be the underlying disease. The association of Campylobacter jejuni strains has led to confirmation that anti-ganglioside antibodies are pathogenic and that axonal GBS involves an antibody and complement-mediated disruption of nodes of Ranvier, neuromuscular junctions and other neuronal and glial membranes. Now, ongoing clinical trials of the complement inhibitor eculizumab are the first targeted immunotherapy in GBS

The effect of copper upon the development of bacteria in sea water and the isolation of specific bacteria

Copper is used extensively in the eradication of various types of disease-producing microorganisms, especially fungi, as well as other organisms which are a nuisance to water supplies, such as algae and certain animal forms. It is also known that traces of copper are essential for the growth of many of the lower forms of life. The extensive literature on the relation of copper to microbial development is largely limited to the above two phenomena. Comparatively little is known, however, of the effect of copper upon a mixed microbiological population consisting of many organisms with different metabolic processes. It is known, for example, that the growth of plants in certain soils, as peats, will respond markedly to the application of small amounts of copper (5). The development of fungi in copper-free media has been suggested as a means of determining the concentration of copper in a given soil; this method is based upon the response of A. niger to the presence of small amounts of available copper (3)

Intracoronary gamma-radiation therapy after angioplasty inhibits recurrence in patients with in-stent restenosis

BACKGROUND: Treatment of in-stent restenosis presents a critical limitation of intracoronary stent implantation. Ionizing radiation has been shown to decrease neointimal formation within stents in animal models and in initial clinical trials. We studied the effects of intracoronary gamma-radiation therapy versus placebo on the clinical and angiographic outcomes of patients with in-stent restenosis. METHODS AND RESULTS: One hundred thirty patients with in-stent restenosis underwent successful coronary intervention and were then blindly randomized to receive either intracoronary gamma-radiation with (192)Ir (15 Gy) or placebo. Four independent core laboratories blinded to the treatment protocol analyzed the angiographic and intravascular ultrasound end points of restenosis. Procedural success and in-hospital and 30-day complications were similar among the groups. At 6 months, patients assigned to radiation therapy required less target lesion revascularization and target vessel revascularization (9 [13.8%] and 17 [26.2%], respectively) compared with patients assigned to placebo (41 [63.1%, P=0.0001] and 44 [67.7%, P=0.0001], respectively). Binary angiographic restenosis was lower in the irradiated group (19% versus 58% for placebo, P=0.001). Freedom from major cardiac events was lower in the radiation group (29.2% versus 67.7% for placebo, P<0.001). CONCLUSIONS: Intracoronary gamma-radiation used as adjunct therapy for patients with in-stent restenosis significantly reduces both angiographic and clinical restenosis

Heavy genealogy: mapping the currents, contraflows and conflicts of the emergent field of metal studies, 1978-2010

What is metal studies? How can we define and characterize it? How has it emerged as a body of academic enquiry? What are its dominant disciplinary strands, theoretical concepts and preferred methodologies? Which studies have claimed most attention, defined the goals of scholarship, typical research strategies and values? How has the claim for the legitimacy or symbolic value of metal scholarship been achieved (if it has): over time and through gradual acceptance or through conflict and contestation? How can this process of formation, or strategy of legitimation, be mapped, examined and interrogated and which methods of historical, institutional and cultural analysis are best suited to this task? Working with the most complete bibliography to date of published research on heavy metal, music and culture (the MSBD), this article employs Foucault’s archaeological “method” to examine the institutional, cultural and political contexts and conflicts that inform the genealogy of this scholarship. Such analysis reveals a formative, largely negative account of heavy metal to be found in the “sociology of rock”; a large volume of psychology work, examining heavy metal music preference as an indicator of youth risk, deviance and delinquency; sociological work on youth and deviancy critical of the values of this research and its links to social policy and politics; culminating in the work of Weinstein and Walser, who advocate a perspective sympathetic to the values of heavy metal fans themselves. Following Bourdieu, I interpret such symbolic strategies as claims for expertise within the academic field that are high or low in symbolic capital to the extent they can attain disciplinary autonomy. I then go on to examine the most recent strands of research, within cultural studies and ethnomusicology, concerned with the global metal music diaspora, and consider to what extent such work is constitutive of a coherent subfield of metal studies that can be distinguished from earlier work and what the implications of this might be

Structural and Functional Diversity of Type IV Secretion Systems

Considerable progress has been made in recent years in the structural and molecular biology of type IV secretion systems in Gram-negative bacteria. The latest advances have substantially improved our understanding of the mechanisms underlying the recruitment and delivery of DNA and protein substrates to the extracellular environment or target cells. In this Review, we aim to summarize these exciting structural and molecular biology findings and to discuss their functional implications for substrate recognition, recruitment and translocation, as well as the biogenesis of extracellular pili. We also describe adaptations necessary for deploying a breadth of processes, such as bacterial survival, host–pathogen interactions and biotic and abiotic adhesion. We highlight the functional and structural diversity that allows this extremely versatile secretion superfamily to function under different environmental conditions and in different bacterial species. Additionally, we emphasize the importance of further understanding the mechanism of type IV secretion, which will support us in combating antimicrobial resistance and treating type IV secretion system-related infections

RANTES/CCL5 and risk for coronary events: Results from the MONICA/KORA Augsburg case-cohort, Athero-express and CARDIoGRAM studies

Background: The chemokine RANTES (regulated on activation, normal T-cell expressed and secreted)/CCL5 is involved in the pathogenesis of cardiovascular disease in mice, whereas less is known in humans. We hypothesised that its relevance for atherosclerosis should be reflected by associations between CCL5 gene variants, RANTES serum concentrations and protein levels in atherosclerotic plaques and risk for coronary events. Methods and Findings: We conducted a case-cohort study within the population-based MONICA/KORA Augsburg studies. Baseline RANTES serum levels were measured in 363 individuals with incident coronary events and 1,908 non-cases (mean follow-up: 10.2±

History of clinical transplantation

How transplantation came to be a clinical discipline can be pieced together by perusing two volumes of reminiscences collected by Paul I. Terasaki in 1991-1992 from many of the persons who were directly involved. One volume was devoted to the discovery of the major histocompatibility complex (MHC), with particular reference to the human leukocyte antigens (HLAs) that are widely used today for tissue matching.1 The other focused on milestones in the development of clinical transplantation.2 All the contributions described in both volumes can be traced back in one way or other to the demonstration in the mid-1940s by Peter Brian Medawar that the rejection of allografts is an immunological phenomenon.3,4 © 2008 Springer New York