Samuelsson, Karin & Zetterstrom, R. Ceramides in a Patient with Lipogranulomatosis (Farber's Disease) with Chronic Course. Scand. J . clin. Lab. Invest. 27, 393-405, 1971.Ceramides were analysed by gas-liquid chromatographymass spectrometry in a case of lipogranulomatosis with chronic course. The patient died at 16 years of age. Plasma and a subcutaneous nodule were analysed, one year before he died. The other material was obtained at autopsy. For comparison, corresponding analyses were made on control samples. In a subcutaneous nodule accumulation of ceramides (1 1.9 mgig wet weight) was found. The main components were ceramides with palmitic, behenic, and lignoceric acid. Sphingosine was the main long-chain base. In the kidney the concentration of ceramides was seven times higher in the patient than in the control. The increase was mainly due to ceramides with hydroxy fatty acids (600 pgig wet weight), which were not found in the kidney of the control. There was no indication of accumulation of either ceramides with normal constituents or abnormal ceramides in plasma, spleen, lung, liver, or brain. The patient studied had a special phenotype of lipogranulomatosis. The biochemical study has given indication that this phenotype may correspond to a particular genotype.

SUMMARY Treatment with an anticoagulant (AC) or acetylsalicylic acid (ASA), chosen at random, was given to 241 patients with symptoms of carotid transient attacks of ischemia, some of whom recovered completely within 24 hours (TIA) while the others had slight residual symptoms (TIA-IR).Cerebral infarction was recorded in 4 patients in each of these treatment groups during a mean follow-up period of 20 months. The incidences of TIA and TIA-IR were also similar in the two groups. Severe hemorrhage occurred more often in the AC group, whereas other side reactions, including gastrointestinal disorders, were more common in the ASA group. Recurrent cerebral ischemic events were significantly more common among the patients that had had 2= 2 TIAs in the 14 days immediately preceding randomiza tion, and in those with a history of CVS symptoms more than 14 days before randomization, or those with a carotid bruits. In the group experiencing 5= 2 TIAs in the 14 days prior to randomization the incidence of recurrent cerebral ischemic events was the same for the two types of treatment. Stroke, Vol 14, No 5, 1983TRANSIENT ISCHEMIC ATTACKS (TIA) are re garded as a warning sign of impending stroke -a 7% annual incidence of stroke is an often cited figure. was initially re ceived with enthusiasm, but is now used less frequent ly owing to the high risk of complications.3 In the early fifties anticoagulation (AC) therapy, given for varying periods after TIA, was adopted almost as a standard form of treatment, but from a critical review of 27 papers Brust 4 concluded that its effectiveness had not been convincingly proved, either because none of the studies had included randomized control groups or else because the patient series were too small for a mean ingful statistical analysis. Nonetheless, at many cen ters, the administration of anticoagulant is considered to be the treatment of choice for the TIA patient. 5Subsequently, at the time that the role of platelet ag gregation in the development of arterial thromboembo lism was beginning to be understood trials with agents that inhibit this process was undertaken. In an Ameri can study 6 on patients with carotid TIAs it was found that over an initial 6-month period the incidence of the end points mortality, stroke, recurrent TIAs and retinal infarction, taken together, was significantly lower for patients given acetylsalicylic (ASA), than for those receiving placebo. In a Canadian investigation 7 ASA, either alone or in combination with sulfinpyrazone, was found to lower the mortality and the incidence of stroke for men but not for women ./Two Swedish clini cal trials performed on 125 8 and 156 patients 9 the effi cacies of treatment with anticoagulants and agents to inhibit platelet aggregation (acetylsalicylic acid and dipyridamol) were compared. In the former study no significant difference was observed. In the latter study all the patients received AC treatment initial 2 months after TIAs, before randomization was performed. Dur ing a 2-year follow-up the incidence of cerebral ...

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The etiology of sarcoidosis is unknown, but it has long been suspected to be mycobacterial. In the present study, we used 4 mycobacterial species-specific polymerase chain reaction assays on cerebrospinal fluid obtained from a patient with neurosarcoidosis. Positive hybridization was observed with both the Mycobacterium avium complex probe and the insertion element IS900-specific probe that has been found in M. paratuberculosis species. There was no hybridization with M. tuberculosis or M. avium woodpigeon strain-specific probes. This case report demonstrates that M. paratuberculosis or some closely related M. avium spp which perhaps also carry IS900, or contain closely related DNA sequences, are associated with at least some cases of sarcoidosis disease.

In this study 28 patients with early stage HIV infection (CD4 >280 x 10(6)/l) were subjected to yearly examinations of the nervous system up to 7 years in order to detect any deterioration. Clinical neurological as well as neuropsychological performance was evaluated. The patients also underwent yearly neurophysiological tests (digital EEG, visual evoked potentials, somatosensory evoked potentials, auditory evoked potentials P300 and electroneurography). Every other year, SPECT with (99m)Tc-D,L-hexamethylpropylene amine oxime and brain MRI were performed. Originally, 38 patients were included in the study but only the results of 28 patients who complied with three of more yearly check-ups are presented. The results of yearly investigations of cerebrospinal fluid (CSF) have been presented earlier [Eur J Neurol4 (1997) 1]. All the patients showed signs of HIV in the CSF. Yet, no major deterioration in the neurological, psychological performance, neurophysiological or neuroimaging examinations could be discerned.