Objective: To provide a comprehensive review of the central nervous system (CNS) involvement in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), including the pathogenesis, clinical manifestations, ancillary investigations, differential diagnosis, and treatment. Particular emphasis is placed on the clinical spectrum and diagnostic testing of AAV.Recent Findings: AAV is a pauci-immune small-vessel vasculitis characterized by neutrophil-mediated vasculitis and granulomatousis. Hypertrophic pachymeninges is the most frequent CNS presentation. Cerebrovascular events, hypophysitis, posterior reversible encephalopathy syndrome (PRES) or isolated mass lesions may occur as well. Spinal cord is rarely involved. In addition, ear, nose and throat (ENT), kidney and lung involvement often accompany or precede the CNS manifestations. Positive ANCA testing is highly suggestive of the diagnosis, with each ANCA serotype representing different groups of AAV patients. Pathological evidence is the gold standard but not necessary. Once diagnosed, prompt initiation of induction therapy, including steroid and other immunosuppressants, can greatly mitigate the disease progression.Conclusions and Relevance: Early recognition of AAV as the underlying cause for various CNS disorders is important for neurologists. Ancillary investigations especially the ANCA testing can provide useful information for diagnosis. Future studies are needed to better delineate the clinical spectrum of CNS involvement in AAV and the utility of ANCA serotype to classify those patients.Evidence Review: We searched Pubmed for relevant case reports, case series, original research and reviews in English published between Sep 1st, 2001 and Sep 1st, 2018. The following search terms were used alone or in various combinations: “ANCA,” “proteinase 3/PR3-ANCA,” “myeloperoxidase/MPO-ANCA,” “ANCA-associated vasculitis,” “Wegener's granulomatosis,” “microscopic polyangiitis,” “Central nervous system,” “brain” and “spinal cord”. All articles identified were full-text papers.

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ABSTRACT:The mechanical properties and crosslink density of peroxide-cured ethylene-propylene-diene rubber (EPDM) reinforced with zinc dimethacrylate (ZDMA) were studied. ZDMA was in situ prepared in EPDM matrix through the neutralization reaction of zinc oxide (ZnO) and methacrylate acid (MAA). The effect of ZnO/MAA amount and molar ratio of ZnO/MAA on the properties of the EPDM vulcanizate were investigated in detail. The experimental results showed that EPDM can be greatly reinforced by ZDMA. The excess amount of ZnO considerably increases the tensile strength of the EPDM vulcanizate to reach as high as 37 MPa, whereas its elongation at break keeps over 350%. The process of in situ formation of ZDMA in the EPDM compound was verified by WAXD. Such vulcanizate contains both covalent crosslinks and ionic crosslinks. Crosslink density was determined by an equilibrium swelling method. Dependence of crosslink density on the amount and molar ratio of ZnO/MAA was studied and the extraordinary high tensile strength of the EPDM/ZDMA vulcanizate was related to ionic crosslink density.

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ABSTRACT:The effects of a compatibilizer, namely, an acrylonitrile-butadiene-styrene copolymer (ABS) grafted with maleic anhydrade (MAH) (ABS-g-MAH), on the mechanical properties and morphology of an ABS/polycarbonate (PC) alloy were studied The results showed that a small quantity of ABS-g-MAH has a very good influence on the notched Izod impact strength of the ABS/PC alloy without compromising other properties such as the tensile strength, flexural strength, and Vicat softening temperature (VST). The impact strength of the ABS/PC alloy, to a great extent, depends on the loading of ABS-g-MAH and the degree of grafting (DG) of MAH in the ABS-g-MAH. DSC analysis and SEM observation confirmed that ABS-g-MAH could significantly improve the compatibility of the ABS/PC alloy.

Background Accumulating data have suggested seizures occur frequently in patients with neuronal surface antibody‐mediated autoimmune encephalitis. We aimed to evaluate seizure outcomes and potential factors associated with the development of epilepsy in patients with anti‐N‐methyl‐D‐aspartate receptor (NMDAR), anti‐leucine‐rich glioma‐inactivated 1 (LGI1), and anti‐gamma‐aminobutyric‐acid B receptor (GABABR) encephalitis. Methods Patients with anti‐NMDAR, anti‐LGI1, and anti‐GABABR encephalitis were prospectively recruited from 2014 to June 2019, with a median follow‐up period of 30.5 months (range 8–67 months). Seizure outcomes were assessed and risk factors of epilepsy were analyzed. Results A total of 119 patients with anti‐NMDAR, anti‐LGI1, and anti‐GABABR encephalitis were included, and 83 (69.7%) of them developed new‐onset seizures. By the end of follow‐up, 17 (21.3%) of 80 patients had seizure relapses after intermittent seizure remission or exhibited uncontrolled seizure episodes, contributing to epilepsy. Immunotherapy delay and interictal epileptic discharges (IEDs) were identified to be associated with the development of epilepsy in patients with anti‐NMDAR, anti‐LGI1, and anti‐GABABR encephalitis, particularly anti‐NMDAR encephalitis. Furthermore, multivariate logistic regression analysis demonstrated that immunotherapy delay was an independent predictor for epilepsy. Conclusion Our study suggested that immunotherapy delay and IEDs were associated with the development of epilepsy in patients with anti‐NMDAR, anti‐LGI1, and anti‐GABABR encephalitis. Early diagnosis and treatment were required, and particular consideration should be given to patients with these risk factors.

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