A fatal case of necrotizing sinusitis due to toxigenic Corynebacterium ulcerans

A 77-year-old farmer developed cough with sputum production, fever, bloody nasal discharge and a mass in his right maxillary sinus leading to necrotic ulceration of the sinus. Corynebacterium ulcerans, carrying the beta-phage for the diphtheria toxin and secreting the toxin, was detected microscopically and by culture from the sinusoidal and ulcer discharge. Despite immediate antimicrobial chemotherapy the patient died of pulmonary failure associated with the production of large amounts of very viscous sputum. Identification of the causative agent, pathophysiological aspects and risk factors of this unusal infection are discussed.     

急性上颌窦炎实验动物模型的建立

目的:拟建立急性上颌窦炎的实验动物模型,并探讨窦口的阻塞和致病菌的毒力在急性上颌窦炎的发病机制中的地位。方法:第一天,阻塞单侧窦口,对侧做假手术。次日,注入0.5ml108CFU/ml肺炎链球菌悬浮液。第五天处死动物、观察、分离培养细胞、取材和制作切片。结果:阻塞上颌窦口和注入肺炎链球菌的联合组,鼻部症状明显;进食量减少;鼻窦粘膜水肿、微红,具有较多脓性分泌物,微血管扩张,白细胞浸润;肺炎链球菌的重新分离培养率为100％（与其余组比较具有显著意义P<0.01）。而仅阻塞上颌窦口或仅注入肺炎链球菌或假手术均无明显临床症状及组织病理学改变,细胞培养率也低。结论:窦口的阻塞和致病菌的毒力是上颌窦炎发生发展的重要的条件,其中,窦口的阻塞起着关键性作用;联合阻塞窦口并注入有荚膜的肺炎链球菌能较理想地建立急性上颌窦炎实验动物模型。     

Immunomagnetic enrichment and detection of isolated tumor cells in bone marrow of patients with epithelial malignancies

The detection of isolated tumor cells (ITC) in the bone marrow of patients with epithelial malignancies is an independant prognostic factor for several entities as breast cancer, colorectal cancer or non-small lung cancer. However, with conventional immunocytology using Ficoll density gradient and APAAP staining, only a small proportion of the bone marrow samples can be scanned for cytokeratin-positive (CK+) cells. To improve detection rates, we evaluated the enrichment of ITC by magnetic activated cell sorting (MACS) compared to regularly stained cytospins. Recovery experiments with a CK+ breast cancer cell line (SKBR3) were performed to calculate the MACS enrichment rate. Bone marrow was obtained by aspiration from 20 patients with carcinomas of epithelial origin and from 17 controls. ITC were enriched and stained with magnetically labeled CAM 5.2 antibodies directed to cytokeratin 7 and 8. MACS of SKBR3 seeded in peripheral blood revealed average recovery rates of 62% and 48% and average enrichment factors of 104-fold and 8139-fold of the CK+ cells after one and after two separations, respectively. After immunomagnetic enrichment, CK+ cells were detected in 16 of 20 (80%) cancer patients, whereas only 7 (35%) patients showed CK+ cells without magnetic enrichment (P=0.002). Ten of twelve (83%) patients with metastatic disease (stage M₁) and six of eight (75%) patients without any overt metastases (M₀) had CK+ cells in their bone marrow. None of the negative controls showed any CK+ cells. Enrichment with magnetically labeled anti cytokeratin antibodies increases the detection rate of epithelial cells in bone marrow of cancer patients compared to immunocytology. This revised version was published online in July 2006 with corrections to the Cover Date.     

Low resting potentials in single isolated heart cells due to membrane damage by the recording microelectrode

Single myocytes from adult rat hearts were prepared following the method of Powell and co-workers (9, 10, 11). Low resting potentials (E_m) could be improved by three techniques. (i) Elevation of Ca_o to 7.2 mM which, however, mostly resulted in spontaneity and irreversible contracture. (ii) Pre-incubation in a KB medium (6). (iii) Use of suction pipettes instead of tapered microelectrodes for intracellular recordings (2). It is concluded that low E_m measured previously (11) were due to membrane damage upon microelectrode impalement accopanied by insfufficient healing of the membrane around the electrode insertion.     

Adjunct effect of loratadine in the treatment of acute sinusitis in patients with allergic rhinitis

H₁-blockers are often added to the standard treatment of acute sinusitis, but this is not supported by a controlled study. A multicentric, randomized, double-blind, placebo-controlled, parallel-group study was done in 139 allergic patients (15–65 years) to assess the adjunct efficacy of loratadine in acute exacerbation of rhinosinusitis. Sinusitis was diagnosed by symptoms and confirmed by rhinoscopy and sinus radiograph. Allergy was characterized by skin tests, RAST, and history. Patients were treated with antibiotics (14 days), oral corticosteroids (10 days), and loratadine (10 mg OD) or placebo (28 days). Treatment efficacy was assessed over 28 days by symptom scores quoted daily by patients. Physicians also rated total symptom scores at entry and at day 28. At entry, both groups had similar symptoms. Placebo-treated patients improved significantly, but patients who received loratadine had a significantly greater improvement in sneezing ( P =0.003) after 14 days, and in nasal obstruction ( P =0.002) after 28 days. Physicians found that patients receiving loratadine were significantly improved compared to placebo patients ( P =0. 0125). Loratadine in addition to standard therapy was found to improve the control of some symptoms of sinusitis.     

巨大垂体瘤的经鼻蝶窦进路显微切除术

目的：总结经蝶窦进路显微手术治疗巨大垂体瘤的经验。方法：经蝶窦进路显微手术治疗直径在30mm以上的巨大垂体瘤58例。结果：58例中,镜下全切除者52例、大部分切除者6例,经手术治疗后症状均有不同程度的改善。1例于术后1个月死于垂体危象。余57例患者术后随访2～5a,复发5例均经再次手术治愈。结论：巨大垂体腺瘤的手术治疗仍以经蝶窦进路为首选。     

Transport of urea and amino acids through the isolated human placenta

By means of a method of two-way perfusion of the isolated human placenta the transport of urea from the fetal to the maternal placental circulation and the transport of amino acids in the opposite direction were studied. Experiments showed that the method provides for sufficiently complete perfusion of the intervillous space and creates suitable conditions for the study of placental transport. If the amino nitrogen concentrations in the two circulatory systems are equal, its concentration in the fetal circulation rises in the course of the experiment. On the addition of an amino acid to the maternal circulation, this increase develops to a greater degree. The results of these experiments confirm the view that amino acids are secreted by trophoblast cells into the fetal circulation.Laboratory of Biochemistry, Institute of Obstetrics and Gynecology, Academy of Medical Sciences of the USSR, Leningrad. (Presented by Academician of the Academy of Medical Sciences of the USSR M. A. Petrov-Maslakov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 81, No. 4, pp. 394–397, April, 1976     

Relationship between ischaemic time and ischaemia/reperfusion injury in isolated Langendorff‐perfused mouse hearts

Myocardial functional recovery and creatine kinase (CK) release following various periods of ischaemia were investigated in isolated mouse hearts. The hearts were perfused in the Langendorff mode with pyruvate‐containing Krebs–Hensleit (KH) buffer under a constant perfusion pressure of 80 mmHg, and were subjected to either continuous perfusion or to 5, 15, 20, 25, 30, 45 or 60 min of global ischaemia followed by 45 min of reperfusion. In hearts subjected to ischaemic periods of 5, 15 or 20 min, there was a transient reduction in the left ventricular (LV) dP/dt max during the early phase of reperfusion, while the recovery at the end of reperfusion reached a level similar to that in hearts subjected to continuous perfusion. In hearts subjected to longer ischaemic periods, i.e. 25, 30, 45 or 60 min, the decrease in the cardiac performance was more pronounced and persistent, with significantly lower recovery in LV dP/dt max and higher LV end diastolic pressure (LVEDP) at the end of reperfusion than in the non‐ischaemic hearts. There were no significant differences in the recoveries in coronary flow or in heart rate (HR) between groups. Similarly to the functional recovery, the release of CK showed a clear ischaemic length‐related increase. In conclusion, the Langendorff‐perfused isolated mouse heart could be a valuable model for studies of myocardial ischaemia/reperfusion injury. Future studies using gene‐targeted mice would add valuable knowledge to the understanding of myocardial ischaemia/reperfusion injury.