Survey for the presence and distribution of human herpesvirus 8 in healthy brain

Brain tissues from both sides of the cerebellum and frontal, temporal, parietal, and occipital lobes were collected postmortem from 30 patients for human herpesvirus 8 (HHV-8) detection by PCR. Overall, 42 of 300 (14.0%) samples were positive, with similar rates for each position. Nineteen patients (63.3%) were positive and showed a significant increase in positivity with age (P = 0.007). The results indicate a neuroinvasive and neuropersistent potential of HHV-8.     

Methotrexate infusion in low-risk gestational trophoblastic disease

OBJECTIVES: The current study attempts to evaluate the effectiveness of methotrexate infusion therapy in the management of low-risk gestational trophoblastic disease and to find out whether an increase in the dose intensity can effect a faster remission and a shorter treatment duration. STUDY DESIGN: This is a prospective study. Between June 1990 and August 1998, 59 patients with low-risk trophoblastic disease were treated with methotrexate at a dose of 100 mg/m(2) as an intravenous bolus over 30 minutes followed by a 12-hour infusion of methotrexate at a dose of 200 mg/m(2). Folinic acid was not given unless the serum methotrexate reached a toxic level 24 hours after infusion (toxic level, 10 micromol/L). Actinomycin D was added in patients with a partial response. The follow-up period of these patients ranged from 12 to 113 months, with a median of 58.5 months and a mean of 55.7 months. RESULTS: Fifty-four patients attained a complete biochemical remission. Twenty-eight patients went into biochemical remission after one methotrexate infusion. Five patients showed a partial biochemical response. A relapse developed in 2 of the 54 complete responders at 3 months and 18 months after the initial therapy. Both patients received combination therapy consisting of methotrexate, etoposide, and bleomycin. They went into biochemical remission and have remained disease-free at the time of analysis. All of the 59 patients were in biochemical remission at the time of analysis. No significant side effects were observed except that Stevens-Johnson syndrome developed in 1 patient. CONCLUSIONS: Methotrexate infusion therapy described in this study is effective in the treatment of low-risk gestational trophoblastic disease. The omission of consolidation therapy and folinic acid rescue decreases the cost and duration of treatment.     

Buffy coat PCR for diagnosis of experimental pneumococcal pneumonia

An immunocompetent murine model of pneumococcal pneumonia and bacteremia was used to evaluate a PCR assay based on amplification of the pneumolysin gene. Mice were treated with trovafloxacin to determine the decline in sensitivity of PCR as lung bacterial concentrations decreased and blood cultures became sterile. Forty-three mice were studied for up to 120 h after start of antibiotic treatment. PCR of buffy coat specimens was more sensitive than PCR of plasma. Only 21% of animals had a positive blood culture, whereas 77% of PCR buffy coat assays were positive. After 48 h of therapy all blood culture specimens were sterile, whereas buffy coat PCR was positive in 57.8% of specimens. PCR of buffy coat specimens was negative in all mice colonized nasally with Streptococcus pneumoniae and in rabbits with Escherichia coli bacteremia. Our results demonstrate that our PCR technique using buffy coat specimens is highly specific for invasive pneumococcal disease and remains positive in the majority of animals for at least 48 h after start of antibiotic therapy.     

Pathogenesis of Histoplasma capsulatum

Histoplasma capsulatum is well adapted to be infectious and pathogenic for humans. As a soil fungus with no known requirement for interacting with a mammalian host as part of an obligate lifecycle, its plethora of strategies for successful pathogenesis is particularly remarkable. These features include the dimorphic mold-yeast transition, entry into host macrophages, subcellular localization, intracellular survival and proliferation during active infection, and persistence during clinically inapparent infection with the capacity for reactivation. To thrive within the harsh environment of a professionally phagocytic and antimicrobial host cell, H. capsulatum displays mechanisms for modulating its microenvironmental pH level, resisting host reactive oxygen and nitrogen intermediates and degradative enzymes, and withstanding nutrient starvation conditions, including acquisition of iron and calcium and biosynthesis of nucleic acid precursors. Attention has been focused on identifying virulence-associated phenotypic traits and genes that are differentially expressed under relevant conditions, such as yeast morphotype-specific genes and genes that are up-regulated during infection. These studies, together with the increasing ability to perform molecular genetic manipulations in this fungus, may yield novel antifungal drug or vaccine targets as well as elucidating pathogenic mechanisms.     

Repeated intestinal perforation caused by an incomplete form of Behçet's syndrome

Abstract Behçet's disease, as initially described, is a triad of recurrent oral and genital ulcers and relapsing uveitis. The incomplete form, in which there is no ocular involvement, has been described in Japan and Korea, but this is not commonly recognized in the southern Chinese. We reported herein a rare case of repeated intestinal perforations caused by an incomplete form of Behçet's syndrome in a southern Chinese man.     

Lace-like enhancement pattern of osteosarcoma of rib and liver metastasis in CT scans

The rib is an uncommon site of osteosarcoma. With the use of adjuvant chemotherapy and aggressive surgical resection of the metastatic pulmonary lesions, extrapulmonary metastases are becoming more clinically evident. Primary rib osteosarcoma with extrapulmonary metastasis is exceedingly rare. A case is reported, showing that the pattern of metastasis of rib osteosarcoma is similar to that of primary bone osteosarcoma. The liver metastasis occurred after resection of the metastatic pulmonary lesions. A CT scan of the primary rib lesion and liver metastasis both showed a lace-like enhancement pattern, its histological appearance corresponding with neoplastic osteoid. With the increasing use of CT abdomen for localization of extrapulmonary metastases, lace-like enhancement may be seen more readily in the future.     

Haemangiopericytoma of the trigeminal nerve

A 41-year-old man presented with a 4-year history of progressive right-sided diplopia on lateral gaze and right nasolabial paraesthesia. A CT revealed minor bone erosion of Meckel's cave and of the right petrous apex by a uniformly enhancing lesion at the base of the skull. Magnetic resonance imaging on three occasions over 2 years showed tumour, measuring 4 cm in diameter, with features suggestive of a trigeminal neuroma. At surgery the lesion had the macroscopic appearance of a giant schwannoma. Histopathological findings were that of a meningeal haemangiopericytoma (HPC) of the trigeminal nerve. Intracranial HPC are rare and aggressive tumours of the central nervous system. They usually arise from the falx, tentorium and dural sinuses. The present case is unique as it originates from a cranial nerve.     

Ultrastructure of the Endolimax nana cyst

This is the first report on the ultrastructure of the Endolimax nana cyst. These cysts are mostly ovoid in shape and have a distinct cyst wall measuring 80 nm. The nuclear membrane is without pores or associated chromatin deposits. The cytoplasm does not have mitochondria or a Golgi apparatus but shows elongated tubular structures made up of a double row of ribosome-like particles. The nature and function of this structure is not known, but it appears to be characteristic of this species and has not been reported from any other intestinal ameba. Received: 24 June 1999 / Accepted: 8 September 1999     

Preliminary investigation of follistatin gene mutations in women with polycystic ovary syndrome

Strong evidence for a link between the follistatin gene and polycystic ovary syndrome (PCOS) has recently been found in a well-designed large-scale study. Follistatin binds to activin and affects its functions, e.g. stimulation of FSH synthesis and secretion. Thus, it may play a role in the functional impairment of the FSH-granulosa cell axis in PCOS. In this study, we screened 64 Chinese patients with PCOS for mutations in the entire coding region (including the region encoding alternative carboxy-terminals) of the follistatin gene using polymerase chain reaction (PCR)-based single-stranded conformational polymorphism (SSCP) and DNA sequencing. However, we could not identify a single mutation of either the activating or inhibiting type, using these techniques. Therefore, it would appear that PCOS in the local Chinese population is not caused by mutations in the coding regions of the follistatin gene.     

Evidence for progesterone synthesis by human umbilical cord blood erythrocytes

In order to determine whether human umbilical cord blood erythrocytes are capable of progesterone biosynthesis, sonicated preparations of plasma-free erythrocytes at the range of total cell numbers between 18.4 x 10(9) and 62.9 x 10(9) cells obtained from umbilical cord arterial and venous blood collected from normal pregnant women (n = 6, age 28-39 years) following spontaneous vaginal delivery were incubated with [7n-(3)H]-pregnenolone as substrate. The leucocyte content of the incubates was negligible (<0. 005%). Controls (n = 4, age 29-36 years; 27.6 x 10(9) to 42.7 x 10(9) erythrocytes) obtained from cord blood of normal pregnant women were heat-denatured preparations of cells. Using the reverse-isotope dilution technique, [(3)H]-progesterone was isolated and characterized yielding an overall enzymic conversion which ranged between 0.27 and 0.46%. The results indicate for the first time that cord blood erythrocytes possess the 3beta-hydroxysteroid dehydrogenase-5,4-en isomerase activity and are a source of progesterone in human pregnancy.