Pathogenicity of Phialophora pedrosoi

30 Kaninchen wurden mit Phialophora pedrosoi intravenös (durch eine randständige Ohrvene) infiziert. 15 der Tiere erhielten 2 Tage vor der Inokulation s. c. 100 mg Cortisonacetat und 4 weitere Injektionen alle 2 Tage. Die anderen Tiere erhielten kein Cortisonacetat. Inokuliert wurden 3 Stämme, pro Stamm 5 Kaninchen. 1 Stamm war frisch isoliert, die anderen wurden der Sammlung entnommen und bildeten weniger Konidien.
Keines der 30 Kaninchen starb während des Versuches, so daß planmäßige, in bestimmte Zeitabstände gestufte Autopsien mit mykologischen und histopathologischen Untersuchungen vorgenommen werden konnten.
Die Tiere wurden nach 1, 2, 3, 5 und 8 Wochen getötet. In der Cortisongruppe zeigten 9 Tiere Krankheitsherde, vor allem in der Lunge und Leber, in einem Falle auch in der Niere. Die Herde waren noch nach 2 Monaten aktiv. In der anderen Gruppe erkrankten nur 5 Tiere, und die Krankheitserscheinungen heilten innerhalb von 3 Wochen wieder ab.
Die mikroskopische Untersuchung von infiziertem Gewebe nach Aufhellung in 10 %iger Kalilauge ergab lange braune Fäden. Mit Hämatoxylin und Eosin gefärbte Schnitte zeigten eine nur geringe Gewebsreaktion um die Pilzelemente. In einzelnen Fällen fanden sich bei den nach 4–5 Wochen getöteten Tieren Granulome im Lungengewebe. In Riesenzellen waren runde bis ovale, gelblichbraune Pilzzellen nachzuweisen. Die von A ravysky und A ronson berichtete Hemmung der Riesenzellreaktion durch Cortison war bei den vorliegenden Untersuchungen nicht festzustellen.
Insgesamt wird das Ergebnis der Versuche als Beweis für die Pathogenitätssteigerung von Phialophora pedrosoi durch Cortison interpretiert.     

Mycotoxicosis-Like Reactions in Rats Treated with Micropolyspora faeni

Summary: Groups of rats previously sensitized by intramuscular administration of Micropolyspora faeni antigens, as well as control animals, were challenged intratracheally with live M. faeni. The animals were sacrificed at intervals and their lungs studied microbiologically and histopathologically. Previously sensitized animals developed precipitins to M. faeni and severe pulmonary lesions similar to those seen in myco toxicosis and hypersensitivity pneumonitis. Non-sensitized animals had no precipitins but developed pulmonary lesions of lesser severity.
Zusammenfassung: Bei einigen Gruppen von Ratten, die vorher intramuskulär mit Micropolyspora faeni - Antigenen sensibilisiert worden waren und nicht bei nicht sensibilisierten Kontrollgruppen wurde intratracheal eine Exposition mit lebenden M. faeni - Partikeln durchgeführt. Die Tiere wurden in verschiedenen Abständen getötet. Ihre Lungen wurden mikrobiologisch und histopathologisch untersucht. Vorher sensibilisierte Tiere entwickelten Präzipitine gegen M. faeni und ausgeprägte pulmonale Veränderungen wie sie auch bei Mycotoxicose oder bei Hypersensitivitätspneumonie gesehen werden. Nicht sensibilisierte Tiere entwickelten keine Präzipitinie, jedoch auch Lungenveränderungen, wenn auch von geringerer Ausprägung.     

Profile of gene expression in a murine model of allergic bronchopulmonary aspergillosis

Allergic bronchopulmonary aspergillosis (ABPA) results from the interactions of the Aspergillus allergens and immune system of the patients. We studied the gene expression profile in a mouse model of ABPA. Of the 12,000 genes studied, 1,300 genes showed enhanced expression and represent chemokine, cytokine, growth factor, signal transduction, and transmembrane receptor genes as well as genes related to arginine metabolism.     

High-dose humanized anti-IL-2 receptor alpha antibody (daclizumab) for the treatment of active, non-infectious uveitis

PURPOSE: This study was designed to provide preliminary data regarding the safety and efficacy of high-dose humanized anti-IL-2 receptor (daclizumab) therapy for the treatment of active intermediate, posterior or panuveitis. METHODS: Five patients were recruited into this non-randomized, prospective pilot study of high-dose intravenous induction daclizumab therapy given at doses of 8mg/kg at day 0 and 4mg/kg at day 14. Patients who did not meet a safety endpoint at the 3-week follow-up evaluation were given the option of continuing therapy with subcutaneous daclizumab at 2mg/kg every 4weeks for 52weeks. The primary outcome assessed was a two-step decrease in vitreous haze at day 21. Secondary outcomes evaluated included best-corrected visual acuity, retinal thickness as measured by optical coherence tomography, retinal vascular leakage assessed by fluorescein angiography, anterior chamber and vitreous cellular inflammation. RESULTS: Four male patients and one female patient were enrolled. Diagnoses included birdshot retinochoroidopathy (two patients), Vogt-Koyanagi-Harada's disease, bilateral idiopathic panuveitis and bilateral idiopathic intermediate uveitis. By the 4th week, four of five patients demonstrated a two-step decrease in vitreous haze. The other participant did not meet this criterion until week 20, but all five patients maintained stability in vitreous haze grade throughout their follow-up periods. At enrollment, mean visual acuity (10 eyes in 5 patients) was 69.2 ETDRS letters and following treatment was 78.2 letters (p<0.12). Anterior chamber cell, vitreous cell, and vitreous haze also improved in the majority of eyes. Adverse events were generally mild except for one episode of left-lower lobe pneumonia requiring hospitalization and treatment. CONCLUSION: This is the first demonstration that high-dose daclizumab can reduce inflammation in active uveitis. Daclizumab was well tolerated but there may be a potential increased risk of infection associated with immunosuppression. All five patients demonstrated a decrease in vitreous haze and measures of intraocular inflammation at final follow-up. The results of this small, non-randomized pilot study support the consideration of high-dose daclizumab therapy in cases of active posterior uveitis.     

Percutaneous Cryoablation of Solitary,Sporadic Renal Cell Carcinoma: Outcome Analysis Based on Clear-Cell versus Papillary Subtypes

Purpose

To evaluate treatment outcomes with percutaneous cryoablation (PCA) based on renal cell carcinoma (RCC) histology.

Allergy and "toxic mold syndrome".

BACKGROUND: "Toxic mold syndrome" is a controversial diagnosis associated with exposure to mold-contaminated environments. Molds are known to induce asthma and allergic rhinitis through IgE-mediated mechanisms, to cause hypersensitivity pneumonitis through other immune mechanisms, and to cause life-threatening primary and secondary infections in immunocompromised patients. Mold metabolites may be irritants and may be involved in "sick building syndrome." Patients with environmental mold exposure have presented with atypical constitutional and systemic symptoms, associating those symptoms with the contaminated environment. OBJECTIVE: To characterize the clinical features and possible etiology of symptoms in patients with chief complaints related to mold exposure. METHODS: Review of patients presenting to an allergy and asthma center with the chief complaint of toxic mold exposure. Symptoms were recorded, and physical examinations, skin prick/puncture tests, and intracutaneous tests were performed. RESULTS: A total of 65 individuals aged 1 1/2 to 52 years were studied. Symptoms included rhinitis (62%), cough (52%), headache (34%), respiratory symptoms (34%), central nervous system symptoms (25%), and fatigue (23%). Physical examination revealed pale nasal mucosa, pharyngeal "cobblestoning," and rhinorrhea. Fifty-three percent (33/62) of the patients had skin reactions to molds. CONCLUSIONS: Mold-exposed patients can present with a variety of IgE- and non-IgE-mediated symptoms. Mycotoxins, irritation by spores, or metabolites may be culprits in non-IgE presentations; environmental assays have not been perfected. Symptoms attributable to the toxic effects of molds and not attributable to IgE or other immune mechanisms need further evaluation as to pathogenesis. Allergic, rather than toxic, responses seemed to be the major cause of symptoms in the studied group.     

Help of third-year medical students decreases first-year medical students' negative psychological reactions on the first day of gross anatomy dissection

The assistance of third-year medical students (MS3) may be an easy, inexpensive, educational method to decrease physical and emotional stress among first-year medical students (MS1) on the first day of gross anatomy dissection. In the academic years 2000-2001 and 2001-2002, a questionnaire on the emotional and physical reactions on the first day of dissection was distributed to 84 MS1 at Mayo Medical School (Rochester, MN); 74 (88%) responded. Student perceptions were assessed on a 5-point Likert scale. The 42 second-year medical students (MS2) whose first academic year was 1999-2000 were used as a control group, because they had not had assistance from MS3. MS2 completed the same questionnaire (59% response rate). Data were collected from MS1 on the day of their first gross anatomy dissection. The most frequent reactions were headache, disgust, grief or sadness, and feeling light-headed. Significant differences (alpha < 0.05) were found with use of the chi(2) test to compare the emotional and physical reactions of MS1 and MS2. MS1 had significantly fewer physical reactions (64% vs. 88%), reporting lower levels of anxiety (23% vs. 48%), headache (14% vs. 36%), disgust (9% vs. 20%), feeling light-headed (11% vs. 24%), and reaction to the smell of the cadaver and laboratory (8% vs. 52%). MS1 commented that having MS3 at the dissection table was extremely helpful. They relied less on their peers and felt they learned more efficiently about the dissection techniques and anatomical structures. Using MS3 as assistants is one method to reduce fear and anxiety on the first day of gross anatomy dissection.     

Antigens of aspergillus fumigatus. 1. Purification of a cytoplasmic antigen reactive with sera of patients with aspergillus-related disease.

An antigen has been purified from the mycelial cell sap of Aspergillus fumigatus (strain 507). The same component appears to be present in the extracellular phase (culture filtrate) in a partially degraded form. The cell sap protein has a structure composed of four polypeptides of 45,000 daltons linked through disulphide bonds. The isoelectric point (5.2-5.6) and carbohydrate content (12.5% neutral hexose) indicate that this protein is an acidic glycoprotein. It shows reactions with 75% of sera from patients with aspergilloma and allergic bronchopulmonary aspergillosis and is not reactive with sera from normal individuals of patients with other fungal diseases. It also appears to be a component of other A. fumigatus strains.