Lemierre syndrome associated with 12th cranial nerve palsy—A case report and review

Since the widespread availability and use of antibiotics the prevalence of Lemierre syndrome (L.S.) has decreased. It is a well-described entity, consisting of postanginal septicaemia with thrombophlebitis of the internal jugular vein with metastatic infection, most commonly in the lungs. The most common causative agent is a gram-negative, non-spore-forming obligate anaerobic bacterium, Fusobacterium necrophorum (F.n.). We describe the unusual clinical features of a 12-year-old boy with Lemierre syndrome with isolated hypoglossal nerve palsy – the latter symptom is an extremely rare manifestation of this disease.     

Use of Genetic Testing for Primary Immunodeficiency Patients

Genetic testing plays a critical role in diagnosis for many primary immunodeficiency diseases. The goals of this report are to outline some of the challenges that clinical immunologists face routinely in the use of genetic testing for patient care. In addition, we provide a review of the types of genetic testing used in the diagnosis of PID, including their strengths and limitations. We describe the strengths and limitations of different genetic testing approaches for specific clinical contexts that raise concern for specific PID disorders in light of the challenges reported by the clinical immunologist members of the CIS in a recent membership survey. Finally, we delineate the CIS’s recommendations for the use of genetic testing in light of these issues.     

Expression of basic fibroblast growth factor in desmoplastic melanoma

Basic fibroblast growth factor (bFGF) is an established growth factor for melanocytes and a potent angiogenic factor. The expression of bFGF was investigated in 23 desmoplastic melanomas. (DM) (12 males, median age 64 years, and 11 females, median age 54 years) by immunostaining of formalin-fixed, paraffin-embedded sections with high-affinity purified antibody raised against recombinant human bFGF (Scios Nova, Inc.). The tumors were characterized by level II invasion in 1 case (5%), level IV invasion in 11 cases (48%), level V invasion in 8 cases (35%), and indeterminate in 3 cases. bFGF expression was observed in 22 of 23 tumors (95%), either immune localized to tumor cell nuclei in 17 of 22 tumors (77%), or to the cytoplasm of tumor cells in 5 of 22 tumors (23%). Also in these cases, bFGF was strongly expressed in the nuclei of vascular endothelial cells. Maximal expression was noted in the peripheral blood vessels of 20 tumors (91%) versus intratumoral vessels of 13 DM (59%). In conclusion, the expression of predominantly nuclear bFGF by tumor cells in DM suggests a role in mediating the desmoplastic phenotype. In addition, the localization of bFGF to vascular cndothelium, particularly at the periphery of the tumor, may be relevant to tumor angiogenesis.     

Tungsten (W) bioavailability in paddy rice soils and its accumulation in rice (Oryza sativa)

The aim of this study was to investigate the accumulation characteristics of tungsten (W) by different indica rice cultivars from the soil and to assess the potential risks to human health via dietary intake of W in rice consumption. A total of 153 rice (ear) samples of 15 cultivars and the corresponding surface soil samples were collected from 7 cities in Fujian Province of southeastern China. The available soil W were extracted using H₂C₂O₄·2H₂O-(NH₄)₂C₂O₄·H₂O at pH 3.3). Results showed that the total soil W ranged from 2.03 mg kg^?1 to 15.34 mg kg^?1 and available soil W ranged from 0.03 mg kg^?1 to 1.61 mg kg^?1. The W concentration in brown rice varied from 7 μg kg^?1 to 283 μg kg^?1 and was significantly correlated with the available soil W. The highest mean TF_avail (transfer factor based on available soil W) was 0.91 for Te-you 627 (hybrid, indica rice), whereas the lowest was 0.08 for Yi-you 673 (hybrid, indica rice). The TF_avail decreased with the increase in available soil W, clay content, and cation exchange capacity. The consumption of the brown rice produced from the investigated areas in some cultivars by the present study may cause risks to human health.     

An urgent necessity under general anaesthesia--surgical gloves made into re-breathing bag

Anaesthetic practice in resource-poor countries often requires a lot of improvisation on the part of practitioners in order to meet the needs of patients. Disposables in a low-resource environment are usually stretched beyond the manufacturer's recommended life span. While anaesthetizing a six-month-old baby with cleft lip, the reservoir bag was accidentally torn and was replaced with latex surgical gloves. In the absence of a spare bag this replacement served the patient throughout the period of surgery.     

Rosuvastatin reduces neointima formation in a rat model of balloon injury

Background

Processes of restenosis, following arterial injury, are complex involving different cell types producing various cytokines and enzymes. Among those enzymes, smooth muscle cell-derived matrix metalloproteinases (MMPs) are thought to take part in cell migration, degrading of extracellular matrix, and neointima formation. MMP-9, also known as gelatinase B, is expressed immediately after vascular injury and its expression and activity can be inhibited by statins. Using an established in vivo model of vascular injury, we investigated the effect of the HMG-CoA reductase inhibitor rosuvastatin on MMP-9 expression and neointima formation.

Materials and methods

14-week old male Sprague Dawley rats underwent balloon injury of the common carotid artery. Half of the animals received rosuvastatin (20 mg/kg body weight/day) via oral gavage, beginning 3 days prior to injury. Gelatinase activity and neointima formation were analyzed 3 days and 14 days after balloon injury, respectively. 14 days after vascular injury, proliferative activity was assessed by staining for Ki67.

Results

After 14 days, animals in the rosuvastatin group showed a decrease in total neointima formation (0.194 ± 0.01 mm² versus 0.124 ± 0.02 mm², p < 0.05) as well as a reduced intima/media ratio (1.26 ± 0.1 versus 0.75 ± 0.09, p < 0.05). Balloon injury resulted in increased activity of MMP-9 3 days after intervention for both rosuvastatin treated animals and controls with no significant difference observed between the groups. There was a trend towards a reduction in the number of Ki67-positive cells 14 days after injury.

Conclusions

Rosuvastatin attenuates neointima formation without affecting early MMP-9 activity in a rat model of vascular injury.