Parathyroid adenomas evaluated by Tl-201/Tc-99m pertechnetate subtraction scintigraphy and high-resolution ultrasonography

Thallium-201/technetium-99m pertechnetate subtraction scintigraphy of the parathyroid glands was performed in a prospective study of 33 patients who had undergone bilateral neck exploration for elevated serum calcium and serum parathyroid hormone levels. In 31 cases, the Tl-201/Tc-99m subtraction technique yielded an overall sensitivity of 81%, specificity of 99%, and accuracy of 94% for identifying solitary parathyroid adenomas. Tl-201/Tc-99m subtraction scintigraphy correctly identified 73% of parathyroid adenomas weighing less than 499 mg, 79% of those weighing 500-1,499 mg, and 100% of adenomas weighing more than 1,500 mg. In a subgroup of 24 patients with solitary parathyroid adenomas who underwent both scintigraphy and high-resolution sonography, the sensitivity, specificity, and accuracy of both procedures were similar.     

Dendritic cells activate autologous T cells and induce IL-4 and IL-10 production in myasthenia gravis

Dendritic cells (DC), as initiators and orchestrators of immune responses, control both naive and primed T cell responses. Depending on their maturation stage, DC promote immunity or tolerance. Here we investigated (1) the phenotype and cytokine secretion patterns of IL-10-modulated immature DC (IL-10-DC) and lipopolysaccharide (LPS)-driven mature DC (LPS-DC) in comparison with unmodulated immature DC (imDC) and (2) the effects of IL-10-DC, and of LPS-DC, vs. imDC on autologous T cell responses in patients with myasthenia gravis (MG) compared with healthy controls (HC). All three types of DC derived from MG significantly increased the levels of CD4+CD25+ T cells and of their subfraction expressing CD69, when compared to DC derived from HC. IL-10-DC induced production of IL-10 and IL-4 by T cells from MG patients, but only IL-10 production from HC. LPS-DC activated autologous T cells as reflected by augmented CD25, CD69 and CTLA-4 expression on CD4+ T cells, without differences between MG and HC. This was associated with increased production of both Th1 (IFN-gamma) and Th2 (IL-10 and IL-4) cytokines by T cells. These results indicate that DC-induced activation of autologous T cells is more pronounced in MG than in HC. In addition, DC-induced T cell responses in MG vs. HC are more Th2-prone.     

Non-steroidal anti inflammatory agents decrease bacterial colonisation of contact lenses and prevent adhesion to human corneal epithelial cells

PURPOSE: To investigate non-steroidal anti-inflammatory agents (NSAIDs), salicylic acid, sodium diclofenac and ketorolac for inhibition of bacterial colonization of contact lenses (CL) and human corneal epithelial cells (HCE). METHODS: CLs pre-colonised with Pseudomonas aeruginosa, Haemophilus influenzae, Staphylococcus epidermidis and Streptococcus pneumoniae were exposed overnight to NSAIDs and the number of viable bacteria on the CLs were calculated. Cytotoxicity of NSAIDs to HCE cells was evaluated with the MTT assay. Viable counts were used to measure the adhesion of P. aeruginosa and S. epidermidis to HCE cells in the presence of the least cytotoxic NSAID. RESULTS: All NSAIDs significantly decreased bacterial colonization of CLs in a dose-dependent manner. Salicylic acid (100 mM) completely inhibited colonisation of all species tested and was the least cytotoxic. Salicylic acid also prevented adhesion of P. aeruginosa and S. epidermidis to HCE (60% and 58% inhibition at 60 mM at 2 hours). CONCLUSIONS: Salicylic acid demonstrated potential as a compound for incorporation into anti-bacterial strategies to prevent bacterial contamination of contact lenses. This study highlighted the potential for NSAIDs as anti-bacterial agents and indicates that this class of compound should be investigated for other suitable candidates.     

Fimbrolide-coated antimicrobial lenses: their in vitro and in vivo effects

PURPOSE: To examine the ability of contact lenses coated with fimbrolides, inhibitors of bacterial quorum sensing, to prevent microbial adhesion and their safety during short-term clinical assessment. METHODS: A fimbrolide was covalently attached to commercially available high Dk contact lenses. Subsequently Pseudomonas aeruginosa, Staphylococcus aureus, Serratia marcescens, or Acanthamoeba sp. were added to the lenses and control uncoated contact lenses. Lenses plus microbes were incubated for 24 h, then washed thoroughly to remove non-adherent microbes. Lenses were macerated and resulting slurry plated onto agar plates. After appropriate incubation, the numbers of colony forming units of bacteria (or numbers of Acanthamoeba trophozoites measured using a hemocytometer) from fimbrolide-coated and uncoated lenses were examined. A Guinea Pig model of lens wear was used to assess the safety of lenses worn on a continuous basis for 1 month. In a separate study, 10 subjects wore fimbrolide-coated lenses for 24 h. The responses of the Guinea Pigs and human volunteers to the lenses were assessed by slit lamp examination. RESULTS: The fimbrolides-coated lenses reduced the adhesion of all bacterial strains tested, with reductions occurring of between 67 and 92%. For Acanthamoeba a reduction of 70% was seen. There were no significant differences in ocular responses to fimbrolide-coated lenses compared with controls in either the 1 month animal model or overnight human trial. CONCLUSIONS: Fimbrolide-coated lenses show promise as an antibacterial and anti-acanthamoebal coating on contact lenses and appear to be safe when worn on the eye in an animal model.     

Candida species and yeasts in mouths of infants from a special care unit of a maternity hospital

A group of 99 babies born in hospital and subsequently transferred to the special care unit were examined for the presence of candidas orally. The rate of isolation rose from 6% neonatally to 53% on day 14 of life. Among infants who did not harbour the organisms when discharged from hospital, colonization rapidly took place so that 79% did so at 4 weeks of age, after which the rate fell to 50% at one year of age. The low incidence of clinical candidosis suggests that in these babies as in other groups C. albicans is normally a harmless commensal.     

Dermatomyositis in childhood. Review of eight cases

Eight cases of dermatomyositis in children admitted to Scottish hospitals between 1962 and 1972 have been reviewed. 6 of the 8 were currently in complete remission. In the other 2 cases the disease remained active in 1 and 1 had died of cardiac failure 6 years after the onset of disease. 5 had developed extensive soft tissue calcification for which 2 were treated with ethanehydroxydiphosphonate, one showing definite improvement and the other no change. All had been treated with corticosteroids and two in addition had had cytotoxic agents (methotrexate or cyclophosphamide). The overal prognosis had probably been improved by the use of corticosteroids but not by the cytotoxic drugs. Only one of the patients was incapacitated by residual contractures or calcinosis.