Antibiotic-induced modification ofBacteroides fragilis and its susceptibility to phagocytosis by human polymorphonuclear leukocytes

Bacteroides fragilis grown in the presence of sub-inhibitory concentrations of clindamycin was shown to be altered its degree of encapsulation and susceptibility to phagocytosis by human polymorphonuclear leukocytes. Little polysaccharide capsule could be demonstrated either by light or transmission electron microscopy when the bacteria were grown anaerobically for four hours in the presence of 1/2 MIC of clindamycin. Such clindamycin-grown cells could be opsonized by normal human serum, and although less complement was consumed in the process, were more effectively taken up by the leukocytes than bacteria grown in the absence of the drug (45 % versus 24 %). It was also shown that drug treatment caused significant cellular leakage in the presence of serum, the³H-label appearing extracellularly. In addition there was greater loss of viability of the bacterial cells grown in the presence of the drug and subsequently exposed to the leukocytes for 60 min.     

Otorhinolaryngological manifestations in children with human immunodeficiency virus infection

The otorhinolaryngological manifestations (ENTM) in AIDS were first described in 1983. Continuing research confirmed that the ENTM reached up to 100% of the infected individuals. In the infant population, this percentage is also found, differing by presenting specific ENTM. The main objectives of this study were to define the most common ENTM in HIV children and to observe the difference, when compared to non-infected children. The HIV detection was also correlated with the appearance of the first ENTM. The observational, case-control research involved the study of 40 children over a period of 1 year. It was found that HIV children have a higher occurrence of ENTM, herpes simplex virus gingivostomatitis, cervical lymphadenopathy and parotid hypertrophy. On the other hand, the proportion of children who developed rhinosinusitis, acute otitis media (AOM) and oral candidiasis (OC) were not statistically different among the groups. However, 90% of the HIV children presented at least one ENTM, as opposed to 45% of the immunocompetent children. Differences in the occurrence of the ENTM were noticed, some more suggestive of the HIV infection. Furthermore, the majority of the infected children had their first ENTM diagnosed before the infection of HIV was established.     

Skeletal age determination of the hand: a comparison of methods

Until final completion of maturation processes at the age of approximately 18 years, determination of the skeletal age of the hand plays a central role in forensic age diagnostics in living persons in criminal proceedings. In this process, assessment of hand radiographs relies primarily on the stage of development of the epiphyseal nuclei, the increase in size of the individual bones and of the hand skeleton as a whole, changes in the shape of the various skeletal elements and ossification of the epiphyseal plates. To achieve this, there are a variety of methodological approaches based on two different fundamental principles. The methods proposed by Greulich and Pyle, Thiemann et al. and Gilsanz and Ratib rank among the so-called atlas techniques, whilst the methods proposed by Tanner et al. and Roche et al. are classified as so-called bone-specific techniques. In order to be applicable in the field of criminal procedure, the methods of estimating the skeletal age of the hand developed with clinical aspects in mind must satisfy the demands of a high degree of estimate accuracy and good reproducibility of the estimated results. In the course of the present study, a study population of 92 persons was used to compare the above-mentioned atlas and bone-specific techniques for determining hand skeleton age in view of these qualitative criteria. Estimate accuracy was studied using Pearson’s correlation coefficients, and weighted kappa coefficients were determined for studying the intra-and interobserver agreement of an estimate result. In the inter-method comparison, a basically good agreement was shown between the skeletal ages and the chronological age of the test persons on the one hand and the skeletal age diagnoses of one or of two examiners on the other. No general advantage of the methodological approach of the bone-specific technique was discernible in the course of comparison; in the female gender, particularly, the RUS2 and RUS3 score of the method of Tanner et al. proved unfavourable. For age estimation practice in criminal proceedings, the atlas methods of Greulich and Pyle and Thiemann et al. are particularly recommendable.     

Forensic age assessment of living adolescents and young adults at the Institute of Legal Medicine,Münster,from 2009 to 2018

International Journal of Legal Medicine - Due to high migration inflows to Europe, forensic age assessment of living persons has clearly gained importance. If there is a legal justification for...     

The use of cervical vertebrae plates for cortical substitution in posterior wall acetabular fractures

We report a new technique for operative fixation of posterior wall acetabular fractures that require cortical substitution. This technique uses cervical vertebrae plates that are H-shaped as an alternative to the combination of standard locking or nonlocking pelvic reconstruction plates and cortical substitution plates, ie, spring plates. We believe this technique provides a more robust structural support with the plate acting as a cortical substitute in comminuted fracture patterns. Compared with pelvic reconstruction plates, cervical vertebrae plates are almost twice as wide. Additionally, the plate configuration allows more screws per unit length compared with pelvic reconstruction plates, potentially providing more points of fixation. Finally, cost comparison of the two plates shows the cervical vertebrae plates to be less expensive than standard pelvic reconstruction plates. Our series of 23 consecutive patients shows outcomes similar to the published literature for standard pelvic reconstruction plates, and initial results show no early hardware failure.     

Immunohistochemical expression of fibronectin and C5b-9 in the myocardium in cases of fatal ethanol intoxication

Data from the literature indicate that the pulmonary pressure rises in cases of ethanol intake. We have recently proposed a method for the detection of prevalent right ventricular damage in cases of fatal pulmonary thromboembolism and pulmonary fat embolism. In the present study, we compared the expression of the antibodies against fibronectin and C5b-9 in 19 cases of lethal alcohol intoxications (study group: 5 females, 14 males, mean age 46 years, mean blood ethanol concentration 3.5‰, min. 2.11‰, max. 5.31‰) to a group of 26 cases of fatal pulmonary thromboembolism (PE; group 2: 16 females, 10 males, mean age 56 years). Moreover, a group of 15 cases of hanging (group 3: 5 females, 10 males, mean age 50 years) as well as a group of 18 cases of myocardial infarction (group 4: 5 females, 13 males, mean age 61 years) were investigated as examples of typical cardiac damage due to global hypoxia during agony and ischemic damage, respectively. The results of this study show that fresh cardiac damage can be detected at both ventricles in cases of fatal ethanol intoxication with the antibody against fibronectin. The damage is prevalently localised at the right ventricle (RV), as already observed in cases of acute pulmonary hypertension determining right heart failure. The degree of damage at the RV in cases of ethanol intoxications is lower than the one observed in cases of fatal PE.     

Management of ileostomy trauma produced by a dog bite in a patient with thoracic paraplegia

Urologic trauma produced by dog bites is uncommon. Several previous single reports and small case series have described the treatment of dog bite-induced injuries to the external genitalia. In this report, we describe our treatment of a patient with thoracic paraplegia and an ileal conduit who had extensive trauma to his ileostomy as a result of a bite by the family dog. To our knowledge, the current case is the first report of dog bite-induced ileostomy trauma.