A comparison of histological and immunohistochemical methods for quantifying the pathological lesions of Pick's disease

Counts of Pick bodies (PB), Pick cells (PC), senile plaques (SP) and neurofibrillary tangles (NFT) were made in the frontal and temporal cortex from patients with Pick's disease (PD). Lesions were stained histologically with hematoxylin and eosin (HE) and the Bielschowsky silver impregnation method and labeled immunohistochemically with antibodies raised to ubiquitin and tau. The greatest numbers of PB were revealed by immunohistochemistry. Counts of PB revealed by ubiquitin and tau were highly positively correlated which suggested that the two antibodies recognized virtually identical populations of PB. The greatest numbers of PC were revealed by HE followed by the anti-ubiquitin antibody. However, the correlation between counts was poor, suggesting that HE and ubiquitin revealed different populations of PC. The greatest numbers of SP and NFT were revealed by the Bielschowsky method indicating the presence of Alzheimer-type lesions not revealed by the immunohistochemistry. In addition, more NFT were revealed by the anti-ubiquitin compared with the anti-tau antibody. The data suggested that in PD: (i) the anti-ubiquitin and anti-tau antibodies were equally effective at labeling PB; (ii) both HE and anti-ubiquitin should be used to quantitate PC; and (iii) the Bielschowsky method should be used to quantitate SP and NFT.     

Quantitative liver function in patients with rheumatoid arthritis treated with low-dose methotrexate: a longitudinal study

The objectives were to determine quantitative liver function prospectively in patients with rheumatoid arthritis (RA) treated with low-dose methotrexate (MTX), to search for risk factors for a loss of quantitative liver function and to assess the relationship between quantitative liver function and histological staging. A total of 117 patients with RA (ACR criteria, 85 women, mean age 59 yr) had measurements of galactose elimination capacity (GEC), aminopyrine breath test (ABT) and liver enzymes [aspartate amino transferase (AST), alanine amino transferase (ALT), alkaline phosphatase (AP), 7-glutamyl transferase (GGT), bile acids, bilirubin, albumin] before treatment with weekly i.m. MTX injections and every year thereafter. In 16 patients, liver biopsies were performed. Before the introduction of MTX, mean GEC was 6.6 mg/min/kg [5th to 95th percentile (5-95 PC) 5.1- 8.5; reference range 6.0-9.1] and mean ABT was 0.80% kg/mmol (5-95 PC 0.42-1.30: reference range 0.6-1.0). During treatment with MTX [mean weekly dose 11.8 mg (5-95 PC 5.4-20.2), mean observation period 3.8 yr (5-95 PC 0.4-6.9)], significant declines of GEC (-0.12 mg/min/kg per year. t = 3.30, P < 0.002) and ABT (-0.06% kg/mmol per year, t = 4.81, P < 0.001) were observed. Negative correlations were found between the annual change in GEC and GEC at baseline (Rs = -0.40, P < 0.0001), and the annual change in ABT and ABT at baseline (Rs = -0.43, P < 0.0001). No correlations were found between the annual change in GEC or ABT and weekly MTX dose, age or percentage of increased liver enzymes, and no effect of a history of alcohol consumption > 30 g/week became evident. Two patients with Roenigk grade III had impaired quantitative liver function, while 14 patients with Roenigk grades I and II exhibited a high variability of GEC and ABT from normal to abnormal values. The continuous declines in GEC and ABT observed deserve attention in patients with prolonged treatment. Patients with a low GEC or ABT at baseline seem not to be at increased risk for a further loss of quantitative liver function. An impaired GEC or ABT does not necessarily concur with hepatic fibrosis on histological examination.      

Relationship of antibiotic resistance phenotype to the R-pyocin susceptibility pattern in clinical isolates of Pseudomonas aeruginosa

One hundred sixteen clinical isolates of Pseudomonas aeruginosa were collected from 7 hospitals in Athens. All strains were studied for their susceptibility to cefotaxime, ceftazidime, carbenicillin, aztreonam, imipenem, nalidixic acid, ciprofloxacin, gentamicin, and chloramphenicol. In addition, the R-pyocin susceptibility pattern was determined and the strains were O-serotyped and tested for their agglutination in acriflavine. The isolates included 53 strains resistant to both gentamicin and carbenicillin, 13 to carbenicillin only, 20 to gentamicin only, and 30 sensitive to gentamicin and carbenicillin. The multiresistant isolates displayed relatively higher resistance to all other antibiotics except aztreonam and cefotaxime. Remarkably 30 out of 53 multiresistant isolates reacted with one pyocin only, namely pyocin R2. This R-pyocin response was not encountered in any other strains of the other antibiotic resistance phenotypes. These isolates belonged to the 0-12 serogroup. The 0-12 serogroup was represented only in a minority of strains giving other R-pyocin reactions. It is interesting that strains reacting with pyocin R5 only were mostly susceptible to antibiotics. The results clearly indicate lipopolysaccharide-core mutations in multiresistant clinical isolates of P. aeruginosa. Despite the fact that the R-pyocin resistance pattern can not define the precise possible defect, the multiple and high level resistance associated with R2-pyocin reaction seems to be an interesting trait.     

Microbiological findings of infected root canals and adjacent periodontal pockets in teeth with advanced periodontitis

The purpose of the present study was to examine the flora from the root canals and periodontal pockets of teeth with advanced periodontal disease in order to compare the predominant cultivable microflora from the canals with those found in the adjacent periodontal pockets. Three samples were collected from each of sixteen patients, one from the root canal and two from the adjacent periodontal pocket in two different sites. Criteria for inclusion in the survey were pocket depth of greater than or equal to 7 mm, intact clinical crowns, and lack of periapical lesions. The study has demonstrated that the microorganisms present in the root canals of caries-free teeth with advanced periodontitis generally resembled those found in the adjacent periodontal pockets. The similarity in the recovery of organisms in the current study suggests that the pocket could be the source of the root canal infections. Further investigation is needed to clarify whether such factors as duration of periodontitis and age of the patient play a role in pulpal pathosis and whether the presence of specific bacterial species is also a factor in the etiology and pathogenesis of pulp disease.