Cyclosporin treatment in uveitis

With Cyclosporin, a recently developed immunosuppressant drug, the authors treated eight patients with noninfectious chronic uveitis: intermediate uveitis (4), Behcet's disease (2), chorioiditis (1), and anterior uveitis (1). Therapy had to be discontinued in six patients who responded poorly or manifested severe side effects. In four cases the Cyclosporin concentration in the aqueous humor was determined. In spite of a concentration of about 900 ng/ml there was a deterioration in two cases with intermediate uveitis and Behcet's disease. Only one of the eight patients with intermediate uveitis responded well without any recurrence.     

Total nasal reconstruction with 3D custom made porous titanium prosthesis and free thoracodorsal artery perforator flap: A case report

Total nasal reconstruction is a challenging surgical procedure which usually involves a free flap, forehead flap, and cartilage grafts. In certain failure situations where patients do not accept the idea of anaplastology, possibilities become very limited. We report the case of a patient who underwent several reconstruction steps with multiple failures including free and local flaps and cartilage harvests which showed recurrent episodes of necrosis and infection leading to melting and collapse of reconstructed structures. Furthermore, the patient did not want any anaplastological rehabilitation. We proposed to the patient an innovative method that consists to print a three‐dimensional custom‐made porous titanium prosthesis, based on the original shape of his nose, to replace the cartilage support. This implant was first inserted in a thoracodorsal artery perforator flap for primary integration before the free transfer of the complete structure, two months later. The free transfer was successful without any complication. A stable reconstruction and satisfying result was obtained. The patient did not want additional surgical improvement 24 months post‐operatively, and resumed his professional activities. The possibility of using three‐dimensional custom titanium prostheses to replace the bone and cartilage support seems to be an interesting alternative for patients in the failure situation of nasal reconstruction.     

Presence of mefA and mefE genes in Streptococcus agalactiae

Eighteen unrelated clinical isolates of Streptococcus agalactiae with the M phenotype harbored an mef gene. DNA sequencing showed that one of nine strains contained mefA (producing one amino acid substitution), whereas the remaining eight carried mefE (identity, 100%). Restriction analysis of PCR products indicated that the nine other strains also contained mefE.