A quantitative histomorphologic analysis of lymph node granulomas in sarcoidosis in relation to radiological stage I and II

A decrease in numbers of pulmonary arteries has been implicated in various forms of both human and experimental pulmonary hypertension. However, data in support of this hypothesis have not been conclusive. Especially, intravascular fixation under pressure and the size of the areas of lung tissue subjected to quantitation, may have influenced the results. In order to investigate these factors, we fixed lungs of ten normal rats in three different ways, i.e. by perfusion of the pulmonary vasculature, by immersing collapsed lungs and by instilling the fixative through the trachea with intact thoracic cavity. Subsequently, blood vessels were counted in histological sections. Our study illustrates that perfusion of vessels under pressure decreases the number of recognizable arteries. Also the small areas, used in previous studies for counting vessels, produce unreliable results. Our conclusion is that a decreased number of lung vessels as a factor in pulmonary resistance has not been conclusively demonstrated.     

Deadly vasospasm

A patient with Prinzmetal's variant angina (PVA) developed a cardiac arrest due to coronary vasospasm and subsequent myocardial infarction. After resuscitation postanoxic brain injury was diagnosed. After an initial improvement of consciousness he deteriorated rapidly on the seventh day after admission due to severe brain ischaemia apparently caused by cerebral vasospasm, until ultimately brain death was diagnosed. To our knowledge, the association between PVA and cerebral vasospasm has never been described. The combination suggests that this patient had a generalized vasospastic disorder.     

Epidemiology of MRSA and current strategies in Europe and Japan

The prevalence of health-care associated infections caused by multi-drug resistant organisms has significantly increased over the past decade. Among these organisms, Methicillin-resistant Staphylococcus aureus (MRSA) plays a prominent and increasing role. Because of consequences for patients and the economic burden in course of prolonged treatment following MRSA infections and additional indirect costs for e.g. isolation or antiseptic treatment, this trend will further damage European health-care systems.In 2006, a workshop was initiated at the 8^th International Congress of the German Society of Hospital Hygiene held in Berlin. The aim of this workshop was to give an overview of the current situation of MRSA in selected European countries and to elaborate on potential strategies to prevent MRSA-infections and dissemination. A questionnaire encompassing 20 questions addressed topics such as epidemiology, current measures and future prospects was distributed to representatives from various European countries and Japan. A variety of widely different answers was obtained. It was shown that in all countries prevalence of MRSA is on a rising tide. This trend is observable in all European countries, albeit less strong in The Netherlands, Slovenia, France, Austria and Scandinavian countries. It was conclude that prevention strategies in a united and expanding European Community will become of utmost importance and that rapid screening strategies, e.g. PCR, might be of assistance in such an approach. A potential strategy to improve infection control measures could be the requirement of health-insurance providers to sign contracts only with hospitals able to proof having an infection control management in place.     

Dutch measures to control MRSA and the expanding European Union

The Dutch national policy for the prevention of spread of methicillin resistant Staphylococcus aureus (MRSA) has shown that it is possible to suppress and prevent MRSA from becoming endemic in hospitals. Implementation of effective measures against MRSA w