Zygomycosis. Report of four cases with formation of chlamydoconidia in tissue

The authors describe spheric to ovoid chlamydoconidia and mucoraceous hyphae in tissues from four patients, two with cutaneous and two with pulmonary zygomycosis. The diagnosis in each case was confirmed by immunofluorescence staining and the presence of characteristic hyphae in tissue. It is important that these conidia be recognized, because they can easily be mistaken for other fungi, nematode ova, or other microorganisms in tissue sections, thereby resulting in the potential for misdiagnosis.     

In vivo and in vitro evidence of cell recovery from complement attack in rheumatoid synovium.

In the previous article we have demonstrated, by quantifying terminal complement complexes in synovial fluid, that membrane attack complex activation occurs in the joint in rheumatoid arthritis. Here we describe evidence of synoviocyte resistance to complement attack in vivo and in vitro. Gel filtration of terminal complement complex positive synovial fluid on Sepharose 2B revealed two forms of terminal complement complex: one form, eluting coincident with the column void, did not react with antibody to the fluid-phase inhibitor of complement membrane attack, the S-protein, suggesting that it was composed of membrane attack complexes, the other form, eluting in the included volume, did react with the anti-S-protein antibody, suggesting that it was composed of functionally inactive SC5b-9 complexes. The high molecular weight membrane attack complex peak was demonstrated by electron microscopy to be composed of membrane vesicles bearing many lesions having the typical appearance of complement membrane attack complexes. No discernible structures were present in the lower molecular weight peak. The effects of non-lethal complement membrane attack on human synoviocytes in culture were also investigated. Synoviocytes were relatively resistant to killing by autologous complement, end-point lysis of optimally antibody-sensitized cells never exceeding 60% even at a serum dilution of 1:2. At serum dilutions of 1:20 or less, no significant cell killing occurred despite a high degree of membrane attack pathway activation, suggesting the existence of resistance and recovery mechanisms. Non-lethal complement membrane attack stimulated the release of toxic reactive oxygen metabolites from synoviocytes. These, and other reactive species released during non-lethal complement attack in vivo, may play a significant role in the pathogenesis of rheumatoid arthritis.     

Physiological response and childhood anxiety: association with symptoms of anxiety disorders and cognitive bias.

This study examined the physiological response (skin conductance and heart rate [HR]) of youth exposed to a mildly phobic stimulus (video of a large dog) and its relation to child- and parent-reported anxiety symptoms and cognitive bias in a community-recruited sample of youth (n = 49). The results of this study indicated that HR and skin-conductance response were associated with youth report but not parent report of their child's symptoms of anxiety disorders and that HR response was more strongly associated with anxiety symptoms than skin-conductance response. Physiological response was uniquely associated with youth-reported symptoms of anxiety rather than youth-reported depression. Finally, HR response interacted with cognitive bias in predicting childhood anxiety disorder symptoms in a manner consistent with theories of the etiology of anxiety disorders.     

Collagen binding, elastase production, and slime production associated with coagulase-negative staphylococci isolated from bovine intramammary infections.

Collagen binding, elastase production, slime production, and associated somatic cell counts were determined with 160 strains of coagulase-negative staphylococci isolated from bovine intramammary infections. Mean binding values for type I and II collagen with Staphylococcus epidermidis, S. chromogenes, and S. hyicus strains were 5.8, 6.6, and 7.4 and 4.3, 4.2, and 4.9%, respectively. Eleven of 28 (39.3%) S. epidermidis, 1 of 38 (2.6%) S. chromogenes, and 1 of 94 (1.1%) S. hyicus strains were elastase positive. Slime production was noted with 12 (42.9%) S. epidermidis, 1 (2.6%) S. chromogenes, and 11 (11.7%) S. hyicus strains. No differences in somatic cell counts were observed with type I or type II collagen binding, elastase production, or slime production with S. epidermidis or S. chromogenes. However, somatic cell counts associated with S. hyicus strains with collagen type I binding affinities of greater than 5 and type II binding affinities of greater than 3 were 320.7 x 10(3) compared with 163.9 x 10(3) for strains with lower binding affinities.     

Evaluation of the Staph-Zym system with staphylococci isolated from bovine intramammary infections

A total of 148 staphylococci isolated from bovine intramammary infections were used to evaluate the Staph-Zym system (ROSCO, Taastrup, Denmark). The overall accuracy of the system was 91.9%. The system correctly identified all strains of Staphylococcus aureus, Staphylococcus simulans, and Staphylococcus xylosus and 95% of Staphylococcus intermedius strains. Of 33 Staphylococcus hyicus strains, 31 (93.9%) were classified correctly by the Staph-Zym system, as well as 8 (80%) of 10 Staphylococcus chromogenes strains. All 11 Staphylococcus epidermidis strains and the 1 Staphylococcus haemolyticus strain included in the study were identified, but the Staph-Zym system had difficulty distinguishing strains of Staphylococcus warneri and Staphylococcus hominis from other species in the S. epidermidis group. The Staph-Zym system correctly identified all six S. xylosus strains and two of three Staphyloccus sciuri strains. The Staph-Zym system was considered an acceptable alternative to conventional methods for identification of bovine mammary gland isolates.     

Identification of veterinary pathogens by use of commercial identification systems and new trends in antimicrobial susceptibility testing of veterinary pathogens.

Veterinary diagnostic microbiology is a unique specialty within microbiology. Although isolation and identification techniques are similar to those used for human pathogens, many veterinary pathogens require unique cultivation or identification procedures. Commercial identification systems provide rapid, accurate identification of human pathogens. However, the accuracy of these systems with veterinary pathogens varies widely depending on the bacterial species and the host animal from which it was isolated. Increased numbers of veterinary strains or species in the data bases of the various systems would improve their accuracy. Current procedures and interpretive criteria used for antimicrobial susceptibility testing of veterinary pathogens are based on guidelines used for human pathogens. The validity of these guidelines for use with veterinary pathogens has not been established. As with fastidious human pathogens, standardized methodologies and quality control isolates are needed for tests of organisms such as Actinobacillus pleuropneumoniae and Haemophilus somnus. Furthermore, interpretive criteria for veterinary antimicrobial agents based on the MIC for veterinary pathogens, the pharmacokinetics of the antimicrobial agent in the host animal, and in vivo efficacy of the antimicrobial agent are needed. This article reviews both the commercial identification systems evaluated with veterinary pathogens and current methods for performing and interpreting antimicrobial susceptibility tests with veterinary pathogens. Recommendations for future improvements in both areas are discussed.     

Haemodynamic model of a unilateral iliac stenosis with an aortoiliac bypass

A hydrodynamic model for the part of the human arterial network below the renal arteries has been constructed using specially fabricated distensible tubes and a pulsatile pump to simulate an aortoiliac bypass. The experiments and the computer model indicated that no ‘steal’ occurred due to the insertion of the bypass graft. Also, the results showed that the length of the stenosis had a non-systematic apparent effect on the physiological significance of the obstruction and that the kinetic power represented only a small percentage of the total power. The total power efficiency of the bypass graft was unaffected by its elastic properties. The experimental investigation also indicated that the pressure drop across the stenosis was considerably larger than the drop calculated using the Poiseuille flow relationship when the stenosis was severe. Therefore, a critical arterial stenosis value cannot be defined as an obstruction of a constant percentage reduction of luminal area. It varies directly with the effective cross-sectional area and inversely with the flow rate. The value of angiography in assessing the functional significance of any arterial stenosis is there-fore limited. A better method for evaluation requires quantitative measurements of local blood pressure and blood flow, not only at rest, but also under conditions creating augmented flows due to exercise.     

Disseminated cryptococcosis presenting as cellulitis with necrotizing vasculitis.

Patients with disseminated cryptococcosis infrequently present with cutaneous involvement. Skin lesions, when present, are usually multiple and polymorphous in appearance. Cellulitis caused by Cryptococcus neoformans is rare, and necrotizing vasculitis associated with cryptococcal vascular invasion has not to our knowledge been reported. We report here a case of disseminated cryptococcosis in a renal transplant recipient who had cellulitis and necrotizing vasculitis and in whom a diagnostic skin biopsy allowed for early therapy with cure and salvage of the renal allograft.     

Temporal pattern of herpes simplex virus type 1 infection and cell death in the mouse brain stem: influence of guanosine nucleoside analogues

Levels of bystander death occurring in herpes simplex virus type 1 (HSV-1)-infected mouse brain stems were studied, as well as the extent to which bystander death is influenced by guanosine nucleoside analogue treatment. Consecutive sections from brain stems of HSV-1-infected mice were stained alternately for (i) viral infection and (ii) cell death (TUNEL assay). Virus antigen was detectable in brain stems on day 3 of infection, while TUNEL staining was comparatively lower. An increase in the extent of TUNEL staining was observed on day 4 of infection. Despite this increase, however, the ratio of TUNEL-stained to infection marker-stained tissue still indicated that the amount of TUNEL staining remained lower than infection staining at this time point. On days 5 and 6 of infection, TUNEL staining continued to increase and the TUNEL/infection marker ratio switched on day 6 in favour of excess TUNEL staining, which was observed in and around the foci of infection, suggesting bystander death. The excess TUNEL staining on day 6 of infection was further increased on treatment with antivirals. The significance and implications of these results are discussed with respect to the nature and mechanism of action of the TUNEL assay, dynamics of primary HSV-1 infection, immunological influences and potential effects of antiviral treatment. The potential problems of the TUNEL assay are considered in the context of viral infection and the TUNEL assay, in combination with infection marker staining, may potentially provide a model system for quantitative analysis of true bystander death during HSV infection in vivo.