Paragonimiasis presenting with unilateral pseudochylothorax: case report and literature review

A 64-y-old female previously treated for lung fluke presented with shortness of breath and moderate left pleural effusion. Thoracentesis was performed and milky pleural effusion was obtained. Paragonimus ova and rhomboidal cholesterol crystals were found. Paragonimiasis was diagnosed, and the patient was treated with praziquantel 25 mg/kg/d.     

No increase in cervicovaginal proinflammatory cytokines after Carraguard use in a placebo-controlled randomized clinical trial

BACKGROUND: Assessment of cervicovaginal cytokine levels may be helpful to evaluate subclinical epithelial inflammation during safety evaluations of candidate microbicides. METHODS: Fifty-five HIV-seronegative Thai women were enrolled in a safety trial of the candidate microbicide Carraguard and were randomized to use Carraguard or placebo gel before vaginal sex. Cervicovaginal lavages were collected at baseline and after 1 month of gel use; levels of interleukin (IL)-1beta, IL-6, IL-8, and secretory leukocyte protease inhibitor (SLPI) were measured using microwell plate-based enzyme immunoassays. Median levels were compared between the baseline and 1-month follow-up visits using paired t tests; the median change between groups was compared using Wilcoxon rank sum tests. Women were examined for the presence of genital findings; the association between genital findings and cytokine levels was studied. RESULTS: No increase in levels of proinflammatory cytokines after use of Carraguard gel or placebo gel was observed during the study. The median change from the baseline to 1 month of follow-up was not significantly different between Carraguard and placebo groups (IL-1beta: -0.3 pg/mL vs. -3.93 pg/mL; P = 0.4, IL-6: -0.3 pg/mL vs. 0 pg/mL; P = 0.3, IL-8: -40.1 pg/mL vs. -53.2 pg/mL; P = 0.8, and SLPI: -26.5 pg/mL vs. 12.6 pg/mL; P = 0.07). Genital findings with intact epithelium were found in 16 (29%) women; these women tended to have somewhat higher IL-6 levels than those with normal epithelium (14.9 pg/mL vs. 8.8 pg/mL; P = 0.08). CONCLUSION: We found no increase in proinflammatory cytokines after Carraguard and placebo gel use, suggesting that neither gel causes inflammation. Further studies to assess the role of cytokines in microbicide safety studies are warranted.     

Persistent infra-orbital nerve hyperaesthesia after blunt orbital trauma

Background: Hyperaesthesia involving the infra-orbital nerve is rarely associated with orbital floor fracture. Methods: An 11-year-old boy and a 34-year-old man had persistent and severe hyperaesthesia in the distribution of the infra-orbital nerve 12 and 26 months, respectively, after blunt orbital trauma. Results: Surgical decompression of the infra-orbital nerve resulted in rapid and complete resolution of the hyperaesthesia in both cases. Conclusion: Persistent hyperaesthesia of the infra-orbital nerve is another indication for exploration of the orbital floor following blunt orbital trauma.     

Exposure to lead, cadmium and chromium among spray painters in automobile body repair shops

Environmental and biological monitoring of lead, cadmium and chromium levels in spray painters is reported. All of the study subjects worked in automobile body repair shops that had no standard spraying room. They were divided into 2 groups, those who wore an aerosol-removing respirator while spraying (n=20) and those who did not wear the respirator (n=50). Air in the breathing zone of each subject was sampled and analyzed for lead, cadmium and chromium levels. The subjects' blood lead levels and urinary cadmium and chromium levels were also measured along with those of a control group. The mean environmental and biological levels of these metals between the two groups of the painters were not significantly different (p>0.05). However, the biological levels of the metals were significantly higher in the study groups than in the control group (p<0.01). On-site observations revealed that improper use of an aerosol-removing respirator, lack of an isolated spraying room and poor personal hygiene habits caused the failure to prevent heavy metal exposure among the automobile spray painters.     

Role of matrix Gla protein in parathyroid hormone inhibition of osteoblast mineralization

Parathyroid hormone (PTH) exerts biphasic effects on bone, dependent on the frequency and dose of administration. The catabolic actions of PTH on bone have been associated with continuous treatment, an increase in osteoblast-mediated resorption of bone via osteoclast activation, and inhibition of osteoblast activity and mineralization. Downregulation of differentiation markers and inhibition of mineralization by PTH have been reported in primary calvarial explants and osteoblast cell lines. Using MC3T3-E1 osteoblast-like cells, we have shown that matrix Gla protein (MGP) can be induced by PTH, and that this induction may explain the PTH-mediated inhibition of osteoblast biomineralization. MGP is a known inhibitor of mineralization, and mice deficient in Mgp show severe vascular calcification and premature bone mineralization. This review discusses the role of MGP in mineralization, comparing bone and vascular mineralization. In addition to MGP, the regulation and possible role of osteopontin, another known regulator of osteoblast mineralization, in PTH-mediated regulation of bone and vascular mineralization is discussed.     

House dust mite allergen levels in Chiang Mai homes

The quantitative assays for house dust mite (HDM) allergens provide a valid index of exposure and can be used for risk evaluation. We assessed group I HDM allergen levels in mattress and living room floor dust from 35 Chiang Mai homes and identified factors associated with high allergen levels. One-third of mattress and living room floor dust had group I HDM allergen levels of between 2-10 microg/g. Two-thirds of mattress dust and a small amount of living room floor dust had group I HDM allergen levels of over 10 microg/g. The geometric means of Der p I, Der f I and total group I allergens in mattress and living room floor dust were 8.61, 2.88, and 15.81 microg/g and 1.61, 0.27 and 2.43 microg/g, respectively. Mattresses made of kapok and rugs kept in the living room were associated with high group I allergen levels.