Association between impaired IL-10 production following exposure to Staphylococcus aureus enterotoxin B and disease severity in eosinophilic chronic rhinosinusitis

Background

IL-10 is a major anti-inflammatory cytokine that prevents inflammation-mediated tissue damage. We characterized the production of IL-10 by sinonasal tissue cells following exposure to Staphylococcus aureus enterotoxin B (SEB), which elicits cellular responses and is associated with the pathogenesis of eosinophilic chronic rhinosinusitis (ECRS).

胃嗜酸性肉芽肿48例病因探讨

目的　探讨胃嗜酸性肉芽肿 (GEG)的可能的发病原因。方法　回顾分析 48例GEG的临床表现及病理特点 ;采用改良Giemsa法检测幽门螺杆菌 (Hp)。结果　GEG有明显的性别差异 ,术前误诊率高 ,68 8%病变组织中有淋巴滤泡 ,Hp阳性检出率 69 6% ,周围血中 11例嗜酸性白细胞增高。结论　Hp感染、性激素水平及过敏反应有可能与GEG发病有关     

Reflux oesophagitis in Italy (Diomede project)

AIMS: A multicentric observational study was performed to update the available information on reflux oesophagitis in Italy. METHODS: In phase I, the number and severity of reflux oesophagitis diagnosed in 1 year (2003) were reported together with the associated endoscopic findings. In phase II, oesophagitis patients consecutively referred in a 3-month period were analysed. A multivariate analysis was used to identify the risk factors for severe oesophagitis. RESULTS: 253,992 upper endoscopies were collected. The overall prevalence of oesophagitis was 14.8% and the endoscopic findings associated with oesophagitis were hiatus hernia (46.3%), duodenal ulcer (10.7%), gastric ulcer (3.6%) and Barrett's oesophagus (2.9%). In phase II, 1542 reflux oesophagitis patients were analysed (60.3% males; mean age 50.7 +/-16.6 years). Only 53.4% of patients reported heartburn and/or regurgitation as main complaint. Severe symptoms, age > 50 years, hiatus hernia and male gender were identified as independent predictors of severe oesophagitis. CONCLUSIONS: Oesophagitis is the most frequent among the peptic diseases of the upper gastro-intestinal tract. Only half of the oesophagitis patients reported typical reflux symptoms as dominant. Advanced age, male gender, severe symptoms and hiatus hernia were independent risk factors for severe disease.     

Eosinophilic granuloma of the sternum in a child treated with closed biopsy

Langerhans cell histiocytosis is a rare neoplastic proliferative disorder of the Langerhans cells. The clinical course is variable, ranging from a low symptomatic single bone lesion to fatal multiple organ involvement. Rarely, the sternum can be the first and single location of the disease. We report on a 12‐year‐old boy who presented with an aggressive lytic lesion of the proximal sternum associated with local pain and afternoon fever. Histopathological analysis of the closed biopsy specimen indicated eosinophilic granuloma of bone/Langerhans cell histiocytosis. Soon after the biopsy procedure the pain and fever subsided. Computed tomography at 2 months showed healing of the lytic lesion. The patient received no other type of treatment. At 2 year follow up he was symptom and disease free.     

颌面部骨嗜酸性肉芽肿18例临床分析

目的:分析颌面部骨嗜酸性肉芽肿的临床及X线特点。方法:对18例颌面部骨嗜酸性肉芽肿资料,分别从患者性别、发病年龄、临床表现、发病部位、X线表现、误诊情况、治疗等方面进行回顾性分析。结果:18例颌面部骨嗜酸性肉芽肿患者,男11例,女7例;平均发病年龄16.62岁,平均病程5.5个月;11例为单发,7例为多发,共计29个部位,其中累计下颌骨21处(72.8%),上颌骨4处(13.8%),颅骨3处(10.3%),颧骨1处。主要临床表现为牙齿松动,牙龈肿胀、溃烂、疼痛、面部肿胀伴压痛。X线表现为颌骨中央不规则、溶解样破坏,破坏区呈地图状、网状、虫蚀样改变,骨破坏边缘不清晰。易误诊为骨肉瘤(3例),牙源性粘液瘤(2例),恶性淋巴瘤(1例),浆细胞骨髓瘤(1例),低分化癌(1例),其他恶性肿瘤(4例)。治疗方法6例采取单纯手术,7例采取手术+放疗,3例采取手术+化疗,1例采取手术+放疗+化疗。平均随访5年,14例无复发。结论:该病变特点显著,应正确诊断和治疗。     

Relationship between severity and symptoms of reflux oesophagitis in elderly patients in Japan

Since information concerning reflux oesophagitis in the elderly is limited, particularly in Japan, the severity and symptomatic profiles of reflux oesophagitis in elderly patients were investigated. One hundred and nineteen patients with reflux oesophagitis found among 2278 endoscopy cases between 1993 and 1996 were investigated in this study. The patients were divided into two groups, elderly and non-elderly. The severity of reflux oesophagitis was estimated by the Los Angeles classification. The presence or absence of typical symptoms (heartburn and regurgitation) was determined by interview. Reflux oesophagitis was not only more frequently found in the elderly group, but was more severe than in the non-elderly. Although the degree of manifestation of typical symptoms was similar between the elderly and the non-elderly with high-grade oesophagitis, the elderly patients with mild reflux oesophagitis were less symptomatic than the non-elderly. Mild reflux oesophagitis in the elderly may be missed due to its rarity of typical reflux symptoms and a substantial number of elderly persons might have subclinical reflux oesophagitis.     

Multiple Cerebral Infarctions Accompanied by Subcortical and Subarachnoid Hemorrhaging in Bilateral Border Zone Areas in a Patient with Eosinophilic Granulomatosis with Polyangiitis

Eosinophilic granulomatosis with polyangiitis (EGPA) is often associated with peripheral neuropathy, but reports of central nervous system involvement are quite rare. We herein report a patient with EGPA first identified as having hypereosinophilia who later developed asthma, eosinophilic otitis media, sinusitis, and hemorrhagic colitis. She subsequently developed hemiparesis. Head magnetic resonance imaging revealed multiple cerebral infarctions with subcortical and subarachnoid hemorrhaging colocalized at the bilateral border zone areas. She was diagnosed with EGPA-induced stroke and successfully treated with oral prednisolone. Inflammation in the small cerebral arteries in EGPA may induce bilateral border zone infarction with colocalizing subcortical and subarachnoid hemorrhaging.