Anti-IL-6-receptor antibody promotes repair of spinal cord injury by inducing microglia-dominant inflammation

We previously reported the beneficial effect of administering an anti-mouse IL-6 receptor antibody (MR16-1) immediately after spinal cord injury (SCI). The purpose of our present study was to clarify the mechanism underlying how MR16-1 improves motor function after SCI. Quantitative analyses of inflammatory cells using flow cytometry, and immunohistochemistry with bone marrow-chimeric mice generated by transplanting genetically marked purified hematopoietic stem cells, revealed that MR16-1 dramatically switched the central player in the post-traumatic inflammation, from hematogenous macrophages to resident microglia. This change was accompanied by alterations in the expression of relevant cytokines within the injured spinal cord; the expression of recruiting chemokines including CCL2, CCL5, and CXCL10 was decreased, while that of Granulocyte/Macrophage-Colony Stimulating Factor (GM-CSF), a known mitogen for microglia, was increased. We also showed that the resident microglia expressed higher levels of phagocytic markers than the hematogenous macrophages. Consistent with these findings, we observed significantly decreased tissue damage and reduced levels of myelin debris and Nogo-A, the axonal growth inhibitor, by MR16-1 treatment. Moreover, we observed increased axonal regeneration and/or sprouting in the MR16-1-treated mice. Our findings indicate that the functional improvement elicited by MR16-1 involves microglial functions, and provide new insights into the role of IL-6 signaling in the pathology of SCI.     

Specific cutaneous involvement in Hodgkin's disease.

In Hodgkin's disease (HD) specific cutaneous involvement is rare. When it occurs, retrograde lymphatic spread, direct extension from the underlying lymph nodes, and hematogenous dissemination are the mechanisms usually implicated. Among 349 patients with HD diagnosed and followed-up at our institution from 1969 to 1990, three (0.85 per cent) presented specific cutaneous involvement. In two cases with mixed cellularity subtype, skin lesions displayed histologic features similar to those found in the lymph node. Treatment with combination chemotherapy resulted in rapid disappearance of the lesions in two patients but was ineffective in the third. Previous reports of cutaneous involvement in HD, its differential diagnosis, prognostic significance, and treatment are briefly reviewed.     

Two decades of acute hematogenous osteomyelitis in children: are there any changes?

Our purpose was to compare the clinical course of acute hematogenous osteomyelitis (AHO) 20 years ago and today in the Department of Paediatric Surgery, Kaunas Medical University Hospital, Lithuania. Retrospective data analysis from patients aged 1–16 years with confirmed diagnosis of AHO was performed. The data were collected from 1982 to 2003. The incidence of AHO per year for 1,00,000 children (0–16 years) was analyzed for that period. The patients were divided into two groups—group A, treated in 1982–1983, and group B, treated in 2002–2003. The number of patients, patient age, duration of illness, complications, and length of hospital stay were compared using statistical methods for nonparametric data analysis (Mann–Whitney U test, chi-square criterion). Linear regression was used for incidence analysis. Population data were obtained from the Lithuanian Statistics Department. From 1982–2003, 758 patients were treated. The incidence of AHO increased from 1982. There was no statistically significant difference between the periods 1982–1983 and 2002–2003 in median patient age (10.36 and 10.72 years, respectively), in gender proportion (20.4% and 29.8% of the cases were girls), or in median duration of symptoms until admission (4 days and 3 days, respectively, p=0.058). Median hospital stay and duration of antibiotic therapy were longer in the period 1982–1983 (50 days and 43 days) than during 2002–2003 (29 days and 29 days). The differences in frequency of positive blood cultures (36.4% in group A and 64.9% in group B, p=0.046) and frequency of periosteal abscess (40.8% in group A and 19.3% in group B, p=0.015) were statistically significant. An increase in AHO incidence is seen when comparing contemporary data and the data from two decades ago, but nowadays the clinical course is less complicated and is marked by shorter hospital stays and shorter duration of antibiotic therapy.     

The clinicopathological significance of preoperative serum-soluble interleukin-2 receptor concentrations in operable non-small-cell lung cancer patients

Background Serum-soluble interleukin-2 receptor (IL-2R) concentrations have been found to be elevated in cancer patients. However, the importance of this finding in patients with non-small-cell lung cancer (NSCLC) has not been previously established. Methods Preoperative serum-soluble IL-2R concentrations were determined in 65 consecutive patients with operable NSCLC. The correlation of preoperative serum-soluble IL-2R concentrations with various clinicopathological features of this cancer was evaluated to clarify the clinical significance of this parameter. Results Although serum-soluble IL-2R concentrations were not significantly higher in operable NSCLC patients than in normal controls (P=.1180), serum-soluble IL-2R concentrations were significantly higher in patients with stage IIIB or IV disease than in normal controls (P=.0001). The presence of intrapulmonary metastasis was the only clinicopathological feature that was significantly correlated to serum-soluble IL-2R concentration (P=.0004). The sensitivity of serum-soluble IL-2R concentration in identifying the presence of intrapulmonary metastasis was 87.5%; specificity was 75%. Conclusions Elevated preoperative serum-soluble IL-2R concentrations in patients with operable NSCLC reflect the occurrence of intrapulmonary metastasis. Preoperative examination of serum-soluble IL-2R concentrations may be valuable in the detection of the intrapulmonary metastasis preoperatively.     

Immunohistochemical expression of E-cadherin in metastatic brain tumors

The adhesion molecule E-cadherin has been shown to influence malignant transformation of tumors, including local and distant metastases. We examined the expression of E-cadherin to determine its relationship to the development of metastasis in metastatic brain tumors. Immunohistochemistry for E-cadherin and Ki-67 was carried out in 76 formalin-fixed, paraffin-embedded archival specimens of metastatic brain tumors and in 14 corresponding available primary tumors from patients who received treatment for metastatic brain tumors. The primary tumors were mainly lung cancers (51.3%), followed by gastrointestinal tumors (28.9%). E-cadherin was expressed in 62 (81.5%) of 76 cases examined. In metastatic adenocarcinomas, a consistent tendency for E-cadherin expression was noted, regardless of the degree of differentiation or the extent of spread of the disease (P=0.4). There was a direct correlation between E-cadherin expression and high MIB-1 index in all metastatic brain tumors (P=0.0007). Pairwise analysis in 14 primary tumors and the corresponding metastatic specimens revealed high E-cadherin and MIB-1 staining in metastatic brain tumors. These results provide a unique association between E-cadherin, systemic metastasis, and proliferation potential in metastatic brain tumors.     

Hematogenous cells in experimental Japanese encephalitis

Summary Four adult mice were injected with³H-thymidine repeatedly so that in their brains only circulating blood cells were labelled with³H-thymidine. They then received an intracerebral injection of Japanese encephalitis virus, were sacrified on the 3rd, 4th and 5th day after inoculation: the brains were examined by light and electron microscopic autoradiography. Inflammatory cells appearing in the brain parenchyma and perivascularly in the acute stage of the experimental Japanese encephalitis are derived from circulating mononuclear leukocytes. They assume the shape of rod cells and are the main constituents of the glial nodule in the brain parenchyma. Their fine structural characteristics are discussed.     

Analysis of the Microbiome Based on 16S rRNA Gene Signature in Women with Preterm versus Term Birth

Objective::To characterize and compare the microbiome signature in the maternal, intrauterine, and fetal environments and the associated bacterial species in wo...     

Pedunculated hepatocellular carcinoma and splenic metastasis

Only a few cases of pedunculated hepatocellular carcinoma (P-HCC) have been reported in the literature. The common sites of extrahepatic metastases in patients with HCC are the lungs, regional lymph nodes,kidney, bone marrow and adrenals. Metastasis to spleen is mostly via hematogenous metastasis, direct metastasis to spleen was very rare. We report a case of P-HCC presenting as a left upper abdominal lesions which involved the spleen that was actually a P-HCC with splenic metastasis. This case is unique as P-HCC directly involved the spleen which is not via hematogenous metastasis.     

血源性传染病在基层医务人员暴露情况分析

目的：了解基层医务人员血源性传染病职业暴露情况,以降低暴露风险.方法：对546名医务人员进行有关锐器刺伤、暴露类型、防护用品使用等问卷调查.结果：各岗位人员均存在职业暴露风险,尤以护士暴露几率最高.职业暴露以皮肤受伤暴露占81.1%.部分人员能采取手套、口罩、眼罩等自我防护措施.结论：基层医务工作者在日常工作中有较高的血源性疾病职业暴露比例,应加强各项预防措施的实施.     

Implant retention and high rate of treatment failure in hematogenous acute knee and hip prosthetic joint infections

ObjectivesOnly few studies evaluated hematogenous prosthetic joint infections. We aimed to describe the characteristics of these infections and factors associated with management failure.MethodsWe selected hematogenously-acquired infections, defined by the occurrence of infectious symptoms more than a year after implantation among records of patients treated for hip and knee prosthetic joint infections at Montpellier University Hospital between January 2004 and May 2015. Failure was defined by death due to prosthesis-related infection, need for prosthesis removal in case of conservative treatment, or recurrence of infectious signs on a new prosthesis.ResultsForty-seven patients with hematogenous prosthetic joint infection were included (33 knee infections and 14 hip infections). Infectious agents were streptococci (43%), Staphylococcus aureus (43%), Gram-negative bacilli (13%), and Listeria monocytogenes (2%). Thirty-one patients were initially treated with debridement and implant retention and 15 with prosthesis removal (three with one-stage surgery, 10 with two-stage surgery). The median duration of antibiotic therapy was 66.5 days. The overall failure rate was 52% (24/48), 71% (22/31) with implant retention strategy, 13% (2/15) with prosthesis removal, and 63% (12/19) in case of Staphylococcus aureus infection. Conservative treatment was appropriate (arthrotomy on a well-implanted prosthesis without sinus tract and symptom onset <21 days) in 13/31 patients (42%) with a failure rate still high at 69% (9/13). The only factor associated with failure was conservative surgical treatment.ConclusionThe high risk of failure of conservative treatment for hematogenous prosthetic joint infections should lead to considering prosthesis replacement as the optimal strategy, particularly with Staphylococcus aureus.