Suppurative corneal ulceration in Bangladesh

Suppurative keratitis is an important preventable cause of blindness, particularly in the developing world. This study analyses 142 cases of suppurative keratitis referred to Chittagong Eye Infirmary, Bangladesh. Some 53.5% of cases were bacterial and 35.9% were fungal. The five most common pathogens were: Pseudomonas sp. 24%, Streptococcus pneumoniae 17%, Aspergillus sp. 13%, Fusarium sp. 7% and Curvularia sp. 6%. Gram stain and culture results were consistent in 62.6% of cases. Previous antibiotic treatment was a significant factor for failure of culture isolation and less so for Gram stain failure. On Gram stain, 55.9% of pseudomonal cases were missed, but only 2% of fungal cases were missed. Over all, Gram stain had a sensitivity of 62% and positive predictive value of 84% for bacterial cases, and 98% and 94% for fungal cases, respectively. Fungal ulcers were typically filamentous, but an antecedent history of trauma was not common. The most frequent injury was due to rice grains, but the inoculum appeared to be introduced during eye washing with contaminated water. Pseudomonal ulcers occurred most frequently in the monsoon season, and Fusarium cases were seen only in the hot, dry season.     

Psychiatric mental health nursing: challenge and change

. We invited Dr Peplau to provide a personal reflection on the recent history of psychiatric nursing and her thoughts on immediate challenges facing the profession. The paper is an individual scholar's commentary on the way that psychiatry has waxed and waned over the years, in relation to nursing. This historical review discovers and reports a challenge to current practice. Dr Peplau describes a professional shift that is pulling nurses toward the subordinate role observed earlier this century. The paper draws attention to how contemporary practice can be positively influenced, e.g., by giving a structure to the allocation and conduct of nurse–patient time.     

A novel 37-Kd adhesive membrane protein from cloned murine bone marrow stromal cells and cloned murine hematopoietic progenitor cells

The adhesion of hematopoietic progenitor cells to bone marrow stromal cells is critical to hematopoiesis and involves multiple effector molecules. Stromal cell molecules that participate in this interaction were sought by analyzing the detergent-soluble membrane proteins of GBI/6 stromal cells that could be adsorbed by intact FDCP-1 progenitor cells. A single-chain protein from GBI/6 cells having an apparent molecular weight of 37 Kd was selectively adsorbed by FDCP-1 cells. This protein, designated p37, could be surface-radiolabeled and thus appeared to be exposed on the cell membrane. An apparently identical 37- Kd protein was expressed by three stromal cell lines, by Swiss 3T3 fibroblastic cells, and by FDCP-1 and FDCP-2 progenitor cells. p37 was selectively adsorbed from membrane lysates by a variety of murine hematopoietic cells, including erythrocytes, but not by human erythrocytes. Binding of p37 to cells was calcium-dependent, and was not affected by inhibitors of the hematopoietic homing receptor or the cell-binding or heparin-binding functions of fibronectin. It is proposed that p37 may be a novel adhesive molecule expressed on the surface of a variety of hematopoietic cells that could participate in both homotypic and heterotypic interactions of stromal and progenitor cells.     

Benign lesions mimicking malignant tumors of the esophagus

Three cases of benign lesions which mimicked malignant tumors of the esophagus are described. In all three cases, two inflammatory pseudotumors and one case of diffuse leiomyomatosis, the clinical presentations, radiologic features, and gross pathologic findings led to the mistaken diagnosis of carcinoma at thoracotomy. The benign nature of the processes was recognizable only on microscopic examination. Although most benign tumors of the esophagus are localized solitary lesions that are easily distinguished from carcinoma, occasionally benign conditions may present as infiltrative, ulcerated mass lesions. Inflammatory pseudotumor and diffuse leiomyomatosis should be included in the differential diagnosis of esophageal malignancies.     

Antioxidants can delay liver cell maturation which in turn affects {gamma}-glutamyltranspeptidase expression

In normal rats just before weaning the majority of hepatocytesare mononucleated diploids, but within days the number of binucleatedcells reaches a peak (50%) before declining again and thereis a steady shift of diploid to tetraploid nuclei. When weanlingrats were exposed to ethoxyquin (EQ), the conversion of 2N nucleito 4N and 8N nuclei as measured by flow cytometry was sloweddown. The rapid rise in the number of binucleate cells was alsodelayed, although the long-term effect was an increased numbercompared with age-matched controls. It appeared that when EQwas present in the diet, significant numbers of diploid hepatocytesundergoing DNA synthesis also underwent mitosis and cytokinesisgiving rise to new diploid hepatocytes. However, many hepatocytesfrom animals maintained on a control diet did not undergo cytokinesis.Thus the slower ‘conversion’ of 2N to 4N nucleiin treated hepatocytes was due in part to promotion of cytokinesisin diploid cells undergoing DNA synthesis. The ploidy of a cellwould be expected to affect gene expression. EQ is a very potentinducer of -glutamyltranspeptidase (GGT), but expression dependedon the age of the animals, the length of treatment time andapparently the ploidy status of the liver. In weanling ratstreated with EQ for 7 days, >80% of the hepatocytes expressedGGT, while in 42 day old rats similarly treated <50% werepositive for this enzyme. GGT expression was closely correlatedwith the percentage of 2N nuclei present in hepatocytes, suggestingthat it was more easily induced in cells containing these nucleithan in those containing nuclei of higher ploidy. Although butylatedhydroxytoluene (BHT), at the same concentration in the diet,had a similar negative effect on weight gain as did EQ, it hadno effect on ploidy, nor did it induce GGT to the same extentas EQ.     

Response from lieberman and colleagues

Respond on comments on Lieberman's article: Cyclosiloxanes Produce Fatal Liver and Lung Damage in Mice. Environ Health Perspect 107:161-165