Treatment of Acquired Bilateral Nevus of Ota-Like Macules (Hori''s Nevus) with a Combination of the 532 nm Q-Switched Nd:YAG Laser Followed by the 1,064 nm Q-Switched Nd:YAG Is More Effective: Prospective Study

BACKGROUND: Acquired bilateral nevus of Ota-like macules (Hori's nevus) is a common dyschromatosis among Asian women. Q-switched lasers have been used successfully as a treatment modality. OBJECTIVE: The purpose of this study was to compare the efficacy of using the Q-switched 532 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser followed by the 1,064 nm laser versus the Q-switched 1,064 nm Nd:YAG laser alone in the treatment of Hori's nevus. METHODS: This is a prospective left-right comparative study. Ten women with bilateral Hori's nevus were recruited and treated with a combination of the Q-switched 532 and 1,064 nm Nd:YAG lasers on the right cheek and the Q-switched 1,064 nm Nd:YAG laser alone on the left cheek. Only one laser treatment session was performed. The degree of pigmentation was objectively recorded with a mexameter. Subjective assessment was made by both patients and two blinded, nontreating dermatologists. RESULTS: At 6 months, there was a statistically significant difference (p = .009) of 35.10 points using objective mexameter measurements between the two sides, favoring the side treated with a combination of 532 and 1,064 nm laser treatment. Subjective grading by the patients and blinded dermatologists also confirmed that combination therapy was more successful after one treatment. Although combination treatment had a higher incidence of mild postinflammatory changes, this disappeared within 2 months. CONCLUSIONS: Concurrent use of the Q-switched 532 nm Nd:YAG laser in combination with the 1,064 nm laser is more effective in pigment clearance than the Q-switched 1,064 nm Nd:YAG laser alone for Hori's nevi.     

Cyclosporin-A nephrotoxicity and acute cellular rejection in renal transplant recipients: correlation between radionuclide and histologic findings

Serial radionuclide studies using both Tc-99m DTPA (perfusion) and I-131 hippuran (tubular function) were correlated with histologic findings in 25 patients with renal transplants. These cases included 15 cases of cyclosporin-A nephrotoxicity (CsA-NT) and ten cases of acute cellular rejection that were retrospectively selected on the basis of biopsy findings and favorable clinical response to therapy specific for each of these conditions. The serial radionuclide studies enabled the correct diagnosis in 12 of 15 cases of CsA-NT and eight of ten cases of acute rejection. Posttherapy radionuclide studies, furthermore, demonstrated improvement consistent with clinical response. In all cases, the radionuclide results were available at least 24 hours before biopsy findings. These results indicate that serial radionuclide studies evaluating interval changes in both perfusion and tubular function are of significant value in the diagnosis and follow-up of CsA-NT and acute cellular rejection in transplant recipients. This initial experience suggests a sensitivity of 80%.     

Inducing capacity of the combinations mecillinam-ampicillin and mecillinam-ceftazidime in comparison with the capacity of the compounds administered separately

The inducing capacity of mecillinam in combination with ampicillin or ceftazidime was compared with that of the compounds administered separately and related to the inducing capacity of cefoxitin (1 and 10 micrograms/ml) for the chromosomal beta-lactamases from Enterobacter cloacae, Serratia marcescens, Citrobacter freundii, indole-positive Proteus, and Acinetobacter strains. In the majority of the strains all compounds tested alone or in combination showed a lower inducing capacity than cefoxitin at both concentrations (less than twofold); in a few strains a moderate inducing capacity was observed. In general, the inducing capacity of cefoxitin 10 micrograms/ml was similar to that of 1 microgram/ml. Only in two E. cloacae, two S. marcescens and two indole-positive Proteus strains did 10 micrograms/ml cefoxitin show a distinctly higher inducing capacity. The variation in inducing capacity within one species and between the species was remarkable.     

Meningitis due toFusobacterium necrophorum subspeciesnecrophorum. Case report and review of the literature

Summary This paper reports a case of fatal meningitis caused byFusobacterium necrophorum subsp.necrophorum in a previously healthy five-year-old child. The organism was isolated in pure culture from the cerebrospinal fluid and from intracranial pus obtained at autopsy. The role ofF. necrophorum in the development of meningitis is reaffirmed and its isolation and identification are discussed. The clinical presentation of the present case resembles the previously published reports and highlights the poor prognosis in spite of appropriate antibiotic treatment.

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Meningitis durch Fusobacterium necrophorum Subspecies necrophorum. Fallbeschreibung und Literaturübersicht

Zusammenfassung In der vorliegenden Arbeit wird der Fall eines vorher gesunden fünfjährigen Kindes beschrieben, das an einer Meningitis, verursacht durchFusobacterium necrophorum Subspeciesnecrophorum, verstorben ist. Der Keim wurde aus Liquor und autoptisch entnommenem intrakranialem Eiter in Reinkultur isoliert. Die Rolle vonFusobacterium necrophorum als Meningitiserreger und die Techniken zur Isolierung und Identifikation des Keimes werden diskutiert. Der vorgestellte Fall ähnelt früher publizierten Beschreibungen und verdeutlicht die schlechte Prognose der Infektion auch bei adäquater Antibiotika-Therapie.

     

Activity of beta-lactamase in Pseudomonas aeruginosa as studied by HPLC

Mutants with increased resistance were selected from a clinical isolate of Pseudomonas aeruginosa using ceftazidime, piperacillin and carbenicillin. The MICs of these antibiotics and of ticarcillin were determined for the parent strain and for the selected mutants. Subsequently, cell-free extracts of the strains were prepared and the rates of hydrolysis of several beta-lactam substrates by the extracts were determined by HPLC procedures. It appeared possible to determine beta-lactamase activities in the crude cell extracts at the low substrate concentrations which may be attainable in the periplasm of Gram-negative bacteria. It is concluded that the increased drug MICs for mutants selected with ceftazidime or piperacillin, but not for those selected with carbenicillin, were caused by increased chromosomal beta-lactamase activity.     

Evidence for lectin-mediated adherence ofMoraxella catarrahlis

Summary Clinical isolates ofMoraxella catarrhalis (n=86) were evaluated for their haemagglutinating activity with different types of erythrocytes. Of all the isolates tested, 12 did not agglutinate with any of the erythrocytes, whereas 65 reacted with human erythrocytes of type A, B, and 0, and 26 with erythrocytes from rabbit, guinea pig, dog, or rat. None of the isolates agglutinated with sheep and goat erythrocytes. The agglutination titres ranged from 0 to 64. Among these isolates, 13 different agglutination patterns could be distinguished. The agglutinating activity was Ca²⁺-dependent and was inhibited by proteases, by temperatures exceeding 50°C and by the addition of D-glucosamine or D-galactosamine. The adherence capacity of theM. catarrhalis isolates to tracheal epithelium correlated with their agglutination titre and could be inhibited by the same treatments. These data provide strong evidence that adherence ofM. catarrhalis is mediated by lectins located on the bacterial surface.

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Nachweis lektin-vermittelter Adhärenz vonMoraxella catarrhalis

Zusammenfassung 86 klinische Isolate vonMoraxella catarrhalis wurden auf ihre Fähigkeit zur Agglutination mit verschiedenen Erythrozytenarten geprüft. 12 der geprüften Isolate zeigten keinerlei Agglutination mit Erythrozyten. 65 reagierten mit menschlichen Erythrozyten der Blutgruppen A, B und 0 und 26 mit Erythrozyten von Kaninchen, Meerschweinchen, Hunden oder Ratten. Keines der Isolate agglutinierte Erythrozyten von Schafen oder Ziegen. Die Agglutinationstiter lagen in einem Bereich von 0–64. Die Isolate boten 13 verschiedene Agglutinationsmuster. Die Agglutinationsfähigkeit war abhängig von Ca⁺⁺ und wurde durch Proteasen, Temperaturen über 50°C und die Zugabe von D-Glukosamin oder D-Galaktosamin gehemmt. Die Fähigkeit vonM. catarrhalis, sich an Trachealepithel anzuheften, korrelierte mit dem Agglutinationstiter und konnte durch dieselben Behandlungen gehemmt werden. Diese Daten bieten deutliche Hinweise dafür, daß die Adhärenz vonM. catarrhalis durch Lektine auf der Oberfläche der Bakterienzelle vermittelt wird.

     

The prevalence of anti-Helicobacter (Campylobacter) pylori antibodies in patients and healthy blood donors

An enzyme linked immunosorbent assay (ELISA) with a sonicated suspension of Helicobacter (Campylobacter) pylori as antigen was used to detect anti-H. pylori antibodies in 517 patients without dyspepsia or peptic ulcer symptoms and 401 healthy blood donors. The criterion of seropositivity was determined from a receiver operating curve computed with the values of optical densities of 48 sera from dyspeptic patients with proven helicobacter-associated gastritis and 16 sera from dyspeptic patients with normal antral mucosa and no microbiological or histological evidence of H. pylori infection. The 227 (44%) seropositive persons amongst the patient group appeared to be significantly higher than the 142 (35%) sera with antibodies in the blood donors tested (p less than 0.03), even when adjustment was made for increasing age. We conclude that the prevalence of antibodies against H. pylori increases with age and that although antibodies are more prevalent in patients attending a hospital than in healthy blood donors, seropositivity suggestive of current or past infection can be found in one third of a randomly chosen population of blood donors.