Tuberculosis of the Colon in a Kidney Transplant Patient

ABSTRACT A 58-year-old woman experienced recurrent fever episodes after kidney transplantation. She was treated with antibiotics because of suspicion of staphylococcus infection. Abdominal pain combined with haemorrhagic diarrhoea occurred eight months after transplantation. A barium enema revealed a stenotic process in the middle part of the ascending colon mimicking carcinoma, and hemicolectomy was consequently performed. Histological examination revealed tuberculosis with little granuloma formation and abundant acid-fast tubercle bacilli in the mucosa and submucosa, and only slight perigranulomatous reactions. The patient was successfully treated with triple antituberculous chemotherapy without deterioration of allograft function. Tuberculosis should be suspected in immuno-suppressed patients suffering from pyrexia of unknown origin, even when chest X-ray is normal.     

Preoperative Diagnosis of Renovascular Hypertension

ABSTRACT The gain in the diagnostic power of the routine preoperative bilateral renal vein renin investigation by the inclusion of an acute stimulation of renin release was studied in 25 hypertensive patients with fibromuscular (FMD) and 44 with arteriosclerotic (AS) renovascular disease. Nine FMD and 17 AS patients had renal vein renin ratios ≥1.50 under unstimulated conditions. Of these 26 patients, 8 in each group improved after surgical treatment. Among the 14 FMD and 24 AS patients with ratios <1.50, another 9 FMD and 7 AS patients improved after operation. After acute stimulation of renin release, no less than 18 FMD and 26 AS patients had a unilateral renin secretion from the diseased kidney and of these, 14 FMD and 14 AS patients were successfully treated with operation of the stenosis. Thus the stimulation was necessary for correct preoperative diagnosis in 38% of 32 successfully operated patients, and at the same time the predictive value of a negative test increased from 0.58 to 0.80. It is concluded that acute stimulation of renin release greatly improves the diagnostic power of the renal vein renin investigation in renovascular hypertension.     

Oral electrochemical action after soft drink rinsing and consumption of sweets

Abstract – The aim of this study was to investigate the influence of pH changes in dental plaque and saliva on the magnitude of the galvanic current created when amalgam restorations make contact in the oral cavity. Ten persons with 46 contacts between amalgam fillings in all participated in the experiments. Potential, polarization, and pH measurements were performed before and after Coca-Cola and orange juice rinsing and intake of sweets, which were used as test products. Distilled water was used as a control. The measurements were performed 2, 5, 10, 20, and 30 min after the rinsing or intake. There was no statistically significant difference in the current magnitude after any test product or between the time intervals after the different products. The results indicated that changes of the plaque and saliva pH for a short time after food and soft drink intake do not influence the magnitude of the galvanic current flowing between amalgam restorations in contact.     

Electrochemical potentials of amalgam restorations in vivo

Abstract The potentials of 407 amalgam restorations have been determined in vivo. The measurements were performed with very high impedance equipment, and relative to a Ag/AgCl reference electrode. The readings varied from — 23 mV to —595 mV, with 90% of the readings confined to within — 127 mV to —431 mV and a mean value of —226.1 mV. Of the restorations, 394 were measured twice, and no significant difference could be found between the first and the second reading. During the study, eight new restorations were inserted. Their potentials varied from —180 mV to —565 mV, with a mean of —339.4 mV, which was significantly lower than that of the older restorations.     

CYTOFLUOROMETRIC QUANTIFICATION OF SOMATOPETAL AXONAL TRANSPORT: EFFECTS OF A CONDITIONING LESION AND 2,5-HEXANEDIONE

Cytofluorometric quantification of axonally transported fluorescein isothiocyanate (FITC)-labelled wheat germ agglutinin (WGA) from the injection site in the snout area was performed in the facial nucleus at various times during regeneration of one of the facial nerves. Measurements were made on single neurons on both operated and non-operated sides in three different groups of mice 8, 12 and 16 days after a nerve crush, Group 1: (control group) animals with a nerve crush, Group 2: animals with a conditioning lesion (nerve injury) made 3 days before the nerve crush, and Group 3: animals exposed daily to 2,5-hexanedione from 2 weeks before nerve crush until killing. A conditioning lesion caused a more rapid return of transport in regenerating nerves but there was no evidence for an increase in the total amount of transported FITC-WGA. For mice exposed to 2,5-hexanedione a transient increase of tracer transport in regenerating nerves could be demonstrated on day 12 after nerve crush. On day 16, however, a reduction of transport was seen in both operated and non-operated nerves. This study shows that it is possible experimentally to manipulate the influx of macromolecules to the nerve cell body from the periphery during nerve regeneration, and the present method offers the opportunity to study quantitatively the effects of various treatments on reinnervation of a muscle.     

Strong Suppression by Mononuclear Leukocytes From Cord Blood of Human Newborns on Maternal Leukocytes Associated With Differences in Sensitivity to Prostaglandin E2*

ABSTRACT: We have tested peripheral mononuclear leukocytes (PML) from the cord blood of newborns, from sera of their mothers, and from sera of nonrelated nonpregnant adult women for sensitivity to suppressive exogenous prostaglandin E₂ (PGE₂). Endogenous PG production was simultaneously inhibited by indomethacin 2.8 μM. The phytohemagglutinin-stimulated (PHA-stimulated) uptake of tritiated thymidine (³H-TdR) by PML from the mothers and the nonpregnant women was suppressed by the exogenous PGE₂ at a concentration of 1.4 × 10^?8 M, 100 times less than the one required to suppress the PML from newborns (1.4 × 10^?6 M). In addition, 1.4 × 10^?7 M or less of PGE₂ reversed the suppression of neonatal PML to stimulation. The maternal PML were reversed into stimulation at 1.4 × 10^?9 of exogenous PGE₂. The amount of endogenous PGE₂ synthesized by 1 × 10⁶ fresh, nonstimulated neonatal PML according to gas chromatography-mass spectrometry assay was 5 ng (1.4 × 10^?8 M). The synthesis increased to 27 ng/10⁶ cells after 18 hours' incubation. These concentrations are similar to the ones of exogenous PGE₂ at which neonatal PML were slightly stimulated but the maternal cells were still suppressed. Preincubation for 18 h at 37°C decreased the PGE₂-induced suppression of the adult PML but did not change the response of the neonatal PML.     

Alloiococcus otitidis —otitis media pathogen or normal bacterial flora?

During the last decade a new potential otitis media pathogen, Alloiococcus otitidis, has been studied. It is still not clear whether this bacterium really is a pathogen, although it has been found in a high percentage of middle ear effusions in children. The present study aimed to investigate the presence of A. otitidis in the nasopharynx and outer ear canals, and to develop a culture method that would make it possible to isolate A. otitidis from these locations. Nasopharyngeal samples (n=129) from children below 6 years were investigated by conventional culture on blood agar plates with 6% saline and rabbit antisera against A. otitidis, and by a PCR method. In the same way, we investigated 10 samples from vestibulum nasi of healthy persons, 68 samples from outer ear canals of patients with acute or chronic ear problems, and 24 samples from outer ear canals of healthy persons. In a rat model of acute otitis media, we instilled living A. otitidis into rat middle ears through the tympanic bulla and evaluated the outcome clinically by otomicroscopy at days 3, 6 and 14. Of the 129 nasopharyngeal cultures, 9 were positive for A. otitidis by PCR, but none by the culture method. Of the 68 samples from patients with running ears, 4 were positive for A. otitidis by PCR, but none by the culture method. Of the 24 healthy ear canals, 7 were positive for A. otitidis by PCR and 3 of them also by the culture method. No A. otitidis could be found from the vestibulum nasi. The rat experiment showed that the reactions in the middle ears were mild; we could not provoke a purulent acute otitis media in any of the rats. There was a 7% prevalence of A. otitidis in children below 6 years. The highest prevalence (29%) was found in outer ear canals of healthy persons, which strongly suggests that A. otitidis is part of the normal bacterial flora of the outer ear canal. The doubtful pathogenicity is also confirmed by the fact that—in the rat model—A. otitidis elicited only a mild response in the middle ear. It was possible to isolate A. otitidis using a blood agar plate with 6% saline.     

Atrial synchronous ventricular pacing in ischaemic heart disease

Atrial synchronous pacing has been considered contraindicatedin patients with a high degree of atrioventricular block andconcomitant ischaemic heart disease. The rationale for thisview was a fear of provoking angina pectoris by a rate-dependentincrease in myocardial oxygen consumption. As possible problemswith atrial synchronous pacing in patients with ischaemic heartdisease have not been extensively studied we have examined whetherthese patients could benefit from this more physiological methodof pacing. Thirteen patients with ischaemic heart disease and a high degreeof atrioventricular block were supplied with pacemakers, programmableboth in reference to the pacing mode (ventricular inhibited(VVI) or atrial synchronous ventricular inhibited (VDD)) andfor maximal synchronous rate. The patients were examined withthe pacemaker programmed in the VVI and VDD modes. Maximal exercisecapacity was determined by means of bicycle ergometry. Therewas a statistically significant increase in exercise capacitywhen comparing VVI (67+24) with VDD (79+25, P<0.001) pacingwith suitable programming of maximal synchronous rate. No patientexperienced increased anginal pain on VDD pacing and all preferredVDD compared to VVI pacing. In conclusion, VDD pacing shouldnot be considered contraindicated in patients with ischaemicheart disease and a high degree of atrioventricular block, andmay on the contrary, contribute to further clinical improvement.     

Acid Instillation Increases Gastric Luminal Prostaglandin E2 Output in Man

ABSTRACT. The capacity of the gastroduodenal mucosa to maintain integrity when exposed to acid and pepsin may require formation of endogenous prostaglandins (PG). The gastric mucosa is capable of PG biosynthesis, and PGE₂ is present in the gastric contents of man. The purpose of this study was to examine if acidification of the human stomach affects the output of PGE₂. Gastric perfusion was made with 150 mM HC1 in seven healthy subjects pretreated with a histamine-2-receptor blocker (ranitidine). Gastric luminal PGE₂ was measured by gas chromatography-mass spectrometry. Basal output of PGE₂ was 1.42 ± 0.24 pmol/min (mean+SEM), which increased to 5.37 ± 0.91 pmol/min (p < 0.02) during acid perfusion. Gastric acidification did not cause mucosal damage as judged by luminal DNA. We conclude that PGE₂ is synthesized in the gastric mucosa even during nearly complete inhibition of parietal cell secretion. Luminal acid, a likely physiological stimulator of mucosal defense, induces a fivefold increase in PGE₂ output from the intact mucosa.