后部葡萄膜黑色素瘤^125I板放射治疗后的脂质渗出

目的：研究葡萄膜黑色素瘤^125I板放射治疗后与脂质渗出相关的因素。设计：回顾性、干预性、病例系列研究。方法：回顾139例用^125I板放射治疗的葡萄膜黑色素瘤的连续患者的病历记录，脂质渗出作为主要的测量结果。结果：19例患者检出有脂质渗出（13．7％），从放射治疗到脂质渗出的平均时间为10个月（极差3～23个月）。脂质渗出与患者年龄较低（P=0．0002）、低密度脂蛋白增加（P=0．004）、高密度脂蛋白减少（P=0．026）、肿瘤体积增加（P=0．024）及渗出性视网膜脱离（P=0．016）相关。脂质渗出患者伴有视力差（P〈0．0001）及新生血管性青光眼增加（P=0．01）。结论：葡萄膜黑色素瘤^125I板放射治疗后的脂质渗出与眼部预后差相关。脂质渗出相关的因素与辐射性视网膜病变的相关因素完全不同，这些因素为治疗并发症提供依据。     

Deregulation of the Rb and p53 pathways in uveal melanoma

Uveal melanoma is the most common primary eye cancer, yet its molecular pathogenesis is poorly understood. In this study, we investigated the immunohistochemical expression of proteins in the Rb and p53 tumor suppressor pathways in 33 uveal melanomas from enucleated eyes. Strong nuclear staining for Rb was present in most tumors. However, a few cases displayed weak nuclear staining and strong cytoplasmic staining (possibly indicating Rb mutation), and this aberrant staining correlated strongly with failed radiotherapy or thermotherapy before enucleation. Staining for cyclin D1 was positive in most tumors and was associated with advanced age and larger tumor size, which are both poor prognostic factors. Generally, immunostaining for p53 was weak (suggesting a lack of p53 mutations), although p53 positivity correlated strongly with staining for phosphorylated Rb, supporting the notion that inappropriate phosphorylation of Rb can induce p53. Strong immunostaining for MDM2, which can functionally block p53 activity, was observed in most tumors and correlated significantly with female sex. Strong cytoplasmic staining was observed for Bcl2, which can inhibit both p53-dependent and -independent apoptosis. We conclude that Rb and p53 are mutated infrequently in uveal melanoma, but their respective pathways may be functionally inactivated.     

New chromogenic identification and detection of Staphylococcus aureus and methicillin-resistant S. aureus

This paper describes a new chromogenic plate medium, CHROMagar Staph aureus (CHROMagar, Paris, France), for the identification of Staphylococcus aureus on the basis of colony pigmentation. The abilities of CHROMagar Staph aureus, thermostable nuclease (DNase), and mannitol salt agar (MSA) to identify S. aureus isolates (n = 114) and discriminate between S. aureus and coagulase-negative staphylococci (CoNS; n = 22) were compared. CHROMagar Staph aureus proved to be more sensitive and specific than DNase and MSA, allowing a reliable, simple, and rapid method for the identification of S. aureus isolates. All CoNS encountered in this study with the exception of S. chromogenes could be easily differentiated from S. aureus on this medium. The supplementation with 4 microgram of oxacillin or methicillin per ml allowed simple identification of methicillin resistance in hospital-acquired S. aureus strains which show multiple-drug resistance profiles. Community-acquired methicillin-resistant S. aureus strains showing non-multi-drug resistance profiles require further evaluation on this new chromogenic medium. Methicillin or oxacillin resistance of all S. aureus isolates was confirmed by the detection of penicillin-binding protein 2a, encoded by the mecA gene, using the latex slide agglutination MRSA-Screen test (PBP 2' Test, DR900M; Oxoid).