A Study on Using Improved Methenamine-silver Stain to Diagnosis of Pneumocystis carinii

ＡＳｔｕｄｙｏｎＵｓｉｎｇＩｍｐｒｏｖｅｄＭｅｔｈｅｎａｍｉｎｅ－ｓｉｌｖｅｒＳｔａｉｎｔｏＤｉａｇｎｏｓｉｓｏｆＰｎｅｕｍｏｃｙｓｔｉｓｃａｒｉｎｉｉＣｈｅｎＸｉｗｅｉ（陈锡慰）（ＤｅｐａｒｔｍｅｎｔｏｆＰａｒａｓｉｔｏｌｏｇｙ，ＮａｎｊｉｎｇＭｅ...     

An outbreak of Pneumocystis carinii pneumonia in children with malignancy

An outbreak of Pneumocystis carinii pneumonia (PCP) in three patients within a 6 week period was reported. Two patients had acute lymphoblastic leukaemia and one had brain-stem glioma. They shared common features of immuno-suppression and absence of cotrimoxazole prophylaxis and had been nursed in the same room. The severity of PCP and its response to treatment may be related to the degree of immunosuppression. Because of the morbidity and mortality of PCP, chemoprophylaxis should be given to all at-risk cases. Furthermore, isolation of patients with PCP should be considered in view of increasing evidence of nosocomial transmission.     

Focal lung uptake of Gallium-67 in patients with acquired immunodeficiency syndrome secondary to pneumocystis carinii pneumonia

It is generally accepted that the lung uptake of ⁶⁷Ga in patients with pneumocystis carinii pneumonia (PCP) is diffuse and bilateral. Three cases of focal lung uptake of ⁶⁷Ga in AIDS patients with PCP but without other opportunistic infection are described. While focal lung uptake is characteristic of opportunistic infections other than PCP, we wish to emphasize that focal uptake of gallium in the chest does not rule out PCP and may represent its earliest stage of presentation.     

Indium-111 labelled pooled human immunoglobulin imaging to monitor the efficacy of specific therapy for Pneumocystis carinii pneumonia

Functional imaging is ideally suited to monitoring the effect of specific therapy on disease processes. In this pilot study five patients with AIDS and Pneumocystis carinii pneumonia (PCP) were imaged with Indium-111 labelled pooled human immunoglobulin (111In-HIG) during infection and after therapy for PCP. The lung activity of t t tln-HIG, measured as a lung/heart ratio, was calculated in a study performed during infection with PCP and after therapy. In all five patients the lung/heart ratio of t t 1ln-HIG was reduced after treatment. The mean reduction in heart/lung ratio was 27% (range 12%-53%). If these results are confirmed by a larger study, ¹¹In-HIG will be useful in monitoring the response of PCP to therapy in patients with AIDS.     

肾移植术后并发卡氏肺孢子虫病活检的病理学研究

报告肾移植术后５例并发卡氏肺孢子虫肺炎。采用纤维支气管镜活检，分别对印片及组织进行银染和ＨＥ染色。病变为上皮细胞脱落，有时增生呈立方状；炎症反应；各种类型渗出物（包括泡沫状渗出物、泡沫细胞团及絮状蛋白渗出物）等３种改变。重点讨论了本病的组织病理学特征，并对不典型病变形成机理加以讨论。     

卡氏肺孢子虫的超微结构观察

采用皮下注射醋酸可的松和低蛋白饲养方法诱发SD大鼠自然感染卡氏肺孢子虫后,取其肺组织,按常规方法进行透射电镜的系统观察。结果除为Yoshida提出的卡氏肺孢子虫生活史的有性增殖和无性增殖循环的最新设想提供了某些形态学依据外,还继Vossen等之后再次发现该病原在1型肺泡上皮细胞内寄生的情况。本文最后就卡氏肺孢子虫对宿主的致病机理进行了讨论。     

地塞米松诱发大鼠卡氏肺孢子虫肺炎实验研究

目的 在地塞米松磷酸钠诱导下建立大鼠卡氏肺孢子虫肺炎的动物模型。方法 将40只雌性SD大鼠随机分为实验组和对照组,前者皮下注射地塞米松磷酸钠,1mg/次,2次/w;后者不做任何处理。观察两组大鼠的发病情况,并每隔3周两组各取5只动物进行病原学检查。结果 实验组大鼠第6周开始发病,肺印片、支气管肺泡灌洗液沉渣中查到卡氏肺孢子虫包囊及滋养体;对照组大鼠无异常表现,病原学检查阴性。结论 在地塞米松磷酸钠诱导下可成功建立大鼠卡氏肺孢子虫肺炎动物模型。     

卡氏肺孢子虫感染动物模型建立与电镜观察

（1）目的 观察卡氏肺孢子虫及病变肺组织超微结构,探讨卡氏肺孢子虫的可能致病机制。（2）方法 肌注地塞米松诱发大鼠卡氏肺孢子虫肺炎,取其肺组织,按常规方法进行透射电镜观察。（3）结果 电镜下第22-28天即可观察到卡氏肺孢子虫的感染,以包囊为主;第43-56天达重度感染,以滋养体为主,肺泡腔内多见,肺间质中少见,中性粒细胞、肺泡巨噬细胞和Ⅱ型肺泡上皮细胞内也可见到。（4）结论 大滋养体伸出丝状伪足与Ⅰ,Ⅱ型肺泡上皮细胞粘连使上皮细胞发生变化。Ⅱ型上皮细胞发生凋亡。     

磺胺脱敏方案治疗系统性红斑狼疮合并卡氏肺孢子菌肺炎一例病例分析

 目的报道一例系统性红斑狼疮（systemic lupus erythematosus,SLE）合并卡氏肺孢子菌肺炎（Pneumocystis pneumonia,PCP）的临床表现以及按照治疗指南对该例有磺胺过敏史的患者使用磺胺脱敏方案治疗的过程。方法参与我院重症监护病房收治的一例系统性红斑狼疮（systemic lupus erythematosus,SLE）合并卡氏肺孢子菌肺炎（Pneumocystis pneumonia,PCP）,并有磺胺过敏史患者的治疗讨论,并对其临床资料进行回顾性分析。结果与结论此病例因磺胺药物过敏,采取抗感染并磺胺脱敏方法治疗后,症状缓解,痰涂片卡氏肺孢子菌肺炎阴性。通常认为感染是威胁自身免疫性疾病患者生命的主要原因,临床对于系统性红斑狼疮合并卡氏肺孢子菌肺炎采取综合性治疗是必要的措施。对于磺胺过敏而使用替代药物有禁忌证或疗效不理想的患者,建议参照治疗指南磺胺药物脱敏方案进行救治。     

Acquired Immunodeficiency Syndrome (AIDS)

The Acquired Immunodeficiency Syndrome (AIDS), caused by the human immunodeficiency virus (HIV), also called the human T-lymphotropic virus type III/lymphadenopathy-associated virus [HTLV-III/LAV], has affected over 23,000 people; more than half of those with the disease have died. The actual case fatality rate approaches 100%. AIDS affects all groups and classes of people, although some are at special risk. Distribution of the disease is worldwide. The illness' effects on the body are widespread; of special interest are the ophthalmologic manifestations. The eye may be infected by various viruses (cytomegalovirus, varicella-zoster virus, herpes simples virus or HIV itself), toxoplasma gondii, candida sp, cryptococcus neoformans, M. tuberculosis, or M. avium-intracellulare. Kaposi's sarcoma may affect the eye as well. Retinal vascular abnormalities (e.g., cotton-wool spots, vasculitis) are not uncommon in AIDS. The syndrome may present with neuro-ophthalmologic manifestations. No effective treatment for the illness is currently available, although several hold promise and there is hope for an AIDS vaccine. Prevention of infection through reduction of risks appears to be the only defense against AIDS at this time.