误诊2年的左上臂难辨认体癣1例

报道1例由须癣毛癣菌引起的难辨认体癣。患者女,45岁,左臂伸侧多处红斑、丘疹伴脱屑、瘙痒2a余。曾多次就医诊断不明,患处皮损取活检做病理检查倾向于＂银屑病＂但疗效不佳。刮取皮屑镜检见真菌菌丝,小培养见葡萄串状小分生孢子及螺旋菌丝,尿素酶试验阳性,毛发穿孔试验阳性,鉴定为须癣毛癣菌。经内服特比萘芬和外用萘替芬酮康唑乳膏治疗28d后皮损消退,复查真菌阴性。     

须癣合并面颈部体癣1例

患者男,57岁。面部红斑、丘疹、唇部脓疱灼痛2个月余。曾口服和外用多种中药治疗无效且呈加重趋势。取皮屑、胡须镜检见大量真菌菌丝,培养见棒状分隔大分生孢子、葡萄串状小分生孢子。尿素酶实验阳性、毛发穿孔实验阳性,鉴定为须癣毛癣菌。经内服伊曲康唑胶囊和外用盐酸布替萘芬乳膏治疗10 d后病情好转,2个月后皮损消退。复查真菌阴性。     

难辨认癣1例

36岁女性患者,右小腿丘疹红斑、脓疱、渗液伴瘙痒5个月。查体见:右小腿可见大小不等的丘疹红斑,伴有糜烂渗液。真菌荧光镜检:阳性,真菌培养:须癣毛癣菌,诊断:难辨认癣。口服伊曲康唑分散片0.1 g,2次/日,外用酮康唑乳膏2次/日,治疗2周后,皮损明显好转,治疗1个月后,右小腿皮肤基本恢复正常,目前随访中。     

误诊为头皮脓肿经抗生素及植皮治疗无效的脓癣——附2例报告

目的 报道2例误诊为头皮脓肿经长期抗生素及植皮治疗失败的须癣毛癣菌所致的脓癣病患者,分析脓肿和脓癣的鉴别要点。方法 例1为9岁男童,头皮外伤后脓肿、溃疡28d,经抗生素治疗无效,行植皮术后5d再发生脓肿溃疡。取皮损处断发行10％KOH涂片镜检、培养,发现并分离出致病真菌,沙堡弱琼脂培养基上呈白色粉状菌落,可使含尿素培养基变红,即尿素酶试验阳性,小培养见螺旋菌丝及分隔棒状大分生孢子,鉴定为须癣毛癣菌。例2为8岁女童,头顶脓肿、溃疡24d,抗感染治疗不愈而接受植皮,术后7d再发脓性丘疹。从皮损处标本中发现、分离出致病真菌,经上述方法鉴定为须癣毛癣菌。结果 2例患者结合真菌学检查和临床表现确诊为脓癣,予伊曲康唑100mg／d内服近2个月皮损均痊愈,但供皮区遗留瘢痕和色素改变。结论 真菌病原学检查是避免脓癣误诊的关键,伊曲康唑内服治疗脓癣有效、安全。     

母女共患须癣毛癣菌感染3例CSCD

病例1,女,9岁,头皮红斑、丘疹、脱屑,伴脓肿1个月,切开引流术后1 d;病例2,女,9岁,鼻背红斑2周伴脓疱3 d。病例3,女,38岁,面部红斑、脱屑,伴瘙痒1周。病例1、2为孪生姐妹,病例3为病例1、2的母亲。3例患者皮损经真菌镜检、培养及分子生物学测序均鉴定为须癣毛癣菌。病例1密切接触过流浪猫。病例1诊断为脓癣,经口服甲泼尼龙(美卓乐)片,口服伊曲康唑胶囊,外用酮康唑洗剂后病情明显好转。病例2、3诊断为面癣,外用卢立康唑4周后痊愈,未留瘢痕。以上病例目前仍在随访中。     

面癣误诊1例

报道由须癣毛癣菌感染引起并被长期误诊的面癣1例。患者女,37岁,因"面部反复红斑、丘疹、水疱伴瘙痒半年"就诊。多次被误诊为单纯疱疹、脓疱疮、湿疹、皮肤感染、脂溢性皮炎及玫瑰痤疮等,先后应用抗病毒、抗感染和抗过敏治疗,皮损未能完全消退并逐渐扩大。再次就诊,真菌学直接镜检阳性,真菌培养为须癣毛癣菌。给予口服特比萘芬片、外用联苯苄唑乳膏治疗后痊愈。     

脓癣的发病情况和病原菌变迁:上海地区19年的回顾性研究

目的了解近19年间上海地区脓癣的发病情况、病原菌及其变迁。方法选取头皮屑及头发真菌直接镜检阳性和(或)真菌培养为皮肤癣菌者,记录其临床表现、感染方式及动物接触史等。结果头癣患者1 009例,其中男性437例,女性572例;年龄20 d～93岁,平均10.44岁;脓癣114例(11.30%),其中男性44例,女性70例。年龄20 d～68岁,平均10.60岁,5～10岁最多见(45.61%),其次为5岁以下儿童(31.58%)。感染方式:发内型48例,发外型66例。真菌培养阳性的脓癣95例,其中犬小孢子菌29例(30.53%)、紫色毛癣菌21例(22.11%)、须癣毛癣菌19例(20.00%)、红色毛癣菌15例(15.79%)、断发毛癣菌7例(7.37%)、石膏样小孢子菌4例(4.21%)。脓癣的发病呈上升趋势,须癣毛癣菌脓癣尤为显著。结论上海地区脓癣主要发生于10岁以内儿童,犬小孢子菌是最常见的致病菌,发外型感染较发内型多见。     

须癣毛癣菌致儿童脓癣1例

报道由须癣毛癣菌引起的儿童头部脓癣1例.患儿为4岁幼女,因头皮部丘疹1个月,脓肿4d就诊.内服青霉素V钾无效.取断发镜检查见发外真菌孢子,培养鉴定为须癣毛癣菌,细菌培养为棒状杆菌.经内服和外用特比萘芬抗真菌,静脉输入头孢噻肟钠联合克林霉素及万古霉素抗细菌治疗,12d后脓肿减轻,细菌培养阴转,但真菌培养仍阳性,继续抗真菌治疗2个月后皮损消退,真菌检查阴性.     

面部糖皮质激素依赖性皮炎伴难辨认癣1例

报道面部糖皮质激素依赖性皮炎伴难辨认癣1例.患者男,40岁,面部弥漫红斑、脱屑、丘疹,伴瘙痒、灼热症状,反复发作7a.曾在外院被诊断为脂溢性皮炎、湿疹、接触性皮炎,给予多种糖皮质激素药膏外用.取面部皮屑做真菌直接镜检为阳性,经鉴定为红色毛癣菌.诊断为面部激素依赖性皮炎、难辨认癣.给予伊曲康唑100 mg/次,2次/d,口服;第1周给予曲安奈德益康唑乳膏2次/d外用;第2周给予舍他康唑2次/d外用.2周后患者皮损明显好转,停用口服药物,给予他克莫司1次/d外用.4周后,患者皮损达临床治愈.     

须癣毛癣菌所致面部体癣继发癣菌疹1例

报道1例由须癣毛癣菌引起面部体癣后继发的癣菌疹。患者女,10岁,因右眶周红斑、鳞屑10 d就诊。鳞屑直接镜检查见菌丝,培养生长的菌落鉴定为须癣毛癣菌。内服特比萘芬、外用萘替芬酮康唑乳膏治疗8 d后面部及颈胸部出现片状红斑,考虑为癣菌疹,加服抗过敏、抗炎药物(左西替利嗪、复方甘草酸苷片)、外用卤米松/三氯生软膏14 d后皮损消退。     

Life support for 10 weeks with successful fetal outcome after fatal maternal brain damage.

A 31 year old woman in whom subarachnoid and intracerebral haemorrhage occurred during the second trimester of pregnancy was sustained in intensive care with a respirator for 10 weeks. Computed tomography of the brain showed bilateral intraventricular haemorrhages. Because of drug resistant hypotonic episodes at 31 weeks'' gestation caesarean section was performed, and a boy was delivered. The woman died of spontaneous cardiac arrest two days after caesarean section, and the boy showed normal development. Life support can be continued for several weeks in a modern intensive care unit after fatal insult to the brain even in a pregnant woman without affecting the fetus.     

石膏样小孢子菌面部感染1例并文献回顾

报道1例由石膏样小孢子菌感染所致的面癣.患者为5岁男童,外伤后致右侧面颊部红斑、丘疹、脓疱20余日于我科就诊.真菌镜检显示菌丝阳性;真菌培养生长石膏样小孢子菌.皮损外用酮康唑乳膏两周后复诊,痊愈.随诊观察1个月未见复发.     

Relationship between microtubules and Golgi apparatus in hepatocytes: a quantitative study during experimental nephrosis

In many cell types, microtubules are preferentially associated with the Golgi apparatus. However, the existence of a functional link between these two organelles is still hypothetical. To gain insight into this question, the relationships between microtubules and the Golgi apparatus were studied in rat hepatocytes during experimental nephrosis induced by the aminonucleoside of puromycin. This condition is known to cause prolonged stimulation of plasma protein production by the hepatocytes. Rats were studied 2, 4, 5, 10 and 20 days after aminonucleoside injection. The amount of albumin was measured in serum and hepatic microsomes by laser immunonephelometry. The volume densities of microtubules around the Golgi apparatus and in the remaining cytoplasm were measured by ultrastructural morphometry. Changes of the Golgi apparatus were analysed by measuring the volume density of the whole organelle and the respective proportion of saccules and vesicles. Proteinuria began 5 days after aminonucleoside injection and was accompanied by a decrease in serum albumin and a rise in microsomal albumin. These changes were still more striking after 10 days, but protein and albumin levels were almost back to normal after 20 days. Concomitantly, the volume density of the microtubules increased significantly around the Golgi apparatus (32% after 10 days), and not in the remaining cytoplasm. The Golgi apparatus was enlarged (80% after 10 days) with a higher ratio of secretory vesicle to saccule volume densities. These results show that additional microtubules are present around the Golgi apparatus during the enhanced production of plasma proteins which occurs in nephrosis. They suggest that in hepatocytes, microtubules play a part in the Golgi apparatus function of plasma protein processing.     

Relationship between microtubules and Golgi apparatus in hepatocytes: a quantitative study during experimental nephrosis

In many cell types, microtubules are preferentially associated with the Golgi apparatus. However, the existence of a functional link between these two organelles is still hypothetical. To gain insight into this question, the relationships between microtubules and the Golgi apparatus were studied in rat hepatocytes during experimental nephrosis induced by the aminonucleoside of puromycin. This condition is known to cause prolonged stimulation of plasma protein production by the hepatocytes. Rats were studied 2, 4, 5, 10 and 20 days after aminonucleoside injection. The amount of albumin was measured in serum and hepatic microsomes by laser immunonephelometry. The volume densities of microtubules around the Golgi apparatus and in the remaining cytoplasm were measured by ultrastructural morphometry. Changes of the Golgi apparatus were analysed by measuring the volume density of the whole organelle and the respective proportion of saccules and vesicles. Proteinuria began 5 days after aminonucleoside injection and was accompanied by a decrease in serum albumin and a rise in microsomal albumin. These changes were still more striking after 10 days, but protein and albumin levels were almost back to normal after 20 days. Concomitantly, the volume density of the microtubules increased significantly around the Golgi apparatus (32% after 10 days), and not in the remaining cytoplasm. The Golgi apparatus was enlarged (80% after 10 days) with a higher ratio of secretory vesicle to saccule volume densities. These results show that additional microtubules are present around the Golgi apparatus during the enhanced production of plasma proteins which occurs in nephrosis. They suggest that in hepatocytes, microtubules play a part in the Golgi apparatus function of plasma protein processing.     

Biphasic hypothermia in mice infected with a parasitic nematode, Trichinella spiralis.

In BALB/c mice infected with Trichinella spiralis, changes in body temperature (Tb) were observed over 35 days after the infection. T. spiralis infection induced hypothermia two times at 7 and 28 days after infection. The initial decrease persisted for about one week with a peak (37.1 +/- 0.62 degrees C) around 10 days after the infection, while the later phase persisted for at least one week. Both 10 and 35 days after the infection, there were remarkable decreases in Tb. The serum glucose level of infected mice at 10 days was significantly (p < 0.01) decreased compared with that of control mice at the same number of days, while the level in infected mice at 35 days was not decreased. Moreover, the later phase of hypothermia was prevented by the cyclooxygenase inhibitor indomethacin (10 mg/kg i.p.), while the initial phase was not. We conclude that hypothermia was caused by two different mechanisms, involving the effects of hypoglycemia and prostaglandins.     

蜜蜂螺原体的分离鉴定及致病性研究

从患"爬蜂病"的蜜蜂体内分离到一株螺原体M10,具有典型的螺原体形态和运动性,能透过0.22μm孔径的滤膜,在含青霉素浓度为2000U/mL的R-2培养基中生长良好。该菌株生长需要血清,能利用葡萄糖、精氨酸、不能利用尿素,其16S rDNA序列与Spiroplasma melliferum BC-3(=ATCC33219)同源性为99.86%。通过饲喂菌液的方式,发现供试蜜蜂4d开始出现"爬蜂病"病症,15d内71%的蜜蜂死亡,说明M10对蜜蜂具有较强的致病性,且感染致死的蜜蜂体内螺原体的分离率为100%,利用螺原体特异性16S rDNA引物在感染致死的蜜蜂的不同部位(头、胸、腹、足)均能扩增出螺原体16S rDNA,反映了螺原体对蜜蜂的系统性侵染。     

Suloctidil increases the rat brain cortex microvascular regeneration after a lesion

A "cavity" lesion made by aspiration in the rat occipital cortex induces a parenchymal and a vascular reaction in its vicinity. The first was mainly characterized by cellular necrosis and gliosis, the second by an increase of the vascular network. In vehicle treated rats, a 50% significant increase of the vascular network was observed around the cavity 4 days after the lesion, in comparison to the uninjured contralateral cortex. The effects of a vasoactive substance, suloctidil, on the vascular reaction was studied in the brain cortex. A single oral dose of suloctidil (30 mg/kg; 2 hours before the sacrifice) gave the same effect as the vehicle group. After 8 days of suloctidil oral administration (30 mg/kg; twice daily: 4 days before lesion and 4 days after) a significant increase (123%) of the vascular network was observed around the cavity. The hypothetical ways by which a chronic treatment of suloctidil induces this increase of the neovascularization observed after cortical lesion are discussed.     

Burkitt's lymphoma in the boy: infiltration in the stomach, colon and the retroperitoneum--ileocecal invagination

A 4-year-old boy was hospitalised because showing signs of weakness, slight pain in the abdomen and while urinating. The symptoms occurred 7 days before hospitalisation. The boy did not vomit, nor did he have the urge to vomit, the defecation was regular showing no traces of blood. The physical visit a soft and painless tumefaction was confirmed ileocecally. The echography tests and the computed tomography suggested invagination, not excluding the second substrate. Barium enema showed irreductible invagination. The operative test showed that it was about the ileocolic invagination with extreme thickening of the cecum, the ascedental colon, the intestine and the retroperitoneum walls. A resection of the small intestine and a ileocolic anastomosis was performed. The pathohistological test shows the primar abdominal Burkitt's lymphoma. In spite of the subsequent therapy the boy dies three weeks after the first symptoms' manifestation. We, herewith, suggest at the importance of the echography analysis when diagnosing the Burkitt's tumor and give advantage to this analysis against the computerized tomography. We also point at the huge level of malignancy of the Burkitt's tumor in this boy.