Cryptococcus neoformans: A central nervous system isolate from an AIDS patient that is rhinotropic in a normal mouse model

A strain of Cryptococcus neoformans that was isolated from the cerebrospinal fluid of a human diagnosed as having acquired immunodeficiency syndrome (AIDS), and that produced cutaneous lesions in experimentally infected, normal mice is described. Although no unusual cutaneous manifestations were noted in the patient's records, this isolate of C. neoformans proved to be dermotropic when injected intravenously into CD-1 mice. The LD₅₀ at 28 days post infection ranged from 3.6–7.5×10⁵ cells per mouse, and in vitro growth rate studies demonstrated that this isolate grew well at 35 °C and at 37 °C, but did not grow at 40 °C and higher. This isolate was rhinotropic producing large granulomatous lesions in the nasal tissues. Other cutaneous tissues affected were the periocular tissues, ears, feet and tail, although the granulomas were nodular in structure and less necrotic than the nasal lesions. The brain, lungs, liver, kidneys and spleen also were culture positive for C. neoformans. Histopathologically, each affected tissue examined had large densities of yeast cells and a chronic, granulomatous host response. Animals surviving the infection appeared to develop a commensal-type relationship with the infective yeast. This is the first report of an isolate of C. neoformans from an AIDS patient that has caused cutaneous manifestations in an animal model. The model described in this report may be useful for elucidating pathogenic mechanisms of cryptococcosis, particularly cutaneous manifestations of the disease.     

一种引致人体原发性皮肤毛霉病的非高温根毛霉属真菌

由石家庄中国人民解放军白求恩国际和平医院皮肤科李成龙大夫提供的一株人体皮肤病菌经我们研究鉴定为毛霉目(Mucorales)毛霉科(Mucoraceae)根毛霉属(Rhizomucor)的一个种,并定名为多变根毛霉新种(Rhizomucor variabilis Zheng & G.-q.Chen sp. nov.)。据李大夫介绍,这株菌是从一名居住在江苏农村到该医院看病的女病人的手上病部分离的。这个病人没有一般真菌病病人所患有的其他疾病如糖尿病、白血病等等。她也没有患有其他毛霉病,因此她的皮肤毛霉病是原发性的而不是继发性的。我们查阅文献结果,国内由根毛霉属真菌引致的毛霉病过去仅有过一次肺部感染的报道;国外则有过较多次数的由根毛霉引致的人体毛霉病,主要为肺部疾病并可引致继发性的皮肤病,尚未见有由根毛霉属引起的原发性皮肤毛霉病的报道。无论国内、外引起人体毛霉病的根毛霉均为微小根毛霉[Rhizomucor pusillus(Lindt) Schipper,包括Mucor pusillus Lindt,Mucor parasiticus Lucet & Costanin等异名]一种。因此,本病例为我国第二例由根毛霉弓l起的人体毛霉病及第一例由根毛霉引起的人体皮肤毛霉病,同时又是全世界第一例由根毛霉属除微小根毛霉以外的另外一个种引起的人体毛霉病,很可能还是全世界第一例由根毛霉引起的人体原发性皮肤毛霉病。多变根毛霉与根毛霉属内所有过去已报道过的种都有显著差异。它的最适生长温度为24-30℃,最低9℃,最高38℃;其他种均为高温真菌,它们的最高生长温度可达55℃或更高。形态方面,多变根毛霉也与属内其他已知种明显不同。它的菌落高达4-8 mm并呈鲜明的浅黄色;其他已知种菌落低矮,除奈尼塔尔根毛霉(Rhizomucor nainitalensis Joshi)外全部为深暗灰色,奈尼塔尔根毛霉菌落色泽虽然较浅,但为浅灰或灰黄色,与多变根毛霉的鲜明黄色不同。它的假根异常发达并可从菌体的各个部位如菌丝、匍匐丝、孢子枝、孢子囊、囊轴上长出;其他已知种的假根一般都不发达且从未见有从孢子枝、孢子囊、囊轴等处长出的描述。它的孢子枝的分枝常常长于主枝;其他已知种则分枝长度一般不超过主枝。它的囊轴形状多变:球形、近球形、扁球形、卵形、椭圆形、梨形等等,两边对称或不对称,溢缩或不绕缩,纵向深裂或不作纵向深裂;其他已知种的囊轴形状通常为倒卵形至梨形的规则形状。它的囊领明显;其他已知种的囊领均很不明显至缺如。它的孢囊孢子形状和大小变化都较大,卵形、椭圆形、矩圆形、近球形、近三角形或其他各种不规则形状,长度范围2.5-16.5 μm;其他已知种除上面已经提到过的奈尼塔尔根毛霉外,它们的孢囊孢子形状仅限于卵形、椭圆形、近球形等较规则的形状,长度范围总是在3-6 μm范围内,奈尼塔尔根毛霉的孢囊孢子形状虽然多变,但其决度亦在3-6 μm的范围内。此外,多变根毛霉的孢子囊、囊轴、孢囊孢子等各种构造均较大;其他已知种则较小,其中肿梗根毛霉[Rhizomucor tauricus (Milko & Schkurenko) Schipper]虽亦较大,但除此之外与多变根毛霉迥异。多变根毛霉未见有接合孢子,将我们保存的全部微小根毛霉菌株与它分别配对时,或将我们的几对别的属的(+)(-)测试菌株与它分别配对时,均未见形成接合孢子或有任何反应。     

又一种引致人体原发性皮肤毛霉病的非商温根毛霉属真菌

一年多以前,我们报道了一种引致人类原发性皮肤毛霉病的病原真菌Rm6并定名为多变根毛霉((Rhizomucor variabilis Zheng & G.-q. Chen)。最近我们又发现了它的另外一个变种Rm7。它是北京医科大学第一医院的王端礼教授分离的,原编菌号4873。Rm7的病人和Rm6的情况很相近。她也是一个女病人,来自农村,患的同样是原发性皮肤病而没有患有其他的毛霉病或其他疾病,她的病也没有传染给她的家人。不同的是,她来自我国北部的河北省而不是南部的江苏省;她的病史更长,达16年之久;她的病部在脸上而不是在手上,并造成进食困难。Rm7和Rm6的培养物相似,也是亮黄色,但比较低矮。它与Rm6一样是非高温真菌,最适、最高、最低温度同样分别是24-30, 38,和9℃形态上的亲缘性也是显而易见的:两者都有匍匐菌丝和较发达的假根;孢子枝也是假轴分枝;孢子囊壁也是缓慢消解;有很不规则形状的囊轴;有明显的囊领;都有大量厚垣孢子。Rm7与Rm6的主要区别在于:(1)假根只从匍匐菌丝和气生菌丝上长出而不从孢子枝、孢子囊或囊轴等各处长出;(2)孢子枝可连续分枝达7次之多;(3)孢子枝在分枝处往往有一个隔膜;(4)往往在10天以上的培养物中才出现不规则形状的囊轴;(5)从未见有囊托;(6)孢囊孢子形状较规则,较短而不超过11 μm;(7)孢子囊和囊轴均较小,直径相应不超过70及30 μm.因此,我们将Rm7鉴定为Rm6的一个变种,并定名为较规则多变根毛霉新变种(Rhizomucor variabilis var. regularior Zheng & G.-q. Chen var.nov.)。这样,在根毛霉属内可以承认的共计5种6分类群。     

Synaptic repression at crayfish neuromuscular junctions. II. Evidence for calcium involvement

The inability of synaptic junctions to generate normalsized postsynaptic potentials under normal physiological conditions was studied at crayfish neuromuscular synapses. Synaptic repression in the superficial flexor muscle system of the crayfish was induced by surgery: the nerve was cut in the middle of the target field, and the lateral muscle fibers were removed. After this surgery, the remaining medial synapses were unable to generate normal-sized junction potentials (jp) over the medial muscle population. In an attempt to study the mechanism underlying this response, we varied the extracellular calcium concentration of the Ringers solution bathing the preparation, in both repressed and control animals, while monitoring the size of the same junction potential. The junction potential generated by the spontaneous activity of the nerve increased in size with increasing calcium concentrations in control animals, but failed to do so in repressed animals, that is, changes in external calcium concentrations did not affect repressed synapses. However, in the presence of the calcium ionophore A23187, control and repressed synapses both show an increase in the junction potential sizes they generate. Our data suggest that calcium is involved in the mechanisms that underlie synaptic repression in this crustacean neuromuscular system. © 1993 John Wiley & Sons, Inc.     

Automated localisation and boundary identification of superficial femoral artery on MRI sequences

In this paper, an automated method to localise the right superficial femoral artery (SFA) and identify its boundary on magnetic resonance imaging (MRI) sequences without contrast medium injection is proposed. Some anatomical knowledge combined with the mathematical morphology is used to distinguish SFA from other vessels. Afterwards, the directional gradient, continuity and the local contrast are applied as features to identify the artery's boundary using dynamic programming. The accuracy analysis shows that the system has average unsigned errors 3.1 ± 3.1% on five sequences compared to experts' manual tracings.     

MHO对苹果虎皮病发生和果皮活性氧代谢的影响

为研究6-甲基-5-庚烯-2酮(MHO)诱导苹果虎皮病发病以及对果皮活性氧代谢的影响,该实验将冷藏210d的红星苹果用0.5、1.0、2.0mL/L的MHO进行外源处理后,测定其内源MHO含量,在25℃下放置10d后,期间定期测定货架期果皮中的MDA、O2.-、H2O2含量,以及PPO、SOD、CAT、POD活性的变化。结果表明,随着MHO处理浓度的增加,红星苹果果皮中MDA、O2.-、H2O2的含量也随之增加;果皮中的PPO活性逐渐上升,SOD、CAT、POD的活性随着MHO的处理浓度增加而降低;随着MHO处理浓度的增加,果实虎皮病的发病率也随之升高,同时果皮内源MHO含量也随之逐渐增加。研究认为,外源MHO可能通过降低抗氧化酶活性进而参与苹果虎皮病的发病过程。     

Comparison of five different scoring methods in the evaluation of inflammatory infiltration (tumor‐infiltrating lymphocytes) in superficial spreading and nodular melanoma

The objective of our study was to compare the five different scoring methods of tumor‐infiltrating lymphocytes (TILs) assessment in a group of 213 cases of superficial spreading and nodular melanoma. The scoring methods include (a) Clark scoring; (b) Melanoma Institute Australia system; (c) scoring system used in the study of Saldanha et al.; (d) scoring system used in the TCGA study and modified by Park et al.; and (e) the system recently proposed by the “International Immuno‐Oncology Biomarker Working Group” for TILs scoring in all solid tumors. Prediction of survival with three main outcomes—disease‐specific‐free survival, local recurrence‐free survival, and distant metastasis‐free survival—was evaluated. The prognostic value of TILs showed statistical significance in univariate analysis regarding all three of the outcomes only for three of the five evaluated methods; the Clark scoring, the Melanoma Institute Australia system, and the system proposed by the “International Immuno‐Oncology Biomarker Working Group”. However, in multivariate analysis with covariants including Breslow thickness, type of melanoma, location, sex, and age, we did not find TILs to be an independent prognostic factor.     

Deep subcutaneous adipose tissue: a distinct abdominal adipose depot

Objective: Abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) display significant metabolic differences, with VAT showing a functional association to metabolic/cardiovascular disorders. A third abdominal adipose layer, derived by the division of SAT and identified as deep subcutaneous adipose tissue (dSAT), may play a significant and independent metabolic role. The aim of this study was to evaluate depot‐specific differences in the expression of proteins key to adipocyte metabolism in a lean population to establish a potential physiologic role for dSAT. Research Methods and Procedures: Adipocytes and preadipocytes were isolated from whole biopsies taken from superficial SAT (sSAT), dSAT, and VAT samples obtained from 10 healthy normal weight patients (7 women and 3 men), with a mean age of 56.4 ± 4.04 years and a mean BMI of 23.1 ± 0.5 kg/m². Samples were evaluated for depot‐specific differences in insulin sensitivity using adiponectin, glucose transport protein 4 (GLUT4), and resistin mRNA and protein expression, glucocorticoid metabolism by 11β‐hydroxysteroid dehydrogenase type‐1 (11β‐HSD1) expression, and alterations in the adipokines leptin and tumor necrosis factor‐α (TNF‐α). Results: Although no regional differences in expression were observed for adiponectin or TNF‐α, dSAT whole biopsies and adipocytes, while intermediary to both sSAT and VAT, reflected more of the VAT expression profile of 11β‐HSD1, leptin, and resistin. Only in the case of the intracellular pool of GLUT4 proteins in whole biopsies was an independent pattern of expression observed for dSAT. In an evaluation of the homeostatic model, dSAT 11β‐HSD1 protein (r = 0.9573, p = 0.0002) and TNF‐α mRNA (r = 0.8210, p = 0.0236) correlated positively to the homeostatic model. Discussion: Overall, dSAT seems to be a distinct abdominal adipose depot supporting an independent metabolic function that may have a potential role in the development of obesity‐associated complications.     

Estado actual de la histoplasmosis diseminada progresiva en pacientes con infección por el VIH en un hospital de tercer nivel en Perú

BackgroundProgressive disseminated histoplasmosis (PDH) is an endemic disease in most of Latin America, especially among patients with HIV. There are few reports about this disease in Peru.AimsTo describe the clinical, epidemiological and mycological features of patients with PDH and HIV evaluated in a tertiary hospital.MethodsA retrospective study to find out the data of patients diagnosed with PDH and HIV in the period 2000–2019 was carried out. For the statistical analysis of quantitative variables, measures of central tendency and dispersion were used; for the qualitative variables, absolute and relative frequencies were used.ResultsForty-three male patients with PDH were diagnosed in the study period, with a median age of 33 years (IQR: 29–38 years) and a median CD₄ lymphocytes count of 39 cells/mm³ (IQR: 20–83 cells/mm³). Eighty six percent of the patients were born or had travelled to the jungle, 58.1% were alcohol users and 16.1% had a history of pulmonary tuberculosis. When compared to histopathology, the culture had a better sensitivity to achieve a diagnosis (p < 0.05).ConclusionsPeruvian patients with PDH and HIV infection were mainly young male adults that were born or had travelled to the jungle, with a CD₄ count below 100 cells/mm³. In patients with the described characteristics it would be advisable to check for PDH. Implementing rapid diagnostic tests is also necessary.