Optic nerve tuberculoma. A case report.

An intrinsic tuberculoma of the left optic nerve was found at necropsy in a 1 1/2-year-old child with tuberculous meningitis and disseminated miliary tuberculosis.

Mucoepidermoid tumor of the lacrimal sac.

A 58-year-old man had a mucoepidermoid tumor of the lacrimal apparatus. Histologically the tumor exhibited clumps and nests of neoplastic cells that showed an admixture of squamous and mucussecreting cells. Histochemical stains for glycoproteins were useful in arriving at the correct diagnosis. Biologically the tumor seemed to be locally aggressive but not metastatic and should be differentiated histologically from the conventional squamous cell carcinomas, adenoid cystic carcinomas, adenocarcinomas, and adenoacanthomas. Large advanced lesions may be managed only by radical surgery, and the margins should be carefully studied for residual tumor. Frequent follow-up is recommended to detect early recurrence.

Gastric cytomegalic inclusion bodies diagnosed by histologic examination of endoscopic biopsies in patients with gastric ulcer.

Gastric cytomegalovirus (CMV) inclusion bodies, indicating CMV infection were detected in three patients with erosions and ulcers in the upper gastrointestinal tract. In all cases, histologic examination of endoscopic biopsies enabled a diagnosis of CMV infection to be made quickly and safely. We emphasize the importance of the histologic examination of gastrointestinal biopsies in the early diagnosis of CMV infection.

Histopathological and immunofluorescence study of the choroid plexus in hepatosplenic schistosomiasis mansoni.

A histopathological and immunofluorescence (IMF) study of the choroid plexus was performed in 8 cases of hepatosplenic schistosomiasis mansoni and in 20 cases which had resulted in death with no evidence of liver or brain involvement by schistosomiasis or other disease process, and in which renal disease and arterial hypertension were also excluded (control group). IgA, IgG, IgM, C3, and C1q were investigated. Positive IMF in the choroid plexus was found in 75% of the schistosomiasis group. IgA and IgG were the immunoglobulins (Ig) most frequently found. C3 was also commonplace. Histologic examination of the choroid plexus showed changes in 87.5% of the schistosomiasis group. The most frequently found change was characterized by focal, linear, occasionally nodular, subepithelial deposition of a homogeneous, acidophilic, and PAS positive substance, apparently in relation to the epithelial basement membrane, with thickening of this structure. In the control group, the IMF in the choroid plexus was negative in all cases, and only 2 cases (10%) presented histopathological changes of the choroid plexus with a pattern similar to that of the schistosomiasis group. The demonstration of the deposition of Ig and fractions of the complement system, and of histological changes in the choroid plexus in a liver disease which is known to exhibit circulating immune complexes and glomerulopathy with deposition of Ig and fractions of the complement system suggests an etiopathogenetic relationship between both findings.

Human pulmonary granulomas caused by Chrysosporium parvum var. crescens (Emmonsia crescens).

Multiple lung nodules were found at autopsy of a 56-year-old man who died of unrelated cause. The nodules contained adiaspores which were identified as those of Chrysosporium parvum var. crescens.

Phaeohyphomycotic cyst: a clinicopathologic study of the first four cases described from Brazil.

Four cases of phaeohyphomycosis in the form of chronic and isolated cysts are presented. The cysts were strictly confined to the subcutaneous tissue, with no involvement of the corresponding skin. Patients were asymptomatic, without satellite lesions or regional lymphadenopathy. The clinicopathologic importance of this type of phaeohyphomycosis is discussed. As far as we know, our cases are the first described from Brazil.

Glomerulonephritis in Salmonella-Schistosoma mansoni association.

In 3 patients with Salmonella-Schistosoma mansoni association and clinical evidence of renal lesions, a percutaneous renal biopsy was performed. Renal function, assessed by endogenous creatinine clearance, was abnormal in 2 cases and serum levels of complement were decreased in all cases. Immune complex glomerulonephritis, evidenced by the presence of immunoglobulin and complement in the glomeruli was demonstrated in all cases. S. dublin and S. typhimurium antigens were found in the mesangium and in the capillary walls of 2 patients. After treatment with chloramphenicol, the S. mansoni infection persisted, but the clinical, laboratory, and immunopathological alterations were resolved. These findings suggest a direct role for Salmonella in the pathogenesis of glomerulonephritis described in patients with associated Salmonella and S. mansoni infections.

The tumoral form of schistosomiasis: report of a case with cerebellar involvement.

The tumoral form of schistosomiasis mansoni is rare and has not been described in the brain, in which schistosome eggs usually elicit a granulomatous inflammation. A 20-year-old Brazilian man had the tumoral form of schistosomiasis of the cerebellum which was treated surgically. Histological study of the excised cerebellar mass demonstrated a massive granulomatous reaction around Schistosoma mansoni eggs and massive necrotic areas. To our knowledge, this is the first case of schistosomiasis mansoni of the brain presenting as a posterior fossa mass with the characteristic necrotic granulomas.

Testicular schistosomiasis mansoni: a differential diagnostic problem with testicular neoplasias.

We report a case of testicular schistosomiasis mansoni that was surgically treated as a tumor. Massive enlargement of the testicle (twice the original volume) was due to an extensive granulomatous reaction.

Dose effect of oral Saccharomyces boulardii treatments on morbidity and mortality in immunosuppressed mice.

Survival, weight loss, translocation and histological alterations in the terminal ileum, liver and spleen were studied in mice simultaneously immunosuppressed with cyclophosphamide and treated or not with Saccharomyces boulardii until the death of all animals. The animals were divided into five groups: C1 (not immunosuppressed, not treated); C2 (immunosuppressed, not treated); B1 (immunosuppressed, treated with S. boulardii 10.0 mg); B2 (immunosuppressed, treated with S. boulardii 1.0 mg) and B3 (immunosuppressed, treated with S. boulardii 0.1 mg). Survival was higher in group B3 than in the other immunosuppressed groups. Weight loss was observed for all groups except C1. By day 7, some animals from each group were killed by ether inhalation for the determination of bacterial translocation and histopathological examination. Bacterial translocation to the liver was lower in groups C1 and B3 than in the other groups. The highest translocation to the liver and spleen was observed in group B1. Low S. boulardii translocation was observed in some animals, principally to the mesenteric lymph nodes. Histopathological examination showed a decrease in epithelial cell turnover with villus length reduction and loss of brush borders in group C2. Relative protection against these alterations was obtained when the animals were treated with the yeast, independently of the dose. Higher expression of the lymphoid component was also noted in the ileal lamina propria, liver and spleen of mice treated with the yeast, together with activation of the reticulo-endothelial system, when compared with group C2 where lymphocyte depletion was observed. This study suggests a relative protection of immunosuppressed animals by treatment with S. boulardii, but this phenomenon was inversely proportional to the yeast dose.

Body distribution of Tityus serrulatus scorpion venom in mice and effects of scorpion antivenom.

In the present study we report the distribution of Tityus serrulatus scorpion venom in serum and various tissues of CFI mice and the efficacy of antivenom in reducing venom concentration. The animals were injected s.c. with 10 micrograms of scorpion venom, divided into groups of four animals and killed at different times from 15 min to 24 hr. Blood samples and samples of different tissues (heart, lung, liver, kidney, spleen, brain and injection site) were collected. Maximum venom levels occurred at 15 min in the kidney and liver and at 30 min in serum, lung, heart and spleen. After 2 hr the venom decreased rapidly in serum and in all other organs until venom levels were no longer detectable after 8 hr. No venom was detected in the central nervous system. In another experiment, 10 microliters of scorpion antivenom was injected i.v. together with the venom, and a rapid reduction of venom concentration was observed in the blood and tissues. In the third experiment, anti-scorpion venom was injected i.v. 1 hr after venom administration, and partial reduction of venom concentration was detected in tissues (lung and kidney). These studies contribute to the elaboration of more objective treatment that may result in a more economic, efficient and controlled use of scorpion antivenom in stings involving humans.

Experimental root canal infections in conventional and germ-free mice.

A small animal model was evaluated to study the interrelationships between microorganisms after their implantation in root canals (inferior central incisors) using germ-free (GF) and conventional (CV) mice. The selected microorganisms were: Porphyromonas endodontalis (ATCC 35406), Eubacterium lentum (ATCC 25559), Peptostreptococcus anaerobius (ATCC 27337), Fusobacterium nucleatum (ATCC 10953), Escherichia coli (ATCC 25922), and Enterococcus faecalis (ATCC 4083). Only P. anaerobius, E. coli, and E. faecalis, respectively, were able to colonize when inoculated alone into the root canal of both CV and GF mice. E. lentum, when inoculated alone colonized only in CV animals. P. endodontalis and F. nucleatum were unable to colonize in CV and GF animals after single inoculation. It is concluded that the experimental animal model presented herein is valuable for ecological studies of root canal infections and that only some strict anaerobic bacteria are able to colonize mice root canals when inoculated by themselves alone in pure culture.

Evaluation of microbial infiltration in restored cavities--an alternative method.

This work evaluated the efficacy of an improved method used to determine the frequency of bacterial infiltration and bacterial population levels and morphotypes in cavities restored with adhesive composites in conventional mice. By using the alternative methodology suggested in this work, bacteria from microleakage were recovered and identified in cavities subjected to restoration procedures that used acid etching of the dentin and dentin adhesives used with light-curing resin. The methodology presented herein seems to be more effective than the one normally used to investigate the presence of bacteria, which uses acid demineralization of dental structures for the histological processing of tissues. The results suggest that the methodology presented in this work made it possible to recover and identify Gram-negative and Gram-positive bacteria from microleakage. Frequencies of microleakage and bacterial population levels in restored cavities using two different adhesive systems were not statistically different (p < 0.05).

Immune complexes in the choroid plexus in liver cirrhosis.

A histopathologic and immunofluorescence study of the choroid plexus was performed in 12 cases of liver cirrhosis (cirrhosis group) and in 20 patients who died of diseases with no evidence of liver or brain involvement, and in which renal disease and alcoholism were also excluded (control group). IgA, IgG, IgM, C3, and C1q were investigated by direct immunofluorescence technique. Positive immunofluorescence in the choroid plexus was found in 83.33% of the cirrhosis group. IgA and IgG were the immunoglobulins more frequently found. C3 was also commonly found. Histologic examination of the choroid plexus showed changes in 66.67% of the cirrhosis group characterized, mainly, by subepithelial deposition of a homogeneous, acidophilic, and periodic acid-Schiff-positive substance, with thickening of the epithelial basement membrane. In the control group, the immunofluorescence in the choroid plexus was negative in all cases and only two cases (10%) presented histopathologic changes of the choroid plexus with a pattern similar to that of the cirrhosis group.

Protective effect of Saccharomyces boulardii against the cholera toxin in rats.

The effect of orogastric administration of Saccharomyces boulardii on the anatomopathological aspect of the jejunal villi was studied in male Fischer rats (weighing about 40 g) orogastrically infected with a culture of Vibrio cholerae. Experimental and control groups received lyophilized S. boulardii (25 mg suspended in 0.5 ml saline) or 0.5 ml saline, respectively, three times a day for 10 days by gastric intubation. On day 5 of treatment, 0.5 ml of a culture of V. cholerae containing 10(8) viable cells was inoculated by gastric intubation into both groups. Histopathological examination of the jejunal mucosa showed extensive lesions of the superficial epithelium of the villi from the control group whereas few lesions of this superficial epithelium were observed in the experimental group. These data show that the inhibition of the action of the cholera toxin on enterocytes by S. boulardii suggested by recent results in vitro can be demonstrated in vivo.

Functional and histopathological renal changes induced in rats by Bothrops jararaca venom.

1. Ninety-eight adult female rats were injected with 14 micrograms/g B. jararaca venom intraperitoneally to determine functional and histopathological renal changes. 2. Glomerular filtration rate, renal plasma flow, filtration fraction, osmolar clearance, water transportation in collecting ducts, urinary sodium excretion, fractional sodium excretion, albuminuria, urinalysis, plasma creatinine, urinary output and mean arterial pressure were studied before and 24 and 48 h after venom administration. Light microscope examination of the kidneys was carried out in another group of rats before and 2, 5 and 24 h after venom administration. 3. Treated animals developed acute renal failure characterized by a decrease in glomerular filtration rate, osmolar clearance, and fractional and urinary sodium excretion, and by an increase in plasma creatinine. There was also a decrease in renal plasma flow and mean arterial pressure. Histopathological examination of the kidneys indicated mild proliferation of the mesangial matrix and degenerative changes of the tubules characterized by loss of brush border and cytoplasmic vacuolation. 4. The hemodynamic changes probably played an important role in the pathogenesis of the functional and histopathologic renal changes developed by the animals after venom injection.

Intragastric infection of germfree and conventional mice with Salmonella typhimurium.

The present study investigates the lethality of intragastric Salmonella typhimurium infection of germfree (GF) and conventional (CV, not germfree) mice. The introduction of only 10 viable S. typhimurium into the gastrointestinal tract of GF mice resulted in death of all animals within 8 days of inoculation. In contrast, the 50% lethal dose for CV mice was 4.7 x 10(3) viable organisms. The results demonstrate that resident microbes protect mice from the pathogenic effect of S. typhimurium infection.

Intragastric infection of conventional and germfree mice with Giardia lamblia.

The effects of experimental infection with Giardia lamblia were studied in 30-day old conventional and germfree CFW mice (7 animals in each group) of both sexes. Cysts were observed in the feces of both groups 6 to 7 days after intragastric infection of each animal with about 2.5 x 10(5) G. lamblia trophozoites. Fecal cyst level was statistically higher in germfree mice (about 10(5) cysts/g feces) when compared with the conventional group (about 10(4) cysts/g feces). The peak of infection in the conventional group apparently occurred on the 10th day after infection as indicated by an increase of fecal weight and by histopathological examination. Intense infiltration of the lamina propria and high reactional hyperplasia of the lymphoid component were observed in the conventional group. There was no infiltration or hyperplasia in germfree infected mice and fecal weight was relatively constant throughout the experiment. These results suggest that, as is the case for other intestinal pathogenic protozoa, the intestinal microflora is indispensable for the expression of the pathogenicity but not for the multiplication of G. lamblia.

The acute phase of experimental infection with Trypanosoma cruzi is more severe in mice monoassociated with strict anaerobic bacteria.

1. The influence of some components of the normal human intestinal flora on the acute phase of experimental infection with strain CL of Trypanosoma cruzi was studied in 30-day-old germ-free or gnotobiotic CFW (LOB) mice monoassociated with Bacteroides fragilis, Peptostreptococcus sp or Clostridium sp by intragastric inoculation of 10(6) bacteria 10 days before the intraperitoneal infection with 5 x 10(3) trypomastigotes/g body weight. 2. Significantly earlier parasitemia peak and mortality were observed in Bacteroides fragilis- and Clostridium-associated mice (16.75 +/- 0.96 and 15.00 +/- 1.15 days, respectively) when compared with germfree animals (18.83 +/- 1.17 days). More precocious mortality (10.40 +/- 2.06 days) and, curiously, much lower blood parasitemia were observed in Peptostreptococcus-associated mice than in other gnotobiotic mice. 3. The extent of cardiac tissue parasitism decreased in the following order: germfree, B. fragilis-associated, Clostridium-associated, and Peptostreptococcus-associated animals. The levels of inflammatory reaction decreased in the following order: germfree, Peptostreptococcus-associated, Clostridium-associated, and B. fragilis-associated mice. 4. These results show that the acute phase of experimental infection with T. cruzi was more severe in mice associated with strict anaerobic bacteria when compared with germfree animals. This suggests that a normal intestinal flora may be another factor, in addition to nutritional and genetic factors, responsible for the different susceptibility of organisms of the same species infected with T. cruzi.

Immune responses of germfree mice to experimental infection with Trypanosoma cruzi.

1. The immune responses to Trypanosoma cruzi infection of germfree mice were compared to the responses of infected conventional mice. Two groups (40 animals in each group) of 2-month old female CFW germfree and conventional mice were used. The IgM and IgG which bound to the surface of T. cruzi epimastigotes determined by ELISA were significantly lower in germfree than in conventional mice (1/3 and 1/5 for IgM and IgG, respectively). 2. After infection there was a three-fold increase in the circulating levels of these immunoglobulins in germfree but not in conventional mice. Twenty-one days after T. cruzi inoculation, both IgG and IgM levels were similar in germfree and conventional animals. 3. Footpad swelling after T. cruzi-antigen inoculation was initially four-fold more intense in germfree than in conventional mice. 4. These results suggest that the reduced humoral immune response of germfree mice during the initiation of experimental Chagas' disease may be responsible for the more severe parasitism when compared to conventional mice.