The intraspecies diversity of C. albicans triggers qualitatively and temporally distinct host responses that determine the balance between commensalism and pathogenicity.

The host immune status is critical for preventing opportunistic infections with Candida albicans. Whether the natural fungal diversity that exists between C. albicans isolates also influences disease development remains unclear. Here, we used an experimental model of oral infection to probe the host response to diverse C. albicans isolates in vivo and found dramatic differences in their ability to persist in the oral mucosa, which inversely correlated with the degree and kinetics of immune activation in the host. Strikingly, the requirement of interleukin (IL)-17 signaling for fungal control was conserved between isolates, including isolates with delayed induction of IL-17. This underscores the relevance of IL-17 immunity in mucosal defense against C. albicans. In contrast, the accumulation of neutrophils and induction of inflammation in the infected tissue was strictly strain dependent. The dichotomy of the inflammatory neutrophil response was linked to the capacity of fungal strains to cause cellular damage and release of alarmins from the epithelium. The epithelium thus translates differences in the fungus into qualitatively distinct host responses. Altogether, this study provides a comprehensive understanding of the antifungal response in the oral mucosa and demonstrates the relevance of evaluating intraspecies differences for the outcome of fungal-host interactions in vivo.

Induction of colonic adenocarcinoma in the rat by X-irradiation.

In work to determine whether X-radiation could be used to induce tumors of the colon in outbred Holtzman rats, a technique was devised so that only the descending colon could be irradiated with a collimated X-ray beam and tumorigenic exposures in the kilo-Roentgen range were delivered. Ninety male Holtzman rats were divided into 6 exposure groups of 15 animals each. In the first group only the colon was exposed to 2500 R; in the second group the colon was exposed to 3500 R and the exposures were increased by 1000-R increments up through 6500 R; the sixth group was sham irradiated. Animals in each of the irradited groups developed mucoid adenocarcinomas with the highest incidence (47%) obtained inthe 4500-R group. Histopathologically, the induced tumors bear a close resemblance to human colon adenocarcinoma, and the development of pulmonary metastases in one of the animals with multiple primary tumors demonstrated their malignancy. The usefulness of the animal model is discussed.

Endoscopic lateralization of the vocal cord in abductor paralysis of the larynx.

Endoscopic surgical operations of the larynx have many desirable features, including the conservative nature of these procedures, plus the ability to produce surgical changes predictable from the onset. For several years the direct lateralization of the vocal ligament after the removal of a preassessed amount of thyroarytenoid muscle appeared to be the simplest and most accurate surgical procedure. The resection of this wedge of muscle was easily performed with laryngeal microcautery. Posterior cicatricial webs can be easily removed with this instrument. Simple suturing techniques are also described, including the practicability of using padded buttons plus lead fishing sinkers to adjust the tension and secure these sutures on the surface of the neck. So far 16 patients have been rehabilitated using this technique, including 6 patients with posterior commissure webs. These anatomical techniques should be considered because of their obvious simplicity.

Suturing techniques in endolaryngeal surgery.

In the past 15 years surgery of the endolarynx has been greatly expanded. This development has been the product of three main factors: technological advancements such as the microcautery, improved knowledge about the healing properties of the endolarynx, and new surgical techniques. These types of approaches are being increasingly used in the treatment of complex reconstructive procedures of the larynx. An integral part of these new procedures are special suturing techniques. At present suturing techniques are being used to fulfill a number of requirements, including approximation and lateralization of anatomical structures for operative or exposure purposes, intraoperative retraction of endotracheal tubes, closure of wounds and securement and fixation of skin grafts, intralaryngeal molds, and interfacing Silastic sheeting materials. With amazing simplicity the above requirements can be met if a few basic steps are comprehended and followed.

Laryngeal structure following microcauterization.

The paper supports and reaffirms the objectives of contemporary laryngology in the treatment of cancer of this organ. These objectives are, first and foremost, the eradication of the tumor, and second, the preservation of function. A relatively recent contribution to the "state of the art" has been the development of the field of microlaryngology. The introduction of the surgical microscope has provided the laryngologist with better means to judge the type, localization and extent of neoplastic lesions. Reports indicate that superficial limited carcinomas of the larynx with good vocal cord mobility can be successfully treated by vocal cord stripping and/or radiotherapy. This paper presents the serious challenge posed by these limited tumors when they recur after radiotherapy. In a selected number of these patients radical surgery has been prevented by treating these recurrent tumors with the microcautery. Some of these patients, so treated, have been free of disease for more than three years after their recurrent tumors were destroyed with the microcautery. During this time these patients have enjoyed adequate voices. Extensive studies that have been performed in dogs with the microcautery indicate that: a. An excellent recovery of the larynx is the rule, if microcauterization is carried out superficially. These initial experiments were performed on 10 dogs, duplicating the type and extension of microcauterization, as this procedure is usually performed clinically in the treatment of patients. b. The anterior and posterior commissures of the larynx were found understandably vulnerable to severe degrees of cauterization.

Aneurysms of the petrous portion of the internal carotid artery.

Aneurysms of the petrous portion of the internal carotid artery are rare lesions. One case is reported here and 18 others have been found in the literature. These lesions usually arise in young men who present with auditory dysfunction. The aneurysm is usually discovered as a pulsating purple mass in the middle ear and mistaken for a glomus jugulare tumor. A definitive diagnosis can be made by carotid angiography. Subtraction techniques are very helpful. Carotid ligation or trapping is the treatment of choice.

Experimental granuloma of the larynx.

This paper describes a series of experiments that were performed in dogs, attempting to reproduce in the laboratory a chronic granulomatous reaction of the larynx. The purpose of this work was to learn about the possible pathogenesis of these lesions and to find the reasons behind their chronicity and recurrence. The practical aspects of this research were to formulate and, hopefully, to develop reasonable diagnostic and therapeutical approaches that could be used in the treatment of patients. The positive and negative results of these experiments indicate that the granulomatous response is probably influenced not only by external factors, but also by intrinsic factors. Clinically these findings led to the concept of not circumscribing judgment to the peripheral changes only, but to the assessment of all facts surrounding each individual case.

Study of the ventilation of middle ear using radioactive xenon.

The greatest contribution of nuclear medicine has been to make possible dynamic measurements of regional function. It is conceivable that if this technology could be successfully used to measure the ventilation and clearance of the middle ear, answers to some of the most crucial problems in otology may be found. The objectives of this paper are three-fold: 1) A descriptive account of radiotracers and radiodetectors with emphasis on Xenon133. 2) The development of scintillographic techniques for the dynamic study of the ventilation of the ear and sinuses. 3) The methods that are being explored for the quantification of these functions.

Microcauterization in reconstructive surgery of the larynx.

The increased interest in microcauterization is related to its simplicity, accuracy, and economy. Because of its intrinic nature, microcauterization has been found to be a suitable method in the removal of cicatricial bands from the larynx, even in those patients whose larynges are difficult to expose. Some endolaryngeal suturing techniques have been developed and successfully used in combination with microcauterization in the conservative management of difficult laryngeal problems, including a congenital interarytenoid cleft. A combination of this technique has also been successfully employed in the prompt rehabilitation of a meaningful group of patients afflicted with bilateral abductor paralysis of the vocal cords.

Failure to find a humoral factor which influences the compensatory response after resection of the rat small bowel.

Small bowel resection was performed in one parabiont of a parabiotic rat pair to determine whether there was a "humoral" or other circulating factor present which could influence the compensatory response seen in the remainder of the small bowel. Following intestinal resection in one parabiont, there was an increase in DNA synthesis in the intestine of that member provided at least 40% of the small intestine was removed. The compensatory response seen in a resected animal was not observed in its parabiotic partner, even though an attempt was made to make the potentially responding animal more sensitive to the influence of any circulating "factors" by resecting its intestine as well. The results obtained are in disagreement with the one closely related report in the literature; it is suggested that there is no good evidence for the existence of a resection-induced circulating factor with the capability of crossing a vascular anastomosis and controlling proliferation of small intestinal epithelium.

Quantitative assessment of rabbit alveolar macrophage function by chemiluminescence.

Rabbit alveolar macrophages (RAM) were cultured for 24 hr with concentrations ranging from 3 to 12 micrograms/ml of vanadium oxide (V2O5), a known cytotoxic agent, or with high-molecular-weight organic by-products from coal gasification processes. After culture the cells were harvested and tested for functional capacity using three types of indicators: (1) luminol-amplified chemiluminescence (CL), which quantitatively detects photon emission due to respiratory burst activity measured in a newly designed instrument with standardized reagents; (2) the reduction of nitro blue tetrazolium-saturated polyacrylamide beads, a semiquantitative measure of respiratory burst activity; and (3) phagocytic efficiency, defined as percentage of cells incorporating immunoglobulin-coated polyacrylamide beads. Chemiluminescence declined linearly with increasing concentrations of V2O5 over the dose range tested. Dye reduction and phagocytic efficiency similarly decreased with increasing V2O5 concentration, but were less sensitive indicators of functional impairment than CL as measured by the amount required to reduce the response to 50% of untreated cells. The effect of coal gasification condensates on RAM function varied, but in general these tests also indicated that the CL response was the most sensitive indicator.

Toxicological effects on mice following inhalation exposures to fluidized-bed coal combustor fly ash.

Toxicological effects of exposure to reaerosolized fly ash from a fluidized-bed coal combustor were evaluated in mice following 500- and 1000-hr inhalation exposures. Alveolar macrophage function, organ histology, and hematopoiesis were assessed following 24-hr/day exposures in two 500-hr experiments. There was little mutagenicity detected by the Ames assay in the samples of the fly ash tested. The chemical characteristics of the fly ash were very similar to those of fly ash produced during conventional coal combustion. However, physical characterization revealed that the fluidized-bed combustion fly ash was not fused as is commonly the case in conventionally combusted fly ash, and as a result had a very large surface area. The function of the alveolar macrophages of exposed mice was impaired, and there were significant changes in the histology of the lung, including cellular infiltration and hyperplasia of bronchiolar and alveolar epithelium. These changes are characteristic of pulmonary responses to chronic irritation of the lung.