Influenza A virus and TLR7 activation potentiate NOX2 oxidase-dependent ROS production in macrophages.

Influenza A virus infects resident alveolar macrophages in the respiratory tract resulting in Toll like receptor 7 (TLR7) activation that triggers an inflammatory response to resolve the infection. Macrophages are also major sources of reactive oxygen species (ROS) via the NOX2-containing NADPH oxidase. Although ROS are crucial for pathogen clearance, in response to influenza A virus, ROS are touted as being culprit mediators of the lung tissue injury. The aim of the present study was to determine whether influenza A virus infection and TLR7 activation of macrophages, results in alterations in their ROS production. Here we demonstrate using immunofluorescence that influenza A virus (Hong Kong X-31 strain; H3N2) internalizes in RAW264.7 cells and mouse alveolar macrophages within 1 h, resulting in a significant enhancement in the stimulated NOX2 oxidase-dependent oxidative burst, although virus had no effect on basal ROS. The specific TLR7 agonist imiquimod (10 µg/ml) elevated basal superoxide production and, in a similar fashion to influenza A virus, enhanced NOX2 oxidase-dependent oxidative burst. By contrast, the TLR3 agonist, poly I:C (1-100 µg/ml) failed to influence the oxidative burst to NOX2 oxidase. A peptide corresponding to the region 337-348 on p47phox conjugated to a HIV-tat, designed to inhibit the phosphorylation of Ser346 on p47phox suppressed the influenza A virus- and imiquimod-induced enhancement in the oxidative burst. In conclusion, this study demonstrates for the first time that influenza A virus and TLR7 activation enhance the NOX2 oxidase-dependent oxidative burst in macrophages, which might underpin the acute lung injury to influenza A virus infection.

Carotenoids found in Bacillus.

AIMS: To identify the diversity of pigmented aerobic spore formers found in the environment and to characterize the chemical nature of this pigmentation. MATERIALS AND RESULTS: Sampling of heat-resistant bacterial counts from soil, sea water and the human gastrointestinal tract. Phylogenetic profiling using analysis of 16S rRNA sequences to define species. Pigment profiling using high-performance liquid chromatography-photo diode array analysis. CONCLUSIONS: The most commonly found pigments were yellow, orange and pink. Isolates were nearly always members of the Bacillus genus and in most cases were related with known species such as Bacillus marisflavi, Bacillus indicus, Bacillus firmus, Bacillus altitudinis and Bacillus safensis. Three types of carotenoids were found with absorption maxima at 455, 467 and 492 nm, corresponding to the visible colours yellow, orange and pink, respectively. Although the presence of other carotenoids cannot be ruled out, these three predominant carotenoids appear to account for the pigments obtained in most pigmented bacilli, and our analysis reveals the existence of a C30 biosynthetic pathway. Interestingly, we report the presence of a water-soluble pigment that may also be a carotenoid. The function of carotenoids is photoprotection, and carotenoid-containing spores exhibited significantly higher levels of resistance to UV radiation than non-carotenoid-containing Bacillus species. SIGNIFICANCE AND IMPACT OF THE STUDY: This study demonstrates that pigmented bacilli are ubiquitous and contain new carotenoid biosynthetic pathways that may have industrial importance.

Is neck ultrasound necessary for early stage oral tongue carcinoma with clinically N0 neck?

OBJECTIVES: To define the necessity of neck ultrasound for investigation of T1 and T2 oral tongue carcinoma with N0 neck. METHODS: The medical records of all patients with early stage (T1-2 N0) oral tongue cancer treated surgically between January 1985 and December 2000 were reviewed. Patients with 30 neck dissections were identified for analysis. The result of neck ultrasound examination was correlated with the histological examination. RESULTS: The sensitivity, specificity and overall accuracy of ultrasound examination were found to be 47%, 93% and 70%, respectively. The implication of ultrasound examination with respect to elective neck treatment was discussed in the management of the N0 neck. CONCLUSIONS: It is concluded that ultrasound alone is inadequate for making decisions regarding neck management of patients with T1 and T2 N0 carcinoma of the tongue and cannot replace a policy of elective neck dissection.

Kuttner tumour (chronic sclerosing sialadenitis) of the submandibular gland: sonographic appearances.

Patients with Kuttner tumours present with clinical features simulating a submandibular tumour. This article aims to familiarise sonologists with the sonographic appearances of these tumours, to help in their differentiation from other salivary lesions. In 13 patients with histologically or cytologically proven Kuttner tumours, the features evaluated on sonography included: shape and border of the gland, internal architecture, duct dilatation, presence/absence of calculi and presence and distribution of vascularity. There was diffuse involvement of the submandibular glands in 11 patients and focal involvement in 2. The majority (9 of 11) of the patients with diffuse involvement showed sonographic appearances simulating a "cirrhotic" liver; 2 showed diffuse heterogeneous involvement with duct dilatation and calculus. Doppler showed prominent intraglandular vessels, with no evidence of displacement. Focal lesions (2 of 11) were seen as hypoechoic, heterogeneous "masses," with a radial branching vascular pattern within, on Doppler. In conclusion, sonographic features may help in identifying Kuttner tumours of the submandibular glands.

Human dirofilariasis of the buccal mucosa: a case report.

Human dirofilariasis is a helminthic zoonosis that is common in some parts of the world. A sporadic case of dirofilariasis affecting the buccal mucosa has been reported in a non-endemic area of southern China. Clinical findings, diagnosis, pathogenesis and management are discussed. This is the fourth case of human dirofilariasis involving the oral mucosa reported in world literature.

Minimal invasive approach of gastric and esophageal mobilization in total pharyngolaryngoesophagectomy: total laparoscopic and hand-assisted laparoscopic technique.

BACKGROUND: To evaluate early results in total pharyngolaryngoesophagectomy (PLE) by minimally invasive approaches for patients suffered from pharyngoesophageal tumor. METHODS: Between April 1998 and September 2001, 12 consecutive patients underwent either total laparoscopic (n = 9) or hand-assisted laparoscopic (n = 3) gastric mobilization plus transhiatal esophageal resection in total PLE. The operative data and postoperative outcomes were evaluated. RESULTS: Total PLE by minimally invasive approach was successfully performed in 11 patients, and 1 patient required conversion due to uncontrolled bleeding. The median total operative time was 8.5 h (range, 5-11 h) and the abdominal laparoscopic stage usually took less than 4 h. The median time for extubation was 2 days (range, 1-4 days) and the median ICU stay was 2 days (range, 1-20 days). There was no 30-day mortality, and major complications occurred in 5 patients (42%). CONCLUSION: Minimally invasive PLE is a feasible and safe alternative to conventional open surgery for patients with pharyngoesophageal carcinoma.

The use of stereotactic navigation guidance in minimally invasive transnasal nasopharyngectomy: a comparison with the conventional open transfacial approach.

The purpose of this paper is to study the efficacy of applying stereotactic navigation guidance to nasopharyngectomy via a minimally invasive transnasal approach as compared with the conventional open transfacial approaches. The nasopharynx is the centre of the anterior skull base, which is remote from the surface of the facial skeleton. It is well known that there are several surgical approaches for access to resect tumours from the nasopharynx. However, the open techniques have been associated with much morbidity and only provide access to, and identification of, the ipsilateral internal carotid artery that forms the lateral boundary and resection limit of the nasopharynx. The coupling of stereotactic navigation guidance and a minimally invasive transnasal approach for nasopharyngectomy allows the surgeon to identify and protect the internal carotid artery bilaterally at the nasopharynx. This technique reduces operating time and morbidity to a minimum and yet is oncologically sound for resecting nasopharyngeal lesions. We compare 15 patients who underwent the stereotactic navigation guidance approach with 20 patients who received a conventional open transfacial approach.

Immunohistochemical investigations of neurofilament M' and alphabeta-crystallin in the magnocellular layers of the primate lateral geniculate nucleus.

The magnocellular and parvocellular pathways are two major processing streams in the primate visual system. Using high-density grid arrayed cDNA clones to hybridize to cDNA probes from cortical regions of each pathway, a list of candidate differentially expressed genes was produced [Mol. Brain Res. 82 (2000) 11-24]. Magnocellular pathway candidates include neurofilament M' and alphabeta-crystallin. Using antibodies generated against these proteins, immunohistochemical analysis revealed preferential staining of the magnocellular layers in the primate lateral geniculate nucleus, providing verification of two candidate magnocellular-enriched genes.

Fibromatosis of the head and neck region.

OBJECTIVE: Five cases of head and neck fibromatosis were analyzed. The imaging and pathologic findings, surgical management, and clinical outcome were discussed. STUDY DESIGN AND SETTING: A retrospective study of 5 adult head and neck fibromatosis cases, evaluating long-term follow-up results of conservative treatment. RESULTS: The 5 patients (2 male and 3 female) ranged in age from 16 to 51 years. The lesion size ranged from 1 to 8 cm. Four cases had limited surgical resection; 1 case was followed only. One of the surgically treated cases had a recurrence that was irradiated. All patients were well for a follow-up period of 2 to 8 years. CONCLUSION: Aggressive excision of head and neck fibromatosis cannot be achieved easily. Vigilant follow-up with or without conservative surgical excision achieves good disease control. Low dose radiotherapy can be used for inoperable cases. SIGNIFICANCE: Judicious conservative treatment should be attempted for head and neck fibromatosis to achieve optimal functional preservation.

A case of parotid mucoepidermoid carcinoma complicated by fatal gastrointestinal bleeding.

Mucoepidermoid carcinoma is one of the most common of the salivary gland neoplasms. Histologically, it is classified as either a low-, intermediate-, or high-grade tumor, and there are significant differences in prognosis among the different grades. Patients with low-grade disease have an excellent chance of survival. High-grade tumors behave aggressively, and they frequently manifest as local recurrences and distant metastases. We describe a case of a high-grade mucoepidermoid carcinoma of the parotid gland that had metastasized to the skin, stomach, and liver. The disease culminated in a rapidly fatal bleeding from the stomach metastasis. Such a complication is unusual and to our knowledge has not been previously reported. We briefly discuss the clinical features, biologic behavior, and treatment of this tumor.

Cowden's disease with vocal fold involvement.

Cowden's disease is a hereditary disorder characterized by oropharyngeal fibrosis and multiple hamartomas with potential malignant changes. We treated a 47-year-old man who had fibrotic lesions on the left vocal fold and an extensive amount of papillomatous lesions on the mucosa of the lips, tongue, and pharyngeal wall and on the skin of the axillae and buttocks. The pattern of distribution and the histopathologic features of these mucocutaneous lesions were diagnostic of Cowden's disease. To the best of our knowledge, this is the first reported case of Cowden's disease involving a vocal fold.

Basal cell adenocarcinoma of the salivary gland: report of a case with morphology on fine needle aspiration cytology.

BACKGROUND: Basal cell adenocarcinoma of the parotid is rare and prone to recur. CASE: A 54-year-old woman had a history of afacial mass 12 years earlier that had been excised and was diagnosed as low grade adenocarcinoma of the parotid. Over the years, the patient had multiple local and lymph node recurrences. Histology of the excised local recurrent tumor showed basal cell adenocarcinoma, and FNAC of a separate recurrent nodule was performed. The aspirate showed moderate cellularity of basaloid cells with mildly pleomorphic nuclei, small nucleoli and occasional mitotic figures. The cells were mostly single, but some formed clusters with a rosettelike pattern of tumor cells surrounding central eosinophilic globules. A second, less prominent population of smaller cells with dark-staining nuclei was also noted. The differential diagnosis included adenoid cystic carcinoma, polymorphous low grade adenocarcinoma, and basal cell and pleomorphic adenoma. CONCLUSION: The cytologic features of basal cell adenocarcinoma are not distinctive, but the presence of two cell populations with moderate pleomorphism and a rosettelike pattern with central, eosinophilic globules may assist with its differentiation from other salivary gland neoplasms.