Colonization of the tracheal epithelium of pigs by filamentous bacteria resembling cilia-associated respiratory bacillus.

Warthin Starry staining revealed filamentous bacteria colonizing the tracheal epithelium of 41 of 88 (46.6%) pigs submitted for necropsy at 2 midwestern veterinary diagnostic laboratories. The bacteria were interspersed between and oriented parallel to the cilia. In 4 of 4 colonized pig tracheas, filamentous bacteria were demonstrated by transmission electron microscopy. The bacteria were approximately the same length and diameter as cilia, and in areas of heavy colonization the bacteria outnumbered cilia. The filamentous bacteria were similar in location and morphologic characteristics to cilia-associated respiratory (CAR) bacilli of rats, mice, rabbits, and cattle. Results of immunoperoxidase staining and polymerase chain reaction analysis indicated that the pig CAR bacillus is a different bacterium than the rat CAR bacillus. Rat CAR bacillus causes chronic respiratory disease in rats and mice. The association, if any, between pig CAR bacillus and swine respiratory disease is unknown.

[Pertinence of the preoperative exploration in the evaluation of the risk of lymph node metastasis in endometrial cancer]. / Pertinence du bilan préoperatoire dans l'évaluation du risque de métastases ganglionnaires d'un cancer endométrial.

PURPOSE: To assess the relevance of MRI, endometrial biopsy and curettage in the diagnosis of endometrial cancer at high risk of lymph node metastasis. PATIENTS AND METHODS: A retrospective study on continuous series of patients treated for endometrial cancer limited to the uterus between 2004 and 2008, results of preoperative evaluation of tumor stage using MRI, histological type and grade by endometrial curettage and biopsies were compared to final histological examination. RESULTS: One hundred and sixty-nine patients were included in the study. Ninety (53.3%) had MRI, 112 (66.2%) curettage and 61 (36.6%) endometrial biopsy using Pipelle de Cornier. Sensibility (SN), specificity (SP), positive (PPV) and negative predictive values (NPV) of MRI, in the diagnosis of endometrial cancer at high risk of lymph nodes metastases were of 65.6%, 87.2%, 77.7%, 79.2%. For EB and curettage SN, SP, PPV and NPV were of 42.9%, 96.9%, 85%, 79.5%; 80.6%, 98.3%, 96.2% and 90.6% respectively. 37.8% of cancers diagnosed to be at low risk of lymph node metastasis were at high risk in definitive histologic examination. DISCUSSION AND CONCLUSION: Preoperative evaluation by MRI, endometrial curettage and biopsy has good diagnostic value in the identification of endometrial cancer susceptible to benefit from lymphadenectomy. Underestimation, however, is encountered in approximately one third of cases.

Prevention of rejection in cardiac transplantation by blockade of the interleukin-2 receptor with a monoclonal antibody.

BACKGROUND: Alloantigen-activated T cells express the high-affinity interleukin-2 receptor. Specific blockade of this receptor with the human IgG1 monoclonal antibody daclizumab may prevent rejection of allografts after cardiac transplantation without inducing global immunosuppression. METHODS: We randomly assigned 55 nonsensitized patients undergoing a first cardiac transplantation to receive either induction therapy with daclizumab (1.0 mg per kilogram of body weight), given intravenously within 24 hours after cardiac-transplantation surgery and every two weeks thereafter, for a total of five doses, or generalized immunosuppressive therapy. Concomitant immunosuppression was achieved in both groups with cyclosporine, mycophenolate mofetil, and prednisone. The primary end points were the incidence and severity of acute rejection, and the length of time to a first episode of biopsy-confirmed rejection. RESULTS: Of the 55 patients in the study, 28 were randomly assigned to receive daclizumab and 27 served as the control group. During induction therapy, the mean frequency of acute rejection episodes (defined as a histologic grade of 2 or higher according to the classification of the International Society of Heart and Lung Transplants) was 0.64 per patient in the control group and 0.19 per patient in the daclizumab group (P=0.02). Acute rejection developed in 17 of 27 patients in the control group (63 percent), as compared with 5 of 28 patients in the daclizumab group (18 percent; relative risk, 2.8; 95 percent confidence interval, 1.1 to 7.4; P=0.04). Throughout follow-up, there were nine patients with episodes of acute rejection of histologic grade 3 in the control group, as compared with two in the daclizumab group (P= 0.03), and the time to a first episode of rejection was significantly longer in the daclizumab group (P=0.04). There were no adverse reactions to daclizumab and no significant differences between the groups in the incidence of infection or cancer during follow-up. CONCLUSIONS: Induction therapy with daclizumab safely reduces the frequency and severity of cardiac-allograft rejection during the induction period.