Purpura fulminans associated with Streptococcus pneumoniae septicemia in an asplenic pediatric patient.

Purpura fulminans is a rapidly progressive syndrome of small-vessel thrombosis and hemorrhagic necrosis of the skin accompanied by disseminated intravascular coagulation. We describe a case of Streptococcus pneumoniae septicemia in an asplenic 5-year-old boy on oral tacrolimus, with a past medical history of multivisceral organ transplantation and subsequent development of purpura fulminans on his chest and distal extremities. The acute infectious form of purpura fulminans is usually caused by gram-negative bacteria. Cases secondary to gram-positive encapsulated bacteria usually occur when individuals are immuno-suppressed or have anatomic or functional asplenia. Our patient had both, which likely increased his susceptibility, and he responded well to antimicrobial therapy in addition to prophylactic coverage in the setting of his immunosuppression. We review the literature for similar cases due to S. pneumoniae in the pediatric population and discuss the etiology and treatment of purpura fulminans.

Over two hundred polypeptides resolved from the human erythrocyte membrane.

A modification of O'Farrell's method of two-dimensional polyacrylamide gel electrophoresis has allowed for the resolution of erythrocyte membranes showing up to 200 individual components. Data is presented which indicates that this protein heterogeneity is not produced by artifactual protein-protein aggregation, ednogenous protease activity of secondary charge modification. Similar patterns are obtained when the samples are added to the unpolymerized isoelectric focusing gel, and isolated and stored in protease inhibitor. Individual spots could be eluted off of stained gels, resolubilized under extreme detergent solubilization conditions and run on one-dimensional gels; these run as sodium dodecyl sulfate in the solubilization procedure. The method chosen for solubilization prior to isoelectric focusing appears to cause selective aggregation of all or most of the spectrin and band 3 proteins. This further allows for excellent resolution of more components.

Organizational differences in the membrane proteins of normal and irreversibly sickled erythrocytes.

Using two-dimensional gels, no unique membrane proteins were detected in irreversibly sickled cells. Membranes from irreversibly sickled cells were shown to cross-link much more readily with dithiobis(succinimidyl propionate) than normal erythrocyte membranes. Increased binding of band 4.5 protein and increased intra-chain disulfides were also demonstrated. These changes may correlate to enhanced cellular rigidity.

Epithelioid leiomyoma of the bladder: an unusual cause of voiding symptoms.

Epithelioid leiomyoma of the bladder is a rare benign neoplasm. A 63-year-old woman with a 2-year history of frequency and urgency was found to have a bladder mass on intravenous urography and subsequent cystoscopy. The mass was removed endoscopically. The patient's symptoms resolved.

Androgen receptor antigen density and S-phase fraction in prostate cancer: a pilot study.

PURPOSE: To determine whether quantitative flow cytometric androgen receptor density expression (MFC ratio) in prostate cancer was associated with S-phase fraction. METHODS: Flow cytometry was performed to determine DNA aneuploidy, S-phase fraction, percentage of androgen receptor (AR)-positive cells, and MFC ratio in prostate cancer patients. RESULTS: MFC ratio showed distinct clustering. Eight patients had a low MFC ratio of 1.78-2.74, while 10 patients had high MFC ratios between 4.99 and 6.48. The S-phase fraction had average values of 11.05 vs 4.92 in tumors with high vs low MFC ratio (P<0.01). CONCLUSION: S-phase fraction was significantly higher in tumors with high AR density.

Freeze-etch localization and distribution of concanavalin A in normal and irreversibly sickled erythrocytes.

Normal red blood cells and irreversibly sickled red cells (ISCs) were incubated in Concanavalin A (Con A) prior to freeze-etching. The Con A molecules could be visualized on the cells without conjugating the Con A to a larger molecule. No differences in the number or distribution of the Con A binding sites were observed between normal red cells and ISCs. Moreover, the number and distribution of the intramembranous particles (IMP) present on the fracture face of the cytoplasmic membrane leaflet were the same in normal cells and ISCs. Thus, the membrane differences that do exist between normal red cells and ISCs in terms of cell shape and adhesiveness are not reflected in Con A binding or IMP number and distribution.

Comparative analysis of volatile metabolomics signals from melanoma and benign skin: a pilot study.

The analysis of volatile organic compounds (VOC) as biomarkers of cancer is both promising and challenging. In this pilot study, we used an untargeted approach to compare volatile metabolomic signatures of melanoma and matched control non-neoplastic skin from the same patient. VOC from fresh (non-fixed) biopsied tissue were collected using the headspace solid phase micro extraction method (HS SPME) and analyzed by gas chromatography and mass spectrometry (GCMS). We applied the XCMS analysis platform and MetaboAnalyst software to reveal many differentially expressed metabolic features. Our analysis revealed increased levels of lauric acid (C12:0) and palmitic acid (C16:0) in melanoma. The identity of these compounds was confirmed by comparison with chemical standards. Increased levels of these fatty acids are likely to be a consequence of up-regulated de novo lipid synthesis, a known characteristic of cancer. Increased oxidative stress is likely to cause an additional increase in lauric acid. Implementation of this study design on larger number of cases will be necessary for the future metabolomics biomarker discovery applications.

The hypocholesterolemic and antiatherogenic effects of topically applied phosphatidylcholine in rabbits with heritable hypercholesterolemia.

To test possible hypocholesterolemic and antiatherogenic effects of transdermally administered phosphatidylcholine (PC), we applied a 33% solution of PC in ethanol containing 0.01% butylated hydroxytoluene as antioxidant, to the shaved back of a strain of inbred rabbits which spontaneously developed hypercholesterolemia (serum cholesterol above 110 mg/dl) and severe atherosclerotic lesions especially in the aortic arch. After the topical application of PC, increases of choline-containing phospholipids in blood were observed, reaching a plateau in 24-48 hr. There were significant reductions in serum cholesterol and LDL cholesterol in the treated animals 2-3 weeks after the treatment. Atherosclerotic lesions in the aortic arch were clearly less severe in the animals repeatedly treated with topical PC. The hypocholesterolemic and antiatherogenic effects of topical PC could be the result of increased cholesterol efflux from extrahepatic tissues and enhanced reverse cholesterol transport.

Púrpura fulminante en relación con septicemia por Streptococcus pneumoniae en un paciente pediátrico asplénico / Purpura Fulminans Associated with Streptococcus pneumoniae Septicemia in an Asplenic Pediatric Patient

La púrpura fulminante es un síndrome rápidamente progresivo de trombosis de pequeños vasos y necrosis hemorrágica de la piel que se acompaña de coagulación intravascular diseminada. Describimos un caso de septicemia por Streptococcus pneumoniae en un niño de 5 años de edad tratado con tacrolimus oral, con una historia médica previa de trasplante de múltiples vísceras y sin bazo, y el desarrollo subsiguiente de púrpura fulminante en su pecho y la parte distal de sus extremidades. La forma aguda infecciosa de púrpura fulminante es debida habitualmente a bacterias gramnegativas. Los casos secundarios a bacterias grampositivas encapsuladas ocurren por lo general cuando los individuos están inmunosuprimidos o presentan asplenia funcional o anatómica. Nuestro paciente presentaba ambas condiciones, lo cual con seguridad aumentó su susceptibilidad, y respondió bien a la terapia antimicrobiana además de a la cobertura profiláctica en el contexto de su inmunosupresión. Revisamos la literatura buscando casos similares debidos a Streptococcus pneumoniae en la población pediátrica y discutimos la etiología y el tratamiento de la púrpura fulminante (AU)

Purpura fulminans is a rapidly progressive syndrome of small-vessel thrombosis and hemorrhagic necrosis of the skin accompanied by disseminated intravascular coagulation. We describe a case of Streptococcus pneumoniae septicemia in an asplenic 5-year-old boy on oral tacrolimus, with a past medical history of multivisceral organ transplantation and subsequent development of purpura fulminans on his chest and distal extremities. The acute infectious form of purpura fulminans is usually caused by gram-negative bacteria. Cases secondary to gram-positive encapsulated bacteria usually occur when individuals are immuno-suppressed or have anatomic or functional asplenia. Our patient had both, which likely increased his susceptibility, and he responded well to antimicrobial therapy in addition to prophylactic coverage in the setting of his immunosuppression. We review the literature for similar cases due to S. pneumoniae in the pediatric population and discuss the etiology and treatment of purpura fulminans (AU)