RESUMO
AIMS: In this study, we evaluated the therapeutic efficacy of selected probiotics in a mouse model of birch pollen (BP)-induced allergic rhinitis. METHODS AND RESULTS: Oral administration of Lactobacillus plantarum CJLP133 and CJLP243 ameliorated the symptoms of BP-induced allergic rhinitis by reducing airway hyperresponsiveness, and both the histological scores and the number of infiltrated cells in the nasal cavities and lungs. Compared with those from vehicle-treated mice, bronchoalveolar lavage fluid and draining lymph node samples from CJLP133 and CJLP243-administrated mice showed diminished numbers of immune cells, increased secretion of a Th1-type cytokine (IFN-γ) and decreased production of Th2-type cytokines (IL-4, IL-5 and IL-13). Consistent with these results, levels of IL-4, IL-5, IL-13, serum IgE and BP-specific serum IgG1 were decreased, whereas secretion of IFN-γ and BP-specific serum IgG2a was augmented upon administration of CJLP133 and CJLP243 in mice. CONCLUSION: Oral administration of L. plantarum CJLP133 and CJLP243 alleviates symptoms of BP-induced allergic rhinitis in mice by recovering Th1/Th2 balance via enhancement of the Th1-type immune response. SIGNIFICANCE AND IMPACT OF THE STUDY: Lactobacillus plantarum CJLP133 and CJLP243 have therapeutic effects on BP-induced allergic rhinitis in an animal model.
Assuntos
Betula/imunologia , Lactobacillus plantarum/fisiologia , Pólen/imunologia , Probióticos/administração & dosagem , Rinite Alérgica/tratamento farmacológico , Administração Oral , Animais , Líquido da Lavagem Broncoalveolar/imunologia , Citocinas/genética , Citocinas/imunologia , Modelos Animais de Doenças , Feminino , Humanos , Pulmão/efeitos dos fármacos , Pulmão/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Rinite Alérgica/imunologiaRESUMO
We report a 57-year-old woman with concurrent tubulointerstitial nephritis and uveitis syndrome (TINU) and Fanconi's syndrome. She presented with sudden onset of bilateral ocular pain, blurred vision, acute renal failure, glucosuria and proteinuria. Slit lamp examination revealed acute bilateral anterior uveitis. Tubulointerstitial nephritis was confirmed by kidney biopsy. Laboratory examination revealed normoglycemic glucosuria, proteinuria, normal anion-gap metabolic acidosis, phosphaturia, urinary uric acid wasting and kaliuresis leading to hypokalemia. Her vision and renal function improved gradually after systemic steroid therapy. There have been rare reports of TINU syndrome which had features of Fanconi's syndrome. The prevalence of TINU syndrome may be underestimated, and its association with Fanconi's syndrome requires further investigation.
Assuntos
Síndrome de Fanconi/complicações , Biópsia , Técnicas de Diagnóstico Oftalmológico , Síndrome de Fanconi/diagnóstico , Síndrome de Fanconi/tratamento farmacológico , Feminino , Humanos , Rim/patologia , Rim/fisiopatologia , Pessoa de Meia-Idade , Nefrite Intersticial/complicações , Nefrite Intersticial/diagnóstico , Nefrite Intersticial/tratamento farmacológico , Nefrite Intersticial/fisiopatologia , Recuperação de Função Fisiológica , Esteroides/uso terapêutico , Resultado do Tratamento , Uveíte/complicações , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte/fisiopatologia , Visão OcularRESUMO
OBJECTIVES: To estimate the prevalence of spondyloarthritis (SpA) and the clinical features of human leucocyte antigen (HLA)-B27-associated acute anterior uveitis (HLA-B27 uveitis) in Chinese patients. METHODS: We conducted a retrospective cohort study using a structured chart review to record the complete ocular history, including the onset of uveitis, month of uveitis attack, specific eye involvement, the time of first attack, and rheumatic manifestations from 1987 to 2004. A total of 504 patients with HLA-B27 uveitis were consequently enrolled consecutively from the uveitis clinic of Taipei Veterans General Hospital. RESULTS: In total, 1719 attacks of uveitis in 504 patients were recorded. Females tended to have a higher frequency of attack than males, and those with a disease course of less than 5 years showed more uveitis recurrence. The same eye attacks were observed in 156 of 332 patients (47%), more than the expected percentage compared with attacks with random-eye occurrence (p < 0.001). A significantly higher number of uveitis attacks occurred in winter. SpA-related acute anterior uveitis (AAU) was found in 387 patients (76.8%). Ankylosing spondylitis (AS) occurred in 214 patients (42.5%), with a significantly higher prevalence in males than in females (p < 0.001). Undifferentiated SpA (USpA)-related AAU occurred in 150 patients (29.8%), with a significantly higher prevalence in females than in males (p < 0.001). Patients with SpA had an earlier onset of uveitis (p = 0.01) and a greater number (> or = 6) of attacks (p = 0.03). CONCLUSIONS: The prevalence of SpA was high in the Chinese population with HLA-B27-associated uveitis. The association with SpA indicated an earlier age of uveitis onset and a greater likelihood of having a higher number of uveitis attacks.
Assuntos
Antígeno HLA-B27/imunologia , Espondilartrite/epidemiologia , Uveíte Anterior/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , China/etnologia , Estudos de Coortes , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Espondilartrite/imunologia , Espondilartrite/patologia , Taiwan/epidemiologia , Uveíte Anterior/imunologia , Uveíte Anterior/patologia , Adulto JovemRESUMO
This study investigated the inhibitory effects of 2'-benzoyloxycinnamaldehyde (BCA) on cancer cells, including various drug-resistant cancer cell lines. To observe this activity, the anticancer drug-resistant cell lines were established by continuously exposing the parental cells to 5-fluorouracil (5-FU) and cyclophosphamide (CDDP), and examining the cells with the MTT assay and flow cytometric analysis. The BCA treatment produced similar growth inhibitory effects and apoptotic cell death on the drug-resistant cancer cells as their parental cells. The activation of the p38-mitogen activated protein kinase, an increased level of reactive oxygen species (ROS) generation and downregulation of Bcl-2 were observed in both the drug resistant and non-drug resistant cell lines. The GSH treatment effectively inhibited BCA-induced apoptosis by blocking ROS generation, suggesting that ROS is a major regulator in BCA-induced apoptotic cell death. These results suggest that BCA can be a useful drug candidate for treating drug-resistant cells.
Assuntos
Acroleína/análogos & derivados , Antineoplásicos/farmacologia , Apoptose , Benzoatos/farmacologia , Proliferação de Células/efeitos dos fármacos , Resistencia a Medicamentos Antineoplásicos , Neoplasias/metabolismo , Acroleína/farmacologia , Linhagem Celular Tumoral , Citometria de Fluxo , Humanos , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismoRESUMO
OBJECTIVES: To develop a cross-cultural dialogue for enriching our understanding of how an ethical environment can be constructed in fostering tube-feeding decisions in patients with advanced dementia (AD). DESIGN AND DATA SOURCE: Drawing on the findings of two prospective case studies conducted in Boston and Hong Kong, this paper compares the decision-making patterns of forgoing tube feeding for AD patients and their emergent ethical dilemmas typified in a special dementia care unit in Boston (BCU) and a long-term care unit in Hong Kong (HKCU). FINDINGS: Differences in forgoing tube feeding decision are delineated in the two places. No-tube-feeding practice was sustained in BCU in two ways: advance decision-making with respect paid to the patient's wishes and advance proxy decision-making focused on patient comfort. With life preservation as the prevailing value in the Hong Kong medical system, only strong family request coupled with medical evidence of patient's ability to continue hand-feeding that tube feeding would be discontinued. All patients died with some form of artificial feeding. CONCLUSION: A paradigm shift of values underpinning the practice of forgoing tube feeding in the context of palliative care is observed in three aspects. First, the emphasis on prognostication based on biomedical markers in predicting the length of survival is shifted to a focus on the "diagnosis of dying". Second, the overriding concern in conventional medical practice with preserving life is shifting to an overriding concern of "what is best for the patient." Third, in the last days of life, the conventional approach of "trying to do everything for the patient" had shifted from a technological to a relational one. Palliative measures for relieving discomfort and providing a peaceful and dignified environment in which the patient could die are the primary concern. Although the predominant medical culture in Hong Kong is biomedical, voices from the patients and family members challenge this conventional practice, and suggest that the alternative model may be a better choice.
Assuntos
Demência/psicologia , Demência/terapia , Nutrição Enteral , Ética Clínica , Cuidados Paliativos/ética , Diretivas Antecipadas , Idoso , Idoso de 80 Anos ou mais , Boston/etnologia , Comparação Transcultural , Tomada de Decisões , Hong Kong/etnologia , Humanos , Cuidados Paliativos/métodos , Defesa do PacienteRESUMO
Human peroxiredoxin II (Prx II) has been known to function as an antioxidant enzyme in cells. Using head-and-neck cancer cell lines, we investigated whether Prx II expression is related to the resistance of cells to radiation therapy in vivo and in vitro, and whether a Prx II antisense serves as a radiosensitizer. Increased expression of Prx II was observed in tissues isolated from the patients who did not respond to radiation therapy, whereas Prx II expression was weak in tissues from the patients with regressed tumors. Enhanced expression of Prx II in UMSCC-11A (11A) cells was also observed after treatment with gamma radiation. This increased expression conferred radiation resistance to cancer cells because overexpression of Prx II protected 11A cells from radiation-induced cell death, suggesting that blocking Prx II expression could enhance radiation sensitivity. Treatment of 11A cells with a Prx II antisense decreased induction of Prx II, enhancing the radiation sensitivity. From these results, we suggest that stress-induced overexpression of Prx II increases radiation resistance via protection of cancer cells from radiation-induced oxidative cytolysis and that a Prx II antisense can be used as a radiosensitizer.
Assuntos
Antioxidantes/uso terapêutico , Oligonucleotídeos Antissenso/uso terapêutico , Peroxidases/uso terapêutico , Tolerância a Radiação/efeitos dos fármacos , Antioxidantes/metabolismo , Apoptose/efeitos dos fármacos , Northern Blotting , Morte Celular/efeitos dos fármacos , Terapia Combinada , Relação Dose-Resposta à Radiação , Raios gama , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Immunoblotting , Peroxidases/metabolismo , Peroxirredoxinas , Radiossensibilizantes/uso terapêutico , Fatores de Tempo , Células Tumorais CultivadasRESUMO
Two 5-fluorouracil (5-FU)-resistant cell lines from a Korean gastric cancer cell line were established by incubation of the cells with increasing concentration of 5-FU, and the resultant cell lines showed an over 800-fold increased resistance to 5-FU. To identify the mechanism of 5-FU resistance, the expressions of genes involved in 5-FU metabolism were examined by reverse transcriptase-polymerase chain reaction (RT-PCR). Expressions of orotate phosphoribosyltransferase (OPRT), thymidine phosphorylase (TP), and uridine phosphorylase (UP) were significantly downregulated in these cell lines, resulting in low incorporation of 5-FU into nucleic acids. In contrast, an increased expression of thymidine kinase (TK) was observed in 5-FU-resistant cells. These results strongly indicate that blocking of 5-FU incorporation into nucleic acids and TK overexpression may play a major role in 5-FU resistance in these cells. Interestingly, these cell lines showed cross-resistance to paclitaxel, cisplatin, and doxorubicin, suggesting that other factors such as HSP27 and Mn-SOD could be also involved in the mechanism of multidrug resistance in these cell lines.
Assuntos
Antimetabólitos Antineoplásicos/farmacologia , Resistencia a Medicamentos Antineoplásicos/genética , Fluoruracila/farmacologia , Neoplasias Gástricas/genética , Antimetabólitos Antineoplásicos/metabolismo , Western Blotting , DNA/metabolismo , Relação Dose-Resposta a Droga , Fluoruracila/metabolismo , Regulação Enzimológica da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Orotato Fosforribosiltransferase/genética , RNA/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia , Superóxido Dismutase/metabolismo , Timidina Quinase/genética , Timidina Fosforilase/genética , Células Tumorais Cultivadas/citologia , Células Tumorais Cultivadas/efeitos dos fármacos , Células Tumorais Cultivadas/metabolismo , Uridina Fosforilase/genéticaRESUMO
PURPOSE: To report two young healthy women who developed endogenous Candida endophthalmitis after undergoing surgically induced abortion. METHOD: Case reports. RESULTS: In two eyes of two patients, a diagnosis of Candida endophthalmitis was established by typical fundus appearance, positive vaginal culture, and, in one case, positive vitreous culture. After vitrectomy and intravitreal amphotericin B injection, one eye of one patient had a best-corrected visual acuity of 20/200, whereas one eye of one patient, who had systemic corticosteroid treatment before the correct diagnosis, developed recurrent retinal detachment and a best-corrected visual acuity of counting fingers. CONCLUSIONS: Induced abortion may cause endogenous Candida endophthalmitis in young healthy pregnant women. Systemic corticosteroid treatment may increase the risk of endophthalmitis.
PIP: Reported, in this article, are the cases of two young women who developed endogenous Candida endophthalmitis after induced abortion. Both women experienced transient fever, chills, and abdominal pain after the abortion and were given antibiotics. The diagnosis of endophthalmitis was established on the basis of typical fundus appearance, positive vaginal culture, and (in one case) positive vitreous culture. In the first woman, who received vitrectomy and intravitreal amphotericin B injection, the affected eye had a best corrected visual acuity of 20/200. In the second woman, who was given systemic corticosteroid treatment before the correct diagnosis was reached, recurrent retinal detachment developed and the best corrected visual acuity was counting fingers. It appears that Candida organisms harbored in the genital tract are directly inoculated into the venous system during induced abortion. Once in the blood, if sufficient fungal load is present, Candida albicans tends to localize in the choroid and to spread toward the retina and vitreous cavity. The immunosuppressive effect of corticosteroids further increases the risk of endophthalmitis.
Assuntos
Aborto Induzido/efeitos adversos , Candidíase/etiologia , Endoftalmite/microbiologia , Infecções Oculares Fúngicas/microbiologia , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Candida albicans/isolamento & purificação , Candidíase/tratamento farmacológico , Candidíase/cirurgia , Endoftalmite/tratamento farmacológico , Endoftalmite/cirurgia , Infecções Oculares Fúngicas/tratamento farmacológico , Infecções Oculares Fúngicas/cirurgia , Feminino , Fundo de Olho , Humanos , Gravidez , Recidiva , Descolamento Retiniano/etiologia , Vagina/microbiologia , Esfregaço Vaginal , Acuidade Visual , Vitrectomia , Corpo Vítreo/microbiologiaRESUMO
The activity coefficients of glycylglycine in four aqueous electrolyte solutions (+NaCl, +NaBr, +KCl and +KBr) were obtained at 298.2 K. The mean ionic activity coefficient of the electrolyte in aqueous solutions containing the peptide was determined from measurements of the potential differences of a cation and an anion ion-selective-electrode, each vs. a double junction reference electrode. The results show that the nature of the anion has a major effect on the activity coefficients of glycylglycine. Comparison of activity coefficient data for glycylglycine with literature data for glycine, both in aqueous NaCl solutions, indicates that the effect of the electrolyte is larger for the peptide than for the amino acid. For the peptide, in all cases, the effect of the electrolyte is more important at low molalities of the electrolyte. The Wilson equation was used to correlate the activity coefficient data obtained. The correlation results were satisfactory for the region of concentrated electrolyte.
Assuntos
Eletrólitos/química , Glicilglicina/química , Algoritmos , Fenômenos Químicos , Físico-Química , Modelos Químicos , Soluções , ÁguaRESUMO
Peroxiredoxin II (Prx II) has been known to be induced by various oxidative stimuli and to play an important protective role from oxidative damage by hydrogen peroxide (H2O2). In this study, we observed that cisplatin as well as H2O2 induced Prx II expression. To examine the correlation between the increased expression of Prx II and chemoresistance, we prepared a Prx II-overexpressing cell line, SNU638 cells, and found it to be more resistant to cell death induced by cisplatin and H2O2 than neo-transfectant cells. We also observed that enhanced expression of Prx II inhibited cisplatin- and H2O2-induced apoptosis, demonstrating that resistance to these cytotoxic agents was due to inhibition of apoptosis. The above results led us to suggest that the overexpressed Prx II protein inhibits cisplatin-induced apoptosis, thereby contributing to chemoresistance of tumor cells, especially to oxidative stress producing anticancer drugs.
Assuntos
Antineoplásicos/farmacologia , Antioxidantes , Cisplatino/farmacologia , Peroxidases/fisiologia , Resistencia a Medicamentos Antineoplásicos , Regulação da Expressão Gênica , Humanos , Peróxido de Hidrogênio/farmacologia , Peroxidases/biossíntese , Peroxidases/genética , Peroxirredoxinas , Neoplasias Gástricas/tratamento farmacológico , Células Tumorais CultivadasRESUMO
Ocular manifestations have been reported in up to 60% of individuals infected with human immunodeficiency virus (HIV) in the United States, and it is becoming increasing apparent that these ocular manifestations almost invariably reflect extent of progression of the disease. The prevalence of ocular abnormalities among acquired immunodeficiency syndrome (AIDS) patients in Taiwan has not been reported. In the present study, we examined and followed up the ophthalmic conditions of a total of 274 HIV-infected patients during the period from March 1993 to May 1999. The results show that cotton-wool spots was the most common ocular finding in this series of patients with AIDS, occurring in 22 (32.8%) of 67 AIDS patients. Cytomegalovirus (CMV) retinitis was the most commonly seen opportunistic ocular infection, occurring in 14 (20.8%) of 67 AIDS patients. These findings suggest that AIDS patients should be closely followed for signs of opportunistic ocular disease which may initially be asymptomatic. Close co-operation between the ophthalmologist and the internist is essential to ensure timely therapeutic intervention, which can decrease the risk of further complications including visual impairment and blindness.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Oftalmopatias/complicações , Adolescente , Adulto , Idoso , Contagem de Linfócito CD4 , Retinite por Citomegalovirus/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hemorragia Retiniana/etiologiaRESUMO
INTRODUCTION: T-PLS (Twin-Pulse Life Support) is the first commercial pulsatile ECLS (Extra Corporeal Life Support) device (1). The dual sac structure of T-PLS can effectively reduce high membrane oxygenator inlet pressure and hemolysis. To verify both the use of T-PLS for ECLS and the advantages of T-PLS, we tested various models. METHOD AND RESULTS: In the partial CPB (cardio pulmonary bypass) model (swine), T-PLS (N = 6), and Biopump (N = 2), a single pulsatile pump (N = 2), were compared. In the case of single pulsatile flow, during pump systole, pressure increased to 700 - 800 mmHg at the inlet port of the membrane oxygenator. fHb, a hemolysis measurement value, was about 80 mg/dL at 3 hours. On the contrary, because of T-PLS's dual sac system, the pressure of T-PLS had a maximum value of about 250 mmHg and fHb was similar to that of the commercial centrifugal pumps. In the total CPB model (bovine, N = 6), the heart was stopped via cardioplegia (Kcl). T-PLS flow was maintained at 3.0-4.5 L/min. T-PLS functioned like a natural heart, having a pulse pressure of 26-43 mmHg and a pulse rate of 40-60 bpm (beats per minute). In the emergency case model (canine, N = 6), T-PLS was started 10 minutes after cardiac arrest from electronic shock. In spite of cardiac arrest for a period of 40 minutes, the heart was recovered after defibrillation. In the ARDS (Acute Respiratory Distress Syndrome) model (canine, N = 6), minimal ventilator parameters were set: tidal volume 130 ml, respiration rate = bpm, FiO2 = 10%. Three hours after starting T-PLS, PO2 of the carotid artery blood (after 2 hours: 195 +/- 89.4; after 3 hours: 258 +/- 99.3 mmHg) was above half the value of the femoral artery but was within normal range. CONCLUSION: It is suggested that a portable pulsatile ECLS like T-PLS may be used as a CPB device and as an alternative CPR (cardiopulmonary resuscitation) device in the case of cardiac arrest. Due to the pulsatile flow, oxygenated blood is delivered to the patient without overloading the ARDS patients heart.
Assuntos
Ponte Cardiopulmonar/instrumentação , Oxigenação por Membrana Extracorpórea/instrumentação , Insuficiência Cardíaca/terapia , Animais , Bovinos , Modelos Animais de Doenças , Cães , Desenho de Equipamento , Fluxo PulsátilRESUMO
A review of 240 consecutive Chinese patients with endogenous uveitis seen over a 3-year period was made in Taiwan. The frequency of major types of uveitis was 110 cases (45.8%) of acute anterior uveitis, 43 cases (17.9%) of Behçet's disease, 22 cases (9.2%) of Harada's disease, 10 cases (4.2%) of peripheral uveitis, 6 cases (2.5%) of virus-induced uveitis and 5 cases (2.1%) of Fuchs' heterochromic cyclitis. Only 1 case (0.4%) of sarcoidosis was found. Of the 110 cases of acute anterior uveitis, 80.9% presented with HLA-B27 antigen. The incidences of types of endogenous uveitis in Chinese differ from those in Caucasians, Japanese and Negro races in the USA.
Assuntos
Povo Asiático , Uveíte/etnologia , Adulto , Idoso , China , Feminino , Antígenos HLA/análise , Antígeno HLA-B27 , Herpes Zoster Oftálmico , Humanos , Masculino , Pessoa de Meia-Idade , Uveíte/classificação , Uveíte/imunologia , Acuidade VisualRESUMO
Clinical manifestations and immunogenetic aspects of Behçet's disease were investigated in the Veterans General Hospital of the National Yang-Ming Medical College, Taiwan. Diagnosis of Behçet's disease was made according to the diagnostic criteria proposed by the Japanese Research Committee of Behçet's disease. Fifty-three patients including 33 men and 20 women have been diagnosed as having Behçet's disease in the past 10 years; 20 cases with the complete type and 33 cases with the incomplete type. About half of these cases were diagnosed in the past 2 years, predominantly by ophthalmologists. Of the 53 cases, ocular lesions were found in 35 cases, 25 men and 10 women. The ages of the onset of the ocular lesions ranged from 10 to 50 years, with the peak distribution between 20-30 years. Bilateral involvement was seen in 24 men and 8 women, and a total of 67 eyes were affected; 37 eyes (55.2%) had the final visual acuity of 0.1 or lower. Immunogenetic study revealed that the incidence of HLA-B51 was significantly higher in the patients than in the normal population.
Assuntos
Síndrome de Behçet/complicações , Antígenos HLA-B , Adolescente , Adulto , Síndrome de Behçet/epidemiologia , Síndrome de Behçet/imunologia , Criança , Oftalmopatias/classificação , Oftalmopatias/complicações , Feminino , Antígenos HLA/análise , Antígeno HLA-B51 , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , TaiwanRESUMO
Toxoplasmic retinochoroiditis is an important opportunistic retinal infection in human immunodeficiency virus (HIV)-infected patients. It may present as diffuse necrotizing retinochoroiditis instead of a focal lesion and may be the initial manifestation of HIV infection. A 50-year-old heterosexual man presented with blurred vision in his left eye of 3 months' duration. Fundus examination revealed diffuse necrotizing retinochoroiditis, mainly at the posterior pole, with marked vitritis in the left eye. Serologic studies and aqueous fluid antibody titers indicated recent toxoplasmic infection. Positive enzyme immunoassays (EIA) and Western blot tests proved HIV infection. The retinochoroiditis and vitritis improved after an antitoxoplasmic regimen with trimethoprim-sulfamethoxazole (TMP-SMX). Nonetheless, toxoplasmic encephalitis developed 6 months after the onset of ocular toxoplasmosis and responded well to TMP-SMX. This is the first case of toxoplasmic retinochoroiditis as the initial manifestation of AIDS reported in Taiwan. We suggest that Toxoplasma infection should be included in the differential diagnosis of diffuse necrotizing retinochoroiditis and vitritis. We also recommend that adults with newly diagnosed ocular toxoplasmosis be screened for HIV infection.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/etiologia , Corioidite/etiologia , Retinite/etiologia , Toxoplasmose Ocular/etiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Corioidite/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Retinite/diagnóstico , Toxoplasmose Ocular/diagnósticoRESUMO
A total of 103 cases with ocular involvement of Behcet's disease, seen over a period of 19 years (1970 to 1988), were collected from the ophthalmological departments of 6 major medical centers in Taiwan. The yearly number of patients who first visited these hospitals from 1979 through 1983 was about 5 cases and about 14 cases from 1984 to 1988. The domiciles of the patients were most commonly (51.5%) in Northern Taiwan. All 103 patients were Chinese, of which 78 (75.7%) were men and 25 (24.3%) were women; the male to female ratio was 3.1. Extraocular symptoms of Behçet's disease, major or minor, and their frequencies among these patients included; oral ulcers, 97.1%, skin lesions, 74.8%; genital ulcers, 61.2%; arthritis, 47.6%; gastrointestinal lesions, 14.6%; epididymitis, 5.8%; central nervous system lesions, 2.9%; vascular lesions, 1.9%; pulmonary lesions, 2.9% and urinary lesions, 4.9%. Fifty-one (49.5%) patients were of the complete type and 52 (50.5%) of the incomplete type. The peak distribution of ages at the onset of the ocular lesions, was from 20 to 40 years. As for visual prognosis, 37.9% of the 198 diseases eyes had a visual acuity of 0.5 or better, 9.1% between 0.5 and 0.1, 25.3% between 0.1 and 0.01 and 27.8% were 0.01 or worse. In 24 (12.1%) eyes, the vision was completely lost. In HLA studies, a significantly increased incidence of HLA-A26 (p less than 0.01) and HLA-B51 (p less than 0.001) was found.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Síndrome de Behçet/epidemiologia , Oftalmopatias/epidemiologia , Adolescente , Adulto , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/tratamento farmacológico , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Taiwan/epidemiologiaRESUMO
Human immunodeficiency virus type 1 (HIV-1) can be transmitted through blood transfusion. The first transfusion-acquired immunodeficiency syndrome (AIDS) patient in Taiwan was a 46-year-old woman who received two units of whole blood during a hysterectomy at a provincial hospital in 1985. In 1991, she experienced a herpes zoster infection. In March 1993, she had extensive herpetic gingivostomatitis and another herpes zoster attack, and was treated at the same hospital. Two months later, she had oral candidiasis and was treated at a medical center. She was not tested for HIV-1 infection until she developed Pneumocystis carinii pneumonia in June 1993. In February 1994, and developed cytomegalovirus retinitis and died 6 months later. Donor blood given to the patients during the hysterectomy was HIV-1 positive. The donor's HIV infection was discovered in 1991 and he died of AIDS in 1993. As blood centers in Taiwan did not start screening for HIV-1 until January 1988, it is urgently recommended that any individual who received a blood transfusion between 1984 and 1987 in Taiwan and who currently experiences repeated episodes of opportunistic infections have an HIV-1 blood test. The receipt of a blood transfusion between 1984 and 1987 should be listed by the Department of Health as an indication for HIV-1 screening.
PIP: In June 1993, in Taiwan, a woman admitted to a local hospital with cough, fever, chills, and difficult breathing who tested positive for HIV-1 infection was transferred to Taipei Veterans General Hospital. In January 1985, at a provincial hospital, then 46 years old, she underwent an anterior total hysterectomy and bilateral salpingo-oophorectomy during which she received two units of whole blood. One of the blood donors was an AIDS patient who had been treated at the same hospital in 1991 and who had died in 1993. In the interim between hospitalizations, she had two episodes of herpes zoster infection, including oral ulcers diagnosed as herpetic gingivostomatitis, and an episode of oral candidiasis. Physicians at the Taipei Veterans General Hospital diagnosed oral candidiasis, herpes simplex type 1 virus infection forming ulcers on her lips, and Pneumocystis carinii pneumonia in June 1993. Her CD4 count was 0 and her CD8 count was 20%. Treatment consisted of intravenous (IV) trimethoprim/sulfamethoxazole (TMP/SMX) and oral zidovudine, fluconazole, and acyclovir. She continued this medication after discharge in August 1993. She was readmitted to Taipei Veterans General Hospital in February 1994 for blurred vision. She was diagnosed with cytomegalovirus retinitis. Her CD4 count was up to 1% and her CD8 count was down to 8%. The candidiasis infection had extended from her oral cavity to the esophageal mucosa. She was put on IV ganciclovir, TMP/SMX, and fluconazole. She was discharged 3 weeks after admission. Her condition deteriorated thereafter, resulting in her death in August 1994. Up until this study, this HIV/AIDS case was listed with 79 other HIV/AIDS patients as unknown cause. During the 8 years between HIV exposure and her diagnosis of AIDS, she had unprotected sexual intercourse with her husband. Neither the husband nor any of her four children have AIDS. Screening for HIV-1 in Taiwan began in January 1988. The authors urgently recommend that anyone who received a blood transfusion between 1984 and 1987 in Taiwan and who currently suffers repeated episodes of opportunistic infections undergo an HIV-1 blood test.
Assuntos
Síndrome da Imunodeficiência Adquirida/transmissão , HIV-1 , Reação Transfusional , Feminino , Humanos , Pessoa de Meia-Idade , TaiwanRESUMO
It was found that long-term therapy with topical antiglaucoma drugs may increase the number of fibroblasts and inflammatory cells in the conjunctiva and Tenon's capsule then decrease the success of glaucoma filtering surgery. Since some dopamine antagonists and agonists are reported to have ocular hypotensive effects, they could potentially be used as clinical antiglaucoma agents in future. In this study, several dopamine antagonists and agonists were evaluated in their effects on the fibroblast proliferation of ocular tissues with cultured human ocular Tenon's fibroblast cells. It was found that dopamine antagonists inhibited [3H]-thymidine uptake to 10.8%, 14.4%, 42.2% and 72.4% of control in domperidone, 28.6%, 67.7%, 96.9% and 99.2% in haloperidol, 9.8%, 18.9%, 103.5% and 104.6% in moperone and 9.8%, 24.7%, 70.8% and 96.9% in loxapine respectively, while the 0.5% concentration of drugs were dissolved in dimethyl sulfoxide (DMSO) followed by dilution in culture medium to final concentrations ranging from 0.05%, 0.005%, 0.0005% to 0.00005%. In the case of dopamine agonist, bromocriptine, the proliferation of cultured human Tenon's fibroblast cells was also inhibited for 25.1% of the control at 0.05% concentration and 92.3% of the control at 0.00005% concentration. These results indicate that these dopamine drugs have a potential long-term application in the treatment of glaucoma without having the stimulating effect on the proliferation of human Tenon's fibroblast cells.
Assuntos
Agonistas de Dopamina/farmacologia , Antagonistas de Dopamina/farmacologia , Fibroblastos/efeitos dos fármacos , Células Cultivadas , Dimetil Sulfóxido/farmacologia , Domperidona/farmacologia , Relação Dose-Resposta a Droga , Haloperidol/farmacologia , HumanosRESUMO
In this study, various commercially used antiglaucoma drugs and corticosteroids were investigated in their effects on porcine corneal endothelial cells especially in cellular glucose uptake. Cellular glucose uptake directly affects the pumping efficiency in corneal endothelial cells. Following the cells' treatment with various antiglaucoma eyedrops for 100 min, the 3H-2-deoxyglucose uptake in cultured porcine corneal endothelial cells was affected by betaxolol from 3.1% (1.6 mM), 181% (0.16 mM) to 158% (0.016 mM), by timolol from 93% (0.79 mM), 227% (0.079 mM) to 151% (0.0079 mM), by carteolol from 141% (3.4 mM), 180% (0.34 mM) to 97% (0.034 mM), by levobunolol from 80% (1.5 mM), 98% (0.15 mM) to 90% (0.015 mM), by dipivefrin from 116% (0.2 mM), 176% (0.02 mM) to 108% (0.002 mM) and by pilocarpine from 115% (9.6 mM), 210% (0.96 mM) to 210% (0.096 mM) when the cells were compared with a control medium. In the presence of various corticosteroids, the glucose uptake in corneal endothelial cells was affected by fluorometholone from 160% (0.26 mM), 139% (0.026 mM) to 107% (0.0026 mM), by dexamethasone from 85% (0.25 mM), 117% (0.025 mM) to 109% (0.0025 mM) and by betamethasone from 95% (0.25 mM), 96% (0.025 mM) to 99% (0.0025 mM). These results show that the commercial eyedrops of antiglaucoma drugs and corticosteroids will not decrease the cellular glucose uptake in cultured porcine corneal endothelial cells except when incubated with high concentrations of betaxolol, levobunolol and dexamethasone.