Pioderma gangrenoso. Presentación de un caso

El pioderma gangrenoso es una enfermedad inflamatoria, poco común, de etilogía desconocida, caracterizada por la infiltración neutrófila estéril de la dermis, que puede o no estar asociada con enfermedades sistémicas. Su descripción clásica es la presencia de una o más lesiones ulceradas cutáneas, dolorosas, de aspecto infeccioso, bordes irregulares, socavados y con una desmesurada respuesta al trauma local denominado patergia. Se presenta el caso de una paciente de 58 años de edad, con lesiones en piel de dos meses de evolución y varios tratamientos previos sin mejorar. Al ser reevaluada, fue diagnosticado y tratado su caso como un pioderma gangrenoso con evolución satisfactoria.

Pyoderma gangrenosum is a rare inflammatory disease of unknown etiology characterized by sterile neutrophilic infiltration of the dermis, which may or may not be associated with systemic disease. Its classic description is the presence of one or more ulcerated skin lesions, painful, with an infectious appearance, irregular edges, undermined and with an excessive response to local trauma called pathergy. The case of a 58-years-old patient is presented, with skin lesions of two months' evolution and several previous treatments without improvement. Upon reassessment, her case was diagnosed and treated as pyoderma gangrenosum with satisfactory evolution.

Relationship between neutrophil chemotactic function and chemokine receptor in the early stage of deep second- and third-degree burns / 中国基层医药

Objective:To investigate the relationship between neutrophil chemotactic function and chemokine receptor in the early stage of deep second- and third-degree burns.Methods:Twenty patients with severe burns (burn group) who received treatment within 6 hours after burns in Yantai Yeda Hospital from January 2019 to June 2020 were included in this study. Twenty healthy controls (healthy group) who concurrently received physical examination in the same hospital were also included. The general data and laboratory examination indexes in each group were analyzed. The correlation between neutrophil chemotactic function and chemokine receptor was evaluated.Results:There were no significant differences in general data between the two groups (all P > 0.05). At 1, 3 and 5 days after admission, the number of neutrophils, the number of white blood cells, and procalcitonin, C-reactive protein, interleukin-6, interleukin-10, and tumor necrosis factor-α levels in the burn group were significantly higher than those in the healthy control groups ( F = 12.56, 13.45, 15.78, 17.83, 22.56, 13.39, 10.82, all P < 0.05). At 1, 3 and 5 days after admission, neutrophil migration distance in the burn group was (1 510.22 ± 108.45) μm, (1 380.90 ± 115.67) μm, (1 026.10 ± 95.48) μm, respectively, which were significantly shorter than (1 944.67 ± 139.20) μM in the healthy control group ( t = 23.44, 25.67, 27.52, all P < 0.05). At 5 days after admission, chemokine receptors 1 and 2 positive rates in the burn group were (47.40 ± 1.76)% and (75.33 ± 2.42)%, respectively, which were significantly lower than (95.24 ± 4.89)% and (97.78 ± 2.10)% in the healthy control groups ( t = 4.92, 5.67, both P < 0.05). Correlation analysis showed that neutrophil migration distance was positively correlated with chemokine receptor expression in patients with deep second- and third-degree burns ( r = 0.72, 0.61, both P < 0.05). Conclusion:Neutrophil chemotactic function and chemokine receptor expression decrease in the early stage of deep second- and third-degree burns.

Enhanced tumor homing of pathogen-mimicking liposomes driven by R848 stimulation: A new platform for synergistic oncology therapy

Although multifarious tumor-targeting modifications of nanoparticulate systems have been attempted in joint efforts by our predecessors, it remains challenging for nanomedicine to traverse physiological barriers involving blood vessels, tissues, and cell barriers to thereafter demonstrate excellent antitumor effects. To further overcome these inherent obstacles, we designed and prepared mycoplasma membrane (MM)-fused liposomes (LPs) with the goal of employing circulating neutrophils with the advantage of inflammatory cytokine-guided autonomous tumor localization to transport nanoparticles. We also utilized in vivo neutrophil activation induced by the liposomal form of the immune activator resiquimod (LPs-R848). Fused LPs preparations retained mycoplasma pathogen characteristics and achieved rapid recognition and endocytosis by activated neutrophils stimulated by LPs-R848. The enhanced neutrophil infiltration in homing of the inflammatory tumor microenvironment allowed more nanoparticles to be delivered into solid tumors. Facilitated by the formation of neutrophil extracellular traps (NETs), podophyllotoxin (POD)-loaded MM-fused LPs (MM-LPs-POD) were concomitantly released from neutrophils and subsequently engulfed by tumor cells during inflammation. MM-LPs-POD displayed superior suppression efficacy of tumor growth and lung metastasis in a 4T1 breast tumor model. Overall, such a strategy of pathogen-mimicking nanoparticles hijacking neutrophils in situ combined with enhanced neutrophil infiltration indeed elevates the potential of chemotherapeutics for tumor targeting therapy.

Advances in Study on Role of Neutrophil Infiltration in Helicobacter pylori Infection-related Diseases / 胃肠病学

Helicobacter pylori (Hp) is a microaerophilic Gram-negative bacterium that colonizes the gastric mucosa. After colonization, many proteins expressed by Hp, such as Helicobacter pylori urease (HPU), neutrophil-activating protein (NAP), outer membrane protein (OMP), cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA), may serve as antigens to mediate neutrophil chemotaxis. Thereafter, neutrophils infiltrate in gastric mucosa and play roles in mucosal immunity via secreting cytokines and releasing reactive oxygen species (ROS) and myeloperoxidase (MPO). This article reviewed the advances in study on the role of neutrophil infiltration in Hp infection-related diseases.

Efficacy of ambroxol hydrochloride in the treatment of exacerbation of chronic obstructive pulmonary disease / 中国基层医药

Objective To observe the efficacy of ambroxol hydrochloride in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods From January 2015 to December 2017,84 patients with COPD exacerbation in Zhuji Central Hospital were selected and randomly divided into two groups according to the digital table,with 42 cases in each group.The control group was treated with routine therapy,the observation group was treated with ambroxol hydrochloride on the basis of routine treatment.The course of treatment in both two groups was 14 days.The clinical efficacy,clinical symptom disappearance time,pulmonary function index,inflammation index and adverse reaction were compared between the two groups.Results The total effective rate in the observation group was 95.24％ (40/42),which was higher than that in the control group (78.57％,33/42),and the difference was statistically significant(x2 =5.126,P ＜ 0.05).The disappearance time of cough,wheezing,sputum and dampness in the observation group was (4.01 ± 0.68) d,(3.22 ± 0.60) d,(3.62 ± 1.25) d,(4.16 ± 0.72) d,respectively,which were shorter than those in the control group [(5.32 ± 1.17)d,(4.66 ± 1.12)d,(4.50 ± 1.83)d,(5.10 ± 1.06)d] (t =6.274,7.345,2.573,4.754,all P ＜ 0.05).After treatment,the forced expiratory volume,oxygen partial pressure,carbon dioxide partial pressure,C-reactive protein,neutrophil count and total white blood cell count in the observation group were (0.99 ± 0.32) L,(71.36 ± 7.61) mmHg,(42.28 ± 4.39) mmHg,(8.71 ± 2.46) mg/L,(6.40 ± 3.19) × 109/L,(6.11 ± 3.28) × 109/L,respectively,which in the control group were (0.80 ± 0.20) L,(65.28 ±7.29)mmHg,(48.40 ±6.00)mmHg,(13.60 ±4.50)mg/L,(11.45 ±5.27) × 109/L,(7.81 ±3.82) × 109/L,respectively,and the differences between the two groups were statistically significant (t =3.263,3.739,5.335,6.179,5.313,2.188,all P ＜ 0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).Conclusion Ambroxol hydrochloride can shorten the time of disappearance of clinical symptoms,improve the clinical efficacy and improve the pulmonary function and inflammation related indicators in the exacerbation period of COPD.

Efficacy of ambroxol hydrochloride in the treatment of exacerbation of chronic obstructive pulmonary disease / 中国基层医药

Objective@#To observe the efficacy of ambroxol hydrochloride in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD).@*Methods@#From January 2015 to December 2017, 84 patients with COPD exacerbation in Zhuji Central Hospital were selected and randomly divided into two groups according to the digital table, with 42 cases in each group.The control group was treated with routine therapy, the observation group was treated with ambroxol hydrochloride on the basis of routine treatment.The course of treatment in both two groups was 14 days.The clinical efficacy, clinical symptom disappearance time, pulmonary function index, inflammation index and adverse reaction were compared between the two groups.@*Results@#The total effective rate in the observation group was 95.24%(40/42), which was higher than that in the control group(78.57%, 33/42), and the difference was statistically significant(χ2=5.126, P<0.05). The disappearance time of cough, wheezing, sputum and dampness in the observation group was (4.01±0.68)d, (3.22±0.60)d, (3.62±1.25)d, (4.16±0.72)d, respectively, which were shorter than those in the control group [(5.32±1.17)d, (4.66±1.12)d, (4.50±1.83)d, (5.10±1.06)d](t=6.274, 7.345, 2.573, 4.754, all P<0.05). After treatment, the forced expiratory volume, oxygen partial pressure, carbon dioxide partial pressure, C-reactive protein, neutrophil count and total white blood cell count in the observation group were (0.99±0.32)L, (71.36±7.61)mmHg, (42.28±4.39)mmHg, (8.71±2.46)mg/L, (6.40±3.19)×109/L, (6.11±3.28)×109/L, respectively, which in the control group were (0.80±0.20)L, (65.28±7.29)mmHg, (48.40±6.00)mmHg, (13.60±4.50)mg/L, (11.45±5.27)×109/L, (7.81±3.82)×109/L, respectively, and the differences between the two groups were statistically significant(t=3.263, 3.739, 5.335, 6.179, 5.313, 2.188, all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).@*Conclusion@#Ambroxol hydrochloride can shorten the time of disappearance of clinical symptoms, improve the clinical efficacy and improve the pulmonary function and inflammation related indicators in the exacerbation period of COPD.

Sweet's syndrome associated with Crohn's disease

Abstract: Sweet's syndrome is an uncommon benign skin disorder, whose pathogenesis remains unknown. Its classic form is more common in women and presents itself as papular-nodular, painful and erythematous or violaceous lesions. It mainly affects the face, neck, and upper limbs. Fever and neutrophilic leukocytosis are also common features. Although it is considered a systemic disease marker in more than half of patients, the association of this condition with Crohn's disease is rare, with few cases reported in the literature, of which, none in Brazil. We report the case of a patient with Crohn's disease who developed the classical features of Sweet's syndrome.

Expression and clinical significance of induced sputum neutrophil S100 A8/A9 in children with bronchial asthma / 天津医药

Objective To investigate the expression and clinical significance of neutrophil S100A8/A9 in induced sputum in children with bronchial asthma. Methods A total of 108 cases of bronchial asthma patients in the FourthAffiliated Hospital of Nanchang University were involved in the study form October 2014 to October 2015. According to the severity of the disease, the patients were divided into mild group (n=40), moderate group (n=36) and severe group (n=32). Twenty health children were taken as control group at the same period. All the patients were treated with budesonide aerosol for three months, and the control group was received aerosol inhalation for normal saline (NS). The ratio of forced expiratory volume in one second and forced vital capacity (FEV1/FVC, FEV1%) were used to evaluate the pulmonary function in two groups. The asthma control questionnaire (AcQ-5) score was used to estimate the asthma control effects. The expression level of neutrophil S100A8/A9 mRNA in induced sputum was detected by real-time PCR. The correlation of S100A8/A9 mRNA, AcQ-5 score and FEV1%was analyzed. Results Before the treatment, the FEV1%decreased, while the AcQ-5 score and express level of S100A8/A9 mRNA significantly increased with the severity of disease (all P<0.01). Three months after treatment, asthma was completely controlled in 60 patients, partial controlled in 31 cases and uncontrolled in 17 cases. With the improvement of the therapeutic efficacy, the FEV1%significantly decreased, while the express level of S100A8/A9 mRNA significantly increased (all P < 0.01). The express level of S100A8/A9 mRNA in induced sputum neutrophils was negatively correlated with FEV1%(r=-0.327 and-0.406 respectively, P<0.05), which was positively correlated with ACQ-5 score (r=0.704 and 0.817, P<0.05). Conclusion The level of S100A8/A9 expression in induced sputum neutrophil is positively correlated with the severity of asthma, which can be used as clinical indicators of the severity and the efficacy of asthma.

A Case of Neutrophilic Myositis

Neutrophilic myositis is a very rare disease histologically characterized by neutrophil infiltration of muscle tissues. We report a case of a 47-year-old man who presented with acute onset of severe swelling and pain on his left shoulder with high fever. He was initially suspected of having cellulitis, but intravenous antibiotics did not improve his symptoms. Similar swelling and pain then developed on both calves. Investigations with magnetic resonance imaging of the lower legs and muscle biopsy led to a diagnosis of neutrophilic myositis. High dose glucocorticoid dramatically improved his symptoms within days. Clinicians need to be aware of this rare disease as a cause of acute febrile myositis mimicking infection.

Ofuji disease: a rare dermatosis and its challenging therapeutic approach

Abstract: Eosinophilic pustular folliculitis (EPF) or Ofuji disease is a rare dermatosis, prone to recurrence and chronicity. The peak incidence occurs in the third decade of life and its exact etiology remains unknown. Evidence suggests that the expression of adhesion molecules and the production of cytokines activate the follicular unit, but the stimulus that triggers these changes remains unclear. The three clinical variants reported in the literature include classic EPF, immunosuppression-associated EPF, and infancy-associated EPF. We report a case of eosinophilic pustular folliculitis with peculiar epidemiological characteristics, which represents a challenging therapeutic scenario.

Analysis of efficacy of comprehensive treatment in patients with chronic sinusitises / 天津医药

Objective To assess clinical efficacy of comprehensive treatment on chronic sinusitises (CRS) with neutro?phils infiltration and eosinophilic infiltration as pathological features. Methods A total of 256 CRS patients whose symp?toms were not been improved after surgery (visual analog scale>6,3 months after surgery) were included in this study. Dif?ferent comprehensive treatments were given to the patients according to the different types of cell infiltration. The visual ana?log scale (VAS), Lund-Kennedy and nasal histopathological examination were observed after treatment in patients. Results After different comprehensive treatments, the VAS and Lund-Kennedy were improved in patients with eosinophils infiltra?tion, but the number of eosinophils was not reduced. The VAS, Lund-Kennedy and the number of neutrophils were signifi?cantly improved in patients with mainly neutrophils infiltration. Conclusion According to different immune pathological characteristics, patients of CRS should be given different comprehensive treatments. There is a obvious efficacy for patients with neutrophil infiltration.

Effect and mechanism of exogenous carbon monoxide against excessive neutrophil infiltration in liver and lung tissues during sepsis / 中华创伤杂志

Objective To determine the inhibitory effect and mechanism of exogenous carbon monoxide against excessive neutrophil infiltration in liver and lung tissues during sepsis.Methods Thirty-two mice were subjected to sham operation (sham group),cecal ligation and perforation (CLP) group,CLP with 8 mg/kg of exogenous carbon monoxide releasing molecule Ⅱ (CORM-2) (CORM-2 group),and CLP with 8 mg/kg of inactive variants of CORM-2 (iCORM-2) (iCORM-2 group) according to the random number table,with 8 mice per group.Liver and lung tissues were collected at 24 hours after surgery to examine the pathologic changes,myeloperoxidase (MPO) activity and malonaldehyde (MDA) content.Another 60 mice were enrolled into the same 4 groups with 15 mice per group and were tested for 72-hour survival rate.Bone marrow neutrophils were isolated and divided into normal control group,1 μg/ml lipopolysaccharide (LPS) group,1 μg/ml LPS plus 10 μmol/L CORM-2 group (low dose group),1 μg/ml LPS plus 50 μmol/L CORM-2 group (high dose group),1 μg/ml LPS plus 50 μmol/L iCORM-2 group (iCORM-2 group).Under the agarose chemotaxis,qPCR and immunofluorescence detection of formyl peptide receptor 1 (FPR1) were performed.Results CLP group presented enhanced activity of MPO [liver:(9.1 ± 1.1) U/g,lung:(16.3 ± 2.8) U/g],increased MDA content [liver:(76.5 ±11.3) nmol/mg,lung:(32.4 ± 10.3) nmol/mg] and 72-hour survival rate of 20％ as compared with the sham group (all P ＜ 0.05).CORM-2 group showed inhibited activity of MPO [liver:(5.2 ± 0.8) U/g,lung:(7.5 ± 2.4) U/g],increased MDA content [liver:(46.7 ± 6.1) nmol/mg,lung:(23.8 ±7.3) nmol/mg] and 72-hour survival rate of 67％ as compared with the sham group (all P ＜ 0.05).LPS enhanced neutrophil migration (61.3 ± 7.1) (P ＜ 0.05) and expression of FPR1 which was enriched in the membrane.Meanwhile,neutrophil migration was significantly inhibited in a dose-dependent of CORM-2 (low dose group:43.3 ±6.1,high-dose group:23.3 ±5.9) (P＜0.05).Conclusions Exogenous carbon monoxide is effective to inhibit the excessive neutrophil infiltration,attenuate oxidative stress or pathological injury,and improve the survival from sepsis.The mechanism is associated with the down-regulation of FPR1,inhibition of FPR1 enrichment in the membrane,and decreased neutrophil migration.

Oral administration of curcumin (Curcuma longa) can attenuate the neutrophil inflammatory response in zymosan-induced arthritis in rats

PURPOSE: To evaluate the effect of curcumin in the acute phase of zymosan-induced arthritis. METHODS: Twenty-eight male rats were subjected to intra-articular infiltration of zymosan of both knees and, in four the infiltration was made with saline. The animals were divided into five groups second received every six hours by gavage: corn oil by (positive and negative control); curcumin (100 mg/kg); prednisone 1 mg/kg/day; prednisone 8 mg/kg. All animals were sacrificed after six, 12, 24 and 48 hours of the infiltration. The knees were removed for evaluation of neutrophil infiltration. The number of neutrophils was counted by computer-assisted analysis of the images. The neutrophil infiltrate was stratified into four grades: 0 = normal; + = mild; ++/+++ = moderate; > ++++ = severe. The results were compared using the Mann-Whitney test and the variance by Kruskal-Wallis test adopting a significance level of 5% (p<0.05). RESULTS: Curcumin reduces inflammatory activity in the first six hours after zymosan-induced arthritis when compared to saline (p<0.01). This was also observed in animals subjected to administration of prednisone (1 mg/kg) and those treated with prednisone (8 mg/kg). Curcumin was more effective than lower doses of prednisone in the first six hours after induction of the arthritis. After 12, 24 and 48 hours, curcumin does not have the same anti-inflammatory effects when compared to prednisone. After 48 hours, prednisone is more effective than curcumin in reducing the inflammatory infiltrate regardless of the dose of prednisone used. CONCLUSION: Oral administration of curcumin reduces inflammation in the first six hours after experimentally zymosan-induced arthritis. .

The effect of bone marrow mononuclear cells transplantation on brain injury after intracerebral hemorrhage in rats / 中华行为医学与脑科学杂志

Objective To investigate the effect of intravenously transplanted bone marrow mononuclear cells (BMMNCs) on brain injury and inflammation after intracerebral hemorrhage(ICH) in rats.Methods Experimnental ICH models were performed by stereotaxic injection collagenase Ⅳ into caudate putamen,rats that underwent ICH were randomly divided into four groups:sham operation group,ICH group,PBS group,BMMNC-treated group.The BMMNCs were injected intravenously into rats after ICH.The neurobehavioral function was evaluated on days 1,3,7,14 by the modified neurological severity score,and the brain edema was examined by wet-dry weighting method on day 3 after cell transplantation.Immumofluorecence staining was used to identify the number of activation of microglia and infiltration of neutrophils in the brain after ICH.Results The neurological score in BMMNCtreated group on days 7,14 was significantly improved compared with those in ICH group and PBS group(P＜O.05).Compared to the ICH group ((81.09 ± 0.83) ％) and PBS group ((80.99 ± 0.79) ％),there was a significant decreasc in thc brain water content in BMMNC-treated group((78.62±0.97) ％) (P＜0.05).The number of activation of microglia and infiltration of neutrophils were both significantly lower in BMMNC-treated group ((55.8±22.1)/mm2,(49.6± 12.9)/mm2) compared to ICH group and PBS group (respectively (125.0 ± 20.7) /mm2,(86.8±13.6/mm2))(P＜0.01).Conclusion Administration of BMMNCs can significantly reduce edema and improve neurologic function by inhibiting the activation of microglia and infiltration of neutrophils.

Effects of D-002 on aspirin-induced ulcers and neutrophil infiltration on the gastric mucosa / Efecto del D-002 sobre la úlcera inducida por aspirina asociada al infiltrado de neutrófilos en la mucosa gástrica

Introduction: the gastric mucosa is susceptible to the effects of aggressive factors, which are counterbalanced by mucosal defensive factors. Acid peptic diseases result from the imbalance between these aggressive and defensive factors. Aspirin-induced ulcer is a model of NSAIDs-induced damage in which neutrophil infiltration plays a key role. Objective: this paper investigates the protective effect of D-002 against aspirin-induced ulcers and associated neutrophil infiltration in the gastric mucosa. Methods: rats were randomized into six groups of 8 rats each. A negative vehicle control, and five aspirin (300 mg/kg)-treated groups: a positive control, orally treated with the vehicle, three with D-002 (25, 50 and 100 mg/kg, respectively) and other with 10 mg/kg Omeprazole. Five hours after induced damage the rats were sacrificed. The stomachs were removed and opened, and lesions examined macroscopically and microscopically. Ulcer indexes and neutrophil infiltration per ulcer areas were measured. Results: all positive, none negative, controls exhibited aspirin-induced ulcers. Oral treatment with D-002 (25-100 mg/kg) dose-dependently and significantly reduced aspirin-induced gastric lesions (37 to 75 ), the mean number of microscopic ulcers (40 to 72 por ciento) and neutrophil infiltration (41.7 to 83.1 por ciento) in the rat gastric mucosa. Conclusion: Oral treatment with D-002 (25-100 mg/kg) effectively protects against aspirin-induced ulcers and decreases the neutrophil infiltration in the gastric mucosa induced by aspirin ulceration

Introducción: la integridad de la mucosa gástrica depende del balance entre los factores agresivos y defensivos. La úlcera inducida por aspirina es un modelo de daño por antiinflamatorios no esteroidales en el cual el infiltrado de neutrófilos desempeña una función fundamental. Objetivo: evaluar el efecto protector del D-002 sobre la úlcera inducida por aspirina asociada al infiltrado de neutrófilos en la mucosa gástrica. Métodos: las ratas fueron aleatorizadas en seis grupos de ocho animales cada uno. Un control negativo con vehículo y cinco grupos tratados con aspirina (300 mg/kg): un control positivo, tratado por vía oral con vehículo, tres grupos con D-002 (25, 50 and 100 mg/kg respectivamente) y otro con omeprazol 10 mg/kg. Cinco horas después de inducido el daño las ratas fueron sacrificadas y se extrajeron sus estómagos para su análisis morfológico. Se determinó el índice de úlcera, el número de úlceras microscópicas y el número de neutrófilos por área ulcerada. Resultados: todos los controles positivos y ninguno negativo mostraron lesiones en la mucosa. El tratamiento por vía oral con D-002 (25-100 mg/kg) redujo de modo significativo y dependiente de la dosis el índice de úlceras gástricas (37-75 percent), el promedio de úlceras microscópicas (40- 72 percent) y la infiltración de neutrófilos (41,7-83,1 percent) en la mucosa de las ratas. Conclusiones: el tratamiento por vía oral con D-002 (25-100 mg/kg) protege la mucosa gástrica de las ratas del daño inducido por aspirina, lo que disminuye el índice de úlcera y el infiltrado de neutrófilos

Dermatoses neutrofílicas: parte II / Neutrophilic dermatoses: part II

Neste artigo são abordadas as dermatoses neutrofílicas, complementando o artigo anterior (parte I). São apresentadas e comentadas as seguintes dermatoses: pustulose subcórnea de Sneddon-Wilkinson, dermatite crural pustulosa e atrófica, pustulose exantemática generalizada aguda, acroder matite contínua de Hallopeau, pustulose palmoplantar, acropustulose infantil, bacteride pustular de Andrews e foliculite pustulosa eosinofílica. Uma breve revisão das dermatoses neutrofílicas em pacientes pediátricos também é realizada.

This article addresses neutrophilic dermatoses, thus complementing the previous article (part I). The following dermatoses are introduced and discussed: subcorneal pustular dermatosis (Sneddon-Wilkinson disease), dermatitis cruris pustulosa et atrophicans, acute generalized exanthematous pustulosis, continuous Hallopeau acrodermatitis, palmoplantar pustulosis, infantile acropustulosis, Andrews' pustular bacteride and eosinophilic pustular folliculitis. A brief review of neutrophilic dermatoses in pediatric patients is also conducted.

Ventilação mecânica de curta duração com altos níveis de O2 em pulmões de ratos idosos / Short courses of mechanical ventilation with high-O2 levels in elderly rat lungs

PURPOSE: To evaluate the effects of mechanical ventilation (MV) of high-oxygen concentration in pulmonary dysfunction in adult and elderly rats. METHODS: Twenty-eight adult (A) and elderly (E), male rats were ventilated for 1 hour (G-AV1 and G-EV1) or for 3 hours (G-AV3 and G-EV3). A and E groups received a tidal volume of 7 mL/kg, a positive end-expiratory pressure of 5 cm H2O, respiratory rate of 70 cycles per minute, and an inspiratory fraction of oxygen of 1. We evaluated total protein content and malondialdehyde in bronchoalveolar lavages (BAL) and performed lung histomorphometrical analyses. RESULTS: In G-EV1 animals, total protein in BAL was higher (33.0±1.9 µg/mL) compared with G-AV1 (23.0±2.0 µg/mL). Upon 180 minutes of MV, malondialdehyde levels increased in elderly (G-EV3) compared with adult (G-AV3) groups. Malondialdehyde and total proteins in BAL after 3 hours of MV were higher in elderly group than in adults. In G-EV3 group we observed alveolar septa dilatation and significative increase in neutrofiles number in relation to adult group at 60 and 180 minutes on MV. CONCLUSION: A higher fraction of inspired oxygen in short courses of mechanical ventilation ameliorates the parameters studied in elderly lungs.

OBJETIVO: Avaliar os efeitos da ventilação mecânica com alta concentração de oxigênio em animais adultos e idosos. MÉTODOS: Vinte e oito ratos machos (adultos e idosos; n=7 por grupo) foram divididos em ventilados por 1 hora (G-AV1 e G-EV1) e ventilados por 3 horas (G-AV3 e G-EV3). Os grupos receberam volume corrente de 7 mL/kg, pressão positive ao final da expiração de 5 cmH2O, frequência respiratória de 70 ciclos por minuto e fração inspirada de oxigênio de 100 por cento. Ao final do experimento avaliamos no lavado brônquio-alveolar as proteínas totais, malondialdeído, celularidade e a histomorfometria do parênquima pulmonar. RESULTADOS: Em animais idosos ventilados por 1 hora (G-EV1) as proteínas totais no lavado brônquio-alveolar aumentaram (33.0±1.9 µg/mL) quando comparados com os adultos (G-AV1; 23.0±2.0 µg/mL). Após 180 minutos de ventilação mecânica os níveis de malondialdeído e as proteínas totais estavam elevadas nos animais idosos (G-EV3) quando comparadas com os adultos (G-AV3; p<0.001). No grupo de animais idosos (G-EV3) observamos ainda dilatação dos septos alveolares e aumento significativo no número de neutrófilos em relação aos adultos ventilados, tanto aos 60 quanto aos 180 minutos de ventilação mecânica (p<0.001). CONCLUSÃO: A ventilação mecânica com alta fração inspirada de oxigênio por um curto período de tempo favoreceu os parâmetros pulmonares estudados nos animais idosos.

Effects of histidine and N-acetylcysteine on diclofenac-induced anti-inflammatory response in acute inflammation in rats.

The intra-plantar injection of carrageenan elicited an inflammatory response characterized by increase of the paw thickness and infiltration of neutrophils in paw tissues. Histidine, n-acetylcysteine and diclofenac decreased paw thickness, and neutrophil infiltration in the paw tissues. The anti-inflammatory effect induced by co-administration of histidine and n-acetylcysteine with diclofenac, was more than that obtained from histidine and n-acetylcysteine administered alone. The results suggested that histidine, n-acetylcysteine and diclofenac produced anti-inflammatory activities by reducing paw edema and neutrophil infiltrationin induced by carrageenan. Inhibition of cyclooxygenase products such as prostaglandins may be involved in the anti-inflammatory effects induced by histidine and n-acetylcysteine.

Pathologic Findings of Experimental Post-traumatic Syringomyelia

An experimental model was devised to elucidate the role of spinal blockade in post-traumatic syringomyelia. 38 White adult rabbits were divided into four groups:in Group 1, eight animals received traumatic injury only to the midthoracic area via the weight-drop method but no further treatment;in Group 2, 12 animals received a traumatic injury following injection of 100mg kaolin suspended in 1cc normal saline into subarachnoid space at the midthoracic trauma level;in Group 3, nine animals received traumatic injury following injection of 200mg kaolin in 1cc of normal saline into subarachnoid space;in Group 4, nine animals without injury received an injection of 00mg kaolin in 1cc normal saline solution into subarachnoid space at the midthoracic level. The subjective criteria for syrinx formation were the presence of a definite round cyst having a smooth margin and an upper or lower extension of more than 2cm from the injured site. Syrinx formation was seen in 12.5% in Group 1, 41.7% in Group 2, 55.5% in Group 3 , and 0% in Group 4(p<0.05). In subarachnoid space, the specimen of trauma and kaolin groups showed neutrophils infiltration and obstruction of subarachnoid space on acute stage. The pathologic changes in subarachnoid space on chronic stage were infiltration of kaolin-laden macrophages and chronic arachnoiditis. In parenchyma, hemorrhagic necrosis of the cord, edema, microinfarcts and liquefaction of hematoma were found on acute stage, and multiple cysts in white mater, cell-debris-laden macrophages in the cyst, formation of foam cells, microcysts, and large yst were shown. In Group 4, the same findings as other groups were shown in the subarachnoid space, but in the parenchyma there was no cyst formation. The results suggest that subarachnoid block secondary to adhesive arachnoidities is important in initiating the extension of the syringomyelia cavity that have already formed at the time of initial injury.

The Effects of Intravenous Adenosine on Reperfusion Injury after Experimental Acute Myocardial Infarction in Open Chest Anesthetized Dogs

BACKGROUND: Since reperfusion early after acute myocardial infarction has been demonstrated to reduce the infarct size and mortality, many drugs and interventions to reduce the reperfusion injury have been tried with limited success. Adenosine, a potent coronary vasodilator, has been reported to counteract a few mechanisms implicated with reperfusion injury, however, its effects and exact mechanisms to reduce the reperfusion injury have not been clearly elucidated. METHODS AND RESULTS: Effects of adenosine upon infarct size reduction and upon postulated mechanisms involved in the reperfusion injury such as no reflow phenomenon and neutrophil infiltration were evaluated in anesthetized open chest dog model where acute myocardial infarction was induced by 90 minute left anterior descending coronary artery occlusion followed by 240 minute reperfusion. Adenosine(3.75 mg/min) was administered intravenously for total 90 minutes from 30 minutes before reperfusion. Compared to control group(n=6), infarct area/risk area ratio was significantly lower in adenosine group(n=6)(34+12% vs. 22+/-11, p=0.04), although risk area/total left ventricular area ratio were similar in both groups. Myocardial blood flows(MBF), measured by radiolabelled microspheres, of the infarcted regions during coronary occlusion were similar in both groups, however, both subepicardial MBF(0.63+/-0.15ml/min/g vs. 0.95+/-0.31, p=0.02) and subendocardial MBF(0.45+/-0.08 ml/min/g vs. 0.69+/-0.27, p=0.02) were higher in daenosine group. Neutrophil infiltration, semiquantitatively measured under light microscope, were less severe in daenosine group,compared to control group. CONCLUSION: Intravenous adenosine administered before coronary reperfusion appears to reduce infarct size by limiting reperfusion injury through improving no reflow phenomenon and preventing neutrophil infiltration to the ischemic myocardium during reperfusion.