Subcutaneous lesions and bacteraemia due to Stenotrophomonas maltophilia in three leukaemic patients with neutropenia.

Subcutaneous lesions were seen in three of 13 neutropenia patients who had Stenotrophomonas (Xanthomonas) maltophilia bacteraemia. The characteristic clinical presentation resembled leukaemic infiltrates, and were different from deep ulcers or subcutaneous nodules caused by Pseudomonas aeruginosa. The three patients had acute leukaemia and were treated with intensive combination chemotherapy. All had previously been treated with broad-spectrum antibiotics, and each patient recovered after proper combination antibiotic treatment given according to sensitivity testing.

Lectin staining of renal cell tumours with special emphasis on oncocytomas.

There are conflicting results respecting the segmental tubular origin of renal oncocytomas, a type of tumour said to be highly differentiated and benign, though metastases have been described. The aim of this study was, by applying different lectins on renal cell carcinomas (n = 50) and oncocytomas (n = 12), to search for patterns which could indicate a specific segmental origin of oncocytomas and perhaps elucidate the differentiation of this tumour. The following lectins were applied: jacalin, peanut agglutinin (PNA), wheat germ agglutinin (WGA), phytohemagglutinin E (PHA-E), concanavalin A (Con A), and Dolichos biflorus agglutinin (DBA). The results show that oncocytomas are positive when jacalin, a Lectin that stains distal tubules and collecting tubules, is used, supporting the view that the tumour derives from distal or collecting tubules. The staining of the oncocytomas is generally polarized as in normal kidney tubules underlining that the tumour is highly differentiated. Two oncocytomas with aggressive behaviour showed areas with a diffuse pattern suggesting lower differentiation.

Trichinella infection and clinical disease.

Trichinellosis is caused by ingestion of insufficiently cooked meat contaminated with infective larvae of Trichinella species. The clinical course is highly variable, ranging from no apparent infection to severe and even fatal disease. We report two illustrative cases of trichinellosis. Returning to Denmark a few days after having eaten roasted pork in the Republic of Serbia, a female patient suffered from severe vomiting, epigastric pain, diarrhoea, and later myalgia, arthralgia, generalized oedema, and prostration. A biopsy showed heavy infestation with Trichinella spiralis, 2000 larvae/g of muscle. Life-threatening cardiopulmonary, renal and central nervous system complications developed. The patient recovered after several months. Her husband, who also ate the pork, did not have clinical symptoms, but an increased eosinophil count and a single larva in a muscle biopsy confirmed infection. The epidemiology, clinical manifestations, diagnosis, treatment and prevention of trichinellosis are reviewed.

Morphometric studies on treated and untreated heterotransplanted malignant tumours.

Short-term therapy effects on heterotransplanted tumours are important to know in order to study the action of anticancer treatment. They are, however, difficult to assess due to interference from such factors as edema, vascular swelling and necrosis. Non-invasive methods such as NMR can be of some use, but the applicability is limited since background noise from the host animal organism may confound measurements. We studied a series of Cisplatine-treated bladder carcinomas heterotransplanted to nude mice and their untreated controls in order to illustrate short-term chemotherapy effect. We applied simple unbiased morphometric methods on formalin-fixed and paraffin-embedded material in order to obtain an unbiased estimate of the volume of the whole tumour and the volume of vital tumour tissue on day 1 and day 3 after treatment, at which time no gross changes in tumour size were evident. Furthermore, we estimated the number of tumour cells in the tumours. The estimate was based on measurement of the mean nuclear volume and the nuclear volume fraction in combination with the measured volume of vital tissue in the tumour. The pronounced therapy effects seen in this experimental system may be of potential interest in monitoring effects at the clinic.

Oestrogen receptor investigations in bladder tumours.

Transitional cell tumours of the bladder in 12 men and 12 women were investigated for oestrogen receptors. All tumours and surrounding urothelium were found to be receptor-negative.

Interferon alpha-2b treatment of symptomatic chronic vulvodynia associated with koilocytosis.

In an open study with identical criteria for diagnosis, 16 female patients with typical symptoms of chronic vulvodynia associated with acetowhitening of the vestibular epithelium and koilocytosis in biopsy specimens received recombinant interferon alpha-2b 5 MIU intralesionally 3 times weekly for 3 weeks or subcutaneously 3 times weekly for 8 weeks. Three months after end of therapy, clinical symptoms had disappeared in 7 (70%) of the 10 patients treated intralesionally, compared with only one (16%) of the 6 patients treated subcutaneously. In addition, the last 3 (30%) patients in the first group had a partial response to therapy. The acetowhitening persisted in all patients. The koilocytosis remained unchanged in 13 (81%) of the 16 patients. Our results indicate that recombinant interferon alpha-2b administered intralesionally seems to be efficacious in reducing clinical symptoms in vulvodynia with suspected human papillomavirus infection but does not eliminate the infection. Subcutaneous administration had neither symptomatic nor antiviral effect. A placebo-controlled study is needed, but with our present knowledge we recommend intralesionally administered interferon as a symptomatic treatment of vulvodynia.

In vivo 31P magnetic resonance spectroscopy and 1H magnetic resonance imaging of human bladder carcinoma on nude mice: effects of tumour growth and treatment with cis-dichloro-diamine platinum.

In vivo 31P NMR spectroscopy and 1H NMR imaging were used to examine the bladder T24B carcinoma in nude mice during untreated growth and in response to chemotherapy by Cis-dichloro-diammine-platinum (CDDP) at a dose of 8 mg/kg i.p. Untreated growth was associated with an increase of inorganic phosphate and phosphomonoesters and a decrease of phosphocreatine. Fast growing tumours and early stage of regrowth after treatment presented a higher phosphocreatine/beta NTP ratio. Following CDDP treatment, 31P metabolite ratios and pH were significantly altered compared with age-matched controls, as early as 6 hours after treatment. Although necrotic area was clearly visible in MRI, no treatment effect could be detected on the images of treated tumours.

Comparative studies between nude and scid mice on the growth and metastatic behavior of xenografted human tumors.

The growth and metastatic behavior of three human tumor cell lines and a human colon carcinoma previously passaged in vivo were compared between nude mice and scid mice after xenotransplantation. The three human tumor lines included a bladder carcinoma (T24B), a melanoma (RPMI 7931) and a lacZ gene-transduced breast cancer (MDA-MB-435 BAG). The lacZ gene codes for beta-galactosidase, which can be stained blue with chromogenic substrate X-gal, thus allowing the highly sensitive detection and quantitative examination of human cancer metastasis in host mice. Adult (7-14 weeks) NMRI nude and C.B-17 SCID mice were inoculated with 0.5-5 x 10(6) tumor cells s.c. Comparable take rate, latent period and growth rate of implanted tumors were observed in nude and scid mice for each of the cell lines tested. At the time of autopsy, which varied from 6 to 11 weeks after inoculation, a significantly higher incidence of spontaneous lung metastasis was discovered in scid mice (96%) than in age-matched nude mice (27%, total P less than 0.001). In vitro assays for NK cell-mediated cytotoxicity revealed no significant differences between the two strains of mice. Our results suggest that nude and scid mice are equally suitable for propagating human tumors. However, the metastatic capacity of human tumor cells appears to be better expressed in scid mice. Scid mice may therefore provide an advantageous model for the study of human tumor metastasis.

[Human papillomavirus--(HPV)/balanoposthitis--a new disease?]. / Human papillomavirus--(HPV)/balanoposthitis--en ny sygdomsenhed.

Two cases of symptom-producing balanoposthitis associated with Human papillomavirus infection are described. These patients had spotty, macular, erythematous rash on the glans penis and prepuce. The symptoms and objective findings resemble those of Candida infection but the diagnosis can be established by histological examination of biopsy from the acetowhite elements.

Subclinical human papilloma virus infection in condylomata acuminata patients attending a VD clinic.

In 37 (77%) of 48 patients with external genital warts, application of 5% acetic acid revealed areas of acetowhite epithelium. The lesions were not clinically apparent before acetic acid was applied but were easily detected without the use of a colposcope. In a control group of 20 patients with chlamydial urethritis and no history of genital warts, none had acetowhite genital lesions. Histological examination of biopsy specimens from the flat acetowhite lesions showed HPV infection with koilocytosis in 29 (78%) and in 3 (8%) intra-epithelial neoplasia grade II-III. Using in situ hybridization with commercially available biotinylated DNA probes, HPV types 16/18 could be detected in 7 (24%) patients with koilocytosis and in 3 (100%) patients with dysplasia. Simultaneous infection with HPV types 6/11, 16/18, and 31/33/35 was found in 8 of the 13 HPV DNA-positive patients. It is concluded that subclinical HPV-induced acetowhite lesions are common among patients with genital warts and that these flat lesions may be associated with a high grade of dysplasia. Consequently, routine use of the acetic acid test on the genital epithelium is recommended in patients with condylomata acuminata in order to diagnose and treat all HPV-infected areas.

Clonidine-induced immune complex disease.

We report upon a 46-year-old woman, who developed immune complex disease after treatment with clonidine for one year. The diagnosis was verified with histological demonstration of IgG and IgM complexes as well as complement C1q, C3c and C4 between muscle fibres and at the dermo-epidermal junctions. The patient's symptoms abated and the abnormal results of blood tests reverted to normal following cessation of clonidine therapy.