Hepatic histopathology in two populations of the mummichog, Fundulus heteroclitus.

The pollution-tolerant mummichog, Fundulus heteroclitus, inhabits a heavily contaminated estuary, Piles Creek (PC), in Linden, NJ. PC contaminants include PAHs, PCBs and many metals, including high Hg and Pb. PC mummichog livers and kidneys were compared with those from a pristine estuary in Tuckerton (TK), NJ, by standard histopathological methods, with quantification by computerized image analysis. PC livers had > 2 x the lipid ratios of TK livers. Cell sizes and shapes were not different between populations. TK livers had a 25% incidence of basophilic areas and an age-related 30% incidence of macrophage aggregates; PC livers had none of these lesions. PC livers had a 100% incidence of necrotic foci, compared with 55% of TK livers. Inflammation was noted in 50% of TK livers but only 27% of PC livers. Curiously, the TK livers had a 45% incidence of metacercarial cysts of a digenetic trematode, while none were found in the PC livers. The TK focal necrosis and macrophage aggregates coincided with parasite infestation. There were no observed kidney lesions in either population. Positive biomarkers in this species thus included high hepatic lipid content, possibly necrosis, but no other lesions. The lack of trematode cysts in PC livers may reflect the lack of an intermediate host in this low biodiversity estuary.

[Ultra-high dosage streptokinase lysis in dysfunction of a St. Jude aortic prosthesis]. / Ultrahochdosierte Streptokinase-Lyse bei Dysfunktion einer St.-Jude-Aortenprothese.

HISTORY AND CLINICAL FINDINGS: A 64-year-old man was hospitalised because of progressively worsening dyspnoea over the preceding few months. Three years previously he had undergone aortic valve replacement (St. Jude Medical bileaflet valve) for severe aortic stenosis and some regurgitation. He was much improved postoperatively and one year after the operation echocardiography demonstrated a well functioning prosthetic valve and a transvalvar pressure gradient (by Doppler echocardiography) of 28 mm Hg. On admission the patient reported to have stopped phenprocoumon 9 months before admission. The patient was in cardiac failure, grade III (NYHA classification). On auscultation there was a 4/6 crescendo-decrescendo systolic murmur and a 2/6 early diastolic decrescendo murmur maximal over the second right ICS. INVESTIGATIONS: Echocardiography confirmed the suspected diagnosis of dysfunction of the prosthetic valve, one leaflet being immobile, with severe outflow obstruction (peak transvalvar pressure gradient 101 mm Hg) combined with severe regurgitation. At fluoroscopy one leaflet moved normally, the other one being fixed between opening and closing positions. TREATMENT AND COURSE: As thrombosis was the most likely cause of the prosthetic valve dysfunction, thrombolysis treatment was started. After administration of 9 mill. IU streptokinase both leaflets showed normal movement. The peak transvalvar gradient (by echocardiography) was now 40 mm Hg and there was only slight regurgitation. No complications were noted. After oral anticoagulation for 6 months the prosthetic valve was functioning normally with unchanged movement pattern of both leaflets. CONCLUSION: Thrombolysis may be successful in thrombotic dysfunction of a prosthetic valve. If there are no contraindications, this form of treatment should be tried before reoperation is undertaken.

[Tobramycin sensitivity of bacteria from the Klebsiella-Enterobacter group (author's transl)]. / Tobramycin-Emphfindlichkeit von Keimen der Klebsiella-Enterobacter-Gruppe

In 300 strains of the Klebsiella-Enterobacter group which were isolated from pathological material from the Bonn University Hospitals in early 1975, the sensitivity to tobramycin was investigated comparatively in a serial dilution test and agar diffusion test. 80% of the strains were seen to be classifiable as sensitive and further 3% as moderately sensitive. The rate to resistance corresponds to that of gentamycin. No difference in resistance behaviour was ascertained in the two bacterial species investigated. However, strains isolated from the urogenital tract are significantly more resistant than pathogens isolated from the respiratory tract.