Biomedical subjects
Publications and source records attributed to A Skarin.
Although malignant mesothelioma is known to spread hematogenously, brain metastases are rare. In the patient presented herein, multiple unilateral symptomatic central nervous system metastases developed that were diagnosed by computed tomography and documented at autopsy. Since malignant mesothelioma is occurring more frequently in the population at risk (asbestos workers), this complication may be observed more commonly in the future.
Twenty-four strains of Mobiluncus mulieris and 27 strains of Mobiluncus curtisii were tested with respect to 6 different biochemical characteristics: arginin-decarboxylase activity, beta-galactosidase activity, synergistic hemolysis with Staphylococcus aureus, hydrolysis of hippurate, migration through soft agar and reduction of nitrate. Antigens of the same strains, prepared by ultrasonication, were subjected to sodium dodecyl sulphate-polyacrylamide gel electrophoresis followed by immunoblotting using polyclonal rabbit antisera against two of the M. mulieris strains and five of the M. curtisii strains. Two different strongly reacting protein antigens could be detected in the M. mulieris strains. These strains could be separated into three groups based on the possession of either of the two antigens or both. In the M. curtisii strains, 10 strongly reacting protein antigens could be detected. Four strains possessed only one of these antigens, one did not possess any, while the remaining strains possessed different sets of 9 of them. Within each species common protein antigens were detected. No antigens were found which were shared by both species. The biochemical characteristics studied could not differentiate between the antigenic groups in any of the species. None of the antigenic subgroups of M. curtisii found in the present study was identical with any of the two subspecies (curtisii and holmesii) which have been proposed.
On a solid agar medium the growth-inhibitory effect of 9 Lactobacillus strains cultured from vaginal content was tested on bacteria cultured from vaginal content of women with bacterial vaginosis: Mobiluncus, Gardnerella vaginalis, Bacteroides and anaerobic cocci. Inhibition zones were observed in the growth of all of the strains isolated from women with bacterial vaginosis around all lactobacilli. The inhibitory effect of the lactobacilli was further tested on various anaerobic and facultatively anaerobic species, both type strains and fresh extragenitally cultured strains. Four Bacteroides fragilis strains as well as 2 out of 4 Staphylococcus aureus strains were clearly inhibited by the lactobacilli. The inhibition zones were generally wider at pH 5.5 than at 6.0. For all inhibited strains, (the S. aureus excepted) a low pH on the agar around the lactobacilli correlated to wider growth-inhibition zones.
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A retrospective analysis of 144 patients with stage I-II non-Hodgkin's lymphoma (NHL) treated between June 1968 and December 1980 was performed. Patients were staged by bone marrow biopsy, chest radiography, blood chemistries, and either bipedal lymphangiography, computerized axial tomography, or surgical exploration of the abdomen. Patients were subclassified by extent of disease; minimal disease was defined as less than 10 cm and involved one or two contiguous sites, while patients with disease exceeding these limitations were considered to have extended stage I-II disease. Treatment consisted of radiation therapy (RT) alone in 74 patients and 70 patients were treated with chemotherapy with or without RT. Combination chemotherapy in patients with diffuse undifferentiated (DU) or diffuse histiocytic (DH) lymphoma resulted in a significantly higher 6-year survival as compared to patients treated with RT alone. For minimal disease DU/DH patients, the 6-year survival with chemotherapy +/- RT was 96% as compared to 61% with RT alone (P = .03). For extended disease DU/DH patients the 6-year survival with chemotherapy +/- RT was 56% as compared with 18% with RT alone (P = .003). This survival advantage from the initial use of chemotherapy was not seen in any of the other histologic subgroups.
Primary lymphomas of the CNS are rare tumors accounting for less than 2% of all extranodal non-Hodgkin's lymphomas. The treatment for this disease has been disappointing. Radiation therapy and surgery have produced consistently poor control of this disease, with a median survival of 15 months. We have reviewed ten cases of primary lymphoma of the CNS treated at the Joint Center for Radiation Therapy or Dana-Farber Cancer Institute (Boston) from 1968 to 1981. All patients had biopsy-proven CNS lymphomas without systemic disease at presentation. In our series, control of CNS lymphoma was seen only in patients receiving craniospinal radiation or CNS-penetrating chemotherapy.
A chemotherapy combination of cyclophosphamide, doxorubicin, and cisplatin (CAP) was administered to 30 patients with stage III M0 or M1 (supraclavicular nodes) unresectable non-small cell lung cancer before and after radiotherapy. All patients had mediastinal metastases and most had T2 or T3 primary lesions. The response rate (complete plus partial) after two cycles of CAP was 47%, which increased to 66% (24% complete response rate) following radiotherapy. The overall median survival from initiation of chemotherapy was 9 months. CNS relapse occurred in five (26%) of 19 responding patients who did not receive prophylactic cranial irradiation in the early part of the study.
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Ninety-four women colonized with anaerobic curved rods (CR) and/or Gardnerella vaginalis, were studied. Of these women, 34 were culture-positive for the long variant of CR. Eight of these latter women also harboured the short variant of these bacteria. In women colonized with CR, none had a predominance of lactobacilli in their vaginal flora, which was the case in 26 of the 60 women not harbouring CR. G. vaginalis was isolated from all 94 women. Mycoplasma hominis occurred significantly more often in women colonized with CR and G. vaginalis as compared with women not harbouring CR, but who were colonized with G. vaginalis (p less than 0.0005). The recovery rate of chlamydiae and gonococci was remarkably low, i.e. the organisms were isolated from one case each. Women colonized with CR complained of foul-smelling vaginal discharge significantly more often than women not found to harbour such organisms (p less than 0.001). In all women with CR, the number of leukocytes per high-power field of vaginal secretion exceeded that of 'clue cells'. Such cells were found in all patients with CR, but not in women with a lactobacilli-dominated flora, despite the fact that they all harboured G. vaginalis. Bacterial vaginosis might be due to a symbiotic infection with G. vaginalis and CR, possibly in conjunction with other anaerobes and/or M. hominis.
By DNA-DNA hybridization we could recognize two distinct groups of anaerobic curved rods (CR) that had been isolated from the vaginal content of women with bacterial vaginosis. On the basis of morphological studies these two groups correlated with one group of short, Gram-variable, curved rods (SCR) and another consisting of similar but somewhat longer rods (LCR). The SCR had up to four flagella per cell and the LCR up to eight. Among 79 biochemical tests, only tests for ONPG and arginine dehydrolase differentiated the two groups, SCR being positive and LCR negative. The gas chromatographic analysis of spent culture medium revealed that LCR, but not SCR, produced oxalacetic and oxalic acids. The groups were also differentiated by gas-chromatographic/mass-spectrometric patterns of certain cellular fatty aldehydes. Cell wall structure and presence of cytoplasmic inclusions did not distinguish SCR from LCR. On the basis of DNA-DNA hybridization values the SCR formed a more heterogeneous group than did LCR. Of all biochemical tests performed, only the production of alpha-galactosidase separated two strains of SCR that showed a low percentage of hybridization along with the rest of the SCR strains. Our study does not support a subdivision of SCR.
Twenty strains of anaerobic curved rods isolated from vaginal secretion were studied with light and transmission electron microscopy. Ten of the strains were of a short (approx. 1.5 microns) Gram-variable type, while ten were of a long (approx. 3 microns) Gram-negative type. The former had one to four flagella and the latter between one and eight. The flagella originated from the concave aspect of the cells. Thin sections of both types of bacteria revealed an approximately 30 nm thick cell wall with no outer membrane, similar to that of most Gram-positive bacteria. An electron-dense zone in the middle of the cell wall, atypical of Gram-positive bacteria, was found, however. Amorphous and electron-translucent cytoplasmic inclusions, not membrane-enclosed, were detected. These inclusions stained metachromatically with Albert's stain.
The fatty acid compositions of forty-five strains of anaerobic curved rods isolated from vaginal content were analysed by gas chromatography. Twenty-six of the strains were of a short Gram-variable type and 19 of a long Gram-negative type. The bacteria were subjected to alkaline saponification, after which the liberated fatty acids were methylated using boron trichloride-methanol. The samples were introduced onto a cross-linked (SE-54) fused silica capillary column. The major peaks in the chromatograms from all strains corresponded to C14:0, C16:0, C18:2, C18:1 and C18:0 fatty acids. Five additional components were seen, three of them identified by mass spectrometry as fatty aldehydes (saturated and unsaturated) of 16 to 18 carbon atoms, whereas the remaining two were not identified. The fatty aldehydes indicated the presence of plasmalogens in the bacterial strains studied. With two exceptions, all of the short rods were distinguishable from the long ones by the presence of one aldehyde and two unidentified compounds, all three eluting between C16:0 and C18:2.
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