Clin Exp Immunol, 1993 Jun, 92(3), 437 - 41 T cell receptor V beta repertoire in HIV-infection individuals: lack of evidence for selective V beta deletion; Boyer V et al.; The gradual decline of CD4+ T lymphocytes in HIV-infected individuals culminates in the lethal immunosuppression of AIDS . The mechanism of CD4+ T cell loss is currently unknown, but has recently been suggested to occur as a result of an HIV-encoded superantigen which facilitates a selective deletion of T cells expressing specific V beta genes . To verify and extend such observations, peripheral blood leucocytes (PBL) from 15 HIV+ individuals, 10 of which had very low CD4 T cell counts (< 200/mm3), were analysed for T cell receptor (TCR) V beta gene expression . In contrast to a recent study, the results presented here fail to provide evidence that selective loss of V beta-bearing T cells occurs in HIV+ individuals . Furthermore, when PBL from HIV+ individuals were stimulated with Staphylococcal enterotoxin B (SEB), T cells expressing V beta subfamilies known to engage this superantigen were expanded, indicating that such cells were not deleted and were responsive to stimulation by a bacterial superantigen . Collectively, these data suggest that CD4 loss in HIV patients does not occur in a V beta-selective, superantigen-mediated fashion. J Neuroimmunol, 1993 Jun, 45(1-2), 83 - 8 Effects of staphylococcal enterotoxin B on T cell receptor V beta utilization and clinical manifestations of experimental allergic encephalomyelitis; Kalman B et al.; Staphylococcal enterotoxin B (SEB) is a superantigen (SA) that up-regulates and then subsequently down-regulates and deletes T cells expressing V beta 8 T cell receptor (TcR) chains (Marrack and Kappler, 1990; Johnson et al., 1991) . We have investigated the effect of SEB on experimental allergic encephalomyelitis (EAE) in PL/J mice, where the predominant encephalitogenic T cells are V beta 8+ (Acha Orbea et al., 1988; Zamvil et al., 1988) . SEB did not enhance induction of EAE when administered prior to or after immunization for EAE . PL/J mice pretreated with SEB developed anergy and deletion of V beta 8 bearing cells and concomitant reduction in the incidence of EAE . Following SEB pretreatment, a redistribution in the TcR utilization of MBP-specific lymphocytes occurred . As a result, there was a low frequency of V beta 8 and expansion of other, normally less frequent, myelin basic protein (MBP)-specific clones . These observations indicate that systemic exposure to superantigen can influence organ-specific autoimmune diseases . We observed V beta-specific elimination, rather than activation, of autoimmune clones, a finding of potential therapeutic value . Modification of the TcR repertoire by systemic exposure to this SA indicates plasticity of immune reactivity and demonstrates a mechanism by which an environmental exposure (SEB) can influence a genetically determined, T cell mediated autoimmune disease. Transfusion, 1993 Jun, 33(6), 450 - 7 The use of a chemiluminescence-linked universal bacterial ribosomal RNA gene probe and blood gas analysis for the rapid detection of bacterial contamination in white cell-reduced and nonreduced platelets; Brecher ME et al.; Because of the rising incidence of bacterial growth and septic platelet transfusions in aging units, platelet storage is currently limited in the United States to 5 days . This approved shelf life of platelets might be altered if methods were devised to rapidly detect infected units and/or to decrease the incidence of bacterially contaminated platelets . An investigation was conducted on the effect of a prototype blood collection system with an in-line filter for the production of white cell-reduced platelet-rich plasma on the growth of bacteria in platelets prepared from whole blood that had been inoculated with Staphylococcus epidermidis . Additional studies were conducted with a chemiluminescence-linked ribosomal RNA (rRNA) gene probe and with blood gas analysis to identify possible methods for the rapid detection of bacterial contamination . All units were followed for 9 days of storage . The filtration of the platelet-rich plasma resulted in an approximate 2 log10 reduction in white cells with an average loss of 6.7 percent of platelets . Filtration did not appear to alter bacterial growth . In all platelet units that supported growth, pO2 dropped to negligible values and pCO2 rose relative to culture-negative units . The changes were most sensitive and specific beyond 5 days of storage . The universal bacterial rRNA probe assay was able to detect S . epidermidis in concentrations as low as 1 x 10(3) colony-forming units per mL in some cases and reliably detected all units contaminated at a concentration of 1 x 10(4) colony-forming units per mL.(ABSTRACT TRUNCATED AT 250 WORDS) Int J Cancer, 1993 May 28, 54(3), 482 - 8 Superantigen-induced cytokines suppress growth of human colon-carcinoma cells; Dohlsten M et al.; We have recently demonstrated that the superantigen staphylococcal enterotoxin A (SEA) conjugated to colon-carcinoma-reactive monoclonal antibodies (MAbs) directs T cells to lyse human colon-carcinoma cells, representing a potential novel tumor therapy . To further analyze the mechanism of antitumor effects of superantigen-activated T cells, we compared the activity of free and MAb-conjugated SEA in a long term in vitro co-culture assay of human peripheral-blood mononuclear cells (PBMC) and colon-carcinoma cell lines . Activation of resting T lymphocytes with SEA conjugated to the colon-carcinoma-reactive MAb C215 or free SEA resulted in strong inhibition of the growth of all studied colon-carcinoma cell lines . The growth of WiDr colon-carcinoma cells was unaffected by the presence of unactivated mononuclear cells, whereas addition of pM concentrations of SEA or C215-SEA conjugate completely suppressed tumor-cell growth . The suppressive effect was mediated by both CD4+ and CD8+ T cells and required the presence of MHC-Class II+ monocytes . The inhibition of tumor-cell growth was to a large extent mediated by soluble factors present in supernatants from SEA- or C215-SEA-activated mononuclear cells . Quantitation of cytokine mRNA in SEA-activated mononuclear cells by the reverse transcriptase-polymerase chain reaction (RT-PCR) revealed strong induction of mRNA encoding the cytokines IL-1 alpha, IL-1 beta, IL-2, IL-6, TNF-alpha, TNF-beta and IFN-gamma . The use of cytokine-specific MAb demonstrated that IFN-gamma was of major importance for the tumor-growth-inhibitory activity in supernatants of SEA-activated lymphocytes . Addition of recombinant cytokines to WiDr colon-carcinoma cells showed that TNF-alpha was able to act synergistically with IFN-gamma to suppress tumor-cell growth . The local production of tumor-suppressive cytokines induced by MAb-targeted superantigens is likely to be of particular relevance for inhibition of the growth of tumor cells not expressing the targeted tumor-associated antigen. Biochemistry, 1993 May 18, 32(19), 5222 - 32 Effects of amino acid substitutions on the pressure denaturation of staphylococcal nuclease as monitored by fluorescence and nuclear magnetic resonance spectroscopy; Royer CA et al.; In the present study we have used high hydrostatic pressure coupled with either time-resolved and steady-state fluorescence or NMR spectroscopy in order to investigate the effects of amino acid substitutions on the high-pressure denaturation properties of staphylococcal nuclease . This protein has been shown previously to be structurally heterogeneous in its native state . On the NMR time scale, four distinct interconverting conformational forms arise from the population of both cis and trans Xaa-Pro peptide bonds (His46-Pro47 and Lys116-Pro117) {Evans et al . (1989) Biochemistry 28, 362; Loh et al . (1991) in Techniques in Protein Chemistry II, pp 275-282, Academic Press, New York} . Mutations in the protein sequence have been shown to change the distribution among the various forms {Alexandrescu et al . (1989) Biochemistry 28, 204; Alexandrescu et al . (1990) Biochemistry 29, 4516} . Time-resolved fluorescence on a series of mutants with altered equilibria for cis/trans isomerism about the 116-117 peptide bond did not reveal any simple relationship between the position of the cis/trans equilibrium in the folded state and the heterogeneity of the fluorescence decay . However, the specific dynamic properties of each mutant, as revealed by time-resolved fluorescence, do appear to be correlated with their partial molar volume changes of denaturation . A striking finding is that mutation of either (or both) of the prolines that exhibits structural heterogeneity to glycine greatly alters the stability of the protein to pressure . These mutations also result in decreased chain mobility as assessed by time-resolved fluorescence . It appears that packing defects, which allow for peptide bond cis/trans heterogeneity in the wild-type protein, are removed by the Pro-->Gly substitutions. J Immunol, 1993 May 15, 150(10), 4331 - 7 Role of CD8 in staphylococcal enterotoxin B-mediated lysis by cytotoxic T lymphocytes; Hoo WS et al.; Recent evidence has suggested that recognition of superantigens such as the staphylococcal enterotoxins by CTL occurs independently of the accessory molecule CD8 . These conclusions are based on the observation that antibodies to CD8 do not appear to be effective inhibitors of T cell lysis that is mediated by enterotoxin . This is in contrast to the well-known inhibitory effects of anti-CD8 antibodies on T cell activation by most peptide/class I complexes . In this study, we show that lysis of staphylococcus enterotoxin B (SEB)-bearing target cells by the mouse alloreactive CTL clone 2C is inhibited by anti-CD8 antibodies . SEB-mediated lysis by a polyclonal population of mouse CTL was also inhibited by anti-CD8 antibodies, but only under conditions where the SEB concentration is low . Inhibition occurs even when class I negative Daudi cells are used as targets . Thus, the observed inhibition does not appear to be due to the prevention of intercellular interactions between CD8 and class I molecules but is probably a consequence of preventing the intracellular association of CD8 and TCR . At the high ligand densities used in most previous studies, very few of the CD8/TCR complexes may be required for activation . Under these conditions, lysis may appear to be CD8 "independent" because 1) there are a sufficient number of preexisting CD8/TCR complexes for activation; or 2) prohibitively high concentrations of antibody would be needed to saturate unassociated CD8. J Immunol, 1993 May 15, 150(10), 4284 - 91 Superantigen-induced peripheral tolerance inhibits T cell responses to immunogenic peptides in TCR (beta-chain) transgenic mice; Perkins DL et al.; TCR (beta-chain) transgenic mice were tolerized with the superantigen staphylococcal enterotoxin B (SEB) . Three to 28 days after tolerization with SEB, flow cytometry of peripheral T cells showed the persistence of SEB-unresponsive T cells that did not express reduced levels of the TCR (beta-chain) transgene . Stimulation of the tolerized T cells with a panel of superantigens (SEC1), mitogens (Con A, PHA, and pertussis toxin) and mAb (anti-CD3 epsilon) did not induce T cell proliferation . In contrast to other models, exogenous rIL-2 did not reverse unresponsiveness and induce proliferation . In addition, lymphokines rIL-4 and rIL-6 also did not induce proliferation . However, the unresponsive T cells did respond to the combination of PMA plus ionomycin, but not to PMA or ionomycin alone . Thus, the block in signal transduction in the anergic state occurs between the stimulation of cell surface receptors and the activation of protein kinase C and the increase in intracellular calcium . In addition, these results show that mature T cells tolerized with the superantigen SEB are unresponsive to a wide array of T cell stimuli, indicating a block in a common signal transduction pathway. J Chromatogr, 1993 May 7, 637(1), 55 - 62 Glycosidase digestion, electrophoresis and chromatographic analysis of recombinant human granulocyte colony-stimulating factor glycoforms produced in Chinese hamster ovary cells; Clogston CL et al.; Recombinant human granulocyte colony stimulating factor (G-CSF) produced in Chinese hamster ovary cells is glycosylated . The carbohydrate compositional analysis indicated that G-CSF molecule contains sialic acid, galactose and galactosamine . By isolation and characterization of the purified glycopeptides obtained from cleavages by Staphylococcal aureus V-8 protease and cyanogen bromide, the O-linked glycosylation site was confirmed to be a Thr residue at position 133 . Neuraminidase and O-glycanase digestion followed by sodium dodecyl sulfate polyacrylamide and isoelectric focusing gel electrophoreses distinguished two possible carbohydrate structures attached at Thr-133: structure A, NeuNAc-Gal-beta(1,3)-GalNAc-O-Thr; and structure B, NeuNAc-Gal-beta(1,3)-{NeuNAc}-GalNAc-O-Thr . Different glycoforms, undigested or after glycosidase digestion, can also be separated by ion-exchange or reversed-phase high-performance liquid chromatography . The approach described in this report provides a simple and valuable procedure to characterize glycoprotein structures containing simple carbohydrate moieties. Protein Sci, 1993 May, 2(5), 851 - 8 NMR analysis of staphylococcal nuclease thermal quench refolding kinetics; Kautz RA et al.; Thermally unfolded staphylococcal nuclease has been rapidly quenched to temperatures near 0 degree C and the refolding behavior examined using an NMR kinetic experiment . Unfolded protein, exhibiting random coil chemical shifts, persists following the quench and refolds in two distinct kinetic phases . A protein folding intermediate with a trans Lys 116-Pro 117 peptide bond is transiently overpopulated and relaxes to the predominantly cis native cis-trans equilibrium . The rate of trans-->cis isomerization in the native-like nuclease intermediate is approximately 100-fold faster than that observed in a Lys-Pro model peptide . The activation enthalpy of 20 kcal/mol observed for the nuclease Lys 116-Pro 117 peptide bond is comparable to that observed for other X-Pro isomerizations. Protein Sci, 1993 May, 2(5), 838 - 50 Stress and strain in staphylococcal nuclease; Hodel A et al.; Protein molecules generally adopt a tertiary structure in which all backbone and side chain conformations are arranged in local energy minima; however, in several well-refined protein structures examples of locally strained geometries, such as cis peptide bonds, have been observed . Staphylococcal nuclease A contains a single cis peptide bond between residues Lys 116 and Pro 117 within a type VIa beta-turn . Alternative native folded forms of nuclease A have been detected by NMR spectroscopy and attributed to a mixture of cis and trans isomers at the Lys 116-Pro 117 peptide bond . Analyses of nuclease variants K116G and K116A by NMR spectroscopy and X-ray crystallography are reported herein . The structure of K116A is indistinguishable from that of nuclease A, including a cis 116-117 peptide bond (92% populated in solution) . The overall fold of K116G is also indistinguishable from nuclease A except in the region of the substitution (residues 112-117), which contains a predominantly trans Gly 116-Pro 117 peptide bond (80% populated in solution) . Both Lys and Ala would be prohibited from adopting the backbone conformation of Gly 116 due to steric clashes between the beta-carbon and the surrounding residues . One explanation for these results is that the position of the ends of the residue 112-117 loop only allow trans conformations where the local backbone interactions associated with the phi and psi torsion angles are strained . When the 116-117 peptide bond is cis, less strained backbone conformations are available . Thus the relaxation of the backbone strain intrinsic to the trans conformation compensates for the energetically unfavorable cis X-Pro peptide bond . With the removal of the side chain from residue 116 (K116G), the backbone strain of the trans conformation is reduced to the point that the conformation associated with the cis peptide bond is no longer favorable. J Med Microbiol, 1993 May, 38(5), 354 - 9 Clearance and tissue distribution of staphylococcal enterotoxin A in the rat and potential use of adsorbents for removal from plasma; Nagaki M et al.; Many of the profound effects of staphylococcal septicaemia are thought to be the result of entry of enterotoxins into the systemic circulation . The aim of this study was to investigate the disposition of staphylococcal enterotoxin A (SEA) in the rat and its possible removal from blood . SEA labelled with 125I was administered intravenously (250 micrograms/kg) to rats . The blood clearance of SEA showed a biphasic pattern; an initial fast disappearance (half-life c . 3 min) was followed by a slower one (half-life c . 2 h) . Thirty minutes after injection of 125I-labelled SEA, most of the radioactivity was concentrated in the kidneys, indicating that renal excretion was the main route of elimination of SEA . The adsorption capacities of polymer-coated activated charcoal (DHP-1 and Adsorba 150C), uncharged resin (Amberlite XAD-7), anion exchange resin (Dowex-1) and polymyxin B matrix were assessed by measurement of the equilibrium adsorption isotherms for SEA . DHP-1 charcoal, Amberlite XAD-7 resin and Dowex-1 resin adsorbed similar amounts of SEA in human plasma . Plasma perfusion experiments were performed in vitro with small columns containing either charcoal or resin adsorbents . Over 4 h perfusion, DHP-1 charcoal removed 50% of the initial amount of 125I-SEA, Adsorba 150C charcoal 8.1% of SEA and Amberlite XAD-7 resin 32.5% of SEA . These results suggest that it may be feasible to develop the adsorbent columns for direct removal of SEA from the plasma of patients with staphylococcal septicaemia. Proc Natl Acad Sci U S A, 1993 May 1, 90(9), 3811 - 4 Atomic force microscopy of biochemically tagged DNA; Murray MN et al.; Small fragments of DNA of known length were made with the polymerase chain reaction . These fragments had biotin molecules covalently attached at their ends . They were subsequently labeled with a chimeric protein fusion between streptavidin and two immunoglobulin G-binding domains of staphylococcal protein A . This tetrameric species was expected to bind up to four DNA molecules via their attached biotin moieties . The DNA-protein complex was deposited on mica and imaged with an atomic force microscope . The images revealed the protein chimera at the expected location at the ends of the strands of DNA as well as the expected dimers, trimers, and tetramers of DNA bound to a single protein. J Exp Med, 1993 May 1, 177(5), 1481 - 5 Bacterial superantigens mediate T cell deletions in the mouse severe combined immunodeficiency-human liver/thymus model; Baccala R et al.; The ability to analyze T cell receptor (TCR) thymic repertoire shaping in humans by self and foreign ligands is hampered by the lack of suitable models . We recently documented that the mouse severe combined immunodeficiency (SCID)-human fetal liver/thymus model recapitulates the TCR V beta gene repertoire of human thymocytes . Here, we show that an exogenous superantigen, staphylococcal enterotoxin B, administered to such mice induces clonal deletions in both CD4+8- and CD8+4- cells involving the same human V beta clones that are selected in vitro by this toxin . This model, therefore, may allow comprehensive studies into the effects of microbial and other agents on human T cell thymic selection processes in a biologically relevant setting. Infect Immun, 1993 May, 61(5), 1743 - 9 Effect of growth conditions on expression and antigenicity of Staphylococcus epidermidis RP62A cell envelope proteins; McDermid KP et al.; Staphylococcus epidermidis RP62A (ATCC 35984) was grown in tryptic soy broth (TSB), iron-depleted TSB (TSB-Fe), iron-reconstituted TSB-Fe (TSB+Fe), a chemically defined medium, and fetal calf serum (FCS) and on silastic disks in chambers that were sutured to the pig peritoneal wall . Bacterial cell wall proteins were extracted by digestion with recombinant lysostaphin, separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and detected by silver staining . Cell wall proteins from TSB-, chemically defined medium-, or FCS-grown cells had a complex profile of greater than 25 protein bands spanning the full molecular mass range . By contrast, a digest obtained from in vivo-grown cells had only five major proteins of 40 kDa or greater . Proteins of 130 and 106 kDa were present in the cell envelopes of TSB-Fe- and in vivo-grown cells but not in those grown in TSB or TSB+Fe . A 43-kDa protein expressed by in vitro-grown cells and 52- and 96-kDa proteins expressed by in vivo-grown cells reacted with antisera from pigs with the chamber implants and from catheterized, paracatheter-inoculated pigs but not with hyperimmune sera from pigs immunized with TSB-grown cells . The data indicate that S . epidermidis, growing under in vivo conditions, expresses antigens distinct from those that are grown in vitro. Eur J Immunol, 1993 May, 23(5), 1197 - 200 Clonal deletion as direct consequence of an in vivo T cell response to bacterial superantigen; Wahl C et al.; To date clonal deletion of peripheral mature T cells is restricted to in vivo model systems characterized by prolonged exposure of mice to antigens and clonal T cell expansion preceding clonal deletion . Here we describe that upon challenge of mice with the superantigen staphylococcal enterotoxin B two immediate events become imposed on ligand-reactive V beta 8+ T cells in lymph node cells draining the local site of injection . First, and within hours V beta selective clonal deletion is initiated via an apoptotic process . Second, the remaining V beta 8+ T cells first develop a profound state of ligand-specific unresponsiveness and subsequently initiate clonal in vivo growth . It is suggested that the dichotomy of events observed reflects a direct consequence of T cell receptor occupancy in the context of inappropriate signalling. J Immunol, 1993 May 1, 150(9), 3785 - 92 Profound deletion of mature T cells in vivo by chronic exposure to exogenous superantigen; McCormack JE et al.; It has been noted previously that superantigens can under different circumstances stimulate activation, expansion, anergy, and/or deletion of reactive T cells in vivo and in vitro . Here, we present a detailed examination of the expansion and deletion of T cells in vivo in response to the superantigens staphylococcal enterotoxin A (SEA) in the B10.BR mouse . Mice were either acutely or chronically exposed to varying doses of SEA, and the relative level of T cells bearing SEA-reactive V beta elements was followed over time in lymphocytes purified from peripheral blood, lymph nodes, mesenteric lymph nodes, and spleen . In most cases, an initial sharp rise in the proportion of reactive T cells was followed by a dramatic decline . Cells of the CD4+ and CD8+ lineages displayed subtle differences in their kinetics of activation and deletion, as well as their sensitivity to different doses of SEA . Furthermore, cells bearing either of two V beta elements previously characterized as SEA-reactive showed some differences in their responses to SEA treatment . Acute exposure usually caused the disappearance of only 50% to 70% of reactive T cells; however, chronic exposure to SEA caused almost complete deletion of target T cells . Deletion was evident even in animals treated with very low doses of SEA, doses that were too small to cause any apparent T cell proliferation . Thus, proliferation does not appear to be a prerequisite for peripheral deletion of T cells. J Immunol, 1993 May 1, 150(9), 3776 - 84 Acquired resistance to superantigen-induced T cell shock . V beta selective T cell unresponsiveness unfolds directly from a transient state of hyperreactivity; Miethke T et al.; TCR V beta selective T cell activation and systemic release of T cell-derived lymphokines causing lethal shock in D-galactosamine (D-Gal)-sensitized mice depicts only one facet of in vivo challenge with the superantigen staphylococcal enterotoxin B (SEB) . An immediate second major aspect represents the induction of peripheral unresponsiveness in SEB-reactive V beta 8+ T cells . SEB causes in vivo within 4 h resistance to an otherwise lethal challenge with SEB plus D-Gal, as well as to a challenge with the heterologous ligand toxic shock syndrome toxin 1 plus D-Gal . Contrary to the first challenge, no serum-borne IL-2 and TNF are discernible during the second challenge . On the other hand, kinetic analyses in vitro of LN cells draining the site of the first in vivo challenge indicate that SEB-reactive T cells develop via a transient state of hyperreactivity into a profound state of ligand-specific unresponsiveness . Yet unresponsive V beta 8+ T cells express IL-2R and are responsive to the growth-promoting effect of IL-2 . Cyclosporin A does not impair sequential induction of hyperreactivity and unresponsiveness with concomitant IL-2R expression, but effectively blocks systemic IL-2 and TNF release during the initial hyperreactive phase . Taken together, the in vitro data imply that ligand-specific hyperreactivity followed immediately by ligand-specific unresponsiveness represents a hallmark of in vivo challenge with the superantigen SEB . The in vivo data suggest the existence of additional suppressive elements masking the ligand specificity of the state of unresponsiveness induced by SEB. Pathol Biol (Paris), 1993 May, 41(5), 500 - 8 {Infectious complications of venous catheters}; Rey D; Infection is the most frequent complication of venous catheters . The various types of infection are defined, followed by a review of the modalities of contamination of a catheter . The microorganism most frequently involved is Staphylococcus . The bacteriological diagnosis of a venous catheter infection is essentially based on semiquantitative culture according to Maki's technique or a quantitative method (Cleri or Brun-Buisson) . Bacteriological diagnostic methods are also being developed to allow maintenance of the catheter . Treatment is primarily preventive, while, in addition to systemic antibiotics, curative treatment may also consist of attempts to maintain the infected catheter in place and the so-called "antibiotic lock" technique. Z Naturforsch {C}, 1993 May-Jun, 48(5-6), 488 - 94 Differential effect of Hg(II) on {d(A)n.d(T)n} and {d(A-T)n.d(A-T)n} sequences: circular dichroism (CD) measurements and endonuclease digestion studies using poly{d(A).d(T)} and poly{d(A-T).d(A-T)} as substrates; Ok SR et al.; The long-wavelength positive CD bands of poly{d(A).d(T)} and poly{d(A-T).d(A-T)} become inverted upon the addition of Hg(ClO4)2 . Poly{d(A).d(T)} requires higher levels of mercury to undergo inversion than poly{d(A-T).d(A-T)} . Mercurated poly{d(A).d(T)} is digested more rapidly than the control by DNase I or staphylococcal nuclease at low levels of Hg(ClO4)2 . Let r identical to {Hg(ClO4)2}added/{DNA-P} . A 4- to 5-fold rate increase occurs with DNase I at r = 0.25; a 2-fold increase with staphylococcal nuclease at r = 0.2 . By contrast, digestion of poly{d(A-T).d(A-T)} decreases immediately with increasing r . The noted rate increases appear to be due to a modification of poly{d(A).d(T)} helix structure prior to the chiroptical conversion . The modification is interpreted as a widening of the minor groove, permitting, thus, a better binding of DNase I to its substrate . The overall changes in CD as well as enzymatic digestion rates are taken to signal mercury-induced alterations in helix screwness from right-to-left . They are totally reversible subsequent to the removal of mercury. J Exp Med, 1993 May 1, 177(5), 1451 - 9 The selective ablation of interleukin 2-producing cells isolated from transgenic mice; Minasi LE et al.; To better understand the requirement for interleukin 2 (IL-2) in specific immune responses, we have established the use of cell ablation to selectively eliminate T cells that produce IL-2 . To accomplish this we have generated transgenic mice that express the herpes simplex virus 1-thymidine kinase (HSV-TK) gene under the transcriptional control of the murine IL-2 promoter that renders IL-2-producing cells sensitive to the cytotoxic effects of the antiviral drug ganciclovir (GANC) . HSV-TK activity was specifically expressed in activated T cells from transgenic mice . When CD4 T cells from transgenic mice were stimulated with the superantigen staphylococcal enterotoxin A (SEA) in the presence of GANC, proliferation and IL-2 production were almost completely inhibited and the activated CD4+V beta 3+ T cell population, eliminated . Proliferation was not restored by adding IL-2, showing that most proliferating cells are not bystander cells . In contrast, the proliferative response to concanavalin A (Con A) was only partially inhibited by treatment of CD4 T cells with GANC, although the efficiency of eliminating IL-2-producing cells was shown to be comparable with that achieved using SEA . This suggests that a portion of the proliferative response to Con A occurs via an alternative pathway not requiring IL-2 synthesis and release. J Biomol NMR, 1993 May, 3(3), 297 - 306 Measurement of two- and three-bond 13C-1H J couplings to the C delta carbons of leucine residues in staphylococcal nuclease; Vuister GW et al.; A new 1H-detected 3D NMR experiment is described that permits quantitative measurement of two- and three-bond 13C-1H couplings in proteins with selectively 13C-enriched methyl sites . The method is demonstrated for staphylococcal nuclease selectively {5,5 13C}-labeled in all 11 leucine positions and ligated with thymidine 3',5'-biphosphate and Ca2+ . Two- and three-bond 13C methyl-proton couplings are reported and, together with the measured three-bond JC alpha C delta in uniformly 13C-enriched staphylococcal nuclease, the chi 2-angles and the stereospecific assignments of the C delta methyl group with respect to the prochiral beta-protons were determined . The same residues that were previously found to have high degrees of internal mobility on the basis of 13C relaxation times have measured coupling constants that are indicative of motional averaging. Zentralbl Veterinarmed B, 1993 May, 40(3), 206 - 14 Staphylococcus intermedius: current knowledge on a pathogen of veterinary importance; Greene RT et al.; It has been 16 years since the identification of S . intermedius as a new species . Numerous investigations using cell wall and DNA analytic methods have now clearly demonstrated significant differences to warrant the creation of this new species . However, studies investigating virulence factors associated with S . intermedius have not uncovered evidence that differentiates virulent from non-virulent isolates . Therefore, at the present time, it is difficult for veterinary clinicians and microbiologists to determine the clinical significance of many S . intermedius isolates . Host-bacterial interactions and the hosts' immune status appear to be the factors most crucial in determining the outcome of infections, not the virulence of the organism . Continued research in the virulence factor field will hopefully lead to a better understanding on how we can differentiate virulent from nonvirulent isolates of S . intermedius. J Antimicrob Chemother, 1993 May, 31 Suppl D, 103 - 11 Experimental foreign body infection in mice; Espersen F et al.; A number of experimental foreign body infections have been described . We present here an easy, reproducible staphylococcal foreign body infection model in mice . The failure of treatment with methicillin and gentamicin is demonstrated, while the usefulness of antibiotic prophylaxis is documented . The usual correlations between pharmacokinetic parameters and the effect of antibiotics in vivo seem not to hold when a foreign body is present . The model may be applicable to large-scale evaluation of different antibiotic regimens. Aust N Z J Ophthalmol, 1993 May, 21(2), 99 - 103 Fusidic acid prophylaxis before cataract surgery: patient self-administration; Gray TB et al.; In a placebo-controlled, randomised, double-blind clinical trial, the authors evaluated the efficacy of patient-administered 1% fusidic acid viscous eye drops in clearing the commonest organisms causing pseudophakic endophthalmitis (Staphylococcus epidermidis and aureus) from the lids and conjunctivae of 79 patients before cataract surgery . The treatment group self-administered fusidic acid viscous eye drops four times daily for seven days before surgery; the placebo group received inert ophthalmic drops . Fellow eyes of both groups remained untreated as a natural control . Lower fornix and lid margin cultures were taken from both eyes before and after treatment . Before treatment, there was no statistical difference in organism counts between the groups . After treatment, eyes receiving fusidic acid were more likely to be free of clinically relevant Staphylococcus spp . than all pre-treatment eyes (for lids, P << 0.001; conjunctivae, P = 0.02) . A highly significant (P < 0.001) number of lid margins were rendered 'clinically clean' (i.e., 0-49 organisms/swab) by fusidic acid when compared with untreated eyes . Treatment also effectively (P < 0.05) reduced the numbers of bacteria isolated from conjunctivae . This study indicates that there is a highly significant reduction of Staphylococcus spp . (P << 0.001), non-Staphylococcus spp . (P << 0.001) and attainment of sterile eyes (P << 0.001) at operation gained by patient self-administration of 1% fusidic acid four times daily for seven days before surgery. Thorax, 1993 May, 48(5), 578 - 80 Pneumatoceles and pneumothoraces complicating staphylococcal pneumonia: treatment by synchronous independent lung ventilation; Lohse AW et al.; A 54 year old man with a staphylococcal sepsis developed staphylococcal pneumonia complicated by multiple pneumatoceles and bilateral tension pneumothoraces caused by bronchopleural fistulae . Excessive enlargement of the right sided pneumatoceles and a tension pneumothorax not improved by drainage led to mediastinal shift and compression of the right lung . Reversal of the mediastinal shift and closure of the bronchopleural fistulae was achieved by assisted independent lung ventilation. AIDS Res Hum Retroviruses, 1993 May, 9(5), 455 - 64 Regulation of HIV production by blood mononuclear cells from HIV-infected donors: I . Lack of correlation between HIV-1 production and T cell activation; Moran PA et al.; The relationship between production of HIV-1 by peripheral blood mononuclear cells (PBMCs) from HIV-1-infected donors and the level of T cell activation by various stimuli was examined . Stimulation of PBMCs with soluble anti-CD3 antibody or staphylococcal enterotoxin/superantigen (SAg) was found to be 100-1000 times more effective at inducing production of HIV-1 than was stimulation with immobilized anti-CD3 or various other T cell activating agents . However, proliferation of CD4+ T cells and lymphokine production following stimulation with soluble anti-CD3 were less than with immobilized anti-CD3 . To determine whether immobilized anti-CD3 stimulated cells may produce a factor(s) that suppresses HIV production, dual-chamber coculture experiments were performed in which soluble and immobilized anti-CD3-stimulated CD8-depleted PBMCs were separated by porous membranes . Stimulation of cells by immobilized anti-CD3 suppressed HIV-1 production by soluble anti-CD3-stimulated cells in the inner chamber, suggesting that diffusible factor(s) are involved in suppressing HIV-1 production . Experiments in which exogenous cytokines were added to cells stimulated with soluble anti-CD3 did not reveal the suppressive factor(s) produced; however, IL-7 was found to markedly increase HIV-1 production . Both T cells and monocytes were found to be required for soluble anti-CD3 to induce high levels of HIV-1 production, suggesting a role for adhesion molecules . Our results thus show that (1) soluble anti-CD3 is a powerful stimulus for HIV production, (2) there is not an absolute correlation between the level of HIV-1 production and T cell activation following stimulation of PBMCs with T cell activating agents, (3) immobilized anti-CD3 stimulation produces a factor that decreases HIV replication, and (4) T cell monocyte interactions are important for production of HIV-1 following stimulation with soluble anti-CD3. Nippon Jibiinkoka Gakkai Kaiho, 1993 May, 96(5), 810 - 7 {Gamma delta T cells in the palatine tonsil--immunohistological and functional study}; Kawaguchi T; In the present study, the gamma delta T cell content of the tonsillar T cell population has been evaluated for the first time . Flow cytometric analysis showed that 1.56% of T cells in palatine tonsils obtained from patients with recurrent tonsillitis (n = 17) expressed the gamma delta T cell receptor . Next, the tissue distribution of these cells in palatine tonsil was examined immunohistologically . Gamma delta T cell receptor positive cells and CD3 positive cells were counted in the crypt epithelium, tonsillar epithelium on the free surface and in the interfollicular space (n = 29) . The gamma delta T cell content of the whole T cell population in each of these regions was calculated and compared . It was demonstrated that T cells in the crypt epithelium contained more gamma delta T cell receptor bearing cells than did T cells infiltrating the tonsillar epithelium on the free surface . T cells in the interfollicular space included even fewer gamma delta T cells . The gamma delta T cell content of tonsillar T cells showed a gradual decrease with age in each region . Then, infiltration of gamma delta T cells in the crypt epithelium was compared among recurrent tonsillitis, hypertrophic tonsil and focus tonsil (PPP) specimens . Recurrent tonsillitis showed the highest gamma delta T cell content in T cells infiltrating the crypt epithelium . There was no remarkable infiltration of these cells in the crypt epithelium of focus tonsil . Furthermore, the gamma delta T cell population was isolated from tonsillar lymphocytes and stimulated with staphylococcal enterotoxin A (SEA), staphylococcal enterotoxin B (SEB) and toxic shock syndrome toxin-1 (TSST-1).(ABSTRACT TRUNCATED AT 250 WORDS) J Hosp Infect, 1993 May, 24(1), 47 - 61 Daily scrub with chlorhexidine reduces skin colonization by antibiotic-resistant Staphylococcus epidermidis; Hedin G et al.; The aim of this study was to establish whether long-term use of chlorhexidine would prevent skin colonization by antibiotic-resistant Staphylococcus epidermidis . Ten nurses, working on a ward for haematological disorders, volunteered to participate in the test . They washed one arm every morning for three weeks with chlorhexidine gluconate, ('Hibiscrub' ICI Pharmaceuticals) . The other arm served as a negative control . Samples from the antecubital fossa of both arms were taken two to three times a week during the wash period and two weeks thereafter, giving a total of 216 samples . The appearance of resistant S . epidermidis with different antibiograms was analysed . During the wash period the total bacterial counts and the counts of the resistant S . epidermidis strains on the test arm were both about one-tenth of those on the control arm, a significant difference (P < 0.05) . Moreover, there were significantly fewer resistant S . epidermidis on the test arm, 1.3 per sample, than on the control arm, 2.5 per sample (P < 0.01) . Most of the resistant S . epidermidis were only found once or a few times on the same site, after which they disappeared, though a few persisted on the skin even during 'Hibiscrub' washing . In an agar dilution test, chlorhexidine minimum inhibitory concentrations (MICs) of persisting strains were the same as for strains disappearing from the skin following 'Hibiscrub' washing, 1.0 or 2.0 mg l-1, but somewhat higher than MICs of strains isolated from healthy carriers outside the hospital whose MICs were 0.5 mg l-1 . The relative contribution to the skin counts by those S . epidermidis strains found only occasionally were compared with those found repeatedly but no difference in reduction was found between these categories during 'Hibiscrub' washing. AIDS Res Hum Retroviruses, 1993 May, 9(5), 465 - 73 Regulation of HIV production by blood mononuclear cells from HIV-infected donors: II . HIV-1 production depends on T cell-monocyte interaction; Diegel ML et al.; Cell-cell interactions induced between T cells and monocytes by certain soluble anti-CD3 monoclonal antibodies (MAbs) were previously shown to be required for high-level production of HIV-1 by peripheral blood mononuclear cells (PBMCs) from infected donors . Staphylococcal enterotoxin or superantigen (SAg) is another mitogen inducing monocytes-T cell interactions that exhibit potent induction of HIV-1 production . Antibodies to several adhesion molecules were used to test the requirements for T cell- and monocyte-associated adhesion molecules in HIV-1 production following activation with anti-CD3 or SAg . Blocking of either CD2-LFA-3, or CD18-ICAM-1, inhibited anti-CD3- or SAg-induced HIV-1 production by more than 90% without inhibiting CD4+ T cell proliferation . Inhibition of HIV production was observed when either the T cell or monocyte coreceptor was bound by MAbs to these adhesion molecules . Blocking of CD28-B7 interactions by soluble CTLA-4 fusion protein, a CD28 homolog, inhibited both HIV-1 production and CD4+ T cell proliferation . Fc binding was not required for HIV-1 inhibition by MAbs to CD2 and CD18, because Fab or F(ab')2 fragments of these MAbs inhibited HIV-1 production by more than 80% . A chimeric single-chain MAb to CD2 was produced, containing heavy and light chain variable regions from MAb 35.1 to CD2 linked to the constant regions of human IgG1 (CD2 SFv-Ig) . This humanized CD2 SFv-Ig inhibited HIV-1 production by 30% to > 98% . These results thus indicate that simultaneous engagement of multiple adhesion pathways between T cells and monocytes are required for HIV production by patients PBMCs and may have implications for therapy of HIV infections. J Immunol, 1993 May 1, 150(9), 3873 - 81 Study of activation of murine T cells with bacterial superantigens . In vitro induction of enhanced responses in CD4+ T cells and of anergy in CD8+ T cells; Yan XJ et al.; Primary and secondary responses of murine CD4+ T cells and CD8+ T cells upon stimulation with staphylococcal enterotoxin E (SEE) bearing superantigenic properties were examined . Both isolated C57BL/6 splenic CD4+ T cells and CD8+ T cells proliferated and produced IL-2 and IFN-gamma upon stimulation with SEE in substantial levels . The amounts of IL-2 were greater in CD4+ T cells and those of IFN-gamma were somewhat greater in CD8+ T cells . SEE-induced CD4+ T lymphoblasts, larger parts of which bore the V beta 11 element in their TCR, proliferated, produced IL-2 and IFN-gamma, and showed toxin-dependent cytotoxicity in substantial levels upon restimulation with SEE . By contrast, SEE-induced CD8+ T lymphoblasts, the larger part of which bore the V beta 11 element, did not show the first two of the three responses at all upon restimulation with SEE, whereas these cells showed greater cytotoxicity . The CD8+ T lymphoblasts did not suppress the reactivity of the CD4+ T lymphoblasts . Both SEE-induced CD4+ T lymphoblasts and CD8+ T lymphoblasts proliferated and produced IL-2 and IFN-gamma in comparable levels upon stimulation with rIL-2 or mAb to CD3 or V beta 11. Biull Eksp Biol Med, 1993 May, 115(5), 475 - 6 {Correlation of protein content in salivary gland tissue, oral mucosa and saliva in experimental staphylococcal sialoadenitis}; Mikhailov VV et al.; The dependence between the total content and excretion of protein (P) in salivary gland tissue (SGT), oral mucosa (OM) and saliva has been investigated . The difference between P contents in intact gland and during staphylococcus sialoadenitis has been shown . After 2 hours of staphylococcus toxin injection in non-stimulated SGT P contents are not changed, and in saliva--are increased . After 24 hours in non-stimulated SGT P contents are decreased, in OM P contents are increased . By stimulation of SGT, P contents increases, in OM--decreases. Biochim Biophys Acta, 1993 Apr 21, 1163(1), 81 - 8 Molecular dynamics study of the stability of staphylococcal nuclease mutants: component analysis of the free energy difference of denaturation; Yamaotsu N et al.; The stability of two mutants G88V (Gly-88-->Val) and A69T (Ala-69-->Thr) of staphylococcal nuclease was analyzed by molecular dynamics simulations . The calculated free energy differences of denaturation for G88V and A69T were -1.1 and -2.8 kcal/mol, respectively . These values are in good agreement with the experimental values . The free energy differences divided into electrostatic and van der Waals components were analyzed . These two mutants are mainly destabilized due to van der Waals interactions . There is little difference between the electrostatic contribution to the free energy change in the native state and that in the denatured state . In each mutant structure, a small cavity appears in the vicinity of the perturbed residue . It is suggested that intramolecular van der Waals interactions of the mutants are weaker than those of the wild-type . Furthermore, analyses of the contributions of each residue near the perturbed residue and of water to the free energy difference of denaturation suggest that the interaction between water and the perturbed residue plays a very important role in the stability of staphylococcal nuclease, and that a small hydrophobic core consisting of the three aromatic rings (Tyr-27, Phe-34, Phe-76) and the side chain of Met-32 is also important for the stability. Proc Natl Acad Sci U S A, 1993 Apr 15, 90(8), 3275 - 9 The alpha aneurism: a structural motif revealed in an insertion mutant of staphylococcal nuclease; Keefe LJ et al.; The x-ray crystal structure of a mutant of staphylococcal nuclease that contains a single glycine residue inserted in the C-terminal alpha-helix has been solved to 1.67 A resolution and refined to a crystallographic R value of 0.170 . This inserted glycine residue is accommodated in the alpha-helix by formation of a previously uncharacterized bulge, which we term the alpha aneurism . A conformational search of known protein structures has identified the alpha aneurism in a number of protein families, including the histocompatibility antigens and hemoglobins. Vet Rec, 1993 Apr 3, 132(14), 351 - 3 A comparison of lincomycin hydrochloride and clindamycin hydrochloride in the treatment of superficial pyoderma in dogs; Harvey RG et al.; Thirty dogs with superficial pyoderma were randomly allocated to treatments with either lincomycin hydrochloride (22 mg/kg twice daily) or clindamycin hydrochloride (11 mg/kg once daily), initially for three weeks . Samples were taken from pustules, from adjacent apparently uninvolved skin, and from the nares . These were submitted for bacterial culture and sensitivity testing . The dogs were re-examined after three weeks treatment and samples for bacteriology were taken from the nares, from any pustules that were present or from skin in the area that was previously affected; the treatment was extended if necessary . Seventy-one per cent of the dogs given lincomycin hydrochloride responded within three weeks compared with 81 per cent of the dogs treated with clindamycin hydrochloride . The overall response rates, including those given longer courses of treatment were 93 per cent for those treated with lincomycin hydrochloride and 94 per cent for those treated with clindamycin hydrochloride, and there was no statistically significant difference between the groups either after three weeks treatment or after extended treatment . The microbiological results demonstrated that Staphylococcus intermedius was present on the skin adjacent to pustules and suggested that the nasal carriage of S intermedius was a result of cutaneous colonisation. Protein Sci, 1993 Apr, 2(4), 567 - 76 Thermal unfolding of staphylococcal nuclease and several mutant forms thereof studied by differential scanning calorimetry; Tanaka A et al.; The effects of eight mutations on the thermodynamics of the reversible thermal unfolding of staphylococcal nuclease have been determined over a range of pH and protein concentration by means of differential scanning calorimetry . Variation of the protein concentration was included in our study because we found a significant dependence of the thermodynamics of protein unfolding on concentration . Values for the change in the standard free energy of unfolding, delta delta G0d, produced by the mutations in the pH range 5.0-7.0 varied from 1.9 kcal mol-1 (apparent stabilization) for H124L to -2.8 kcal mol-1 (apparent destabilization) for L25A . As has been observed in numerous other cases, there is no correlation in magnitude or sign between delta delta G0d and the corresponding values for delta delta Hd and T delta delta S0d, the latter quantities being in most cases much larger in magnitude than delta delta G0d . This fact emphasizes the difficulty in attempting to correlate the thermodynamic changes with structural changes observed by X-ray crystallography. Vet Microbiol, 1993 Apr, 34(4), 363 - 72 Antibiotic-resistance and plasmids in Staphylococcus hyicus isolated from pigs with exudative epidermitis and from healthy pigs; Wegener HC et al.; A total of 100 S . hyicus strains isolated from healthy piglets and piglets with exudative epidermitis originating from 100 different herds was examined for drug-resistance and prevalence of plasmids . Resistance to macrolide/linosamide antibiotics could be related to plasmids in 55 (93%) of the 59 resistant strains: A plasmid of 2.4 kb mediating resistance to macrolides and lincosamides was observed in 25 strains, and a plasmid of 11.5 kb mediating resistance to both macrolides/lincosamides and tetracycline was observed in 30 strains . A plasmid with a molecular weight of 4.5 kb was shown by curing experiments to be associated with resistance to tetracycline in 12 strains . All together, 47 strains were resistant to tetracycline . In 42 (89%) of these strains tetracycline-resistance was found to be encoded by plasmids . Fifty six strains were resistant to streptomycin, and resistance was associated with the presence of a 4.4 kb plasmid in 17 strains studied . Resistance to penicillin, observed in 44 strains, and resistance to kanamycin, observed in 15 strains, could not be related to plasmids in any of these strains . The 11.5 kb plasmid was observed in 39% of the strains isolated from piglets with EE, and in 7% of the strains isolated from healthy piglets . Despite its higher prevalence in strains from piglets with EE, the 11.5 kb plasmid could not be shown to encode production of capsule or exfoliative substances: factors which might play a role in the development of exudative epidermitis in piglets. J Antibiot (Tokyo), 1993 Apr, 46(4), 661 - 7 Octapeptide derivatives of teicoplanin antibiotics; Malbarba A et al.; A series of octapeptide derivatives of teicoplanin-A2 component 2 (CTA/2), its aglycone (TD), and the L-lysyl derivatives of an amide of CTA/2 and TD, were prepared by condensation of the terminal amino group with N-hydroxysuccinimidyl esters of tert-butyloxycarbonyl (BOC) L- and D-amino acids, followed by acidic (TFA) removal of the BOC protecting function . The antimicrobial properties of these compounds were compared with those of the corresponding unmodified antibiotics and their N15-acetyl derivatives . The most active derivatives were the octapeptides with N-terminal glycine or lysine whose in vitro activity was comparable to that of the parent teicoplanins . The glycinyl and lysyl derivatives of CTA/2 showed better activity than CTA/2 against clinical isolates of Staphylococcus epidermidis and S . haemolyticus for which teicoplanin MICs were relatively high . No significant difference in their antibacterial activity was observed between octapeptides containing L- or D-lysine. Can J Vet Res, 1993 Apr, 57(2), 119 - 25 Staphylococcus hyicus virulence in relation to exudative epidermitis in pigs; Wegener HC et al.; Staphylococcus hyicus strains with different phage types, plasmid profiles, and antibiotic resistance patterns were isolated from piglets with exudative epidermitis . The strains could be divided into virulent strains, producing exudative epidermitis, and avirulent strains, producing no dermal changes when injected in experimental piglets . The results showed that both virulent and avirulent strains were present simultaneously on diseased piglets . This constitutes a diagnostic problem . Concentrated culture supernatants from nine virulent strains injected in the skin of healthy piglets produced a crusting reaction in all piglets . Acanthosis was observed in the histopathological examination of the crustaceous skin . Concentrated culture supernatants from nine avirulent strains produced no macroscopic or microscopic skin changes . Protein profiles from all virulent strains and seven out of nine avirulent strains showed a high degree of protein band homology . An approximately 30 kDa protein present in all concentrated culture supernatants capable of producing skin changes, could not be detected in samples that did not produce skin changes . No other protein showed a similar association . It is concluded that crusting reaction of piglet skin is a suitable indicator of virulence in S . hyicus in relation to exudative epidermitis, and that virulent strains produce a 30 kDa protein, absent in concentrated culture supernatants from avirulent strains . This 30 kDa protein might be an exfoliative toxin. J Appl Bacteriol, 1993 Apr, 74(4), 411 - 6 Fibronectin and proteolytic fragments of fibronectin interfere with the adhesion of Staphylococcus epidermidis to plastic; Dunne WM et al.; The adhesion of five strains of slime-positive Staphylococcus epidermidis to plastic microwells was significantly diminished (P < 0.005) in a concentration-dependent fashion when wells were previously coated with increasing concentrations (1.6-13.1 micrograms cm-2) of human fibronectin (FN) . The adhesion of four of five strains was significantly reduced when wells were coated with 3.2 micrograms cm-2 of FN and at concentrations > or = 6.5 micrograms cm-2 the adhesion of all slime-positive strains was significantly reduced . The coating of microwells with chymotryptic fragments of FN containing the heparin-binding, gelatin-binding, or cell-binding domains also reduced bacterial adhesion but none of the fragments exceeded the anti-adhesive activity of intact FN . A comparison of FN-coated or albumin-coated microwells showed that both proteins caused a significant reduction in the adhesion of test strains to plastic but that the anti-adhesive activity of FN was greater than albumin at all concentrations tested . The adhesion of the slime-negative phase variant of one of the test strains to plastic was neither enhanced nor reduced by FN coating indicating that the production of an exopolysaccharide by Staph . epidermidis influences interactions with protein-coated surfaces . These results support the contention that FN does not mediate the adhesion of all strains of Staph . epidermidis to plastic surfaces. J Pediatr Surg, 1993 Apr, 28(4), 627 - 9 Persistent catheter-related bacteremia: clearance with antibiotics and urokinase; Ascher DP et al.; A patient with terminal osteogenic sarcoma and catheter-related coagulase-negative staphylococcal bacteremia was treated with vancomycin and blood cultures were positive for 4 days documented with quantitative colony counts . Urokinase therapy was initiated and was associated with a transient bacteremia with markedly increased colony counts of coagulase-negative Staphylococcus prior to eradication of the catheter-related infection . We feel that the combination of urokinase and appropriate antibiotics may be an effective method to eradicate line-associated coagulase-negative staphylococcal infection in selected patients. Clin Podiatr Med Surg, 1993 Apr, 10(2), 249 - 69 Infection and the older patient; Abramson C; An increasing number of elderly patients are in and out of doctors' offices, hospitals, nursing homes, and so forth, under continual medical care . Numerous invasive procedures allow for casual transfer of infectious diseases by fellow patients as well as health care workers . Dramatic increases in infectious diseases such as foot infections, pneumonia, staphylococcal infections and, because of necessary invasive and blood transfusion procedures, AIDS can be expected in the future . The elderly patient is often a debilitated, compromised, immunodeficient host who is highly susceptible to any number of infections . With this in mind as the population grows older, clinicians must begin to apply Universal Precautions in their practices if they have not already done so, and not underestimate any disease or symptom in any patient, regardless of their age or their condition. Cutis, 1993 Apr, 51(4), 276 - 8 Transfer of bacteria associated with cryotherapy; Wolf R et al.; The aim of this study was to determine whether living bacteria can be transmitted by cryosurgery with carbon dioxide . Cultures were taken from the outer layer of the ice before starting treatment, and again at the end of the working day during ten consecutive working days . Each of ten dry ice blocks was sterile prior to use . Staphylococcus epidermidis was isolated from six of the latter following use . This finding indicates that the dry ice was contaminated during the procedure and that bacteria were transmitted from the patient's skin to the dry ice and to culture media . The medical implications of this finding require serious consideration regarding the risk of infection to both patient and clinical personnel from this procedure. Transplantation, 1993 Apr, 55(4), 785 - 9 Renal transplantation following immunoadsorption in highly sensitized recipients; Ross CN et al.; Five highly sensitized patients, with panel reactivity greater than 80% for 1.75-5 years, were treated by extracorporeal staphylococcal protein-A immunoadsorption, prednisolone, and cyclophosphamide . The five patients underwent treatment of 18-40 (mean 31) liters of plasma, respectively in 4-7 (mean 5.6) sessions . This reduced the titer of cytotoxic antibodies to sensitizing antigens to < 1/8 in all cases and abolished reactivity to crossreacting antigens . Two patients required retreatment following resynthesis of cytotoxic antibodies . All five patients have been transplanted, and four of these now have stable serum creatinines of 168 mumol/L at 34 months, 208 mumol/L at 29 months, 96 mumol/L at 5 months, and 125 mumol/L at 3 months posttransplantation . One patient had primary graft dysfunction due to acute tubular necrosis; the kidney was removed after eight weeks and showed cortical necrosis without evidence of acute rejection. Am J Kidney Dis, 1993 Apr, 21(4), 411 - 8 Biocompatibility of a glucose-polymer-containing peritoneal dialysis fluid; de Fijter CW et al.; The currently available glucose-containing peritoneal dialysis fluids (PDF), which are all hyperosmolar, are toxic to the cells present in the peritoneal cavity . However, glucose-polymer solutions, being isosmolar, may have improved biocompatibility in this respect . We therefore compared in vitro the effects of PDF containing glucose-polymers with that of glucose solutions on the function of donor granulocytes and monocytes (MN), and on the viability of mesothelial cells . In addition, the function of peritoneal macrophages (PMO) of eight patients was studied in a randomized cross-over setting following intraperitoneal exposure to glucose-polymer-versus glucose-monomer-containing fluid of comparable ultrafiltration capacity . Donor granulocytes, as well as MN, showed significantly better phagocytosis of both Staphylococcus epidermidis and Escherichia coli after incubation in the glucose-polymer solution as compared with the 3.86% glucose-containing fluid . Their oxidative metabolism, as measured by chemiluminescence, also showed that the glucose-polymer solution was less inhibitory than fluids containing 2.27 or 3.86% glucose . Patient-derived PMO showed a significantly better phagocytic capacity for S epidermidis and E coli, a significantly higher killing of E coli, and a significantly higher chemiluminescence response after intraperitoneal exposure to the glucose-polymer solution as compared with the glucose-monomer-based fluid . Increasing the osmolality of the glucose-polymer solution to that of the respective glucose solutions blunted the favorable effect on phagocyte function, suggesting the beneficial effect to be osmolality-mediated . However, no major difference was observed between the glucose-polymer solution and the glucose-based fluid in their effects on mesothelial viability.(ABSTRACT TRUNCATED AT 250 WORDS) Br J Rheumatol, 1993 Apr, 32(4), 339 - 41 Vertebral osteomyelitis due to Staphylococcus epidermidis; De Wit D et al.; Vertebral osteomyelitis due to Staphylococcus epidermidis is extremely rare and usually occurs in the context of immunosuppression in association with an adequate portal of entry for infection . This paper reports a case of vertebral osteomyelitis due to S . epidermidis in a man with no evidence of immunosuppression or obvious portal of entry . The patient presented with severe back pain but there were no clinical signs of infection . Radiographs and computerized tomographs showed destruction of thoracic vertebral bodies and an adjacent soft tissue mass . S . epidermidis was grown from multiple blood cultures . All isolates had identical antibiograms and biochemical profiles . There was evidence of healing of the vertebral bodies and resolution of the soft tissue mass after appropriate antistaphylococcal treatment. Eur J Immunol, 1993 Apr, 23(4), 815 - 9 Clonal deletion of thymic mature T cells induced by staphylococcal enterotoxin B in murine fetal thymus organ culture; Aiba Y et al.; The present study aims at investigating the intrathymic maturational stage of T cells at which clonal deletion can be induced . Staphylococcal enterotoxin B (SEB) was added to organ cultures of murine fetal thymus lobes at various time points of culture, and V beta 8-expressing cells were assayed on day 14 . V beta 8 low-expressing (V beta 8lo) cells were reduced to 40-60% of the control receiving no SEB, though the reduction was ambiguous when SEB was given on day 13 . In marked contrast, V beta 8 high-expressing (V beta 8hi) cells were virtually completely deleted in all groups including the group given SEB on day 13 . Most of the V beta 8hi cells that were deleted by 24 h of treatment with SEB were shown to be of the CD4+8- mature phenotype, though CD4-8+V beta 8hi cells were also deleted . It was further shown that the thymic V beta 8hi CD4+8- cells recovered from organs cultured for 14 days without SEB responded to immobilized anti-V beta 8 monoclonal antibody, indicating that V beta 8hi cells, which were highly sensitive to clonal deletion, were functionally competent mature T cells . These results strongly suggest that the thymus is capable of eliminating all T cells recognizing antigen present in the thymus regardless of the maturational stage of T cells. Eur J Immunol, 1993 Apr, 23(4), 809 - 14 Effects of intrathymic injection of organ-specific autoantigens, parietal cells, at the neonatal stage on autoreactive effector and suppressor T cell precursors; Murakami K et al.; Thymectomy on day 3 after birth (3d-Tx) induces autoimmune gastritis (AIG) in 81%, and oophoritis (AIO) in 25% of BALB/c mice at the age of 2 to 3 months . Intrathymic, but not intraperitoneal injection of syngeneic parietal cells into sex-matched BALB/c mice within 24 h of birth resulted in almost complete prevention of the development of AIG in these mice in which 3d-Tx was performed . The prevention induced was parietal cell specific, since the development of AIO was not inhibited in female mice . Moreover, the injection of BALB/c liver cells, Mls-matched (BALB/c) and -disparate (DBA/2) B blasts which resulted in V beta 6 T cell deletion, as well as the injection of staphylococcal enterotoxin B failed to prevent the diseases . These findings suggested that recognition of an autoantigen in the thymus is necessary for the induction of tolerance, and that involvement of Mls-1 antigens in the pathogenesis of AIG, as has been suggested previously (Schwartz, R . H., Cell 1989 . 57: 1073), was unlikely . T cells that suppress the development of organ-specific autoimmune diseases in 3d-Tx mice seem to maintain the unresponsiveness of autoreactive T cells at the periphery in normal mice . In agreement with our previous observations, we found that intraperitoneal (i.p.) injection of spleen cells from 3-month-old normal mice into 3d-Tx mice on day 10 after birth prevented the development of AIG, whereas spleen cells from age-matched AIG+ (mice with AIG) or AIG- (mice without AIG) 3d-Tx mice failed to do this . This implies that the suppressor cells probably affect the differentiation of effector-precursor to effector . In fact, these suppressor cells did not inhibit the adoptive transfer of AIG to nu/nu BALB/c mice by spleen cells from 3d-Tx mice manifesting AIG . By negative selection using monoclonal antibody and complement, it was confirmed that the phenotype of the suppressor cell was CD4 . In contrast to 3d-Tx, 10d-Tx did not induce AIG, indicating the peripheralization of the suppressor cell by that time . On the other hand, intrathymic injection of parietal cells immediately after birth did not affect suppressor cell generation, implying that some T cells, including suppressor cells, escape thymus selection . We postulate that these cells correspond to the precursors of the autoreactive effector T cells and suppressor T cells that are present in normal mice. J Neurosurg, 1993 Apr, 78(4), 630 - 7 T-cell receptor V-gene usage in neoplasms of the central nervous system . A comparative analysis in cultured tumor infiltrating and peripheral blood T cells; Merlo A et al.; The use of tumor-infiltrating lymphocytes in the treatment of central nervous system (CNS) neoplasms has met with serious obstacles due to difficulty of culture and poor characterization . Since in other tumors the therapeutic effects of tumor-infiltrating lymphocytes have been shown to rely on T-cell receptor engagement, the authors addressed the question as to whether expression of T-cell receptor variable (V) domains in cultured tumor-infiltrating lymphocytes from CNS is different from that of autologous cultured peripheral blood mononuclear cells . Infiltrating lymphocytes from CNS neoplasms, including primary malignancies, metastatic cancers, and meningiomas, were cultured in the presence of interleukin-2 and anti-CD3 monoclonal antibodies (MoAb's) in order to obtain optimum growth of T cells . Autologous peripheral blood mononuclear cells from the same patients were similarly cultured . After 4 to 5 weeks of culture, 97.3% +/- 2.6% (mean +/- standard deviation) of the resulting cell populations were CD3-positive lymphocytes . The expression of T-cell receptor V domains was then studied by using a panel of 12 MoAb recognizing gene products from T-cell receptor V-alpha 2, V-beta 5, 6, 8, and 12, V-gamma 4 and 9 families, and from two subfamilies of V-delta 2 . Remarkably, in over 70% of all paired measurements, percentages of T cells expressing discrete T-cell receptor V-gene products were found to be virtually identical in tumor- and peripheral blood-derived cultured cell populations, with differences never exceeding 1% . In contrast, a different expression of individual V-gene products, concerning both alpha/beta and gamma/delta T-cell receptors, could be detected between cultured tumor-infiltrating lymphocytes and autologous peripheral blood-derived T lymphocytes in seven of 12 patients . In two cases, significant differences between the two populations were also observed in the proliferative responses obtained upon stimulation with staphylococcal enterotoxins that trigger defined V-beta T-cell receptors . Altogether, these data suggest that the T-cell receptor repertoire of cultured tumor-infiltrating lymphocytes from CNS tumors, suitable for use in adoptive immunotherapies, differs from that of autologous cultured peripheral blood mononuclear cells. J Appl Physiol, 1993 Apr, 74(4), 1972 - 80 Staphylococcal alpha-toxin induced ventilation-perfusion mismatch in isolated blood-free perfused rabbit lungs; Walmrath D et al.; Gas exchange conditions in blood-free perfused isolated rabbit lungs were assessed by the use of the multiple inert gas elimination technique . Under baseline conditions, unimodal narrow distribution of perfusion and ventilation to midrange-ventilation-perfusion (VA/Q) areas was noted . Intravascular challenge with staphylococcal alpha-toxin caused a rapid increase in pulmonary arterial pressure (to > 40 mmHg within approximately 15 min) and delayed-onset (> 10-15 min) lung edema formation, with unaltered ventilation pressures . The vasoconstrictor response was paralleled by a progressive, severe leftward shift of perfusion to areas with low-VA/Q ratios, accompanied by a minor fraction of shunt flow . At pulmonary arterial pressures > 40 mmHg, extreme VA/Q mismatch with near absence of perfusate flow to midrange-VA/Q areas was registered . Vasoconstrictor response and VA/Q mismatch, but not the progressive edema formation, were virtually completely suppressed in lungs pretreated with acetylsalicylic acid or the thromboxane receptor antagonist BM 13505 . Moreover, "rescue" application of BM 13505 after onset of alpha-toxin-induced pressor response and gas exchange abnormalities completely reversed pressure elevation and loss of VA/Q matching . We conclude that the marked vasoconstrictor response to staphylococcal alpha-toxin is paralleled by severe VA/Q mismatch with predominant perfusion of low-VA/Q areas independent of lung edema formation . Pressor response and VA/Q mismatch, but not vascular leakage, are suppressed by thromboxane inhibition. Am J Physiol, 1993 Apr, 264(4 Pt 1), G708 - 17 Beta-adrenergic inhibition of electrical and mechanical activity in canine colon: role of cAMP; Smith TK et al.; The effects of beta-adrenergic receptor stimulation on the electrical and mechanical activity of canine colonic circular muscles were compared with forskolin (Fsk), a known stimulator of adenylate cyclase . The actions of isoproterenol (Iso) were mediated by beta 2-receptors . Iso and Fsk increased intracellular adenosine 3',5'-cyclic monophosphate (cAMP) levels in both the presence and absence of acetylcholine (ACh), whereas ACh (0.3 microM) alone reduced cAMP levels . These agents caused inhibition of spontaneous and ACh-induced contractions . Inhibition was associated with a reduction in the amplitude and duration of electrical slow waves recorded near the submucosal border . Near the myenteric border, Iso and Fsk hyperpolarized the membrane by up to 30 mV and changed the pattern of electrical rhythmicity . These effects were mimicked by 8-bromo-cAMP (1-3 mM) . Contractile inhibition with Fsk and Iso was associated with a decrease in the amplitude and duration of Ca2+ transients measured with fura-2 fluorescence . cAMP (10-300 microM) reduced the Ca2+ sensitivity of the contractile apparatus in muscles permeabilized with staphylococcal alpha-toxin . The actions of Iso appear linked to cAMP . We hypothesize that cAMP produces relaxation both by modulation of membrane ionic channels with a consequent decline in the entry of Ca2+ as well as through a decrease in the sensitivity of the contractile apparatus to Ca2+. Avian Dis, 1993 Apr-Jun, 37(2), 536 - 41 Staphylococcosis of turkeys . 6 . Development of penicillin resistance in an interfering strain of Staphylococcus epidermidis; Whitehead SS et al.; Staphylococcus epidermidis strain 115, used as an interfering agent to help reduce the incidence of staphylococcosis in turkeys, was converted into a penicillin- and chloramphenicol-resistant strain designated 115R . This was accomplished by introducing a plasmid carrying the beta-lactamase (penicillinase) and chloramphenicol-resistance genes into S . epidermidis 115 by electroporation . The resultant strain, 115R, was an efficient producer of beta-lactamase and had marked increased resistance to penicillin and chloramphenicol . A beta-lactamase DNA probe was used to confirm the presence of the beta-lactamase gene in strain 115R . S . epidermidis strain 115R retained the characteristics of tissue adherence, bacteriocin production, and non-virulence that were present in the original non-transformed strain 115, and in addition should theoretically remain colonized in poults following treatment with penicillin. Hum Immunol, 1993 Apr, 36(4), 259 - 67 Signal transduction mechanisms of HLA-DR-mediated interleukin-1 beta production in human monocytes . Role of protein kinase C and tyrosine kinase activation; Palkama T et al.; The signal transduction pathways leading to the expression of IL-1 beta in human monocytes via HLA-DR stimulation were investigated . SEB, a staphylococcal enterotoxin that binds to HLA-DR molecules, induced IL-1 beta expression in human monocytes . Protein synthesis inhibition by cycloheximide did not inhibit SEB-mediated IL-1 beta signal, indicating that protein synthesis is not required for the MHC class-II-mediated IL-1 beta expression . The effect of PKC, PKA, and tyrosine kinase inhibitors on HLA-DR-mediated IL-1 beta mRNA expression was then determined . H7, a preferential PKC inhibitor, completely inhibited IL-1 beta signal induced by SEB . The role of PKC on HLA-DR-mediated IL-1 beta induction was further confirmed by the ability of SEB to activate PKC on monocytes directly when measured with labeled phorbol ester ({3H}Pbt2)-binding capacity of whole cells . HA 1004, a preferential PKA inhibitor, and isobutyl-methyl-xanthine (IBMX), which inhibits the degradation of cAMP, had no effect on SEB-induced IL-1 beta signal, excluding the role of cAMP on HLA-DR-mediated IL-1 beta expression . Two tyrosine kinase inhibitors, genistein and dihydroxycinnamate, both inhibited SEB-induced IL-1 beta mRNA in monocytes . SEB also induced enhanced tyrosine phosphorylation of several proteins in human monocytes when determined with antiphosphotyrosine immunoblotting . Our results demonstrate that both PKC and protein tyrosine kinases are involved in HLA-DR-induced IL-1 beta expression in human monocytes. Minerva Anestesiol, 1993 Apr, 59(4), 187 - 92 {Pneumonia in severe head injury . A prospective study}; Mergoni M et al.; Impairment of the state of consciousness is an important contributing factor in the onset of respiratory tract infections; in this study the data were collected prospectively to investigate the incidence and clinical implications of pneumonia in a population of head injured patients . The study was conducted on all patients treated at our centre throughout 1990 . The incidence of pneumonia in the head injured was 10.8% versus 7.3% in the rest of the patients . Mortality in the group with pneumonia was not significantly different from the group without pneumonia . The average time of onset was on the fifth day from admission . The lung injury score (LIS) on the sixth day, the time on artificial ventilation and the length of stay in intensive care were significantly greater in those with pneumonia (1.18, 14.6 days and 21.9 days versus 0.8, 4.2 days and 12.9 days respectively) . Staphylococcus was the single most frequently isolated germ . Our study concludes that pneumonia represents a relatively frequent and early complication in patients with head injury, and it is associated with prolonged artificial ventilation and longer staying in ICU. Ginekol Pol, 1993 Apr, 64(4), 193 - 6 {Phagocytosis and bactericidal capacity of polymorphonuclear neutrophils in neonates}; Orzeszko-Spaczynska A et al.; Phagocytosis and bactericidal capacity of polymorphonuclear neutrophils (PMN) obtained from umbilical venous blood was estimated in 30 neonates and their mothers by the use of fluorochrome microassay of Pantazis and Kniker . Phagocytosis of Staphylococcus was similar in both groups and controls, while intracellular bacteria killing was significantly impaired in PMN obtained from the neonates . These results may indicate that increased susceptibility to infection observed in neonates may be partly caused by PMN function impairment. Wiad Lek, 1993 Apr, 46(7-8), 308 - 10 {Diagnostic and therapeutic difficulties in staphylococcal sepsis}; Adrych K et al.; A case is described of a 38-year-old man treated for three years for diabetes mellitus admitted to an internal department for elucidation of the cause of protracted fever . Staphylococcal sepsis was diagnosed with pneumonia and retroperitoneal abscess . Surgical treatment was given and targeted antibiotic-therapy was administered . The patient was discharged from the hospital after 38 days as cured . An observation of 18 months failed to show the recurrence of the infection. Int J Syst Bacteriol, 1993 Apr, 43(2), 237 - 44 Staphylococcus pasteuri sp . nov., isolated from human, animal, and food specimens; Chesneau O et al.; A new novobiocin-susceptible species of the genus Staphylococcus, Staphylococcus pasteuri, is described on the basis of the results of a study of seven strains isolated from human, animal, and food specimens . DNA relatedness experiments (S1 nuclease method) showed that these strains form a homogeneous genomic species related at DNA homology levels of 2 to 13% to 27 type strains representing known Staphylococcus species . The use of a method based on rRNA gene restriction site polymorphism provides clear-cut distinction between this new species and Staphylococcus warneri, which is the most similar species phenotypically . The type strain of the new species is strain BM9357 (= ATCC 51129). Cardiovasc Surg, 1993 Apr, 1(2), 113 - 7 Sartorius myoplasty in the treatment of exposed arterial grafts; Sladen JG et al.; The long-term success of sartorius myoplasty in 14 of 16 patients who presented with an exposed vascular graft in an infected groin is described . The presenting complications were wound dehiscence (ten patients), hemorrhage (two), skin erosion (two), late bilateral fistulas (one) and false aneurysm (one) . Ten grafts were prosthetic and six autogenous . Positive cultures were obtained from 15 wounds; four grew Staphylococcus epidermidis, the remainder mixed or Gram-negative bacteria . Each groin was radically debrided, including the surface of the arterial graft, and, if possible, closed immediately with a sartorius myoplasty applied directly to the graft . Twist, fan and loop myoplasties were equally effective . Grossly infected wounds were debrided initially and obviously infected grafts were replaced in situ before myoplasty . Sartorius myoplasty is recommended as an elegant solution for the infected groin in which there is an exposed arterial graft. Antibiot Khimioter, 1993 Apr-May, 38(4-5), 33 - 7 {Antibacterial therapy of acute pyo-destructive lesions in the lungs}; Mustafin DG; Clinical analysis of the efficacy of modern antibacterial therapy in 721 patients with acute infectious destructive process in the lungs was performed . The peculiarities of the program of the antibacterial therapy and its intensity in 367 patients with lung abscesses, 282 patients with mainly staphylococcal destructive processes in the lungs and 72 patients with septic metastatic destructive processes in the lungs were revealed . The target-aimed treatment of the patients in complex with bronchial sanation, correction of the immune deficiency, detoxication and quantum hemotherapy provided good results in 96 per cent of the cases. Gen Physiol Biophys, 1993 Apr, 12(2), 95 - 111 Relation between ionic channel conductance and conductivity of media containing different nonelectrolytes . A novel method of pore size determination; Sabirov RZ et al.; The effects of nonelectrolytes on conductivity and viscosity of KCl solutions as well as on ion channel conductance were studied . Mobility of ions in solutions were found to solely depend on percent concentration (w/w) of the nonelectrolytes added and to be effectively independent on their chemical nature (sugars or polyglycols) and molecular size . Proportional changes in both the ion channel conductance and the conductivity of bulk solution induced by low m . w . nonelectrolytes may be used as a criterion of diffusion mechanism of ion transport through channels . The slope of the dependence of ion channel conductance on conductivity of bulk solution containing different concentrations of nonelectrolytes is a good measure of channel permeability for nonelectrolyte . A new method of pore size determination is introduced . Results of practical application of this simple method to three types of ion channels (formed by alpha-latrotoxin, staphylococcal alpha-toxin and its N-terminal fragment) are shown . The advantages and disadvantages of the method are discussed. Arch Fr Pediatr, 1993 Apr, 50(4), 331 - 3 {Treatment of neutropenia in Shwachman's syndrome with granulocyte growth factor (G-CSF)}; Grill J et al.; BACKGROUND . Patients with Shwachman syndrome have neutropenia and depressed neutrophil chemotaxis and are therefore susceptible to recurrent infections . The diversity of causative microbial agents makes prevention of infection difficult . Some may be life-threatening, despite antibiotic therapy and even leukocyte transfusion . PATIENT . A 15 day-old boy presented with a staphylococcal cutaneous abscess . Neutropenia was detected when he was 45 day-old and Shwachman syndrome was diagnosed at the age of 8 months . He was then suffering from pneumonia plus pancreatic insufficiency, metaphysical chondroplasia and short stature . Frequent infections continued through childhood, but became less frequent from the age of 11 years . At 17 years, he still had neutropenia (polymorphonuclear leukocytes less than 300/mm3) and profound depressed chemotaxis . He was given subcutaneous injections of recombinant human granulocytes colony stimulating factor (rhG-CSF), 1 microgram/kg/day, for 15 days . The polymorphonuclear count increased above 1000/mm3 during the second week of treatment, and this effect was seen again during a second course of rhG-CSF . The benefit was not sustained when treatment was discontinued . CONCLUSION . These results confirm earlier reports of the effect of 5 micrograms/kg/day of rhG-CSF but the responses were greater and earlier . While more precise information concerning the treatment of this disease is required, rhG-CSF can be useful in patients with severe infections. J Immunol, 1993 Apr 1, 150(7), 3062 - 9 SEB induced anergy: modulation of immune response to T cell determinants of myoglobin and myelin basic protein; Gaur A et al.; Superantigens have the ability to stimulate a subset of T cells based upon their expressed TCR beta-chain . It has been demonstrated that the administration of staphylococcal enterotoxin B (SEB) in mice leads to unresponsiveness in V beta 8+ T cells in vivo which are the same T cells that could be stimulated in vitro by this enterotoxin . We present here data on the effect of SEB administration in DBA/2 and (PL/J x SJL)F1 mice on their T cell response to two different T cell determinants, the responses against which are dominated by the use of V beta 8+ T cells . Treatment of mice with SEB not only diminished their primary T cell proliferative response to these determinants, but also was able to effectively reduce the memory T cell response . SEB treatment, however, showed only a modest effect in preventing Ac 1-11-induced experimental autoimmune encephalomyelitis in H-2u mice. Biochem Biophys Res Commun, 1993 Mar 31, 191(3), 1211 - 7 Identification of binding domains on the superantigen, toxic shock syndrome-1, for class II MHC molecules; Soos JM et al.; Toxic shock syndrome toxin-1 (TSST-1) is a member of the staphylococcal enterotoxin superantigen family . In order to determine the regions on the TSST-1 molecule involved in binding to class II MHC, seven overlapping peptides of the entire TSST-1 molecule were synthesized and tested for their ability to compete with 125I-TSST-1 for binding to class II MHC on murine A20 cells and HLA on Raji cells . Peptides corresponding to N-terminal amino acid residues 39 through 68 and C-terminal residues 155 through 194 competed with 125I-TSST-1 for binding to class II MHC . Also, binding studies with class II MHC beta-chain peptides indicate that regions encompassed by I-A beta b(30-60) and I-A beta b(60-90) are binding regions for TSST-1 . Thus, we have identified binding domains on the TSST-1 molecule for class II MHC molecule receptors on antigen presenting cells. Biochemistry, 1993 Mar 16, 32(10), 2534 - 41 Effect of proline mutations on the stability and kinetics of folding of staphylococcal nuclease; Nakano T et al.; The role of proline in the stability and kinetics of folding of wild-type staphylococcal nuclease and its P117G, P117T, and P31A mutants was examined as a function of guanidinium thiocyanate (Gdn-SCN) concentration . Replacement of Pro-117 with Gly or Thr caused small increases in stability, whereas substitution of Pro-31 by Ala led to a small decrease in stability . The slopes of the plots of delta G against denaturant concentration (m) for the mutant proteins are significantly smaller than for the wild-type, suggesting a decrease in the solvent-accessible surface area of the denatured state relative to that of the wild-type . The rates of unfolding and refolding were monitored using tryptophan fluorescence . The kinetic traces for refolding in the presence of Gdn-SCN were triphasic for the wild-type protein and P31A but biphasic for P117G and P117T mutants . The slower phases were typically 10% of the total amplitude except in the transition region . The rates of the fastest and medium phases of the wild-type were essentially unaffected by the mutations . Double-jump experiments in which the protein was unfolded in a high concentration of denaturant for a short time period and then refolded to final Gdn-SCN concentrations near the Cm revealed a fast increase in fluorescence emission corresponding to formation of the native state, followed by a slower decrease with an amplitude that varied with the guanidine concentration and time of unfolding.(ABSTRACT TRUNCATED AT 250 WORDS) Blood, 1993 Mar 15, 81(6), 1521 - 6 Acute infectious mononucleosis stimulates the selective expression/expansion of V beta 6.1-3 and V beta 7 T cells; Smith TJ et al.; Acute infectious mononucleosis (AIM) is caused by the Epstein-Barr virus (EBV) and is characterized by a proliferation of atypical lymphocytes, predominantly CD8+ T cells . Various diseases associated with T-cell activation have been shown to stimulate the selective expansion of certain V beta (variable region of the T-cell receptor beta chain) expressing T-cell populations . The purpose of this investigation was to determine if the proliferation of T cells accompanying AIM is associated with selective expression/expansion of distinct populations of V beta T cells . We determined V beta expression in eight patients with clinical and laboratory evidence of AIM, including an atypical lymphocytosis . Gel electrophoresis and quantitative analysis were performed on cDNA amplified by the polymerase chain reaction (PCR) using different V beta region primers . Gel electrophoresis analysis showed prominent V beta 6.1-3 and V beta 7 bands in all eight patients with AIM but not in the controls . Quantitative PCR analysis showed that the V beta 6.1-3 and V beta 7 mean PCR ratios increased, respectively, from 163.0 +/- 22.5 and 142.3 +/- 5.5 in controls to 339.9 +/- 38.8 (P < .03) and 396.1 +/- 45.6 (P < .01) in the eight patients with AIM . Two of the eight patients who had increased V beta 6.1-3 and V beta 7 expression were retested after clinical resolution of AIM and no longer had evidence of increased V beta 6.1-3 and V beta 7 T-cell expression . AIM is associated with a selective increased expression of V beta 6.1-3 and V beta 7 T cells present at the time of initial clinical symptoms and atypical lymphocytosis . This increased expression resolves following recovery from AIM . This V beta-specific selective expression resembles the super-antigen response seen after staphylococcal toxin stimulation and may be caused by EBV triggering of selective expansion of V beta 6.1-3 and V beta 7 T-cell subsets. J Immunol Methods, 1993 Mar 15, 160(1), 97 - 105 Assessment of the suitability of commercially available SpA affinity solid phases for the purification of murine monoclonal antibodies at process scale; Godfrey MA et al.; Eight commercially available staphylococcal protein A (SpA) affinity chromatography solid phases were evaluated in order to establish their potential for the large-scale purification of a murine monoclonal antibody (MAb, mIgG1) . The antibody was produced in-house, serum-free, in a hollow fibre bioreactor . Solid phases were tested for the effects of salt concentration, pH, and the presence of MAb on ligand leakage and flow rate . These effects were compared using the solid phases in stirred-tank (roller-mixing) and flow-through (packed-bed) modes of operation . Ligand leakage in the absence of MAb was generally at its lowest when the solid phases were used in a flow-through mode . In this mode of operation increasing the inorganic salt concentration and pH of the washing/adsorption buffer from 150 mM at pH 8.6, to 3 M at pH 8.9, typically produced a 10% increase in MAb capacity of the solid phases (20% for Sepharose CL-4B) . However, contamination of the purified antibodies was also greatly increased due to an elevated level of background ligand leakage from the matrices . Residual contaminating levels of SpA in affinity purified MAbs were lowest with a low salt (NaCl, 150 mM) glycine (1 M) adsorption/washing buffer . Maximal antibody capacity was achieved for all matrices on frontal analysis (breakthrough curves), as opposed to a pulse mode of use . The largest capacity was found for Prosep A 'high capacity' (12-15 mg/ml column volume), where capacity approached its experimentally determined theoretical capacity (C/Co = 0.5) regardless of its mode of use . The relatively high MAb capacity of Prosep A 'high capacity' was further reflected in a superior dynamic isotherm . Frontal analysis, however, generally resulted in a greater SpA contamination of the purified MAbs . Under these conditions the lowest levels of SpA contamination were found for the Prosep A 'high capacity', and Repligen solid phases (12 ppm) on purifying 12.8 and 4.3 mg of MAb respectively . For the large scale downstream processing of a MAb for therapeutic applications, Prosep A 'high capacity', would appear to be the most appropriate of the solid phases tested. J Immunol, 1993 Mar 15, 150(6), 2148 - 59 Accessory cell function of keratinocytes for superantigens . Dependence on lymphocyte function-associated antigen-1/intercellular adhesion molecule-1 interaction; Nickoloff BJ et al.; A growing body of evidence points to a role for epidermal keratinocytes as active participants in immunologic reactions . Inasmuch as certain T cell-mediated skin diseases, such as psoriasis and atopic dermatitis, are triggered by microbial infection, we asked whether multipassaged human keratinocytes could provide the costimulatory signals necessary to induce autologous T cell proliferation in response to bacterial-derived super-antigens . On exposure to IFN-gamma, keratinocytes are induced to express HLA-DR and HLA-DQ class II MHC Ag, and the lymphocyte function-associated Ag-1 counter-receptor intercellular adhesion molecule-1 (ICAM-1) . This change in keratinocyte phenotype is accompanied by the ability of these cells to support T cell proliferation induced by two different bacterial-derived superantigens, staphylococcal enterotoxins A and B . Superantigen-driven proliferation in the presence of IFN-gamma-treated keratinocytes was significantly inhibited (70-90% reduction) by mAb against the LFA-1 alpha- or beta-chain or ICAM-1 . Proliferation was not inhibited by mAb against the CD28 ligands BB-1 or B7, even though these keratinocytes express BB-1 . In addition to previous defined roles for class II MHC Ag, stimulation of LFA-1 on the T cells by ICAM-1 on the keratinocytes also plays an important costimulatory role in this superantigen-mediated response . The accessory cell capability of keratinocytes was not unique to superantigen driven responses as PHA, as well as anti-CD3 mAb also induced vigorous T cell proliferation when IFN-gamma-treated keratinocytes were added . However, IFN-gamma-treated keratinocytes consistently failed to provoke an allogeneic response . These data demonstrate that 1) keratinocytes can serve as accessory cells for T cell proliferation using a variety of different stimuli, 2) the LFA-1/ICAM-1 interaction plays a major role in keratinocyte-mediated costimulation, and 3) previous reports in which IFN-gamma-treated keratinocytes failed to support T cell proliferation to nominal or alloantigens, may reflect impaired Ag presentation via class II MHC molecules, rather than lack of necessary costimulatory signals . These findings highlighting the accessory cell function of keratinocytes may have implications for our understanding of the pathogenesis of immunologic disorders of the skin. J Biol Chem, 1993 Mar 5, 268(7), 5285 - 92 Functional complementation of staphylococcal alpha-hemolysin fragments . Overlaps, nicks, and gaps in the glycine-rich loop; Walker B et al.; The final steps in assembly of the lytic pore formed by staphylococcal alpha-hemolysin (alpha HL) involve the formation of a nonlytic oligomeric pore precursor, followed by the formation of a transmembrane channel . In this study, truncation mutants of alpha HL encompassing the NH2-terminal or COOH-terminal half of the polypeptide chain and all, part, or none of the central glycine-rich loop were obtained by in vitro, coupled transcription and translation of mutant plasmid DNAs . These polypeptides were unable to oligomerize upon or cause lysis of rabbit erythrocytes (rRBCs) . Twenty-one pairs of the same truncation mutants constituting discontinuous alpha HL chains with overlaps, nicks, and gaps in the central loop were obtained by cotranslation . When incubated with rRBCs, many of the pairs were able to form hetero-oligomers with wild-type alpha-hemolysin (s-alpha HL) and most of these formed homo-oligomers in the absence of s-alpha HL . However, only members of a subset of these pairs were able to lyse the cells . The lytic combinations contained overlaps, nicks, or gaps, but only two pairs, with nicks between amino acid residues 128 and 129 and between 131 and 132 had hemolytic activities approaching that of the wild-type polypeptide . Active combinations could also be obtained by separately translating NH2- and COOH-terminal truncation mutants and then combining them . These findings suggest that the integrity of the central loop is of little significance for oligomer formation but that it is more important for the final step in pore assembly or alternatively for determining the correct structure of the conductive channel . Our findings disagree with previous reports of NH2- and COOH-terminal fragments with hemolytic activity and of the prevention of hemolysis by proteolytic cleavage in the central loop . This discord is attributed to experimental and interpretative ambiguities in the earlier protein chemistry . For example, we show that loss of hemolytic activity after treatment with trypsin is not due to cleavage after Lys-131, as previously proposed, but to the removal of a small NH2-terminal peptide through cleavage after Lys-8. J Perinatol, 1993 Mar-Apr, 13(2), 153 - 8 Central venous catheters in low birth weight infants: incidence of related complications; Schiff DE et al.; To test the hypothesis that the incidence of central venous catheter-related complications is increased in very low (< 1000 gm) and low (1001 to 1500 gm) birth weight infants compared with larger infants, we retrospectively analyzed the charts of 51 infants with gestational ages 24 to 42 weeks, weighing 0.43 to 12.2 kg at catheter insertion, who had 69 catheters placed at 1 week to 11 months of age between January 1986 and June 1989 at our hospitals . The incidence of infectious and mechanical complications and the frequency of total and infection-related complications were significantly greater for infants weighing < 1000 gm at catheter insertion (p < 0.05) . Oxacillin-resistant coagulase-negative Staphylococcus organisms accounted for 14 of the 17 episodes of catheter-related septicemia (82%) . Six of these episodes were initially treated with antibiotics but without catheter removal; none resolved with catheter salvage . Central venous catheters in very low and low birth weight infants had an 85% and 64% incidence of associated complications, respectively, and should be used with caution in these patients. Acta Paediatr, 1993 Mar, 82(3), 324 - 6 Successful trimethoprim-sulfamethoxazole therapy in a patient with hyperimmunoglobulin E syndrome; Hattori K et al.; A male patient with hyperimmunoglobulin E syndrome is described . Recurrent lymphadenitis and cutaneous staphylococcal abscesses were resistant to various antibiotics, and chemotaxis and hydrogen peroxide production of polymorphonuclear leukocytes were impaired . Following trimethoprim-sulfamethoxazole therapy, he was free from the above infections, and impaired polymorphonuclear leukocyte functions recovered and serum IgE decreased to approximately one-fifth of its initial level . Subsequent irregular medications, however, resulted in impairment of polymorphonuclear leukocyte functions and an increased serum IgE concentration, which recovered after regular resumption of trimethoprim-sulfamethoxazole treatment . From these results, the beneficial effects of trimethoprim-sulfamethoxazole in hyperimmunoglobulin E syndrome are clinically apparent, but in vitro studies failed to demonstrate the positive effect of trimethoprim-sulfamethoxazole on polymorphonuclear leukocytes and their mechanism still remains to be elucidated. Optom Vis Sci, 1993 Mar, 70(3), 185 - 91 Microbial contamination of hydrophilic contact lenses: quantitation and identification of microorganisms associated with contact lenses while on the eye; Hart DE et al.; Previous studies have demonstrated the presence of microorganisms on hydrogel contact lenses under various usage conditions . We conducted this study to quantify and identify viable bacteria and fungi associated with hydrogel contact lenses while on the eye . We removed the lenses from patients' eyes using aseptic techniques and cultured them to identify loosely adherent, as well as lens bound, microorganisms . Lenses were vortexed in a transfer medium (thereafter called the lens extract) and the lenses were then incubated in an agar sandwich separately from the transfer medium . We cultured 108 lenses (82 daily wear and 26 extended wear) from 49 patients . Bacteria were cultured from 38% (41) of the lenses; for 31 of these 41 lenses bacteria were isolated only from the lens extracts (made by vortexing lenses in a transfer medium), suggesting a transient association with the lenses . No fungi were isolated . Counts of less than 10 colony forming units (CFU)/lens were observed on 89% of the lenses . Staphylococcus epidermidis were the most frequently isolated bacteria . A statistically significant relation was observed between increased CFU/lens and increased lens age for extended wear lenses (p = 0.028). Natl Med J India, 1993 Mar-Apr, 6(2), 67 - 70 Antibiotics in febrile neutropenia: a randomized prospective comparison of two combinations; Madiajagane R et al.; BACKGROUND . Problems of initial empirical antibiotic therapy in febrile neutropenia are further complicated by other factors such as cost and the pattern of infective organisms in a particular institution . We, therefore, conducted a randomized study comparing the efficacy of two sets of antibiotics which differed in their spectrum of action, availability and price . METHODS . Sixty episodes of febrile neutropenia in 40 patients who were not on any prophylactic antibiotics were randomized into one of two arms--cefotaxime and gentamicin or ciprofloxacin and gentamicin . Depending upon the response by 72 hours, they were crossed over to the other arm or continued with the same combination . Empirical antifungal therapy was added in those who did not become afebrile . RESULTS . Infection was documented either clinically, bacteriologically or radiologically in 42% of the febrile episodes . The commonest organism isolated was Klebsiella and the commonest organism producing bacteraemia was the Staphylococcus . The temperature was reduced to normal without cross-over in 53% of the febrile episodes with cefotaxime and gentamicin and in 60% with ciprofloxacin and gentamicin (p > 0.05) . After cross-over the temperature came down in 30% of the episodes with cefotaxime and gentamicin (initial combination) and 40% with ciprofloxacin and gentamicin (initial combination; p > 0.05) . The overall response rate without empirical antifungal therapy was 83% in the patients on cefotaxime and gentamicin (initial combination; p > 0.05) . While both the arms of the study had a 100% response rate, there was no significant difference between the efficacy of the antibiotic combinations . The ciprofloxacin-gentamicin combination is one-third as expensive as cefotaxime-gentamicin and is more readily available . CONCLUSION . We recommend the use of ciprofloxacin and gentamicin as the initial drug combination and cefotaxime and gentamicin only when the former is not effective. Z Kardiol, 1993 Mar, 82(3), 172 - 4 {Detection of pacemaker electrode infection using intravascular ultrasound}; Kerber S et al.; The case of a 60-year-old man who developed fever 14 months after last implantation of a DDD pacemaker system is reported . Though staphylococcus epidermidis could be identified in several blood cultures, transthoracic and transesophageal echocardiograms and scintigraphy with antibodies to human leucocytes could not identify any focus of infection . The percutaneous intravascular and intracavitary ultrasound examination clearly demonstrated a vegetation within the subclavian vein, being attached to the ventricular lead; within that segment of the vein the atrial lead showed a small hyperdense structure . Further vegetations along the leads within the right atrium and ventricle could be ruled out . Subsequent removal of the pacemaker system caused resolution of the signs of inflammation. AIDS Res Hum Retroviruses, 1993 Mar, 9(3), 241 - 6 T cell response to staphylococcal superantigens by asymptomatic HIV-infected individuals exhibits selective changes in T cell receptor V beta-chain usage; Bisset LR et al.; Recognition that the murine mammary tumor C-type retrovirus and the replication-defective murine leukemia virus have "superantigen" properties raises the specter that human immunodeficiency virus might also generate T cell impairment and destruction as a result of inherent superantigen properties . The observation that individuals with AIDS lack the expression of several T cell receptor V beta-chain genes lends support to this hypothesis . Staphylococcal exotoxins represent another class of superantigen with a similar ability to stimulate large numbers of T cells bearing specific T cell receptor V beta-chain types . To examine the hypothesis that T cells from HIV-infected individuals may be exposed to a superantigen during the infection process, we have compared the ability of T cells from asymptomatic HIV-infected donors and healthy donors to respond to stimulation with several known staphylococcal exotoxin superantigens . Following in vitro stimulation with staphylococcal enterotoxin D and staphylococcal enterotoxin E, asymptomatic HIV-infected individuals responded with a significantly different T cell receptor V beta-chain usage to that observed for healthy individuals . This skewed V beta-chain usage is likely to reflect preferential conditioning of T cells bearing specific V beta-chains as a result of HIV infection, supporting the hypothesis of superantigen involvement early in the course of infection. Oral Surg Oral Med Oral Pathol, 1993 Mar, 75(3), 391 - 6 Postextraction osteomyelitis in a bone marrow transplant recipient; Barasch A et al.; This report describes a case of mandibular osteomyelitis after a dental extraction in a patient who subsequently underwent bone marrow transplantation (BMT) for lymphoblastic lymphoma . Surgical guidelines consistent with National Cancer Institute recommendations were followed for the extraction, which was performed before initiation of the myelosuppressive conditioning regimen . However, moderate tenderness developed at the extraction site beginning 10 days after marrow infusion . On day 26 the patient became febrile and blood culture-positive for Staphylococcus epidermidis . Radiographs exposed on day 28 demonstrated changes consistent with low-grade osteomyelitis, including diffuse loss of lamina dura and an irregular osseous rarefaction extending 1 cm posterior to the extraction site . Although the indwelling Hickman catheter was the presumed source for bacteremia, clinical and radiographic data led to consideration of mandibular osteomyelitis as an alternative cause . Characteristics of this infection in BMT recipients are reviewed . Recommendations for dental extractions and prophylactic antibiotic regimens for catheterized BMT recipients are also discussed . Although mandibular osteomyelitic lesions are not common in profoundly immunosuppressed BMT recipients, prompt recognition and treatment are essential when the disease occurs. J Clin Microbiol, 1993 Mar, 31(3), 490 - 3 Numerical approach to reference identification of Staphylococcus, Stomatococcus, and Micrococcus spp; Rhoden DL et al.; A numerical-code system for the reference identification of Staphylococcus species, Stomatococcus mucilaginosus, and Micrococcus species was established by using a selected panel of conventional biochemicals . Results from 824 cultures (289 eye isolate cultures, 147 reference strains, and 388 known control strains) were used to generate a list of 354 identification code numbers . Each six-digit code number was based on results from 18 conventional biochemical reactions . Seven milliliters of purple agar base with 1% sterile carbohydrate solution added was poured into 60-mm-diameter agar plates . All biochemical tests were inoculated with 1 drop of a heavy broth suspension, incubated at 35 degrees C, and read daily for 3 days . All reactions were read and interpreted by the method of Kloos et al . (G . A . Hebert, C . G . Crowder, G . A . Hancock, W . R . Jarvis, and C . Thornsberry, J . Clin . Microbiol . 26:1939-1949, 1988; W . E . Kloos and D . W . Lambe, Jr., P . 222-237, in A . Balows, W . J . Hansler, Jr., K . L . Herrmann, H . D . Isenberg, and H . J . Shadomy, ed., Manual of Clinical Microbiology, 5th ed., 1991) . This modified reference identification method was 96 to 98% accurate and could have value in reference and public health laboratory settings. EMBO J, 1993 Mar, 12(3), 861 - 7 OB(oligonucleotide/oligosaccharide binding)-fold: common structural and functional solution for non-homologous sequences; Murzin AG; A novel folding motif has been observed in four different proteins which bind oligonucleotides or oligosaccharides: staphylococcal nuclease, anticodon binding domain of asp-tRNA synthetase and B-subunits of heat-labile enterotoxin and verotoxin-1 . The common fold of the four proteins, which we call the OB-fold, has a five-stranded beta-sheet coiled to form a closed beta-barrel . This barrel is capped by an alpha-helix located between the third and fourth strands . The barrel-helix frameworks can be superimposed with r.m.s . deviations of 1.4-2.2 A, but no similarities can be observed in the corresponding alignment of the four sequences . The nucleotide or sugar binding sites, known for three of the four proteins, are located in nearly the same position in each protein: on the side surface of the beta-barrel, where three loops come together . Here we describe the determinants of the OB-fold, based on an analysis of all four structures . These proposed determinants explain how very different sequences adopt the OB-fold . They also suggest a reinterpretation of the controversial structure of gene 5 ssDNA binding protein, which exhibits some topological and functional similarities with the OB-fold proteins. Proteins, 1993 Mar, 15(3), 312 - 21 Binding interactions of kistrin with platelet glycoprotein IIb-IIIa: analysis by site-directed mutagenesis; Dennis MS et al.; The binding interactions between platelet fibrinogen receptor, glycoprotein (GP) IIb-IIIa, and kistrin, a snake venom disintegrin protein that contains the adhesion site recognition sequence Arg-Gly-Asp (RGD) and potently inhibits platelet aggregation, have been investigated by site-directed mutagenesis of a synthetic kistrin gene . Kistrin was expressed as a fusion protein in Escherichia coli under control of the alkaline phosphatase promoter . This construction included the stII signal sequence to direct secretion to the periplasmic space and one synthetic (Z) domain of Staphylococcal protein A to allow affinity purification using IgG Sepharose . Kistrin was cleaved from the Z-domain by site-specific proteolysis using a mutant subtilisin BPN' and purified by reverse-phase HPLC . This approach facilitated the rapid purification of a set of 43 alanine replacement mutants whose relative affinity for GP IIb-IIIa was measured by competition with immobilized kistrin and by inhibition of platelet aggregation in human platelet-rich plasma . Alanine replacements at R49, G50, and D51 led to weaker inhibitors of platelet aggregation by 90-fold, 2-fold, and > 200-fold, respectively . The conservative D51E mutant was still > 100-fold less potent whereas R49K had a minor effect (1.8-fold), implying the critical nature of the aspartate for high affinity binding . However, mutations outside of the RGD region led to proteins indistinguishable from kistrin, suggesting no substantial secondary binding interactions . Furthermore, reduced kistrin is not active . We therefore propose that a favorable conformation of the RGD region alone is responsible for the high affinity binding of kistrin to GP IIb-IIIa. Clin Infect Dis, 1993 Mar, 16(3), 435 - 8 Staphylococcal meningitis can present as an abscess of a single lateral ventricle; Robinson EN Jr; Ventricular obstruction and hydrocephalus are recognized complications of neurosurgical procedures and meningitis that has been previously treated . The confinement of bacterial meningitis solely to a lateral ventricle in an otherwise healthy individual, however, is rare . I describe a case in which a ventricular abscess occurred as the presenting manifestation of staphylococcal meningitis in a man who had no history of head trauma or neurosurgery. Transfusion, 1993 Mar, 33(3), 234 - 42 Treatment of refractoriness to platelet transfusion by protein A column therapy; Christie DJ et al.; Ten thrombocytopenic patients (platelets < 10-24 x 10(9)/L) who were refractory to platelet transfusion were investigated for their responsiveness to staphylococcal protein A column therapy . Nine patients had previously been treated with steroids, intravenous immune globulin, and/or other forms of immunosuppressive therapy without improvement in their transfusion response . All patients were receiving multiple platelet transfusions without achieving 1-hour corrected count increments (CCIs) > or = 7500 . Eight patients had antibodies that reacted with platelets and were directed against HLA class I antigens, ABO antigens, and/or platelet-specific alloantigens . Plasma (500-2000 mL) from each patient was passed over a protein A silica gel column and then returned to the patient . Patients received from 1 to 14 treatments . A positive response to protein A therapy was defined as at least a doubling of the pretreatment platelet count and/or two successive 10- to 120-minute posttransfusion CCIs > or = 7500 . Following plasma treatments, 6 of 10 patients responded with daily platelet counts that averaged 48 +/- 11 x 10(9) per L as compared with counts of 16 +/- 7 x 10(9) per L (p < 0.0005) before treatment . Posttransfusion CCI values determined in four of these patients averaged 2480 +/- 810 and 10,010 +/- 3540 (p < 0.005) before and after treatment, respectively . In contrast, among the four unresponsive patients, platelet counts averaged 10 +/- 9 and 13 +/- 10 x 10(9) per L (p = NS), respectively, while posttransfusion CCIs were 700 +/- 1410 and 1520 +/- 2460 (p = NS), respectively.(ABSTRACT TRUNCATED AT 250 WORDS) J Neurosurg Sci, 1993 Mar, 37(1), 19 - 23 Efficacy of ampicillin/sulbactam combination in experimental shunt infections caused by Staphylococcus epidermidis . A light and scanning electron microscope study; Gedikoglu Y et al.; In this study, the efficacy of ampicillin/sulbactam combination in reactions of periventricular tissue of the lateral ventricle induced by the presence of infected (Staphylococcus epidermidis) silicone rubber shunt tubing was examined by using light and scanning electron microscopy . It was demonstrated that reactive changes to implants had occurred in periventricular tissue in the control group . In infected shunt tubing without given prophylactic antibiotic group, generalized meningitis and ventriculitis, loss of integrity of ependymal cells, numerous inflammatory cells, bacterial colonies, exuda and even pus were seen . It was also shown that rarely inflammatory reactions, minimal disintegration of ependymal cells, no bacterial colonies, and phagocytes were present in the group which was given prophylactic ampicillin/sulbactam combination per and postoperatively . We think that ampicillin/s