Infect Immun, 1985 Jan, 47(1), 247 - 52 Cytotoxicity of human serum for Leishmania donovani amastigotes: antibody facilitation of alternate complement pathway-mediated killing; Hoover DL et al.; Mechanisms that mediate recovery from leishmanial infection have not been fully characterized but are generally believed to involve interactions between T lymphocytes and macrophages . A major role for serum-mediated effector mechanisms in the protection of humans from reinfection with Leishmania, however, has not been ruled out . In this report, amastigotes of L . donovani were incubated with dilutions of serum from normal subjects and from patients with kala-azar . Normal serum was cytotoxic for parasites at a dilution of greater than or equal to 1:20 . Cytotoxicity did not occur in the presence of EDTA, was abolished by heating serum to 56 degrees C for 30 min, and was not diminished by prior adsorption of normal serum with parasites at 0 degree C . Killing proceeded normally in the presence of magnesium-ethylene glycol-bis(beta-aminoethyl ether)-N, N-tetraacetic acid, however, and was fully effected by C2-deficient serum . These studies indicated that killing of amastigotes, unlike that of promastigotes, was mediated via the alternate pathway of serum complement . In further studies, cytotoxicity of normal serum was enhanced three- to fivefold by factors in patient serum . This enhanced cytotoxicity also proceeded via the alternate complement pathway . Factors that enhanced cytotoxicity were characterized as parasite-specific immunoglobulin G: they eluted with immunoglobulin G on column chromatography, were adsorbed by immobilized staphylococcal protein A, and were not removed from the parasite surface by extensive washing . Thus, infection of individuals with L . donovani resulted in the production of a new, qualitatively and quantitatively distinct immune mechanism directed against the amastigote form of the parasite, namely, antibody-directed, alternate complement pathway-mediated cytotoxicity . These results provide a mechanistic framework for a role of humoral factors in human resistance to reinfection with L . donovani. Clin Pediatr (Phila), 1985 Jan, 24(1), 40 - 1 Subdural collection of intravenous fat emulsion in a neonate . Complication of central venous catheterization for total parenteral nutrition; Stine MJ et al.; An infected subdural collection of intravenous fat emulsion (Intralipid) was diagnosed in a 5-week-old premature infant who was receiving total parental nutrition (TPN) through a facial vein cutdown . This fluid was successfully drained and the infection, due to Staphylococcus epidermidis, was treated with vancomycin . We postulate that the subdural collection occurred as a result of septic thrombosis of the internal jugular vein with subsequent retrograde flow and infiltration of Intralipid from the bridging veins into the subdural space . This complication of central TPN has not been reported previously. J Immunol, 1985 Jan, 134(1), 167 - 71 Defective IFN-gamma production in the human neonate . I . Dysregulation rather than intrinsic abnormality; Wakasugi N et al.; Cord blood leukocytes (CBL) stimulated with PHA, Con A, or with the monoclonal antibody OKT3 proliferate normally but produce very low titers of IFN-gamma . This defect was not observed with maternal leukocytes collected at the time of delivery, indicating that the defective production of IFN-gamma in CBL is not a mere consequence of a hormonal change associated with labor . CBL produced large amounts of IFN-gamma (comparable to those observed in adult control and in mothers) after stimulation with staphylococcal enterotoxin A (SEA) . Furthermore, gamma-irradiation with as little as 500 or 1000 rad, or incubation at 37 degrees C for 24 hr, reversed the defect in PHA-induced IFN-gamma secretion . This finding indicates that the defective secretion of IFN-gamma of CBL is not intrinsic, but rather is the consequence of a subtle dysregulation . We could not find evidence for a defective accessory function with cord blood monocytes, because the addition of adherent cells from adult donors did not reverse the defect . In co-cultures of adult leukocytes and CBL, PHA-induced IFN-gamma secretion was comparable to that of adult cultures tested alone . Nonirradiated CBL were not able to suppress IFN-gamma secretion by irradiated autologous leukocytes . Together, our results suggest that the defective PHA-induced IFN-gamma secretion of CBL is the result of an original type of dysregulation and is associated with an excessive sensitivity to suppressive signals rather than excessive suppressor function. Contemp Top Immunobiol, 1985, 15, 239 - 56 Trials of staphylococcal protein A-treated plasma infusions in cancer therapy: clinical effects and implications for mode of action; MacKintosh FR et al.; The data presented here indicate that patients with advanced cancer exhibit a modest but definite objective response rate to biweekly infusions of autologous plasma treated with purified, covalently bound staphylococcal protein A in a relatively nontoxic treatment program . The possibility that responses could be enhanced by alteration of treatment parameters, improved patient selection, and/or combined therapy remains to be explored . In vitro studies indicate that tumor cell killing can be produced in an ovarian cancer cell line using ascitic fluid of some ovarian cancer patients that has been treated with small amounts of protein A covalently linked to silica gel or agarose . This may be a suitable model system for exploration of possible humoral mechanisms of protein A-associated tumoricidal effects . The available literature indicates an antitumor effect of protein A-treated patient plasma in a variety of in vitro systems, as well as in animal and human tumors in vivo . Preliminary investigations of the mechanism of these effects are inconsistent and support the view that several different mechanisms of tumor cell killing may be operative in different settings. Vestn Khir Im I I Grek, 1985 Jan, 134(1), 65 - 8 {Management of the perineal wound in the postoperative treatment of patients with cancer of the rectum}; Knysh VI et al.; The material showing causes of the appearance of purulent complications of the perineum would after extirpation of the rectum for cancer is presented . The pathogenes of the purulent infection were found to be polyresistant staphylococcus and gram-negative intestinal flora in most cases . The authors recommend using antibiotic therapy directly at the time of performing the operation, good drainage of the postoperative wound, irradiation of the postoperative wound by a laser radiation of a harmless intensity. Toxicon, 1985, 23(1), 87 - 104 Amino acid sequences of phospholipases A2 from the venom of an Australian elapid snake (king brown snake, Pseudechis australis); Nishida S et al.; Two basic phospholipases A2 (Pa-11 and Pa-13) have been isolated from the venom of an Australian elapid snake, Pseudechis australis (king brown snake) . The reduced and S-carboxymethylated phospholipases A2 were digested with trypsin and the resulting peptides were purified by a combination of chromatography on a DEAE-cellulose DE-52 column and gel filtration procedures . Eleven main peptides from Pa-11 and 9 peptides from Pa-13 could account for the amino acid compositions of the respective enzyme molecules . The alignment of the tryptic peptides and unelucidated regions of the amino acid sequences of tryptic peptides were established by the analysis of the peptides obtained by chymotryptic and/or Staphylococcal protease digestions . Each phospholipase A2 consisted of a single chain of 118 amino acid residues, including 14 half-cystine residues . Although Pa-11 is enzymatically 30-times as active as Pa-13 and highly toxic as compared to Pa-13, they are highly homologous in their amino acid sequences . They are also homologous to the enzymes from mammalian pancreas and the other snake venom phospholipases A2, especially to those from snakes belonging to the subfamilies Acanthophiinae and Laticaudinae. Pediatr Infect Dis, 1985 Jan-Feb, 4(1), 52 - 5 Comparison of lysis-direct plating and broth methods for pediatric blood cultures: clinical relevance and cost effectiveness; Stutman HR et al.; To determine the clinical significance and therapeutic impact of pediatric blood cultures, we analyzed 1650 cultures comparing conventional broth and direct plating methods . The rate of positive cultures was 5.8% . Of 96 positive cultures 68 were deemed clinically significant . The mean time to detection was 23.8 and 33.7 hours, and the sensitivity was 89 and 83% in the Isolator and broth systems, respectively . The overall rate of insignificant isolates was 1.7% and was similar for both methods . Clinical interventions based on blood culture results occurred in 39 patients, primarily those with pneumococcal and staphylococcal bacteremia . Only six of 28 clinically insignificant isolates had negative impact . Use of the pediatric Isolator permitted earlier institution of appropriate therapies and shorter duration of unneeded or toxic therapies without frequent negative impact . Since direct costs were comparable the Isolator system may be a clinically valuable and cost effective alternative to conventional methodology. Infect Immun, 1985 Jan, 47(1), 242 - 6 Production of neutralizing monoclonal antibodies to Escherichia coli heat-stable enterotoxin; Brandwein H et al.; In an effort to develop new approaches to the study and control of infectious diarrhea, we prepared murine monoclonal antibodies to the Escherichia coli heat-stable enterotoxin (STa) . The toxin was purified from E . coli culture media and conjugated to bovine serum albumin . The STa-bovine serum albumin conjugate was used to immunize BALB/c mice, and the immune spleen cells from these mice were fused with SP2/0 myeloma cells . Resultant hybridomas were screened in an enzyme-linked immunosorbent assay protocol against 500 ng of STa-bovine serum albumin bound to microtiter wells as the solid-phase antigen . Five stable clones were selected and grown further in ascites fluid, which demonstrated anti-STa activity at dilutions of up to 1:500,000 in the enzyme-linked immunosorbent assay for heat-stable enterotoxin . In a competitive enzyme-linked immunosorbent assay format, the antibodies recognized several human and porcine strains of STa to various extents, but did not recognize E . coli heat-labile toxin, cholera toxin, or staphylococcal enterotoxin B . The antibodies were all able to bind lactoperoxidase-labeled {125I}STa, and antibody 20B3 was also able to dissociate {125I}STa bound to toxin receptors on rat jejunal villous cells . Preincubation of STa with antibodies 20B3 or 20F5 led to a concentration-dependent neutralization of toxin activity in a suckling mouse intestinal secretion assay . These antibodies are likely to provide new tools for the continued study of STa structure-function relationships and may lead to improved diagnosis and treatment of E . coli-induced infectious diarrhea. Mol Gen Mikrobiol Virusol, 1985 Jan, (1), 25 - 9 {Isolation and characteristics of membrane fraction of rabbit T lymphocytes specifically binding the staphylococcal enterotoxin type A}; Noskov AN et al.; The lymphocyte membranes from rabbit thymus were shown to bind specifically the staphylococcal enterotoxin type A (SEA) . The glycolipid components were demonstrated to be absent from the SEA receptor complex on the surface of T-lymphocytes . The mild conditions were elaborated for the receptor membrane fraction solubilization by triton X-100 . The affinity chromatography method was used to isolate the SEA binding membrane fraction, the major component of which is a protein with a 42,000 mol mass . The isolated preparation inhibits the specific binding of {125I}-SEA on the cellular (by T-lymphocytes) and subcellular (by membranes) levels. Int J Biochem, 1985, 17(7), 781 - 6 Membrane protein from rabbit T-lymphocytes, specifically binding staphylococcal enterotoxin A (SEA); Ezepchuk YuV et al.; The presence of specific binding of SEA with membranes of lymphocytes from rabbit thymus is established . Components of a glycolipid nature are absent in the composition of the receptor complex for SEA on T-lymphocytes . Suitable conditions for the solubilization of the receptor membrane fraction by Triton X-100 are described . The SEA-binding membrane fraction is isolated by means of an affinity-chromatography method . The main component of the fraction is a protein with molecular mass 42 kd . The isolated protein inhibits the specific binding of {125I} SEA on cell (T-lymphocytes) and subcell (membrane) levels. Clin Ther, 1985, 8(1), 100 - 17 Infections in immunocompromised patients . II . Established therapy and its limitations; Periti P et al.; Diseases affecting host defense mechanisms include neutropenia, aplastic anemia, leukemia, lymphocytopenia (B- and T-lymphocyte abnormalities), deficiencies of complement, splenectomy, diabetes mellitus, renal failure, and autoimmune diseases . Immunocompromised patients face frequent life-threatening complications of infections, particularly when they are hospitalized and receiving cytotoxic myelosuppressive drugs . Oral antimicrobial agents affect the flora of the host's alimentary tract, enhancing colonization by resistant, potentially pathogenic, strains and species, especially in a hospital environment . Nalidixic acid, oxolinic acid, pipemidic acid, polymyxins, co-trimoxazole, polyene antibiotics, and framycetin, which preserve anaerobic colon flora, do not affect the host's colonization resistance and can be given in oral doses high enough to suppress and clear susceptible potential pathogens from the intestinal tract . Such prophylactic treatment permits patients to stay hospitalized in ward conditions . In the compromised host who has fever and suspected septicemia, a decision concerning treatment should be made within an hour of notification of the patient's condition . In acute stages of life-threatening infection, the principal aim of antimicrobial chemotherapy is to provide the most potent treatment; at this stage, the accompanying side effects are less important . An essential component of therapy should be an aminoglycoside paired with a beta-lactam antibiotic . Because the incidence of staphylococcal resistance to antibiotics is high, preliminary sensitivity-testing is essential when staphylococcal sepsis threatens the life of a compromised host . Despite aggressive antibiotic therapy, more than half of immunocompromised patients and patients with severe underlying diseases die when gram-negative bacteria invade their blood . In these patients, medical or surgical removal of the septic focus is a major part of management, but plasma or plasma fractions should be given to correct hypovolemia, and an agent such as dopamine should be administered if volume replacement fails to restore adequate blood pressure . A high dose of corticosteroids should have a beneficial effect, and, for neutropenic patients with gram-negative bacteremia or fever, transfusion with functional neutrophils improves survival. Pediatr Neurosci, 1985-86, 12(3), 127 - 33 Reduced bacterial adherence to silicone plastic neurosurgical prosthesis; Gower DJ et al.; Bacteria have been shown to adhere to smooth surfaces, such as shunts, by secreting a complex polysaccharide coat called the glycocalyx . We assume that if bacterial adherence could be reduced to zero, foreign-body-related infections would be essentially eliminated . This study describes a new technique for quantitating bacterial adherence to plastic using radioactive chromium, and demonstrates that presoaking the silicone plastic surgical tubing used for ventriculoperitoneal and ventriculoatrial shunts in bacitracin A solution (50,000 units in 250 ml) reduces the adherence of Staphylococcus epidermidis by 54% . We conclude that pretreatment of a hydrocephalic shunt tubing with an aqueous bacitracin solution before its implantation may help to reduce the postoperative shunt infections due to direct contamination of the shunt at the time it is inserted. J Clin Invest, 1985 Jan, 75(1), 119 - 23 Antineutrophil autoantibodies in Graves' disease . Implications of thyrotropin binding to neutrophils; Weitzman SA et al.; The hyperthyroidism of Graves' disease may be caused by autoantibodies to thyrotropin (TSH) receptors . We have found that patients with this disease have autoantibodies to neutrophils as well, which can be displaced by TSH . Using a radiochemical opsonic assay, we found serum antibodies against homologous neutrophils in 6 of 11 Graves' patients . With a staphylococcal protein A-binding assay, we detected circulating antibodies to homologous neutrophils in 10 of 20 patients, while finding cell-bound antibody on autologous neutrophils in 7 of 8 (including 2 with negative serum tests) . Use of human 125I-TSH in a radioligand binding assay revealed that TSH bound to neutrophils rapidly (maximum binding within 10 min at 22 degrees C, pH 7.4), specifically (less than 20% nonspecific binding), and reversibly . Adding TSH to the radiochemical assay resulted in a dose-dependent inhibition of opsonic antibody activity in serum from patients with Graves' disease . In contrast, TSH did not inhibit antibody activity of serum from patients with immune neutropenia not associated with thyroid disease . Our findings suggest a basis for the association of Graves' disease with neutropenia . Furthermore, the discovery of such antineutrophil antibodies in Graves' disease permits detection of cell-bound antibody when free antibody is not present. Acta Ophthalmol Suppl, 1985, 173, 80 - 2 Bacterial growth in the conjunctival sac and the local defense of the outer eye; Jensen OL et al.; 25 patients admitted for cataract surgery were subjected to conjunctival bacterial culturings preoperatively and during the postoperative observation period . Simultaneously lactoferrin (LF), lysozyme (LY) and secretory immunoglobulin A (s-IgA) were measured in tears . The preoperative flora disclosed the growth of Staphylococcus albus (SA) and diphtheroids . Other species were only sporadically present . There was a significant rise in number of patients affected by SA and diphtheroids postoperatively (from 60 to 80%), whereas other bacteria were not present to any significant extent . LF, LY and s-IgA concentration decreased to about 50% of the preoperative level in the early postoperative period gradually returning towards their initial concentration . Correlating an antibacterial score with bacterial score we found a significant inverse relationship between the two (P less than 0.05). Ann Med Interne (Paris), 1985, 136(5), 398 - 400 {Right endocarditis in disseminated aspergillosis}; Riou B et al.; A 53 year old man with an anaplastic bronchial carcinoma was hospitalised for septic shock and acute respiratory distress after a cutaneous, probably staphylococcal infection, and died in spite of anti-staphylococcal antibiotherapy . The autopsy showed pulmonary, cardiac, cerebral and renal aspergillosis . A right heart aspergillous endocarditis, very rare in this pathology, was also discovered but there were no cardiac valves lesions . The patient was in an "immunodepressed" state as usually observed in pulmonary aspergillosis . The endocardial localisation of aspergillosis and the "pseudo-miliary" appearances of the pulmonary lesion indicated an extra-pulmonary portal of entry, cutaneous or intravenous which is unusual in this pathology . This hypothesis is supported by previous reports of pulmonary aspergillosis where right heart endocarditis is exceptionally rare and by aspergillous left heart endocarditis after open heart surgery where pulmonary aspergillosis is absent. Int J Biochem, 1985, 17(3), 373 - 9 Formation of HCN by human phagocytosing neutrophils--1 . Chlorination of Staphylococcus epidermidis as a source of HCN; Stelmaszynska T; Phagocytosis of Staphylococcus epidermidis by human neutrophils is accompanied by HCN liberation . The amount of HCN evolved is significantly higher when the bacteria are damaged by penicillin . One of the substrates yielding HCN during phagocytosis are N-dichloroglycyl residues of bacterial peptidoglycan formed by the chlorinating myeloperoxidase-H2O2-Cl- system of neutrophils . HCN deriving from the bacterial structures constitutes 6-12% of total HCN liberated during phagocytosis, which indicates that there are other substrates for HCN production . Chlorination process within phagocytosing neutrophils seems to be essential for formation of both, total HCN and that deriving from bacterial structures. J Immunopharmacol, 1985, 7(4), 479 - 88 Effects of Wy-18,251 (3-p-chlorophenyl)thiazolo{3,2-a}benzimidazole- 2-acetic acid), levamisole and indomethacin on the generation of murine T suppressor cells in vitro; Rogers CM et al.; In vitro culture of normal BALB/c spleen cells with staphylococcal enterotoxin B (SEB) activates antigen non-specific suppressor T cells (Ts) which can be assayed by their ability to suppress antibody production in a plaque assay . Addition of the experimental immunomodulatory drug Wy-18,251 (10-100 microM) to cultures of spleen cells plus SEB significantly increased Ts activity relative to cultures without the drug . Similar results were obtained with levamisole, but, in contrast, indomethacin (0.1-10 microM) inhibited SEB-induced suppressor cell activity . The ability of Wy-18,251 to augment Ts activity could be therapeutically useful in the treatment of those autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus, in which hyperactive B cell function is a characteristic feature. Arch Immunol Ther Exp (Warsz), 1985, 33(2), 261 - 73 Results of bacteriophage treatment of suppurative bacterial infections . VI . Analysis of treatment of suppurative staphylococcal infections; Slopek S et al.; Analysis of phage therapy results was carried out on 273 cases of spontaneous and postoperative septic staphylococcal infections . The treatment appeared effective in 254 (93.0%) cases . Detailed analysis of the results obtained in particular disease categories revealed that staphylococcal bacteriophages may be efficiently applied in the treatment of suppurative staphylococcal infections resistant to antibiotics. Zh Mikrobiol Epidemiol Immunobiol, 1985 Jan, (1), 45 - 8 {Development of a diagnostic test system for detecting soluble staphylococcal antigens by an immunoenzyme method}; Gavriliaka RD et al.; ELISA is used for detecting the soluble staphylococcal antigen in patients with purulent septic infections . The optimum conditions for the assay have been established: the dose of staphylococcal gamma globulin for plate sensitization should be 5.0-10.0 micrograms/ml, the pH of the buffer solution 9.6-10.0, the time and temperature of incubation 18-20 hours at 4 degrees C or 5 hours at 37 degrees C . The possibility of using plates manufactured in the USSR has been shown . The sensitivity of the above diagnostic test system is 0.005 microgram/ml. Biochem Soc Symp, 1985, 50, 221 - 33 Membrane damage by channel-forming proteins: staphylococcal alpha-toxin, streptolysin-O and the C5b-9 complement complex; Bhakdi S et al.; One mechanism through which cells can be damaged involves insertion of alien proteins into the membrane bilayer and the formation of hydrophilic transmembrane pores . Three examples for this process are discussed, namely membrane damage by staphylococcal alpha-toxin, streptolysin-O, and by the terminal C5b-9 complement complex . Common to all is the principle of a transition of the proteins from a water-soluble state to an amphiphilic state, occurring through the appearance or exposure of apolar surfaces during oligomerization of the protein molecules into supramolecular aggregates . The resulting complexes or protein oligomers insert spontaneously into the target lipid bilayer and assume properties akin to those of integral membrane proteins . The protein channels can be isolated from membranes after their solubilization by mild detergents and characterized on a bio-immunochemical and ultrastructural level. Nauchnye Doki Vyss Shkoly Biol Nauki, 1985, (7), 23 - 6 {Participation of Ca-dependent systems in thrombocyte aggregation induced by the action of staphylococcal toxin and ADP}; Brill' GE; The mechanism of ADP and staphylococcal toxin effect on the platelet aggregation has been studied on the rabbit's platelet-rich plasma . Ca2+-channels blockade of the cell membrane by verapamil resulted in considerable inhibition of aggregation induced by ADP and some weakening of toxin action . Binding of extracellular calcium EDTA inhibited sharply or blocked the aggregation of both inductors . It has been concluded that Ca2+ transport into cell is necessary chain in ADP and staphylococcal toxin effect but under the action of toxin transport Ca2+ into platelet is brought through a verapamil-resistant Ca2+-channels forming in the membrane under the interaction with toxin. Acta Microbiol Pol, 1985, 34(2), 159 - 65 The survival of Staphylococcus epidermidis in raw milk with different somatic cell count; Bassalik-Chabielska L et al.; The antibacterial activity of an individual quarter milk sample cannot be evaluated by the number of somatic cells in milk and number of S . epidermidis cells surviving (-0,509, the most bactericidal . This was shown to be due to the fact that the strain of Staphylococcus epidermidis Se 25 is very sensitive to complement and also sensitive to cell free skimmed milk . A second stimulation of the udder enhances significantly the cell response to the stimulant . A negative and highly significant correlation coefficient exists between the number of somatic cells in milk and number of S . epidermidis cells surviving (0.509, P less than or equal to 0.01). Eur J Biochem, 1984 Dec 17, 145(3), 573 - 7 A novel form of gastric inhibitory polypeptide (GIP) isolated from bovine intestine using a radioreceptor assay . Fragmentation with staphylococcal protease results in GIP1-3 and GIP4-42, fragmentation with enterokinase in GIP1-16 and GIP17-42; Carlquist M et al.; A novel form of gastric inhibitory polypeptide (GIP), later also referred to as glucose-dependent insulinotropic polypeptide, has been isolated from bovine upper intestine . The purification was monitored by a recently developed radioreceptor assay, specific for GIP, using membrane preparations from hamster beta-cell tumors . A combination of ion-exchange and reverse-phase high-performance liquid chromatography was used in the isolation which resulted in homogeneous bovine GIP . Bovine GIP is, like porcine GIP, composed of 42 amino acid residues . The sequence is: Tyr-Ala-Glu-Gly-Thr-Phe-Ile-Ser-Asp-Tyr-Ser-Ile-Ala-Met-Asp-Lys-Ile-Arg- Gln-Gln - Asp-Phe-Val-Asn-Trp-Leu-Leu-Ala-Gln-Lys-Gly-Lys-Lys-Ser-Asp-Trp-Ile-His- Asn-Ile - Thr-Gln, which differs from that of the previously characterized porcine GIP by having isoleucine instead of lysine at position 37 . Upon proteolytic digestion of GIP with the staphylococcal V8 protease and with enterokinase, two fragments are formed in each case, corresponding to GIP1-3, GIP4-42, and GIP1-16, GIP17-42, respectively. Eur J Biochem, 1984 Dec 17, 145(3), 469 - 76 Primary structure of alpha-clostripain light chain; Gilles AM et al.; The primary structure of light chain of alpha-clostripain was determined by sequence analysis of peptides derived from tryptic digests purified by reverse-phase high-performance liquid chromatography . The 22 isolated tryptic peptides were aligned by peptides derived from chymotryptic and staphylococcal V8 proteinase digests . The light chain contains 133 amino acids residues and has a relative molecular mass of 15400 . The prediction of its secondary structure is given. J Biol Chem, 1984 Dec 10, 259(23), 14711 - 20 Two isoenzymes of glyceraldehyde-3-phosphate dehydrogenase in Caenorhabditis elegans . Isolation, properties, and immunochemical characterization; Yarbrough PO et al.; Two glyceraldehyde-3-phosphate dehydrogenases have been separated and purified from the nematode Caenorhabditis elegans . As defined by starch gel electrophoresis, the faster-migrating isoenzyme, glyceraldehyde-3-phosphate dehydrogenase-2, increases its activity during postembryonic development . In contrast, the slower-migrating isoenzyme, glyceraldehyde-3-phosphate dehydrogenase-1, is enriched in isolated embryos . Both isoenzymes were initially purified by ammonium sulfate fractionation, gel filtration, and NAD+-agarose affinity chromatography . The separation of both isoenzymes as well as their purification to homogeneity was obtained by preparative chromatofocusing . The subunit molecular weight of each isoenzyme is 38,500 +/- 500 . A tetrameric native molecular weight of 157,000 +/- 2000 was determined for glyceraldehyde-3-phosphate dehydrogenase-2 . Monospecific rabbit polyclonal antibodies were initially raised against the major isoenzyme and subsequently used to characterize both isoenzymes . Staphylococcus aureas V8 protease digests of each isoenzyme were separated electrophoretically and stained immunochemically, providing evidence that the two isoenzymes differed in their amino acid sequences . Developmental immunocytochemical studies suggest that the embryonic-enriched isoenzyme, glyceraldehyde-3-phosphate dehydrogenase-1, is present in all cells . The second isoenzyme, exhibiting the major activity during postembryonic larval development, may define a body-wall-muscle specific activity which is located within the actin-containing I and A zones of the nematode's sarcomeres. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1984 Dec, 258(2-3), 213 - 22 Comparison of the bio-physical and biological properties of staphylococcal protein-A extracted by salt-washing and conventional procedure; Tewari R et al.; Staphylococcal protein A could be extracted in large amounts by simple stirring of the cells with physiological saline (pH 7.8) . The amount of protein A obtained by the technique was found to be the same as obtained by lysozyme/lysostaphin techniques (45 micrograms/ml) . The protein A extracted by salt-washing technique was of higher molecular weight (71,000) and differing in some biological properties like complement fixation from the protein A prepared by lysostaphin technique. Antimicrob Agents Chemother, 1984 Dec, 26(6), 793 - 6 Experimental evaluation of chlorhexidine gluconate for ocular antisepsis; Hamill MB et al.; Chlorhexidine gluconate is a bisguanide germicide currently available with 70% isopropanol (Hibistat, Hibitane) or a detergent (Hibiclens, Hibiscrub) for preoperative skin preparation . As these solvents are toxic to the cornea, we investigated the safety and efficacy of aqueous chlorhexidine solutions for ophthalmic use . Chlorhexidine in Tris-glycine buffer was evaluated for retardation of epithelial regeneration after experimental corneal abrasion in rabbits . Irrigant concentrations of 2.0 and 4.0% chlorhexidine significantly slowed the healing rate (0.546 and 0.076 mm/h, respectively) compared with saline controls (0.938 mm/h) . Irrigant concentrations of less than or equal to 1% did not statistically delay healing (P greater than 0.4) . In a separate group of animals, the right conjunctivae of pigmented rabbits were inoculated with Staphylococcus epidermidis (approximately 10(7) organisms per eye) and irrigated with 40 microliters of aqueous chlorhexidine in concentrations of 0.1, 0.5, and 1.0%; the left eyes were irrigated with saline or left untreated . Quantitative conjunctival cultures were obtained, and the total number of organisms recovered per eye was calculated . All chlorhexidine-treated eyes showed significant reduction in organisms compared with either untreated or saline-irrigated control eyes (P less than 0.001) . In vitro antimicrobial susceptibility testing demonstrated chlorhexidine in concentrations of 0.1 to 4% to be highly active against a variety of gram-positive and gram-negative bacterial pathogens by disk diffusion and broth diffusion assays . Topical aqueous chlorhexidine may be an alternate agent for preoperative conjunctival antisepsis. J Antimicrob Chemother, 1984 Dec, 14 Suppl D, 67 - 71 Pathogenesis and management of Staphylococcus epidermidis 'plastic' foreign body infections; Peters G et al.; Staphylococcus epidermidis infections on foreign bodies made of plastic are caused by special and complex mechanisms . The staphylococcal cells are able to adhere to and grow on polymer surfaces in vivo and in vitro . In the course of colonization they produce an extracellular substance ('slime') which eventually covers them . It is thought that the staphylococcal slime has several biological functions, including promoting adhesion and protection against both antibiotics and host defence mechanisms . In patients, the removal of a colonized device should be accompanied by the parenteral administration of highly effective antistaphylococcal drugs, such as vancomycin. J Neurosurg, 1984 Dec, 61(6), 1072 - 8 Factors causing acute shunt infection . Computer analysis of 1174 operations; Renier D et al.; A series of 1174 operations performed on 802 hydrocephalic children was analyzed in an effort to find the factors causing acute postoperative infection . Culture of the cerebrospinal fluid (CSF) samples during the operation was positive in 33 cases . These cases were excluded from the series . Ninety infections were observed in the remaining 1141 operations, an overall rate of 7.9% . Most of these infections were meningitis (56 cases) . Staphylococcus epidermidis was the bacterium most frequent identified (44%) . Statistically significant relationships were found between shunt infection and the following factors: 1) age: infection was 2.6 times as frequent before 6 months than after 1 year of age (p = 0.03); 2) poor condition of the skin; 3) presence of intercurrent seats of infection at the time of surgery; 4) type of operation: the rate of infection was 8.4% in primary shunt insertions, 5% in shunt revisions, and 17.5% in reinsertions following shunt removal for infection (p = 0.0001); 5) end of the shunt requiring revision: an infection rate of 7.7% followed revision of the ventricular catheter alone, and 2.6% followed revision of the other end alone (p = 0.012); and 6) postoperative wound dehiscence or scalp necrosis . The surgical team involved was poorly correlated with the rate of infection (p = 0.12) . No statistically significant relationships have been found between infection and 1) etiology of hydrocephalus: 2) sex; 3) recent neurosurgical operation before the shunt procedure; 4) preoperative presence of an external drainage tube or CSF fistula; 5) lumbar or ventricular taps, or ventriculography; 6) number of previous operations performed on the shunt; 7) time (month and year) of operation; or 8) sugar level and cell count in the CSF. Circulation, 1984 Dec, 70(6), 1024 - 9 Catheter ablation of the atrioventricular junction: a report of the percutaneous mapping and ablation registry; Scheinman MM et al.; An international registry was formed to collate data for patients undergoing attempted catheter ablation of the atrioventricular (AV) junction and insertion of a permanent pacemaker . Over the past 2 years, data was submitted for 127 patients who were followed for a mean of 9.9 +/- 8.2 months . The most common arrhythmia treated was chronic or paroxysmal atrial fibrillation or flutter (78 patients, 61%); the remainder had supraventricular tachycardia due to AV node reentry, ectopic atrial tachycardia, or incorporated an accessory pathway . A single shock of 150 to 400 J was effective in producing chronic third-degree AV block in 45 patients while two or more shocks were used in an additional 45 patients . There was no significant difference in the total cumulative energy used in successful and unsuccessful procedures . Immediate complications related to the shock included ventricular fibrillation (one patient), pericardial tamponade (one patient), and transient hypotension (one patient) . No chronic sequelae occurred as a result of these complications . Late complications (1 day to 1 month) included ventricular tachycardia (three patients), sepsis involving the pacemaker pocket (two patients), staphylococcal sepsis from temporary pacing catheter (one patient), thrombophlebitis (one patient), thrombosis of the left subclavian vein (one patient), and hemothorax (one patient) . Follow-up evaluation revealed chronic third degree AV block in 90 (71%) and AV conduction resumed but no drugs were required for arrhythmia control in eight (6.5%) and arrhythmia control was achieved with previously ineffective drugs in 16 (13%) . Thirteen patients (10%) had no improvement and five of these patients underwent cardiac electrosurgery for direct His bundle ablation.(ABSTRACT TRUNCATED AT 250 WORDS) Antimicrob Agents Chemother, 1984 Dec, 26(6), 857 - 62 Comparison of fortimicins with other aminoglycosides and effects on bacterial ribosome and protein synthesis; Moreau N et al.; Fortimicins are bicyclic aminoglycoside antibiotics that contain a fortamine moiety instead of the deoxystreptamine found in other aminoglysides . Fortimicin A had a bactericidal effect on Escherichia coli and Staphylococcus epidermidis and was found to inhibit protein synthesis in vivo . In vitro, fortimicin A inhibited polyuridylic acid-directed phenylalanine polymerization and induced misreading, as shown by leucine incorporation . In contrast, fortimicin B had no effect on either polymerization or misreading . In assays programmed with natural mRNA, only a weak polymerization inhibition effect was observed with fortimicin A, whereas a strong stimulation was seen in the presence of fortimicin B . Both fortimicins A and B inhibited dissociation of 70S ribosomes into their subunits and neither was able to displace {3H}dihydrostreptomycin, {3H}tobramycin, or {3H}gentamicin from their respective binding sites on the 70S particle. J Immunol, 1984 Dec, 133(6), 3163 - 6 Staphylococcal protein A binding to the Fab fragments of mouse monoclonal antibodies; Young WW Jr et al.; Two mouse IgG1 monoclonal antibodies specific for the Lewis(a) human blood group antigen were purified on protein A-Sepharose by using buffers of decreasing pH for elution . Unlike other IgG1 antibodies that eluted at pH 7.0 to 6.0, these antibodies could only be eluted at pH 4.0 to 3.0 . The Fab and F(ab')2 fragments of these antibodies also eluted at pH 4.0 to 3.0, although the Fc fragment of one eluted at pH 6.0 . This interaction of protein A with Fab was not due to anti-protein A antibody activity, because the presence of Lewis(a) trisaccharide did not prevent the binding of Fab to protein A-Sepharose and because Fab that had bound to solid phase hapten could still be recognized by protein A . Thus, certain mouse IgG1 antibodies possess determinants in their Fab portion recognized by protein A, allowing for the purification of such Fab fragments on protein A-Sepharose. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1984 Dec, 258(2-3), 360 - 7 Enterotoxigenicity of Staphylococcus intermedius strains isolated from dogs; Fukuda S et al.; Dogs (n = 100) were examined for the presence of enterotoxigenic Staphylococcus intermedius . Enterotoxigenic strains were isolated from the nasal cavities of 43 (43.0%) out of 100 dogs . Of the 50 enterotoxigenic strains isolated, 23 (46.0%) produced enterotoxin A, 17 (34.0%) enterotoxins A and C, 8 (16.0%) enterotoxin C, and only two (4.0%) enterotoxins A and B . The amount of enterotoxin produced on semisolid brain heart infusion medium by the 17 enterotoxin A producing strains of S . intermedius was 10-160 ng per ml . Enterotoxin A production by S . intermedius strains was ony one tenth to one hundredth of that of S . aureus strains from staphylococcal food poisoning outbreaks. Zh Mikrobiol Epidemiol Immunobiol, 1984 Dec, (12), 94 - 7 {Staphylococcal induction of suppressors of macrophage phagocytic activity}; Vikhot' NE; During experimental infection caused by S . aureus, strain Smith, the formation of suppressors of the phagocytic activity of macrophages was induced in the peritoneal cavity and the spleen of intact and infected mice . Thus, in the cultivation of macrophages of the infected mice together with nonadhering cells of the peritoneal exudate of the infected animals the phagocytic index was 0.75 +/- 0.09; in the presence of splenocytes of the infected mice the phagocytic index for macrophages of the intact and infected animals was 0.64 +/- 0.12 and 0.89 +/- 0.04, respectively . Splenocytes of the intact mice, when cultivated together with macrophages of the infected mice, enhanced phagocytic activity during the first hours of cultivation and suppressed it after prolonged cultivation (12 hours); the phagocytic index was 1.37 +/- 0.18 and 0.82 +/- 0.03, respectively. Scand J Immunol, 1984 Dec, 20(6), 493 - 501 Demonstration of a helper factor(s) with T-cell-replacing activity in synovial fluid; Al-Balaghi S et al.; Cell-free synovial fluid (SF) obtained from patients with rheumatoid arthritis contains a helper factor(s) capable of augmenting the generation of plaque-forming cells (PFC) in pokeweed mitogen (PWM)-stimulated normal peripheral blood mononuclear cells (PBMC) . This helper factor behaves like a polyclonal B-cell activator, in that it triggers the formation of IgM, IgG, and IgA PFC . However, SF has little or no effect on the proliferation of PWM-activated PBMC . Furthermore, SF was capable of replacing T cells for PWM-induced differentiation but not proliferation of enriched human blood B lymphocytes . No helper factor or T-cell-replacing activity was found in SF from patients with traumatic synovitis . Fractionation of SF containing helper activity on staphylococcal protein A column indicated that the activity is induced by biologically active molecules distinct from materials that preferentially bind to protein A such as IgG immune complexes . We conclude that the present activity has striking similarities to the recently described B-cell differentiation factor that is produced by specifically activated T-cell lines in vitro. Jpn J Antibiot, 1984 Dec, 37(12), 2349 - 54 {In vitro activity and clinical evaluation of ceftriaxone in the field of obstetrics and gynecology}; Ninomiya K et al.; In vitro activity of ceftriaxone (CTRX) was examined by agar plates dilution method against 398 strains isolated from the infections in the field of obstetrics and gynecology . MIC90 of CTRX against Staphylococcus (107 strains), E . coli (54 strains), K . pneumoniae (27 strains), Peptococcus and Peptostreptococcus (106 strains) and Bacteroides (104 strains) was more than 100 micrograms/ml, less than 0.20 micrograms/ml, less than 0.20 micrograms/ml, 6.25 micrograms/ml and 50 micrograms/ml, respectively . The concentrations of CTRX 16.9 hours after 1 hour intravenous drip infusion with 1 g were 46.2 micrograms/ml in the uterine artery, 48.0 micrograms/ml in the cubital vein, 11.0 micrograms/g in the endometrium, myometrium and cervix uteri, and 14.0 micrograms/g in the portio vaginalis . These concentrations of CTRX in the serum and uterine tissues were higher than the level required to inhibit 90% of the strains of E . coli, K . pneumoniae, and Peptococcus and Peptostreptococcus, isolated from the infections in the field of obstetrics and gynecology . Clinical efficacy of CTRX was evaluated in 7 cases consisting of 2 with puerperal fever and one each with puerperal intrauterine infection, intrauterine infection, pyometra, adnexitis and Bartholin's abscess . Clinical and bacteriological efficacies were seen in 6 and 4 cases, respectively . Neither noteworthy adverse reactions nor laboratory abnormalities were observed throughout this study. Cell, 1984 Dec, 39(3 Pt 2), 469 - 78 Torsional stress promotes the DNAase I sensitivity of active genes; Villeponteau B et al.; Active genes are known to have an altered chromatin structure that is preferentially sensitive to digestion with DNAase I . We find that when chicken red blood cells are incubated in media containing the topoisomerase II inhibitor novobiocin, the preferential DNAase I sensitivity of the active beta-globin genes is reversed in vivo with as little as 20 min of drug treatment . Control experiments suggest that inhibition of a topoisomerase II is responsible for this alteration in active gene conformation . Reversal of DNAase I sensitivity can also be induced in vitro by partial cleavage of the nuclear DNA with staphylococcal nuclease . We propose that the altered structure around active genes is maintained by continuous DNA supercoiling and that in the absence of this superhelical tension active chromatin reverts to a less DNAase I-sensitive ground state. Nucleic Acids Res, 1984 Nov 26, 12(22), 8457 - 74 Organization of the GAL1-GAL10 intergenic control region chromatin; Lohr D; A defined, "far upstream" promoter element, the Upstream Activator Sequence (UAS), which mediates the galactose dependent induction of expression of the GAL10 gene in yeast, is the locus of an anomalous, mainly expression independent chromatin structure . The UAS chromatin shows three symmetrical DNase I hypersensitive sites in brief digests, a loss of the 10 bp DNase I ladder pattern in more extensive digests and an enhanced staphylococcal nuclease sensitivity . This anomalous structure is confined to a small region of the UAS . The surrounding chromatin, including the TATA box regions shows a more typical, but expression dependent nucleoprotein, probably nucleosomal, organization . Such an arrangement may be a common feature of eukaryotic genes. S Afr Med J, 1984 Nov 3, 66(18), 685 - 7 {Staphylococcal pneumonia : a review of 18 cases at Tygerberg Hospital}; Roos JS; A retrospective study of 18 cases of staphylococcal pneumonia is described . The majority of patients were young males without any predisposing factors . A vasculitic rash, three-organ failure and diffuse intravascular coagulation were poor prognostic factors . The value of steroids was doubtful but plasmapheresis probably played a part in the survival of 3 patients with fulminating staphylococcal pneumonia . The case fatality rate for the whole group was 38% . Primary staphylococcal pneumonia probably had a better prognosis but left more residual lung damage than the secondary form of the disease. Eur J Biochem, 1984 Nov 2, 144(3), 417 - 23 The primary structure of calf thymus glutaredoxin . Homology with the corresponding Escherichia coli protein but elongation at both ends and with an additional half-cystine/cysteine pair; Klintrot IM et al.; The primary structure of calf thymus glutaredoxin was determined by analysis of the {14C}carboxymethylated protein and the proteolytic fragments obtained by treatments with trypsin, chymotrypsin, CNBr and staphylococcal Glu-specific extracellular protease . The active center has the structure Cys-Pro-Tyr-Cys, with the redox-active cysteines/half-cystines located at positions 22 and 25 in the polypeptide chain . This active center is identical in amino acid sequence and similar in position to that of Escherichia coli glutaredoxin, suggesting this structure to be typical for glutaredoxins and distinguishing them from the distantly related thioredoxins . However, the two glutaredoxins also exhibit considerable differences . Calf thymus glutaredoxin is extended at both ends and has 31% overall residue identities with the corresponding E . coli protein . In contrast to the bacterial glutaredoxin, the calf thymus protein contains two additional half-cystines/cysteine residues at positions 74 and 78, which may be of regulatory significance. Eur J Cancer Clin Oncol, 1984 Nov, 20(11), 1377 - 88 Tumour regression after extracorporeal affinity chromatography of blood plasma across agarose beads containing staphylococcal protein A; Hakansson L et al.; The therapeutic effect of absorbing plasma from tumour patients with immobilized staphylococcal protein A was tested . Plasma prepared by centrifugation was passed over protein A-Sepharose and then reinfused into the patient . Five patients were thus treated . One with malignant melanoma and one with renal adenocarcinoma showed measurable regression of metastatic lesions . In another with malignant melanoma a subcutaneous metastasis showed histopathological changes compatible with a therapeutic effect . In two patients, one with malignant melanoma and one with renal adenocarcinoma, no signs of regression were found . No severe adverse effects of the treatment were observed. J Gen Microbiol, 1984 Nov, 130 ( Pt 11), 3029 - 35 Plasmid involvement in production of and immunity to the staphylococcin-like peptide Pep 5; Ersfeld-Dressen H et al.; The staphylococcin-like peptide Pep 5 is produced by the penicillin resistant strain Staphylococcus epidermidis 5 . This strain is immune to the peptide . Plasmid analysis of S . epidermidis 5 by agarose gel electrophoresis and electron microscopy demonstrated five plasmids with molecular weights ranging from 5.8 X 10(6) to 29 X 10(6) . Variants of S . epidermidis 5 not producing Pep 5 or which had become penicillin sensitive were induced by various curing treatments . Strains lacking the 13.9 X 10(6) mol . wt plasmid (pED502) had lost penicillin resistance, and those lacking the 12.3 X 10(6) mol . wt plasmid (pED503) failed to produce Pep 5 . pED503 is also responsible for the immunity of the producer cell to Pep 5 . Plasmid pED502 could be transformed into S . aureus RN 981 which then became resistant to penicillin . pED503 could not be transformed into S . aureus RN 981, but could be transformed into S . epidermidis 5 variants previously cured of this plasmid; the transformants then regained the properties of Pep 5 production and immunity. Antibiotiki, 1984 Nov, 29(11), 834 - 6 {Antitoxic effect of leukocytic interferon in in vivo experiments}; Babaiants AA et al.; Leukocyte interferon of various species origin (human, swine, mice) protected mice from the lethal dose of staphylococcal toxin . Endogenic mouse interferon and exogenic serum mouse interferon had no such effect . The suspension of waste leukocytes had also a protective activity . The results of the study evidence the presence of antitoxic factor in the leukocytes. Am J Vet Res, 1984 Nov, 45(11), 2376 - 9 Antimicrobial susceptibility patterns of canine Staphylococcus intermedius isolates from veterinary clinical specimens; Phillips WE Jr et al.; Sixty-six Staphylococcus intermedius isolates from canine clinical specimens were tested for susceptibility to various antimicrobial agents by the Bauer-Kirby disk diffusion method and a commercial microdilution system . All isolates were susceptible to cephalothin, cloxacillin, gentamicin, methicillin, and vancomycin . Resistance to ampicillin, penicillin G, and tetracycline was frequent . There was an overall 87% agreement of results from the disk diffusion and microdilution methods for 10 antimicrobial agents . There was greater than or equal to 94% agreement between the 2 methods for 7 antimicrobics; discrepancies were minor. J Dairy Sci, 1984 Nov, 67(11), 2580 - 9 Effects of premilking udder preparation on bacterial population, sediment, and iodine residue in milk; Galton DM et al.; Udder preparations that wet both udder surfaces and teats had the highest standard plate count in milk compared with methods that wet teats only . Physical action of cleaning teats with a dry towel lowered bacterial count compared with preparations wetting both udder surfaces and teats . Methods resulting in lowest bacterial counts were the use of water hose, wet towel, or premilking disinfectant teat dip followed by drying with paper towels . Counts of coliform and Staphylococcus sp . followed similar trends . In most comparisons, addition of udder wash sanitizer was of marginal or no benefit . Standard plate count of teat rinses after udder preparation confirmed the benefit of cleaning and drying teats . Physical manipulation of teats during cleaning was essential for lowering sediment in milk . Drying of teats with a paper towel for at least 10 s after dipping with a 1% iodophor disinfectant dip was essential for reducing iodine residue . Both premilking and postmilking disinfectant teat dipping with a 1% iodophor teat dip caused higher iodine residue in milk than premilking disinfectant dip with subsequent drying . A .5% iodophor teat dip contributed less iodine in milk than a 1% iodophor teat dip . Premilking udder preparation affects bacterial count, sediment, and iodine residue in milk. Ophthalmology, 1984 Nov, 91(11), 1384 - 8 Vitrectomy for macular pucker; Michels RG; Vitreous surgery was used to treat 130 consecutive cases with epiretinal membranes causing macular pucker . The membrane: (1) occurred after otherwise successful retinal reattachment surgery in 78 eyes (60%), (2) was idiopathic in 28 eyes (22%), (3) was associated with other ocular disorders in 20 eyes (15%), and (4) in four eyes may have been developmental . The abnormal tissue was successfully removed in 128 of 130 eyes, and vision improved at least two lines on the Snellen chart in 108 eyes (83%) . Postoperative visual acuity was 20/20 in five eyes (4%), 20/25 to 20/40 in 41 eyes (31.5%), 20/50 to 20/100 in 64 eyes (49%), 20/200 in 15 eyes (11.5%), and 20/400 in five eyes (4%) . Complications included one case of sterile endophthalmitis and one case of infective endophthalmitis (Staphylococcus epidermidis) . Peripheral retinal tears occurred in six eyes (5%) . No posterior retinal breaks occurred in this series . Later retinal detachment occurred in eight eyes (6%) requiring further retinal surgery . Progressive postoperative nuclear sclerotic lens changes occurred in 31 (34%) of 90 phakic eyes . Sizable amounts of epiretinal tissue recurred postoperatively in four eyes (3%). Immun Infekt, 1984 Nov, 12(6), 279 - 85 {Molecular basis for the pathogenicity of S . aureus alpha-toxins}; Bhakdi S et al.; Staphylococcal alpha-toxin is produced by most strains of S . aureus and is considered a major pathogenic factor of these bacteria . The toxin is produced as a water-soluble molecule of MW 34000 . Binding to a membrane target is accompanied by the formation of ring-structured hexamers with outer and inner diameters of 10 and 2-3 nm, respectively . The toxin rings carry lipid-binding surfaces that allow for insertion into and firm embedment within the membrane . Small transmembrane channels are thus generated that can induce a variety of pathological cellular changes . Large doses of toxin will generally cause cell lysis and death . However, sub-cytolytic toxin doses can also elicit major pathophysiological reactions . When introduced into the circulation of an isolated and perfused rabbit lung, the toxin causes steep rises in the pulmonary artery pressure, and lung edema results as a consequence of increases in vascular permeability occurring in parallel . These processes are the result of the activation of the arachidonic acid cascade by alpha-toxin in the lung . Studies using cultured endothelial cells as targets subsequently led to a hypothesis that would explain how membrane channel formation by a toxin could be linked to the observed arachidonic acid cascade activation . In essence, we propose that the toxin pores serve as non-physiological calcium channels, and that calcium influx triggers the observed reactions . It is probable that many other pathophysiological processes including inflammatory tissue reactions derive from such secondary effects of toxin action.(ABSTRACT TRUNCATED AT 250 WORDS) Infect Immun, 1984 Nov, 46(2), 448 - 52 Effect of thioglycolate on phagocytic and microbicidal activities of peritoneal macrophages; Leijh PC et al.; Brewer thioglycolate-elicited mouse peritoneal macrophages were as active as resident peritoneal macrophages in the phagocytosis of opsonized Staphylococcus epidermidis but were unable to kill ingested microorganisms . This decreased functional activity was restricted to Brewer thioglycolate-elicited macrophages, since peritoneal macrophages elicited with NIH thioglycolate, alone or supplemented with agar and methylene blue, were as active as resident peritoneal macrophages . No effect of agar on the functional activities of macrophages was observed . A defective intracellular killing by peritoneal macrophages due to Brewer thioglycolate was seen only after an intraperitoneal injection with thioglycolate, not after in vitro incubation of resident macrophages with thioglycolate . The results of this study show that, depending on the kind of thioglycolate used, the functional characteristics of elicited macrophages may alter . However, none of the forms of thioglycolate investigated induced the recruitment of activated macrophages. Infect Immun, 1984 Nov, 46(2), 354 - 60 Comparative observations of fever and associated clinical hematological and blood biochemical changes after intravenous administration of staphylococcal enterotoxins B and F (toxic shock syndrome toxin-1) in goats; Van Miert AS et al.; The present investigation was undertaken to examine the characteristics of purified toxic shock syndrome toxin-1 (staphylococcal enterotoxin F) given intravenously to dwarf goats (dose, 0.02 to 20 micrograms kg-1) . Rectal temperature, heart rate, rumen motility, plasma zinc and iron concentrations, and certain other blood biochemical and hematological values were studied and compared with the changes seen after intravenous administration of staphylococcal enterotoxin B (dose, 0.02 to 0.5 micrograms kg-1) . Similar changes such as fever, tachycardia, inhibition of rumen contractions, drop in plasma zinc and iron concentrations, lymphopenia, and a decrease in serum alkaline phosphatase activity were observed . In contrast to the effects of toxic shock syndrome toxin-1, staphylococcal enterotoxin B induced colic, watery diarrhea with pseudomembranes, hemoconcentration, and a more pronounced increase in blood urea nitrogen . The results obtained demonstrate that (i) in the goat staphylococcal enterotoxin B is much more potent than toxic shock syndrome toxin-1 and (ii) the goat is a useful model to study the gastro-intestinal effects caused by staphylococcal enterotoxin B . The present finding that no clear relationship could be found between the temperature response and the alterations in zinc and iron levels in plasma support the theory that the febrile reactions and the changes in plasma trace metals are mediated by different polypeptides released by activated macrophages. Clin Cardiol, 1984 Nov, 7(11), 624 - 6 Staphylococcal abscess complicating endocardial aneurysmectomy; Schneiderman H et al.; Subendocardial left ventricular aneurysmectomy relieved previously intractable ventricular tachycardia in a 68-year-old man with severe coronary artery disease . Staphylococcal septicemia developed postoperatively; an infected venoclysis site may have provided the portal of entry . Autopsy confirmed staphylococcal abscess at the epicardial aspect of the ventriculotomy, constituting the first reported case, to our knowledge, of this complication following endocardial surgery. Br J Nutr, 1984 Nov, 52(3), 595 - 605 Leucine and isoleucine requirements of the kitten; Hargrove DM et al.; In separate experiments the isoleucine and leucine requirements of the kitten were determined on the basis of growth and nitrogen retention . The dietary concentrations of isoleucine tested were (g/kg diet) 1.4, 2.2, 3.0, 3.8, 4.6 and 9.0 with adequate (12.0 g/kg diet) leucine . The levels of leucine tested were (g/kg diet) 5.0, 7.5, 9.0, 10.5, 12.0 and 20.0 in diets containing adequate (9.0 g/kg diet) isoleucine . In both experiments six male and six female kittens received each dietary level of isoleucine or leucine for periods of 10 d in a balanced 6 X 6 Latin-square experimental design . Asymptotic curves were fitted to the response relationships and the minimal dietary requirements for maximal response were estimated from the values at 0.95 of the asymptote . On this basis, the requirements for maximal growth were 6.2 g isoleucine/kg and 7.8 g leucine/kg diet . The requirements for maximal N retention were higher; 8.4 g isoleucine and 10.6 g leucine/kg diet . The isoleucine requirements suggested by this method are probably overestimations and might be slightly above 4.6 g/kg diet . Plasma isoleucine and leucine concentrations were not useful in estimating the requirements . Plasma leucine increased rectilinearly with increasing dietary leucine while the response of plasma isoleucine to increasing dietary isoleucine was non-rectilinear . Neither response relationship exhibited a breakpoint at the level of requirement . Below the suggested minimal requirement for leucine there were significant increases in the concentrations of isoleucine and valine in the plasma . Dietary isoleucine below the level of requirement had no effect on plasma valine and leucine . Dietary leucine had no effect on the plasma concentrations of methionine, phenylalanine and threonine, suggesting that the effect of decreasing dietary leucine on plasma isoleucine and valine is a result of decreased oxidation rather than decreased protein anabolism . In a separate experiment six kittens, presented a diet containing 2.2 g isoleucine/kg, developed crusty exudates around their eyes within 27 d and six kittens, presented diets containing 3.8 g isoleucine/kg, showed this clinical sign but with less severity within 47 d . Cultures of conjunctival swabs taken from the most severely affected kittens showed the presence of staphylococcal species, suggesting that in isoleucine-deficient kittens there was impaired resistance to these dermal microbes. Pediatrics, 1984 Nov, 74(5), 832 - 7 Staphylococcus epidermidis bacteremia in neonates: further observations and the occurrence of focal infection; Noel GJ et al.; The frequency and clinical significance of Staphylococcus epidermidis isolates from blood cultures of neonates collected during a 17-month period in The New York Hospital neonatal intensive care unit (NICU) were reviewed . Twenty-three episodes of clinically significant S epidermidis bacteremia were detected using the criteria of isolation from 3/3 blood culture bottles from a single culture, or isolation from two or more blood cultures taken at different times, or simultaneous isolation from blood and fluid, pus or vascular catheter . Of these 23 episodes of S epidermidis bacteremia, ten were associated with colonized vascular catheters, and four episodes occurred in infants with necrotizing enterocolitis . Focal S epidermidis infection occurred in ten episodes, and persistent bacteremia occurred frequently in this setting . S epidermidis was the most frequent cause of bacteremia in the Neonatal Intensive Care Unit during the period reviewed . Of the isolates determined to be clinically significant, 74% were resistant to methicillin and cephalothin and 91% were resistant to gentamicin . All isolates were sensitive to vancomycin . In addition to removing vascular catheters suspected of being colonized and searching for potential sites of focal infection, an antibiotic regimen that includes vancomycin should be initiated once significant S epidermidis bacteremia has been recognized in the neonate. J Clin Oncol, 1984 Nov, 2(11), 1277 - 80 Totally implantable system for peritoneal access; Pfeifle CE et al.; A totally implantable system for providing access to the peritoneal cavity was evaluated . Fifty-six Port-A-Cath (Pharmacia Nu Tech, Piscataway, NJ) peritoneal access systems were implanted in 54 cancer patients receiving intraperitoneal chemotherapy . The catheters are accessed by transcutaneous placement of a Huber point needle through a silicone septum at the top of the portal . A total of 32 patient years of experience are reported . The Port-A-Caths have been in place for a median of 22 weeks (range, one to 85) . A total of 401 entries have been made for paracentesis, chemotherapy administration, antibiotic administration, peritoneal lavage for cytology, and catheter flushing . There have been six episodes of peritonitis (five Staphylococcus epidermidis, one S aureus) in three patients . There have been no mechanical failures of the Port-A-Caths . Loss of bidirectional flow through the catheter due to fibrin deposition about the catheter has been the major cause of catheter failure . Patient acceptance of the Port-A-Cath has been excellent. Clin Orthop, 1984 Nov, (190), 239 - 40 Osteomyelitis of the great toe secondary to phlebotomy; Puczynski MS et al.; A premature infant developed Staphylococcus osteomyelitis secondary to multiple punctures of the great toe for drawing blood . The infection responded well to antibiotic therapy. Exp Hematol, 1984 Nov, 12(10), 788 - 93 Demonstration of two distinct antibodies in autoimmune hemolytic anemia with reticulocytopenia and red cell aplasia; Mangan KF et al.; To determine the mechanism of the aplastic crisis in a patient with autoimmune hemolytic anemia (AIHA) and reticulocytopenia who developed red cell aplasia simultaneously, serum- and IgG-separated fractions were examined for the presence of erythroid progenitor cell inhibitors . The patient's red cell autoantibody was a complement-independent IgG that reacted with the little-e antigen of the Rh complex . A complement-dependent serum IgG inhibitor directed against erythroid colony- and burst-forming units but not granulocyte-macrophage units was detected in samples before treatment with extracorporeal staphylococcal protein-A immunoadsorption and corticosteroids . The erythroid progenitor cell inhibitor persisted in samples multiply adsorbed against type-ee red cells and was not detected in heat eluates prepared from these red cells . A reticulocytosis occurred when serum IgG levels were reduced to 27% of pretreatment values . At this point, the erythroid progenitor cell inhibitor was not detectable in vitro . These findings suggest that the development of the aplastic crisis in some patients with AIHA may be associated with the presence of two distinct IgG antibodies, one directed at the mature red cell and the other at the erythroid progenitor cells. J Vasc Surg, 1984 Nov, 1(6), 750 - 6 The relevance of arterial wall microbiology to the treatment of prosthetic graft infections: graft infection vs . arterial infection; Macbeth GA et al.; One potential, but poorly studied source for intraoperative contamination of vascular grafts is the native artery to which the prosthetic graft is attached . The purpose of this study was to analyze the relationship between arterial wall microbiology and graft infection . Between July 1, 1981, and March 31, 1982, arterial specimens were cultured from 88 (30%) of 298 patients undergoing clean, elective arterial reconstructive procedures . Control cultures were obtained from adjacent adipose or lymph node tissue . Positive cultures were obtained from 38 of 88 (43%) of the arterial walls cultured but from none of the control cultures (0 of 20) (p less than 0.001) . The most common organism cultured was Staphylococcus epidermidis (27 of 38; 71%) . Our overall graft infection rate since January 1, 1981, is 0.9% (3 of 335) . All three graft infections occurred in patients with positive arterial cultures . Arterial and graft cultures were also obtained from 20 patients treated for 22 graft infections over the past 13 years . Organisms recovered included staphylococcal species (36%), enteric organisms (46%), and mixtures of the two (18%) . These patients with culture-positive graft infections were divided retrospectively into two groups: those with positive and those with negative arterial cultures . Positive arterial cultures were associated with suture line disruption in 8 of 14 cases (57%), but there were no arterial disruptions in patients with negative cultures (0 of 8) (p less than 0.01) . These data document a significant correlation between positive arterial wall cultures and subsequent prosthetic infection and also suggest that infection involving the arterial wall is a major determinant of the morbidity and mortality associated with the treatment of prosthetic graft sepsis. Cancer Res, 1984 Nov, 44(11), 4962 - 6 Effect of antineoplastic agents on gamma-interferon production in human peripheral blood mononuclear cells; Cesario TC et al.; Since gamma-interferon (IFN-gamma) is a potent immunomodulator and patients receiving certain antineoplastic agents are at risk of unusual infections, we have determined the effect of certain antineoplastic agents on IFN-gamma production . Induction of peripheral blood mononuclear cells from normal donors in the presence and absence of various antineoplastic agents was achieved using phytohemagglutinin (8 micrograms/ml) . Supernatants were then separated by centrifugation, dialyzed, and assayed for interferon . Cell viability was always greater than 85% with or without the presence of drugs . Hydrocortisone was found to eliminate IFN-gamma production if added within 24 hr after the phytohemagglutinin . The suppression of IFN-gamma production occurred with hydrocortisone concentrations as low as 0.65 microgram/ml, was associated with a diminished proliferative response to the lectin, and occurred with other interferon inducers including staphylococcal enterotoxin A . Adriamycin (0.4 microgram/ml) and vincristine (0.08 microgram/ml) also diminished IFN-gamma production, but only if the peripheral blood mononuclear cells were pretreated with the drugs . Methotrexate, 5-fluorouracil, and 6-mercaptopurine failed to influence the yield of IFN-gamma . These results are significantly different from experiments previously reported using alpha- and beta-interferons and suggest an important mechanism by which these drugs can produce immunosuppression. J Clin Immunol, 1984 Nov, 4(6), 455 - 60 Effects of staphylococcal protein A-treated human leukemic serum on autologous leukemic blast growth and mitogenesis of lymphocytes; Spitzer TR et al.; Sera and leukemic blasts of 14 patients with acute myelogenous leukemia were stored at -70 degrees C . In eight patients in whom a remission was achieved, peripheral blood lymphocytes were cultured together with irradiated autologous leukemic cells in treated serum (serum adsorbed with protein A Sepharose) or control serum (Sepharose-treated) . Lymphocyte activation was determined after 7 days in culture by {3H}thymidine incorporation . In the absence of stored leukemic blasts, significantly more {3H}thymidine incorporation occurred in six of the eight patients' lymphocytes cultured in treated serum compared to control . Enhanced activity was observed in all eight patients when irradiated leukemic blasts were cocultured with autologous lymphocytes in treated serum . In five patients, the addition of 10% or more of control serum to treated serum inhibited lymphocyte mitogenesis . Protein A immunoadsorption may allow increased stimulation of acute myelogenous leukemia remission peripheral blood lymphocytes, which is further enhanced in some patients by the presence of autologous leukemic cells . This change in lymphocyte activation may contribute to the antitumor effects of treating serum with protein A. J Immunol, 1984 Nov, 133(5), 2693 - 7 Humoral immunity in experimental syphilis: the demonstration of IgG as a treponemicidal factor in immune rabbit serum; Blanco DR et al.; The neutralizing activity present in immune rabbit serum (IRS) against virulent Treponema pallidum was shown to be mediated by IgG and complement . IgG was isolated and purified from both IRS and nonimmune rabbit serum (NRS) by the use of an affinity system in which staphylococcal protein A was conjugated to Sepharose 4B . The purity of the isolated IgG fractions was demonstrated by both immunoelectrophoresis and SDS-polyacrylamide gel electrophoresis . Fractions of IgG were tested for specific neutralizing activity as measured by an in vitro-in vivo neutralization test . Lesions failed to develop at 80% of the sites inoculated with treponemal suspensions containing IgG from IRS in the presence of unheated NRS as a source of complement; delayed atypical lesions were observed at the remaining sites . In contrast, typical lesions developed at all sites inoculated with suspensions containing IgG from IRS in the presence of heated NRS . They were significantly delayed, however, as compared with lesion development at control sites inoculated with suspensions containing IgG from NRS . These results provide the first direct evidence for an IgG complement-mediated treponemicidal mechanism operative in immune serum from rabbits with latent syphilis. Infect Immun, 1984 Nov, 46(2), 361 - 6 Ultrastructural localization of specific gonococcal macromolecules with antibody-gold sphere immunological probes; Robinson EN Jr et al.; In an effort to determine the ultrastructural location of specific macromolecules on the surface of intact microorganisms and in experimentally infected tissues, a new method of rapidly conjugating antibodies to gold spheres via a staphylococcal protein A intermediary has been developed . This new technique provides the excellent density of marking and versatility of sphere size provided by existing gold methods, but decreases preparation time, decreases the chance of bacterial contamination of antibody reagents, and increases specificity of marking . Staphylococcal protein A-coated gold spheres were conjugated with antibodies from rabbits immunized with purified gonococcal pili . The resulting gold-antibody conjugates allowed demonstration of antibody binding to pilus structures of the same gonococcal strain whose pili were used to raise the antibody and demonstration of the lack of antibody recognition of pilus structures on two other gonococcal strains . The failure of gold spheres to attach to isogenic nonpiliated clones of the homologous gonococcus indicated the absence of pilus antigens on the surface of these organisms . The use of a double label--small gold spheres conjugated to anti-pilus antibody and larger gold spheres conjugated to anti-protein I antibody--allowed the simultaneous localization of two gonococcal antigens. Gene, 1984 Nov, 31(1-3), 301 - 4 Construction of Staphylococcus plasmid vector pCA43 conferring resistance to chloramphenicol, arsenate, arsenite and antimony; Kreutz B et al.; The arsenate (Asa), arsenite (Asi) and antimony (III) (Amo) resistance region of the Staphylococcus xylosus 29.5-kb plasmid pSX267 has been recloned in S . carnosus using the chloramphenicol resistance (CmR) plasmid pC194 . In several deletion steps we constructed a 5.9-kb plasmid, pCA43, which confers resistance to Cm, Asa, Asi and Amo salts . pCA43 possesses unique sites for the restriction endonucleases PvuII, StuI, BamHI, AvaII, HindIII, PstI, XbaI and BclI . Insertional inactivation was achieved with StuI (affecting Cm resistance), BamHI (affecting only Asa resistance), AvaII, HindIII and PstI (affecting Asa, Asi and Amo resistances) . Plasmid stability was tested and found to be high after DNA insertion into the BamHI or HindIII sites. Infect Control, 1984 Oct, 5(10), 489 - 91 Evaluation of skin antisepsis prior to blood culture in neonates; Champagne S et al.; In our Intensive Care Nursery, coagulase-negative staphylococcus is the most frequent blood culture isolate . As skin antisepsis is critical in preventing blood culture contamination, we examined the efficacy of the chlorhexidine tincture (CH) used in our nursery for this purpose . Staphylococcus epidermidis colonized the forearms of 88% of infants tested, in a mean density of 10(4) organisms/cm2 . Following a 60-second application of CH (0.5% in 70% ethanol), bacterial growth from forearm skin remained abundant in 15/38 infants (39.4%) . Cleansing with 70% isopropyl alcohol, followed by CH as above, left abundant residual growth in only 1/37 infants (2.7%) (P less than 0.001) . All 136 S . epidermidis tested were susceptible to CH (MIC less than 5 micrograms/ml) and 14 of 15 exposed to CH 0.02% were rapidly killed (greater than or equal to 98% fall in viable counts within 90 sec) . We conclude that two-phase antisepsis using isopropanol followed by CH is a more effective preparation for blood culture in neonates than is CH alone. Pathology, 1984 Oct, 16(4), 441 - 6 Acute hematogenous staphylococcal osteomyelitis: evaluation of cloxacillin therapy in an animal model; Emslie KR et al.; A reproducible avian model of acute hematogenous staphylococcal osteomyelitis was used to investigate various aspects of antibiotic therapy using a single antibiotic, cloxacillin . The effects of both delaying antibiotic administration and increasing the frequency of antibiotic administration on the outcome of the disease were evaluated . Following bacterial inoculation, a delay in commencing therapy for 4 d in comparison to 1 d significantly reduced the likelihood of a favourable outcome . An increase in the frequency of antibiotic administration from once to 4 times daily resulted in significant improvement in the recovery rate of chickens . Whilst repeated antibiotic administration controlled the systemic effects of the disease and improved the clinical status of chickens, the local bone lesion was not always sterilized . The role of antibiotic therapy in acute hematogenous osteomyelitis is discussed in relation to these findings. Jpn J Antibiot, 1984 Oct, 37(10), 1780 - 4 {Prevention of postoperative infection following cardiac catheterization in pediatric field . Study of air-borne bacteria in X-ray room and evaluation of an antibiotic used for prevention of postoperative infection}; Kuno Y et al.; As part of preventive measures against postoperative infection following cardiac catheterization in infants with cardiac diseases, especially falling bacteria in X-ray room was studied . Moreover, a synthetic penicillin, ticarcillin (TIPC), was used as preventive antibiotic against postoperative infections due to falling bacteria which probably contaminate the air in the X-ray examination room, and the efficacy and side effects of the drug were observed . As result, coagulase-negative Staphylococcus was detected the most, followed by Micrococcus and then by fungus . The number of these 3 organisms corresponded to 90.3% of the total number of falling bacteria detected during operation . The number of falling bacteria during operation was 5.1 times larger than that before operation . Taking into account normal flora of skin, falling bacteria present in the X-ray room and causative organisms of bacterial endocarditis, TIPC was administered to 30 cases intravenously 5 times at a dose of 30 mg/kg every 8 hours for the purpose of preventing possible postoperative infections following cardiac catheterization . The drug was effective to prevent such infections in all cases . No side effects were noted in any case, in peripheral blood and hepatic function tests and other observations. J Antimicrob Chemother, 1984 Oct, 14(4), 359 - 66 In-vitro synergy testing of triple antibiotic combinations against Staphylococcus epidermidis isolates from patients with endocarditis; Yu VL et al.; In-vitro synergy testing was performed against ten blood or valve isolates of Staphylococcus epidermidis taken from patients with endocarditis . A three-dimensional microtitre checkerboard method was used for evaluation of vancomycin-rifampicin-gentamicin . The triple combination of vancomycin plus rifampicin plus gentamicin was found to be synergistic in 70% of the isolates . Vancomycin plus rifampicin was not synergistic . Oral agents including dicloxacillin, rifampicin, and fusidic acid were also evaluated . Four methicillin-resistant isolates were relatively resistant to dicloxacillin (MIC greater than 0.79 mg/l) but all four isolates were susceptible to fusidic acid alone and rifampicin alone . The triple combination of dicloxacillin plus fusidic acid plus rifampicin was found to be synergistic in 50% of the isolates and generally superior to any two-drug combination raising the possibility of an effective oral combination of antibiotics. EMBO J, 1984 Oct, 3(10), 2423 - 30 Three-dimensional structure of bovine pancreatic DNase I at 2.5 A resolution; Suck D et al.; The three-dimensional structure of bovine pancreatic deoxyribonuclease I (DNase I) has been determined at 2.5 A resolution by X-ray diffraction from single crystals . An atomic model was fitted into the electron density using a graphics display system . DNase I is an alpha, beta-protein with two 6-stranded beta-pleated sheets packed against each other forming the core of a 'sandwich'-type structure . The two predominantly anti-parallel beta-sheets are flanked by three longer alpha-helices and extensive loop regions . The carbohydrate side chain attached to Asn 18 is protruding by approximately 15 A from the otherwise compact molecule of approximate dimensions 45 A X 40 A . The binding site of CA2+-deoxythymidine-3',5'-biphosphate (Ca-pdTp) has been determined by difference Fourier techniques confirming biochemical results that the active centre is close to His 131 . Ca-pdTp binds at the surface of the enzyme between the two beta-pleated sheets and seems to interact with several charged amino acid side chains . Active site geometry and folding pattern of DNase I are quite different from staphylococcal nuclease, the only other Ca2+-dependent deoxyribonuclease whose structure is known at high resolution . The electron density map indicates that two Ca2+ ions are bound to the enzyme under crystallization conditions. Am J Vet Res, 1984 Oct, 45(10), 2084 - 5 Staphylococcus sciuri subsp lentus associated with goat mastitis; Poutrel B; An organism recovered from mastitic milks of goats was identified as Staphylococcus sciuri subsp lentus . Isolation of this organism in pure cultures from individual half-udder samples of 5 goats of 18 affected, confirms that it possesses pathogenic potential. Arch Intern Med, 1984 Oct, 144(10), 2083 - 4 'Culture-negative' prosthetic valve endocarditis . Hazards of postoperative steroid therapy for unexplained fever; Hilton E et al.; Two patients had prolonged unexplained fever along with multiple negative blood cultures after cardiac valve replacement surgery . Following the administration of corticosteroids for presumed postpericardiotomy syndrome, both patients improved symptomatically and defervesced, only to have positive blood cultures for Staphylococcus epidermidis shortly thereafter . The theoretical and practical risks of the empiric use of anti-inflammatory agents for unexplained post-operative fever are reviewed . "Culture-negative" prosthetic valvular infection due to prior antibiotic prophylaxis or therapy must be strongly considered in the evaluation of such unexplained fever. Laryngoscope, 1984 Oct, 94(10), 1277 - 80 Reconstruction of post-traumatic sinus osteomyelitis; Lekas MD et al.; Osteomyelitis with a fistulous tract of the left fronto-nasal area . The patient received an Anzio Beachhead WW II right fronto-nasal injury repaired with a lucite cranioplasty . A staphylococcal infection involved the remnant of the left frontal sinus with a fistula at the nasion near the orbital ridge . Bone scan revealed increased activity consistent with osteomyelitis . Patient was treated with intravenous oxacillin . The lucite skull prosthesis was removed 2 weeks after admission via the bilateral osteoplastic coronal flap approach with fat obliteration of the residual frontal sinus . The intravenous oxacillin was maintained for 48 days and the patient was discharged . The patient was later readmitted for a cranioplasty using a preformed tantalum plate . The nasal flange of the tantalum caused a deformity that did not allow the patient to wear his glasses . His third admission was for reconstruction of the tantalum and nasal deformity via a W-shaped incision. Am J Hematol, 1984 Oct, 17(3), 225 - 36 Human monocyte interaction with antibody-coated platelets . I . General characteristics; Court WS et al.; The interaction of human monocytes with antibody-coated and normal platelets was studied using an assay system that employed rate zonal centrifugation to separate monocyte-associated (bound) platelets from free platelets . At a monocyte:platelet ratio of 1:10, monocytes bound 21.2 +/- 6.6% of antibody-coated platelets and less than 2.2 +/- 1.3% of control platelets . Monocyte binding of antibody-coated platelets was rapid and inhibited by monomeric IgG and staphylococcal protein A . Specific binding was positively related to the number of monocytes present and the amount of IgG displayed on the platelet surface . Transmission and scanning electron micrographs illustrate the membrane binding of antibody-coated platelets to monocytes and suggest that phagocytosis of platelet targets occurs as well . Thus, these observations indicate that monocytes can participate in Fc-receptor binding of anti-PlA1-sensitized platelets . This novel assay may be useful in the analysis of monocyte-macrophage Fc-receptor interaction with platelets sensitized with IgG from both iso- and autoimmune disorders as well as in the characterization of treatment modalities which may alter monocyte Fc-receptor recognition and binding. Arch Mal Coeur Vaiss, 1984 Oct, 77(10), 1146 - 50 {Acute suppurative mediastinitis in heart surgery performed under extracorporeal circulation}; Amrein C et al.; The incidence of acute suppurative mediastinitis after open heart cardiac surgery in a 5 year retrospective study was found to be 1.56% . The commonest causal agent was the DNAse + coagulase + staphylococcus (68.8%) . All cases were treated with bactericidal antibiotics and local measures (dosed chest irrigation-drainage in 1 or 2 stages) . Adult men, early and/or late reoperation, immediate postoperative complications (cardiovascular collapse, haemorrhage) were positive risk factors . On the other hand, the type of underlying cardiac disease, the duration of surgery and bypass time, emergency surgery, and protocols of prophylactic antibiotic therapy did not seem to influence this risk . No sources of exogenous contamination, no notions of epidemics or periodicity were discovered in this study . The clinical course may be complicated, especially by renal failure . Thirty-two of the 109 patients studied died . However, the prognosis has improved in the last 5 years in relation to technical advances in intensive care and, above all, to adoption of 1 stage dosed chest irrigation-drainage: the mortality rate has fallen from 37.2% in the first period to 20% more recently . When a cure is obtained, it is complete and there are no sequellae . Nevertheless, irrespective of the adoption of draconian measures of asepsis and protocols of prophylactic antibiotic therapy, the risk of acute postoperative mediastinitis persists . This suggests that the efficacy of the patient's local (and general) anti-infective immunity defenses may vary in the presence of constant mediastinal bacterial contamination despite aleatory preventive measures, due to the remenance of the skin flora. Blood, 1984 Oct, 64(4), 807 - 16 Abnormal prothrombin crossed-immunoelectrophoresis in patients with lupus inhibitors; Edson JR et al.; Prothrombin deficiency has been known to occur in association with lupus inhibitors for over 25 years . We studied 21 patients with lupus inhibitors and found that four of five with prothrombin deficiency and ten of 16 with quantitatively normal prothrombin had abnormal prothrombin crossed-immunoelectrophoresis (CIEP) characterized by material moving slower in the first dimension of electrophoresis than normal prothrombin . In two patients with prothrombin deficiency, all prothrombin measured by quantitative assay and all slow-moving material on CIEP were removed by treatment with Staphylococcal protein A (SPA) . These patients had free antibody, which bound to normal plasma prothrombin, forming larger amounts of slow-moving material on CIEP . A third patient with prothrombin deficiency had only partial removal of prothrombin after SPA treatment . Two patients with quantitatively normal prothrombin had all slow-moving material on CIEP and about one fourth of the prothrombin by quantitative assay removed by SPA treatment . There was no correlation among the strength of the inhibitor, the presence of a "cofactor effect," and the prothrombin abnormality . These data suggest that heterogeneous antiprothrombin antibodies, with or without prothrombin deficiency, are present in the majority of patients with lupus inhibitors. J Comp Pathol, 1984 Oct, 94(4), 543 - 57 Fever and changes in plasma zinc and iron concentrations in the goat: the role of leukocytic pyrogen; Van Miert AS et al.; In goats with trypanosomiasis (T . vivax or T . congolense) no marked fall in plasma zinc concentration was seen despite high temperature peaks, whereas plasma concentrations of iron tended to undergo some decline . In goats infected with Ehrlichia phagocytophila, there was a marked decline in plasma zinc and iron to low values on the 3rd and 4th day, respectively . Circulating endogenous pyrogen (EP) or leukocytic endogenous mediator (LEM) could not be detected in plasma from febrile goats with tick-borne fever . The intravenous injection of leukocytic pyrogen (LP) in kids caused characteristic monophasic febrile reactions, whereas no significant changes in plasma trace metals were found . So, previous evidence purporting to show that LP is similar to or may be identical with LEM is demonstrably inconclusive . Intravenous injection of E . coli lipopolysaccharide (LPS) or staphylococcal enterotoxin B (SEB) induced fever and lowering of plasma zinc and iron concentrations . The decrease in those trace metal values was more persistent in goats given SEB than in those given E . coli LPS . After intramammary infusion of SEB or E . coli LPS, fever and significant decreases in plasma zinc and iron concentrations were observed but no clear relationship was found between the temperature responses and the alterations in plasma trace metal concentrations . Furthermore, the decrease in plasma iron concentration developed more rapidly in goats given SEB than in those given E . coli LPS, whereas the decrease in plasma zinc concentrations in the former was more delayed . These data support the theory that the concentrations of zinc and iron in plasma are regulated by different mechanisms, whereas febrile reactions are mediated by another type of endogenous protein. Burns Incl Therm Inj, 1984 Oct, 11(1), 16 - 25 An epidemiological profile and trend analysis of wound flora in burned children: 7 years' experience; Bowser-Wallace BH et al.; A retrospective chart review was conducted of 5418 culture and sensitivity reports from 93 paediatric burn patients to determine profiles of wound flora and invasive organisms, trend analysis and patterns of antibiotic resistance . Coagulase-positive Staphylococcus was the predominant burn wound pathogenic isolate and the predominant invasive organism for burns less than 60 per cent BSA . Pseudomonads were the predominant invasive organism for burn wounds greater than or equal to 60 per cent BSA . Only 7 per cent of all pathogenic isolates were fungi . A significant association was demonstrated between increasing burn size and an increasing incidence of Gram-negative and invasive organisms . Silver sulphadiazine remains a very effective topical agent for the control of bacterial and fungal growth in burn wounds after 10 years of intensive use in this burn unit . Pseudomonad isolates were routinely multi-drug resistant . Pseudomonad isolates from wounds treated topically with a silver sulphadiazine-cerium nitrate mixture were frequently resistant to aminoglycosides, colistin and carbenicillin . It is concluded from this review that severe restrictions on antibiotic usage within burn units, and strict internal environmental control within burn units may help to decrease the incidence of nosocomial resistant strains and cross infection . Regular monitoring of burn wound flora, and the protocol for wound care used in treating these patients have been effective in preventing septic episodes and death due to sepsis. J Infect Dis, 1984 Oct, 150(4), 535 - 45 Study of staphylococcal toxic shock syndrome toxin in human epithelial cell culture; Kushnaryov VM et al.; Staphylococcal toxic shock syndrome toxin (TST) inhibited growth of normal human epithelial (Chang) cells in culture, increasing the generation time 28% and 64% at concentrations of 4 X 10(-7)M and 8 X 10(-7)M, respectively . Fluorescence and electron microscopy of the cells treated with TST revealed the location of TST in the coated pits, specialized areas of the cell membrane known to contain high-affinity receptors for other polypeptide ligands . TST was labeled with 125I without detectable damage to the molecule and was shown to bind specifically to epithelial cells . A 100-fold excess of unlabeled TST inhibited binding of 125I-labeled toxin to the cells . Binding data indicated 10(4) receptor sites per cell for TST and a dissociation constant of 4 X 10(-9)M . Specific high-affinity binding of 125I-labeled TST to epithelial cells and the location of receptor sites in coated pits implies a possibility that the toxin is internalized by receptor-mediated endocytosis. J Am Acad Dermatol, 1984 Oct, 11(4 Pt 1), 653 - 60 New insight into the causes of immunodeficiency disorders; Ammann AJ; The ability to define subpopulations of immunologically competent lymphocytes has permitted an enhanced understanding of the interaction between functionally distinct components of the immune system . T cells can provide help in antibody formation or they may suppress antibody production . Abnormal immunoregulatory mechanisms have been demonstrated in the hyperimmunoglobulin E-recurrent infection syndrome . This disorder is associated with a marked elevation of IgE and specific elevations of IgE antibodies directed toward staphylococcal antigens . Abnormal T cell regulation of immune responses has been demonstrated . Graft-versus-host disease (GVHD) occurs in an immunodeficient patient who has received an infusion of immunocompetent cells . The diagnosis of graft-versus-host (GVH) reaction may be complicated by the protean manifestations of the disorder . The acute form, consisting of a maculopapular rash, fever, and diarrhea, may be confused with acute infection or drug reaction . Chronic GVHD has been incorrectly diagnosed as histiocytosis X, acrodermatitis enteropathica, or scleroderma . Utilizing chromosome markers and/or identification of histocompatibility antigens, the presence of circulating lymphocytes from donor immunocompetent cells (blood transfusion, maternal source) can be documented . The development of sensitive technics for identifying cells can establish a precise diagnosis . Certain immunodeficiency disorders can be identified by biochemical means . Biotin-dependent multiple carboxylase enzyme deficiency is associated with a chronic dermatitis, alopecia, ataxia, and secondary infection of the skin with Candida . The disorder responds promptly to the administration of biotin with correction of dermatologic, neurologic, and immunologic abnormalities. Chemioterapia, 1984 Oct, 3(5), 278 - 80 Inhibition of beta-lactamase production in gram-positive and gram-negative strains by sub-inhibitory concentrations of nalidixic acid; Repetto A et al.; We found it of interest to try to determine a microbiological parameter for the effects that sub-inhibitory doses of a chemotherapeutic agent may have on bacteria . To this end, the antibacterial activity of nalidixic acid was analyzed and our attention was directed to evidence of the production of beta-lactamase by 60 strains . The tests carried out showed that sub-inhibitory concentrations of nalidixic acid, from 2 to 64 times lower than the MIC (minimum inhibitory concentrations), were able to inhibit production of penicillinases in the 14 strains of Staphylococcus spp . tested, while only in 7 of the 21 strains of Gram-negative bacteria . Strains from our collection of beta-lactamase producing bacteria were analyzed, and our results confirmed that nalidixic acid inhibits plasmidic and chromosomic beta-lactamases. Cornell Vet, 1984 Oct, 74(4), 354 - 60 Effect of beta-lactamase of Staphylococcus intermedius on disk agar diffusion susceptibility tests; Roy AF et al.; Clinical strains of canine Staphylococcus intermedius (n = 120) were tested for susceptibility to beta-lactam antimicrobics (n = 6) by the standardized disk agar diffusion method and for beta-lactamase (BL) production . Significant differences between susceptibilities for BL producing (n = 68) and non-producing (n = 52) strains were found for penicillin G and ampicillin . Zone sizes of BL producing strains were significantly smaller than those of non-producers for penicillin G, ampicillin, cephalothin, carbenicillin and amoxicillin-clavulanic acid but not for methicillin . However, all strains were sensitive to cephalothin and amoxicillin-clavulanic acid; only one strain was resistant to methicillin; and one strain was intermediate in susceptibility to carbenicillin . Although 62 (52%) strains were sensitive to penicillin G and ampicillin based on established zone size interpretive criteria, 15 (24%) of these strains produced BL . Zone size measurements obtained with beta-lactam antimicrobics that are highly susceptible to inactivation by BL are not reliable and should be disregarded for canine S . intermedius which produce BL. Surgery, 1984 Oct, 96(4), 791 - 800 Serologic response to human melanoma lines from patients with melanoma undergoing treatment with vaccinia melanoma oncolysates; Wallack MK et al.; Specific active tumor immunotherapy methods offer the possibility of increasing the immunogenicity of tumor cells . One of these methods is viral oncolysis, in which tumor cells are modified by viral infection . We prepared vaccinia melanoma oncolysates (VMO) from human melanoma lines infected with vaccinia virus . In a preliminary trial at Washington University, sera from 12 patients with melanoma with stage I and II disease were obtained before and during treatment with VMO . The reactivity of these sera to melanoma lines was examined with a Staphylococcus protein A assay that detects most human IgGs . Our data demonstrate that, during treatment with VMO, sera from all 12 patients developed reactivity to melanoma lines . Selected sera were also tested in a double blind study by the C3-mixed hemadsorption assay, which detects mostly IgM . Results from this assay were in complete agreement with those obtained by the Staphylococcus protein A assay: Pretreatment sera were generally negative and sera obtained during treatment were positive . The specificity of these responses is presently under investigation . Our findings indicate that, as a consequence of treatment with VMO, a reactivity develops in the patients' sera . This reactivity is probably due to both IgG and IgM antibodies and its directed toward antigens expressed on human melanoma lines. Infect Immun, 1984 Oct, 46(1), 224 - 30 Ingestion and intracellular survival of Brucella abortus in human and bovine polymorphonuclear leukocytes; Riley LK et al.; Bovine polymorphonuclear leukocytes (PMNs) were found to be significantly more bactericidal than human PMNs against a smooth-intermediate strain of Brucella abortus (45/0), whereas there was no difference in bactericidal activity of the two kinds of PMNs against a rough strain of B . abortus (45/20) . Electron microscopy of thin sections of PMNs revealed that both strains of B . abortus were readily ingested; however, the extent of degranulation was significantly less than in PMNs incubated with an extracellular parasite, Staphylococcus epidermidis . Amounts of myeloperoxidase and lactoferrin released through exocytosis by PMNs incubated with S . epidermidis were 4.7- and 1.2-fold greater, respectively, than those released from PMNs incubated with B . abortus 45/0 . When azurophil and specific granules were isolated after incubation of PMNs with either B . abortus 45/0 or S . epidermidis, results showed that the extent of degranulation by both types of granules was greater in PMNs incubated with S . epidermidis than in those incubated with B . abortus 45/0 . Amounts of degranulation by azurophil and specific granules were similar in PMNs incubated with either the smooth-intermediate strain 45/0 or the rough strain 45/20 . Degranulation was not stimulated when glutaraldehyde-killed strain 45/0 was substituted for viable cells . These data suggest that B . abortus does not stimulate an effective level of degranulation after ingestion, as observed with extracellular parasites, and that the smooth intermediate strain 45/0 is more resistant to intraleukocytic killing system than the rough strain 45/20. Biochem Biophys Res Commun, 1984 Sep 17, 123(2), 444 - 51 Rat atrial natriuretic factor: isolation, structure and biological activities of four major peptides; Misono KS et al.; Four peptides possessing both natriuretic activity and smooth muscle relaxant activity were isolated from rat atrium and their amino acid sequences determined . The four peptides designated ANF-I, ANF-II, ANF-III and ANF-IV containing 35, 31, 30 and 25 amino acid residues, respectively, were obtained in a molar ratio of 4:60:20:16 . The predominant species ANF-II, which may represent the native form of ANF, has the following sequence: (H2N)-G-P-R-S-L-R-R-S-S-C-F-G-G-R-I-D-R-I-G-A-Q-S-G-L-G-C-N-S-F-R-Y-(COO H) in which Cys-10 and Cys-26 are disulfide linked . Cleavage of the aspartyl linkage at position 16 by staphylococcal protease caused complete inactivation, indicating that the ring conformation is essential . The dose-response relationships determined for the four peptides in relaxing norepinephrine-induced contraction of rabbit thoracic aorta showed half-maximum relaxation at concentrations ranging from 1.5 X 10(-9) to 2.5 X 10(-9) M . Comparable dose-response relationships were observed in relaxation of carbacol-induced contraction of chick rectum strips as tested with ANF-II and ANF-IV. J Immunol Methods, 1984 Sep 4, 72(2), 461 - 9 Microtiter radioimmunoprecipitation assay of HSV-1 polypeptides with recovery and SDS-PAGE analysis of precipitated proteins: usefulness as screening test for large numbers of specimens including hybridoma supernates; McKendall RR et al.; Immunoprecipitation of radiolabeled polypeptides from complex mixtures of proteins was performed in polystyrene microtiter plates using staphylococcus protein A and various antibody preparations . The method is (1) rapid, (2) uses multichannel micropipettor technology, (3) handles large numbers of specimens easily, (4) requires very small volumes of antigen and antibody (5-50 microliters), (5) provides replicates for statistical analysis and (6) allows recovery of precipitated proteins for direct SDS-PAGE analysis of precipitated proteins . We have shown it is useful as a test to screen large numbers of sera or to characterize monoclonal antibody-containing samples. J Surg Res, 1984 Sep, 37(3), 202 - 7 Tissue oxygen tension in externally stabilized tibial fractures in rabbits during normal healing and infection; Aro H et al.; Permanently implanted Silastic tonometers were used to measure average extracellular oxygen tension in the medullary cavity of osteotomized rabbit tibias stabilized with external pin fixation . During uncomplicated healing the baseline bone pO2 rose slowly with time from 10 to 20 mm Hg while during staphylococcal infection pO2 varied between 8 and 15 mm Hg and showed no correlation with the healing time . The maximal response of the bone pO2 to oxygen breathing correlated linearly with the healing time whether the osteotomy was infected or not . On the 42nd day the maximal pO2 during systemic hyperoxia was 85 mm Hg for the control bones, 42 mm Hg for the osteotomized bones, and 30 mm Hg for the infected osteotomized bones . The results indicate moderate bone tissue hypoxia during uncomplicated healing and more profound hypoxia during healing affected by infection. Infection, 1984 Sep-Oct, 12(5), 342 - 4 {Staphylococcus epidermidis causing infections in trauma surgery}; Hansis M et al.; During 27 months at the Tubingen Accident Hospital, Staphylococcus epidermidis could be found in 464 of 1824 bacteriological wound swabs . This normally had to be considered as contamination . However, in at least 69 cases, S . epidermidis alone undoubtedly caused or maintained a fresh or chronic infection of the bone and soft tissue following aseptic orthopedic surgery, whereby the infection was temporarily sustained by S . epidermidis during pathogen change . The findings are demonstrated and compared with the literature. Prikl Biokhim Mikrobiol, 1984 Sep-Oct, 20(5), 694 - 8 {Effect of gamma irradiation on immobilized trypsin}; Ryl'tsev VV et al.; The effect of ionizing radiation of 0.05-10 Mrad on trypsin immobilized on dialdehyde cellulose was being studied . After irradiation the activity of native trypsin decreases by 25%, as compared with the initial, while the activity of immobilized trypsin remains constant . Before immobilization cellulose undergoes special pretreatment that leads to a decrease in the initial contamination . Some samples of modified cellulose were contaminated by staphylococcus culture (200,000 microbes per 0.2 g) and then exposed to irradiation of 0.05-0.4 Mrad . A distinct correlation between the irradiation dose (0.05-0.4 Mrad) and contamination of the object was registered. Vet Microbiol, 1984 Sep, 9(5), 487 - 95 Production of enterotoxin(s) by Staphylococcus hyicus; Adesiyun AA et al.; Five strains of Staphylococcus hyicus (3 of subspecies hyicus and 2 of chromogenes) were tested serologically for their ability to produce known and unknown enterotoxin(s) and were also examined using monkey bioassays . None of the 5 strains produced any detectable level of the known enterotoxins A--E . However, all of them produced emetic responses in 2 or more of 6 cynomologus monkeys when culture growth was fed intragastrically . One of the 5 strains (S . hyicus subspecies hyicus, VII 76) produced emetic responses in 3 of 6 monkeys with 50 ml of culture growth . The other 4 strains required 1 l of culture broth (concentrated 20-fold) to produce an emetic response in at least 2 of 6 monkeys . Enterotoxin production is, therefore, not unique to S . aureus species . Since some of these organisms do not produce coagulase and thermonuclease, they would be ignored in food hazard evaluation. Diagn Microbiol Infect Dis, 1984 Sep, 2(4), 293 - 9 Incidence, adherence, and antibiotic resistance of coagulase-negative Staphylococcus species causing human disease; Needham CA et al.; Fifty-two isolates of coagulase-negative Staphylococcus species recovered from the blood or intravenous catheters of patients with clinically significant disease were compared to 60 similar isolates from patients who were presumably colonized . All isolates were identified and evaluated for ability to adhere to smooth surfaces, and resistance to anti-staphylococcal penicillins . S . epidermidis, S . hominis, and S . haemolyticus were the most frequently occurring species, representing 65%, 15%, and 10%, respectively, of disease isolates and 57%, 25%, and 8% of colonizers . The seven other species recovered accounted for only 10% of the total in both groups . Differences in isolation rates of each species within the two groups were not significant and were reflective of their reported incidence in the normal flora . All species of coagulase-negative Staphylococcus (except S . capitis and S . cohnii, which were isolated in very small numbers) were capable of adhering to smooth surfaces . S . hominis disease isolates were all capable of adherence, and the difference between the disease isolates and colonizers was statistically significant (p less than 0.02) . This was not true for any other species that was analyzed nor for all isolates considered as a whole . Resistance to anti-staphylococcal penicillins was documented for all coagulase-negative Staphylococcus species, and was more frequent in S . epidermidis disease isolates than colonizers (p less than 0.05) . No correlation was found between resistance to antistaphylococcal penicillins and ability to adhere. J Clin Pathol, 1984 Sep, 37(9), 1029 - 31 Influence of glycaemic normalisation by an artificial pancreas on phagocytic and bactericidal functions of granulocytes in insulin dependent diabetic patients; Gin H et al.; Ten insulin dependent diabetic patients were maintained in normoglycaemia for 36 h with an artificial pancreas . Circulating polymorphonuclear leucocytes were extracted and incubated with staphylococcus before and after treatment; phagocytic and bactericidal activities were studied . Granulocytes from diabetic patients showed a decreased ability to absorb staphylococcus and a reduced capacity for intracellular destruction of bacteria . These two functions were improved after 36 h of normoglycaemia but were not corrected. Infect Immun, 1984 Sep, 45(3), 566 - 71 Staphylococcal toxic shock toxin specifically binds to cultured human epithelial cells and is rapidly internalized; Kushnaryov VM et al.; Staphylococcal toxic shock syndrome toxin (TST) was labeled with 125I under mild conditions without apparent destruction of the molecule . {125I}TST bound specifically to human epithelial (Chang) cells in culture; the binding was inhibited by a 100-fold excess of unlabeled toxin . Scatchard analysis of the binding data indicated about 10(4) receptor sites per cell and a dissociation constant (Kd) of 4 X 10(-9) M . When cells pretreated with TST at 4 degrees C were swiftly transferred to 37 degrees C, the amount of surface-bound toxin rapidly declined, as determined by release of noninternalized label from the cell surface . Half-time (t1/2) of internalization was about 1.5 min . Ultrastructural studies showed that toxin labeled with ferritin-conjugated antibodies entered the cytoplasm via coated pits forming coated vesicles in the first 2 min of incubation at 37 degrees C . The coated vesicles coalesced with transport vesicles that are ultrastructurally unlike receptosomes . Thus, the unusual ultrastructural pattern of this internalization suggests that TST is initially internalized by receptor-mediated endocytosis and then enters an alternate pathway involving translocation in special transport vesicles, perhaps to other cells. Crit Care Med, 1984 Sep, 12(9), 838 - 9 Prolonged high-frequency jet ventilation; Mendez M et al.; A 26-yr-old woman with bilateral staphylococcal pneumonia developed respiratory failure . Conventional ventilation failed and high-frequency jet ventilation (HFJV) was successfully instituted . Bronchopleural fistulas required prolonged (73 days) support with HFJV . A bronchoscopy performed after 37 days of mechanical support showed no abnormalities . Computed tomography (CT) of the chest demonstrated severe cystic abnormalities . Pulmonary function tests performed 1 and 6 months after recovery showed small-airway dysfunction . HFJV proved safe for prolonged use. Ann Otol Rhinol Laryngol, 1984 Sep-Oct, 93(5 Pt 1), 483 - 7 Natural cytotoxicity and interferon production in patients with recurrent respiratory papillomatosis; Naiman HB et al.; The observation that interferon (IFN) therapy causes regression of lesions in some patients with recurrent respiratory papillomatosis (RRP) raises the possibilities that these patients may have abnormalities in endogenous IFN production or in antitumor immune responses stimulated by IFN . We have measured IFN production and natural cytotoxicity (NK activity) in nine patients with RRP, three of whom were receiving exogenous IFN at the time of testing . Production of IFN-gamma induced by the T cell mitogen Staphylococcus enterotoxin A was normal in all patients . Production of IFN-alpha induced by two viruses (Sendai and Newcastle disease viruses) was normal in the six untreated patients, but significantly lower in the patients on IFN therapy . Natural cytotoxicity against K562 target cells, both spontaneous and IFN-stimulated, was normal in all RRP patients tested . Thus, we have shown that the NK-IFN system was intact in untreated patients with RRP . IFN-alpha production in the RRP patients on IFN therapy was low . The significance of these findings is discussed. J Clin Invest, 1984 Sep, 74(3), 849 - 58 Staphylococcal alpha-toxin elicits hypertension in isolated rabbit lungs . Evidence for thromboxane formation and the role of extracellular calcium; Seeger W et al.; Staphylococcal alpha-toxin is known to damage mammalian cell membranes . Studies of erythrocytes indicate that the native toxin generates a discrete transmembrane channel with an effective diameter of 2-3 nm . (Fussle, R., S . Bhakdi, A . Szeigoleit, J . Tranum-Jensen, T . Kranz, and H.J . Wellensiek . 1981 . J . Cell Biol . 91:83-94.) In isolated rabbit lungs, perfused with recirculating blood- and plasma-free perfusion fluid, the mediation of a toxin-provoked vascular pressor response by the triggering of the arachidonic acid cascade and its dependence on extracellular calcium were investigated . Dose-dependent pulmonary artery pressor responses were elicited by the injection of 0.5-5 micrograms staphylococcal alpha-toxin into the pulmonary artery . The pressor responses were completely abolished by preincubation of the toxin with neutralizing antibodies or by preformation of alpha-toxin hexamers in vitro . They were accompanied by the release of the arachidonic acid metabolites thromboxane B2 and 6-keto-prostaglandin F1 alpha (stable metabolites of thromboxane A2 and prostaglandin I2, respectively) into the perfusion fluid . They were blocked by inhibitors of thromboxane synthetase, cyclooxygenase, and phospholipase, as well as by substances that interfere with calcium-calmodulin function . alpha-Toxin induced selective release of potassium, but not lactatedehydrogenase into the medium . Calcium depletion of the intravascular space did not suppress the toxin-dependent potassium release but did abrogate the pressor response and the release of the arachidonic acid metabo