FEBS Lett, 1995 Mar 6, 360(3), 231 - 4 The observation of a hedamycin-d(CACGTG)2 covalent adduct by electrospray mass spectrometry; Wickham G et al.; Covalent binding of the antitumour antibiotic hedamycin to the self-complementary hexadeoxyribonucleotide 5'-CACGTG-3' has been investigated by electrospray ionization mass spectrometry (ESI-MS) . Ions due to double-stranded forms of the free 5'-CACGTG-3' and the hedamycin-5'- CACGTG-3' adduct have been observed in ESI mass spectra and their identity has been confirmed by resolution of individual charge states in ESI-MS spectra . Clear evidence that specific base-paired associations are being observed in ESI-MS is provided by the results of a titration experiment involving alkylated and non-alkylated complementary strands . This work demonstrates the potential of this powerful new tool for studying ligand-DNA binding. Vet Rec, 1995 Mar 4, 136(9), 217 - 20 Severe post-dipping dermatitis and subcutaneous fluid swellings associated with two outbreaks of sheep scab (Psoroptes ovis infestation) Sargison ND, Scott PR, Clarke CJ, Penny CD, Pirie RS. Large subcutaneous fluid swellings developed on some of the sheep in two flocks infested with Psoroptes ovis during the two weeks after they had been plunge-dipped in phenol-based solutions . The swellings contained between 1 and 10 litres of exudate and affected 4 per cent of the sheep in each flock . The sheep with subcutaneous fluid swellings or exudative dermatitis had significantly lower serum albumin concentrations than the unaffected sheep (P < 0.05) . In most cases secondary bacterial infections of the exudate occurred and these necessitated intensive antibiotic therapy . The severity of the skin lesions posed a serious welfare problem. Presse Med, 1995 Mar 4, 24(9), 454 - 8 {Infection from arterial prostheses}; Goeau-Brissonniere O; Infection is a rare complication after implantation of arterial prostheses but the consequences can be particularly severe, both in terms of functional outcome and mortality . Due to this double risk, experimental models have been developed to better understand the pathophysiological mechanisms involved and elaborate preventive and curative strategies . Arterial allografts for in situ replacement constitute a major advance for the prevention of infection . An antibiotic-impregnated protein network fixed to the prosthesis is another promising approach, both for the prevention and the treatment of infected prostheses. Southeast Asian J Trop Med Public Health, 1995 Mar, 26(1), 188 - 92 Vaginal scrub prophylaxis in abdominal hysterectomy; Vinkomin V; This study was aimed at reducing postoperative infection after abdominal hysterectomy in Chon Buri Hospital . Thirty patients scheduled for total abdominal hysterectomy were randomly divided equally into two groups of 15 patients each and received different preoperative preparation procedures . Group I patients received the procedure routinely used at Chon Buri Hospital comprising vaginal scrubbing in the evening before the operation day followed by abdominal scrubbing in operating room, whereas group II patients received the same treatment as Group I with additional vaginal scrubbing with 10% povidone-iodine immediately prior to the operation . All patients were given routinely antibiotics prophylaxis . After removal of the uterus, the discharge from the vaginal cuff was taken before and after closing the vaginal stump for aerobic and anaerobic cultures . Only 3 of group II patients (20%) were culture-positive before closure of vaginal cuff compared with 11 (73%) of group I patients (p < 0.01) . After closure of the vaginal cuff, the positive bacterial culture declined to 5 (33%) in group I and 2 (13%) in group II (p > 0.05) . Most of isolated organisms were vaginal normal flora . Postoperative infection with E . coli occurred in 2 patients of group I and none of group II (p > 0.05) . Our results suggested that additional prophylactic vaginal scrubbing reduced postoperative bacterial infections, but this observed reduction did not reach a statistically significant level . Thus a larger sample size is needed to substantiate whether vaginal scrubbing could be advocated in a routine practice. Am J Physiol, 1995 Mar, 268(3 Pt 2), F391 - 7 H(+)-peptide cotransport in Madin-Darby canine kidney cells: expression and calmodulin-dependent regulation; Brandsch M et al.; The transport of the dipeptide glycylsarcosine was studied in the kidney cell lines OK, LLC-PK1, and Madin-Darby canine kidney (MDCK), grown as confluent monolayers on impermeable plastic supports . Uptake of the dipeptide in OK and LLC-PK1 cells was slow, was not inhibited by other peptides, and was not influenced by an inwardly directed H+ gradient, indicating lack of expression of the H(+)-peptide cotransport system in these cells under our conditions . In contrast, uptake of the dipeptide in MDCK cells was rapid and was found to be stimulated by an inwardly directed H+ gradient . This stimulation was markedly reduced by the protonophore carbonyl cyanide p-trifluoromethoxy-phenylhydrazone . The H+ gradient-dependent uptake of glycylsarcosine was inhibited by dipeptides and tripeptides and by the beta-lactam antibiotic cephalexin but not by the amino acids glycine and leucine . The uptake was saturable and apparently occurred via a single transport system . The Michaelis-Menten constant for the system was 1.3 +/- 0.1 mM, and the maximal velocity was 13.3 +/- 0.7 nmol.30.min-1.mg protein-1 . Treatment of MDCK cells with the calmodulin antagonists N-(6-aminohexyl)-5-chloro-1-napthalenesulfonamide (W-7), CGS-9343B, or calmidazolium inhibited the glycylsarcosine uptake by 40-50% in a time- and dose-dependent manner . In contrast, the uptake of alanine, leucine, glucose, and taurine was found to be stimulated by treatment with W-7 . Kinetic analysis revealed that the inhibition of the peptide transport activity was mainly associated with a decrease of the maximal velocity of the system.(ABSTRACT TRUNCATED AT 250 WORDS) Medicine (Baltimore), 1995 Mar, 74(2), 107 - 8 AIDS in India; Bartlett JG; PIP: The first case of AIDS in India was reported in 1986 . It is now estimated, however, that more than 1.5 million people in the country are infected with HIV, with current projections indicating that India will have more cases of AIDS than any other country in the world by the year 2000 . The HIV epidemic in India is similar in many ways to the epidemics in sub-Saharan Africa and Thailand . Heterosexual intercourse is the main mode of viral transmission, with prostitution and an high prevalence of genital ulcer diseases appearing to be the major contributing factors . Wasting is especially common and Pneumocystis carinii appears to be rare . Tuberculosis is the most dominant opportunistic pathogen among people with HIV in India . The high rates of antibiotic use and abuse, however, suggest the development of multi-drug resistance now or in the near future . The serious nature of the HIV epidemic in India reflects the lack of public health efforts and public education . For example, there is no standardized national program to report cases, the illegal status of homosexuality and prostitution make it difficult to get reliable data on risk factors in official reports, much of the blood supply is not screened, and HIV education is extremely limited . One survey found 40% of physicians unaware that HIV causes AIDS, and 25% believing that AIDS can be transmitted through causal contact . Reprehensible conditions, indeed, ten years into the epidemic . Am Fam Physician, 1995 Mar, 51(4), 821 - 6 Screening for Chlamydia trachomatis infection; Skolnik NS; Infection with Chlamydia trachomatis can be either symptomatic or asymptomatic . In adults, complications include infertility, chronic pelvic pain and ectopic pregnancy . Complications in newborns include conjunctivitis and pneumonia . Screening of asymptomatic women at high risk for the disease can identify candidates for antibiotic therapy . Until recently, chlamydia cell culture was the only diagnostic test and it was not widely available . Because the specificity of cell culture is 100 percent, it remains the standard against which other tests are measured . The recent development of nonculture tests makes it feasible for most laboratories and physicians' offices to offer testing . The main disadvantage of nonculture tests is low specificity . A positive screening test in a woman at low risk should be confirmed by a second test . Routine screening and treatment of patients who are at high risk can decrease the incidence, complications and transmission of chlamydial infection. Am J Respir Crit Care Med, 1995 Mar, 151(3 Pt 2), S70 - 4 Aerosolized dornase alfa (rhDNase) for therapy of cystic fibrosis; Hodson ME; The major causes of morbidity and mortality in cystic fibrosis (CF) are the obstruction and damaged airways that result from the accumulation of viscid and infected secretions . Dornase alfa, also called recombinant human DNase I (rhDNase), cleaves extracellular DNA, which is present in inordinately high concentrations in purulent CF airway secretions . Dornase alfa has been found to increase the pourability and reduce the viscoelasticity of CF sputum in vitro and, in an animal model, to increase its mucociliary transportability . Short-term (10-day) Phase I and II clinical trials showed dornase alfa to be safe and effective in improving pulmonary function in clinically stable CF patients with mild to moderate pulmonary disease (FVC > or = 40% of predicted value) . A long-term (24-week) Phase IIB clinical trial demonstrated the importance of administering dornase alfa daily to maintain its efficacy . A large-scale, long-term, Phase III clinical trial, consisting of a 24-week double-blind period and a 24-week open-label extension, confirmed these findings and further demonstrated that dornase alfa reduces the incidence of respiratory tract infectious exacerbations requiring parenteral antibiotic therapy . Dornase alfa also decreased the rate of hospitalizations, the number of days missed from work or school, and the frequency of CF-related symptoms . Adverse events were limited to upper airway irritation (i.e., voice alteration, laryngitis, pharyngitis), rash, chest pain, and conjunctivitis . These manifestations generally were mild and transient, and they did not limit the use of dornase alfa . A small proportion (2 to 4%) of patients developed serum antibodies to dornase alfa, but no patient developed anaphylaxis.(ABSTRACT TRUNCATED AT 250 WORDS) Am J Surg, 1995 Mar, 169(3), 320 - 3 The surgical implications of chronic granulomatous disease; Eckert JW et al.; BACKGROUND: Chronic granulomatous disease (CGD) of childhood is a rare congenital abnormality of the phagocyte NADPH oxidase system . Affected neutrophils and macrophages have an ineffective respiratory burst and cannot destroy certain phagocytized bacteria and fungi . CGD patients usually present with recurrent pyogenic and fungal infections . Catalase-positive bacteria are frequently involved, since they metabolize the hydrogen peroxide they produce, making it unavailable for augmentation of microbicidal activity in CGD neutrophils . Afflicted patients also have a tendency to form granulomas, which can lead to obstruction of the gastrointestinal and genitourinary tracts . METHODS: Charts of 10 patients with CGD were reviewed for age at diagnosis, surgical procedures, complications of these procedures, and medical treatment . RESULTS: Eight of the 10 children were male . The average age at first presentation was 18 months (range 2 days to 9.8 years) . Each child developed a mean of 9.9 infections and an average of 1.4 infections per year . All required surgical procedures, with an average of 2.9 procedures each . Five children had operative procedures for infections that preceded the diagnosis of CGD . The procedures performed most frequently were incision and drainage of soft-tissue abcesses (7) or perirectal abscess (3), thoracentesis (3), and bronchoscopy (3) . Three children had poor wound healing following surgery . Two developed partial gastric outlet obstruction which resolved with antibiotic therapy . One developed granulomatous cystitis with obstruction which responded to antibiotics . CONCLUSIONS: Since patients with undiagnosed CGD may present with surgical problems, surgeons need to be familiar with this condition . The diagnosis should be suspected in children who have recurrent or unusual infections or unexplained problems with wound healing. Hepatology, 1995 Mar, 21(3), 674 - 9 Two different dosages of cefotaxime in the treatment of spontaneous bacterial peritonitis in cirrhosis: results of a prospective, randomized, multicenter study; Rimola A et al.; Cefotaxime (CTX) is considered one of the first-choice antibiotics in the therapy of spontaneous bacterial peritonitis (SBP) in cirrhosis . Because CTX is largely metabolized in the liver, this drug may also be effective in SBP by administering lower doses than those habitually used . To investigate this possibility, a prospective, randomized, multicenter study was performed to compare the therapeutic efficacy of two different dosages of CTX in 143 patients with SBP: 71 (group I) were allocated to receive a high dose (2 g every 6 hours, which is one of the most frequently recommended doses in this infection), and 72 (group II) were allocated to receive a low dose (2 g every 12 hours) . At inclusion, both groups were similar in relation to clinical and laboratory data, with the exception of a higher incidence of positive ascitic fluid culture in group I than in group II (59% vs . 40%; P = .029) . The rate of infection resolution was similar for both groups (77% vs . 79%) . Hospital survival was also similar in both groups (69% vs . 79%) . No difference was observed between patients with positive or negative ascitic fluid cultures with regard to infection resolution and patient survival . The duration of antibiotic therapy was similar in both groups (9.0 +/- 3.3 days in group I vs . 8.8 +/- 3.1 days in group II) . In a subset of 13 patients from group I and 11 patients from group II CTX levels were determined in serum (peak and trough) and ascitic fluid (concomitantly with trough serum) . Peak serum levels were similar in patients from both groups.(ABSTRACT TRUNCATED AT 250 WORDS) J Bacteriol, 1995 Mar, 177(5), 1216 - 24 Regulation of daunorubicin production in Streptomyces peucetius by the dnrR2 locus; Otten SL et al.; Sequence analysis of the dnrR2 locus from the cluster of daunorubicin biosynthesis genes in Streptomyces peucetius ATCC 29050 has revealed the presence of two divergently transcribed open reading frames, dnrN and dnrO . The dnrN gene appears to encode a response regulator protein on the basis of conservation of the deduced amino acid sequence relative to those of known response regulators and the properties of the dnrN::aphII mutant . Surprisingly, amino acid substitutions (glutamate and asparagine) at the putative site of phosphorylation (aspartate 55) resulted in a reduction rather than a complete loss of DnrN activity . The deduced DnrO protein was found to be similar to the Streptomyces glaucescens tetracenomycin C resistance gene repressor (TcmR) and to two Escherichia coli repressors, the biotin operon repressor (BirA) and the tetracycline resistance gene repressor (TetR) . The dnrN::aphII mutation was suppressed by introduction of the dnrI gene on a plasmid . Since the introduction of dnrN failed to restore antibiotic production to a dnrI::aphII mutant, these data suggest the presence of a regulatory cascade in which dnrN activates the transcription of dnrI, which in turn activates transcription of the daunorubicin biosynthesis genes. Pediatrics, 1995 Mar, 95(3), 373 - 7 The diagnostic utility of bronchoalveolar lavage in immunocompetent children with unexplained infiltrates on chest radiograph; Rock MJ; OBJECTIVE . To assess the diagnostic utility of bronchoalveolar lavage (BAL) in a heterogeneous group of immunocompetent children with unexplained infiltrates on chest radiograph . DESIGN . This was a retrospective case series . SETTING . The setting was a tertiary care referral center in an urban children's hospital . PATIENTS . Twenty-five consecutive children, median age 4 years 6 months, had flexible bronchoscopy with BAL . Preprocedure diagnoses were right middle-lobe syndrome (3 patients), granulomatous lung disease (3 patients), adult respiratory distress syndrome (3 patients), and persistent infiltrate on chest x-ray (16 patients) . The majority of patients were receiving parenteral antibiotics before bronchoscopy . BAL fluid was sent for bacterial, viral, fungal, and, if indicated, mycobacterial cultures . RESULTS . Twenty-seven procedures were performed in 25 patients . A specific diagnosis was made in eight (30%) of the procedures . Four patients had viral infections, two had fungal infections, one had a bacterial infection, and one had a mixed fungal and bacterial infection . CONCLUSION . Submitting BAL fluid for bacterial, viral, and fungal culture can be helpful in diagnosing infection in immunocompetent children . Empiric antibiotic therapy remains the standard treatment for pneumonia in children . Bronchoalveolar lavage may yield a diagnosis in patients unresponsive to empiric antibiotics . Careful selection of patients, a bronchoscopist skilled in the procedure, and the risk/benefit ratio all must be considered. JAMA, 1995 Mar 1, 273(9), 712 - 20 Foot infections in diabetic patients . Decision and cost-effectiveness analyses; Eckman MH et al.; OBJECTIVE--To examine the cost-effectiveness of approaches to the diagnosis and treatment of patients with type II (non-insulin-dependent) diabetes mellitus (NIDDM) who have foot infections and suspected osteomyelitis . DESIGN--Decision and cost-effectiveness analyses were performed using a Markov model . We examined the prevalence of osteomyelitis, the major complications and efficacies of long-term antibiotic therapy and surgery, and the performance characteristics of four diagnostic tests (roentgenography, technetium Tc 99m bone scanning, indium in 111-labeled white blood cell scanning, and magnetic resonance imaging) . Data were drawn from the English-language literature using MEDLINE searches and bibliographies from selected articles . SETTING--Primary care . PATIENTS--Patients with NIDDM who had foot infections and suspected osteomyelitis but no signs of systemic toxicity . INTERVENTIONS--Following hospitalization for surgical debridement and intravenous antibiotic therapy: (1) treatment for presumed soft-tissue infection, (2) culture-guided empiric treatment for presumed osteomyelitis, (3) 71 combinations of diagnostic tests preceding antibiotic therapy for osteomyelitis, (4) 71 combinations of tests preceding amputation, and (5) immediate amputation . MAIN OUTCOME MEASURES--Quality-adjusted life expectancy, average costs . RESULTS--Culture-guided empiric treatment for osteomyelitis with 10 weeks of oral antibiotic therapy has similar effectiveness to testing followed by a long course of antibiotic therapy if any test result is positive . However, empiric treatment is the least expensive strategy . CONCLUSIONS--Noninvasive testing adds significant expense to the treatment of patients with NIDDM in whom pedal osteomyelitis is suspected, and such testing may result in little improvement in health outcomes . In patients without systemic toxicity, a 10-week course of culture-guided oral antibiotic therapy following surgical debridement may be as effective as and less costly than other approaches. Reprod Toxicol, 1995 Mar-Apr, 9(2), 159 - 64 Teratogenic effects of DA-125, a new anthracycline anticancer agent, in rats; Chung MK et al.; DA-125 is a new anthracycline antitumor antibiotic derived from adriamycin . Preclinical studies suggest that it may have greater activity and less cardiac toxicity than adriamycin . The potential of DA-125 to induce embryotoxicity was investigated in the Sprague-Dawley rat . One hundred twenty mated SD rats (sperm in vaginal lavage = day 0) were distributed among three treated groups and a control group . DA-125 was given at dose levels of 0, 0.1, 0.3, and 1.0 mg/kg/day administered intravenously to pregnant rats from days 7 to 17 of gestation . All dams were subjected to caesarean section on day 20 of gestation . At 1 mg/kg/day, reduced food intake, reduced body weight, and decreased spleen weight were observed in dams . An increase in the resorption rate and a reduction in the fetal weight were also found . In addition, various types of external, visceral, and skeletal malformations occurred at an incidence of 11.9, 41.8, and 14.5%, respectively . Characteristic malformations included exencephaly, gastroschisis, cleft lip, dilatation of lateral and third ventricles, and fused ribs, among others . There were no signs of maternal toxicity or embryotoxicity at 0.1 and 0.3 mg/kg . The results show that DA-125 is teratogenic at a minimally maternally toxic dose in rats. Vopr Med Khim, 1995 Mar-Apr, 41(2), 8 - 11 {Production and some properties of covalent conjugates of total histone and kanamycin}; Matiushichev VB et al.; A complex containing total histone and antibiotic kanamycin was produced under optimal conditions using glutaric aldehyde . The obtained water-soluble covalently bound conjugates of these substances were identified by means of enzyme labelled immunoassay and their molecular mass estimated . The validity of new class of highly effective drugs, which may be produced basing on the principles studied, was substantiated considering that histones exhibit the transport properties and are able to augment hematoencephalic barrier permeability. Eur Respir J, 1995 Mar, 8(3), 467 - 9 Occupational asthma, rhinitis and urticaria due to piperacillin sodium in a pharmaceutical worker; Moscato G et al.; A 28 year old man with no history of atopy was referred to our hospital for possible work-related asthma . He had been employed in the production section of a pharmaceutical company for 2 yrs, and in the last 2 months he had complained of dyspnoea, wheezing, chest tightness, symptoms of rhinitis and a cutaneous rash when exposed to powdered antibiotics . Symptoms disappeared after being transferred to the packaging section . When the subject was admitted to our department he was asymptomatic . Basal lung function tests were in the normal range . Bronchial challenges with methacholine and with ultrasonically-nebulized distilled water were negative . Skin-prick test with piperacillin sodium gave a strong positive response at a very low concentration . Specific inhalation challenge with piperacillin sodium resulted in an immediate asthmatic reaction, and also reproduced rhinitis symptoms and the cutaneous rash . A control challenge with lactose, and the specific challenge test with cefuroxime sodium (another antibiotic to which the patient was exposed at the workplace) were negative . We conclude that piperacillin sodium is an agent that can cause occupational asthma. Stem Cells, 1995 Mar, 13(2), 94 - 100 Hematopoietic growth factors for the treatment of severe chronic neutropenia; Dale DC; Severe chronic neutropenia (SCN) is a rare but important cause of recurrent fevers, oropharyngeal ulcerations and severe infections . In three forms of SCN, i.e., congenital neutropenia (Kostmann's syndrome and related syndromes), idiopathic neutropenia (both childhood and adult), and cyclic neutropenia, it is now established that long-term treatment with the hematopoietic growth factor, recombinant human granulocyte colony stimulating factor (rHuG-CSF or Filgrastim), can elevate blood neutrophil counts to the normal range in most patients, with a concomitant reduction in infection-related events including fever, oral ulcerations, antibiotic use and symptoms of inflammation . Treatment with this growth factor causes an increase in the number and maturity of marrow cells of the neutrophilic series; other cell lines are largely unaffected . Marrow stimulation and expansion are reflected by the occurrence of bone pain early in therapy, as well as some increase in spleen size in most cases . Adverse effects of therapy are infrequent in both children and adults, and long-term treatment with daily or every-other-day s.c . injections of rHuG-CSF are well accepted . Because of the risk that some patients with chronic neutropenia may have or develop myelodysplasia and/or leukemia, careful pretreatment evaluations (blood, bone marrow and cytogenetics) and long-term observations are extremely important . An international registry for patients with SCN has been established to maintain records and further investigate these conditions. J Child Neurol, 1995 Mar, 10(2), 105 - 9 Does iron deficiency raise the seizure threshold? Kobrinsky NL, Yager JY, Cheang MS, Yatscoff RW, Tenenbein M. To determine the effect of iron status on the seizure threshold, measures of iron sufficiency were prospectively evaluated in 51 children presenting to a pediatric emergency department with a febrile illness with (26) or without (25) an associated febrile seizure . A higher proportion of children from the febrile seizure group had a family history of mental retardation (5/26 versus 0/25, P = .02) or of previous febrile seizures (10/26 versus 2/23, P = .01) . The two groups were otherwise comparable for age, sex, race, family history of afebrile seizures, temperature at presentation, white blood cell count, differential, and vitamin and antibiotic use . Patients with febrile seizures were less frequently iron deficient as defined by a free erythrocyte protoporphyrin level above 0.80 ng/L (2/23 versus 10/25, P < .01), hemoglobin concentration less than 110 g/L (1/26 versus 6/25, P < .03), hematocrit less than 0.30 L/L (0/22 versus 4/25, P < .02), mean corpuscular hemoglobin less than 20 pg (0/25 versus 3/24, P < .04), mean corpuscular volume less than 65 fL (0/26 versus 4/24, P < .02), and platelet count higher than 550 x 10(9)/L (0/26 versus 3/25, P < .04) . This association was even stronger when adjusted for differences in family history . None of the patients in the febrile seizure group was being treated for iron deficiency at presentation, whereas three of 25 controls used an iron supplement (P < .04) . Iron deficiency may protect against the development of febrile seizures. Childs Nerv Syst, 1995 Mar, 11(3), 129 - 32 Timing of surgery in patients with infected spinal dermal sinuses: report of two cases; Calvit MF et al.; In the past, if infection was present at the time a spinal dermal sinus was discovered, the sinus opening and cerebrospinal fluid were sterilized with a course of appropriate antibiotic therapy prior to the surgical intervention . The cases of two children with an infected spinal dermal sinus are reported here . One patient developed acute paraplegia during the initial stage of antibiotic therapy, and the second patient, who was admitted only with signs of fever and irritability, experienced after antibiotic therapy a complete myelographic blockade secondary to a large infected intradural dermoid tumor . The authors stress the importance of early neuroradiological and neurosurgical management of these lesions, even when an infection is present. Neurol Med Chir (Tokyo), 1995 Mar, 35(3), 160 - 4 Diagnosis and treatment of brainstem abscess using magnetic resonance imaging and microsurgical aspiration--case report; Imai H et al.; A 6-year-old boy presented with a pontine abscess initially misdiagnosed as brainstem glioma, but he deteriorated rapidly and developed new symptoms of respiratory distress . Magnetic resonance (MR) imaging revealed a rapidly growing mass lesion in the pons . Microsurgical evacuation of the abscess via a suboccipital retromastoid approach resulted in neurological improvement and resolution of the lesion on MR images . Brainstem abscess can be successfully treated with early, accurate diagnosis based on MR imaging and appropriate microsurgical and antibiotic management. J Clin Gastroenterol, 1995 Mar, 20(2), 154 - 6 D-lactic acidosis in a patient with jejunoileal bypass; Kadakia SC; D-Lactic acidosis is an unique complication of jejunoileal bypass occurring because of alteration of colonic bacterial flora with selective proliferation of D-lactate-producing bacteria . The D-lactate accumulation in the serum is associated with encephalopathy, which responds to oral antibiotic drugs in most patients . Because gastroenterologists may encounter such patients for some time to come, we report a new case and review the literature. Vnitr Lek, 1995 Mar, 41(3), 179 - 81 {Drugs affecting gastric acidity in the therapy of ulcer disease}; Jirasek V; The most substantial factor in the pathogenesis of peptic ulcers of the gastroduodenum is a preserved HCl secretion (frequently hypersecretion) and the presence of Helicobacter pylori . In some of the ulcers a part is played by non-steroid antirheumatic drugs . In the treatment inhibition of acid secretion by antagonists of H2 receptors proved useful as they heal approximately 80% ulcers in the course of four weeks . Drugs of this group however, do not resolve the main problem of anti-ulcerous treatment, i.e . the liability of ulcers to relapse . 70-80% of the patients develop a relapse within one to two years . Moreover, in 5-10% of the patients the ulcers are resistant to treatment with H2 receptor antagonists . An obvious advance in treatment are inhibitors of the proton pump which intensely inhibit HCl secretion independently on the type of stimulation . At present in clinical practice omeprazole, lansoprazole and pantoprazole are used, all being derivates of benzimidazole . They are the drugs of choice in ulcers resistant to H2 receptor antagonists, in severe forms of reflux oesophagitis in Zollinger-Ellison's syndrome, in ulcers induced by non-steroid antirheumatics . The most substantial fact is that in combination with amoxacillin (or another suitable antibiotic) in 70-80% of cases they eradicate also Helicobacter pylori and heal in a large percentage (70-80%) the ulcerous defect within two weeks. Res Vet Sci, 1995 Mar, 58(2), 123 - 7 Disposition of antimony and aminosidine in dogs after administration separately and together: implications for therapy of leishmaniasis; Belloli C et al.; The pharmacokinetic behaviour of aminosidine (15 mg kg-1) and antimony (25.65 mg kg-1 as N-methylglucamine antimoniate), administered subcutaneously either separately or together was studied on four dogs . The results demonstrated that antimony (Sb) did not significantly modify the kinetics of aminosidine (AM) but that the kinetic behaviour of the metal was markedly influenced by the antibiotic, as shown by the differences in mean residence time (MRT), elimination rate constant (Kel) and area under the curve (AUC) with and without the antibiotic (MRT{Sb} = 243.8 +/- 29.5 minutes, MRT{Sb+AM} = 1067.9 +/- 199.2 minutes; Kel{Sb} = 0.008 +/- 0.001 min-1, Kel{Sb+AM} = 0.0015 +/- 0.0003 min-1; AUC{Sb} = 21,024.6 +/- 4448.5 micrograms min ml-1, AUC{Sb+AM} = 130,478.5 +/- 30,481.7 micrograms min ml-1) . The persistence of high serum concentrations of antimony when it was administered with aminosidine suggests that the therapeutic doses commonly used should be reduced and that the interval between administration should be increased to avoid the metal reaching toxic concentrations. HNO, 1995 Mar, 43(3), 188 - 90 {Unilateral recurrent nerve paralysis in suspected Lyme borreliosis}; Neuschaefer-Rube C et al.; Cranial nerve palsy can often be observed in Borrelia burgdorferi infection . A dysphonic patient with a long lasting left-sided recurrent nerve palsy was treated with ceftriaxone, an antibiotic drug for the therapy of Lyme borreliosis . On the 7th day of application the paretic vocal fold showed recovering movements up to regular vocal fold function and normal stroboscopic results . Clinical and serologic constellations and their therapeutical implications are discussed. Z Orthop Ihre Grenzgeb, 1995 Mar-Apr, 133(2), 166 - 75 {The use of massive allograft in reconstruction following resection of bone tumors of the extremities}; Wuisman P et al.; Reported are indications, techniques and clinical outcome of 45 patients with resection of a primary malignant or aggressive benign tumor of the extremities, reconstructed with an allograft . The goal of this procedure is to achieve a wide resection of the tumor and to reconstruct the defect saving the limb . Bridging the osseous defect, we used an osteochondral allograft (14), intercalary allograft (16), allograft arthrodesis (14) and composite reconstruction (1) . There were 3 deep infections, 3 superficial infections, 2 pseudarthrosis and 1 rejection found as complications . After local revision of the infections by allograft explantation and temporary implantation of antibiotic-loaded chains, another allograft could be implanted with success . Using different, individual adapted operative methods and allografts, a broad spectrum of bone defects after resection of bone tumors and, if necessary revisions, can be treated. Med J Malaysia, 1995 Mar, 50(1), 42 - 51 Outcome of inborn compared with outborn very low birth weight infants admitted to level 3 Malaysian nurseries . Neonatal Data Collection Group; Therapeutic lamellar keratectomy in the management of nontuberculous Mycobacterium keratitis refractory to medical treatments; Department of Ophthalmology, National Cheng Kung University Hospital, Tainan, Taiwan, R.O.CNontuberculous Mycobacterium keratitis is characterized by its indolent course and poor response to antibiotic drugs . Between November 1989 and September 1993, 10 eyes diagnosed to have nontuberculous Mycobacterium keratitis underwent therapeutic lamellar keratectomy in conjunction with fortified topical medications . Nine operated eyes (90%) recovered with a shortened course and healed with an inactive scar . Six patients (60%) achieved a visual acuity of 20/40 or better postoperatively . For recalcitrant nontuberculous Mycobacterium keratitis, therapeutic lamellar keratectomy is highly recommendable for patients with intractable paracentral or peripheral ulcer, for uncompliant patients, for patients who cannot tolerate drug-induced ocular toxicity, or when penetrating keratoplasty is to be reserved for late rehabilitation of the eye. Eur J Gastroenterol Hepatol, 1995 Mar, 7(3), 283 - 6 Primary pulmonary hypertension developing 11 years after a splenorenal shunt for portal hypertension in hepatic cirrhosis; Shah HA et al.; OBJECTIVE: To describe a patient with pulmonary and portal hypertension and to review the pathogenesis and management of this condition . PATIENT: A 22-year-old woman with portal hypertension and liver cirrhosis who later developed pulmonary hypertension . INTERVENTIONS: The patient received antibiotic therapy and underwent a splenectomy and proximal splenorenal shunt for portal hypertension . She later received hydralazine, digoxin and warfarin for pulmonary hypertension . MAIN OUTCOME MEASURES: After undergoing a splenorenal shunt the patient made a good recovery . However, she later developed pulmonary hypertension and died after undergoing a hysterectomy and a bilateral salpingo-oophorectomy . CONCLUSIONS: The concomitant development of portal and pulmonary hypertension in the same patient has a poor prognosis . The treatment available for patients with these conditions is unsatisfactory and most patients eventually die as a result of cardiovascular disease . Cardiopulmonary and liver transplantation should be considered in suitable patients. Nippon Jibiinkoka Gakkai Kaiho, 1995 Mar, 98(3), 368 - 79 {Distortion-product otoacoustic emissions in kanamycin-treated guinea pig cochlea}; Kumagai S; Measurement of distortion-product otoacoustic emissions (DPOAE) is widely accepted as one of the most valuable tools for evaluating the frequency of specific cochlear pathology . Previous studies have revealed that distortion-product levels in the ear canal are definitely correlated with degree of damage in the cochlea . However, there seem to be no clear data of help in predicting the distribution and grade of damage in the cochlea quantitatively on the basis of the results of this non-invasive test . The present study is designed to assess correlations between degree of outer hair cell (OHC) damage by a potent ototoxic antibiotic, kanamycin, and DPOAE levels at the characteristic frequency at the site . Guinea pigs were used after daily intramuscular administration of kanamycin for 7 or 10 days . DPOAE levels were measured using a system (CUBDIS: Etymotic Research) with 78 frequency combinations of iso-intensity primaries from 0.5kHz to 16kHz of f2 . The frequency ratio (f2/f1) was set at 1.2 . Distortion-product level plots versus f2 (DP-grams) were constructed . The integrity of the OHC system was evaluated histologically by the succinic dehydrogenase (SDH) method under a light microscope . Cochleograms were constructed by calculating percentages of intact OHCs along the basilar membrane in 1-mm blocks . The DP-grams and the histopathological cochleograms showed essentially identical patterns in the kanamycin-damaged guinea pig cochlea . The results suggest that: 1) The generation of DPOAE requires functioning OHCs . 2) DPOAE measurement provides information allowing prediction of OHC damage distribution in the cochlea without histological investigations . 3) Careful setting of primary levels and other parameters is necessary to reliably predict the pathology . 4) Attempts to detect of minimal OHC damage could fail . 5) DPOAE seem very useful for monitoring cochlear function in clinically. J Clin Pathol, 1995 Mar, 48(3), 223 - 5 Iron metabolism and fungal infections in patients with haematological malignancies; Iglesias-Osma C et al.; AIM--To determine whether iron metabolism influences the incidence of systemic fungal infection in patients with haematological malignancies . METHODS--The study population comprised 74 patients who had undergone myeloablative chemotherapy . Systemic fungal infections were classified as confirmed (histological confirmation or characteristic septate hyphae) or possible (antibiotic resistant fever which resolved following administration of intravenous amphotericin B, together with either typical radiographic lesions or massive oropharyngeal candidiasis) . Parameters of iron metabolism included serum iron concentrations, total iron binding capacity, serum transferrin, and ferritin concentrations and transferrin saturation values . RESULTS--Patients who developed a fungal infection had substantially increased transferrin saturation values and ferritin concentrations at diagnosis together with low serum transferrin and high serum iron concentrations . This profile was present in patients with a fungal infection regardless of the underlying haematological disorder . CONCLUSION--Increased transferrin saturation values and high ferritin concentrations may be additional risk factors for the development of systemic fungal infection in patients with haematological malignancies. Toxicol Lett, 1995 Mar, 76(2), 127 - 34 Gentamicin-induced kidney damage and lipid peroxidation in rats; Fauconneau B et al.; Although it has been reported that injections of gentamicin induces lipid peroxidation in rat renal cortex (Ramsammy et al . (1985) Biochem . Pharmacol . 34, 3895-3900), our results showed no modification of thiobarbituric-reagent substances (TBARS) or in analysis of the polyunsaturated fatty acid profile . Moreover, endogenous vitamin E and glutathione were not consumed . In in vitro systems, gentamicin incubated with microsomes, homogenates and kidney slices from the normal rat failed to induce lipid peroxidation . We show that the increase in TBARS in vivo detected by Ramsammy et al . was wrongly attributed to the oxidant power of gentamicin . As this antibiotic does react positively to thiobarbituric acid in the presence of a system generating free radicals, it is possible that these authors accidentally introduced such a system into their experiments. Aust Fam Physician, 1995 Mar, 24(3), 379 - 85 The management of male subfertility by in vitro fertilisation techniques; Kovacs G et al.; Although IVF was developed for the treatment of tubal infertility, it is clear that it has a significant application in treatment of couples where the problem is one of male subfertility . This is particularly relevant because, despite the developments in reproductive medicine, in most males there is no identifiable cause for the poor semen quality . Therefore, for these men there is no efficacious method of treatment . Varicocele ligation and the use of agents such as clomiphene citrate, mesterolone empirical antibiotic therapy, and anabolic steroids have not been show to be beneficial when subject to controlled trials . The concept of improving the chance of fertilisation by taking the oocytes to the sperm in vitro is therefore the first feasible therapeutic option available to these subfertile couples . However, these possibilities should not obviate the need for a thorough assessment of the subfertile male and continuing research into the basis of male infertility . During the past decade new methods of sperm preparation, modified methods of insemination, and the use of microinjection have been developed . IVF is now a realistic option for couples if the male is subfertile . It has been suggested by some critics of these techniques that the brunt of the discomfort and risk has to be borne by the women where the problem appears to be solely with the male partner . Nevertheless, as having children is a 'couple' decision, prospective couples need to consider whether such procedures are acceptable to them.(ABSTRACT TRUNCATED AT 250 WORDS) J Intraven Nurs, 1995 Mar-Apr, 18(2), 92 - 6 Peripherally inserted central catheter exchange using a breakaway sheath: a new approach; Fabian B; There is an increasing demand for the use of peripherally inserted central catheters (PICC) . In hospitals, clinics, nursing homes, skilled care centers, hospices, alternative care centers, and homes, more PICC lines are being inserted . Therapies are complex and involve lengthy protocols to combat multiple diseases and antibiotic-resistant infections. Minerva Anestesiol, 1995 Mar, 61(3), 71 - 5 {Long-term results of a hearing screening in critically ill patients dismissed from an intensive care unit}; Cavaliere F et al.; AIM . To evaluate the auditive function of a group of critical patients after discharge from an ICU . DESIGN . An audiological screening was carried out 90-120 days after discharge . PATIENTS . Eighteen patients, that had been admitted to a polyvalent ICU for head injury, stroke or complicated neurosurgical procedures . They had all been in a coma . INTERVENTIONS: all the patients had undergone orotracheal intubation and mechanical ventilation lasting more than a week as well as ototoxic drugs (aminoglycosides and furosemide) administration . Antibiotic plasma levels had been monitored . MEASUREMENTS AND RESULTS . At examination, only 7 subjects were aware of being hypoacusic; no other symptom was reported . However audiometry and impedentiometry revealed the presence of mono or bilateral middle ear effusion in 11 subjects (61%) and high frequency neurosensorial hypoacusia in 2 cases (11%) . Human voice frequencies were poorly affected by both transmissive and neurosensorial damages so that subjects did not report any hearing loss . CONCLUSIONS . Neurosensorial hypoacusia was probably caused by amynoglycoside toxicity in spite of blood level monitoring; ABR could be effective in preventing toxic damage by detecting early hearing impairment . Middle ear effusion occurrence is difficult to be prevented but appropriate medical therapy is usually effective after the recovery from coma. J Diarrhoeal Dis Res, 1995 Mar, 13(1), 39 - 43 Genetic analysis of tetracycline-resistant plasmids in enteropathogenic Escherichia coli isolated from patients in Nigeria; Daini OA et al.; Genetic analysis of antibiotic-resistant plasmids from 102 serologically defined strains of enteropathogenic Escherichia coli from Nigeria was carried out . All the isolates were screened for susceptibility to antibiotics, and 47 were found resistant to tetracycline . A total of 138 plasmids was isolated by agarose gel electrophoresis . Transformation and conjugation experiments showed that 57.4% of the resistant strains carried R-plasmids ranging in sizes from 2 to 46 x 10(6) daltons . Plasmid-determined resistance to tetracycline, ampicillin and streptomycin was found . Restriction endonuclease analysis of three of the commonest plasmids: p1679, p529 and p1479 revealed relatedness with respect to function and structure . The DNA segment on which TcR gene is located on each of them was identified by cloning into the vector plasmid pGL101 . The recombinant plasmids pOADI and pOAD2 gave full expression of TcR gene when transformed into E . coli DHI . Furthermore, the tetracycline-resistant strains were examined for their phenotypic behaviour with respect to tetracycline and its lipophilic analogs. Bull Cancer, 1995 Mar, 82(3), 202 - 7 {Combination of mitoxantrone-vinorelbine as first-line chemotherapy for metastatic breast carcinoma}; Ferrero JM et al.; A phase II trial was performed to assess the efficacy and toxicity of the combination mitoxantrone (MXN) and vinorelbine (VNR) as first-line chemotherapy for metastatic breast cancer . Forty-one patients with metastatic disease or local relapse recruited between March 1991 and April 1993 received a first-line chemotherapy treatment consisting in 12 mg/m2 intravenous (IV) bolus of MXN on day 1 followed by a 20-minute perfusion of 25 mg/m2 of VNR on days 1 and 8 . Cycles were repeated every 21 days until evidence of disease progression or of severe toxicity . Thirty-seven patients were evaluable for response and all 41 for toxicity . An objective response was observed in 19 patients (51%; 95% confidence interval, 45 to 74%) . The response was complete in a further 11 (30%) . Median time to treatment failure was 9 months . Median survival was 14 months . There were no treatment-related deaths . Limiting toxicity was myelosuppression . Leukopenia occurred in 29 patients (71%) and was grade 3 or 4 in nine of these (15%) . Grade 2 or 3 anemia was encountered in six patients (15%), grade 1 thrombocytopenia in one, neurotoxicity (constipation) in two, and grade 2 or 3 alopecia in 12 (29%) . Nausea/vomiting requiring antiemetic treatment was experienced by only two patients (5%) . There were two cases of septicemia treated by antibiotic therapy in hospital. JPEN J Parenter Enteral Nutr, 1995 Mar-Apr, 19(2), 133 - 6 Peripherally inserted central catheters: a report of 2506 catheter days; Loughran SC et al.; BACKGROUND: The establishment of reliable central venous access is essential in the management of patients with major complications, including pneumothorax and hemopneumothorax . Although peripherally inserted central catheters (PICCs) offer advantages over traditional central venous approaches, PICC lines are associated with a number of insertion and maintenance problems, including clotting and catheter fracture . These complications often result in catheter removal before completion of prescribed therapy . METHODS: We conducted a retrospective descriptive study in a convenience sample of 322 consecutively placed PICC lines . Study variables included size of catheter, tip placement, infused solutions, patient diagnosis, and unit of line placement . The rationale for line discontinuance as well as for complication rates is described . RESULTS: Complication rates for infection and central venous thrombosis were less than 1% . Phlebitis occurred in 9.7% of patients, and catheter fracture occurred in 9.7% of patients . Two distinct clusters of phlebitis, early and late development, were observed . Early phlebitis is attributable to the mechanics of insertion, and late phlebitis is attributable to chemical and patient-specific causes . Catheter fractures were primarily related to tearing of the catheter during insertion or traction on the catheter-hub junction (51.6%) . CONCLUSIONS: The majority of published data about PICC lines is in the area of chemotherapy or antibiotic infusion . Our study supports the use of PICC lines in patients receiving a variety of solutions, primarily parenteral nutrition . With an experienced, team approach to catheter placement and maintenance, PICC lines provide reliable, cost-effective venous access and reduce many of the complications of central venous access in a variety of clinical settings. Comp Biochem Physiol C Pharmacol Toxicol Endocrinol, 1995 Mar, 110(3), 321 - 7 Inhibitory effect of sodium ursodeoxycholate on basal and stimulated short-circuit current across the isolated toad skin; Alonso CE et al.; The effect of sodium ursodeoxycholate (U) on short-circuit current (SCC), an index of basal and stimulated net ion transport across isolated skins of Bufo arenarum toads, was tested . U inhibited basal SCC when added to the epidermal side of the skins . The inhibitory effect was reversible after rinsing the preparation during 60 min . U also inhibited the natriferic response to oxytocin, db-cAMP and theophylline by 82%, 49% and 47%, respectively . Inhibition of SCC by exposure to U was reversed by the polyene antibiotic nystatin . In turn, SCC induced by nystatin in the amiloride-treated skin was insensitive to U and blocked by ouabain, a Na+, K(+)-ATPase inhibitor . These results strongly suggest that the effect of U is exerted at the apical membrane of sodium transporting cells, and rule out the existence of an additional site of inhibitory action of U. Bone Marrow Transplant, 1995 Mar, 15(3), 479 - 81 Pulmonary nocardiosis in a patient with a bone marrow transplant . Bone Marrow Transplantation Team; Shearer C et al.; Infection with nocardia is rare in BMT patients . We described the first reported case of pulmonary nocardiosis in an allogeneic marrow recipient with graft-versus-host disease . The patient developed nocardial infection while receiving trimethoprim-sulfamethoxazole as prophylaxis against Pneumocystis . The salient clinical presentation was right lower lung consolidation; the diagnosis was established by prolonged incubation of an open lung biopsy specimen . Antibiotic therapy included timentin and later, imipenem . However, the patient died with uncontrolled infection . Necropsy revealed nocardial lung abscesses and disseminated infection from cytomegalovirus. Biofizika, 1995 Mar-Apr, 40(2), 317 - 22 {Intensification of the ionophoric effect of polymyxin M by free fatty acids . Dependence of the length of the fatty acid chain}; Podgaets ER et al.; Mechanisms of potentiation of ionophoric effect of polymyxin M by free fatty acids was studied using measurement of electrical properties of bilayer lipid membranes . Among used unsaturated fatty acids the palmitic acid appeared to be the most effective . The obtained dependence of ionophoric effect of membrane antibiotic on the chain length of the fatty acid may be explained by the existence of the complex of special size appropriate to the membrane thickness . We suppose that free fatty acid and polymyxin M form the ion-conducting structure in lipid bilayer. Antibiot Khimioter, 1995 Mar, 40(3), 16 - 21 {Multifactor analysis of the action of norfloxacin on the humoral immune response}; Iordanova AI et al.; Multifactor analysis of the norfloxacin action on the primary immune response to the bacterial antigen (EV vaccine fraction 1) and cellular antigen (sheep erythrocytes) in mice was carried out with using a wide variety of the doses and administration times . In the doses corresponding to the average therapeutic ones norfloxacin was shown to have no effect on the humoral immune response to the bacterial and cellular antigens . In the subtherapeutic doses norfloxacin increased it thus mainly stimulating the synthesis of the IgM antibodies . In the doses exceeding the therapeutic ones the antibiotic lowered the antibody content . The diverse type immunoregulatory action of norfloxacin on the content of the IgG and IGM antibodies could be useful in the rational choice of fluoroquinolones for the treatment of patients with selective deficiency of immunoglobulins of various classes. In Vivo, 1995 Mar-Apr, 9(2), 113 - 5 The effects of roxatidine on neuromuscular transmission; Bossa R et al.; We have investigated the effects of the H2 receptor antagonist roxatidine on the neuromuscular transmission by using the sciatic nerve-gastrocnemius muscle preparation of the rat in vivo . Roxatidine, administered by i.v . injection, potentiates the neuromuscular blockade induced by d-tubocurarine, pancuronium and aminoglycoside antibiotic, kanamycin . Moreover, the drug alone is capable of producing a blockade on the preparation stimulated at high frequency . The neuromuscular blockade induced by roxatidine is partially reversed by 4-aminopyridine but not by dimaprit. Biol Chem Hoppe Seyler, 1995 Mar, 376(3), 179 - 85 Nitric oxide generation during cellular metabolization of the diabetogenic N-methyl-N-nitroso-urea streptozotozin contributes to islet cell DNA damage; Kroncke KD et al.; The N-methyl-N-nitroso-urea streptozotocin is an antibiotic with diabetogenic, carcinogenic and antitumor activity thought to act via alkylation of DNA and proteins . Evidence points to a release of bioactive nitric oxide (NO) from streptozotocin as an additional cytotoxic activity of this drug . Here we show by EPR spectroscopy, that NO is not generated during spontaneous decay of streptozotocin but that its metabolization in rat hepatocytes and pancreatic islet cells yields NO . This NO formation is not due to a NO synthase (NOS) activity since NO formation in hepatocytes in the presence of streptozotocin is not blocked by the NOS inhibitor NG-methyl-L-arginine . By iNOS-specific RT-PCR no positive signal for specific mRNA presence was obtained in streptozotocin-treated cells, proving that iNOS activity was not induced during cell isolation procedures and did not account for the NO release . Furthermore, early DNA-strand breaks induced either by SZ or by the NO donor nitroprusside were both significantly reduced in the presence of an intracellular NO scavenger . In contrast, DNA damage found after incubation with the purely alkylating agent methylmethanesulfonate was not inhibited by the NO trap . These results prove that intracellular formation of NO occurs during degradation of SZ within cells . This NO appears to contribute significantly to streptozotocin-induced cytotoxicity. Bone Marrow Transplant, 1995 Mar, 15(3), 349 - 51 G-CSF after autologous bone marrow transplantation for malignant diseases in children . Spanish Working Party for Bone Marrow Transplantation in Children; Madero L et al.; The use of recombinant human granulocyte-stimulating factor (G-CSF) has been shown to effectively accelerate granulocytic recovery after autologous bone marrow transplantation (BMT) in adults . The experience, however, is limited in children . We evaluated the hematopoietic reconstitution in 41 consecutive children undergoing autologous BMT for hematologic malignancies (21 acute lymphoblastic leukemia, five non-Hodgkin's lymphoma) and solid tumours (seven neuroblastoma, two brain tumor, three Ewing's sarcoma, two Wilms' tumor, one rhabdomyosarcoma) . Their ages ranged from 2 to 16 years (mean 7.2 years) . rhG-CSF was given at a dose of 10 micrograms/kg/day i.v . in a 2h infusion from day +1 until +28 or until the absolute neutrophil count (ANC) was > 1 x 10(9)/L . These patients were compared with a similar historical control group of 38 children who did not receive rhG-CSF after autologous BMT . The number of cells infused was similar in both groups . At the dose and schedule used in the present study, rhG-CSF was well tolerated and no side-effects were observed . The number of cell infused was similar in both groups . At the dose and schedule used in the present study, rhG-CSF was well tolerated and no side-effects were observed . Our data show that rhG-CSF accelerates engraftment and reduces the number of febrile days and antibiotic use . Furthermore, patients who were treated had less infections. J Membr Biol, 1995 Mar, 144(2), 131 - 45 Ion selectivity of colicin E1: III . Anion permeability; Bullock JO et al.; The antibiotic protein colicin E1 forms ion channels in planar lipid bilayers that are capable of conducting monovalent organic cations having mean diameters of at least 9 A . Polyvalent organic cations appear to be completely impermeant, regardless of size . All permeant ions, whether large or small, positively or negatively charged, are conducted by this channel at very slow rates . We have examined the permeability of colicin E1 channels to anionic probes having a variety of sizes, shapes, and charge distributions . In contrast to the behavior of cations, polyvalent as well as monovalent organic anions were found to permeate the colicin E1 channel . Inorganic sulfate was able to permeate the channel only when the pH was 4 or less, conditions under which the colicin E1 protein is predominantly in an anion-preferring conformational state . The less selective state(s) of the colicin E1 channel, observed when the pH was 5 or greater, was not permeable to inorganic sulfate . The sulfate salt of the impermeant cation Bis-T6 (N,N,N',N'-tetramethyl-1,6-hexanediamine) had no effect on the single channel conductance of colicin E1 channels exposed to solutions containing 1 M NaCl at pH 5 . The complete lack of blocking activity by either of these two impermeant ions indicates that both are excluded from the channel lumen . These results are consistent with our hypothesis that there is but a single location in the lumen of the colicin E1 channel where positively charged groups can be effectively hydrated . This site may coincide with the location of the energetic barrier which impedes the movement of anions. Curr Eye Res, 1995 Mar, 14(3), 209 - 14 Effects of topical FK506 on endotoxin-induced uveitis (EIU) in the Lewis rat; Hikita N et al.; FK506 is a macrolide antibiotic and a potent immunosuppressant . To investigate the effect of topical FK506 on acute ocular inflammation, we evaluated its action on the development of endotoxin-induced uveitis (EIU) . At two different concentrations of 0.05% and 0.3%, topical FK506 was applied to Lewis rats with EIU . In aqueous, the mean number of inflammatory cells per microliter +/- SEM was 2,389 +/- 1,277, 1,571 +/- 1,562, 898 +/- 882, and 69 +/- 152 for rats treated with vehicle alone, 0.05%, 0.3% FK506, and 1% prednisolone acetate . The median of histological grades was 2, 1.5, 0.8, and 0.5 for animals treated with these 4 different regimens respectively . Analysis of aqueous protein showed a small reduction in FK506-treated animals . Mean blood levels of FK506 were low in rats treated with topical FK506 (0.05%, 0.84 ng/ml; 0.3%, 2.0 ng/ml) suggesting that its therapeutic effect was not secondary to the systemic absorption of the drug . Although FK506 is not as effective as prednisolone, 0.3% FK506 produced significant decreases in the mean aqueous inflammatory cell number and histological inflammatory score as compared to control vehicle alone . We conclude that topical FK506 can suppress EIU in a dose-dependent fashion and may be an alternative medication for patients with anterior uveitis and contra-indication to topical steroid. J Neurosci Methods, 1995 Mar, 57(1), 27 - 35 Perforated-patch recording with gramicidin avoids artifactual changes in intracellular chloride concentration; Kyrozis A et al.; The antibiotic gramicidin, when incorporated into lipid membranes, forms pores that are exclusively permeable to monovalent cations and small unchanged molecules . We report the use of gramicidin for perforated patch-clamp recordings in the whole-cell mode . Recordings were performed in cultured rat spinal cord dorsal horn neurons . Cells had stable resting potentials and series resistances for times routinely exceeding 60 min . To test if intracellular chloride concentration ({Cl}i) remains stable with this technique, we measured responses to agonists of glycine and GABAA receptors, both of which gate chloride conductances . The driving force for these responses remained stable at values that differed significantly from values that would be expected if {Cl-}i were biased towards pipette {Cl-} . We conclude that gramicidin perforated-patch recording, in addition to other properties of the perforated-patch recording technique, has the advantage of not altering {Cl-}i . It is, therefore, an electrophysiological method particularly suitable for studies of anionic channels when {Cl-}i is a variable of interest, as well as for studies of homeostatic {Cl-}i regulation. Leuk Lymphoma, 1995 Mar, 17(1-2), 139 - 45 Economic analysis of prophylactic G-CSF after mini-BEAM salvage chemotherapy for Hodgkin's and non-Hodgkin's lymphoma; Dranitsaris G et al.; The objectives of this study were to compare the costs of managing lymphoma patients who underwent mini-BEAM salvage chemotherapy with G-CSF prophylactic support against a group of similar patients without growth factors . Methods used included: 1) A retrospective chart review was conducted to estimate the average length of hospitalization and resource consumption for the management of fever and neutropenia in the two groups of patients and 2) An economic analysis was then performed from a hospital perspective which considered only institutional resource utilization . Costs of antibiotic support and monitoring, lab tests as well as G-CSF were calculated . Results demonstrated that overall, patients who received prophylactic G-CSF after chemotherapy required 2 fewer hospital days compared to controls . The administration of G-CSF resulted in a savings of approximately $1580/patient relative to control . When the initial G-CSF expenditure was included in the analysis, the total net cost/patient was similar between the two groups . In conclusion, the results of the current study support the routine use of G-CSF in patients receiving salvage chemotherapy with mini-BEAM . The initial G-CSF expenditure would be offset by reduced hospitalization. Bioorg Khim, 1995 Mar, 21(3), 188 - 96 {Cleavage of a double-stranded DNA target by bleomycin derivatives of oligonucleotides, forming a ternary complex}; Sergeev DS et al.; Hexadecathymidylate derivatives, containing covalently-bound antitumor antibiotic bleomycin A5, were shown to form a triple-helix complex with double-strand 30-bp DNA-target and to carry out within this complex complementary-addressed DNA modification . Fivefold excess of reagent in relation to target leads to non-specific cleavage mainly of pyrimidine-rich DNA strand . Total degrees of the target-strand cleavage by 5'- and 3'-bleomycin derivatives of hexadecathymidylate were 25 and 35% for purine-rich strand and 47 and 36% for pyrimidine-rich strand . Degrees of non-specific cleavage by 5'-bleomycin derivative of hexadecanucleotide that does not form triple-helix were 6 and 16% for purine- and pyrimidine-rich strands, respectively . Comparison of these data has shown that site-specific cleavage prevailed nonspecific one . Triplex of 5'-bleomycin derivative with DNA melted by 5 degrees C lower (m.p . 40 degrees C) than the similar triplex of hexadecathymidylate . Temperature lowering from 50 to 20 degrees C increases the DNA-cleavage degree according to the increase in the part of target molecules involved in triple-helix formation. Mov Disord, 1995 Mar, 10(2), 195 - 200 Oculofacial-skeletal myorhythmia in central nervous system Whipple's disease: additional case and review of the literature; Simpson DA et al.; A case of oculofacial-skeletal myorhythmia associated with cerebral Whipple's disease is presented . This peculiar abnormal movement disorder consists of a convergent-divergent pendular nystagmus associated with a synchronous, rhythmic movement of the mouth, jaw, and extremities . The movements in previous cases have responded inconsistently to a variety of broad-spectrum antibiotic drugs, and antiepileptic, muscle relaxant, antispastic, and psychotropic drugs . The current patient's mental status improved after starting intravenous ceftriaxone but improvement of the abnormal movements occurred only after the addition of oral valproate . Current treatment consists of intravenous trimethoprim-sulfamethoxazole for 2 weeks followed by oral trimethoprim-sulfamethoxazole twice daily for 1 year . Presented here is an alternative treatment of intravenous ceftriazone followed by oral trimethoprim-sulfamethoxazole in combination with valproate for abnormal movements not responsive to antibiotic drugs alone. J Clin Oncol, 1995 Mar, 13(3), 652 - 9 Can cytotoxic dose-intensity be increased by using granulocyte colony-stimulating factor? A randomized controlled trial of lenograstim in small-cell lung cancer; Woll PJ et al.; PURPOSE: The use of granulocyte colony-stimulating factor (G-CSF) to increase cytotoxic dose-intensity was assessed in a randomized trial in better-prognosis small-cell lung cancer (SCLC) . Both control and G-CSF arms were subject to the same dose-intensification strategy . PATIENTS AND METHODS: Patients with newly diagnosed SCLC and either no or one adverse prognostic factor were randomized to receive vincristine, ifosfamide, carboplatin, and etoposide (VICE) alone or with recombinant human (rHu)G-CSF (lenograstim) 5 micrograms/kg/d between cycles . Six chemotherapy cycles were given, with prophylactic cranial irradiation after cycle 1 and thoracic irradiation after cycle 3 . There was no fixed dose interval . In both arms, patients were eligible for re-treatment when the WBC count was > or = 3 x 10(9)/L and platelet count was > or = 100 x 10(9)/L . No dose reductions were permitted . Dose-intensity was expressed relative to standard every-4-weeks VICE . RESULTS: Sixty-five consecutive patients in one institution were randomized to control (n = 31) or G-CSF (n = 34) . WBC and neutrophil counts were consistently higher in G-CSF patients than in the control group, but there were no significant differences in the incidence of febrile neutropenia, antibiotic or transfusion requirements, or days in hospital . In both treatment arms, the median dose-intensity was greater than one for each cycle (control group, P = .0009; G-CSF group, P = .0001) . The G-CSF group received a significantly higher dose-intensity than the control group, with the greatest difference in the first three cycles (1.34 v 1.17, P = .001) . There were more chemotherapy-related deaths in the G-CSF group than in the control group (six v one), but this group had a better 2-year survival rate (32% with G-CSF, 95% confidence interval {CI}, 16 to 48; 15% with controls, 95% CI, 2 to 27) . CONCLUSION: The dose-intensity of VICE chemotherapy was increased in both groups . Patients randomized to receive G-CSF achieved a significantly higher dose-intensity than controls . Despite early toxicity, they had a better 2-year survival rate. Am J Gastroenterol, 1995 Mar, 90(3), 455 - 9 Tacrolimus (FK 506), a treatment for primary sclerosing cholangitis: results of an open-label preliminary trial; Van Thiel DH et al.; Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease of the liver that is characterized by progressive cholestasis and the development of secondary biliary cirrhosis . There is no widely recognized therapy for this disease, although anti-inflammatory agents (steroids), immunosuppressive agents (methotrexate), anti-fibrotics (colchicine), and choleretic agents (ursodeoxycholic acid) have been used in various small series . In the present study, Tacrolimus (FK 506), a new and powerful immunosuppressive macrolide antibiotic, has been used to treat 10 patients with PSC . Each subject had a liver biopsy, ERCP with visualization of the intra- and extrahepatic biliary tree, and a panel of hematological, serological, and biochemical laboratory tests before the initiation of the FK 506 therapy . The FK 506 was administered orally at 12-h intervals and was monitored by serial plasma FK 506 trough levels . After 360 days of treatment, the median serum bilirubin level was reduced by 75%, and the serum alkaline phosphatase was reduced by 70% . Moreover, the serum ALT and AST levels were reduced by 80 and 86%, respectively . No change in the serum level of BUN and creatinine levels occurred as a consequence of the FK 506 treatment . These data demonstrate that: 1) FK 506 can be used to treat PSC; 2) the response to FK 506 by patients with PSC is rapid; and, 3) no adverse effect on the serum BUN and creatinine levels was observed . It is anticipated that FK 506 will become an important agent for the treatment of patients with PSC because of its powerful immunosuppressive activity. Circ Res, 1995 Mar, 76(3), 412 - 7 Rapamycin-FKBP inhibits cell cycle regulators of proliferation in vascular smooth muscle cells; Marx SO et al.; Multiple growth factors can stimulate quiescent vascular smooth muscle cells to exit from G0 and reenter the cell cycle . The macrolide antibiotic rapamycin, bound to its cytosolic receptor FKBP, is an immunosuppressant and a potent inhibitor of cellular proliferation . In the present study, the antiproliferative effects of rapamycin on human and rat vascular smooth muscle cells were examined and compared with the effects of a related immunosuppressant, FK520 . In vascular smooth muscle cells, rapamycin, at concentrations as low as 1 ng/mL, inhibited DNA synthesis and cell growth . FK520, an analogue of the immunosuppressant FK506, is structurally related to rapamycin and binds to FKBP but did not inhibit vascular smooth muscle cell growth . Molar excesses of FK520 blocked the antiproliferative effects of rapamycin, indicating that the effects of rapamycin required binding to FKBP . Rapamycin-FKBP inhibited retinoblastoma protein phosphorylation at the G1/S transition . This inhibition of retinoblastoma protein phosphorylation was associated with a decrease in p33cdk2 kinase activity . These observations suggest that rapamycin, but not FK520, inhibits vascular smooth muscle cell proliferation by reducing cell-cycle kinase activity. RNA, 1995 Mar, 1(1), 95 - 101 Inhibition of the hammerhead ribozyme by neomycin; Stage TK et al.; A series of antibiotics was tested for stimulation or inhibition of the hammerhead ribozyme cleavage reaction . Neomycin was found to be a potent inhibitor of the reaction with a Kl of 13.5 microM . Two hammerheads with well-characterized kinetics were used to determine which steps in the reaction mechanism were inhibited by neomycin . The data suggest that neomycin interacts preferentially with the enzyme-substrate complex and that this interaction leads to a reduction in the cleavage rate by stabilizing the ground state of the complex and destabilizing the transition state of the cleavage step . A comparison of neomycin with other aminoglycosides and inhibitors of hammerhead cleavage implies that the ammonium ions of neomycin are important for the antibiotic-hammerhead interaction. Biochemistry, 1995 Feb 21, 34(7), 2267 - 75 Specific binding of the biradical analog of neocarzinostatin chromophore to bulged DNA: implications for thiol-independent cleavage; Yang CF et al.; The enediyne anticancer antibiotic neocarzinostatin chromophore generates a single, site-specific break at a bulge in DNA in a thiol-independent reaction, involving intramolecular drug activation under general base catalysis {Kappen, L . S., & Goldberg, I . H . (1993) Biochemistry 32, 13138-13145} . As part of an effort to elucidate the three-dimensional structure of the active complex formed between the labile drug and bulged DNA, we have studied the binding of stable drug products generated in the course of the cleavage reaction with oligodeoxynucleotides containing the bulged structure . By use of fluorescence quenching, we have found that one drug product, which is also formed in the absence of bulged DNA and most closely resembles the biradical intermediate in the cleavage reaction, specifically binds bulged DNA with a Kd in the low micromolar range and competitively inhibits the cleavage reaction . Other drug products, including one formed only in the presence of bulged DNA, fail to bind to the bulged DNA . Implications of these results for the proposed mechanism of bulge-specific cleavage and for the role of the DNA bulge in generating a unique drug product are discussed. Biochim Biophys Acta, 1995 Feb 15, 1233(2), 145 - 52 Target size analysis of the peptide/H(+)-symporter in kidney brush-border membranes; Boll M et al.; The apparent functional molecular mass of the kidney peptide/H(+)-symporter was determined by radiation inactivation in brush-border membrane vesicles (BBMV) of rat kidney cortex . Purified BBMV were irradiated at low temperatures with high energy electrons generated by a 10-MeV linear accelerator at doses from 0 to 30 megarads . Uptake studies were performed with {3H}cefadroxil, a beta-lactam antibiotic which serves as a substrate for the kidney peptide/H(+)-symporter . Inhibition of influx of {3H}cefadroxil into BBMV was used to determine the functional molecular mass of the transporter . Additionally, direct photoaffinity labeling of the transport- and/or binding proteins for {3H}cefadroxil in control and irradiated BBMV was performed to determine the molecular mass of the putative transporter by SDS-polyacrylamide gel electrophoresis . Initial rates of pH-gradient dependent uptake of {3H}cefadroxil decreased progressively as a function of radiation dose . The apparent radiation inactivation size (RIS) of the transport function was found to be 414 +/- 16 kDa . Direct photoaffinity labeling yielded labeled membrane proteins with apparent molecular masses of 130 kDa and 105 kDa, respectively . The proteins displayed different labeling characteristics with respect to incubation time, specificity and the response to irradiation . It appears that only a 105 kDa protein is directly involved in transport function since (a) only it showed a specific pH gradient dependent labeling pattern and (b) the covalent incorporation of {3H}cefadroxil into this protein decreased parallel to the loss of transport function in irradiated BBMV . The peptide/H(+)-symporter in kidney brush-border membranes therefore appears to have a monomer mass of 105 kDa and may function in an oligomeric arrangement. Blood, 1995 Feb 15, 85(4), 1095 - 103 The pro region of human neutrophil defensin contains a motif that is essential for normal subcellular sorting; Liu L et al.; Human defensins (human neutrophil peptides) HNP 1-3 are 29-30 amino acid antibiotic and cytotoxic peptides highly abundant in the cytoplasmic granules of polymorphonuclear leukocytes . The peptides are produced from 94 amino acid (aa) prepropeptides by proteolytic cleavage of the signal sequence and stepwise removal of the 44-45 aa anionic propiece . To study the role of the propiece, we constructed five in-frame deletions in preproHNP-1 cDNA between the signal peptidase site and the amino-terminus of the mature defensin region (aa 21-64) . The wild type HNP-1 cDNA and the deletion mutants were ligated into the pBabe-Neo retroviral vector, expressed in GP+E86 packaging derivative of NIH 3T3 cells, then transduced into the 32D cl3 granulocytic cell line . For each construction and both cell lines, we measured the accumulation of the various defensin forms in cells and media by 24-hour labeling or pulse-chase with 35S-cysteine- and immunoprecipitation/sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) . Deletions in the amino-terminal two-fifths of the propiece, delta 21-28 and delta 21-38, had only minor effects on defensin biosynthesis in both cell lines and did not interfere with the accumulation of mature defensin in the granules of 32D cl3 cells . Deletions in the carboxyterminal three-fifths of the propiece (delta 21-51 and delta 21-64) diminished net defensin synthesis, blocked constitutive secretion of prodefensin in both cell lines, and interfered with defensin accumulation in cytoplasmic granules of 32D cl3 cells . These effects were reproduced by the smaller deletion delta 40-51, which contains highly conserved secondary structure . The propiece segment 40-51 appears to be essential for the subcellular trafficking and sorting of HNP-1 defensin. Rev Prat, 1995 Feb 15, 45(4), 461 - 4 {Eyelid and lacrimal abscesses}; Fayet B et al.; Nonspecific eyelid abscesses are rare, whereas periorbital infections occur more frequently . Localisation of a maximum number of inflammatory signs is essential for diagnosis . A superior external localisation suggest dacryoadenitis or infection of a dermal cyst and the end of the eyebrow . An internal canthal localisation would reflect lacrimal disorder . In the adult, the main cause of infection is acute dacryocystitis . After antibiotic and anti-inflammatory drug treatment, dacryocystorhinotomy is necessary to preclude recurrence . In the newborn, bilateral forms of dilatation of the lacrimal sacs can lead to respiratory distress . The treatment of choice is resection of the endonasal pouches. J Mol Biol, 1995 Feb 10, 246(1), 164 - 79 Solution structure of a quinomycin bisintercalator-DNA complex; Chen H et al.; The quinomycin antibiotic UK-63052 (designated QN) exhibits a chemical structure related to the antibiotic echinomycin which is known to bisintercalate into DNA . Common features among these antibiotics include two heterocyclic aromatic ring systems propagating from a cross-bridged cyclic octadepsipeptide scaffold . We report on the solution structure of the QN-d(A1-C2-A3-C4-G5-T6-G7-T8) complex (one QN molecule per duplex) based on a combined NMR-molecular dynamics study including intensity-based refinement . The 3-hydroxy quinaldic acid rings bisintercalate into the duplex at (A3-C4).(G5-T6) steps and stack with flanking Watson-Crick A3.T6 and C4.G5 base-pairs . The intercalation sites at (A3-C4).(G5-T6) steps are wedge-shaped and unwound, with significant unwinding also observed at the (C4-C5).(C4-G5) step bracketed between the intercalation sites . The cross-bridged cyclic octadepsipeptide is positioned in the minor groove with the methyl groups on its Ala and NMe-MCp residues directed towards and making van der Waals contacts with the minor groove edge of the duplex . A pair of adjacent intermolecular hydrogen bonds between the Ala backbone atoms and the G5 minor groove edge (Ala-NH to G5-N(3) and G5-NH2e to Ala-CO) account for the sequence specificity associated with complex formation . The solution structure of the QN-DNA oligomer complex, which contains only Watson-Crick base-pairs flanking the bisintercalation site, is compared with the crystal structure of the related echinomycin-DNA oligomer complex, which contains Hoogsteen base-pairs on either side of the bisintercalation site. FEMS Microbiol Lett, 1995 Feb 1, 126(1), 55 - 61 Physiological factors affecting streptomycin production by Streptomyces griseus ATCC 12475 in batch and continuous culture; Reza Fazeli M et al.; Conditions of growth are described for the production of streptomycin by Streptomyces griseus ATCC 12475 using chemically defined minimal medium and complex medium . It was found using batch cultures that early synthesis of the antibiotic occurred during growth in minimal medium but was delayed until the onset of stationary phase in complex medium . This effect was independent of whether spores or vegetative cells were used as inoculum . Stability of streptomycin biosynthesis in continuous culture was dependent on dilution rate and medium employed . Cultures were highly unstable when grown on complex medium but could be maintained in steady states in continuous culture using minimal medium when the dilution rate was increased in a stepwise manner, starting at a dilution rate of 0.02 h-1 (15% of mumax) . The effect of changing dilution rate on growth, streptomycin production and the level of streptomycin phosphotransferase was examined using this technique. Mol Pharmacol, 1995 Feb, 47(2), 307 - 13 Characterization of two affinity states of adenosine A2a receptors with a new radioligand, 2-{2-(4-amino-3-{125I}iodophenyl)ethylamino}adenosine; Luthin DR et al.; Adenosine analogs substituted in the 2-position with arylamino groups have been found to have high affinity and selectivity for A2a adenosine receptors . Two such compounds, 2-{2-(4-aminophenyl)ethylamino}adenosine and 2-{2-4-amino-3-iodophenyl)ethylamino}adenosine (I-APE), were synthesized and found to be potent coronary vasodilators (ED50 < 3 nm) . These compounds bind weakly to A1 adenosine receptors of rat cortex (Ki > 150 nM) . 125I-APE was synthesized and the new radioligand was found to bind to two affinity states of rat striatal A2a adenosine receptors (Kd = 1.3 +/- 0.1 nM and 19 +/- 4.5 nM) . The high affinity site represents a previously unrecognized small (15-20%) fraction of A2a adenosine receptors coupled to G proteins . Guanosine 5'-O-(3-thio)triphosphate (GTP gamma S) reduces specific binding of 125I-APE half-maximally at a concentration of 45 +/- 2 nM . {3H}CGS21680 also binds to two affinity states of A2a receptors on striatal membranes (Kd = 3.9 +/- 0.9 and 51 +/- 5.5 nM), although in previous studies single Kd values ranging from 5 to 15 nM have been reported . This high affinity site is substantiated by the finding that the IC50 of CGS21680 in competition with 125I-APE binding to striatal membranes is shifted leftward in membranes diluted for 4 min before filtration, to selectively dissociate radioligand from low affinity receptors . Assuming that agonist radioligands bind to both coupled and uncoupled forms of striatal A2a adenosine receptors, we could simulate with the computer the finding that the decrease in specific binding induced by GTP gamma S (100 microM) is variable and depends on radioligand concentration, ranging from 20 to 90% . Unlike 125I-APE, {3H}CGS21680 is charged at physiological pH, and treatment of membranes with the pore-forming antibiotic alamethicin uncovers cryptic {3H}CGS21680 but not 125I-APE binding sites . We conclude that the GTP gamma S-sensitive high affinity form of the A2a adenosine receptor can be preferentially labeled by 125I-APE, due to both its high specific activity and its physicochemical properties . Possible functional manifestations of poor coupling of A2a adenosine receptors to G proteins are discussed. J Nutr, 1995 Feb, 125(2), 183 - 8 Investigations into the actions of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1(7-36)amide on lipoprotein lipase activity in explants of rat adipose tissue; Knapper JM et al.; The direct actions of glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1(7-36)amide and insulin on lipoprotein lipase activity in explants of rat epididymal adipose tissues were investigated . Lipoprotein lipase was extracted into the incubation medium by heparin release of lipoprotein lipase and measured by fatty acid release from a glyceroltriolein emulsion . Insulin and glucose-dependent insulinotropic polypeptide caused a significant stimulation of lipoprotein lipase activity over a dose range of 0.25-4 nmol/L and 4-8 nmol/L, respectively . Explants incubated in the presence of both insulin and glucose-dependent insulinotropic polypeptide (at 0.5 and 4 nmol/L, respectively) showed levels of lipoprotein lipase activity significantly greater than that seen with either hormone alone . Neither insulin- nor glucose-dependent insulinotropic polypeptide-stimulated lipoprotein lipase was modified by the presence of the antibiotic actinomycin-D in the incubation medium, indicating that these two hormones exert their actions on the pre-existing cellular pool of lipoprotein lipase . Glucagon-like polypeptide-1(7-36)amide, over a dose range of 1-8 nmol/L, did not stimulate lipoprotein lipase activity . This study indicates that glucose-dependent insulinotropic polypeptide, in addition to stimulating insulin secretion, has a direct biological action on adipose tissue and in vivo, together with insulin, may promote lipoprotein lipase activity postprandially. J Pharmacol Exp Ther, 1995 Feb, 272(2), 511 - 8 Comparison of A4 and A2a binding sites in striatum and COS cells transfected with adenosine A2a receptors; Luthin DR et al.; A putative A4 adenosine receptor is characterized by a distinct structure activity profile of compounds in competition for {3H}2-phenylaminoadenosine ({3H}CV 1808) binding sites on rat brain membranes assayed at 4 degrees C . We now confirm that A4 binding sites can be demonstrated on ice-cold membranes of rat striatum and demonstrate a similar binding site on COS cells transfected with rat A2a adenosine receptors (COS/A2a) . The characteristic A4 potency order is: CV 1808 > {1R-(1 alpha, 2 alpha, 3 beta, 5 beta)}-3-(2,6-diamino-N2-(3-carbethoxyphenyl)-9 H-purin-9-yl)-5'-(N-ethylcarbamoyl)-1,2-cyclopentanediol (CGS 22988) >> 5'-N-ethylcarboxamidoadenosine (NECA) > or = 2-{4-(2- carboxyethyl)phenylethylamino}-5'-N-ethylcarboxamidoadenosine (CGS 21680); 9-chloro-2-(2-furyl){1,2,4}-triaolo{1,5-c}-quinazolin-5-a min e (CGS 15943) only partially inhibits binding at 1 microM . If {3H}CGS 21680 is used for ice-cold assays, or if either {3H}CV 1808 or {3H}CGS 21680 are used for assays at 21 degrees C, the potency order of competing compounds changes markedly and becomes characteristic of A2a adenosine receptor binding sites; CGS 15943 > or = CGS 21680 congruent to NECA > CGS 22988 > or = CV 1808 . Binding of {3H}CGS 21680, but not {3H}CV 1808, is significantly enhanced by the pore-forming antibiotic, alamethicin . Guanosine 5'-O-(3-thiotriphosphate) decreases the binding of both radioligands to striatal membranes at 21 degrees C significantly more than to membranes on ice.(ABSTRACT TRUNCATED AT 250 WORDS) Tijdschr Diergeneeskd, 1995 Feb 1, 120(3), 75 - 7 {Discospondylitis and immune-mediated polyarthritis in a Bernese mountain-dog}; van der Wel TJ et al.; In this case report we describe the clinical picture and treatment of a Bernese mountain dog with discospondylitis and a presumably reactive immune-mediated polyarthritis . The clinical signs consisted of apathy, fever, anorexia, and a stiff gait . The diagnosis was based on the typical radiographic signs of discospondylitis and the cytology of the synovial fluid . The dog was treated with a broad-spectrum antibiotic for 6 weeks and thereafter with a synthetic glucocorticoid for the polyarthritis . Five months after cessation of therapy, the dog was free from the initial signs. J Pediatr, 1995 Feb, 126(2), 313 - 6 Short-term use of amoxicillin-clavulanate during upper respiratory tract infection for prevention of acute otitis media; Heikkinen T et al.; We performed a randomized, double-blind, placebo-controlled study to determine whether acute otitis media could be prevented by antibiotic therapy initiated promptly after the appearance of symptoms of upper respiratory tract infection . One hundred four children aged 1 to 4 years received a 7-day course of either amoxicillin-clavulanate or placebo . Acute otitis media developed in 9 (18%) of the 50 children receiving amoxicillin clavulanate and in 12 (22%) of the 54 children receiving placebo (p = 0.59). J Infect Dis, 1995 Feb, 171(2), 356 - 61 Biliary complications in the treatment of unsubstantiated Lyme disease; Ettestad PJ et al.; Treatment of unsubstantiated Lyme disease has led to serious complications in some cases . Two case-control studies, based on information in clinical records of patients discharged with a diagnosis of Lyme disease during 1990-1992, were conducted at a central New Jersey hospital . Twenty-five patients with biliary disease were identified, and 52 controls were selected from 1352 patients with suspected Lyme disease . Only 3% of 71 evaluatable subjects met the study criteria for disseminated Lyme disease . Patients with biliary disease were more likely than were antibiotic controls to have received ceftriaxone and more likely than ceftriaxone controls to have received a daily ceftriaxone dose > or = 40 mg/kg and to be < or = 18 years old . Fourteen of 25 biliary case-patients underwent cholecystectomy; all had histopathologic evidence of cholecystitis and 12 had gallstones . Thus, treatment of unsubstantiated diagnoses of Lyme disease is associated with biliary complications. Am J Respir Crit Care Med, 1995 Feb, 151(2 Pt 1), 353 - 9 Asthma self-management education program by home monitoring of peak expiratory flow; Ignacio-Garcia JM et al.; A prospective controlled trial of home monitoring of peak expiratory flow rate (PEFR) was conducted to determine the usefulness of an objective measure of lung function in association with an education program and a medication self-management plan in reducing morbidity in adult patients with asthma . Thirty-five patients managed themselves, using peak flow readings as the basis for the therapeutic plan coupled with educational intervention, whereas 35 control patients used symptoms and spirometric data for following physicians' treatment plans . After a 6-mo study period, patients in the experimental group showed statistically significant improvements in morbidity parameters (days lost from work, acute asthma attacks, days on antibiotic therapy, physician consultations, and emergency room admissions for asthma), increases in FVC, FEV1, and FEV1/FVC, mean PEFR and mean morning PEFR, decrease in percentage of the mean PEFR amplitude, and a reduction in the use of inhaled beta-agonists, oral theophylline, and oral prednisone . Although improvements in some of these parameters were also found in the control group, they did not reach the levels of significance obtained in the experimental group . The personal use of an objective measure of lung function in association with a medication self-management plan leads to improvement in the patient's condition. J Am Acad Dermatol, 1995 Feb, 32(2 Pt 1), 192 - 8 Pustular vasculitis of the hands; Strutton G et al.; BACKGROUND: Several patients were observed with a peculiar cutaneous eruption limited to the dorsa of the hands and fingers . Clinically the lesions had some resemblance to those seen in Sweet's syndrome, but biopsy specimens showed severe leukocytoclastic vasculitis . OBJECTIVE: Our purpose was to characterize this eruption clinically and histologically and compare it with previously described diseases . METHODS: Six patients observed since 1977 are described . Skin biopsy specimens were obtained . RESULTS: In six women (age, 41 to 79 years) a symmetric eruption of papules and plaques limited to the dorsa of the radial sides of the hands and first three digits developed . The lesions resembled those of Sweet's syndrome and were associated with fever, sterile culture, blood neutrophil leukocytosis, nonresponse to antibiotic therapy, and rapid response to prednisone . Biopsy specimens showed a severe leukocytoclastic vasculitis . CONCLUSION: These patients appear to have a distinct entity that we have termed pustular vasculitis of the hands. Thromb Haemost, 1995 Feb, 73(2), 180 - 5 Urokinase therapy in neonates with catheter related central venous thrombosis; Wever ML et al.; The results of fibrinolytic therapy with urokinase were evaluated in 26 neonates with catheter related central venous thrombosis . Complete thrombolysis could be achieved in 13 patients (50%), partial thrombolysis in 3 patients (12%) . No effect was seen in 10 patients (38%) . Therapy success was influenced by age, size and location of the thrombus . Coincidence of infection occurred in 16 patients (62%) . Mild hemorrhagic complications were seen in 2 patients (8%), no other significant side effects were observed . Nine patients with residual thrombosis were treated with oral anticoagulants following urokinase resulting in resolution of the thrombus in 6 patients within 3 months (67%) . The incidence of asymptomatic recurrent thrombosis was high (28%) . Urokinase might be an effective and safe treatment for central venous thrombosis in neonates . Prophylactic antibiotic therapy during the infusion of urokinase and long-term treatment with oral anticoagulants after thrombosis are advisable . Early detection of thrombosis might enhance the success rate of fibrinolytic therapy . Therefore, we strongly recommend routine echocardiographic screening of central venous catheters. Diagn Cytopathol, 1995 Feb, 12(1), 76 - 80 Sialadenitis with crystalloid formation: a report of six cases diagnosed by fine-needle aspiration; Johnson FB et al.; Six cases of sialadenitis diagnosed by fine-needle aspiration contained large numbers of crystalloids . Light microscopy, ultrastructure, and chemical analysis suggest that the crystalloids represent crystallized salivary alpha-amylase . The inflammatory swelling may mimic benign and/or malignant neoplasms of the salivary glands . Drainage and/or antibiotic therapy may allow surgery to be avoided in these patients. J Vet Med Sci, 1995 Feb, 57(1), 173 - 6 Effect of terdecamycin on experimentally induced swine dysentery in pigs; Ueda Y et al.; The authors evaluated the effect of terdecamycin, a novel antibiotic, on experimentally induced Serpulina (S.) hyodysenteriae infection in pigs . In a prophylactic test, feed containing terdecamycin was fed to pigs for 7 days before inoculation and 21 days after inoculation . Dysenteric diarrhea, development of lesions in the large intestinal mucosa and colonization of S . hyodysenteriae in colonic mucosa were completely inhibited by treatment with 5 ppm or 10 ppm terdecamycin . In the therapeutic test, an unmedicated feed was fed to pigs inoculated with S . hyodysenteriae, until the typical mucohemorrhagic diarrhea appeared after inoculation, and was then changed to the medicated feed for 10 days . By treating with 20 ppm terdecamycin, the clinical signs in the pigs were improved and S . hyodysenteriae was completely eradicated. Acta Paediatr Jpn, 1995 Feb, 37(1), 12 - 6 Helicobacter pylori colonization in children with peptic ulcer disease . III . Diagnostic value of the 13C-urea breath test to detect gastric H . pylori colonization; Yamashiro Y et al.; The efficiency of the 13C-Urea Breath Test (13C-UBT) for the detection of Helicobacter pylori colonization in gastric mucosa was evaluated . The 13C-UBT was performed in five pediatric and six adult subjects who had had upper gastrointestinal endoscopy within 2 weeks . H . pylori colonization was confirmed in two pediatric and three adult subjects with peptic ulcer combined with antral gastritis, by histological examination of antral biopsy specimens . When an individual with H . pylori colonization ingested a solution containing 13C-urea, a significant amount of 13CO2 appeared in the respiratory CO2 within 10 min . The mean cumulative percentage dose of 13C recovered in the breath over 30 min in the cases with H . pylori colonization was significantly higher than that in those who were not colonized (4.91 vs 0.41, P < 0.001) . In addition, the effect of antibiotic on the eradication of H . pylori from gastric mucosa was monitored by 13C-UBT in two cases . The values of cumulative percentage dose of 13C over 30 min fell to the same levels as those observed in H . pylori negative subjects after just 2 weeks treatment with amoxicillin; however, positive results were obtained again 1 month after the withdrawal of amoxicillin . In summary, 13C-UBT is a simple, reliable, non-invasive method in the diagnosis of gastric H . pylori colonization especially for pediatric patients. Br J Surg, 1995 Feb, 82(2), 170 - 1 Primary anastomosis with transverse colostomy as an alternative to Hartmann's procedure; Maddern GJ et al.; Hartmann's procedure remains the favoured option in patients with acute left colonic and sigmoid disease, despite the well documented morbidity and mortality associated with reversal . In 40 patients with left colonic pathology, primary anastomosis was performed; 32 had a covering transverse colostomy . There were six hospital deaths, five in the transverse colostomy group . Closure was not attempted in seven of the 27 patients surviving with a colostomy (three refused, four had disseminated malignancy) . In the 20 undergoing closure, there was no morbidity or mortality . With advances in intensive care, antibiotic therapy and anaesthesia, it is reasonable to consider alternatives to Hartmann's procedure, particularly when subsequent reconstruction is envisaged. J Dairy Sci, 1995 Feb, 78(2), 412 - 20 Effects of a colostrum substitute and of dietary brewer's yeast on the health and performance of dairy calves; Seymour WM et al.; We tested the effects of substituting a whey protein concentrate for dam's colostrum at first feeding and of 1% brewer's yeast in dry feed on calf health and performance . Eighty-four calves were assigned to four preweaning and eight postweaning treatments based on feeding either dam's colostrum or a whey protein concentrate at birth and either yeast or no yeast in the dry feed both before and after weaning . After the first feeding, all calves were fed colostrum through 4 d of age and an all milk protein milk replacer from d 5 to 46 of age . Daily feed intakes, health measurements, and weekly BW were recorded . Calves fed whey protein concentrate at birth had similar health parameters and greater feed efficiency than calves fed colostrum over the preweaning period . Addition of 1% brewer's yeast to the dry feed apparently reduced the incidence of fever and the number of associated antibiotic treatments during the preweaning period, but had no effects thereafter . Under the conditions of this study, whey protein concentrate was an effective substitute for dam's colostrum at first feeding, and 1% brewer's yeast fed in dry feed may reduce susceptibility to infection prior to weaning. J Pharm Sci, 1995 Feb, 84(2), 226 - 7 Comparison of the crystallinity of imipenem samples by X-ray diffraction of amorphous material; Crocker LS et al.; The intensity of X-rays diffracted by amorphous material in samples of the beta-lactam antibiotic imipenem {(5R,6S)-3-{{2-(formimidoyl-amino)ethyl}thio}-6-{(R)-1- hydroxyethyl}-7-oxo-1-azabicyclo{3.2.0}hept-2-ene-2-carboxylic acid} was used to compare the crystallinity of the samples . The method makes use of the intensity in the X-ray powder diffraction (XRPD) pattern at a diffraction angle of 28 degrees (2 theta), at which no crystalline peaks are observed . A linear relationship (R2 = 0.9999) exists between amorphous intensity and crystallinity for synthetic mixtures of amorphous and crystalline imipenem . Sample preparation techniques ordinarily used in XRPD experiments were utilized. Arch Pediatr, 1995 Feb, 2(2), 147 - 9 {Tuberculous dacryocystitis}; Cotton JB et al.; BACKGROUND--Acute infection and inflammation of the nasolacrimal sac may complicate congenital obstruction of the nasolacrimal duct . Acute dacryocystitis is uncommon later and tuberculosis is exceptionally responsible for it . CASE REPORT--A 4 1/2 year-old boy was admitted because he suffered from acute left dacryocystitis with fever and cervical adenitis . Involvement of both lacrymal gland and lymph node persisted despite antibiotic and corticosteroid therapy . Needle biopsy of the lymph node showed presence of Mycobacterium tuberculosis and excision revealed caseating granulomas . The tuberculin skin test was positive while pulmonary tuberculosis was discovered in the patient's father . The patient was successfully given izoniazid, rifampin for 9 months and pyrazinamide for 2 . Drainage of the sac area was necessary after 1 month of treatment followed by dacryocystorhinostomy . CONCLUSION--This rare case of tuberculous dacryocystitis permits to delineate the difficulties of ophthalmologic therapy. Nihon Kyobu Shikkan Gakkai Zasshi, 1995 Feb, 33(2), 202 - 8 {A case of hypersensitivity pneumonitis probably caused by a humidifier in winter}; Nakagawa A et al.; A 64-year-old man was admitted complaining of cough, hemoptysis, dyspnea, and fever . His chest X-ray film on admission showed reticulo-granular shadows in both lung fields . Ausculation of his chest revealed fine crackles in both lower zones . After admission, he was treated with antibiotics, but his chest-radiographic appearance worsened temporarily, and sputum cytology results were repeatedly positive . Diagnosis was difficult . Differential cell count of the bronchoalveolar lavage fluid showed lymphocytosis, with a high CD 4/8 ratio . Transbronchial lung biopsy specimens revealed Masson bodies and alveolitis . With antibiotic therapy alone, his condition improved, and he was discharged . Five and a half hours later, his symptoms worsened and he was readmitted . His chest X-ray film on the second admission was almost the same as that on the first admission . His symptoms became less severe, and his condition improved without treatment . Hypersensitivity pneumonitis was diagnosed . Because the onset was in February, this was not considered to be a case of so-called summer type hypersensitivity pneumonitis a provocation test was done with water from the humidifier he had been using at home . The white blood cell count increased and PaO2 decreased significantly, so the result of the provocation test was thought to be positive . Therefore, so-called humidifier lung was strongly suspected . The results of sputum cytology on the first admission were probably falsely positive. J Pharmacol Toxicol Methods, 1995 Feb, 33(1), 35 - 45 Combination of computerized morphonuclear and multivariate analyses to characterize in vitro the antineoplastic effect of alkylating agents; Pauwels O et al.; The influence of 13 anticancer alkylating agents on cell proliferation, cell cycle parameters, and morphonuclear characteristics was monitored in vitro on three neoplastic cell lines . This monitoring was carried out by means of the digital cell image analysis of Feulgen-stained nuclei . This computer-assisted microscope analysis of chromatin texture made it possible to assess 15 morphonuclear parameters . These 15 parameters were submitted to multivariate analyses, that is, principal-components analyses followed by the canonical transformation of the data . The 13 alkylating agents included four nitrogen mustards (chlormethine, chlorambucil, melphalan, and cyclophosphamide), two nitrosoureas (carmustine and lomustine), two platinum analogues (cisplatine and carboplatine), two ethyleneimine derivatives (thiotepa and investigational PE1001), one antibiotic (mitomycin C), one alkylsulfonate (busulfan), and one triazene (dacarbazine) . The mouse MXT mammary and the human J82 and T24 bladder tumor cell lines were used in this study . The results show that these alkylating agents induced specific modifications to the chromatin pattern according to the subclass to which they belong . In other words, the multivariate statistical analyses of the 15 parameters made it possible to identify, at least partly, distinct subclasses of alkylating agents according to their mechanisms of action . As a validation of the methodology, the results also show that most of the alkylating agents induced an increase in the percentage of cells in the G2 phase, while some sometimes induced an increase in the percentage of cells in the S phase of the cell cycle. Postgrad Med J, 1995 Feb, 71(832), 98 - 101 Descending necrotising mediastinitis; Alsoub H et al.; Descending necrotising mediastinitis is a rare but serious complication of oropharyngeal infections with high mortality . Diagnosis is frequently delayed, contributing to this high mortality, but awareness of such a complication and early diagnosis using computed tomographic scanning leads to prompt surgical drainage, proper antibiotic therapy, and survival. Ophthalmologe, 1995 Feb, 92(1), 31 - 4 {Monotherapy vs combination therapy with topical prednisolone and indomethacin}; Hessemer V et al.; The anti-inflammatory effects of topical steroids and nonsteroidal anti-inflammatory drugs (NSAID) are claimed to be additive, according to fluorophotometric measurements . This finding was reevaluated using laser flare-cell photometry . PATIENTS AND METHODS: Thirty patients (61-79 years of age) without pre-existing deficiencies of the blood-aqueous barrier were investigated preoperatively as well as on day 1 and 3 after ECCE with IOL implantation . The laser flare-cell photometer (model FC-1000; Kowa Company) which was used for examination enables sensitive and exact in vivo determination of aqueous flare . The patients were randomly assigned to one of the following three treatment groups: group A, monotherapy with prednisolone 1% eyedrops (Inflanefran forte); group B, monotherapy with indomethacin 1% eyedrops (Chibro Amuno); group C, combination therapy with prednisolone 1% + indomethacin 1% eyedrops . One drop of either drug was administered five times per day to each patient, beginning immediately after completion of surgery . In addition, all patients received antibiotic therapy with gentamicin . Parabulbar or oral steroids were not administered . RESULTS: Under monotherapy with prednisolone, the flare (photon counts/ms) on days 1 and 3 postoperatively averaged 30.9 and 27.8, respectively . Under indomethacin monotherapy, the flare values were similar (no significant differences) . Under combination therapy with prednisolone+indomethacin, however, the flare values were significantly lower both on day 1 (24.2) and on day 3 (20.6) . CONCLUSIONS: Combination therapy with topical prednisolone+indomethacin thus seems superior to monotherapy with either of these agents . This confirms the previous fluorophotometric finding that the anti-inflammatory effects of topical steroids and NSAID are additive, a phenomenon attributable to different pharmacological sites of action. Tuber Lung Dis, 1995 Feb, 76(1), 4 - 10 Acute respiratory infections in children: a community-based study comparing a primary health center and a pediatric unit, Republic of Guinea; Sow O et al.; OBJECTIVE: A community-based study was carried out in the Republic of Guinea in order to evaluate the frequency of occurrence, severity of illness, risk factors and the results of planned treatment of acute respiratory infections (ARI) in children under the age of 15 years . DESIGN: The study was performed over a 1-year period in 2 distinct areas, 1 rural and 1 urban . A total of 2622 ARI were identified among children under 15 years of age . In the rural area, data were collected by primary health-care workers and by 2 physicians who were trained to supervise the study . RESULTS: Among the rural population, 1422 ARI were identified . In the city center, Conakry, 1200 ARI were identified in one children's hospital . The child population under 5 years of age was significantly greater in the rural area (95.2%) than in the city center (83.2%) (P < 0.0001) . Malnutrition affected 10.6% of all the children . There were discrepancies in symptoms and signs affecting the 2 groups but the severity scores, including children under 5 years of age, were not significantly different: including children under 5 years of age, were not significantly different: 10-11% of the children were considered to have severe disease and 6.2% required urgent referral to hospital . Upper and lower respiratory infections (URI and LRI) were equally represented (49.9% and 50.1% respectively) . Distribution of each type of ARI was significantly different in the 2 groups: there were significantly more URI in the city center, especially tonsillitis . Bronchitis and bronchopneumonia occurred significantly more often in the rural area . Pneumonia and bronchopneumonia represented 9.8% of all ARI . Use of antibiotic therapy was known in 2557 patients: 1268 URI and 1289 LRI . In children with URI, 69.7% did not receive antibiotic therapy, 29.9% received 1 antibiotic and 0.03% received 2 antibiotics successively . Children from the city center received significantly more antibiotics than in the rural health center . In children with LRI, 17.8% did not receive antibiotic therapy, 81.7% received 1 antibiotic and 0.05% received 2 antibiotics successively . There was no significant difference between the 2 centers in antibiotic prescription . Clinical outcome showed that 93% of children were considered to be cured at day 7 and 99.4% at day 14 . 14 children with severe pneumonia died . The infection cost (antibiotics plus other drugs prescribed as supportive care) was 0.45 US$ per child in the rural area and 9.7 US$ in the children's hospital . CONCLUSION: This supervised study constitutes the first large longitudinal study concerning respiratory infections in West Africa . It demonstrates that simple guidelines are valid in order to prevent mortality and complications . Care appropriate to population requirements in term of infectious diseases can be delivered with low cost and low technology. J Clin Microbiol, 1995 Feb, 33(2), 428 - 31 Isolation of Coxiella burnetii from heart valves of patients treated for Q fever endocarditis; Muhlemann K et al.; Coxiella burnetii was isolated from the valve material of two patients who underwent valvectomy because of progressive congestive heart failure due to endocarditis . In each case antibiotic therapy was administered for several months prior to valvectomy . Classical histopathological examination of the valves did not reveal an etiology . However, coxiella-like organisms were demonstrated in valvular material with Koster, Stamp, and Giemsa stains, and the organisms were grown in cell culture . Antibody titers were consistent with the diagnosis of chronic C . burnetii infection . This report illustrates the advantage of simple and fast staining techniques and cell culture for the demonstration and isolation of C . burnetii in the heart valve tissue of patients with Q fever endocarditis. J Clin Microbiol, 1995 Feb, 33(2), 419 - 27 Immunoblot interpretation criteria for serodiagnosis of early Lyme disease; Engstrom SM et al.; We monitored the antibody responses of 55 treated patients with early Lyme disease and physician-documented erythema migrans . Six sequential serum samples were obtained from patients before, during, and until one year after antibiotic therapy and analyzed by in-house enzyme-linked immunosorbent (ELISA) and immunoblot assays . An immunoblot procedure utilizing a gradient gel and an image analysis system was developed . A relational database management system was used to analyze the results and provide criteria for early disease immunoblot interpretation . Recommended criteria for the immunoglobulin M (IgM) immunoblot are the recognition of two of three proteins (24, 39, and 41 kDa) . The recommended criteria for a positive IgG immunoblot are the recognition of two of five proteins (20, 24 {> 19 intensity units}, 35, 39, and 88 kDa) . Alternatively, if band intensity cannot be measured, the 22-kDa protein can be substituted for the 24-kDa protein with only a small decrease in sensitivity . Monoclonal antibodies were used to identify all these proteins except the 35-kDa protein . With the proposed immunoblot interpretations, the sequential serum samples were examined . At visit 1, the day of diagnosis and initiation of treatment, 54.5% of the serum samples were either IgM or IgG positive . The peak antibody response, with 80% of the serum samples positive, occurred at visit 2, 8 to 12 days into treatment . The sensitivities of the IgM and IgG immunoblot for detecting patients that were seropositive into the study period were 58.5 and 54.6%, respectively, at visit 1 and 100% at visit 2 . Twenty percent of the patients remained seronegative throughout the study . The specificities of the IgM and IgG immunoblots were 92 to 94% and 93 to 96%, respectively . The IgM immunoblot and ELISA were similar in sensitivities, whereas the IgG immunoblot had greater sensitivity than the IgG ELISA (P = 0.006). J Korean Med Sci, 1995 Feb, 10(1), 62 - 5 A case of shunt nephritis; Lee HS et al.; Nephritis associated with a chronically infected ventriculoatrial shunt is known as shunt nephritis . A 6-year-old girl with prior history of a ventriculoatrial shunt presented complaining of fe