Characterization of genetically distinct subgroup of Candida albicans strains isolated from oral cavities of patients infected with human immunodeficiency virus

During the course of a study of oral Candida albicans strains from 60 human immunodeficiency virus-infected patients over a 2.5-year period, 18 of the 295 C. albicans isolates had genomes that failed to hybridize with a C. albicans-specific DNA probe (27A). These strains were germ tube positive and chlamydospore positive and were identified as C. albicans by the ID 32C test (API Systems, Montlieu, France). These strains were analyzed for the presence of two other C. albicans-specific DNA segments by PCR. The first was a C. albicans 1,348-bp species-specific sequence, and the second was a 1,059-bp C. albicans repetitive element. The probe 27A-hybridizing strains yielded PCR products which differed from those of the nonhybridizing strains. Five of these genetically atypical C. albicans strains and 98 of the C. albicans strains were then analyzed for purported virulence factors. The genetically atypical C. albicans strains, in comparison with typical C. albicans strains, produced greater amounts of extracellular proteinase (P = 0.038, Student's t test), adhered to a greater degree to buccal epithelial cells (P = 0.018, Student's t test), and were less susceptible to the antifungal drug 5-flucytosine (P = 0.0003, Mann-Whitney test). Analysis of these strains with other common antifungal drugs showed no statistically significant variation in susceptibility. The results of this study indicated that these genetically atypical C. albicans strains possess increased virulence in comparison with typical C. albicans strains.

A longitudinal study of the change in resistance patterns and genetic relationship of oral Candida albicans from HIV-infected patients

Candida albicans is an important opportunistic pathogen in the oral cavity of HIV-infected patients. C. albicans was isolated repeatedly over a period of 30 months from the mouth-swills of five males with category IV HIV infection who suffered from recurrent pseudomembranous oral candidosis and were being treated with fluconazole. C. albicans was identified by the germ tube test, carbon assimilation by the API 20C test (bioMerieux sa, Marcy, l'Etoile, France) and morphology on cornmeal Tween 20 agar. Sensitivity testing was performed with a disk diffusion method using neosensitabs (Rosco Diagnostica, Taasrup, Denmark) and the broth microdilution assay using RPMI 1640 medium. Isolates from the five patients taken between 14 and 30 months apart (mean = 23 months) showed the development of resistance to several antifungal agents, notably fluconazole, miconazole and itraconazole by the disc diffusion method and markedly higher minimum inhibitory concentrations (MICs) for fluconazole by the broth microdilution assay. Genetic relatedness of the C. albicans strains was assessed using the mixed-linker polymerase chain reaction method. Four patients had isolates which were genetically identical, while one patient had isolates of varying genetic type. This study has shown that in HIV-infected patients with recurrent oral pseudomembraneous candidosis, the development of drug resistance to antifungal agents may either be due to increased resistance of a single strain or replacement with a more resistant strain.

Effect of foot position on gastrocnemius/soleus stretching in subjects with normal flexibility

Following injury to the ankle or lower extremity, stretching of the gastrocnemius/soleus complex is commonly prescribed. Many authors recommend stretching the gastrocnemius/soleus complex with the foot placed in a supinated position. No research is available, however, that supports the efficacy of stretching in the supinated vs. the pronated position. Therefore, the purpose of this study was to compare the effect of stretching the gastrocnemius/soleus complex in two foot positions: supinated and pronated. Eleven female and eight male subjects completed 10 stretching sessions with one foot supinated and the other foot pronated. Each stretching session consisted of four 20-second stretches. On pretest and posttest measurements, maximum dorsiflexion range of motion and stretching force exerted through the foot were recorded for each subject. Foot position for the testing procedures and the stretching phase was standardized with individually constructed footprint templates. A two-way analysis of variance (stretching position and time) was used to compare pretest and posttest ankle dorsiflexion measurements. Results indicated a significant increase in dorsiflexion (p = 0.01, pronation + 6.36%, supination + 6.24%) but no significant difference between stretching positions (p = 0.23). We concluded that gastrocnemius/soleus complex stretching in either foot position is effective for increasing dorsiflexion range of motion in healthy subjects with normal flexibility of the gastrocnemius/soleus complex.

Snoring may be linked to culture

The estimates of the incidence of snoring in adults that have been provided by four epidemiological studies vary from 16-89% of the population. Collectively, these data are completely confounded by country of origin and thus may reflect cultural differences that contribute to snoring. While the etiology of snoring is not fully known, speculation has focused on gender and age as primary factors that contribute to this behavior. Within the limitations imposed by the designs of these four studies, we compared the relative strength of the relationships between snoring and gender, age, and culture. These analyses suggest that certain variables associated with cultures appear to be more salient than both gender and age, as determinants of snoring.

Possible association of the extended MHC haplotype B44-SC30-DR4 with autism

We previously reported that the complement C4B null allele appears to be associated with infantile autism. Since the C4B null allele is known to be part of the extended or ancestral haplotype [B44-SC30-DR4], we investigated the incidence of [B44-SC30-DR4] in 21 autistic children and their parents. This extended haplotype was increased by almost six-fold in the autistic subjects as compared with healthy controls. Moreover, the total number of extended haplotypes expressed on chromosomes of autistic subjects was significantly increased as compared with those expressed on chromosomes of healthy subjects. We conclude that a gene related to, or included in, the extended major histocompatibility complex may be associated with autism.

Blood pressure and renal blood flow responses to dietary calcium and sodium intake in humans

This study was designed to determine the interaction between salt and calcium intake on blood pressure (BP) and renal blood flow (RBF) in a predominantly white population. We measured BP and RBF (P-aminohippurate [PAH] clearance) in hypertensive patients after 7 days on a low salt/low calcium diet and again after either a high salt/high calcium diet (HS/HC) or a high salt/low calcium (HS/LC) diet for another 7 days. Compared to low salt BP, both high salt diets increased BP, but the increase with high salt/low calcium was significantly greater than with high salt/high calcium (+14.6 +/- 3.9/+8.2 +/- 1.7 mm Hg v +7.5 +/- 1.9/+2.5 +/- 1.4 mm Hg; systolic/diastolic, both P less than or equal to .05). PAH clearance increased 26 +/- 13 mL/min/1.73 m2 on the HS/HC diet but only 10 +/- 17 mL/min/1.73 m2 on HS/LC (P = .05 between groups). These data suggest that a low calcium diet may contribute to the phenomenon of salt sensitivity in a white population. The low calcium intake appears to affect both the systemic and renal vasculature.

Altered operant behavior of adult rats after perinatal exposure to a 60-Hz electromagnetic field

Rats were sham exposed or exposed perinatally to a 60-Hz electromagnetic field, 22 days in utero and the first 8 days post partum. Each of the 30 once-daily exposures was 20 h in duration. The electric component of the field was vertical 30 kV/m rms, and the magnetic field component was 100 microTG rms. Later, as adults, male rats were trained to emit an operant response when reinforced with food on a multiple, random-interval schedule. Exposed rats (N = 21) gradually came to respond at significantly lower rates than did sham-exposed controls (N = 20). This finding was confirmed and extended in a second, independently performed experiment. After a sequence including operant conditioning followed by experimental extinction of responding and then by a suspension of conditioning and finally by more than a month of reconditioning, slower rates of responding were found to persist in the adult animals. The evidence of altered behavior several months after combined, fetal-neonatal exposure to an electromagnetic field presents an interesting contrast with other findings: Field-exposed rats did not differ from sham-exposed rats in terms of body mass, physical appearance, grossly observed activity level, or incidence of disease.

A large trial of intravenous Conray 325 and Niopam 300 to assess immediate and delayed reactions

The trial was designed as an investigation into the incidence of both immediate and delayed reactions to the intravenous administration of Conray 325 (sodium iothalamate) (844 patients) and Niopam 300 (iopamidol) (855 patients) for urographic examination. Information was obtained from questionnaires returned by patients about a week after their examination, with a response rate of 81%. Significant differences were found in the incidences of both types of reactions to the two media with respect to nausea and vomiting, arm pain, and taste in the mouth, which was commoner in patients receiving Conray 325, whereas the incidence of delayed skin rashes and parotid swelling was commoner with Niopam 300. The occurrence of a flu-like illness, so-called "iodism", was found to be equal for the two contrast media.

Current spectrum of intestinal obstruction

In a 12-month prospective study incorporating four neighbouring district general hospitals, 228 patients required a total of 236 admissions with intestinal obstruction. The aetiological factors included adhesions 75 (32 per cent), malignant disease 61 (26 per cent), strangulated hernias 59 (25 per cent), volvulus 10 (4 per cent), acquired megacolon 6 (3 per cent), pseudo-obstruction 4 (2 per cent), faecal impaction 6 (3 per cent) and miscellaneous 15 (6 per cent). The peak incidence for obstruction due to adhesions, malignant disease and strangulated hernias each occurred in the eighth decade. Surgery was performed within 48 h of admission in 29 per cent adhesive obstructions (22), 30 per cent obstructions due to malignant disease (18) and 68 per cent strangulated hernias (40)--bowel resection rates in these three groups were 13.5, 50 and 29 per cent, respectively. The overall mortality was 11.4 per cent (26 deaths) and postoperative mortality was 12.3 per cent (19 deaths). During the 12-month study period, 228 patients required a total of 2993 inpatient hospital days as a result of intestinal obstruction. Postoperative adhesions have become the commonest cause of intestinal obstruction but strangulated hernias and intra-abdominal malignant disease still account for 50 per cent of all cases and mortalities. Obstruction due to strangulated hernias and intra-abdominal malignant disease typically occurs in the elderly age group where a more aggressive policy of elective surgical intervention is likely to be associated with increased postoperative morbidity and mortality.

In vitro cultivation of the exoerythrocytic stage of Plasmodium berghei from sporozoites

When inoculated with sporozoites of Plasmodium berghei, the human embryonic lung cell line WI38 supports the complete asexual developmental cycle of the exoerythrocytic stage. Cultured parasites were sensitive to primaquine, were shown to resemble parasites in living hosts by immunofluorescent antibody tests, and on subinoculation into mice induced a red blood cell infection, the gametocytes of which produced sporozoites in anopheline mosquitoes.