Comparison of paralytic toxins in aquaculture of purple clam in Taiwan

Food poisoning incidents due to ingesting the cultured purple clam Soletellina diphos occurred in western Taiwan in February 1991. Clam specimens, sediment and the dinoflagellate Alexandrium tamarensis were collected and assayed for lethality as paralytic shellfish poison (PSP). The lethality of purple clam, wet sediment and phytoplankton was 1700 mouse units per specimen (MU/specimen), 0.05 MU/g and 3.6 x 10(-5) MU/cell, respectively. The toxins obtained from clam, sediment and phytoplankton consisted of gonyautoxins 1-4, along with trace amounts of neosaxitoxin.

Acute renal failure and severe thrombocytopenia induced by rifampicin: report of a case

We report on a patient who developed life-threatening thrombocytopenia and acute renal failure after the reinstitution of rifampicin therapy for pulmonary tuberculosis. This combined reaction is rarely reported. Supportive treatment and withdrawal of rifampicin led to complete recovery. The increased incidence of drug-resistant tuberculosis and the need for the reintroduction of rifampicin therapy may lead to more such reactions being observed.

[Pulmonary nocardiosis with skin and subcutaneous dissemination. An imitator mimicking tuberculosis]

Nocardiosis is a localized or disseminated infection caused by an aerobic bacteria, usually introduced through the respiratory tract. The pulmonary event may provoke an acute or chronic process mimicking tuberculosis. We herein report a case of pulmonary nocardiosis with skin and subcutaneous dissemination, presenting with the clinical manifestations similar to pulmonary tuberculosis. A 60-year-old male was admitted to the hospital because of a left upper cavitary lung lesion in combination with old treated pulmonary tuberculosis, chronic obstructive pulmonary disease, diabetes mellitus, and drug-induced adrenal insufficiency. Clinical presentations manifested as pulmonary tuberculosis in the beginning, but the left cavitary lung lesion progressed to both lungs and disseminated to produce skin and subcutaneous abscesses in spite of antituberculous therapy. Eventually, Nocardia spp. was found by the Gram's stain, the modified acid-fast stain, and cultures of sputum and subcutaneous abscesses. Thereafter, he received treatment for nocardiosis with trimethoprim/sulfamethoxazole for 30 weeks. Twenty-six months later after discontinuing trimethoprim/sulfamethoxazole, the recurrence of Nocardia was noted from sputum. Therefore, if there is no improvement after antituberculous therapy for patient with the cavitary lung lesion due to possible pulmonary tuberculosis, then the possibility of nocardiosis should be considered, especially when progressive lung lesion or extrapulmonary dissemination develops.

Serum gastrin levels in children with peptic ulcer disease

Fasting serum gastrin values were measured by radioimmunoassay in 53 children with peptic ulcer disease. The mean fasting serum gastrin levels for children with chronic duodenal ulcer, acute gastric ulcer, acute duodenal ulcer who were younger than two years old and acute duodenal ulcer who were older than two years old were: 46.2 +/- 25.7 pg/mL, 46.9 +/- 43.5 pg/mL, 47.9 +/- 12.0 pg/mL and 37.5 +/- 17.8 pg/mL, respectively. Children with peptic ulcer disease did not have elevated fasting serum gastrin levels when compared with age-matched controls. We conclude that a fasting serum gastrin value cannot be used as a screening test for peptic ulcer disease in children, except for Zollinger-Ellison syndrome.

[Comparison of two commercial potassium chloride tablets for slow-release in an in vitro dissolution test]

Two commercial slow-release potassium chloride tablets, Slow-K and Addi-K have the characteristics of slow-release in the different dissolution conditions. The two tablets had similar dissolution profiles in simulated intestinal fluid (pH 6.8), simulated gastric fluid (pH 1.2) and water; which indicates that, the dissolution rates of the two commercial potassium chloride tablets are independent of the pH values of the dissolution medium. The release patterns of potassium chloride fitted the First order model and Higuchi matrix model. These were distinguished by differential rate treatment, which showed that the release followed the First order pattern. It was found that the dissolution rate of Addi-K were more rapid than Slow-K in different dissolution conditions.

Pulmonary manifestations of Staphylococcus aureus septicemia

This study includes 140 episodes (138 cases) of Staphylococcus aureus septicemia, made up mostly of community-acquired, nonintravenous drug abuse (nonIVDA) cases. Unlike other series, injury wounds and skin or soft tissue infections were the most common sites of primary infection. In spite of a different patient population and lack of cases with tricuspid valvular endocarditis, the lungs were still the most common site of secondary infectious foci and most developed within two weeks of onset of the septicemia.

Thoracic actinomycosis--review of 9 cases

Nine cases of thoracic actinomycosis treated in the period from 1976 to 1990 were reviewed. Among them, 4 cases were children. The clinical symptoms and laboratory examinations were non-specific. Chest roentgenographic manifestations including nodular (3 cases), infiltrations (4 cases), and infiltrations with pleural changes (2 cases) were also non-specific. Chest wall masses were noted in four patients. There were no cases correctly diagnosed on admission. The diagnosis of thoracic actinomycosis was made from thoracotomy in 6 cases, from culture of chest wall mass incisional specimens in 2 cases and from bronchoscopic biopsy in 1. All the patients received antibiotics, however the varied duration of postoperative antibiotics did not change the outcome. No mortality or recurrence was noted in our 9 patients with a mean follow-up of 1.9 years (from 2 months to 6 years.) We conclude that surgical intervention is still the cardinal method for diagnosis and treatment. Establishment of the role of postoperative antibiotics will need further prospective study. The prognosis of thoracic actinomycosis is fairly good.

Mycoplasma pneumoniae pneumonia: clinical analysis of 45 cases

Mycoplasma pneumoniae (M. Pneumoniae) is a primarily pathogen of the respiratory tract. The clinical characteristics, laboratory findings, and roentgenographic patterns of 45 patients with serologically proven M. pneumoniae pneumonia admitted to Chang Gung Hospital from 1981 to 1989 have been reviewed. There were 23 males and 22 females. Forty-one (91%) were below 40 years old and 13 patients (29%) were below 5 years old. Fever, cough and chest rales were the most common symptoms and signs. A transient mild elevation of liver enzymes was seen in 33% of the patients, most of whom were below the age of ten (73%). A leukocyte count over 15,000/cu mm was not rare (16%). Roentgenographic features included unilateral infiltration (84%), lower lobe predominance (60%), and either confluent (56%) or patchy (33%) consolidation. Pleural effusion occurred in 24% of the patients. Complete resolution of chest roentgenography took from 8 to 42 days with a mean of 20 days. The response of fever to treatment with erythromycin took from 1 to 6 days with a mean of 3 days. There were no life threatening pulmonic or extrapulmonic complications.

Multifocal atrial tachycardia as a prognostic indicator in patients with severe chronic obstructive pulmonary disease requiring mechanical ventilation

The records of 121 patients admitted to the Medical Intensive Care Unit (MICU) of Chang Gung Memorial Hospital with severe chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation were reviewed retrospectively. Eighty-seven percent (20/23) of the patients with multifocal atrial tachycardia (MAT) expired during their ICU admission in contrast to 23.5% (23/98) of those without MAT. The only differences between these two groups were incidence of cor pulmonale, and right axis deviation, right bundle branch block, pulmonale P in electrocardiogram. MAT might be considered as a grave prognostic sign in patients with COPD severe enough to require mechanical ventilation.

Pneumonia preceding respiratory failure. A rare, easily misleading clinical manifestation in adult Arnold-Chiari malformation

A 47-year-old woman was admitted for bilateral lower lobe pneumonia with respiratory distress. Two episodes of respiratory failure developed despite improvement of pneumonia after antibiotic chemotherapy. Loss of consciousness and quadriplegia accompanied the last episode of respiratory failure. Arnold-Chiari malformation type 1 was diagnosed and a suboccipital craniectomy was performed. The neuromuscular and respiratory disorders greatly improved after operation. We believe that ACM 1 should be considered when an adult develops unexpected respiratory failure after improvement of the primary pulmonary condition. This disease is potentially treatable by surgical management, and if it is misdiagnosed, will be fatal.

Mucosal ornithine decarboxylase, polyamines, and hyperplasia in infected intestine

Ornithine decarboxylase (ODC), through the regulation of polyamine biosynthesis, influences normal mucosal growth and cell proliferation. The purpose of our study was to determine whether mucosal ODC activity and polyamines play a role in the dramatic increase in mucosal mass and crypt elongation associated with parasite-induced inflammation in the small intestine. Rats were inoculated orally with L1 larvae of the parasitic nematode Trichinella spiralis and killed at different times during the enteric phase of infection. Duodenal and jejunal mucosal ODC activities increased significantly from 2 to 14 days, peaking 7 days postinfection (PI). By 21 days PI, enzyme activity had returned to near normal values. In the ileal mucosa, ODC activity was increased only at 7 days PI. Increases in ODC activity were paralleled by increases in mucosal putrescine, spermidine, and spermine content. Infection with T. spiralis induced DNA synthesis and evoked a significant rise in DNA, RNA, and protein content in the mucosa. Increases in nucleic acid and protein levels were most prominent in the proximal half of the small intestine where the majority of worms reside. Treatment of rats with alpha-difluoromethylornithine (DFMO) prevented the infection-induced elevations in mucosal ODC activity, polyamine levels, DNA synthesis, and DNA, RNA, and protein content without influencing the development of inflammation or the parasite's life cycle. These results suggest that mucosal hyperplasia caused by infection may be regulated, in part, by the growth-promoting effects of ODC, presumably through the stimulation of crypt cell proliferation. Thus ODC may be an important determinant of the intestinal response to infection.

Differential effects of FSH on the activities of S-adenosyl-L-methionine decarboxylase and ornithine decarboxylase in Rat sertoli cells

Follicle stimulating hormone (FSH) modulates testicular function via Sertoli cells. The effect of FSH on S-adenosyl-L-methionine decarboxylase (AdoMetDC) activity was investigated in cultured Sertoli cells isolated from 18-day-old rats. In contrast to our previous finding that FSH inhibited Sertoli cell ornithine decarboxylase (ODC) activity, FSH stimulated AdoMetDC activity 160 to 300% above the level of the control cells during the initial 2 to 6 hours of treatment. The stimulated enzyme activity declined to 20 to 30% below the control values by 12 hours of exposure to FSH, and then rebounded to 120 to 125% of control values. To determine whether or not the initial opposite effects of FSH on AdoMetDC and on ODC activities are mediated by the same mechanism, various agents which increase intracellular cAMP level were used. All agents studied stimulated Sertoli cell AdoMetDC activity at 5 hours after their inclusion while they significantly inhibited ODC activity. In the presence of FSH, the stimulatory effect of these agents on AdoMetDC was either equal to or slightly greater than that caused by FSH or either agent alone. The combination of dbcGMP with FSH or with dbcAMP resulted in a synergistic or additive effect on AdoMetDC, as well as ODC, activity. The data suggest that the action of FSH on AdoMetDC activity in Sertoli cells is also mediated through cAMP, as concluded previously for ODC activity. Regardless of the effects of FSH on both enzymes, ODC always exhibited a relatively greater activity than did AdoMetDC in cultured rat Sertoli cells.

Therapeutic studies of cefepime (BMY 28142) in murine meningitis and pharmacokinetics in neonatal rats

Cefepime (BMY 28142) was compared with ceftazidime, cefotaxime, and moxalactam for efficacy in treating experimental meningitis in mice and neonatal rats. Mice were infected intracranially with Streptococcus pneumoniae, S. agalactiae, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa and treated intramuscularly. Five- to eight-day-old neonatal rats were injected intracisternally with Haemophilus influenzae, S. pneumoniae, and S. agalactiae and treated intraperitoneally. Cefepime was found to be the most active compound against induced meningitis in mice infected with S. agalactiae. Cefepime was as active as cefotaxime against Staphylococcus aureus meningitis, slightly more active than cefotaxime against S. pneumoniae and E. coli, and as active as ceftazidime against K. pneumoniae and P. aeruginosa meningitis. Cefepime was found to be the most active compound against S. pneumoniae and S. agalactiae meningitis in neonatal rats. Against H. influenzae, cefepime was as active as moxalactam and cefotaxime. Ceftazidime was the least active compound. The pharmacokinetics of cefepime in neonatal rats were similar to those of ceftazidime. Both compounds penetrated well into cerebrospinal fluid and brain tissues of uninfected neonatal rats. Relative concentrations were twice as high as those of cefotaxime and moxalactam.

Comparative study: bond strength and microleakage with dentin bond systems

Four commercial bond agent-composite systems were tested with respect to the strength of the bond to bovine dentin and their ability to seal class 5 erosion lesions without cavity preparation. At seven days there was no significant difference in the bond strengths of the four bonding agents, Scotchbond, Gluma, Tenure, and Scotchbond 2. Restorations placed with Gluma had significantly less leakage than those placed with other bond agents. At 90 days the bond strength of Tenure was reduced and was significantly less than that of the other systems, while Gluma and Scotchbond 2 restorations exhibited significantly less leakage than Scotchbond and Tenure. There was an inverse correlation (r2 = .5460) between bond strength and marginal leakage of class 5 restorations.

Treatment for collapsed lung in critically ill patients. Selective intrabronchial air insufflation using the fiberoptic bronchoscope

A new, simpler method to re-expand collapsed lungs was introduced in 14 procedures in 12 critically ill patients. To close the bronchus, we wedge the fiberoptic bronchoscope into each segment or subsegment of the collapsed lung instead of using a balloon cuff. Room air was then insufflated into the atelectatic alveoli after repetitive sputum suctioning and bronchial washing with normal saline solution. Complete re-expansion was achieved in 12 of the 14 procedures and partial in two. The average alveolar-arterial oxygen pressure difference (P[A-a]O2) declined from 217.5 before the procedure to 200.3, 150.0 and 152.2, respectively at 30 minutes, 12 hours and 24 hours after. There were no complications.

Fasting serum gastrin values in normal Chinese children

To determine the reference ranges and developmental pattern of serum gastrin in Chinese children, fasting serum samples of 362 Chinese infants and children aged from newborns to 14 years were measured by radioimmunoassay. All the participants were healthy and were without gastrointestinal disorders. The mean gastrin values for cord blood (111.55 +/- 68.05 pg/ml) and newborns (100.05 +/- 72.43 pg/ml) are higher than those for adult controls (43.85 +/- 15.59 pg/ml). The mean gastrin value achieves its highest level of 179.86 +/- 94.61 pg/ml on the 3rd day of age. Physiologic hypergastrinemia persists throughout the whole neonatal period. The mean gastrin value for infants between 6 days and 6 months of age is 96.08 +/- 50.05 pg/ml, this decreases to 76.73 +/- 44.23 pg/ml at 7 to 12 months of age, and to 75.89 +/- 43.88 pg/ml at 1 year of age. It reaches the low adult level (40-45 pg/ml) at about 2 years of age.

The clinical manifestations of the tuberculous pleural effusion in adult patients

The clinical data of 52 patients with tuberculous pleural effusion were analyzed. Their average age was 48 years old. Thirty two (62%) of them were sick for less than one week. Fever, chest pain and cough were the predominant pictures. Six of the 52 patients had coexisting disease. Intermediate strength protein purified derivative (PPD) test was found to be positive in 14 out of 31 (45%) patients. Their pleural effusions were usually unilateral, right-sided, and nearly half of them occupied more than half of the hemithorax. One third of these patients and concomitant pulmonary tuberculosis and pleural effusion. None of the patients had grossly bloody effusion. All of the effusions were exudative, and the glucose levels in the pleural fluid were invariably above 60 mg/dl. Presence of mesothelial cells in the pleural fluid was found in 28% of them, but none of the patients presented with significant eosinophils in the pleural fluid. Pleural fluid and sputum cultures for Mycobacterium tuberculosis usually reveal a negative study unless a concomitant pulmonary lesion was present. Combined antituberculosis and prednisolone treatment decreased the duration of constitutional symptoms and hastened the resolution of pleural effusion. In conclusion, tuberculous pleural effusion should be considered in elderly patients presenting with massive exudative pleural effusion even with a negative PPD study. Cultures of sputum and pleural fluid are less helpful in patients without parenchymal disease. Prednisolone is recommended in extremely ill patients.

Fever characteristics in tuberculosis--clinical observation in 597 cases

Fever characteristics were analyzed in 597 cases of tuberculosis diagnosed by positive culture for mycobacteria tuberculosis admitted to Chang Gung Memorial Hospital between March 1984 and February 1986. Among them, fever was noted in 356 cases (60.0%). Several factors were predisposing to the absence of fever: having a past history of tuberculosis (p less than or equal to 0.01), having a limited lung lesion (p less than 0.05), having an infection with isoniazide (INH) resistant strain (p less than 0.05). Fever typically developed in the late afternoon or evening in 66% of the cases, and this typical fever was significantly more common in patients less 60 years of age (p less than 0.05). The fever was low grade (less than 38.5 degrees C) in 59% of the cases. Among the 137 cases whose fever courses were completely monitored in the hospital, there were 30 cases (22%) whose fever subsided within 3 days after the start of antituberculous chemotherapy, 102 cases (74%) within 1 week and 128 cases (93%) within 2 weeks. Fever resolved within 4 weeks in all but one patient. There was no clinical factor predisposing to the delay of time for the fever to resolve including sex, age, immunocompromised condition, having a past history of tuberculosis, the infectious site(s) of tuberculosis, the extent of pulmonary involvement, the presence of cavitation in pulmonary involvement, and infection with resistant strains.

In vitro and in vivo antibacterial activities of BMY 40062, a new fluoronaphthyridone

The in vitro and in vivo activities of a new naphthyridone, BMY 40062, were compared with those of ciprofloxacin and ofloxacin. BMY 40062 showed about threefold more activity than ciprofloxacin showed and four- to eightfold more activity than ofloxacin showed against staphylococci, streptococci, and enterococci. BMY 40062 showed generally twofold less activity than ciprofloxacin showed against most species of the family Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter spp. but twofold more activity than ofloxacin showed against these organisms. BMY 40062 and ofloxacin were more active than ciprofloxacin against Bacteroides fragilis and Clostridium difficile. The antiureaplasmal and antichlamydial activities of BMY 40062 were similar to those of the tetracyclines and were 4- and 16-fold, respectively, higher than those of ciprofloxacin. The in vitro activities of BMY 40062 were influenced by pH and magnesium, although these factors appeared to affect the activity of BMY 40062 against P. aeruginosa to a lesser extent than those of ciprofloxacin and ofloxacin. BMY 40062 was found to be bactericidal, and cross-resistance with other fluoroquinolones was observed. In mouse protection tests, the efficacy of BMY 40062 reflected its in vitro potency. BMY 40062 exhibited longer half-life, higher maximum concentration in serum, greater area under the curve, and better bioavailability in mice after oral dosing than ciprofloxacin. Compared with ofloxacin, BMY 40062 had a lower maximum concentration in serum but a much longer half-life in mice. BMY 40062 was more effective than ciprofloxacin and ofloxacin in penetrating mouse macrophages and killing macrophage-associated Staphylococcus aureus.

Airway lesions presenting with a normal chest X-ray

From August 1980 to December 1987, 2,020 patients were proved by bronchoscopy to have endobronchial lesions at Chang Gung Memorial Hospital, Taipei. The chest roentgenograms, reviewed by 2 thoracic physicians and 1 radiologist, were reported to be normal in 31 of these patients. The incidence of airway lesions with a normal chest X-ray was 1.5% (31 out of 2,020 cases). These 31 patients included 18 males and 13 females, and their ages ranged from 7 months to 75 years with a mean of 40.3 years. The leading diseases in these cases were tracheal cancer (8 cases), tracheal and/or bronchial tuberculosis (6 cases), bronchogenic carcinoma (5 cases), tracheal schwannoma (2 cases), tracheal cyst (1 case) and bronchial adenoma (1 case). The trachea and main bronchi were the two most frequent sites of radiologically occult endobronchial lesions. Although the majority of the lesions occupied more than 50% of the diameter of the airway lumen, they were not well demonstrated in the routine chest radiological studies. Location, size and nature of the lesions were the major consideration that contributed to the normal-looking appearance of the chest X-ray. Alertness to the symptoms, physical signs and clinical history led to further investigation and the final diagnosis. The conclusion is that some airway lesions may present with a normal chest X-ray and delay the diagnosis. Careful history taking and observation of clinical symptoms and signs are important in the final diagnosis of these patients.

[Cytomegalovirus pneumonitis in renal transplantation--a case report]

Cytomegalovirus pneumonitis is a severe complication of renal transplantation. It usually occurs in the first 3-4 months after transplantation. Herein, we describe a 21 year-old male patient with chronic renal failure who received a successful cadaveric renal transplantation after regular hemodialysis three times per week for 3 years. Cyclosporin A and Methylprednisone were used for immunosuppressants after operation. The allograft kidney function improved gradually in two weeks. Serum BUN and creatinine were lowered to 25 mg/dl and 1.7 mg/dl respectively. Bacterial pneumonia developed on the 16th postoperative day. The control of pneumonia rapidly improved after the use of broad spectrum antibiotics. However, bilateral diffuse pulmonary infiltrations developed 21 days later. He received transbronchoscopic diagnostic procedures including TBLB without definite diagnosis. The final diagnosis was obtained by open lung biopsy, in which intranuclear inclusion body was found. The patient expired on the 55th postoperative day despite adjustment of immunosuppresant dosage and use of antiviral therapy.

The changing profiles of L-ornithine decarboxylase and S-adenosyl-L-methionine decarboxylase activities in testicular cell types during sexual maturation of male rats

To understand the involvement of polyamines in testicular maturation and spermatogenesis, the activity of two enzymes involved in the polyamine synthetic pathway, L-ornithine decarboxylase (ODC) and S-adenosyl-L-methionine decarboxylase (AdoMetDC) were determined in whole testis and isolated testicular cell types during the sexual maturation of male rats. ODC activities per mg protein in whole testis and cultured Sertoli cells from 12- to 14-day-old rats were very high but declined as the age of the animals increased. ODC activities in both germ cells and interstitial cells increased as the age of the rats increased, reached a maximum at 22 days and then declined rapidly. On the other hand, AdoMetDC activity in whole testis, Sertoli cells, germ cells and interstitial cells was highest from 27 to 35 days, 18 to 22 days, 22 to 27 or 35 days, and 27 days of age, respectively, then decreased and remained at a constant lower level after 45 days. After 35 or 45 days of age, cellular AdoMetDC activities were relatively higher than ODC activities in the whole testis and germ cells, while the activity of both enzymes was comparable in the Sertoli cells. Correlation of these data with the development of germ cells during rat testicular maturation suggests that the high ODC activity in both Sertoli and germ cells is associated mainly with cell proliferation while the increase in AdoMetDC activity is most likely associated with the maturation of Sertoli cells and the meiosis of germ cells, particularly the formation of pachytene spermatocytes and the meiotic cell division of spermatocytes into spermatids.

Polyamine profiles in rat testis, germ cells and Sertoli cells during testicular maturation

Polyamine cellular concentrations (putrescine, spermidine and spermine) in the rat testis and testicular cell types were determined by fluorescence spectroscopy of their dansyl derivatives. A method is described to separate dansylated polyamines by high performance liquid chromatography in less than 12 minutes. In rat Sertoli cells, polyamine concentrations (per mg DNA) were greater than those in germ cells and the testis. The concentrations of all three polyamines increased with age. Concentrations of spermidine and spermine in germ cells also increased with age and leveled off after 27 to 35 days. On the other hand, higher putrescine levels were found in the testis of young rats (13 to 22 days) while the greatest spermidine and spermine contents were observed in the testis from rats of 31 to 35 days old. Of great interest, Sertoli cells from all age groups studied released a relatively large quantity of putrescine and a smaller amount of spermidine, but no spermine, into culture media. The amount of polyamine released by Sertoli cells varied with the age of the animal. Sertoli cells from 27-day-old rats released the greatest quantity of putrescine on a per mg DNA basis. The release of putrescine increased after hypotonic treatment that removed contaminating germ cells from the remaining Sertoli cells. It is concluded that cellular polyamine levels in the rat testis, germ cells and cultured Sertoli cells and the amount of polyamines released by Sertoli cells were age-dependent during the first wave of spermatogenesis.

Corticosteroids in the treatment of tuberculous pleurisy. A double-blind, placebo-controlled, randomized study

A prospective, double-blind, randomized study of the role of corticosteroids in the treatment of tuberculous pleurisy was performed in 40 patients. All patients received adequate antituberculosis chemotherapy (isoniazid, 300 mg/day; rifampin, 450 mg/day; ethambutol, 20 mg/kg/day) for more than nine months. They were randomly assigned to take prednisolone 0.75 mg/kg/day orally or placebo for the initial treatment, which was tapered gradually for the next two to three months. Twenty-one were treated with steroids and 19 were given a placebo. The two groups were identical with regard to age, sex, duration from onset of symptoms to diagnosis, and initial amount of pleural effusion. The mean duration from symptoms (fever, chest pain, dyspnea) to relief was 2.4 days in the steroid-treated group, and 9.2 days in the placebo group (p less than 0.05). Complete reabsorption of pleural effusion occurred an average of 54.5 days in the steroid-treated group and 123.2 days in the placebo group (p less than 0.01). The development of residual pleural thickening was not influenced by the administration of corticosteroids. No serious side effects were noted during the treatment in either group. We conclude that the administration of corticosteroids, in conjunction with antituberculosis chemotherapy, will resolve the clinical symptoms more quickly and hasten the absorption of pleural effusion in patients with tuberculous pleurisy.

Riu's stain in the diagnosis of pulmonary cryptococcosis. Introduction of a new diagnostic method

Pulmonary cryptococcosis is thought to be a rare disease. Clinically, it presents no characteristic symptoms, signs or chest x-ray film findings. Most of the reported cases of pulmonary cryptococcosis were not diagnosed either antemortem or before surgical intervention. A simple diagnostic method, Riu's stain, can be used routinely in bronchoscopic brushing smears, or for needle aspiration cytologic studies, making pulmonary cryptococcosis easy to diagnose.

Inhibition of ornithine decarboxylase activity by follicle stimulating hormone in primary culture of rat Sertoli cells

The effect of follicle stimulating hormone on the activity of ornithine decarboxylase (ODC) was determined in primary culture of rat Sertoli cells. Three different FSH preparations (NIH oFSH-S-15, S-16, and eFSH) inhibited ODC activity in rat Sertoli cells under different media conditions. The inhibition was both time- and dose-dependent. The mechanism of the FSH inhibitory effect was studied using dibutyryl cyclic adenosine monophosphate (dbcAMP), 1-methyl-3-isobutylxanthine (MIX), forskolin, and isoproterenol. All of these agents, known to elevate cellular cAMP levels, inhibited ODC activity in cultured rat Sertoli cells. The combined effect of each of these substances plus FSH was either greater than, or equal to, that of FSH alone, and was not additive. Dibutyryl cyclic guanosine monophosphate had no effect on the ODC activity. These findings suggest that FSH inhibition of ODC activity in the rat Sertoli cell may be mediated by cAMP.

Fiberoptic bronchial blockade in a small bronchopleural fistula

A patient with bronchopleural fistula was successfully treated by selective intrabronchial injection of doxycycline and blood under fiberoptic bronchoscopic guidance. This simple and relatively noninvasive therapeutic approach is an effective and safe alternative in treating selective patients with a bronchopleural fistula.

Suppression of steroid receptor-chromatin interaction by inhibitors present in ammonium sulfate-fractionated rat testicular androgen receptor preparations

Tritiated androgen receptor complex was partially purified by ammonium sulfate precipitation at 15 to 37% saturation from rat testicular or prostatic cytosols. A greater amount of prostatic tritiated androgen receptor complex bound to rat Sertoli cell chromatin than tritiated testicular androgen receptor complex. However, the testicular androgen receptor complex was more potent in competing for binding of either tritiated androgen receptor complex preparation to the Sertoli cell chromatin. Combining equal amounts of tritiated testicular and prostatic androgen receptor complexes resulted in lower binding than that observed with tritiated prostatic androgen receptor complex alone, while doubling the concentration of tritiated prostatic androgen receptor complex led to a 2-fold increase in binding. It is conceivable that the partially purified testicular androgen receptor complex preparations contain factor(s) that inhibit the binding interaction of tritiated androgen receptor complex with chromatin, while there is no evidence for the presence of such inhibitors in tritiated prostatic androgen receptor complex preparations. Fractionation of testicular cytosol on DEAE-cellulose yielded a flow-through fraction with inhibitory activity and a bound fraction containing tritiated androgen receptor complex that was eluted with 0.3 M KCl and also showed inhibitory activity. These factors also inhibited the binding of tritiated estradiol receptor complex to chromatin. They were non-dialyzable and their inhibitory effect was abolished after heating at 60 C for 30 minutes. It is concluded that ammonium sulfate-fractionated rat testicular androgen receptor complex preparations contain inhibitors of steroid receptor-chromatin interaction. The inhibitory factors can be fractionated into two distinct fractions by DEAE-cellulose column chromatography. They are nondialyzable and heat-labile. The precise chemical nature of the postulated inhibitor(s) remains to be determined.

BMY 28100, a new oral cephalosporin

BMY 28100, a new oral cephalosporin with a (Z)-propenyl side chain at the 3 position and a p-hydroxyphenylglycyl substituent at the 7 position, was evaluated in comparison with cefaclor and cephalexin and, when appropriate, ampicillin and vancomycin. In vitro, BMY 28100 was more active than the reference cephalosporins against streptococci, Staphylococcus aureus, Staphylococcus epidermidis, Listeria monocytogenes, Haemophilus influenzae, Propionibacterium acnes, Clostridium perfringens, and Clostridium difficile. BMY 28100 was comparable to cefaclor and more active than cephalexin against Staphylococcus saprophyticus and ampicillin-susceptible strains of Branhamella catarrhalis; but against ampicillin-resistant strains of B. catarrhalis, BMY 28100 was comparable to cephalexin and more active than cefaclor. Against Neisseria gonorrhoeae, BMY 28100 was comparable to cephalexin, but less active than cefaclor. Members of the family Enterobacteriaceae overall were equally susceptible to BMY 28100 and cefaclor but were less susceptible to cephalexin. In human serum, BMY 28100 was 45% protein bound. After an oral dose to mice, 82% of the drug was recovered in urine. The oral therapeutic efficacy of BMY 28100 in systemically infected mice reflected its activity in vitro.

Testicular cytosol factors inhibit the binding of steroid-receptor complexes to chromatin

Testicular and prostatic androgen-receptor complexes as well as uterine estradiol-receptor complexes, partially purified by ammonium sulfate precipitation (15-37%), were bound to germ cell chromatin. At equivalent concentrations, less testicular androgen-receptor complexes bound to chromatin than did the other two steroid-receptor complexes. Addition of a partially purified testicular androgen-receptor preparation with prostatic androgen-receptor or uterine estradiol-receptor preparation to the binding interaction mixture reduced the binding of either of the latter two steroid-receptor complexes to chromatin. These data suggest the presence of inhibitory factor(s) in the testicular receptor preparations. Testicular cytosols were fractionated by ammonium sulfate precipitation into fractions A (15-37% saturation), B (37-50%) and C (50-75%). All fractions inhibit binding of these steroid-receptor complexes to chromatin. Fractions A and B appear to be heat labile, while fraction C was more stable. Further fractionation of A and C fractions on DEAE cellulose yielded A1 and C1 (filtrates) as well as A2 and C2 (0.3 M NaCl eluents), respectively. Subfractions A1, A2, and C2 contained inhibitory factors for the binding of steroid-receptor complexes to chromatin while C1 showed no effect. These data demonstrated that testicular cytosol contains a variety of inhibitory factors which affect the binding of both androgen-receptor and estradiol-receptor complexes to chromatin.

Localization of ornithine decarboxylase in rat testicular cells and epididymal spermatozoa

We have employed a monospecific, polyclonal antibody to ornithine decarboxylase (ODC) for the immunocytochemical localization of ODC in freshly isolated testicular cells, epididymal spermatozoa, and cultured Sertoli cells. Antigenically detectable material was present in the cytoplasm of all cell types tested and was highly concentrated in the acrosomal vesicle of round spermatids and in the acrosome region of epididymal spermatozoa. The specific enzymatic activity of ODC, as measured biochemically, was much higher in the interstitial cells than in the other testicular cell types, and no ODC activity was detected in the epididymal spermatozoa or in the Sertoli cells after 5 days in culture. These studies showed that, while all testicular cell types studied contained ODC-like immunoreactive molecules, only testicular germ cells and interstitial cells exhibited detectable ODC activity.

Antibacterial activity of phosphanilic acid, alone and in combination with trimethoprim

We explored the antibacterial activity of phosphanilic acid (P), an analog of sulfanilic acid, alone and in combination with trimethoprim (T; TP, 1:5) with sulfamethoxazole (S) and co-trimoxazole, the combination of this sulfonamide with trimethoprim (TS, 1:5) as the reference. P resembled S in spectrum but, in addition, had significant activity against Pseudomonas aeruginosa. The overall frequency and degree of synergism with TP were lower than with co-trimoxazole. P, like S, was strongly affected by changes in inoculum size and was not bactericidal. P was well absorbed parenterally but not orally in mice. Despite low (but prolonged) blood levels, P, given orally to mice, was effective in treating infections caused by P. aeruginosa. However, against most experimental infections the therapeutic effectiveness of P, as well as that of TP, administered either intramuscularly or orally was unimpressive. Based on in vivo data, the therapeutic application of P or TP would appear to be limited.

Differential release of polyamines by cultured rat Sertoli cells

Cellular and media concentrations of polyamines in Sertoli cell cultures were determined by fluorescent spectroscopy of dansylated compounds after separation by high-performance liquid chromatography. In spite of low cellular levels of putrescine, the Sertoli cells released relatively large amounts of putrescine and spermidine even after several media changes. The inclusion in the culture media of cortisol, insulin, and thyroxine significantly elevated cellular polyamine levels, altered the spermidine to spermine ratio, and enhanced putrescine release by 3- to 4-fold. No spermine, however, was detected in the media under any of the conditions studied. The polyamine concentrations in cultured Sertoli cells from 13-day-old rats and the pattern of polyamine release by these cells differed significantly from those in the Sertoli cells from 46-day-old rats. These data demonstrate the differential release of polyamines by cultured rat Sertoli cells. The profiles of polyamine secretion appear to be age-dependent, and the significance of this phenomenon is discussed.

Comparison of a new cephalosporin, BMY 28142, with other broad-spectrum beta-lactam antibiotics

BMY 28142, a new broad-spectrum semisynthetic cephalosporin, was evaluated in vitro and in vivo in comparison with ceftazidime, cefotaxime, moxalactam, and cefoperazone. The activity of BMY 28142 compared favorably with the activities of the other compounds against both Pseudomonas aeruginosa and Staphylococcus aureus and was somewhat greater against members of the family Enterobacteriaceae. The influence of inoculum size on MICs of BMY 28142 was small for most of the isolates tested, except Enterobacter species. With Enterobacter strains, a marked inoculum effect was found with all of the compounds, and the effect was more pronounced in broth than agar. Still, MICs of BMY 28142 in broth did not exceed 16 micrograms/ml. Of 37 Enterobacteriaceae strains resistant to one or more of the comparison beta-lactams, none were resistant, at a low inoculum size (10(4) CFU), to BMY 28142, compared with 3 for moxalactam, 18 for ceftazidime, 23 for cefotaxime, and 34 for cefoperazone; at an inoculum size of 10(6) CFU, the number of resistant strains was 12, 17, 25, 34, and 37, respectively. Binding to human serum proteins approximated 19%. Recovery of 73% of the drug in mouse urine indicated good bioavailability. The in vitro profile was sustained in vivo by the results obtained with experimental infections in mice. BMY 28142 was as effective as ceftazidime against systemic infection with P. aeruginosa and as effective as cefotaxime against systemic infection with S. aureus. Overall, infections with 18 of 20 strains representing nine genera were responsive to BMY 28142 at doses equivalent to or lower than those of the most effective of the comparison compounds.

Effect of sodium molybdate on the binding of androgen-receptor complexes to germ cell and Sertoli cell chromatin

This study explores the effect of molybdate on androgen receptors in relation to chromatin binding. Two fractions of testicular and prostatic cytosol were obtained by ammonium sulfate precipitation at 15-37% (I) and 37-47% (II) saturation. Both fractions from either tissue exhibited specific binding of [3H]-androgens which was thermolabile. With the exception of testicular fraction II, all fractions bound to Sertoli cell and germ cell chromatin. Prostatic [3H]-androgen-receptor complexes isolated from cytosols in the presence of 10 mM sodium molybdate showed a decreased ability (only 20-40%) to bind to either Sertoli cell or germ cell chromatin. Similarly, testicular [3H]-androgen-receptor complexes isolated in the presence of molybdate bound less well (60-70%) to Sertoli cell chromatin. On the other hand, inclusion of molybdate subsequent to ammonium sulfate precipitation did not significantly alter the binding ability of the receptor complexes to either chromatin. Also, the presence of molybdate during the receptor-chromatin interaction did not significantly decrease the ability of either prostatic or testicular androgen-receptor complexes to bind to Sertoli cell chromatin. These results indicate that the addition of molybdate prior to ammonium sulfate precipitation may impede the activation of androgen-receptor complexes by salt, resulting in a decreased ability of the steroid-receptor complexes to bind to chromatin acceptor sites. The data also indicate that molybdate exerts its inhibitory effect directly on the nonactivated receptor complexes and not on the chromatin acceptor sites.

Specificity and nature of the rapid steroid-stimulated increase in Sertoli cell nuclear RNA polymerase activity

This report explores the ability of various steroids to rapidly stimulate Sertoli cell RNA polymerase II activity and to compete with [3H]-androgens for nuclear and cytosol binding sites. Nuclear RNA polymerase II activity was significantly stimulated by a 1 nM concentration of the androgenic compounds testosterone, dihydrotestosterone (17 beta-hydroxy-5 alpha-androstan-3-one). R1881 (methyltrienolone) and 5 alpha, 17 beta-diol and also by the potent progestins 6 alpha methylprogesterone and R5020 (17,21-dimethyl-19-nor-4-pregna-3,20-dione). Progesterone, 17 alpha-hydroxyprogesterone, estradiol, androsterone, and 5 alpha-androstan-3 beta, 17 beta-diol were ineffective at 1 nM. Cytosol binding and nuclear accumulation of [3H]-androgen was effectively reduced by 100 fold molar excess of those androgens and progestins which stimulated RNA polymerase II activity. These data suggest that androgens and progestins bind to at least some of the same proteins in the Sertoli cell and may elicit the rapid stimulation of RNA polymerase II activity via a common mechanism. Agarose gel electrophoresis of the nuclear RNA synthesized as a result of exposure to testosterone indicated that is was heterodisperse and in part polyadenylated. Electrophoresis of the poly A+-RNA demonstrated that testosterone administration increased the incorporation of [3H]-UTP into RNA that was larger than 28 S.

Isolation of Candida albicans and their sensitivity to antifungal agents

During 1978 and 1979 outbreaks of candidiasis were encountered in about 500,000 broiler chickens on 30 farms, 30,000 guinea fowl on 4 farms, 500 geese on 1 farm, and 10 penguins in a zoo. This represents the first report of avian candidiasis in Taiwan. Diagnoses were based on typical gross and microscopic pathology consistent isolation of Candida albicans from crop and esophageal lesions, virulence of isolates in rabbits, identification of the isolates as C. albicans serotype A by chlamydospore and germ tube formation, fermentation tests, and agglutination by specific antisera, and the lack of any sign of fowl pox or trichomoniasis. The upsurge of candidiasis is attributed to the modernization stressors which interact deleteriously with opportunistic pathogens. In vitro sensitivity testing recorded the following order of effectiveness against 20 isolates: nystatin greater than gentian violet greater than copper sulfate = propionic acid = p-hydroxy benzoic acid greater than calcium propionate = propylene glycol.