Rapid identification of motile Aeromonas. The clinical relevance and taxonomy of motile Aeromonas species are areas of current controversy. Strains of motile Aeromonas isolates (n = 60) from various sources were identified to species level using the following tests (all incubated at 30 degrees and 37 degrees C): esculin hydrolysis; formation of gas from glucose; production of acetoin; production of acid from mannitol and arabinose; decarboxylation of lysine and ornithine, dihydrolation of arginine; and pyrazinamide hydrolysis in a semisolid medium. The tests' results were similar at incubation temperatures of 30 degrees and 37 degrees C. Of the strains, 59 (98%) of 60 were identified to species level by the full battery of tests: 25 as A. hydrophila, 18 as A. caviae, 14 as A. sobria, one as A. veronii, and one as A. schubertii. (The only A. veronii and A. schubertii isolates identified were ATCC strains). All (25 of 25) strains of A. hydrophila and 17 (94%) of 18 of A. caviae hydrolyzed pyrazinamide in less than 24 hr, whereas all strains of A. sobria showed no pyrazinamidase activity. Absence of pyrazinamidase was, thus, a convenient phenotypic marker for A. sobria. Four additional tests (esculin hydrolysis, acetoin production, lysine decarboxylation, and gas production from glucose) identified within 24 hr all examples of the three common species of Aeromonas. Recently proposed species did not contribute to our ability to discriminate among stool, other clinical, and environmental isolates of Aeromonas spp.


High pentamidine levels associated with hypoglycemia and azotemia in a patient with Pneumocystis carinii pneumonia. We report on a patient who presented with a Pneumocystis carinii pneumonia. Intravenous pentamidine (4 mg/kg/day) was given for 14 days without the occurrence of adverse effects. During this treatment, the mean (+/- SD) serum pentamidine trough concentration was 94 +/- 16 ng/ml. Three days later, the patient was admitted because of fever, and pentamidine (4 mg/kg/day) was again started. Fasting hypoglycemia and azotemia then occurred; the mean serum trough pentamidine level was 190 +/- 10 ng/ml during this week of treatment. We conclude that the occurrence of hypoglycemia and azotemia during pentamidine therapy may not be idiosyncrasic, but seemed associated in our patient with high levels of serum pentamidine.


Acquisition of coccidioidomycosis at necropsy by inhalation of coccidioidal endospores. Coccidioidomycosis is accepted as being noncontagious because the infectious arthroconidial form of Coccidioides immitis is not produced in humans and other mammalian hosts. However, disseminated coccidioidomycosis developed in a veterinarian who autopsied a horse with disseminated disease but without draining lesions or productive cough. We postulate transmission occurred by inhalation of tissue-phase endospores aerosolized in the course of dissection.


Cefdinir (FK482), an orally administered cephalosporin in vitro activity comparison against recent clinical isolates from five medical centers and determination of MIC quality control guidelines. Cefdinir, a new oral cephalosporin, was compared to cefaclor, cefadroxil, cefixime, and cefuroxime against greater than 5000 recent aerobic clinical isolates. This multicenter study revealed broad-spectrum cefdinir activity against all Enterobacteriaceae (MIC50s, 0.06-2 micrograms/ml) except Enterobacter cloacae, Morganella morganii, Proteus vulgaris, and Serratia marcescens (MIC50s, greater than or equal to 4 micrograms/ml). Oxacillin-susceptible staphylococci (MIC90s, 0.5-2 micrograms/ml), beta-hemolytic Streptococcus group B (MIC90, 0.06 micrograms/ml), and Acinetobacter lwoffii were also susceptible to cefdinir. The activity of cefdinir was similar to that of cefixime and cefuroxime against Gram-negative organisms and superior to all tested oral cephems when tested against Gram-positive cocci. None of the cephalosporins were active against oxacillin-resistant Staphylococcus spp., enterococci, Pseudomonas spp., or Xanthomonas maltophilia. MIC quality control range guidelines were established for the strains recommended by the National Committee for Clinical Laboratory Standards documents.


Persistence of the same Candida albicans strain despite fluconazole therapy. Documentation by pulsed-field gel electrophoresis. Candida albicans and other Candida species have emerged as major nosocomial pathogens associated with a high mortality. Therapeutic options for fungal infections are limited. Amphotericin B has been the mainstay of treatment for serious systemic candidal infections, but it is relatively toxic and associated with a variety of side effects. Fluconazole has been proposed as alternative therapy for the treatment of systemic candidiasis including candidemia. We report the case of a patient with fungemia in whom fluconazole failed to eradicate C. albicans and C. tropicalis. These pathogens were recovered from sputum and urine cultures, respectively, on day 12 of intravenous fluconazole therapy. Molecular epidemiologic techniques employing pulsed-field gel electrophoresis confirmed the persistence of the same C. albicans strain. Susceptibility studies showed a marked change in MICs of fluconazole between 24 and 48 hr, with an increase from less than or equal to 1.25 to greater than 80 micrograms/ml. Controlled trials will be needed to delineate the role of fluconazole in the treatment of disseminated candidiasis and its efficacy in comparison with amphotericin B. Amphotericin B should remain the drug of choice for such infections until data from controlled trials are available.


The activity of metal compounds against aerobic and anaerobic bacteria. We evaluated the antimicrobial activity of two metal compounds, JM-1397 (OsO2[xylyl]2) and JM-2469 (AuCl[S2CPEt3]). Both inhibited methicillin-susceptible and methicillin-resistant Staphylococcus aureus at concentrations of 0.5-2 micrograms/ml, with a minimum inhibitory concentration (MIC90) of 1 microgram/ml for JM-1397 and 0.5 microgram/ml for JM-2469. Similar concentrations inhibited methicillin-susceptible and -resistant coagulase-negative staphylococci (S. epidermidis, S. haemolyticus, and S. saprophyticus). JM-2469 inhibited group A, B, C, F, and G beta-hemolytic streptococci and viridans group streptococci at 1-8 micrograms/ml (MIC90 4 micrograms/ml) but Enterococcus faecalis and E. faecium had MICs of 8-16 micrograms/ml. JM-1397 had MICs for these organisms of greater than 64 micrograms/ml. Bacteroides fragilis, other Bacteroides, and Clostridium species were inhibited by less than or equal to 0.12-4 micrograms/ml (MIC90, 0.5 microgram/ml). MICs of both compounds for Enterobacteriaceae and Pseudomonas spp. were greater than 64 micrograms/ml. These studies show that osmium and gold compounds have potential as topical agents against Gram-positive and anaerobic species.


Vertical transmission of human immunodeficiency virus type 1. Prognostic value of IgA antibody to HIV-1 polypeptides during pregnancy. In a retrospective study of 31 pregnant women infected with human immunodeficiency virus type 1 (HIV-1), nine (29%) infants presented unequivocal signs of HIV-1 infection (persistent p24 antigenemia and/or positive virus isolation). All serum samples obtained from the others, during pregnancy and on delivery, were studied for specific antibody (IgA) production by immunoblotting analysis to establish a possible link between the presence of a defined antibody class and mother-to-child viral transmission. The majority (16 of 22) of HIV-1-seropositive mothers who delivered uninfected children showed IgA antibody to low-molecular-weight HIV-1 polypeptides during pregnancy. Among those who delivered infected babies, only one showed a weak IgA reactivity to HIV-1 during pregnancy. Thus, our results suggest that immunoblotting study of IgA may be a diagnostic adjunct to predict the risk of mother-to-child HIV-1 transmission.


Copepods associated with a perirectal abscess and copepod pseudo-outbreaks in stools for ova and parasite examinations. We observed copepods, an intermediate host for several human parasites, in material obtained from a perirectal abscess of a 22-year-old man with Crohn's disease. We subsequently noted copepod "outbreaks" in stool specimens submitted for ova and parasite examination. Copepods in the hospital tap water supply were the source for one "outbreak".


Evaluation of an improved DNA probe for diagnosis of pertussis. A Bordetella pertussis specific subclone, pRZ61, of a Bordetella genus-specific clone, pB23, was evaluated on nasopharyngeal aspirates of 179 patients with suspected pertussis. Hybridization was performed directly after spotting or after 1-3 days of preculture of the nylon membranes on solid culture medium. A direct comparison of the two probes was obtained by reprobing with the subclone the same membranes that had been hybridized with the parent probe. pRZ61 detected 50% of the serologically defined cases of pertussis, that is, had the same sensitivity as standard culture. Specificity as compared with serology was close to 100%. The increasing sensitivity and the corresponding decreasing specificity after preculture noted for pB23 was not seen with the subclone. The study showed that the improved probe represents a rapid diagnostic method in pertussis.


Catheter-related bacteremia and fungemia. Reliability of two methods for catheter culture. The purpose of this study was to analyze 98 febrile patients with suspected catheter-related bacteremia (CRB) or fungemia (CRF) and compare two different methods, one semiquantitative (SQ) (Maki's method) and the other quantitative (Q) (modification of Brun-Buisson method) to determine each ability for diagnosing CRB. Twelve patients had CRB or CRF. The sensitivity, specificity, positive, and negative predictive values, and efficiency using the Maki method were 83%, 84%, 42%, 97%, and 83%, respectively. The same parameters using the other method were as follows: 92%, 84%, 44%, 99%, and 84%, respectively. Although the diagnostic reliability in each method was similar, the Maki method was quicker and easier to perform in clinical microbiology laboratories.


Evaluation of two ELISA's for detecting Chlamydia trachomatis from endocervical swabs. Two enzyme immunoassays (EIAs) detecting Chlamydia trachomatis from endocervical swabs, Syva MicroTrak (MT) and Abbott Chlamydiazyme (CZ), were compared with a tissue culture (TC) standard. Initially, 8% (100 of 1250) of specimens were TC positive, yielding sensitivities of 94% (94 of 100) for MT and 79% (79 of 100) for CZ with identical 98% specificities (1129 of 1150 for MT and 1130 of 1150 for CZ). Discrepant specimens were retested by both EIAs and assayed for elementary bodies (EBs) by a fluorescent antibody test. After discrepancy analysis, 9.5% (118) of 1240 patients were either TC or EB positive, yielding sensitivities of 94.1% for MT (111 of 118) and 79.7% for CZ (94 of 118) with identical specificities of 100% (1122 of 1122). These results indicate that the MT is significantly more sensitive (p less than 0.05, McNemar test) than CZ in detecting C. trachomatis from endocervical swabs.


Ventricular/vascular interaction in health and heart failure. In summary, the concept of aortic input impedance, which has been examined in detail, requires evaluation of the flow and pressure pulsations within the ascending aorta to determine an input impedance spectrum. This function describes the load imposed on the ejecting left ventricle by the systemic vasculature in terms of pulsatile and steady-flow components and is independent of changes in ventricular performance. The components contain information about the mechanical properties of the large vessels (elastance), arteriolar bed (resistance), and waves reflected (reflectance) within the arterial system. Our investigations indicate that in health the mechanical characteristics of the vasculature appear to minimize pulsatile and steady-flow loading components. The optimal loading pattern is influenced by aging and hypertension so that elastance is increased. This alteration increases the pulsatile flow component of loading, which has the potential to limit left ventricular responses to exercise. In patients with heart failure, the vascular system presents an increase in pulsatile and steady-flow load to the diseased left ventricle. Here the altered loading pattern is due to increased resistance, elastance, and reflectance. The left ventricle has a markedly diminished response to power output in the face of this altered vascular load. With vasorelaxation, all components of vascular loading decrease and result in markedly improved generation of left ventricular power and cardiac output. Recent evidence suggests that agents inducing vasorelaxation can influence various regions of the aorta and large vascular beds in a different manner. This would result in the ability to alter elastance, resistance, and reflectance selectively to affect pulsatile and steady-flow components of load.(ABSTRACT TRUNCATED AT 250 WORDS)


Performance characteristics of a commercial antibody-capture enzyme immunoassay for detection of Toxoplasma-specific IgM antibodies. Antibody-capture enzyme immunoassay (EIA) for the detection of Toxoplasma-specific IgM has been shown to provide significantly higher specificity than the indirect IgM EIA. A new commercially available antibody-capture EIA (PLATELIA Toxo IgM EIA) converted 99 out of 100 false-positive Toxo-plasma IgM determinations to true negative. Experiments using Toxoplasma IgM calibrators demonstrated the antibody-capture EIA is approximately eightfold more sensitive than a new automated microparticle EIA for Toxoplasma IgM antibodies (IMX Toxo IgM EIA), and approximately equal in sensitivity to the indirect immunofluorescence assay. Precision studies of the antibody capture EIA using low, medium, and high calibrators gave coefficients of variation ranging from 3.0%-4.5% for within-run and 5.2%-11.4% for run-to-run variation experiments. Interference from high levels of bilirubin, albumin, hemoglobin, and lipid was not detected. Sera from patients with inflammatory or infectious disorders were tested for interference in the antibody-capture EIA. False-positive Toxoplasma IgM results were not observed, but low-level negative interference was detectable when patient sera was mixed with Toxoplasma-positive sera. Preparations of purified human IgM also produced negative interference in the antibody-capture EIA for Toxoplasma IgM.


Antibacterial oxazolidinones. In vitro activity of a new analogue, E3709. The oxazolidinone compound E3709, which contains a 4-pyridyl group, was found to be more active in vitro than other members of this series, such as DuP 721. MIC90 for staphylococci(including methicillin-resistant isolates), streptococci (including Enterococcus faecalis), Clostridia, and diphtheroids was less than 0.5 micrograms/ml. Haemophilus influenzae, Moraxella catarrhalis, and Bacteroides fragilis were less susceptible, with an MIC90 between 2 and 8 micrograms/ml. E3709 MICs of Gram-negative species ranged from 100 to greater than 1000 micrograms/ml. At a concentration of 10 micrograms/ml, E3709 was bactericidal for selected Gram-positive species. A postantibiotic effect of 3 hr was observed against staphylococci. Resistance to E3709 was not detected.


Cefmetazole and trospectomycin in vitro susceptibility testing interpretive criteria and quality control guidelines for Neisseria gonorrheae. Cefmetazole and trospectomycin were tested in a multilaboratory trial to establish Neisseria gonorrhoeae susceptibility testing criteria and quality control (QC) guidelines. Cefmetazole was active against the penicillinase-producing isolates and has an MIC90 of 16 micrograms/ml, the breakpoint MIC previously used for nonfastidious species. However, a single-dose gonorrhea regimen (1 g i.m.) would require a lower less than or equal to 2 micrograms/ml breakpoint with a correlate zone (greater than or equal to 33 mm) consistent with similarly used cephamycins (cefoxitin and cefotetan). An intermediate category was proposed for MICs greater than 2-4 micrograms/m (28-32 mm) pending more clinical experience with higher and/or prolonged cefmetazole dosing regimens. Trospectomycin was active (MIC90, 8 micrograms/ml) against all spectinomycin-susceptible gonococci. A susceptible breakpoint MIC of less than or equal to 16 micrograms trospectomycin per milliliter was proposed with a correlate zone diameter of greater than or equal to 17 mm. An intermediate category was also suggested for trospectomycin at 32 micrograms/ml (14-16 mm). QC guidelines were established for 30-micrograms cefmetazole and 30-micrograms trospectomycin disk diffusion tests and the GC agar base MICs using a multilaboratory study design consistent with National Committee for Clinical Laboratory Standards (NCCLS) M23-T guidelines. Both drugs were stable in GC agar plates for 21 days stored at 2 degrees-5 degrees C.


Lack of predictability of cefotetan in vitro susceptibility tests against cefotetan-resistant anaerobic bacteria in determining clinical and bacteriologic efficacies. Interpretive criteria for cefotetan in vitro susceptibility testing appear to be clinically relevant when applied to aerobic bacteria. To determine whether the same was true for anaerobic bacteria, we conducted a retrospective analysis of intraabdominal, gynecologic, and skin and skin structure infections treated with cefotetan. Of the infections, 202 contained at least one anaerobe isolate. Of the 51 patients, 47 (92.9%) from whom one or more cefotetan-resistant anaerobes were isolated were clinically cured or showed improvement. Similarly, cefotetan was efficacious for 95.4% of the patients harboring only cefotetan-susceptible anaerobes. Favorable bacteriologic responses were observed in 94.1% and 97.4% of these patient groups, respectively. The data suggests that the therapeutic utility of cefotetan against anaerobic bacteria cannot be accurately predicted on the basis of in vitro susceptibility test results alone but may be explained by a variety of factors, as discussed in this report.


In vitro activity of cefprozil (BMY 28100) and cefepime (BMY 28142) against Streptococcus pneumoniae, Branhamella catarrhalis, and Haemophilus influenzae, and provisional interpretive criteria for disk diffusion and dilution susceptibility tests with Haemophilus influenzae. The in vitro activities of two new cephalosporins, an oral agent, cefprozil and a parenteral compound, cefepime, were assessed against recent clinical isolates of Streptococcus pneumoniae, Moraxella (Branhamella) catarrhalis, and Haemophilus influenzae. In general, both cefprozil and cefepime MICs were higher for beta-lactamase-producing strains of M. catarrhalis in comparison to strains that lacked beta-lactamase. By contrast, beta-lactamase-positive and -negative strains of H. influenzae had similar cefprozil and cefepime minimum inhibitory concentrations (MICs). The MIC90 values for cefprozil were 0.12, 32, 4.0, and 0.5 micrograms/ml versus S. pneumoniae, H. influenzae, and beta-lactamase-positive and negative strains of M. catarrhalis, respectively. In comparison to three other oral cephalosporins included in this study, cefaclor, cefuroxime axetil, and cefixime, cefprozil was the most active agent against S. pneumoniae, the least active against B. catarrhalis, and equivalent in activity to cefaclor against H. influenzae. The cefepime MIC values against S. pneumoniae, H. influenzae, and beta-lactamase-positive and negative strains of M. catarrhalis were 0.03, 0.25, 2.0, and 0.5 micrograms/ml, respectively. Cefepime was less active than ceftriaxone for all three organism groups, however, was in all cases more active than cefixime, cefuroxime, cefaclor, and cefprozil.(ABSTRACT TRUNCATED AT 250 WORDS)


Evaluation of the teicoplanin broth microdilution and disk diffusion susceptibility tests and recommended interpretive criteria. Comparative teicoplanin in vitro susceptibility data were generated for 1201 Gram-positive US clinical trial isolates using standardized broth microdilution and disk diffusion techniques. Based on the results of this study, the following interpretive criteria for teicoplanin are recommended: for MIC tests, less than or equal to 8 micrograms/ml = susceptible, 16 micrograms/ml = moderately susceptible, and greater than or equal to 32 micrograms/ml = resistant; and for disk (30 micrograms) tests, greater than or equal to 14 mm = susceptible, 11-13 mm = intermediate, and less than or equal to 10 mm = resistant.


In vitro activity of mersacidin (M87-1551), an investigational peptide antibiotic tested against gram-positive bloodstream isolates. We measured the in vitro activity of mersacidin (formerly M87-1551) against 183 clinical isolates (vancomycin susceptible) and 12 additional vancomycin-resistant strains of Gram-positive bacteria. The activity for mersacidin increased an average twofold (range, 1.7- to 7.6-fold) in a calcium-enriched medium. The minimum inhibitory concentration (MIC)90 for mersacidin was 8-32 times higher than vancomycin for staphylococci, 4-64 times higher for enterococci, and up to 32 times higher for other organisms tested. The MIC90 for MDL 62873, a comparison compound, was less than or equal to 0.5 micrograms/ml for all species except Staphylococcus haemolyticus (MIC90, 4 micrograms/ml), and it was greater than or equal to 4-fold more active than vancomycin. Against selected vancomycin-resistant strains, mersacidin had MICs greater than or equal to 16 micrograms/ml for enterococci, 4-32 micrograms/ml for Pediococcus, and less than or equal to 2 micrograms/ml for Leuconostoc species. Mersacidin may have some clinical utility in documented infections caused by staphylococci, nonenteric streptococci, Pediococcus, and Leuconostoc.


The rapid emergence of fluoroquinolone-methicillin-resistant Staphylococcus aureus infections in a community hospital. An in vitro look at alternative antimicrobial agents. The introduction of ciprofloxacin on an unrestricted basis into a 900-bed community hospital resulted in the emergence of high-level fluoroquinolone resistance among methicillin-resistant Staphylococcus aureus (MRSA) during the subsequent 18 months. Susceptibility testing revealed several old and new compounds to which all the S. aureus strains were susceptible. When an MRSA strain became resistant to ciprofloxacin it also exhibited high-level resistance to ofloxacin, fleroxacin, norfloxacin, and enoxacin. Two new experimental fluoroquinolones, WIN 57273 and CI-960, exhibited good activity against all test strains. Among the glycopeptide compounds, mupirocin and teicoplanin were approximately fourfold more active than vancomycin and ramoplanin. Rifampin and trimethoprim-sulfamethoxazole (TMP/SMZ) showed good activity against most strains as did imipenem. For clindamycin, gentamicin, and tetracycline susceptibilities exhibited a bimodal distribution with at least 10% of strains having resistant MIC values. Surprisingly, the addition of sulbactam potentiated the activity of ampicillin against the ciprofloxacin-resistant MRSA strains, however, sulbactam had little effect on cefoperazone activity against these same strains. Time-kill kinetic studies of selected antimicrobials against ciprofloxacin-resistant strains indicated good killing by vancomycin, ampicillin-sulbactam, and TMP/SMZ. Teicoplanin was less bactericidal than vancomycin while these same strains rapidly developed resistance to rifampin even at concentrations 8 x MIC. These data indicate certain alternative compounds within our study warrant further investigation, especially in vivo, against multiply-resistant staphylococci.


Use of fluoride tablets and effect on prevalence of dental caries and dental fluorosis. A study was executed to investigate the relation between the use of fluoride tablets by children in the age period 1.5-6 yr on the one hand and the caries experience at the age of 6 and 15 yr and the prevalence of fluorosis at the age of 15 yr on the other hand. The year of birth of the child, the motivation of the mother to engage in preventive dental behavior, the level of her school education and her place of birth were taken into account as possible confounding factors. A significant relation was found between the use of fluoride tablets and the prevalence of fluorosis. The most important predicting factor for the caries experience of the child was the mother's motivation to engage in preventive dental behavior. An effect of fluoride tablets on the caries experience could not be demonstrated.


Decline in caries prevalence in 6-14-year-old schoolchildren during 1975-85 in Shizuoka, Japan. The purpose of this study was to examine changes in caries prevalence during 1975-85 in Japanese schoolchildren who did not have an apparent change in fluoride exposure. A total of 2872 schoolchildren aged 6-14 yr in two primary schools and one junior high school in Shizuoka city, Japan, were examined in 1985. The caries prevalence in 1985 was then compared with data which had been collected in a longitudinal survey on schoolchildren in the same primary and junior high schools by Katayama in 1970-75. The results indicated that DMFT and DMFS indices in 1985 were significantly lower than those in 1970-75 in all the examined ages (P < 0.01). The DMFT indices at age 12 were 3.60 in 1985 and 5.47 in 1970-75. Remarkable decreases in DMFT at age 12 were observed in maxillary incisors (50%), followed by maxillary molars (24%) and mandibular molars (22%). The decline in caries prevalence in the examined area may be mainly attributed to several factors other than use of fluoride, such as changes in dietary pattern, an increasing dental awareness and promotion of dental health care. But the percentage decrease per annum of DMFT index at age of 12 in the examined population was relatively low (-4.1%) in comparison with other industrial countries. Comparing the results with data from national dental surveys, it can be considered that rural areas in Japan do not exhibit a similar decline of caries prevalence as in Shizuoka city, but there will be a lot of districts exhibiting significant reduction in caries prevalence in the near future.


Prevalence of non-cavitated and cavitated carious lesions in a random sample of 7-9-year-old schoolchildren in Montreal, Quebec. This report describes the prevalence of non-cavitated and cavitated carious lesions in 911 randomly selected children in grades one through three on the Island of Montreal, Quebec, Canada. The criteria for diagnosis were developed for a longitudinal epidemiological study of restorative treatment decisions by dentists practising under a provincial dental insurance program for children. The intra- and inter-examiner reliability correlation coefficients of the two examiners were excellent (Kappa > or = 0.80). The most frequent carious lesion found in the examined children were non-cavitated carious lesions (incipient) within 1.5 of the gingival line on smooth tooth surfaces, and stained or non-cavitated carious lesions on pits and fissures. Out of 911 children in the study, 19.6% had sealants. Children whose parents completed a university education had a significantly lower prevalence of non-cavitated and cavitated carious lesions and fillings, and a significantly higher mean number of sealants than children whose parents had only primary school education. Education status of the parents was a significant risk marker of children with high caries experience and these children had a significantly higher mean number of non-cavitated carious lesions. This study has found that non-cavitated carious lesions are significantly more prevalent than cavitated carious lesions in children.


Risk indicators and potential risk factors for caries in 5-year-olds of different ethnic groups in Amsterdam. The aim of this study was threefold: first, to assess the oral health of Turkish, Moroccan, Surinamese, Dutch and "other" 5-yr-old children living in Amsterdam; second, to identify risk indicators for caries, in addition to ethnicity; and third, to identify potential risk factors related to differences in caries experience in these children. Results showed the mean dmfs scores of Turkish and Moroccan children to be much higher than that of the Dutch and Surinamese children; 8.1 and 8.2 versus 3.6 and 3.4, respectively. The educational level of the parents and the gender of the children were important risk indicators, in addition to ethnicity. The age of the child at which the parents had started to brush their child's teeth, the use of fluoride tablets and the regularity of the brushing behavior in the past could be identified as potential risk factors.


Relationship of microbial and salivary parameters with dental caries in Brazilian pre-school children. Caries examination and collection of paraffin wax-stimulated saliva samples were performed in 37 children, 3-6 years old, in a child-care facility at the Vidigal slum, Rio de Janeiro, Brazil. The levels of mutans streptococci and lactobacilli in saliva were estimated by the Cariescreen and by the Dentocult tests and the saliva secretion rate was determined. Statistical analysis was performed on surface-based and patient-based caries prevalence rates (SBCPR and PBCPR), and related to bacterial and salivary parameters. The results show that 31 of the 37 children were caries active. The SBCPR for the primary dentition was 6.7% +/- 1.0%. Occlusal surfaces were the most affected by decay. Regression analysis revealed that mutans streptococci salivary levels were significantly associated with the SBCPR (P = 0.0001). Similarly, lactobacilli salivary levels were significantly associated with the SBCPR (P = 0.0001). No significant association could be found between the saliva secretion rate and the SBCPR. When regression analysis was used to model dependence of the SBCPR on both organisms, the mutans streptococci and lactobacilli salivary levels were significantly associated with the SBCPRs (P = 0.0021 and 0.0118, respectively), and salivary levels of these organisms accounted for 57% of the SBCPR variability. These findings indicate that the levels of mutans streptococci and lactobacilli in saliva are significantly related to the SBCPRs on the primary dentition of these children.


Restorative treatment thresholds and agreement in treatment decision-making. It has been recognised for many years that treatment decision-making among dentists often shows wide variation. This study sought to examine the effect of dentists' stated treatment thresholds as a source of variation between them. Twenty dentists made 360 treatment decisions about the approximal surface of extracted teeth seen in simulated bitewing radiographs. They also stated their personal treatment thresholds, i.e. the depth of lesion which they intended to restore. One hundred and ninety pairwise comparisons of treatment decisions showed that only 16% of the dentist pairs showed substantial agreement. Dentist pairs who reported that they held the same interventive threshold achieved exactly the same mean level of agreement in treatment decision-making as dentist pairs who disagreed about the appropriate threshold for restorative intervention. The study suggests that restorative thresholds which are reported to be used by dentists may be poorly correlated with the number of positive treatment decisions actually made.


Assessment of dental health state utilities. The term "health state utility" implies the assigning of a numerical value to a state of health. Assessment of the success of health care procedures, using health state utilities, enables evaluation of available treatments and procedures in terms of differing health outcomes and therefore facilitates cost-benefit analyses. Although measurement of general health state utilities has become increasingly common in medicine using a variety of techniques, few attempts have as yet been made in dentistry to place valuations on different dental health states. The absence of tried and tested methods for measuring tooth quality make the benefits gained from preventive and restorative dental programmes difficult to quantify. The aim of this study was to assess the average utility values, held by a group of dentists and a group of members of the general public, for four different tooth states which it was hypothesised would have different values. These were 1) a decayed and painful posterior tooth; 2) a decayed and non-painful posterior tooth; 3) a posterior tooth which had been restored and would need further restorative treatment and 4) a permanently restored posterior tooth. A standard gamble questionnaire was used to elicit the utility values which were then substituted as "weightings" in a modified version of the "T-health" index (1). The results show that it is possible to assess dental health state utility values using the standard gamble method and that the average utility values of the dentists in the study were consistently higher than those of the general public.(ABSTRACT TRUNCATED AT 250 WORDS)


A new Norwegian index of orthodontic treatment need related to orthodontic concern among 11-year-olds and their parents. A new index of orthodontic treatment need was introduced in Norway in 1990. On a morphologic and functional basis the four groups very great (A), great (B), obvious (C) and little/no (D) need were defined for social insurance refunding. The purpose of the present study was to investigate to what extent the new index corresponded with orthodontic concern among potential orthodontic patients and their parents. Of 104 randomly selected fourth grade children, 99 (48 girls, 51 boys, mean age 10.7 yr) presented themselves for clinical examination and interview. One parent was asked to accompany the child, and 93 parents attended. On the basis of clinical examination, morphologic measurements on study casts, and X-rays, the children were allocated to one of the four groups defined by the index. In separate questionnaires the children and the parents were asked to assess satisfaction with own/child's dental arrangement and desire for orthodontic treatment. The interview data were transformed into a composite measure representing orthodontic concern. The results indicated that orthodontic concern was significantly related to index group. For the individuals who expressed concern the new index seemed to be meaningful for allocation of public subsidies, as most individuals (85%) who expressed concern exhibited malocclusions fulfilling the criteria for receiving public subsidies of treatment costs. However, more than 50% of the individuals allocated to group B (great need) did not experience a need for treatment.


A method to compare cost-effectiveness of dental treatments: adhesive bridges compared to conventional bridges. The cost-effectiveness of a dental restoration depends primarily on the durability and the cost of the restoration. In this report a method is described to compare the cost-effectiveness using the durability data of adhesive bridges and conventional bridges. The study shows that, for the situation in the Netherlands, the breakeven point for equal cost-effectiveness compared to conventional bridges is achieved when the 50% survival for adhesive bridges is approximately 6.5 yr. Clinical data indicate a higher cost-effectiveness for anterior adhesive bridges. The method described in this report is considered to be useful for comparing cost-effectiveness of dental restorations in different situations.


Coefficients of relationship by isonymy among oral cancer registrations in Scottish males. The role of inherited susceptibility to oral cancers was studied by comparing groups of cancer patients and controls in terms of the coefficient of relationship by isonymy (Ri), both within and between Regions of mainland Scotland. Surname distributions for 3658 male cancer cases were derived from the Scottish Cancer Register for the years 1959-85. Control distributions were derived from a total of 32,468 male deaths in Scotland for 1976. For cancer of the floor of mouth, there was no evidence for increased isonymy in patients compared to controls and therefore no indication that familial factors contribute to cancer at this site. For cancer of the tongue there was a suggestion of increased isonymy within but not between Regions, perhaps reflecting environmental risk factors common to members of the same family. For cancers of the lip and salivary gland there was evidence of increased isonymy both within and to a lesser extent between Regions, suggesting a genetic contribution. There is corroborative evidence from other sources for a heritable component in salivary gland cancer but the reasons for the similar pattern of results in cancer of the lip are less clear.


Incidence and severity of phenytoin-induced gingival overgrowth in epileptic patients in general medical practice. This investigation examines the incidence of phenytoin-induced gingival overgrowth in a population of epileptic patients who attend General Medical Practices for treatment of their epilepsy and compares the gingival changes with an otherwise healthy group of patients. The plaque score, gingival index, and gingival overgrowth did not differ significantly between the two groups (P > 0.05). A significant correlation was observed between plaque score and gingival overgrowth in the phenytoin-treated patient, but in this group there was no correlation between gingival overgrowth and salivary concentration of the drug. The overall incidence of clinically significant overgrowth (13%) is considerably less than in other studies.


Remaining teeth, oral dryness and dental health habits in middle-aged Norwegian rheumatoid arthritis patients. The aim of the study was to assess the effect of rheumatoid arthritis (RA) upon dental health. A questionnaire was mailed to all seropositive rheumatoid arthritis (RA) patients aged 44-56 yr in the files of the two main departments of rheumatology in South Eastern Norway. Data were obtained from 125 patients, constituting 91% of the target group. The number of remaining teeth in these patients was not related to disease duration or physical dysfunction, whereas a relationship to prolonged use of medication for pain relief was indicated. Factors known to affect tooth loss in the general population, such as smoking habits, dental attendance, interdental cleaning habits, previous dental disease, and place of residence were found to be important in RA patients as well. The RA patients from Oslo had a mean number of 25 remaining teeth, which is the same as reported for the general Oslo population at this age. Oral dryness was reported by more than 50% of the RA patients, but was not related to the number of teeth. The conclusion is that serious and long lasting rheumatoid arthritis had little influence on the number of remaining teeth in this middle-aged group of Norwegians.


Oral health conditions and denture treatment needs in institutionalized elderly people in Japan. Oral health conditions, including dental conditions, temporomandibular joint (TMJ) conditions, denture status, and oral hygiene status, were assessed on 1908 institutionalized elderly people 65 yr of age and older at 29 of the 30 existing institutions in the city of Kitakyushu, Japan. The percentage of edentulous people was 27% in the 65-74-yr-old group, and increased with age to 56% in the 85 yr and older group. In dentate persons, the mean number of remaining teeth and DF teeth were 13.4 and 8.6, 9.5 and 6.8, and 8.4 and 6.5 in the groups aged 65-74 yr old, 75-84 yr old, and 85 yr and older, respectively. 81% of all the persons examined had no unusual symptoms in their TMJ. A clicking sound was the most frequent symptom (17%). Hygiene of both their teeth and dentures was very poor. Of all the subjects, 36% needed new full and/or partial denture(s), and 41% needed only repair. When the institutionalized elderly people were compared according to their general health condition, no clear differences were observed in percentage of edentulousness, mean number of remaining teeth and DF teeth, and TMJ conditions. However, a higher level of both untreated teeth and denture treatment needs, and poorer oral hygiene, was found in elderly people having poor general health than was observed in those with better health.(ABSTRACT TRUNCATED AT 250 WORDS)


Prognosis of overdenture abutments in the aged: effect of denture wearing habits. The effect of denture wearing habits was studied in 35 overdenture wearers (20 day-and-night wearers, 15 day-wearers) during a period of 3 yr with controlled oral hygiene. Prior to prosthetic treatment intensive instruction and motivation in oral hygiene were carried out and the patients were recalled 2-4 times yearly during the study period. Before treatment mean Plaque Index (PlI) and Gingival Index (GI) were 1.5 and 1.6, respectively, in both groups of patients. At day 0, 1 yr, 2 yr and 3 yr mean PlI and GI were 0.3-0.5 and 0.6-0.8, respectively, in the group of day-wearers and 0.5-1.0 and 1.0-1.2, respectively, in the group of day-and-night wearers. This difference was statistically significant. Furthermore, during the study period 16% of the abutment tooth surfaces showed attachment loss (1-4 mm) in the group of day-and-night wearers against 7% of the tooth surfaces in the group of day-wearers. This difference was statistically significant. During the 3 yr 36 carious lesions developed in the group of day-and-night wearers, but none in the group of day-wearers. The results of this study have shown that day-and-night wearing of dentures is a major periodontitis and caries risk factor in complete overdenture wearers with controlled oral hygiene.


Observations on production of hemolysin, heat-labile enterotoxin and antimicrobial drug resistance among enterotoxigenic Escherichia coli from pigs. A total of 52 isolates of Escherichia coli belonging to enterotoxigenic serotypes from piglets with diarrhea were examined for hemolysis, production of cholera-like enterotoxin (LT) and susceptibility to 10 antimicrobial drugs. A strong association between production of LT and hemolysis was seen. Ninety percent of 29 hemolylic isolates were LT+ whereas 100% of 23 nonhemolytic isolates were LT- in a commercial latex agglutination assay. Antimicrobial susceptibility tests employing disc diffusion showed that resistance to trimethoprim-sulfamethoxazole (TMS), neomycin and tetracycline was significantly less among LT+ isolates compared to LT- ones. Enrofloxacin was the only antimicrobial drug to which all the 52 isolates were susceptible.


Epidemiology of an outbreak of leptospirosis in man and dog. An outbreak of leptospirosis in man and dog occurred during the monsoon in Madras city, India. 48 (50.5%) of the 95 human sera tested were positive for leptospirosis. Of these, 32 showed the presence of agglutinin to serovar icterohaemorrhagiae. 20 (21.3%) of the 94 canine sera tested were positive for leptospirosis. Of these, 10 had agglutinins to serovar icterohaemorrhagiae and 9 to serovar canicola. Among murine reservoirs, 8 (25%) of 32 rat sera and 10 (41.6%) of 24 bandicoot sera were positive. Bandicoot and rat sera contained 70 and 50% of agglutinins to serovar icterohaemorrhagiae, respectively. Urine culture lead to isolate a icterohaemorrhagiae strain from a patient and a canicola one from a dog. The changing trends of epidemiology in the transmission of leptospirosis to man and dog has been discussed.


Change in interleukin 2 production by lymphocytes during maturation of young cats. Lymphocytes from four specific-pathogen free cats were tested for their interleukin 2 activity every week beginning when the cats were 12 weeks old and ending when they were 26 weeks old. Lymphocytes from cats > or = 20 weeks old released significantly more interleukin 2 than those obtained from these cats at earlier ages when stimulated with calcium ionophore A23187 and phorbol myristate acetate. The change of interleukin 2 levels with maturation of young cats may represent an important difference in their level of defense to infections with various pathogens.


A cytotonic, cholera toxin-like protein produced by Campylobacter jejuni. 1. Campylobacter jejuni is a major cause of gastroenteric infection. 2. This organism appears to produce both cytotonic and cytotoxic virulence factors. 3. We report here that culture filtrates of some clinical isolates of C. jejuni induce elongation of Chinese hamster ovary (CHO) cells in vitro but do not cause inhibition of fluid absorption in the rat ileum. 4. These culture filtrates contain low levels of a protein which cross-reacts immunologically with the cholera toxin. 5. The cholera toxin-like protein of C. jejuni behaved identically to cholera toxin on non-denaturing polyacrylamide gel electrophoresis. 6. Under denaturing conditions, however, this protein displayed no subunit structure and a molecular weight of approximately 50 kDa with many higher molecular weight aggregates. 7. In conclusion, isolates of C. jejuni produced small amounts of enterotoxin when grown in vitro. 8. The toxin cross-reacted immunologically with cholera toxin and has a similar native structure, but does not appear to possess subunits.


Isolation of lactose-binding lectins from axolotl (Ambystoma mexicanum). 1. Lactose-inhibitable hemagglutination activity was identified in extracts of axolotl (Ambystoma mexicanum) larvae. 2. Two types of lectin were isolated from extracts by affinity chromatography on lactose-Sepharose. 3. A thiol-independent lectin of subunit mol. wt 15 kDa and a thiol-dependent lectin of subunit mol. wt 18 kDa were identified. 4. The 15 kDa and a 18 kDa polypeptides were weakly reactive with polyclonal anti-human galaptin serum.


Enzymological studies of melanin concentrating hormone (MCH) and related analogues. 1. Salmon melanin concentrating hormone (MCH) is a cyclic heptadecapeptide possessing the following primary structure: Asp-Thr-Met-Arg-Cys-Met-Val-Gly-Arg-Val-Tyr-Arg-Pro-Cys-Trp-Glu-Val. 2. In the fish, Synbranchus marmoratus, skin bioassay MCH5-15 is equipotent to MCH whereas MCH5-14, which comprises only the ring structure, is about 100-fold less active. 3. MCH and two fragment analogues, MCH5-15 and MCH5-14, were studied to determine their relative stability in the presence of fish serum and purified proteolytic enzymes, trypsin and alpha-chymotrypsin. 4. After 4 hr incubation in fish serum, MCH5-15 retained 1/100, MCH5-14 1/1000 and MCH only 6/1000 of the potency of the native hormone. 5. The three peptides were also very resistant to degradation by purified proteolytic enzymes involving the following relative order of resistance: MCH5-14 > MCH5-15 > MCH. MCH5-14 potency was not altered after a 1 hr incubation in either enzyme whereas MCH retained 1/10 and 4/100 of its original potency, and MCH5-15 retained 1/10 and 8/10 of its original potency, after 1 hr in trypsin and alpha-chymotrypsin, respectively.


Inhibitory effect of sulfhydryl group on Ca(2+)-ATPase activity in the plasma membrane-rich fraction from bovine parotid gland. 1. The present study demonstrated that the Ca(2+)-ATPase activity of the plasma membrane-rich fraction from bovine parotid gland was decreased by the addition of reducing agents. 2. Ca(2+)-ATPase activity staining on SDS-PAGE gels was lost in the presence of 2-mercaptoethanol. 3. Among all the reducing agents tested, GSH was the most effective in inhibiting Ca(2+)-ATPase. 4. The Ca(2+)-ATPase activity decreased by the GSH was restored by the addition of an oxidizing reagent. However, oxidation with an oxidizing reagent subsequent to alkylation of the reduced enzyme with iodoacetamide resulted in no restoration of activity. 5. The decrease of Ca(2+)-ATPase activity by GSH is due to a decrease in the Vmax of the enzyme. 6. These results suggest that the disulfide bond in this enzyme protein is necessary to maintain the activity of this enzyme.


Presence of D-aspartate oxidase and free D-aspartate in amphibian (Xenopus laevis, Cynops pyrrhogaster) tissues. 1. This paper is the first report on the presence of D-aspartate oxidase activity and free D-aspartate in the amphibian tissues. 2. The presence of D-aspartate oxidase activity in tissues of clawed toad (Xenopus laevis) and Japanese newt (Cynops pyrrhogaster) was demonstrated by requirements for enzyme activity, selective inhibition with meso-tartrate and substrate specificity. 3. In each animal, the highest activity was found in kidney, followed by liver and brain, and no gender difference in the specific activity was observed in each tissue. 4. A small but significant amount of D-aspartate was detected in liver and kidney, irrespective of species. 5. In the newt, there was a gender difference in the hepatic and renal content of D-aspartate and not in the D-/D+L-aspartate ratio.


Differential expression of the platelet-derived growth factor-A and -B genes during maturation of monocytes to macrophages. 1. Regulation of platelet-derived growth factor (PDGF)-A and -B gene expression was studied using resting monocytes, in vitro matured monocytes and alveolar macrophages. 2. Resting monocytes constitutively transcribed both PDGF-A and -B genes. When monocytes matured to macrophages in vitro, the transcription rates of both genes increased markedly. 3. Consistent with the transcription rates, resting monocytes constitutively expressed both PDGF-A and -B mRNAs. Interestingly, the PDGF-B mRNA levels increased markedly after the maturation, whereas the PDGF-A mRNA did not change. 4. Alveolar macrophages constitutively transcribed both PDGF-A and -B genes at almost the same rates. However, these cells contained 5-fold more PDGF-B mRNA than PDGF-A mRNA. 5. Immunohistochemical study using anti-PDGF-AA and anti-PDGF-BB antibodies suggested that PDGF-BB homodimers were more abundant than -AA homodimers or -AB heterodimers in alveolar macrophages and in vitro matured monocytes. 6. Together these observations indicate that in vitro matured monocytes and alveolar macrophages preferentially express PDGF-B mRNA and produce PDGF-BB homodimers, despite the equal transcription rates for both PDGF-A and -B genes.


Arginase distribution in tissues of domestic animals. 1. A new colorimetric method was used for determination of arginase in different tissues of some domestic animals. 2. In all species studied liver was the richest source of arginase. 3. Significant differences were observed in the specific activity of arginase in livers from different species. 4. In all species, besides liver, kidney and brain also contained significant levels of arginase. 5. In the dog, in addition to the three organs mentioned above, lung, heart, spleen and skeletal muscle showed some arginase activity. 6. In sheep and cattle significant arginase activity was observed in the rumen. No differences were observed between epithelial and muscular layers of different parts of digestive system in all species studied. 7. These results are discussed in terms of the possible role of arginase in different tissues of animals.


Comparison of sex steroid hormone-dependent induction of chick oviduct delta-aminolaevulinic acid dehydratase during primary and secondary stimulation. 1. A comparative study on primary and secondary stimulation of oviduct delta-aminolaevulinic acid dehydratase (ALAD) (EC 4.2.1.24) was carried out with oestradiol-17 beta and/or testosterone administration in immature female chickens during 15-day-primary stimulation, 20-day-withdrawal and 15-day-secondary stimulation periods. 2. Compared with primary stimulation in oestrogenized birds, synthesis and degradation rates of oviduct ALAD molecule during secondary stimulation increased 3.4- and 1.8-fold respectively, resulting in a rapid induction of the enzyme. 3. Specific activity of oviduct ALAD in oestradiol-plus-testosterone treated birds became significantly higher than that of oestradiol alone during secondary stimulation, whereas no significant changes were observed during primary stimulation.


Effect of adenine metabolites on survival of Drosophila melanogaster of low xanthine dehydrogenase activity. 1. Low xanthine dehydrogenase (LXD) mutant Drosophila melanogaster were fed 0.2% adenine for 7 generations, no adenine for the next 2 generations (relaxed) and 0.2% adenine again for the next 3 generations (rechallenged) to obtain adenine-resistant lines of Drosophila (LXD-adenine). Flies grown without adenine served as LXD-controls. 2. Purines ranked as follows; adenine > adenosine > AMP > inosine > IMP in decreasing order of toxicity to LXD-adenine flies. 3. Addition of ribose to 9N position, or phosphate or carboxy to 6C position of the purine ring alleviated the toxicity. 4. More LXD-adenine offspring survived than did LXD-control offspring rechallenged with adenine.


Postnatal development of hepatic xanthine oxidase in baby pigs and turnover of purine catabolites at reduced ambient temperature. 1. The activity of xanthine oxidase in liver samples of baby pigs up to 4 weeks of age was investigated. On the 3rd day of life the turnover of hypoxanthine and of uric acid were measured after intravenous injection of 3H- and 14C-labelled tracers into animals kept at normal (32 degrees C) and reduced (20 degrees C) ambient temperature. 2. Hepatic xanthine oxidase activity increased progressively from 2 to 28 days of age (r = 0.689; P < 0.001). The increase of Vmax and of KM within 3-4 weeks was about 4.5-fold. 3. In 3-day-old baby pigs kept at normal temperature, pool size and turnover was about 10-fold higher for hypoxanthine than for uric acid. 4. At reduced ambient temperature, the pool size of uric acid increased 3.9-fold (P < 0.01) and turnover 1.6-fold (P < 0.05). For hypoxanthine the increases were insignificant.


Effects of a new calf thymus protein on 3-hydroxy-3-methylglutaryl-CoA reductase activity in rat (Rattus bubalus) hepatocyte cells (BRL-3A). 1. In a previous paper we described the purification steps of a new calf thymus protein able to activate the LDL receptor catabolism. 2. In this paper we examine the modulatory effect of this new calf thymus protein on 3HMG-CoA reductase activity in rat hepatocyte cells to better clarify the role of this protein on cholesterol metabolism. 3. The results obtained show that the calf thymus protein inhibits the HMG-CoA reductase, and support the hypothesis that the activation of LDL receptor catabolism is mediated by a decreased amount of cellular cholesterol following HMG-CoA reductase inhibition.


Evidence for melanogenesis in the retinal pigment epithelium of adult cattle and golden hamster. 1. The ultrastructure of the retinal pigment epithelium (RPE) of adult Syrian golden hamsters and cattle was examined with respect to pigment granules and phagosomes involved in degradation of disk membranes from rod outer segments. 2. In the RPE of cattle, phagosomes were found that contained an electron-dense melanin-like material that was not autofluorescent and therefore not lipofuscin. 3. Disk membranes of rods are about 4 nm thick and become enlarged (7-20 nm) and electron-dense during degradation in the RPE. 4. Additionally electron-dense vesiculo-globular bodies (10-100 nm) were found in phagosomes during disk membrane degradation and in mature melanin granules. 5. In the RPE of adult hamsters that had been exposed to intense light, premelanosomes containing unmelanised filaments with a striated periodicity were found in the cytoplasm or in association with mature melanin granules. Early and late stage melanosomes were also present. Phagosomes in the RPE contained degraded disk membranes, melanin-like material and melanofilaments. 6. Dopa oxidase was detected ultrastructurally within shed disk membranes that were in close contact with the microvilli of the RPE. 7. The possibility of melanogenesis within phagosomes during disk membrane degradation is discussed.


Physical studies of the hemocyanin of the marine gastropod, Kelletia kelleti (Forbes). 1. The hemocyanin of the Californian whelk, Kelletia kelleti, investigated at pH and ionic conditions close to physiological, has a molecular weight close to 9.0 x 10(6) and a sedimentation constant of 114S, characteristic of the di-decameric structure of molluscan hemocyanins. Light-scattering measurements at pH 8.0, 0.05 M Mg2+, 0.01 M Ca2+ gave a molecular weight of 9.0 +/- 0.6 x 10(6), and scanning transmission electron microscopy produced nearly the same particle mass of 9.22 +/- 0.50 x 10(6) daltons (Da). 2. Light-scattering measurements on the fully dissociated monomers in the presence of 8.0 M urea and at pHs 10.6 and 11.0 gave molecular weights of 4.50 x 10(5)-4.91 x 10(5), that are close to one-twentieth of the mass of the parent di-decameric hemocyanin assembly. 3. Changes in pH produced a bell-shaped molecular weight profile, with molecular weights close to 9.0 x 10(6) in the pH region of about 5.5-8.0, and progressive dissociation to 4.5 x 10(5) Da monomers in the region below pH 4.0 and above pH 9.0 or 10, depending on the absence or presence of stabilizing Mg2+ ions (0.01 M). 4. In the absence of divalent ions some aggregation of hemocyanin was found at pHs close to 5.0, with observed molecular weights above 10 x 10(6) (investigated at a hemocyanin concentration of 0.10 g/l). The early studies of Condie and Langer (Science 144, 1138-1140, 1964) had shown that Kelletia kelleti hemocynanin aggregates at acidic pHs close to the isoelectric point, forming linear polymers of the hemocyanin di-decamers.(ABSTRACT TRUNCATED AT 250 WORDS)


Seasonal changes in the activity of rhodanese in frog (Rana temporaria) liver. 1. The investigators studied annual changes in rhodanese activity in mitochondria and cytosol of frog liver cells (Rana temporaria) and found that the value of the enzyme-specific activity was higher in mitochondria than in cytosol, showing significant seasonal fluctuations. 2. The character of changes in the rhodanese activity in mitochondria, regardless of the sex of the studied animal, was demonstrated to be dependent upon the seasonal changes in frog thyroid gland function. 3. In the supernatant fraction of R. temporaria liver homogenate, seasonal changes of rhodanese specific activity seemed to be related to changes in hepatic function.


Preparation of unsaturated disaccharides by eliminative cleavage of heparin and heparan sulfate with heparitinases. 1. Six kinds of unsaturated disaccharides were prepared by enzymatic digestion of heparin and heparan sulfate with heparitinases I0 and IV, and subsequent column chromatography. They were identified by HPLC showing good separation from each other. 2. The content of each unsaturated disaccharide fraction was determined colorimetrically, and found to range from 130.7 to 722.3 mumol. 3. Molecular extinction coefficient of each unsaturated disaccharide was calculated from absorbance at a wavelength of around 230 nm where a peak appeared on the ultraviolet spectrum of each disaccharide solution at pH 2. The values varied from 6000 to 6600.


A network thermodynamic model of the concentrating properties of the rabbit/rat kidney in the steady state using the electronic network simulation program SPICE. A model for the simulation of the diluting and concentrating properties of the rabbit and rat kidney is developed. Translation of the physical model into an electronic one brings the model into a form that can be handled by the electronic network simulation program SPICE. The steady state responses of both kidneys to various inputs are calculated under certain conditions.


A computer model for the study of electrical current flow in the human thorax. Electrocardiography has played an important role in the detection and characterization of heart function, both in normal and abnormal states. In this paper we present an inhomogeneous, anisotropic computer model of the human thorax for use in electrocardiography with emphasis on the calculation of transthoracic potential and current distributions. Knowledge of the current pathways in the thorax has many applications in electrocardiography and has direct utility in studies pertaining to cardiac defibrillation, forward and inverse problems, impedance tomography, and electrode placement in electrocardiography.


Real-time abdominal fetal ECG recording using a hardware correlator. A real-time fetal ECG monitoring system using abdominal recording is presented. The system is based on an IBM AT compatible personal computer. The computer lacks the performance required for real-time analysis. Therefore, a new design of a fast hardware correlator board was developed to enhance the computer throughput. The technique is based on a cross-correlation procedure. An averaged maternal ECG waveform is derived using the cross-correlation function for the waveform's alignment. With this procedure a template signal corresponding to one complete maternal ECG is obtained. The averaged maternal ECG is then subtracted from the abdominal signals. Thus, it is possible to detect all the fetal ORS complexes in spite of their coincidence with the maternal ECG. An average fetal ECG is then extracted to improve the signal-to-noise ratio, making it possible to recognize fetal P and T waves.


Treatment time for Amersham caesium-137 manual afterloading system. Currently, the Amersham caesium-137 afterloading system is widely used for gynecological treatment of tumors in uterine cervix. This paper introduces an expert system to determine the time of exposure of an Amersham afterloading system based on different combinations of applicator sources. The efficiency of the expert system achieves 93% of the clinical decisions taken by physicians. It is evaluated by both the experimental results and the actual clinical decisions.


Simple SAS macros for the calculation of exact binomial and Poisson confidence limits. Statistical analysis using confidence intervals is now a preferred approach in the medical literature, and confidence limits for binomial proportions and Poisson counts are commonly required. Normal approximations of varying accuracy are often used in such situations and it is not generally realised that non-iterative exact solutions are available. This paper shows that the exact binomial and Poisson confidence limits can be expressed very simply in terms of the inverse beta and inverse gamma distributions, and describes two macros in the SAS programming language to perform the computations. The exact solutions are compared with some approximations and further applications of the techniques are described.


Reuleaux triangle somatocharts.

Reuleaux triangle somatocharts. The three-numeral somatotype index to quantitatively represent human body type has gained general acceptance since being proposed in 1940. The two-dimensional Reuleaux triangle somatochart has been a customary format for graphically representing three-dimensional somatotype data. This paper presents the traditional, quick plot somatochart, the rationale for development of the Health-Carter 1980 somatochart with scaled axes and, based on that rationale, a proposal for a somatochart utilizing a traditional x, y-coordinate axis system. Two completed somatocharts are presented; one showing mean somatotypes of collegiate rugby, football and soccer players, and another depicting phenotypic changes in somatotype after diet and exercise.


Evaluating agreement between two methods for measuring the same quantity: a response. A method comparison study is typically concerned with evaluating the agreement between a "new" method against an "established" method for measuring the same quantity. Various statistical indices have been advocated for measuring the extent to which two methods give identical readings, that is, absolute method agreement. This article scrutinizes two contending statistical indices, the intraclass correlation and the "limits of agreement", for measuring absolute method agreement, and found neither index to be without deficiency. Notwithstanding, each index can serve a useful role in quantitating method agreement in carefully considered situations.


Clinical, immunological and bacteriological evaluation of adverse reactions to skin-penetrating titanium implants in the head and neck region. Between 1977 and October 1989, 445 patients have been treated with bone-anchored skin-penetrating titanium implants for anchorage of facial prostheses or bone-conducting hearing aids, at the Ear, Nose and Throat Department at Sahlgren's Hospital in Gothenburg. The majority of patients had no adverse skin reactions, while a few patients were responsible for the majority of the adverse reactions. The aim of our study was to analyse differences between these groups. We started a clinical study on 9 patients with a clinical history of adverse skin reactions around the titanium implants and 9 patients without adverse skin reactions were used as controls. None of the patients had delayed hypersensitivity to titanium. Microbiological analyses showed that when there was clinical irritation, Staphylococcus aureus could be isolated.


Contact dermatitis from telefax paper.

Contact dermatitis from telefax paper. A nonatopic female secretary developed hand dermatitis after 1 year of full-time work with telefax paper. Her dermatitis improved on sick leave and vacation and relapsed at work. Patch testing showed allergic reactions to several fragrances, balsam of Peru, colophony and neomycin. In 3 patch test sessions, her own telefax papers gave a doubtful reaction which persisted for 4 days, but it could not be determined whether the reactions were allergic or irritant. The colophony content of the telefax paper was about 1%, and it was possible that colophony in the telefax paper was responsible for the weak path test reactions. Accordingly, the contact dermatitis would have been allergic. The patient has now been relocated, does not handle telefax paper, and is symptomless. We concluded that our patient had an occupational hand contact dermatitis induced by telefax paper and possibly caused by colophony allergy.


Study of dose-response relationship in contact sensitivity using an in vitro assay. Dose-response relationships in contact sensitivity were evaluated in guinea pigs using an in vitro assay. Guinea pigs were sensitized with different doses of 1-chloro-2,4-dinitrobenzene (DNCB) and challenged with DNCB and 2,4-dinitrobenzene sulfonic salt (DNBS). Lymph node cells from sensitized and control guinea pigs were cultured in the presence of different doses of DNCB and DNBS at 8 x 10(5) cells/well, respectively. The sensitivity was evaluated by the lymphocyte transformation test (LTT), which was assessed by uptake of 3H-thymidine. The results indicated that there were significant correlations between the doses of sensitizers and the values of LTT in both phases of induction and challenge. Thus, the presence of higher numbers of LTT-reactive lymphocytes in the circulation may well correlate with the sensitizing doses. The values examined by in vitro assay correlated well with patch test readings (r = 0.653), indicating that following the increment of degree of patch test reactions, the values of SI were also increased. The in vitro LTT may discriminate between positive patch test reactions and negative or doubtful reactions, but not between weak positive and strong positive reactions. The in vitro assay reproduced the cross-reaction between DNCB and DNBS which was confirmed in vivo.


Sensitization to azo dyes: negative patch tests to yellow and red azo dyes in printed paper. An over 2 x fold increase in para-aminoazobenzene allergy was observed in patients with allergic contact dermatitis during the years 1990-1991. Presuming that an increase in colour-printed newspapers might be a new unrecognized source of clinical allergy to azo dyes, patch tests were performed in 32 patients with an established p-aminoazobenzene allergy using a series of important azo dyes used in offset printing ink (Pigment Yellow 12, Pigment Yellow 13, Pigment Red 53, Pigment Red 57), as well as with dye-containing inks and specimens of colour-printed newspaper containing these azo dyes. In 25 out of the 32 patients (78%), positive patch tests were seen to textile azo dyes, in particular to Disperse Orange 3 (24 patients). In none of the 32 patients were reactions observed to the azo dyes used in printing ink, to the inks used or to the colour-printed paper specimens, indicating that these products were apparently not a cause of contact dermatitis in our group of patients with azo dye sensitization.


Allergic contact dermatitis from formaldehyde. A case study focussing on sources of formaldehyde exposure. Formaldehyde is a common contact allergen. The prognosis of formaldehyde-sensitive patients is generally considered to be bad because of widespread exposure to formaldehyde. 11 patients with eczema and a positive patch test to formaldehyde were interviewed by a dermatologist and a toxicologist/chemist and instructed to fill in a questionnaire on exposure to chemical products. The content of formaldehyde and formaldehyde releasers in such products was examined using the database of the Danish Product Register (PROBAS) and by supplemental inquiries of manufacturers or importers. All the patients used one or more products containing formaldehyde or formaldehyde releasers. Sources of exposure were cosmetics and personal care products, dishwashing liquids, water-based paints, photographic products, etc. Patients were advised to use alternatives to those products containing formaldehyde or formaldehyde releasers. The status of 10 out of the 11 patients' eczema at follow-up was about 1/3 healed, 1/3 improved and in 1/3 no change. When the relevance of positive patch test reactions to formaldehyde was based on information obtained on exposure, a very high rate of current relevance was found. Computerized data on product composition allows the screening of products for contact allergens and also generates lists of contact allergens indicated for patch testing, based on the patients' own products.


Electrical impedance applied to non-invasive detection of irritation in skin. Healthy volunteers were subjected to irritation by sodium lauryl sulphate at concentrations in the range 0.002% to 5.0% applied in Finn Chambers for 24 h. Test sites were visually assessed 1 h and 24 h after cessation of exposure. At the same times electrical impedance was measured with a new impedance device which allows non-invasive local measurements to a controlled depth. Close agreement between concentration and an irritation index calculated from electrical impedance parameters was found over the whole concentration range for most test persons. At concentrations below 0.2%, visual scores were zero. These results suggest that electrical impedance can be used as an objective tool to record irritation, and further that electrical impedance might be a more sensitive method than the commonly used visual readings.


Contact sensitivity to flavourings and perfumes in atopic dermatitis. 16 children with atopic dermatitis and 4 nonatopics were skin tested with flavourings and perfumes. Immediate reactions to balsam of Peru and fragrance-mix were found in 9 atopics, and none among nonatopics. An irritant is more probable than an immunologic mechanism. Allergen solutions should probably be assayed at a lower concentration in atopic patients. This study points to a possible aggravating factor from perfumes and flavourings ingested, inhaled, or used as cosmetics.


Oscar Wilde's skin disease: allergic contact dermatitis? During the last years of his life, Oscar Wilde (1856-1900) suffered from a suppurating otitis media as well as from an unidentified skin disease. The eruption was localized to his face, arms, chest and back and itched severely. A new theory is suggested, based on the fact that Wilde almost certainly used a dye to conceal his rapidly graying hair. He sensitized himself to p-phenylenediamine and developed a stubborn allergic contact dermatitis. Patch testing, the only proof of such a diagnosis, had not yet been devised.


Erythema induced by organic solvents: in vivo evaluation of oxygenized and deoxygenized haemoglobin by reflectance spectroscopy. (i) using a new non-invasive technique capable of evaluating quantitatively and qualitatively the haemoglobin content of the skin (ii) to evaluate delipidization induced by organic solvents. 11 Caucasians treated for 1 min in a randomized manner on the volar forearm with a mixture of chloroform/methanol (2:1) (CM) and ether/acetone (1:1) (EA) to delipidize the skin. erythema was evaluated by computerized remittance spectroscopy immediately after delipidization and hourly for 2 h. only CM application induced subjectively observed and objectively quantified erythema. Erythema was related to a significant increase in oxygenized haemoglobin content due to dilatation of arterioles in the subpapillary plexus (P less than 0.01). The increased blood flow induced a significant (P less than 0.01) reduction in de-oxygenized haemoglobin in venous vessels immediately after CM application. short contact with certain potent solvent mixtures causes erythema, possibly due to massive lipid extraction and damage of the skin barrier. Using computerized remittance spectroscopy the visible erythema was composed of an increase in oxygenized haemoglobin and a relative decrease in deoxygenized haemoglobin.


Clinical manifestations and antibiotic treatment of Lyme disease. As the incidence of Lyme disease increases in Connecticut and world-wide, considerable attention has been given to its prompt diagnosis and treatment. Creating further interest in this infection is the awareness that inappropriate therapy may result in significant disabling sequelae many years later. In this review, we focus mainly on current treatment options, but stress that the recommendations may change appreciably, as more information appears on the efficacy of new antibiotics.


Pulmonary carcinosarcoma: report of a case with unusual histologic features. An unusual case of a 56-year-old male with carcinosarcoma of the lung containing three malignant mesenchymal elements is reported. The clinical, radiographic, gross, and immunohistochemical findings are presented. The theories addressing the histogenesis of carcinosarcoma are discussed with special emphasis on the findings in this case.


Repeat coronary artery bypass: a seven-year experience. Repeat coronary artery bypass (RCAB) procedures were performed on 323 patients from March 1984 through December 1990. The mean interval between bypass operations was 7.8 years. The operative mortality rate was 4.6%; six of the 15 deaths (40%) occurred in the operating room. Fourteen of the 15 operative deaths (93.3%) were cardiac, all but one of which were due to ventricular failure. Follow-up data for 83 of 91 (91.2%) patients at least five years following RCAB show that 64 (77.1%) are still alive, 39 (60.9%) of whom remain free of cardiac symptoms. Findings in this report, which are notably consistent with those of previous reports, are a significantly higher operative mortality rate and higher risk of death in the operating room in patients undergoing repeat bypass compared with those having initial coronary artery bypass. The challenge of reducing the mortality risk following coronary reoperation is discussed in this report.


Financial aspects of the provision of care to AIDS patients at Hartford Hospital. Data on the provision of care to persons with AIDS at Hartford Hospital are presented for the years 1988 and 1989. Approximately 2% of the total operating loss from uncompensated care at the hospital was due to patients with AIDS during both of those years. While the hospital continues to show a net surplus of revenues over expenses, the operating loss incurred by the hospital for the provision of care to hospitalized case-definition AIDS patients increased by 88.1% between 1988 and 1989.


Hageman factor deficiency presentation and implications for management. One of the more fascinating aspects of patient management arises when dealing with coagulation disorders. Factor XII deficiency, first described by Ratnoff in 1968, is one such coagulation disorder which provides some interesting challenges in management. Factor XII deficiency has been shown to be an inherited autosomal recessive disorder. The presence of Hageman factor abnormality trait can be clinically suspected in a patient with a prolonged activated partial thromboplastin time (APTT), normal prothrombin time (PT), normal bleeding time, and no clinical history of bleeding. Once suspected, the deficiency can be confirmed by normalization of partial thromboplastin time (PTT) with normal aged plasma and by factor assay. The importance of understanding the mechanism of factor XII deficiency has clinical significance when attempts are made to heparinize individuals who have this deficiency. Three methods can be used to monitor therapy: the chromogenic heparin assay, the citrated thrombin time, and the recalcified thrombin time. Two cases are presented.


Risk management alert: a summary of perinatal cases. Connecticut Medical Insurance Company (CMIC) cases related to obstetrical care and the newborn represent the single most costly exposure to the Company. CMIC undertook the review of its perinatal cases, open and closed, to identify common elements that increased the liability exposure of individual physicians as well as the overall exposure to the Company.


A study of gemeprost alone, dilapan or mifepristone in combination with gemeprost for the termination of second trimester pregnancy. It is well established that abortion can be induced successfully in midtrimester of pregnancy by gemeprost vaginal pessaries. A randomised study was carried out to determine the efficacy of mifepristone and dilapan in combination with gemeprost for second trimester termination between 12-18 weeks' gestation. A contemporary group of women treated with gemeprost alone was used as a control group. A single course of 4 x 1 mg gemeprost pessaries was administered every six hours. If abortion had not occurred after 24 hours, a further course of 5 x 1 mg pessaries was administered every three hours over the next 24 hours. In the first twenty hours after administration of gemeprost, 95%, 85% and 72% of women aborted in the mifepristone, dilapan and the control group, respectively. The median induction-abortion interval in the mifepristone group (6.6h) was significantly shorter than the other two groups and fewer pessaries were required to induce abortion. The incidence of diarrhoea and vomiting was lower in the mifepristone than the other two study groups. This study demonstrated the efficacy of mifepristone in combination with gemeprost and this regimen is associated with fewer gastrointestinal side effects.


A randomized clinical trial of mifepristone (RU486) for induction of delayed menses: efficacy and acceptability. Mifepristone (RU486) should be useful for inducing menstrual bleeding in women with menses delayed up to 10 days. We evaluated this potential use for "menstrual regulation" in a randomized clinical trial with 16 women, half of whom received a single 600 mg dose and half of whom received a placebo. Four of eight women in each treatment group proved to be pregnant. Seven of eight who received mifepristone were not pregnant at two-week follow-up, in contrast to four of eight who received the placebo (p = 0.15). Mifepristone may hold promise for "menstrual regulation" for women who do not have access to medical confirmation of pregnancy or who choose not to have this determination made.


Triphasic combination of ethinyl estradiol and gestodene. Long-term clinical trial. A triphasic oral contraceptive containing ethinyl estradiol and gestodene was used by 1933 women for up to 36 cycles in order to evaluate contraceptive efficacy, general tolerance and cycle control. Altogether, 30,763 treatment cycles were recorded. Two pregnancies were seen, both of them classified as user failure. The rates of spotting and breakthrough bleeding fell below the rates of the pre-treatment cycle after the first three months of treatment. Adverse events were mostly minor with breast tension and headaches the most common complaints. After the first three cycles, the incidence of most complaints was the same as or even lower than in the pre-treatment cycle. Blood pressure and body weight remained practically unchanged. The trial preparation provided reliable contraception with good general tolerance and cycle control when taken for up to three years.


Pharmacokinetics of gestodene in 12 women who received a single oral dose of 0.075 mg gestodene and, after a wash-out phase, the same dose during one treatment cycle. The pharmacokinetics of gestodene (GEST) was determined in 12 healthy women (age 22 to 34 years), following single dose administration of 0.075 mg GEST. The same preparation was also administered during one treatment cycle after a wash-out phase of 1 week. After single dose administration, maximum concentrations of GEST in the serum were 4.9 +/- 2.5 ng/ml. Post maximum drug levels declined biphasically with half-lives of 0.2 +/- 0.2 h and 14.9 +/- 6.7 h, respectively. The apparent clearance was calculated to be 0.8 +/- 0.4 ml x min-1 x kg-1. The free fraction of GEST was 1.3 +/- 0.3% and the fractions bound to SHBG and albumin were 64.3 +/- 10.7% and 34.4 +/- 10.4%, respectively. The results showed that there was a gradual decrease in serum trough levels of GEST during the cycle, due to a concomitant and equally high decrease in SHBG concentrations in the serum of about 26%. At the end of one treatment cycle, the free fraction of GEST increased to 1.8 +/- 0.5%, the SHBG-bound fraction decreased to 57.0 +/- 10.2% and the albumin-bound fraction increased to 41.3 +/- 9.9%. Total serum clearance increased during the same time period from a mean value of 0.8 to about 1.2 ml x min-1 x kg-1. The clearance of unbound GEST, however, remained unchanged. An examination of the free GEST concentrations revealed the same time course of GEST trough levels during the cycle as the simulated curve. This was derived from the pharmacokinetic parameters which were obtained after single dose administration. Thus, the present study showed that the pharmacokinetics of GEST can be fully explained on the basis of single dose pharmacokinetics and the changes in serum protein binding which were caused by a reduction of SHBG levels in the serum during chronic treatment with GEST. There was no evidence of GEST inhibiting its own metabolism.


Use of injectable progestin (medroxyprogesterone acetate) in adolescent health care. To assess medroxyprogesterone acetate (DMPA) prescription practices in adolescent health care practices, an anonymous questionnaire was distributed to 160 American and Canadian physicians attending the 1991 meetings of either the Society for Adolescent Medicine or the North American Society for Pediatric and Adolescent Gynecology. Of 54 (33.7%) physicians who responded, 33 (61.1%) reported prior prescription of an injectable progestin (DMPA) as a form of birth control. Of those, 15 (45.5%) had prescribed it to 10 or more adolescents. Twelve (57%) pediatricians but only 3 (25%) gynecologists reported prescribing DMPA to 10 or more adolescents (p = 0.074). Female physicians were more likely to have prescribed DMPA to adolescents than male physicians (p = 0.009). Mental retardation was considered the strongest "potential indication" for DMPA administration by 48 physicians responding to a 5-point Likert scale. The study suggests that physicians with interest or expertise in Adolescent Medicine are using DMPA as a form of birth control for selected young women in spite of the lack of Food and Drug Administration approval. A centralized DMPA registry is suggested to monitor adverse outcomes in users.


Long-term use of depot-norethisterone enanthate: effect on blood lipid fractions. This is the third report of a metabolic study on 56 long-term users (24 for 2-5 yr; 32 for over 5 yr) of the injectable contraceptive norethisterone enanthate (Net-En) and deals with the effects on the blood levels of lipoprotein fractions. There was no significant difference between this group and a group of 30 non-users in serum concentrations of triglycerides, total cholesterol, low density and very low density lipoproteins. There was a significant reduction in mean high density lipoprotein levels between the controls and the user groups (16% for the intermediate duration and 12% for the longer duration). Age, ethnic group, body-mass index and a close family history of cardiovascular disease were taken into account, as were various lifestyle factors: diet, exercise, alcohol consumption and smoking. In a smaller group, levels of apoproteins A and B were also assayed. There was a significant reduction in apoprotein A between controls and all users, but the significance was lost on adjusting for confounding variables. Consideration was given to the ratio of total cholesterol to high density lipoprotein cholesterol as an index of coronary risk. There were no significant differences in the total cholesterol:HDL-C ratio between controls and user groups. There was a significant interaction with ethnic group (Caucasian or Afro-Caribbean) in the response to duration of use.


Carbohydrate metabolism before and after Norplant removal. Changes in carbohydrate metabolism, measured by oral glucose tolerance test, were studied in Norplant users before and after removal. The mean area under the glucose curve rose from 24.7 min mmol/L before Norplant insertion to 35.1 min mmol/L before removal and decreased to 26.1 min mmol/L four weeks after Norplant removal. The areas before insertion and after removal were not statistically different (95% confidence interval -3.3 to 0.56, P = 0.16). The mean areas under the insulin curves before insertion (53.14 min uU/L) and after removal (59.46 min uU/L), however, were significantly different (95% confidence interval -7.64 to -5.0, P less than 0.0001). We conclude that changes in carbohydrate metabolism induced by Norplant are reversible once the implants are removed. While the changes in glucose induced by Norplant returned to pre-insertion levels within 4 weeks after removal, insulin changes were slower to return to pre-insertion values.


Effect of Norplant-2 rods on haemostatic function. A longitudinal study on one-hundred Singaporean women using Norplant-2 rod implant for contraception and their effects on the haemostatic function was carried out. There was a decrease in vitamin K-dependent Factors II, VII and a tendency towards lowered fibrinolytic activity after prolong use of Norplant-2 rods. The results indicate that the Norplant-2 rod implant system does not contribute towards hypercoagulable state but increased platelets and accelerated platelet aggregation observed will require further study to ascertain whether there is a concomitant increase in platelet activation.


Influence of different progestogens on blood pressure of non-anaesthetized male spontaneously hypertensive rats. The aim of the study was to find out if synthetic progestins with significant antimineralocorticoid activity would have a beneficial effect on blood pressure. Male spontaneously hypertensive rats were treated daily for four weeks with different progestogens by subcutaneous injection. Arterial pressure of the conscious animals was measured at three-day intervals. Progestogens were dosed on the basis of their progestogenic activity, whereby the dosages corresponded to the 10-fold effective dose for inhibition of ovulation in rats. For comparison, spironolactone as well as progesterone itself were included in the study. After four weeks' treatment, plasma volume, extracellular fluid volume (ECFV) and the sodium and potassium concentrations in the plasma were measured. In control animals, there was a slight decrease in blood pressure over the four-week experimental period. Progesterone and spironolactone similarly influenced blood pressure. A new progestin with significant antialdosterone activity, dihydrospirorenone (code No. ZK 30.595), slightly but significantly decreased the ECFV, plasma sodium concentration and slightly but insignificantly decreased blood pressure as compared to vehicle-treated controls. Synthetic progestins lacking this antimineralocorticoid activity did not decrease blood pressure, but rather induced a slight increase in this animal model. The results clearly support the hypothesis that synthetic progestins, like endogenous progesterone, all of them with inherent antialdosterone activity, decrease the ECFV and so might have an impact on extracellular fluid hemostasis as well as blood pressure regulation.


Bacteria and yeast on the surface and within non-inflamed hair follicles of skin biopsies from cats with non-neoplastic dermatoses. Coccoid bacteria and/or yeasts were found in the surface keratin or exudate or, rarely, the pilar canal of non-inflamed hair follicles upon light microscopic examination of skin biopsies from 57 of 338 cats (16.9%) with non-neoplastic skin disorders. The presence of these microorganisms did not appear to suggest a specific dermatosis, nor the existence of a clinically relevant infection in the majority of cases.


Bacteria and yeast on the surface and within non-inflamed hair follicles of skin biopsies from dogs with non-neoplastic dermatoses. Coccoid bacteria and/or yeasts were found in the surface keratin or exudate and/or in the pilar canal of non-inflamed hair follicles upon light microscopic examination of skin biopsies from 191 of 3,387 dogs (5.6%) with non-neoplastic skin disorders. The presence of surface cocci and/or yeast did not appear to suggest a specific dermatosis, nor the existence of a clinically relevant infection in the majority of cases. However, follicular cocci and/or yeast almost always indicated the presence of a clinically relevant infection.


Microscopic anatomy of the skin of the woodchuck (Marmota monax): comparison of woodchuck hepatitis virus-infected and non-infected animals. Thirty-three woodchucks were used in this study. Seventeen animals were healthy adults, not infected with woodchuck hepatitis virus (WHV); 10 were healthy adults infected with WHV; 4 were noninfected neonates; 2 were infected neonates. Within the 4 groups of woodchucks, no histologic differences were detected on the basis of sex or age. Neither were histologic findings different between infected and noninfected woodchucks of similar ages. The average thickness of skin (as measured from the skin surface to the inner limit of the dermis) from the general haired body area was 2394 microns. The skin was thickest on dorsal body areas, and gradually became thinner on ventral body and medial limb areas. The epidermis consisted of 4 layers: stratum basale, stratum spinosum, stratum granulosum, and stratum corneum. A stratum lucidum was present only in the epidermis of the footpads. There was no clear distinction between the superficial dermis and the deep dermis, except for the subtle differences in arrangement and size of collagen fibers. Elastic fibers were seen throughout the dermis, being more prominent in the superficial portion. Both compound and simple hair follicle arrangements were seen, with compound being more common. The arrectores pilorum muscles were largest in the skin over the dorsal body areas. Sebaceous glands were present either within the outer root sheath of hair follicles or in the dense connective tissue surrounding hair follicles. No apocrine sweat glands were found. However, there were abundant eccrine sweat glands in the subcutaneous fat of the footpads.


Skin disorders of the laboratory woodchuck (Marmota monax): a retrospective study of 113 cases (1980-1990). An 11-year retrospective study was conducted on the dermatoses occurring in 113 woodchucks from a colony at the College of Veterinary Medicine at Cornell University. Bacterial dermatitis was the most common dermatologic disorder, accounting for 70.2% of the cases. The highest incidence of bacterial dermatitis occurred in September/October prior to hibernation and in February/March during the breeding season. Other dermatoses observed during the study period included Taenia crassiceps infection, microfilarial dermatitis, telogen defluxion, various neoplastic and hyperplastic lesions, and various neonatal conditions associated with trauma and/or bacterial infection. No association was found between any of these dermatoses and the presence of woodchuck hepatitis virus infection.


The use of retrievable electrodes for recording gastric myoelectric activity after spontaneous gastric dilatation volvulus in dogs. Gastric myoelectric activity was measured in 10 dogs with spontaneous gastric dilatation-volvulus (GDV). Myoelectric activity was recorded with temporary, retrievable wire electrodes placed on the serosal surface of the stomach after derotation and tube gastrostomy. Gastric myoelectric activity was recorded for 1 hour daily, beginning with the day of surgery (less than 24 hours), 24, 48, 72, 96, 120, 144, and 168 hours after surgery. Recordings were also obtained for 1 hour daily after feeding, beginning 24 hours after surgery. Bradygastria was the predominate dysrhythmia immediately after surgery and at hour 24. The mean slow wave frequency was more than normal at hours 48 to 168 due to an increase in tachygastria and arrhythmias. The slow wave frequency significantly decreased after feeding at hours 120 and 144. The overall mean percentage of dysrhythmias was significantly decreased after feeding at hour 72 only. The mean percentage of spike activity ranged from 37.7 +/- 12.5 to 75.7 +/- 6.2 throughout the 8-day study period. Thus, gastric myoelectric activity was disrupted in these dogs with spontaneous GDV and subsequent tube gastrostomy. Feeding did not greatly diminish these dysrhythmias.


Secretion of tumor necrosis factor by endotoxin-treated equine mammary exudate macrophages: effect of dexamethasone and pentoxifylline. Secretion of tumor necrosis factor (TNF) by equine mammary exudate macrophages (MEM phi) exposed to bacterial lipopolysaccharide (LPS) was dose-dependent and was maximal (216.5 +/- 51.9 U/ml) at 100 micrograms LPS/ml, the highest concentration tested. All concentrations of dexamethasone tested (10(-8) to 10(-4) M) significantly (P less than or equal to 0.05) inhibited TNF production by MEM phi when the agent was added 1 hour before LPS. Pretreatment with pentoxifylline at concentrations greater than 3 micrograms/ml also significantly (P less than or equal to 0.05) reduced secretion of TNF by MEM phi. The inhibitory effect of dexamethasone (10(-4) M) was observed when the agent was added to MEM phi from 30 minutes before until 4 hours after LPS. Pentoxifylline (100 micrograms/ml) significantly (P less than or equal to 0.05) suppressed TNF when added from 2 hours before until 2 hours after LPS; however, when pentoxifylline addition was delayed until 8 hours post-LPS, TNF production was enhanced. These apparent inhibitory effects of dexamethasone and pentoxifylline were not due to reduced macrophage viability or to interfering effects of the agents at the level of the TNF bioassay.


Primary pulmonary chondrosarcoma in a dog. Extraosseous chondrosarcomas are uncommon in the dog, and those originating in the lung are rare. This report presents a 9-year-old Beagle dog with a pulmonary mass which caused depression, fever, tachypnea, cough, and laboratory abnormalities. The mass was composed predominantly of chondroid tissue, and was histologically diagnosed as chondrosarcoma.


Daily variability of equine fecal strongyle egg counts. Fecal egg counts often are used for diagnosing equine strongyle infections and estimating the number of eggs shed in the feces. An individual egg count should be interpreted in view of the normal fluctuation of egg numbers in an individual horse. In this study, the daily variability of strongyle fecal egg counts from horses was investigated. The Cornell-McMaster egg-counting technique was used to estimate the eggs per gram of feces in repeated daily fecal samples from 39 horses. The variation of the daily egg counts across 4 days was greater than would be expected if a consistent number of eggs were produced and dispersed randomly in the feces. The means and variances of the daily counts from each horse had a logarithmic relationship. For practical purposes, however, the fluctuation of egg counts is low enough for the fecal egg count to be used to identify horses for treatment, to estimate pasture contamination, or to assess response to therapy.


Preoperative and postoperative hemostatic profiles of dogs undergoing ovariohysterectomy. Hemostatic profiles were evaluated in 15 healthy dogs immediately before and 24 hours after celiotomy for routine ovariohysterectomy. Prothrombin time, activated partial thromboplastin time, fibrinogen, fibrin degradation products, antithrombin III activity, platelet count, and hemogram were measured. There were no significant changes in prothrombin time, activated partial thromboplastin time, fibrin degradation products, antithrombin III activity, or platelet count. Fibrinogen concentration was significantly higher following surgery. Postoperative leukocyte differential counts were typical of stress leukograms, and were characterized by leukocytosis, neutrophilia, lymphopenia and eosinopenia. Mild decreases in packed cell volume, red blood cell count and hemoglobin concentration were consistent with minor blood loss during surgery or fluid retention and hemodilution postoperatively. It was concluded that celiotomy and routine ovariohysterectomy in healthy dogs did not alter hemostatic profiles 24 hours after surgery. Abnormal postoperative hemostatic profiles should not be attributed to surgery alone; other causes of abnormal hemostatic profiles should be investigated.


Metabolic fate of FCE 22716, a new antihypertensive agent, and of its N-oxide (FCE 24220) in the rat. [3H]-FCE 22716 and [3H]-FCE 24220 were given both orally and intravenously to the rat. Radioactivity was mainly eliminated by the faecal route after oral administration in both cases. After intravenous administration, renal excretion was twice the faecal one in the case of FCE 22716, whereas for FCE 24220 the two routes were equal. In urine FCE 22716 was eliminated almost completely unchanged after both oral and intravenous administration. FCE 24220 was extensively reduced to FCE 22716 after oral administration, whereas after intravenous treatment, this reduction, although important, was not complete.