Co-existence of colonies with different serotypes and other biological characteristics in clinical isolates of Pseudomonas aeruginosa

The biological characteristics of individual colonies of Pseudomonas aeruginosa from 138 specimens were investigated. Of these isolates, 90 (65.2%) formed colonies of similar appearance and morphology, and 48 (34.8%) formed colonies which differed either in appearance or morphology. The individual colonies of 138 isolates were tested for serotype. The former 90 isolates formed only the colonies with one kind of serotype, whereas 17 of the latter 48 isolates formed the colonies with more than one kind of serotype. All the 9 isolates tested also differed in other biochemical characteristics: acid productions from xylose, mannitol and maltose, urease production and gelatin liquefaction. beta-Lactamase activity was investigated in 7 isolates forming colonies with more than one serotype. There were no marked differences in beta-lactamase activity among the different colonies in 5 isolates but marked differences among those in the other 2 isolates.

Simultaneous analysis of mucosal and submucosal hemodynamics using infrared electronic endoscopy: effects of intraluminal acid on ulcer scars

BACKGROUND AND STUDY AIMS

This report describes the use of an infrared electronic endoscope for the assessment of gastric mucosal and submucosal hemodynamics in ulcer scars.

METHODS

The experimental ulcer scars were induced by acetic acid injection in five anesthetized dogs. Indices of mucosal hemoglobin content (IHb) and its oxygenation (ISO2) were calculated from reflectance spectra of the mucosa at 569, 577, 586, and 650 nm, which were obtained through an optic probe. The gastric submucosal vascular diameter was assessed by comparison with a reference wire under infrared endoscopic observation.

RESULTS

The index of mucosal hemoglobin content measured by reflectance spectrophotometry was significantly higher at the ulcer scars than in the intact mucosa before the ulcer induction. Intraluminal administration of 0.2 N hydrochloric acid lowered IHb and ISO2 only at the ulcer scars. The diameters of the gastric submucosal veins beneath the ulcer scars decreased markedly after the acid administration.

CONCLUSION

The results suggest abnormal responses of gastric mucosal and submucosal circulation at ulcer scars to intraluminal acid. Infrared electronic endoscopy is therefore a useful tool for the simultaneous analysis of mucosal and submucosal circulation in the stomach.

Blocking the orexin system following therapeutic exposure promoted between session habituation, but not PTSD symptom reduction

There is a need to identify strategies to increase the effectiveness of treatments for posttraumatic stress disorder (PTSD). Sleep is often disturbed in PTSD and has been implicated in learning processes that underlie recovery from PTSD, including extinction of conditioned fear. Our prior study suggested that diminished arousal during sleep may enhance benefits of therapeutic exposure for PTSD. The orexin system regulates arousal, and blocking the system diminishes arousal and promotes sleep. We, therefore, examined whether a dual orexin receptor antagonist, suvorexant, administered following evening exposure sessions, would enhance their therapeutic effectiveness for PTSD. In this randomized double-blind placebo-controlled trial, adults with PTSD completed four written narrative exposure (WNE) sessions, two of which took place in the evening, and two the next morning. Participants received either suvorexant or placebo after each evening WNE. We found that suvorexant increased N3 sleep and decreased N2 sleep and rapid-eye-movement latency measured by polysomnography. Between session habituation indexed by subjective distress ratings was greater with suvorexant, but there was no group difference in the reduction of PTSD severity from baseline to 1-week follow-up. No safety concerns emerged. The present findings provide preliminary support for enhancement of an effect of therapeutic exposure for PTSD by suvorexant. Further studies with larger samples are needed to translate the present findings into clinical applications, including studies to develop optimal suvorexant administration and exposure session schedules to achieve persistent benefits to sleep and possibly greater treatment augmentation.

Altered monoamine metabolism in the hypothalamus of the genetically obese yellow (Ay/a) mouse

Changes in hypothalamic monoamine metabolism were investigated in the genetically obese yellow (Ay/a) mouse. At the age of 6 weeks when there was no difference in body weight between black (a/a) and yellow (Ay/a) mice, the contents of norepinephrine (NE), dopamine (DA) and their main metabolites (MHPG, DOPAC) were already significantly reduced in yellow (Ay/a) mice. Reduction of 5-hydroxytryptamine (5-HT) level and an increasing 5-HIAA/5-HT ratio has been observed. When a significant increase in body weight in the yellow (Ay/a) mouse at the age of 12 weeks was present, both NE and DA contents have been increased in the hypothalamus of the obese mouse. MHPG level was lower than in the lean mouse, resulting in an increase of MHPG/NE ratio. The present study suggests that the observed reduction in hypothalamic NE and DA metabolism might be involved in the development of overweight gain in the yellow (Ay/a) mouse.

Peptide histidine methionine and vasoactive intestinal peptide levels in human cerebrospinal fluid: age-related changes and absence of a correlation with serum prolactin

Serum levels of prolactin (PRL), peptide histidine methionine (PHM) and vasoactive intestinal peptide (VIP) were measured in 97 subjects and cerebrospinal fluid (CSF) levels of PHM and VIP were measured in 50 subjects by specific radioimmunoassays to investigate correlations between them. The chromatographic studies revealed that PHM and C-terminal extended form of PHM, peptide histidine valine occurred in human serum and CSF. Significant age-related increases of CSF PHM (P < 0.02) were observed in both males and females, whereas an age-related decrease of serum PRL level was found in females (P < 0.01). In contrast, neither serum VIP, serum PHM nor CSF VIP changed significantly with age. There was a significant positive correlation (P < 0.002) between VIP and PHM in serum, but not in CSF. The close relation between VIP and PHM in serum meets one's expectation because of their derivation from a common precursor. In CSF, these two peptides did not change in parallel with each other. These results may reflect the alteration in metabolism of PHM in CSF. Finally, there was no correlation between serum PRL concentrations and either serum or CSF levels of the peptides, suggesting that neither VIP nor PHM levels in CSF as well as in serum can influence the basal PRL secretion in subjects without endocrine disorders.

[Evaluation of mycobacteria growth indicator tube (MGIT), an automated culture system for detection of mycobacteria from clinical specimens]

We compared the Mycobacteria Growth Indicator Tube 960 (MGIT 960) and Ogawa medium (OM) for the detection of mycobacteria (acid fast bacteria: AFB) using 882 sputum specimens. Overall, 120 strains of AFB were isolated by the MGIT 960 system and 99 strains of AFB were isolated by using OM. As far as Mycobacterium tuberculosis is concerned, 88 and 71 isolates were achieved by the MGIT 960 and OM respectively. A total of 28 isolates (18 isolates of M. tuberculosis and 10 isolates of nontuberculous mycobacteria: NTM) were detected by the MGIT 960 only whereas only 2 isolates (1 M. tuberculosis and 1 NTM) were detected by OM only. Of these sputum specimens, 72 were smear positive for AFB. The rates of smear negative but culture positive specimens were 8.0% (65 out of 809) for the MGIT 960 system and 6.2% (50 out of 809) for OM. The contamination rate for MGIT 960 was only 1.2%. The average time required for detection of M. tuberculosis was 14.1 days by the MGIT 960 system and 24.6 days by OM. For the NTM, the average detection time were 8.3 days for the MGIT 960 system and 22.8 days for OM. These results indicate that the MGIT 960 system allows detection of mycobacteria significantly faster than OM.

Noonan's syndrome with syringomyelia

A case of Noonan's syndrome with cervical syringomyelia is presented here representing the second reported instance of such association. A CT of metrizamide myelography revealed a high density in the middle subintradural space in the cervical region below C2. Sensory dissociation was minimal and localized in the left C4. It could not be determined whether this association between syringomyelia and Noonan's syndrome is related or represents a chance.

Feeding behavior and ambulatory activity in rats with d-galactosamine-induced hepatic failure

This study was undertaken to investigate changes in feeding behavior and ambulatory activity, in rats with D-galactosamine (D-GAL)-induced hepatic failure. D-GAL was administered (1000 mg/kg) IP at 1800, just before the dark phase. The first significant decrease of ambulatory activity in rats with hepatic failure was observed between 0000 and 0300 h. A significant increase in drinking behavior was observed between 1800 and 2100 h, and a significant decrease was observed between 2100 and 0300 h. A significant decrease in food intake occurred between 1800 and 2400 h. Thereafter, there was no difference in food intake. In conclusion, we demonstrated significant changes in ambulatory activity, drinking behavior and food intake produced by D-GAL. A wide variation in systems, including monoamine turnover, and amino acid disturbance could be expected in these animals, and such changes might also have contributed to the results observed.

Thymic carcinoma associated with pinealoma and terminating with peroxidase-negative acute myeloid leukemia

Thymoma is associated with a wide variety of syndromes. However, an association with peroxidase-negative acute myeloid leukemia and pinealoma, although feasible due to the marked influence of this tumor on the lymphoid system, has not been described previously. A patient with thymic carcinoma and pinealoma who developed peroxidase-negative acute myeloid leukemia as a late event is presented in this report.

Role of prostaglandin E2 and leukotriene B4 in skin reaction induced by transdermal application of propranolol

Dermal application of propranolol (PRL) induced formation of erythema and edema, and pseudoeosinophil infiltration in epidermis and dermis at the application site in guinea pigs. We investigated the production of prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) at the application site of PRL and the role of these inflammatory chemical mediators in the occurrence of the skin reactions. PGE2 was found to be produced at the application site slightly after the accumulation of PRL released from the adhesive bandage in the patch test, and the amount of PGE2 increased continuously, with a peak value obtained at 24 h after application. The time-course changes resembled those of delta a* value, the index of erythema formation determined by colorimetric measurement, and edema formation. The production of PGE2 by dermal application of PRL was suppressed by local pretreatment with dexamethasone or indomethacin. However, no notable production of LTB4 was observed at the application site of PRL.

Lymphoepithelial lesion of the parotid gland

We describe a case of lymphoepithelial lesion of the parotid gland, also known as salivary lymphoepithelial lesion. Lymphoepithelial lesions are usually seen in conjunction with autoimmune disease of the salivary glands and these lesions do not always remain benign. Our case consisted of two masses that had different imaging features. Moreover, we could investigate the changes of the size and internal architecture on imaging due to the postponement of surgical intervention on the masses. At review 6 months later, the size of the masses had increased. The aims of this paper were to: (1) investigate the contribution of gray-scale sonography, power Doppler sonography, magnetic resonance imaging, and computed tomography to the diagnosis; and (2) consider the appropriate imaging modality to follow-up this case to monitor for recurrence or malignant transformation.

Central hypothyroidism due to isolated TRH deficiency in a depressive man

A depressive man was evaluated for developing chronic fatigue and cold intolerance, in whom laboratory findings showed decreased thyroid hormone levels (T4, 2.7 micrograms dl-1; T3, 0.76 ng ml-1) with normal blood levels of TSH. A single bolus injection of TRH (500 micrograms) significantly stimulated prolactin secretion, but did not cause an increase in blood TSH levels (basal level, 1.2 microU ml-1 vs. 1.3 microU ml-1 30 min after injection). By contrast, TRH-induced TSH stimulation occurred after repeated injection of TRH for 4 consecutive days (basal level, 1.5 microU ml-1 vs. 5.6 microU ml-1 30 min after injection). Blood thyroid hormone concentrations were restored to normal levels after long-term administration of TRH. Other pituitary functions remained unchanged. A diagnosis of central hypothyroidism due to isolated TRH deficiency was made in this case, and the data presented here indicate that partial resistance of pituitary thyrotrophs to TRH may be associated with depression.

Myocardial uptake of an iodinated branched fatty acid analog, assessed by SPECT, may detect metabolic derangement of the myocardium in diabetic patients with coronary heart disease

The clinical implications of single-photon emission computed tomography using both a beta-methyl-branched fatty acid analog, 123I-15-(p-iodophenyl)-3-methyl-pentadecanoic acid (BMIPP), and thallium-201 (201Tl) were assessed in 30 patients with myocardial infarction (MI), 8 diabetics, 4 patients with impaired glucose tolerance, and 18 nondiabetic patients. Discordant decreases in BMIPP uptake, as compared with 201Tl uptake, in diabetic patients were significantly (p < 0.01) more frequent than in nondiabetic patients. The left ventricular (LV) ejection fraction in diabetics was significantly (p < 0.05) reduced and the LV diastolic dimension was significantly increased (p < 0.01), as compared with those in nondiabetic subjects. Analysis of peripheral blood showed no significant differences among the three test groups in metabolic abnormality. A discordant decrease in BMIPP uptake, as compared with Tl uptake, in cardiac tomography may indicate a metabolic derangement of the myocardium in diabetic patients with MI.

Cardiopulmonary dysfunctions caused by intravenous collagen-induced release of ADP and ATP from platelets

Bovine tendon collagen suspension (4.5 mg/kg) was injected rapidly into the femoral vein of 14 normal (untreated) and 8 busulfan treated rats. Trasient effects included decreased platelet counts and arterial PO2, increased central venous pressure, apnea, bradycardia and variable A-V block. These findings were most prominent within 1 minute after injection and subsided or disappeared by 10 minutes. During this period, ADP and ATP in platelet-free plasma from carotid arterial blood were measured in a liquid scientillation counter using the firefly luciferase assay. In normal (untreated) rats, collagen injection was followed by increases in plasma ADP and ATP, a rise in plasma hemoglobin and minimal changes of fibrinogen and hematcrit. Pathological observations indicated the platelet emboli in pulmonary vessels. In contrast, rats made thrombocytopenic by intraperitoneally infected busulfan prior to collagen injection had minimal or no change in platelet count, plasma ADP, ATP, hemoglobin, fibrinogen, or cardiopulmonary functions following collagen injection. These findings suggest that collagen injection causes release of ADP and ATP from platelets; released ADP induces platelets to form aggregates which lodge in the coronary and pulmonary microcirculations and elsewhere, resulting in thrombocytopenia and the cardiopulmonary dysfunction, in the presence of shear, of red cells with vessel surfaces altered by platelet aggregates.

Failure of anti-TSH receptor antibodies (TRAb) to predict the outcome of the course of Graves' disease following withdrawal of antithyroid drug

Nineteen patients with Graves' disease were regarded as euthyroid at the end of therapy. Follow-up studies were performed for further 3 years. TSH binding inhibitor immunoglobins (TBII) were measured by radioreceptor assay. Thyroid stimulating antibodies (TSAb) were measured by a sensitive cAMP accumulation using FRTL-5 cells. Most of the patients showed negative TBII at the end of therapy, while TSAb-positive patients were approximately 50%. The relapse rates during post therapeutic period were 33.3% in TSAb-positive group and 40% in TSAb-negative group, which were not significantly different between the two groups. It was thought that determination of TSAb activity at the end of therapy, in addition to TBII, appears to play a permissive role in predicting the outcome of the course of Graves' disease following discontinuation of antithyroid drug therapy.

L-dopa-induced asterixis

Three cases with the occurrence of asterixis during the administration of L-dopa were reported. Liver and metabolic functions were normal in all the patients. Upon the appearance of asterixis no other involuntary movements probably resulting from an excess administration of L-dopa were observed. Asterixis occurred accompanied by clinical symptoms such as hallucination and a mild clouding of consciousness by insomnia. Because of its reversal with drug withdrawal, asterixis seemed to be L-dopa-related. The biochemical basis of asterixis is not known but may involve the dopaminergic or serotonergic system.

High-resolution CT findings of macrophage activation syndrome: a case report

Macrophage activation syndrome (MAS) is a rare disorder characterised by benign, reactive, excessive, well-differentiated macrophage proliferation, secondary to an immune dysregulation in response to some triggering agents such as viral infection. We report a 3-year-old girl with MAS and pulmonary involvement. This is the first radiographic description of MAS on high-resolution CT.