Chemically induced porphyria: prevention by prior treatment with phenobarbital

The excessive induction of hepatic delta-aminolevulinic acid synthetase in rats after the administration of porphyria-inducing compounds is prevented by prior treatment with phenobarbital. Studies in vivo and in vitro indicate that phenobarbital prevents the induction of chemical porphyria by increasing the rate of detoxification of inducers by way of drug-metabolizing enzymes of the hepatic endoplasmic reticulum.

Comparison of macrocomplement and microcomplement fixation techniques used in fungus serology

A comparative evaluation was performed on the micro- and macrocomplement fixation (CF) tests that are used as standard procedures in the serodiagnosis of blastomycosis, coccidioidomycosis, and histoplasmosis. Tests with 937 sera from suspected and culturally proven cases of these diseases against yeast-form antigens of Blastomyces dermatitidis and Histoplasma capsulatum and against the soluble antigens, coccidioidin and histoplasmin, revealed that the microtiters were within +/- 1 dilution of the macrotiters in 83 to 93% of the sera. Tests on randomly coded quality control sera revealed the microform of the CF test to be highly reproducible. Our studies indicate that the results obtained by the two tests have similar diagnostic and prognostic interpretations. Because of the sensitivity, reproducibility, economy, and ease of performance, the microtest is highly recommended for use in fungus serology.

Application of agglutinins for the rapid and accurate identification of medically important Candida species

Agglutinins have been prepared against the medically important Candida species. Crude antisera to the various species demonstrated intense cross-reactions with heterologous yeastlike fungi as well as with many true yeasts. However, carefully monitored adsorptions of selected antisera allowed the production of six factor sera that proved useful in a slide agglutination test. These six sera permitted the rapid and specific identification of C. guilliermondii, C. krusei, C. parapsilosis, and C. pseudotropicalis. They also allowed the delineation of two groups: (i) C. albicans (type A)-C. tropicalis and (ii) C. albicans (type B)-C. stellatoidea. C. albicans type A could be readily distinguished from C. tropicalis by its ability to form germ tubes in serum. C. stellatoidea could be distinguished from C. albicans type B by its predominantly filamentous growth on a nutritionally deficient medium. The medically important Candida species could be identified within 24 hr by the combined use of serological and morphological procedures.

Effects of neostigmine and atropine on motor activity of ileum, colon, and rectum of anaesthetized subjects

In unanaesthetized patients atropine and neostigmine in doses normally used by anaesthetists to reverse muscle relaxants produced a pronounced increase in bowel activity. This response occurred whether atropine was given before or simultaneously with neostigmine.The response still occurred in 38% of patients anaesthetized without halothane, and possibly this increase in motility might endanger a recently constructed anastomosis. The ileum appeared particularly prone to neostigmine stimulation, and anastomoses involving ileum would seem especially at risk. When halothane was used during anaesthesia the response was completely inhibited during the period studied.

Value and interpretation of serological tests for the diagnosis of cryptococcosis

MAXIMAL SEROLOGICAL DIAGNOSIS OF CRYPTOCOCCOSIS MAY BE ACCOMPLISHED THROUGH THE CONCURRENT USE OF THREE TESTS: the latex agglutination (LA) test for cryptococcal antigen, and the indirect fluorescent antibody (IFA) and tube agglutination (TA) tests for Cryptococcus neoformans antibodies. These tests were applied to 141 serum and cerebral spinal fluid specimens from 66 culturally proven cases of cryptococcosis and to 42 sera from normal subjects and from patients with other systemic mycotic diseases. The LA test was sensitive and completely specific; of the sera from proven cases, 55% were positive. With the TA test, 37% of the specimens were positive and the test was highly specific. With the IFA test, 38% of the specimens were positive and the test appears to be the least specific of the three. Cross-reactions were most evident with blastomycosis and histoplasmosis case sera. When the three tests were used concurrently, 87% of the cryptococcosis case specimens were positive and permitted a presumptive diagnosis of C. neoformans infections in 61 (92%) of the 66 patients whose specimens were examined.

Development and use of a polyvalent conjugate to differentiate Histoplasma capsulatum and Histoplasma duboisii from other pathogens

Previous investigations have demonstrated the existence of five Histoplasma capsulatum serotypes. Available specific fluorescent-antibody reagents stain only four of the five serotypes. Antibodies produced against the most complete H. capsulatum serotype were labeled with fluorescein isothiocyanate to develop a reagent specific for H. capsulatum that was reactive with all the known serotypes. The unadsorbed reagent not only stained all the H. capsulatum serotypes, but it also stained cultures of Blastomyces dermatitidis, H. duboisii, several Candida species, and a variety of other fungi. Adsorption of the conjugate with antigens of C. albicans produced a reagent that intensely stained only H. capsulatum, H. duboisii, and B. dermatitidis. Differentiation of B. dermatitidis from the Histoplasma species was accomplished by application of a B. dermatitidis specific fluorescent antibody to antigens positive with the H. capsulatum reagent. At present, differentiation of H. capsulatum from H. duboisii may be accomplished only by animal inoculation. Our data substantiate the antigenic relationships hypothesized earlier, and they indicate that H. capsulatum shares at least two antigens with the other fungi that were studied.

Fluorescent-antibody reagent for the identification of Cryptococcus neoformans

A sensitive and diagnostically applicable conjugate for the rapid and accurate detection and identification of Cryptococcus neoformans has been developed. C. neoformans rabbit antisera were produced by 14 daily intravenous injections of 36 million cells for a total dosage of approximately 500 million cells. Cross-staining reactions with species of Cryptococcus other than C. neoformans, as well as with Candida species, were eliminated by adsorption of the C. neoformans conjugate with cells of C. diffluens and C. krusei.

General anaesthesia in ophthalmology

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Effects of a single histoplasmin skin test on the serological diagnosis of histoplasmosis

Numerous reports have indicated that a single histoplasmin skin test may stimulate humoral antibodies to Histoplasma capsulatum antigens in histoplasmin-hypersensitive individuals. Although these investigations concur that antibody elevations are evoked, they vary in the reported degree of incidence and response induced, and they cast doubt on the interpretation of serological tests in the diagnosis of histoplasmosis. Histoplasmin-hypersensitive subjects (114) were bled prior to administration of the skin test, 2 days later, at the time this test was read, and 15 and 30 days after testing. No significant antibody titers were observed at 2 days. At 15- and 30-day intervals, only 17 (15%) of the subjects demonstrated circulating antibodies. All 17 showed agar gel bands; 5 demonstrated no complement-fixation (CF) titers, 10 produced CF antibodies ranging from 1:8 to 1:16, and 2 demonstrated titers of 1:32. The data suggest that skin testing does not interfere significantly with antibody levels in sera drawn approximately 2 days after administration of antigen. However, since titers as high as 1:32 were obtained at later intervals, such reactions should be evaluated cautiously and only after consideration of clinical findings.

Unforeseen complications encountered during dental anaesthesia. Cardiac arrhythmias during dental anaesthesia

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