[Effect of antral gastritis and cytokines on Helicobacter pylori associated duodenal ulcer]

OBJECTIVE

To investigate the role of cytokines and antral gastritis in the development of duodenal ulcer that associated with Helicobacter pylori (H. pylori) infection.

METHOD

48 cases of duodenal ulcer with different degrees of H. pylori infection (35 cases with H. pylori infection and 13 patients without H. pylori infection,) were investigated by measuring the level of gastric mucosal cytokines and the degree of antral gastritis.

RESULTS

Compared with H. pylori negative cases, the patients with H. pylori positive duodenal ulcer had higher level of gastric mucosal IL-8, TNF alpha, MPO, MDA and severer antral gastritis. IL-8, TNF alpha, MPO and MDA were positirely correlated with H. pylori density and they were highly correlated with each other. However IL-6 did not have such specific properties.

CONCLUSION

Cytokines may be an important factor that links gastritis and duodenal ulcer associated with H. pylori infection.

[Relationship of cytokines and cold-heat syndrome differentiation in patients of duodenal ulcer]

OBJECTIVE

To explore the relationship of cytokines and Cold-Heat Syndrome in patients of duodenal ulcer.

METHODS

Cold-Heat Syndrome Differentiation was done in 48 patients of duodenal ulcer, and the levels of interleukin-8 (IL-8), interleukin-6 (IL-6), tumor necrosis factor (TNF), malonyldialdehyde (MDA), marrow peroxidase (MPO) in gastric mucosa biopsy were measured and compared with those of 10 normal subjects.

RESULTS

Levels of IL-8, TNF, MPO and MDA in Heat Syndrome were higher than those in Cold Syndrome (P < 0.05), while IL-6 level showed no significant relationship with Cold-Heat Syndrome.

CONCLUSION

Cytokines IL-8, TNF, MPO and MDA are correlated with Cold-Heat Syndrome in duodenal ulcer patients and which might be one of the molecular mechanisms of Cold-Heat Syndrome Differentiation.

[Clinical and laboratory studies with typhoid fever 178 patients]

One hundred and seventy-eight cases of typhoid patients were studied on clinical and bacteriological aspects. The main clinical findings were as follows: (1) Most of the cases had sustained fever (66.3%). (2) Gastroenterial symptoms developed as the disesase progressed. (3) Rose spots were found in 32.6% of them. (4) Liver and spleen were enlarged in 69.5% of the cases. (5) Blood eosinophil disappeared in most of the patients and leukopenia was noted in 94.3%. (6) There were toxic hepatitis (47.1%), toxic myocarditis (22.4%) and intestinal hemorrhage (19.7%) as complications. In the drug sensitivity test, the number of ampicillin-resistant and chloramphenicol-resistant strains of salmonella typhi was increased more than that seen 5 years ago (P < 0.05), however 100% of the strains were sensitive to amikacin, tobramycin, norflexacin, oflexacin and the third generation of the cephalosporin. For the time being, norflexacin and oflexacin were good and suitable drugs for the treatment of typhoid fever.

In vitro and in vivo activities of moxifloxacin and clinafloxacin against Mycobacterium tuberculosis

On 10% oleic acid-albumin-dextrose-catalase-enriched 7H11 agar medium, the MIC at which 90% of the isolates are inhibited for 20 strains of Mycobacterium tuberculosis was 0.5 microg of sparfloxacin (SPFX) or moxifloxacin (MXFX) per ml and 1.0 microg of clinafloxacin (CNFX) per ml, indicating that the in vitro activities of SPFX and MXFX were virtually identical and were slightly greater than that of CNFX. However, the in vivo activities of these drugs in a murine tuberculosis model differed considerably. Female Swiss mice were infected intravenously with 6.2 x 10(6) CFU of the H37Rv strain and treated for 4 weeks, beginning the next day after infection, with isoniazid (INH) serving as the positive control. By the criteria of 30-day survival rate, spleen weight, gross lung lesion, and mean number of CFU in the spleen, treatment with CNFX at up to 100 mg/kg of body weight six times weekly displayed no measurable effect against M. tuberculosis, whereas both SPFX and MXFX were effective; administration six times weekly of either of the latter two drugs demonstrated dosage-dependent bactericidal effects, as measured by enumeration of CFU in the spleens, and MXFX appeared more bactericidal than the same dosage of SPFX. Of the three fluoroquinolones, only MXFX at 100 mg/kg six times weekly appeared as bactericidal as INH at 25 mg/kg six times weekly. Thus, MXFX may be an important component of the newer combined regimens for treatment of tuberculosis.

Bactericidal activity of a single-dose combination of ofloxacin plus minocycline, with or without rifampin, against Mycobacterium leprae in mice and in lepromatous patients

To develop a fully supervisable, monthly administered regimen for treatment of leprosy, the bactericidal effect of a single-dose combination of ofloxacin (OFLO) and minocycline (MINO), with or without rifampin (RMP), against Mycobacterium leprae was studied in the mouse footpad system and in previously untreated lepromatous leprosy patients. Bactericidal activity was measured by the proportional bactericidal method. In mouse experiments, the activity of a single dose of the combination OFLO-MINO was dosage related; the higher dosage of the combination displayed bactericidal activity which was significantly inferior to that of a single dose of RMP, whereas the lower dosage did not exhibit a bactericidal effect. In the clinical trial, 20 patients with previously untreated lepromatous leprosy were treated with a single dose consisting of either 600 mg of RMP plus 400 mg of OFLO and 100 mg of MINO or 400 mg of OFLO plus 100 mg of MINO. The OFLO-MINO combination exhibited definite bactericidal activity in 7 of 10 patients but was less bactericidal than the RMP-OFLO-MINO combination. Both combinations were well tolerated. Because of these promising results, a test of the efficacy of multiple doses of ROM in a larger clinical trial appears justified.

Once-weekly rifapentine-containing regimens for treatment of tuberculosis in mice

The bactericidal activities of several once-weekly rifapentine (P)-containing combination regimens against Mycobacterium tuberculosis, and their ability to prevent the selection of rifampin (R)-resistant mutants, were compared with those of the standard six-times-weekly regimen consisting of R, isoniazid (H), and pyrazinamide (Z) in a mouse experiment. Mice were infected intravenously with 1.3 x 10(7) cfu of M. tuberculosis strain H37Rv, and 8 wk of treatment began on Day 14 after infection, when mice were randomly allocated to an untreated control group and nine treatment groups of 30 mice each. At the end of 8 wk of treatment, all the tested regimens showed promising bactericidal activities. Once-weekly P alone was less bactericidal than six-times-weekly R alone; likewise, the once-weekly P-containing combined regimens were less bactericidal than the six-times-weekly standard regimen. However, the difference in killing was about 1 log10, which represented only a fraction of the overall 4 log10 to 5 log10 magnitude of killing effects. The addition of streptomycin (S) improved the bactericidal effect of once-weekly PHZ, and the effect of once-weekly PHZS was further enhanced when it was preceded by 2 wk of daily HZS. The latter regimen achieved the same level of activity as the standard six-times-weekly regimen. All of the once-weekly P-containing combined regimens were able to prevent the selection of R-resistant mutants, whereas monotherapy with R or P selected resistant mutants in approximately 50% of animals.

Laser Frequency-Modulated Spectroscopy of a Laser-Guided Plasma in Sodium Vapor: Line Positions for NaH (A1Sigma+-X1Sigma+), Na (9-13d and 11-14s), and Ar (5p-4s)

Laser frequency-modulated (FM) spectroscopy has been used as an axial probe of a laser-guided electric discharge in sodium-argon vapor contained in an optically accessible metal heat pipe oven. Absorption measurements in the region 23 106-23 881 cm-1 provided accurate line positions (&plusmn;<0.006 cm-1) for 141 transitions in the v' = 3-8 <-- v" = 0 and v' = 5-9 <-- v" = 1 bands of NaH (A1Sigma+-X1Sigma+). In addition, 18 transitions of Na (3p to 9-13d and 11-14s) and 10 of argon (5p-4s) were measured. Analysis of the spectrum indicates that perhaps all absorption signals are due to neutrals NaH, Na, and Ar and are observed via "population" modulation. Copyright 1997 Academic Press. Copyright 1997Academic Press

Prevention of the selection of clarithromycin-resistant Mycobacterium avium-intracellulare complex

The prevalence of clarithromycin-resistant mutants in untreated bacterial populations of Mycobacterium avium-intracellulare complex (MAC) has been demonstrated to be between 10(-7) and 10(-8) colony-forming units (CFUs) in the beige mouse model. Selection of these mutants occurred during clarithromycin monotherapy if treatment was initiated when the bacterial population size reached approximately 10(8) CFUs per spleen. Likewise, selection of clarithromycin-resistant MAC was induced in AIDS patients during therapy with clarithromycin alone or in combination with drugs that were ineffective for the treatment or prevention of MAC infection. Because the emergence of clarithromycin resistance during preventive therapy was observed exclusively in AIDS patients with CD4+ cell counts < or = 25 cells/microliter, clarithromycin monotherapy can be recommended for the prevention of MAC infection in AIDS patients with CD4+ cell counts of > or = 50 cells/microliter. However, a clarithromycin-containing combination regimen is recommended for patients with CD4+ cell counts < 50 cells/microliter. Since preliminary animal experiments and clinical trials indicate that amikacin, ethambutol or rifabutin in combination with clarithromycin may prevent, or at least delay, the selection of clarithromycin-resistant mutants, further preventive trials are urgently needed to confirm these observations.

High relapse rate among lepromatous leprosy patients treated with rifampin plus ofloxacin daily for 4 weeks

Fifty-one lepromatous leprosy patients, all of whom had relapsed after previous dapsone (DDS) monotherapy, were treated between 1990 and 1991 with 600 mg of rifampin (RMP) plus 400 mg of ofloxacin (OFLO) daily for 4 weeks, and the great majority of the patients were followed up at least once a year after completion of the treatment. After only 173 patient-years of follow-up, 5 relapses had been detected; the overall relapse rate was 10.0% (confidence limits, 1.7 and 18.3%), or 2.9 relapses (confidence limits, 0.4 and 5.4) per 100 patient-years. The unacceptably high relapse rate indicated that 4 weeks of treatment with daily RMP-OFLO was unable to reduce the number of viable Mycobacterium leprae organisms to a negligible level. In addition, the M. leprae from one of the relapses were proved to have multiple resistance to DDS, RMP, and OFLO. To avoid further relapses, the follow-up was terminated and the great majority of the patients were retreated with the standard 2-year multidrug therapy from 1994. No further relapse has been diagnosed since the beginning of retreatment.

[Preliminary study on erythrocyte immunity during sensorineural hearing loss of unknown etiology]

Red cell immune function was determined in 50 patients with sensorineural deafness and 30 healthy persons as control. The results showed that in patients with sensorineural deafness, the red cell C3b receptor (RBC-C3bR) rosette formation rate (15.10 +/- 1.66) was lowered markedly than controls (18.95 +/- 1.16, P < 0.001) and the red cell surface immune complex (RBC-IC 9.94 +/- 1.68) was elevated markedly than controls (7.44 +/- 1.17, P < 0.001). The results indicate that the red cell immunity in the patients with sensorineural deafness of unknown etiology is lowered.

Comparative activities of amikacin against Mycobacterium avium complex in nude and beige mice

After 4 weeks of treatment, clarithromycin (CLAR) and amikacin showed similar antimicrobial activities against the Mycobacterium avium complex in mice. There was a difference, however, in the effectiveness of the drugs in different types of mice: both drugs displayed bactericidal effects in beige mice but only bacteriostatic effects in nude mice. Because the effectiveness of CLAR is less in nude mice than in beige mice, the predictive value of the nude mouse model for the efficacy of chemotherapy is less than that of the beige mouse model.

[The study of mutation in exon 17 of insulin receptor gene in essential hypertensive pedigrees]

Using the molecular scanning technique of single-stranded conformational polymorphism, we examined the exon 17 of the insulin receptor (INSR) gene in 44 subjects of 6 essential hypertensive pedigrees and 2 normotensive pedigrees. In addition the serum levels of glucose and insulin during an oral glucose tolerance test (OGTT); blood lipid, and plasma angiotension II and angiotensinogen were done on these pedigrees. Upon direct sequence analysis, 5 individuals were found a single nucleotide substitution at the codon 1058 (CAC-->CAT), which didn't change the amino acid sequence. Among the five individuals 4 of them were from the families with history of hypertension, only one was from normotensive pedigree. Compared with those without the mutation, the individuals with the mutation had a lower ratio of fasting blood glucose to fasting serum insulin level (P < 0.01) and an elevated plasma Ang II concentration. (There was no significant difference, P > 0.05, probably due to the mutant cases which we studied were small). Thus, we conjectured that the mutation in codon 1,058 of the INSR gene might be related with the insulin resistance in hypertensive patients and subjects with the positive hypertensive history.

Which aminoglycoside or fluoroquinolone is more active against Mycobacterium tuberculosis in mice?

To identify the most active aminoglycoside or fluoroquinolone for the treatment of tuberculosis, the in vivo activities of four different aminoglycosides and three different fluoroquinolones were compared with that of isoniazid (INH) in a murine tuberculosis model. Mice were each inoculated intravenously with 2.3 x 10(7) CFU of Mycobacterium tuberculosis H37Rv. Treatment began the next day (D1) after inoculation and continued for 4 weeks, at the frequency of six times weekly with one of the following regimens: INH, 25 mg/kg; ofloxacin, 200 mg/kg; levofloxacin, 100 or 200 mg/kg; sparfloxacin (SPFX), 50 mg/kg; and streptomycin, kanamycin, amikacin (AMIKA), and isepamicin, all at 200 mg/kg. The dosages of the treatments were presumably equivalent to their clinically tolerated dosages. The severity of infection and effectiveness of the treatment were assessed by the survival rate, spleen weights, gross lung lesions, and the numbers of CFU in the spleens. The results indicate that INH is more bactericidal than any of the aminoglycosides or fluoroquinolones tested, that AMIKA is the most active aminoglycoside, and that SPFX at 50 mg/kg is far more bactericidal than the treatment with other fluoroquinolones.