Inheritance of height and maturity in crosses between pearl millet landraces and inbred Tift 85DB

Over 300 landraces of pearl millet were collected in Burkina Faso and grown at the Coastal Plain Experiment Station in Tifton/GA. At Tifton, these landraces are predominantly tall and late-maturing. The photoperiod requirements of these landraces hinder evaluation of their performance in the field and their use in breeding programs. A conversion program has been initiated to transfer genes for dwarf stature and early flowering into the tall, late-maturing landraces. The inbred Tift 85DB is being used as a donor of genes for the dwarf and early characteristics, and was crossed to nine randomly selected landraces from Burkina Faso. The parents, F1, F2, and backcrosses to each parent were grown in the field and evaluated for plant height at anthesis and time in days from planting to anthesis. In general, plant height of F1s was taller than the tallest parent, and in all crosses the maturity of F1s was intermediate between the parents. Numbers of loci conferring height varied among crosses, ranging from 0 to 9.6, and averaged 1.6. Estimated numbers of loci conferring maturity ranged from 0 to 12.8 and averaged 3.4. Broad-sense heritability estimates for height and maturity averaged 60.2 and 65.7%, respectively. Corresponding narrow-sense estimates averaged 23.8 and 48.2%. Joint scaling tests revealed that additive-genetic effects were highly significant for both traits, but dominance and epistatic-genetic effects contributed to the inheritance of each trait in some crosses. The low gene numbers, high heritability estimates, and preponderance of additive-genetic effects suggest that selection for these traits should be effective.

Nocardiosis in transplant recipients

Nocardia is an increasingly important opportunistic pathogen in immunosuppressed patients, especially solid organ transplant recipients. Infection is most often caused by Nocardia asteroides and presents as lung disease in 80% to 90% of infected transplant patients. Radiographic findings are nonspecific and include nodular infiltrates, cavitation, and pleural effusion. Dissemination to other organs, especially to the central nervous system (CNS) and skin, occurs in up to 40% of transplant recipients. A presumptive diagnosis is most rapidly made by the direct visualization in tissue, lower respiratory secretions, or wound drainage of filamentous, gram-positive, beaded rods that are partially acid fast. Specimens for culture should be held for at least 3 weeks when the diagnosis is suspected. The prognosis of nocardial infection is related to the site of disease, rapidity of diagnosis, and extended treatment with a sulfonamide. Mortality is highest in patients with CNS involvement. Prophylactic trimethoprim-sulfamethoxazole should be considered in transplant centers with excess rates of nocardial infection. Hopefully, future refinement of immunosuppressive regimens will be accompanied by a reduction in frequency of Nocardia infections in transplant recipients.

Nocardial infections in renal transplant recipients

Upon review of the English literature and the patients at our hospital, we identified 94 renal transplant recipients with nocardiosis. These patients were further evaluated and compared to nonrenal transplant patients with nocardiosis. We found that these patients were similar in presentation, course, and therapeutic outcome to non-transplant patients. Survival was related to underlying disease, site of infection, rapidity with which the diagnosis was made and, especially, the inclusion of a sulfa compound in the antimicrobial regimen. Transplant centers with high rates of Nocardia infection should consider trimethoprim/sulfamethoxazole prophylaxis for at least the first year after transplantation.

Serious infections with Edwardsiella tarda. A case report and review of the literature

Edwardsiella tarda, a member of the family Enterobacteriaceae, has recently become recognized as pathogenic, especially in patients with an underlying illness. In the present report, a patient had sickle cell hemoglobinopathy and E tarda bacteremia. Other cases of serious infection with Edwardsiella are reported in the literature. Edwardsiella infection may present as bacteremia, enteric fever, gastroenteritis, localized infection, and an asymptomatic carrier state. On the basis of this review, bacteremia with E tarda often has been associated with septic shock and has a high mortality, but this may be related to the usual presence of a serious underlying illness in these patients.

Achievement, well-being, intelligence, and stress reaction in adult children of alcoholics

The purpose of this study was to examine the relations among achievement, well-being, intelligence, and stress reaction in a sample of adult children of alcoholics on whom little research has been conducted. 44 such persons were tested on subscales of the California Psychological Inventory and scores compared with those of 92 control subjects. Also given were a subscale of the Sixteen Personality Factor Questionnaire and the Impact of Event Scale. The adult children of alcoholics over-all showed lower well-being and lower achievement than controls, but those with high well-being scored higher on both achievement scales than controls with low well-being and other adult children of alcoholics with low well-being. These adults showed no significant stress reaction on the Impact of Event Scale.

Cutaneous blastomycosis as a complication of transthoracic needle aspiration

A patient with an ill defined density in the left upper lobe underwent transthoracic needle aspiration. A diagnosis of Blastomyces dermatitidis was made from the aspiration. The patient later returned with a cutaneous ulcer at the site of needle aspiration. B dermatitidis was subsequently recovered from the skin lesion.

Parenteral benzyl alcohol-induced hypersensitivity reaction

An uncommon hypersensitivity reaction due to parenteral benzyl alcohol administration is reported. One patient treated with benzyl alcohol-preserved cytarabine, vincristine, and heparin solutions developed a systemic hypersensitivity reaction on three separate occasions. Hypersensitivity to benzyl alcohol was confirmed by skin testing. Clinically, the patient presented with a fever and a maculopapular rash on the chest and arms. None of the reactions were life-threatening or required hospitalization of the patient.

Nifedipine: kinetics and hemodynamic effects in patients with liver cirrhosis after intravenous and oral administration

The pharmacokinetics and hemodynamic effects of nifedipine were studied in patients with liver cirrhosis and in age-matched healthy control subjects. In a randomized order each subject received nifedipine by intravenous infusion (4.5 mg in 45 minutes) and as a tablet (20 mg). After intravenous nifedipine patients had a longer elimination t1/2 (420 +/- 254 vs. 111 +/- 22 minutes; P less than 0.01), a greater volume of distribution (1.29 +/- 0.60 vs. 0.97 +/- 0.42 L/kg), and a lower systemic clearance (233 +/- 109 vs. 588 +/- 140 ml/min; P less than 0.001). Plasma protein binding of nifedipine was lower in the patients (P less than 0.001). After oral nifedipine systemic availability was much higher in patients (90.5% +/- 26.2% vs. 51.1% +/- 17.1%; P less than 0.01) and maximal in patients with a portacaval shunt. Blood pressure decreased and heart rate increased after intravenous nifedipine and these effects could be fitted to plasma concentrations by a sigmoidal model. Maximal effects on heart rate and diastolic blood pressure were not different in liver cirrhosis. When free drug levels were considered, the concentrations corresponding to half the maximal effect were also not different. Blood pressure changes with oral nifedipine were comparable with those after intravenous infusion. We conclude that in patients with liver cirrhosis the pharmacokinetics of nifedipine are considerably altered; dose reduction is recommended when such patients need oral nifedipine.

Cefadroxil-induced ampicillin-exacerbated pemphigus vulgaris: case report and review of the literature

A 77-year-old patient is described who developed pemphigus vulgaris temporally with the administration of cefadroxil. The disease improved when the drug was discontinued but was exacerbated with the administration of ampicillin. This may be the first case of possible cefadroxil-induced and only the second case of ampicillin-induced pemphigus vulgaris reported. The pathophysiology, diagnosis, and treatment of pemphigus vulgaris is briefly described. Drug-induced pemphigus is reviewed. By far the most incriminated drug has been penicillamine. It is postulated that the sulfhydryl group of penicillamine alters the intercellular cement substance into an antigenic structure with subsequent antibody formation. The chemical similarity between penicillamine, the penicillins, and the cephalosporins is alluded to and the potential for cross-sensitivity between the penicillins and cephalosporins is emphasized. Although the pemphigus vulgaris could have occurred by chance, it seems probable that it was drug-induced.

Mechanics of the basilar membrane in Caiman crocodilus

Vibration measurements were made at a number of positions near the proximal (basal) end of the basilar membrane, and on the columella footplate, of Caiman crocodilus using a capacitive probe. The measurements established the existence of a mechanical travelling wave in this species. They showed no significant change of mechanical tuning with temperature, and were highly significantly different from previous reports of neural temperature sensitivity (Smolders, J. and Klinke, R. (1984): J. Comp. Physiol. 155, 19-30). Thus the neural sensitivity to temperature change appears not to depend upon basilar membrane mechanics. One interpretation of this is that the basilar membrane passively precedes an active temperature-sensitive filter. It was also found that the limbus supporting the basilar membrane had a measurable, but unturned, vibration and that the effect of draining scala tympani for the measurements was to increase the basilar membrane tuning frequency by a factor of about 1.5.

Arteriography and selective embolisation in the control of life-threatening haemorrhage following facial fractures

Bleeding after serious facial fractures may be of such life-threatening proportions that it is sometimes impossible to control it by traditional methods. Super-selective arteriography allows accurate localisation of the bleeding site and immediate embolisation of the offending vessel is a highly effective manoeuvre. Two clinical cases are reported.

Doxorubicin-induced hypersensitivity reactions

An uncommon side effect of the anthracycline antibiotics is allergic reactions. We report three patients treated with doxorubicin hydrochloride who developed systemic hypersensitivity reactions to the drug. In all three cases, the onset of the reaction coincided with the initiation of the doxorubicin, and was confirmed by rechallenge with the drug. An urticarial rash with pruritus was the primary clinical manifestation seen in all cases. All reactions responded to treatment with diphenhydramine, or diphenhydramine and hydrocortisone. None of the reactions were life-threatening or required hospitalization of the patient. In two patients, use of the drug was discontinued because of the reaction. Pretreatment with diphenhydramine, prednisone, and cimetidine may have reduced the severity of the reaction in one patient.

Patient selection and survival after peritoneovenous shunting for nonmalignant ascites

Patient selection and survival after peritoneovenous shunting for nonmalignant ascites was assessed in 30 patients undergoing 44 peritoneovenous shunting procedures over a 5-year period. Indications for peritoneovenous shunting included refractory ascites alone, refractory ascites complicated by hepatorenal syndrome, and nonrefractory but recurrent ascites. Fifty-six percent of shunting procedures were complicated by shunt malfunction and an additional 13% ended in shunt removal or ligation. Serious perioperative morbidity occurred in 47% of patients. Mean duration of shunt function was significantly less (p less than 0.05) in the patients with hepatorenal syndrome (15 +/- 5 days) compared to the patients with refractory ascites alone (45 +/- 13 days), or the patients with nonrefractory ascites (64 +/- 34 days). Mean survival was 265 +/- 87 days. Survival of patients with nonrefractory ascites (767 +/- 214 days) was significantly longer (p less than 0.05) than that seen in patients with hepatorenal syndrome (28 +/- 5 days) or in patients with refractory ascites alone (256 +/- 148 days). Combined inhospital mortality was 30%. It was significantly greater (p less than 0.05) in patients with hepatorenal syndrome (70%) than in patients with refractory ascites alone (14%) or in patients with nonrefractory ascites (0%). We conclude that patient selection significantly influences survival after peritoneovenous shunting and may account for the varying results reported by other groups.

Ambulatory use of high-dose intravenous morphine for severe pain

A case is presented that describes the use of an intravenous morphine infusion to treat severe pain in an outpatient setting. The patient had severe pain secondary to tumor involvement of the brachial plexus. Morphine was administered as a concentrated solution (50 mg/ml), using an autosyringe (model AS-2F) via a Hickman catheter. The dose was titrated to pain relief. A dose of 200-250 mg/h was required.