Gonorrhoea: signs, symptoms and serogroups

Over 19 weeks, 104 male patients attending a genitourinary medicine clinic with gonococcal urethritis were asked to complete a questionnaire detailing symptoms. Sixty-seven questionnaires were duly completed. The examining nurse documented signs. Ninety-one isolates of Neisseria gonorrhoeae were serogrouped and auxotyped, 55 of these were from patients who had completed a questionnaire. Patients presented earlier if they had a past history of gonorrhoea (p = 0.02). The serogroup of N. gonorrhoeae did not influence the amount of discharge, the presence of meatal inflammation, dysuria or penile tip irritation or the delay in presentation after appearance of discharge. Auxotype AHU was not associated with asymptomatic gonorrhoea.

Concurrent salmonellosis and histoplasmosis in AIDS: an unusual co-existence in Britain

A patient is described with systemic salmonellosis which was unresponsive to therapy. Histoplasma capsulatum was isolated after death and we suggest that dysfunction of the reticuloendothelial system by H. capsulatum may have altered the prognosis.

Cavitating pulmonary cryptococcosis developing in an HIV antibody patient despite prior treatment with fluconazole

Disseminated cryptococcosis developed in an HIV antibody positive patient who was taking fluconazole for oral candidiasis. This case highlights the poor response to therapy that may be seen, and the severe pulmonary complications that may ensue. The use of fluconazole prior to the development of cryptococcosis did not confer protection.

Polymer membranes in clinical sensor applications. II. The design and fabrication of permselective hydrogels for electrochemical devices

Hydrogels, particularly the tough, low water content materials, have potential advantages in the field of clinical biosensors because of their established use as medical polymers. The factors that control transport behaviour in these polymers are discussed with particular reference to ion selectivity. The nature of the transport behaviour in relation to coated wire electrode performance is presented and an extension of these permselectivity studies to the fabrication of miniaturized devices, such as ISFETs, is described. Linear soluble hydrogel polymers, coated on to sensor substrates, may be converted to insoluble membranes using solid photosensitive aromatic monomers, such as N-vinyl carbazole. Photolithographic patterning is achieved using a UV source together with appropriate masking, followed by an oxygen plasma etch process. Gas plasma etching, which selectively removes uncross-linked (masked) areas forms the basis of an all dry, low-temperature patterning process capable of giving micrometre-scale resolution. This novel photographic process, which does not damage or extract enzymes or ionophores, can advantageously be extended to the fabrication of poly(vinylchloride)-based membranes.

Polymer membranes in clinical sensor applications. III. Hydrogels as reactive matrix membranes in fibre optic sensors

The potential of hydrogel copolymer membranes in clinical sensors, based on fibre optics, is addressed. The particular properties of the membranes of relevance in this application are the ease of refractive index modulation and the potential of the hydrogel to act as a permselective barrier in which a colorimetric agent may be immobilized. The results presented illustrate the complexity of colorimetric and refractive index effects together with their dependence on pH and tonicity for hydrogels of a given composition range. The incorporation of an acryloyl-functionalized reagent (bromopyrogallol red) is used to illustrate the way in which a working pH sensor based on these combined properties may be designed and fabricated.

Polymer membranes in clinical sensor applications. I. An overview of membrane function

Polymer membranes are used in a wide variety of molecular sensing devices many of which are of potential clinical interest. The role of the polymer and the physical properties required of it are, however, rarely clearly defined. An extensive review is presented of the range of polymers whose use as membranes is described in the sensor literature. This forms the basis of an overview of membrane function in potentiometric amperometric and fibre optic sensors. In particular, the interaction of permeability, permselectivity and transmembrane potential is highlighted, together with the role of polymer membranes as matrices for the immobilization of reactive chemical and biological agents.

Experience with liposomal amphotericin B (AmBisome) in cryptococcal meningitis in AIDS

Three patients with AIDS who had cryptococcal meningitis were treated with liposomal amphotericin B after unsuccessful treatment with fluconazole and conventional amphotericin B. One patient responded but relapsed nine weeks later; he responded to a second course of treatment but again relapsed and subsequently died. Another patient deteriorated despite an improvement in cryptococcal antigen titres. The third patient was found to have culture negative CSF and treatment was therefore stopped. None of the patients suffered any adverse effects and renal function improved in all after conventional amphotericin was stopped and liposomal amphotericin B commenced.

A double-blind comparison of the effects of gradual withdrawal of lorazepam, diazepam and bromazepam in benzodiazepine dependence

Using a double-blind procedure, 68 patients with putative benzodiazepine dependence were randomly allocated to one of three groups given lorazepam (n = 22), diazepam (n = 23) or bromazepam (n = 23) in doses equivalent to those of the patients' original benzodiazepine. After four weeks the dosage was reduced in 25% quantities until no further benzodiazepines were taken. A total of 23 patients dropped out during the study, ten on lorazepam (one of whom committed suicide), seven on diazepam and six on bromazepam. There were few differences in withdrawal symptoms between the three groups but, despite the higher dropout rate, these symptoms were somewhat less marked in the lorazepam group. Withdrawal symptoms were greater in patients who had taken a benzodiazepine for greater than 5 years and were most marked in those with personality disorders, predominantly dependent ones.

Rebound cue state following a single dose of haloperidol

It has been reported that chronic administration of haloperidol produces an amphetamine-like rebound cue state. The experiments reported here were designed to assess whether a similar rebound phenomenon would result from a single dose of haloperidol. Rats were trained to discriminate .5 mg/kg amphetamine from distilled water. Five groups were formed to allow testing of haloperidol's effect at 12, 18, 24, 30, and 36 hr postinjection. Each animal was given 0, .5, 1.0, and 1.5 mg/kg haloperidol at its appropriate injection time in a counterbalanced fashion with one week between each test. A shift in the dose-response function of amphetamine that occurred during these weeks, however, precluded appropriate analysis of haloperidol's effects. Given this result, a second experiment was conducted using a between-subjects design. Half of the animals were injected with 1 mg/kg haloperidol 23 hr prior to testing, whereas the others were injected with distilled water. When tested, the haloperidol group responded 33% of the time on the amphetamine-correct lever, whereas the control group responded at 20%. The observation of posthaloperidol rebound in the between-subjects study and the failure to find significant temporal patterns of rebound phenomena using a within-subjects design have both theoretical and methodological importance.

Comparative assessment of efficacy and withdrawal symptoms after 6 and 12 weeks' treatment with diazepam or buspirone

Fifty-one out-patients presenting with generalised anxiety disorder were included in a double-blind trial, and treated with either buspirone (a new non-benzodiazepine antianxiety drug) or diazepam over 6 or 12 weeks, after which they were abruptly withdrawn and continued on placebo to 14 weeks. Ratings of anxiety and other symptoms were administered fortnightly and additional withdrawal symptoms noted. Forty patients completed the study; 8 of the 11 drop-outs were taking buspirone. Both drugs reduced anxiety, diazepam more rapidly, but with greater withdrawal symptoms, particularly after 6 weeks. Regular treatment with diazepam for 6 weeks leads to a significant risk of pharmacological dependence that is not present with buspirone.

Effects of ethanol on amino acid transport in basolateral liver plasma membrane vesicles

Ethanol has been reported to inhibit hepatocellular processes such as gluconeogenesis and protein synthesis that depend, in part, on amino acid uptake. Since previous studies in cultured hepatocytes indicate that ethanol may have a direct and selective inhibitory effect on amino acid transport, the effects of ethanol on amino acid uptake into basolateral (sinusoidal) rat liver plasma membrane (blLPM) vesicles were examined. Uptake of [3H]alanine, [3H]leucine, and [35S]cysteine was measured by a rapid Millipore filtration technique in the presence of inwardly directed Na+ and K+ gradients and under tetramethylammonium (TMA+)- and Na+-equilibrated conditions. Ethanol preincubation produced a concentration-dependent inhibition of Na+-dependent alanine and cysteine uptake; no effect was observed on either Na+-independent alanine and cysteine uptake or Na+-independent leucine transport. Ethanol had no effect on L-alanine transport under Na+-equilibrated conditions; however, initial rates of 22Na flux were enhanced in the presence of ethanol. On the basis of differences in 2-(methylamino)isobutyrate and L-cysteine sensitivity, ethanol inhibition of Na+-dependent alanine transport in blLPM vesicles largely but not exclusively corresponded to the hormone-responsive system A for amino acid transport described in isolated hepatocytes. Kinetic analysis showed that ethanol treatment resulted in an alteration in the apparent maximum velocity of reaction (Vmax) of Na+-dependent alanine transport without affecting the apparent Km for alanine. The inhibitory effects of ethanol on the time course of Na+-dependent alanine uptake were reversible.(ABSTRACT TRUNCATED AT 250 WORDS)

Long-term interdisciplinary management of multiple mesiodens and delayed eruption: report of case

This report adds to existing knowledge on the treatment of mesiodens, emphasizing the need to individualize the treatment plan, and demonstrates the importance of interdisciplinary cooperation in total patient care.

Na+-glycine cotransport in canalicular liver plasma membrane vesicles

By use of purified rat canalicular liver plasma membrane (cLPM) vesicles, the present study determined the driving forces for glycine transport across this membrane domain. Initial rates of [3H]glycine uptake (10 microM) in cLPM vesicles were stimulated by an inwardly directed Na+ gradient but not by a K+ gradient. Na+ gradient-dependent uptake of glycine demonstrated cation specificity for Na+, dependence on extravesicular Cl-, stimulation by an intravesicular-negative membrane potential, and inhibition by dissipation of the Na+ gradient with gramicidin D. Na+ gradient-dependent glycine cotransport also demonstrated greater sensitivity to inhibition by sarcosine than 2-(methylamino)-isobutyric acid. Accelerated exchange diffusion of [3H]glycine was demonstrated in the presence of Na+ when cLPM vesicles were preloaded with glycine but not with L-alanine or L-proline. Substrate velocity analysis of net Na+-dependent [3H]glycine uptake over the range of amino acid concentrations from 5 microM to 5 mM demonstrated two saturable transport systems, one of high capacity (2.2 +/- 0.2 nmol.mg protein-1.15 s-1) and low affinity (11.2 +/- 1.7 mM) and one of low capacity (51 +/- 14 pmol.mg protein.15 s-1) and comparatively high affinity (66 +/- 12 microM). These results indicate that, in addition to previously described neutral and anionic amino acid transport systems, Na+ gradient-dependent glycine transport mechanisms are present on the canalicular domain of the liver plasma membrane. These canalicular reabsorptive mechanisms may serve to reclaim some of the glycine generated within the canalicular lumen from the intrabiliary hydrolysis of glutathione.

Study of the possible enteropancreatic circulation of pancreatic amylase in the dog

The possible existence of an enteropancreatic circulation of amylase was investigated in the dog. Endogenous amylase concentration in pancreatic venous blood was consistently greater than that in arterial blood, indicating a net flux of amylase from the pancreas to blood. Less than 0.02% of the metabolic clearance of 125I-amylase was accounted for by 125I-amylase in pancreatic secretions, indicating a minimal flux of amylase from the blood to pancreatic secretions. The venous-arterial amylase concentration across gut segments containing large quantities of amylase was not significantly different from 1.00, indicating absorption of less than 0.2% of the luminal amylase per hour. No 125I-amylase was detectable in serum after endoscopic instillation of labeled enzyme into the duodenum. These studies demonstrate negligible intestinal absorption of amylase and negligible pancreatic extraction of amylase, indicating negligible enteropancreatic circulation of pancreatic amylase in the dog.

Perhydro-β-Carotene in the Green River Shale

Several triterpenes and the tetraterpene perhydro-beta-carotene have been identified in the branched-cyclic hydrocarbon fraction of this Eocene shale. The analytical procedure included thiourea adduction followed by combined gas chromatography and mass spectrometry.