Penetration of latamoxef, cefoperazone and piperacillin into the sputum of patients with cystic fibrosis

Concentrations of latamoxef, cefoperazone and piperacillin, administered intravenously, were measured in serum and sputum of cystic fibrosis patients with recurrent pulmonary infections, chronically colonized with Pseudomonas aeruginosa. Serum pharmacokinetic data were consistent with prior reports. Peak sputum to peak serum concentrations were approximately 3% for each antimicrobial. However, the more prolonged sputum concentrations of piperacillin were reflected in greater areas under the sputum concentration-time curve and a longer duration above the MIC50 of tested P. aeruginosa strains for that drug.

Flow cytometric analysis of micronuclei found in cells after irradiation

Exposure of mammalian cells to either ionizing radiation or mutagenic and carcinogenic substances can induce chromosome aberrations. These aberrations in turn may give rise to micronuclei which can be found in cells during the interphase after division. A two-step method is presented that allows separation of micronuclei from cell nuclei. They can then be measured and analysed according to their DNA content in a flow cytometer. The method involves an initial detergent treatment of cells followed by a second treatment with sucrose and citric acid. Micronuclei with DNA content larger than 2% of the G1-nuclei can be measured. The method is tested and compared with microscopic observations of micronucleated cells in irradiated, asynchronous, and synchronized Ehrlich ascites tumour cells growing in vitro. The agreement between the flow cytometric technique and microscopic observations is excellent when the dose-dependent number of micronuclei per cell is taken into consideration.

Altered glucose tolerance, insulin response, and insulin sensitivity after massive weight reduction subsequent to gastric bypass

We have studied an otherwise normal group of morbidly obese subjects and compared them with patients who had experienced massive weight loss after loop gastric bypass. Compared to normal controls (NLCs), morbidly obese control patients (OBCs) had abnormal glucose tolerance curves (after glucose ingestion), elevated basal insulin levels, and increased plasma insulin concentrations, suggesting insulin insensitivity. The latter has been corroborated by the measurement of decreased insulin binding in these patients. Postoperative (PO) patients were hyperglycemic after taking oral glucose, but all PO patients had a rapid decrease in plasma glucose concentration, half reaching hypoglycemic levels. PO basal insulin levels and insulin receptor number were not statistically different from those in NLCs, indicating up-regulation of insulin receptors (and therefore, increased insulin sensitivity) postoperatively. Hyperinsulinemia seen in the PO group (greater than that in OBCs, P less than 0.001) after administration of oral glucose occurred simultaneously with a doubling of plasma concentration of gastric inhibitory polypeptide. Massive weight loss in patients after gastric bypass was accompanied by an improvement in insulin receptor number, basal hyperinsulinemia, and glucose tolerance. In addition, postoperative patients demonstrated symptomatic reactive hypoglycemia which may have resulted from the hyperinsulinemia seen subsequent to ingestion of glucose.

Regulation of calcium homeostasis in the heart by taurine

The role of taurine in maintaining calcium and potassium homeostasis in excitable tissues is discussed. These effects of taurine appear to be related to its interaction with a low affinity binding protein of the cell membrane. This conclusion is based on the observation that the sulfinic acid analog of taurine, hypotaurine, also interacts with this protein and mimics these actions of taurine, whereas two other analogs, beta-alanine and isethionic acid, have little affinity for the binding protein and fail to exhibit taurine-like activity. The possibility that a relationship exists between the low affinity protein and sarcolemmal calcium pools is considered.

Involuntary movement disorders--each has a meaning all its own

Degenerative processes in the corpus striatum, neuroleptics drugs, thyroid disease, and Parkinson's disease are all causes of abnormal spontaneous movements in the elderly. Differential diagnosis is essential for selecting the proper therapy, and the patient's history often provides the key.

Periodic respiration. The capnographic interpretation

Different type of periodic respiration are difficult to distinguish clinically although their identification may influence the diagnosis, prognosis and treatment. Often other forms of abnormal respiration are mistaken for periodic. Four capnograms are shown illustrating (1) true Cheyne-Stokes respiration, (2) irregular "pseudo-periodic" respiration a) after fentanyl, and b) in the presence of a brain tumour and (3) regular respiration interspersed with deep sighs which was diagnosed clinically as Cheyne-Stokes respiration. A plea is made for the routine use of capnography in order to provide a visual record of respiration.

[Thermographically visualized cutaneous reactions after irradiation with fast electrons (author's transl)]

A comparison was made between thermographically visualized cutaneous reactions of two groups of patients after a therapy with fast electrons. One group underwent one-series irradiation, the other group received two series with an interval of 21 days. The cutaneous reaction after the interval only appeared following considerably higher doses than with one-series therapy. This difference indicates the recuperative capability of normal tissue after the exposition to subtolerance effects. The data were evaluated using a function derived from the Ellis-formula. A "biological dosimeter" can be developed based on thermic reactions of subcutaneous connective tissue.

Physostigmine for cardiac and neurologic manifestations of phenothiazine poisoning

Psychotropic drugs such as the phenothiazine neuroleptics and tricyclic antidepressants are known to cause electrocardiographic abnormalities as well as a central anticholinergic syndrome. Physostigmine is known to reverse the central muscarinic anticholinergic manifestations by inhibition of the enzyme cholinesterase. An unusual case of trifluoperazine overdose, in which the patient presented with cardiac arrhythmias and a central anticholinergic syndrome, is presented. Treatment with physostigmine reversed the central anticholinergic syndrome as well as the electrocardiographic abnormalities. Effects of phenothiazines on altering cardiac status are also discussed.

Prolactin suppression by (-) delta-9-tetrahydrocannabinol (THC): involvement of serotonergic and dopaminergic pathways

(-) delta-9-Tetrahydrocannabinol (THC) was previously shown to suppress serum PRL levels (SPL) in rats. In the present study, various pathways by which THC suppresses PRL secretion were investigated. THC abolished the elevated SPL induced by either 5-hydroxytryptophan or melatonin. The SPL suppression after THC treatment was abolished upon treatment with cyproheptadine. These results suggest on involvement of a serotonergic pathway in the suppressive effect of THC on PRL secretion. Elevated SPL induced by a low dose of the dopaminergic blocker pimozide was suppressed after treatment with THC. However, elevated SPL, induced by a high dose of pimozide or by any dose of perphenazine (a less specific dopaminergic blocker), were not reduced by combined treatment of either of these drugs with THC. It seems that THC also enhances the dopaminergic activity in the pathway that controls PRL secretion. In addition, the pimozide-induced SPL elevation dropped upon combined treatment of cyproheptadine and pimozide. As cyproheptadine alone, and in the dose used, did not affect SPL, it is proposed that the serotonergic and dopaminergic pathways that control PRL secretion do not necessarily act independently of one another.

Paradoxial response to dopaminergic agents in parkinsonism

A patient with the classical stigmata of parkinsonism was treated on three separate occasions with levodopa, a combination of levodopa and carbidopa, and lergotrile mesylate, a direct-acting dopamine-receptor agonist. All three treatment regimens resulted in dose-related increases in parkinsonian features. To our knowledge, this response has not been previously described. Lergotrile did not alter CSF homovanillic acid concentration. It is suggested that this rare paradoxical motor response to dopaminergic agents may be associated with dysfunction of the postsynaptic dopamine receptor site.

Getting started with a scanning transmission electron microscope coupled to a small computer

A scanning transmission electron microscope (STEM) equipped with a laser-heated gun was coupled to a small computer. Several alterations to the commercially obtained parts of this system are described. On-line operation procedures were developed aiming to reduce the amount of radiation of the specimen area of interest. The resulting system is capable of recording information at the 1.0 to 1.5 nm resolution level by taking advantage of the efficiency of a STEM in recording the information and in controlling the irradiation conditions. These features are important in the study of biological material.

Comparison of Frank's and McFee's lead systems using multivariate statistics

Two widely used orthogonal corrected 3-lead system - the Frank and the McFee systems - were studied in order to evaluate whether a significant difference in diagnostic performance could be observed; in the case of a positive answer, we would be able to advocate one system instead of the other. No such overall difference was noticed. Although +/- 17% discrepancies were found on the individual classification level (a patient correctly classified with system A and missed with system B and conversely), the practical implication is negligible since each system is responsible for +/- half of these discrepancies. Multivariate analysis, as already largely proved by Pipberger's group, drastically ameliorates the diagnostic results. Special caution has been given to the number of selected discriminators in order to enhance repeatability of the results; the reproducibility, using the approach developed by Cornfield, was found excellent. Some particular features as to the choice and location of the best discriminators were found somewhat puzzling by the autors but no deterministic explanation could be offered: the selection of the variables, indeed, rested on statistical bases and not on the (sometimes fragmentary) knowledge of what is going on in the heart and how these events relate to surface waveform patterns.

Production of Lymphotoxin and Migration Inhibitory Factor by Established Human Lymphocytic Cell Lines

A number of continuous human lymphoid cell lines were examined for in vitro synthesis of the effector molecules, lymphotoxin (LT) and migration-inhibition factor (MIF). Twenty-six of a total of 39 lines established from human peripheral blood lymphocytes produced LT activity and 7 of 8 lines assayed secreted MIF. The amounts of LT elaborated varied considerably from one cell line to another and some lines apparently secreted none at all. The cell-toxin secreted in vitro by line 5287 displayed physical properties that were analogous to those of the cell-toxin secreted by phytohemagglutinin-activated normal human lymphocytes.