Biogeographic distribution and molecular epidemiology of Clostridioides (Clostridium) difficile in Western Australian soils

Clostridioides (Clostridium) difficile is a leading cause of infectious diarrhea in humans and production animals and can be found in a variety of environmental sources. The prevalence and diversity of multi-locus sequence type clade 5 strains of C. difficile in Australian production animals suggest Australia might be the ancestral home of this lineage of One Health importance. To better understand the role of the environment in the colonization of humans and animals in Australia, it is important to investigate these endemic sources. This study describes the prevalence, molecular epidemiology, and biogeographic distribution of C. difficile in soils of Western Australia. A total of 321 soil samples from remote geographical locations across the eight health regions of Western Australia were screened for C. difficile and isolates characterized by PCR ribotyping and toxin gene profiling. C. difficile was isolated from 31.15% of samples, with the highest prevalence in the Perth Metropolitan Health Region (49.25%, n = 33/67). Overall, 52 different strains [PCR ribotypes (RTs)] were identified, with 14 being novel, and 38% (38/100) of isolates being toxigenic, the most common of which was RT014/020. Five unique novel isolates showed characteristics similar to C. difficile clade 5. This is the first study of C. difficile isolated from soils in Australia. The high prevalence and heterogeneity of C. difficile strains recovered suggest that soils play a role in the survival and environmental dissemination of this organism, and potentially its transmission among native wildlife and production animals, and in community and hospital settings.IMPORTANCEClostridium difficile is a pathogen of One Health importance. To better understand the role of the environment in human and animal colonization/infection, it is critical that autochthonous reservoirs/sources of C. difficile be investigated. This is the first study of C. difficile isolated from soils of Western Australia (WA). Here, the ecology of C. difficile in WA is described by examining the geographic distribution, molecular epidemiology, and diversity of C. difficile isolated from soils across WA.

Geographical variations in the prevalence of atopic sensitization in six study sites across Canada

BACKGROUND

Geographical variations in atopic sensitization in Canada have not been described previously. This study used the standardized protocol of the European Community Respiratory Health Survey-1 (ECRHS-1) to investigate the distribution and predictors of atopic sensitization in six sites across Canada and to compare the results with some ECRHS-1 centers.

METHODS

Adults aged 20-44 years in six study sites across Canada underwent allergy skin testing using 14 allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae) cat, cockroach, grasses (Timothy grass, Kentucky grass), molds (Cladosporium herbarium, Alternaria alternata, Aspergillus fumigatus, Penicillium), trees (tree mix, birch, Olea europea), and common ragweed.

RESULTS

The overall prevalence of atopy (skin test over 0 mm to any allergen) was 62.7%. There was significant geographical variation in the prevalence of atopy in the six study sites (lowest 55.6% [95% C.I.51.3-59.9] in Prince Edward Island, highest 66.0 [61.7-70.3] in Montreal) and of sensitization to each of the allergens tested even after adjustment for confounders. When the first eight of the nine allergens in the ECRHS were used to estimate the prevalence of atopic sensitization, the prevalence of atopy in Canada was 57% compared with 35.2% overall for centers in the ECRHS. The prevalence of atopy in Vancouver (57% [52.3-61.8]) was close to that of Portland, Oregon (52.1% [46.2-58.0]).

CONCLUSION

There was a significant variation in atopic sensitization among different study sites across Canada. The prevalence of atopic sensitization is relatively high in Canada compared with sites in the ECRHS and this may, in part, account for the high prevalence of asthma and asthma symptoms in Canada.

Canadian Thoracic Society Asthma Management Continuum--2010 Consensus Summary for children six years of age and over, and adults

BACKGROUND/OBJECTIVE

To integrate new evidence into the Canadian Asthma Management Continuum diagram, encompassing both pediatric and adult asthma.

METHODS

The Canadian Thoracic Society Asthma Committee members, comprised of experts in pediatric and adult respirology, allergy and immunology, emergency medicine, general pediatrics, family medicine, pharmacoepidemiology and evidence-based medicine, updated the continuum diagram, based primarily on the 2008 Global Initiative for Asthma guidelines, and performed a focused review of literature pertaining to key aspects of asthma diagnosis and management in children six years of age and over, and adults.

RESULTS

In patients six years of age and over, management of asthma begins with establishing an accurate diagnosis, typically by supplementing medical history with objective measures of lung function. All patients and caregivers should receive self-management education, including a written action plan. Inhaled corticosteroids (ICS) remain the first-line controller therapy for all ages. When asthma is not controlled with a low dose of ICS, the literature supports the addition of long-acting beta2-agonists in adults, while the preferred approach in children is to increase the dose of ICS. Leukotriene receptor antagonists are acceptable as second-line monotherapy and as an alternative add-on therapy in both age groups. Antiimmunoglobulin E therapy may be of benefit in adults, and in children 12 years of age and over with difficult to control allergic asthma, despite high-dose ICS and at least one other controller.

CONCLUSIONS

The foundation of asthma management is establishing an accurate diagnosis based on objective measures (eg, spirometry) in individuals six years of age and over. Emphasis is placed on the similarities and differences between pediatric and adult asthma management approaches to achieve asthma control.

Human serum albumin induced hypotension in the postoperative phase of cardiac surgery

Hypotension associated with the rapid infusion of human serum albumin products was first recognised in Australasia in the early 1970s. An association with the angiotensin converting enzyme inhibitor class of drugs (ACE-I) followed, leading to a proposed mechanism involving bradykinin generation through pre-kallikrein activator (PKA) presence in the infused fluid. The newer generation albumin products (Albumex) contain very low concentrations of PKA and are generally thought safe to use in most patient populations. Anecdotal reports of paradoxical hypotension with rapid infusion of 4% albumin in our department led to an audit of practice over three months. Four out of 36 patients (11%) who received 4% albumin intravenously experienced paradoxical hypotension. Three of these patients were taking ACE-I preoperatively (P=0.04). There was no observed hypotension associated with intravenous infusion of crystalloid fluid. We believe 4% albumin should be used with caution, particularly in those patients receiving ACE-I preoperatively.

Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer

We have previously demonstrated that a clinical model can be safely used in a management strategy in patients with suspected pulmonary embolism (PE). We sought to simplify the clinical model and determine a scoring system, that when combined with D-dimer results, would safely exclude PE without the need for other tests, in a large proportion of patients. We used a randomly selected sample of 80% of the patients that participated in a prospective cohort study of patients with suspected PE to perform a logistic regression analysis on 40 clinical variables to create a simple clinical prediction rule. Cut points on the new rule were determined to create two scoring systems. In the first scoring system patients were classified as having low, moderate and high probability of PE with the proportions being similar to those determined in our original study. The second system was designed to create two categories, PE likely and unlikely. The goal in the latter was that PE unlikely patients with a negative D-dimer result would have PE in less than 2% of cases. The proportion of patients with PE in each category was determined overall and according to a positive or negative SimpliRED D-dimer result. After these determinations we applied the models to the remaining 20% of patients as a validation of the results. The following seven variables and assigned scores (in brackets) were included in the clinical prediction rule: Clinical symptoms of DVT (3.0), no alternative diagnosis (3.0), heart rate >100 (1.5), immobilization or surgery in the previous four weeks (1.5), previous DVT/PE (1.5), hemoptysis (1.0) and malignancy (1.0). Patients were considered low probability if the score was <2.0, moderate of the score was 2.0 to 6.0 and high if the score was over 6.0. Pulmonary embolism unlikely was assigned to patients with scores < or =4.0 and PE likely if the score was >4.0. 7.8% of patients with scores of less than or equal to 4 had PE but if the D-dimer was negative in these patients the rate of PE was only 2.2% (95% CI = 1.0% to 4.0%) in the derivation set and 1.7% in the validation set. Importantly this combination occurred in 46% of our study patients. A score of <2.0 and a negative D-dimer results in a PE rate of 1.5% (95% CI = 0.4% to 3.7%) in the derivation set and 2.7% (95% CI = 0.3% to 9.0%) in the validation set and only occurred in 29% of patients. The combination of a score < or =4.0 by our simple clinical prediction rule and a negative SimpliRED D-Dimer result may safely exclude PE in a large proportion of patients with suspected PE.

Control of GluR1 AMPA receptor function by cAMP-dependent protein kinase

Modulation of postsynaptic AMPA receptors in the brain by phosphorylation may play a role in the expression of synaptic plasticity at central excitatory synapses. It is known from biochemical studies that GluR1 AMPA receptor subunits can be phosphorylated within their C terminal by cAMP-dependent protein kinase A (PKA), which is colocalized with the phosphatase calcineurin (i.e., phosphatase 2B). We have examined the effect of PKA and calcineurin on the time course, peak open probability (P(O, PEAK)), and single-channel properties of glutamateevoked responses for neuronal AMPA receptors and homomeric GluR1(flip) receptors recorded in outside-out patches. Inclusion of purified catalytic subunit Calpha-PKA in the pipette solution increased neuronal AMPA receptor P(O,PEAK) (0.92) compared with recordings made with calcineurin included in the pipette (P(O,PEAK) 0.39). Similarly, Calpha-PKA increased P(O,PEAK) for recombinant GluR1 receptors (0. 78) compared with patches excised from cells cotransfected with a cDNA encoding the PKA peptide inhibitor PKI (P(O,PEAK) 0.50) or patches with calcineurin included in the pipette (P(O,PEAK) 0.42). Neither PKA nor calcineurin altered the amplitude of single-channel subconductance levels, weighted mean unitary current, mean channel open period, burst length, or macroscopic response waveform for recombinant GluR1 receptors. Substitution of an amino acid at the PKA phosphorylation site (S845A) on GluR1 eliminated the PKA-induced increase in P(O,PEAK), whereas the mutation of a Ca(2+), calmodulin-dependent kinase II and PKC phosphorylation site (S831A) was without effect. These results suggest that AMPA receptor peak response open probability can be increased by PKA through phosphorylation of GluR1 Ser845.

Use of a clinical model for safe management of patients with suspected pulmonary embolism

BACKGROUND

The low specificity of ventilation-perfusion lung scanning complicates the management of patients with suspected pulmonary embolism.

OBJECTIVE

To determine the safety of a clinical model for patients with suspected pulmonary embolism.

DESIGN

Prospective cohort study.

SETTING

Five tertiary care hospitals.

PATIENTS

1239 inpatients and outpatients with suspected pulmonary embolism.

INTERVENTIONS

A clinical model categorized pretest probability of pulmonary embolism as low, moderate, or high, and ventilation-perfusion scanning and bilateral deep venous ultrasonography were done. Testing by serial ultrasonography, venography, or angiography depended on pretest probability and lung scans.

MEASUREMENTS

Patients were considered positive for pulmonary embolism if they had an abnormal pulmonary angiogram, abnormal ultrasonogram or venogram, high-probability ventilation-perfusion scan plus moderate or high pretest probability, or venous thromboembolic event during the 3-month follow-up. All other patients were considered negative for pulmonary embolism. Rates of pulmonary embolism during follow-up in patients who had a normal lung scan and those with a non-high-probability scan and normal serial ultrasonogram were compared.

RESULTS

Pretest probability was low in 734 patients (3.4% with pulmonary embolism), moderate in 403 (27.8% with pulmonary embolism), and high in 102 (78.4% with pulmonary embolism). Three of the 665 patients (0.5% [95% CI, 0.1% to 1.3%]) with low or moderate pretest probability and a non-high-probability scan who were considered negative for pulmonary embolism had pulmonary embolism or deep venous thrombosis during 90-day follow-up; this rate did not differ from that in patients with a normal scan (0.6% [CI, 0.1% to 1.8%]; P > 0.2).

CONCLUSION

Management of patients with suspected pulmonary embolism on the basis of pretest probability and results of ventilation-perfusion scanning is safe.

Activity-dependent modulation of glutamate receptors by polyamines

The mechanisms by which polyamines block AMPA and kainate receptors are not well understood, but it has been generally assumed that they act as open-channel blockers. Consistent with this, voltage-jump relaxation analysis of GluR6 equilibrium responses to domoate could be well fit, assuming that spermine, spermidine, and philanthotoxin are weakly permeable open-channel blockers. Analysis of rate constants for binding and dissociation of polyamines indicated that the voltage dependence of block arose primarily from changes in koff rather than kon. Experiments with changes in Na concentration further indicate that the voltage dependence of polyamine block was governed by ion flux via open channels. However, responses to 1 msec applications of L-Glu revealed slow voltage-dependent rise-times, suggesting that polyamines additionally bind to closed states. A kinetic model, which included closed-channel block, reproduced these observations but required that polyamines accelerate channel closure either through an allosteric mechanism or by emptying the pore of permeant ions. Simulations with this model reveal that polyamine block confers novel activity-dependent regulation on calcium-permeable AMPA and kainate receptor responses.

Acute barium intoxication following ingestion of ceramic glaze

A case of deliberate overdose of barium sulphide in a psychiatric setting is presented, with resulting flaccid paralysis, malignant arrhythmia, respiratory arrest and severe hypokalaemia, but ultimately with complete recovery. The degree of paralysis appears to be related directly to serum barium levels. The value of early haemodialysis, particularly with respiratory paralysis and hypokalaemia, is emphasised.

Permeation and block of rat GluR6 glutamate receptor channels by internal and external polyamines

1. Polyamine block of rat GluR6(Q) glutamate receptor channels was studied in outside-out patches from transiently transfected HEK 293 cells. With symmetrical 150 mM Na+ and 30 microM internal spermine there was biphasic voltage dependence with 95% block at +40 mV but only 20% block at +140 mV. Dose-inhibition analysis for external spermine also revealed biphasic block; the Kd at +40 mV (54 microM) was lower than at +80 (167 microM) and -80 mV (78 microM). 2. For internal polyamines relief from block was most pronounced for spermine, weaker for N-(4-hydroxyphenylpropanoyl)-spermine (PPS), and virtually absent for philanthotoxin 343 (PhTX 343), suggesting that permeation of polyamines varies with cross-sectional width (spermine, 0.44 nm; PPS, 0.70 nm; PhTX 343, 0.75 nm). 3. With putrescine, spermidine, or spermine as sole external cations, inward currents at -120 mV confirmed permeation of polyamines. For bi-ionic conditions with 90 mM polyamine and 150 mM Na+i, reversal potentials were -12.4 mV for putrescine (permeability ratio relative to Na+, PPut/PNa = 0.42) and -32.7 mV for spermidine (PSpd/PNa = 0.07). Currents carried by spermine were too small to analyse accurately in the majority of patches. 4. Increasing [Na+]i from 44 to 330 mM had no effect on the potential for 50% block (V1/2) by 30 microM internal spermine; however, relief from block at positive membrane potentials increased with [Na+]i. In contrast, raising [Na+]o from 44 to 330 mM resulted in a depolarizing shift in V1/2, indicating a strong interaction between internal polyamines and external permeant ions. 5. The Woodhull infinite barrier model of ion channel block adequately described the action of spermine at membrane potentials insufficient to produce relief from block. For 30 microM internal spermine such analysis gave Kd(O) = 2.5 microM, z theta = 1.97; block by 30 microM external spermine was weaker and less voltage dependent (Kd(O) = 37.8 microM and z delta = 0.55); delta and theta are electrical distances measured from the outside and inside, respectively. 6. Fits of the Woodhull equation for a permeable blocker adequately described both onset and relief from block by spermine over a wide range of membrane potentials. However, the rate constants and z delta values estimated for block by internal spermine predicted much stronger external block than was measured experimentally, and vice versa. 7. An Eyring rate theory model with two energy wells and three barriers explained qualitatively many characteristic features of the action of polyamines on GluRs, including biphasic I-V relationships, weaker block by external than internal spermine and low permeability.

No change in complication rate using spring-loaded gun compared to traditional percutaneous renal allograft biopsy techniques

The previous methods to biopsy renal allografts at our institution involved the use of the Franklin-Silverman or Tru-Cut needles. Unfortunately they had a significant rate of post biopsy bleeding secondary to deep penetration when excess force was used to penetrate a tough transplant capsule. Although spring loaded biopsy devices have been widely used for native kidney biopsies over the past three years, the complication rate for renal allograft biopsies has not been sufficiently evaluated. We describe our experience using a disposable spring loaded biopsy device on transplanted renal grafts. Fifty-four biopsies were performed with the device, all under ultrasound guidance. The ASAP automatic biopsy system by Medi-tech was used comprising of a spring loaded gun with a 15 cm long 15 GA needle echogenic tip and 17 mm specimen notch. All patients were ultrasounded immediately post biopsy to look for hematomas. Compared to 55 previous biopsies performed using Tru-Cut needles, we conclude that the ASAP automated biopsy system proved equally effective in obtaining adequate tissue for diagnosis with fewer post-biopsy hematomas compared to traditional biopsy methods.

Inward rectification of both AMPA and kainate subtype glutamate receptors generated by polyamine-mediated ion channel block

CA2+-permeable glutamate receptors assembled from subunits containing a GLN residue at the RNA editing site in membrane domain 2 show strong inward rectification. In HEK 293 cells transfected with the kainate receptor subunit GluR6(Q), inward rectification is lost in outside-out patches, suggesting a role for diffusible, cytoplasmic factors. Inclusion of different polyamines in the internal solution restored inward rectification, whereas Mg2+ (1 mM) was inactive. Spermidine (Kd[0 mV] = 5.5 microM) was of higher affinity than spermidine (Kd[0 mV] = 25.4 microM) or putrescine (Kd[0 mV] = 1.2 mM). AMPA receptors assembled from GluRA(flip) showed even higher affinity for spermine (Kd[0 mV] = 1.5 microM). Analysis of the voltage dependence of whole-cell responses predicted intracellular free spermine and spermidine concentrations of 51 and 153 muM, respectively.

Structural determinants of allosteric regulation in alternatively spliced AMPA receptors

The flip and flop splice variants of AMPA receptors show strikingly different sensitivity to allosteric regulation by cyclothiazide; heteromers assembled from GluR-A and GluR-B also exhibit splice variant-dependent differences in efficacy for activation by glutamate and kainate. The sensitivity for attenuation of desensitization by cyclothiazide for homomeric GluR-A was solely dependent upon exchange of Ser-750 (flip) and Asn-750 (flop), and was unaffected by mutagenesis of other divergent residues. In contrast, substantial alteration of the relative efficacy of glutamate versus kainate required mutation of multiple residues in the flip/flop region. Modulation by cyclothiazide was abolished by mutation of Ser-750 to Gin, the residue found at the homologous site in kainate-preferring subunits, whereas introduction of Ser at this site in GluR6 imparted sensitivity to cyclothiazide.

Species-dependent functional properties of non-NMDA receptors expressed in Xenopus laevis oocytes injected with mammalian and avian brain mRNA

1. Species-dependent variation in the functional properties of non-NMDA receptors was investigated by intracellular recording in Xenopus laevis oocytes injected with rat, chick and calf brain mRNA. 2. In all mRNA-injected oocytes, kainic acid (KA), domoic acid (Dom) and 5-bromowillardiine (BrW) evoked large, maintained membrane currents, in contrast to the smaller, desensitizing responses elicited by alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), quisqualic acid (QA) and L-glutamic acid (L-Glu). Dose-response curves for KA in oocytes injected with calf (EC50 = 96.4 +/- 12.3 microM; mean +/- s.e. mean), chick (87.0 +/- 8.9 microM) or rat (88.7 +/- 4.3 microM) brain mRNA were similar. 3. Current-voltage (I-V) relationships determined with KA inwardly rectified in oocytes injected with calf or chick mRNA; whereas, outward rectification was observed in oocytes injected with rat brain mRNA. 4. In oocytes injected with rat brain mRNA, AMPA antagonized responses evoked by KA in a competitive manner. The absolute amplitudes of KA and AMPA responses in the same oocytes were significantly correlated, which is consistent with both agonists acting on the same receptor-ionophore complex. 5. In contrast, in oocytes injected with calf or chick brain mRNA, AMPA (QA and L-Glu) antagonized the response evoked by KA in a non-competitive manner. The response amplitudes of KA compared to AMPA, QA or L-Glu in the same oocytes were not correlated suggesting discrete receptor-ionophores. 6. This study favours the existence of distinct non-NMDA receptor subtypes that are equi-sensitive to KA. The expressed receptors from different species of mRNA may be distinguished by their voltage sensitivities and the type of antagonism exerted by AMPA on KA-activated responses. Our observations may reflect further heterogeneity of non-NMDA receptors in the central nervous system of different vertebrate species.

Subpopulations of neonatal rat sensory neurons express functional neurotransmitter receptors which elevate intracellular calcium

We have attempted to identify which subpopulations of rat sensory neurons possess functional neurotransmitter receptors which elevate the free concentration of intracellular calcium. Subpopulations of sensory neurons were identified using three accepted criteria: (i) the distribution and proportion of neurons with differing somatic diameters; (ii) the expression of substance P-like immunoreactivity; and (iii) the responsiveness of each neuron to capsaicin. The total neuronal population was primarily grouped into three classes according to somatic diameter and defined as small- (< 17 microns), intermediate- (17-25 microns) and large- (> 25 microns) sized neurons. It was not possible to distinguish between small and intermediate-sized neurons since a similar percentage of each class expressed substance P-like immunoreactivity or sensitivity to capsaicin. Large-sized neurons did not possess these characteristics and, therefore, represented a distinct neuronal population. In single, intact neurons of differing diameter, the ability of a variety of receptor agonists to elevate the free concentration of intracellular calcium was determined using the calcium-sensitive indicator, Fura-2. Local application of capsaicin, adenosine, bradykinin, ATP and substance P elevated the resting level of the free concentration of intracellular calcium in small and intermediate-sized neurons. The large-sized neurons were unresponsive to these receptor agonists with the exception of ATP. The response to ATP was relatively transient in nature and did not differ between neurons of differing somatic diameter.(ABSTRACT TRUNCATED AT 250 WORDS)

Thiocyanate ions selectively antagonize AMPA-evoked responses in Xenopus laevis oocytes microinjected with rat brain mRNA

1 Responses to kainate (KA), willardiine and alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) were recorded from rat brain mRNA-injected Xenopus laevis oocytes by use of a two-electrode voltage clamp. 2 Thiocyanate (SCN-; 50 microM-4 mM) ions reversibly and selectively inhibited the membrane current responses to AMPA in a non-competitive manner without affecting KA or willardiine-induced responses. 3 The inhibition of AMPA-induced responses by SCN- was dependent on the SCN- concentration with an estimated IC50 of 1 mM. The antagonism was not dependent on the AMPA concentration. 4 The response to a high concentration of AMPA (100-200 microM) exhibited a peak inward current which declined to a steady-state. SCN- inhibited the steady-state current more than the peak response. The inhibition was unaffected by prior incubation with concanavalin-A (Con-A; 10 microM). 5 Responses to KA were antagonized by AMPA in a competitive manner, suggesting that both agonists may activate a common receptor-channel complex. This interaction between two non-NMDA agonists was not affected by the SCN(-)-induced inhibition of the AMPA response. 6 AMPA-induced responses recorded from large cultured cerebellar neurones by whole-cell recording were also inhibited by SCN- in a non-competitive manner. The AMPA-induced peak current was less affected than the steady-state response. 7 We conclude that SCN- can inhibit the response to AMPA in expressed non-NMDA receptors in Xenopus oocytes and also in native receptors in cultured cerebellar neurones. One possible mechanism of action for SCN- inhibition of responses to AMPA may involve a Con-A-insensitive, non-NMDA receptor-mediated desensitization.

Interplay between expressed non-NMDA receptors and endogenous calcium-activated chloride currents in Xenopus laevis oocytes

Current-voltage (I-V) relationships of glutamate receptors activated by the non-NMDA receptor agonist, kainate (KA), were determined in Xenopus laevis oocytes injected with either calf or chick brain mRNA. In most injected oocytes (n = 44; 84%), I-V plots to 80 microM KA exhibited inward rectification; however, in some oocytes (n = 7; 16%), the KA-evoked membrane current showed only slight outward rectification. A comparison between the resting membrane properties of injected oocytes with the KA-evoked currents revealed that weak outward rectification was often observed in oocytes possessing predominant voltage-activated calcium-dependent chloride currents (ICl(Ca)). In these oocytes, replacement of extracellular calcium (2 mM Ca2+) with magnesium ions (Mg2+), or the addition of the chloride channel blocker, anthracene-9-carboxylic acid (500 microM to 1 mM A9C), reduced ICl(Ca) and also altered the nature of the KA I-V plot revealing inward rectification. It is proposed that the responses mediated by expressed non-NMDA receptors may be influenced by the activation of endogenous calcium-dependent membrane currents in Xenopus laevis oocytes.

Interaction of 5-bromowillardiine with non-NMDA receptors expressed in Xenopus laevis oocytes injected with chick brain mRNA

Excitatory amino acid (EAA) receptors were studied in Xenopus laevis oocytes microinjected with 1-day-old chick brain mRNA using a two-electrode voltage clamp technique. EAA agonists could be differentially characterised according to their current/voltage (I/V) relationships; I/V plots to kainate (KA) and domoate (Dom) inwardly rectified at positive membrane potentials whereas quisqualate (QA), alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and L-glutamate (L-Glu) produced linear I/V plots. Interestingly, the non-NMDA (N-methyl-D-aspartate) agonist, 5-bromowillardiine (BrW), displayed properties similar to KA and Dom. It is proposed that BrW acts as a KA-like agonist on chick EAA receptors expressed in Xenopus oocytes.

Ataxia in Listeria monocytogenes infections of the central nervous system

From 1976 to 1981 Listeria monocytogenes was second only to Neisseria meningitidis as the cause of bacterial infections of the central nervous system in adults at our hospital. None of the patients with Listeria infection was immunosuppressed or had an underlying malignancy. Ataxia was an initial feature in five of the eight patients, and in three of them it persisted beyond their discharge from the hospital. Ataxia was not a feature of the clinical picture of 14 other adult patients with meningococcal and pneumococcal meningitis. Our data indicate that L monocytogenes should be suspected as the etiologic agent in an adult with ataxia and infection of the central nervous system.

Fat emulsion vehicle for intravenous administration of an aqueous insoluble drug

Formulation of a sterile preparation for the parenteral administration of a water insoluble drug is described. Methyl CCNU was first dissolved in absolute alcohol and slowly added to a fat emulsion, Intralipid. The preparation was found to be stable for eight hours at room temperature and seven days under refrigeration. After administration of the preparation to approximately 100 patients, no significant side effects were attributed to the fat emulsion.