In vitro activity of fluvastatin, a cholesterol-lowering agent, and synergy with flucanazole and itraconazole against Candida species and Cryptococcus neoformans.

Fluvastatin, a cholesterol-lowering drug, exhibited minimal activity (MICs of 64 to >128 microg/ml) against Candida species and Cryptococcus neoformans. When fluvastatin was combined with fluconazole or itraconazole, both synergistic and additive effects were noted (fractional inhibitory concentration indices of < or = 0.156 to 0.

Controlled trial of intrapleural streptokinase in the treatment of pleural empyema and complicated parapneumonic effusions.

Objective: To compare the efficacy of adjunctive intrapleural streptokinase (SK) with simple closed chest tube drainage (Drain) in the treatment of empyemas and complicated parapneumonic effusions.

Method: This was a controlled study of 52 patients (mean age, 57 years; 41 men) with pleura space sepsis. Forty patients (77%) had empyema and 12 had complicated parapneumonic effusions.

Birth of a western lowland gorilla (Gorilla gorilla gorilla) following in vitro fertilization and embryo transfer.

A 21-year-old multiparous female exhibiting 31-41 day menstrual cycles was given hFSH (225 IU/day, Metrodin 75, from cycle day 3 through 9 (menses = day 1) and hCG (10,000 IU, Profasi, on day 10 to stimulate follicular development. At 35 h after hCG, under isoflurane (AErrane) anesthesia, follicles were aspirated by controlled suction under transvaginal ultrasound guidance. Metaphase II oocytes (n = 11) were placed in modified human tubal fluid (mHTF, 100 microliters) medium under oil at 37 degrees C in humidified 5% CO2.

Pigmented sweat gland tumor mimicking melanoma.

Eccrine poroma, a common adnexal neoplasm, usually presents as a solitary, smooth, flesh-colored nodule on the foot or hand. Eccrine porocarcinoma is extremely rare and much more variable in its morphology and location. Both tumors can contain melanocytes and melanin.

Multicenter evaluation of proposed standardized procedure for antifungal susceptibility testing of filamentous fungi.

A multicenter study was conducted to expand the generation and analysis of data that supports the proposal of a reference method for the antifungal susceptibility testing of filamentous fungi. Broth microdilution MICs of amphotericin B and itraconazole were determined in 11 centers against 30 coded duplicate pairs of Aspergillus spp., Fusarium spp.

Treatment of complicated parapneumonic effusions and pleural empyema: a four-year prospective study.

We studied prospectively the microbiologic findings, management, including the use of intrapleural streptokinase to improve pleural drainage, and outcome of 33 patients with complicated parapneumonic effusions (6) frank empyema (27) treated by our unit over a 4-year period. The mean age was 61 years, with more male (26) than female (7) patients. Seventy-nine percent of the patients had some form of underlying illness, especially chronic lung disease (46%), followed by diabetes mellitus (23%).

The significance of elevated progesterone at the time of administration of human chorionic gonadotropin may be related to luteal support.

Purpose: Our purpose was to determine if the progesterone concentration on the day of HCG administration is associated with the establishment of pregnancy in IVF patients.

Methods: Concentrations of progesterone on the day of hCG were examined retrospectively in 293 patients with ovarian hyperstimulation induced by GnRH agonist with hMG and/or FSH. Patients were grouped based on progesterone concentration: < 0.

Identification of a locus involved in the utilization of iron by Actinobacillus pleuropneumoniae.

The cloned afu locus of Actinobacillus pleuropneumoniae restored the ability of an Escherichia coli K-12 mutant (aroB) to grow on iron-limited media. DNA sequence analysis of the fragment showed that there are three genes designated afuA, afuB and afuC (Actinobacillus ferric uptake) that encode products similar to the SfuABC proteins of Serratia marcescens, the HitABC proteins of Haemophilus influenzae, the FbpABC proteins of Neisseria gonorrhoeae and the YfuABC proteins of Yersinia enterocolitica. The three genes encode a periplasmic iron-binding protein (AfuA), a highly hydrophobic integral cytoplasmic membrane protein with two consensus permease motifs (AfuB) and one hydrophilic peripheral cytoplasmic membrane protein with Walker ATP-binding motifs (AfuC), respectively.

Diffuse large cell lymphoma of B-cell type associated with reactive hemophagocytosis.

Some lymphomas, virtually all phenotypically of the T-cell type, have been associated with the phenomenon of hemophagocytosis. Only two B-cell lymphomas, one T-cell-rich and the other an angiocentric lymphoma, have been observed to exhibit this phenomenon. A case is reported of a diffuse large cell lymphoma of the B-cell type associated with reactive hemophagocytosis.

Near-hanging caused by a toy necklace.

Hanging injuries and fatalities are rare among children and are usually unintentional. In this report we describe a 23-month-old girl who almost died when she accidentally hanged herself with a popular toy necklace, and we discuss recent epidemiological trends in accidental strangulations among children. This case emphasizes the need for increased awareness among consumers, health care providers, and product manufacturers about the dangers of toys such as the one described here.

Postantibiotic effect of ceftibuten on respiratory pathogens.

The postantibiotic effect (PAE) of ceftibuten, a novel beta-lactamase-stable cephem, was determined for Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. The ceftibuten PAE after a 2-hour exposure to 2 micrograms/ml (4 x minimum inhibitory concentration) for S. pyogenes was 2.

Detection of Mycobacterium tuberculosis in sputum, pleural and bronchoalveolar lavage fluid using DNA amplification of the MPB 64 protein coding gene and IS6110 insertion element.

Two gene sequences specific for Mycobacterium tuberculosis were evaluated for the diagnosis of pulmonary tuberculous (PTB) in pleural fluid (PF), bronchoalveolar lavage fluid (BAL) and sputum (Sp). The 240 bp sequence (nts 460-700) coding for the MPB 64 protein coding gene and the 123 bp IS6110 insertion element present in multiple copies in the mycobacterial genome were amplified using the polymerase chain reaction. Fifty-nine clinical specimens were studied.

Colonic histiocytic neoplasm mimicking malignant histiocytosis and presenting as intussusception.

It is now apparent that distinction between the so-called malignant histiocytosis and lymphoma can be made using panels of established immunohistochemical markers and/or genotypic analysis. Many, if not all, of the previously diagnosed cases of malignant histiocytosis have been shown to be of lymphoid, rather than histiocytic, lineage. We report a rare case of colonic histiocytic neoplasm accompanied by a lymphoreticular dissemination that mimicked that of malignant histiocytosis.

Sequence analysis of leukotoxin secretion determinants from a Pasteurella haemolytica-like organism.

The pHLBD genes encoding the secretion functions for the 105 kDa RTX leukotoxin of Pasteurella haemolytica-like (PHL) organism has been cloned and sequenced. Like analogous genes from other RTX determinants, the pHLBD genes lie immediately downstream from the leukotoxin structural gene, pHLA. Although isolated from a diverse group of gram-negative organisms, the pHLBD genes and the characterized RTX BD genes from other organisms exhibit a high degree of homology at both the DNA and predicted amino acid sequence levels.

In vitro activity of SCE-2787, a new cephalosporin with potent activity against Pseudomonas aeruginosa and members of the family Enterobacteriaceae.

The in vitro activity of SCE-2787, 7-[(Z)-2-(5-amino-1,2,4-thiadiazol-3- yl)-2-methoxyiminoacetamido]-3-(1-imidazo[1,2-b]pyridazinium)methy l-3- cephem-4-carboxylate, was compared with those of ceftazidime, ceftriaxone, and imipenem against recent clinical isolates. SCE-2787 inhibited 50% of tested isolates of the family Enterobacteriaceae at < or = 0.25 micrograms/ml.

In vitro activity of the new fluoroquinolone CP-99,219.

The in vitro activity of the new fluoroquinolone CP-99,219 [7-(3-azabicyclo[3.1.0]hexyl)naphthyridone] was compared with those of four other quinolones against 541 gram-negative, 283 gram-positive, and 70 anaerobic bacterial isolates.

Pulmonary blastoma in an adult presenting as a chronic loculated effusion: a diagnostic problem.

A 33 year old woman posed a diagnostic problem for two years with recurrent left sided chest pain and radiographic features suggestive of a loculated effusion. Diagnosis was finally made at thoracotomy which revealed an encapsulated cystic mass. Histological examination confirmed a rare monomorphic pulmonary blastoma.

Comparison of employees' white blood cell counts in a petrochemical plant by worksite and race.

To determine if employment within a petrochemical plant's quality control (QC) laboratory had any significant effect on the hematopoietic system, and in specific, the white blood cell (WBC) counts, all employees of the QC laboratory were evaluated retrospectively. Trend analysis, linear regression, and Students t tests were performed on all employees of the QC laboratory and on a simple random sample of the rest of this Caribbean petrochemical plant's male employees. Trend analyses revealed a downward trend in 82.

Spread of spinal anaesthesia with 0.5% bupivacaine: influence of the vertebral interspace and speed of injection.

Three millilitres of plain 0.5% bupivacaine were injected intrathecally at two different spinal interspaces (L2/3 and L4/5) and at two different speeds (15 and 30 sec) in four groups of ten patients. Injection at L2/3 over 15 sec produced a significantly higher mean maximum spread of analgesia (T6.

Idiopathic lipoid pneumonia in an adult treated with prednisolone.

The treatment of lipoid pneumonia, an uncommon chronic lung condition, is generally conservative. We describe a patient with idiopathic lipoid pneumonia who was successfully treated with oral steroids with improvement of chest radiographic abnormalities.

Moraxella catarrhalis respiratory infection in adults.

Moraxella catarrhalis (MC) is an upper respiratory tract commensal which may also be pathogenic. In this report we examined the clinical features, microbiology and therapeutic response in 30 consecutive adult patients with pneumonia who had MC isolated in the sputum. The mean age was 66 years with an equal sex ratio.