Oligosaccharide sequences attached to an inert support (SYNSORB) as potential therapy for antibiotic-associated diarrhea and pseudomembranous colitis.

Toxin A produced by Clostridium difficile, the causative agent of pseudomembranous colitis and antibiotic-associated diarrhea, was shown to bind to synthetic oligosaccharide sequences attached to an inert support (SYNSORB). The oligosaccharide sequences that bind to toxin A were related to sequences previously identified as potential receptors for the toxin. Various SYNSORBs containing a variety of oligosaccharides were examined for their potential to neutralize toxin A activity from toxin-containing solutions as well as clinical stool samples from patients with either pseudomembranous colitis or antibiotic-associated diarrhea.

Magnetic resonance imaging-enhancing lesions of the labyrinth and facial nerve. Clinical correlation.

Objective: Gadolinium-enhanced magnetic resonance imaging (MRI) is useful in assessing inflammatory and neoplastic lesions of the labyrinth and facial nerve. The following cases demonstrate the ability of MRI to differentiate neoplastic from inflammatory lesions within the labyrinth.

Patients Or Other Participants: Nine patients were selected with enhancing lesions of the labyrinth and the facial nerve identified on MRI.

Adhesion of hard spheres under the influence of double-layer, van der Waals, and gravitational potentials at a solid/liquid interface.

The deposition process of colloidal particles or microorganisms on flat surfaces is analyzed by means of computer simulations. Interparticle interactions (double layer and van der Waals) and weak gravitational forces are taken into account; hydrodynamic interactions, on the other hand, are neglected. In particular, the deposition probability as a function of the deposition location of a particle in the presence of one or two identical fixed particles is discussed.

Computed tomographic diagnosis of X-linked congenital mixed deafness, fixation of the stapedial footplate, and perilymphatic gusher.

Stapes surgery for fixed footplate associated with X-linked congenital mixed hearing loss usually results in a "gusher" and severe worsening of hearing. Four patients with X-linked deafness were diagnosed by the characteristic temporal bone computed tomography (CT) findings of enlarged internal auditory canal, hypoplasia of the cochlear base, absent bony modiolus, abnormal vestibular aqueduct, and enlarged labyrinthine facial nerve canal. Three patients were scanned after stapes surgery resulted in a gusher and, in two patients, severe worsening of their hearing loss.

Apparent lower rates of streptococcal toxic shock syndrome and lower mortality in children with invasive group A streptococcal infections compared with adults.

Since 1985 there have been worldwide reports of increases in severe invasive Group A streptococcal (IGAS) infections. We reviewed the charts of all children with IGAS infections (defined as isolation of Group A streptococcus from a normally sterile site) presenting to our institution over a 7-year period (January, 1985, to December, 1991) and the literature. Streptococcal toxic shock syndrome required hypotension and multisystem organ involvement.

Pharmacokinetic profile of a new fluoride preparation: sustained-release monofluorophosphate.

The pharmacokinetic profiles of a sustained-release monofluorophosphate (MFP-SR) preparation (76 mg) and of plain MFP (76 mg) were compared in six osteoporotic females. These studies were performed in a randomized, crossover, double-blind design to select a preparation that would result in therapeutic serum levels while avoiding high serum peak values. Following a single dose of 76 mg MFP-SR, the serum fluoride levels remained within the accepted therapeutic range (5-10 microM/liter) for 24 hours.

Utility of thallium-201 and iodine-123 metaiodobenzylguanidine in the scintigraphic detection of neuroendocrine neoplasia.

Metaiodobenzylguanidine (MIBG) is a specific marker for neuroendocrine tumours, such as phaeochromocytoma, neuroblastoma, medullary thyroid cancer (MTC) and paraganglioma, but it suffers in some cases (especially in MTC) from a lack of sensitivity. Thallium is a well-known marker of cellularity with a great sensitivity and a lack of specificity. In order to determine whether the association of these two markers is able to improve the detection of neuroendocrine lesions, 137 scintigraphic examinations using MIBG and thallium were performed in 101 patients referred for suspicion or follow-up of neuroendocrine tumours.

Coexistence of Paget's bone disease and diffuse idiopathic skeletal hyperostosis in males.

The coexistence of Paget's bone disease (PBD) and diffuse idiopathic skeletal hyperostosis (DISH) of the spine is controversial and could have implications for the pathogenic mechanisms involved in these disorders. In order to assess the prevalence of DISH in patients with Paget's disease, a prospective controlled study was carried out in which roentgenograms were obtained from a group of 50 consecutive ambulatory patients previously diagnosed as having PBD (25 males and 25 females; mean age: 66.2 +/- 8.

Antibody detection errors due to acidic or unbuffered saline.

Isotonic saline solutions, buffered with potassium phosphate or sodium phosphate salts, were evaluated in parallel with unbuffered saline to determine if they improved antibody detection by solid phase red cell adherence or hemagglutination methods. Saline buffered to a pH of 7.0 to 7.

A case of ocular ischaemic syndrome in a young insulin dependent diabetic male.

It is well known that diabetic patients are at an increased risk of the earlier development of significant atherosclerotic disease. We wish to report the case of a young insulin-dependent diabetic with an 18 months history of rapidly progressing 'diabetic' retinopathy who presented with right-sided weakness and was found to have severe carotid artery disease. We suggest that the sudden proliferation in his retinopathy was due to retinal ischaemia secondary to the carotid artery stenosis and we wish to present this as a case of ocular ischaemic syndrome in a young diabetic patient.

Aggressive toxoplasma retinitis.

Toxoplasma infection is a common cause of infectious uveitis. It usually produces a characteristic fundal appearance, with evidence of previous inflammation. However, it may occur in an atypical and aggressive form.

Bone-resorption markers galactosyl hydroxylysine, pyridinium crosslinks, and hydroxyproline compared.

We compared the clinical performances of four bone-resorption (BR) assays (hydroxyproline, HYP; galactosyl hydroxylysine, GHYL; deoxypyridinoline, DPD; and pyridinoline, PYD) in subjects with different BR rates: normal (adult men and premenopausal women), mildly increased (postmenopausal osteoporotic women), high (Paget disease patients), and very high (children). The discrimination power (Z score) and the accuracy (estimated by receiver-operating characteristic analysis) for GHYL, DPD, and PYD were compared with those for HYP. Discrimination power and accuracy were similar for high- and very-high-BR groups for all four assays.

Spinal fractures during fluoride therapy for osteoporosis: relationship to spinal bone density.

Recent studies report that fluoride therapy for osteoporosis increases spinal bone density without improving vertebral fracture rate, challenging the notion that restoration of bone mass improves bone fragility. To further evaluate this issue, the relationship between spinal bone density and vertebral fracture rate was examined in a large number of fluoride-treated, osteoporotic patients. A retrospective assessment was made of clinical data collected from our observations of 389 osteoporotics treated with fluoride 30 +/- 8 mg/day (mean +/- SD) (equivalent to 66 +/- 17 mg NaF/day) and calcium 1500 mg/day for 28 +/- 18 months.

Choroidal neurofibromatosis with congenital iris ectropion and buphthalmos: relationship and significance.

We report a case of unilateral buphthalmos in neurofibromatosis-1 without the other classical characteristics of the François syndrome (triad of unilateral buphthalmos, homolateral eyelid plexiform neuroma, and homolateral facial hemihypertrophy) and emphasize the difficulties in early diagnosis. The painful buphthalmic right eye was enucleated at the age of 13 months. Histopathology demonstrated diffuse choroidal neurofibromatosis in association with congenital iris ectropion syndrome.