Bactericidal action of oral ampicillin/sulbactam against Mycobacterium leprae.

We reported previously that an injectable form of ampicillin/sulbactam, Unasyn, was bactericidal to Mycobacterium leprae multiplying in mouse foot pads. In this study, we examined the effect of an orally active form of ampicillin/sulbactam, Sultamicillin, on the growth of M. leprae in mice.

Oropharyngeal leprosy in art, history, and medicine.

Advanced lesions of the face, nasopharynx, and oropharynx have played an important role in the medical and social history of Hansen's disease. Renaissance artists included detailed portrayals of these lesions in some of their paintings, a testimony not only to their artistic skill and powers of observation but also to the common presence of these patients in European cities and towns of the period. The disease is now understood as a broad immunologic spectrum of host responses to Mycobacterium leprae, with a variety of clinical and pathologic manifestations in nerve, soft tissues, and bone.

Leprosy.

Leprosy is an ancient disease which is still poorly understood and often feared by the general public and even by some healthcare professionals. Fortunately, improvements in the management of leprosy over the past three decades have diminished the stigma and greatly altered the outlook for patients. Public understanding of the disease has benefited from WHO's goal of eliminating leprosy as a public health problem by the year 2000.

Evaluation of multidensity orthotic materials used in footwear for patients with diabetes.

Selected combinations of multidensity orthotic materials were tested under simulated walking conditions found in the forefoot of diabetic patients. Materials were compared for therapeutic effectiveness by their stress/strain properties and dynamic compression set. Results showed that all of the multidensity materials experienced losses in performance throughout the testing period of 100,000 cycles, with the greatest losses occurring within the first 10,000 cycles.

Evaluation of a self-administered sensory testing tool to identify patients at risk of diabetes-related foot problems.

Objective: To study the use of a self-administered sensory testing tool designed to identify individuals at risk for diabetes-related foot problems and determine the inter-rater reliability between patient and provider sensory evaluations.

Research Design And Methods: Nine centers in eight states with established foot prevention centers mailed 196 self-screening testing materials to randomly selected patients with diabetes scheduled for follow-up appointments. Patients were instructed to perform a sensory test using a 10-g nylon filament at specified sites on the foot and to complete a brief survey form before their appointment.

Green fluorescent protein reporter microplate assay for high-throughput screening of compounds against Mycobacterium tuberculosis.

An optimal assay for high-throughput screening for new antituberculosis agents would combine the microplate format and low cost of firefly luciferase reporter assays and redox dyes with the ease of kinetic monitoring inherent in the BACTEC system. The green fluorescent protein (GFP) of the jellyfish Aequorea victoria is a useful reporter molecule which requires neither substrates nor cofactors due to the intrinsically fluorescent nature of the protein. The gene encoding a red-shifted, higher-intensity GFP variant was introduced by electroporation into Mycobacterium tuberculosis H37Ra and M.

Evaluation of a polymerase chain reaction-based universal heteroduplex generator assay for direct detection of rifampin susceptibility of Mycobacterium tuberculosis from sputum specimens.

In a double-blind study, 655 sputum specimens were obtained from individuals suspected of having tuberculosis and were analyzed for the presence of Mycobacterium tuberculosis and rifampin susceptibility with use of a polymerase chain reaction (PCR)-based universal heteroduplex generator assay (PCR/UHG-Rif). Of the specimens containing viable M. tuberculosis, 100% of the smear-positive (n = 41) and 50% of the smear-negative (n = 6) specimens tested positive for the organism by PCR/UHG-Rif.

The force/time relationship of clinically used sensory testing instruments.

The stimuli of commonly used sensibility measurement instruments tested in this study demonstrate unequivocally that "hand-held instruments" produce variations in application force from one stimulation to another, one instrument to another, and from one examiner to another. These application force variations cannot be compensated for by care in technique and need to be controlled for measurement reliability. Only the Semmes-Weinstein monofilaments provide some control of force during application and can be considered force controlled if calibrated and applied correctly.

Microplate alamar blue assay versus BACTEC 460 system for high-throughput screening of compounds against Mycobacterium tuberculosis and Mycobacterium avium.

In response to the need for rapid, inexpensive, high-throughput assays for antimycobacterial drug screening, a microplate-based assay which uses Alamar blue reagent for determination of growth was evaluated. MICs of 30 antimicrobial agents against Mycobacterium tuberculosis H37Rv, M. tuberculosis H37Ra, and Mycobacterium avium were determined in the microplate Alamar blue assay (MABA) with both visual and fluorometric readings and compared to MICs determined in the BACTEC 460 system.

Effects of essential fatty acid deficiency on prostaglandin E2 production and cell-mediated immunity in a mouse model of leprosy.

Results from animal and in vitro studies suggest that essential fatty acid (EFA) deficiency enhances cell-mediated immunity by reducing production of prostaglandins with immunosuppressive actions. However, direct experimental evidence that EFA deficiency enhances T-lymphocyte function in vivo has not been obtained. In this study, athymic (nu/nu) mice were infected in the footpads with Mycobacterium leprae and fed a linoleic acid-free diet.

Comparison of the roles of reactive oxygen and nitrogen intermediates in the host response to Mycobacterium tuberculosis using transgenic mice.

Objective: To study the role of reactive oxygen intermediates (ROI) and reactive nitrogen intermediates (RNI) in host response to Mycobacterium tuberculosis.

Design: M. tuberculosis infection (i.

Needed research in chemotherapy of leprosy related to the individual patient.

The chemotherapy of leprosy was rendered markedly more effective by the introduction of WHO/MDT in 1981. The prospects for further improvements, both by shortening duration and by developing fully supervisable intermittent regimens, appear good at this time. These developments should aid the efforts to attain the goal of elimination of leprosy as a public health problem.

Granulomas Induced by Mycobacterium leprae.

Leprosy, a chronic infectious disease caused by Mycobacterium leprae, affects primarily the skin, mucous membranes, and peripheral nerves. It is characterized by a spectrum of symptoms, largely a result of the immunological response of the host to the antigens of M. leprae.

Thalidomide can be either agonistic or antagonistic to LPS evoked synthesis of TNF-alpha by mononuclear cells.

The effect if thalidomide on tumor necrosis factor alpha (TNF-alpha) produced in vitro by lipopolysaccharide (LPS) stimulated human cells was investigated. In cultures of LPS stimulated human mononuclear cells enriched for adherent cells and in cultures of LPS stimulated human monocytes of the cell line-THP-1, thalidomide enhanced the synthesis of TNF-alpha. When cultures of unfractionated peripheral blood mononuclear cells were stimulated with LPS, thalidomide decreased the synthesis of TNF-alpha.

A virtual five-link model of the thumb.

Most researchers have modelled the thumb as three rigid links with connections of two universal joints (carpometacarpal joint and metacarpo-phalangeal joint), and a hinge joint (interphalangeal joint). Although this produces the required number of degrees of freedom, the resulting motion is not anatomically accurate. In this work, the thumb is modelled as a five-link manipulator with the virtual links connected by hinge joints-one for each degree of freedom of the thumb.

First ray joint limitation, pressure, and ulceration of the first metatarsal head in diabetes mellitus.

Measurements of first ray mobility, pressure, and other variables were made on 19 diabetic patients with a history of ulceration at the first metatarsal head, 20 diabetic patients with a history of ulceration at other locations of the forefoot, 19 matched diabetic controls, and 19 matched nondiabetic controls. Patients with a history of first metatarsal head ulceration had significantly less first ray mobility and significantly higher pressure at the first metatarsal head compared with the other groups. Regression analysis found a moderate inverse linear relationship between first ray dorsiflexion and peak pressure at the first metatarsal head (R2 = 0.

Threshold detection and Semmes-Weinstein monofilaments.

Semmes-Weinstein monofilaments provide a repeatable instrument stimulus with a small standard deviation in contrast to other handheld test instruments, making them an optimum choice for objective sensory testing in a variety of clinics. Normal sensory detection thresholds for the entire body, and the stimulus force for each filament, were determined by Weinstein. He found a nylon filament of 0.

Application of biomechanics to tendon transfers.

This article has focused on considerations important in the application of biomechanics to tendon transfers and has used an example protocol. Different surgeries require different protocols. What is most important is that specific protocols are used, and that they are both safe and effective.

Exacerbation of acute and chronic murine tuberculosis by administration of a tumor necrosis factor receptor-expressing adenovirus.

Tumor necrosis factor (TNF) plays a pivotal role in inflammatory phenomena that culminate in either pathogenesis or resistance in mycobacterial disease. The regulatory role of TNF in murine tuberculosis was examined by administering a recombinant adenovirus encoding a fusion protein consisting of the human 55-kDa TNF receptor extracellular domain and the mouse IgG heavy chain domain (AdTNFR). During acute infections with Mycobacterium tuberculosis, AdTNFR pretreatment induced elevated mycobacterial burdens of 1 log10 in the tissues of H37Ra-infected mice and 2 log10 (spleen and liver) and 4 log10 (lungs) in H37Rv-infected mice.

Thalidomide does not perturb CD2, CD4, CD5, CD8, HLA-DR, or HLA-A, B, C molecules in vitro on the membranes of cells with immune potential.

Thalidomide dramatically relieves the signs and symptoms of erythema nodosum leprosum (ENL). ENL is an acute inflammatory complication of lepromatous leprosy. The cause(s) of ENL as well as the mechanism of action of thalidomide in arresting ENL are unknowns.