Treatment of Multidrug-Resistant Vancomycin-Resistant Enterococcus faecium Hardware-Associated Vertebral Osteomyelitis with Oritavancin plus Ampicillin.

Weekly oritavancin plus ampicillin continuous infusion combination therapy was used to successfully treat a deep spine vancomycin-resistant infection associated with hardware. Checkerboard and time-kill assays confirmed synergy between these two antibiotics. Further synergies of oritavancin and ampicillin with rifampin or the endogenous human antimicrobial peptide cathelicidin LL-37 were demonstrated.

Retrospective Review of Billowing Phenomenon-A Mimic of Endoleak Following Placement of Endologix Covered Stent for the Treatment of Abdominal Aortic Aneurysm.

Background: Billowing is a unique computed tomography (CT) finding of the Endologix stent graft where a rim of contrast is observed outside the stent's endoskeleton but still contained within the graft cover. The purpose of this study is to evaluate the incidence and clinical outcome of billowing following an Endologix stent-graft placement.

Methods: All patients who underwent abdominal aortic aneurysm (AAA) repair with endovascular placement of an Endologix stent graft from January 2002 to September 2013 and who were followed with imaging were included in the study.

Distal Radial Artery Embolization: An Alternative Approach towards Access Preservation and Limb Salvage in Radiocephalic Arteriovenous Fistulae Complicated by Steal Syndrome.

The incidence of radiocephalic arteriovenous fistulae complicated by ischemic steal syndrome is low; however, its sequelae can be quite devastating. Traditional management includes open ligation of the distal radial artery. This series details 4 cases of successful embolization of the distal radial artery for flow interruption to treat ischemic steal syndrome and salvage functional dialysis access.

Uremic pericarditis: a report of 30 cases and review of the literature.

Patient: Male, 71 • Male, 69 • . Female, 49.

Final Diagnosis: Uremic pericarditis.

Fatal pulmonary embolism after hemodialysis vascular access declotting.

Patient: Male, 59 FINAL DIAGNOSIS: Pulmonary embolism Symptoms: Cardiac arrest • chest pain • dyspnea

Medication: - Clinical Procedure: Angioplasty Specialty: Nephrology.

Objective: Rare disease.

Background: Vascular access is the lifeline of hemodialysis patients and access problems are a major source of morbidity and mortality for these patients.

Strongyloides stercoralis infection in transplanted patients.

Patient: Male, 36.

Final Diagnosis: Strongyloidiasis.

Symptoms: Abdominal pain • anorexia • eosinophilia • fever • letargy • weight loss.

Ion-selective electrode and anion gap range: What should the anion gap be?

Background: Using flame photometry technique in the 1970s, the normal value of anion gap (AG) was determined to be 12 ± 4 meq/L. However, with introduction of the autoanalyzers using an ion-selective electrode (ISE), the anion gap value has fallen to lower levels.

Methods: A retrospective study of US veterans from a single medical center was performed to determine the value of the anion gap in subjects with normal renal function and normal serum albumin and in patients with lactic acidosis and end-stage renal disease on dialysis.

Gemcitabine induced hemolytic uremic syndrome.

Background: Gemcitabine is frequently used for the treatment of many cancers. Not infrequently it leads to development of hemolytic uremic syndrome, presenting with hemolytic anemia, acute kidney injury and occasionally peripheral edema, livedo reticularis and digital necrosis.

Case Report: A 78 year old man with non-small cell lung cancer developed uremic syndrome following treatment with multiple chemotherapy agents including gemcitabine.

Moraxella Catarrhalis peritonitis.

Background: Peritonitis continues to be a major complication of peritonitis in peritoneal dialysis patients. Recent advances in connectology and better patient training have decreased the incidence of peritonitis in the last two decades. Peritonitis in PD patients is usually due to gram positive and less often due to gram negative organisms.

A comparative study of the prevalence of hyperkalemia with the use of angiotensin-converting enzyme inhibitors versus angiotensin receptor blockers.

Background And Objectives: Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are increasingly used in a variety of settings including heart failure, renal failure, arterial hypertension, and diabetic nephropathy. The objective of this study was to investigate the prevalence of hyperkalemia with ACEI and ARB use, in a population of the United States veterans. DESIGN, SETTINGS, MATERIAL, AND MEASUREMENTS: Retrospective observational cohort study of 1163 patients on ACEIs and 1168 patients on ARBs in a single Veterans Affairs Medical Center.

Oxidative stress: a potential basis for potentiation of noise-induced hearing loss.

In the past two decades, researchers have determined that a broad range of environmental and occupational contaminants can interact with noise to enhance noise-induced hearing loss. This manuscript focuses upon the hypothesis that chemicals that promote oxidative stress might increase the risk of noise-induced hearing loss. Evidence is presented that confirms the role of oxidative stress in the production of hearing loss by both carbon monoxide and by acrylonitrile when noise is present at the time of chemical exposure.

Mediolateral graft tympanoplasty for anterior or subtotal tympanic membrane perforation.

Objective: To describe and evaluate the mediolateral graft tympanoplasty for the reconstruction of anterior or subtotal tympanic membrane (TM) perforation.

Study Design And Setting: Retrospective study of 100 patients who underwent the mediolateral graft tympanoplasty at community and tertiary care centers from 1995 to 2001. All patients underwent preoperative and postoperative audiograms.

In vivo and in vitro evidence that the high osteoblastic activity in C3H/HeJ mice compared to C57BL/6J mice is intrinsic to bone cells.

Two inbred mouse strains, C3H/HeJ (C3H) and C57BL/6J (B6), displayed a profound difference in femoral peak bone density. We have previously shown that the difference could be attributed to a greater bone formation rate (BFR) that was due to a higher osteoblastic activity [measured by a mineral apposition rate (MAR)] in the C3H (high density) than B6 (low density) mice. The present study sought to determine (1) whether the BFR/MAR differences between the two mouse strains present in weight-loaded endochondral bones are also seen in less weight-loaded membranous bones and (2) whether the difference in osteoblastic activity was seen in vitro in the absence of systemic factors.

Reconstruction of mastoidectomy defect with titanium mesh.

Objective: Intact-canal-wall mastoidectomy procedures leave an unsightly depression in the postauricular area. Until now, there have been few reports of successful reconstruction of mastoidectomy defects, and none using titanium mesh. When secondary mastoidectomy is not anticipated, as in endolymphatic sac shunt procedures, the postauricular defect resulting from mastoidectomy can be eliminated by reconstruction using titanium mesh.

Effect of platelet activating factor with and without receptor antagonist (WEB2170) on morphology of isolated cochlear outer hair cells.

Platelet activating factor (PAF), generated from biologically active phospholipids, has been implicated as a potent inflammatory mediator and has been shown to be involved in many pathological processes, especially in inflammation and allergy. It has been suspected that PAF may be one of the inflammatory mediators in middle ear effusion that can induce sensorineural hearing loss, as observed in chronic otitis media. The PAF receptor antagonist WEB2170 has been studied extensively, and its inhibitory effects against various PAF actions are well proven in otologic systems.

Effect of inhibitors of leukotriene and/or platelet activating factor on killed H. influenzae induced experimental otitis media with effusion.

Our previous studies have shown that leukotriene (LT) and platelet activating factor (PAF) are important inflammatory mediators (IMs) in the pathogenesis of otitis media with effusion (OME). The purpose of this study was to determine the effect of a LT-inhibitor and/or PAF-antagonist on experimentally induced OME by killed H. influenzae in chinchillas.

Effects of nitric oxide on morphology of isolated cochlear outer hair cells: possible involvement in sensorineural hearing loss.

Hypothesis: One of the inflammatory mediators of otitis media, nitric oxide, can damage cochlear outer hair cells.

Background: Free radicals, including nitric oxide, have been detected in middle ear effusion. Increasing evidence implicates free radicals in the pathogenesis of otitis media and possibly in the development of sensorineural hearing loss.

Effect of round window membrane application of nitric oxide on hearing and nitric oxide concentration in perilymph.

Nitric oxide (NO), a free radical, has been found to be important in the development of middle ear effusions. However, the effect of NO in the middle ear effusion on cochlear function and on perilymph concentrations of NO has not been reported. We placed S-nitroso-N-acetylpenicillamine (SNAP), a NO donor compound, on the round window membrane (RWM) of adult chinchillas.

Abnormalities of serum antielastin antibodies in connective tissue diseases.

Background: Antibodies (Abs) to alpha-elastin (elastin breakdown product) and tropoelastin (elastin precursor) are found in the serum of all human subjects and correlate with their respective serum peptide levels; however, peptide levels vary with age and some disease states. This study was undertaken to determine if serum elastin Abs, peptides, and elastin metabolism were altered in autoimmune diseases by detecting a changing ratio of serum anti-alpha:tropoelastin Ab levels.

Methods: Serum from patients with a variety of connective tissue diseases, including 28 with systemic lupus erythematosus (SLE), 24 with scleroderma, 18 with rheumatoid arthritis (RA), 10 with polymyositis, and 39 with vasculitis, was compared with serum from 19 age-matched healthy subjects for levels of antitropoelastin and anti-alpha-elastin Abs.

Apoptosis may determine the release of skeletal alkaline phosphatase activity from human osteoblast-line cells.

Although quantitative measurement of skeletal alkaline phosphatase (sALP) activity in serum can provide an index of the rate of bone formation, the metabolic process that determines the release of sALP - from the surface of osteoblasts, into circulation-is unknown. The current studies were intended to examine the hypothesis that the release of sALP from human osteoblasts is a consequence of apoptotic cell death. We measured the release of sALP activity from human osteosarcoma (SaOS-2) cells and normal human bone cells, under basal conditions and in response to agents that increased apoptosis (TNF-a, okadiac acid) and agents that inhibit apoptosis (IGF-I, calpain, and caspase inhibitors).

Quantitation of soluble and skeletal alkaline phosphatase, and insoluble alkaline phosphatase anchor-hydrolase activities in human serum.

Background: The current studies were intended to compare the circulating levels of total and anchorless (soluble) skeletal and hepatic ALP isoenzyme activities, and insoluble ALP anchor-hydrolase activity in serum of postmenopausal women.

Methods: Preliminary studies of the insoluble ALP anchor-hydrolase activity in serum revealed a pH optimum of pH 5-6.5, a sensitivity to inactivation by heat at temperatures >45 degrees C (t(1/2)=8-9 min at 60 degrees C), and an apparent K(M) (at pH 7.

Circulating antibodies to guanosine in systemic lupus erythematosus: correlation with nephritis and polyserositis by acute and longitudinal analyses.

Systemic lupus erythematosus (SLE) is characterized by autoantibodies, including antibodies to the nucleosides of DNA. Guanosine is the most immunogenic nucleoside. In this study serum antiguanosine antibody levels were compared with disease activity, determined by their SLEDI score, in 86 patients with SLE.

Effects of dietary calcium depletion and repletion on dynamic determinants of tibial bone volume in two inbred strains of mice.

As an adjunct to our efforts to identify the genes that determine peak bone density, we examined phenotypic differences between two inbred strains of mice, C3H/HeJ (C3H) and C57BL/6J (B6), which are of similar size but differ with respect to peak bone density (e.g., C3H mice have 53% higher femoral bone density than B6 mice).

Exercise and mechanical loading increase periosteal bone formation and whole bone strength in C57BL/6J mice but not in C3H/Hej mice.

To identify the genes, and the mechanisms that account for the 53% higher peak bone density in C3H/HeJ (C3H) mice compared with C57BL/6J (B6) mice, we are performing quantitative trait locus and phenotypic analyses. The phenotypic studies revealed differences in bone formation and resorption, and showed that hindlimb immobilization (by sciatic neurectomy) caused a greater increase in endosteal resorption in the tibiae of B6 compared with C3H mice. The current studies were intended to examine the hypothesis that the bones of C3H mice are less sensitive to mechanical loading than the bones of B6 mice.

Morphine and gastroduodenal motility.

This study investigated the effects of intravenous morphine on gastric antral and duodenal motility in healthy volunteers. Intravenous morphine (both infusion and bolus) increased duodenal motility, typically as bursts of contractions similar to phase III of the migrating motor complex. Intravenous infusion of morphine 40 microg/kg/hr rapidly increased duodenal motility in nine of 10 subjects; in eight it was phase III-like.