Nasal immunization with group B streptococci can induce high levels of specific IgA antibodies in cervicovaginal secretions of mice

We have studied the cervicovaginal antibody responses in mice, by ELISA, following mucosal immunizations with group B streptococci (GBS) serotype III/R4. Immunizations were carried out either: (1) rectally with GBS alone; (2) rectally with GBS plus cholera toxin (CT); (3) nasally with GBS alone; (4) nasally with GBS+CT; or (5) nasally under general anesthesia with GBS+CT. Nasal immunizations with GBS alone led to at least tenfold higher levels of specific IgA-antibodies to GBS in cervicovaginal secretions than with any other immunization. These mucosal antibody levels were higher than after rectal immunizations, and 2-17 times higher than the corresponding IgA antibody levels in sera. Markedly lower cervicovaginal antibody levels were found in mice which had received GBS together with CT as a mucosal adjuvant than in mice immunized by the same routes with GBS alone. Our observations indicate that a nasal vaccine consisting of GBS might induce sufficient antibody levels to protect against genital colonization of these bacteria.     

Cytologic diagnosis of transitional cell carcinoma of the urinary bladder. Comparison with endoscopical and pathological findings on 538 cases

There were investigated 583 cases with tumors of the urinary bladder and 612 patients with non-malignant diseases of the urinary tract. Samples of voided urine were taken from all cases and direct smears fixed by drying were stained by rapid blue polychrome-tanin Dr?gan method Cytological results were compared with endoscopical and pathological findings. The overall rate of real positive results was 91.7% and false negative results were noticed in 8.3% of cases. A direct relationship between real positive results and histological "G" was found. Causes for false negative results were: tumor developed in a bladder diverticulum, calcified tumor, irradiated tumor, insufficient quantity of voided urine, chronic urinary infections and underestimation of cytological criteria of cellular malignancy. There were 9 false positive results in patients with nonmalignant diseases, due to lithiasis, chronic renal failure and chronic urinary infections. The cytological grade of differentiation was performed by the method purposed by Friedman and Ash, and concordance with the standard histological finding was 76.4%. Urine cytology is thought to be a useful method in the primary diagnosis and recurrences of transitional cell carcinoma of the urinary bladder, in all patients with hematuria, recurrent infections of the urinary tract and neglected lithiasis.     

Use of lambda phage DNA as a hybrid internal control in a PCR-enzyme immunoassay to detect Chlamydia pneumoniae

An inherent problem in the diagnostic PCR assay is the presence of ill-defined inhibitors of amplification which may cause false-negative results. Addition of an amplifiable fragment of foreign DNA in the PCR to serve as a hybrid internal control (HIC) would allow for a simple way to identify specimens containing inhibitors. Two oligonucleotide hybrid primers were synthesized to contain nucleic acid sequences of the Chlamydia pneumoniae 16S rRNA primers in a position flanking two primers that target the sequences of a 650-bp lambda phage DNA segment. By using the hybrid primers, hybrid DNA comprising a large sequence of lambda phage DNA flanked by short pieces of chlamydia DNA was subsequently generated by PCR, cloned into a plasmid vector, and purified. Plasmids containing the hybrid DNA were diluted and used as a HIC by adding them to each C. pneumoniae PCR test. Consequently, C. pneumoniae primers were able to amplify both chlamydia DNA and the HIC DNA. The production of a 689-bp HIC DNA band on an acrylamide gel indicated that the specimen contained no inhibitors and that internal conditions were compatible with PCR. Subsequently, a biotinylated RNA probe for the HIC was transcribed from a nested sequence of the HIC and was used for its hybridization. Detection of the HIC DNA-RNA hybrid was achieved by enzyme immunoassay (EIA). This PCR-EIA system with a HIC was initially tested with 12 previously PCR-positive and 14 previously PCR-negative specimens. Of the 12 PCR-positive specimens, 11 were reconfirmed as positive; 1 had a negative HIC value, indicating inhibition. Of the 14 previously PCR-negative specimens, 13 were confirmed as true negative; 1 had a negative HIC value, indicating inhibition. The assay was then used with 237 nasopharyngeal specimens from patients with pneumonia. Twenty-one of 237 (8.9%) were positive for C. pneumoniae, and 42 (17.7%) were found to inhibit the PCR. Specimens showing inhibitory activity were diluted 1:10 and were retested. Ten specimens were still inhibitory to the PCR and required further DNA purification. No additional positive samples were detected and 3 nasopharyngeal specimens remained inhibitory to PCR. Coamplification of a HIC DNA can help confirm true-negative PCR results by ruling out the presence of inhibitors of DNA amplification.     

Isolation of Chlamydia pneumoniae from the coronary artery of a patient with coronary atherosclerosis. The Chlamydia pneumoniae/Atherosclerosis Study Group

BACKGROUND: Atherosclerosis is pathologically similar to a chronic inflammatory response. Recent reports have suggested that Chlamydia pneumoniae may play a role in the pathogenesis of atherosclerosis. OBJECTIVE: To determine, by using various detection methods, whether C. pneumoniae is present in the coronary arteries of patients with coronary atherosclerosis. DESIGN: Multicenter investigation. SETTING: The Jewish Hospital Heart and Lung Institute in Louisville, Kentucky, and several laboratories. PATIENTS: 12 patients seeking heart transplantation. MEASUREMENTS: Culture for C. pneumoniae was done in HEp-2 cell monolayers. Other methods of detection included polymerase chain reaction (PCR) assay, immunocytochemistry, transmission electron microscopy, and in situ hybridization. RESULTS: Chlamydia pneumoniae was cultured from atherosclerotic plaques in one patient with severe coronary artery disease. The organism was found in the atheromas of this patient by PCR assay, immunocytochemistry, electron microscopy, and in situ hybridization. In addition, at least one testing method showed C. pneumoniae in coronary artery tissue in six of nine additional patients with coronary atherosclerosis. CONCLUSIONS: This study provides direct evidence of the presence of viable C. pneumoniae in atheromatous lesions. A chronic inflammatory response caused by a persistent infection of the coronary arteries may explain the link between C. pneumoniae and atherosclerosis.     

The diagnosis of Pneumocystis carinii pneumonia by cytologic evaluation of Papanicolaou and Leishman-stained bronchoalveolar specimens in patients with the acquired immunodeficiency syndrome

The presence of foamy alveolar casts or flocculent material in Papanicolaou and Leishman-stained smears of bronchoalveolar lavage (BAL) fluid is said to be indicative of infection with Pneumocystis carinii. We have investigated the sensitivity and specificity of this method of diagnosing pneumocystis pneumonia in patients with the acquired immunodeficiency syndrome (AIDS). Patients (n = 114) with diffuse lung infiltrates were submitted to fibreoptic bronchoscopy and BAL. Seventy of them were patients with AIDS. The other 44 individuals were not infected by the human immunodeficiency virus (HIV). Pneumocystis carinii organisms were identified on Grocott's methenamine silver (GMS)-stained BAL smears in 30 patients with AIDS. Flocculent material was present in the Papanicolaou and Leishman-stained smears from all of these cases. Conversely, P. carinii were not seen on GMS-stained smears in the remaining 84 individuals with or without AIDS. No flocculent material was observed in Papanicolaou or Leishman-stained smears in these 84 patients. We concluded that the presence of flocculent material in Papanicolaou or Leishman-stained smears of BAL fluid is indicative of P. carinii pneumonia in patients with AIDS.     

Coping with a diagnosis of multiple sclerosis.

Examined the relation between coping and depression in 38 women and 12 men (aged 21–58 yrs) recently diagnosed with multiple sclerosis (MS). A semistructured interview was used to assess how Ss coped with the onset of disabling illness, and to assess depressive symptomatology. According to Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) criteria, 18 Ss were diagnosed with major depression, 11 Ss were diagnosed with adjustment disorder with depressed mood, and 21 Ss did not satisfy the criteria for any affective disorder. Interview results indicate that nondepressed Ss were more likely to use present focus and avoidance/denial strategies to deal with illness onset than Ss with major depression or adjustment disorder. Discussion addresses why these strategies may be an adaptive means of dealing with the onset of MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of the stages of change in exercise adherence model among older adults with a cardiac diagnosis

Open-label buspirone was studied in 25 prepubertal psychiatric inpatients (age 8.0 +/- 1.8 years, 76% boys) presenting with anxiety symptoms and moderately aggressive behavior. Patients with severe aggression, requiring rapid treatment with mood stabilizers or neuroleptics, were excluded. A 3-week titration (maximum 50 mg daily) preceded a 6-week maintenance phase at optimal dose. Buspirone was discontinued in 6 children (25%): 4 developed increased aggression and agitation, and 2 developed euphoric mania. For the 19 patients who completed the study, mean optimal dose was 28 mg daily. Among completers, depressive symptoms were reduced 52% by Week 6 on Children's Depression Inventory (p < or = 0.001). Decreased aggressivity was reflected in a 29% reduction on Measure of Aggression, Violence, and Rage in Children [MAVRIC] ratings (p < or = 0.02) and in 86% less time in seclusion or physical restraints (p < or = 0.02). Clinical Global Assessment scores improved (CGAS 41 vs. 54, p < or = 0.01). Only 3 children improved sufficiently to continue buspirone after the study. Residual aggressivity and global functioning remained problematic. Buspirone may pose behavioral risks in treating moderate aggressivity in 24% of children with anxiety; in the others, the therapeutic effects on aggression, anxiety, and depression were limited but significant.     

Comparison of two serological methods and a polymerase chain reaction-enzyme immunoassay for the diagnosis of acute respiratory infections with Chlamydia pneumoniae in adults

Chlamydia pneumoniae is a common respiratory tract pathogen. Serological methods currently used for the diagnosis of C. pneumoniae infection lack specificity, give ambiguous results from a single serum sample and often provide only a retrospective diagnosis. A prospective study was undertaken to assess whether PCR could be a useful addition to the serological techniques routinely practised for diagnosis. This study investigated 68 adult patients with a diagnosis of acute respiratory infection. Acute and convalescent serological determination of antibodies to C. pneumoniae were performed by means of an rELISA test and a micro-immunofluorescence (MIF) test. Nasopharyngeal aspirates or bronchoalveolar lavage specimens and bronchial aspirates obtained from the 68 patients were evaluated by PCR-enzyme immunoassay (PCR-EIA) for the presence of C. pneumoniae and by immunofluorescence assay and cell culture for virus identification. Mycoplasma pneumoniae serology was also performed. Eight patients (11.8%) were positive by either rELISA or PCR-EIA, or both, with an infection rate of 5 (18.5%) of 27 in patients with community-acquired pneumonia, 2 (9%) of 22 in asthmatic patients and 1 (5%) of 19 in patients with an exacerbation of chronic obstructive pulmonary disease. Serological evidence of acute infection was found in four of these patients with the rELISA test and in three others with the MIF test. PCR-EIA detected C. pneumoniae DNA in four specimens, but there were concordant results with both rELISA and PCR-EIA in only one patient A positive PCR-EIA was also obtained in a patient who did not show an antibody response in acute serum. The discrepancy between serological and PCR-EIA results reflects the difficulties in routine laboratory diagnosis of C. pneumoniae infection and the necessity for further studies with optimised techniques.     

Performance and cost-effectiveness of selective screening criteria for Chlamydia trachomatis infection in women. Implications for a national Chlamydia control strategy

At 9 mM glucose, experimental results show that mitochondrial phosphate depletion (induced by glucose phosphorylation, catalyzed by mitochondrial hexokinase) reduces the activities of the respiratory chain, oxidative phosphorylation, and glutaminase. Consequently, the 14C-lactate oxidation to 14CO2 is lowered in the presence of glucose. The fall of ATP level triggers a high aerobic glycolysis by deinhibiting fructose-6-P kinase. NADH, generated by enhanced glyceraldehyde-3-P dehydrogenase activity, increases the reducing power. Moreover, the lactate dehydrogenase (LDH) system is shifted toward lactate formation, while NAD+ is regenerated and the oligomycin-inhibited ATP production is replaced by the iodoacetate-inhibited ATP production. From 14CO2 production and lactate accumulation it is calculated that about 60% of 14C-glucose which disappears is channelled into extraglycolytic reactions. On the contrary, 82% of glucose below l mM is metabolized through non-glycolytic reactions. The pyruvate kinase-M2 (PK-M2) inhibition does not limit the glycolytic flow from 9 mM glucose, but it may cause sustained gluconeogenesis.     

Use of magnetic resonance cholangiography in the diagnosis of choledocholithiasis: prospective comparison with a reference imaging method

OBJECTIVES: Evaluate cartilaginous healing in rabbits in response to surgically created thyroid cartilage fractures. Compare healing between laryngeal fracture repair techniques. STUDY DESIGN: Animal model. MATERIALS AND METHODS: Laryngectomy specimens were analyzed at 10 weeks, following paired wire fixation (n = 7) and miniplate fixation (n = 7) of thyroid cartilage fractures. RESULTS: Cartilaginous unions were present in all seven of the miniplated repairs, while fibrous unions were present in six of the wired repairs. The measure of distraction at the fracture site was significantly greater in the wired repairs compared with the plated repairs (P = .005). Furthermore, in five of seven miniplated repairs no distraction at the healed fracture site was present. CONCLUSIONS: The results demonstrate the ease, tolerability, and superiority of the miniplate fixation technique for the thyroid cartilage fractures, based on a rabbit model.     

Use of a multiple-choice procedure with college student drinkers.

[Correction Notice: An erratum for this article was reported in Vol 21(2) of Psychology of Addictive Behaviors (see record 2007-08148-016). The article was inadvertently published with the order of authorship reversed. Carrie Little was the first author on this article; Christopher J. Correia was the second author.] The Multiple-Choice Procedure (MCP) was developed to investigate the relationship between drug preferences and alternative reinforcers. The current studies were designed to validate survey and laboratory versions of the MCP with college student drinkers. In Study 1, 320 undergraduates with a recent history of alcohol consumption used a survey version of the MCP to make 120 discrete hypothetical choices between two amounts of alcohol and escalating amounts of money delivered immediately or after a 1-week delay. In Study 2, 21 undergraduates completed a laboratory version of the MCP to make 120 discrete choices involving real alcohol and monetary payments. Responses to both versions of the MCP were related to measures of alcohol use and varied as a function of delay associated with the money choice. Responses to the survey version of the MCP also varied as a function of the amount of alcohol hypothetically available. The results of the 2 studies are consistent with a behavioral choice perspective of alcohol use, which focuses on preferences in the context of competing alternative reinforcers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intraepithelial carcinoma of the cervix uteri. 1) Cytologic detection in gynecologic practice. Our exerience with 15,000 smears

The best results in screening for subclinical cancer of the cervix are given by cytological studies. The authors in reviewing their experience in this method of screening studied the result of 15,000 smears which gave a diagnosis of 37 cases of intra-epithelial carcinoma of the cervix, which means 1 case of carcinoma in situ diagnosed in every 400 smears. Although the technique is very simple it has to be carried out according to strict criteria at the time of taking the smear, of fixing it immediately and of staining it. There is a group of patients who are at high risk about the age of forty, when there is a marked influence due to parity. But only a systematic policy will bring about diagnosis of pre-invasive carcinoma in cases where the cervix is clinically healthy. The cytology is usually characteristic, though the diagnosis may be difficult during pregnancy, or when hormone contraception is being used or when there is a trichomonas infection present. This explains why we find false positives in 0.03 per cent of cases in this study and false negatives in 0.03 per cent of cases. Their rarity means that the method is 99.94 per cent reliable. Finally, the cervical smear gives an opportunity for studying the vaginal microbial flora as well as the cyto-hormonal state.     

Teacher-implemented behavior modification in a case of organically based epilepsy.

Achieved significant reduction of seizures in an 11-yr-old epileptic girl through a contingency management program implemented by her classroom teacher which shifted the focus from her actual seizures to seizure-free time periods. A chart of "good times" was kept by the teacher, and rewards given at the completion of a totally seizure-free week at school. Seizures diminished from an average of 3/wk to 1/wk over the treatment period. The program was discontinued due to the teacher's unwillingness to reinstate it following the child's lengthy absenteeism and changes in her medication. Seizures then returned to the baseline rate. Lack of adequate controls made it impossible to attribute success entirely to the behavioral intervention. It is unlikely, however, that such dramatic change could be the result of chance, the continuation of her medication, or her continued traditional psychotherapy. Results suggest the need for more heuristic case studies of seizure disorders treated as an operant chain and the need for subsequent tightly controlled research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of pulse oximetry in the diagnosis of accidental bronchial intubation during laparoscopic surgery. Description of a clinical case

In the present article a case of accidental bronchial intubation during laparoscopic cholecystectomy is described. Endotracheal tube was probably displaced by gas distension of the abdomen during laparoscopy. Indeed, under these circumstances, carina may move cephalad. Initially, tube displacement was not diagnosed by either auscultation of breath sounds, or ETCO2 monitoring. Instead, a decrease in arterial oxygen saturation, as monitored by pulse oximetry, quickly allowed diagnosis and correction of the problem. It is concluded that pulse oximetry is more sensitive than other methods in providing early warning of tube displacement during laparoscopy.     

Topographic diagnosis of hearing loss in patients with ischemic heart disease. Use of high-rate brain stem evoked response audiometry

Hearing loss in patients with ischemic heart disease traditionally has been attributed to atheromatous cerebral vascular disease. In this study, the site of the auditory lesion was sought in patients with ischemic heart disease and perceptive hearing loss. Standard brainstem evoked response audiometry (BSER) with increased stimulation rate (ISR) were performed. Sixty-seven patients admitted for coronary artery disease were examined. Fifty-seven recordings were complete and evaluable. All the cases of hearing loss were endocochlear. In 4 patients. BSER and ISR detected subclinical retrocochlear lesions that were compatible with ischemic disease. The results suggest that selective early cochlear ischemia can occur in young persons with heart disease. The sensitivity of BSER with ISR for detecting ischemic brainstem lesions was confirmed.     

Use of a paradoxical intervention with a couple: An interactional analysis.

Examined the immediate impact of a paradoxical intervention in couple counseling involving the couple and the therapist, using content analysis of discourse and sequential statistical methods. The therapist reframed the symptom of insomnia to include couple dynamics. Discourse before, during, and after intervention was coded, using the Penman Coding system. The proportion of message codes and critical interactional patterns changed among the 3 participants. By the end of the interview, the power struggle between the man and the therapist de-escalated. The woman's use of high-power, positive symmetrical behaviors with her partner emerged, and the symmetrical, negative involvement patterns between the partners were eliminated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)