Candida fungemia in neonates treated with fluconazole: report of forty cases, including eight with meningitis

PURPOSE OF THE STUDY: To assess efficacy and safety of fluconazole in neonates with Candida fungemia. STUDY DESIGN: Multicenter prospective protocol of all fungemias appearing between January 1, 1993, and December 31, 1997, in four major university hospitals. RESULTS: Forty neonates, 28 of them with very low birth weight (<1500 g; 30.5 median gestation week), with documented Candida albicans fungemia were treated with intravenous fluconazole in a daily dosage of 6 mg/kg once daily for 6 to 48 days. Thirty-four received fluconazole as monotherapy and 6 received it in combination with amphotericin B. Thirty-two (80%) were cured; 4 of them relapsed despite at least 14 days of therapy, but they were ultimately cured without sequelae. Eight other neonates died, 4 because of fungal infection and 4 because of prematurity or hemorrhage or lung failure, with fungemia (20% overall and 10% attributable mortality). Two neonates had elevated liver enzymes during fluconazole therapy and 2 others had elevated serum creatinine during fluconazole monotherapy. In none of them did these abnormalities necessitate discontinuation of antifungal therapy. In 8 neonates fungal meningitis developed as a complication of fungemia. All but 3 fungemias were C. albicans; 3 were Candida parapsilosis. CONCLUSIONS: Fluconazole was safe and effective antifungal therapy even in complicated or Candida fungemia in neonates and in infants with very low birth weight.     

Molecular size-dependent leakage of intracellular molecules from frog skeletal muscle fibers permeabilized with beta-escin

The permeability of beta-escin-treated cell membrane was characterized in terms of the permeant molecular size, by monitoring the leak of cytoplasmic molecules in frog skeletal muscle fibers. With a low concentration of beta-escin (5 microM), most of the cellular ATP was lost within 30-40 min (as revealed by rigor force generation), whereas a fluorescence-labeled dextran injected into the cytoplasm (approximately 10 kDa) and cytoplasmic proteins (14-80 kDa) slowly leaked out of the cell. A high concentration of beta-escin (50-100 microM) accelerated the leak of large molecules. Therefore, low concentrations of beta-escin may be used as a means of permeabilizing the cell membrane to relatively small molecules, while retaining a major fraction of the cellular macromolecules.     

Inhibition of G1 cyclin expression in normal rat kidney cells by inostamycin, a phosphatidylinositol synthesis inhibitor

We previously reported that inostamycin, an inhibitor of CDP-DG: inositol transferase, inhibited cell proliferation in normal rat kidney (NRK) cells by blocking cell cycle progression at the G1 phase. In the present paper, we report the effect of inostamycin on the serum-induced activation of Ser/Thr protein kinases that are involved in G1 progression. In quiescent NRK cells mitogen-activated protein kinase (MAP kinase) and casein kinase II were activated within 15 min after serum addition. Neither activation was affected by the treatment with inostamycin. However, in the inostamycin-treated cell, cyclin-dependent kinase 2 (CDK2) failed to be activated after serum stimulation. Since serum-induced expression of cyclin E was also suppressed by inostamycin, this inhibitor would appear to block CDK2 activation by inhibiting cyclin E expression. Furthermore, inostamycin also inhibited cyclin D1 expression induced by serum; and consequently, hyperphosphorylation of retinoblastoma protein (pRB) by RB-kinases such as CDK4 and CDK2 was abolished, which would result in elimination of functional inactivation of pRB. Thus, early G1 arrest in NRK cells by inostamycin is due to the inhibition of cyclin D1 and E expressions.     

De novo epileptic confusional status in a patient with cobalamin deficiency

A 80-year-old man with cobalamin deficiency and no history of epilepsy developed a partial complex epileptic confusional status (ECS) unresponsive to acute i.v. diazepam. Brain CT scan and MRI investigation ruled out a focal cerebral lesion. Therapy with high doses (10,000 micrograms i.m. daily) of cobalamin alone was started, and the patient fully recovered in the following 72-hour. Control EEGs repeatedly performed days and weeks later showed progressive disappearance of the frontal interictal spiking, while the patient was on monotherapy with cobalamin (5,000 micrograms i.m. weekly). A month later the patient unfortunately discontinued replacement therapy and 13 weeks later he developed a fatal convulsive epileptic status. To our knowledge the association of ECS and cobalamin deficiency has not been previously reported.     

COMMENTS ON THE DETERMINATION OF FRIABILITY AND UNMODIFIED GRAINS

The Analysis Committee of the European Brewery Convention is aware that the Friabilimeter sometimes is used on samples that do not comply with the field of application. The precision of the method is also overlooked by some users. The field of application, precision of the method as well as the need for frequent testing of the instrument is therefore stressed in more detail than in the earlier published method by the EBC Analysis Committee.     

Multiterminal light-emitting logic device electricallyreprogrammable between OR and NAND functions

A monolithic multiterminal logic device that functions both optically and electrically as an ORNAND gate, is demonstrated for the first time. The device, based on the real-space transfer of hot electrons into a complementary collector layer, has been implemented in an InGaAs/InAlAs/InGaAs heterostructure grown by molecular beam epitaxy. Excellent performance is obtained at room temperature. The collector current and the optical output power both exhibit the OR and the NAND functions of any two of the three input terminals, these functions being interchangeable by the voltage on the third terminal     

Application of the integral definition of the curl operator tonumerical solutions in electromagnetics

The definition of the curl operator in terms of an integral is shown to lead to a method for numerical solutions that facilitates the use of mixtures of cells having different shapes and different dielectric properties. The derivation is followed by examples for, waveguides, mixtures of different cells, and a method for increasing the accuracy when an equation is known for the field on the outer boundary. Thus, these results suggest that the formal definition of the curl operator has more than pedagogical value. This definition is taught in an undergraduate class at Florida International University