Dynamical quark mass at finite temperature.
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Journal Article↗
Biomedical subjects
B Wong
Publications and source records attributed to B Wong.
Continuous high-grade mycobacterium avium-intracellulare bacteremia in patients with the acquired immune deficiency syndrome.
Serial quantitative blood cultures were performed before and during treatment in four patients with the acquired immune deficiency syndrome (AIDS) and Mycobacterium avium-intracellulare bacteremia. Initial colony counts were 350 to 28,000 cfu/ml, the counts declined substantially with treatment in two patients, and they declined modestly with treatment but rose when it was stopped in the other two. In one patient who was studied in detail, most of the circulating organisms were within the leukocytes, colony counts in blood subjected to lytic agents were 1.9- to 5.2-fold higher than in unlysed blood, and there were 10(5) to 10(6) times more organisms per gram in several tissue specimens obtained at autopsy than per milliliter of blood. It is concluded that continuous high-grade bacteremia is common in patients with AIDS and severe M. avium-intracellulare infections and that serial quantitative blood cultures provide a potential means for studying treatment in these patients.
Acquired Immunodeficiency Syndrome↗
Stereoisomeric configuration of arabinitol in serum, urine, and tissues in invasive candidiasis.
Because routine analytical methods cannot differentiate D- from L-arabinitol, a combined microbiological and gas chromatographic method was developed to study the stereoisomeric configuration of the arabinitol in humans and rats with invasive candidiasis. D-Arabinitol was defined as the difference between arabinitol concentrations measured with and without incubation with 5.0 X 10(5) blastospores of Candida tropicalis strain CT 12 at 37 C for 24 hr. The yeast consumed at least 95% of the D-arabinitol and none of the L-arabinitol added to normal serum and urine. D-Arabinitol as a fraction of D,L-arabinitol was 0.43 +/- 0.15 (mean +/- SD) in the urine of 10 normal humans, 0.82 +/- 0.12 in the serum or urine of five patients with cancer and invasive candidiasis (P less than .001), and 1.0 in the kidneys of rats with candidiasis. Because most or all of the excess arabinitol in body fluids or tissues in candidiasis was the D isomer, which is produced by fungal metabolism, stereospecific quantitation of arabinitol should improve the sensitivity of this approach to diagnosis of candidiasis.
Animals↗
Infections caused by Mycobacterium avium complex in immunocompromised patients: diagnosis by blood culture and fecal examination, antimicrobial susceptibility tests, and morphological and seroagglutination characteristics.
The Mycobacterium avium complex, only rarely described as an invasive pathogen in humans, has recently been reported to frequently cause disseminated disease in patients with the acquired immune deficiency syndrome. Between February 1981 and February 1984 at Memorial Sloan-Kettering Cancer Center, 30 patients with acquired immune deficiency syndrome, 3 patients with leukemia, and 2 patients with congenital severe combined immunodeficiency syndrome developed disseminated M. avium complex infection. Mycobacteria were often found in multiple sites both antemortem and postmortem. Blood cultures were a reliable method for detecting disseminated infection, and the new lysis blood culture systems provided an efficient technique for determining the number of organisms per milliliter of blood. Acid-fast stains and cultures of fecal specimens were also helpful in diagnosing infection. Most of the mycobacteria were serovar 4 (77%), and most (86%) produced a deep yellow pigment. All isolates were susceptible to standard concentrations of clofazimine, cycloserine, and ansamycin, but tended to be resistant to isoniazid, streptomycin, ethambutol, ethionamide, and rifampin.
Acquired Immunodeficiency Syndrome↗
Evaluation of the aldononitrile peracetate method for measuring arabinitol in serum.
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Animals↗
Electrocardiographic effects of probucol. A controlled prospective clinical trial.
Probucol is known to prolong QT intervals in some patients and to produce fatal arrhythmias in selected animal species. To assess the prevalence and clinical relevance of this effect in a controlled manner, we analyzed electrocardiograms (ECGs) and medical events in patients during a placebo-controlled crossover trial comparing single or combined administration of probucol and colestipol. Forty-two Type II hyperlipoproteinemic patients were studied for eighteen to twenty-four months. Two cardiologists independently read the tracings which were previously arranged randomly without names or dates. There were no statistical differences between the reports of the ECG parameters by the two cardiologists. The mean QTc interval of the entire patient population was lengthened after probucol administration without reaching statistical significance when compared to placebos or colestipol treatments. Forty-eight % of the patients showed lengthening of the QTc interval during probucol treatment by 11 to 70 msec increment over baseline placebo. The remaining had either no change or shortening of the interval. There were no statistically significant differences in means of R-R, PR, QRS, QTc or QoT intervals among placebo, probucol., colestipol and probucol plus colestipol treatments. It is concluded that probucol prolonged QT intervals in the electrocardiograms of about one half of patients receiving the drug with no other clinical or statistically significant evidence of cardiotoxicity or electrocardiographic effects.
Adult↗
Parasitic diseases in immunocompromised hosts.
In patients with compromised host defenses, diseases caused by protozoans and nematodes appeared, a few years ago, to be declining in importance. However, the outbreak of the acquired immunodeficiency syndrome (AIDS) among homosexual men, parenteral drug abusers, and other groups has made it necessary for physicians to familiarize themselves again with the manifestations of these diseases in abnormal hosts. The groups of patients at greatest risk, the usual clinical syndromes in abnormal hosts, and current approaches to diagnosis, treatment, and prevention of infections due to Pneumocystis carinii, Toxoplasma gondii, Strongyloides stercoralis, and organisms of the genus Cryptosporidium are reviewed. Because so many cases of these infections have recently occurred among patients with AIDS, recent experience with these diseases in AIDS patients at Memorial Sloan-Kettering Cancer Center is summarized.
Acquired Immunodeficiency Syndrome↗
Clinical correlations of serial quantitative blood cultures determined by lysis-centrifugation in patients with persistent septicemia.
The potential clinical value of colony counts determined by the lysis-centrifugation blood culture method was studied by reviewing the records of eight patients with persistent septicemia in whom colony counts were available on at least 3 days. Colony counts of the five patients who survived decreased steadily as the patients improved. One of the three patients who died had counts repeatedly below 1.0 CFU/ml while she was clinically stable and higher counts when her condition deteriorated. Two patients died despite decreasing colony counts. One was improving and died unexpectedly of an unrelated cause; the other died of candidiasis, but declining serial arabinitol/creatinine ratios suggested a partial response to therapy. In addition, septicemia related to infected intravenous catheters was documented by demonstrating large differences in colony counts determined simultaneously from two different sites in two patients and by demonstrating a precipitous drop in CFU per milliliter after removal of the infected catheter in one patient. Routine availability of colony counts appears to be an important advantage of the lysis-centrifugation method.
Adolescent↗
Central-nervous-system toxoplasmosis in homosexual men and parenteral drug abusers.
Central-nervous-system toxoplasmosis developed in 7 of 269 patients with the acquired immunodeficiency syndrome reported to the New York City Health Department through July 1982. Focal neurologic abnormalities, mass lesions on computed-tomographic brain scans, lymphocytic cerebrospinal fluid pleocytosis, and detectable IgG antibody to Toxoplasma gondii were common; but IgG titers of 1:1024 or more, IgM antibody to T. gondii, and positive open brain biopsies were uncommon. Serologic findings suggested that the disease resulted from recrudescent rather than primary infection. Four of five patients improved when treated with sulfonamides and pyrimethamine, but 2 had relapses. An aggressive diagnostic approach and sometimes even empiric therapy are warranted when central-nervous-system toxoplasmosis is suspected in a seropositive patient with the acquired immunodeficiency syndrome.
Acquired Immunodeficiency Syndrome↗
Mucormycosis following bone marrow transplantation.
Disseminated mucormycosis, presenting with a cutaneous lesion, developed in a 20-year-old woman following bone marrow transplantation. The infecting organism was identified as Rhizopus rhizopodiformis. Despite early diagnosis and therapy with amphotericin B, the patient died.
Adult↗
Serum arabinitol concentrations and arabinitol/creatinine ratios in invasive candidiasis.
Serum arabinitol concentrations and arabinitol/creatinine ratios were determined in 25 cancer patients with invasive candidiasis, 73 severely ill cancer patients who did not have invasive candidiasis, and 15 uninfected patients with chronic renal failure. Elevated arabinitol concentrations were found in patients with renal failure and invasive candidiasis. Serum arabinitol concentrations exceeded 1.19 micrograms/ml in 13 of 18 patients with invasive candidiasis who were studied when renal function was normal and in three of 52 control patients. Among patients with renal failure, 10 of 14 with invasive candidiasis but only four of 36 control patients had serum arabinitol concentrations of greater than 5.85 micrograms/ml. Serum arabinitol and creatinine concentrations were strongly correlated. The arabinitol/ creatinine ratio exceeded 1.5 in 16 of 25 patients with invasive candidiasis but in only three of 88 control patients. Increased serum arabinitol concentrations appear to reflect increased production of arabinitol by yeast in individuals with invasive candidiasis.
Candidiasis↗
Comparative recovery of bacteria and yeasts from lysis-centrifugation and a conventional blood culture system.
Blood cultures obtained with a lysis-centrifugation (L-C) system and a conventional two-bottle broth system were compared for the recovery of bacteria and yeasts from 7,000 cultures. The L-C system recovered significantly more total organisms, Escherichia coli, and Candida spp. and detected more patients with bacteremia and fungemia due to members of the family Enterobacteriaceae and yeasts. The broth system recovered significantly more streptococci and detected significantly more low-level Pseudomonas bacteremias. Polymicrobic bacteremia and fungemia were detected equally well by either culture system. Aerobic organisms grew equally well on blood, chocolate, or brain heart infusion agar plates used for L-C inoculation. A total of 82% of colony counts measured no more than 10 CFU/ml of blood, and it was at these low levels that enhanced detection of organisms by either system was observed. The L-C system isolated organisms and detected yeasts more rapidly than did the broth system. Contaminants occurred in 8.2% of L-C cultures and 1.9% of broth cultures. Low colony counts on L-C plates occurred for both Staphylococcus epidermidis contamination and septicemia.
Bacteria↗
Routine aerobic terminal subculturing of blood cultures in a cancer hospital.
Routine terminal aerobic subcultures of macroscopically negative blood culture bottles were evaluated during a 15-month period when 30,000 blood cultures were processed. Each blood culture set consisted of a vented and an unvented 50-ml broth bottle. Forty-eight pathogens and 47 contaminants were isolated only from terminal subcultures. Twenty-two of the significant isolates were yeasts (usually recovered from vented bottles), and 10 were Pseudomonas aeruginosa (usually recovered from unvented bottles). Blood cultures that were positive by terminal subculture provided clinically relevant information in many cases, whether other blood cultures were positive or not. Microbiology laboratories, particularly those in hospitals where yeasts and P. aeruginosa are commonly isolated from blood specimens, should evaluate carefully the need for terminal subcultures of blood culture bottles before abandoning their use.
Adult↗
Unexplained severe pulmonary hypertension in the older age group.
Two cases of unexplained severe pulmonary hypertension were seen in the older age group. Although classified as primary pulmonary hypertension, the clinical course of these patients was very unusual because of their age and relatively long duration of diseases. The long period of follow-up allowed assessment of both the difficulties of making a definite diagnosis of primary pulmonary hypertension in the older age group and the noninvasive methods which were particularly helpful. Making the diagnosis of primary pulmonary hypertension in the older age group is important because there are now drugs which can ameliorate the severity of pulmonary hypertension.
Aged↗
Comparative studies on immunological characteristics of IDDM among Asian populations.
Very little information is available related to possible differences in immunological characteristics of IDDM among Asian populations, though it has been reported that IDDM is associated with Bw54-DR4 and B17-DR3 in Japanese and Chinese, respectively. There is virtually no report related to comparative studies on Bf-DM association among Asian populations, while Bf-DM association is reported to be stronger than HLA-DM association in Caucasians. In the present paper, the results of our studies on anti-thyroid antibodies (ATA) of IDDM in Japanese, Chinese and Filipinos are presented. In Japanese, the incidence of ATA positive was higher in IDDM with a duration of less than one year (35.7%) than that in the patients with a duration of one year or more (12.5%). But, there was no such a duration dependent decrease in the incidences of ATA among Chinese or Filipino IDDM. The frequency of BfSS in Filipinos is lower than in Japanese or Chinese. However, no association was found between Bf phenotypes and IDDM in Asian populations. These results indicate that autoimmunity is transient in Japanese IDDM, but persistent in Chinese and Filipinos, and that it is too early to postulate in general that Bf-IDDM association in general populations is stronger than HLA-IDDM association.
Autoantibodies↗
Aspergillosis of the cerebral ventricles in a heroin abuser. Case report and review of the literature.
Aspergillosis of the cerebral ventricles developed in a 36-year-old heroin abuser who died during the sixth week of illness. The diagnosis was not made during life. A review of our case and of four previous cases from the literature indicates that aspergillosis should be considered in parenteral drug abusers with the syndrome of chronic meningitis or ventriculitis. The diagnosis is difficult to establish, but serologic tests may be helpful. This form of CNS aspergillosis can be cured with antifungal drugs.
Adult↗
Measurement of glycosylated haemoglobin at high altitudes.
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Altitude↗
Comparison of oral propranolol and verapamil for combined systemic hypertension and angina pectoris. A placebo-controlled double-blind randomized crossover trial.
The relative efficacies of oral verapamil, a calcium-entry blocking drug, and propranolol, a beta-adrenergic blocking drug, were compared in 12 patients who had both stable angina pectoris and mild to moderate systemic hypertension, using a placebo-controlled, double-blind, randomized crossover protocol. Compared with placebo, both propranolol and verapamil decreased the frequency of anginal attacks and the number of nitroglycerin tablets consumed, and increased exercise duration and total work; there were no significant differences in the antianginal effect of the two drugs. Both verapamil and propranolol reduced the supine and standing systolic and diastolic blood pressure measured at rest; compared with propranolol, however, verapamil had greater effects on standing diastolic blood pressure (p less than 0.002). Resting heart rate was reduced from placebo baseline with large doses of both drugs; compared with verapamil, however, propranolol exerted greater effects on resting heart rate and rate-pressure product. Plasma renin activity was increased from placebo baseline with verapamil (p less than 0.05), but was reduced with propranolol (p less than 0.05); no significant change in plasma aldosterone was seen with either drug. Verapamil appears to be a safe and effective treatment alternative to propranolol for relieving anginal symptoms, improving exercise tolerance, and reducing elevated systemic blood pressure in patients with both angina pectoris and mild to moderate systemic hypertension.
Adrenergic beta-Antagonists↗