Disseminated Pseudallescheria boydii infection in a nonimmunocompromised host.

We present a highly unusual case of pulmonary Pseudallescheria boydii infection in a nonimmunocompromised host with a cavitating mass lesion. The diagnosis was confirmed by open lung biopsy. The patient was treated at another institution with course of amphotericin B, considered an ineffective therapy for this infection, and presented to us with direct extension and invasion of the left atrial appendage and the pulmonary artery, followed by massive pulmonary embolization and hematogenous dissemination to the liver, spleen, kidney, pancreas, and brain.

Successful use of nasal-CPAP for obstructive sleep apnea in Hunter syndrome with diffuse airway involvement.

A patient with Hunter syndrome and diffuse airway obstruction had daytime hypersomnolence, snoring, and alveolar hypoventilation. Polysomnography showed severe obstructive sleep apnea. In the past, all reported cases of sleep apnea in patients with mucopolysaccharidoses had been treated with tonsillectomy/adenoidectomy or tracheostomy. This patient, in whom tracheostomy would have been very difficult due to the diffuse nature of his airway involvement, was successfully treated with high pressure nasal CPAP and supplemental oxygen.

Effects of loading and unloading the respiratory system on respiratory control and muscle function.

To determine the effects of internal respiratory loading and unloading on respiratory neuromuscular function, ventilatory (Vi), occlusion pressure (P0.15), transdiaphragmatic pressure (Pdi) and diaphragmatic electromyogram (EMGdi) responses to CO2 rebreathing were assessed in 6 normal volunteers rebreathing gas mixtures denser (63% SF6, 30% O2, 7% CO2) and less dense (63% He, 30% O2, 7% CO2) than air (63% N2, 30% O2, 7% CO2). Loading with SF6 decreased the Vi response to CO2 rebreathing and increased P0.15 and Pdi for a given EMGdi, while the greater the increase in pressure response the less was the decrease in Vi. Unloading with He had the opposite effect. The pattern of breathing was altered with SF6, with Ti and Te increasing and frequency decreasing, while there was no change in timing with He. Internal loading of inspiration and expiration with SF6 elicits compensatory responses that depend on changes of respiratory timing and enhanced diaphragm efficiency. Adjustments to unloading are generally opposite to that observed with loading.

[The determination of ectodermal derivatives in various species of amphibia]. / Determinatsiia proizvodnykh éktodermy u raznykh vidov amfibii.

The process of labyrinth determination has been studied in amphibians (three Urodela and seven Anura species) using homoplastic transplantation of ear ectoderm, containing labyrinth material onto the abdominal wall of embryos of the same stage of development. The stage of appearance of organ-specific properties in ear ectoderm was determined and the increase of these properties in the course of development was observed. The frequency of ear vesicles formation, the level of their differentiation and their size served as criteria. These criteria allow to align the studied species into a row, where organ-specific properties appear earlier and most completely in representatives of Ranidae family and in Bufo viridis, and weakest, in smooth newt. A comparison of properties of labyrinth material and other areas of ectoderm allowed to conclude that specific differences in determination of different ectodermal primordia are based on specific peculiarities of the whole ectoderm. The appearance of these differences can be explained by the shift in the beginning of gastrulation towards later stages of cleavage during the evolution of amphibians.

Respiratory muscle function during CO2 rebreathing with inspiratory flow-resistive loading.

We investigated the respiratory muscle contribution to inspiratory load compensation by measuring diaphragmatic and intercostal electromyograms (EMGdi and EMGic), transdiaphragmatic pressure (Pdi), and thoracoabdominal motion during CO2 rebreathing with and without 15 cmH2O X l-1 X s inspiratory flow resistance (IRL) in normal sitting volunteers. During IRL compared with control, Pdi measured during airflow and during airway occlusion increased for a given change in CO2 partial pressure and EMGdi, and there was a greater decrease in abdominal (AB) end expiratory anteroposterior dimensions with increased expiratory gastric pressure (Pga), this leading to an inspiratory decline in Pga with outward AB movement, indicating a passive component to the descent of the abdomen-diaphragm. The response of EMGic to IRL was similar to that of EMGdi, though rib cage (RC)-Pga plots did infer intercostal muscle contribution. We conclude that during CO2 rebreathing with IRL there is improved diaphragmatic neuromuscular coupling, the prolongation of inspiration promoting a force-velocity advantage, and increased AB action serving to optimize diaphragm length and configuration, as well as to provide its own passive inspiratory action. Intercostal action provides increased assistance also. Therefore, compensation for inspiratory resistive loads results from the combined and integrated effort of all respiratory muscle groups.

Diaphragmatic EMG and transdiaphragmatic pressure measurements with a single catheter.

A single gastroesophageal catheter was used for simultaneous measurements of diaphragmatic electromyogram (EMGdi), esophageal, and gastric pressures in 10 normal volunteers. The catheter consisted of 2 polyethylene tubes, each with an outer diameter of 1.70 mm and an inner diameter of 1.19 mm, 2 platinum wire coils, and esophageal and gastric latex balloons. In all subjects studied, the increase in EMGdi, quantified as the average rate of rise of inspiratory moving average activity, and transdiaphragmatic pressure (Pdi) were linearly related to the increase in end-tidal PCO2 during CO2 rebreathing (range of r, 0.88 to 0.99 and 0.85 to 0.99, respectively). The relation between changes in EMGdi and that of Pdi, mean inspiratory flow, and occlusion pressure were also linear (range of r, 0.83-0.99, 0.73-0.99, and 0.84-0.99, respectively), indicating reliable recordings of EMGdi and Pdi during CO2 rebreathing in upright normal humans.

[Formation of the cortical reaction in the process of oocyte maturation in the starred sturgeon]. / Stanovlenie kortikal'noi reaktsii v protsesse sozrevaniia ootsitov sevriugi.

The chronology of maturation process and cortical reaction development was studied in the Volga sevryuga oocytes. The germinal vesicle breakdown was first noted at 14 tau 0 following the injection of hypophysial suspension to the female and observed in the vast majority of oocytes at 17 tau 0; different phases of the I maturation division were found at 21 to 25 tau 0 and metaphase II at 33 tau 0. The ability to respond by cortical reaction to the activating stimulus (glass needle pricking) was first observed at 17 tau 0, i.e. soon after the germinal vesicle breakdown, but the appearance of the ability for cortical reaction was not connected causatively with the latter process. The cortical reaction in the maturing oocytes (17 to 25 tau 0) is characterized by the following features: in some oocytes the rate of the wave of granule breakdown is much lower than in the mature eggs; in ca. 80% of oocytes with the normal rate of cortical reaction the process of release of the contents of cortical granules in inhibited in the animal pole region and accordingly the contact of cytoplasm with the membranes is preserved in this region for a long time.

[Cortical reaction in starred sturgeon eggs following fertilization and artificial activation]. / Kortikal'naia reaktsiia v iaitse sevriugi pri oplodotvorenii i iskusstvennoi aktivatsii.

An electron microscopical study of the fertilized sevryuga eggs has shown that 3 sec after insemination the most cortical granules in the region of the animal pole are already dehiscing and 10 to 30 sec the cortical granules release their contents under the membrane, but between the groups of cortical granules the contact of the cytoplasm with the membrane is still preserved. The full separation of the membrane observed under the light microscope at these times of fixation (San Felice fluid) is an artifact due to changes in the cortical cytoplasm properties. The rate of spreading of the cortical reaction over the egg surface is reduced from the animal pole to the vegetative one. By the criterion of the first changes discernible under the light microscope (formation of vacuoles and cytoplasmic threads between them) the maximal rate in the region of the animal pole amounts 360.5 mcm/sec and the average rate of the whole egg 46.5 mcm/sec; by the criterion of membrane separation the average rate amounts to 26.8 mcm/sec (at the temperature 21.9 degrees). The average rate of spreading of the cortical reaction in the sevryuga eggs is close to that in the sturgeon (Acipenser güldenstädti) and exceed ca. 3 times that in the sea urchin and teleostean eggs. The cortical reaction spreads at the same rate both in the fertilized and activated sevryuga eggs.