Red cell aplasia responsive to immunoglobulin therapy as initial manifestation of human immunodeficiency virus infection.

A patient who presented with pure red cell aplasia as the initial manifestation of human immunodeficiency infection is described. The patient had no signs of other autoimmune processes or immunologic or histologic evidence of parvovirus B19 infection, although we detected parvovirus B19 DNA in his serum. This patient had a complete, although temporary, response to a single course of immunoglobulin therapy and is currently responding to a second treatment.

Sleep deprivation and cognitive testing in internal medicine house staff.

There is increased concern about the effects of sleep deprivation on physician performance. We administered four standard tests of cognitive function to 23 university hospital house staff. Each physician served as his or her own control, and the tests were administered at rest, after a night on call, and after a night of sleep for recovery. The study was designed so that normal learning would minimize any deterioration in the post-on-call test performance. Statistically significant deterioration occurred in 3 of the 4 tests after a night on call. Even physicians acclimated to sleep deprivation on a regular, every-third-or-fourth-night basis showed functional impairment. The results have implications for patient care under conditions where house staff are stressed by sleep deprivation and prolonged fatigue.

Reversible chalcosis.

A patient with an initially undiagnosed copper containing intraocular foreign body developed chalcosis 4 1/2 years after penetrating injury. The case was followed for approximately 15 years after which time the foreign body expelled itself with complete reversal of the ocular signs and improvement in visual acuity.

Streptococcal L-forms isolated from Drosophila paulistorum semispecies cause sterility in male progeny.

The Drosophila paulistorum complex contains six semispecies that do not normally interbreed. In the laboratory, crosses between semispecies produce fertile daughters and sterile sons. Microbial endosymbionts have been observed in all D. paulistorum flies that display this male sterility. Streptococcal L-forms have been isolated from the Andean-Brazilian (Mesitas) and Transitional (Santa Marta) semispecies and cultured in artificial medium. Transfer of these L-forms from their native hosts into reciprocal semispecies resulted in sterile male progeny. When L-forms were inoculated into the semispecies from which they had been isolated, most of the male progeny were fertile. Control streptococcal L-forms did not show this sterility pattern.

Retinal angiomatous mass. A complication of retinal detachment surgery.

Retinal angiomatous masses were observed as a very late complication in four patients following scleral buckling procedures with drainage of subretinal fluid. The lesions manifested 5-19 years after the original surgical procedure, and the presenting complaint was decreased vision secondary to vitreous clouding. In three patients a vascularized retinal mass greater than 3 disc diameters in size was observed at the site of choroidal perforation for drainage of subretinal fluid. A fourth patient demonstrated a similar lesion in the location of a suture used to anchor the encircling element, possibly the point of accidental choroidal perforation. Three of the four patients were treated by photocoagulation or cryocoagulation with cicatrization of the angiomatous mass and obliteration of the vascular net. This resulted in clearing of vitreous opacities and subretinal exudates, with restoration of vision to a level prior to the onset of symptoms.

Simultaneous ocular and orbital involvement from metastatic bronchogenic carcinoma.

A 64-year-old man presented with a nonrhegmatogenous retinal detachment, proptosis, and ptosis. Clinical examination, fluorescein angiography, B-scan ultrasonography and computed tomographic (CT) scan confirmed the presence of concomitant intraocular tumor and orbital mass. The CT scan of the chest and a lung biopsy specimen revealed the presence of an unsuspected asymptomatic bronchogenic carcinoma that rapidly developed widespread metastases. Metastasis to the eye from bronchogenic carcinoma may occur simultaneously with orbital metastasis, and this may be associated with rapid progression and growth.

Characteristics of the Drosophila paulistorum Male Sterility Agent in a Secondary Host, Ephestia kuehniella.

Crosses among the six semispecies of Drosophila paulistorum produce sterile male hybrids. This sterility is caused by an agent which has characteristics of a microorganism. It is pathogenic in a secondary host, the larvae of the Mediterranean meal moth, Ephestia kuehniella, and can be serially passaged in Ephestia, where it is lethal. The agent was passaged back into D. paulistorum, where it induced sterility in males of a semispecies different from that of origin of the agent. Infectious particles were obtained from an extract of infected Ephestia by ultracentrifugation in a sucrose-Ficoll-metrizamide gradient. Both crude and purified extracts were lyophilized and stored indefinitely without loss of killing power. The agent was destroyed by low pH, lipid solvents, ultraviolet light, and exposure to a temperature of 56 degrees C for 30 min. It appeared to be sensitive to tetracycline and insensitive to penicillin, suggesting that the agent is not a virus, but more likely a cell wall-deficient bacterium or mycoplasma-like organism.

Spore germination, colony development, and secondary metabolism in Penicillium brevicompactum: a radiogas chromatographic and morphological study.

A study of the first 76 h of development of spores of Penicillium brevicompactum in batch-mode shake culture indicates that mycophenolic acid biosynthesis begins when the hyphae of germinating spores aggregate to form pellets. Supplies of mycophenolic acid so produced augment a pre-existing pool of the material that is associated with the dormant spore. Although acetate metabolism is active at all stages of development, incorporation of [1-(14)C]acetate into 2,4-dihydroxy-6-(1',2'-dioxopropyl)benzoic acid, another secondary metabolite of the fungus, could not be demonstrated. The significance of these data are considered in terms of the function of mycophenolic acid and the substituted benzoic acid in the producing organism.

A unique cause of female sterility inDrosophila melanogaster.

Histological studies do not permit the distinction between an oocyte, ovary or oviduct malformation as the primary cause of sterility in females homozygous for the Hairywing 49c allele inDrosophila melanogaster. Reciprocal transplantations of larval ovaries between homozygous mutant larvae and normal larvae demonstrate that the sterility is due to a malfunctioning of the oviduct, presumably at the junction of the common oviduct and the uterus. This failure of the oviduct to function normally appears to represent a unique cause of female sterility in this organism.