Viral infection induces dependence of neuronal M2 muscarinic receptors on cyclooxygenase in guinea pig lung.

Inhibitory M2 muscarinic receptors on parasympathetic nerve endings in the lungs decrease release of acetylcholine, inhibiting vagally induced bronchoconstriction. Neuronal M2 receptor function can be studied using selective agonists and antagonists such as pilocarpine and gallamine. In pathogen-free guinea pigs indomethacin (1 mg/kg) did not alter the effect of either gallamine or pilocarpine, thus in pathogen free animals neuronal M2 muscarinic receptors function independently of cyclooxygenase products. However, in guinea pigs infected with virus, (which causes temporary loss of M2 receptor function), and then allowed to recover for 8 wk (to allow recovery of M2 receptors), indomethacin prevented both gallamine's potentiation and pilocarpine's inhibition of vagally induced bronchoconstriction. This new effect of indomethacin was not blocked by the addition of a 5-lipoxygenase inhibitor, AA861. However, the selective COX II inhibitor, L-745,337, had the same effect as indomethacin. Since exposure to ozone also caused neuronal M2 receptors to become dependent upon cyclooxygenase the effects of viral infection are likely to be due to inflammation. Thus, despite apparent recovery of normal M2 receptor function after viral infection or ozone, linkage of these receptors is chronically altered such that they become largely dependent on the activity of COX II.

A comprehensive strategy for designing a Web-based medical curriculum.

In preparing for a full featured online curriculum, it is necessary to develop scaleable strategies for software design that will support the pedagogical goals of the curriculum and which will address the issues of acquisition and updating of materials, of robust content-based linking, and of integration of the online materials into other methods of learning. A complete online curriculum, as distinct from an individual computerized module, must provide dynamic updating of both content and structure and an easy pathway from the professor's notes to the finished online product. At the College of Physicians and Surgeons, we are developing such strategies including a scripted text conversion process that uses the Hypertext Markup Language (HTML) as structural markup rather than as display markup, automated linking by the use of relational databases and the Unified Medical Language System (UMLS), integration of text, images, and multimedia along with interface designs which promote multiple contexts and collaborative study.

CPMCnet: an integrated information and internet resource.

The Network and Computer Systems department of the Health Sciences Library developed CPMCnet, an UNIX-based information and Internet server at Columbia-Presbyterian Medical Center. The project linked Gopher and World-Wide Web protocols as well as clients into an integrated application, providing the advantages of both. Development and use of CPMCnet has opened new channels of communication among information providers and end-users.

Common bacterial skin infections. Diagnostic clues and therapeutic options.

Prompt, accurate characterization of skin infections can help avoid serious, more invasive complications. With appropriate empirical therapy, treatment failure can be prevented. The authors of this article discuss several common skin infections, including bite wound infections, and recommend various drug regimens to consider when planning initial therapy.

Clinical, scholarly & campus information hypertext tools at Columbia-Presbyterian Medical Center.

In conjunction with other researchers at Columbia-Presbyterian Medical Center (CPMC) we have developed a number of hypertext and free text retrieval computer applications aimed at an extremely diverse audience which includes students and faculty in a university setting as well as health care providers and patients in hospital and clinic settings. Hypertext and free text systems offer features which make them ideal for presenting information in a wide variety of contexts; however, they also have several major weaknesses which must be addressed before these applications can be useful tools. We have learned to maximize the strengths and minimize the weaknesses to present material in a manner that is individualized to the needs of each user from the research scientist in the lab to the patient at the bedside.

Circadian rhythmicity restored by neural transplant. Immunocytochemical characterization of the graft and its integration with the host brain.

It is well established that overt circadian rhythms are permanently disrupted following lesions of the hamster hypothalamic suprachiasmatic nucleus (SCN). In the present study, we show that implantations of brain grafts containing the fetal SCN reestablish circadian rhythms of locomotor activity in adult hamsters previously made arrhythmic by SCN lesions. The restoration of free-running rhythms in conditions of constant darkness is correlated with the presence in the graft of neuropeptides normally present in the SCN of unlesioned hamsters, including vasoactive intestinal polypeptide (VIP), neuropeptide Y (NPY), and vasopressin (VP). In several recipients, grafts were found to receive retinal input, and appeared to send efferents into the host brain. Not all functions of the SCN were reinstated by the graft: animals with restored locomotor rhythms did not show gonadal regression in the absence of light, and failed to synchronize (entrain) to light intensities to which SCN-intact animals responded.

Norfloxacin in the treatment of complicated and uncomplicated urinary tract infections. A comparative multicenter trial.

In a multicenter, prospective treatment study, 59 patients with complicated or uncomplicated urinary tract infections (UTIs) were treated with norfloxacin (400 mg orally twice daily) and compared with 45 patients treated with trimethoprim/sulfamethoxazole. Norfloxacin was relatively safe and highly effective in treating both uncomplicated UTIs (86 percent cure rate) and complicated UTIs (75 percent cure rate). Failure of trimethoprim/sulfamethoxazole therapy was associated with initial bacterial resistance, e.g., from Pseudomonas aeruginosa and Serratia marcescens; such multiresistant bacteria were successfully treated with norfloxacin. Thus, norfloxacin appears to extend the range of oral agents available to treat UTIs.

Ciprofloxacin versus cinoxacin in therapy of urinary tract infections. A randomized, double-blind trial.

In a prospective, randomized, double-blind trial, ciprofloxacin (250 mg orally, twice daily) was compared with cinoxacin (500 mg orally, twice daily) in 60 patients with urinary tract infections. Most patients were women with uncomplicated urinary tract infections. Escherichia coli was the most common isolate (36 patients). Clinical and microbiologic cure occurred in 20 of 24 (83 percent) evaluable patients treated with ciprofloxacin, compared with 15 of 21 (71 percent) evaluable patients treated with cinoxacin. Ciprofloxacin was well tolerated and had a low incidence of minor side effects that included Candida vaginitis, headache, and gastrointestinal intolerance. Relapse or failed therapy was not associated with the development of resistance.