Identification of secondary metabolites from Streptomyces violaceoruber TU22 by means of on-flow LC-NMR and LC-DAD-MS.

For rapid screening of natural products from Actinomycetes, a combination of on-line couplings LC-NMR, LC-DAD-MS and HPLC-PDA, as well as MALDI-TOF-MS is particularly suitable. Simultaneous use of these coupling techniques provides considerable advantages for the rapid identification of natural compounds in mixtures. The results of our present investigation on secondary metabolite products of Streptomyces violaceoruber TU 22 showed that more than 50% of the identified metabolites are new compounds. The structures of four new polyketides (granaticin C, metenaticin A, B and C) as well as four known ones (granaticin A, granatomycin E, daidzein and genistein) have been elucidated using LC-NMR, LC-MS/MS and -MS(n) techniques in combination with two-dimensional NMR spectroscopy.

Hemodynamic effects of intrathecal sufentanil compared with epidural bupivacaine in laboring parturients.

STUDY OBJECTIVES: To provide information on the central hemodynamic effects of intrathecal sufentanil after a standard intravenous preload using thoracic bioimpedance monitoring to obtain noninvasive measurements of cardiac index (CI), stroke index (SI), and systemic vascular resistance (SVR). To compare hemodynamic parameters after intrathecal sufentanil labor analgesia to those after a standard dose of epidural bupivacaine in laboring parturients. DESIGN: Randomized, double-blind study. SETTING: Labor and delivery unit in a university hospital. STUDY DESIGN: 40 ASA status I parturients were randomized into two groups receiving analgesia with combined spinal-epidural technique. Group SUF received 10 micrograms of intrathecal sufentanil followed by 12 ml of saline through an epidural catheter; Group BUP received 2 ml of intrathecal saline followed by 12 ml of 0.25% epidural bupivacaine. Heart rate (HR), blood pressure (BP), and thoracic bioimpedance monitoring were recorded. Pain scores, fetal HR, and side effects were noted. MEASUREMENTS AND MAIN RESULTS: No significant changes from baseline were seen in CI, SI, or SVR index. Mean arterial pressure was lower in Group BUP at 10 and 20 minutes after induction of analgesia. Mean HR was lower in Group SUF at 20 and 30 minutes after induction. Two patients in Group SUF and four patients in Group BUP experienced hypotension requiring ephedrine. Pain scores were lower in Group SUF at 10 minutes after induction of analgesia; subsequent pain scores and duration of analgesia were similar. Fourteen patients in Group SUF experienced itching. CONCLUSIONS: No significant differences in CI, SI, or SVR index were seen after either method of analgesia. A few patients in both groups experienced hypotension requiring treatment with ephedrine. Both techniques of labor analgesia appear to provide effective pain relief but care must be taken with either method to monitor maternal BP.

Alkaloids from Hippeastrum equestre. Part I. Phamine, a new phenanthridone alkaloid.

From the bulbs of Vietnamese Hippeastrum equestre Herb. (Amaryllidaceae), besides the well known alkaloids lycorine, tazettine, and hippeastrine, a new alkaloid, phamine, has been isolated. Its structure was established by spectroscopic methods.

Diagnosis of nosocomial pneumonia in mechanically ventilated patients. Comparison of a plugged telescoping catheter with the protected specimen brush.

Protected samples of lower respiratory tract secretions processed by quantitative culture techniques are recommended to diagnose nosocomial bacterial pneumonia in intubated, mechanically ventilated patients. To evaluate the accuracy of a simple and inexpensive sampling device in this setting, we compared quantitative cultures of paired single-sheathed plugged telescoping catheter (PTC) and protected specimen brush (PSB) samples in 55 patients during 78 suspected episodes of nosocomial pneumonia. PTC and PSB samples were taken in randomized order, and patients were also randomized to have PTC samples taken "blindly" or via a fiberoptic bronchoscope. Fifteen PSB and 27 PTC samples were culture positive (greater than or equal to 10(3) cfu/ml). The two sampling procedures gave similar results in 58 (74%) episodes. A major discrepancy occurred in 20 episodes, including six false negatives of PSB in episodes of proved pneumonia, four possible false positives of PSB, and 10 possible false positives of PTC (three of which rapidly evolved towards overt pneumonia). The sensitivity and specificity of PTC were 100 and 82.2%, and those of PSB were 64.7 and 93.5%, respectively. Blinded or directed PTC samples had similar concordance with PSB samples taken via bronchoscopy. We conclude that PTC is at least as accurate as PSB in the bacteriologic diagnosis of nosocomial pneumonia in intubated patients, and that its use can result in substantial cost savings, especially when fiberoptic bronchoscopy is not otherwise indicated.

Severe hypokalaemic paralysis from an unusual cause mimicking the Guillain-Barré syndrome.

We report a case of hypokalaemic quadriparesis occurring 37 years after a bilateral ureterosigmoidostomy. The history and physical signs as well as cerebrospinal fluid analysis initially led to a diagnosis of Guillain-Barré syndrome. Acidosis and profound hypokalaemia were present and a dramatic improvement occurred after rapid correction of the potassium depletion. The underlying mechanism of potassium depletion which occurs after this mode of urinary diversion are briefly discussed.