Descending thoracic aortitis due to Haemophilus influenzae: a case report and literature review.

Aortitis due to Haemophilus influenzae especially involving the descending thoracic aorta is rarely encountered. We present a case and literature review concerning Haemophilus influenzae aortitis. This article serves to enhance the awareness of this extremely rare disease.

Differences in sexual desire between women with clinical versus biochemical signs of hyperandrogenism in polycystic ovarian syndrome.

The role androgens play in female sexual desire remains unclear. We investigated whether androgen sensitivity or elevated androgen levels contributed to sexual desire using a motivational model of sexual desire. Eighty-five women diagnosed with polycystic ovary syndrome (PCOS) were categorized depending on whether they exhibited clinical symptoms of androgen sensitivity or high biochemical androgen levels. Additionally, instead of looking at desire as a uniform construct, we divided desire based on the reasons why women experienced desire, thus distinguishing desire to have sex for relational purposes from the desire to have sex for mating selection or physical pleasure. Findings confirmed that clinical signs suggesting sensitivity to androgen levels, but not biological levels of androgens per se predicted levels of sexual desire. Moreover, in agreement with our hypothesis, we found support for a relationship between androgen sensitivity and some, but not other aspects of sexual desire. Cues that are most closely related to mating selection were significantly associated with androgen sensitivity, but not cues associated with desiring sex to feel emotionally close or create a love bonding with a partner. This study presents a new way to investigate desire and shows some preliminary findings on the importance to consider androgen sensitivity when investigating the relationship between sexual desire and hormones.

Spontaneous fusion of the midfoot following reflex sympathetic dystrophy. A case report and review of the literature.

Reflex sympathetic dystrophy syndrome (RSDS) is a well-defined entity, caused by many clinical conditions, leading to pain, stiffness, and vasomotor changes in the affected region. In this case, a 49-year-old man presented with a history of right foot pain secondary to a fall. Plain radiographs did not reveal any fractures or bony fusions. Upon follow-up, a history consistent with that found in RSDS was given. Radiographs at 7 and 11 weeks revealed increasing osteopenia, lytic lesions, and absent joint spaces in the first through third metatarsocuneiform articulations suggesting ankylosis. Other possible causes of ankylosis, including infection, inflammatory and metabolic conditions, were excluded.

Detection of bacteriuria and pyuria by URISCREEN a rapid enzymatic screening test.

A multicenter study was performed to evaluate the ability of the URISCREEN (Analytab Products, Plainview, N.Y.), a 2-min catalase tube test, to detect bacteriuria and pyuria. This test was compared with the Chemstrip LN (BioDynamics, Division of Boehringer Mannheim Diagnostics, Indianapolis, Ind.), a 2-min enzyme dipstick test; a semiquantitative plate culture method was used as the reference test for bacteriuria, and the Gram stain or a quantitative chamber count method was used as the reference test for pyuria. Each test was evaluated for its ability to detect probable pathogens at greater than or equal to 10(2) CFU/ml and/or greater than or equal to 1 leukocyte per oil immersion field, as determined by the Gram stain method, or greater than 10 leukocytes per microliter, as determined by the quantitative count method. A total of 1,500 urine specimens were included in this evaluation. There were 298 specimens with greater than or equal 10(2) CFU/ml and 451 specimens with pyuria. Of the 298 specimens with probable pathogens isolated at various colony counts, 219 specimens had colony counts of greater than or equal to 10(5) CFU/ml, 51 specimens had between 10(4) and 10(5) CFU/ml, and 28 specimens had between 10(2) and less than 10(4) CFU/ml. Both the URISCREEN and the Chemstrip LN detected 93% (204 of 219) of the specimens with probable pathogens at greater than or equal to 10(5) CFU/ml. For the specimens with probable pathogens at greater than or equal to 10(2) CFU/ml, the sensitivities of the URISCREEN and the Chemstrip LN were 86% (256 of 298) and 81% (241 of 298), respectively. Of the 451 specimens with pyuria, the URISCREEN detected 88% (398 of 451) and Chemstrip LN detected 78% (350 if 451). There were 204 specimens with both greater than or equal to 10(2) CFU/ml and pyuria; the sensitivities of both methods were 95% (193 of 204) for these specimens. Overall, there were 545 specimens with probable pathogens at greater than or equal to 10(2) CFU/ml and/or pyuria. The URISCREEN detected 85% (461 of 545), and the Chemstrip LN detected 73% (398 of 545). A majority (76%) of the false-negative results obtained with either method were for specimens without leukocytes in the urine. There were 955 specimens with no probable pathogens or leukocytes. Of these, 28% (270 of 955) were found positive by the URISCREEN and 13% (122 of 955) were found positive by the Chemstrip LN. A majority of the false-positive results were probably due, in part, to the detection of enzymes present in both bacterial and somatic cells by each of the test systems. Overall, the URISCREEN is rapid, manual, easy-to-perform enzymatic test that yields findings similar to those yielded by the Chemstrip LN for specimens with both greater than or equal to 10(2) CFU/ml and pyuria or for specimens with greater than or equal to 10(5) CFU/ml and with or without pyuria. However, when the data were analyzed for either probable pathogens at less 10(5) CFU/ml or pyuria, the sensitivity of the URISCREEN was higher (P less than 0.05).

Evaluation of the rapid CLEARVIEW Chlamydia test for direct detection of chlamydiae from cervical specimens.

The CLEARVIEW Chlamydia test (Unipath, Mountain View, Calif.), a 30-min immunoassay, was compared to a standard tissue culture technique for the direct detection of chlamydiae from 677 cervical specimens obtained from 667 patients. For data analysis, 15 specimens were eliminated because of toxicity in the culture and 14 were eliminated because of failure of the extracted specimen to migrate in the CLEARVIEW test, one of the latter group being culture positive. Of the remaining 648 specimens, 40 were culture positive, of which 38 were detected by the CLEARVIEW test, and 12 specimens were positive only by the CLEARVIEW test. Therefore, the CLEARVIEW in comparison with culture was easier to perform, more rapid, and in this low prevalence (6.2%) population had a 95.0% sensitivity, 98.0% specificity, and 76.0% positive and 99.7% negative predictive values.

Comparison of monoclonal antibody and calcofluor white stains for the detection of Pneumocystis carinii from respiratory specimens.

Three monoclonal antibody staining kits, from Genetic Systems, Disease Detection International, and Meridian Diagnostics, were compared with calcofluor white for the direct detection of Pneumocystis carinii in respiratory specimens. Of the 150 specimens tested, 23 were found positive for P. carinii by any of the four stains; 13 were bronchoalveolar lavage, 7 were induced sputum and 3 were expectorated sputum specimens. All stains detected the positive bronchoalveolar lavage specimens, the Genetic Systems stain detected six induced sputum specimens, and the other stains each detected four induced sputum specimens. The monoclonal antibody stains detected all three expectorated specimens, while the calcofluor stain detected only one. Overall, the sensitivities of the stains were 96% for Genetic Systems, 87% for both Disease Detection International and Meridian Diagnostics, and 78% for calcofluor.

Comparison of the mechanism of action of busulfan with hepsulfam, a new antileukemic agent, in the L1210 cell line.

1,7-Heptanediol disulfamate (hepsulfam, NSC 329680) is a new antileukemic agent with close structural similarity to busulfan. The mechanism of action of hepsulfam is not known and it has recently been entered into Phase I clinical trials by the National Cancer Institute. Waud et al. have recently shown that hepsulfam has good antitumor activity against mouse L1210 leukemia in vivo (Waud et al., Proc. Am. Assoc. Cancer Res., 29:333, 1988). In contrast, busulfan was inactive against this model tumor system. In the present study, we have compared the in vitro cytotoxicity of hepsulfam with that of busulfan and we also examined the ability of these compounds to induce DNA damage in the L1210 leukemia cell line. Our results show that L1210 leukemia cells were 7-fold more sensitive to hepsulfam than busulfan. Only hepsulfam produced an appreciable quantity of DNA interstrand cross-linking in L1210 cells, with the peak of cross-link formation being delayed 12 h following a 2-h drug treatment. In contrast, both compounds also produced DNA-protein cross-linking, again with the formation of peak levels being delayed 6-12 h after drug treatment. At equimolar concentrations, hepsulfam produced a greater quantity of DNA interstrand cross-links and DNA-protein cross-links than busulfan. In contrast, busulfan produced a greater quantity of DNA-protein cross-links, when compared to hepsulfam at equitoxic concentrations.