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We present 2 cases of Aspergillus endocarditis occurring in lung transplant recipients, both of whom were treated with early surgical intervention and triazole anti-fungal agents. Neither had evidence of airway colonization/infection with Aspergillus post-transplant, suggesting hematogenous spread of fungi at the time of surgery as a possible mechanism of infection. One case was successfully treated and discharged from the hospital, but, despite initial recovery, death occurred 10 months later due to a recurrence of Aspergillus endocarditis. Aspergillus endocarditis should be considered a relapsing disease and survivors of the condition should receive ongoing anti-fungal therapy.

A diet supplemented with flaxseed, rich in alpha-linolenic acid and plant lignans (the latter, potent platelet-activating factor receptor antagonists), was tested in a murine model of lupus nephritis. MRL/lpr female mice (n = 25) were fed 15% flaxseed diet for 14 weeks commencing at 10 weeks of age. As controls, 30 MRL/lpr mice received a standard rodent diet without flaxseed. Isotope-glomerular filtration rate (14C-inulin clearance) was measured at 9, 16, and 24 weeks of age. Proteinuria was assessed at 2-week intervals. Spleen lymphocyte proliferation, quantitated by DNA analysis, was evaluated using flow cytometry at 9, 13, 19, and 21 weeks of age. Mortality was recorded throughout the study. Glomerular filtration rate at 16 weeks was greater in flaxseed-fed mice (0.15 +/- 0.03 mL/min) compared with controls (0.06 +/- 0.04 mL/min; P = 0.01). The onset of proteinuria (Albustix, Ames Division, Miles Laboratories, Rexdale, Ontario, Canada;or = 2+) was delayed by 4 weeks in the flax-treated mice. The percentage of flaxseed-fed mice with proteinuria was lower than the control mice up to 21 weeks of age (39% v 58%; P = 0.01). Spleen lymphocyte proliferation (percentage of cells in S-phase) at 13 weeks of age was significantly higher in the control group (22.9 +/- 5.0, P = 0.01) but not in the flaxseed group (17.2 +/- 4.9) compared with baseline (9 weeks of age) values (13.0 +/- 3.5). Mortality was lower in the flaxseed-fed mice versus the control mice (assessed by Mantel-Haenszel (log-rank) test; P0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Nitric oxide (NO) is a simple molecule implicated in neuronal transmission, endothelium-dependent vasodilatation, and macrophage immunologic activation. Enzymes responsible for NO synthesis constitute a family with at least three distinct isoforms - neuronal (NOS1), endothelial (NOS3), and inducible tissue. NO synthase enzymatic activity is constitutively expressed but activation of the calcium/calmodulin signaling pathway is required for maximal activity. Constitutive NO synthases contrast with a pathway for NO synthesis evident in macrophages, Kupffer cells, hepatocytes, vascular smooth muscle, and mesangial cells, among others. NO synthase activity is induced in these cell types by cytokines or bacterial wall products over a period of many hours. 14 refs., 1 fig.

ISOLATION OF ATYPICAL MYCOBACTERIA IN LUNG AND HEART-LUNG TRANSPLANT RECIPIENTS K. Thaning, N. Roy, A.V. Hall, M.E. Hodson, M.R. Carby, Transplant Medicine, Harefield Hospital, Middlesex, United Kingdom; Transplant Medicine, Harefield Hospital, Middlesex, United Kingdom; Microbiology, Harefield Hospital, Middlesex, United Kingdom; Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom