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To prospectively evaluate the efficacy of the saline dextran extraction method in the human cytomegalovirus (CMV) pp65 antigenemia assay (Ag-pp65).In a 2 months period we studied all the blood samples from immunodepressed patients. The extraction of leukocytes polymorphonuclear (LPMN) was obtained with a 6% dextran solution in 0.9% saline. The total leukocytes population was counted and the percentage of LPMN obtained was established. Simultaneously the LPMN were cultivated into the MRC-5 cell line by the shell vial method (SVC).The 144 blood samples studied were divided in three groups depending of the positivity in the pp65-AG and/or in the SVC. The patients with both assays positive presented the lower overall leukocyte and LPMN counting, with a difference statistically significance with the pp65-Ag negative. No statistically difference was observed in the overall count of leukocytes in the pp65-Ag negative group. The overall percentage of LPMN obtained was 87%. The median value of pp65-Ag positive samples was 48/100,000 LPMN, this value would be 51/100,000 LPMN with the application of the real percentage of LPMN obtained (p0.05).The saline dextran extraction method presented a high efficacy in the majority of blood samples studied. The immunological status and the presence of a CMV infection or disease in the patient were the principal factors that influence the extraction method. In general there is no need to adjust the pp65-Ag value obtained with this method to the real one.

To evaluate prospectively the efficacy of different clinical samples and cellular lines in the isolation of Enteroviruses from pediatric patients.In the period july-1997 to july-1999 we analyze the samples of 102 pediatric patients (2 years old) with an unknown febrile etiology syndrome. After the process of decontamination the samples were inoculated in the MRC-5, Hep-2 and Vero cell lines by the shell-vial assay. After 2-3 days of incubation the monolayers were stained by a monoclonal antibody against VP1; then the strains were identified as Poliovirus, ECHO-virus or Coxsacke by specific antibodies.96 clinical samples were studied (45 pharyngeal swabs, 28 feces, 13 cerebrospinal fluid, 5 bloods, 4 urines and one bronchoalveolar lavage). Enteroviruses were isolated in 48 patients (47%), corresponding to 60 clinical samples (62.5%). The enteroviruses were isolated in 75.5% of pharyngeal swabs, 71.4% of feces, 30.7% of cerebrospinal fluid, one blood (20%) and the bronchoalveolar lavage. 28 patients presented simultaneously both pharyngeal and rectal swabs; in this group the use of both samples permitted the isolation of Enteroviruses in 26 cases (92.8%). Of 60 Enteroviruses, 59 (98.3%) were isolated in the MRC-5 cell line, 23 (38.3%) in the Hep-2, and 14 (23.3%) in the Vero; the MRC-5 demonstrated a significant difference in the isolation of Enteroviruses compared with the other cell lines. The Enteroviruses were identified as 30 (50%) ECHO-virus, 15 (25%) as Poliovirus vaccine, 12 (20%) could not to be identified and in 3 cases (5%) no growth of virus was detected in the culture. The MRC-5 cell line was significatively superior to the other in the isolation of the different Enteroviruses.To obtain the maximum diagnostic efficacy in front a patient with a possible infection by Enteroviruses, is necessary to use different clinical samples, specially the more related to the infection focci (cerebrospinal fluid or blood). The MRC-5 cell line has been the most efficace in the isolation of Enteroviruses independently of the type of clinical sample or the viral genus. The shell-vial assay is a good method for the isolation and identification of Enteroviruses isolated from clinical samples.

S. lugdunensis is a recently described staphylococcal species with morphologic characteristic similar to those of S. aureus. It has been associated to a variety of clinical infections. In this paper we present the clinical and microbiological features of S. lugdunensis isolates from 25 patients.We have studied the S. lugdunensis isolates obtained from clinical specimens in our laboratory over a three-year period, 1994-96. For all isolates we determined the presence of clumping factor, Dnase, free coagulase in tube and ornithine decarboxylase (ODC). Full identification was performed with API ID32-Staph strips (bioMérieux) and antimicrobial susceptibility with commercial broth microdilution MIC panels (PASCO System, Difco).We obtained 38 S. lugdunensis isolates from 25 patients. The clinical specimens were: breast exudate/pus (8), blood (5), surgical wound (2), urine (2), nasal exudate (2), peritoneal fluid (1), pleural fluid (1), venous catheter (1), Tenckoff catheter (1), bartholin pus (1), ulcer (1). The isolates were considered clinically significant in 20 patients, whereas those of the remaining 5 patients were considered mere colonizers. All isolates were clumping factor (+), ODC (+), Dnase (-) and free coagulase (-). 16/23 (69.5%) were susceptible to penicillin and only one isolate was methicillin-resistant.We have isolated S. lugdunensis from a great variety of clinical specimens (blood, sterile body fluids, urine, skin, abscesses and nasal mucosa). It is specially remarkable the association with non-puerperal mastitis. The presence of clumping factor in all isolates can easily lead to misidentification as S. aureus. The ODC test appears as a good screening method for detecting S. lugdunensis. S. lugdunensis shows a good susceptibility to betalactamic an other antimicrobial agents.

To compare the capacity of conventional centrifugation and spontaneous sedimentation to detect the presence of cytomegalovirus (CMV) in urine samples.We studied urine samples from 45 renal transplant recipients. After decontamination half of each sample was centrifuged (1,500 rpm for 10 minutes) and the other half was allowed to sediment at room temperature for 30 minutes. From the supernatant of each of these 250 microliters was inoculated in a shell-vial (MRC-5). Cultures were incubated for 48 hours at 37 degrees C and stained by an indirect immunofluorescence assay. The samples considered totally toxic were re-inoculated after dilution 1:1 with maintainance medium.Of 845 urine samples analyzed, 743 (88%) were negative and 102 (12%) positive. 66 (7.8%) were considered toxic: 35 (4.1%) partially toxic and 31 (3.6%) totally toxic. Of the centrifuged urine samples 86.2% were positive against 98% of the sedimented samples (p = 0.004). Of the 31 samples considered totally toxic, 17 (2.2%) corresponded with negative urine samples and 14 (13.7%) with positive samples. Off these, 12 (85.7%) were detected in centrifuged samples and 2 (14.3%) in sedimented samples (p = 0.001).The percentage of toxicity in the urine samples was low (7.8%) which does not seem to suggest the need for systematic dilution of all samples. The sedimentation process enabled us to detect a greater number of urine samples positive for CMV with a lower rate of toxicity of the monolayers. The use of this process would reduce the number of samples requiring reinoculation.

Leiomyosarcomas represent 10–20% of malignant tumors in the small bowel and 1% of those located in the large bowel. These tumors have aspecific symptoms depending on their size, location and histology. Intestinal leiomyosarcomas may be the cause of numerous types of surgical emergency. We report 2 cases of intestinal leiomyosarcoma in the jejunum and transverse colon. Both were diagnosed during an emergency exploratory celiotomy. The clinical features on admission were similar to those of acute abdomen. The main cause of surgical emergency was an extremely rare complication of gastrointestinal leiomyosarcoma: a severe hemoperitoneum. We briefly describe the surgical emergencies caused by intestinal leiomyosarcomas as well as the surgical methods employed in these cases.

A prospective parallel and blind comparative study was carried out to evaluate the diagnostic efficacy of two available anti-pp65 monoclonal antibodies (clone 95/12 and the pool 1C3 + AYM-1) for the cytomegalovirus (CMV) antigenemia assay.We carried out a comparative study of 107 blood samples from immunodepressed patients (renal transplant and AIDS patients) with suspected disseminated infection by CMV. The PMNLs were obtained using the method of sedimentation in saline dextran. Slides were stained by an indirect immunofluorescence assay with two commercially available monoclonal antibodies.Of the 107 blood samples studied 33 (30.8%) had a positive antigenemia test. The clone 95/12 detected 30 (90.9%) samples and the pool 31 (93.9%), no statistically significant difference was observed in the sensitivity of two reagents (p = 0.42). The values of the mean CMV-positive cell count obtained with the clone 95/12 was 60.6 vs 61.9 with the monoclonal pool (p = 0.026).No significant difference was detected between the two commercial monoclonal antibodies. However the pool detected a slightly superior CMV-positive cell count.

We report on a 65-year-old white woman who was hospitalized because of symptoms of an acute adrenocortical insufficiency. A CT scan revealed the presence of a large mass in the left kidney that infiltrated the adrenal gland. Fine needle aspiration cytology of the mass under imaging control failed to achieve a correct diagnosis, and nephrectomy was undertaken with a preoperative diagnosis of renal cell carcinoma. However, the frozen section reveals a neoplasm of large lymphoid cells with a diffuse growth pattern. Immunohistochemistry confirms the B-cell nature of the neoplasm (CD20+). The final diagnosis was non-Hodgkin B-cell high grade centroblastic lymphoma (KIEL classification). Postoperative studies failed to show lymph node or bone marrow infiltration by neoplastic cells. We found reports on only 60 malignant lymphomas, considered to be primary to the kidney. They usually affect middle-aged people, can be diagnosed with imaging techniques, and seem to show a better prognosis than other types of lymphoma.

We report a case of primary endobronchial non-Hodgkin Lymphoma, an unusual extranodal lymphoma, in a 62 year old patient, which begins with malaise, marked respiratory symptoms and empyema. We especially discuss its diagnostic's criteria and its clinicoradiologic manifestations. We argue over its pathologic, immunohistochemical and cytogenetic features according to the REAL classification of lymphomas. On previous experience and the good response of this case, we propose chemotherapy followed radiotherapy may would be a suitable therapeutic approach.

We report a prospective comparative study of the efficacy of three commercial cell lines in the isolation of the parainfluenza (PI) virus from nasopharyngeal samples.In a 16 months period we studied all nasopharyngeal samples from patients with the suspension of a viral respiratory infection. The compared cell lines were LLC-MK2 and MDCK. All samples were processed by the shell-vial assay, incubated 3 days at 36 degrees C. The monolayers were stained by an indirect immunofluorescence assay with a monoclonal antibody against the nucleoprotein of the PI virus.In the study period 746 samples were analyzed, 46 PI virus were isolated, all belonged to the serotype 3. The LLC-MK2 cell line isolated 44 viruses (95.6%) and the MDCK cell line 41 (89.1%), no statistically significant differences were detected (p = 0.14) (qualitative sensitivity). In 84.8% of positive samples, the PI virus was isolated simultaneously in the two cell lines. Neither cell line isolated all PI virus. No statistical differences were detected in the quantitative sensitivity, although the LLC-MK2 cell line detected a slightly more samples with a low viral load (70.4 vs 68.2%).In view of the results obtained in this study, we believe that anyone of the two cell lines would be used in the isolation of the PI virus from respiratory samples.

Alkaline hydrolysis was performed on a series of different vegetable oils. The unsaponifiable lipid matter was extracted with ethyl ether, and the class of 4,4-desmethylsterols (sterols) plus the triterpene diols (diols) erythrodiol, uvaol, and betulinol were isolated by thin-layer chromatography. A validated method using the acetate derivatives of sterols instead of their silyl ethers is presented. The acetate derivatives were analyzed by high resolution gas chromatography (HRGC). Retention time, precision, recovery studies, and absolute response factors were calculated for these esters, and GC/mass spectrometric structure of the assigned retention times was confirmed for the sterols and triterpene diols.

The accelerometers used for the measurement of microvibrations or microgravity applications, such as active control of space structures, attitude control, scientific payloads, or even on-Earth testing of structures at very low-excitation levels, require a dedicated calibration procedure that includes the gravitational effects. Otherwise, on-Earth calibrations can be inaccurate due to the collateral projection of the local gravity onto the sensitive axis. An on-Earth calibration technique for the 107102s amplitude range and 0-100-Hz frequency range is described. Special attention has been given to the modeling of gravitational effects on the response of the calibration device and the accelerometer itself. The sensitivity and resolution tests performed on piezoelectric accelerometers showthe accuracy andthe potential of thistechnique. Typical scale factorun certainty, which hasbeen carefully analyzed, is of the order of 2% at acceleration levels of 10sg.

A new technique for multistep phase-contrast image processing is presented. The N-step method consists of simply forming the linear average of the N — 1 adjacent phase-difference signals. It has similar noise reduction properties as other multistep techniques, but the simplicity of the noise variance of the N-step technique allows intuitive insight into phase-difference phase-contrast processing and noise reduction, which can aid in the design of efficient and improved phase-contrast imaging sequences. As well, the computational simplicity of the N-step phase-difference technique compared with any other known multistep technique is advantageous. Like other multistep techniques, it has far more efficient noise reduction properties than simple two-step, multiple average phase-contrast imaging, even when normalized for total scan time. A three-step phase-difference velocity image has 50% less variance than an image acquired with two steps and two scans averaged but is obtained in 25% less scan time. Given its advantages, it should now be the chosen technique for increasing velocity-to-noise and contrast-to-noise ratios in all phase-difference phase-contrast clinical applications.

We performed an study of the possible benefits derived from the use of two vials, incubated for 24 and 72 h respectively, in the isolation of CMV from the leukocyte polymorphonuclear (LPMN) of peripheral blood (viremia) in immunosuppressed patients, using the shell-vial culture technique.The blood samples with EDTA were fractionated by sedimentation with saline dextran. The LPMN-rich upper layer was used for the isolation of CMV in the shell-vial cell culture (MRC-5 cell line) and to prepare the antigenemia pp65 assay. The cultures were stained at 18-24 h (first vial) and 72 h (second vial) with an indirect immunofluorescence assay with a monoclonal antibody against p72 CMV antigen.We studied 878 blood samples of which 247 (28.1%) were positive for CMV. Of the positive samples, 211 (85.4%) were detected in the first vial, and 220 (89%) in the second vial. Neither of the two vials detected all positive samples. An overall toxicity of 3%, in the positive samples, and 8.5% in positive samples was detected, respectively. Of the 28 toxic samples, 25.9% were detected in the first vial and 85.1% in the second (p0.001). The use of the second vial increased the number of positive samples in 14.5% (36 blood samples).In view of the results obtained in this study it would seem that, in order to obtain the maximum diagnostic yield in the isolation of CMV from LPMN of peripheral blood in immunosuppressed patients by means of the shell-vial culture, it is necessary to inoculate all the LPMN extracted into two vials. The lengthening of the incubation period up to 72 h for one of the vials leads to an increased in the isolation of CMV of 14.5% with a low overall toxicity.

Metastatic infiltration of the liver is an uncommon cause of acute hepatic failure. We describe the case of a 55-yr-old man who presented with signs and symptoms of liver disease. Diagnostic testing revealed a small cell carcinoma of the lung with massive hepatic metastases.

Data regarding orthopaedic work-force is presented. Data is based on information obtained from the Puerto Rico Board of Medical Examiners, the Puerto Rico Department of Health and orthopaedic surgeon's practice. The purpose of this study is to compare the local orthopaedic manpower with the American Academy of Orthopaedic Surgeons most recent national manpower survey and to provide a database of the local orthopaedic work-force.

Mapping analyses of monoclonal antibodies (MAbs) directed against the amino-terminus of the adenomatous polyposis coli (APC) gene product revealed that epitopes recognized by the MAbs FE9, CF11 and AC4 constitute different peptide sequences encoded by the APC exons 1, 2 and 3, respectively. The protein pattern detected with these specificity-defined immunoreagents, however, differed depending on the particular antibody used on Western blots of cellular urea extracts. APC exon 15-positive "classic" p300apc polypeptide chains were identified by the MAb FE9, MAb CF11 and the C-terminus-specific MAb IE1, but only weak signals were obtained with the AC4 MAb, which defines an exon 3-encoded epitope. In contrast with this immunoreactivity, 2 novel high m.w. products of approx. 150/160 and 200 kDa were exclusively recognized by the AC4 MAb, which was shown to bind to the APC exon 3-encoded peptide sequence SRESTGYL. A molecular form of some 400 kDa was identified to represent a disulfide-bound oligomer of the p150/160apc molecules. The novel APC-related molecules did not contain exon 1- and exon 15-encoded epitopes, as confirmed with the help of the FE9 and IE1 MAbs, respectively. This observation was corroborated by the fact that these novel proteins were not truncated in a collection of familial adenomatous polyposis patients with stop mutations in exon 15. We conclude, that APC MAb AC4-reactive p150/160 and p200 polypeptide chains represent novel genuine products of the APC gene devoid of exon 1- and exon 15-encoded protein interaction domains.

Vegetable oils used for food consist predominantly of triglycerides, that is, glycerol esters of fatty acids. Some significant fatty acids and their shorthand designations are shown in Table 7.1. Fatty acids contribute 94–96% of the total weight of the triglycerides. The fatty acids in vegetable oil triglycerides generally follow a pattern whereby those in the middle or 2-position of the glyceride molecule are unsaturated. Only small amounts of saturated acids are present in the 2-position, except when they are present at high concentrations in an oil or solid fat, such as coconut or palm kernal oil. Procedures for analysis of triglycerides were described by Litchfield (1972) and Christie (1986). Pancreatic lipase hydrolysis has been used to determine the fatty acid composition in the 2-position of oils and has been expanded to include stereospecific analyses (Litchfield, 1972; Breckenridge, 1978; Christie, 1986; Laakso and Christie, 1990; Christie et al., 1991; Sempore and Bezard, 1991; Damiani et al., 1994).

To study the prevalence of virulence factors (adhesion, invasion, cytotoxicity and hemolytic activity) and to establish the presence of pathovars (virulence phenotype) in C. jejuni strains isolated in pediatric patients with inflammatory and secretory diarrhea and asymptomatic carriers.We analyzed 95 strains of 48 patients with inflammatory diarrhea (blood and mucus in feces), 30 patients with secretory diarrhea (watery) and 17 strains isolated in asymptomatic children (control group). The study of adherence capacity, invasion and cytotoxicity was made in the Hep-2 cell line, and the analysis of hemolytic activity in blood agar plates with a 5% sheep's blood. The pathovars were defined by the cellular adhesion (phenotypes A and a) and the cytotoxicity (phenotypes E and e).29.1% of inflammatory strains presented adherence capacity, 66.6% were invasive, 64.5% cytotoxic and 52.1% hemolytic. In the secretory strains the values were 70, 20, 10 and 6.6% respectively; in the control group the 11.7% presented adherence capacity and 5.8% were invasive. We obtained difference statistically significative for the secretory strains in the adherence capacity, and in inflammatory strains in the adherence capacity, cytotoxicity and hemolysis. The phenotype Ae predominate in the secretory strains, and the phenotype ae in the strains belonging to the control group. No pathovar predominates in the inflammatory strains.The analysis of virulence markers permit us to establish the pathogenic behaviour of the C. jejuni strains isolated in patients with diarrhea. The study of the adherence capacity and cytotoxicity (pathovars) would be used as a virulence markers and to predict the inflammatory or secretory nature of the diarrhea caused by C. jejuni strains.

The aim was to evaluate the efficacy of the API-Campy system in the biochemical identification of 62 hippurate negative campylobacter strains isolated from the faeces. The strains were identified manually as 34 nalidixic acid susceptible C coli (NAS), 20 nalidixic acid resistant C coli (NAR), and eight C lari. The 34 strains of NAS C coli were identified as such by the API-Campy system. Of the 20 strains of NAR C coli, 15 (75%) were correctly identified by the commercial system. None of the five NAR C coli strains which were also erythromycin resistant was identified as such by the system. The eight C lari strains could not be identified by the API-Campy system because the bionumber obtained does not exist in the database of the computer system. The API-Campy system could be very useful for the identification of NAS C coli. However, failure to allow for a higher percentage of resistance to nalidixic acid in this species does not permit good identification of NAR strains. More important discrepancies are observed in C lari strains. In order to improve the identification of NAR C coli and C lari stains, it is advisable to include, or recommend as complementary, the indoxyl acetate hydrolysis test.

We report the in vitro antibiotic susceptibility of 1,220 strains belonging to the thermotolerant Campylobacter species, isolated from the feces of pediatric patients with diarrhea in the period from 1987 to 1993. The strains were identified as 1,148 C. jejuni isolates and 72 C. coli isolates. The overall results show that the strains showed drug resistance as follows: 51.8% to ampicillin, 4.4% to clindamycin, 2.6% to chloramphenicol, 21.2% to tetracycline, and 1% to gentamicin. Twenty-one strains (1.7%) displayed resistance to the combination of amoxicillin-clavulanic acid, and 3.2% of the strains were resistant to erythromycin (MIC of > or = 4 micrograms/ml), with a notable difference according to the species under consideration. While C. jejuni remained stable at 0.9 to 4% resistance to erythromycin, for C. coli the percentages detected ranged from 0 to 33%, with overall rates of 2.5 and 15.2% for the two species, respectively. Resistance to nalidixic acid (MIC of > or = 32 micrograms/ml) was found in 27.2% of the strains (27.8% for C. jejuni and 18% for C. coli), and resistance to ciprofloxacin (MIC of > or = 4 micrograms/ml) was found in 24.2% of the strains for C. jejuni and 15.2% for C. coli). Cross-resistance between nalidixic acid and ciprofloxacin was found in 89.1% of the strains (type 1 mutants), while 10.9% were resistant to nalidixic acid but susceptible to ciprofloxacin (type 2 mutants).

The differential clinical and epidemiological characteristics of pediatric patients (14 years) with gastroenteritis caused by rotavirus or adenovirus were studied.A retrospective study was performed in patients with viral gastroenteritis diagnosed from January 1990 to December 1992. The detection of viral particles was carried out by the agglutination system with latex particles sensitized with antibodies versus rotavirus and adenovirus. Clinical and epidemiological characteristics of the patients were collected reviewing the medical records and emergency charts.Two hundred eighty-nine patients corresponding to 240 cases of infection by rotavirus (83.1%) and 48 (16.9%) by adenovirus, were analyzed. Diarrhea by rotavirus predominated in the winter months (59.7% of the cases from December to March). Nonetheless, those caused by adenovirus were seen throughout the year with a stable incidence being observed. Statistically significant differences were seen in both groups (p0.001) with rotavirus infection having a greater tendency to admission and greater incidence of vomiting, fever (39 degrees C) and underlying disease. The presence of leukocytosis was different in the adenovirus group as were the greater length of duration of diarrhea prior to attending the Emergency Department (5.2 days) and the total length of stay (11.2 days). No other associated enteropathogenic organisms were detected in 86.3% of the infections by rotavirus and in the 89.8% of those caused by adenovirus. In regard to age group distribution prevalence of diarrhea by rotavirus was observed during the first 3 months of life (76.6%) while adenovirus group it went up to 24 months of age with similar percentages.Diarrhea by rotavirus is mainly presented in the winter, with vomiting and its shorter in length and the symptoms less prolonged than diarrhea caused by adenovirus. Rotavirus diarrhea generally affect patients admitted with some underlying disease. Nonetheless, microbiologic diagnosis is required to establish the definitive etiology of both clinical processes.

Campylobacter bacteria are frequent, and usually slight causes of diarrhea in a normal host while in an immunosuppressed host the diarrhea may lead to severe pictures. The aim of this study was to analyze the clinical features of gastroenteritis by Campylobacter spp. in hospitalized seronegative patients and in those with HIV infection.A retrospective study of the cases of gastroenteritis by Campylobacter spp. in adult patients admitted in the authors' hospital from January 1988 to July 1993 was carried out.Of the 20 patients studied with gastroenteritis by Campylobacter spp., 13 (65%) had HIV infection. The mean age of the patients was 38 years (range: 18-68 years) with 70% of the cases being males. Seventy seven percent of the HIV positive patients showed diagnostic criteria for AIDS while 71% of the seronegative patients showed a base disease and/or received steroid therapy. The length of the diarrhea was greater in the patients with HIV infection on comparison with the seronegative patients (25 vs. 6 days). The diarrhea persisted for more than 2 weeks in more than half of the cases of seropositive patients. Fever continued a mean of 24 days in the HIV positive patients as compared with only 5 days in the HIV negative cases. Most of the former patients were treated with erythromycin with good response. Gastroenteritis recurred in one patient and another patient with HIV infection presented a pseudoappendicular picture. No case of bacteremia was detected in either the seropositive or seronegative patients. Campylobacter jejuni was isolated in most of the cases with a high percentage of resistence to quinolone drugs. The mean CD4 lymphocyte count in HIV positive patients was 131/mm3 (range: 1-774). Mean survival following diagnosis of gastroenteritis by Campylobacter spp. was 8.9 months (range: 1-17) in the patients with AIDS.Gastroenteritis by Campylobacter spp. in hospitalized patients was related with immunosuppressive states. A clinical profile of prolonged febrile diarrhea was common in HIV positive patients and was associated with a low number of CD4 lymphocytes, advanced HIV infection and short survival.

We report the clinical characteristics of three adult patients with a chronic gastroenteritis (more than 10 days duration) due to Plesiomonas shigelloides. The three patients presented previously an underlying disease; a chronic liver disease (alcoholic and viral) and a cancer disease. Although the immunosuppressed condition of the patients, the diarrhea was moderate with 6-12 movements/day; the feces were liquid with mucose and blood. No one patient presented fever but all of them had important abdominal pain. Two patients were treated with cotrimoxazole and ciprofloxacin because of their underlying disease. We review the clinical characteristics of chronic diarrhea caused by P. shigelloides in adult patients, and the possibility that this microorganism would be considered a true enteropathogen.

DC-SIGN and Langerin are two C-type lectins involved in the initial steps of HIV infections: the former acts as a viral attachment factor and facilitates viral invasion of the immune system, the latter has a protective effect. Potential antiviral compounds targeted against DC-SIGN were synthesized using a common fucosylamide anchor. Their DC-SIGN affinity was tested by SPR and found to be similar to that of the natural ligand Lewis-X (LeX). The compounds were also found to be selective for DC-SIGN and to interact only weakly with Langerin. These molecules are potentially useful therapeutic tools against sexually transmitted HIV infection. © 2011 The Royal Society of Chemistry., This work was supported by the FIRB program CHEM-PROFARMANET (RBPR05NWWC), the Marie Curie ITN FP7 project CARMUSYS (PITN-GA-2008-213592) and Comune di Milano (Convenzione 55/2008). Exact mass were obtained from CIGA (Centro interdipartimentale grandi apparecchiature, Università degli Studi di Milano).

A comparative retrospective study was performed on the bacterial etiology of the diarrheal processes which affect a healthy cohort and those which affect HIV-positive patients. From 1988 to 1991, 10,230 coprocultures were obtained of which 27.3% were positive in the healthy cohort and 16.8% in the HIV-positive group. Of the 43 cases in the latter, 24 (12.2%) were adults and 18 (33.9%) were pediatric patients. The primary enteropathogenic microorganism isolated in the HIV-positive group were 17 (40.5%) S. enterica (I), 16 (38.1%) Campylobacter sp., and 9 (21.4%) aeromonas sp. Even though the overall percentage of enteropathogen detection hardly showed any differences between the two groups, it is worth mentioning that there was a certain predominance of diarrheas due to S. enterica (I) in the healthy cohort as compared to the incidence of diarrheas due to Campylobacter sp. and Aeromonas sp. in HIV-positive patients. There does not appear to be strong differences between the incidence of the various enteropathogens in the two groups, perhaps a simple reflection their geographic and local prevalence.

The aim of the study was to assess the microbiological characteristics and the clinical aspects of pediatric patients (age14 years) with infectious diarrhea due to one of the species included among the mesophilic Aeromonas group (AMs) from January 1989 to December 1991.The samples (stools) were processed following the routine methodology recommended. For isolation of AMs the XDCA medium was used and identification of species was performed by gas production tests from glucose and esculin hydrolysis. Clinical and epidemiologic features were recorded by means of a retrospective analysis of the clinical histories.In 30.3% of the 7,653 stool-cultures studied, an enteropathogenic microorganism identified as S. enterica (I) was isolated in 979 (12.8%), 536 cases to Campylobacter sp. (7.0%) infection, 58 to Shigella sp. (0.7%), 56 to Y. enterocolitica (0.7%, 221 to rotavirus (2.8%) and 49 to adenovirus (0.6%) The presence of AMs was detected in 282 patients (3.7%), representing 12% of the all positive stool-cultures. The species isolated were A. caviae (54.9%), A. sobria (21.9%) and A. hydrophila (23.1%). In 56% of the cases the AMs were isolated as the single pathogen. Thirty-nine point seven percent of the isolations were performed in patients aged less than 12 months (17% with less than 3 months). The A. caviae species was found to be predominant among the breast-fed babies (51.7%). Seventy percent of the children of 0-3 months presented A. caviae as unique pathogen. A total of 84.3% of the children infected with A. caviae, had been or were being fed with artificial lactation. AMs predominated in the late summer-early fall months (August-October) reading the maximum rate of isolations in these months (35.3 cases/month).Infections gastroenteritis due to mesophilic Aeromonas in the authors' geographic area appears to affect males mainly, and presents as an acute self-limited diarrhea, community-acquired. The predominance of A. caviae during the lactation period and in the first three months of life are data which should be further considered and confirmed.

We describe a method for the typing and quantitation of Klebsiella pneumoniae serotype O1 lipopolysaccharide (LPS) based on inhibition in an enzyme-linked immunosorbent assay of a reaction of known O1 LPS antigen and anti-O1 antibody by unknown LPS extracts. Serotype O1 was found in 32% of the 124 K. pneumoniae clinical isolates tested, showing that this serotype is frequent among the eight O serotypes which have been described previously.