四氢喋呤对兔缺血再灌注损伤内皮功能的保护作用

目的　研究四氢喋呤 (BH4 )对兔实验性缺血再灌注 (MI R)损伤中一氧化氮 (NO)、丙二醛 (MDA)、超氧化物歧化酶 (SOD)水平及心肌梗死面积的影响。方法　 2 4只新西兰兔随机分为假手术组、模型组和药物干预组 3组。制备MI R模型 ,观察BH4 预处理后MI R损伤中NO、MDA、SOD水平的变化及对心肌梗死面积的影响。结果　模型组较假手术组NO显著减低 [(2 8± 10 ) μmol L比(116± 17) μmol L ,P <0 0 1],MDA水平明显升高 [(5 8 3± 10 4 )nmol L比 (7 0± 1 8)nmol L ,P <0 0 1],SOD活性明显减低 [(2 6 8± 17)nu ml比 (340± 2 4 )nu ml,P <0 0 5 ];而BH4 预处理组较模型组NO明显升高 [(6 2± 17) μmol L比 (2 8± 10 ) μmol L ,P <0 0 1],MDA明显减低 [(30 9± 6 1)nmol L比(5 8 3± 10 4 )nmol L ,P <0 0 1],SOD活性无明显改变 [(2 88± 2 0 )nu ml比 (2 6 8± 17)nu ml,P >0 0 5 ];BH4 预处理组和模型组心肌梗死面积差异有显著性 [(18± 4 ) %比 (16± 4 ) % ,P <0 0 5 )。结论　MI R导致内皮功能紊乱。BH4 对内皮功能有保护作用 ,从而减轻再灌注损伤。     

子宫内膜异位症与T辅助细胞亚群及其细胞因子的关系

目的　探讨T辅助细胞 (Th)亚群中的T辅助细胞 1(Th1)和T辅助细胞 2 (Th2 )所分泌的细胞因子在子宫内膜异位症 (EM )发病中的作用。方法　应用细胞因子体外诱生培养技术对 35例EM患者及 18例健康育龄妇女外周血单个核细胞 (PBMC)加入植物血凝素 (PHA)进行培养诱生 3天 ,收集上清液。采用酶联免疫吸附试验双抗体夹心法 (ELISA)分别测定血浆及PBMC培养上清中Th1类因子干扰素 γ(IFN γ)及Th2类因子白细胞介素 (IL) 4、6、10的含量。结果　EM患者PBMC诱生培养上清中IL 4、IL 6、IL 10水平 [(37 36±13 6 5 )、(6 94 32± 110 93)、(80 39± 2 3 0 2 )ng/L]比对照组 [(2 6 36± 4 32 )、(5 2 6 35± 10 2 34)、(5 9 73±2 0 32 )ng/L]明显升高 ,差异有显著性 (P均 <0 0 1)。EM患者的IFN γ为 (10 87 3± 380 9)ng/L ,与对照组的(16 37 8± 340 8)ng/L比较差异有显著性 (P <0 0 1)。EM患者PBMC诱生培养上清中IFN γ/IL 4为 36 4 7±19 4 1,与对照组的 74 86± 13 4 2比较差异有显著性 (P <0 0 1)。在血浆中 ,除了EM组的IL 4、IL 6水平[(36 2 8± 17 4 6 )、(16 4 6± 5 4 8)ng/L]与对照组 [(2 2 4± 5 2 0 )、(12 32± 3 6 7)ng/L]比较差异有显著性 (P均<0 0 5 )外 ,两组IL 10、IFN      

倒卵叶五加总皂甙对大鼠心肌缺血/再灌注损伤后细胞凋亡的作用及机制

目的　探讨倒卵叶五加总皂甙 (SAOH)对大鼠缺血心肌再灌注后细胞凋亡的作用。方法　采用结扎左冠状动脉前降支再灌注复制大鼠心肌缺血再灌注损伤 (IRI)的模型 ,结扎前 10 min舌下静脉注射 SAOH,测定心肌缺血3 0 min后再灌注 6h心肌组织丙二醛 (MDA)和血浆超氧化歧化酶 (SOD)的含量 ,并用末端脱氧核苷酸转移酶介导的带生物素的 d UTP缺口末端标记 (TUNEL)的方法及免疫组化观察左心室心肌细胞凋亡及凋亡相关基因 Bcl- 2和 Bax的蛋白表达。结果　再灌注 6h后 ,SAOH1 组 (5 0 mg/ kg)及 SAOH2 组 (10 0 mg/ kg)较 IRI组 ,心肌组织 MDA含量明显减少 [(4.89± 0 .2 6)、(3 .5 7± 0 .2 1) nm ol/ mg· pro vs(6.97± 0 .3 4) nmol/ mg· pro,P值均 <0 .0 1];血浆 SOD活性明显提高 [(9.88± 0 .18)、(11.40± 0 .3 7)μIU / L vs (3 .3 9± 0 .2 4)μIU / L ,P值均 <0 .0 1];心肌细胞凋亡指数 (AI)显著减少 [(14.67± 3 .0 5 ) %、(7.49± 2 .62 ) % vs(2 1.96± 7.68) % ,P值均 <0 .0 1];Bax蛋白表达明显减少 [(7.73± 1.84) %、(5 .0 2± 1.0 1) % vs (18.5 9± 5 .68) % ,P值均 <0 .0 1];而心肌 Bcl- 2蛋白的表达显著增加 [(12 .5 1± 3 .42 ) %、(17.48± 4.72 ) % vs(7.3 2± 2 .0 5 ) % ,P值 <0 .0 5 ,<0     

高血压病患者血清Ⅰ型和Ⅲ型前胶原浓度变化及其临床意义探讨

目的　探讨高血压病 (EH)患者心肌纤维化的无创性检测指标。方法　采用放免法测定 30例正常人和 6 0例EH患者 (伴心肌肥厚者 35例和不伴心肌肥厚者 2 5例 )血清Ⅰ型前胶原 (PCⅠ )和Ⅲ型前胶原 (PCⅢ )的浓度 ,用M型超声测算左室重量指数 (LVMI) ,用多普勒超声测定二尖瓣口舒张早期和晚期最大血流速度 (VE 和VA)。结果　①EH患者血清PCⅠ和PCⅢ均明显高于正常对照组 [(4 6 6 5± 11 0 1)μg/Lvs (34 31± 5 91) μg/L ,P <0 0 5和 (146 0 0± 2 9 35 ) μg/Lvs (96 2 4± 2 1 18) μg/L ,P <0 0 1]。②EH非左室肥厚组血清PCⅢ浓度明显高于正常对照组 [(12 0 6 2± 16 2 3) μg/Lvs(96 2 4± 2 1 18) μg/L ,P <0 0 1],而血清PCⅠ与正常对照组无差别 [(33 73± 6 83) μg/Lvs (34 31± 5 91) μg/L ,P >0 5 ];EH左室肥厚组血清PCⅢ高于非肥厚组 [(16 4 14±2 2 2 8) μg/Lvs (12 0 6 2± 16 2 3) μg/L ,P <0 0 1]和正常对照组 [(16 4 14± 2 2 2 8) μg/Lvs (96 2 4± 2 1 18) μg/L ,P <0 0 1];血清PCⅠ亦高于非肥厚组 [(5 5 88± 12 86 ) μg/Lvs(33 73± 6 83) μg/L ,P <0 0 1]和正常对照组 [(5 5 88±12 86 ) μg/Lvs (34 31± 5 91) μg/L ,P <0 0 1]。③血清PCⅢ与V     

2型糖尿病肾病患者血清细胞粘附分子变化与氧化应激的关系

目的　探讨 2型糖尿病肾病患者 (DN)血清细胞粘附分子变化及其与氧化应激的关系。　方法　检测DN患者血清可溶性细胞间粘附分子 1(sICAM 1)、可溶性血管细胞粘附分子 1(sVCAM 1)、血清丙二醛 (MDA)含量和超氧化物歧化酶 (SOD)活性。　结果　早期DN及DN患者血清sVCAM 1水平〔分别为 (1 75± 0 48)、(1 91± 0 2 7)mg/L〕明显高于对照组〔(1 6 7± 0 72 )mg/L ,P <0 0 5和0 0 1〕 ,DN组明显高于单纯糖尿病 (DM)组〔(1 5 8± 0 39)mg/L ,P <0 0 5〕 ;DM组、早期DN组和DN组患者血清sICAM 1〔分别为 (75 6 0 0± 12 5 47)、(80 2 2 1± 12 4 81)、(897 6 0± 10 5 80 ) μg/L〕明显高于对照组〔(5 82 6 4± 10 2 73) μg/L ,P <0 0 0 1〕 ,其中DN组明显高于单纯DM组和早期DN组 (分别P <0 0 1和<0 0 5 ) ;单纯DM组、早期DN组和DN组患者血清SOD活性〔分别为 (86 5 9± 13 85 )、(85 6 9±11 32 )、(71 73± 16 35 )NU/L〕显著性低于对照组〔(92 73± 11 2 5 )NU/ml,P <0 0 1〕 ,MDA含量〔分别为(3 99± 1 36 )、(4 2 6± 1 95 )、(6 5 0± 2 98)nmol/ml〕显著性高于对照组〔(3 72± 0 5 7)nmol/ml,P <0 0 1〕。DM患者血清sVCAM 1与sICAM 1、收缩压、尿素氮 (BUN)和肌酐 (Cr)呈正相     

催乳素对Graves 病甲状腺细胞与自体外周血单个核细胞体外相互作用的影响

目的　研究催乳素对Graves病 (GD)甲状腺细胞与自体外周血单个核细胞 (PBMC)在体外共同培养时相互作用的影响。方法　利用免疫荧光染色和流式细胞仪等 ,测定在不同羊催乳素(oPRL)水平进行共同培养时PBMC的活化、增殖反应和甲状腺细胞对人类白细胞抗原基因复合体(HLA) DR及CD4 0 的表达。结果　oPRL浓度为 2 0 0 μg/L时与GD甲状腺细胞共同培养的PBMC中CD4 CD2 5 细胞百分率 [(13 0 8± 2 5 4) % ,P <0 0 1]和增殖指数 [(17 82± 3 0 2 ) % ,P <0 0 1]及 10 0 0μg/L时的增殖指数 [(16 5 7± 2 5 6 ) % ,P <0 0 5 ]均较 0 [分别 (10 15± 2 6 0 ) %和 (14 38± 2 6 4) % ]、12 5及 5 0 μg/L时有显著增加。在 2 0 0和 10 0 0 μg/L时相应甲状腺细胞中CD4 0 细胞百分率 [(4 8 2 5± 6 6 3) % ,(5 2 2 8± 6 94) % ]和平均荧光强度 (dMF ;42 94± 10 2 4,49 5 1± 12 34)明显低于 0 [(5 8 38± 6 6 2 ) %和 6 7 30± 2 0 2 0 ]、12 5及 5 0 μg/L剂量组。而在 5 0 μg/L时其HLA DR 细胞百分率[(4 6 79± 7 5 1) % ,P <0 0 1]和dMF(2 1 0 2± 5 43 ,P <0 0 1)显著高于 0 [(33 5 1± 8 5 8) %和 13 91±3 88]、12 5、2 0 0及 10 0 0 μg/L剂量组。除此以外 ,oPRL各剂量组间差异均     

风湿性和先天性心脏病患者心房肌内游离钙的测定

目的　通过对风湿性心脏病 (RHD)窦性心律 (SR)和心房颤动 (AF)患者及先天性心脏病(CHD)窦性心律患者心房肌细胞内游离钙 (Ca2 + )浓度的比较研究 ,探讨心房肌细胞内Ca2 + 超载是RHDAF的原因还是结果。　方法　用酶解法获得人心房肌单个细胞 ,以Fluo 3为指示剂 ,用激光共聚焦显微镜技术测量细胞内游离Ca2 + 浓度。　结果　RHDAF组心房肌细胞内Ca2 + 浓度明显高于SR组[(5 17± 98)nmol/L对 (2 6 2± 6 5 )nmol/L ,P <0 0 1];RHDSR组心房肌细胞内Ca2 + 浓度明显高于CHD组[(2 6 2± 6 5 )nmol/L对 (137± 4 5 )nmol/L ,P <0 0 1]。　结论　RHDSR患者心房肌细胞内已经存在Ca2 + 超载 ,是AF的易发因素 ,而RHDAF患者心房肌细胞内Ca2 + 浓度进一步升高 ,提示钙超载既是AF的原因也是结果。     

D-二聚体与冠心病病情及冠状动脉病变稳定性的相关研究

目的 :探讨血浆D 二聚体 (D dimer,DD)与冠心病(CHD)病情及冠状动脉病变稳定性的关系。方法 :对 1 1 0例观察对象按照冠状动脉造影病变形态学特征分为 :简单病变组 3 2例 ,复杂病变组 5 6例 ,正常对照组 2 2例。同时 ,根据临床CHD病情分为 :急性心肌梗死 (AMI)组 1 1例、不稳定型心绞痛 (UAP)组 49例 ,稳定型心绞痛(SAP)组 2 8例 ,正常对照组 2 2例。用酶免法 (ELASA)检测血浆DD含量 ,比较不同组间DD含量。结果 :血浆DD含量复杂病变组 [( 0 .499± 0 .2 1 4)mg/L]高于简单病变组 [( 0 .3 2 9± 0 .1 73 )mg/L]及正常对照组 [( 0 .3 1 9± 0 .1 2 6)mg/L],差异均有统计学意义 (P <0 .0 1 )。AMI组 [( 0 .5 93± 0 .3 44 )mg/L]和UAP组 [( 0 .471± 0 .2 1 4)mg/L]明显高于SAP组 [( 0 .2 92±0 .1 0 1 )mg/L]及正常对照组 [( 0 .3 1 9± 0 .1 2 6)mg/L],差异均有统计学意义 (P <0 .0 1 )。结论 :血浆DD含量与冠状动脉病变稳定性及CHD病情严重性相关 ,DD是冠状动脉病变活动性的血液标志物。     

抑制核因子-κB对糖尿病肾病的作用

目的　研究抑制核因子 κB(NF κB)活性对糖尿病肾病 (DN)及糖尿病大鼠肾组织纤维连接蛋白 (FN)mRNA表达的作用。方法　将纯种雄性Wistar大鼠分为 :A组为正常对照组 (1 1只 ) ,B组为糖尿病无干预组 (1 1只 ) ,C组为吡咯烷二硫基甲酸酯 (PDTC ,NF κB抑制剂 )干预组 (9只 )。饲养 1 8周后 ,以电泳迁移率变动分析技术检测肾组织NF κB活性 ,透射电镜检测肾小球基底膜厚度及系膜基质密度 (系膜基质面积 /系膜面积 ) ,逆转录PCR检测FNmRNA表达 ,收集 2 4h尿测定尿白蛋白排泄率 (UAE)。结果　NF κB活性在B组大鼠肾组织 [(1 85± 0 54)× 1 0 6 ]显著高于A组 [(0 0 7± 0 1 1 )×1 0 6 ,P <0 0 1 ] ,C组 [(0 2 5± 0 2 5)× 1 0 6 ]显著低于B组 (P <0 0 1 )。B组与A组比较 ,UAE[(2 1 8±1 98)mgvs (0 41± 0 47)mg ,P <0 0 1 ]、肾小球基底膜厚度 [(531 6± 1 0 7 6)nmvs (31 2 4± 2 5 4)nm ,P<0 0 1 ]及系膜基质密度 [(56 41± 6 78)vs (33 95± 5 2 2 ) ,P <0 0 1 ]均有显著差异 ;UAE(0 56± 0 72 )mg、肾小球基底膜厚度 (31 5 8± 2 1 4)nm及系膜基质密度 (37 97± 7 37)在C组均显著低于B组 (P值均 <0 0 1 )。FNmRNA表达在B组大鼠肾组织 (0 73± 0 2 6)显著高于A组 (0 31± 0     

白细胞介素-17的表达与狼疮肾炎关系初探

目的　了解狼疮肾炎 (LN)病人白细胞介素 17(IL 17)在血浆、尿液及肾组织中表达水平与LN发病相关性。方法　建立正常对照、活动期和非活动期LN组 ,用酶联免疫吸附法(ELISA)测定其血浆和尿液IL 17水平 ;制备正常对照、WHOⅣ型和非Ⅳ型肾组织标本 ,采用微波免疫组织化学染色法 ,光镜观察IL 17在肾组织中的表达。结果　血浆IL 17均测不出 (<5 pg/ml) ;尿液IL 17水平 ,活动期LN病人 (2 9± 5 ) pg/ml较正常对照 (3 3± 0 8)pg/ml和非活动期LN病人(9 6± 0 9) pg/ml明显升高 (P <0 0 0 1) ,且非活动期LN病人较正常对照亦明显升高 (P <0 0 0 1) ;免疫组织化学显示 ,WHOⅣ型LN较非Ⅳ型和正常对照组 ,单位肾小球细胞数 [(117± 31) / gcs(肾小球横向联合切面 )较 (4 3± 8) /gcs和 (34± 7) / gcs]明显升高 (P <0 0 1) ,单位肾小球IL 17+ 细胞数(Ng) [(33± 8) /gcs较 (8 2± 1 6 ) / gcs和 0 ]明显增多 (P <0 0 1) ,每平方毫米肾小管、间质IL 17+ 细胞数 (Nt) [(2 9± 9) /mm2 较 (8 8± 1 5 ) /mm2 和 0 ]亦明显增多 (P <0 0 1)。相关分析显示Ng与肾小球细胞增多、肾组织活动指数、尿蛋白、尿N 乙酰 β 氨基葡萄糖苷酶 (NAG)、血肌酐及尿IL 17亦呈正相关 ;Nt与肾组织活动指数、肾小管间质损害程度、尿     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.