一氧化氮合酶2抑制剂改善大鼠心肌梗死后心功能的作用

目的 :探讨一氧化氮合酶 2 (NOS2 )改善心肌梗死 (MI)后心功能障碍的作用。方法 :选用选择性NOS2抑制剂S 甲基硫脲 (SMT)抑制NOS2。于MI后 4周观察SMT对心功能的影响。结果 :MI组MI后 4周 ,心肌NOS2表达及血浆一氧化氮 (NO)水平均较假手术组升高 [(0 .2 6 1± 0 .0 2 5 )∶(0 .0 92± 0 .0 11)A·μm-2 ,P<0 .0 5 ];(4 6 .6± 4 .2 )∶(30 .6± 2 .1) μmol/L ,P <0 .0 5 ]。SMT干预 4周可使MI后血浆NO水平降低 [(2 6 .6±2 .2 )∶(4 6 .6± 4 .2 ) μmol/L ,P <0 .0 5 ],心室肥厚减轻 ,MI范围缩小 ,心功能改善 [左室舒张末压 (6 .1± 0 .7)∶(11.0± 1.2 )mmHg(1mmHg =0 .133kPa) ,P <0 .0 5 ];中心静脉压 (0 .8± 0 .1)∶(1.6± 0 .2 )mmHg ,P <0 .0 5 ]。结论 :抑制NOS2可以改善MI后心功能。NOS2及其产物NO在MI后心功能障碍的发生发展过程中起促进作用     

一氧化碳与肝硬化高动力循环的关系

目的　研究肝硬化大鼠血浆一氧化碳 (CO)水平与血流动力学改变之间的关系。方法　将SD大鼠分为两组 ,四氯化碳肝硬化模型组 (n =10 )及正常对照组 (n =10 ) ,用联二亚硫酸盐还原法测定血浆CO的含量 ,镉柱还原法测定血浆一氧化氮 (NO)的含量 ,根据胆红素的生成量测定组织血红素氧合酶 (HO)的活性 ,插管法测定血压、心率及门静脉压力。结果　与对照组相比 ,肝硬化组血浆CO、NO水平显著升高 [(18.6 9± 1.86 ) μmol/L ,(43.12± 3.2 5 ) μmol/L比 (10 .2 7± 1.2 1) μmol/L ,(2 7.75±2 .72 ) μmol/L ,P均 <0 .0 1],门静脉压力 (PP)亦明显升高 [(16 .6 7± 0 .6 3)cmH2 O比 (8.82± 0 .2 9)cmH2 O ,P <0 .0 1],平均动脉压 (MAP)明显减低 [(15 .92± 0 .74 )kPa比 (18.93± 0 .71)kPa ,P <0 .0 1]。肝硬化组血浆CO、NO水平与MAP呈负相关 (r =- 0 .6 7,- 0 .74 ;P <0 .0 5 ,P <0 .0 1)。肝硬化组脾脏HO活性升高 80 % ,小肠HO活性升高 10 0 % ,肠系膜组织HO活性升高 330 % ,而肝脏、肾脏HO活性变化不明显。结论　CO作为一种新信号分子 ,可能参与肝硬化高动力循环的发生。     

甘露醇及维生素C、E联合治疗急性脑梗死的临床研究

目的　研究甘露醇 ,维生素C、E联合治疗急性脑梗死的疗效。方法　用甘露醇、维生素C、E(MCE)联合治疗急性脑梗死 2 6 8例 ,用维脑路通静滴作为对照组治疗 172例 ,比较两组治疗前后 15天和 30天的神经功能缺损评分。随机抽取MCE组中 38例 ,对照组中 34例进行SOD及MDA测定 ,并比较入院当日及治疗 15天时的变化。结果　神经功能缺损评分MCE组治疗前 18 4± 6 8,15天为 10 2± 8 2 ,30天为 8 0± 5 6 ;对照组治疗前为17 8± 7 8,15天为 15 8± 6 8,30天为 13 8± 7 2。治疗 15天时MCE组明显优于对照组 (P <0 0 1) ,30天时也明显优于对照组 (P <0 0 1)。治疗 15天后MCE组及对照组SOD分别为 (98 36± 8 0 8) μU/L及 (88 48± 6 36 )μU/L ,MDA分别为 (4 2 8± 0 48) μmol/L和 (5 46± 0 36 ) μmol/L。两组比较差异非常显著 (P <0 0 1)。结论　MCE联合抗自由基治疗较传统的基础药物治疗后神经功能缺损评分减少明显 ,SOD值上升及MDA值下降亦明显。     

血脂异常对血清细胞黏附分子水平的影响

目的 :探讨血脂异常对血清细胞间黏附分子 1(ICAM 1)、血管细胞黏附分子 1(VCAM 1)和E 选择素水平的影响。方法 :入选 12 0例研究对象 ,其中高胆固醇血症 (Ⅰ组 ) 31例 ;高三酰甘油血症 (Ⅱ组 ) 30例 ;混合性高脂血症 (Ⅲ组 ) 2 9例 ;血脂正常 (Ⅳ组 ) 30例。用酶联免疫吸附法检测血清ICAM 1、VCAM 1和E 选择素水平 ,比较上述 3个指标在各组间的差异。结果 :总胆固醇水平 ,Ⅰ组 [(6 .5 5± 0 .6 7)mmol/L]和Ⅲ组 [(6 .2 7±0 .6 7)mmol/L]显著高于Ⅳ组 [(4.38± 0 .4 9)mmol/L],P <0 .0 1;三酰甘油水平 ,Ⅱ组 [(3.39± 0 .6 0 )mmol/L]和Ⅲ组 [(3.4 4± 0 .6 2 )mmol/L]显著高于Ⅳ组 [(1.39± 0 .4 0 )mmol/L],P <0 .0 1。同时 ,血清ICAM 1水平在Ⅰ组 [(76 4± 71) μg/L]、Ⅱ组 [(74 9± 71) μg/L]和Ⅲ组 [(82 3± 80 ) μg/L]明显高于Ⅳ组 [(6 0 4± 6 7) μg/L],P <0 .0 1;血清VCAM 1水平在Ⅰ组 [(1837± 16 4 ) μg/L]、Ⅱ组 [(1836± 16 0 ) μg/L]和Ⅲ组 [(196 3± 181) μg/L]明显高于Ⅳ组 [(130 7± 14 9) μg/L],P <0 .0 1;血清E 选择素水平在Ⅰ组 [(6 6± 12 ) μg/L]、Ⅱ组 [(70± 14 ) μg/L]和Ⅲ组 [(81± 17) μg/L]明显高于Ⅳ组 [(39± 11) μg/L],P <0 .0 1。结论 :血脂异常可使血清I     

原钒酸钠对成骨细胞株MC 3T3-E1增殖的影响及其与一氧化氮浓度的关系

目的　探讨原钒酸钠对成骨细胞株MC3T3 E1增殖的影响及其是否与一氧化氮 (NO)浓度有关。　方法　以噻唑蓝 (MTT)比色法检测MC3T3 E1细胞增殖及增殖抑制情况 ,用酶还原法测定细胞培养物上清液中NO的浓度。　结果　在低浓度 (2 5～ 10 0 μmol/L)原钒酸钠作用 2 4h后 ,MC3T3 E1细胞MTT测定值 (2 5 μmol/L时为 0 3380± 0 0 0 4 5、5 0 μmol/L时为 0 340 0±0 0 14 1、10 0 μmol/L时为 0 384 0± 0 0 313)较对照组 (0 2 5 4 0± 0 0 16 7)明显增加 (P均 <0 0 0 1) ;高浓度 (≥ 5 0 0 μmol/L)时则明显下降 ,5 0 μmol/L时为 0 2 16 0± 0 0 182 ,10 0 μmol/L时为 0 192 0±0 0 179(P均 <0 0 1) ;且作用 2 4、4 8和 12 0h细胞增殖趋势一致。细胞培养上清液中的NO浓度与MTT测定值成正比。 2 5 μmol/L原钒酸钠时NO浓度为 (17 2 0 8± 0 70 1) μmol/L ,5 0 μmol/L时为(7 386± 1 0 39) μmol/L ,空白对照组为 (15 341± 0 0 4 1) μmol/L。且低浓度原钒酸钠能减弱NO合酶(NOS)抑制剂L 硝基精氨酸甲酯 (L NAME)的细胞增殖抑制作用。　结论　低浓度原钒酸钠能促进MC3T3 E1细胞的增殖 ,高浓度则抑制增殖。NO可能参与调节原钒酸钠对MC3T3 E1增殖的作用。     

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     

一氧化氮对哮喘大鼠基质金属蛋白酶的表达调控

目的　观察一氧化氮 (NO)对哮喘大鼠基质金属蛋白酶 (MMP)及金属蛋白酶组织抑制物表达的影响 ,探讨其在哮喘气道结构重建中的作用。方法　 30只雄性Wistar大鼠随机分为对照组、哮喘组和左旋精氨酸组 (L Arg组 ) ,每组 1 0只。肺组织作病理切片并HE染色 ,通过病理图像分析系统测定支气管基底膜周径 (Pbm)、总管壁面积 (WAt)、内壁面积 (WAi) ,平滑肌面积 (WAm)等形态学参数。用NO与一氧化氮合酶 (NOS)试剂盒测定肺组织中亚硝酸盐 /硝酸盐 (NO- 2 /NO- 3)水平与NOS活性。半定量逆转录聚合酶链反应技术 (RT PCR)分析肺组织中MMP 2与TIMP 1mRNA的表达。结果(1 )WAt/Pbm、WAi/Pbm及WAm/Pbm哮喘组 [分别为 (2 5 3± 2 1 ) μm2 / μm、(2 0 4± 2 3) μm2 / μm、(4 2±2 0 ) μm2 / μm]和L Arg组 [分别为 (35 1± 2 6) μm2 / μm、(2 5 3± 2 0 ) μm2 / μm、(8 7± 1 5) μm2 / μm]与对照组 [分别为 (2 0 8± 1 3) μm2 / μm、(1 5 3± 2 1 ) μm2 / μm、(3 1± 1 1 ) μm2 / μm]比较 ,差异有显著性(P <0 0 1 ) ;L Arg组与哮喘组比较差异亦有显著性 (P <0 0 5)。 (2 )肺组织中NO- 2 /NO- 3水平哮喘组[(7 2± 2 1 )nmol/mg]和L Arg组 [(1 1 8± 1 7)nmol/mg]与对照组 [(3 1± 1 2 )n     

吸氧对慢性缺氧高二氧化碳大鼠肺血管L-精氨酸转运的影响

目的　探讨慢性缺氧 (O2 )高二氧化碳 (CO2 )对大鼠肺动脉L 精氨酸 (L Arg)转运的影响与吸氧的作用。方法　将 4 0只大鼠以随机区组设计法分成 4组 ,用 0 2mmol/L和 5 0mmol/L [3 H] Arg将肺动脉孵育 ,测定其对 [3 H] L Arg的摄取率、一氧化氮合酶 (NOS)活性与一氧化氮 (NO2 /NO3)含量。每组 1 0只。正常对照组 (A组 )、慢性缺O2 4周后伴高CO2 4周组 (B组 )、慢性缺O2 4周伴高CO24周后吸空气 4周组 (C组 )及慢性缺O2 4周伴高CO2 4周后吸O2 4周组 (D组 )。结果　 (1 )肺动脉平均压 (mPAP)、右心室 (RV)和左心室 +室间隔 (LV +S)重量比值 (RV/LV +S) :B组 (33% )与A组(35 % )比较差异有显著性 (P均 <0 0 1 ) ;D组 (2 4 % )与C组 (2 4 % )比较 ,差异也有显著性 (P均 <0 0 5 )。 (2 )离体孵育的肺动脉摄取低浓度 (0 2mmol/L)和高浓度 (5 0mmol/L) [3 H] L Arg比较 :B组分别为 [(3 0 4± 0 1 6 ) μmol·g-1 min-1 ]、[(8 1 2± 0 1 4 ) μmol·g-1 ·min-1 ],A组分别为 [(4 6 2± 0 5 5 )μmol·g-1 ·min-1 ]、[(1 1 2 4± 1 0 2 ) μmol·g-1 ·min-1 ],A、B两组比较差异有显著性 (P均 <0 0 1 ) ;而D组分别为 [(4 30± 0 1 8) μmol·g-1 ·min-1 ]、[(1 2 31± 0 6 5 ) μmol·g-1 ·m     

老年糖尿病患者自由基与微血管并发症关系的探讨

目的　探讨老年糖尿病患者自由基和抗氧化能力的变化及其与微血管并发症的关系。　方法　测定 6 5例老年糖尿病患者和 6 5例健康老年对照者血浆或红细胞中脂质过氧化物 (LPO)、超氧化物岐化酶 (SOD)、过氧化氢酶 (CAT)、谷胱甘肽过氧化物酶 (GSH PX)、维生素C(VC)、维生素E(VE)、β 胡萝卜素 (β CAR)、谷胱甘肽 (GSH) ,同时测定患者的空腹血糖、餐后 2h血糖、糖化血红蛋白(HbA1c)、空腹和餐后 2hC肽、血脂、尿微量白蛋白排泄率、肌电图。　结果　老年糖尿病患者LPO(42 97± 6 99)nmol/g高于健康老年组 (31 5 9± 7 4 4 )nmol/g ,SOD(1712 4 4± 15 7 0 4 )U/L、CAT(2 17 0 1± 2 9 36 ) μg/g、GSH PX(2 1 0 1± 3 38)× 10 -10 U/RBC、VC(40 98± 10 5 1) μmol/L、VE(16 4 4± 2 4 5 ) μmol/L、β CAR(1 19± 0 2 3) μmol/L、GSH(0 98± 0 16 )nmol/L低于健康老年组〔分别为 (192 8 38± 14 3 4 4 )U/L、(2 6 4 4 0± 6 3 5 5 ) μg/g、(2 5 16± 6 4 1)× 10 -10 U/RBC、(5 2 2 3± 10 5 1) μmol/L、(2 3 0 4± 5 38) μmol/L、(1 6 3± 0 4 0 ) μmol/L、(1 2 5± 0 2 0 )nmol/L〕 ,合并糖尿病微血管并发症者变化更加明显 ,LPO和年龄呈正相关 (r=0 310 ,P <0 0 5 ) ,SOD、C     

四氢生物喋呤对内皮细胞产生一氧化氮和超氧阴离子的影响

目的探讨四氢生物喋呤(BH4)对人脐静脉内皮细胞产生一氧化氮(NO)和超氧阴离子(O-2)的影响.方法在培养液中分别加入不同浓度的D-葡萄糖、胰岛素和BH4,24 h后取细胞培养液分别测定一氧化氮合酶(NOS)、超氧化物歧化酶(SOD)活性、NO和O-2浓度.结果BH4(10、100、500μmol/L)使内皮细胞NOS活性增高,500 μmol/L BH4使内皮细胞NO产生增加,10或100 μmol/LBH4对内皮细胞产生NO有增加的趋势,但与对照组比较无显著性差异(P＞0.05);25 mmol/L葡萄糖+BH4(10、100、500 μmol/L)对内皮细胞产生NO与对照组比较无显著性差异(P＞0.05);高浓度胰岛素(10、100、1 000 mU/L)+BH 4(10、100、500 μmol/L)使内皮细胞NOS活性增强,NO产生增加.BH4(10、100、500μmol/L)对内皮细胞SOD活性无明显影响,但可以改善25 mmol/L葡萄糖对内皮细胞SOD活性的影响;胰岛素+BH4对内皮细胞SOD活性无明显影响(P＞0.05).BH4(10、100、500 μmol/L)使内皮细胞产生O-2减少,并可以改善25 mmol/L葡萄糖对内皮细胞产生O-2影响;胰岛素+BH4组O-2浓度明显低于对照组和不同浓度胰岛素组(P＜0.01).结论BH4可以增加培养的人脐静脉内皮细胞NOS活性,使NO产生增加而使O-2水平下降.     

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.     

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.     

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.     

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.