THE PROTECTIVE ACTION OF A SPECIFIC ENZYME AGAINST TYPE III PNEUMOCOCCUS INFECTION IN MICE

The bacterial enzyme which decomposes the purified capsular polysaccharide of Type III Pneumococcus in vitro also destroys the capsules of the living organisms growing in media and in the animal body. Potent preparations of this same enzyme protect mice against infection with virulent Type III Pneumococcus. The protective action is type-specific. The protective activity of the specific enzyme is destroyed by heat (70°C. for 10 minutes). The enzyme remains in an effective concentration 24 to 48 hours after its injection into normal mice. The enzyme has been found to exert a favorable influence on the outcome of an infection already established at the time of treatment. A definite relationship has been found to exist between the activity of the enzyme in vitro and its protective power in the animal body. The mechanism of the protective action is discussed with special reference to the relation between the decapsulation of the bacteria by the enzyme and the phagocytic response of the host.     

THE USE OF THE FINAL HYDROGEN ION CONCENTRATION IN DIFFERENTIATION OF STREPTOCOCCUS H?MOLYTICUS OF HUMAN AND BOVINE TYPES

1. Under the conditions of these experiments, there appears to be a distinct and constant difference in the final hydrogen ion concentration of Streptococcus hæmolyticus from human and bovine sources. 2. Of 124 strains of Streptococcus hæmolyticus from known human origin, 116 reached a final hydrogen ion concentration of from pH 5.0 to 5.3. Only 8 reached a pH more acid than 5.0 and none more acid than pH 4.8. 3. Of 45 strains of Streptococcus hæmolyticus from bovine sources, including 26 strains isolated from milk and the udder of cows, and 19 from cream cheese, 40 reached a final hydrogen ion concentration of pH 4.3 to 4.5. Of the remaining 5 which reached a pH of 5.0 to 5.2, two were of known human type and three of uncertain diagnosis. 4. A rapid and practical application of this method is proposed as a presumptive test in the differentiation of human and bovine types of Streptococcus hæmolyticus.     

Translation of First North American 50 and 70 cc Total Artificial Heart Virtual and Clinical Implantations: Utility of 3D Computed Tomography to Test Fit Devices

Since the creation of SynCardia's 50 cc Total Artificial Hearts (TAHs), patients with irreversible biventricular failure now have two sizing options. Herein, a case series of three patients who have undergone successful 50 and 70 cc TAH implantation with complete closure of the chest cavity utilizing preoperative “virtual implantation” of different sized devices for surgical planning are presented. Computed tomography (CT) images were used for preoperative planning prior to TAH implantation. Three‐dimensional (3D) reconstructions of preoperative chest CT images were generated and both 50 and 70 cc TAHs were virtually implanted into patients' thoracic cavities. During the simulation, the TAHs were projected over the native hearts in a similar position to the actual implantation, and the relationship between the devices and the atria, ventricles, chest wall, and diaphragm were assessed. The 3D reconstructed images and virtual modeling were used to simulate and determine for each patient if the 50 or 70 cc TAH would have a higher likelihood of successful implantation without complications. Subsequently, all three patients received clinical implants of the properly sized TAH based on virtual modeling, and their chest cavities were fully closed. This virtual implantation increases our confidence that the selected TAH will better fit within the thoracic cavity allowing for improved surgical outcome. Clinical implantation of the TAHs showed that our virtual modeling was an effective method for determining the correct fit and sizing of 50 and 70 cc TAHs.     

Mycobacterium fortuitum osteomyelitis in a peripheral blood stem cell transplant recipient

Mycobacterium fortuitum is an uncommon, but well-recognized, pathogen in immunocompromised hosts, with special predilection for bone and soft tissue infections in solid organ transplant recipients. We describe a case of osteomyelitis due to this pathogen in a peripheral blood stem cell transplant recipient.     

A clinical study assessing the tolerability and biological effects of infliximab, a TNF-alpha inhibitor, in patients with advanced cancer

BACKGROUND: Tumour necrosis factor-alpha (TNF-alpha) is an important regulator of the chronic inflammation contributing to tumour progression. Infliximab, an anti-TNF-alpha monoclonal antibody was investigated in this trial of patients with advanced cancer. The primary objectives were to determine the safety profile and biological response of infliximab in a cancer population. Clinical response was a secondary objective. PATIENTS AND METHODS: Forty-one patients received infliximab at 5 mg/kg (n = 21) or 10 mg/kg (n = 20) i.v. at 0 and 2 weeks and then every 4 weeks. Post-treatment samples were measured for changes in plasma and serum TNF-alpha, CCL2, IL-6 and C-reactive protein (CRP). RESULTS: Infliximab was well tolerated with no dose-limiting toxic effects. At both doses of infliximab, neutralisation of serum TNF-alpha was observed after 1 h while plasma CCL2, IL-6 and serum CRP were decreased 24 and 48 h following infliximab administration. Seven patients experienced disease stablisation (range 10-50+ weeks). There was no evidence of disease acceleration in any patient. CONCLUSIONS: Infliximab treatment was safe and well tolerated in patients with advanced cancer. There was evidence of biological activity with baseline TNF-alpha and CCL2 being correlated with infliximab response.