RESUMEN
Crystal structure, specific heat, thermal expansion, magnetic susceptibility and electrical resistivity studies of the heavy fermion system CeNi(9-x)Cu(x)Ge(4) (0≤x≤1) reveal a continuous tuning of the ground state by Ni/Cu substitution from an effectively fourfold-degenerate non-magnetic Kondo ground state of CeNi(9)Ge(4) (with pronounced non-Fermi-liquid features) towards a magnetically ordered, effectively twofold-degenerate ground state in CeNi(8)CuGe(4) with T(N) = 175 ± 5 mK. Quantum critical behavior, [Formula: see text], is observed for [Formula: see text]. Hitherto, CeNi(9-x)Cu(x)Ge(4) represents the first system where a substitution-driven quantum phase transition is connected not only with changes of the relative strength of the Kondo effect and RKKY interaction, but also with a reduction of the effective crystal field ground state degeneracy.
RESUMEN
INTRODUCTION: Although an analgesic effect is an essential component of the mode of action of bisphosphonates, its physiological mechanisms are still unclear. Beta-endorphin release plays an important role in the analgesic effect of both calcitonin and raloxifene. As patients with Paget's disease receive large doses of bisphosphonates within relatively short time periods, we examined whether repeated pamidronate infusion therapy would cause measurable change in beta-endorphin levels MATERIALS & METHODS: Visual analog scale (VAS) scores of pain intensity, beta-endorphin levels, and alkaline phosphatase activity of 11 patients with Paget's disease (7 with the mono- and 4 with the polyostotic form) were determined at baseline, as well as after 3 and 6 infusions (on Days 6 and 12 of treatment, respectively). Eleven untreated patients with Paget's disease (7 with the mono- and 4 with the polyostotic form) served as controls. RESULTS: It was established that in the course of pamidronate infusion therapy BE levels remained constant, whereas the values in serum alkaline phosphatase and pain intensity scores were significantly reduced. CONCLUSIONS: Although high-dose pamidronate therapy does mitigate pain substantially (as demonstrated by the reduction of VAS scores), its analgesic action is probably unrelated to the enhancement of beta-endorphin release.
Asunto(s)
Analgésicos/administración & dosificación , Difosfonatos/administración & dosificación , Osteítis Deformante/tratamiento farmacológico , Dolor/tratamiento farmacológico , betaendorfina/sangre , Anciano , Conservadores de la Densidad Ósea/administración & dosificación , Femenino , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Osteítis Deformante/complicaciones , Osteítis Deformante/metabolismo , Dolor/etiología , Dolor/metabolismo , Dimensión del Dolor , Pamidronato , Proyectos PilotoRESUMEN
Among 52 patients diagnosed as acute myeloid leukemia (AML), nine cases were found in which interleukin-5 (IL-5) induced a proliferative response in the leukemic cells, as measured by the stimulation of DNA synthesis or colony formation in vitro. All cases (n = 7) with the cytogenetic abnormality t(8;21)(q22;q22) belonged to this group of IL-5 responders. Of the additional two cases, one had an apparently normal karyotype, but the other expressed a dicentric chromosome 21, an abnormality also involving the breakpoint region 21q22. The leukemic cells of the IL-5 responsive patients could also be stimulated to proliferate by IL-3, GM-CSF and G-CSF, and in some cases by IL-6 or M-CSF. Immunophenotypic analysis revealed the presence of the immature hematopoietic cell antigen CD34, the myelomonocytic maturation antigens CD13 and CD33, in association with the B-cell related surface marker CD19 on the leukemic cells. Immunoglobulin mu and T-cell receptor beta-genes in the leukemic cells were in germline configuration. Upon incubation in colony culture, clonogenic cells were capable of producing progeny showing eosinophilic or neutrophilic maturation following stimulation with IL-5 or G-CSF, respectively. It is concluded that IL-5 responsive AML represents a subgroup of leukemia with distinct immunotypic and cytogenetic features.
Asunto(s)
Interleucina-5/farmacología , Leucemia Mieloide/genética , Antígenos CD/análisis , División Celular/efectos de los fármacos , Aberraciones Cromosómicas/genética , Aberraciones Cromosómicas/inmunología , Aberraciones Cromosómicas/patología , Trastornos de los Cromosomas , Cromosomas Humanos Par 21 , Femenino , Reordenamiento Génico de Linfocito B , Reordenamiento Génico de Linfocito T , Genes de Inmunoglobulinas , Factor Estimulante de Colonias de Granulocitos/farmacología , Factor Estimulante de Colonias de Granulocitos y Macrófagos/farmacología , Humanos , Técnicas In Vitro , Interleucina-3/farmacología , Leucemia Mieloide/inmunología , Leucemia Mieloide/patología , Masculino , Receptores de Antígenos de Linfocitos T/genética , Células Tumorales CultivadasRESUMEN
The treatment of healthy, undamaged plants of the Lima bean Phaseolus lunatus with solutions of a beta-glucosidase from bitter almonds (at 5 U.ml-1) through the petiole results in an enhanced emission of volatiles to the environment. The compounds are identical with those emitted in response to infestation with the red spotted spider mite Tetranychus urticae. Dominant products are the two acyclic homoterpenes 4,8-dimethyl-1,3E,7- dimethylnonatriene (homoterpene I) and 4,8,12-trimethyl-1,3E,7E,11-tridecatetraene (homoterpene II) which are of sesquiterpenoid and diterpenoid origin. Therefore, a beta-glucosidase of the herbivore may be considered as the true elicitor for the odor induction. Homoterpene I and most other of the herbivore-induced volatiles can also be triggered by treatment of the plant with solutions of jasmonic acid (JA) at 100 nmol.ml-1 to 10 mumol.ml-1. The C16 homoterpene II is not significantly induced by JA. The time-course of the enzymatic- and the JA-triggered induction of the volatiles is identical. The dose-response to JA parallels previous reports on alkaloid induction in cell cultures. In corn plants (Zea mays) JA triggers the emission of all volatiles which are known to be emitted in response to the damage by the beet army worm Spodoptora exigua. In summary, the emission of volatiles after damage by a herbivore resembles the production of phytoalexins in response to an attacking microorganism and uses similar elicitors and internal transduction pathways.
Asunto(s)
Ciclopentanos/farmacología , Diterpenos/metabolismo , Fabaceae/efectos de los fármacos , Plantas Medicinales , Sesquiterpenos/metabolismo , Zea mays/efectos de los fármacos , beta-Glucosidasa/farmacología , Animales , Fabaceae/metabolismo , Ácaros , Oxilipinas , Enfermedades de las Plantas , Hojas de la Planta/metabolismo , Volatilización , Zea mays/metabolismoRESUMEN
Between 1972 and 1982, 15 episodes of tuberculosis-related bronchopleural fistula (BPF) were observed in 13 patients at a municipal hospital in New York City. All 13 had a history of inadequate treatment for pulmonary tuberculosis, and seven had one or more associated chronic debilitating conditions. Past pleural inflammation with resultant fibrothorax appeared to be the source of the late BPF formation in at least seven patients, while rupture of a cavity during active disease was likely in four. Clinical presentation ranged from life-threatening tension-pneumothorax to incidental discovery, a long-term wasting illness being the most common form. Diagnosis was not difficult. Antituberculosis chemotherapy and tube suction were generally employed in treatment, with further surgical drainage procedures done when necessary and possible; open window thoracostomy was usually successful (four of seven BPFs closed, one stable for years), as were one case each of pleuropneumonectomy and decortication. When surgery was not feasible, long-term tube drainage was a useful alternative.
Asunto(s)
Fístula Bronquial/etiología , Fístula/etiología , Enfermedades Pleurales/etiología , Tuberculosis Pulmonar/complicaciones , Adulto , Anciano , Fístula Bronquial/diagnóstico , Fístula Bronquial/terapia , Femenino , Fístula/diagnóstico , Fístula/terapia , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Pleurales/diagnóstico , Enfermedades Pleurales/terapiaRESUMEN
The present study was undertaken to compare the effects of the pure antiestrogen ZM 182780 (ZM) and the partial agonist tamoxifen (TAM) on ovulation and peripheral hormone levels in the rat. Adult female rats were treated with ZM (5 mg/kg/d) or TAM (5 mg/kg/d) and sacrificed at varying times during the estrous cycle. ZM and TAM were able to inhibit ovulation to nearly the same extent (60% and 70%, respectively). ZM induced a persistent diestrus whereas TAM led to a mixed picture in the vaginal smear. Both antiestrogens suppressed the preovulatory surge of LH, FSH and progesterone but had no effect on basal FSH values. In contrast to TAM, ZM caused an increase in basal levels of LH. Moreover, basal and preovulatory levels of estradiol and androgens were increased by ZM. By contrast, TAM decreased basal and preovulatory values of LH, estradiol, and androgens. These data suggest that ZM inhibits not only the positive but also negative feedback effect of estrogens and TAM seems to inhibit only the positive feedback. Moreover, it is conceivable that the suppressed preovulatory progesterone surge induced by ZM and TAM could be responsible for the antiovulatory effect.
Asunto(s)
Estradiol/análogos & derivados , Antagonistas de Estrógenos/farmacología , Estro/fisiología , Ovulación/fisiología , Hipófisis/fisiología , Tamoxifeno/farmacología , Animales , Estradiol/sangre , Estradiol/metabolismo , Estradiol/farmacología , Estro/efectos de los fármacos , Femenino , Hormona Folículo Estimulante/sangre , Hormona Folículo Estimulante/metabolismo , Fulvestrant , Hormona Luteinizante/sangre , Hormona Luteinizante/metabolismo , Ovulación/efectos de los fármacos , Hipófisis/efectos de los fármacos , Prolactina/sangre , Prolactina/metabolismo , Ratas , Ratas Wistar , Relación Estructura-ActividadRESUMEN
The present study was undertaken to investigate intraovarian mechanism(s) for the antiovulatory effect of Onapristone (ON), because antiprogestins possessing the same antiprogestational activity and inhibiting the preovulatory LH surge to the same extent differ in their antiovulatory potency. Ovulation was induced by treating immature female rats with pregnant mare serum gonadotropin (PMSG) for folliculogenesis and hCG for the induction of ovulation. The animals were treated twice with ON (200 mg/kg 42 h and 48 h after PMSG) and killed at different times. The ovulation rate was assessed by counting the number of ova in the fallopian tubes and uteri. Blood and ovaries were collected for radioimmunoassay (RIA) of steroid hormones and histological analysis for 3beta-hydroxysteroid dehydrogenase (3beta-HSDH), 17beta-hydroxysteroid dehydrogenase (17beta-HSDH), progesterone (PR), estrogen (ER) and androgen (AR) receptors. Treatment with ON totally blocked ovulation and the progesterone (P4) surge was significantly diminished in comparison to the control (6-8 h post-hCG), whereas androgen levels remained unaffected. The decreased P4 concentrations correlated well with a reduced staining intensity of 3beta-HSDH in granulosa cells of tertiary follicles. Moreover, we observed a down-regulation of PR in granulosa cells of tertiary follicles. Additionally, in secondary and tertiary follicles the expression of AR between 0 and 6 h after hCG was reduced. These results suggest that the antiovulatory effect of the antiprogestin ON is related to down-regulation of intraovarian progesterone, caused by attenuated 3beta-HSDH activity and PR expression. One can thus assume that intraovarian P4 is an important factor for the induction of ovulation. An effect of ON on the staining intensity of 17beta-HSDH in theca and granulosa cells could not be observed at any time. In conclusion, the inhibition of ovulation induced by the antiprogestin, ON, could be related to decreased intraovarian progesterone production through reduced 3beta-HSDH activity and the down-regulation of PR.
Asunto(s)
Regulación hacia Abajo/efectos de los fármacos , Gonanos/farmacología , Antagonistas de Hormonas/farmacología , Ovario/fisiología , Ovulación/efectos de los fármacos , Receptores de Progesterona/biosíntesis , 17-Hidroxiesteroide Deshidrogenasas/metabolismo , 3-Hidroxiesteroide Deshidrogenasas/metabolismo , Androstenodiona/sangre , Androstenodiona/metabolismo , Animales , Gonadotropina Coriónica/farmacología , Estradiol/sangre , Estradiol/metabolismo , Femenino , Gonadotropinas Equinas/farmacología , Células de la Granulosa/metabolismo , Cinética , Ovario/efectos de los fármacos , Inducción de la Ovulación , Embarazo , Ratas , Ratas Wistar , Receptores Androgénicos/biosíntesis , Receptores de Estrógenos/biosíntesis , Células Tecales/metabolismoRESUMEN
Progesterone antagonists often differ in regard to their potency to block ovulation in rats although they may possess similar 'antiprogestational' (abortive) activity. Therefore, the questions arose as to: (a) whether antiovulatory and antiprogestational effects (on endometrial and mammary gland parameters) of antiprogestins correlate at all; and (b) which mechanism(s) may be responsible for their ability to abolish ovulation. To answer these questions we set out to compare the influences of two progesterone antagonists, Onapristone (ON) a very potent and ZK 136798 only a weak inhibitor of ovulation, to assess changes on the one hand on typical progestational actions and on the other hand on factors known to regulate ovulation. For this purpose immature PMSG/hCG primed and adult female rats and infantile female rabbits were treated either with ON, ZK 136798 or vehicle in different treatment schedules. In these investigations ON and ZK 136798 showed similar antiprogestational activities on the progesterone-induced development of mammary glands (rats) and the secretory transformation of endometrium (rabbits). ON blocked an induced or a spontaneous ovulation, whereas ZK 136798 only revealed a very weak antiovulatory effect. Both ON and ZK 136798 stimulated basal levels of LH, estradiol, and testosterone, whereas the preovulatory LH surge was decreased to the same extent. Interestingly, in contrast to ZK 136798, ON reduced the preovulatory increase in progesterone secretion. These results clearly indicate: (a) that antiovulatory potency and antiprogestational activity may not be correlated in the rat; and (b) that decreased preovulatory levels of progesterone following treatment with ON may play an important role in intraovarian mechanism(s) contributing to a blocking of ovulation.
Asunto(s)
Androstenos/farmacología , Gonanos/farmacología , Antagonistas de Hormonas/farmacología , Ovulación/efectos de los fármacos , Progesterona/antagonistas & inhibidores , Animales , Depresión Química , Endometrio/efectos de los fármacos , Estradiol/metabolismo , Estro/efectos de los fármacos , Femenino , Hormona Luteinizante/metabolismo , Glándulas Mamarias Animales/efectos de los fármacos , Inducción de la Ovulación , Progesterona/metabolismo , Conejos , Ratas , Testosterona/metabolismoRESUMEN
The lung is a frequent site of hematogenous metastases of many diverse tumors including soft-tissue sarcoma. The authors present a case with unilateral metastatic spread presenting as a giant lung mass, a pattern which, to the authors' knowledge, has not been reported in the literature.
Asunto(s)
Leiomiosarcoma/secundario , Neoplasias Pulmonares/secundario , Neoplasias Uterinas/diagnóstico , Adulto , Femenino , Humanos , Leiomiosarcoma/diagnóstico , Neoplasias Pulmonares/diagnósticoRESUMEN
Surface potential difference, conductance, and elasticity changes of bilayer lipid membranes induced by the antivirus drugs amantadine and remantadine were measured. An influence on the human erythrocyte shape was shown. Both drugs are stomatocytogenic. The adsorption at the cytoplasmatic membrane was electrophoretically proved. The heat-induced vesiculation is partly inhibited. No microvesicles were observed. Instead, large tails which did not detach from the cell body were seen. The general conclusion is that these amphiphilic adamantane derivatives are membrane agents which modify membrane interaction processes, possibly by influencing the bending properties.
Asunto(s)
Adamantano/análogos & derivados , Amantadina/farmacología , Deformación Eritrocítica/efectos de los fármacos , Lípidos de la Membrana/metabolismo , Rimantadina/farmacología , Elasticidad , Espectroscopía de Resonancia por Spin del Electrón , Humanos , Membranas Intracelulares/efectos de los fármacos , Factores de TiempoRESUMEN
These studies analyze the regulation of progesterone receptors (PRs) in central and peripheral tissues with the aim of further understanding mechanistically the inhibition of ovulation by progesterone antagonists (PA). Therefore, it was of interest to investigate the influence of the progesterone receptor antagonist, Onapristone (ON), on PRs in the ovary, pituitary (PT), and hypothalamus (HYP), since ON effectively inhibits ovulation in rats. For this study PMSG/hCG-primed immature and adult female rats were treated with ON. Immunohistochemistry was used for the detection of PRs. Progesterone (P4) and estradiol (E2) levels were determined by RIA. PR expression in the ovaries of immature rats was not detectable until after hCG administration. In these animals, ON caused a reduction in the staining intensity of PR in the tertiary follicles at the time when the preovulatory P4-surge was inhibited (6 h post hCG). Adult rats treated for 15 days with ON showed a decreased PR expression in PT and HYP. At this time (proestrus, 7 p.m.) the P4 and E2 levels are significantly lowered. These results suggest that after treatment with ON the expression of PR is reduced in the ovary, PT and HYP. The regulation of PR in the ovary seems to be less dependent on estrogens than on LH. Thus, it is conceivable that the reduced PR expression after ON treatment may be a result of decreased LH sensitivity in the ovary. In the pituitary and hypothalamus, PR expression is stimulated by estrogens and progesterone, and therefore the fall in the P4 and E2 levels in ON-treated animals may be responsible for the reduced PR expression in PT and HYP, and may contribute to the antiovulatory effect of ON. We therefore conclude that the mechanism of the antiovulatory potency of progesterone antagonists is based on a reduced preovulatory P4-production and PR expression in the ovary and also on the down-regulation of PR in the anterior pituitary and hypothalamus.
Asunto(s)
Gonanos/farmacología , Antagonistas de Hormonas/farmacología , Hipotálamo/metabolismo , Ovario/metabolismo , Hipófisis/metabolismo , Receptores de Progesterona/metabolismo , Animales , Gonadotropina Coriónica/farmacología , Regulación hacia Abajo , Estradiol/sangre , Femenino , Gonadotropinas Equinas/farmacología , Hipotálamo/efectos de los fármacos , Inmunohistoquímica , Ovario/efectos de los fármacos , Hipófisis/efectos de los fármacos , Progesterona/antagonistas & inhibidores , Progesterona/sangre , Ratas , Ratas Wistar , Receptores de Progesterona/efectos de los fármacosRESUMEN
Based on our experience, we would like to offer a few pragmatic suggestions for the practicing clinician. These recommendations are summarized in Tables 1 and 2. The first encounter with most patients gives the impression of either a dramatic acute infection, usually in the lungs, central nervous system, or gastrointestinal tract (in this order of frequency), or that of a chronic wasting disease. The former is frequently superimposed on the latter. The exploration of AIDS risk factors and a few easily detectable physical signs are the most important clues to the correct clinical diagnosis. Once AIDS is suspected, an aggressive and rapid approach for diagnosis is justified. Selected individually for each patient, the most commonly successful tests include bronchoscopy with BAL and/or transbronchial lung biopsy; bone marrow, lymph node, or liver biopsy with both microbiologic and pathologic processing of the material; blood (and often spinal fluid) cultures for fungal organisms; cranial computerized tomographic scan; and toxoplasma serology. Other tests, while potentially useful, are less important in immediate decision-making and treatment. In all cases of respiratory compromise or symptoms related to the chest, PCP has to be ruled out by invasive methods if the suspicion of AIDS is sufficiently strong. The diagnosis of one opportunistic infection should not be interpreted as a final answer. Rather, it should stimulate more vigilant efforts to uncover additional infections and other AIDS-related diseases if any abnormalities remain unexplained or persist despite treatment. Chest radiology should not be the main tool to diagnose or monitor lung infections.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Enfermedades Pulmonares/diagnóstico , Neumonía por Pneumocystis/complicaciones , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Adulto , Antibacterianos/uso terapéutico , Diagnóstico Diferencial , Humanos , Neumonía por Pneumocystis/tratamiento farmacológico , Neumonía por Pneumocystis/fisiopatologíaAsunto(s)
Tuberculosis Pulmonar/diagnóstico , Análisis Costo-Beneficio , Diagnóstico Diferencial , Emigración e Inmigración , Predicción , Costos de la Atención en Salud , Hospitales Comunitarios , Humanos , Huésped Inmunocomprometido , Esputo/citología , Esputo/microbiología , Factores de Tiempo , Tuberculosis Resistente a Múltiples Medicamentos/diagnósticoAsunto(s)
Anticuerpos Antibacterianos/análisis , Bacterias/inmunología , Infecciones Bacterianas/diagnóstico , Bronquitis/microbiología , Líquido del Lavado Bronquioalveolar/análisis , Neumonía/diagnóstico , Esputo/microbiología , Anciano , Anciano de 80 o más Años , Infecciones Bacterianas/complicaciones , Bronquitis/inmunología , Enfermedad Crónica , Humanos , Masculino , Persona de Mediana Edad , Neumonía/complicacionesRESUMEN
We report on precise low-temperature specific-heat measurements, C(T), of YbRh2Si2 in the vicinity of the antiferromagnetic phase transition on a single crystal of superior quality (residual resistivity ratio of approximately 150). We observe a very sharp peak at T_{N}=72 mK with absolute values as high as C/T=8 J/mol K2. A detailed analysis of the critical exponent alpha around T_{N} reveals alpha=0.38 which differs significantly from those of the conventional universality classes in the Ginzburg-Landau theory, where alpha< or =0.11. Thermal-expansion measurements corroborate this large positive critical exponent. These results provide insight into the nature of the critical magnetic fluctuations at a temperature-driven phase transition close to a quantum critical point.
RESUMEN
The nature of quantum criticality in CeCoIn5 is studied by low-temperature thermal expansion alpha(T). At the field-induced quantum critical point at H = 5 T a crossover scale T* approximately 0.3 K is observed, separating alpha(T)/T proportional, variant T(-1) from a weaker T(-1/2) divergence. We ascribe this change to a crossover in the dimensionality of the critical fluctuations which may be coupled to a change from unconventional to conventional quantum criticality. Disorder, whose effect on quantum criticality is studied in CeCoIn(5-x)Sn(x) (0 < or = x < or = 0.18), shifts T* towards higher temperatures.
RESUMEN
In addition to previous observations indicating that membrane potential changes generated by various Donnan- and Nernst-potentials lead to erythrocyte shape transformations, we show in this paper that diffusion potential change, induced by valinomycin, governs erythrocyte shape transformations. In low KCl-medium valinomycin, transferring the positive Nernst-potential into a negative diffusion potential, transforms stomatocytes into echinocytes. Using modified erythrocytes with a reversed K/Na ratio, even positive diffusion potentials can be induced by valinomycin. In these cases, stomatocytes can be generated by valinomycin. It is shown that, additionally, valinomycin in large concentrations is itself stomatocytogenic, and that the fluorescent dye diS-C3-(5) also induces stomatocytes. This, however, is a side effect which does not contradict the potential dependence of shape transformation. Using non washed erythrocytes, resuspended in plasma, valinomycin, inducing negative diffusion potential, transforms most erythrocytes to echinocytes despite the stomatocytogenic effect of albumin.
Asunto(s)
Eritrocitos/citología , Valinomicina/farmacología , Albúminas/farmacología , Benzotiazoles , Carbocianinas/farmacología , Eritrocitos/efectos de los fármacos , Eritrocitos/fisiología , Humanos , Concentración de Iones de Hidrógeno , Potenciales de la Membrana/fisiología , Potasio/sangre , Sodio/sangreRESUMEN
A Drosophila P-element derivative (pUChsneo) integrated into the telomeric region of the left arm of the second chromosome of Anopheles gambiae was used to clone the proximally flanking An. gambiae sequences. Molecular analyses revealed that the pUChsneo construct was partially duplicated and had integrated into a subterminal minisatellite. This satellite has a repeat unit of 820 bp and is located exclusively at the tip of 2L. No sequence similarity to subterminal minisatellites from other dipterans was detected, but some structural features such as tandem subrepeats are shared. The end of the chromosome was mapped with respect to restriction sites in pUChsneo at approximately generation 100 after the integration event. Considering inevitable terminal nucleotide loss due to incomplete DNA replication, we conclude that the chromosome end must have undergone a dramatic elongation process since it was mapped in generation 23.
Asunto(s)
Anopheles/genética , Telómero , Transgenes , Animales , Secuencia de Bases , ADN , Elementos Transponibles de ADN , Drosophila melanogaster/genética , Femenino , Repeticiones de Microsatélite , Datos de Secuencia Molecular , Recombinación Genética , Mapeo RestrictivoRESUMEN
We reviewed the records of the microbiology laboratory of the Veterans Administration Medical Center, Bronx, New York in order to determine the prevalence, epidemiology and complete antibiotic susceptibility profile of amikacin-resistant aerobic and facultative gram-negative bacilli isolated from clinical specimens submitted for culture between January 1, 1980 and May 1, 1981. Of more than 5000 gram-negative rods isolated during this 16-month period, 2.8% were determined to be resistant to amikacin by the disc diffusion method. Eighty-eight of the amikacin-resistant organisms were unique isolates derived from cultures on 74 patients located throughout the hospital. Urine (51%) and sputum (27%) were the predominant sources of specimens yielding resistant strains. These organisms represented seven different genera of Enterobacteriaceae (58%) or Pseudomonas aeruginosa (31%) and other glucose non-fermenting species (11%). Resistance to amikacin was usually associated with resistance to gentamicin, tobramycin and most of the other antimicrobials tested. Twenty percent of isolates were susceptible to only a single antimicrobial, and another 5% were resistant to every agent routinely tested. Although geographic clustering of a small number of amikacin-resistant organisms occurred twice (a strain of Proteus mirabilis on the spinal cord injury service and a strain of P. aeruginosa on one medical ward), the vast majority of isolations were consistent with a pattern of endemic resistance.