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Biomedical subjects

M Goldner

Publications and source records attributed to M Goldner.

At least 37 records · Page 2Linked to original sources

Hospitalization effect in acute mania.

We studied 31 patients meeting DSM-III criteria for bipolar affective disorder, manic type. All were treated in hospital, 18 on an open ward and 13 on a psychiatric intensive-care unit. Despite the use of only moderate doses of medication, dramatic clinical improvement was observed over the first 48 hours of treatment using the Brief Psychiatric Rating Scale and Beigel Mania Rating Scale as objective rating measures. Significantly greater improvement occurred in the psychiatric intensive-care unit in comparison to the open ward. We suggest that hospitalization effect is of prime importance in the early management of the acutely manic patient.

Adult↗

Cytidine 5'-monophospho-N-acetyl neuraminic acid and a low molecular weight factor from human blood cells induce lipopolysaccharide alteration in gonococci when conferring resistance to killing by human serum.

Recently evidence has been obtained that a minute amount of cytidine 5'-monophospho-N-acetyl neuraminic acid (CMP-NANA) or a closely related compound is the low Mr factor in human red blood cells which induces Neisseria gonorrhoeae (BS4(agar] to resistance to killing by fresh human serum. Induction of gonococci to resistance by both CMP-NANA and semi-purified low Mr factor from red blood cells was accompanied by a 35-55% reduction of silver staining of lipopolysaccharide separated in SDS-PAGE gels of proteinase K digests. These alterations in lipopolysaccharide are probably responsible for conferring serum resistance. However, lipopolysaccharide-containing digests from resistant as well as from susceptible gonococci neutralised serum bactericidal activity. These observations may have wider implications since CMP-NANA is a sialylating agent wide-spread in mammalian tissues and LPS is ubiquitous amongst Gram-negative pathogens.

Antibodies, Bacterial↗

Protein changes associated with induced resistance of Neisseria gonorrhoeae to killing by human serum are relatively minor.

Serum-susceptible (SS) Neisseria gonorrhoeae were induced to resistance (SR) to complement-mediated killing by fresh human serum (FHS) by a small-Mr factor(s) from guinea-pig blood in 3 h at 37 degrees C, but not in the presence of bacteriostatic concentrations of chloramphenicol or neomycin, indicating that proteins mediated the acquisition of resistance. SDS-PAGE protein profiles of lysates of equal numbers of gonococci showed only two qualitative differences between SR and SS organisms, both in minor components (a protein A of about 205 kDa in the former and not the latter and vice versa for a protein B of about 16 kDa). Many proteins, however, including the three principal outer-membrane proteins, were present in larger amounts in SR gonococci. The lack of major changes in proteins when resistance is acquired was confirmed by immunoblotting the two protein profiles with the IgG of hyper-immune rabbit anti-SR and anti-SS sera, of rabbit anti-SR serum after absorption by SS organisms and of FHS used alone and after absorption with SS organisms. The IgM of FHS, which is responsible for most of the bactericidal activity, showed only faint reactions with a few proteins common to both SS and SR gonococci and no reactions when the FHS was absorbed with SS gonococci. This is in contrast to the strong and different reactions given with lipopolysaccharide (LPS) components of SS and SR organisms, which, prepared from the former organisms, neutralize the bactericidal activity of FHS. Hence, the relatively small protein changes accompanying induction are less likely to be directly responsible for serum resistance than the more profound LPS changes.

Bacterial Proteins↗

Gonococci in vivo and in vitro. Further studies on the host and bacterial determinants of gonococcal resistance to killing by human serum, and by phagocytes.

A small M, heat and acid labile, host inducer(s) of gonococcal resistance to complement mediated killing by fresh human serum (-FHS), being purified from red blood cell (RBC) extracts, produced changed in lipopolysaccharide (LPS) structure, surface antigens and proteins; and acquirement of resistance related to loss of a target antigen for bactericidal IgM, possibly LPS components. A 20 kDalt. lipoprotein with a high content of glutamic acid isolated from outer membranes of a gonococcal strain selected in vivo is a determinant of gonococcal resistance to killing by human phagocytes. Sonic extracts of gonococci may contain a cytotoxin for human phagocytes. At the 4th International Pathogenic Neisseriae Conference, we reported (Parsons et al. 1985) that conditions in vivo induced phenotypic change leading to gonococcal resistance to complement-mediated killing by human serum; and, also, selected gonococcal types which showed a greater resistance to intracellular killing by human phagocytes than laboratory strains. Furthermore, evidence was presented that not only was resistance to complement mediated killing important in gonococcal pathogenesis, but also resistance to phagocytic defences. This paper describes the continuance of our studies on the determinants of induced serum resistance and of resistance to killing by phagocytes including toxicity to these cells. Each section begins by summarising previous work that was referenced in Parsons et al. (1985).

Animals↗

Red blood cells, a source of factors which induce Neisseria gonorrhoeae to resistance to complement-mediated killing by human serum.

Lysates of guinea pig or human red blood cells (RBC) contain far more of the factors that induce resistance in gonococci to complement-mediated killing by fresh human serum that do plasma or serum. As was previously found with serum, most of the resistance-inducing activity of guinea pig RBC lysates was found in ultrafiltrates with molecular weights of less than 5000. In contrast, and as with human serum, most of the resistance-inducing activity of human RBC lysates did not pass ultrafilters which removed molecules of less than 5000 daltons, although some active material of low molecular weight was present.

Animals↗

Penetration of the outer membrane of Pseudomonas aeruginosa by synergistic combinations of beta-lactam and aminoglycoside antibiotics.

The mechanism of the synergistic action of carbenicillin-gentamicin and moxalactam-tobramycin combinations against Pseudomonas aeruginosa ATCC 9027 was investigated. Disruption of the outer membrane penetration barrier by EDTA treatment enhanced the activity of both combinations against the cells during growth for 100 min in exponential phase. However, there was no loss of the synergistic activity of the antibiotics as a result of this treatment. A procedure involving minimal inhibitory concentration testing in the presence of rifampin did not detect any destabilization of the outer membrane barrier by any of the four drugs over an 18-h period. The combined evidence indicates that beta-lactamaminoglycoside synergy is not mediated by the outer membrane of this organism.

Aminoglycosides↗

Limited contribution of the outer-membrane penetration barrier towards intrinsic antibiotic resistance of Pseudomonas aeruginosa.

The role of the outer membrane (OM) was investigated in relation to the high level of intrinsic antibiotic resistance of Pseudomonas aeruginosa ATCC 9027. OM penetration barriers were measured by comparing turbidimetric growth curves of EDTA-treated and normal cells exposed to carbenicillin, moxalactam (LY 127935), gentamicin, tobramycin, rifampin, novobiocin, and vancomycin. OM barriers were also measured for carbenicillin and moxalactam in P. aeruginosa strain K 799/61, a hypersusceptible mutant presumed to have lost its penetration barrier in the cell envelope. Most antibiotics penetrated the OM efficiently and there was little difference between the two strains. The evidence therefore suggests that intrinsic resistance of P. aeruginosa, especially to the beta-lactam antibiotics, is not mainly due to the OM. A penetration barrier situated deeper within the cell envelope is hypothesized, the size of which in relation to any antibiotic may be estimated by comparing the IC50 values of EDTA-treated cells of the two strains.

Anti-Bacterial Agents↗

The biological aspects of oral pathogenicity.

The bacteria in the oral region tend to localize in the form of plaque deposits on tooth surfaces and in gingival crevices. The "metabolic nature" of this complex flora focuses on the reversible interactions between the plaque flora and their environmental modifications. The environmental circumstances will influence the range of expression in situ for the plaque (oral) organisms. Then, it is suggested that the potential for caries induction or periodontal disease may develop when conditions approaching extremes of environment result in altered metabolism and antigenicity of particular oral organisms.

Bacteria↗

The intracellular survival and growth of gonococci in human phagocytes.

In reassessment of previous tests for intracellular survival, results have been confirmed and additional evidence obtained indicating that some gonococci can survive and multiply in human phagocytes. Use was made of the ability of penicillin to penetrate phagocytes and to kill only actively growing organisms. In microscopic counts on 33 urethral exudate smears, an average of 49% of gonococci were associated with polymorphonuclear phagocytes. The organisms were unevenly distributed amongst the phagocytes, with most cells uninfected and some containing large numbers. Many phagocytes also remained uninfected in tests in vitro with low gonococcal inocula although experiments with large inocula showed that most phagocytes could ingest gonococci. It is proposed that ingestion of one gonococcus may stimulate the phagocytes to take up more. Phagocytes were killed and disintegrated after ingesting large numbers of gonococci and similar effect in vivo may be responsible for the large clumps of organisms seen in urethral exudate. These results underline the probable importance in the pathogenesis of gonorrhoea of intracellular survival in phagocytes.

Blood Bactericidal Activity↗

Phenotypically determined resistance of Neisseria gonorrhoeae to normal human serum: environmental factors in subcutaneous chambers in guinea pigs.

Some gonococci obtained from human urethral exudate or from subcutaneously implanted chambers in guinea pigs show a resistance to killing by human serum which is lost on sub-culture in vitro after a few generations. The environmental factors which may influence the phenotypic expression of resistance to serum killing were investigated in guinea pig chambers and in chamber fluid in vitro. The redox potential in chambers before and after infection was lower than that of heart blood but conditions were not anaerobic; H2O2 increased the redox potential but did not decrease gonococcal serum resistance. The chambers were slightly alkaline before and after infection. When the concentration of glucose (depleted in infected chambers by the abundant polymorphonuclear cells) was restored to excess, the serum resistance of the gonococci was unaffected. Concentrations of free amino acids in chambers changed little during infection. Gonococci adapted to growth in chambers and subsequently rendered serum-sensitive by growing once on agar reverted to serum-resistance after 0.5 to 1 h incubation in chamber fluid in vitro at 37 degrees C but not at 25 degrees C or 4 degrees C. After 16 to 24 h growth at 37 degrees C, resistance was again lost. The reversion to serum resistance did not occur in a complex laboratory medium. Examination of the chamber fluid after growth of gonococci in vitro showed depletion of lactate, glutamine and proline.

Acetates↗

Outer-membrane penetration barriers as components of intrinsic resistance to beta-lactam and other antibiotics in Escherichia coli K-12.

A new technique has been devised to investigate the penetration of antibiotics through the gram-negative outer membrane; the application here was to study intrinsic resistance of Escherichia coli K-12. Exponential cells in broth were briefly treated with 2.5 mM ethylenediaminetetraacetic acid at 5 degrees C to disrupt the outer membrane penetration barrier, and the response of treated and untreated cells to antibiotics was compared by turbidimetry. A barrier index was derived to describe the ability of 7 beta-lactam and 10 other antibiotics to penetrate the outer membrane of strain Y10. There was correlation between the molecular weight and log(10) barrier index (r = 0.59, P congruent with 0.01). The envelope mutant D22 (envA) had low barrier indexes for erythromycin, rifampin, ampicillin, and cloxacillin. For the beta-lactams, outer membrane penetration and affinity for inner membrane target site(s) triggering cell lysis were measured as independent components of the overall activity; although penetration and overall activity varied greatly, the affinities of most were within a narrow range.

Anti-Bacterial Agents↗

Penetrability of the outer membrane of Neisseria gonorrhoeae in relation to acquired resistance to penicillin and other antibiotics.

Acquired antibiotic resistance in Neisseria gonorrhoeae is principally associated with three genetic markers, penA, mtr, and penB. penA is a specific marker for penicillin resistance, whereas mtr and penB are nonspecific in conferring resistance to penicillin and several other antibiotics as well. It has been suggested that the nonspecific markers may cause a general decrease in the penetrability of the gonococcal outer membrane. To investigate this, antibiotic penetration of the outer membrane was studied in two isogenic strains-FA19 (susceptible parent) and FA140 (containing penA, mtr, and penB)-and also in a clinical isolate with multiple resistance. The method involved brief treatment of exponential cells with ethylenediaminetetraacetic acid at 5 degrees C to disrupt the outer membrane barrier. The 50% inhibitory concentrations of antibiotics for treated and normal cells were measured turbidimetrically, and from their ratios outer membrane penetration barriers were calculated. Small barriers were observed for actinomycin D and benzylpenicillin, and these were very similar in the susceptible and resistant strains. Also, in FA140 no significant barriers for rifampin, erythromycin, and tetracycline were detected. These results suggest that mechanism(s) other than reduced outer membrane penetrability underlie acquired resistance due to penA, mtr, and penB.

Anti-Bacterial Agents↗

Streptococcus mutans, an assessment of its physiological potential in relation to dental caries.

Streptococcus mutans converts low levels of sucrose to lactic acid, but at high levels favours synthesis of glucans for plaque accumulation. Thus, the continued exposure to sucrose fluxes would select microorganisms in the oral cavity (S. mutans being a prototype) with highly specialized adaptation and potential dental caries activity. The bacteria that have evolved physiological systems to function efficiently under these conditions are the lactic acid bacteria. These organisms survive in environments where carbohydrate availability is constantly changing. High tolerances to acidic environments may be an important determinant in establishing the ecology of the carious lesion. Also, the intercellular polysaccharide storgae (glycogenamylopectin) and extracellular polymer reserves (levan and soluble glucan) are important during carbohydrate depletion. Further, the formation of insoluble glucans is a prerequisite for the caries process on smooth surfaces of teeth through plaque development. These conditions could result in an increase in S. mutans and cariogenic microorganisms. As a result, this process may be best understood as a manifestation of an amphibiotic shift.

Carbohydrate Metabolism↗

Reagin-like activity of serum in human peridonotal disease.

The serum from patients with periodontitis produced a passive cutaneous anaphylaxis reaction in monkeys when tested against subgingival plaque. This detection of reaginic antibodies shows that patients with periodontitis make immunoglobulin E antibodies to plaque constituents.

Animals↗