Internist, Critical Care Specialist, Pulmonologist (lungs)
39 years of experience

Accepting new patients
Maedgen Area
TTU Medical Pavillion
3601 4th St
Lubbock, TX 79430
806-743-3150
Locations and availability (4)

Education ?

Medical School Score Rankings
Washington University at St. Louis (1971)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Associations
American Board of Internal Medicine

Affiliations ?

Dr. Nugent is affiliated with 5 hospitals.

Hospital Affilations

  • University Medical Center - Lubbock
  • Lincoln County Medical Center
  • TX Tech Physicians Associates
  • Grace Medical Center
  • University Medical Cent
  • Publications & Research

    Dr. Nugent has contributed to 55 publications.
    Title Effect of Pioglitazone on Platelet Aggregation in a Healthy Cohort.
    Date February 2011
    Journal Cardiology
    Excerpt

    Peroxisome proliferator-activated receptor (PPAR) agonists can favorably influence atheroma proliferation, lipoprotein metabolism and macrovascular complications. Pioglitazone, one of the thiazolidinedione compounds, is a PPAR ligand activator and a clinically important PPAR agonist. There is controversy in the literature about its potential antiplatelet effects. Its direct platelet inhibition is a novel hypothesis tested in animal models and in human populations with underlying diabetic and/or cardiovascular diseases. The present study was aimed to test the hypothesis of direct platelet aggregation inhibition with the use of pioglitazone in a healthy population.

    Title A 20-year-old Woman with Severe Asthma Refractory to Primatene Mist.
    Date January 2011
    Journal Chest
    Title Placental Growth Factor: a New Kid on the Block?
    Date October 2010
    Journal Southern Medical Journal
    Title Emotional Stress and Tako-tsubo Cardiomyopathy: Observations on 2 Distinct Clinical Phenotypes.
    Date April 2010
    Journal Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research
    Excerpt

    Tako-tsubo syndrome is a transient cardiomyopathy usually precipitated by an acute emotional or physiological stress. Our study objectives were to review and analyze the impact of emotional stress on clinical variables, echocardiographic characteristics, and short-term outcomes in patients with tako-tsubo syndrome.

    Title Klippel-trenaunay Syndrome and Radial Artery Coronary Graft Spasm.
    Date December 2009
    Journal Journal of the College of Physicians and Surgeons--pakistan : Jcpsp
    Excerpt

    A 75-year-old woman with known diagnosis of Klippel-Trenaunay syndrome presented with acute onset of chest pain, dyspnea and elevated cardiac enzymes. She had triple vessel coronary artery disease on subsequent coronary angiography. Given the unavailability of venous conduits secondary to lower extremity varicosities, coronary artery bypass grafting with radial and internal mammary arterial grafts was carried out. The radial artery graft went into spasm two days later and required intracoronary vasodilators to relieve the spasm. The patient remained hypotensive and finally expired.

    Title Postpartum Depression and Apical Ballooning Syndrome (takotsubo Syndrome).
    Date October 2009
    Journal Journal of Obstetrics and Gynaecology Canada : Jogc = Journal D'obstétrique Et Gynécologie Du Canada : Jogc
    Excerpt

    Acute cardiac complications occur occasionally during pregnancy and in the immediate postpartum period. Some of these cardiac scenarios are rare and provide a diagnostic challenge. We report a case of apical ballooning syndrome (ABS), also known as takotsubo cardiomyopathy or broken-heart syndrome, in a postpartum patient.

    Title Acute Stress Cardiomyopathy and Deaths Associated with Electronic Weapons.
    Date July 2009
    Journal International Journal of Cardiology
    Excerpt

    Deaths associated with the use of electronic weapons almost always occur in young men involved in either civil disturbances or criminal activity. These situations are associated with high levels of circulating catecholamines and frequently associated with drug intoxication. The mechanism for these deaths is unclear. Clinical studies indicate that these high voltage electrical pulses do not cause cardiac arrhythmia. Acute stress cardiomyopathy provides an alternative explanation for deaths associated with electronic weapons and may provide a better explanation for the usual time course associated with taser deaths. Patients with acute stress cardiomyopathy usually have had an emotional or physical stress, have high circulating levels of catecholamines, present with an acute coronary syndrome but have normal coronary vessels without significant thrombus formation. They have unusual left ventricular dysfunction with so-called apical ballooning. This presentation has been attributed to the direct effects of catecholamines on myocardial cell function. Alternative explanations include vasospasm in the coronary microcirculation and/or acute thrombosis followed by rapid thrombolysis. Similar events could occur during the high stress situations associated with the use of electronic weapons. These events also likely explain restraint-related deaths which occur in independent of any use of electronic weapons. Forensic pathologists have the opportunity to provide important details about the pathogenesis of these deaths through histological studies and careful evaluation of coronary vessels.

    Title An 18-year-old Woman with Hyperammonemia.
    Date April 2009
    Journal Chest
    Title Regional Transient Osteoporosis of the Foot and Vitamin C Deficiency.
    Date July 2007
    Journal Clinical Rheumatology
    Excerpt

    We describe the clinical presentation and diagnostic tests of a patient with regional transient osteoporosis (RTO) of the foot. This patient presented with a 4-month history of left-foot pain, nonpitting edema, and brownish discolorations of both feet. He had a history of tobacco abuse, alcohol abuse, and malnutrition. Radiological studies revealed severe osteopenia in the feet, and a MRI revealed bone marrow edema. The bone biopsy was consistent with RTO. This patient also had vitamin C deficiency. This case suggests a link between vitamin C deficiency and RTO, a hypothesis supported by our review of relevant literature on osteoporosis and vitamin C.

    Title Organizing Pneumonia and Pulmonary Eosinophilic Infiltration Associated with Daptomycin.
    Date May 2007
    Journal The Annals of Pharmacotherapy
    Excerpt

    OBJECTIVE: To report a case of organizing pneumonia with pulmonary eosinophilic infiltrates in a patient receiving daptomycin. CASE SUMMARY: An 84-year-old man developed bilateral, irregularly shaped nodules and infiltrates in the mid and peripheral lung and multiple mediastinal lymph nodes following treatment with intravenous daptomycin for infection of his left knee prosthesis. His other symptoms included decreased appetite, weight loss (6.8 kg over 4-6 wk), malaise, and generalized weakness after 4 weeks of daptomycin therapy. Transthoracic needle biopsy revealed organizing pneumonia with scattered eosinophils. His symptoms and results of computed tomography (CT) scan improved in the month following discontinuation of daptomycin. The Naranjo probability scale indicated a probable reaction to daptomycin. DISCUSSION: Pulmonary reactions have been reported with numerous drugs and have a wide range of clinical and radiographic presentations. Clinical trials have shown that daptomycin is well tolerated and has an adverse effect profile similar to that of vancomycin and the semisynthetic penicillins. This case report suggests that chronic use of daptomycin caused organizing pneumonia with eosinophilic infiltrates in a patient treated for an infected knee prosthesis. A definite mechanism for this reaction is not known. We speculate that the chronic administration of daptomycin allowed drug accumulation in surfactant in the alveolar spaces. This may result in higher concentrations of drug near the alveolar epithelial surface, which could injure the epithelium, resulting in organizing pneumonia. CONCLUSIONS: Development of new pulmonary infiltrates in patients treated with chronic daptomycin therapy should alert healthcare workers to this potential association.

    Title Gitelman-like Syndrome After Cisplatin Therapy: a Case Report and Literature Review.
    Date July 2006
    Journal Bmc Nephrology
    Excerpt

    BACKGROUND: Cisplatin is a well-known nephrotoxic antineoplastic drug. Chronic hypokalemic metabolic alkalosis with hypomagnesemia and hypocalciuria is one of the rare complications associated with its use. CASE PRESENTATION: A 42-year-old woman presented with a 20 year-history of hypokalemic metabolic alkalosis with hypomagnesemia and hypocalciuria after cisplatin-based chemotherapy for ovarian cancer. This patient has had chronic muscle aches and fatigue and has had episodic seizure-like activity and periodic paralysis. Only thirteen other patients with similar electrolyte abnormalities have been described in the literature. This case has the longest follow-up. CONCLUSION: Cisplatin can cause permanent nephrotoxicity, including Gitelman-like syndrome. This drug should be considered among the possible causes of chronic unexplained electrolyte disorders.

    Title A 44-year-old Woman with Polyarthritis, Fever, and Hilar Adenopathy.
    Date April 2006
    Journal Chest
    Title Acute Cardiac Toxicity Associated with High-dose Intravenous Methotrexate Therapy: Case Report and Review of the Literature.
    Date December 2005
    Journal Pharmacotherapy
    Excerpt

    A 36-year-old woman was hospitalized for preoperative chemotherapy for osteosarcoma. She received intravenous fluids for 12 hours for volume expansion, then methotrexate 24 g (12 g/m2) over 6 hours. This was followed by intravenous leucovorin 200 mg over 1 hour. Two hours after the methotrexate infusion the patient developed chest pain and bradycardia. An electrocardiogram revealed sinus pauses, and telemetry recordings indicated a 4-beat run of ventricular tachycardia. A cardiac work-up consisting of cardiac enzyme level determination, two-dimensional echocardiography, and an adenosine technetium-99m tetrofosmin stress test was negative for structural and ischemic heart disease. The patient recovered without treatment and, approximately 2 weeks later, received a second course of methotrexate at half the dose without complication. One month later the patient received treatment with doxorubicin and cisplatin; 2 days later she died unexpectedly at home. Clinicians should be aware that high-dose methotrexate can cause cardiac symptoms and arrhythmias in previously healthy adults. This complication warrants attention and needs additional clinical investigation.

    Title Churg-strauss Syndrome: Diagnostic Difficulties and Pathogenesis.
    Date March 2003
    Journal The American Journal of the Medical Sciences
    Excerpt

    A 52-year-old woman with a history of chronic obstructive pulmonary disease presented with symmetrical polyarthritis involving her metacarpophalangeal and proximal interphalangeal joints, knees, ankles, and hips and with a purpuric rash involving her lower extremities. She had a history of recurrent episodes of purulent otitis often associated with myalgias and arthralgias. Laboratory studies at presentation included leukocytosis with 16% eosinophils, an elevated rheumatoid factor titer, and an elevated antineutrophil cytoplasmic antibody titer. Cultures from the right ear canal grew. Skin biopsy revealed leukocytoclastic vasculitis with pericapillary eosinophils. The patient was treated with prednisone and then with azathioprine after the rash relapsed during the tapering of prednisone. Four months after her initial presentation, she developed bilateral foot drop. A sural nerve biopsy revealed vasa nervosum vasculitis. The diagnosis of Churg-Strauss syndrome was established, and she was treated with an increased dose of azathioprine and a slowly tapering prednisone regimen. This case report suggests that patients with Churg-Strauss syndrome can present with a syndrome suggesting rheumatoid arthritis. In this particular patient, recurrent staphylococcal infections may have triggered the vasculitic process.

    Title Management of Hepatic Hydrothorax with a Peritoneovenous (denver) Shunt.
    Date July 1990
    Journal Southern Medical Journal
    Excerpt

    One patient with alcoholic cirrhosis and a massive hydrothorax resistant to medical management and thoracocentesis was treated with a Denver peritoneovenous shunt. This patient's progress has been followed for 14 months and the pleural effusion has not recurred.

    Title Flow Volume Loops in Diagnosis.
    Date March 1990
    Journal Chest
    Title Immunologic Hemorrhagic Pneumonia Caused by Isocyanates.
    Date February 1990
    Journal The American Review of Respiratory Disease
    Excerpt

    The occurrence of hemoptysis, dyspnea, and bilateral pulmonary opacities progressed to respiratory failure in a 34-yr-old man. Recovery occurred with corticosteroid therapy. In the absence of evidence for an infectious etiology, the possibility of immunologic trimellitic anhydride (TMA) hemorrhagic pneumonitis was considered when the lung biopsy excluded Goodpasture's and other diseases and because the patient was a spray painter. Serologic evaluation for antibodies against TMA was requested. Because the immunologic studies for TMA were negative, and because the patient was a spray painter, immunoassays for three isocyanates conjugated to human serum albumin (HSA) were carried out although there was no specific history of isocyanate exposure at that time. High levels of IgG and IgE antibodies were detected against hexamethylene diisocyanate (HDI)-HSA and toluene diisocyanate (TDI)-HSA. Further investigation documented exposure to spray paint that contained HDI and another isocyanate. The paint was sprayed on warm metal, and subsequently the worker developed an acute illness. Further plant studies were not possible. We propose that the pathogenesis of this case of hemorrhagic pneumonitis is immunologic because of uncontrolled exposure to HDI and TDI, is analogous to the immunologic hemorrhagic pneumonia caused by TMA, and should be considered as a possible cause of a similar acute lung disease after isocyanate exposure.

    Title Correlation of Chest Roentgenograms with Pulmonary Function and Bronchoalveolar Lavage in Interstitial Lung Disease.
    Date January 1990
    Journal Chest
    Excerpt

    We used the ILO classification for occupational lung disease to determine whether there was any correlation between the type and/or severity of pulmonary infiltration on chest roentgenograms and either pulmonary function tests or the types of inflammatory cells present in BAL fluid in patients with interstitial lung disease. Of the 62 patients evaluated (27 with sarcoidosis, 18 with IPF, and 17 with a CV disease and lung involvement), 49 had irregular linear opacities and 13 had normal chest x-rays. There were no significant correlations between the types of cells present in BAL fluid and the various categories of infiltrate or profusion of the infiltrates within each disease group. In patients with sarcoidosis, more extensive infiltration (profusion) was associated with lower FEV, (p less than 0.01). In patients with IPE, linear opacity type, profusion, and the presence or absence of honeycombing were not related to the severity of pulmonary function abnormalities. We conclude that the ILO classification for analysis of chest roentgenograms can be applied to patients with interstitial lung disease not associated with an occupational exposure and that this approach is useful, especially for communication. However, these data provide no information regarding the inflammatory process in the lung and limited information regarding abnormalities in pulmonary function.

    Title The Utility of Bronchoalveolar Lavage and Transbronchial Lung Biopsy Combined with Energy-dispersive X-ray Analysis in the Diagnosis of Silicosis.
    Date December 1989
    Journal The American Review of Respiratory Disease
    Excerpt

    We used analytical electron microscopic techniques, including energy-dispersive X-ray analysis, to evaluate a patient with diffuse infiltrates and a history of silica exposure. We identified silica particles in digested bronchoalveolar lavage fluid, sectioned alveolar macrophages recovered by lavage, and parenchymal specimens obtained by transbronchial biopsy. This analysis confirmed our clinical suspicion (a sporadic case of accelerated silicosis) and eliminated the need for additional, more complicated, diagnostic procedures.

    Title Uniformity of Bronchoalveolar Lavage in Patients with Pulmonary Sarcoidosis.
    Date February 1988
    Journal The American Review of Respiratory Disease
    Excerpt

    Sarcoidosis is a granulomatous disease of unknown cause characterized by a lymphocytic alveolitis. Previous studies have shown that the inflammatory cell population of the distal lung units of patients with this disorder can be accurately assessed using bronchoalveolar lavage (BAL). The present study evaluated the uniformity of BAL between different sites of the lung in patients with sarcoidosis. In general, there was a good correlation between sites for percentages of lymphocytes (LYM) (r = 0.750, p less than 0.0001), LYM number (r = 0.356, p = 0.0007), percentages of neutrophils (NEUT) (r = 0.917, p less than 0.0001), NEUT number (r = 0.999, p less than 0.0001), and macrophage (MAC) number (r = 0.858, p less than 0.001). Despite the good overall correlation, we found that 43% of the patients with high percent LYM (greater than 30%) had this finding on one side only. These patients did not differ from the group as a whole based on radiographic stage of their disease but did differ in the number of radiographs demonstrating focal infiltrates (2 of 28 patients with both sides less than 30% LYM, 2 of 14 with both sides greater than 30% LYM, and 4 of 9 with only one side greater than 30% LYM p less than 0.05 by chi-square); and in each situation the highest percent LYM was seen on the side with focal changes on the chest radiograph.(ABSTRACT TRUNCATED AT 250 WORDS)

    Title Vocal Cord Paresis and Glottic Stenosis: a Late Complication of Poliomyelitis.
    Date January 1988
    Journal Southern Medical Journal
    Excerpt

    A patient with spinobulbar poliomyelitis had residual dysfunction of the ninth and tenth cranial nerves, which produced bilateral vocal cord paresis and recurrent aspiration. Critical glottic stenosis developed 28 years after the initial episode of poliomyelitis; this course appeared to be explained by fibrosis of the intrinsic laryngeal muscles and ankylosis of the right cricoarytenoid joint. Thus it appears that significant upper airway obstruction may develop as a late complication in patients with stable neurologic deficits and chronic immobility of the vocal cords.

    Title Pneumonia Due to Histoplasma Capsulatum in a Bone Marrow Transplant Recipient.
    Date January 1988
    Journal Thorax
    Title Interaction Between Candida Agglutinins and Antifungal Agents.
    Date October 1987
    Journal Mycopathologia
    Excerpt

    Antifungal agents alter the function and morphology of Candida cell membranes and cell walls. We observed that brief (30 minute) exposure to either amphotericin B or clotrimazole inhibited the agglutination of Candida blastoconidia by murine bronchoalveolar lavage fluid. This inhibition required continuous drug presence. Neither amphotericin nor clotrimazole inhibited Candida agglutination by concanavalin A or pooled human serum. These results demonstrate that antifungal drugs can produce rapid changes in the surface characteristics of some fungi.

    Title Alveolar Macrophage Gold Retention in Rheumatoid Arthritis.
    Date October 1987
    Journal The Journal of Rheumatology
    Excerpt

    Alveolar macrophages obtained by bronchoalveolar lavage (BAL) were evaluated by electron dispersive microanalysis (EDX) for the presence of elemental gold. EDX revealed gold in 90% (9/10) of patients with RA who were currently receiving chrysotherapy or who had discontinued chrysotherapy less than 24 months before BAL. All patients who had discontinued chrysotherapy more than 24 months before BAL (range: 3-14 years) were EDX negative (4/4), as were patients with RA who had never received gold therapy (5/5). Seven patients with RA (7/19) had clinical evidence of interstitial lung disease and 12 patients (12/19) had no interstitial lung disease. There was no correlation between chrysotherapy and the development of interstitial lung disease. These results demonstrate that gold is retained for prolonged periods in pulmonary tissue macrophages but do not identify any relationship between gold and chronic rheumatoid lung disease.

    Title Effect of Candida Morphology on Amphotericin B Susceptibility.
    Date May 1987
    Journal Antimicrobial Agents and Chemotherapy
    Excerpt

    We showed that brief exposures to amphotericin B (AmB) inhibited the induction of new Candida germ tubes and the lengthening of partially induced germ tubes. Blastoconidia with germ tubes were more susceptible to AmB killing, and this varied directly with the induction period and the AmB exposure period. AmB did not preferentially affect germ tube adherence to fibrin matrices.

    Title Candidacidal Factors in Murine Bronchoalveolar Lavage Fluid.
    Date April 1987
    Journal Infection and Immunity
    Excerpt

    Respiratory secretions provide an efficient method for protecting the large surface area of the lower respiratory tract. To determine whether lung secretions contribute to antifungal defenses, we tested bronchoalveolar lavage fluid for fungicidal activity. Candida albicans (blastoconidia) was incubated in unconcentrated cell-free lavage fluid from Swiss Webster mice and then cultured quantitatively to measure residual viability. In control buffer the residual fractions of viable fungi were 1.03 +/- 0.12 at 60 min and 0.84 +/- 0.05 at 120 min, whereas the residual fractions in lavage fluid were 0.64 +/- 0.07 and 0.23 +/- 0.05, respectively (P less than 0.05 by t tests). This activity was trypsin sensitive and heat stable (56 degrees C) and did not require divalent cations. It did not sediment with the surfactant fraction of lung lavage fluid. Unconcentrated lavage fluid reduced the adherence of C. albicans to serum-coated glass tubes to 2.3 +/- 1.5% of that of control Candida suspensions (n = 5, P less than 0.05 by t test). It did not alter Candida ingestion or intracellular processing by alveolar macrophages. Lavage fluid also killed clinical isolates of Candida tropicalis and Torulopsis glabrata but did not kill Candida krusei or Candida parapsilosis. Lavage fluid was concentrated and passed through an acrylamide-agarose gel matrix. The chromatogram indicated that the candidacidal activity eluted in a peak with a molecular weight range of 29,000 to 40,000. After electrophoresis on 15% sodium dodecyl sulfate-polyacrylamide gels, these fractions resolved into three bands. These were transferred to nitrocellulose and then eluted with Triton X-100; this procedure permitted the isolation of a single band of candidacidal activity with a molecular weight of 29,000. In summary, murine lavage fluid contains a heat-stable protein with direct antifungal activity. This soluble factor may contribute to lung defense processes by reducing fungal viability and adherence to tissue surfaces.

    Title Effect of Alkylating Agents on the Clearance of Staphylococcus Aureus from Murine Lungs.
    Date March 1987
    Journal Journal of Leukocyte Biology
    Excerpt

    Alkylating agents have several effects on cellular host defense responses which could increase either the frequency or the severity of pulmonary infections. In addition, some of these agents directly injure lung parenchyma and could have effects on intrapulmonary killing processes independent of any effect on phagocyte number and function. We have used a murine model for staphylococcal clearance to evaluate the effect of cyclophosphamide and mechlorethamine on intrinsic lung defenses. Single doses of mechlorethamine (40 micrograms IV) or of cyclophosphamide (150 mg/kg IP) reduce peripheral blood neutrophil counts and spleen weights on day 3 after injection; with the exception of neutrophil counts in mechlorethamine-treated mice, these parameters returned to normal by days 10-12. Both drugs reduced the number of alveolar macrophages recoverable by bronchoalveolar lavage on days 10-12 but not day 3. Mechlorethamine delayed the clearance of Staphylococcus aureus 502A from the lung on both days 3 and 12, but cyclophosphamide did not alter clearance on either day 3 or 10. The defect in clearance in mechlorenthamine-treated mice resolved by 3 wk after drug administration. These results demonstrate that alkylating agents do not have uniform effects on antibacterial processes in the murine lung. Since the mechlorethamine effect on staphylococcal elimination appears independent of its effect on macrophage numbers, these results suggest that staphylococcal clearance also depends on nonphagocytic host defense factors.

    Title Effects of Sublethal Concentrations of Amphotericin B on Candida Albicans.
    Date October 1986
    Journal The Journal of Infectious Diseases
    Excerpt

    Because sublethal concentrations of antibodies can have important effects on bacteria and may aid host defenses, even in the absence of direct microbial killing, the effect of brief sublethal exposures to amphotericin B on Candida albicans blastoconidia was evaluated. Amphotericin B (0.01-1.0 micrograms/ml for 60 min) inhibited germ tube formation and yeast adherence to both serum-coated plastic surfaces and fibrin matrices. These effects were not reversed by cation (K+ or Mg++) supplementation. Amphotericin B pretreatment accelerated clearance of C. albicans from the peritoneal surfaces of mice and reduced the inflammatory stimulus associated with this clearance, at least as measured by neutrophil influx. However, pretreatment did not facilitate killing of C. albicans by either neutrophils or monocytes in vitro. Thus sublethal concentrations of amphotericin B inhibit two activities of C. albicans that probably contribute to surface colonization and tissue invasion. These results provide one explanation for the clinical benefits observed with short courses of amphotericin B therapy for surface-limited candidal infections (e.g., esophagitis).

    Title Effects of Cyclosporine on Pulmonary Clearance of Staphylococcus Aureus and Pseudomonas Aeruginosa.
    Date August 1986
    Journal The Journal of Infectious Diseases
    Title Inhibitory Effects of Chlorpromazine on Candida Species.
    Date August 1985
    Journal Antimicrobial Agents and Chemotherapy
    Excerpt

    Chlorpromazine was tested for antifungal activity by using Candida albicans and standard assays. The MIC of chlorpromazine was 35 micrograms/ml; the minimal fungicidal concentration was also 35 micrograms/ml. The minimal effective concentration was 2.2 to 3.5 micrograms/ml (using assays based on quantitative cultures and growth). There was a slight positive interaction between chlorpromazine and amphotericin B but no interaction between chlorpromazine and rifampin. Chlorpromazine also inhibited C. krusei, C. parapsilosis, C. tropicalis, and Torulopsis glabrata. We conclude that phenothiazines have direct anti-Candida activity and that these drugs appear to have a broad antimicrobial spectrum.

    Title Stimulated Human Alveolar Macrophages Secrete Interferon.
    Date June 1985
    Journal The American Review of Respiratory Disease
    Excerpt

    Alveolar macrophages were isolated by bronchoalveolar lavage from normal subjects to determine whether these cells can be activated to produce interferon. Macrophages were incubated for 24 h, and the supernatants were assayed for interferon using a plaque reduction assay (vesicular stomatitis virus and human amnion cells). The macrophages did not spontaneously release detectable amounts of interferon, but macrophages stimulated with either mitogens or classic inducers did release antiviral activity (titer range, 32 to 962 units/ml). Interferon activity was detectable after 4h incubation. In general, macrophages that responded to one stimulating agent responded to all tested, and concanavalin A (25 micrograms/ml) produced the highest titer (mean, 335 units/ml). Peripheral blood lymphocytes at cell densities (1 X 10(5)/ml) comparable to that present in the macrophage suspension did not produce detectable amounts of interferon using identical culture and assay conditions. There was no difference between monocytes and alveolar macrophages in the amounts of interferon produced after 24 h, and there was also no apparent effect of cigarette smoking on the production of interferon by alveolar macrophages. Alveolar macrophages appeared to release gamma-interferon with mitogen stimulation (Con A) and alpha-interferon with UV-inactivated influenza A virus stimulation. We conclude that stimulated human alveolar macrophages can secrete both alpha- and gamma-interferon. This capacity for interferon production by alveolar macrophages may have important implications for antiviral defenses in the lung and may modulate certain pulmonary inflammatory and immune processes.

    Title Modulation of Pulmonary Clearance of Bacteria by Antioxidants.
    Date May 1985
    Journal Infection and Immunity
    Excerpt

    To further delineate the mechanisms underlying murine pulmonary defenses against bacterial infection, we studied the effects of antioxidant enzymes and hydroxyl radical scavengers on pulmonary clearance processes. Intratracheal injection of catalase and superoxide dismutase resulted in prolonged intraalveolar residence of the enzymes, but caused no decrease in rates of clearance of either Staphylococcus aureus 502A or Pseudomonas aeruginosa PAO1. In contrast, dimethylsulfoxide and dimethylthiourea caused significant depression of clearance of P. aeruginosa without altering clearance of S. aureus. These results provide further differentiation between clearance processes affecting gram-negative and gram-positive bacteria and suggest that murine clearance of gram-negative organisms may be in part mediated by reactions which generate hydroxyl anion. In vivo administration of agents which inhibit hydrogen peroxide-, superoxide-, or hydroxyl anion-mediated reactions do not alter normal clearance of S. aureus.

    Title Intralipid Effects on Reticuloendothelial Function.
    Date September 1984
    Journal Journal of Leukocyte Biology
    Excerpt

    Malnourished patients frequently received parenteral nutrition with Intralipid, a lipid emulsion that accumulates in the reticuloendothelial tissue in some patients. To examine the potential of this emulsion as a risk factor for infection, I evaluated its effect on peritoneal clearance processes and on macrophage function. Mice treated with Intralipid (0.5 ml intraperitoneally) twice daily for 4 days had delayed clearance of Staphylococcus aureus from the peritoneal cavity and had increased staphylococcal dissemination to renal tissue. However, this regimen did not alter the neutrophil influx into the peritoneum elicited by this bacterial challenge. Intralipid also delayed the clearance of inert carbon particles from the peritoneal cavity. Peritoneal macrophages incubated with Intralipid (40% vol/vol) in tissue culture media for 18 hr became rounded and more phase dense, and these cells had multiple homogeneous cytoplasmic deposits. This Intralipid exposure reduced phagocytic and pinocytic activities in these monolayers, and the phagocytic defect persisted for at least 24 hr after cells were removed from media supplemented with Intralipid. In summary, these results demonstrate that Intralipid inhibits peritoneal clearance processes and that this alteration probably reflects impaired macrophage (free cells) and reticuloendothelial function. In some patients this form of nutritional therapy may increase the risk of infection.

    Title Verapamil Inhibits Influenza A Virus Replication.
    Date August 1984
    Journal Archives of Virology
    Excerpt

    Calcium channel blockers reduce Ca++ flux through membrane channels and may inhibit intracellular Ca++-dependent synthetic and regulatory activities by binding to calmodulin. We have found that Verapamil, a calcium channel blocker, inhibits influenza virus replication in Madin-Darby canine kidney cells and in murine pulmonary macrophages and that this antiviral effect occurs with drug addition late in the replication cycle. Chlorpromazine, a drug which binds to calmodulin, also inhibited influenza virus replication in these tissue culture systems. We suggest that Verapamil and chlorpromazine inhibit influenza virus replication by interfering with calmodulin-dependent intracellular activities necessary for late synthetic steps or virus assembly steps and that calcium channel blockers provide a new probe for investigating influenza virus replication.

    Title Pulmonary Clearance of Candida Albicans in Neutropenic Mice.
    Date August 1984
    Journal The Journal of Infectious Diseases
    Title Pseudomonas Aeruginosa Clearance in Mice: Comparison of Tissue, Strain, and Corticosteroid Effects.
    Date April 1984
    Journal Infection and Immunity
    Excerpt

    We used a murine model to determine whether chronic corticosteroid therapy has uniform effects on bacterial clearance processes in different tissues. After a 2-week regimen of oral prednisolone, Swiss Webster mice were challenged with Pseudomonas aeruginosa strain PAO1 or virulent derivatives of PAO1 (IP-8 and IT-10). Chronic corticosteroid therapy delayed the clearance of strain PAO1 from the peritoneal cavity. However, steroid treatment did not reduce the neutrophil influx, did not reduce the in vivo phagocytic capacity of neutrophils, and did not alter bactericidal activity of peritoneal exudate cells in vitro. Virulent isolates (IP-8 and IT-10) replicated in the peritoneal cavity in steroid-treated mice even though the neutrophil influx was similar to control mice. In contrast to the abnormal peritoneal clearance, all strains were rapidly cleared from the lungs of control and steroid-treated mice after aerosol challenge. Neutrophil influx into bronchoalveolar spaces was greater in steroid-treated mice than in control mice. All mice (control and steroid treated) survived these challenges, except for some steroid-treated mice infected intraperitoneally with IP-8. These results demonstrate that chronic steroid therapy alters bacterial clearance processes on the peritoneal surfaces to a greater extent than in the lower respiratory tract. The explanation for this altered clearance in the peritoneum is unclear, but cannot be explained by reductions in neutrophil migration to inflammatory stimuli. Therefore, the infectious risk associated with chronic corticosteroid therapy appears to depend on both the tissue and the virulence of the bacterial strain and may reflect alterations in clearance processes other than neutrophil migration.

    Title Thoracic Gas Volume Measurement. Increased Variability in Patients with Obstructive Ventilatory Defects.
    Date March 1984
    Journal Chest
    Excerpt

    We measured the thoracic gas volume (FRC) in normal subjects and patients by body plethysmography to determine the within-subject variability and to identify factors which might influence the variability. The coefficient of variation (CV), a measure of variability, was significantly greater in patients with obstructive ventilatory defects than in patients with restrictive ventilatory defects and normal subjects, and there was a direct correlation between the CV and the FRC and an inverse correlation between the CV, the FEV1/FVC, and the FEV1. These results suggest that the disease state and its severity influence the variability in FRC measurements and that both factors should be considered in the interpretation of serial pulmonary function studies measuring lung volumes.

    Title Tracheal Function During Influenza Infections.
    Date January 1984
    Journal Infection and Immunity
    Excerpt

    Studies with animal models have demonstrated that viral respiratory tract infections suppress bacterial clearance processes in the lung and that this alteration in host defenses appears to explain the excessive mortality from bacterial pneumonia during influenza epidemics. However, since the pathogenesis of postinfluenza pneumonia and other pneumonias probably involves the aspiration of normal nasopharyngeal flora, injury to major airways associated with influenza infections could also contribute to the development of bacterial pneumonia by increasing bacterial deposition in the peripheral lung. We investigated this possibility by evaluating tracheal clearance processes and spontaneous changes in the tracheal flora in a murine model for acute influenza. During fine-particle aerosol exposures to Staphylococcus aureus, influenza-infected mice retained the same number of bacteria on their proximal tracheal surfaces as did control mice, and the relative adherence of the staphylococci to the trachea was similar in both groups of mice. However, the clearance of viable staphylococci from the trachea was significantly delayed in influenza-infected mice. Control and influenza-infected mice were also evaluated for changes in their normal tracheal flora. Mice with established influenza infections had more frequent spontaneous colonization with gram-negative bacteria, more bacterial isolates per animal, and higher bacterial concentrations in tracheal homogenates than control mice. These changes in tracheal flora were most pronounced on day 7 after virus inoculation and persisted after virus titers were undetectable, but eventually resolved by day 14 after virus infection. Tetracycline therapy started 2 days after virus inoculation prevented the increased colonization. This impaired clearance function and increased spontaneous colonization were associated with morphological evidence of mucosal regeneration. We conclude that spontaneous changes in tracheal flora occur during influenza infections, that these changes reflect, in part, impaired clearance functions, and that such changes could contribute to the development of pneumonia regardless of the clearance capacity of the lung parenchyma.

    Title Pulmonary Tissue Resistance to Candida Albicans in Normal and in Immunosuppressed Mice.
    Date December 1983
    Journal The American Review of Respiratory Disease
    Excerpt

    We characterized the clearance of Candida albicans from the lung using a murine model for pulmonary aspiration. Swiss Webster mice uniformly survived intratracheally administered boluses of C. albicans (1 to 30 X 10(5) colony-forming units of yeast) which killed the majority of mice (more than 85%) when injected intravenously. Clearance studies, using quantitative cultures of lung homogenates, demonstrated rapid elimination of C. albicans from the lung after a 6-h delay; the residual fractions of viable fungi were 8.3 and 0.7% of the initial inoculums at 24 and 48 h, respectively, after inoculation. The number of leukocytes in the bronchoalveolar spaces increased twofold to threefold after deposition, and this primarily reflected a neutrophil influx. Histologic studies supported the bronchoalveolar lavage results and revealed a diffuse interstitial neutrophilic infiltrate and clusters of inflammatory cells in air spaces at 6 and 24 h after Candida deposition. Examination of lavage pellets demonstrated that both neutrophils and macrophages ingested C. albicans in vivo. Immunosuppression (orally administered prednisolone for 2 wk) delayed the clearance of C. albicans from the lung. However, evaluation of neutrophil migration into bronchoalveolar spaces and of the in vivo ingestion capacity of both macrophages and neutrophils did not identify differences that could explain this delayed clearance in steroid-treated mice. The fungicidal activity of pulmonary leukocytes was measured with in vitro assays and was similar in phagocyte cultures from control and steroid-treated mice. In summary, intrinsic pulmonary defense factors and recruited neutrophils rapidly and completely clear C. albicans from the lung after bolus deposition.(ABSTRACT TRUNCATED AT 250 WORDS)

    Title Bronchodilator Testing: Confidence Intervals Derived from Placebo Inhalations.
    Date August 1983
    Journal The American Review of Respiratory Disease
    Excerpt

    We developed criteria for a statistically significant response to an inhaled bronchodilator by measuring changes in spirometry during blinded placebo inhalation in 40 patients referred to our pulmonary function laboratory for routine testing. Ninety-five percent confidence intervals for the absolute difference and the percent change after placebo inhalation were developed for PEFR, FVC, FEV1, FEV1%, and FEF25-75% using two-tailed t-distributions. Baseline pulmonary functions and clinical factors had no apparent effect on the placebo responses. Using these confidence intervals, we evaluated 72 patients referred to our pulmonary function laboratory for bronchodilator testing. Forty-three patients had a significant change in at least one of the above parameters. We could identify 38 (88%) of these responders using the confidence interval for the percent change in FEV1, percent change in FEV25-75%, and the absolute difference in FEV1, which were 12.3%, 45.1%, and 0.18 L, respectively. In contrast, ACCP criteria would have identified only 20 of these responders. We conclude that this method provides a simple and accurate approach for evaluating changes in routine spirometry.

    Title Macrophage Function in Pulmonary Alveolar Proteinosis.
    Date July 1983
    Journal The American Review of Respiratory Disease
    Excerpt

    We studied the lavage fluid recovered from a symptomatic patient with pulmonary alveolar proteinosis using in vitro assays for macrophage function. The alveolar macrophages from this patient had reduced phagocytic capacity. The particulate fraction from the cell-free lavage fluid (20,000 X gravity pellet) induced a pronounced phagocytic defect in normal mouse peritoneal macrophages but did not impair intracellular degradative activity. These results suggest that the lipoproteinaceous debris in patients with alveolar proteinosis can induce a phagocytic defect in alveolar macrophages, which probably increases the accumulation of more debris and may contribute to the increased risk of pulmonary infection.

    Title Chronic Glucocorticosteroid Therapy Impairs Staphylococcal Clearance from Murine Lungs.
    Date March 1983
    Journal Infection and Immunity
    Excerpt

    Since the clearance of Staphylococcus aureus from murine lungs after aerosol exposure depends only on regional defense processes and does not require the recruitment of neutrophils or other systemic factors, we used this model for pulmonary clearance to evaluate the effect of chronic glucocorticosteroid therapy on intrinsic pulmonary defense responses. Mice treated with oral prednisolone for 2 or more weeks had delayed clearance of S. aureus at both 6 and 22 h after aerosol exposure. Mice treated with prednisolone for 1 week had delayed clearance at 22h, and mice treated for 2 days had normal clearance. In mice that had been treated for 2 weeks, clearance returned to normal after 2 weeks off therapy, but not after 1 week. Prednisolone did not appear to alter the number of phagocytes in bronchoalveolar spaces or their ingestion capacity. These results suggest that chronic steroid therapy can alter pulmonary clearance functions independent of any effect on immune or inflammatory responses.

    Title Staphylococcal Clearance and Pulmonary Macrophage Function During Influenza Infection.
    Date March 1983
    Journal Infection and Immunity
    Excerpt

    Direct infection of pulmonary macrophages with influenza virus in vitro does not alter macrophage functions necessary for staphylococcal clearance. To determine whether these functions are altered during viral pneumonitis, we evaluated macrophages recovered from influenza-infected mice which had undergone aerosol challenge with Staphylococcus aureus. Sublethal infection with influenza A/PR8 produced patchy hemorrhagic pneumonia in CF1 mice and significantly reduced the intrapulmonary killing of staphylococci inhaled during aerosol challenge. However, only a small fraction of macrophage monolayers established from animals with influenza expressed viral hemagglutinin on their plasma membrane, and alveolar macrophages from infected mice ingested staphylococci and yeast cells in vitro at the same rate as control macrophages. The in vitro intracellular bactericidal activity against staphylococci ingested in vivo was comparable in monolayers from control and PR8-infected mice. In experiments with more severe influenza infections (mortality greater than 50% by day 7), a larger fraction of the staphylococci recovered by bronchoalveolar lavage appeared to be ingested in vivo during the aerosol exposure in the PR8-infected mice than in the control mice, but intracellular killing by macrophages during in vitro incubation was similar in control and PR8 monolayers. Hence, the severity of viral infection did not influence intracellular bactericidal activity. In virus-infected mice, a significantly larger fraction of viable staphylococci in the lower respiratory tract at the end of aerosol exposure was adherent to the trachea and major bronchi. In summary, PR8 infection established by intranasal inoculation impaired staphylococcal killing in the lung even though these infections did not alter in vivo ingestion rates or in vitro intracellular killing rates of macrophage populations in bronchoalveolar spaces.

    Title The Pathogenesis of Pneumonitis Due to Murine Cytomegalovirus.
    Date October 1982
    Journal The Journal of Infectious Diseases
    Excerpt

    Virus replication and interstitial pneumonia were studied in BALB/c mice inoculated intranasally with murine cytomegalovirus (MCMV). In normal mice MCMV replicated in lung tissue but did not produce any consistent histologic abnormalities through day 21. The addition of a single dose of cyclophosphamide (0.20 mg/g) 24 hr after virus inoculation resulted in a slight increase in lung virus titers on day 10. No histologic abnormalities were noted before day 10. However, 22 or 32 virus-infected mice treated with a single dose of cyclophosphamide but only two of 26 simultaneously mock-infected, cyclophosphamide-treated mice developed severe interstitial pneumonia 10-14 days after inoculation. In contrast, animals given cyclophosphamide (0.05 mg/g) every five days after the initial dose developed a 10-fold increase in lung virus titer, but interstitial pneumonia was not observed. These data suggest that the interstitial pneumonitis seen with MCMV pulmonary infection may be immunologically mediated rather than the result of direct viral damage to the lung.

    Title Nonphagocytic Clearance of Staphylococcus Aureus from Murine Lungs.
    Date September 1982
    Journal Infection and Immunity
    Excerpt

    Several investigations of host and bacterial factors critical to staphylococcal clearance from lungs suggest that alveolar macrophages may not provide the principal defense against inhaled staphylococci. We evaluated possible contributions of extracellular bactericidal activities in lungs with a standard aerosol challenge model by using methods which allowed recovery of macrophages for in vitro bactericidal assays and recovery of intrapulmonary staphylococci for clearance studies. Macrophages recovered by a gentle lavage technique immediately after aerosol exposure contained 6.0 +/- 2.3 colony-forming units of viable staphylococci per 100 glass-adherent macrophages. These intracellular staphylococci were killed in vitro with a half-life of 10.8 +/- 2.1 h, which is identical to our results with a completely in vitro system for ingestion and killing. However, 99.4 +/- 0.2% and 94.9 +/- 1.5% of the viable cocci recovered in bronchoalveolar lavage at 0.5 and 6.0 h after aerosol exposure were sensitive to lysostaphin, a rapidly bactericidal enzyme with no demonstrable activity against intracellular organisms and therefore, presumably extracellular. Photomicrographs from lavage pellets obtained 0.5, 1.5, 3.0, and 5.5 h after aerosol exposure confirmed the presence of numerous extracellular cocci. These extracellular cocci were eliminated at the same rate as whole lung cocci (half-life = 3.07 and 3.14 h, respectively) and at a much faster rate than intracellular cocci. In summary, we found large numbers of extracellular staphylococci in bronchoalveolar spaces during the first 6 h after aerosol exposure that are inactivated at the same rate as the whole lung bacterial population. Since only a small number of staphylococci are ingested by macrophages and intracellular bactericidal activity appears too slow to explain intrapulmonary killing, we conclude that an as yet unidentified extracellular killing process contributed to staphylococcal clearance.

    Title Inhibition of Macrophage Phagocytosis After Contact with Ingestible Particles.
    Date December 1981
    Journal Journal of the Reticuloendothelial Society
    Title Cellular Retinoic Acid-binding Protein in Human Lung Carcinomas.
    Date September 1981
    Journal Journal of the National Cancer Institute
    Excerpt

    Cellular retinoic acid-binding protein (CRABP) was detected in the cytosol of 11 human non-small-cell lung cancer specimens. Neither normal lung nor a small-cell lung cancer specimen contained this binding protein. The quality of CRABP per milligram of cytosol protein ranged from 48.3 to 426.5 fmol.

    Title Effect of Influenza Infection on the Phagocytic and Bactericidal Activities of Pulmonary Macrophages.
    Date August 1980
    Journal Infection and Immunity
    Excerpt

    The effect of mouse-adapted influenza A/PR/8/34 virus on pulmonary macrophage function was evaluated by using an in vitro system which allowed direct virus interaction with macrophages and then separate analysis of the steps required for bacterial clearance by macrophages. Infection of macrophages with this virus resulted in the appearance of a hemagglutinating activity on the macrophage surface; expression of this activity was inhibited by amantadine, 2-deoxyglucose, and cycloheximide and by pretreatment of the virus inoculum with ultraviolet light and specific antiserum. Since there was no release of extracellular virus, this growth cycle appeared to be incomplete (abortive). After influenza infection, net ingestion of viable Staphylococcus aureus by macrophage monolayers was unaltered and there was no change in the fraction of the monolayer which ingested cocci over a wide range of bacterial inputs. Influenza-infected macrophages also inactivated intracellular S. aureus at a rate indistinguishable from controls. Therefore, these in vitro studies do not support the hypothesis that the defect in pulmonary antibacterial mechanisms associated with influenza infections results from a direct effect of virus infection on either the phagocytic or bactericidal activity of resident pulmonary macrophages.

    Title Characterization of Group H Streptococcal Temperate Bacteriophage Phi 227.
    Date May 1977
    Journal Journal of Virology
    Excerpt

    phi 227, a temperate phage from a group H streptococcus (Streptococcus sanguis), was propagated vegetatively in group H strain Wicky 4-EryR, and its characteristics were determined. A procedure dependent on multiplicity of infection, incubation time, and treatment of crude lysates with diatomaceous earth was found to optimize phage yield, resulting in titers of 1 X 10(10) to 2 X 10(10) PFU/ml. Without prior treatment with diatomaceous earth, subsequent purification procedures (methanol, ammonium sulfate, polyethylene glycol) gave recoveries of less than 1% of crude lysate titers. Adsorption of phi227 to host cells was relatively unaffected by the medium, but calcium (not substituted by magnesium) was required for formation of infectious centers. The phage receptor was present on purified cell walls, resisted trypsin and heat, and was removed ty hydrochloric acid, trichloracetic acid, and hot formamide: however, formamide-extracted material failed to inactivate phage, and the nature of the receptor is unknown. Single-step growth experiments showed a latent period of 39 min and a burst size of 100 PFU/infectious center; results were unaffected by omission of supplemental Ca2+, by supplementation with Mg2, addition of glucose, or changes of pH between 6.35 and 8.0; but increased temperature (40 to 43 degrees C) shortened the latent period and decreased the burst size. The latent period was prolonged in genetically competent host cells and in chemically defined medium; and in the latter, the burst size was smaller. Phage replication was sensitive to those metabolic inhibitors which inhibited the host streptococcus: these included rifampin, fluorodeoxyuridine, hydroxyurea, dihydrostreptomycin, and 6-P-hydroxyphenylazouracil. The data suggest that phi227 does not code for a rifampin-resistant RNA polymerase. However, in a rifampin-resistant host strain, phage replication and lysogen formation were both decreased suggesting that altered host core polymerase had less affinity for (some) promotors on the phi227 template. In transfection, a Ca2+-dependent stabilization step that was inhibited by Mg2+ was demonstrated; transformation was not affected by either Ca2+ or Mg2+, and the site and nature of the stabilization are unknown. More than one molecule of DNA was required for plaque formation. Biophysical characterization showed a type B phage of buoyant density (CsCl) 1.50, containing five proteins and 54.8% DNA. The duplex linear DNA had a molecular weight (calculated from contour length) of 23.2 X 10(6) and a guanine plus cytosine content (calculated from melting point) of 42.3 mol%. Similar characterizations of streptococcal phages, including biophysical data, have not been previously available.

    Title Plasmodium Knowlesi: Morphology and Course of Infection in Rhesus Monkeys Treated with Clindamycin and Its N-demethyl-4'-pentyl Analog.
    Date October 1976
    Journal Experimental Parasitology
    Title Attributes of Potential Utility in Differentiating Among "group H" Streptococci or Streptococcus Sanguis.
    Date March 1976
    Journal Journal of Dental Research
    Title Cellular Location of Alpha-hemolysin in Staphylococcus Aureus.
    Date November 1975
    Journal Infection and Immunity
    Excerpt

    Protoplast fractionation techniques were used to prepare subcellular fractions of three strains of Staphylococcus aureus for the analysis of alpha-hemolysin activity. More than 90% of the cellular hemolytic activity was localized in the periplasm, only a trace was detected in the cytoplasm, and none was found in either plasma membranes or mesosomes. This cellular portion constituted approximately 4 to 10% of the total hemolytic activity of the culture. The erythrocyte lysis spectrum and Sephadex G-100 filtration studies indicated that the cellular hemolysin closely resembles the extracellular form.

    Title Preparation of Protoplasts of Group H Streptococci (streptococcus Sanguis).
    Date April 1975
    Journal Applied Microbiology
    Excerpt

    Stable protoplasts of several strains of group H streptococci (Streptococcus sanguis) can be prepared by use of group C streptococcal phage-associated lysin in the presence of 30% raffinose. Sucrose cannot be substituted for raffinose. Protoplast formation did not require the addition of Mg2+; however, this cation enhanced their stability. Some other strains, also presumptive group H streptococci, were not sensitive to phage-associated lysin.

    Title Cellular Location of Degradative Enzymes in Staphylococcus Aureus.
    Date February 1975
    Journal Journal of Bacteriology
    Excerpt

    Staphylococus aureus, ATCC 6538P, was fractionated into protoplast membranes, mesosomal vesicles, periplasm, and cytoplasm. These fractions and the culture fluid were then assayed for various degradative enzyme activities. They were not restricted to a single fraction nor dispersed homogeneously, but were distributed predominantly (on the basis of specific activity) as follows: nuclease in the culture fluid; alkaline phosphatase, 5'-nucleotidase, and acid phosphatase in the periplasm; adenosine triphosphatase in the protoplast membrane; and protease (low levels) in mesosomal vesicles. No significant esterase nor cell wall hydrolytic activity was found in any fraction. S. aureus 80/81 was studied for penicillinase activity after induction with benzyl penicillin; this enzyme was localized in the mesosomal vesicles. Electron microscopy did not reveal any ultrastructural changes associated with secretion of the extracellular fraction. Overall, these studies demonstrate that degradative enzymes are located in several surface compartments and that, therefore, the mesosome does not function as a prototype lysosome in S. aureus.

    Title Low-dose Oral Interferon {alpha} Possibly Retards the Progression of Idiopathic Pulmonary Fibrosis and Alleviates Associated Cough in Some Patients.
    Date
    Journal Thorax

    Similar doctors nearby

    Dr. Teddy Mitchell

    Internal Medicine
    23 years experience
    Lubbock, TX

    Dr. David Hodges

    Internal Medicine
    27 years experience
    Lubbock, TX

    Dr. Steven Berk

    Internal Medicine
    35 years experience
    Lubbock, TX

    Dr. Nathan McLaughlin

    Internal Medicine
    4 years experience
    Lubbock, TX

    Dr. Shannon Yarbrough

    Internal Medicine
    4 years experience
    Lubbock, TX

    Dr. Cihan Cevik

    Internal Medicine
    11 years experience
    Lubbock, TX
    Search All Similar Doctors