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Of 16 children with primary duodenal ulcer, 11 had complete relief of symptoms with initial full dose cimetidine therapy. After stopping cimetidine two of these 11 relapsed, six are in remission and three occasionally complain of abdominal pain requiring antacids. The remaining five children showed no improvement al all. Only one out of the 16 children showed side-effects due to cimetidine. Although there was wide variation in dosage of cimetidine and duration of therapy, no significant difference was noted in the dosage regimen of responders and non-responders to cimetidine. We suggest, full dose cimetidine 20 to 40 mg/Kg/dayfor 4 to 8 weeks, followed by 8 mg/Kg nocte daily for another 4 to 8 weeks.

One hundred and ninety six Asian, 89 African, 96 Chinese and 98 Scottish children from 173 families were studied to assess growth in relation to country of birth, time of parental residence in Scotland, child order in family, social class, living conditions and dietary factors. The growth measurements (standardised height, weight and bone age) differed between ethnic groups. The Africans were the tallest and Scottish the shortest. In all immigrant groups, children born in Scotland were on average, taller and more advanced in bone age than those born in their country of origin. In this study, there was no demonstrable effect on growth of social class or of living conditions. Dietary variable showed a lack of coherent effects on growth.

Cadherins are recognized as the principal mediators of homotypic cellular recognition and play a demonstrated role in the morphogenic direction of tissue development. We report here the identification of a structurally unique, kidney-specific member of the cadherin multigene family (Ksp-cadherin). cDNA cloning and molecular analysis of the 130-kDa protein confirmed that it was novel and indicated that it most closely resembled members of the LI-cadherin/HPT-1 cadherin subgroup. The predicted protein possesses the definitive cadherin-specific sequence motifs LDRE, DXND, and DXD in well conserved sequential arrangement, and the characteristic cysteine residues found in the last ectodomains of almost all known cadherins. Like LI-cadherin and HPT-1, Ksp-cadherin lacks the prosequence and HAV adhesion recognition sequence typical of most classical cadherins, and possesses a truncated cytoplasmic domain (18-22 amino acids). When expressed in a transient Vaccinia/T7 expression system, Ksp-cadherin displayed the classic calcium sensitivity to trypsin proteolysis that is observed in all cadherins. Immunolocalization studies and Northern analysis indicated that expression of Ksp-cadherin was kidney-specific and limited to the basolateral membranes of renal tubular epithelial cells. In summary, we have identified and cloned a novel, kidney-specific member of the cadherin multigene family that we propose be designated Ksp-cadherin.

The laboratory diagnosis of Pneumocystis carinii pneumonia in humans includes the identification of cysts in stained lung tissue impression smears. By using a mouse model, we compared the number of cysts in lung tissue impression smears with those contained in a concentrate of homogenized lung tissue. Eleven C3H/HEN mice developed P. carinii infection after corticosteroid injections, a low protein (8%) diet, and tetracycline administered in drinking water. Impression smears were prepared with freshly bisected lung tissue. Smears of concentrates were prepared with sediment from centrifuged lung tissue homogenates. All smears were made in duplicate, stained with toluidine blue O or methenamine silver, coded, randomized, and examined. The concentrate preparations contained more cysts per microscopic field than the impression preparations (P less than 0.01). Concentrates prepared by grinding with a mortar and pestle contained more cysts than concentrates prepared by blending with a Stomacher (P less than 0.05). Cysts were detected equally well with either the toluidine blue O or silver stain (not significant). Lung tissue concentrates were superior to lung tissue impressions for detecting P. carinii cysts in mice. Use of lung tissue concentrates should be considered for the diagnosis of human P. carinii infection.

Duplicate antimicrobial susceptibility test results were reviewed over a 1-year period to determine whether repeat testing of sequential isolates with the same identification from the same patient and specimen site was necessary. In our institution, repeat testing is always needed for coagulase-negative staphylococci and Pseudomonas aeruginosa and is needed after 3 days for members of the family Enterobacteriaceae, but it is not routinely necessary for Staphylococcus aureus.

A blood culture was performed by adding a vented Septi-Chek bottle (Roche Diagnostics, Div. Hoffmann-LaRoche Inc., Nutley, N.J.) to a standard BACTEC system (Johnston Laboratories, Inc., Towson, Md.) blood culture. The yield of bacteremic patients, the clinical significance of organisms detected, and the cost of the combination system were compared with those of the standard BACTEC system alone. Each culture included 20 ml of blood divided among a BACTEC 6B aerobic bottle (5 ml), a BACTEC 7D anaerobic bottle (5 ml), and a Septi-Chek bottle equipped with a slide subculture attachment (10 ml). Significant isolates grew in 9.6% of the 2,269 cultures evaluated. The combination BACTEC plus Septi-Chek system detected 25% more bacteremic patients than the BACTEC system alone, 129 patients versus 103. The 26 bacteremic patients detected by only the added Septi-Chek bottle included 7 whose organism was isolated from blood alone and 19 whose organism was in mixed or pure culture from a second source. Detection of the organism resulted in alteration of antimicrobial therapy in 17 of these 26 patients. The combination system, which cultured a 20-ml blood volume, cost $11,000 more during the study period than the BACTEC system alone, which cultured a 10-ml volume. Reimbursement under the diagnosis-related group system was increased by $23,000 as a result of documentation of sepsis in these 26 patients. Blood volume and, possibly, the use of multiple blood culture systems are important factors when selecting a blood culture procedure for routine use.