The association between bacteremia and gastrointestinal neoplasms is well known. Since the first association between Streptococcus bovis bacteremia and colonic neoplasms was reported in 1977 (1Klein R.S. Recco R.A. Catalano M.T. et al.Association of Streptococcus bacteremia, and underlying gastrointestinal disease.Arch Intern Med. 1977; 297: 800-802Google Scholar), other streptococcal species and bacteria associated with underlying colonic malignancy include S. sanguis, S. salivarius, S. equinus, S. milleri, S. agalactiae, group G streptococci, and Clostridium septicum(2Marinella M.A. Streptococcus sanguis bacteremia associated with cecal carcinoma case report and review of the literature.Am J Gastroenterol. 1997; 92: 1541-1542PubMed Google Scholar, 3Legier J.F. Streptococcus salivarius meningitis and colonic carcinoma.South Med J. 1991; 84: 1058-1059Crossref PubMed Scopus (24) Google Scholar, 4Gilon D. Moses A. Carcinoma of the colon presenting as Streptococcus equinus bacteremia.Am J Med. 1989; 86: 135-136Abstract Full Text PDF PubMed Scopus (8) Google Scholar, 5Rich M.W. Radwany S.M. Streptococcus milleri septicemia in a patient with colorectal carcinoma.Eur J Clin Microbiol Infect Dis. 1993; 12: 225Crossref PubMed Scopus (6) Google Scholar, 6Wiseman A. Rene P. Crelinsten G.L. Streptococcus agalactiae endocarditis an association with villous adenomas of the large intestine.Ann Intern Med. 1985; 103: 893-894Crossref PubMed Scopus (19) Google Scholar, 7Kornbluth A.A. Danzig J.B. Bernstein L.H. Clostridium septicum infection and associated malignancy. Report of 2 cases and review of the literature.Medicine (Baltimore). 1989; 68: 30-37PubMed Google Scholar). We report an association between Gemella morbillorum and colon cancer. An 89-year-old woman came to the emergency room because of generalized body weakness and a nonproductive cough of 3 weeks' duration. She reported vague, lower abdominal pains, as well as significant weight loss over the past few months. She reported no hematemesis, vomiting, jaundice, melena, hematochezia, or change in stool habits. Her medications included aspirin and nonsteroidal anti-inflammatory agents. There was no family history of malignancies. On admission, her vital signs were normal except for an oral temperature of 39.4°C. Examination of her heart and lungs was unremarkable. Her abdomen was slightly distended, and no masses were palpable. A rectal examination revealed no masses and heme-negative stools. Laboratory data included a white blood cell count of 19,100 ×103 cells per μL with 85% neutrophils, hemoglobin of 10.4 with mean corpuscular volume of 82 fL, and normal platelets. Liver function tests were normal. Radiographs of the chest and abdomen were unremarkable. A sonogram of the liver, gallbladder, and pancreas revealed a normal-size liver with no gallstones and a normal pancreas. Results of urine cultures were negative. Blood cultures later revealed growth of G. (Streptococcus) morbillorum. A subsequent colonoscopy revealed a fungating mass in the cecum. Biopsy specimens showed a well-differentiated adenocarcinoma. A transesophageal echocardiogram showed a calcified mitral annulus, no vegetations, and normal left ventricular function. The patient improved greatly after a 2-week course of intravenous penicillin and gentamycin therapy, and results of repeat blood cultures were negative. She refused to undergo surgery or chemotherapy for the colon cancer. How neoplasms of the colon predispose to bacteremia is not understood. The normal intestinal barrier may be disrupted in neoplastic tissues, permitting bacterial translocation into the blood stream (8Diethch E.A. Berg R. Bacterial translocation from the gut a mechanism of infection.J Burn Care Rehab. 1987; 8: 475-482PubMed Google Scholar). Gemella morbillorum is a commensal organism in the gastrointestinal, respiratory, and genitourinary tracts in humans. Human infections are rare, but the spectrum of disease is very similar to that caused by S. viridans. Isolated cases of endocarditis, septic shock, arthritis, and meningitis have been reported (9Debast S.B. Koot R. Mas J.F. Infections caused by Gemella morbillorum.Lancet. 1993; 342: 560Abstract PubMed Scopus (46) Google Scholar, 10Omran Q. Wood C.A. Endovascular infection and septic arthritis caused by Gemella morbillorum.i. 1993; 16: 131-134Google Scholar). Treatment consists of intravenous penicillin and gentamycin. Gemella morbillorum is now on the list of bacteria that should lead to a search for an underlying colonic neoplasm.

Cisplatin, a widely used chemotherapeutic agent, induces a sensory neuropathy with selective loss of vibration sense and proprioception. Here we demonstrate that neurotrophin-3 (NT-3), a member of the nerve growth factor family of neurotrophic factors, restored to normal levels the reduced H-reflex-related sensory nerve conduction velocity induced by cisplatin in rats. NT-3 treatment corrected an abnormal cytoplasmic distribution of neurofilament protein in large sensory neurons in dorsal root ganglia and the reduction in the numbers of myelinated fibers in sural nerves caused by cisplatin. The NT-3-dependent reversal of cisplatin neurotoxicity thus suggests the possible use of NT-3 in the treatment of peripheral sensory neuropathy.

In many cell systems, cell-cell and cell-matrix interactions are mediated by integrins, a family of cell surface heterodimeric glycoprotein receptors. Osteoclast integrins may play a role in the process of bone resorption. Osteoclasts express the alpha v and beta 3 subunits of the vitronectin receptor and adhere to a wide range of proteins in vitro, all which contain the amino acid sequence Arg-Gly-Asp (RGD), an adhesion site recognition sequence common to many protein ligands that bind to integrins. The effect of kistrin, an RGD-containing snake venom protein, on osteoclast-mediated bone resorption was investigated in vivo and in vitro. When kistrin was infused into normocalcemic and hypercalcemic mice, serum calcium was significantly lowered at 3 and 6 h after the start of infusion, indicating an inhibitory effect on osteoclast activity in vivo. In vitro, kistrin potently inhibited bone resorption by isolated rat osteoclasts cultured on slices of bovine bone, and kistrin also inhibited the attachment of 293 cells expressing recombinant human alpha v beta 3 to fibrinogen (IC50 = 1 nM). These results indicate the potential therapeutic use of RGD-containing molecules for hypercalcemia of malignancy or for other disorders associated with bone loss.

The reproductive hormone, relaxin, inhibits collagen synthesis in vitro by normal human dermal fibroblast. In the present study, recombinant human relaxin is shown to modulate collagen accumulation and organization by mesenchymal cells in vivo in two rodent models of fibrosis: 1) fibrotic infiltration of polyvinyl alcohol sponge implants in rats, and 2) capsule formation around implanted osmotic pumps in mice. In the sponge, relaxin inhibits collagen accumulation, a measured by hydroxyproline content, in a dose-responsive manner by up to 25-29% in animals receiving 30 ng/ml relaxin, a finding supported by a decrease in collagen-specific trichrome staining in sections of sponges from relaxin-treated animals. In mice, the capsules surrounding relaxin-containing pumps are thinner and less dense than are capsules from control pumps. Ultrastructurally, control capsules are composed of densely packed parallel arrays of collagen fibrils, whereas fibrils more frequently are not packed in parallel arrays and are less abundant in treated capsules.