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7786543
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[Hemidiaphragmatic paralysis as a manifestation of familial brachial plexus neuropathy].
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We present a patient with familial brachial plexus neuropathy (FBPN) who is in the second generation of a family found to have this disease. The patient suffered phrenic paralysis, which has only been previously described in association with FBPN in 4 similar cases, all of which also involved the left phrenic nerve. The side of phrenic paralysis's was unrelated to the side where brachial plexus lesions occurred. We believe that paralysis of the diaphragm, although rare, can be considered a sign of FBPN and that therefore this disease should be included in the differential diagnosis of such paralysis. This is particularly so whenever family or personal history suggest that the peripheral nervous system may be involved, compromising the brachial plexus, or whenever facial or digital dysmorphia is present.
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7786537
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Congenital pulmonary arteriovenous fistula.
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Pulmonary arteriovenous fistula wherein the malformation has venous drainage directly to the left atrium is a rare anomaly. Two case reports present such unusual arteriovenous malformations successfully treated by surgery.
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7786541
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[Classification of head injuries based on computerized tomography: prognostic value].
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A new classification system for head injury based on the findings of computerized tomography was used in a population of 809 head injured patients. The system emphasizes the status of mesencephalic cisterns, the degree of midline shift and the presence or absence of mass lesions, allowing high risk patients to be identified and outcome to be predicted.
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7786540
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[Preparation of a levodopa/carbidopa solution in ascorbic acid (citridopa) and chromatographic and electrochemical assessment of its stability over 24 hours].
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Levodopa/inhibitor improves motor function in parkinsonian patients. In its usual tablet form, however, its efficacy is reduced after several years, partially due to absorption deficiencies and changes in plasma kinetics; thus, other therapeutic strategies to provide a stable, easy to prepare formula are being sought. One such approach could be to dissolve L-dopa/carbidopa in ascorbic acid. This report describes the preparation method and demonstrates the stability of the sample using High pressure liquid cromatography (HPLC) with electrochemical detection. Regardless of the number of tablets the patient takes, the concentration of L-dopa/carbidopa/ascorbic acid remains constant (1/0.25/2 mg/ml). Thus, a patient taking 5 tablets of Sinemet Plus a day, would pulverize them in a glass, ceramic or marble mortar and add them to a measuring cup containing a 1 gram tablet of vitamin C (Redoxon) dissolved in 500 cc of cold water. This would be shaken or stirred until the Sinemet powder had dissolved. A few particles remaining in suspension after this process would be of no concern. The liquid would be stored in the refrigerator in an opaque or aluminum foil-covered glass bottle or, if possible, in several small dose-size vials. Using a measuring cup, a test tube and a syringe, the correct volume can be drawn out of the bottle and shaken well before drinking. The solution would be taken at regular intervals throughout the day (which vary from one patient to another) to maintain stable plasma L-dopa levels.
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7786538
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Isolated right ventricular unloading for postcardiotomy right ventricular failure in a child.
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Severe right ventricular (RV) failure after total correction of double outlet RV (DORV) with pulmonary atresia was completely reversed with extracorporeal mechanical RV unloading in a 2.5-year-old child. The patient could be weaned after 168 h of RV assist device (RVAD) support using a centrifugal Bio-Medicus pump and was discharged from the hospital without adverse effects. This experience of isolated RV unloading in a child encourages further application of RVAD in pediatric patients.
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7786536
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Pyoderma gangrenosum as a complication of coronary artery bypass grafting.
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A 60-year-old male patient developed progressive wound ulcerations, simulating wound sepsis after coronary bypass operation. The condition did not respond to intensive antibiotic therapy. Based on clinical signs and biopsy, the diagnosis of pyoderma gangrenosum was made and successfully treated with cyclosporin A. Pyoderma gangrenosum, although extremely rare, must be considered as a possible diagnosis in wound complications unresponsive to traditional therapy.
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7786535
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Descending necrotising mediastinitis: a case report and review of the literature.
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We report a case of descending necrotising mediastinitis complicating an oropharyngeal infection in a 25-year-old male. The clinical presentation, the diagnosis and the management of this rare disease and its complications are discussed in this case report with a brief review of the literature.
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7786534
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Changes in gastric tissue oxygenation during mobilisation for oesophageal replacement.
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We have measured changes in gastric tissue oxygen tension (PtO2, mmHg), with a modified Clark oxygen electrode, in eight patients (median age 59 years, range 52 to 74) undergoing oesophagectomy for carcinoma. Operations were performed with a cervical anastomosis and the stomach mobilised on the right gastric and gastroepiploic arteries. Tissue oxygen tension was measured in the gastric fundus at 4 points: (1) before mobilisation, (2) after mobilisation with the stomach in the abdomen, (3) with the fundus lifted to the neck and (4) after anastomosis. From a mean of 77 mmHg before mobilisation, PtO2 was halved to 36 mmHg after mobilisation with no further fall after transposition to the neck or anastomosis. Arterial oxygen concentration (PaO2), mean arterial pressure (MAP) and oxygen delivery (DO2) were similar at each point. Tissue oxygen tension was correlated with PAO2 at points 1 and 4 but MAP only at point 1 and DO2 not at all. These findings document the relationship of gastric PtO2 to mobilisation of the stomach and demonstrate the important influence of PaO2 on PtO2.
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7786533
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Incidence of deep and superficial sternal infection after open heart surgery. A ten years retrospective study from 1981 to 1991.
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Between January 1981 and December 1991, 4137 adult patients underwent various cardiac procedures via a median sternotomy under cardiopulmonary bypass. The overall infection rate was 1.33%, including superficial wound infections (SWI) (1.18%) and deep sternal infection (DSI) (0.145%). Pericardial and retrosternal suction drains with a vent allowed a better drainage of blood and serosities and probably contributed to our low DSI rate. Eleven factors predisposing to infection were evaluated by Fisher's exact test. Only the operative urgency (P = 0.006), reexploration for bleeding (P = 0.00001) and preoperative renal failure (P = 0.0005) were statistically significant. Twenty of our infected patients had no risk factors for infection. When the risk factors described in the literature were applied to our infected patients, only one had no risk factor.
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7786532
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Posterior pericardiotomy reduces the incidence of supra-ventricular arrhythmias following coronary artery bypass surgery.
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A prospective study of 100 patients undergoing coronary artery bypass surgery was performed to demonstrate the effectiveness of a posterior pericardiotomy in reducing the incidence of pericardial effusions and, consequently, reducing the incidence of supraventricular arrhythmias in the post-operative period. Pericardial effusion occurred in 4 of 50 patients following a posterior pericardiotomy, whereas effusion occurred in 20 of 50 patients in whom a pericardiotomy was not created (P < 0.0005). Supra-ventricular arrhythmias occurred in 4 patients in the pericardiotomy group and 18 in the group treated without pericardiotomy (P < 0.005). No complications resulted from this procedure. We conclude that pericardiotomy is a simple, safe and effective method for reducing the incidence or pericardial effusion and thereby post-operative supra-ventricular arrhythmias.
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7786531
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Comparison of propafenone to atenolol for the prophylaxis of postcardiotomy supraventricular tachyarrhythmias: a prospective trial.
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To compare the efficacy of propafenone to atenolol in the prevention of supraventricular tachyarrhythmias (SVT) following cardiac surgery, 207 consecutive patients were randomly allocated to receive either propafenone 300 mg twice daily (105 patients) or atenolol 50 mg once daily (102 patients) orally for 7 days after operation. Double blinding was achieved using placebos. The end point was the development of a SVT which was symptomatic, recurrent, or lasting over 2 minutes, or the occurrence of adverse effects possibly attributable to the drugs. The groups were well matched for age, sex, bypass- and cross-clamp times, and other data. Thirteen patients in the propafenone group and 11 in the atenolol group developed SVT during the first week after operation. (P = 0.89, non significant, chi-squared with Yates' correction). In our study propafenone and atenolol were of approximately equal efficacy in preventing post cardiotomy SVT. Propafenone may have an advantage in being less negatively inotropic than atenolol; it could therefore be used in patients with poor left ventricular function or marginal haemodynamics when a beta blocker is contraindicated.
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7786530
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Delivery pressure of the cardioplegic solution influences myocardial protection.
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To investigate whether cardioplegic solution (CS) delivery pressure influences myocardial protection, intermittent infusions of CS at different pressures were used in an isolated Langendorff rat heart preparation. In group 1 the hearts were kept arrested for 210 min at 12 degrees C with intermittent infusions of 5 ml CS every 20 min at 30 cm H2O (22 mmHg) pressure, in group 2 the same volume of CS was infused at 100 cm H2O (73.5 mmHg) pressure, in group 3 at 145 cm H2O (106.5 mmHg) pressure and in group 4 at 238 cm H2O (175 mmHg) pressure. There was a significantly higher coronary resistance in groups 1 and 4 (7.3 +/- 0.2 RU and 6.9 +/- 0.2 RU) than in groups 2 and 3 (4.2 +/- 0.2 RU and 4.2 +/- 0.2 RU) (P < 0.05) during the ischemic period. There were no significant differences between group 2 and 3 in the reperfusion period. Groups 2 and 3 showed higher coronary flow and left ventricle developed pressure than group 1 and 4. Hearts from group 1 and 4 had lower adenosine triphosphate (7.88 +/- 0.44 mumol.g-1, 5.56 +/- 0.56 mumol.g-1) (P < 0.05) and creatine phosphate (24.66 +/- 0.47 mumol.g-1, 15.34 +/- 0.94 mumol.g-1) (P < 0.05) content at the end of the reperfusion period than group 2 (10.56 +/- 0.41 mumol.g-1, 30.06 +/- 0.38 mumol.g-1) and group 3 (14.13 +/- 0.69 mumol.g-1, 35.25 +/- 0.78 mumol.g-1).(ABSTRACT TRUNCATED AT 250 WORDS)
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7786529
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Interrupted warm blood cardioplegia for coronary artery bypass grafting.
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Continuous warm blood cardioplegia has been used with good clinical outcome in both antegrade and retrograde delivery. However, the continuous delivery of cardioplegia is sometimes interrupted for adequate visualization and flow is not constant with heart manipulation during operation. We studied the effects of interrupted antegrade delivery of warm blood cardioplegia on myocardial metabolism and clinical results after surgery. Fifty-five patients undergoing isolated coronary bypass surgery received warm blood cardioplegia (n = 29) or cold crystalloid cardioplegia (n = 26) in an antegrade fashion. During reperfusion, myocardial oxygen consumption, lactate extraction, creatinine kinase isoenzyme (CK-MB), and malondialdehyde (MDA) were measured. Post-operatively, serum CK-MB and cardiac output (CO) were determined over a period of time. Myocardial oxygen extraction in the warm group was significantly greater than in the cold group 1 min after reperfusion (P < 0.02). The results revealed a tendency for patients in the warm group to have prior lactate extraction, although the difference did not reach statistic difference (P < 0.10). After removal of the aortic cross-clamp, the heart returned to sinus rhythm spontaneously in 90% of the patients with warm cardioplegia and 15.4% of those with a cold heart (P < 0.01). Postoperatively, there was no significant CK-MB or MDA release in either group except for one patient with perioperative myocardial infarction. After operation inotropic support was required for two and one patient in the warm and cold groups, respectively, although there were significantly more patients with poor left ventricular function in the warm, than in the cold, group (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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7786528
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Replacement of the ascending aorta and aortic arch with bovine pericardial grafts. A preliminary report.
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Bovine pericardial (BP) grafts have been clinical use at Biocor Hospital since 1989 for replacement or repair of the ascending aorta (AsAo) and initial segment of the aortic arch (AoAr). The main advantages of BP grafts that have justified their clinical application are much easier surgical technique, perfect hemostasis and low cost. From Feb/89 to Feb/94, 88 BP grafts were implanted in the AsAo or the AoAr. There were 33 valved conduits, 47 non-valved conduits and 8 patches. The main indication for the procedure was acute dissection of the aorta, accounting for 50% of the cases. The total hospital mortality was 20.4%. Follow-up was obtained in all but two patients. Patients who survived 2 or more years postoperatively (n = 31) underwent either an echocardiographic or an angiographic study in order to access the behavior of the graft, which was perfect in all of them. The current follow-up is short and complications such as calcification may still develop. However the present study has clearly shown the superior handling and better hemostasis of BP grafts compared to the classical Dacron prosthesis.
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7786527
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Modified operation technique for orthotopic heart transplantation.
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Atrioventricular (AV) valve dysfunction with tricuspid regurgitation is a common finding after orthotopic heart transplantation (HTx). In 20 patients the heart transplantation was performed with bicaval anastomoses and the results were compared to the precedent 20 patients operated with the standard technique. The right atrium of the recipient was completely removed and the caval anastomoses were performed on the beating heart during reperfusion. Using an interrupted suture line, no stenoses at the venous anastomoses were seen as known from the early implantation technique in heart-lung transplantation. Due to a more stable sinus rhythm only 15% of the patients in the bicaval group needed prolonged pacing (> 30 min) versus 55% (P < 0.01) in the group with standard operation. One to 3 months after surgery the transthoracic echocardiographic evaluation of the AV valve function showed tricuspid valve regurgitation (TVR) in 20% of the patients with bicaval anastomoses versus 75% with a right atrial anastomosis (P < 0.001). Tricuspid valve regurgitation during the first 2 weeks (in 31% of recipients with bicaval and in 70% with atrial anastomoses) improved in all recipients with bicaval anastomoses and in 14% of the recipients with atrial anastomosis. The modification of the operation technique did not result in significantly longer bypass time (75 +/- 14 versus 68 +/- 14 min) and ischemia time (44 +/- 12 versus 41 +/- 9 min with local organ procurement and 111 +/- 24 versus 101 +/- 19 min with distant organ procurement). The AV valve function and the postoperative rhythm after orthotopic HTx can be improved by implanting the heart with bicaval anastomoses.
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7786523
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Differential utilization of linoleic and arachidonic acid by cultured human keratinocytes.
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The essential fatty acid, linoleic acid (LA), is required for the epidermal barrier and LA is also the precursor fatty acid for arachidonic acid (AA). Both fatty acids are imported from systemic sources, because AA is also not synthesized in the epidermis. The present studies were undertaken to compare the uptake and incorporation into cellular lipid of these fatty acids and to determine whether they compete with one another in these processes in relation to keratinocyte differentiation. The incorporation of [14C]LA and/or [14C]AA into phospholipids and triglycerides was examined in keratinocytes cultured under submerged and lifted conditions. In submerged (less well-differentiated) cultures, more LA was incorporated into phospholipids than AA, while AA was incorporated into triglycerides to a greater extent. When given together, neither fatty acid influenced the total and/or relative uptake and lipid distribution of the other. Compared to submerged cultures, the uptake of LA increased 2-fold in lifted (differentiated) cultures, while the uptake of AA was unchanged. Lifting increased the proportion of AA incorporated into phospholipids, but did not alter the distribution of LA among phospholipids or triglycerides. These data suggest that the essential fatty acids, LA and AA, which are destined for different metabolic roles within the keratinocyte do not compete with one another during their uptake and distribution among cellular lipid species. Furthermore, as keratinocytes differentiate in culture, their increased requirement for LA for the synthesis of barrier lipids may be achieved through the preferentially enhanced uptake and lipid incorporation.
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7786525
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Use of human skin recombinants as an in vitro model for testing the irritation potential of cutaneous irritants.
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Two human skin recombinants, the epidermis reconstructed on the deepidermized dermis (RE-DED) or on fibroblast-populated collagen matrix (Living Skin Equivalent, LSE), were used to study the irritating effect of sodium lauryl sulfate (SLS). The extent of cytotoxicity induced after a 24-hour exposure period to increasing concentrations of SLS (0-5%) was evaluated on the basis of (1) morphological perturbations, (2) changes in the expression of differentiation-specific protein markers (keratin 1, 10, 6, 16, involucrin and transglutaminase), (3) cell membrane integrity (LDH leakage) and (4) release of proinflammatory mediators (PGE2, IL-1, IL-6 and IL-8). SLS induced significant changes in epidermal morphology and changes in the expression and localization of differentiation-specific protein markers when applied topically in concentrations higher than 1% on RE-DED and higher than 0.1% on LSE. The exposure of both human skin recombinants to SLS resulted in a dose-dependent release of LDH, PGE2 and IL-1 alpha and in an increase in keratinocyte intracellular IL-1 levels. Upon application of 5% SLS on RE-DED the total (intra- and extracellular) IL-1 levels remained high but due to cell damage the intracellular IL-1 level was markedly decreased and the extracellular IL-1 level increased. Similar observations have been made with LSE after application of 0.5% SLS. However, with LSE the extracellular IL-1 alpha levels were found to be about 100 times lower than those measured with RE-DED. Exposure of LSE to SLS induced a marked increase of IL-6 production in fibroblasts incorporated in the collagen matrix. Contrary to LSE, both intra- and extracellular levels of IL-6 were low in unexposed controls and were only marginally modulated by the exposure of the RE-DED to SLS. In addition, a dose-dependent increase in IL-8 release was observed upon application of SLS on RE-DED. The results of the present study indicate that concentrations of SLS required to induce epidermal irritancy in vitro approximate those inducing irritation in human skin in vivo. All parameters used in the present study for evaluation of toxicity can serve as useful endpoints for screening of contact skin irritancy in vitro. Compared to RE-DED, the LSE seems to be more susceptible to SLS. The differences in sensitivity between LSE and RE-DEd can be ascribed to reported differences in their stratum corneum barrier function.
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7786524
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Regulatory effects of antipsoriatic agents on interleukin-1 alpha production by human keratinocytes stimulated with gamma interferon in vitro.
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It is known that keratinocytes produce and secrete interleukin-1 (IL-1) de novo and that this process can be enhanced by various stimulators. IL-1 has been shown to be a potent proinflammatory cytokine which mediates inflammation in various cutaneous disorders. It has also been demonstrated that gamma-interferon (IFN-gamma) which is released from infiltrated T cells can be detected in inflamed lesional sites. In order to understand the effects of IFN-gamma on IL-1 production by keratinocytes in such inflammatory lesions, normal human keratinocytes (NHKs) and human squamous cell carcinoma cell line (HSC-1) cells were cultivated with recombinant human IFN-gamma (rIFN-gamma) and IL-1 levels were measured by ELISA. The effects of antipsoriatic agents such as hydrocortisone (HC), cyclosporin A (CsA), 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] and its analogue MC903 on IL-1 production by keratinocytes were also investigated. IL-1 release by both NHK and HSC-1 cells was accelerated by stimulation with rIFN-gamma dose-dependently, although IL-1 alpha was released only transiently by rIFN-gamma-stimulated NHKs in serum-free keratinocyte growth medium containing HC. Antihuman IFN-gamma antibody inhibited IL-1 alpha release by HSC-1 cells stimulated with rIFN-gamma, suggesting that IL-1 alpha release from keratinocytes is upregulated by IFN-gamma. HC (5 micrograms/ml), 1,25(OH)2D3 (10(-6) M) and MC903 (10(-6) M), but not CsA (5 micrograms/ml), inhibited IL-1 alpha production by HSC-1 cells stimulated with 100 U/ml of rIFN-gamma.(ABSTRACT TRUNCATED AT 250 WORDS)
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7786522
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Inhibitor of the release of mast cell mediators does not improve the psoriatic plaque.
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The number of mast cells is increased in psoriatic lesions and this is particularly prominent in their early phase. Mediators released by mast cells may interfere with various aspects of cutaneous inflammation and epidermal proliferation. Therefore, the aim of the present investigation was to find out whether a 4-week treatment period with Tiacrilast, a highly potent inhibitor of mast cell degranulation, might have antipsoriatic potential. A total of 31 patients with plaque-type psoriasis were evaluated after treatment with a 3% Tiacrilast hydrogel and hydrogel alone, in a double-blind, placebo-controlled, within-patient comparative study. No statistically significant improvement of the Tiacrilast-treated plaques compared to the hydrogel-treated sites could be demonstrated. Therefore, the present study does not provide evidence of a potential role of mast cell degranulation in the treatment of psoriasis.
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7786521
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Treatment of psoriasis with anthrones-chemical principles, biochemical aspects, and approaches to the design of novel derivatives.
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Antipsoriatic anthrones are probably the most commonly used topical agents in the treatment of psoriasis. There is growing evidence that the biochemical basis for their mechanism of action at the molecular level is related to their redox activity leading to the production of active oxygen species, which include singlet oxygen, superoxide anion radical, and hydroxyl radical. These species are involved in a variety of oxidative effects affecting cellular targets that have been implicated both in the mode of action and the skin-irritating properties of antipsoriatic anthrones: interaction with DNA, inhibition of various enzyme systems associated with cell proliferation and inflammation, such as glucose-6-phosphate dehydrogenase and inflammation, such as glucose-6-phosphate dehydrogenase and 5-lipoxygenase, and destruction of membrane lipids. Furthermore, the application of this information to the design of novel derivatives is discussed. In particular, compounds with diminished oxygen radical-generating properties have been developed, which may permit a separation of antipsoriatic and inflammatory effects. Some of the novel anthrone analogs which produced significantly less amounts of oxygen radicals than dithranol compared favorably in biological tests with this known antipsoriatic drug as an alternative method of treating psoriasis.
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7786520
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The effects of attentional factors on an inhibitory jaw reflex in man.
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Electromyographic recordings (EMGs) were made from the active masseter muscle, of the inhibitory reflex evoked by application of electrical stimuli to the skin of the upper lip in fifteen human subjects. In control sequences, the reflex had a mean latency of 42 +/- 1.1 ms and a mean duration of 45 +/- 2.1 ms. The magnitude of the reflex (measured by integration of the EMG) was reduced (by 18 +/- 7.0%, n = 11; P < 0.05, Student's t test) while the subjects concentrated on a visual feedback signal in order to maintain a steady level of EMG activity. It was further reduced (by 25 +/- 3.6%, n = 10; P < 0.001, Student's t test) when the subjects additionally undertook mental calculations (the 17-times table). These effects were predominantly in the later parts of the responses. They occurred regardless of whether the baseline activity in the masseter muscle was inadvertently raised or lowered during the conditioning procedures. It is concluded that attentional factors can modulate jaw reflexes in man by exerting an influence on the reflex pathway at a point prior to the motoneurones. The underlying mechanism may involve the activation of descending inhibitory pathways and/or a facilitation of mechanisms underlying excitatory responses in jaw closing muscles.
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7786519
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Haemodynamic responses to an angiotensin II receptor antagonist (GR 117289) in maternal and fetal sheep.
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An AT1-specific angiotensin II receptor antagonist (GR117289; 1 mg/kg I.V. bolus) was administered daily to ten chronically catheterized, normotensive ewes during late pregnancy (from 126 +/- 1 days) until parturition (139 +/- 1 days); five control animals received an equivalent volume of vehicle solution. Following drug administration, mean maternal blood pressure decreased from 87 +/- 1 mmHg to a minimum of 79 +/- 1 mmHg at 0.5 h (P < 0.05; n = 10) and remained low for 4-6 h without any concomitant change in fetal blood pressure or maternal and fetal heart rates. In animals fitted with flow probes, uterine blood flow decreased from 443 +/- 21 to 363 +/- 27 ml/min at 0.5 h post-drug (P < 0.05; n = 6); this change was positively correlated with the reduction in maternal blood pressure. The mean decrements in uterine and umbilical blood flows measured by steady-state infusion of tritiated water were -611 +/- 171 ml/min at 4-6 h (P < 0.05; n = 5) and -71 +/- 19 ml/min at 0.5-1 h (P < 0.05; n = 5), respectively. Significant reductions (P < 0.05; n = 10) in fetal arterial oxygen tension (-1.6 +/- 0.4 mmHg), saturation (-6.6 +/- 1.6%) and content (-0.3 +/- 0.1 mumol/ml) were evident at 0.5 h post-drug and were maintained for 6-12 h. Umbilical oxygen delivery decreased at 0.5-1 h following drug administration (P < 0.01; n = 5), but was unaccompanied by any significant change in fetal oxygen consumption. Chronic decreases in daily fetal pH and blood oxygen content occurred in GR117289-treated ewes. There were no significant differences in gestational length or neonatal outcome between vehicle- and GR117289-treated groups of ewes with single fetuses.
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7786518
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Renal, endocrine and vascular effects of atrial natriuretic peptide in a novel vasopressin-deficient genetically hypertensive strain of rat.
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In the absence of the potentially confounding influence of vasopressin in hypertension, the effects of atrial natriuretic peptide (ANP) on arterial blood pressure and renal handling of water and sodium were assessed from comparison of responses to intravenous ANP infusion in anaesthetized vasopressin-deficient New Zealand genetically hypertensive (DI/H) rats and their normotensive substrain (DI/N). After 320 min of hypotonic saline infusion, plasma ANP concentration was significantly higher in DI/H compared with DI/N rats. ANP administration increased circulating ANP concentration in both groups. Plasma angiotensin II concentration was higher in DI/H than in DI/N rats; infusion of ANP raised circulating angiotensin II in both groups though this achieved statistical significance only in DI/N rats. Plasma aldosterone concentrations were initially similar in normotensive and hypertensive animals and, in both, were reduced markedly by I.V. ANP infusion. Administration of ANP produced sustained hypotension in both groups. However, the hypotensive effect of ANP was more pronounced in DI/H compared with DI/N rats. Heart rate was initially similar in the two groups, and infusion of ANP produced no detectable change. By comparison with animals maintained on hormone-free infusate, urine flow increased markedly over the 80 min period of ANP infusion in both groups, by 142% in DI/H rats and 127% in DI/N rats. ANP administration produced a natriuresis in both groups but the increase in Na+ excretion was much greater in DI/H (342%) than in DI/N (139%) rats. It appears from the current study that vasopressin-deficient hypertensive rats are more sensitive to ANP with regard to effects on blood pressure and renal excretion than their vasopressin-deficient normotensive substrain. These differences may, in part, reflect adjustments to long-term elevation in blood pressure and in plasma ANP concentration in hypertension and, in part, rely on the associated disturbances in related endocrine systems.
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7786517
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Responses to reduced water intake, including dehydration natriuresis, in sheep excreting sodium predominantly in urine or in faeces.
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Sheep which were predominantly urinary excretors (U) or faecal excretors (F) of sodium were exposed to a 75% reduction of water intake for 72 h. The experiment was performed on moderate, low or high sodium intakes (0.4, 0.05 or 1.2 mmol kg-1 day-1) to test the hypothesis that dehydration natriuresis was not a cause of sodium depletion but a defence against hypernatraemia. Dehydration caused elevation of plasma sodium concentration, osmolality, antidiuretic hormone (ADH) and oxytocin but, as in other experiments, a fall in haematocrit. The two higher levels of sodium intake were associated with dehydration natriuresis but also a smaller increase in faecal sodium excretion in both U and F sheep. On low sodium intake, however, neither urinary nor faecal sodium excretion increased in either group of sheep although the rise in plasma sodium concentration caused by dehydration was similar. Thus, when there is a risk of sodium depletion, due to low sodium intake, dehydration natriuresis does not occur, consistent with the hypothesis. Active sodium transport inhibitor (ASTI) and atrial natriuretic peptide (ANP) fell rather than rose during dehydration. Since aldosterone is suppressed by the higher levels of sodium intake, none of these hormones is likely to mediate dehydration natriuresis in sheep. F sheep showed more effective renal and faecal water conservation when dehydrated. During water restriction, the urinary potassium excretion of U sheep was significantly reduced, unlike that of F sheep; moreover, the latter maintained an identical plasma potassium concentration between baseline and restriction period, whereas in U sheep it was 0.3 mmol l-1 higher during water restriction. Increased drinking rather than reduced urine output was the basis of rehydration when ad lib. water intake was restored.
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7786516
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Depression of ventilation by dopamine in cats: effects of bilateral cervical sympathetic and vagal trunk section.
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The contribution of sympathetic and vagal inputs to ventilatory depression induced by dopamine was studied in eighteen anaesthetized, spontaneously breathing, normoxic cats. Breathing was via a tracheostomy. Dopamine (20 micrograms (kg body wt)-1) was injected intravenously in the intact animal, then after section of the cervical sympathetic trunks, and finally after midcervical vagotomy. Dopamine, injected as a bolus, induced depression of ventilation, affecting predominantly the volume component of the breathing pattern at all experimental stages. The extent of volume reduction was larger and different from that in intact animals following section of sympathetic (P < 0.05) and vagal trunks (P < 0.01). The respiratory cycle was significantly prolonged (P < 0.01) prior to vagotomy, due entirely to the increase in the expiratory time (TE). Bilateral section of the carotid sinus nerves performed in six cats virtually abolished postdopamine ventilatory depression.
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7786515
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Recognition of a pharyngo-oesophageal sphincter inhibitory reflex in dogs and its role in deglutition.
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The present study describes the 'pharyngo-oesophageal sphincter inhibitory reflex' and its clinical significance. The study was performed on twelve anaesthetized dogs. A balloon-tipped catheter was placed within the pharyngo-oesophageal sphincter (POS) and another in the pharynx. The POS response to distension of the pharynx with a balloon filled with 2, 4 or 6 ml of water was recorded before and after application of local anaesthetic to the POS, and after successive section of the anatomical constituents of the POS. Upon pharyngeal distension, POS pressure was reduced; the greater the distension, the greater the pressure reduction. The anaesthetized POS did not respond to pharyngeal distension. Section of the cricopharyngeus muscle did not influence the resting POS pressure or the POS response to pharyngeal distension. The POS pressure dropped significantly (P < 0.0001) and was unresponsive to pharyngeal distension after section of both the cricopharyngeus muscle and the oesophageal circular muscle bundles. This shows that the cricopharyngeus muscle is not involved in the upper oesophagus sphincter mechanism.
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7786514
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Influence of stretch on excitation threshold of single frog ventricular cells.
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The excitation threshold of enzymatically dissociated single frog ventricular myocytes was measured as a function of cell length or sarcomere length. Field stimulation with 3 ms duration rectangular current pulses was applied via two platinum wire electrodes oriented either parallel or perpendicular to the long axis of the cell. Excitation threshold was measured as the amplitude of applied current, with an error of less than 1%. Single cells were held isometrically by two glass pipettes and wrapped around an optical fibre, which was used to control cell length. Sarcomere length was measured using video microscopy and a phase-locked loop system. Changes in cell length and sarcomere length were induced by mechanical stretch and release of the whole cell. The excitation threshold decreased with increasing resting length (preload), and increased with decrease of the cell length back to its original length, regardless of the orientation of the electric field. The measured change in excitation threshold with stretch was of the order of 1%/% strain. These results suggest that stretch affects the excitation threshold of cardiac cells by factors other than simple shape changes in the cell, perhaps through the activity of mechanosensitive ionic channels.
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7786512
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Composition and viscosity of interstitial fluid of rabbits.
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Open-ended plastic tubes were used as capsules for obtaining interstitial fluid from rabbits. The capsule was a 2.5 cm long plastic tube with an inner diameter of 6 mm. Three small incisions were made in the dorsal mid-line of the anaesthetized rabbit; two capsules were inserted into each incision. A sample of capsular fluid was obtained 6 weeks later by inserting a hypodermic needle through the skin. The volume of fluid obtained from the capsule was sufficient for the analysis of total protein, albumin, albumin:globulin ratio, colloid osmotic pressure and the fluid viscosity. Despite the significantly lower total protein, albumin, globulin and colloid pressure of intracapsular fluid compared with plasma, the intracapsular fluid was found to have a greater viscosity. It is our opinion that the increased viscosity of the intracapsular fluid is due to the presence of a high molecular weight substance other than albumin and globulin, possibly hyaluronan.
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7786513
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Comparison of synovial PO2 and sympathetic vasoconstrictor responses in normal and acutely inflamed rabbit knee joints.
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Experiments were performed to assess the effect of acute inflammation of the rabbit knee joint on the partial pressure of oxygen in synovial fluid (Ps,O2) and nerve-mediated vasoconstrictor responses of articular blood vessels. With the hypodermic needle oxygen electrode sited within the synovial cavity in the posterior region of the knee joint, mean (+/- S.E.M.). Ps,O2 was 37.4 +/- 3.6 mmHg (n = 10) in the inflamed group, which differed significantly (P < 0.05) from that occurring in the normal group from a different series (48.2 +/- 3.1 mmHg; n = 18). Ps,O2 was found to decrease with increasing depth of penetration of the oxygen electrode into the joint cavity of the inflamed knee, as in the normal knee. The lowest values were observed close to articular cartilage. Absolute blood flow was measured using radiolabelled microspheres whilst relative changes in blood flow were assessed using laser Doppler flowmetry. The former technique showed that the inflamed joints had a significantly higher blood flow. Electrical stimulation of the posterior articular nerve (PAN) of the knee resulted in vasoconstriction of knee joint blood vessels, which was accompanied by a reduction in Ps,O2. The frequency-response and voltage-response profiles to electrical stimulation of the PAN, although differing in magnitude, showed a high degree of correlation between blood flow and Ps,O2. The frequency-response profile to electrical stimulation of the PAN shifted to the right in inflamed joints compared with normal joints, suggesting a reduction in the efficacy of the sympathetic nervous system in regulating blood flow to the inflamed joints. Although the inflamed joint had a higher blood flow, Ps,O2 was lower compared with the normal joint. The results of this study show significantly altered blood flow, Ps,O2 and nerve-mediated constrictor responses in the acutely inflamed joint. These are related to the inflammatory response and may contribute to the pathogenesis of arthritis.
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7786511
|
Glutamate-immunoreactivity in identified vagal afferent terminals of the cat: a study combining horseradish peroxidase tracing and postembedding electron microscopic immunogold staining.
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Using electron microscopic immunohistochemistry we have shown that strong glutamate-immunoreactivity (glutamate-ir) is present in neuronal cell bodies of the nodose ganglion, axons in the tractus solitarius and afferent terminals in the nucleus tractus solitarii. Vagal afferent fibres were specifically labelled by transganglionic retrograde transport of horseradish peroxidase (HRP). Fifty-seven per cent of the HRP-labelled terminals in the dorsomedial medulla were found to contain a high level of glutamate-ir, suggesting that a population of vagal afferent fibres uses glutamate as a neurotransmitter substance. There were no apparent ultrastructural differences between glutamate-ir and non-glutamate-ir vagal afferent terminals, both classes mainly containing rounded vesicles and forming asymmetric synapses. However, some difference in their preference for postsynaptic target was noted. The great majority (83%) of non-glutamate-ir vagal afferent terminals made axodendritic synapses, but only just over half (57%) of the glutamate-ir vagal terminals made synaptic contact with dendrites. Approximately 13% of the HRP-labelled terminals were found to make synaptic contact with HRP-labelled dendrites or soma of motoneurones of the dorsal vagal motor nucleus, confirming the existence of monosynaptic connections between vagal afferent fibres and vagal motoneurones.
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7786507
|
Antimicrobial drug resistance in Staphylococcus aureus isolated from cattle in Brazil.
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Isolates of Staphylococcus aureus obtained from apparently healthy cattle in the State of Paraiba, Brazil were characterized in relation to resistance to 21 antimicrobial agents. Among the 46 isolates obtained, resistance to penicillin was most frequent, followed by resistance to cadmium, streptomycin, arsenate, tetracycline, mercury, erythromycin and kanamycin/neomycin. All isolates were susceptible to fusidic acid, ethidium bromide, cetrimide, chloramphenicol, benzalkonium chloride, doxycycline, gentamicin, methicillin, minocycline, novobiocin, rifamycin, tylosin and vancomycin. Only six isolates were susceptible to all the drugs tested. With respect to the antibiotics, multi-resistant isolates were uncommon. These results are probably a consequence of the peculiarities of local drug usage pressures. In relation to metal ions, resistance to mercury was rare while resistance to arsenate was relatively frequent, which contrasts with the situation for human Staph. aureus strains. After treatment with ethidium bromide, elimination of resistance to penicillin, tetracycline, streptomycin, erythromycin and cadmium was observed, which was consistent with the genetic determinants being plasmid-borne.
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7786506
|
Formation of viable but nonculturable Salmonella during starvation in chemically defined solutions.
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Salmonella enteritidis enters a viable-but-nonculturable state when exposed to starvation in aquatic environments. This study determined starvation survival of this pathogen in chemically defined solutions and tested the ability of nonselective enrichment to detect viable-but-nonculturable cells. Starvation of Salm. enteritidis at 7 degrees C in 7.35 mmol l-1 potassium phosphate buffer resulted in complete loss of culturability after 5 weeks with maintenance of a substrate-responsive population of over 10,000 cell ml-1. Starvation at 21 degrees C and starvation in saline solutions or lower concentrations of phosphate buffer resulted in prolonged survival of a culturable population although this population was lower than the total viable population. Enrichment using lactose broth did not allow resuscitation of viable-but-nonculturable cells even after 5 d of incubation at 35 degrees C.
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7786505
|
Evaluation of methods for the isolation and detection of Escherichia coli O157 in minced beef.
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This study has evaluated enrichment and detection procedures for the isolation and detection of Escherichia coli O157 inoculated into minced beef. The use of a 24 h enrichment in modified EC broth containing novobiocin allowed low numbers of contaminating cells to multiply to levels detectable on culture media and by ELISA test kits. Total analysis time was reduced by the use of the Dynabead immunomagnetic separation system. The use of the Petrifilm Test Kit-HEC for E. coli O157:H7 and Organon Teknika EHEC-TEK system detected low numbers of contaminating cells following enrichment and reduced analysis time by 1 d. The incorporation of cefixime and tellurite into Sorbitol MacConkey Agar increased the rate and ease of isolation of E. coli O157 and its use is therefore recommended.
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7786504
|
Discrepancy between Penner serotyping and polymerase chain reaction fingerprinting of Campylobacter isolated from poultry and other animal sources.
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Thirty-four Campylobacter jejuni or coli strains, isolated from various livestock and darkling beetles from two Dutch poultry farms during different broiler production cycles, were subjected to Penner serotyping and polymerase chain reaction (PCR) fingerprint analysis. Ten different Penner serotypes were determined in the isolates. Visual scoring of the PCR fingerprints resulted in 14 clearly different profiles. Some strains with identical Penner serotypes exhibited different PCR fingerprints and conversely strains with different serotypes produced identical PCR fingerprints. Discrepancies between Penner serotyping and PCR fingerprinting were most obvious between isolates from different animal sources. Indications for the occurrence of genomic rearrangements were found. The inconsistency between serotyping and fingerprinting of Campylobacter strains suggests that conventional typing methods should be used in combination with fingerprinting if the epidemiological factors that contribute to Campylobacter colonization of live chickens are to be assessed reliably.
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7786502
|
The detection of Salmonella in skimmed milk powder enrichments using conventional methods and immunomagnetic separation.
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Skimmed milk powders were spiked with one of three Salmonella serovars and incubated in buffered peptone water for 24 h. No false-negative results were obtained by immunomagnetic separation (IMS), compared to seven for selenite cysteine, one for Müller-Kauffmann tetrathionate and two for Rappaport-Vassiliadis enrichment broths. Salmonella virchow was detected and enumerated during the pre-enrichment incubation by IMS and indirect conductance techniques. The Salm. virchow cell number did not increase after 12 h incubation and remained at 3 x 10(6) cfu ml-1. IMS was able to capture Salm. virchow cells at cell numbers ca 50 ml-1 in the presence of a 1000 greater number of non-salmonella cells.
|
7786501
|
Energy dispersive analysis of X-rays study of the distribution of chlorhexidine diacetate and cetylpyridinium chloride on the Pseudomonas aeruginosa bacteriophage F116.
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Using an energy dispersive analyser of X-rays fitted to a scanning electron microscope, chlorhexidine was shown not to bind onto F116 bacteriophage, unlike cetylpyridinium chloride, which possibly penetrated the phage. This could explain the difference in viricidal activity between the two compounds.
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7786500
|
X-ray microanalysis of chlorhexidine-treated cells of Saccharomyces cerevisiae.
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The use of energy dispersive analysis of X-rays (EDAX) to identify and quantify the presence of chlorhexidine diacetate (CHA) within Saccharomyces cerevisiae cells was examined. Chlorine was used as the elemental marker tag. Saccharomyces cerevisiae cells exposed to 1000 micrograms ml-1 CHA took up increasing amounts of CHA over a time period of 30 s to 30 min. Electron probe micro-analysis was employed to examine the specific accumulation of CHA across the treated cells. These results showed that CHA was distributed evenly between the cell wall, cytoplasm and vacuoles of cells pre-treated with this concentration of CHA for 30 min. The EDAX system therefore provides a useful tool for examining the qualitative and quantitative effects of chlorhexidine on yeast cells, although quantitative data must be interpreted with caution.
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7786499
|
Efficacy of the E-test in evaluating the antimicrobial susceptibility of anaerobic bacteria of veterinary interest.
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A study was made of the sensitivity of 39 clinical isolates of anaerobic bacteria to 10 antimicrobial agents. Minimal inhibitory concentrations (MICs) were calculated using a new method--the E-test (AB Biodisk, Solna, Sweden)--and compared with those obtained using the conventional agar dilution method. Agreement between the MICs obtained by the two methods with a variation of +/- 2 dilutions was 78.7%. The E-test, though less sensitive than the conventional agar dilution method, may be of value in clinical veterinary practice when rapid selection of treatment for a given infectious process is required.
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7786498
|
Sensitivity of Campylobacter spp. to irradiation in poultry meat.
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The sensitivity of Campylobacter jejuni (three strains), Camp. coli (three strains), Camp. fetus (one strain) and Camp. lari (one strain) to irradiation in poultry meat was investigated. There was no significant difference in the counts obtained on Blood or Skirrows agar. Preston agar gave a significantly lower recovery of the pathogens after irradiation so these results were not included in calculations of D10 values. The D10 values ranged from 0.12 to 0.25 kGy and there was a significant difference in the radiation sensitivity between different Campylobacter spp. and within strains of the same species. These values indicate that Campylobacter spp. are more radiation-sensitive than Salmonella and Listeria monocytogenes irradiated under similar conditions. Therefore irradiation treatments suggested to eliminate the latter from poultry carcasses would also be sufficient to remove Campylobacter.
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7786497
|
An assessment of environmental factors influencing acid tolerance and sensitivity in Escherichia coli, Salmonella spp. and other enterobacteria.
|
Environmental factors such as temperature, pH and nutrient level affect enterobacterial acid sensitivity, as do the presence of phosphate and Na+ and the extent of aeration. The mechanisms governing these effects are partially understood and the involvement of phoE, fur and atp in acid tolerance, of phoE, envZ, tonB, (p)ppGpp and cAMP in salt-induced acid sensitivity and of rpoS in stationary-phase acid tolerance are of particular interest. It should be noted that surface attachment enhances acid resistance.
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7786496
|
Microbiological criteria for retail foods. Professional Food Microbiology Group (PFMG) of the Institute of Food Science and Technology (IFST).
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This article proposes that microbiological criteria should only be drawn up and applied to foods if there is a full understanding and consideration of raw material selection, production process, packaging and finished product characteristics. The combined knowledge and expertise of public sector microbiologists and food industry microbiologists and technologists need to be harnessed in the establishment of such criteria. In this manner, microbiological criteria could be derived to the overall benefit of the consumer. A meeting of the Society for Applied Bacteriology held in November 1994 considered the issue of microbiological standards for foods and, in this paper, the recently formed PFMG presents an opinion on the 'Provisional microbiological guidelines' published by the Food Surveillance Group of the Public Health Laboratory Service.
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7786495
|
Manipulating the immune response in allergic disease: targeting CD4+ T cells.
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CD4+ T lymphocytes play an important role in the induction and maintenance of inflammatory responses in allergic diseases. In this review, we examine some of the recent developments that have expanded our knowledge of how T cells recognize and respond to common environmental allergens. In addition, we discuss the role of allergen-derived peptides and their derivatives in the modulation of the immunological activity of allergen-specific T cells, and their potential application for immune intervention. It appears that the ability to redress the balance between qualitatively different subsets of functional components of the immune system may guide the development of therapy.
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7786494
|
Application of enzymes to the synthesis of surfactants.
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Recent progress in the application of isolated enzymes to the preparation of surface-active compounds demonstrates the feasibility of an alternative to organosynthetic methods. Processes such as the syntheses of monoglycerides, sugar fatty acid esters, (lyso)phospholipids, anomerically pure alkyl glycosides and amino acid-based surfactants are discussed, highlighting some of the advantages of enzymatic methods over conventional organic syntheses and whole-cell systems.
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7786490
|
Two cationic peroxidases from cell walls of Araucaria araucana seeds.
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We have previously reported the purification and partial characterization of two cationic peroxidases from the cell walls of seeds and seedlings of the South American conifer, Araucaria araucana. In this work, we have studied the amino acid composition and NH2-terminal sequences of both enzymes. We also compare the data obtained from these analyses with those reported for other plant peroxidases. The two peroxidases are similar in their amino acid compositions. Both are particularly rich in glycine, which comprises more than 30% of the amino acid residues. The content of serine is also high, ca 17%. The two enzymes are different in their content of arginine, alanine, valine, phenylalanine and threonine. Both peroxidases have identical NH2-terminal sequences, indicating that the two proteins are genetically related and probably are isoforms of the same kind of peroxidase. The amino acid composition and NH2-terminal sequence analyses showed marked differences from the cationic peroxidases from turnip and horseradish.
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7786492
|
Molluscicidal saponins from Catunaregam nilotica.
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Two new saponins were isolated from the fruits of Catunaregam nilotica Stapf, syn. Lachnosiphonium nilotica; Randia nilotica; Xeromphis nilotica. Their structures were determined mainly by spectroscopic methods as 3- O-[O-alpha-L-rhamnopyranosyl-(1-->3)-O-[O-beta-D-glucopyranosyl-(1 -->3)]- beta-D-glucopyranosyl]oleanolic acid and 28-O-beta-D- glucopyranosyl-3-O-[O-alpha-L-rhamnopyranosyl-(1-->3)-O[O-beta-D- glucopyranosyl]-beta-D-glycopyranosyl]oleanolate. The monodesmosidic saponin is a potent molluscicide against the schistosomiasis transmitting snail Biomphalaria glabrata with a LC50 value of 3 ppm. In addition two known saponins, 3-O-[2', 3'-di-O-(beta-D-glucopyranosyl)-beta-D- glucopyranosyl]oleanolic acid and 3-O-[O-beta-D-glucopyranosyl(1-->3)- beta-D-glucopyranosyl]oleanolic acid, were identified and their molluscicidal activity determined, the LC50 values being 26 and 3 ppm, respectively. Initial molluscicidal screening of the crude water and ethanol extracts revealed 100% snail mortality at concentrations of 100 and 50 ppm, respectively. The haemolytic activity of the molluscicidal saponins was determined as well and the HC50 values towards bovine erythrocytes found to be 3 ppm for the new saponin, and 16 and 2 ppm, respectively, for the two known saponins.
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7786491
|
Structural features of fungal beta-D-glucans for the efficient inhibition of the initiation of virus infection on Nicotiana tabacum.
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Glucans of fungal origin have been shown to inhibit the early stages of infection of Nicotiana by numerous viruses of different taxonomic groups. Several glucans were isolated from the cell walls of Phytophthora parasitica, Phytophthora megasperma f. sp. glycinea (Pmg) and Fusarium oxysporum, and their antiviral activity compared on tobacco leaves inoculated with tobacco mosaic virus. These polysaccharides consist of a mixture of (1-->3)(1-->6)-beta-D-glucans with M(r) varying from 1.1 x 10(3) to 2 x 10(6). Requirements for a prominent antiviral activity of the fungal polysaccharides are a beta-(1-->3)(1-->6)-D-glucan structure with mono-, di-, tri- or tetra-glucosidic side branches attached to a linear main chain of beta-(1-->3)-linked-D-glucose residues. Very high activity is correlated with a high degree of branching at position 6 and with the size and glycosidic nature of the side chains. The molecular masses and the organized structure of fungal beta-D-glucans are not essential for their antiviral activity. The structural motif for antiviral activity in Nicotiana is distinct from that required for elicitation of phytoalexins in soybean cotyledons.
|
7786489
|
Cucurbitacin glycosides from Cabeça-de-negro.
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Five cucurbitacin glycosides named cabenosides D-L were isolated from 'Cabeça-de-negro', the roots of Caput nigri. Among them, the structures of cabenosides D-H were elucidated as 10 alpha-cucurbit-5-en-11-oxo-3 beta,24R,25-triol-3-O-beta-D-glucopyranoside, 10 alpha-cucurbit-5-en-24-oxo-3 beta, 11 alpha,25-triol-25-O-beta-D- glucopyranosyl, [3,O-beta-D-glucopyranoside, 3-O-beta-D-glucopyranosyl-(1-2)-beta-D-glucopyranoside, 3-O-beta-D-glucopyranosyl-(1-6)-beta-D-glucopyranoside] and 10 alpha-cucurbit-5-en-11,24-dioxo-3 beta,25-diol-25-O-beta-D- glucopyranosyl, 3-O-beta-D-glucopyranosyl-(1-6)-beta-D-glucopyranoside, respectively, on the basis of chemical and spectral evidence.
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7786488
|
Cucurbitacin glycosides from Caput nigri.
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The chemical structures of cabenosides I-L were investigated. These are four of the 12 cucurbitacin glycosides isolated from 'Cabeça-de-negro', the roots of Caput nigri. By means of chemical analyses the structures of cabenosides I-L were elucidated as 10 alpha-cucurbit-5-ene-3 beta,11 alpha,20S,24 xi,25-pentaol [3, 25-di-O-beta-D-glucopyranoside, and 3-O-beta-D-glucopyranosyl-(1-2)-beta-D-glucopyranosyl (sophorosyl), 25-O-beta-D-glucopyranoside], and 10 alpha-cucurbit-5,20,24-triene-11-oxo-3 beta,26-diol [3-O-beta-D-glucopyranosyl-(1-6)-beta-D-glucopyranosyl (gentiobiosyl), 26-O-beta-D-glucopyranoside and 3,26-di-O-gentiobioside], respectively.
|
7786487
|
Steroidal glycosides from Cynanchum caudatum.
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The aerial part of Cynanchum caudatum afforded 10 new pregnane glycosides which had sarcostin or deacylmetaplexigenin as the aglycone moiety. The structures of these compounds were elucidated by spectroscopic methods and from chemical evidence.
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7786485
|
Mazusaponins I-IV, triterpene saponins from Mazus miquelii.
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From whole plants of Mazus miquelii, four new saponins designated as mazusaponins I-IV and a known saponin, ilexoside VIII, were isolated and the structures of the new compounds elucidated as 3-O-alpha-L-arabinopyranosyl siaresinolic acid 28-O-beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranosyl ester, 3-O-alpha-L-arabinopyranosyl pomolic acid 28-O-beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranosyl ester, 3-O-alpha-L-rhamnopyranosyl-(1-->2)-alpha-L-arabinopyranosyl siaresinolic acid 28-O-beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranosyl ester and 3-O-alpha-L-rhamnopyranosyl-(1-->2)-alpha-L-arabinopyranosyl pomolic acid 28-O-beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranosyl ester, respectively, by spectroscopic data and chemical evidence.
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7786486
|
Saponins from Hacquetia epipactis.
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Four new estersaponins were isolated from hacquetia epipactis. Using GC-MS, FAB-MS and various 2D-NMR techniques they were identified as 3-O-[beta-D-glucopyranosyl-(1-->2)-[alpha-L-arabinopyranosyl-(1--> 3)]- beta-D-glucuronopyranosyl-(1-->)]-21-acetyl-22-(2-methylbutyryl)- barringtogenol C (hacquetiasaponin 1), the corresponding 21-(2-acetoxy-2-methylbutyryl)-22-acetyl-derivative (hacquetiasaponin 2), 3-O-[beta-D-glucopyranosyl-(1-->2)-[alpha-L-arabinopyranosyl- (1-->3)]-beta-D-glucuronopyranosyl-(1-->)]-21-acetyl-22-(2-methylb utyryl)- R1-barrigenol (hacquetiasaponin 3) and its corresponding 21-(2-acetoxy-2-methylbutyryl)-22-acetyl-derivative (hacquetiasaponin 4).
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7786482
|
Antiallergic dimeric prenylbenzoquinones from Ehretia microphylla.
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The ethyl acetate-soluble portion of the MeOH extract of Ehretia microphylla showed inhibitory activity on exocytosis in antigen-stimulated rat basophils. The bioassay-guided separation of this fraction afforded five biologically active compounds. By means of chemical and spectroscopic methods, the structures of these compounds, which include microphyllone, a unique dimeric prenylbenzoquinone, and its congeners, were elucidated.
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7786483
|
(S)-13-hydroxygeranylgeraniol-derived furanoditerpenes from Bifurcaria bifurcata.
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Two new diterpenes were isolated from a sample of the brown alga Bifurcaria bifurcata collected from Brittany on the Atlantic coast and their structures established by spectroscopic methods. The new diterpenes are derived from (S)-13-hydroxygeranylgeraniol by terminal cyclization and oxidation leading to a furan-3-yl ring or a beta,gamma-epoxy-gamma-lactone. One of them showed a cytotoxic effect to fertilized sea urchin eggs. The chemical shifts of the methyl groups and quaternary carbons in (S)-13-hydroxygeranylgeraniol have been revised to take account of the results obtained in a 2D NMR long-range C-H correlation experiment and the absolute configuration at C-13 determined for the first time. The geographical variation in the diterpenoid composition of B. bifurcata was also studied.
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7786481
|
A ferulic acid ester of sucrose and other constituents of Bhesa paniculata.
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A novel derivative of sucrose, beta-(3,6-di-O-feruloyl)-fructofuranosyl-alpha-(2,3,4,6-tetra-O-ac etyl)- glucopyranoside, was isolated from the wood of Bhesa paniculata. Its structure was determined by a combination of 2D 1H-1H and 1H-13C correlation NMR spectroscopy. The known compounds, glycerol 1-9',12'-octadecadienoate, beta-sitosterol, (+/-)-pinoresinol, methyl 3,4-dihydroxybenzoate, 4-hydroxy-3-methoxybenzoic acid, anofinic acid and 2-(1'-methylethenyl)-benzofuran-5-carboxylic acid were also isolated.
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7786480
|
A bidesmosidic triterpene saponin from Cephalaria transsylvanica.
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The structure of cephalaria saponin B, isolated from Cephalaria transsylvanica was elucidated as 3-O-([beta-D-xylopyranosyl(1-->4)-alpha-L-rhamnopyranosyl(1-->2)-beta-D- xylopyranosyl]-[28-O-beta-D-glucopyranosyl])-3beta,23-dihydroxy-12(13)-oleanene-28-oic acid.
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7786479
|
Triterpene saponins from Aster yunnanensis.
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Four new triterpene saponins, asteryunnanosides A, B, C and D, have been isolated from Aster yunnanensis and their structures deduced as 2 alpha,3 beta,23-trihydroxyolean-12-en-28-oic acid-28-O-alpha-L-rhamnopyranosyl-(1-->2)-beta-D-glucopyranoside, 2 alpha,3 beta,23-trihydroxyolean-12-en-28-oic acid-28-O-beta-D-glucopyranosyl-(1-->2)-beta-D-glucopyranoside, 2 alpha,3 beta-dihydroxyolean-12-en-28-oic acid-28-O-alpha-L-rhamnopyranosyl-(1-->2)-beta-D-glucopyranoside and 2 alpha,3 beta-dihydroxyolean-12-en-28-oic acid-28-O-beta-D-glucopyranosyl-(1-->2)-beta-D-glucopyranoside, respectively, by means of spectral and chemical data.
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7786478
|
Isolation of triterpene saponins from Gypsophila capillaris.
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Four novel triterpenoid saponins have been isolated from Gypsophila capillaris. Three were monodesmosidic: 3 beta-hydroxyolean-12-en-23,28-dioic acid 28-O-[beta-D-glucopyranosyl-(1-->3)-beta-D-glucopyranosyl-(1-->2)] [beta-D-galactopyranosyl(1-->6)]beta-D-glucopyranoside, 3 beta-hydroxyolean-12-en-23-oxo-28-oic acid 28-O-[beta-D-glucopyranosyl-(1-->2)-beta-D-galactopyranosyl-(1-->3)] [beta-D-glucopyranosyl(1-->6)]beta-D-galactopyranoside, 3 beta-hydroxyolean-12-en-23,28-dioic acid 28-O-[beta-D-glucopyranosyl-(1-->2)-beta-D-galactopyranosyl-(1-->3)] [beta-D-glucopyranosyl(1-->6)]beta-D-galactopyranoside. The fourth was bisdesmosidic: 3 beta-hydroxyolean-12-en-23,28-dioic acid 23-O-beta-D-glucopyranosyl-28-O-[beta-D-glucopyranosyl-(1-->2)-beta-D- galactopyranosyl-(1-->3)][beta-D-glucopyranosyl-(1-->6)]beta-D- galactopyranoside. The structures of the compounds were elucidated by 1D and 2D NMR techniques and from other spectroscopic evidence.
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7786477
|
Triterpenoid saponins from Clematis chinensis.
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From the roots of Clematis chinensis, two new triterpenoid saponins, named clematichinenoside A and B, were isolated and their structures were elucidated as 3-O-beta-D-ribopyranosyl-(1-3)-alpha-L-rhamnopyranosyl-(1-2)-alpha -L- arabinopyranosyl oleanolic acid 28-O-beta-D-glucopyranosyl ester and 3-O-beta-D-glucopyranosyl-(1-4)-beta-D-ribopyranosyl-(1-3)-alpha-L - rhamnopyranosyl-(1-2)-alpha-L-arabinopyranosyl hederagenin 28-O-alpha-L-rhamnopyranosyl-(1-4)-beta-D-glucopyranosyl-(1-6)- beta-D-glucopyranosyl ester, respectively. In addition oleanolic acid, hederagenin and seven known saponins were obtained.
|
7786475
|
Diterpenoids from Isodon eriocalyx var. laxiflora.
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Three new, seco-ent-kaurane diterpenoids, laxiflorins A, B and C, together with four known diterpenoids eriocalyxin B, oriodonin, and maeocrystals A and B, were isolated from the leaves of Isodon eriocalyx var. laxiflora. Their structures were assigned by a combination of one- and two-dimensional NMR techniques and computer modeling calculations. Laxiflorin C displayed weak cytotoxic activity.
|
7786473
|
Specific binding assay for biotin based on enzyme channelling with direct electron transfer electrochemical detection using horseradish peroxidase.
|
A model 'homogeneous' format enzyme channelling specific binding assay for biotin based on peroxide-sensitive horseradish peroxidase mediatorless enzyme electrodes is described. The procedure involved the immobilisation of avidin onto the surface of printed carbon horseradish peroxidase (HRP) enzyme electrodes and the competitive binding of biotin and biotinylated glucose oxidase. Upon addition of glucose, hydrogen peroxide was generated via the glucose oxidase label. Direct electron transfer between the electrodes and HRP resulted in the detection of H2O2 by electroenzymic reduction at +50 mV vs Ag/AgCl. The cathodic current response could be measured in the presence of excess biotinylated glucose oxidase by incorporation of catalase in homogeneous solution to scavenge H2O2 generated in the bulk before it diffused to the electrode surface. The assay showed greatest sensitivity over the range of biotin concentrations 0.07 to 2 micrograms ml-1 in the presence of 10 micrograms ml-1 excess biotinylated glucose oxidase in the bulk solution.
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7786474
|
A matter of some sensitivity.
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The development of sensitive chromatographic and spectroscopic techniques for the isolation and structure determination of natural products has greatly facilitated phytochemical investigations. Chemical investigations of herbarium material have resulted in the isolation of indole, quinoline and isoquinoline alkaloids from a wide number of plants. Examples of novel natural products from higher plants are given and include alkaloids, terpenoids, phenolics and quinones. Some plants investigated have not yielded the types of constituents which would have been predicted from them. Plant tissue cultures provide alternative sources of biologically active compounds and examples investigated include Cinchona, Ailanthus, Brucea and Artemisia for antiprotozoal compounds and Datura for tropane alkaloids. Biological tests are useful for bioassay-guided fractionation of plant extracts and examples of the isolation of a series of natural products with antiprotozoal and cytotoxic activities are given. Chemical and biological investigations into the traditional medicine Dragon's blood (Croton lechleri) from S. America and a Chinese prescription for the treatment of atopic eczema are described. The use of radio-ligand binding assays for the detection of a wide range of biological activities is discussed. Sensitivity of chemical and biological techniques has greatly improved prospects for finding new drug entities from plants and for investigating traditional medicines. Basic phytochemical investigations should continue to be encouraged especially in view of the rapid loss of plant species.
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7786472
|
Integrated implantable device for long-term glucose monitoring.
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In this study we report the development of an integrated implantable device for glucose monitoring. The dimensions of the device (5.0 x 7.0 x 1.5 cm) allow implantation under the abdominal skin of a large animal for in vivo evaluation of sensor performance. The experimental set-up includes amperometric glucose biosensor, a miniature potentiostat, an FM signal transmitter, a power supply and an antenna and receiver linked to a computer-based data acquisition system. The device performance was evaluated in vitro using a ten-day continuous test and other long-term operation experiments. The biosensor was tested in different model solutions that simulated the physiological environment in which it will be ultimately used. A linear response to glucose concentration was obtained up to 25 mM glucose, with a sensitivity of less than 0.5 microA/mM. The ability of the biosensor to measure glucose levels in serum was also tested, and a good correlation demonstrated between glucose serum levels measured by routine technique and those measured using the biosensor (R2 = 0.993; slope = 0.996). Initial results obtained from the short-term subcutaneous implantation of the sensor demonstrate its potential for the monitoring of glucose concentration in vivo.
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7786471
|
An approach for an immunoaffinity AIDS sensor using the conservative region of the HIV envelope protein (gp41) and its monoclonal antibody.
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A monoclonal antibody for the conservative region of gp41, which is one of the HIV envelope proteins, was produced. The antigen determining site of gp41 was examined using the epitope mapping technique, followed by an enzyme linked immunosorbent assay. Some peptides had comparable affinities for the monoclonal antibody, but the peptide EGIEE, having a slightly weaker immunoaffinity than gp41, was the most preferable for the construction of an immunoaffinity AIDS sensor. For the detection of gp41, EGIEE was labelled with catalase and used as a mimic antigen; it was bound to the antibody present on an immuno-membrane and, due to the replacement reaction of the mimic antigen by gp41, indirect quantitative measurement of gp41 was possible using an oxygen electrode. Anti-gp41 antibody was also detected using a mimic antibody, which was chemically modified with polyethylene glycol. An immunoaffinity AIDS sensor was constructed using the mimic molecules which were tailored to have a suitable immunoaffinity for HIV antigen and/or antibody.
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7786470
|
Retained activities of some membrane proteins in stable lipid bilayers on a solid support.
|
Highly stable lipid bilayers, composed of biologically relevant lipids such as phosphatidylcholine, phosphatidylethanolamine and cholesterol, were formed on platinum surfaces. Bacteriorhodopsin isolated from purple membrane (PM) from Halobacterium halobium, cytochrome oxidase from bovine heart, acetylcholinesterase from bovine brain and the nicotinic acetylcholine receptor from Torpedo electric organ were also incorporated into these reconstituted membranes. The proteins retained their biological activities. Some of them were active several weeks after the reconstitution and after several cycles of assay, washing and storage.
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7786469
|
Potentiometric butyrylcholine sensor for organophosphate pesticides.
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A highly sensitive potentiometric butyrylcholine (BuCh) sensor based on plasticized poly(vinyl chloride) membrane was fabricated using tetrakis (3,5-bis[2-methoxy-hexafluoro-methyl] phenyl) borate (HFPB) as a cation exchanger. The sensor showed a Nernstian response from 10(-1) M to 10(-6) M for BuCh. The detection limit of the sensor was 1.8 x 10(-7) M. The potential stability, lifetime and detection limit of the BuCh-sensor were improved in comparison with corresponding parameters of BuCh-sensors using prepared other cation exchangers. This improvement was proved to be due to higher hydrophobicity of the cation exchanger, HFPB. Enzyme activity of butyrylcholinesterase (BuChE) was determined by the BuCh-sensor fabricated. Since the selectivity coefficient of the BuCh-sensor for BuCh against a product of the enzyme reaction, choline, was as low as 6.3 x 10(-3), the sensor was not affected by interference from choline even when the enzyme reaction proceeded up to about 80%. Michaelis parameters for the BuChE reaction were obtained by the sensor. Determinations of organophosphate pesticides, 2,2-dichlorovinyldimethylphosphate and o-(4-bromo-2-chlorophenyl)o-ethyl S-propylphosphothiolate) were conducted by measuring inhibition of enzyme activity. The enzyme reaction rate was related to the concentration of pesticides. Pesticides were successfully determined between micromole and sub-nanomole levels by the BuCh-sensor.
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7786467
|
[Intake of addictive drugs and traffic safety--a report of experiences of the Vienna federal police department].
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Urine samples of 27 individuals with extremely conspicuous behaviour in road traffic were analysed by means of the Abbott ADx-analyser for cocaine metabolites, cannabinoids and opiates. Gas chromatography/mass spectrometry (GC/MS) confirmed positive results. 52% of those 26 positive samples confirmed the simultaneous consumption of two drugs. In 16% all three drugs tested could be found positive, exceeding the threshold values given for the tests hundred fold. Without exception, all 25 urine samples found positive in the ADx-analyser belonged to young people (22 males, 3 females) with 48% of them born between 1968 and 1970. 84% of tested people had previous convictions and 68% had drug addiction records. We also see this project as the beginning of continuing investigations of other drugs and pharmaceuticals. Given the fact that 25 out of 27 samples were found to be positive we most certainly detected nothing but the "tip of the iceberg". We should strive, in conjunction with other European countries, for a political solution to the problem of the illegal and legal consumption of drugs and pharmaceuticals and their effect on driving performance.
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7786466
|
[Arterial and venous alcohol elimination in 10 polytrauma patients].
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Alcohol elimination was examined in 10 patients involved in accidents while intoxicated. The influence of trauma, particularly polytrauma resulting in haemorrhage shock and its therapeutic treatment were analysed. The blood alcohol concentrations were determined according to the usual forensic criteria (2 alcohol dehydrogenase and 2 gas chromatography measurements). Observation periods ranged from 3 hours 45 minutes to 12 hours 35 minutes, with blood being drawn at intervals ranging from 45 minutes to 185 minutes (on average 70 minutes). Results of two patients (delta 60 = 0.22/1000/h and 0.28/1000/h) who only had 3 venous drawn and results of a deceased patient from whom only four arterial samples could be obtained (beta 60 = 0.21/1000/h) were disregarded when working out the average values. The blood alcohol curve plateaued in the case of the deceased patient as well as in the case of a patient whose hepatic circulation was curtailed for approximately half an hour during surgery. The blood alcohol curves for the remaining patients for uniformly linear with beta 60 values between 0.17/1000/h and 0.21/1000/h (mean = 0.18/1000/h +/- 0.01) in arterial samples and 0.18/1000/h and 0.21/1000/h (mean = 0.18/1000/h +/- 0.01) in venous samples. Given our results and the existing literature, we feel that retrograde calculations of the BAC can be justified in patients with polytrauma, despite the small number of patients included in the study. Naturally, the usual forensic criteria have to be taken into account, as well as individual situations. Examples that can be mentioned here are liver failure or curtailment of hepatic circulation during surgery.
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7786465
|
[Indicators for alcohol abuse in female drunk drivers. (Comparative study with alcohol intoxicated male automobile drivers)].
|
Women account for about 12% of all cases of drink driving in German cities. Little is known about their drinking behaviour and the extent of their alcohol misuse. In order that these questions may be clarified, three major studies were evaluated. In these studies, additional indicators for alcohol misuse such as GGT or methanol and acetone+isopropanol or indeed CDT, GGT, methanol and acetone+isopropanol were measured in blood samples. The results were compared with studies of the same kind on male car drivers. There were no significant differences in the ages of males and females. However, there were no differences at all regarding the frequency of the blood alcohol levels or the CDT. Indicators levels of chronic alcohol abuse, such als GGT levels above 70 U/L, methanol levels above 10.00 mg/kg or acetone+isopropanol concentrations above 9.00 mg/kg were approximately the same with women as they were with men. This demonstrates an increasing similarity amongst male and female DWI drivers regarding the drinking behaviour and alcohol abuse.
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7786464
|
[Alcohol and traffic safety--study of epidemiology (II. 1990/1991 status].
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With the co-operation of a further 13 institutes and as a continuation of our own epidemiological-statistical survey, we recorded the total and relative distribution (frequency profile) of the blood alcohol concentration of car drivers for the 3rd quarter 1990 and the 1st quarter 1991. The participating institutes recorded almost 27,000 blood samples and compared them with results of the first part of the study (1989). The survey dealt separately with sex-, age- and time of day-distribution of drivers involved and not involved in road accidents. One of our repeatedly presented field research into the problem of "alcohol and road safety", once again, provided to be a useful method in the run-up to the unprejudiced alcohol test which we are striving for. We noticed characteristic changes in the frequency profiles of the old and the new counties (Bundesländer) in Germany in the 1st (1989) and the 2nd (1990/91) report of the study. The results of Police supervisory operations in the administrative district of Cologne have basically given useful indications as to their epidemiological-statistical value as evidence.
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7786463
|
Tracing lost research participants.
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This paper discusses search strategies that were used to locate research participants with whom researchers had lost contact during a 13 year longitudinal study. The information that proved to be most useful in tracing 'lost' participants was a record of correct names and next of kin. The most cost effective method of re-establishing contact was via the telephone.
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7786459
|
Patients' experiences of nursing interventions during hospitalisation with an AIDS-defining illness.
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The aim of this phenomenologically informed study was to explore the experience of being hospitalised with an AIDS-defining illness. Eight men recently hospitalised with an AIDS-defining illness were asked at interview to describe the meaning of AIDS for them and the nursing interventions they experienced as helpful and unhelpful while they were in hospital. The findings pertaining to participants' experiences of nursing interventions are highlighted in this paper. Overall, the interventions experienced as helpful were those which the participants interpreted as being motivated by care. Conversely, the interventions described as unhelpful were those that suggested to the participants a lack of care on the part of nurses. The main implications of patients' experiences for nursing practice are discussed.
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7786461
|
The clinician and the academic: nursing experience and academic study.
|
This study was conducted at an Australian university which uses telephone group tutorials to enable off-campus students to link their academic and practice worlds. Audiotapes of the content of the 16 teletutorials in one first year unit of the university's Bachelor of Nursing course and interviews with the tutor and 10 of the registered nurses who were student participants were transcribed for analysis. Analysis of the tapes and texts revealed that there was discernible tension between the students' roles as 'expert' clinicians and 'novice' students and, further, that this was a reflection of inherent tension between faculty rhetoric, reality/belief and practice. It became evident that these tensions would become problematic and impact on both the tutor's and students' perceptions of the course.
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7786456
|
Gender bias in cardiology: are women missing out on PTCA?
|
The purpose of this study was to determine if there were differences in the ages of women and men who underwent percutaneous transluminal coronary angioplasty (PTCA), in the duration of PTCA procedures performed on women and men and in the percentage of women and men treated with PTCA relative to the gender distribution of deaths attributed to coronary heart disease. The study was conducted as a retrospective audit of the operation records of 959 PTCA procedures performed over a two year period in a cardiology clinic in a Sydney teaching hospital. Results indicate that, on average, women were older than men when they underwent PTCA, that the average duration of the procedure was longer for women than men and that disproportionately fewer women aged 65 and over were treated with PTCA. The results suggest that gender bias in the delivery of PTCA cannot be discounted and that further research is needed on the clinical needs of women with coronary heart disease.
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7786457
|
Blood letting for BSL: the effects of timing and sites on blood volume.
|
The purpose of this study was to establish the most appropriate timing and site for obtaining an adequate volume of blood for accurate measurement of blood sugar levels by blood glucose monitors. The 248 samples of blood used in the study were collected from 18 men and 16 women recruited from a group of people with type II diabetes mellitus who were attending an outpatient Diabetes Centre. Neither the timing between lancing and collecting the blood nor the sites from which blood was obtained significantly affected the volume of blood samples. Sufficient blood to give an accurate measure of blood sugar levels from monitors requiring 30, 15-18 and five microlitres of blood was obtained from 37%, 65% and 98% of the procedures respectively.
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7786458
|
Relinquishing the sick role: convalescence and rehabilitation.
|
This paper examines the problems of patients who have been considered by their doctors to have received adequate rehabilitation and to be ready to relinquish the sick role. The sick role is discussed in its historical context and convalescence and rehabilitation are considered as alternative approaches to medical and nursing care. It is argued that many patients leaving hospital are frightened because they do not feel well and they will receive little if any follow-up or support after discharge. It is the author's belief that many patients need to convalesce because the very essence of their being is still ill.
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7786453
|
The impact of critical incidents in paediatric hospitals: a review.
|
Literature addressing critical incidents involving hospitalised children is reviewed and circumstances that produce critical incidents are discussed. It is argued that critical incidents often have a major impact on children and their families and on staff, and particularly nursing staff, in paediatric intensive care and burns, oncology and emergency units. Some strategies for assisting children, families and staff to cope with severe trauma, life-threatening illness and death in paediatric hospitals are presented.
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7786452
|
Domestic violence: are we listening? Do we see?
|
This article reports on a study of female victims of abuse who had been hospitalised for treatment of injuries inflicted by their spouses. A phenomenological approach was adopted wherein four women were interviewed to elicit their perceptions of their last hospital experience. Four major themes emerged from analysis of the interview data, these were that the women consistently experienced: disengagement and loss of status; disempowerment and lack of control; stigma and social isolation and a sense of being misunderstood. The results of the study are discussed in relation to women's expectations of nurses' attitudes and nursing interventions.
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7786451
|
Measuring pain in neonates: evaluating an instrument and developing a common language.
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This paper describes the development and evaluation of the Pain Assessment Tool (PAT), a scoring system that was developed by a group of neonatal nurses to assess neonates' pain. To test the practical application of the tool and to compare the scoring system with nurses' subjective pain assessments, a pilot study was conducted with a sample of 20 neonates during the 24 hours following their surgery. The study found that PAT effectively quantified neonates' pain and that PAT scores reflected nurses' perceptions of the pain experienced by neonates. Based on the PAT scores, 15 babies experienced discomfort that required nursing comfort measures and eight babies needed both comfort measures and analgesia to relieve pain. Recommendations for future use of the Pain Assessment Tool are discussed.
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7786450
|
Job-sharing a clinical teacher's position: an evaluation.
|
The aim of this study was to evaluate the effects on staff of having two teachers share one clinical teaching position in their intensive care unit (ICU). Three, six and 12 months after the job-sharing arrangement was initiated, an 11 item questionnaire was distributed to 26 students in post-registration critical care courses, 41 clinical staff in ICU and 9 RN-managers with responsibilities for the unit. The overall response rate to the three questionnaires was 58%. All groups agreed that job-sharing was a viable alternative to full-time work. Three months after the shared position was initiated, there was uncertainty about the consistency of the teachers' performance and the adequacy of communication between them. Nine months later, there was a high level of positive responses to all areas of the teachers' performance. Most respondents felt they could approach either teacher and that more diverse ideas were generated by having two people in the teaching position.
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7786449
|
Five cases of cytomegalovirus infection detected by in situ hybridization and antigenemia assay.
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We report five cases of cytomegalovirus infection in immunocompromised patients which were detected by either cytomegalovirus antigenemia assay or in situ hybridization. Four cases had leukemia and the other had chronic renal failure. All the three BMT recipients suffered from GvHD. Interestingly, there was an unique case of CMV disease without a history of BMT, which reminded us that CMV could attack immunocompromised patients who had not undergone transplantation, too. Four out of five cases died. We think that cytomegalovirus infection or disease should not be regarded as a minor problem in post-transplantation infection in Korea.
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7786447
|
Stimulation of Cl- secretion by AlF4- and vanadate in T84 cells.
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We investigated the mechanism of Cl- secretion by fluoroaluminate(AlF4-) and sodium orthovanadate(vanadate) using the human colonic T84 cell line. T84 cell monolayers grown on collagen-coated filters were mounted in Ussing chambers to measure short circuit current(ISC). Serosal addition of AlF4- or vanadate to T84 monolayers produced a sustained increase in ISC. Removal of Ca2+ from the serosal bathing solution partially inhibited AlF4-(-)and vanadate-induced ISC, and readministration of Ca2+ restored AlF4-(-)and vanadate-induced ISC. Carbachol application in the presence of forskolin, AlF4- or vanadate induced a synergistic increase of ISC. Forskolin and vanadate significantly increased cellular cAMP level, while carbachol and AlF4- did not. Carbachol, AlF4- and vanadate significantly increased [Ca2+]i. After Na+ in mucosal bathing solution was replaced with K+, and the mucosal membrane of T84 cell was permeabilized with amphotericin B, AlF4-, vanadate, and carbachol increased K+ conductance, but forskolin did not. After sodium chloride in serosal bathing solution was replaced with sodium gluconate and the serosal membrane was permeabilized with nystatin, forskolin, AlF4-, and vanadate increased Cl- conductance, but carbachol did not. AlF4-(-)induced ISC was remarkably inhibited by the pretreatment of pertussis toxin(2 micrograms/ml) for 2 hours. These results indicate that AlF4- and vanadate can increase Cl- secretion via simultaneous stimulation of Cl- channel and K+ channel in T84 cells. However, the AlF4- action is mostly attributed to stimulation of pertussis toxin-sensitive G-proteins, whereas the vanadate action mostly results from G protein-independent mechanisms.
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7786448
|
Bilateral fractures of Hydroflex penile prostheses: an unusual complication.
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We report bilaterally fractured Hydroflex implants in 2 patients. One fracture was complete and three were incomplete. All the fractures occurred at the junction of the rear reservoir and the inflation chamber.
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7786446
|
Modulation of transglutaminase expression in rat skeletal muscle by induction of atrophy and endurance training.
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The persistence of muscle fiber number regardless of size reduction in muscle atrophy has not yet been fully explained. For the mechanism inherent in skeletal muscle tissues for preventing cellular death, the protective function of muscle tissue through transglutaminases has been tested, since the enzyme is responsible for structural stabilization and participates in signal transduction. In the present experiment, hindlimb suspension for two weeks caused a marked muscle atrophy in Wistar female rats. Comparison of muscle weight and histological analysis showed that suspension-induced atrophy in the hindlimb was more prominent in the soleus muscle, comprised mainly of type I fiber than that in the plantaris muscle of type II fibers. The immunohistochemical analysis with antitransglutaminase C antibody (anti TGase C Ab) showed that some atrophic bundles of soleus muscle were positively reacted with the antibody. The anti-TGase C Ab-reactive substances were observed to disappear significantly after endurance exercise, indicating their characteristic atrophy-dependency. The enzymatic analysis of transglutaminase showed the increase in activity in the atrophic soleus muscle tissue, compared with that in the normal or exercise-trained muscle tissues. From these results, the expression of TGase in the atrophic muscle is suggested to be the possible marker for muscle atrophy and its expression is probably related with the protective mechanism of the muscle tissue to prevent further cellular damage in the atrophic process.
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7786445
|
CYP1A2 activity as a risk factor for bladder cancer.
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CYP1A2, CYP2D6 and N-acetyltransferase activities were estimated in 100 patients with bladder cancer and 84 control subjects from measurements of theophylline, metoprolol and isoniazid and their metabolites in urine, respectively. The frequency of occurrence of slow acetylators of isoniazid and poor metabolizers of metoprolol were 16.7% and 1.2% in the control group and 16.3% and 2.0% in the cancer patient group. These differences were not significant. The recovery ratio of 1-methyluric acid(1-MU) from theophylline was significantly higher in patients with bladder cancer than in control subjects(0.340 +/- 0.016 versus 0.260 +/- 0.020, p < 0.05). The 1-MU recovery ratio was a significant, independent risk factor among the metabolic capacities tested as shown by logistic regression analysis, controlling for N-acetylation of isoniazid, hydroxylation of metoprolol, age, sex, and smoking. We concluded that the capacity for 3-demethylation of theophylline, as a reflection of CYP1A2 activity, is significantly associated with increased risk of nonoccupational urinary bladder cancer.
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7786444
|
Gene cloning of the human cytomegalovirus (HCMV) antigen reactive with the serum from a HCMV-infected patient.
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The human cytomegalovirus(HCMV) gene encoding the protein reactive with the sera of HCMV-infected patient was cloned and characterized. A reactive phage clone was screened from a lambda gt11 expression library of cDNA of HCMV AD169 strain using HCMV-infected patient sera. The recombinant protein was expressed as 138 kDa-fusion protein with beta-galactosidase, which was reactive with IgM or IgG HCMV antibody-positive sera, but not with anti-HCMV antibody-negative sera. A homology search of the DNA sequence of the cloned gene with HCMV AD169 sequences revealed that it was composed of 709 base pairs spanning between 0.174 and 0.177 map units of the UL32 region of the HCMV AD169 strain genome. This position corresponded to a part of the gene encoding 150 kDa phosphoprotein-(pp150), a major tegument protein, which was reported as an immunogenic protein which evoked strong and longstanding antibody response and had no sequence homology with the proteins of other herpesviruses. These results suggested that pp150 was an immunogenic protein in natural HCMV infection and therefore this clone was regarded as a useful candidate for developing an antigen for the serodiagnosis of HCMV.
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7786443
|
Plexiform malignant peripheral nerve sheath tumor(MPNST) in infancy and childhood--a case report.
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We present a congenital plexiform cellular tumor with high mitotic activities arising in the right thigh of a 3-days-old infant. This subcutaneous tumor measured 6.5 x 4.5 cm in diameter with multinodular, whitish, elastic cut surface. Microscopically, the tumor was composed of fascicles of closely packed uniform spindle cells with frequent nuclear palisadings. The most remarkable finding was frequent mitoses(4-5/10 HPF). The tumor cells were strongly positive for S-100 protein, myelin basic protein and vimentin, and weakly positive for Leu 7. On electron microscopic examination, the spindle cells were found to be surrounded by continuous basal lamina and had interlocking long cytoplasmic processes. Although the prognosis of this tumor is difficult to predict, aggressive behavior such as recurrences may be suggested, but it is less likely to be metastatic. Further accumulation of similar unusual cases may be helpful in evaluation of its biologic behavior.
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7786442
|
Ipsilateral synchronous renal cell carcinoma and transitional cell carcinoma.
|
The simultaneous occurrence of renal cell carcinoma(RCC) and transitional cell carcinoma(TCC) in the same kidney is unusual. We report a 53-year-old man with ipsilateral synchronous renal adenocarcinoma and renal pelvic transitional cell carcinoma with severe hypercalcemia and a huge staghorn calculus in the opposite kidney. The patient was admitted to the hospital because of left flank pain and intermittent fever which he had had for 2 months. Computerized tomography revealed a huge stone in the right kidney and a mass in the upper pole with an irregular calcified pelvis in the left enlarged kidney. Left radical nephrectomy was done. A section of the specimen revealed a renal cell carcinoma located at the upper pole and a papillary transitional cell carcinoma arising from the renal pelvis. This is a rare case of combined renal malignancies.
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7786441
|
Adult T-cell leukemia/lymphoma in a Korean--a case report.
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The clinicopathologic features of a Korean patient with adult T-cell leukemia/lymphoma(ATLL) are presented. A 51-year-old man, who has lived in Korea since birth, had multiple cutaneous nodules and multiple lymphadenopathy for the previous two months. A histopathologic study of the lymph node and skin lesion revealed T-cell non-Hodgkin's lymphoma of pleomorphic type, medium and large cell type. Peripheral blood examination showed leukemic features with 30% of abnormal lymphoid cells. HTLV-I proviral DNA pX region was detected in the DNA from peripheral blood mononuclear cells(PBMC) and the specific gag, pol, and env HTLV-I sequences were detected in the lymph node using polymerase chain reaction technique. Human T-cell leukemia/lymphoma type I(HTLV-I) antibodies were present in the serum. An immunophenotypic study of the lymph node revealed CD4 positive and CD8 negative helper/inducer T cell type surface markers. This case is the acute type, i.e. prototypic ATLL. He was treated with an intensive chemotherapy including cyclophosphamide, etoposide, doxorubicin, vincristine, and prednisone. Despite initial transient improvement, the tumor progressed after three cycles of the regimen and became refractory to further chemotherapy. These clinicopathologic findings, including the immunophenotypic analysis, established with certainty the diagnosis of HTLV-I-induced adult T-cell leukemia/lymphoma.
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7786440
|
Bilateral primary pigmented nodular adrenocortical disease--a case of report describing a rare cause of Cushing's syndrome.
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A case of Cushing's syndrome due to bilateral pigmented nodular adrenal disease in a 35-year-old male is presented. The adrenals showed multiple, black, variable sized nodules. Histologically the cells contained lipofuscin and either had a clear cytoplasm or an eosinophilic cytoplasm with a prominent nucleus. Lymphocytic infiltration and fatty metaplasia within the nodules are two of the prominent histological features. There is extreme internodular atrophy which suggests that primary pigmented nodular adrenocortical disease is a non-adrenocorticotropic hormone dependent condition. Since the disorder appears to involve primarily the cortex of both adrenals, the treatment of choice is bilateral adrenalectomy followed by steroid replacement. The characteristic clinicopathological manifestations that separate this diagnosis from other types of adrenal disease are also discussed. This is the first reported case in Korea to be documented with the pertinent clinicopathological findings.
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7786439
|
Familial clustering of hepatitis B and C viruses in Korea.
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In order to evaluate the familial clustering of hepatitis B virus(HBV) and hepatitis C virus(HCV) infections and to elucidate the possible routes of HCV transmission among Korean adults with chronic liver disease, 137 household contacts of 51 chronic carriers of HBsAg and 111 household contacts of 38 controls, and 181 household contacts of 96 anti-HCV positives and 102 household contacts of 76 anti-HCV negatives were tested from July 1990 to March 1994. Of 71 non-vaccinated household contacts of HBsAg carriers, 10 gave positive result for HBsAg(14.1%), but none of the household contacts of the controls were positive for HBsAg(p < 0.05). Familial clustering of HBV infection was found, when the offspring of carriers and controls were compared. A significantly higher percentage of the offspring of carriers were positive for HBV infection(54.6% vs 15.4%, p < 0.05) with OR of 6.6(95% Cl; 1.3-34.5). No evidence of familial clustering of HCV infection was found with 2.2%(4/181) anti-HCV positivity among the household contacts of index cases, similar to 1.0%(1/102) among those of controls. History of acute hepatitis(OR 3.2), transfusion(OR 3.2), and acupuncture(OR 2.5) were associated with an increased risk of HCV infection. In conclusion, HBV has strong familial clustering whereas HCV does not in Korea.
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7786438
|
Acute promyelocytic leukemia is a distinct subset of acute myelocytic leukemia with unique clinicopathologic characteristics including longer duration of relapse free survival: experience in 13 cases.
|
Acute promyelocytic leukemia(APL) is a subtype of acute myelocytic leukemia(AML) associated with unique features such as the presence of atypical promyelocytes and bleeding tendency due to disseminated intravascular coagulation(DIC). In a retrospective study, we analyzed 96 cases of AML seen at our hospital between June, 1989 and December 1993. Thirteen cases of APL(14%) were identified and their clinicopathologic characteristics were analyzed. The 86 cases of other types of AML served as controls. The distinct clinicopathologic features of APL as contrasted to other types of AML included younger age of patients, shorter duration of symptom before diagnosis, higher level of albumin at presentation, and a higher proportion of patients having coagulation abnormalities (75 vs. 25%). Bone marrow cellularity was higher in APL when compared to other types of AML (100 vs. 90%, P = 0.013). Of 13 patients with APL, 4 died of bleeding/sepsis between days 2 to 4 after admission. Seven of 9 patients who received induction therapy achieved complete remission(CR). CR rate in APL was similar to other types of AML (78 vs. 64%, P = 0.743). Five of seven patients who achieved CR remain in continuous CR at 9+ to 42+ months. CR duration is significantly longer in APL when compared to other types of AML (P = 0.029). In conclusion, this study showed that APL is a distinct entity among subtypes of AML with clinically significant bleeding tendency and rapidly fatal course if untreated. With appropriate antileukemic therapy, CR can be achieved in the majority of patients and the patients show a longer duration of CR when compared to other types of AML.
|
7786437
|
Suprasellar granular-cell tumour, presenting with intraventricular haemorrhage.
|
A case of suprasellar granular-cell tumour (GCT), presenting with intraventricular haemorrhage is described. The authors emphasize the exceptional character of spontaneous haemorrhage for a GCT, although haemorrhagic state during surgery has often been reported and may hinder total removal. Preoperative arteriography discloses a suprasellar blush in half of the cases. This facilitates the preoperative diagnosis. By taking special preoperative and operative precautions against haemorrhage complete removal can be carried out provided there is no encasement of the optic chiasm.
|
7786436
|
Intracerebral haemorrhage due to amphetamine abuse: report of two cases with underlying arteriovenous malformations.
|
Amphetamine abuse may be complicated by intracerebral, subdural or subarachnoid haemorrhage. The causative mechanism is probably a combination of vasculitis and induced hypertension. Most cases of intracerebral haemorrhage are subcortical. Only one case of amphetamine-induced intracerebral haematoma where there was also an underlying arteriovenous malformation has been previously reported. We report two cases of intracerebral haematoma due to amphetamine abuse whether an underlying AVM was found at the time of surgery. This possibility should be considered in cases of amphetamine-induced intracerebral haemorrhage.
|
7786433
|
Supratentorial haemangioblastoma not associated with Von Hippel Lindau complex or polycythaemia: case report and literature review.
|
Solitary or multiple supratentorial haemangioblastomas are rare and may be associated with Von Hippel Lindau complex (VHLC), polycythaemia or a family history of VHLC. An extensive review of the literature (1902-1992) has revealed 112 cases. They account for 2-8% of all haemangioblastomas and are commonly intraparenchymatous (86.8%) and infrequently intraventricular (6.6%). However, a meningeal location 5.6%) is extremely rare. Only one case of a solitary leptomeningeal haemangioblastoma has previously been reported and this was associated with a family and personal history of VHLC, cerebellar haemangioblastoma and renal carcinoma. We report a solitary solid left parietal leptomeningeal haemangioblastoma mimicking a meningioma or a secondary deposit on computed tomography in a 72-year-old male. There were no manifestations of or a family history of VHLC or polycythaemia.
|
7786434
|
Subdural empyema in an HIV positive patient.
|
A subdural empyema with a Salmonella species as the likely causative organism is presented. We believe that this is the first reported case of such an infection in an HIV positive patient. The difficulties in treatment and diagnosis are discussed.
|
7786432
|
Cavernous haemangioma in the cavernous sinus.
|
A case of intracavernous sinus cavernous hemangioma is reported. The tumor was totally resected en masse. The management of the lesion and technical issues concerning the surgery are discussed.
|
7786431
|
CT-directed perineural infiltration in the localization of radicular pain in a patient with neurofibromatosis.
|
Computed tomography-guided infiltration of lumbar or sacral nerve roots with local anaesthetic can be a valuable aid in localizing the spinal level from which radicular pain originates especially when multiple abnormalities are present. This is illustrated by the case of a young woman with neurofibromatosis complaining of sciatica.
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7786430
|
Results of cortical resection for intractable epilepsy using intra-operative corticography without chronic intracranial recording.
|
Twenty-four patients with intractable partial epilepsy underwent surgery between 1969 and 1988. Localization was by non-invasive means using scalp EEG and CT. In 12 cases the focus was temporal and in eight frontal. Craniotomy was undertaken with intraoperative electrocorticography (ECoG). Ten cases had a standard temporal lobectomy, seven a topectomy, four topectomy with tumour excision and one tumour excision alone. Two cases did not have a resection. Pathology revealed a mass lesion in 12 cases, hippocampal sclerosis in two and gliosis in six. Mean length of follow-up was 7.4 was. Fourteen patients (64%) were seizure free, two (9%) almost seizure free, four (18%) had worthwhile improvement and two (9%) no improvement. Of the temporal resections, 9 out of 12 (75%) were seizure free and of the extratemporal resections 5 out of 10 (50%) were seizure free. Removal of a mass lesion carried the most favourable prognosis for seizure outcome: 10 our of 12 (83%) of the cases with mass lesions, but 3 out of 6 (50%) of the cases with gliosis were seizure free. In two of the frontal resections removal of tumour resulted in disappearance of contralateral frontal independent spikes. It is concluded that where sufficient information exists to localize seizure activity by non-invasive means, invasive recording is unnecessary. The utility of intraoperative ECoG is discussed. It may be of limited use in cases of standard resection of when a mass lesion is present, but ECoG can prove useful to delineate the epileptogenic area in cases where there is o mass lesion and the results can still be rewarding.
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7786429
|
The surgical treatment of Chiari malformation association with atlantoaxial dislocation.
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Five cases of Chiari malformation associated with atlantoaxial dislocation are presented. A lateral plate and screw fixation was performed in all cases. Reversal foramen magnotomy was performed in three cases and two patients underwent the conventional posterior bony decompression for Chiari malformation. In an average postoperative follow-up period of 8 months (range 3 months to 2 years) neurological symptoms and signs improved in all patients, with radiological and clinical evidence of bony union and stability of the craniovertebral region. The surgical problems encountered in such cases where a posterior decompression was required in addition to a fixation procedure are enumerated in this report. The advantages of the proposed operations are described.
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7786427
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Rathke's cleft cysts within a growth hormone producing pituitary adenoma.
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Two cases with a unique association of Rathke's cleft cysts and a growth hormone-secreting pituitary adenoma in the same tumour tissue are reported. The embryological pathogenesis, diagnostic evaluation and treatment of these lesions are discussed.
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