The transport of thiamine, riboflavin and pyridoxal 5'-phosphate by human placenta.

In the present examination the concentrations of thiamine, riboflavin and pyridoxal 5'-phosphate in blood plasma of pregnant women and venous and arterial cord plasma were determined. In maternal plasma the concentration was 4.5 nmol/l (thiamine), 22.2 nmol/l (PLP), 8.7 nmol/l (free riboflavin) and 84.5 nmol/l (FAD + FMN). In venous cord plasma the concentration was 45.9 nmol/l (thiamine), 112.1 nmol/l (PLP), 40.6 nmol/l (free riboflavin) and 49.1 nmol/l (FAD + FMN). Therefore the gradients of concentration between maternal plasma and venous cord plasma were 1:10 for thiamine, 1:4.7 for free riboflavin and 1:5 for PLP. For the coenzyme forms of vitamin B2 the maternal circulation showed the higher concentration (1.7:1). Therefore an active transplacentar transport mechanism was assumed. The vitamin concentrations in cord arteria were significantly lower than that in cord vene, indicating a massive retention by the fetus.


The impact of iron deficiency on the flux of folates within the mammary gland.

The purpose of the present study was to examine whether impaired milk folate secretion during maternal iron deficiency is due to an altered flux of folates within the mammary secretory cell. Specifically we sought to determine whether the folate substrates of methionine synthase and the products of folylpolyglutamate synthetase are altered during iron deficiency in vivo. Rats were fed diets containing 0.5, 2.0 or 7.0 mg/kg folate and 8(Fe-) or 250(Fe+)mg/kg Fe throughout gestation and lactation. On day 17 of lactation dams were milked and killed. The concentration of reduced, methylated (5-CH3-H4), nonmethylated short and long chain forms of folate in milk were determined using a differential microbiological technique. Total mean milk folate concentrations among Fe- dams fed 2.0 and 7.0 mg/kg folate were half that of Fe+ dams fed 2.0 and 7.0 mg/kg folate. Despite this, the relative proportion of reduced, 5-CH3-H4, short and long chain folates did not differ in milk from Fe+ or Fe- dams. Approximately 75% of milk folates were methylated. Only Fe+ dams fed 7.0 mg/kg folate produced milk containing significant quantities of incompletely reduced folates. In conclusion, activity of the mammary epithelial cell enzymes methionine synthase and folylpolyglutamate synthetase in vivo, are unaffected by iron deficiency and therefore are not responsible for the dramatic reduction in milk folate secretion.


Relationship among the fatty acid composition of various lipid fractions in normally nourished German adults.

The relationship among the fatty acid (FA) composition of plasma cholesteryl esters (CE), plasma phospholipids (PL), total erythrocyte lipids, erythrocyte phosphatidylethanolamine (PE), erythrocyte phosphatidylcholine (PC), and total lipids of the subcutaneous fat (SCF) was investigated by parallel analyses of samples from 47 normally nourished German adults. Each lipid fraction revealed a characteristic FA pattern. A close relation between major FA in plasma lipids, especially in CE, and those in PC was found. The FA composition of PE, however, appeared to be more independent from plasma values. Of all FA in SCF only linoleic acid values showed a correlation to the values in CE and PC. It is concluded that, in clinical studies, FA analyses of total plasma lipids or total erythrocyte lipids fractions should be avoided in favour of separate analyses of various lipid fractions.


Bile salt-independent retinyl ester hydrolase in the rat lacrimal gland.

The lacrimal gland secretes retinol and synthesizes and stores retinyl esters. In this study, presence of retinyl ester hydrolase in rat lacrimal gland was investigated. A bile salt-independent retinyl ester hydrolase was identified in lacrimal gland homogenates and microsomes which were incubated in a tris-maleate buffer with retinyl palmitate as substrate. Retinol produced was measured by HPLC and activity expressed as pmoles retinol produced/mg protein/hr. In homogenates, the enzyme activity had a pH optimum at pH 6 and maximum specific activity of 57.7 pmoles/mg/hr. In microsomes, the activity was optimal at pH 7 and maximum specific activity was 1073 pmoles/mg/hr. In contrast, rat liver retinyl ester hydrolase had a pH optimum at pH 8 and a specific activity of 24.7 pmoles/mg/hr. These observations demonstrate that a complete cycle of retinyl ester metabolism is present in the lacrimal gland.


Nursing's next advance: an internal classification for nursing practice.

An International Classification of Nursing Practice (ICNP) is needed to support the processes of nursing practice and advance the knowledge necessary for cost-effective delivery of quality nursing care. Below, the authors present their case for developing such a system that will provide nursing with a nomenclature, a language and a classification that can be used to describe and organize nursing data. It is their belief that this landmark project is achievable and that ICN should lead the work in collaboration with its member associations, the World Health Organization and key national, international, governmental and nongovernmental groups. But to ensure that the system will be adaptable across borders, nurses and organizations are being encouraged to share their ideas and research on such a system.


Operative fixation of unstable pelvic ring injuries in polytrauma patients.

Sixteen polytraumatized patients with a variety of unstable pelvic ring fractures were treated with operative fixation. We have found that an aggressive approach with adequate early stabilization of the pelvis offers many advantages over conservative management particularly in polytraumatized patients.


Familial cryptogenic fibrosing alveolitis: a case report.

A family of seven siblings is described, all of whom, developed finger clubbing during their third decade. Three of the seven developed cryptogenic fibrosing alveolitis (CFA). Of the remaining four siblings, two have died prematurely from conditions possibly associated with cryptogenic fibrosing alveolitis. The youngest two siblings remain asymptomatic at present. This paper reports one of the most concentrated incidences of the rare familial form of CFA.


The fundamentals of professional regulation.

Regulation or deregulation is becoming an increasingly important issue in society. Health care is one target in the debate about the nature, amount and locus of control necessary to ensure safe health services to all. As professionals responsible for providing a part of the essential health services, nurses are caught up in the movement. Therefore nursing has an obligation to understand and participate in the development, administration and monitoring of all types of regulatory controls that touch on nursing education and practice, and the healthcare services themselves.


Cost-effective caring.

Cost containment is the key issue in healthcare systems and a key concept that nurses must grasp in this time of shrinking budgets and growing demand for health care. As healthcare budgets come under increasing scrutiny, nurses must prove their cost-effectiveness. To ensure the maintenance of quality care, national nurses' associations have a strong role to play in supporting research efforts into nursing's real worth (not only in cost terms) and gathering and disseminating this information to demonstrate the value of quality nursing. To get nurses worldwide to campaign for cost-effectiveness, ICN will focus on "Quality, Costs and Nursing" in its celebration of International Nurses' Day in 1993.


Nurses: an image change still needed.

In Australia the image of nurses has not changed, despite advances in nursing practice, education and research. The stereotyped image affects how nurses practice and the future of the nursing profession. Below, a look at how the nurses' image affects nursing practice and suggestions on how this image can be improved.


Snuffles in infants--infection or autonomic dysfunction.

The presence of excess nasal mucus causing noisy nasal breathing with an obvious mucus discharge (snuffles) is a common problem in infants in the first three months of life. The presence of "snuffles" has traditionally been ascribed, unproven, to an upper respiratory tract infection despite there being no other signs of an acute infection in the majority of infants with "snuffles". To assess the possible role of impaired vasomotor control (autonomic function) in the pathogenesis of snuffles we measured the effect of a change from the supine to the upright position on resting blood pressure in 50 infants with "snuffles" and 50 healthy control infants. The mean age in both groups was 7 weeks post delivery, all infants were attending a well baby clinic for a routine examination, had no signs of an acute infection and none were on any medication (including nasal drops). A fall of greater than 10% of resting blood pressure was taken to indicate postural hypotension. Four of fifty infants in the control group compared to 22 of 50 in the snuffles group demonstrated postural hypotension (Chi square 16.84, p less than 0.001). The results suggest that in some infants "snuffles" may be associated with impaired vasomotor control.


Classical caesarean section through the posterior uterine wall.

We report a case of myomectomy and classical caesarean section through the posterior uterine wall necessitated by 180 degrees dextro-rotation of a gravid uterus with large fibroids. The non-specific clinical course and rarity of pathological torsion of the gravid uterus makes the preoperative diagnosis difficult. Ultrasound recognition antenatally of a fibroid changing its position should help with the prediction preoperatively of uterine rotation.


Splenic pseudocyst: aspiration or cyst decapsulation.

A 12 year old boy with a splenic pseudocyst is reported. Percutaneous drainage resulted in complete emptying but rapid reaccumulation. Cyst decapsulation with splenic preservation was curative and is recommended for definitive therapy of splenic pseudocysts.


Foreign body complications of central venous catheterisation in critically ill patients.

In three critically ill patients, central venous catheter--associated foreign bodies were identified while the patients were in the intensive care unit. Two patients had fragments of retained catheter; in the third patient a guide-wire was lost within the vascular tree. The catheter fragments were associated with clinical symptoms while side effects were not observed with loss of the guide-wire. All three foreign bodies were removed without complications.


Hyperhomocysteinaemia: a risk factor for extracranial carotid artery atherosclerosis.

Hyperhomocysteinemia arising from impaired methionine metabolism, and usually due to a deficiency of cystathionine beta-synthase is a significant and independent risk factor for symptomatic vascular disease. It is not known if hyperhomocysteinemia in apparently healthy asymptomatic subjects is associated with atherosclerosis and whether such a relationship is independent of conventional risk factors. The prevalence of asymptomatic extracranial carotid artery atherosclerosis was determined by duplex ultrasound examination in 25 obligate heterozygotes with respect for cystathionine beta-synthase deficiency (whose children were known to be homozygous for this genetic defect) and in 21 controls. Hyperhomocysteinemia was determined by a standard methionine-loading test and conventional risk factors were also recorded. Twelve of 25 obligate heterozygotes and 8 of 21 normal controls had evidence of extracranial carotid artery atherosclerosis. Hyperhomocysteinemia as a genetic trait was not a significant risk marker, but the actual homocysteine level was associated with an increased risk of carotid disease. After adjustment for the effects of other significant risk factors, the odds ratio of hyperhomocysteinemia for carotid disease was 1.038 per unit increase in homocysteine level (P = 0.03). Hyperhomocysteinemia is a weak risk factor for asymptomatic extracranial carotid atherosclerosis and the relative risk associated with this genetic trait is less than that observed in a study of patients presenting with clinical manifestations of vascular disease.


Normal bone density in Irish women: is American normative data suitable for use in Ireland?

The objective of the study was to determine whether or not U.S. normal data for female Vertebral Bone Mineral Density is suitable for use in an Irish population. One hundred and fifty-six healthy Caucasian women of permanent Irish domicile had bone densitometry performed using single energy quantitative computed tomography of L2, L3 and L4 vertebrae. We found that comparison of our results to normal American data shows a slight and progressive increase in bone mineral content of postmenopausal American women with age relative to the Irish population. This difference is small and not sufficient to justify development of separate normal values for Irish women. We conclude that this discrepancy may be due to a combination of environmental and racial factors or to the more rigorous exclusion criteria applied in our study.


Tuberculosis in the west of Ireland 1986-1990.

A review of mycobacteria isolated from clinical samples from the Western Health Board Area (WHBA) for the years 1986 to 1990 was performed to establish the pattern of mycobacterial infection. The incidence of microbiologically proven cases of tuberculosis (13.3/100,000) and of sputum smear positive cases (6.2/100,000) was determined and correlated with notification data. M. bovis accounts for 6.3% of cases of microbiologically confirmed tuberculosis in this area. Resistance to one or more of the first line anti-tuberculous drugs was noted in 5.3% of isolates (excluding pyrazinamide resistance in M. bovis). Clinically significant isolates of mycobacteria other than tuberculosis (MOTT) were rare throughout the five year period. The overall incidence of microbiologically proven cases of tuberculosis is relatively high and M. bovis and drug resistant isolates of M. tuberculosis are relatively common.


Audit of full blood count monitoring in patients on longterm gold therapy for rheumatoid arthritis.

The use of injectable gold in the treatment of rheumatoid arthritis (RA) is hampered by the high incidence of adverse reactions of which myelotoxicity is potentially the most serious. Regular full blood count (FBC) monitoring prior to each injection, a practice which requires much time and effort, has never been fully evaluated. Of 154 patients who were started on gold and followed by the lifetable method for up to 10 years, five patients were withdrawn from treatment because of myelotoxicity, thrombocytopenia in all cases: the two most serious cases occurred early at 3 and 7 months after starting treatment; three mild cases occurred at 17, 37 and 60 months, were of slow onset and reversed spontaneously. Clearly, FBC monitoring is justifiable in the first two years of treatment when the incidence of adverse reaction is highest. Further investigation is required to justify this practice after two years of uncomplicated treatment.


Alfred Parsons on suspected perforated gastric ulcer. 1892.

Alfred Parsons (1864-1952) was noted for his vigour of mind and body and Spartan habits and his dramatic teaching. In 1891 while a junior doctor he cared for three fatal cases of acute perforation of a chronic ulcer of the stomach. In May 1892 he made a passionate plea for early diagnosis and surgery in this condition. The first successful operation was performed in the same month by Ludwig Heusner in Germany.


International incidence of central nervous system tumors in children.

A study of the descriptive epidemiology of central nervous system tumors in children aged 0-14 was undertaken using international incidence data referred to the period 1970-1984. The median incidence rates were found to be 23 per million for males and 19 per million for females. The median cumulative incidence rates were found to be 341 per million for males and 296 per million for females. Males had incidence rates that were about 20 per cent higher than those for females. Variation in incidence rates by age, sex, race, and geographic area are discussed. Data on possible genetic and environmental risk factors for these tumors are reviewed.


Supplementation of polyunsaturated fatty acids in multiple sclerosis.

For several years polyunsaturated fatty acids (PUFAs) and in particular essential fatty acids (EFAs) have been proposed for the treatment of multiple sclerosis (MS). There are contrasting data in literature regarding the effects of the n-6 and the n-3 PUFA series on different aspects of the disease, in particular on the frequency and severity of relapses and platelet function. This can be ascribed to the different criteria of patient selection in relation to the form and severity of disease at the beginning of the various studies. Till now authors have tended to consider the effect of PUFA supplementation only on some clinical aspects of the disease. Modification in the more sensitive indices (immunological or biochemical) of the disease activity should be taken into account and also the influence of dietary lipid intake by patients in relation to n-3 or n-6 EFA supplementation.


Electrocardiographic changes in subarachnoid hemorrhage secondary to cerebral aneurysm. Report of 70 cases.

Electrocardiographic (ECG) alterations in the course of sub-arachnoid hemorrhage (SAH) have frequently been reported. The most frequent anomalies reported were lengthening of the QT interval, very negative or positive deep T waves, elevation or depression of the ST segment and the presence of U waves. We report 70 cases of SAH secondary to rupture of intracranial aneurysm (part of a larger group of 150) with ECG changes. We review the literature with particular regard to discussion of the possible pathogenesis of ECG changes and to the way they may affect the general clinical course.


Nosology of spastic tetraplegic cerebral palsy: clinical review of fifty cases.

The aim of this study is to contribute to the definition of tetraplegic cerebral palsy (TCP) and to verify the classification criteria currently used by reviewing the clinical and neurological aspects of 50 children having non-progressive encephalopathy with neurological involvement of 4 limbs (symmetric 4-limb type, side-asymmetric type, upper-limb dominated type with or without dystonic traits). All severe diplegic patients, i.e. less upper than lower limb involvement and patients with dystonic hyperkinetic syndrome without spastic features were excluded. The data were supplied by the hospital records, evolution of motor performance and the presence or absence of epilepsy, visual problems, language disorders, intellectual impairment. All the children underwent: neurological examination, functional assessment, cognitive evaluation. Severe motor impairment was found in 80% of the patients, whose clinical characteristics led to a diagnosis of severe TCP or "true TCP" according to Hagberg, whereas 20% of them showed mild to moderate impairment with a more favorable prognosis. This group of patients complied with the classification of Michaelis who defined the quadrispastic CP types more broadly and delineated five subgroups also including cases with milder involvement (side-dominated, three-limb dominated tetraparesis). The intellectual assessment showed that, in the severely affected patients, only a small percentage had severe intellectual impairment (IQ less than 50, 37.5%), which contrasts with published data on this pathology, while the majority of the subjects showed moderate (25%) or mild intellectual impairment (32.5%) or normal cognitive function (5%).(ABSTRACT TRUNCATED AT 250 WORDS)


Italian neurologists and euthanasia: a poll.

We have tried to sound out Italian neurologists regarding their attitude to euthanasia, a very controversial issue today. We gave a short multiple-choice questionnaire to neurologists attending a national conference, asking their opinion on some issues related to euthanasia. 75 (25%) of the 300 doctors polled completed the questionnaire. Answers were often contradictory. A trend in favor of passive euthanasia among the respondents and a strong demand for guidelines are evident. Emotional rather than professional or rational factors seem to play a major role in the approach to this dilemma.


Myasthenia gravis associated with Charcot-Marie-Tooth neuropathy: report of a case.

We report the case of a 24 year old woman who developed myasthenia gravis in the course of a mild form of Charcot-Marie-Tooth neuropathy. We describe the clinical manifestations together with the neurophysiological, pathological, serological findings and response to therapy and discuss the unusual association in the light of the relevant literature.


Neurogenic pulmonary edema: a presenting symptom in multiple sclerosis.

Altered cardiovascular and respiratory function is uncommonly encountered in multiple sclerosis, though it may appear late in the course of the disease [4]. Episodes of acute ventilatory failure due to autonomic and/or voluntary respiratory function paralysis have already been described. These episodes are often accompanied by a focal neurological deficit which expresses lesion at the level of the medulla [6]. A demyelinating bulbar lesion leading to altered cardiovascular function is likewise infrequent but when it happens, bradycardia, postural hypotension [2], or acute pulmonary edema without heart failure may occur [1]. We present a case of non cardiogenic acute pulmonary edema which had neither a toxic insult nor an infective agent as etiology, but appeared as the initial manifestation of a multifocal demyelinating syndrome.


A case of successful pregnancy in a woman with Friedreich ataxia.

We report on a 34-year-old woman with advanced FA who achieved a successful pregnancy. The neurological and cardiological features of the disease remained unchanged during and after pregnancy. Because of a slight respiratory impairment, which appeared at the 6th month, cesarean section was performed at the 34th week. FA is not necessarily a bar to successful pregnancy, but early referral to a cardiologist and respiratory monitoring is mandatory. The risk of transmission of the disease for our couple was 1/95.5 compared with 1/36.000 for a non-affected couple.


Rabid bat diagnosed in Hawaii.

Since 1966, the Hawaii State Government has been conducting Fluorescent Rabies Antibody (FRA) testing on animal brains as part of a statewide rabies-surveillance program. On April 3, 1991, the Department of Health (DoH) laboratory diagnosed the first case of rabies detected in the State. A large brown bat, Eptesicus fuscus fuscus, captured in a transport container that had just been off-loaded from a ship at Honolulu harbor, was caught. It's brain was examined and showed typical fluorescent staining patterns for rabies virus. The USPHS Centers For Disease Control (CDC) rabies laboratory confirmed the diagnosis 2 days later. The successful interception of this rabid animal was the result of close cooperation between the private sector (Sea Land Service, Hawaiian Stevedores) and the Hawaii State Government Departments of Health and of Agriculture.


Elimination of preventable blindness from diabetes by the year 2000.

"Diabetes 2000" will parallel a major diabetic retinopathy public information campaign recently announced by the National Eye Institute. The NEI's National Eye Health Education Program (NEHEP), which targets both diabetic retinopathy and glaucoma, is fashioned along the lines of earlier federal initiatives against smoking and high blood pressure. By continuously updating our medical knowledge and skills related to this multisystem disorder, and by forging partnerships between physicians in the effective and efficient management of diabetic patients, we have a unique and important opportunity--we can reduce preventable blindness from diabetes by the year 2000.


Lymph node metastasis in squamous cell carcinoma of the oral cavity: correlation between histologic features and the prevalence of metastasis.

A retrospective study was made of the correlation between preoperative clinical or histologic findings and the prevalence of lymph node metastasis in 60 patients with squamous cell carcinoma of the oral cavity who had histologically confirmed neck metastasis. Of these 60 patients, 39 with clinically N+ necks underwent immediate therapeutic neck dissection, and 21 whose necks were initially N0 but progressed to N+ during observation underwent subsequent therapeutic neck dissection. The primary site, TNM staging, histologic grade of malignancy of biopsy specimen, and location and number of histologically positive lymph nodes were reviewed in each case. The results were as follows: (1) The prevalence of neck metastasis was not significantly correlated with primary site and T stage; however, there was an apparent correlation between histologic grade of malignancy and the prevalence of neck metastasis. Patients with grade I-II histologic malignancy showed limited metastases that involved lymph nodes in levels I-II. On the other hand, patients showing grade III-IV histologic malignancy often had metastases that extended beyond level III, regardless of T stage. These results suggest that histologic grade of malignancy, as well as clinical features, must be taken into consideration when deciding whether supraomohyoid neck dissection is indicated. (2) The group that underwent subsequent neck dissection exhibited less advanced neck metastasis and a better prognosis than the group which underwent immediate neck dissection. These findings show that if they are closely followed up, it is possible to delay neck dissection in N0 patients until a neck metastasis is detected.


Thyroid and parathyroid surgery without drains.

The question of routine wound drainage after thyroid and parathyroid surgery remains controversial among experienced surgeons. Review of the literature failed to reveal any study that established the benefit of drainage after thyroidectomy and parathyroidectomy. A retrospective review of 139 thyroid or parathyroid procedures performed without drainage was conducted. One hundred ten thyroid operations were performed, including unilateral lobectomy with isthmusectomy [82 (74.5%)], total or bilateral subtotal thyroidectomy [26 (23.6%)], and isthmusectomy [2 (1.8%)]. Histologic examination yielded a benign diagnosis in 94 specimens (85.4%); 16 specimens (14.5%) contained thyroid carcinoma. Parathyroid explorations were performed in 29 patients (20.8%) all of whom had adenomas. Postoperatively, there were no instances of wound hematomas, infections, or rebleeding necessitating reoperation. Minor complications included asymptomatic wound seromas (4-30 mL) in five (3.6%) patients, which were aspirated 2 weeks after discharge without further recurrence. This minimal complication rate of 3.6% with undrained neck incisions suggests that routine prophylactic drainage of thyroid and parathyroid wounds is unnecessary.


Bone and gallium scans in postradiotherapy osteonecrosis of the jaw.

The role of radiographic and nuclear imaging in evaluation of postradiotherapy osteonecrosis of the jaw was studied. Patients who had received imaging at diagnosis and following hyperbaric oxygen therapy were studied. Radiographic changes did not correlate with the clinical status of patients. All bone scans were abnormal at the time of diagnosis of osteonecrosis, but remained abnormal following changes in the clinical status of patients. Thus, the bone scan may aid in the detection of osteonecrosis. Gallium uptake did not aid i diagnosis, but did correlate with clinical findings following treatment. Persisting positive gallium scans may indicate the need for surgery following hyperbaric oxygen therapy.


Epidermoid cysts of the cranial bones.

Ectodermally derived tissue in ectopic sites is seen in the head and neck. Extracranial dermoid and epidermoid tumors are relatively rare. While most otolaryngologists are familiar with the cholesteatoma of the otic area, not very many are exposed to this lesion in other sites. Those of the cranial bones are even rarer still. These tumors may expand (1) laterally in the cranial bones, (2) externally to present as masses in the scalp or facial region, or (3) internally to involve the intracranial contents. A patient with a frontal bone epidermoid, whose tumor had expanded in all three directions to erode both inner and outer cortex of cranium and laterally to rupture into the frontal sinus, is discussed. The literature is reviewed and the management of these rare masses is discussed.


Postoperative radioactive iodine evaluation of total thyroidectomy for thyroid carcinoma: reappraisal and therapeutic implications.

The records of 430 patients who underwent total thyroidectomy with radioactive iodine (RAI) uptake studies performed postoperatively were reviewed. Indications for the administration of an ablative dose of iodine 131 are given. The majority (85.4%) had no or low (less than 2%) evidence of focal uptake and therefore were not treated with ablative doses of iodine 131. RAI scanning is necessary postoperatively to determine the completeness of the surgical procedure and to detect residual or metastatic disease. Small foci of residual disease or occult distant metastases can be adequately treated with therapeutic doses of RAI. Nodal or distant metastases that become clinically evident following thyroidectomy are usually not successfully treated with RAI.


Embolization of the ophthalmic artery for control of epistaxis: report of two cases.

Embolization of the internal maxillary artery, an accepted method for control of severe or recurrent posterior epistaxis, usually involves the ipsilateral artery, but occasionally the contralateral vessel and the facial arteries as well. Such endovascular treatment may fail if the vascular supply to the bleeding vessels originates in derivative branches of the ophthalmic artery. We report two unusual cases in which embolization of the ophthalmic artery was performed to control epistaxis. The first patient had a prosthetic eye. In the second, sight in one eye was sacrificed after careful consideration in order to prolong life.


Papillary adenocarcinoma in thyroid hemiagenesis.

Variation in the gross anatomy of the thyroid gland is relatively common. Although thyroid hemiagenesis is felt to be a rare anomaly, its incidence is probably underestimated as the diagnosis is usually incidental. The case of a 41-year-old woman with right thyroid hemiagenesis associated with papillary adenocarcinoma is presented. The diagnosis of hemiagenesis was established by isotope imaging and surgical exploration for a benign nodule. Seven years later she was seen with a recurrent neck mass, and an isotope scan revealed it to be a cold thyroid nodule. As she was diagnosed to have papillary adenocarcinoma, total thyroid lobectomy was performed and at present she remains disease-free.


Glandular odontogenic cyst.

Two cases of glandular odontogenic cysts are reported. The unique histological features, eg, the intraepithelial glandular structure, papillary processes, and eosinophilic cuboidal and larger granular superficial cells are sufficient to warrant glandular odontogenic cyst as a distinct entity. Electron microscopic examination of the superficial eosinophilic cuboidal cells are suggestive of a process similar to apoptosis. Eroded cortical plates suggest an aggressive behavior.


Hamartomas of the nose and nasopharynx.

Hamartomas are easily diagnosed entities when occurring in the lung and gastrointestinal tract. In the nose and nasopharynx, where such lesions are rare, biopsy of a hamartoma containing epithelial proliferation may lead to a misdiagnosis of cancer, with resultant radical and deforming surgery, particularly if they present in adulthood. We encountered three such lesions over 2 years in the Massachusetts Eye Ear Infirmary, and another was retrieved from the recent files. All presented with nonspecific obstructive symptoms of the nose or nasopharynx, and were treated by resection. Follow-up is short, (4 months to 1 year), but in no case has there been recurrence. The clinical diagnosis was malignancy in 2 cases, inflammatory polyp in one.


Patient on-line access to medical records in general practice.

Many patients want more information about health and the computer offers tremendous potential for interactive patient education. However, patient education and the provision of information to patients will be most effective if it can be tailored to the individual patient by linkage to the medical record. Furthermore the Data Protection Act requires that patients can have access to explained versions of their computer-held medical record. We have examined the practicality and possible benefits of giving patients on-line access to their medical records in general practice. Seventy patients (20 males; 50 females) took part in the study. Sixty five of these used the computer to obtain information. The section on medical history was most popular, with 52 people accessing it. More than one in four of the problems were not understood until the further explanation screen had been seen. One in four also queried items or thought that something was incorrect. Most patients obviously enjoyed the opportunity to use the computer to see their own medical record and talk to the researcher. Many patients commented that because the General Practitioner (GP) didn't have enough time, the computer would be useful. Sixty one (87%) (95% CI: 79-95%) thought the computer easy to use and 59 (84%) would use it again. This is despite the fact that 43 (61%) thought they obtained enough information from their GP. This small study has shown that patients find this computer interface easy to use, and would use the computer to look at explanations of their medical record if it was routinely available.(ABSTRACT TRUNCATED AT 250 WORDS)


Survey of the implementation of workplace alcohol and smoking policies among employers in Fife.

A survey of major employers in Fife shows that at present 33% of respondents have implemented written alcohol policies, while 40% have implemented written smoking policies. A total of 19% have both alcohol and smoking policies in place. The initiative for policy development appears to have arisen mainly from management, but trade unions and management have co-operated well during policy formulation. The majority of policies have been implemented for more than three years. A small number of companies in Fife appear to be interested in the development and implementation of written alcohol and smoking policies in the workplace.


Socio-economic factors associated with HIV infection in pregnant women.

The HIV epidemic in women in Edinburgh has characteristics which enable a total population study. We studied retrospectively all women with a known history of injection drug use or with a seropositive drug-using partner in a five year period from 1985-1990. We sought to quantitate lifestyle and environmental factors associated with HIV infection in pregnant women and to test two hypotheses: that infected women would have more adverse socio-economic features, and that there would be a change in these factors with time. There were 244 pregnant women in the study. They were slightly younger than all Edinburgh City women and much less likely to be married. They were much more likely to live in areas of multiple housing deprivation. Only 16% of women, and 28% of partners, were in paid employment; 90% of women smoked and 76% had a history of injection drug use. Some 28% of previous children were in the care of another, often a relative, 8% of women had a recent prison admission, and 58% of those tested had antibodies to Hepatitis B. Univariate analysis showed that none of these factors was significantly different in HIV seropositive women except for prison admission, previous infection with Hepatitis B, which probably all related to type of drug use. Linear logistic regression suggested two other variables which distinguished between groups, but because these are composite, and dependent on incomplete data, this must be interpreted with caution. The same overall associations were found when only women with a history of injection drug use were considered. There was no statistically significant change in these factors with time.(ABSTRACT TRUNCATED AT 250 WORDS)


Collaboration between geriatricians and general surgeons.

The operation over ten years of a simple and practical method of collaboration between general surgeons and geriatricians is described. This was designed, by means of a weekly ward round by geriatricians and consultant surgeons on general surgical wards (120 beds), to give geriatric medical advice and, when appropriate, to arrange transfer for geriatric assessment, medical treatment and rehabilitation, long-term care, or terminal care. Some 240 such transfers are described, comprising approximately 2% of all patients over the age of 65 admitted to the surgical units. The commonest single surgical diagnosis was of malignant disease. A total of 43% had had no operation and 18% had no medical diagnosis. 64% of those transferred for assessment etc. went home, half of them within two weeks, but nearly a third of them after more than four weeks. The system was effective, and benefited both surgeons and geriatricians, at no cost to the former and little to the latter in terms of time or increase in work load.


Trends in hospital discharge rates for pelvic inflammatory disease in Scotland, 1975-1985.

This paper describes trends in hospitalisation for pelvic inflammatory disease in Scotland between 1975 and 1985. The age-standardised hospital discharge rate per 100,000 for all pelvic inflammatory disease in women aged 15-44 rose from 100.1 in 1975 to 143.8 in 1985. Rates of acute pelvic inflammatory disease increased by 58%, from 66.3/100,000 in 1975 to 104.5/100,000 in 1985, but the rate of discharge for chronic disease rose only slightly from 33.8/100,000 to 39.3/100,000. About one quarter of acute cases underwent surgery which enabled confirmation of the diagnosis, and there was no major change in this proportion between 1975 and 1985. The use of laparoscopy steadily increased, but this tended to replace other forms of surgery which could confirm the diagnosis. The percentage of chronic cases which were surgically confirmed increased steadily over the time period studied. A marked decrease in the mean duration of stay--from 9.2 days in 1975 to 4.9 days in 1985--meant that the total number of bed days used by patients with pelvic inflammatory disease fell by 16% between 1975 and 1985 despite the increase in the total number of cases.


The Chief Scientist reports.... Problems in mounting and maintaining longitudinal studies--examples from dental health services research.

There already exists a body of literature on the conduct of classical epidemiological studies. However, guidelines tend towards detailing how such studies should be conducted and may not prepare the reader for the less-than-perfect scenarios that will inevitably be encountered. The Dental Health Services Research Unit in Dundee has been involved in longitudinal studies of dental treatment and dental health since its inception in 1979. The problems encountered in this research are considered under the headings of mounting the studies, samples, data collection, external changes, internal changes, dissemination and curtailment. It is hoped that a description of the often unpredictable problems associated with a particular set of studies will provide an insight which may assist others embarking on analogous projects in health services research.


Theory in health education practice.

Although social and behavioral science theories are claimed to be able to contribute greatly to the effectiveness of health education programs, most practitioners in the profession seem to doubt this, and very few ever deliberately use theories in their work. Some reasons for such diverse views reside in the nature of the theories, in the very different roles they play in the worlds of theory-minded and practice-oriented health educators, respectively, in widespread unrealistic expectations of what theories can and cannot contribute to practice, and in lack of appropriate training in theories and their uses. Suggestions are offered to both practicing and academic health educators on ways to bridge the gap between the two camps, to render theories more useful to practitioners, and to train practitioners and health education students to appreciate the potentials of theories and to acquire skills needed to utilize such potentials.


What's the use of theory?

The barriers to the use of theory in health education practice are addressed by exposing common misperceptions of the nature and usefulness of theory. First, the mystique of theory is addressed through a discussion of theory development and the roots of theory in everyday experience. Two characteristics of theory, generalizability across settings or situations and testability, are described and linked to benefits for practice. Second, a guide for practitioners in applying theory to each stage of the intervention process is provided. A case example illustrates how theory can guide practice as well as the benefits to be gained by applying theory to program development. Finally, the bases for common negative misperceptions of theory are identified and clarified, and the beneficial nature of theory reviewed.


Practitioners' use of theory: examples from a workgroup.

There is a continuing discussion within the field of health education about the relationship between theory and practice. Much of this discussion, particularly that which appears in professional journals, has been developed by academicians and is prescriptive. That is, it identifies ways in which theory should be used by practitioners. The purpose of this article is to facilitate this ongoing discussion by providing descriptive information on how theory is used by a group of health educators who work for the same organization. This information is used as a springboard for discussion more generally about the nature of theory in health education. This article represents the thinking and experiences of a dozen health professionals, in reaction to the question. "How do you use theory in your practice?" The authors believe this information will be useful in helping theoreticians develop more useful theory and helping practitioners increase their understanding of the utility of good theory. The division between theory and practice in the field of health education represents a significant opportunity and challenge to the discipline if energy can be redirected from criticism of the other "camp" to effective collaboration and enhanced effectiveness of health education efforts.


Self-regulation of health behavior: the "take PRIDE" program.

Social cognitive theory, in particular, the construct of self-regulation was the basis for developing an educational program for older adults with heart disease. This paper discusses the theoretical principles utilized and describes the program activities based on them. Data from an evaluation conducted with 246 older heart patients who took part in the education are used to illustrate how social cognitive theory constructs operated empirically.


The integration of theory with practice: a 12-year case study.

Although the integration of health education theory with practice has always been taught, this linkage has not always occurred as a systematic part of program or theory development. This paper reflects the 12-year experience of one health education program which started from a base not soundly grounded in theory and moved to one tightly linked with theory. Throughout this process, outcome data were collected allowing for evaluations of both practice and theory.


The uses of theory in health advocacy: policies and programs.

This paper illustrates the utility of theory for health educators who advocate for health promotion policies and programs. It describes how diffusion of innovation and other social science theories were employed by a statewide coalition called the Health Promotion and Education Council of Virginia in its effort to reduce premature and preventable death and disability in the state. To this end the Council sought legislative action to accelerate the diffusion of health promotion throughout the state. Discussing elements of diffusion theory such as working through opinion leaders, creating information-exchange relationships, and tailoring the attributes of the innovation to achieve its objectives, the paper reviews the process through which the Council became an effective advocate, and the strategies it devised to communicate the innovation of health promotion to legislators. The legislation that was generated by the work of the legislative study committee and future uses of theory are also discussed.


Theory and the empowerment of health education practitioners.

Both the nature of theory and the way it is taught can overpower health education practitioners. As a consequence, myths which maintain theory and practice in separate realms may develop. This paper argues that to remedy this situation, practitioners must be helped to gain greater control of theory. Specific suggestions for accomplishing this goal are offered in a three-part prescription. First, concepts and teaching methods are introduced to dismantle myths about theory and to help practitioners understand its origins, nature, and functions. Second, health educators are encouraged to acknowledge limitations in theories currently guiding their practice. Third, they are shown ways they can exert leadership in developing theory to fill these gaps and build a more adequate knowledge base for confronting contemporary practice problems. Through this exercise of power, health educators will gain control over theory and expand the boundaries of practice, while also enhancing their professional status.


A new variant, HB Muscat [alpha 2 beta (2)32(B14)Leu----Val] observed in association with HB S in an Arabian family.

The silent Hb Muscat with a Leu----Val replacement at position beta 32 was discovered by reversed phase high performance liquid chromatography in two members of an Arabian family from Oman; in one person Hb Muscat occurred with Hb S and in the other with Hb A. Hb Muscat is slightly unstable but its presence has no apparent adverse effect on the health of its carriers. Additional hemoglobin abnormalities observed in this family were a common alpha-thalassemia-2 (-3.7 kb) and Hb S. The beta S haplotypes in the heterozygous carriers and the two sickle cell anemia patients were #19 (Benin) and #20 (Bantu); the latter likely originated from an East African population.


Hb Bab-Saadoun or alpha 2 beta (2)48(CD7)Leu----Pro, a mildly unstable variant found in an Arabian boy from Tunisia.

Hb Bab-Saadoun which has a Leu----Pro substitution at position 48 of the beta chain was detected in a young Arabian boy living in Tunisia. His parents did not have the variant which suggests that it occurred as a spontaneous mutation. The substitution is located in the interhelical CD segment; leucine at beta 48 is an invariable amino acid that may be important as part of a spacer sequence between the two helices and its replacement by proline may affect the stability of the hemoglobin molecule. Hb Bab-Saadoun is unstable in heat and isopropanol stability tests and its chain was best isolated by parachloromercuribenzoate precipitation. It appears unlikely that the presence of Hb Bab-Saadoun results in a hemolytic anemia.


Is there a connection between genomic changes and wide hybridization?

The structural organization of a set of highly repetitive DNA sequences (HRS) of barley (Hordeum vulgare) was studied by blot-hybridization in the genomes of seven Hordeum L. species and several Hordeum x Secale hybrids. The copy numbers of the sequences, and length and intensity of the hybridization fragments varied among barley species; so, this set appeared to be useful as molecular markers for barley species. Structural rearrangements of some HRS were observed in hybrids. It was noteworthy that the genomic changes in the hybrids partially coincided with those that take place during species divergence; so, chromosomal rearrangements are likely to proceed according to certain rules. The possibility of cryptic mobile elements participating in the genomic rearrangements under stress factors of the remote hybridization, is discussed, the primary structure of a Bam HI fragment (999 bp long) of Hordeum vulgare DNA being the example.


[Oncogenes and their significance for head and neck cancers].

During the past few decades medical science has accepted the concept that cancer is a fundamental disorder of cellular growth control. A disorder can originate in some cells through changes in genes (DNA level: gene amplification, mutation and rearrangement) or their expression (RNA and protein levels), and stimulates growth in contrast to surrounding cells. Over the last decade genes affected in the cancer cell have been identified as well as the nature of changes undergone. Only a few of the known oncogenes play a role in head and neck cancer. These are epidermal growth factor receptor, c-myc, the ras gene family, int-2, hst-1 and bcl-1. In some clinical disorders, such as childhood neuroblastoma and breast cancer, oncogenes have been shown to play an important role in tumor staging or as a prognostic parameter. The aim for future therapy is the effective application of oncogenes (or "gene therapy") in clinical practice.


[Critical retrospective evaluation of the treatment of 400 patients with laryngeal cancer].

This retrospective study deals with the outcome of 401 patients with laryngeal carcinoma who were treated between 1975 and 1986 either by operation alone or by operation and irradiation. The patients as a group, the concepts of treatment, and the course of disease as found retrospectively are described. T and N categories are compared with the respective pT and pN categories: T and pT categories corresponded in 83.3% of the cases while there was only a 67.4% correspondence between each N and pN category. The survival rates using the Kaplan-Meier estimation according to the localization and extension of laryngeal tumor, pN category and method of resection are discussed in detail.


[Mucociliary activity of free transplanted respiratory epithelium].

The function of free grafted respiratory epithelium was investigated in inbred rats. In nine of ten animals it could be shown that the respiratory epithelium not only regenerated as an epithelial surface lining but also regained mucociliary activity. The grafted epithelium was able to secrete mucus, which was equal in protein fragmentation to the secretion of normal nasal mucosa. The grafted respiratory epithelium showed normal ciliary function which could be demonstrated by recording the ciliary beat pattern present and by subsequent histological examination. Morphologically, a regular structure of ciliae (9 + 2) was found on the upper pole of the regenerated ciliated cells.


[Combination of velopharyngoplasty and transposition flap of buccal mucosa for primary reconstruction of the soft palate].

Reconstruction of the soft palate after tumor surgery can present a challenge in closing the defect created and achieving a sufficient functional result. We present a new technique for primary reconstruction after partial or total resections of the soft palate. The method is based on the combination of a cranially pedicled pharyngeal mucosa muscle flap with an oral mucosal transposition flap. If partial resection of the lateral pharyngeal wall is also required, the method can be combined with a masseter crossover flap. Our present experience has shown that the surgical technique used will result in an uncomplicated and rapid primary two-layer reconstruction of the soft palate with a comparatively low postoperative complication rate and satisfactory functional results in speaking and swallowing.


[New indications for the rotating chair test for side localization and determination of central compensation in vestibular function disorder].

The horizontal vestibulo-ocular reflex was studied in normals and 35 patients with an acute or compensated unilateral peripheral vestibular deficit (PVD) in order to determine the efficacy of different response measures obtained from a rotating chair test in localizing the deficit side and defining its central compensation. The profiles of chair velocity and the visual fixation period were chosen in such a way that the slow phase velocity profiles were comparable to those obtained during caloric tests. Mean slow phase eye velocity measured during the culmination period elicited by constant chair acceleration of 5 degrees/s2 over 40 s was significantly reduced for rotations towards the side of an acute or compensated PVD. Per-rotatory gain asymmetry (after correcting for spontaneous nystagmus) was not always specific for the side of the deficit and often not significantly different from normal values in the compensated stage of the deficit. In combination both parameters (SPV and gain asymmetry) were reliable indicators (sensitivity 88%) of the underlying pathology and correctly localized the deficit side during the compensated state. The decay of post rotatory SPV followed a more rapid time course than normal during acute and compensated stages of the deficit. It may be concluded from those results that the rotating chair test is a valuable indicator of the presence and side of a peripheral vestibular deficit even when it has been centrally compensated.


[Bilateral Gradenigo syndrome--on the value of an integrated therapy concept including hyperbaric oxygenation and chronic destructive inflammation of the skull base].

The case of a 30-year-old female with bilateral Gradenigo's syndrome is presented in order to detail commonly applied therapy. In particular, the importance of a comprehensive therapeutic approach is emphasized that includes such adjuvant therapeutic options as hyperbaric oxygenation and the administration of specific immunoglobulins. Indications, therapeutic benefits and limitations of treatment modalities are discussed in relationship to current concepts of therapy.


[Rhabdomyoma of the mouth floor--a case report].

We report a rare case of an adult rhabdomyoma of the floor of the mouth in a 52-year-old woman. To date only 25 cases of such tumors have been described in the oral cavity. In spite of its large size (approximately 10 x 8 x 6 cm), the tumor could be completely removed. Up to now, 20 months after the removal of tumor, no recurrences, have occurred.


Comparative study of the knowledge, attitudes, and behaviors of large animal veterinarians, dairy farmers, and dairy processors in Michigan on bovine somatotropin.

A cross-sectional epidemiologic study was conducted to evaluate two objectives. The first was to determine the knowledge, attitudes, and behaviors of large animal (dairy) veterinarians, dairy farmers, and dairy processors in Michigan toward the use of bovine somatotropin (BST). The second was to compare and contrast the data from the large animal veterinarians, dairy farmers, and dairy processors according to the knowledge, attitude, and behavior variables. A written questionnaire was used as an instrument to collect data relating to the objectives. Three basic types of questions were asked of each group: (1) how much do you know about BST? (knowledge-based question), (2) how do you feel about BST? (attitude-based question), and (3) how would you use BST or use dairy products produced through BST biotechnology (behavior-based question)?


Comparison of recoveries from halothane vs isoflurane anesthesia in horses.

Recovery from isoflurane anesthesia was shorter, with no difference in quality, compared with halothane anesthesia in 2 groups of horses. In 1 group, 12 horses scheduled for elective arthroscopy were randomly assigned to receive halothane or isoflurane for maintenance of anesthesia during surgery. In the other group, 6 horses received anesthesia only, on 2 occasions, with halothane on 1 occasion, and isoflurane on the other. Difference in the quality of recovery was not seen between isoflurane and halothane anesthesia in either group. In the group that had surgery, recovery to sternal position was significantly shorter when isoflurane was used. In the group not treated surgically, recovery to sternal and standing positions was significantly shorter with isoflurane.


Use of zinc acetate to treat copper toxicosis in dogs.

Zinc acetate was used for the treatment and prophylaxis of hepatic copper toxicosis in 3 Bedlington Terriers and 3 West Highland White Terriers. Two dogs of each breed were treated for 2 years, and 1 of each breed for 1 year. A dosage of 200 mg of elemental zinc per day was required to achieve therapeutic objectives related to copper, which included a doubling of plasma zinc concentration to 200 micrograms/dl and a suppression of oral 64 copper absorption. The dosage was later reduced to 50 to 100 mg/day to avoid an excessive increase in plasma zinc concentration. The preliminary clinical results were good. Three dogs had mild to moderate active liver disease and high liver copper concentrations at the time of initiation of zinc administration. Biopsy of the liver 2 years later revealed a reduction in hepatitis and copper concentrations. One other dog without active hepatitis also had a reduction in hepatic copper concentrations over a 2-year period. All 6 dogs have done well clinically. On the basis of these findings, we believe zinc acetate to be an effective and nontoxic treatment for copper toxicosis in dogs.


Renal amyloidosis in a family of beagles.

Renal amyloidosis was confirmed in 6 related male and female Beagles, ranging in age from 5 to 11 years. The most commonly reported signs of illness included lethargy, anorexia, vomiting, and weight loss. Common clinicopathologic abnormalities were normocytic, normochromic anemia; hypoalbuminemia; azotemia; hypercholesterolemia; proteinuria; and urine specific gravity values below the normal range. Histologic examination of renal tissue from the 6 Beagles revealed moderate to severe glomerular amyloidosis with inconsistently observed mild medullary interstitial amyloidosis. Congo red-stained kidney sections from 4 of 4 affected dogs were potassium permanganate-sensitive, suggestive of reactive amyloidosis. Hereditary predisposition for renal amyloidosis was suspected in these Beagles.


Frequency of reisolation of Staphylococcus aureus from multiple sequential milk samples.

Bacterial cultures were performed on multiple sequential composite samples of milk from 1,172 cows in 9 dairy herds. If the initial diagnosis of Staphylococcus aureus infection was based on the first positive culture, an average of 37.8% of subsequent cultures on the same cows were negative for S aureus. However, if the initial diagnosis of S aureus infection was confirmed by 2 or 2 of 3 sequential positive cultures and any conversions from S aureus positive to negative were confirmed by 2 or 2 of 3 sequential negative cultures, then only 17.0% converted to a negative diagnosis. Conversion of cows from S aureus culture-positive to -negative varied between herds; 8.1 to 69% for single cultures and 0.0 to greater than 40% for confirmed cultures.


Effects of vaccination against 18 immunogens in beef replacement heifers at weaning.

Humoral immune responses to vaccination, mean daily body-weight gains, morbidity, and mortality were compared in groups of beef replacement heifers from weaning to 4 months after weaning. The only difference in management among groups of heifers was the number and type of vaccines they received. Heifers were vaccinated at weaning (mean age, 205 days) and again 28 days later against 0, 1, 9, 10, 17, or 18 antigens, using commercially available monovalent and multivalent vaccines. The common vaccine component in all treatment groups was a modified-live bovine respiratory syncytial virus. Mean daily gain, morbidity, mortality, and serum neutralization antibody titers to bovine respiratory syncytial virus did not differ among treatment groups. Although the study revealed the safety of vaccinating beef heifers against 18 antigens at weaning, our data emphasized the need for serial vaccination to induce a measurable serum antibody response.


Hypereosinophilia associated with transitional cell carcinoma in a cat.

A 14-year-old spayed female domestic shorthair cat was evaluated because of an abdominal mass and eosinophilia. Widely disseminated, transitional cell carcinoma of the urinary bladder was diagnosed histologically. To further characterize the eosinophilia, eosinophils were separated from other leukocytes and cultured in vitro. Harvested cells were evaluated for density and for in vitro survivability. Results of these tests, hyperplasia of bone marrow eosinophil precursors, and lack of tumor tissue eosinophilic infiltrates suggested that an eosinophilopoietic stimulus of undetermined origin was likely the cause of this cat's hypereosinophilia.


Surgical repair of atresia jejuni in two calves.

Two Holstein calves with similar histories of not defecating since birth were determined to have atresia jejuni. Resection of the distended blind end of the jejunum and the remaining jejunum and ileum followed by a jejunocecostomy was performed. One calf died 7 months after surgery of unknown causes. The second calf has survived for greater than 1 year, and has maintained a growth rate similar to other calves its age. Atresia jejuni has been reported to be a universally fatal disorder of unknown pathogenesis. It has been postulated that intestinal atresia is caused by palpation of the amniotic vesicle at the time of pregnancy diagnosis, between days 36 and 42 of gestation.


Chronic emesis caused by a nematode-induced gastric nodule in a cat.

A spirurid nematode-induced gastric nodule was believed to be responsible for chronic gastric irritation and vomiting in a domestic short-hair cat. Clinical improvement was noticed following surgical removal of the parasitic nodule in the wall of the pylorus. Morphologic characteristics of the parasite were most consistent with Spirocerca lupi. Infection with Spirocerca lupi is most commonly reported in Canids, often resulting in chronic granulomatous disease of the distal portion of the esophagus. In some animals, the lesions transform into fibrosarcomas and osteogenic sarcomas.


Bronchial cartilage dysplasia with multifocal lobar bullous emphysema and lung torsions in a pup.

Bronchial cartilage dysplasia is believed to have caused lobar bullous emphysema in a 5-month-old Chow Chow that had exercise intolerance, progressive dyspnea, and episodic cough. Radiography of the thorax revealed hyperlucency of the left hemithorax, displacement of the mediastinum and heart to the right, and flattening of the diaphragm. The pup died shortly after the radiographs were obtained. Necropsy revealed massive hyperinflation with 180 degrees torsion of the cranial portion of the left cranial lung lobe, and hyperinflation with less than 180 degrees torsion of the right accessory lung lobe. Histologic examination of the affected lung lobes revealed a lack of bronchial cartilage, loss and displacement of alveolar walls, and bulla formation that resembled congenital (infantile) lobar emphysema of human beings. In this pup, lung lobe torsions may have been predisposed by bronchial cartilage dysplasia.


Intestinal fibrosis with partial obstruction in five horses and two ponies.

Fibrosis of the small intestine led to recurrent colic and weight loss in 2 ponies and 5 horses. There was a reduction in the length of the small intestine to one-half normal in horses 4 to 7. Histologic examination revealed substantial small intestinal submucosal fibrosis and arteriole sclerosis. The cause was not determined, but an environmental factor was suspected because 3 horses were from the same farm and the other animals were from within a 10-mile radius of the farm. The submucosal fibrosis appeared to be secondary to sclerosis of arterioles in the submucosa and mesentery, with low blood flow state or altered vessel permeability.


Clinical evaluation of axial pattern skin flaps in dogs and cats: 19 cases (1981-1990).

Nineteen axial pattern skin flaps were used in 16 dogs and cats to provide skin for repair of extensive cutaneous defects. Retrospective evaluation of medical records was used to determine percentage flap survival, postoperative complications, and long-term outcome of axial pattern skin flaps. The most common indication for use of axial pattern flaps was to augment wound closure following tumor resection (n = 7). Other indications included trauma (n = 5), chronic nonhealing wounds (n = 4), urine-induced cellulitis (n = 1), idiopathic dermal necrosis (n = 1), and chronic lymphoplasmocytic dermatitis (n = 1). Mean flap survival (+/- SD) was 96% (+/- 8). Postoperative complications included wound drainage (n = 15), partial dehiscence of the sutured flap (n = 7), distal flap necrosis (n = 6), infection (n = 3), edema (n = 3), and seroma formation (n = 2). After a median follow-up time of 5 months, evaluation of animals indicated that surgery provided successful wound reconstruction with good cosmetic results. Reconstruction of large cutaneous defects is facilitated by axial pattern flap application regardless of cause of wound. Postoperative complications are common but amenable to standard wound management techniques such as drain placement and surgical debridement of devitalized distal flap skin.


Risk factors, clinical signs, and survival in cats with a clinical diagnosis of idiopathic hypertrophic cardiomyopathy: 74 cases (1985-1989).

Population characteristics, risk factors, and survival characteristics were evaluated in 74 cats with hypertrophic cardiomyopathy (HC) seen at North Carolina State University veterinary teaching hospital from 1985 to 1989, and compared with 82 clinically normal cats. The mean (+/- SD) age of cats with HC was 6.5 (4.0) years. Neutered males were at significantly greater risk (odds ratio 3.1) than neutered females. Breed, body weight, or coat color were not determined to be risk factors for HC. Tricolor cats were significantly underrepresented, probably reflecting the male predisposition for HC and not a true risk reduction associated with coat color. Forty-one cats were without clinical signs of heart disease (murmur and/or gallop sound only), 24 were in congestive heart failure, and 9 had systemic arterial embolism, 3 of which had concomitant congestive heart failure. The median survival time for 61 cats with HC, for which survival information could be obtained and that were not euthanatized on day 1, was 732 days. Survival was not affected by age at diagnosis, breed, body weight, or sex. However, clinical signs were important in determining prognosis; cats with heart rates greater than 200 beats/min survived significantly longer (median survival greater than 1,830 days) than those with heart rates greater than or equal to 200 beats/min (median survival = 152 days). Cats without clinical signs (median survival greater than 1,830 days) survived longer than those with clinical signs, and cats in heart failure survived a median of 92 days, compared with 61 days for those with systemic arterial embolism. Analysis of survival revealed no significant difference between the 2 groups of cats with clinical signs; however, all cats with embolism and only 60% of cats with heart failure were dead 6 months after diagnosis.


Enteral feeding of dogs and cats: 51 cases (1989-1991).

Feeding commercial enteral diets to critically ill dogs and cats via nasogastric tubes was an appropriate means for providing nutritional support and was associated with few complications. Twenty-six cats and 25 dogs in the intensive care unit of our teaching hospital were evaluated for malnutrition and identified as candidates for nutritional support via nasogastric tube. Four commercial liquid formula diets and one protein supplement designed for use in human beings were fed to the dogs and cats. Outcome variables used to assess efficacy and safety of nutritional support were return to voluntary food intake, maintenance of body weight to within 10% of admission weight, and complications associated with feeding liquid diets. Sixty-three percent of animals experienced no complications with enteral feedings; resumption of food intake began for most animals (52%) while they were still in the hospital. Weight was maintained in 61% of the animals (16 of 26 cats and 15 of 25 dogs). Complications that did occur included vomiting, diarrhea, and inadvertent tube removal. Most problems were resolved by changing the diet or adhering to the recommended feeding protocol. Nutritional support as a component of therapy in small animals often is initiated late in the course of the disease when animals have not recovered as quickly as expected. If begun before the animal becomes nutrient depleted, enteral feeding may better support the animal and avoid serious complications.


Radioimmunoassay monitoring of thyroid hormone concentrations in dogs on thyroid replacement therapy: 2,674 cases (1985-1987).

Serum iodothyronine concentrations from 4,064 samples submitted for monitoring of thyroid replacement therapy were evaluated in a retrospective study. After exclusion of samples because of the presence of 3,5,3' triiodothyronine (T3) autoantibodies, insufficient numbers of dogs on some commercial preparations or medication with corticosteroids or synthetic T3 preparations, data from 2,674 dogs remained. Data were analyzed by using information on dose, time after dosing, commercial product, and once-a-day or twice-a-day dosing regimens. Serum total thyroxine (T4) and total T3 and estimates of free T4 and free T3 were significantly high in serum from dogs given higher doses of synthetic L-thyroxine orally. Doubling the oral dosage did not double the serum iodothyronine concentrations, perhaps because of poor absorption or more rapid catabolism of the hormones at higher L-thyroxine doses. Wide variation in the therapeutic hormone concentrations was found. Some dogs given low dosages of L-thyroxine had normal iodothyronine concentrations whereas some others given higher dosages had low normal to low concentrations. Monitoring the serum concentrations is an objective way to ensure adequate concentrations for successful therapy. When a therapeutic trial is used as a diagnostic procedure, one should not rule out hypothyroidism unless a therapeutic monitoring sample has indicated that replacement dose and absorption of the exogenous iodothyronine has been adequate. Thyroid hormone concentrations peaked at 4 to 6 hours after oral administration of L-thyroxine for once-a-day and twice-a-day dosage regimens. Higher concentrations were achieved with once-a-day than with twice-a-day regimens at the same total daily dose.(ABSTRACT TRUNCATED AT 250 WORDS)


Potentiation by tumor necrosis factor of mitoxantrone cytotoxicity to human ovarian cancer cell lines.

The cytotoxic activity of human recombinant tumor necrosis factor (rHuTNF) (from 0.01 to 10000 U/ml) was assayed on six human ovarian cancer cell lines and one human cervical carcinoma cell line using a crystal violet assay. rHuTNF was cytotoxic to four cell lines (A2780, A2774, SW626, PA1), while 3 cell lines (IGROV1, SKOV3, Me180) were marginally sensitive to its activity. However, under the same experimental conditions rHuTNF markedly enhanced the cytotoxicity of mitoxantrone, a chemotherapeutic drug targeted at DNA topoisomerase II, in six cell lines. The potentiation of mitoxantrone cytotoxicity was not caused by increased drug accumulation after rHuTNF treatment. No significant increase in cytotoxicity to Me180 cell line was seen when rHuTNF was added to mitoxantrone.


Promoting effects of potassium dibasic phosphate on early-stage renal carcinogenesis in unilaterally nephrectomized rats treated with N-ethyl-N-hydroxyethylnitrosamine.

The effects of potassium dibasic phosphate (PDP), potassium aluminum sulfate (PAS) and copper sulfate (CS) on early-stage renal carcinogenesis were investigated in unilaterally nephrectomized male Wistar rats after N-ethyl-N-hydroxyethylnitrosamine (EHEN) administration. After feeding 1,000 ppm EHEN, or basal diet for 2 weeks and removal of the left kidney at week 3, male Wistar rats were divided into 8 groups of 20 rats each. These groups received the following dietary treatments: 50,000 ppm PDP, 50,000 ppm PAS, 5,000 ppm CS or basal diet, respectively, for 18 weeks from weeks 3 to 20. The average numbers of adenomatous hyperplasias counted as preneoplastic lesions in the EHEN with 50,000 ppm PDP group were significantly higher than in the EHEN alone group or the EHEN followed by 50,000 ppm PAS or 5,000 ppm CS group. The treatment with 50,000 ppm PDP induced renal calcification and promoted the development of preneoplastic lesions in unilaterally nephrectomized rats treated with EHEN, but that with 50,000 ppm PAS or 5,000 ppm CS did not.


Dose dependence of N-hydroxy-3,2'-dimethyl-4-aminobiphenyl-induced rat prostate carcinogenesis.

Groups of F344 rats were administered biweekly intraperitoneal injections of N-hydroxy-3,2'-dimethyl-4-aminobiphenyl (N-OH-DMAB) at a dose of 5, 10 or 20 mg/kg body weight or DMAB, the parent compound, at a dose of 25 mg/kg body weight, for a total of 10 times. Prostate carcinomas in the ventral lobe developed in a N-OH-DMAB dose-dependent manner (0, 17.6 and 66.7%, respectively) with limited tumor yields in other organs. Although intraperitoneal administration of DMAB was similarly found to induce prostate tumors, it also caused severe chemical peritonitis, which resulted in a high mortality. The present data confirmed that intraperitoneal administration of N-OH-DMAB provides a relatively specific induction method for models of prostate carcinogenesis.


Reversibility of carcinogen-induced rat forestomach basal cell hyperplasia is due to squamous cell differentiation.

The mechanisms of reversibility of basal cell hyperplasia in the rat forestomach were investigated. Male F344 rats were given an initial single gastric intubation of N-methyl-N'-nitro-N-nitorosoguanidine and then received 2% butylated hydroxyanisole in the diet from the third week to the 26th week. Rats were killed at weeks 26 and 46 after return to basal diet and their forestomachs were removed. Bromouracil deoxyriboside (BUdR) was administered as a single i.p. injection 1 h before death or by osmotic minipump (120 micrograms/h) continuously for 7 days before death. Additional animals were maintained for 2 or 4 weeks after removal of osmotic minipumps to allow assessment of the fate of proliferating populations. In each case BUdR-labeled cells were demonstrated by immunohistochemistry by immunohistochemistry. At week 26, hyperplastic changes were more pronounced than at week 46. Squamous cells above basal cell hyperplasias were strongly labeled even 4 weeks after cessation of continuous BUdR Three-dimensional reconstruction of persisting basal cell hyperplasias showed almost all basal cells limited to a thin sheet in direct contact with the squamous cell layer, occasional separate islands demonstrating differentiation to squamous cells and formation of epidermal cysts. The results thus showed that the mechanism of reversibility of basal cell hyperplasia involves differentiation of basal cells to squamous cells.


A serine protease-inhibitory benzamidine derivative inhibits the growth of human colon carcinoma cells.

The inhibitory effect of a serine protease-inhibiting tetra-benzamidine derivative, TAPP-Br, on the cell growth of 8 human colon carcinoma cell lines was examined and the mechanism of the inhibition was analyzed. TAPP-Br inhibited the cell growth of all the colon carcinoma cell lines, and this effect was irreversible. The expression of mRNAs for nuclear oncogenes such as MYC, FOS and JUN was decreased by TAPP-Br after treatment for 3 h and the effect continued for 48 h. mRNA expression of epidermal growth factor receptor, transforming growth factor-beta and type IV collagenase was suppressed at 48 h after the initiation of TAPP-Br treatment, suggesting an indirect action of TAPP-Br. TAPP-Br decreased protein kinase C activity in the particulate fraction, whereas it increased the enzyme activity in the soluble fraction. These findings overall suggest that the serine protease inhibitor, TAPP-Br, might inhibit the cell growth of colon carcinoma cell lines through suppressing the expression of genes whose promoter contains a 12-O-tetradecanoylphorbol-13-acetate-responsive element or serum-responsive element.


Therapeutic effect of ansamitocin targeted to tumor by a bispecific monoclonal antibody.

We have constructed a murine hybrid hybridoma that secretes a bispecific monoclonal antibody (mAb) by fusing a hybridoma secreting an anti-ansamitocins mAb with a hybridoma secreting an anti-human transferrin receptor (TfR) mAb that binds to human A431 epidermoid carcinoma cells. The bispecific mAb, reactive to both ansamitocins and TfR, was purified by a combination of hydrophobic column chromatography and hydroxyapatite high-performance liquid chromatography, and evaluated in in vivo experiments using human tumor cell-implanted nude mice. Ansamitocin P-3 targeted through one of the antigen combining sites of the bispecific mAb was potentially more effective in suppressing the growth of established A431 tumor xenografts implanted on nude mice than unconjugated ansamitocin P-3 or the immunoconjugate of ansamitocin P-3 and monospecific anti-ansamitocins antibody, and the targeted ansamitocin P-3 finally eradicated the tumor mass. The bispecific mAb also played an important role in reducing such undesirable side-effects of ansamitocin P-3 as the loss of body weight, the damage to liver functions and the decrease in the number of white blood cells.


Antitumor effect of PSK at a distant site: tumor-specific immunity and combination with other chemotherapeutic agents.

The antitumor effect of PSK, a Coriolus preparation, was analyzed with the double grafted tumor system in which BALB/c mice received intradermal inoculations of syngeneic Meth-A fibrosarcoma in the right (primary tumor, 10(6) cells) and left (distant tumor, 2 x 10(5) cells) flanks. Intratumoral administration of PSK significantly inhibited the growth of not only the right but also the left tumor. PSK also inhibited the growth of a methylcholanthrene-induced fibrosarcoma BAMC-1, and a methylurethane-induced adenocarcinoma Colon 26 in the double grafted tumor system of syngeneic BALB/c mice. However, when the left distant tumor was different from the right Meth-A tumor, the intratumoral administration of PSK in the right tumor was unable to inhibit the growth of the left BAMC-1 or RL male-1 tumor. The PSK-induced immunity, therefore, is tumor-specific and T lymphocytes may play an important role in antitumor memory function. The enhancement of concomitant immunity by PSK treatment was completely impaired by previous intravenous administration of an alkylating agent, cyclophosphamide (CY). The enhancement of sinecomitant immunity by PSK treatment was also impaired by previous CY intravenous administration. The antitumor effect of PSK was suppressed by previous intravenous administration of another alkylating agent, ACNU. It is possible that alkylating agents suppress the function of effector T cells and granulocytes which are very important for the antitumor immune cascade reaction due to PSK treatment. On the other hand, the antitumor effect of PSK was enhanced by previous intravenous administration of an anti-metabolite, 5-fluorouracil.


Protection of survival and hematopoiesis in irradiated mice by 5-fluorouracil.

The effects of whole-body irradiation on survival and the hematopoietic system were studied in mice treated with 5-fluorouracil (5-FU). Animals (ddY-SLC male mice, 8-10 weeks old) were injected with 5-FU (i.p.) as a single dose (150 mg/kg) at various times before or after irradiation with X-rays at graded doses (4.8 to 7.6 Gy). The treatment of mice with 5-FU 5 days before irradiation was the most effective for the reduction of radiation lethality, having a radioprotective effect. The dose reduction factor (DRF) was 1.24. However, treatment with 5-FU at 1 day and 2 hours before, or at various times after irradiation significantly increased the radiation lethality compared to the untreated controls, creating a radiosensitizing effect. The decrease or the increase of radiation lethality exhibited by 5-FU was similar to the radiation-dose relationship pattern shown by endogenous and exogenous CFU-S. The pattern of change of thrombocyte counts in the circulating blood after irradiation was greatly modified by pretreatment with 5-FU 5 days before irradiation, effectively lessening the radiation-induced depression. In contrast, the post-irradiation patterns of leukocyte and erythrocyte variation did not show any significant change due to pretreatment with 5-FU.


Myeloprotective activity of deoxyspergualin: influence on splenic colony-forming cell injury and antitumor activity of mitomycin C in mice.

We have examined the efficacy of deoxyspergualin (DSG) in protecting splenic colony-forming cells (CFU-S) from mitomycin C (MMC)-induced damage. The main findings of the study are as follows. (1) When DSG was administered at doses of 1.5 and 3 mg/kg for 7 days before the MMC injection, the decrease of the femoral CFU-S caused by MMC was diminished on the day after the MMC injection. The optimal dose was found to be 3 mg/kg. (2) In animals receiving 3 mg/kg DSG for at least 3 days preceding the MMC injection, the femoral CFU-S was more than 200% of that in the MMC alone group one day after the MMC injection. (3) The number of femoral CFU-S in the mice which received 3 mg/kg DSG for 3 days prior to MMC was significantly restored day by day and reached 70% of normal at 5 days after the MMC injection, while it was only 13% of normal in the MMC alone group. Moreover, the prior DSG administration significantly diminished the MMC toxicity to circulating platelets. (4) DSG administration (3 mg/kg) 3 days prior to MMC did not weaken the antitumor activity against colon 26 adenocarcinoma or P388 leukemia when compared with MMC alone. These findings have shown the ability of DSG specifically to protect the animals against bone marrow toxicity caused by MMC without interfering with the antitumor activity.


A novel type of phospholipase A2 inhibitor, thielocin A1 beta, and mechanism of action.

Thielocin A1 beta, a novel phospholipase A2 inhibitor, was isolated from Thielavia terricola RF-143. It inhibited various phospholipase A2s in a dose-dependent manner. Among these, group II phospholipase A2 from rat was most sensitive to thielocin A1 beta (IC50 = 0.0033 microM). The inhibition of phospholipase A2 by thielocin A1 beta was independent of Ca2+ and substrate concentration. In addition, the inhibition of rat group II phospholipase A2 was noncompetitive (Ki = 0.0068 microM) and reversible. Furthermore, thielocin A1 beta quenched the relative fluorescent intensity of Naja naja venom phospholipase A2 and in a dose-dependent manner; 50% quench was noted with a molar ratio of thielocin A1 beta/enzyme of 2.2. These observations indicated that inhibition of phospholipase A2 by thielocin A1 beta may result from direct interaction with the enzyme.


Isolation, characterization and biological activities of concanamycins as inhibitors of lysosomal acidification.

Four new analogues of concanamycin family, designated concanamycins D, E, F G, were isolated from the mycelium of Streptomyces sp. A1509 by solvent extraction, silica gel column chromatography and HPLC. Structures of these compounds were identified by the combination of spectroscopic analyses. All of these compounds were structurally related to concanamycins A, B and C, which had been isolated previously, and inhibited the acidification of rat liver lysosomes at 10(-11)-10(-9) M concentration. The structure-activity study showed that the 18-membered macrolide ring and the 6-membered hemiketal ring portions of the molecules of concanamycin family are responsible for potent inhibitory activity.


TA-3037A, a new inhibitor of glutathione S-transferase, produced by actinomycetes. I. Production, isolation, physico-chemical properties and biological activities.

TA-3037A, a new inhibitor of glutathione S-transferase was discovered in the fermentation broth of Streptomyces sp. TA-3037. It was purified by chromatography followed by solvent extraction and then isolated as yellow needles. TA-3037A has the molecular formula of C16H11NO4. It was competitive with the substrate, and the inhibition constant (Ki) was 4.9 microM.


TA-3037A, a new inhibitor of glutathione S-transferase, produced by actinomycetes. II. Structure determination.

TA-3037A, a new inhibitor of glutathione S-transferase, has been isolated from the culture broth of Streptomyces sp. TA-3037. The structure of TA-3037A was defined as (Z)-3-benzylidene-3,4-dihydro-2-oxo-2H-1,4-benzoxazine-5-carboxylic acid by an analysis of spectral properties and chemical studies of TA-3037A and its derivatives.


Tirandalydigin, a novel tetramic acid of the tirandamycin-streptolydigin type. I. Taxonomy of the producing organism, fermentation and biological activity.

Tirandalydigin is a new tetramic acid antibiotic which was discovered in a screen designed to find compounds with activity against pathogenic anaerobic bacteria. It was named tirandalydigin because it possesses structural features that are common to both tirandamycin and streptolydigin. The producing culture, strain AB 1006A-9, is a Streptomyces and was compared to the streptomycetes that synthesize tirandamycin and streptolydigin. It is closely related to the former culture and was named Streptomyces tirandis subsp. umidus. Tirandalydigin has MICs in the range of 0.5 to 32 micrograms/ml against many pathogenic anaerobes, streptococci, enterococci and legionellae.


Studies on viridenomycin, a novel 24-membered macrocyclic polyene lactam antibiotic.

A new antitumor antibiotic, designated AL081, was obtained from the culture filtrate of an actinomycete identified as Streptomyces gannmycicus, and found to be identical with viridenomycin by direct comparison. The structure of the antibiotic was determined by NMR spectral analysis including a variety of two-dimensional techniques to be a novel 24-membered macrocyclic polyene lactam. Viridenomycin prolonged the survival periods of mice bearing P388 leukemia and B16 melanoma cells.


Synthesis and biological activities of cyclopropenone antibiotic penitricin and congeners.

A number of derivatives of the cyclopropenone antibiotic penitricin have been synthesized by the reaction of metalated cyclopropenone acetals with electrophiles. Studies on the antimicrobial structure-activity relationships indicated that the penitricin skeleton, hydroxymethylcyclopropenone, is indispensable for antimicrobial activity. These compounds were also found to display cytotoxic activity.


Isolation and characterization of furanomycin nonproducing Streptomyces threomyceticus mutants.

Stable mutants that are blocked in the production of the polyketide antibiotic furanomycin were generated by treatment of Streptomyces threomyceticus (ATCC 15795) with a combination of N-methyl-N'-nitro-N-nitrosoguanidine (NTG) and ultraviolet light. On the basis of their cosynthetic properties in mixed culture, the mutants were grouped into eleven phenotypic classes. The polarity of the cosynthetic reactions for seven classes of mutants was revealed by filtrate feeding experiments. This allowed them to be arranged in the most probable linear sequence of metabolic blocks. One of the remaining groups of mutants exhibited no cosynthetic behavior and is believed to be blocked in a gene that regulates furanomycin biosynthesis.


Cloning and analysis of a gene (sms13) encoding sannamycin B-glycyltransferase from Streptomyces sannanensis and its distribution among actinomycetes.

A gene encoding sannamycin B-glycyltransferase (sms13) of Streptomyces sannanensis IFO 14239 was identified by cloning and complementation of S. sannanensis mutant SN13 which is blocked at the interconversion of sannamycins B and A. The cloned DNA fragment also permitted the conversion of fortimicin B to A both in S. sannanensis SN13 and Streptomyces lividans TK23. DNA sequences similar to sms13 were detected in all five producers of the fortimicin-group antibiotics, Micromonospora olivasterospora ATCC 21819 (fortimicin-producer), Micromonospora sp. strain SF-2098 ATCC 31580 (SF-2052), Dactylosporangium matsuzakiense ATCC 31570 (dactimicin), Streptomyces tenjimariensis ATCC 31603 (istamycin), and Saccharopolyspora hirsuta ATCC 20501 (sporaricin). This suggests that these genes of similar function from different genera were derived from a common ancestral gene.


A study of the incidence of different fluorescent Pseudomonas species and biovars in the microflora of fresh and spoiled meat and fish, raw milk, cheese, soil and water.

Of 182 various foodstuffs and environmental samples examined, 86% had microflora containing fluorescent Pseudomonas in differing proportions. A computer-aided technique was used to identify most of the 445 fluorescent strains. Pseudomonas fluorescens biovar V-1 was most frequently isolated (24%); it either predominated or was present in all types of samples. Other strains, belonging to the other subgroups of biovar V (V-2, V-4, V-5, V-6 and V-7), together represented 14.3%. We also identified Ps. fluorescens biovars I-1 and I-2 (13.9%), II-1 and II-3 (3.6%), III-1 and III-2 (8.7%), IV-2 (0.7%); Ps. putida A and B (11%); Ps. lundensis (10.3%); group B3 (2%) and Ps. aeruginosa (0.7%). Unidentified strains accounted for 10.6% of the flora, many resembling Ps. fluorescens biovar V. Although the presence of Ps. fluorescens V-1 was often marked, other taxa predominated or were present in large quantities in some particular samples, such as Ps. fluorescens I-1 in raw milk and cheese, Ps. lundensis in spoiled meat and Ps. fluorescens III-1 in spoiled fish. Pseudomonas putida A and B were evident in environmental rather than in food samples.


Nucleotide sequence and structural relationships of a chloramphenicol acetyltransferase encoded by the plasmid pSCS6 from Staphylococcus aureus.

The 4.6 kb chloramphenicol resistance (Cm) plasmid, pSCS6, isolated from a naturally occurring Staphylococcus aureus biotype C encoded an inducible chloramphenicol acetyltransferase (CAT). The respective cat gene and its regulatory region were cloned. Sequence analyses revealed two open reading frames: one for a 9-amino acid leader peptide and the other for the 215-amino acid CAT monomer. Comparisons of the predicted CAT amino acid sequences revealed a high degree of similarity between CAT from pSCS6 and the CAT variants encoded by Cm plasmids of the pC221 family. These close structural relationships suggested an intraspecific exchange of Cm-determinants between Staph. aureus of human and bovine biotype.


Diagnostic application of monoclonal antibodies to outer membrane protein for rapid detection of Salmonella.

Monoclonal antibodies produced to Salmonella enteritidis outer membrane proteins were screened against 57 Salmonella serovars and several related enterobacteria. Those detecting all Salmonella serovars and none of the related enterobacteria were used in a microtitre plate antigen capture ELISA to screen clinical samples. Sixty-one of 2100 samples yielded salmonellas after incubation for 24 h in selective media by conventional culture. Of these 58 were detected by the ELISA. Sixty-five false positives by ELISA were found to be Enterobacter spp. The results show the potential of this ELISA to eliminate a large proportion of the salmonella-negative cultures at an early stage.


Multiple typing techniques applied to a Clostridium perfringens food poisoning outbreak.

Twenty-one stool specimens obtained from persons implicated in two food poisoning outbreaks at the same institution in Smith Falls, Ontario, were examined for Clostridium perfringens. Ninety-two colonies of Cl. perfringens (3-5 per stool specimen) were typed with antisera, bacteriocins and by plasmid analysis. They were also tested for the in vitro production of bacteriocin and enterotoxin. Sixteen of the 21 stool specimens were tested directly for enterotoxin. This was detected in 13, five of which were from individuals listed as 'asymptomatic' food handlers. The predominant strain isolated from 15 of the 21 stool samples produced bacteriocin and enterotoxin in vitro, contained no plasmids, and was of a common bacteriocin type and serotype.


Effect of culture age, pre-incubation at low temperature and pH on the thermal resistance of Aeromonas hydrophila.

The thermal resistance of Aeromonas hydrophila strain NCTC 8049 was determined within the range 48 degrees-65 degrees C with a thermoresistometer TR-SC and McIlvaine buffer. The effects of culture age, pre-incubation at 7 degrees C and the pH of the heating menstruum were evaluated. The pattern of thermal death was dependent on culture age. Cells heated in the late logarithmic growth phase (15 h at 30 degrees C) were twice as resistant as those in the early stage (5 h at 30 degrees C), and the maximum D-value was obtained after 72 h incubation (5.5 total increase). The age of the cells did not affect z-values significantly. The heat resistance of cells incubated for 48 h at 30 degrees C increased (twice) after holding at 7 degrees C for 72 h. Pre-incubation at low temperature of older cultures (72 h, 30 degrees C) did not influence their D-values. Maximum heat resistance was found at pH 6.0 and minimal at pH 4.0. Decreasing the pH from 6.0 to 4.0 reduced D-values by a factor of 5. Although the strain studied was heat-sensitive (D55 degrees C = 0.17 min; z = 5.11 degrees C), survivor curves of cultures older than 50 h showed a significant tailing. Organisms surviving in the tails were only slightly more resistant than were the original population.


Factors affecting antibacterial activity of hop compounds and their derivatives.

The antibacterial effect of weak acids derived from the hop plant (Humulus lupulus L.) increased with decreasing pH. Analysis of the minimum inhibitory concentration of such compounds against Lactobacillus brevis IFO 3960 over pH 4-7 suggests that undissociated molecules were mainly responsible for inhibition of bacterial growth. The antibacterial activity of trans-isohumulone was ca 20 times greater than that of humulone, 11 times greater than that of colupulone and nine times greater than that of trans-humulinic acid when the degree of ionization was taken into account. Monovalent cations (K+, Na+, NH4+, Rb+, Li+) stimulated antibacterial activity of trans-isohumulone but the effect was smaller than that observed with H+. The response to divalent cations varied: Ca2+ had little effect on antibacterial activity, whereas Mg2+ reduced activity. Lipid materials and beta-cyclodextrin also antagonized the antibacterial action of trans-isohumulone.


Effects of chlorhexidine diacetate on Candida albicans, C. glabrata and Saccharomyces cerevisiae.

The effects of chlorhexidine diacetate (CHA) on Candida albicans, C. glabrata and wild-type and mannan, and permeability mutants of Saccharomyces cerevisiae have been studied. A CHA concentration of 10 micrograms/ml had little lethal activity against the Candida strains, but was more effective against S. cerevisiae. Concentrations of 100 and especially 1000 micrograms/ml brought about a much more rapid death of cells. 2-Mercaptoethanol enhanced the activity of CHA to some extent. Some of the mutant strains of S. cerevisiae were rather more sensitive than the wild-type strain. The age of cultures of C. albicans and C. glabrata influenced their response to CHA.


Numerical classification and identification of Aeromonas genospecies.

A total of 176 Aeromonas strains representing all currently characterized genospecies were tested for 329 biochemical characters. Overall similarities of all strains were determined by numerical taxonomic techniques, the UPGMA algorithm and the SSM and the SJ coefficients as measures of similarity. Sixteen clusters (two or more strains) and seven unclustered strains were recovered at the 93.5% similarity level (SSM). Genospecies 1, 4, 5, 6, 7, 9, 12 and 13 were largely represented by single phena, whereas strains of genospecies 2 and 3 were found in closely-related phena. Strains belonging to genospecies 8 formed two distinct biotypes. Strains belonging to genospecies 11 formed a subcluster within a cluster representing different genospecies. In general, similar groupings were obtained with the Jaccard coefficient at a similarity level of 80.0% (SJ) with minor changes in the definition of clusters. The phenetic data showed good correlation with the taxa defined by DNA/DNA hybridization and those obtained by multilocus enzyme analysis. For all genospecies (independent from cluster assignment) 30 diagnostic characters were selected to construct a matrix for probabilistic identification. The correct identification rate of the matrix was 71.51% taking a Willcox probability greater than 0.99, and 83.7% taking a Willcox probability greater than 0.9 as identification threshold levels.


Evaluation of coliforms as indicators of water quality in India.

The total and thermotolerant coliform counts in rural drinking water derived from ground water, piped supplies and surface water are reported for a number of areas in India. To evaluate these counts as indicators of recent faecal contamination the total coliforms and thermotolerant coliforms isolated have been identified. Thermotolerant Escherichia coli formed 11.7% of the total coliforms and 75.1% of the thermotolerant coliforms. Citrobacter sp. (20.4%) and Klebsiella sp. (50.9%) were the other common total coliforms isolated and, among the thermotolerant coliforms, Klebsiella sp. (16.4%) was the only other organism frequently encountered. The total coliform counts were significantly correlated with water temperature. The applicability in tropical areas of standards developed for temperate climates is discussed.