Heat-killed Lactobacillus acidophilus inhibits adhesion of Escherichia coli B41 to HeLa cells. Escherichia coli B41 (O101: K99: F41: ST+) adheres to HeLa 229 cells in a diffuse pattern. Heat-killed (100-105 degrees C) Lactobacillus acidophilus (Lactéol strain) was found to inhibit this adhesion in a dose-dependent manner. This inhibitory action was lost after lysis of the L acidophilus, suggesting steric hindrance of E coli adhesion sites rather than competition for a common binding site. A thermostable factor (100-105 degrees C) excreted by L acidophilus into the medium may be required for the adhesion of L acidophilus to HeLa cells, and for the inhibition of adhesion of E coli to these cells.


[Immunohistochemistry of bovine lymphoid tissue: neutralization of the non-specific reactivities of serum anti-immunoglobulins by bovine serum]. In lymphoid tissue, the presence of high amounts of free proteins and immunoglobulins frequently leads to the observation of non-specific reactivities during immunohistochemical reactions. The types of anti-immunoglobulin sera utilized in these immunohistochemical reactions may be capable of identifying immunoglobulins secreted or harboured by the tissue cells under study, leading to non-specific marking. Incubation of these antisera with serum from the species in which the lymphoid tissue is studied neutralizes the non-specific reactivities connected with the presence of tissue immunoglobulins.


Pharmacokinetics and urinary excretion of sulfadiazine in buffalo calves. Pharmacokinetics and urinary excretion of sulfadiazine were determined in buffalo calves following single oral administration (150 mg/kg). Kinetic evaluation of plasma levels was performed using a 2-compartment model. The absorption half-life and elimination half-life were 3.41 +/- 0.63 and 13.75 +/- 1.94 h, respectively. Based on this study, an optimal dosage regimen of sulfadiazine in buffalo calves would be 165 mg/kg, followed by 75 mg/kg at 12-h intervals. Sulfadiazine was mainly excreted in the urine as free amine, while the percentage of acetylated sulfadiazine was comparatively low.


[Prognostic significance of diagnostic delay in carcinoma of the endometrium: our experience]. Although endometrial carcinoma is characterized by a precocious symptomatology, in 28.4-22.6% of cases at the time of diagnosis it is found to be at clinical stage higher than I. In the present study the diagnostic delay is related to the stage of disease. Our data suggest that diagnostic delay can cause a higher risk of advanced-stage disease; all the cases of stage III and IV disease, in fact, were diagnosed after more than 7 months. Diagnostic delay was also directly related to depth of myometrial invasion; the mean diagnostic delay was significantly shorter in patients with stage I disease and superficial myometrial invasion (3.92 vs 8.76 months) (p < 0.001). Therefore, diagnostic delay is directly related to well-established prognostic variables as well as to clinical stage and depth of myometrial invasion.


[Report on obstetrical activity during the triennium 1985-1987. 4th Obstetrics and Gynecology Clinic, University of Milan, Institute of Biomedical Sciences, S. Gerardo Hospital, Monza]. The data of three years of activity (1985-1987) at the 4th Obstetrics and Gynecology Department of the University of Milan, S. Gerardo Hospital in Monza, for a total of 5595 deliveries and 5672 new-borns are reviewed. Each case of perinatal death has been evaluated for gestational age, weight, way of delivery and preexisting or pregnancy-induced maternal diseases, trying to single out the primary causes of death. In order to compare these data with the ones of the previous three years the results have been divided, following the gestational age, in two groups (less or more and equal than 28 weeks). Late perinatal death rate (including all the babies older than 24 weeks of gestational age, still-born or live-born and dead within the 28th day of life) has been 1.8%, compared to the 2.1% in the previous 3 years. Obstetrical procedures and neonatal outcomes are analyzed in depth. Puerperium was pathological in 8.9% of patients. Only 4.2% of women decided not to breast-fed their babies.


[Isolation of 2 coccidia of the genus Isospora from ducks in France]. The authors isolated 2 Isospora species from ducks: Isospora mandari and Isospora sp. This was the first report of the genus Isospora from the duck in France. One of the 2 isolated species (Isospora sp) has not been described in the duck before.


Disposition kinetics and dosage of cephalexin in cow calves following intramuscular administration. Cephalexin was administered im to cow calves at a dose rate of 10 mg/kg bw. After im administration, the disposition kinetics of cephalexin followed a 1-compartment open model. The values of elimination half-life, volume of distribution and total body clearance were 2.00 +/- 0.13 h, 0.32 +/- 0.02 l/kg and 1.899 +/- 0.199 ml/kg/min, respectively. 58.8% of cephalexin administered was recovered in the urine within 24 h. A satisfactory intramuscular dosage regimen of cephalexin in cow calves would be 15 mg/kg administered at 9-h intervals.


Genetic variation in Brac, Croatia.

Genetic variation in Brac, Croatia. A serological survey of the Dalmatian island of Brac (Croatia), based on a total sample of 747 subjects, shows considerable local genetic variation. While the overall gene frequencies are much as expected from the island's geographical position, the local genetic heterogeneity is made up of differences between the inland and coastal villages, differences between the two coastal areas, and variation among the older inland villages. This heterogeneity is interpreted as deriving from the settlement process (founder effect), random differentiation, and the essentially local marriage pattern.


Is body fat distribution associated with cardiovascular risk factors in childhood? The authors studied the association of cardiovascular risk variables with body fat distribution (BFD) in a cross-sectional sample of 743 Texas schoolchildren of both sexes ages 6-14 years. This association is well known in adults and several useful indices of BFD are available. Whether they are applicable to children remains a question of importance for epidemiological investigations in this age group. Canonical correlations between anthropometric (five skinfolds, four circumferences) and risk (blood pressures, cholesterol, pulse) variables ranged from 0.37 to 0.82 depending on sex/age group (p < 0.01). The skinfold vector suggested an association of risk with central fat at most but not all ages. The circumference vectors, on the other hand, suggest that size or fatness, not BFD, was related to risk. Partial correlation and stepwise regression of fatness and BFD indices with cardiovascular risk factors as dependent variables, showed that 'fatness' or 'size' was more clearly associated with risk factors than BFD. The variables most consistently entering the regression were hip circumference and sum of skinfolds. These results contrast with studies of adults or sexually mature adolescents, in which BFD is more clearly related to CV risk variables and the hip circumference is a 'low-risk' variable.


[Haptoglobin polymorphism--not only a genetic marker]. The biological activities of the haptoglobin polymorphism are controlled by continuous DNA sequences coding for the HP alpha and Hp beta polypeptide chains and forming with a linked Hp related gene the haptoglobin gene complex on chromosome 16. Probably, this DNA domain originates from the gene family of the serine proteases after having lost the informations for the proteolytic functions. Instead of this, the haptoglobins have acquired other qualities, among them the hemoglobin binding capacity, inserted into the Hp beta chain. The Hp polymorphism is constituted by the evolutionary progressive DNA sequences for the Hp alpha chains, which probably have activation functions. The haptoglobins display immunoregulative abilities, which can be immunosuppressive by inhibition of the lymphocyte reactivity or immunoinductive by influencing the IgM biosynthesis, adapted to the functional requirements. In this field, Hp 2-2 has a stronger effect than the two other Hp types. Moreover, the haptoglobins inhibit the prostaglandin synthesis and protect against harmful oxidation processes. These qualities are based on the hemoglobin binding ability and can be realized by Hp 1-1 with the comparatively highest efficacy. Further on, the haptoglobins are protease inhibitors. Finally, Hp 2-2 is associated with higher albumin and ceruloplasmin serum levels than Hp 2-1 and Hp 1-1. Evidently, the haptoglobins are inserted into a widely ramified network of biological functions. The selective advantages and disadvantages of the Hp polymorphism are noticeable under pathological conditions in case of malignant tumors, inflammations, autoimmune diseases, allergic illness, affective psychoses and affective lability favouring addiction.


Haptoglobin subtypes in a Bengalee population sample. HP1 subtyping has been performed on a Bengalee population sample of heterogeneous caste composition. The total sample size comes to n = 140 nonrelated adult individuals (68 males, 72 females). The following allele frequencies were observed: HP*1F = 0.0714, HP*1S = 0.1178, and HP*2 = 0.8107. It can be pointed out that the HP subtype distribution pattern found in the Bengalee sample follows in general the Oriental distribution pattern, though some differences are seen, especially concerning the HP*1F frequency.


Stature, upward social mobility and the nature of statural differences between social classes. Stature and educational level achieved were studied in 10 groups of 19-year-old Polish men born in 1967 and examined in 1986. Each group consisted of subjects equated for (1) parental education and occupation, (2) urban-rural residence and (3) number of children in family. It was found that within each group subjects who were secondary school students or graduates were on average taller than their age-mates who by the time of examination had never moved beyond the level of elementary or basic trade school. This result is consistent with the long-debated hypothesis that in industrial societies upward social mobility tends to be selective with regard to body height. Theoretically, such social selection could be expected to inflate the magnitude of social-class differences in stature by adding to them a genetic component. However, a mechanism can be envisaged by which preferential recruitment of taller individuals to upper social strata might indeed be at work and yet produce no differential distribution of genotypes along the social scale.


ABO segregation distortion in Visakhapatnam, India. Distortions in mother-infant, mother-child and father-child segregation for the ABO system as well as in the sex of offspring are described in a sample from a maternity service and from families of Visakhapatnam, India. Some distortions follow the expected fetomaternal incompatibility depression, others the expected feto-maternal induction of tolerance, and some remain unexplained. A differential action of selective factors on male and female fetuses, infants and children was also found, but no hypothesis could be postulated to explain it. The mother-infant matrix was found to be different from the mother-child matrix probably due to the inclusion of the reproductive time only in the mother-infant matrix. Unexpectedly, father-child segregation distortions were also found.


Relationship between the lingual fossa depth, mesiodistal and bucolingual diameter of dental crown in permanent maxillary incisors with the living Slovenians. On 311 dental stone casts of living children aged from 8 to 12 years, were measured the lingual fossa depth, MD diameter, and the BL diameter of the permanent maxillary incisors. The correlations and the differences of measured variables between left and right incisors, centrals and laterals, male and female incisors as well as the correlations between measured variables themselves were analysed. High left-right symmetry was established, except for directional asymmetry in female centrals. A significant positive correlation in terms of positive allometry between the lingual fossa depth and MD diameter was found. In the light of these results, the significance of the lingual fossa depth as a factor of strength is discussed.


Genetic structure of the Azores: marriage and inbreeding in Flores. Flores is one of the smallest and most westerly islands of the Atlantic archipelago of the Azores. This preliminary account of the population's demography and genetic structure uses dispensations to contract consanguineous marriages taken from the Roman Catholic marriage registers in order to estimate mean inbreeding rates in the population over the period 1860-1980. Comparisons are made with inbreeding rates on the Portuguese mainland and elsewhere in Western Europe, and reasons suggested to explain the rather high rates of inbreeding encountered on Flores.


Windsurfer somatotypes.

Windsurfer somatotypes. On the basis of data gathered during a series of Pre-Olympic Trials and the World Championships, both held at Cagliari (Italy) in 1983 and 1986, respectively, the somatotypes of athletes practicing windsurfing were studied. The sample is composed of 79 male athletes: 22 Sardinians, 31 mainland Italians, and 26 Europeans. The Heath-Carter anthropometric method (1967) was used to somatotype the individuals under study. Both the total sample as well as the three subsamples are characterized by almost identical average values of the three components. A subsample of athletes was formed, who had obtained important performances in their carriers (victories in World, European and Italian championships, participation in the Olympic Games etc.). In this group of top athletes it was seen that the best results in windsurfing are obtained when there is an even development of the three components (2.57-2.68-2.97) or a slight ectomorphic predominance.


Comparison of two bioelectrical impedance analysis models for total body water measurement in children. We compared two bioelectrical impedance analysis models, the right-sided tetrapolar method and an experimental cylindrical method, to total body water (TBW) determined by isotopic dilution in 37 prepubertal children aged 5-9 years, who were divided into development and cross-validation groups. Despite its theoretical advantage, no improvement in predicted TBW was seen with the experimental method. The best predictive equation, using the tetrapolar method, was TBW (kg) = 1.84 + 0.45 (height square/resistance) +0.11(weight); r2 = 0.98; SEE = 0.62 kg.


Growth during puberty in the XYY boy.

Growth during puberty in the XYY boy. The availability of a cohort of eight unselected XYY boys identified by newborn cytogenetic screening has enabled their growth to be studied longitudinally in comparison with controls from the same population. While no difference had been found in dimensions at birth, increased height velocity in childhood resulted in the XYY boys being 7.6 cm taller at the onset of their pubertal growth spurt. Increased intensity of growth at puberty with a peak height velocity of 10.6 cm/year contributed to their adult height of 188.1 cm. XYY boys showed twice the male-female difference in height implying that genes on the Y chromosome exert a quantitative effect on the sexual dimorphism of growth.


[Hermann Schaaffhausen (1816-1893) and the early history of the profession of anthropology]. The most important and best-known merit of Hermann Schaaffhausen is the correct explanation of the Neanderthal man as a fossil human being. Considering his work in the field of paleoanthropology one can designate him as the founder of this anthropological discipline in Germany. Beyond that he was also very active in the "Deutsche Anthropologische Gesellschaft" of the 19th century and played an important role as an editor of the journal "Archiv für Anthropologie". Thus, Hermann Schaaffhausen can be considered as one of the most important founders of Physical Anthropology in Germany. He belongs to those persons to whom German Anthropology owes its acknowledgement as an academic subject in German universities.


Cloning of the Pseudomonas glumae lipase gene and determination of the active site residues. The lipA gene encoding the extracellular lipase produced by Pseudomonas glumae PG1 was cloned and characterized. A sequence analysis revealed an open reading frame of 358 codons encoding the mature lipase (319 amino acids) preceded by a rather long signal sequence of 39 amino acids. As a first step in structure-function analysis, we determined the Ser-Asp-His triad which makes up the catalytic site of this lipase. On the basis of primary sequence homology with other known Pseudomonas lipases, a number of putative active site residues located in conserved areas were found. To determine the residues actually involved in catalysis, we constructed a number of substitution mutants for conserved Ser, Asp, and His residues. These mutant lipases were produced by using P. glumae PG3, from which the wild-type lipase gene was deleted by gene replacement. By following this approach, we showed that Ser-87, Asp-241, and His-285 make up the catalytic triad of the P. glumae lipase. This knowledge, together with information on the catalytic mechanism and on the three-dimensional structure, should facilitate the selection of specific modifications for tailoring this lipase for specific industrial applications.


Cloning and expression of a conjugated bile acid hydrolase gene from Lactobacillus plantarum by using a direct plate assay. The conjugated bile acid hydrolase gene from the silage isolate Lactobacillus plantarum 80 was cloned and expressed in Escherichia coli MC1061. For the screening of this hydrolase gene within the gene bank, a direct plate assay developed by Dashkevicz and Feighner (M. P. Dashkevicz and S. D. Feighner, Appl. Environ. Microbiol. 53:331-336, 1989) was adapted to the growth requirements of E. coli. Because of hydrolysis and medium acidification, hydrolase-active colonies were surrounded with big halos of precipitated, free bile acids. This phenomenon was also obtained when the gene was cloned into a multicopy shuttle vector and subsequently reintroduced into the parental Lactobacillus strain. The cbh gene and surrounding regions were characterized by nucleotide sequence analysis. The deduced amino acid sequence was shown to have 52% similarity with a penicillin V amidase from Bacillus sphaericus. Preliminary characterization of the gene product showed that it is a cholylglycine hydrolase (EC 3.5.1.24) with only slight activity against taurine conjugates. The optimum pH was between 4.7 and 5.5. Optimum temperature ranged from 30 to 45 degrees C. Southern blot analysis indicated that the cloned gene has similarity with genomic DNA of bile acid hydrolase-active Lactobacillus spp. of intestinal origin.


Rapid and sensitive method for detection of Shiga-like toxin-producing Escherichia coli in ground beef using the polymerase chain reaction. A rapid and sensitive method for detection of Shiga-like toxin (SLT)-producing Escherichia coli (SLT-EC) with the polymerase chain reaction (PCR) is described. Two pairs of oligonucleotide primers homologous to SLTI and SLTII genes, respectively, were used in multiplex PCR assays. The first pair generated a ca. 600-bp PCR product with DNA from all SLTI-producing E. coli tested but not from E. coli strains that produce SLTII or variants of SLTII. The second pair generated a ca. 800-bp PCR product with DNA from E. coli strains that produce SLTII or variants of SLTII but not from SLTI-producing E. coli. When used in combination, the SLTI and SLTII oligonucleotide primers amplified DNA from all of the SLT-EC tested. No PCR products were obtained with SLT primers with DNA from 28 E. coli strains that do not produce SLT or 44 strains of 28 other bacterial species. When ground beef samples were inoculated with SLT-EC strains 319 (O157:H7; SLTI and SLTII), H30 (O26:H11; SLTI), and B2F1/3 (O91:H21; SLTII variants VT2ha and VT2hb) and cultured in modified Trypticase soy broth for 6 h at 42 degrees C, an initial sample inoculum of as few as 1 CFU of these SLT-EC strains per g could be detected in PCR assays with DNA extracted from the broth cultures.


Detection of Aeromonas salmonicida from fish by using polymerase chain reaction amplification of the virulence surface array protein gene. A DNA-based assay was developed to detect Aeromonas salmonicida from infected fish by analyzing tissues, feces, and the tank water in which the infected fish were held. This analysis was done both by direct detection from samples and after a bacterial outgrowth step. Polymerase chain reaction (PCR) amplification of a 421-bp sequence from the 3' region of the surface array protein gene (vapA) of A. salmonicida provided a specific and sensitive method for the detection and identification of this important fish pathogen. The sensitivity of PCR detection of A. salmonicida directly from tissues was less than 10 CFU/mg. Furthermore, a detection level of 5 fg, equivalent to approximately 1 cell, was obtained by using purified chromosomal DNA as the template. This highly reproducible assay, which requires 45 min to complete, is therefore sensitive enough to be used as a noninvasive method for monitoring fish populations for the presence of carrier fish. Because the surface protein array (A-layer) is a virulence factor of A. salmonicida, PCR analysis with oligonucleotide primers directed at vapA can also be used to provide information on the potential virulence of a strain.


Electrochemical Ag+ for preservative use. In contact experiments with different experimental conditions, electrochemical Ag+ solutions exhibited better antimicrobial effectiveness against bacteria, a yeast species, and a mold than did analogous silver solutions from inorganic salts. The particular characteristics of electrochemical Ag+, such as the mode of action, effectiveness at low concentrations, and stability, indicate that Ag+ could be used effectively in preservatives.


Microbial transformation of deoxynivalenol (vomitoxin). Microbial inocula from rumen fluid, soil, and contents of the large intestines of chickens (CLIC) and of swine (SLIC) were tested for their ability to transform deoxynivalenol (vomitoxin) in vitro. Microorganisms in (CLIC) completely transformed pure vomitoxin, and this activity was retained through six serial subcultures. No alteration of the toxin by incubation with SLIC was detected, whereas 35% of the vomitoxin was metabolized in the original culture of rumen fluid and 50% was metabolized by the soil sample, though metabolism was decreased in subsequent subcultures of either sample. A single metabolite was isolated and identified as deepoxy vomitoxin. The increase in concentration of deepoxy vomitoxin in the culture medium corresponded with the decrease in vomitoxin concentration. The vomitoxin transformation rate was not affected by either the ratio of CLIC to vomitoxin (5 to 0.2 g of CLIC per mg of vomitoxin) or the initial concentration of vomitoxin (14 to 1,400 ppm) in the medium. Biotransformation of vomitoxin was completely inhibited when the pH in the medium was lowered to 5.20. Sodium azide at a 0.1% (wt/vol) concentration in the medium blocked the transformation of vomitoxin, suggesting that the deepoxidation of vomitoxin is an energy-dependent process. About 50% of the vomitoxin in moldy corn in culture medium was transformed by microorganisms from CLIC. The vomitoxin transformation rate in moldy corn was not affected when the concentration of CLIC changed from 0.2 to 0.8 g/ml of medium. Vomitoxin in the moldy corn was not transformed when CLIC were added to corn without culture medium.(ABSTRACT TRUNCATED AT 250 WORDS)


The beta-mannanase from "Caldocellum saccharolyticum" is part of a multidomain enzyme. The complete sequence of a beta-mannanase gene from an anaerobic extreme thermophile was determined, and it shows that the expressed protein consists of two catalytic domains and two binding domains separated by spacer regions rich in proline and threonine residues. The amino-terminal catalytic domain has beta-mannanase activity, and the carboxy-terminal domain acts as an endoglucanase. Neither domain shows homology with any other cellulase or hemicellulase sequence at the nucleic acid or protein level.


Monoclonal antibodies that detect live salmonellae. Nine immunoglobulin G and nine immunoglobulin M murine monoclonal antibody-producing hybridomas reactive with live Salmonella bacteria were obtained from several fusions of immune spleen cells and Sp2/0 myeloma cells. The antibodies were selected by the magnetic immunoluminescence assay. The monoclonal antibodies were reactive with serogroups A, B, C1, C2, D, E, and K and Salmonella choleraesuis subsp. diarizonae. Each monoclonal antibody proved to be reactive with a distinct serotype. Clinical isolates belonging to these Salmonella serogroups could be detected. Reactivity with non-Salmonella bacteria proved to be minor.


Exploitation of gene(s) involved in 2,4-diacetylphloroglucinol biosynthesis to confer a new biocontrol capability to a Pseudomonas strain. Tn5 mutagenesis and complementation analysis were used to clone a 6-kb genomic fragment required for biosynthesis of 2,4-diacetylphloroglucinol (Phl) from fluorescent Pseudomonas sp. strain F113. A recombinant plasmid, pCU203, containing this region partially complemented a Phl production-negative mutant (F113G22) derived from strain F113. When sugar beet seeds were sown into an unsterilized soil, in which sugar beet was subject to damping-off by Pythium ultimum, the emergence of sugar beet seeds inoculated with strain F113 was significantly greater than that of seeds inoculated with F113G22. Transfer of pCU203 into eight other Pseudomonas strains conferred the ability to synthesize Phl in only one of these strains, Pseudomonas sp. strain M114. Strain M114(pCU203) showed enhanced antagonism towards P. ultimum in vitro and significantly increased the emergence of sugar beet seeds in the same soil compared with emergence induced by the parent strain M114.


Biphenomycin A production by a mixed culture. Production of biphenomycin A by Streptomyces griseorubiginosus 43708 was stimulated by a mixed culture with a partner strain, Pseudomonas maltophilia 1928. This stimulatory effect on biphenomycin A accumulation by the mixed culture was caused by the enzyme activity which strain 1928 possessed. It is suggested that in a mixed culture strain 43708 produces a precursor of biphenomycin A in culture broth and that strain 1928 converts the precursor to biphenomycin A.


Role of hydrogen peroxide in loss of culturability mediated by visible light in Escherichia coli in a freshwater ecosystem. A study was made of the mechanisms by which visible light produces cell dormancy in Escherichia coli, resulting in loss of culturability. Visible light may act directly on the cells or generate photoproducts with a negative effect on the cells. In nonilluminated microcosms the addition of increasing concentrations of hydrogen peroxide, one of the photoproducts formed in natural aquatic systems, gave rise to the formation of nonculturable cells and injured culturable cells, and this negative effect depended on the concentration of peroxide. On the other hand, in illuminated microcosms the addition of compounds which eliminate hydrogen peroxide (i.e., catalase, sodium pyruvate, and thioglycolate) had a protective effect on the E. coli cells, as the CFU counts on minimal medium and on recuperation medium were significantly higher (P < 0.05) than those detected in the absence of these compounds. Furthermore, when hydrogen peroxide was eliminated, the CFU counts on recuperation medium did not fall significantly, indicating that nonculturable cells did not form. These results rule out the direct effect of visible light on the cells and show that hydrogen peroxide, generated photochemically, may be the cause of the loss of culturability of E. coli in illuminated systems.


Relationship of total viable and culturable cells in epiphytic populations of Pseudomonas syringae. The direct viable count method, used to detect viable but nonculturable bacteria in aquatic systems, was modified to examine epiphytic populations of Pseudomonas syringae. Viable-population sizes determined from the number of cells that elongated when incubated with yeast extract and nalidixic acid were compared with those determined by the conventional plate count method. The plate count method accurately determined the number of viable cells in epiphytic P. syringae populations in a state of active growth under conditions of high relative humidity. The plate count method also accurately determined the number of viable cells in P. syringae inoculum, or a growing P. syringae population, subject to desiccation stress under conditions of low relative humidity. In epiphytic populations of P. syringae older than 80 h, however, the plate count underestimated the viable-population size by about two- to fourfold, suggesting that up to 75% of the P. syringae population was nonculturable. These nonculturable cells may have entered a starvation-survival state, induced by low nutrient availability in the phyllosphere environment. Epiphytic P. syringae populations undergoing rapid size changes due to growth and death under fluctuating environmental conditions in the field should be accurately enumerated by the plate count method. However, the possible underestimation of viable-population size under some circumstances should be considered in epidemiological studies of phytopathogenic bacteria and when genetically engineered microorganisms in terrestrial ecosystems are monitored.


Heterotrophic bacteria in an air-handling system. Heterotrophic bacteria from structural surfaces, drain pan water, and the airstream of a well-maintained air-handling system with no reported building-related illness were enumerated. Visually the system appeared clean, but large populations of bacteria were found on the fin surface of the supply-side cooling coils (10(5) to 10(6) CFU cm-2), in drain pan water (10(5) to 10(7) CFU ml-1), and in the sump water of the evaporative condenser (10(5) CFU ml-1). Representative bacterial colony types recovered from heterotrophic plate count cultures on R2A medium were identified to the genus level. Budding bacteria belonging to the genus Blastobacter dominated the supply surface of the coil fins, the drain pan water, and the postcoil air. These data and independent scanning electron microscopy indicated that a resident population of predominantly Blastobacter bacteria was present as a biofilm on the supply-side cooling coil fins.


Characterization of two genes encoding Bacillus thuringiensis insecticidal crystal proteins toxic to Coleoptera species. Bacillus thuringiensis EG2838 and EG4961 are highly toxic to Colorado potato beetle larvae, and only strain EG4961 is toxic to southern corn rootworm larvae. To investigate the cause of the different insecticidal activities of EG2838 and EG4961, cryIII-type genes toxic to coleopterans were cloned from each strain. The cryIIIB gene, cloned as part of an 8.0-kb EcoRI fragment of EG2838 DNA, encoded a crystal protein (CryIIIB) of 74,237 Da. The cryIIIB2 gene, cloned as part of an 8.3-kb PstI-Asp718 fragment of EG4961 DNA, encoded a crystal protein (CryIIIB2) of 74,393 Da that was 94% identical to CryIIIB. Analysis of the transcriptional start sites showed that cryIIIB and cryIIIB2 were initiated from a conserved region located within 130 nucleotides upstream from the translation start sites of both genes. Although the CryIIIB and CryIIIB2 proteins were similar in sequence, they displayed distinct insecticidal activities: CryIIIB was one-third as toxic as CryIIIB2 to Colorado potato beetle larvae, and CryIIIB2, but not CryIIIB, was toxic to southern corn rootworm larvae. Genes encoding crystal proteins of approximately 32 and 31 kDa were located adjacent to the cryIIIB and cryIIIB2 genes, respectively. The 32- and 31-kDa crystal proteins failed to enhance the insecticidal activities of CryIIIB and CryIIIB2.


Gene probe analysis of soil microbial populations selected by amendment with 2,4-dichlorophenoxyacetic acid. Soils with a history of 2,4-dichlorophenoxyacetic acid (2,4-D) treatment at field application rates and control soils with no prior exposure to 2,4-D were amended with 2,4-D in the laboratory. Before and during these treatments, the populations of 2,4-D-degrading bacteria were monitored by most-probable-number (MPN) enumeration and hybridization analyses, using probes for the tfd genes of plasmid pJP4, which encode enzymes for 2,4-D degradation. Data obtained by these alternate methods were compared. Several months after the most recent field application of 2,4-D (approximately 1 ppm), soils with a 42-year history of 2,4-D treatment did not have significantly higher numbers of 2,4-D-degrading organisms than did control soils with no prior history of treatment. In response to laboratory amendments with 2,4-D, both the previously treated soils and those with no prior history of exposure exhibited a dramatic increase in the number of 2,4-D-metabolizing organisms. The MPN data indicate a 4- to 5-log population increase after one amendment with 250 ppm of 2,4-D and ultimately a 6- to 7-log increase after four additional amendments, each with 400 ppm of 2,4-D. Similarly, when total bacterial DNA from the soil microbial community of these samples was analyzed by using a probe for the tfdA gene (2,4-D monoxygenase) or the tfdB gene (2,4-dichlorophenol hydroxylase) a dramatic increase in the level of hybridization was observed in both soils.(ABSTRACT TRUNCATED AT 250 WORDS)


Resistance of proline-containing peptides to ruminal degradation in vitro. Mixed ruminal bacteria utilized an enzymatic digest of casein at a rate faster than that for an enzymatic digest of gelatin, but neither amino acid source was completely utilized even when the incubation period was as long as 96 h. Since the reaction of ninhydrin with the residual nonammonia, nonprotein nitrogen was more than twofold stronger when the samples were hydrolyzed with 6 N HCl, it appeared that much of the residual nitrogen was from peptides. Approximately 66% of the nonammonia, nonprotein, ninhydrin-reactive material could not be recovered as amino acids, but there was a significant decrease in total amino acid nitrogen when the samples were pretreated with a C18 Sep-Pak column to remove peptides. The resistant peptides had an abundance of proline, and subsequent incubations showed that synthetic dipeptides which contained proline were hydrolyzed slowly. Lysine appears to be the amino acid which is most apt to limit ruminant production. Dipeptides containing proline and lysine were hydrolyzed at least fivefold slower than lysine-alanine. Methionine, another potentially limiting amino acid, was also degraded at a slower (2.5-fold) rate when it was present as part of a proline dipeptide.


Effect of sodium chloride on the intracellular solute pools of Listeria monocytogenes. The concentrations of intracellular solutes in Listeria monocytogenes were examined in cells grown at various concentrations of NaCl. At 5% NaCl, cells contained elevated concentrations of potassium and glycine betaine compared with concentrations in cells grown without NaCl. At 7.5% NaCl, cells contained increased concentrations of K+, glycine betaine, glycine, alanine, and proline. Only glycine betaine, choline, or glycine promoted growth on a solidified defined medium containing 4% NaCl; there was no growth at higher concentrations of NaCl in the defined medium.


Presence of human immunodeficiency virus nucleic acids in wastewater and their detection by polymerase chain reaction. The human immunodeficiency virus type 1 (HIV-1) released by infected individuals or present in human and hospital wastes can potentially cause contamination problems. The presence of HIV-1 was investigated in 16 environmental samples, including raw wastewater, sludge, final effluent, soil, and pond water, collected from different locations. A method was developed to extract total nucleic acids in intact form directly from the raw samples or from the viral concentrates of the raw samples. The isolated nucleic acids were analyzed for the presence of HIV-1 by using in vitro amplification of the target sequences by the polymerase chain reaction (PCR) method. HIV-1-specific proviral DNA and viral RNA were detected in the extracted nucleic acids obtained from three wastewater samples by this method. The specificity of the PCR-amplified products was determined by Southern blot hybridization with an HIV-1-specific oligonucleotide probe, SK19. The isolated nucleic acids from wastewater samples were also screened for the presence of poliovirus type 1, representing a commonly found enteric virus, and simian immunodeficiency virus, representing, presumably, rare viruses. While poliovirus type 1 viral RNA was found in all of the wastewater samples, none of the samples yielded a simian immunodeficiency virus-specific product. No PCR-amplified product was yielded when wastewater samples were directly used for the detection of HIV-1 and poliovirus type 1. The wastewater constituents appeared to be inhibitory to the enzymes reverse transcriptase and DNA polymerase.(ABSTRACT TRUNCATED AT 250 WORDS)


Determination of virulence of different strains of Listeria monocytogenes and Listeria innocua by oral inoculation of pregnant mice. A pregnant mouse model was developed to follow the course of infection after peroral inoculation with six different strains of Listeria monocytogenes and one strain of Listeria innocua. Tissues were sampled and analyzed by microbiologic and histologic methods for 5 days postinoculation. In gnotobiotic pregnant BALB/c mice, L. monocytogenes Scott A (SA), serotype 4b, colonized the gastrointestinal tract, translocated to the livers and spleens of mice by day 1 postinoculation, and multiplied in these tissues until day 4. Infection of the placental tissues occurred by days 3 and 4 and was followed by infection of the fetuses. Little damage of colonic and cecal tissues was evident by histologic examination. Livers and spleens showed a cellular immune response; a similar immune response was not detected in the placentas or fetuses. A rough variant of L. monocytogenes SA which was as virulent as the parent strain in mice when injected intraperitoneally was less virulent perorally and did not consistently infect the fetuses. L. monocytogenes ATCC 19113, serotype 3a, did not colonize the gastrointestinal tract, nor was it isolated from any internal tissue. L. monocytogenes strains of serotypes 1/2a and 1/2b behaved like the SA strain in this mouse model. L. innocua colonized the gastrointestinal tract and translocated to the livers and spleens but did not survive in these organs and rapidly disappeared without infecting placental and fetal tissues. In comparison with gnotobiotic mice, conventional pregnant mice inoculated with L. monocytogenes strains showed less consistent infection. These results suggest that the gnotobiotic pregnant mouse is a useful model for detecting differences in virulence relating to colonization, invasiveness, and uteroplacental infection which cannot be detected by intraperitoneal inoculation of mice.


Cyclization characteristics of cyclodextrin glucanotransferase are conferred by the NH2-terminal region of the enzyme. Cyclodextrin glucanotransferase (CGTase; EC 2.4.1.19) is produced mainly by Bacillus strains. CGTase from Bacillus macerans IFO3490 produces alpha-cyclodextrin as the major hydrolysis product from starch, whereas thermostable CGTase from Bacillus stearothermophilus NO2 produces alpha- and beta-cyclodextrins. To analyze the cyclization characteristics of CGTase, we cloned different types of CGTase genes and constructed chimeric genes. CGTase genes from these two strains were cloned in Bacillus subtilis NA-1 by using pTB523 as a vector plasmid, and their nucleotide sequences were determined. Three CGTase genes (cgt-1, cgt-5, and cgt-232) were isolated from B. stearothermophilus NO2. Nucleotide sequence analysis revealed that the three CGTase genes have different nucleotide sequences encoding the same amino acid sequence. Base substitutions were found at the third letter of five codons among the three genes. Each open reading frame was composed of 2,133 bases, encoding 711 amino acids containing 31 amino acids as a signal sequence. The molecular weight of the mature enzyme was estimated to be 75,374. The CGTase gene (cgtM) of B. macerans IFO3490 was composed of 2,142 bases, encoding 714 amino acids containing 27 residues as a signal sequence. The molecular weight of the mature enzyme was estimated to be 74,008. The sequence determined in this work was quite different from that reported previously by other workers. From data on the three-dimensional structure of a CGTase, seven kinds of chimeric CGTase genes were constructed by using cgt-1 from B. stearothermophilus NO2 and cgtM from B. macerans IFO3490. We examined the characteristics of these chimeric enzymes on cyclodextrin production and thermostability. It was found that the cyclization reaction was conferred by the NH2-terminal region of CGTase and that the thermostability of some chimeric enzymes was lower than that of the parental CGTases.


High-level expression of the Streptomyces clavuligerus isopenicillin N synthase gene in Escherichia coli. The pcbC gene, which encodes isopenicillin N synthase (IPNS), was subcloned from Streptomyces clavuligerus into Escherichia coli by using the pT7 series of plasmid vectors. The polymerase chain reaction was used to introduce an NdeI site at the translation initiation codon of pcbC, allowing the gene to be inserted behind an E. coli type of ribosome binding site. This construction directed high-level expression of IPNS, but the IPNS was in an inactive form in inclusion bodies. Active IPNS was recovered by solubilizing and renaturing the protein.


Subculturing of a polychlorinated biphenyl-dechlorinating anaerobic enrichment on solid media. An anaerobic culture capable of dechlorinating polychlorinated biphenyls was subcultured under strict anaerobic conditions on solid media containing sterilized river sediment. The dechlorination activity was transferred as a bacterial colony on a solid medium three times. After two transfers on solid medium, the culture was no longer methanogenic but still dechlorinated a mixture of tri- and tetrachlorobiphenyls. This demonstrates that anaerobic bacteria are responsible for the polychlorinated biphenyl dechlorination and can be grown without polychlorinated biphenyl on solid media.


Assessment of the Accuprobe Listeria monocytogenes culture identification reagent kit for rapid colony confirmation and its application in various enrichment broths. The Accuprobe Listeria monocytogenes Culture Identification Reagent Kit, a nonradioactive probe, was evaluated as a colony confirmation test and in different selective or nonselective enrichment broths. The probe was 100% sensitive and 100% specific when applied to isolated colonies. The minimal detection limit in physiological saline was established to be about 10(5) CFU of L. monocytogenes. Hybridization done directly in broths seeded with L. monocytogenes showed variable results. Three nonselective broths (Todd-Hewitt broth, brain heart infusion broth, and tryptic soy broth) and one selective broth (FDA) gave positive reactions at an inoculum of 5 x 10(6) CFU, whereas two other selective broths (UVM, and PALCAMY) gave negative reactions with up to 10(8) and 10(9) CFU. In FDA broth, the level of detection of L. monocytogenes was not modified by the presence of other organisms in mixed cultures.


Cloning and sequence analysis of genes for dehalogenation of 4-chlorobenzoate from Arthrobacter sp. strain SU. Strains of Arthrobacter catalyze a hydrolytic dehalogenation of 4-chlorobenzoate (4-CBA) to p-hydroxybenzoate. The reaction requires ATP and coenzyme A (CoA), indicating activation of the substrate via a thioester, like that reported for Pseudomonas sp. strain CBS3 (J. D. Scholten, K.-H. Chang, P. C. Babbit, H. Charest, M. Sylvestre, and D. Dunaway-Mariano, Science 253:182-185, 1991). The dehalogenase genes of Arthrobacter sp. strain SU were cloned and expressed in Escherichia coli. Analyses of deletions indicate that dehalogenation depends on three open reading frames (ORFs) which are organized in an operon. There is extensive sequence homology to corresponding gene products in Pseudomonas sp. strain CBS3, suggesting that ORF1 and ORF2 encode a 4-CBA-CoA-ligase and a 4-CBA-CoA dehalogenase, respectively. ORF3 possibly represents a thioesterase, although no homology to the enzyme from Pseudomonas sp. strain CBS3 exists.


Application of ozone disinfection to remove Enterococcus seriolicida, Pasteurella piscicida, and Vibrio anguillarum from seawater. Survival of bacterial fish pathogens, including Enterococcus seriolicida, Vibrio anguillarum, and Pasteurella piscicida, in ozonated seawater was determined in a batch system. Bacterial counts of all fish pathogens decreased at more than 0.040 to 0.060 mg of total residual oxidants (TROs) per liter, whereas no decrease in viable counts was observed at less than 0.018 to 0.028 mg of TROs per liter. The 99% inactivation point was achieved at concentrations of 0.111 mg/liter for E. seriolicida, 0.063 mg/liter for P. piscicida, and 0.064 mg/liter for V. anguillarum within 1 min. Moreover, the mean 99 and 99.9% killing concentration-contact time (C.t) products were 0.123 and 0.186 mg.min/liter for E. seriolicida, 0.056 and 0.084 mg.min/liter for P. piscicida, and 0.081 and 0.123 mg.min/liter for V. anguillarum, respectively. However, the mean 99 and 99.9% C.t products for the mixed population in coastal seawater were 0.200 and 0.621 mg.min/liter. These results strongly suggest that ozone treatment at more than 1.0 mg of TROs per liter for several minutes is able to disinfect seawater for mariculture efficiently.


Direct extraction of bacterial plasmids from food for polymerase chain reaction amplification. In this report we describe a simple and rapid technique using DNA affinity columns that permits direct extraction of bacterial plasmids from a variety of foods for polymerase chain reaction amplification. The procedure was used to detect virulent enteroinvasive Escherichia coli in several artificially seeded matrices, including seafoods, greens, dairy products, enrichment media, and water. Polymerase inhibitors present in both foods and enrichment media were removed efficiently.


Applicability of an immunoblot technique combined with a semiautomated electrophoresis system for detection of staphylococcal enterotoxins in food extracts. We studied the usefulness of an immunoblot technique for the detection of staphylococcal enterotoxins (SEs) in strains and food extracts. Food samples (milk, yogurt, hot dog sausage, cheese, and mayonnaise) were artificially contaminated with SEA through SEE. Protein A did not interfere with the results; it appeared on electrophoresis gels as bands with molecular weights higher than those of the SEs. Other food proteins were not revealed by the technique. The immunoblot technique proved to be fast, specific, and sensitive for the detection of SEs in foods.


Analysis of exopolysaccharide production by Lactobacillus casei CG11, isolated from cheese. Exopolysaccharide-producing Lactobacillus casei CG11 was isolated from soft, white, homemade cheese. In basal minimal medium, it produces a neutral heteropolysaccharide consisting predominantly of glucose (about 75%) and rhamnose (about 15%). Plasmid curing experiments revealed that exopolysaccharide production by strain CG11 is linked to a plasmid approximately 30 kb in size.


African American women and depression: a review and critique of the literature. African American women are often identified as a group at high risk for depression; they are also viewed as either delaying or not seeking treatment for the depression. The assessment, diagnoses, treatment, and prevention of depression in African American women require special sensitivity. To determine whether special sensitivity is shown to this population, this review examines the literature on African American women and depression, and critiques the major scales used in assessing depression. Violence is identified as an additional risk factor for depression in African American women. It is suggested that an interactive approach to risk factors for depression in African American women provides a better basis for psychiatric nursing practice with this population.


Individual psychodynamic psychotherapy with older adults: perspectives from a nurse psychotherapist. This report reviews both historical and current literature pertaining to individual psychodynamic psychotherapy with older adults. Demographic projections for significant increases in the geriatric population are presented and linked with implications for mental health. Barriers to geriatric psychotherapy are examined, and themes common among older persons are identified. Benefits of psychotherapy to patients and psychotherapists are summarized. Literature on adult developmental theory is explored. Unique aspects of gender issues, transference, countertransference, and termination as described in the literature are presented. Implications for nursing practice include a recommendation for increased nursing efforts in the areas of practice, research, and theory building.


Empowerment support with adult female survivors of childhood incest: Part I--Theories and research. This report is concerned with the concept of empowerment support as a nursing intervention that facilitates the development of mastery, competence, self-worth, and control in the adult female survivor of childhood incest. Empowerment support has been derived from Orem's theory of nursing system. In that theory, empowerment support is encompassed in particular "methods of helping." Theories and research that relate to incest trauma and empowerment support are discussed from an interdisciplinary perspective.


Empowerment support with adult female survivors of childhood incest: Part II--Application of Orem's methods of helping. This report addresses the integration and application of empowerment support with Orem's methods of helping, which include (1) providing a developmental environment, (2) psychological support, (3) guiding another, and (4) teaching another. Empowerment support is viewed as basic helping methods (supportive psychotherapy) for the psychiatric nurse to use with adult female survivors of childhood incest.


Stress and coping in families of children with myelomeningocele. This pilot study examined differences in and relationships between parent health-related stressors (child care needs and parental concerns), daily hassles, and coping strategies of 17 mothers and 17 fathers of preschool and school-age children with myelomeningocele (MMC). Help related to play was the most frequent need among mothers; fathers needed the most help with school activities. Among the greatest concerns of both parents were their child's future and sufficient income. Too many things to do was a frequently mentioned hassle by both parents. Having faith in God was the coping strategy mentioned most often by both parents.


Integrating the bio into the biopsychosocial: understanding and treating biological phenomena in psychiatric-mental health nursing. Advances in neuroscientific understandings of the interrelationships between brain, behavior, emotion, and cognition offer new opportunities for psychiatric-mental health nursing. Yet, even though the discipline conceptually embraces a biopsychosocial perspective as part of its holistic mandate, the factual integration of biological sciences into practice, research, and education is limited. Integrating the biological perspective into a holistic paradigm and progressing toward a discipline in which the biological, psychological, and social interact coherently and interdependently requires a dual focus on understanding and treating patients and their social and physical environments. We describe how in the past the discipline has strived toward understanding and treating patients from predominantly psychological and social perspectives. We also show how progress in the biology of mental health and illness provides new avenues for understanding and treating patients' responses to actual and potential health problems. This in turn will contribute to the emergence of a truly holistic discipline of psychiatric-mental health nursing.


Uncovering a hidden language: the effects of listening and talking on blood pressure and heart rate. Listening and talking are essential to everyday life and especially to successful nursing interventions. Whereas the cardiovascular changes that occur during talking have been extensively documented, those that occur during listening have not been studied. Blood pressure (BP) and heart rate (HR) were measured in healthy men (N = 54) and women (N = 55) while they listened and talked. Talking resulted in significant increases in both BP and HR; although also significant, increases during listening were of a lesser magnitude. These cardiovascular changes were affected by the order of the dialogue activities (talking or listening first) and by gender.


Collaboration as a strategy for acquired immunodeficiency syndrome prevention. An eight-session training model used a social interactive framework to combine theoretical and methodological aspects of peer counseling, cross-cultural communication, and transcultural nursing, with a conviction that the participants (volunteers from an ongoing, urban methadone maintenance program) had significant strengths on which to build. The objective was to assist urban, drug dependent black women in taking control of their own lives through collaboration with health care professionals to develop and promote culturally acceptable behavioral alternatives related to reduction of risk for human immunodeficiency virus. The collaborative approach focused on rewards of behavioral change and minimized attention to prevention of negative behaviors, while openly valuing input from the women who are potential health promoters in their own communities. Evaluation of the Peer Counseling Leadership Training Program suggested that the approach facilitated personal risk-reducing behavioral change, improved self esteem, and successfully promoted involvement in community-based prevention efforts.


Validation of addictions nursing diagnoses in a sample of alcohol abstainers 1 year posttreatment. This study examined the fit between 26 Addictions Nursing diagnoses and a sample of clients who had maintained abstinence from alcohol use for 1 year after inpatient treatment for alcohol abuse. Data were obtained from interview transcriptions of 26 successful abstainers. Investigator identification of diagnoses were validated by expert nurse clinicians. Although participants had been abstinent for a year, 73% of the sample showed defining characteristics of 17 of the 26 diagnoses. In addition, the raters identified 3 human responses for which no diagnoses exist, 8 diagnoses that do not have defining characteristics that fit the data, and 13 additional defining characteristics that could be added to the list.


Circadian dysregulation in abused individuals: a proposed theoretical model for practice and research. Trauma in the form of physical and sexual abuse remains a major issue confronting health professionals and society today. Despite the identification of large numbers of children at risk, no studies exist on the association between childhood abuse and the development of acute and long-term disruption of sleep/wake patterns. Furthermore, identification of the most effective nursing interventions to restore healthy sleep rhythms is sorely lacking. As a basic human process, sleep follows a circadian pattern, effecting sleep onset and stages. This article explores a possible model to link the sleep disruption seen in abuse children with circadian and rhythmic theories.


Cognitive nursing interventions with long-term care residents: effects on neurocognitive dimensions. We recently reported that cognitive nursing interventions--such as cognitive-behavioral group therapy and focused visual imagery group therapy--administered over time may produce significant and lasting improvements in overall cognitive status in nursing home residents with slight to moderate cognitive impairment, when compared with subjects participating in educational discussion groups. To further elucidate the cognitive gains made by subjects, we reanalyzed the data focusing on the 15 neurocognitive parameters tested by means of the Modified Mini-Mental State Examination. Main effects of intervention were noted on neurocognitive operations involving abstraction and conceptual thinking, concentration and linguistic manipulation, and execution of auditorily presented language skills. Main effects for time were observed on short and medium term recall, fluency of category retrieval, abstraction and conceptual thinking, concentration and linguistic manipulation, and execution of visually presented commands. Intervention and time were found to produce interaction effects on subjects' ability to visually and linguistically identify objects and their praxic ability to recognize and redraw simple but intersecting geometric figures. From a functional brain perspective, these effects involved brain functions at higher cortical and subcortical/limbic levels, and lower and more basic cortical functions were not affected. These findings underscore the role of psychogeriatric nursing in maintaining or restoring cognitive function in nursing home residents with mild to moderate cognitive impairment, not only for the sake of cognition itself but also for the (corollary) sake of promoting functional independence and self-care in a high-risk population.


The conceptualization of impulsivity for psychiatric nursing practice. This article conceptualizes impulsivity from the perspective of psychiatric nurses in the inpatient setting. A theoretical model of the nature and the process of impulsivity is developed phenomenologically from information obtained from psychiatric nurses and patient chart reviews. The impulsive event is characterized by three elements: (1) precipitants of the behavior, (2) characteristics of the impulsive event, and (3) staff response. The expression of these elements differentiates impulsivity according to patient domains of psychotic and nonpsychotic illnesses. The emerging differentiation provides the opportunity to develop distinct nursing interventions that target the impulsivity within each of these domains.


[Diversity of malaria in the Sahelo-Saharan region. A review apropos of the status in Niger, West Africa]. The concept of epidemiologic facies of malaria underlines the diversity in the expression of the disease in areas where important ecological variations interfere largely with transmission. Niger is quite a border region between the afrotropical fauna from the south and the Palearctic fauna from the north. The last one filters through the mountains where it maybe represents a relic of ancient paleoclimates. Annual variations of the northern limit of Anopheles arabiensis, in the Sahelo-Saharan region including some oasis, are related to temporary breeding places produced by seasonal rainfall, after estivation during the dry season or after a long migration with the wind. An. gambiae s.s is present in the south and along the Niger river, with An. funestus, even till Zinder. The northern limit of An. nili is the Niger river. The permanent variations of the environment induce great differences in the level of transmission between an intermediate stable situation in the south to an unstable one in the north. Epidemic outbreaks appear some years in vulnerable populations. The implementation of a malaria program supposes to take account of the various eco-epidemiologic situations all over the country. Even if mortality and morbidity became lower, natural precaution in some groups of people must be preserved.


[Severe malaria attacks in adults in Cameroon: comparison of 2 therapeutic protocols using quinine via parenteral route]. Increasing frequency and severity of cerebral malaria have become a major problem in the area of Yaoundé (Cameroon, Central Africa). Based on recent findings in pharmacokinetic parameters in cerebral malaria, a quinine infusion regimen (8 mg of quinine base/kg of body weight over 1 h followed by 8 mg of base/kg over 7 h, then 8 mg/kg over 8 h 3 times daily for 3 days) was randomly allocated to 10 patients; 10 others received a more classical regimen currently used in Cameroon of 8 mg of base/kg over 8 h, 3 times daily for 3 days. In the loading dose group, there was a significant decrease in the duration of coma (48%), and the parasite clearance times were reduced by 33%. This regimen has been safe and effective: it is recommended in Yaoundé.


[Feasibility of mosquito control using insecticide-impregnated bednets in rural areas of Cameroon]. The feasibility of using impregnated bednets in a malaria control strategy has been evaluated in a rural area of Cameroon. The benefit is well perceived by the population in terms of protection against nuisance but not in terms of prevention of the disease. The correct use of bednets is, however, unsatisfactory. The material should be adapted to the various sleeping accommodations, and efforts for education and information directed towards the potential users should be intensified.


[Small-scale evaluation of the efficacy of growth-regulating insecticides on larvae of the Simulium damnosum complex (Diptera: Simuliidae)]. The efficacy of insect growth regulators was assessed in small scale tests on larvae of the Simulium damnosum complex (Diptera: Simuliidae) in the Ivory Coast. Three compounds [OMS 2015 (triflumuron), OMS 3009 (teflubenzuron), OMS 3013 (chlorfluazuron)] belong to the group of benzoylphenyl-urea substitutes; these IGR's are supposed to inhibit chitin synthesis. Two other compounds are Juvenile Hormone Analogs (JHA's) (OMS 3007 and OMS 3019). The last compound (OMS 3010) is a phenoxycarbamate. The first three compounds had a low efficacy on blackfly larvae, which is consistent with the literature data for another compound of this group: diflubenzuron. The other three compounds (OMS 3007, OMS 3010 and OMS 3019) were much more efficient, OMS 3010 and OMS 3019 showing high activity at low concentrations. These results would justify further studies on the effect of larval age and exposure parameters, and eventually full scale river tests.


[Results of tuberculosis treatment in a health district in Zaire]. The results of the treatment of tuberculosis have been evaluated among 407 patients distributed into 268 cases of pulmonary tuberculosis with positive smears (TP+), 70 pulmonary forms with negative smears (TP-) and 69 cases of extrapulmonary tuberculosis (TEP). A group 1 of 361 patients including new cases and late relapses and consisting of 236 TP+, 59 TP- and 66 TEP has been put through the treatment pattern: 2S6H7T7 + 10H7T7 or 2S6H7 + 10S2H2. Group 2, of 21 patients consisting of failures, early relapses and previously but irregularly treated cases, was given a pattern: 2R7E7H7Z7 + 10R2H2. In group 3, 25 new cases were given a short treatment: 2R7E7H7Z7 + 4R7H7. In group 1 we have recorded 68.42% cured patients, 8.59% failures and 14.40% neglects of treatment. The remaining 8.59% include deceased, transfers and patients put through extended treatment. The rate of cure was better among TEP patients (95.46%) than among TP- patients (79.66%) and TP+ patients (58.05%); failures were proved to be more frequent among TP+ patients (11.88%) than among TP- patients (3.39%) and TEP patients (1.51%). In group 2 and 3 successes have amounted to 95.24% and 84% respectively. Considering rates of cure, irregular treatments, neglects and failures with standard patterns (group 1), it appears to be desirable that rifampicin-including short patterns are added to antitubercular therapeutic strategies of developing countries.


Mansonella perstans filariasis: failure of albendazole treatment. Infections with Mansonella perstans are common in certain parts of Africa and South America. There is no standard treatment at present. We evaluated the effect of albendazole on microfilaremia in ten consecutive patients. No decrease in microfilarial counts could be demonstrated after a median follow-up period of 45 days. Albendazole was not shown to be useful for treatment of Mansonella perstans filariasis.


Conjunctival rhinosporidiosis. Report of three cases from Zaire. The authors report three cases of conjunctival rhinosporidiosis from Zaire, two of which are believed to be the first documented in the northeastern part of the country. All patients were males. Two patients were very young children, respectively 5 and 6 years old. The third patient was a 35-year-old man. The diagnosis was based on histopathology which revealed the characteristic features of Rhinosporidium seeberi. Total excision was the elective treatment. The disease recurred eleven months later in one case, probably from local dissemination of the parasite during surgery.


[Dental caries, fluoride tablets and enamel opacities]. While fluoridation is the most effective preventive measure against dental caries, it increases the risk of tooth mottling or fluorosis. A total of 2,003 children aged 5 to 21 years were examined by a dentist following the recommendations of WHO and the standardized system of Möller and Poulsen, including X-ray investigation. The clinical aspects of fluorosis were classified on a 5-point scale. Data on the medical history, socioeconomic conditions, oral hygiene, carbohydrate ingestion and fluoride supplements of these patients were also collected. The majority of the 2,003 children, 1687 (84.2%), had never received dietary fluoride supplements. Only 93 (4.64% of the total) of the 316 children who had taken fluoride, regularly ingested the recommended daily dose of 1.0 mg F-. This group had 43.2% fewer incidents of tooth decay, and came from the higher socioeconomic environment. Tooth mottling was 9.58 times more frequent in this group of correctly protected children. However, the clinical aspects of fluorosis were minor, with no esthetic damage. These results suggest that the fluoride dosage regimen commonly proposed is effective against dental caries and does not need any change to reduce the risk of fluorosis.


[Variations of the skin permeability in premature newborn infants. Value of the skin vasoconstriction test with neosynephrine]. The skin of preterm infants is defective as a barrier and does not function like that of mature until about 2 weeks of age. Percutaneous drug absorption was studied by observing the blanching response to aqueous solutions of 10% Neosynephrin applied to a small area of skin on the internal surface of the thigh. The subjects, 10 preterm infants born at gestational ages 29 to 32 weeks (mean: 31 weeks 2 days), were tested when they were aged from day 0 to 7. The controls were 8 normal newborns aged 2 days. All preterm infants were tested a second time at the age 7 to 17 days (mean: 10 days). The blanching response was measured after 5 minutes, and graded on a scale of 0 to 4. The first test was positive grade 2 to 4 in all the preterm babies, while it was negative in the normal newborns. The second test was negative in 7 of the 10 preterm infants; in other 3, the grade was at least 50% lower. Infants nursed under radiant heaters were not different from the other infants. Skin permeability is increased in immature infants, but falls steadily until about the age of 10 days. The results of the Neosynephrin test could be useful in predicting the response to topically administered drug.


[Recessive osteopetrosis. Identification of a form of medium severity]. Several distinct forms of osteopetrosis have been identified. Some of the autosomally recessive inherited forms are benign, much like the autosomal dominant form. Others are more malignant. The clinical data, skeletal radiographs, histological features and histories of 32 children with osteopetrosis were analyzed retrospectively. The 32 patients, belonging to 20 sibships were divided into two groups. The first group included 24 patients, aged 1 day-11 months (mean 4.5 months), suffering from hepatosplenomegaly, anemia, thrombocytopenia and optic atrophy in early infancy. They also had a generalized increase in bone density, abnormal bone remodeling, rachitic lesions and a "bone-within-bone" appearance. Biopsies showed severe bone resorption and myelofibrosis. 19 of the 20 patients whose outcomes were known died during the first year of life. The second group included 8 patients, aged 40 days-3 years (mean: 11 months). Hepatosplenomegaly appeared later, anemia was less severe and thrombocytopenia occurred in only 1 patient. However, all 8 patients suffered from optic atrophy and 3 were deaf. Radiographs showed bone growth without rachitic lesions. Biopsies from 2 patients showed bone resorption, but no myelofibrosis. The outcome was less severe: 6 patients, now aged 8 months to 8 years, have survived, 3 of them for over 5 years. Genetic investigation showed patterns compatible with autosomal recessive inheritance in both groups, with similar sets of features within each sibship. This study reveals a new type of recessively inherited osteopetrosis. It can be classified as an intermediate form, distinct from both the malignant and the benign forms, and also distinct from osteopetrosis with carbonic anhydrase II deficiency.


[Respiratory form mof myasthenia gravis]. Extraocular, facial, bulbar and intercostal muscles are frequently affected in juvenile myasthenia gravis, especially during exacerbations. Acetylcholine receptor antibodies are often present in the blood in this type of myasthenic syndrome. A girl presented with an exertional dyspnea at the age of 13 years, that improved after rest. All investigations were negative, except for lung function tests that showed a restrictive pattern. The diagnosis of juvenile myasthenia gravis was finally made at the age of 15 years because of the recurrence of sudden exertional dyspnea and a history of subtle weakness on repetitive movement leading to poor suckling, together with vocal and occasional swallowing difficulties. Dyspnea immediately improved after intravenous injection of 1 mg neostigmine, but the response was transient. No acetylcholine receptor antibody was found and a search for thymoma proved negative. Ambenonium chloride (Mytelase) was effective on clinical exacerbations, but the only improved test after 9 months of treatment was the functional residual capacity. Anticholinesterase drugs must be tried in patients who present exertional dyspnea without bronchopulmonary or cardiac disease on the presumption of myasthenia gravis even when ocular or bulbar manifestations are absent.


[Sudden newborn infant death in maternity. Anatomo-clinical study of 31 cases]. All cases of sudden and unexpected death occurring in maternity were studied over a period of 6 years (1985-1991). Anamnestic data, results of clinical examination of the body and findings of bacterial screening of body fluids or tissues were collected. The results at necropsy were also collected following the protocol used, with parental consent, in all cases of sudden infant death syndrome. There were 31 cases of sudden and unexpected death. Of these, 48% occurred before the 24th hour of life, 68% before the 36th hour and 84% before the 72nd hour. The majority of death occurred at night (55% between midnight and 6 AM, 90% between 9 PM and 9 AM). Analysis of the data provided a precise cause of death in 25 cases (81%), and a probable cause in 4 cases (13%). The major causes were perinatal anoxia, generally associated with massive amniotic inhalation (16 cases), and maternal-fetal infection (9 cases). No cause was found in 2 cases. Despite the fact that the death occurred unexpectedly, half of the newborns showed warning signs, some hours before the event. These signs were either not detected or ignored. The incidence of sudden death in neonates is 0.15 to 0.36/1,000 live births. Its causes are generally correlated with common neonatal diseases. Its occurrence at night and the existence of warning signs raise questions concerning the care of neonates in maternity.


[Gray platelet syndrome].

[Gray platelet syndrome]. Gray platelet syndrome is a rare (about 40 cases published), inherited disorder characterized by a marked decrease or absence of platelet alpha-granules and platelet specific alpha-granule proteins. A boy, aged 4 years, presented with frequent ecchymoses. Acute idiopathic thrombocytopenia purpura was diagnosed because of his reduced platelet count (36,000/mm3) and recent viral infection. Intravenous gammaglobulin infusion was followed by a small rise in the platelet count (125,000/mm3). The patient was reinvestigated a few months later because of persistent thrombocytopenia and the failure of the immunologic treatment. The bleeding time was long and the platelets on blood smears appeared gray. Electron microscopy revealed numerous vacuoles and very few or no alpha-granules. Platelet aggregation and adhesion were normal, but stimulated platelets failed to liberate factor 4 and beta-thromboglobulin, while the plasma levels of beta-thromboglobulin were elevated. The frequency of gray platelet syndrome is probably underestimated in those diseases resulting in thrombocytopenia and this will continue until blood smears are thoroughly examined. Synthesis of platelet specific alpha-granule proteins seems normal; but these proteins cannot be stored as there are very few, or no alpha-granules. This abnormality could lead to increased levels of such proteins in the plasma.


[Kidney failure induced by administration of acyclovir. Apropos of 2 cases]. There have been several reports of acyclovir-induced renal failure, when the drug has been administered intravenously and/or associated with water restriction. Case n. 1: A 14 year-old boy, was treated with intravenous acyclovir because of an acute encephalitis, possibly due to Herpes viral infection. The acyclovir dose was given erroneously high, 24 mg/kg, 3 times/day, with water restriction, 30 ml/kg/day. Creatininemia increased from 70 to 200 mumol/liter after 48 hours of treatment and was 426 mumol/liter after 5 days. It decreased within a few days after the acyclovir dose was reduced to 6 mg/kg/day and the water intake was increased to 80 ml/kg/day. Case n. 2: A 17 year-old girl was suffering from chronic renal failure due to bilateral kidney hypoplasia associated with hypertension (creatinine clearance: 40 ml/min/1.73 m2). She was given intravenous acyclovir, 20 mg/kg/day, with water restriction, 30 ml/kg/day, to treat acute meningoencephalitis, possibly due to Herpes infection. Creatininemia increased from 200 to 450 mumol/l within 8 days of treatment; it returned to initial values 5 days after cessation of acyclovir and rehydration. These 2 cases confirm the risk of renal impairment when acyclovir is administered intravenously. The risk is greater after bolus injections and when high doses are used. Water restriction is an additional risk, as was the chronic renal insufficiency in our second patient. A scheme of acyclovir therapy based on initial values of creatininemia is mandatory.


Parallel bonded cast attachments for removable partial dentures. The original design of a semi-precision extra-coronal attachment for partial dentures is illustrated, and its fabrication in a cast non-precious bondable alloy is described. A step-by-step method is also described of bonding multiple attachments in parallel for the retention and support of removable partial dentures. Clinical cases are illustrated. The results of trials indicate that the method is clinically viable and, in selected cases, appears to offer distinct advantages over existing retention systems.


Prosthodontic procedures for implant reconstruction. 2. Post-surgical procedures. There is essentially no flexibility in an osseo-integrated implant system, so that the final fit of the prosthesis must be absolutely precise. A simple approach to this problem is presented with details as to impression taking, confirmation of accuracy of the master cast, fitting of the cast metal framework and construction of the superstructure. The information presented describes a full arch fixed restoration attached to mandibular implants, but may easily be followed for the maxilla or modified for quadrant restorations.


Acrylic resins reinforced with woven highly drawn linear polyethylene fibres. 2. Water sorption and clinical trials. The results reported in this paper are part of a continuing study of the reinforcement of acrylic denture base resins with highly drawn linear polyethylene fibres. Water sorption is significantly reduced by incorporation of these fibres, even though the water diffusion processes as such remain broadly unaffected. Clinical trials are encouraging and the reinforced dentures have been well accepted by all the patients.


The adaptation achieved by four root canal filling techniques as assessed by three methods. Four root canal filling techniques--lateral condensation, McSpadden compaction, ultrasonic activation (Enac), and thermoplastic injection (Ultrafil)--were assessed for adaptation of the filling material to the canal wall. The adaptation and leakage were examined quantitatively using an electrochemical method and a linear dye penetration method, and qualitatively by radiographic evaluation. Using the electrochemical method, differences among obturation techniques were relatively small, although a greater proportion of the teeth that had been filled by lateral condensation exhibited no leakage. Radiographically, the techniques appeared to exhibit similar adaptation in the apical 6 mm. The techniques of lateral condensation and ultrasonic activation showed superior control of length of the root canal filling.


One-year clinical performance of PMDM-based dentine bonding agents. Two PMDM-based dentine bonding agents and a microfilled composite were used to restore a total of forty non-undercut caries-free cervical abrasion lesions without enamel etching. Restorations were evaluated over one year and the loss rate calculated using a life table analysis. Marginal staining was assessed from colour photographs on a continuous linear rating scale. After one year, 5 per cent of Tenure bonded restorations were lost compared with 52 per cent of Mirage bonded restorations. Slight marginal staining was evident around Tenure bonded restorations after one year.


Multiple bilateral dens in dente involving all the premolars. Case report. Dens in dente, also known as dens invaginatus, dilated composite odontoma or deep foramen caecum, is a developmental malformation which usually affects maxillary incisor teeth, particularly lateral incisors. It may occur, however, in teeth anywhere within the jaws but other locations are comparatively rare. It can occur within both the crown and the root, although crown invaginations are more common. In this paper a case of multiple bilateral dens in dente involving maxillary and mandibular premolars is presented.


Binder's syndrome due to prenatal vitamin K deficiency: a theory of pathogenesis. There is evidence that vitamin K-deficiency during human pregnancy can be caused by the therapeutic use of warfarin or phenytoin. The pregnancy histories of three cases of Binder's syndrome are reported. One was associated with warfarin exposure, one with phenytoin exposure and one with alcohol abuse. It is proposed that Binder's syndrome can be caused by prenatal exposure to agents that cause vitamin K-deficiency. Sprague-Dawley rats were treated from postnatal day 1 to 12 weeks with daily doses of warfarin (100 mg/kg) and concurrent vitamin K1 (10 mg/kg). This regimen creates a net extra-hepatic vitamin K-deficiency. The treated rats developed with a distinct facial appearance characterized by a markedly reduced snout. Histological examination showed that the normally non-calcified septal cartilage was extensively calcified. It is proposed that normal growth of the septal cartilage is necessary for the development of the profile of the nose and midface and that normal growth will only take place while the septal cartilage is uncalcified.


Regression analysis of dexterity tests and dental students' practical examination results. The desirability of some means of assessing potential dental students' dexterity is discussed and three new practical tests are described. Regression analysis was performed on the results and the subsequent correlations are presented. Further regression analysis was performed on examiners' scores in dental technology showing the inconsistencies. Results were not conclusive and it seems that the tests could possibly be used in an advisory role but little more.


Patient attendance compliance in periodontal therapy. Attendance compliance of patients presenting for periodontal therapy during one calendar year at two practice locations (Perth, Western Australia and Darwin, Northern Territory) was observed over a period of three to four years, depending on whether the patients were seen in the earlier or latter part of the initial year. Both venues (full-time practice and visiting practice every quarter) gave very similar results, of around 10 per cent of patients who dropped out after initial consultation, without commencing treatment. As well, both venues showed a similar trend of subsequent patient 'attrition' after the initial phase of treatment, with the retention of approximately 40 per cent of the original group of patients after three to four years. Of these, a very high proportion (90 per cent) were totally compliant with maintenance recall appointments.


Cardiovascular problems and the elderly. Hypertension and cardiac failure. Hypertension and cardiac failure are common problems in the elderly and lead to considerable illness and death. Many powerful drugs are now available to treat these disorders. Proper anti-hypertensive management is now recognised to significantly reduce stroke and total cardiovascular events in patients up to 80 years of age.


Abuse of the elderly. A hidden problem.

Abuse of the elderly. A hidden problem. Only recently has abuse of the elderly been recognised as a problem. The author describes the types of abuse encountered, provides clues on how to detect them, outlines reasons for the occurrence of abuse and suggests what to do when a case of abuse is identified.


Rational drug therapy in the elderly or how not to poison your elderly patients. Adverse drug reactions are more common and more serious in the elderly. Illness caused by medications is arguably the most significant treatable geriatric health problem. In this review, the author discusses the scope and origins of the problems, and describes some principles for minimising drug toxicity.


Is it dementia?

Is it dementia? The recognition of early dementia remains a difficult task, calling on the clinician's alertness to subtle clues, skillful assessment and selective use of investigations. This approach may lead to earlier diagnosis, which can reduce carer stress, avoid unnecessary treatments and allow planning and management to begin. The diagnosis of dementia is not an end but the beginning of a partnership in which the general practitioner can greatly assist by adopting a caring and supportive role, while managing practical problems as they arise.


Opportunistic cervical screening among 50-70 year olds. A prospective study in general practice. The very young and the elderly remain two of the more regular users of general practitioner services. Opportunistic screening such as immunisation surveillance, blood pressure recording and smoking cessation advice during routine surgery attendances are examples of simple, low-cost, good quality health promotion practices that are acceptable to those screened and are known to provide positive health benefits if properly dealt with. Elderly women, however, remain an at risk group for cervical cancer due to their poor screening rates. This study shows it is possible to substantially raise the screening rate by specifically targeting this age group. Two out of every three women advised to have a Pap smear agreed to the procedure. This resulted in a 73 per cent screening rate at the conclusion of the study. The modern general practitioner should seek to move away from the old shopkeeper role of general practice and instead use every consultation as an opportunity to improve the health standards of patients. This 'pro-active' role sets a greater emphasis on promoting better health through each and every doctor-patient encounter. Much of the workload of general practice has never been fully documented with the result that many of the preventive health measures promoted go unheralded. There is an ongoing need for quality general practice research by general practitioners if we are to maximise our potential in the health care we deliver.(ABSTRACT TRUNCATED AT 250 WORDS)


Clinical trials in general practice. Should I participate? This brief paper outlines the advantages for general practitioners participating in clinical trials. In particular, it is appropriate to conduct research in general practice clinical settings rather than in hospital based trials.


Dr Edward Charles Gawthorn. An expert in practice management. Dr Ted Gawthorn's adult life started as a naval fighter pilot during World War II. He was led to medicine after meeting his future father-in-law who was a GP. An early involvement with the young RACGP led to many years of service and diverse contributions, among the most memorable being the development of the medical record system and the Manual for General Practice.


Phenomenology and the history of psychiatry. Phenomenology is a word much abused in psychiatry. It has come to mean the objective description of the symptoms and signs of psychiatric illness, a synonym for clinical psychopathology as opposed to that other psychopathology which derives from psychoanalytic theory. Thus it is sometimes stated that the phenomenology of a condition is remarkably consistent although its psychopathology is varied. In truth, phenomenology is a technical term in psychiatry with a specific meaning quite distinct from and in a way opposite to that of objective psychopathology. The inappropriate use of the word is unfortunate not only for semantic reasons but also because there is a real danger that the concept to which it refers will be forgotten.


The neglect of prevention in psychiatry. The prevention of mental disorders has been neglected but the public health burden now is too high for this to continue. Nearly one half of all mental and neurological disorders are amenable to primary prevention. Effective measures could be applied even in countries with few resources. By and large these measures all rely on available knowledge and commonly involve sectors other than health. This paper calls attention to the opportunities that offer but that have been so far largely unheeded.


The emergence of clinical psychology departments in Australian teaching hospitals. Over recent years, clinical psychological services have diversified within the health sector, leading to a breakdown in the traditional nexus between clinical psychology and psychiatry, and to the emergence of the interdisciplinary field of behavioral medicine. From their earlier limited role as providers of psychometric assessments in educational and psychiatric hospital settings, clinical psychologists now provide a wide range of therapeutic services and research skills to general hospitals, universities, community health centres, and the private sector. This evolving trend has significant implications for the future structure and direction of clinical practices in clinical psychology, psychiatry and medicine.


Anxiety, depression and HIV related symptomatology across the spectrum of HIV disease. Levels of anxiety and depression were assessed for 207 HIV seropositive homosexual/bisexual men (AIDS = 34, ARC = 72, asymptomatic HIV infection = 101), and 36 seronegative controls. Lymphocyte subset enumeration, history of opportunistic infections, and occurrence of HIV-related symptoms were recorded at the time of assessment. No differences between groups were found on age, educational level, state/trait anxiety or depression scores. Neither the number of symptoms reported, their duration, severity, frequency of occurrence, nor the proportion of patients who reported a specific symptom was different between the three HIV seropositive groups. Severity of anxiety and depression was related to the magnitude of symptomatology, but not associated with either degree of immunodeficiency, number of opportunistic infections or diagnostic group. Principal component analysis extracted five symptom factors (cognitive, affective, psychosocial, neurological and physical), none of which predicted state anxiety scores. However, affective and psychosocial symptom factors predicted trait anxiety and depression scores. The results indicate that ratings of anxiety and depression are independent of stage of HIV infection, may be in part mediated by constitutional and physical symptoms of HIV disease, but are primarily associated with the presence of psychological and psychosocial symptoms.


Assaults by patients: the experience and attitudes of psychiatric hospital nurses. Four hundred and twenty-five nurses working in a 420 bed metropolitan psychiatric hospital were asked to complete a questionnaire about their experience of physical assault by patients and their attitude toward the problem. 61% returned the questionnaire. The overall mean annual rate of assault per nurse was 2.0, with student psychiatric nurses (mean 6.7) significantly more at risk than any other group. Nurses working in the psychogeriatric area reported more than double the rate of assaults reported by nurses working in rehabilitation services. 60% of respondents were female; there were very few sex differences in attitudes to assault. Overall, nurses reported a high tolerance for assault, although they recognised it as an experience that was often very traumatic psychologically. Views about managing assaultiveness differed widely, and this lack of consensus probably hinders the development of optimal strategies to deal with what is a major problem in many psychiatric units.


Obstructive sleep apnoea and depression--diagnostic and treatment implications. Sleep apnoea (OSA), a common sleep disorder, is well recognised as a cause of morbidity including psychiatric disorders. There is increasing recognition of the link between OSA and depression. Sleep changes are intrinsic to depressive disorders, most notably disturbances of REM sleep; OSA causes predominantly REM sleep disturbances. The neuro-vegetative features of depression are similar or identical to the symptoms of OSA-an issue which has not achieved wide clinical recognition. A growing number of studies confirm the statistical link between the two conditions. The implications are twofold: OSA needs to be excluded in cases of chronic or resistant depression and treatment of OSA will make it easier to treat the primary depressive disorder. A new method of treatment for OSA, the Sullivan continuous positive airway pump (CPAP), raises the theoretical possibility of treating depression by this means as well.


Suicide precautions for psychiatric inpatients: a review. This paper reviews the literature on the assessment and management of suicide risk of psychiatric inpatients. Even though a large number of scales have been developed to assist the prediction of suicide for patients admitted for suicide ideas and attempts, none of them were designed to predict suicide in the short term. However the Modified Suicide Intent Scale and the Hopelessness Scale appear to have the potential to predict immediate suicide risk. Risk factors associated with specific psychiatric conditions were all derived retrospectively and their predictive validities have not been established by prospective studies. Important issues relating to the management of suicidal inpatients, such as staff-patient relationships, use of constant observation and medical-legal aspects are reviewed.


Suicide in Singapore, 1986.

Suicide in Singapore, 1986. Three hundred and forty-two cases of suicide in Singapore (1986) were studied. The rates were highest among Indians males. Jumping from a height was the method used by 60% of the subjects, and the predominant associated factor as ascertained by the coroner was illness (51%), both physical and mental. About 40% had seen a doctor in the year prior to their death, and 20% had a history of a previous suicide attempt. The majority of cases killed themselves during the daylight hours.


Youth suicide and gender in Australia and New Zealand compared with countries of the Western world 1973-1987. Based upon standardised mortality figures, between 1973-1987, Australian male suicide rose by 39%, and New Zealand male suicide by 53%. In both countries there were even greater increases in male youth suicides (15-24 years), 66% and 127% respectively. The female suicide statistics were more varied with a fall of -24% in Australia, but an increase of 26% in New Zealand. In both countries however, female youth suicide, relative to their general rates, increased. A comparison of youth suicide in the western world demonstrated that Australia and New Zealand were unique as they were the only countries in which male and female youth suicide levels were higher than their average rates.


Psychiatrists and their patients--confidential information in the wake of spycatcher. This article examines a recent decision of the English Court of Appeal. It concerned a psychiatrist who examined and reported on a convicted murderer in a secure hospital. The report was commissioned by the patient's solicitors as evidence in support of his release. The report was emphatically unfavourable and the doctor insisted that it be revealed to the hospital authorities. The solicitors refused and litigation ensued. The courts were forced to rule on the conflict between the patient's right to privacy and the public interest in revealing the report.


The expert witness in forensic psychiatry. Forensic psychiatry operates at the interface of the Justice and Health systems and has been defined as: "That branch of psychiatry which requires special knowledge and training in the law as it relates to the mental state of the offender, or alleged offender" [1]. As a consequence of working in this area, psychiatrists are often called into court to give evidence as "expert witnesses". This article examines some of the professional and legal issues involved in providing expert testimony. Secondly, it aims to outline some practical guidelines for giving evidence in the court-room. The predominant focus is on criminal, rather than civil, proceedings in which the forensic psychiatrist gives expert testimony; however much of the information is also relevant to other psychiatrists and psychologists undertaking this role in the legal arena.


Phobic reactions of mothers to their own babies. A systematic review was carried out of all patients admitted to a specialised mother-baby unit who had significant phobic avoidance of their own infants. Demographic and diagnostic information on this group showed phobic avoidance to be common and associated with a range of psychiatric illnesses. There was a trend towards association with relatively prolonged admission. The relationship of such avoidance to attachment behaviour from mother to child is discussed. It is recommended that phobic symptoms warrant early recognition and treatment in their own right, simultaneously with treatment of the major illness.


Sexual abuse in Chinese children in Hong Kong: a review of 134 cases. This is a retrospective study of 134 cases of sexual abuse in Chinese children aged 16 years or under in Hong Kong. The data with respect to the victim's age, sex, severity and type (intra- or extrafamilial) of abuse, perpetrator's characteristics and family disturbances were analysed. The overall profile is similar to that reported in the West. The reasons for the apparently low prevalence, younger age of victim and low proportion of male victims are discussed.


Differences between reports from children, parents and teachers: implications for epidemiological studies. This study describes the different prevalences obtained when varying combinations of informants were used to identify emotional and behavioural disorders in a representative sample of 336 children living in two-parent families in the community of Adelaide, South Australia. When different informants were used to identify children with disorders, the estimated prevalences ranged from 3.3 +/- 1.6% to 17.9 +/- 4.1% for younger children, and 6.0 +/- 2.9% to 19.9 +/- 4.9% for older children. Results from the study highlight potential methodological problems which arise in epidemiological studies due to differences between reports from children, parents, and teachers describing childhood emotional and behavioural problems.


Case report of a female-to-male transsexual homicide offender. A 22 year old female-to-male half-Aboriginal transsexual had been exposed to gross neglect and violence, separation and inconsistent cultural supports during childhood. Her mother had also been convicted of homicide in a context of alcohol and violence. Transsexual identification, antisocial behaviours, self mutilation, substance abuse and unmet dependency needs were evident from childhood or early adolescence. The killing was a confrontational peer group stabbing in a brawl under influence of alcohol--the male mode of homicide. This is the first known case in world literature of a female-to-male transsexual guilty of homicide.


Amygdalo-hippocampectomy for pathological aggression. Two patients are reported, one with severe brain damage and epilepsy, and the other with limbic epilepsy, who were treated with unilateral microsurgical amygdalo-hippocampectomy for the control of rage and aggression. Both had significant improvement in their aggressiveness, and the second patient also improved in the frequency of his seizures and psychotic episodes. The significance of these observations for our understanding of the morphophysiological basis of rage and aggression is discussed.