Sartorial eloquence: does it exist in the paediatrician-patient relationship?

OBJECTIVE--To evaluate children''s and parents'' perceptions of hospital doctors'' attire. DESIGN--Questionnaire study asking children and parents to assign positive and negative attributes to five photographs of a male or female doctor dressed formally and informally. SETTING--Outpatient department, Children''s Hospital, Birmingham. SUBJECTS--203 consecutive child-parent pairs attending outpatient clinics over three months. MAIN OUTCOME MEASURES--Children''s and parents'' preferences, assessed by comparing proportions. RESULTS--70% (286/406) of children and parents rated doctors'' dress as important; more children rated it "very important" (27% (54/203) v 14% (29/203), P < 0.01, 95% confidence interval for difference 5% to 21%). Of the 99 children responding, 44 regarded the man in white coat as most competent (44% v 20% expected by chance, P < 0.01, 34% to 54%) and most concerned (32% v 20%, P < 0.01, 23% to 41%). Children also regarded the woman in white coat as most competent; however, male and female doctors in white coats rated lower for friendliness. Asians and regular surgical attenders preferred doctors in white coats. The man in polo shirt and trousers was rated as most friendly (40% v 20% expected by chance, P < 0.01, 30% to 50%) and most gentle (37% v 20%, P < 0.01, 27% to 46%). The woman in tee shirt and slacks also rated most friendly and gentle; however, both casually dressed doctors rated lower for competence. Parents preferred more casual dress but expressed preferences less strongly, and they poorly predicted which outfits their children preferred. CONCLUSIONS--Children regard formally dressed doctors as competent but not friendly; they regard casual dress as friendly but not competent.     

Who undertakes the consultations in the outpatient department?

In a study of all 4275 outpatient consultations over one month in a district general hospital it was found that the clinics in surgical specialties had the largest numbers of patients. In general surgery less than half of new patients and only one third of all patients attending the clinic were seen by a consultant. (Nine months later about a third of all new patients had still not seen a consultant in the clinic.) In the medical clinics just over a quarter of patients were seen by doctors who had less than six months'' experience in their present specialty after registration. Overall, doctors had been on continuous duty for at least 24 hours before a third of consultations. Doctors in training had actually worked during the previous night before attending a quarter of the clinics.Much of the large volume of work is performed by tired, incompletely trained doctors. It is suggested that a greater proportion of the work should be performed by fully trained staff. The workload might be reduced by modifying the pattern of the consultation.     

Pericellular coat of chick embryo chondrocytes: structural role of hyaluronate

Chondrocytes produce large pericellular coats in vitro that can be visualized by the exclusion of particles, e.g., fixed erythrocytes, and that are removed by treatment with Streptomyces hyaluronidase, which is specific for hyaluronate. In this study, we examined the kinetics of formation of these coats and the relationship of hyaluronate and proteoglycan to coat structure. Chondrocytes were isolated from chick tibia cartilage by collagenase-trypsin digestion and were characterized by their morphology and by their synthesis of both type II collagen and high molecular weight proteoglycans. The degree of spreading of the chondrocytes and the size of the coats were quantitated at various times subsequent to seeding by tracing phase-contrast photomicrographs of the cultures. After seeding, the chondrocytes attached themselves to the tissue culture dish and exhibited coats within 4 h. The coats reached a maximum size after 3-4 d and subsequently decreased over the next 2-3 d. Subcultured chondrocytes produced a large coat only if passaged before 4 d. Both primary and first passage cells, with or without coats, produced type II collagen but not type I collagen as determined by enzyme-linked immunosorbent assay. Treatment with Streptomyces hyaluronidase (1.0 mU/ml, 15 min), which completely removed the coat, released 58% of the chondroitin sulfate but only 9% of the proteins associated with the cell surface. The proteins released by hyaluronidase were not digestible by bacterial collagenase. Monensin and cycloheximide (0.01-10 microM, 48 h) caused a dose-dependent decrease in coat size that was linearly correlated to synthesis of cell surface hyaluronate (r = 0.98) but not chondroitin sulfate (r = 0.2). We conclude that the coat surrounding chondrocytes is dependent on hyaluronate for its structure and that hyaluronate retains a large proportion of the proteoglycan in the coat.     

Optical properties of Lactuca and Taraxacum seed and fruit coats: Their role as light filters

The optical properties of seed and fruit coats were examined from several varieties of light-sensitive achenes. Taraxacum vulgare L. and Lactuca sativa L. cv. Grand Rapids achenes with dark fruit coats and L. sativa cvs Huvudsallat and Issallat with white fruit coats were examined. Transmission spectra varied among the different achenes: white fruit coats of Lactuca acted as neutral density filters between 450 and 780 nm, whereas Taraxacum transmitted 2–36% in this region. The ribbed fruit coat structure greatly affected transmission so that at different locations in the same coat, transmission varied between 20 to 80% at 660 and 730 nm. Fruit coats of Grand Rapids lettuce and Taraxacum transmitted more far-red than red light with T₆₆₀/T₇₃₀ ratios of 0.8 and 0.4, respectively. The relationship between the optical properties of fruit coats and light-stimulated germination is discussed.     

Changes in the hydrophobic characteristics of Clostridium perfringens spores and spore coats by heat

The hydrophobic characteristics of Clostridium perfringens NCTC 8679 spores were demonstrated by adherence to toluene in a toluene-aqueous partition system. Spores and spore coat preparations were hydrophobic. Vegetative cells and spores extracted with a dithiothreitol-sodium dodecyl sulfate treatment known to remove spore coats were not hydrophobic. A heat activation treatment (75 degrees C for 20 min) which promotes more rapid spore germination increased the hydrophobicity of intact spores and decreased that of isolated spore coats. The hydrophobic changes were reversed by washing and stabilized by 0.5% glutaraldehyde. Heat-induced hydrophobic changes were observed in spore coats prepared from spores that were preheated and washed before rupturing in a buffer containing glutaraldehyde. These results suggest the occurrence of a heat-induced change in the spore coat (possibly in the conformation of a macromolecule) which was stable only within the architectural confines of the intact spore.     

Career preferences of doctors who qualified in the United Kingdom in 1993 compared with those of doctors qualifying in 1974, 1977, 1980, and 1983.

OBJECTIVE--To report the career preferences of doctors who qualified in the United Kingdom in 1993 and to compare their choices with those of earlier cohorts of qualifiers. DESIGN--Postal questionnaires with structured questions, including questions about choice of future long term career, were sent to doctors a year after qualification. SETTING--United Kingdom. SUBJECTS--All medical qualifiers of 1993, comparing their replies with those from earlier studies of the qualifiers of 1974, 1977, 1980, and 1983. MAIN OUTCOME MEASURES--Choice of future long term career and certainty of choice expressed at the end of the first year after qualification. RESULTS--Questionnaires were sent to 3657 doctors. 2621 (71.7%) replied. Of the 2621 respondents, 70.5% (1849) stated that their first preference was for a career in hospital practice, 25.8% (677) specified general practice, 1.0% (25) specified public health medicine or community health, 1.4% (36) specified careers outside medicine, and 1.3% (34) did not state a choice. By contrast, 44.7% (1416/3168) of the doctors in the 1983 cohort had specified that their first preference was general practice. Among the 1993 qualifiers, general practice was the first career choice of 17.5% of men (227/1297) and 34.0% of women (450/1324). Only 7.4% of men (96/1297) stated that they definitely wanted to enter general practice. Only 7.8% (103/1324) of women qualifiers in 1993 expressed a career preference for surgical specialties. Within hospital practice, comparing 1993 with 1983, choices for the medical specialties and for accident and emergency medicine rose and those for pathology fell. Women were less definite than men about their choice of future long term career. CONCLUSIONS--If the 1993 cohort is typical of the current generation of young doctors, there has been a substantial shift away from general practice as a career choice expressed at the end of the preregistration year. General practice was much more popular among women than men. Few women opted for surgery. The sex imbalance in the percentage of doctors who choose different mainstreams of medical practice seems set to continue.     

Coat condition of ringtailed lemurs,Lemur catta at Berenty Reserve,Madagascar: I. differences by age,sex, density and tourism, 1996–2006

An index of coat condition can be a non‐invasive tool for tracking health and stress at population level. Coat condition in ringtailed lemurs, Lemur catta, was recorded during September–November birth seasons of 1996, 1997, 1999, and 2001–2006 at Berenty Reserve, Madagascar. Condition was scored on a scale from 0: full, fluffy coat with guard hairs present, to 5: half or more of body hairless. Adult males did not differ overall from adult females. Coats were worse in adults than in 2‐year‐old subadults; 1‐year‐old juveniles were intermediate. Mothers and adult males lost coat condition as the season progressed: non‐mother females maintained condition. Years 1999–2002 scored better coats than either 1996–1997 or 2003–2006. Lemurs in high population density areas had worse coats than in natural forest, but tourist presence had less effect than density. Monitoring coat condition in an apparently healthy population reveals differences between population segments, and in a forest fragment with limited immigration or emigration it can track progressive changes, correcting impressions of progressive improvement or degradation over time. Above all it gives a baseline for response to climate changes or eventual pathology. Am. J. Primatol. 71:191–198, 2009. © 2008 Wiley‐Liss, Inc.     

A protein–protochlorophyll complex obtained from inner seed coats of Cucurbita pepo: The resolution of its two pigment groups into true protochlorophyll and a pigment related to bacterial protochlorophyll

1. The inner seed coats of Cucurbita pepo were extracted with aqueous acetone and found to contain pigments with spectra similar to that of protochlorophyll. 2. When the fruits of C. pepo were stored the amount of protochlorophyll-like material in the inner seed coats increased and a form of protochlorophyll absorbing at longer wavelength was apparently formed. 3. The pigment was resolved into two forms of protochlorophyll by chromatography on sugar columns. One form with absorption maxima in ether at 432, 535, 571 and 623mmu was spectroscopically identical with plant protochlorophyll; the other, with absorption maxima at 438, 537, 574 and 624mmu, was spectroscopically identical with bacterial protochlorophyll isolated from the tan mutant of Rhodopseudomonas spheroides. The two phaeoporphyrins obtained from the seed-coat pigments closely resemble the corresponding phaeoporphyrin derivatives of plant protochlorophyll and bacterial protochlorophyll in spectroscopic and partition properties. 4. The pigment in the cells of inner seed coat of C. pepo is concentrated in discrete particles of about 1.7mu diameter. Extracts of the seed coats in a glycerol-glycine buffer were similar in spectroscopic properties to the crude protochlorophyll holochrome, but were not light-transformable. 5. After partial purification of the glycerol-glycine buffer extracts a pigment-protein complex was obtained with absorption maxima at considerably longer wavelengths than in organic solvents. 6. Preparations of the seed-coat protochlorophyll, in the presence of bovine serum albumin, adsorbed on filter paper or in colloidal solution, did not have absorption bands shifted so far to the red region as the natural protein complex isolated from the seed coat. 7. It is suggested that bacterial protochlorophyll (magnesium 2,4-divinylphaeoporphyrin a(5) methyl ester) is involved in the biosynthesis of chlorophyll in both plants and photosynthetic bacteria.     

The Importance of Genetically Determined Seed Coat Characteristics to Seed Quality in Grain Legumes

Comparisons of five pairs of isogenk lines of peas, differingonly in the A gene for seed coat colour showed that white seeds(genotype aa) imbibed more rapidly than coloured seeds (AA),suffered greater imbibition damage revealed by dead tissue onthe cotyledons, and higher solute leakage. Seed-coat pigmentationwas closely associated with slow water uptake, since when expressionof the A gene was suppressed by the recessive pollens gene,the resulting white seeds {palpal AA) imbibed rapidly. The slowwater uptake by coloured seeds was not due to the restrictionof water entry by the seed coat since the differences in imbibitionrate were maintained when a portion of the seed coat was removedand seeds were imbibed with the exposed cotyledon in contactwith moist filter paper. Imbibition of similarly treated seedsby immersion in polyethylene glycol solutions (1–4%) whichincreased the seed/solution wettability, had little effect onthe water uptake of coloured seeds compared to imbibition inwater whereas that of white seeds increased in the first 10mins imbibition. Poor wettability of the inner surface of colouredseed coats did not therefore explain the slow imbibition ofthese seeds. The white seed coats loosened rapidly during imbibitionwhilst the coloured seed coats remained closely associated withthe cotyledons suggesting that the adherence of the seed coatto the cotyledons and therefore the ease of access of waterbetween the testa and cotyledons determines the rate of imbibition.The rapid water uptake by white-coated seeds and the subsequentimbibition damage may explain the high incidence of infectionof these seeds by the soil-bome fungus Pythhan after 2 d insoil. Improved seed quality and emergence may therefore be achievedby breeding for seed coat characteristics leading to reducedrates of imbibition Pisum sativum, isogenic lines, A gene, seed coat colour, imbibition, imbibition damage, wettability, pollens gene, seed quality, grain legumes     

Influence of pericarp and endosperm colour and type on digestibility of grain sorghum by pigs

Twenty-five grain sorghum cultivars were used to study differences in digestible energy, digestible protein and apparent nitrogen retention. Eight pigs were used to evaluate each cultivar. Results indicated that cultivars with a yellow seed coat are significantly superior in digestibility to cultivars with brown seed coats. Cultivars having a yellow endosperm had greater digestibility of energy and protein and more of the absorbed nitrogen was retained than with those cultivars having either white, white corneous or yellow corneous endosperm.     

The surface coats on spores

There are surface coats on the sporocytes and spores of some pteridophytes and bryophytes which will bind one or more of the stains generally used to demonstrate the presence of an acid mucopolysaccharide surface coat in animal cells, viz. Alcian blue, colloidal iron, lanthanum, thorium, silver, SO,-coriphosphine and phosphotungstic acid. This suggests that the composition of the coat substances in the ferns and bryophytes agrees with that in animal cells. It has been found that thorium-staining in the sporocyte and the coat of the young spore of one fern, Botrychium lunaria , can be abolished with neuraminidase, indicating that sialic acid is a principal component of these coats. The spore wall in the pteridophytes (and probably also in the bryophytes) is constructed within these mucopolysaccharide surface coats, and it is suggested that differences in wall form are attributable to qualitative, quantitative and functional differences of the coats.     

Seed coat composition in black and white soybean seeds with differential water permeability

• The seed coat composition of white (JS 335) and black (Bhatt) soybean (Glycine max (L.) Merr) having different water permeability was studied.
• Phenols, tannins and proteins were measured, as well as trace elements and metabolites in the seed coats.
• The seed coat of Bhatt was impermeable and imposed dormancy, while that of JS 335 was permeable and seeds exhibited imbibitional injury. Bhatt seed coats contained comparatively higher concentrations of phenols, tannins, proteins, Fe and Cu than those of JS 335. Metabolites of seed coats of both genotypes contained 164 compounds, among which only 14 were common to both cultivars, while the remaining 79 and 71 compounds were unique to JS 331 and Bhatt, respectively.
• Phenols are the main compounds responsible for seed coat impermeability and accumulate in palisade cells of Bhatt, providing impermeability and strength to the seed coat. JS 335 had more cracked seed coats, mainly due to their lower tannin content. Alkanes, esters, carboxylic acids and alcohols were common to both genotypes, while cyclic thiocarbamate (1.07%), monoterpene alcohols (1.07%), nitric esters (1.07%), phenoxazine (1.07%) and sulphoxide (1.07%) compounds were unique to the JS 335 seed coat, while aldehydes (2.35%), amides (1.17%), azoles (1.17%) and sugar moieties (1.17%) were unique to Bhatt seed coats. This study provides a platform for isolation and understanding of each identified compound for its function in seed coat permeability.

     

Bilayered clathrin coats on endosomal vacuoles are involved in protein sorting toward lysosomes

In many cells endosomal vacuoles show clathrin coats of which the function is unknown. Herein, we show that this coat is predominantly present on early endosomes and has a characteristic bilayered appearance in the electron microscope. By immunoelectron microscopy we show that the coat contains clathrin heavy as well as light chain, but lacks the adaptor complexes AP1, AP2, and AP3, by which it differs from clathrin coats on endocytic vesicles and recycling endosomes. The coat is insensitive to short incubations with brefeldin A, but disappears in the presence of the phosphatidylinositol 3-kinase inhibitor wortmannin. No association of endosomal coated areas with tracks of tubulin or actin was found. By quantitative immunoelectron microscopy, we found that the lysosomal-targeted receptors for growth hormone (GHR) and epidermal growth factor are concentrated in the coated membrane areas, whereas the recycling transferrin receptor is not. In addition, we found that the proteasomal inhibitor MG 132 induces a redistribution of a truncated GHR (GHR-369) toward recycling vesicles, which coincided with a redistribution of endosomal vacuole-associated GHR-369 to the noncoated areas of the limiting membrane. Together, these data suggest a role for the bilayered clathrin coat on vacuolar endosomes in targeting of proteins to lysosomes.     

Relation between general practices' outpatient referral rates and rates of elective admission to hospital.

OBJECTIVE--To examine the variation in rates of admission to hospital among general practices, to determine the relation between referral rates and admission rates, and to assess the extent to which variations in outpatient referral rates might account for the different patterns of admission. DESIGN--A comparison of outpatient referral rates standardised for age and sex and rates of elective admission to hospital for six specialties individually and for all specialties combined. SETTING--19 General practices in three districts in Oxford Regional Health Authority with a combined practice population of 188 610. MAIN OUTCOME MEASURES--Estimated proportion of outpatient referrals resulting in admission to hospital, extent of variation in referral rates and admission rates among practices, and association between admissions and outpatient referrals. RESULTS--Patients referred to surgical specialties were more likely than those referred to medical specialties to be admitted after an outpatient referral. Overall, the estimated proportion of patients admitted after an outpatient referral was 42%. There were significant differences among the practices in referral rates and admission rates for most of the major specialties. The extent of systematic variance in admission rates (0.048) was similar to that in referral rates (0.037). Referral and admission rates were significantly associated for general surgery; ear, nose, and throat surgery; trauma and orthopaedics; and all specialties combined. For most specialties the practices with higher referral rates also had higher admission rates, casting doubt on the view that these practices were referring more patients unnecessarily. CONCLUSION--Rates of elective admission to hospital vary systematically among general practices. Variations in outpatient referral rates are an important determinant of variations in admission rates.     

Interaction of the Bacillus subtilis spore protoplast, cortex, ion-exchange and coatless forms with glutaraldehyde

G orman , S.P. S cott , E.M. H utchinson , E.P. 1984. Interaction of the Bacillus subtilis spore protoplast, cortex, ion-exchange and coatless forms with glutaraldehyde. Journal of Applied Bacteriology 56 , 95–102.
Bacillus subtilis spores with altered ionic content were tested for their susceptibility to lysis with lysozyme or sodium nitrite following treatment with glutaraldehyde. The Ca-form was more sensitive to glutaraldehyde (pH 4.0.and pH 7.9) than the untreated or H-form. Removal of spore coat dramatically increased sensitivity of the spore to glutaraldehyde. Pretreatment of spores, the coats of which had been extensively removed, with glutaraldehyde (pH 7.9) reduced the rate of lysis by lysozyme and by sodium nitrite, whereas glutaraldehyde at pH 4.0.had little effect. Glutaraldehyde pretreatment (pH 4.0 and pH 7.9) reduced the amount of hexosamine released by lysozyme but not by nitrite from isolated cortical fragments. Spore protoplasts were more susceptible to 0.01% (w/v) glutaraldehyde at pH 4.0 and isolated spore coats adsorbed alkaline glutaraldehyde more rapidly. These results are discussed in terms of a possible mode of action of glutaraldehyde on the bacterial spore.     

Patterns and kinetics of water uptake by soybean seeds

Soybean [Glycine max (L.) Merr.] plants produce some seeds (called stone or impermeable seeds) that do not take up water for long periods of time. The present investigation confirmed that the stone seed trait is a feature of the seed coat: isolated embryos from both stone and permeable seeds took up water equally quickly. A whole, permeable seed typically imbibed water initially through its dorsal side, forming wrinkles in the seed coat and delivering water to the underlying cotyledons. Later, some lateral movement of water through the coat occurred, presumably through the air spaces of the osteosclereid layer. Imbibition by seeds was a two-phase process, the first dominated by hydration of the seed coat and the second by hydration of the cotyledons, which was rate-limited by the coat. When hydrated, coats of stone seeds were permeable to water but their hydraulic conductivity, as measured with a pressure probe, was smaller than that of coats from permeable seeds by a factor of five. Hydrated coats of both permeable and stone seeds showed weak osmometer properties.     

Susceptibility to antimicrobial agents of bacteria isolated from pregnant, postpartum women, and newborns from zones with high irradiation risk]

Susceptibility of 350 strains of staphylococci, isolated from pregnant women, puerperal and newborns and of 170 strains, isolated from obstetrical hospital environment at the region with high risk of radiation after accident was determined. The tested bacterial strains were the following: 56--Staphylococcus aureus, 152--S. epidermidis, 142--S. saprophyticus, isolated from women and newborns; strains isolated from hospital environment included 120 strains of S. saprophyticus and 50 strains E. coli. The tested antimicrobial factors were the following: 22 antibiotics, 2 bioantibiotics of the breast milk and blood (lysozyme, betalysin) not separated from the substrate and tested on test-cultures of M. luteus and B. subtilis, and 5 desinfectants. Analysis was performed by common disk-diffusion method and by contact method elaborated before. High resistance of staphylococci to many antibiotics, bioantibiotics and disinfectants was demonstrated. The resistance is considered to be due to high radiation background because it is much higher than resistance frequency of the similar strains isolated at the safe areas. The resistance to antimicrobial factors was higher among the opportunistic and saprophyte staphylococci along with appearance of pathogenic factors and activation of persistence properties.     

Proteomic analysis of the spore coats of Bacillus subtilis and Bacillus anthracis

The outermost proteinaceous layer of bacterial spores, called the coat, is critical for spore survival, germination, and, for pathogenic spores, disease. To identify novel spore coat proteins, we have carried out a preliminary proteomic analysis of Bacillus subtilis and Bacillus anthracis spores, using a combination of standard sodium dodecyl sulfate-polyacrylamide gel electrophoresis separation and improved two-dimensional electrophoretic separations, followed by matrix-assisted laser desorption ionization-time of flight and/or dual mass spectrometry. We identified 38 B. subtilis spore proteins, 12 of which are known coat proteins. We propose that, of the novel proteins, YtaA, YvdP, and YnzH are bona fide coat proteins, and we have renamed them CotI, CotQ, and CotU, respectively. In addition, we initiated a study of coat proteins in B. anthracis and identified 11 spore proteins, 6 of which are candidate coat or exosporium proteins. We also queried the unfinished B. anthracis genome for potential coat proteins. Our analysis suggests that the B. subtilis and B. anthracis coats have roughly similar numbers of proteins and that a core group of coat protein species is shared between these organisms, including the major morphogenetic proteins. Nonetheless, a significant number of coat proteins are probably unique to each species. These results should accelerate efforts to develop B. anthracis detection methods and understand the ecological role of the coat.     

Aqueous pathways dominate permeation of solutes across Pisum sativum seed coats and mediate solute transport via diffusion and bulk flow of water

The permeability of seed coats to solutes either of biological or anthropogenic origin plays a major role in germination, seedling growth and seed treatment by pesticides. An experimental set‐up was designed for investigating the mechanisms of seed coat permeation, which allows steady‐state experiments with isolated seed coats of Pisum sativum. Permeances were measured for a set of organic model compounds with different physicochemical properties and sizes. The results show that narrow aqueous pathways dominate the diffusion of solutes across pea seed coats, as indicated by a correlation of permeances with the molecular sizes of the compounds instead of their lipophilicity. Further indicators for an aqueous pathway are small size selectivity and a small effect of temperature on permeation. The application of an osmotic water potential gradient across isolated seed coats leads to an increase in solute transfer, indicating that the aqueous pathways form a water‐filled continuum across the seed coat allowing the bulk flow of water. Thus, the uptake of organic solutes across pea testae has two components: (1) by diffusion and (2) by bulk water inflow, which, however, is relevant only during imbibition.     

Determining Toxoplasma high-risk autologous and allogeneic hematopoietic stem cell transplantation patients by systematic pre-transplant PCR screening of stem cell originated buffy coat

The diagnosis of Toxoplasma infection or disease in hematopoietic stem cell transplantation (HSCT) patients is achieved mainly by PCR screening; however screening did not find wide field of use in practice due to costly expenditures of PCR. This study aimed to determine patients at high risk of Toxoplasma infection or disease before transplantation by stem cell originated buffy coat PCR and subsequently to screen them. Buffy coats collected from 12 autologous and 18 allogeneic HSCT patients' donors were investigated by PCR before transplantation. After transplantation, blood and sera collected at fixed time intervals were screened by two PCR methods and serological assays. Screening results first time assessed a toxoplasmosis incidence level as 25% in autologous HSCT patients and increased incidence level in allogeneic HSCT patients to 22%. Importantly, buffy coat PCR was first time performed before transplantation, to determine the risk of toxoplasmosis. Buffy coat PCR results showed that four patients were at high risk of toxoplasmosis before transplantation. After transplantation, these patients experienced toxoplasmosis. In conclusion, for the determination of patients at risk of toxoplasmosis, clinicians should consider buffy coat PCR in combination with serology before transplantation. After transplantation, PCR screening can be initiated in high risk patients upon clinical suspicion.