Changes in the composition of the causative agents of wound infection in emergency surgery in the period from 1967 through 1987

The composition of the causative agents of suppurations, isolated from suppurating wounds of patients hospitalized at different departments of the Sklifosovski? Emergency Aid Institute was studied. The proportion of representatives of different microbial families among more than 18,000 strains of the causative agents of wound infection was estimated. Fluctuations in the amount and structure of the agents were analyzed in different clinics over the period of 1967-1987. Under the conditions of emergency aid hospital Staphylococcus aureus proved to be the most frequent causative agent of suppurative inflammatory processes at different departments. At the same time no tendency towards an increase of the etiological role of any microbial family in the development of wound infections was noted. The incidence of different causative agents of suppurations was found to vary at different departments, depending on their specialization and season. The results of observations on the composition of the causative agents of wound infection may be used for the planning and evaluation of antiepidemic measures.     

Surgical implantation of transmitters into fish

Although the Animal Welfare Act does not cover poikilotherms, individual institutions and policies and legal requirements other than the Animal Welfare Act (e.g., the US Public Health Service and the Interagency Research Animal Committee's Principles for the Utilization and Care of Vertebrate Animals Used in Testing, Research, and Training) require the review of projects involving fish by institutional animal care and use committees (IACUCs). IACUCs may, however, lack the knowledge and experience to evaluate fish projects judiciously, especially when the projects are in field settings. Surgeries involving implantation of transmitters and other instruments into the coelom, which now comprise a very common research tool in the study of free-ranging fishes, are examples of surgeries that use a broad spectrum of surgical and anesthetic techniques, some of which would not be considered acceptable for similar work on mammals. IACUCs should apply the standards they would expect to be used for surgeries on homeotherms to surgeries on fish. Surgeons should be carefully trained and experienced. Surgical instruments and transmitters should be sterile. Regulations and laws on the use of drugs in animals should be followed, particularly those concerned with anesthetics and antibiotics used on free-ranging fish. Exceptions to surgical procedures should be made only when circumstances are extreme enough to warrant the use of less than optimal procedures.     

Structure-activity relationship of chalcones and related derivatives as ligands for detecting of beta-amyloid plaques in the brain

A series of novel chalcones and their related derivatives were synthesized and evaluated as beta-amyloid imaging probes. In the structure-activity relationship of binding affinities to synthetic Abeta(1-42) aggregates, compound 14 displayed the highest binding affinity in vitro. beta-Amyloid plaques in the Alzheimer's model mouse brain were visualized with 14. In biodistribution studies using normal mice, [(125)I]14 showed good brain uptake (2.56% ID/g, 2min postinjection) and rapid washout from the brain (0.21% ID/g, 60min postinjection). These results suggest that [(125)I]14 should be further investigated as a potentially useful beta-amyloid imaging probe.     

Immunoprophylaxis of acute respiratory diseases with bacterial multicomponent vaccine VP-4 in children at preschool institutions

The prophylactic action of polycomponent vaccine B[symbol: see text]-4, prepared from the antigens of opportunistic bacteria, on morbidity rate in acute respiratory diseases (ARD) of bacterial and mixed (bacterial and viral) etiology in 121 children aged 2-5 years, attending pre-school institutions was evaluated. For comparison, a group of 118 children of the same age from the same institutions was formed. The vaccine was introduced after the schedule consisting of 3 intranasal and 6-9 oral administrations made at intervals of 3-4 days. The duration of the course of immunization was 26 +/- 4 days. The prophylactic effect of B[symbol: see text]-4 on ARD morbidity was evaluated by the number of ARD cases and their duration per child. The prophylactic effect of B[symbol: see text]-4 on ARD morbidity lasted 14 months (the term of observation) after immunization and was manifested by a decrease in the number and duration of ARD cases after administration of the preparation, also in a group of highly susceptible children.     

Acoustic Pollution in the Oceans: The Search for Legal Standards

The introduction of noise into the marine environment may have significant impacts on marine species and ecosystems. This article examines how the existing international legal framework can be used to address this issue. After providing some background information on sound in the marine environment, the relevant global and regional instruments dealing with the protection of the marine environment, marine pollution, and the conservation of marine species and ecosystems are discussed. The analysis suggests that international law already requires states to address various aspects of this issue. A number of instruments and institutions provide an adequate framework to prescribe rules and standards regarding most sources of acoustic pollution.     

Teratogenicity of 3,3-dimethyl-1-phenyltriazene in the rat: histopathologic and ultrastructural alterations

3,3-Dimethyl-1-phenyltriazene (DMPT) is a methylating agent which is teratogenic, carcinogenic, and mutagenic. A single intraperitoneal injection of 30 mg DMPT/kg given to pregnant rats on day 12 of gestation produces malformations with minimal maternal toxicity. Malformations include skeletal deformities such as micrognathism, cleft palate, and digital malformations, as well as central nervous system hypoplasia. The purpose of the present study was to characterize the light and electron microscopic alterations produced by DMPT. Electron microscopy (EM) revealed that at 4 hr postinjection of DMPT, rare cells of the neural tube contained few membrane-bound aggregations of organelles and condensed chromatin; this change was consistent with apoptosis, a type of cell death characterized by morphologic and biochemical alterations distinct from necrosis. At 8 hr postinjection, apoptosis was more prominent in the neural tube and also observed in the mandibular process. At 16 hr postinjection, numerous apoptotic cells were interspersed with unaffected cells that contained phagocytized apoptotic bodies. Light microscopic examination of DMPT-exposed conceptuses showed apoptosis in the neural tube at 24 hr postinjection. Forty-eight hours postinjection, apoptosis, in decreasing order of severity, was observed in the neural tube, craniofacial processes, limb buds, and somites and liver. Apoptosis was absent in all tissues by 72 hr postinjection. Nervous tissues failed to achieve proper histologic organization, but all other tissues appeared microscopically normal from 72 hr postinjection until the end of gestation. There appeared to be some degree of tissue specificity to the effects of DMPT.     

A nuclear microscopic study of elemental changes in the rat hippocampus after kainate-induced neuronal injury

The effect of intracerebroventricular kainate injection on the elemental composition of the hippocampus was studied in adult Wistar rats, at 1 day and 1, 2, 3, and 4 weeks postinjection, using a nuclear microscope. An increase in calcium concentration was observed on the injected side from 1 day postinjection. The increase peaked at 3 weeks postinjection, reaching a concentration of 18 times normal. Large numbers of glial cells but no neurons were observed in the lesioned CA fields at this time, suggesting that an increased calcium level was present in glial cells. This was confirmed by high-resolution elemental maps of the lesioned areas, which showed very high intracellular calcium concentrations in almost all glial cells. It is possible that the high intracellular calcium level could activate calcium-dependent enzymes, including calpain II and cytosolic phospholipase A2, shown to be expressed in reactive glial cells after kainate injections. In addition to calcium, an increase in iron content was also observed at the periphery of the glial scar at 4 weeks postinjection. Because free iron could catalyze the formation of free radicals, the late increase in iron content may be related to oxygen radical formation during neurodegeneration.     

Antibiotic treatment and post-handling survival of reindeer calves in Alaska

Free ranging reindeer (Rangifer tarandus tarandus) are driven into corral systems and handled each summer on the Seward Peninsula (Alaska, USA). During June and July of 1995-96 reindeer calves were inspected for injury, handled, weighed, and randomly treated with long-acting oxytetracycline. Calves that returned to subsequent handlings within the same year, received treatment only if they had been treated during their first handling. The effects of prophylactic antibiotic treatment and other factors, including weight, handling related injury, and sex on post-handling survival in reindeer calves were evaluated. Return rates of yearlings in 1996 and 1997 were analyzed using logistic regression. Weight change of calves between handlings was examined using a general linear model. Calf weight and handling injury were the only factors that significantly affected calf survival. No factor had a significant effect on calf weight change between handlings. Apparently, long-acting oxytetracycline was not an effective prophylactic treatment for this capture operation. The benefits of prophylactic antibiotic treatment have not been quantified and further studies of the effects and efficacy of prophylactic treatments are recommended. Ineffective treatments should be avoided because they may add additional stress to the captured animal. Managers should evaluate the potential effectiveness of a prophylactic treatment before indiscriminately applying one. Preventing calf injuries was the most effective method of reducing post-handling mortality in this study and should be given a high priority in the design of capture operations.     

Prophylactic mastectomy: indications, options, and reconstructive alternatives

Prophylactic mastectomy continues to be a controversial procedure as a preventive tool against breast cancer. Recent research and other scientific advances, however, have refocused attention on better risk estimation, evidence of efficacy, and improvements in reconstruction. The recently discovered genetic markers BRCA1 and BRCA2 have become increasingly important in determining risk; a BRCA1-positive patient's risk of developing breast cancer by the age of 65 is estimated at 50 percent to 80 percent. BRCA1- and BRCA2-positive breast cancers also tend to be higher grade and occur in younger women (making mammography less effective). Genetically linked breast cancers are usually estrogen receptor negative, making them less susceptible to chemoprevention. Various predictive models and recommendations by experts in the field are also available for today's clinicians to ascertain who should be genetically tested. The benefit of bilateral prophylactic mastectomy, although difficult to estimate, can be evaluated by looking at the incidence of breast cancer in studies of patients who have previously undergone prophylactic mastectomy. The estimated risk reduction from these studies is 80 percent to 95 percent. Similarly, life expectancy is believed to be increased from 2.9 to 5.3 years. The psychological benefits include a 70 percent rate of satisfaction and a decrease in emotional concern over developing breast cancer by 74 percent of women who underwent prophylactic mastectomy. Although reconstruction results may vary, most patients have been very satisfied and some may achieve cosmetic results that are better than their preoperative situation. Patient selection for specific types of reconstruction after prophylactic mastectomy and the decision to proceed should be based on surgical risk and the likelihood of a good outcome. The choice of mastectomy incision should consider the size of the breast, preexisting scars, patient risk factors, and the planned method and goal of reconstruction. The authors propose certain guidelines based on degree of ptosis and cup size when planning prophylactic mastectomies with reconstruction. In certain cases, a nipple-sparing mastectomy may provide cosmetic advantages that could outweigh the additional oncologic risk.     

Feeding, drinking and temperature responses to intracerebroventricular beta-endorphin in the domestic fowl

Four experiments were conducted to evaluate the effect of beta-endorphin (beta-END) on feeding, drinking and colonic temperature in rapidly growing (Rock-Cornish; RC) and slow growing (Single-Comb White Leghorn; SCWL) stocks of chickens. In the first experiment RC cockerels were injected intracerebroventricularly (ICV) with 0, 1.5, 3.0 and 6.0 micrograms of beta-END. In the second experiment RC cockerels were injected ICV with 0.5, 1.0 and 2.0 micrograms of beta-END. Experiments 3 and 4 were conducted identically to Experiment 1 and 2, respectively, except SCWL were used. Administration of beta-END at levels between 1.5 and 6.0 micrograms produced a significant curvilinear increase in feeding in both RC and SCWL chicks. In RC chicks, feeding was significantly elevated at 45 min and from 90 through 240 min postinjection, whereas in SCWL chicks feeding was increased from 90 through 300 min postinjection. Water intake was depressed in RC and SCWL from 60 through 90 min and from 30 through 60 min postinjection, respectively. Significant increases in water occurred at 180 and 300 min postinjection in SCWL. beta-END also induced a significant hyperthermia in RC and SCWL from 30 through 240 min and from 15 through 180 min postinjection, respectively. At low levels of beta-END, i.e., 0, 0.5, 1.0 and 2.0 micrograms, feeding, drinking and body temperature were significantly increased in both stocks. Feeding in RC chicks was stimulated in a linear fashion from 180 through 300 postinjection while feeding in SCWL was stimulated in a curvilinear manner from 180 through 240 min postinjection.(ABSTRACT TRUNCATED AT 250 WORDS)     

Influence of intracerebroventricular (ICV) injection of ACTH (1-24) on plasma gonadotropin in female rats: dose-response study

The intracerebroventricular (ICV) injection of ACTH (1-24) (0.1, 1.0 and 2.5 micrograms) to adult conscious ovariectomized (OVX) rats caused a dose-related inhibition of plasma LH at 10 min postinjection. The ICV injection of ACTH (1-24) (2.5 micrograms) to OVX rats in the absence or presence of a single dose of estradiol benzoate (OVX + EB): a) Decreased significantly plasma LH levels in OVX rats at 10 and 30 min postinjection. b) Decreased significantly plasma LH levels in (OVX + EB) rats at 10 min but not at 30 min postinjection. c) Did not change plasma FSH levels at 10 or 30 min postinjection in both (OVX) or (OVX + EB) rats. d) Did not change plasma ACTH levels at 10 or 30 min postinjection in (OVX) rats. Our observation suggest that ACTH (1-24) inhibited plasma LH, possibly through brain sites of action.     

Arrogance and ignorance in assessing scientific quality in a multidisciplinary academic medical centre

Several academic institutions in the Netherlands and elsewhere develop indices to rank their scientists which will impact evaluation and steering of research. An important part of these indices is based on bibliometric indices. The development of such ranking indices is often seen as the prerogative of management and is kept out of the process where scientific instruments should be presented and evaluated: peer-reviewed journals. In this case the index of the author’s institution is criticised both for the evasion of discussion as for the lack of compensation for bias related to discipline, gender and personal history. Furthermore, it is argued that the ranking based on ‘numbers’ rather than scientific contributions is detrimental to the motivation of the staff suffering under the several modi of bias, is counterproductive for interdisciplinary achievements and discourages young researchers in less scoring disciplines to find their way in the medical academic arena. (Neth Heart J 2010;18:319-22).     

对医保定点医疗机构支付方式改革的思考

医保对定点医疗机构支付方式改革势在必行,应由传统的被动支付向管理型支付方向发展。在需方对医疗机构支付方式上,应确定与参保对象承受能力相适应的费用分担比例,同时组合应用多种支付方式;在医保对医疗机构支付方式上,应由后付制转向预付制、由单一的支付方式转向混合型支付方式。支付方式改革要辅之以加强对医疗机构的监管、加快卫生信息化建设、建立医保谈判机制和注重配套政策支撑等。     

Primary prevention by implantable cardioverter defibrillators: shock proof?

In the last two decades, the focus of implantable cardioverter defibrillator {ICD} trials has mainly been on prophylactic implantation of ICDs in high-risk populations for the prevention of sudden cardiac death. In particular, prophylactic ICDs in high-risk post-MI patients with a depressed left ventricular ejection fraction has resulted in significantly improved survival. These benefits are in addition to those of optimal pharmacological therapy and ICD therapy should be considered the standard of care in these patients.     

Radiolabeled anti-claudin 4 and anti-prostate stem cell antigen: initial imaging in experimental models of pancreatic cancer

Global expression profiling of pancreatic cancers has identified two cell surface molecules, claudin 4 and prostate stem cell antigen (PSCA), as being overexpressed in the vast majority of cases. Two antibodies, anti-claudin 4 and anti-PSCA, were radiolabeled with iodine 125 ((125)I) for imaging pancreatic cancer xenografts in mice using gamma scintigraphy and single-photon emission computed tomography-computed tomography (SPECT-CT). Immunofluorescence staining of intact and permeabilized Colo357 human pancreatic cancer cells showed strong extracellular staining by both anti-PSCA and anti-claudin 4. Biodistribution studies in claudin 4 and PSCA-expressing Colo357 and PANC-1 subcutaneous xenograft models in mice showed that [(125)I]anti-claudin 4 tumor to muscle ratio uptake was 4.3 in Colo357 at 6 days postinjection and 6.3 in PANC-1 xenografts at 4 days postinjection. Biodistribution of [(125)I]anti-PSCA showed tumor to muscle ratio uptake of 4.9 in Colo357 at 6 days postinjection. Planar gamma scintigraphic imaging in Colo357 xenograft-bearing mice showed clear tumor uptake of [(125)I]anti-claudin 4 by 24 hours postinjection and by 48 hours postinjection for [(125)I]anti-PSCA. SPECT-CT imaging with [(125)I]anti-claudin 4 and [(125)I]anti-PSCA in an L3.6PL orthotopic xenograft model showed strong tumor and spleen uptake at 5 days postinjection. Both anti-claudin 4 and anti-PSCA demonstrate promise as radiodiagnostic and possibly radiotherapeutic agents for human pancreatic cancers.     

Anesthetic and nephrotoxic effects of Telazol in New Zealand white rabbits.

Telazol was evaluated as an anesthetic for rabbits. Two groups of five rabbits each were injected intramuscularly with 32 or 64 mg/kg of Telazol, and the depth and duration of anesthesia period monitored. At both doses, the righting reflex was lost within 2 minutes postinjection. Animals in both groups responded to noxious stimuli for the duration of the anesthesia. Hematology and urinalyses were performed daily for 7 days postinjection. Hematologic parameters remained unchanged in both groups. In the high-dose group, blood urea nitrogen and serum creatinine levels increased 1 day postinjection and continued steadily throughout the week. Elevations in urine protein and the presence of casts correlated with this increase. In the low-dose group, blood urea nitrogen and creatinine levels increased and protein was present in the urine of four of five rabbits beginning approximately 5 days postinjection. Histologically, severe renal tubular necrosis was evident 7 days postinjection in all high-dose rabbits and in three rabbits in the low-dose group. Our results indicate that Telazol does not produce analgesia in rabbits and is nephrotoxic at both 32 and 64 mg/kg. We conclude that Telazol is contraindicated for use in rabbits.     

Changes in concentration of serum LH and FSH associated with estrogen-advanced ovulation in 4-day cyclic rats

Changes in concentration of serum luteinizing hormone (LH) and follicle stimulating hormone (FSH) associated with estrogen-advanced ovulation in 4-day cyclic rats were determined. 50 mcg of estradiol benzoate was administered sc on the 1st day of diestrus and LH and FSH were determined by radioimmunoassay 24, 29, and 47 hours postinjection. 48 hours postinjection, ovulation was determined by the presence of ova in the oviduct. Estradiol benzoate caused a significant (p less than .01) increase in serum LH after 24 and 29 hours and a drastic decrease after 47 hours postinjection. FSH increased (p less than .05) after 29 hours postinjection. These results suggest that an ovulatory gonadotropin surge occurs 24 hours ahead of schedule in estradiol-benzoate-treated rats.     

Processing of the propeptide form of rat renal gamma-glutamyltranspeptidase

The biosynthesis of rat renal gamma-glutamyltranspeptidase (EC 2.3.2.2) was studied by sodium dodecyl sulfate gel electrophoresis and fluorography of specific immunoprecipitates obtained at varying times' postinjection with [35S]methionine. At 20 min postinjection 3 endo-beta-N-acetylglucosaminidase H-sensitive bands were observed representing the propeptide (Mr 75 000) large subunit (Mr 49 500) and small subunit (Mr 29 000) of transpeptidase. The alterations in Mr are consistent with removal of 6 N-linked coreoligosaccharides from the propeptide; 4 from the large subunit and 2 from the small subunit. All 3 bands became more diffuse and less endoglycosidase H-sensitive by 40 min and completely resistant by 60 min postinjection. At 20 h postinjection no propeptide remained. Thus, the primary propeptide cleavage reaction occurs prior to the loss of endoglycosidase H sensitivity while about 30% of the propeptide is processed along with the heterodimer and cleaved at a later time.     

Patient selection for prophylactic mastectomy: who is at high risk?

Patient selection for prophylactic mastectomy should be based on an individual assessment of risk factors. These should be correlated with the patient's age, the difficulty of clinical examination, and, in the case of a previous breast cancer, its prognosis. Only then can the patient and her surgeon make an intelligent decision regarding management.     

A chronic carrierlike state is established in nude mice injected with cloned hepatitis B virus DNA.

BALB/c nude mice were injected intrahepatically with hepatitis B virus (HBV) DNA prepared from recombinant plasmids. Hepatitis B surface antigen appeared in the circulation in 19 of 23 mice (82%) 3 to 20 weeks postinjection and persisted for more than 6 months in most animals. Hepatitis B e antigen appeared transiently in the circulation in 12 of the 23 mice (52%) within a few weeks after the appearance of hepatitis B surface antigen. Antibodies to the core, X, and/or polymerase gene products of HBV have also been observed in 14 (61%) of the mice. Histopathological examination of the livers at 7 months postinjection demonstrated that nearly half had characteristics consistent with chronic hepatitis. HBV DNA appeared to be integrated into host liver DNA. No evidence of viral replication was observed in sera or livers from these mice at 7 months postinjection. These results demonstrate that an HBV chronic carrierlike state can be established in mice and that such a model could be used to study host and virus factors important in the establishment and maintenance of HBV-associated chronic liver disease.