Effect of cleft palate repair and pharyngeal flap surgery on upper airway obstruction during sleep

The effect of von Langenbeck palatoplasty and pharyngeal flap surgery on upper airway obstruction during sleep was studied by obtaining polysomnographic sleep studies on 10 patients undergoing each procedure at 1 to 2 days prior to surgery, 2 to 3 days postoperatively, and approximately 3 months postoperatively. The effects of von Langenbeck palatoplasty on sleep-related upper airway obstruction were usually minimal and clinically insignificant, whereas severe obstructive sleep apnea was present in all but one of the patients undergoing pharyngeal flap surgery at 2 to 3 days postoperatively. In most patients the upper airway obstruction was resolved at the 3-month postoperative sleep study. These data suggest that palatoplasty carries with it a very slight risk of upper airway obstruction, whereas pharyngeal flap surgery has as a very frequent concomitant the occurrence of severe obstructive sleep apnea in the immediate postoperative period.     

Patterns of junctional communication in skin: Studies on cultured keratinocytes

Junctional communication has long been suggested to play a role in coordinating the development of multicellular tissues. A better understanding of the patterns of communication between cells in such tissues is important for the identification of areas where this process may have a role. We have investigated the patterns of communication in cultures of human epidermal keratinocytes by iontophoretic injection of Lucifer Yellow CH, using involucrin expression as a marker of cells undergoing terminal differentiation. Cells that lack involucrin (i.e., the basal, proliferating cells) transfer dye preferentially to other involucrin-negative cells, whereas involucrin-positive cells either are not coupled or transfer dye with similar frequency to involucrin-positive and involucrin-negative neighbors. This decrease in communication associated with terminal differentiation was observed in both the presence and the absence of assembled desmosomes. Our observations lead us to speculate that loss of junctional communication may influence the commitment of basal keratinocytes to terminal differentiation.     

Immunoreactivity to the pancreatic polypeptide family in the nervous system of the adult human blood fluke,Schistosoma mansoni

Summary The presence and distribution of neuropeptides belonging to the pancreatic polypeptide family have been demonstrated by an indirect immunofluorescence technique in the nervous systems of adult male and female Schistosoma mansoni. Seven antisera of differing regional specificity to pancreatic polypeptide (PP), peptide YY (PYY) and neuropeptide Y (NPY) were employed on both whole-mount and cryostat-sectioned material. Positive immunoreactivity (IR) was obtained with all antisera except an N-terminally-directed antiserum to NPY. In the CNS, immunoreactivity was restricted to cell bodies and nerve fibres in the anterior ganglia, central commissure and dorsal and ventral nerve cords of both sexes, whereas, in the PNS, positive-IR was present in the plexuses innervating the subtegumental musculature and the oral and ventral suckers. Intense immunoreactivity was observed in a plexus of nerve fibres and cell bodies in the lining of the gynaecophoric canal and in fine nerve fibres innervating the dorsal tubercles of the male. In contrast, in the female, strong immunoreactivity was evident in nerve plexuses innervating the lining of the ovovitelline duct and in the wall of the ootype, but most notably in a cluster of cells in the region of Mehlis' gland. Results suggest that molecules with C-terminal homology to the PP-family are present in S. mansoni. These peptides would appear to be important regulatory molecules in the parasite's nervous system and may play a role in the control of egg production.     

Principal/agent theory and decision making in health care

Principal/agent theory, an economics concept that defines an agency relationship as "a contract under which one or more persons engage another person (the agent) to perform some service on their behalf which involves delegating some decision-making authority to the agent," is held to be applicable to the patient/physician relationship, in contrast to the view that this is a fiduciary relationship, not a contractual one. The distinction between fiduciary and contractual relationships is illuminated in the process of evaluating objections to the application of the principal/agent theory to the patient/physician relationship. The ability of the principal/agent theory to reveal important features of advance directives, understood as public documents rather than as confidential instructions from patient to physician, is also examined.     

Influence of Synchro-Mate-B and breed composition on estrous response and pregnancy rate in spring- and fall-bred Brahman crossbred beef cows

Estrous response, pregnancy rate, and the relationship between palpable corpora lutea (CL) and plasma progesterone concentrations were studied during the spring (n = 149) and fall (n = 146) breeding seasons using postpartum, crossbred beef cows consisting of 0-Brahman, 1 4 - Brahman , or 1 2 Brahman breeding. At the start of each breeding season, a jugular blood sample was collected for progesterone analysis; each cow was palpated for the presence of a CL and randomly alloted within breed to a non-treated control or Synchro-Mate-B (SMB) treatment. Fewer (P<0.01) fall than spring bred cows exhibited estrus within the first 21 d of breeding. Within 48 h of implant removal, 84 and 64% (spring and fall, respectively) of synchronized cows exhibited estrus. In both seasons, more SMB than control cows became pregnant by 7 d of breeding. Percentage of Brahman breeding did not influence estrous response or pregnancy rate. On the basis of 292 evaluations, palpation per rectum correctly assessed ovarian status 74% of the time. These data indicate that although season can influence response. SMB can be used effectively to synchronize Brahman crossbred cows. In addition, it was found that there is a close relationship between palpation per rectum and plasma concentrations of progesterone.     

Changes in bone mineralization pattern: a response to local stimulus in maxilla and mandible of dogs

A pilot study was carried out in order to verify the pattern of changes in mineralization of bone in the maxillas and mandibles of dogs which had a tooth extraction or luxation. Bone mineral content was determined using computerized microdensitometry. Significant changes in patterns of mineralization were found for alveolar bone, cortical bone and trabecular bone at the sites adjacent to the area of operation. These findings suggest that the three envelopes of jaw bones of the dogs are influenced by Regional activation phenomenon (RAP). These results have important implications for the design of clinical studies of periodontium. A more detailed study should elucidate the cellular mechanisms by which these changes occur.     

Experience of the use of probiotics for Salmonellae control in poultry

The Editors of Letters in Applied Microbiology will, at their discretion, publish invited and submitted 'Opinions' on subjects in the general area of Applied Microbiology. They will not be subjected to the normal refereeing procedures and reprints will not be provided. The 'Opinions' will not necessarily represent the views of the Society of Applied Bacteriology or of the Editors. The Editors may invite or readers may submit 'Responses' to published 'Opinions' , provided that they are not merely polemics, and these will also be published at the discretion of the Editors. 'Responses' will be treated precisely like 'Opinions' . They should clearly indicate, in their first sentence, the 'Opinion' to which they are a response.     

Comparison of a competitive enzyme immunoassay kit and the infant mouse assay for detecting Escherichia coli heat-stable enterotoxin

A commercial competitive enzyme immunoassay kit, Escherichia coli ST EIA, was compared with the conventional infant mouse assay for sensitivity and specificity in detecting E. coli heat-stable enterotoxin. Thirty-one of 46 strains of E. coli tested were positive by both assays, while 15 strains were negative. The sensitivity of the ST EIA kit was up to 64-fold lower than the infant mouse assay.     

Evidence of abortive recombination in ruv mutants of Escherichia coli K12

Summary Genetic recombination in Escherichia coli was investigated by measuring the effect of mutations in ruv and rec genes on F-prime transfer and mobilization of nonconjugative plasmids. Mutation of ruv was found to reduce the recovery of F-prime transconjugants in crosses with recB recC sbcA strains by about 30-fold and with recB recC sbcB sbcC strains by more than 300-fold. Conjugative plasmids lacking any significant homology with the chromosome were transferred normally to these ruv mutants. Mobilization of the plasmid cloning vectors pHSG415, pBR322, pACYC184 and pUC18 were reduced by 20- to 100-fold in crosses with ruv rec ⁺ sbc ⁺ strains, depending on the plasmid used. Recombinant plasmids carrying ruv ⁺ were transferred efficiently. With both F-prime transfer and F-prime cointegrate mobilization, the effect of ruv was suppressed by inactivating recA. It is proposed that the failure to recover transconjugants in ruv recA ⁺strains is due to abortive recombination and that the ruv genes define activities which function late in recombination to help convert recombination intermediates into viable products.     

Supplemental chloralose anesthesia in morphine premedicated dogs

This study evaluated the cardiorespiratory stability of six dose-regulated, 12-hour, chloralose anesthetic maintenance protocols. Thirty mongrel dogs were premedicated with morphine sulfate (5mg/kg) and anesthetized with an induction dose of chloralose (80mg/kg). Fifteen animals were permitted to breathe spontaneously and 15 animals were ventilated mechanically to maintain a constant arterial pCO2 (40 +/- 5 mmHg). The spontaneously breathing dogs were separated into three groups in which animals (n = 5) were given different bolus doses of supplemental anesthetic. Initially the spontaneously breathing animals were hypoxemic, acidemic and hypercapnic. No consistent hemodynamic difference was noted among these groups. The mechanically ventilated animals were also divided into three groups that received varying doses of supplemental chloralose by constant infusion. Significant (p less than 0.01) myocardial depression was noted in the heavy-dosed animals by the third hour. Systolic pressure decreased 44%, pulse pressure decreased 37% and peak left ventricular dP/dt decreased 52%. All heavy-dosed animals expired before the eighth hour. Although these data suggest that morphine-premedicated, chloralose-anesthetized animals generally provide a stable cardiopulmonary model, high-dose chloralose supplementation depressed ventilation and produced a dose-dependent cardiotoxicity.