Primary treatment of the infected sternotomy wound with muscle flaps: a review of 211 consecutive cases

Between 1978 and 1987, 15,595 median sternotomies were performed at Emory University Hospitals. Sternal wound infections developed in 246 patients (1.6 percent). Mediastinitis was present in 211 patients, while superficial infections were detected in the remaining 35 patients. Debridement and muscle or omental flap closure were performed in all instances of mediastinitis, with an overall mortality rate of 5.3 percent. The results of this treatment are reviewed, and the evolution of current therapeutic guidelines is described. When compared with closed-catheter irrigation and open granulation techniques, flap closure is shown to result in a fourfold decrease in mortality, an increased success of primary therapy, and a diminished length of hospitalization following treatment. This evidence supports the conclusion that debridement and flap closure should be considered the primary therapy for patients with poststernotomy mediastinitis.     

DFT study of B-like conformations of deoxydinucleoside monophosphates containing Gua and/or Cyt and their complexes with Na+ cation

B-like minimum energy conformations of deoxydinucleoside monophosphate anions (dDMPs) containing Gua and/or Cyt and their Na+ complexes have been studied by the DFT PW91PW91/DZVP method. The optimized geometry of the dDMPs is in close agreement with experimental observations and the obtained minimum energy conformations are consistent with purine-purine, purine-pyrimidine, and pyrimidine-purine arrangements in crystals of B-DNA duplexes. All the studied systems are characterized by pyramidalization of the amino groups, which participate in the formation of unusual hydrogen bond between the carbonyl oxygen of the second base in the dGpdC, dCpdG dDMPs, and their Na+ complexes. In all the obtained structures the bases assume a nearly parallel disposition to each other and this effect is independent on the degree of their spatial superposition. From this it is concluded that the parallel disposition of the bases in the B-like single-stranded conformations is dictated by the sugar-phosphate backbone. Correspondingly, the base-base interactions attain a secondary role in the formation of these spatial structures. The formation of a weak C6-H6...O5' hydrogen bond between cytosine and the phosphate oxygen is reported, in agreement with experimental observations.     

Establishment of arbuscular mycorrhizal plants originating from xerothermic grasslands on heavy metal rich industrial wastes–new solution for waste revegetation

Industrial waste substrata, rich in heavy metals, are poorly suited for plant growth. Efforts are made to establish an appropriate plant cover to reduce erosion and further contamination. Grasses are the usual solution, as they grow fast, thrive on poor substrata and have well-developed root systems. Some of them are also highly dependent on mycorrhizal symbiosis that supports their growth especially on poor and polluted soils. However, the commercially available grasses often meet a lack of well established mycorrhiza on the site and the introduced plant populations dramatically decrease with time, despite large financial input including covering the substratum with soil and intensive watering. The aim of this paper was to select proper plants together with mycorrhizal fungi that could accelerate the establishment of the vegetation and improve its diversity under these extreme conditions, minimizing the financial costs of the reclamation (no use of soil layering and watering). The experiments were carried out under field and laboratory conditions. The plant seeds used originated from dry calcareous grasslands. The seeds were germinated under field conditions or in pots filled with soil supplemented with substratum from the industrial wastes. The seedlings were inoculated with AM fungi and introduced on the field plots a few weeks after germination. The inoculum consisted of either crude inoculum harvested from the dry calcareous grasslands or strains originating from polluted areas. Plants colonized by mycorrhizal fungi established well in the experimental plots. The results suggest that inocula from dry calcareous grasslands are potentially useful in revegetation of industrial wastes. Although in several cases the photosynthetic activity of plants was lower than at the natural sites, almost all plants survived and formed seeds. In all experiments the plant vitality was estimated on the basis of chlorophyll a fluorescence and was useful to show differences between waste substrata, inocula and coexisting plant species. The interactions between mycorrhizal and non-mycorrhizal plants were studied under greenhouse conditions and at least no negative effect of this coexistence was found.     

Contractile responses of the rat vas deferens after epithelium removal

The purpose of the present investigation was to verify the role of the epithelium in the functional response of the rat vas deferens. Our results showed that the contractile effect of cumulative doses of clonidine (3.10(-5)-3.10(-3)) was increased after the removal of the epithelium. The effect of clonidine in epithelium-free vas deferens returned to normal values when an isolated epithelium from another vas deferens was added to the organ bath, showing that the epithelium is responsible for this increase of maximum effect for clonidine. Drugs functionally or structurally related to clonidine, such as oxymetazoline, alpha-methylnorepinephrine and moxonidine, did not have their dose-response curves altered. The curves for other contractile agents, such as noradrenaline, acetylcholine, ATP, 5HT, bradykinin and histamine, or the relaxation induced by isoprenaline and forskolin were also not modified. Electrically-induced contractions at frequencies from 0.1 to 20 Hz and the mechanism of negative feed-back, brought about by clonidine (10(-10)-10(-8) M) through pre-synaptic alpha2-adrenoceptors, were not changed after the removal of epithelium. In conclusion, a significant function of the epithelium in the contractility of the rat vas deferens was demonstrated for clonidine, but not for other agonists.     

Localization of rRNA genes in Phyllostomidae bats reveals silent NORs in Artibeus cinereus

We analyzed the nucleolus organizer regions (NORs) of thirteen bats from genera Phyllostomus, Phylloderma, Trachops, Tonatia, Sturnira, Platyrrhinus, Artibeus and Glossophaga. We used silver staining and FISH with rDNA probe. Nine species had only one Ag-NOR-bearing chromosome pair. Artibeus lituratus, A. jamaicensis and A. fimbriatus presented multiple Ag-NORs located in the short arms of pairs 5, 6 and 7, and an additional mark in the long arm of one chromosome 5 in A. fimbriatus. Artibeus cinereus showed Ag-NORs in the chromosome pairs 10 and 13. The chromosomal location of rRNA genes using FISH agreed with the number and position of NORs in all but one species. In A. cinereus the hybridization signals were seen in three chromosome pairs 9, 10 and 13. This suggests the occurrence of silent NORs in pair 9. Differences in the size and intensity of the hybridization signals were also observed in the pair 9 of A. cinereus.     

X-linked hypophosphatemia in Polish patients. 1. Mutations in the PHEX gene

We present twenty-nine PHEX gene mutations extending our previous work, giving it to a total of 37 different mutations identified in Polish patients with familial or sporadic X-linked hypophosphatemia. Deletions, insertions and nucleotide substitutions leading to frameshift (27%), stop codon (29%), splice site (24%), and missense mutations (20%) were found. The mutations are distributed along the gene; exons 3, 4, 11, 12, 14, 15, 17, 20 and 22 are regions with the most frequent mutation events. Four mutations, P534L, G579R, R549X and IVS15+1nt, recurred in three, four, two and three unrelated patients, respectively. They have also been detected in affected persons from other countries. Twenty-eight mutations are specific for Polish population and almost all of them are unique. Most of the identified mutations are expected to result in major changes in protein structure and/or function.     

Biosynthesis and secretion of several enzymes in Escherichia coli dnaK and dnaJ mutants

Escherichia coli null dnaJ and dnaKdnaJ mutants were defective in the biosynthesis and secretion of several enzymes. The synthesis of beta-galactosidase induced in delta dnaJ and delta dnaKdnaJ mutants was abolished at 42 degrees C and significantly decreased at 30 and 37 degrees C. The activity of alkaline phosphatase in the periplasm in both mutant strains at high temperature was lower than in the wild-type strain. The synthesis of b-type cytochromes was defective in two deletion mutants while the synthesis of nitrate reductase-A at 42 degrees C was influenced by dnaK mutation only. The lack of DnaK and DnaJ does not impair the activity of catechol 2,3-dioxygenase irrespective of growth temperature.     

Production of reactive nitrogen and oxygen intermediates in human granulocytes and monocytes during internalization of live BCG bacilli

The production of nitric oxide (NO) and reactive oxygen intermediates in granulocytes and macrophages from healthy volunteers, infected in vitro with live Bacille Calmette-Guerin (BCG) mycobacteria, was estimated. Significant differences in the biochemical reactions induced by BCG bacilli in granulocytes and monocytes are described. The activity of phagocytes was also investigated in the cultures with cytokines: IFN-gamma, TNF-alpha, GM-CSF, IL-4.