Accounting for Energy and Protein Reserve Changes in Predicting Diet-Allowable Milk Production in Cattle

Current ration formulation systems used to formulate diets on farms and to evaluate experimental data estimate metabolizable energy (ME)-allowable and metabolizable protein (MP)-allowable milk production from the intake above animal requirements for maintenance, pregnancy, and growth. The changes in body reserves, measured via the body condition score (BCS), are not accounted for in predicting ME and MP balances. This paper presents 2 empirical models developed to adjust predicted diet-allowable milk production based on changes in BCS. Empirical reserves model 1 was based on the reserves model described by the 2001 National Research Council (NRC) Nutrient Requirements of Dairy Cattle, whereas empirical reserves model 2 was developed based on published data of body weight and composition changes in lactating dairy cows. A database containing 134 individually fed lactating dairy cows from 3 trials was used to evaluate these adjustments in milk prediction based on predicted first-limiting ME or MP by the 2001 Dairy NRC and Cornell Net Carbohydrate and Protein System models. The analysis of first-limiting ME or MP milk production without adjustments for BCS changes indicated that the predictions of both models were consistent (r(2) of the regression between observed and model-predicted values of 0.90 and 0.85), had mean biases different from zero (12.3 and 5.34%), and had moderate but different roots of mean square errors of prediction (5.42 and 4.77 kg/d) for the 2001 NRC model and the Cornell Net Carbohydrate and Protein System model, respectively. The adjustment of first-limiting ME- or MP-allowable milk to BCS changes improved the precision and accuracy of both models. We further investigated 2 methods of adjustment; the first method used only the first and last BCS values, whereas the second method used the mean of weekly BCS values to adjust ME- and MP-allowable milk production. The adjustment to BCS changes based on first and last BCS values was more accurate than the adjustment to BCS based on the mean of all BCS values, suggesting that adjusting milk production for mean weekly variations in BCS added more variability to model-predicted milk production. We concluded that both models adequately predicted the first-limiting ME- or MP-allowable milk after adjusting for changes in BCS.

[Proseal laryngeal mask]

The Proseal laryngeal mask was introduced into clinical practice in 2000. Since then, many publications, most of them case reports, have discussed the use of this mask. This review considers the possible indications and contraindications for use of this device, techniques for insertion, and complications. The Proseal is compared with the conventional laryngeal mask. We reviewed the literature indexed on MEDLINE through October 2005 using the search terms Proseal laryngeal mask, airway, and anesthesia.

[Neuropsychological intervention in patients with epilepsy]

INTRODUCTION

Neuropsychological evaluation is part of the protocols that are performed in epilepsy surgery units with the aim of selecting suitable candidates for the surgical intervention.

DEVELOPMENT

Yet, neuropsychology can be useful for a wider range of purposes in patients with epilepsy. Identifying the cognitive, emotional and behavioural impairments that cause both the epileptic seizures and the possible underlying neuropathologies that trigger them can provide further knowledge of the functional deterioration suffered by epilepsy patients, whether they are candidates for surgery or not, and help guide their possible rehabilitation. The results of this evaluation can also make it easier to carry out the differential diagnosis to distinguish epileptic seizures from other non-epileptic episodes, such as psychogenic seizures.

CONCLUSIONS

Neuropsychological evaluation in epileptic patients has increased our knowledge of the higher processes, the brain circuits involved in them and the repercussions that brain injury has on them.

[Anesthetic management for left ventricular epicardial lead implantation with minimally invasive thoracoscopic guidance]

Medical treatment for left ventricular (LV) systolic dysfunction and congestive heart failure has improved quality of life for patients but mortality rates have remained unaffected. For a subgroup of such patients with interventricular conduction delays and ventricular contraction dyssynchrony, cardiac resynchronization by placement of a LV epicardial lead is a new approach to management. We report 3 cases in which such electrodes were implanted under the guidance of minimally invasive thoracoscopy. In the first 2 cases it was decided to place the LV electrode using thoracoscopic guidance because of complications or technical difficulties in the percutaneous procedure. In the third case thoracoscopy was used because of deterioration of the patient's condition after implantation of a double-chamber pacemaker and shifting of the lead to the right ventricle. The literature on the anesthetic management of such patients is scarce. Although sedation with general anesthesia and single-lung ventilation is indicated for percutaneous procedures, that technique also proved adequate for the thoracoscopic procedures.

Granulocyteaphaeresis in steroid-dependent inflammatory bowel disease: a prospective, open, pilot study

BACKGROUND

Uncontrolled studies suggest that granulocyteaphaeresis might be useful in the management of active ulcerative colitis.

AIM

To assess the efficacy of granulocyteaphaeresis treatment in active steroid-dependent inflammatory bowel disease.

METHODS

We conducted a multicentre, prospective, open, pilot study in patients with steroid-dependent inflammatory bowel disease. All patients were started on 60 mg/day of prednisone; after 1 week, a five-session programme of granulocyteaphaeresis (once per week) was started. The steroid dose was tapered weekly if there was clinical improvement. Remission was defined as an inactive clinical activity index together with complete withdrawal of steroids at week 6. The patients were followed up for at least 6 months or until disease relapse.

RESULTS

Twenty-six patients (14 ulcerative colitis, 12 Crohn's disease) were included. More than a half had been previously treated with immunomodulators. Remission was achieved in 62 and 70% of ulcerative colitis and Crohn's disease, respectively. During a median follow-up of 12.6 months, six of eight ulcerative colitis patients maintained their clinical remission; however, only one Crohn's disease patient remained in remission after the first 6 months of follow-up.

CONCLUSIONS

Granulocyteaphaeresis is a safe treatment option in inflammatory bowel disease. A five-session programme of granulocyteaphaeresis seems to be efficient in the treatment of steroid-dependent ulcerative colitis, but not in Crohn's disease.

Relative Acidifying Activity of Anionic Salts Commonly Used to Prevent Milk Fever

High cation diets can cause milk fever in dairy cows as they induce a metabolic alkalosis reducing the ability of the cow to maintain calcium homeostasis at the onset of lactation. Adding anions to the diet can offset the effect of the high cation forages by inducing a mild metabolic acidosis, restoring the ability to maintain calcium homeostasis. The difference in mEq of dietary cations and anions (DCAD) is most often expressed as (Na(+) + K+) - (Cl- + S(--)). This equation implies that a mEq of chloride and a mEq of sulfate are equipotent in their ability to alter acid-base balance of the cow. Using blood and urine pH to monitor effects on acid-base balance, experiments were conducted to test the relative acidifying activity of various sulfate and chloride anion sources in nonpregnant, nonlactating Jersey cows. Across all experiments, chloride proved to have about 1.6 times the acidifying activity of sulfate. Calcium and magnesium, ignored by the common DCAD equation, had a small but significant alkalinizing effect when accompanying chloride or sulfate. The ranking of the anion sources tested at a dose of 2 Eq/d, from most to least potent urine acidifier, was hydrochloric acid, ammonium chloride, calcium chloride, calcium sulfate, magnesium sulfate, and sulfur. These data should allow more accurate prediction of the response of late gestation cows to dietary cation-anion manipulation.

Characterization and mRNA expression in an unusual odontogenic lesion in a patient with tricho-dento-osseous syndrome

Odontogenic lesions are rare, but can be associated with significant morbidity. While their molecular determinants are unknown, they likely express many genes common to normal odontogenesis. This study evaluated the histology and mRNA expression of an unusual odontogenic lesion in a patient with a confirmed history of tricho-dento-osseous syndrome.

METHODS

Decalcified, frozen 8 micro m sections of the lesion were cut and mounted on glass slides and stained with hematoxylin/eosin for analysis. The expression of multiple genes associated with normal odontogenesis and related pathologies were evaluated by RT-PCR, where possible in samples of the hard and soft tissue components of the lesion.

RESULTS

Histological examination showed the lesion had large areas of irregular, dentine-like material, enamel matrix, areas of woven immature bone and multiple fully mineralised tooth crowns. Although most of the gene transcripts were amplified from both samples, some, including DLX3/7 and Collagen I demonstrated differential expression.

CONCLUSIONS

This study shows the gene expression profile of aberrant odontogenesis with associated odontoma formation is similar to that of normal tooth and the genes expressed in other odontogenic lesions. While the role of altered gene expression in the development of such lesions has previously been postulated from transgenic models, this is the only report of an odontogenic lesion in a patient with TDO, and begins to elucidate possible gene interactions key to its development.

Schistosomiasis mansoni in areas of low transmission: epidemiological characterization of Venezuelan foci

Severe schistosomiasis is a rare event in Venezuela nowadays, after a successful national campaign by the Schistosomiasis Control Program. Unfortunately, this program has practically disappeared, and snail surveillance in field is not a priority, anymore. Thus, schistosomiasis has become a neglected disease in this country. However, surveys in different populations from the endemic area have shown particular epidemiological features described herein. In five communities we evaluated 2,175 persons and searched for the presence of Biomphalaria glabrata snails. Some markers were used for classifying schistosomiasis foci: mean age of the persons with Schistosoma mansoni eggs in the stools, serological tests, presence of B. glabrata snails, and intensity of infection. Places without B. glabrata snails and with few schistosomiasis cases were defined as "past transmission sites"; a site with abundant snails but few cases was defined as "potential risk"; "new transmission" foci were characterized by the presence of infected snails and young people passing eggs in the stools. A "re-emergent" focus has shared these last features, showing in addition a place where schistosomiasis had been reported before. Recent evidences of active transmission with the increasing dispersion of B. glabrata snails, point out the necessity for the re-establishment of the Schistosomiasis Control Program in Venezuela.

Schistosomiasis mansoni in low transmission areas: abdominal ultrasound

In endemic areas with low prevalence and low intensity of infection, the diagnosis of hepatic pathology due to the Schistosoma mansoni infection is very difficult. In order to establish the hepatic morbidity, a double-blind study was achieved in Venezuelan endemic areas, with one group of patients with schistosomiasis and the other one of non-infected people, that were evaluated clinically and by abdominal ultrasound using the Cairo classification. Schistosomiasis diagnosis was established based on parasitologic and serological tests. The increase of the hepatic size at midclavicular and midsternal lines (in hepatometry) and the hard liver consistency were the clinical parameters able to differentiate infected persons from non infected ones, as well as the presence of left lobe hepatomegaly detected by abdominal ultrasound. The periportal thickening, especially the mild form, was frequent in all age groups in both infected and uninfected patients. There was not correlation between the intensity of infection and ultrasound under the current circumstances. Our data suggest that in Venezuela, a low endemic area of transmission of schistosomiasis, the hepatic morbidity is mild and uncommon. The Cairo classification seems to overestimate the prevalence of periportal pathology. The specificity of the method must be improved, especially for the recognition of precocious pathology. Other causes of hepatopathies must be investigated.

The effect of a ruminal nitrogen (N) deficiency in dairy cows: evaluation of the cornell net carbohydrate and protein system ruminal N deficiency adjustment

Twenty-four multiparous and fifteen first lactation Holstein cows averaging 263 days in milk and weighing 614 kg were fed diets adequate or deficient in ruminal nitrogen (N), based on predictions of the Cornell Net Carbohydrate and Protein System (CNCPS). After adjustment to a low crude protein (CP) total mixed rations (TMR; 12.6% CP), the cows were allocated to 13 blocks based on lactation number, milk production, body condition score, and body weight. Within each block, cows were randomly assigned to one of the 3 treatment (TRT) diets (9.4, 11.1 and 14.1% CP for TRT 1, 2, and 3, respectively). All diets contained the same proportion of high moisture corn, chopped grass hay, and minerals, with urea substituted for corn silage as needed to reach the three CP levels. The TRT diets were then fed to the cows for 4 wk. Milk production was significantly affected by TRT: 15.5, 18.8, and 21.7 kg/d for TRT diets 1, 2, and 3, respectively. DMI was increased significantly as the percentage of CP increased from 9.4 to 14.1% CP: 17.6, 20.0, and 21.2 kg/d for TRT diets 1,2, and 3, respectively. CNCPS predictions for production (with and without the N adjustment for ruminal N deficiency) of metabolizable protein (MP) allowable milk were compared with observed milk production. Using the average individual weekly cow data from all 3 TRT, we found that the CNCPS accounted for 72 and 68% of the variation in MP allowable milk without and with the N deficiency adjustment, respectively. The overall mean bias without the N adjustment was 3.3 kg of milk (over prediction model bias of 14.6%, P < 0.001), and the N adjustment reduced the model over-prediction bias to 0.01 kg of milk (P = 0.96).

Ferromagnetic Coupling through Spin Polarization in a Dinuclear Copper(II) Metallacyclophane

First organic radicals, now metal complexes: A successful extension to metal complexes of a well-known organic radical approach to ferromagnetism is exemplified by the triplet ground-state molecule containing two Cu(II) centers connected by a double m-phenylenediamide skeleton of the cyclophane type shown in the scheme.

Intrinsic changes on automatism, conduction, and refractoriness by exercise in isolated rabbit heart

We have studied the intrinsic modifications on myocardial automatism, conduction, and refractoriness produced by chronic exercise. Experiments were performed on isolated rabbit hearts. Trained animals were submitted to exercise on a treadmill. The parameters investigated were 1) R-R interval, noncorrected and corrected sinus node recovery time (SNRT) as automatism index; 2) sinoatrial conduction time; 3) Wenckebach cycle length (WCL) and retrograde WCL, as atrioventricular (A-V) and ventriculoatrial conduction index; and 4) effective and functional refractory periods of left ventricle, A-V node, and ventriculoatrial retrograde conduction system. Measurements were also performed on coronary flow, weight of the hearts, and thiobarbituric acid reagent substances and glutathione in myocardium, quadriceps femoris muscle, liver, and kidney, to analyze whether these substances related to oxidative stress were modified by training. The following parameters were larger (P < 0.05) in trained vs. untrained animals: R-R interval (365 +/- 49 vs. 286 +/- 60 ms), WCL (177 +/- 20 vs. 146 +/- 32 ms), and functional refractory period of the left ventricle (172 +/- 27 vs. 141 +/- 5 ms). Corrected SNRT was not different between groups despite the larger noncorrected SNRT obtained in trained animals. Thus training depresses sinus chronotropism, A-V nodal conduction, and increases ventricular refractoriness by intrinsic mechanisms, which do not involve changes in myocardial mass and/or coronary flow.

4-hydroxy-2-nonylquinoline: a novel iron chelator isolated from a bacterial cell membrane

The membrane associated iron chelator of Pseudomonas aeruginosa has been extracted from membranes of iron-rich cells with ethanol and purified by reverse phase HPLC. Using 13C NMR and FAB mass spectroscopy, the structure of the chelator has been determined to be 4-hydroxy-2-nonylquinoline. This compound has been previously isolated and named pseudan IX, a name which we use here. We synthesized pseudan IX and show that the spectral properties of the synthesized compound and the purified compound are nearly identical. Also purified from the ethanol extract of membranes is 4-hydroxy-2-heptylquinoline, i.e., pseudan VII. Bacterially purified pseudan IX binds iron as indicated by the incorporation of radiolabeled iron into the chelator and by the formation of pink micelles in a concentrated ethanol extract. The formation of pink micelles upon addition of iron to the synthesized compound indicates that it binds iron.

KIT activation is a ubiquitous feature of gastrointestinal stromal tumors

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and they are generally resistant to chemotherapy and radiation therapy. Most GISTs express the KIT receptor tyrosine kinase protein, and a subset of GISTs contain activating mutations within the KIT juxtamembrane region. We evaluated 48 GISTs, including 10 benign, 10 borderline, and 28 malignant cases, to determine whether KIT expression and activation are general properties of these tumors. Immunohistochemical KIT expression was demonstrated in each case. Somatic KIT mutations were found in 44 tumors (92%), of which 34 (71%) had juxtamembrane region mutations. Other GISTs had KIT mutations in the extracellular region (n = 6) and in two different regions in the tyrosine kinase domain (n = 4). Contrary to previous reports, KIT mutations were not identified preferentially in higher-grade tumors: indeed, they were found in each of 10 histologically benign GISTs. Notably, mutations in all KIT domains were associated with high-level KIT activation/phosphorylation, and KIT activation was also demonstrated in the four GISTs that lacked detectable KIT genomic and cDNA mutations. These studies underscore the role of KIT activation in GIST pathogenesis, and they suggest that activated KIT might represent a universal therapeutic target in GISTs.

[Safety and efficacy of an early deambulation protocol after PTCA with an angio-seal device]

INTRODUCTION

In order to assess the efficacy and safety of an early deambulation (1-2 h) protocol after coronary angioplasty using the Angio-seal collagen plug, we analyzed a consecutive series of patients treated with this device versus a reference group treated with mechanical compression.

PATIENTS AND METHODS

Two hundred and seven coronary angioplasty patients were included from February to August 2000. Ninety-eight were treated with mechanical compression and one hundred and nine with the Angio-seal collagen plug. All patients were followed at discharge and fifteen days after surgery.

RESULTS

Eighty percent of the patients receiving the Angio-seal device achieved immediate hemostasis (< 1 min). In patients with mechanical compression hemostasis was achieved within 30 min in 68.3%, whereas 25.5% of patients required more than 40 min. First deambulation in the Angio-seal group was achieved within 2 h in 94.5% of the patients. The incidence of major complications was low in both groups (1 case in the Angio-seal group and 2 in the C-clamp group) without statistically significant differences. The Angio-seal group showed a lower incidence of overall vascular complications as compared to the C-clamp group (4.6% vs. 14.3%; p = 0.02).

CONCLUSION

Following our protocol, an early deambulation strategy after coronary angioplasty with the use of the Angio-seal collagen plug was feasible, safe and efficacious.

[Acute severe pain in emergencies. The key for efficient analgesia]

OBJECTIVE

To measure severe acute pain (SAP) frequency, to describe SAP management and to bring to view the conditions of analgesia success in emergency medicine.

DESIGN

Multicentre prospective survey: 7 days in Emergency Departments (ED), 30 days in Mobile Intensive Care Units (MICU). Multivariate analysis to measure the independent effect on pain relief of factors identified by Chi squared test.

SETTING

All of 6 ED and 8 MICU of a French region.

PATIENTS

Over 15 years of age.

MAIN OUTCOME MEASURES

Pain intensity was assessed with Visual Analog Scale (VAS) before and after ED or MICU management. SAP group (defined by initial VAS score > 40 mm) was analyzed for pain relief (defined by final VAS score < or = 40 mm). Influence on pain relief through pain aetiology, initial pain intensity, treatment delay and opioid use was analyzed.

RESULTS

1,082 fulfilled medical forms for 3,419 eligible patients. SAP frequency was estimated 36% (CI95 = 34-38%) in ED and 29% (CI95 = 25-33%) in MICU. SAP (n = 368) was often persistent: 45% (CI95 = 43-47%) after discharge from ED and 26% (CI95 = 22-30%) after MICU intervention. The prognostic factors of pain control success revealed by Chi squared test were: MICU (vs ED), treatment delay < or = 3 hours (vs > 3 hours), opioid use (vs non opioid use) and VAS pain level < or = 70 mm (vs > 70 mm). The last 3 factors were confirmed by multivariate analysis. Treatment delay, opioid use, and pain level were found to be determinants of efficient analgesia for SAP.

CONCLUSION

Despite the high frequency of SAP in ED and MICU, pain control is not satisfying. Opioid use and early treatment are determinant in analgesia efficiency for SAP and should be therefore encouraged to improve pain relief in emergency medicine.

Alkane oxidation by a carboxylate-bridged dimanganese(III) complex

A new manganese(II) oxamato dimer possesing an unprecedented Mn2(mu-O2CR)(mu-OH2...O2CR) core has been synthesised, structurally and magnetically characterised, and used as a catalyst for the oxidation of alkanes to alcohols and ketones by ButO2H and O2 in CH2Cl2 at rt.

Residues 137 and 153 of XylS influence contacts with the C-terminal domain of the RNA polymerase alpha subunit

XylS and XylS1 are transcriptional regulators that stimulate transcription from the Pm promoter for the meta-cleavage pathway operon for alkylbenzoate degradation. These regulators that differ in five amino acids interact with alpha-CTD domain of RNA polymerase. These interactions take place preferentially through residues 291 in XylS and 289 in XylS1. Substitution at position 137 and 153 in XylS influence the interactions with alpha-CTD because single and double mutants in these positions turned preferential interactions to residue 289.

Effect of monensin on the performance and nitrogen utilization of lactating dairy cows consuming fresh forage

We conducted a lactation trial with a fresh forage diet in order to evaluate 1) the effects of monensin on nitrogen metabolism, and 2) the Cornell Net Carbohydrate and Protein System (CNCPS). Thirty Holstein cows in midlactation (eight fitted with ruminal fistulas) were gradually introduced to a fresh forage diet. A concentrate mix based on corn meal was fed before the a.m. and p.m. milking times 0730 and 1730 h, then the fresh forage was fed at 0830 and 1830 h. Fifteen cows each were allocated to a control (no monensin) and a treatment group receiving 350 mg/cow per day of monensin in the p.m. concentrate feeding. A 7-d fecal and urine collection period and a 3-d rumen sampling period were conducted with the fistulated cows. After the lactation study was concluded, the fistulated cows were fed forage regrowth and a 3-d rumen sampling period was repeated. Monensin increased milk production by 1.85 kg. Milk fat and protein concentrations decreased and milk fat and protein yields increased, but the effects were nonsignificant. Monensin did not significantly affect DMI. Ruminal ammonia and the acetate-to-propionate ratio decreased with the addition of monensin in both fed forages. Monensin decreased fecal N output, and increased apparent N digestibility by 5.4%. Because of the decrease in ruminal ammonia and increase in apparent N digestibility, we concluded monensin was sparing amino acids from wasteful rumen degradation with a fresh forage diet. The precision of the CNCPS in predicting performance was high (r2 = 0.76), and the bias was low (overprediction of 3.6%). These results indicate that the CNCPS can be used for dairy cows consuming fresh forage and gives realistic predictions of performance.

An active contour model algorithm for tracking endocardiac boundaries in echocardiographic sequences

The use of active contour models to track the boundaries of anatomic structures in medical images is a technique that has attracted a great number of efforts during the last decade. Segmentation techniques based in deformable active contours were proposed first by Kass et al. Because of the problems appearing using these models, some solutions have been introduced, such as balloon force or Gradient Vector Flow force (GVF), derived from the Gradient Vector Flow vectorial field. Results obtained with these forces in the tracking endocardiac task in echocardiographic sequences were not adequate. We have designed a new external force called hybrid force, which, by combining both forces, joins the main features of each one.

"Juvenile" xanthogranuloma: an immunophenotypic study with a reappraisal of histogenesis

The non-Langerhans histiocytoses, a nosologic category to which juvenile xanthogranuoma (JXG) belongs, represent a heterogenous collection of disorders related to the monocyte/macrophage lineage. The dermal dendrocyte was previously proposed as the cell of origin for JXG on the basis of Factor XIIIa reactivity, a suggestion that does not fully explain the occasional xanthogranulomatous proliferations localizing exclusively to extracutaneous sites. This study applies a panel of recently developed immunohistochemical markers to JXGs and relates the phenotype of this process to new concepts of monocyte/dendritic cell ontogeny. Twenty-seven JXG, ten dermatofibromas (DF), and ten age-matched normal skin specimens were stained using standard immunohistochemistry methods, and all JXGs were fascin+ and CD68+, although 26 of 27 were reactive for HLA-DR, 25 of 27 for Factor XIIIa, 25 of 27 for LCA, 21of 27 for CD4, and 8 of 27 for polyclonal s100. Six of those eight polyclonal S100+ cases were also reactive for monoclonal S100. None of those cases was reactive for CD1a, CD3, CD21, CD34, or CD35. Eight of ten dermatofibromas were FXIIIa+; all were negative for HLA-DR, LCA, CD4, and polyclonal s100. In controls, fascin+ dendritic cells were present but did not stain for Factor XIIIa, S100, or CD4. Based on the morphologic and phenotypic overlap of the lesional cells in JXGs and plasmacytoid monocytes, it would appear that the plasmacytoid monocyte might be considered the putative normal counterpart of the major cellular population of JXGs, a proposal that helps explain the extra-cutaneous, visceral, and soft tissue location that have been reported for occasional cases of JXG. We would also conclude that neither Factor XIIIa-nor S100+ results should preclude the diagnosis of JXG, and find that reactivity for CD4 and LCA may be used to distinguish JXG from DF when the latter is heavily lipidized or the former is not.

An open standard platform for interoperability of medical devices

Patient care in Intensive Care Units and Operating Rooms requires sophisticated instrumentation for monitoring, treatment and control. A major technical problem is the communication between devices, since the connection of medical devices from different manufacturers has similar problems to the communication between people from different countries who do not share a common language. Several proprietary solutions have been developed by initiatives from well-known international companies. These proprietary, non-open solutions have not gained general acceptability and have failed to draw upon the immense resources for instrumentation development which are available in the industry. Consequently, a set of open European standards for Medical Device Intercommunication has recently been created (ratified 1999) to provide the ability to connect devices to each other freely and to exchange data between them. The development of such standards has lead to the design and implementation of a network platform over which those standards could be tested and validated. At the same time guidelines have been defined for the development and deployment of open solutions for any kind of medical device, including existing legacy devices. The design and testing of this open standards implementation is described in this paper.

Interactions of the XylS regulators with the C-terminal domain of the RNA polymerase alpha subunit influence the expression level from the cognate Pm promoter

The Pseudomonas putida meta-cleavage operon encodes the enzymes for the catabolism of alkylbenzoates. Activation of meta-operon transcription is mediated by the XylS protein which, upon activation by effectors, binds two sites between -70 and -35 with respect to the main transcription initiation point at the Pm promoter. Two naturally occurring regulators, XylS and XylS1, that differ by only five amino acids, have been analyzed with regard to potential interactions of these positive regulators with the C-terminal domain of the alpha subunit of RNA polymerase (alpha-CTD). For these studies we expressed a derivative of alpha deprived of the entire C-terminal domain (alpha-Delta235) and found that expression from Pm with XylS or XylS1 was significantly decreased. To discern whether alpha-CTD activation depended on interactions with DNA and/or XylS proteins we tested a large collection of alanine substitutions within alpha-CTD. Most substitutions that had an effect on XylS and XylS1-dependent transcription were located in or adjacent to helix 1 and 4, which are known to be involved in alpha-CTD interactions with DNA. Two alanine substitutions in helix 3 (residues 287 and 291) identified a putative region of alpha-CTD/XylS regulator interactions.

Transcription activation by a variety of AraC/XylS family activators does not depend on the class II-specific activation determinant in the N-terminal domain of the RNA polymerase alpha subunit

The N-terminal domain of the RNA polymerase alpha subunit (alpha-NTD) was tested for a role in transcription activation by a variety of AraC/XylS family members. Based on substitutions at residues 162 to 165 and an extensive genetic screen we conclude that alpha-NTD is not an activation target for these activators.

Efficacies of BCG and vole bacillus (Mycobacterium microti) vaccines in preventing clinically apparent pulmonary tuberculosis in rabbits: a preliminary report

Tuberculosis (TB) kills more people in the world today than any other infectious disease, and the number of drug-resistant Mycobacterium tuberculosis isolates is increasing. Vaccines, better than most of the currently available strains of bacille Calmette-Guérin (BCG), are urgently needed to control this disease. TB in rabbits resembles human TB more closely than TB in any other common laboratory animal and a most pertinent method of assessing vaccine efficacy is Lurie's tubercle count method in this species. Vaccinated and control rabbits were infected by aerosol with virulent human-type tubercle bacilli (H37Rv). At necropsy 5 weeks thereafter, the grossly visible primary tubercles in the entire lung were counted. A decrease in the number of such tubercles is a quantitative measure of vaccine efficacy: An effective vaccine prevents microscopic tubercles from growing to grossly visible (clinically apparent) size. The Pasteur substrain of BCG and two substrains of Mycobacterium microti (the vole bacillus) reduced the number of visible primary tubercles an average of 75%, whereas three other substrains of BCG and three other substrains of vole bacilli only reduced the number an average of 40%. These initial studies indicate that Lurie's tubercle-count method in rabbits is a precise way to choose the best available tuberculosis vaccines.

Comparison of models for describing the lactation curve of latxa sheep and an analysis of factors affecting milk yield

The objectives of this work were 1) to compare the goodness-of-fit of empirical models of the lactation curve and 2) to analyze the factors affecting the shapes of the lactation curves, the parameters describing them, and the overall milk yield of Latxa dairy sheep. A total of 14,699 records from 2711 ewes, collected during three consecutive years (1995 to 1997) by the milk recording program of the Latxa ewe of the Basque Country (Spain), were used. Six mathematical models and three fitting procedures were compared. The estimation of model parameters by nonlinear fitting procedures was superior to that by linear regression methods. A nonlinear variable decay model fitted the data better than the other models, as judged by lower mean square prediction error, residual sums of squares, and a lack of first-order positive autocorrelation as assessed by the Durbin Watson coefficient. The effects of the flock, flock-year interaction, month of lambing, length of lactation nested within month of lambing, parity, and number of live lambs born had significant effects on the parameters of the model and the total milk yield (P < 0.01). The prediction of milk yield from the selected model was similar to the estimates obtained with the Fleischmann method currently used by the national breeding program for the Latxa breed.

Extraction of natural complex phenols and tannins from grape seeds by using supercritical mixtures of carbon dioxide and alcohol

Proanthocyanidins are supposed to have some therapeutical properties as antioxidants and antineoplasics. Most of the proanthocyanidins, however, are not commercialized since their separation from natural sources is either very expensive or not well-known. In this work, the feasibility of application of mixtures of carbon dioxide and alcohol under supercritical conditions for selective extraction of some phenolic compounds from grape seeds has been studied, among them some low polymerized proanthocyanidins, their main monomer units, (+)-catechin and (-)-epicatechin, and some low molecular weight phenolic compounds, like gallic acid. An analytical-scale supercritical fluid extractor, whose operation was previously optimized, was used to carry out the experiments. A commercial concentrate of complex phenols and tannins from grape seeds was subjected to supercritical extraction in order to find the best operation conditions before directly extracting defatted milled grape seeds. The solvent capacity was found to increase with pressure and with the amount of alcohol used as cosolvent as expected. Such variation in solvent capacity could be used for design of a selective separation process where individual phenolic compounds or groups of them could be obtained. HPLC coupled with two types of detectors, diode array and mass spectrometry, was used for tentative identification and quantification of complex phenols and tannins in the extracts and in the raw materials used for extraction.

Development of a microparticle-enhanced nephelometric immunoassay for quantitation of human lysozyme in pleural effusion and plasma

A microparticle-enhanced nephelometric immunoassay, based on polystyrene beads coated with antihuman lysozyme antibody, has been developed for lysozyme quantification in sera and pleural effusions. The standard curve extends from 0.58 mg/l to 18.75 mg/l and no antigen effect was observed. The results showed a good serial precision. The intra-assay precision (n = 20) expressed as CV was between 2.2 and 4.2 in three different concentrations. The inter-assay precision, with different calibration curves (n = 12) was between 6.4 and 7.1. The analytical assay showed a sufficient linearity (r > 0.999). There were no interferences either with haemoglobin (up to 4 g/l), lipids (up to 0.5%, expressed as 1% Lipofundina content), or bilirubin (up to 5 mg/dl). The analytical sensitivity was lower than 0.6 mg/l. The correlation with a Micrococcus lysodeikticus turbidimetric assay showed a correlation coefficient of 0.915. We have studied 92 patients with pleural effusion. In each case, pleural fluid adenosine deaminase activity and pleural fluid to plasma lysozyme ratio were determined. The lysozyme ratio showed similar clinical sensitivity and specificity as to adenosine deaminase.

Virulence of Mycobacterium tuberculosis CDC1551 and H37Rv in rabbits evaluated by Lurie's pulmonary tubercle count method

The virulence of the CDC1551 strain of Mycobacterium tuberculosis was compared to that of H37Rv in a rabbit inhalation model. While rabbits that inhaled the two strains produced equal numbers of grossly visible primary tubercles, CDC1551 tubercles were smaller and contained fewer bacilli than H37Rv tubercles. These findings suggest that a miniepidemic near the Kentucky-Tennessee border caused by CDC1551 was due not to increased virulence but to increased transmissibility.

Survival times of Campylobacter coli in sterilized buffalo milk

The survival level of five Campylobacter coli strains isolated from bovine faeces was studied in sterilized buffalo milk kept at 4 degrees C under aerobic conditions. All strains died between 21 and 30 h of storage.

[Hernia of the lumbar discs in persons at work. Results of a retrospective study in a series of 189 consecutive patients]

INTRODUCTION

Owing to recent advances in the diagnosis and treatment of lumbar disc pathology, the functional results obtained have improved, although there are still certain factors which affect this. The results in the work place are particularly problematic.

OBJECTIVE

With the aim of finding an answer to the problem of relapse of the sciatica syndrome in patients operated on for hernia of the lumbar discs, we describe a study carried out in a consecutive group of patients who had had operations for hernias of lumbar discs whilst at work, within the context of revindication involved in this situation.

PATIENTS AND METHODS

We describe the results obtained in a series of 189 patients who had been operated on for lumbar disc pathology. Conventional open surgery was performed in 105 cases. Percutaneous nucleotomy was done in the remainder. In 17.39%, operations were done at more than one level, making a total of 265 discs operated on.

RESULTS

These were considered good when the patient returned to his former work. Good results were obtained in 72% of the patients treated by open surgery and 68% of those treated by percutaneous nucleotomy. The re-operation rate was 8.57% for open surgery and 32.14% for percutaneous nucleotomy (p < 0.05).

CONCLUSIONS

The main reason for re-operation was a recurrence of disc protrusion. Good results were obtained in 80% of those reoperated. All reoperations were done using open surgery techniques. Overall assessment of the cases, including initial and re-operations, gave good results, reaching 83.59% in the current series.

Alfentanil decreases the excitatory phenomena of sodium methohexital

STUDY OBJECTIVE

To evaluate the effects of alfentanil or lidocaine on the excitatory phenomena (myoclonus, cough, hiccough) caused by methohexital anesthesia and on the hemodynamic changes induced by retrobulbar block.

DESIGN

Prospective, randomized, placebo-controlled, double-blind study.

SETTING

University-affiliated, tertiary-care hospital.

PATIENTS

60 ASA physical status II and III patients who were admitted for elective cataract extractions and intraocular lens implantations.

INTERVENTIONS

Patients were randomly assigned to one of three groups. After adequate preoxygenation in the holding area, Group 1 received alfentanil 5 micrograms/kg intravenously (i.v.), Group 2 received lidocaine 1 mg/kg i.v. and Group 3 received the placebo (saline) i.v. Immediately after the bolus injection of the study solution, sodium methohexital 1.5 mg/kg was injected i.v. over 30 seconds. As soon as the eyelid reflex was lost, the retrobulbar block was placed over 5 seconds.

MEASUREMENTS AND MAIN RESULTS

Occurrences of excitatory phenomena were recorded by an independent observer who was blinded as to treatment allocation. Other side effects such as oculocardiac reflex, nausea, vomiting, itching, or chest wall rigidity were recorded. Vital signs were recorded at baseline and 1, 3, and 5 minutes after placement of the block. In the alfentanil group, the incidence of myoclonus or cough was significantly less than in the lidocaine or placebo groups. Alfentanil also decreased systolic and diastolic blood pressure significantly at 1, 3, and 5 minutes after retrobulbar block. Changes in heart rate were not significantly different from baseline.

CONCLUSION

A small dose of alfentanil (5 micrograms/kg i.v.) decreases myoclonus and cough induced by sodium methohexital anesthesia i.v., resulting in improved quality of induction of anesthesia. Alfentanil also attenuates the cardiovascular responses caused by placement of a retrobulbar block.

[Hemorrhagic and edema-forming activity and histologic changes in the mouse footpad induced by venoms from Argentinian Bothrops and Crotalus genuses]

Hemorrhagic, oedema-forming activities and histopathological alterations in the mouse footpad induced by Bothrops and Crotalus snake venoms from Argentina. Hemorrhagic and oedema-forming activities of various Bothrops and Crotalus snake venoms from Argentina were studied, together with histological alterations in the mouse footpad. The highest oedema-forming activity was found in the venom of B. jararaca, followed by B. jararacussu, B. neuwiedii diporus, B. alternatus, and Crotalus durissus terrificus. Regarding hemorrhage, the highest activity was found in the venom of B. neuwiedii diporus, followed by B. jararacussu, B. alternatus, and B. jararaca. No hemorrhage was observed after injection of Crotalus durissus terrificus venom, in agreement with histological observations of injected footpads. Histological analysis revealed a conspicuous inflammatory reaction in the injected footpad, characterized by oedema and an inflammatory infiltrate rich in polymorphonuclear leucocytes. Necrotic blood vessels and dilated lymphatic vessels were observed after injection of B. jararaca and B. jararacussu venoms, and myonecrosis was evident in tissue of mice injected with B. alternatus and B. neuwiedii diporus.

Yeast adaptation on softwood prehydrolysate

Several strains and genera of yeast, including Saccharomyces cerevisiae D5A, Pachysolen tannophilus, S. cerevisiae K-1, Brettanomyces custersii, Candida shehatae, and Candida acidothermophilum, are screened for growth on dilute acid-pretreated softwood prehydrolysate. Selected softwood species found in forest underbrush of the western United States, which contain predominantly hexosan hemicellulose, were studied. This phase of the work emphasized debarked Douglas fir. The two best initial isolates were gradually selected for improved growth by adaptation to increasing prehydrolysate concentrations in batch culture, with due consideration of nutrient requirements. Microaerophilic conditions were evaluated to encourage tolerance of pretreatment hydrolysate, as well as ethanol product. Adaptation and simultaneous saccharification and fermentation (SSF) results are used to illustrate improved performance with an adapted strain, compared to the wild type.

[Relationship of increased body weight, androgens, insulin and family history of hypertension with blood pressure in premenopausal women]

BACKGROUND

The aim of this study was to evaluate whether the body weight increased, the androgens, the insulin and the family history of hypertension were independently associated with hypertension.

PATIENTS AND METHODS

Sixty-two premenopausal women aged 42 y, whose did not have any situation that change the variables to study: blood pressure, body mass index (BMI) and her increase since age of 20, waist to hip ratio, family history of hypertension, smoking, alcohol, exercise, fasting and after oral glucose tolerance test (GTT) glucose and insulin, sex hormone binding globulin (SHBG), serum and salivary testosterone and the free testosterone index. Hypertension was defined as blood pressure > or = 140/90 mmHg. Multivariate analysis and prevalence odds ratio was calculated.

RESULTS

Diastolic blood pressure correlated positively with BMI, waist to hip ratio, increase of BMI, GTT glucose, fasting and GTT insulin, free testosterone index and negatively with SHBG. Systolic blood pressure was only positively correlated with GTT glucose. Into a logistic regression model, the increase of BMI (OR: 1.23; IC: 95%: 1.04-1.5), the family history of hypertension (OR: 7.6; IC 95%: 1.9-29.9) and the free testosterone index (OR: 1.7; IC 95%: 1.1-2.6) were the only variables independently associated with hypertension. The prevalence odds ratio of hypertension according to the presence or not of family history of hypertension decreased when highest increase of BMI was considered.

CONCLUSIONS

Higher free testosterone levels with body weight increased in adulthood and family history of hypertension are independent predictors of hypertension in premenopausal women, whereas fasting insulin levels may be related to family history of hypertension.

Safety profile of WinRho anti-D

WinRho anti-D is manufactured with multiple processes to minimize the risk of transmitting blood-borne diseases such as viruses. These safety features include donor selection, plasma testing, solvent-detergent viral inactivation, and nanofiltration. To date, there has not been any case of viral transmission in association with use of WinRho anti-D. Adverse drug reactions are infrequent and generally mild; the most common are headache, fever, and chills. Some degree of hemolysis is inevitable due to the mechanism of action of WinRho anti-D, but this is predictable and transient. A few cases of intravascular hemolysis have been reported; hypersensitivity reactions are very rare. WinRho anti-D has been shown in both clinical trials and postmarketing surveillance to be safe and effective in the treatment of idiopathic thrombocytopenic purpura (ITP) and in the prevention of Rh isoimmunization.

SUTIL: intelligent ischemia monitoring system

SUTIL is an intelligent monitoring system for intensive and exhaustive follow up of patients in coronary care units. This system processes electrocardiographic and hemodynamic signals in real time, with the main objective of detecting ischemic episodes. In this paper, we describe the tasks included in SUTIL. In addition to basic tasks, those at higher levels will also be presented. Some of these latter tasks attempt to mimic, to some extent, the way in which the human expert operates.

[Tuberculosis of the middle ear. A case report]

A case of tuberculous otitis media in an immunocompetent 11-year-old boy is reported. The difficult diagnosis is highlighted. The bibliography was reviewed.

Adaptation drift suppression in blood glucose self-tuning control

To improve the glycemic regulation in clamping, a modification of the recursive least squares (RLS) estimation to be applied to any self-tuning adaptive control algorithm has been developed. It has been used in combination with a pole assignment controller, and its results have been compared through computer simulation in 12 test models with 3 other algorithms. It produces an improvement in the efficiency and the control cost, and it shows indications of ameliorating the stability. It also has been observed that for glycemic control, a minimum variance controller (control advance moving average controller [CAMAC]) is very efficient, whereas an empirical type of controller (Clemens) requires low control action. Some recommendations are made for the use of the algorithm in clamping in a hypothetical electromechanical endocrine artificial pancreas.

[Hemorrhage induced by snake venoms in Argentina]

Mice of 18 and 20 g were injected intradermally with 0.1 ml of serial dilution of venom in saline solution 0.9 buffered pH 7.2. Groups of 4 animal were formed, they were sacrificed 2 hours after inoculation. Skin of every mouse was put out, and the haemorrhagic area was measured Bothrops alternatus, Bothrops jararaca, Bothrops jararacussu and bothrops neuwiedii venoms were used. Crotalus durissus terrificus did not show any haemorrhagic activity.