Development of a mental script for the mental practice of micro suturing: a methodological approach

INTRODUCTION

Motor imagery and mental practice are important for the acquisition and mastery of surgical skills. The success of this technique relies on the use of a well-developed mental script. In this study, we shared how we developed a mental script for basic micro suturing training by using a low-fidelity rubber glove model.

METHODS

This study applied the design and development research framework. Five expert surgeons developed a mental script by performing a cognitive walkthrough to repair a vertical opening in a rubber glove model, followed by hierarchical task analysis. A draft script was created, and its face and content validity assessed with a checking-back process. Twenty-eight surgeons used the Mental Imagery Questionnaire (MIQ) to assess the validity of the final script.

RESULTS

The process of developing the mental script is detailed. The assessment by the expert panel showed the mental script had good face and content validity. The mean overall MIQ score was 5.2±1.1 (standard deviation), demonstrating the validity of generating mental imagery from the mental script developed in this study for micro suturing in the rubber glove model.

CONCLUSION

The methodological approach described in this study is based on a design and development research framework to teach surgical skills. This model is inexpensive and easily accessible, addressing the challenges of reduced opportunities to practise surgical skills. However, although motor skills are important, the surgeon's other non-technical expertise is not addressed with this model. Thus, this model should act as one surgical training approach, but not replace it.

1282 Evaluation of the Basket in Catheter Technique for Transcystic Bile Duct Exploration and Suspected Ductal Stones

Aim

The ‘Basket-in-catheter’ (BIC) technique facilitates laparoscopic transcystic ductal exploration (LTCE) and increases its success rate, being easier and safer than inserting the basket alone. This study evaluates the benefits in confirmed and suspected ductal stones.

Method

Prospective preoperative, operative and postoperative data on consecutive single session ductal explorations was collected over 28 years and analysed. BIC became our default technique for the transcystic approach to confirmed or suspected bile duct stones.

Results

741 of 1225 (60.5%) attempted LTCE were performed using retrieval baskets without dilating the cystic duct (CD). BIC was used in 646 (87.2%). Of 386 (52.1%) patients undergoing successful stone retrieval 62.7% had clinical and radiological risk factors for ductal stones and 92.0% had positive intraoperative cholangiography. 355 (47.9%) patients had preoperative or operative risk factors for CBD stones and equivocal cholangiography in 25%. Basket trawling was negative and repeat cholangiography confirmed resolution of abnormalities. Choledochoscopy was utilised in 484/1225 (39.5%), either primarily or when blind trawling failed to extract stones. Retained stones occurred in 7 patients, six requiring ERCP. Bile leakage occurred in 6 patients. There were two open conversions, no biliary injuries and no mortality. Post-operative pancreatitis occurred in 7 and recurrent stones in 8 patients.

Conclusions

The BIC technique achieves successful LTCE without CD dilatation in 40%, reducing the need for choledochoscopy and choledochotomy. It facilitates safe and speedy CBD trawling when stones are suspected due to preoperative or operative risk factors or equivocal cholangiography and helps surgeons acquire and consolidate ductal exploration skills.

Polymorphism of PXR gene associated with the increased risk of drug-induced liver injury in Indonesian pulmonary tuberculosis patients

WHAT IS KNOWN AND OBJECTIVE

Tuberculosis is still a major infectious disease in Indonesia. Patients are treated mostly using fixed-dose combination treatment in primary public health facilities. The incidence of antituberculosis drug-induced liver injury (AT-DILI) is approximately 10% among Indonesian tuberculosis patients who used standard fixed combination regimens during the intensive phase of treatment. However, information regarding genetic polymorphism associated with the increase risk of drug-induced liver injury is still limited. The aim of this study was to investigate pregnane X receptor (PXR) gene polymorphisms as one of the risk factors of AT-DILI.

METHODS

In this prospective cohort study, we recruited 106 adult patients diagnosed with pulmonary tuberculosis and treated with category I FDC (fixed-dose combination). The identification of SNP -25385C>T (rs3814055) was conducted by ARMS (amplification refractory mutation system). Hepatotoxicity was defined as ALT and/or AST levels above the normal threshold on the second, fourth and sixth months of monitoring during tuberculosis treatment.

RESULTS AND DISCUSSION

The logistic regression analysis showed that patients with the TT genotype of PXR gene (rs3814055) significantly had a greater risk of AT-DILI (OR 8·89; 95% CI 1·36-57·93, P < 0·05), compared with those of wild-type CC genotype.

WHAT IS NEW AND CONCLUSION

The result suggests that in Indonesian patients with tuberculosis, the risk of having AT-DILI was associated with TT genotype of the PXR gene.

Sensitive and specific detection of α-synuclein in human plasma

alpha-Synuclein (alphasyn) mutations, overexpression, misfolding, and aggregation are associated with Parkinson's disease. This protein has been intensively studied in neuronal systems. However, alphasyn is also present in extracellular fluids, such as cerebrospinal fluid and blood plasma. Recent studies have attempted to quantify its levels and compare these in various extracellular fluids of control and Parkinson's disease subjects. Data from these studies have been difficult to interpret, suggesting that more sensitive, standardized, and well-characterized assays of larger cohorts are required. Here, we describe the development of a new ELISA specifically for quantifying alphasyn in human plasma. An initial assay, using a commercial anti-alphasyn monoclonal antibody (211; Santa Cruz Biotechnology, Santa Cruz, CA) and based on a published protocol, was adapted for use in human plasma. In addition, we have developed a novel alphasyn-specific antibody for the assay that has very high sensitivity and signal:noise characteristics. Assays with either antibody showed high specificity for alphasyn, and detected it in a variety of sample types, including plasma. These assays can now be employed on large cohorts of patients and control subjects to determine whether plasma levels are altered in disease. Although measuring extracellular alphasyn levels may prove to be a useful biomarker of Parkinson's disease, it should also be a powerful tool for basic research aimed at understanding the normal and pathological physiology of alphasyn secretion. .

Clostridium perfringens liver abscess with massive haemolysis

Liver abscesses are commonly caused by Enterobacteriaceae and anaerobes. This report is of a patient with liver abscess with massive haemolysis and multiorgan failure caused by Clostridium perfringens. Despite the reportedly high mortality rate and poor prognostic factors, the patient eventually recovered with prompt treatment.

Fish and chips: implementation of a neural network model into computer chips to maximize swimming efficiency in autonomous underwater vehicles

Recent developments in the design and propulsion of biomimetic autonomous underwater vehicles (AUVs) have focused on boxfish as models (e.g. Deng and Avadhanula 2005 Biomimetic micro underwater vehicle with oscillating fin propulsion: system design and force measurement Proc. 2005 IEEE Int. Conf. Robot. Auto. (Barcelona, Spain) pp 3312-7). Whilst such vehicles have many potential advantages in operating in complex environments (e.g. high manoeuvrability and stability), limited battery life and payload capacity are likely functional disadvantages. Boxfish employ undulatory median and paired fins during routine swimming which are characterized by high hydromechanical Froude efficiencies (approximately 0.9) at low forward speeds. Current boxfish-inspired vehicles are propelled by a low aspect ratio, 'plate-like' caudal fin (ostraciiform tail) which can be shown to operate at a relatively low maximum Froude efficiency (approximately 0.5) and is mainly employed as a rudder for steering and in rapid swimming bouts (e.g. escape responses). Given this and the fact that bioinspired engineering designs are not obligated to wholly duplicate a biological model, computer chips were developed using a multilayer perception neural network model of undulatory fin propulsion in the knifefish Xenomystus nigri that would potentially allow an AUV to achieve high optimum values of propulsive efficiency at any given forward velocity, giving a minimum energy drain on the battery. We envisage that externally monitored information on flow velocity (sensory system) would be conveyed to the chips residing in the vehicle's control unit, which in turn would signal the locomotor unit to adopt kinematics (e.g. fin frequency, amplitude) associated with optimal propulsion efficiency. Power savings could protract vehicle operational life and/or provide more power to other functions (e.g. communications).

An updated unified pharmacophore model of the benzodiazepine binding site on gamma-aminobutyric acid(a) receptors: correlation with comparative models

A successful unified pharmacophore/receptor model which has guided the synthesis of subtype selective compounds is reviewed in light of recent developments both in ligand synthesis and structural studies of the binding site itself. The evaluation of experimental data in combination with a comparative model of the alpha1beta2gamma2 GABA(A) receptor leads to an orientation of the pharmacophore model within the Bz BS. Results not only are important for the rational design of selective ligands, but also for the identification and evaluation of possible roles which specific residues may have within the benzodiazepine binding pocket.

Antifungal susceptibility of Candida albicans biofilms on titanium discs with different surface roughness

Although it is well known that fungal biofilms have increased resistance to antimicrobial agents, limited information is available on the formation of candidal biofilms on implant surfaces with different surface roughness and their resistance to conventional antifungal therapy. In the current study, the effect of increasing the surface roughness of titanium discs on the susceptibility of Candida albicans biofilms to amphotericin B was determined. Grade I commercially pure titanium discs were sandblasted with 99.6% aluminium oxide of different grit sizes, producing surface roughness of 0.90, 1.88 and 3.82 microm (Groups A, B and C), respectively (P < 0.001). The antifungal susceptibility of C. albicans biofilm grown on different Ti discs was determined using XTT assay. The 50% reduction in metabolic activity (50% RMA) of planktonic C. albicans (0.5 microg/mL) was much lower than those from Groups A, B and C (2, 16, 2 microg/mL, respectively), while the 50% RMA from Group B was three-fold higher than those from Groups A and C. In conclusion, difference in titanium surface roughness was associated with variations in the antifungal resistance of the candidal biofilm. Group C appeared to have an optimum surface roughness for biofilm resistance.

Influenza revaccination of elderly travelers: antibody response to single influenza vaccination and revaccination at 12 weeks

The antibody response to a single influenza vaccination and the effect of influenza revaccination was assessed in healthy elderly persons. Travelers > or =65 years old who had received influenza vaccine before travel were enrolled in the study and were offered a second vaccination after 12 weeks. Geographic and age-matched control subjects received a single vaccination. A second influenza vaccination was not associated with increased adverse effects. There was no significant difference between log(10) hemagglutinin-inhibiting (HI) antibody titers or an HI antibody titer > or =1:40 (considered to be protective) in 28 control subjects and 28 revaccinated travelers for any antigen. Probable protection for influenza A antigens remained high 24 weeks after a single immunization and revaccination (A/Sydney/05/97 [H3N2], 92% and 96%, and A/Beijing/262/95 [H1N1], 80% and 96%, respectively). Response to B/Harbin was less throughout the study. A/Sydney antibody titer was lower with more times vaccinated in the previous 5 years. Therefore, a second vaccine did not enhance the immune response.

Recurrence and survival analyses of 1,115 cervical cancer patients treated with radical hysterectomy

Many clinicopathological factors of cervical cancer are still controversial in their prognostic significance. The case records of 1,115 patients who received radical hysterectomy at the Veterans General Hospital, Taipei, from 1980 to 1989 were collected to evaluate prognosis-related factors by univariate and multivariate analyses. The pathology was reviewed retrospectively by one pathologist. Ten parameters known to be prognostic in the literature were included for analysis. Univariate analysis showed that patients with all these factors had higher recurrence rates. However, when the effects of parametrial invasion, progressive stage and stromal invasion were weighed against the presence of lymph node metastasis, their influence on recurrence became unimportant. Nevertheless, these factors still influenced prognosis when there was no lymph node metastasis. Multivariate analysis of both recurrence and survival time in the patients with squamous cell carcinoma shared a consensus that pelvic lymph node metastasis and deep stromal invasion were significant risk factors. We conclude that these simplified and consistent results obtained by multivariate analysis provide a basis for subclassification of patients to predict prognosis and change therapy.

Granulocyte colony-stimulating factor on the growth of human ovarian carcinoma cells in vitro

Granulocyte colony-stimulating factor (GCSF) is a member of a family of glycoprotein hormones that stimulates the proliferation and differentiation of hematopoietic cells in vivo and in vitro. In ovarian cancer chemotherapy, GCSF is used clinically to build up bone marrow function after severe cytotoxicity to granulocytes by chemotherapy. Little is known about the effects of these cytokines on the growth of cancer cells. To study the influence of GCSF on the proliferation of ovarian cancer cells in vitro, five established ovarian cancer cell lines (OC-89-VGH, OC-117-VGH, OCPC-2-VGH, NIH-OVCAR-3, and NIH-SK-OV-3) were treated with the concentration ranging from 0.1 pg to 10 ng GCSF for 5 days and compared with vehicle control. In addition, we also examined the effect of GCSF (0. 01-1.0 ng) on eight primary cultures of fresh ovarian cancer tissues. Cell viability after treatment was measured by Cell Titer AQueous assay and expressed as a percentage of untreated control cultures. A decrease in cell growth (75-85%) was observed in OC-89-VGH, OC-117-VGH and OCPC-2-VGH cell lines while NIH-OVCAR-3 and NIH-SK-OV-3 cells showed minimal growth stimulation. However, all dose-response curves were nonsignificant, suggesting indirect effects. In the eight fresh tumor primary cultures treated with GCSF, no statistical significant difference in growth was observed. In conclusion, our data suggest that GCSF has little or no growth-modulatory effect on human ovarian carcinoma in vitro. Therefore, the clinical use of GCSF is unlikely to have a direct effect on tumor growth.

Sequence analysis and expression of a cDNA clone encoding a 98-kDa allergen in Dermatophagoides farinae

BACKGROUND

The important dust mite allergens identified to date are of molecular weights ranging from 14 to 60 kDa. Our previous protein study indicated that the 98-kDa native paramyosin in Dermatophagoides farinae mite showed IgE reactivity with 82% of the mite-sensitive asthmatic patients suggesting that it is a novel major mite allergen. This study described the isolation and characterization of the cDNA clone encoding the 98-kDa mite allergen.

METHODS

A Dermatophagoides farinae cDNA library was constructed in lambda ZAPII vector and the library was immunoscreened with a monoclonal antibody 642. The cDNA insert was sub-cloned into M13 sequencing vector for single-stranded sequencing. The whole cDNA insert was expressed in pGEX-2T Escherichia coli expression system as a fusion protein with GST. The allergenicity of the recombinant peptides was tested by skin tests and IgE immunoassay. The IgE and IgG immunoassays were performed with sera from 20 mite-allergic patients.

RESULTS

The cDNA clone Df642 was 2134 bp long, coding for a polypeptide of 711 amino acid residues. Protein sequence analysis and alignment confirmed that the deduced polypeptide is a mite paramyosin which is truncated slightly at the N- and C-terminuses. In vivo skin tests and in vitro IgE-binding study showed that 62% (13/21) and 50% (10/20) of the mite-sensitive asthmatic patients reacted positively with the recombinant Dermatophagoides farinae paramyosin, respectively.

CONCLUSION

The study indicated that 98-kDa mite paramyosin is an important allergen.

Synthesis and smooth muscle calcium channel effects of dialkyl 1,4-dihydro-2,6-dimethyl-4-aryl-3,5-pyridinedicarboxylates containing a nitrone moiety in the 4-aryl substituent

A group of dialkyl 1,4-dihydro-2,6-dimethyl-4-¿3-(or 4-)[[(Z)-N- oxo-N-[4-substituted-phenylmethylene (or vinylmethylene)]-lambda 5- azanyl]phenyl¿-3,5-pyridinedicarboxylates 7a-n were synthesized. Reaction of the C-4 nitrophenyl compounds 6a-d with an aryl Grignard reagent afforded the corresponding nitrone derivatives 7a-e. Alternatively, reaction of the aryl hydroxylamine compounds 8a-b prepared by reduction of the nitrophenyl compounds 6c-d with Zn/NH4Cl, or the aryl hydroxylamine compounds 8c-d prepared by reduction of the nitrophenyl compounds 6e-f with 5% rhodium-on-charcoal and 65% hydrazine hydrate, with a 4-substituted-benzaldehyde, benzaldehyde or acrolein afforded the respective nitrone compounds 7f-n. In vitro calcium channel (CC) antagonist activities were determined using the guinea pig ileum longitudinal smooth muscle assay. This class of compounds containing a nitrone moiety on the 1,4-dihydropyridine C-4 phenyl ring exhibited CC antagonist activities (10(-5) to 10(-9) M range) relative to the reference drug nifedipine (IC50 = 1.43 x 10(-8) M). Structure-activity relationships showed that the position of the nitrone moiety on the C-4 phenyl ring was a determinant of CC antagonist activity where the potency order was always meta-nitrone > para-nitrone. The effect of the ester alkyl substituent was variable depending upon whether the nitrone substituent was at the meta or para-position (meta-nitrone, Et > i-Pr approximately Me; para-nitrone, i-Pr > Me approximately Et). In the diethyl ester series of compounds having a meta-nitrone moiety, the difference in potency for the various R2-nitrone substituents varied by a factor of 15-fold (IC50 = 1.51 x 10(-7) to 9.84 x 10(-9) M range) (4-Cl-C6H4- > or = 4-Me-C6H4- approximately C6H5- > or = 4-O2N-C6H4- 4-F3C-C6H4- > > CH2 = CH-). Whole-cell voltage-clamp studies using isolated guinea pig ventricular myocytes indicated that the 4-¿3-[(Z)-N-oxo-N-(phenylmethylene)-lambda 5-azanyl]-phenyl¿ compound 7c (10 microM) is a calcium channel antagonist which decreased the calcium current (ICa).

Alzheimer-type of pathological changes in Chinese

There has been no previous description of the pathological features of Alzheimer's disease and little description of Alzheimer-type changes in Chinese brains. In this study, we examined the brains of 17 cases of Alzheimer's disease and concurrently 95 consecutive autopsy cases of non-demented patients aged above 60. Six standard regions of the brains were stained for beta-amyloid immunostaining, Bielschowsky and Bodian. Neuritic plaques, neurofibrillary tangles and diffuse plaques were quantified as per mm2. The Alzheimer's disease brains exhibited a marked increase of neurodegenerative changes over the non-demented brains. Plaque counts were similar to those proposed by Khachaturian (1985; Arch. Neurol. 42: 1097-1105) and CERAD, although the distribution of tangles was more variable with some regions of the neocortex containing few or no tangles. For the non-demented brains, overall neuritic plaques were seen in 31% and neurofibrillary tangles were seen in 42% of cases, with the overall plaque score being 1.8 per mm2 and tangle score being 0.7 per mm2. No age-dependent variation of plaque count and tangle count could be demonstrated in this group of elderly brains. Comparison with similar studies of Caucasians suggests that neuritic plaques and neurofibrillary tangles were less frequently encountered in aging Chinese brains than among the western populations.

An anterior intradural neurenteric cyst of the cervical spine: complete excision through central corpectomy approach--case report

The case of a cervical intraspinal neurenteric cyst in a 6-year-old boy is reported. The anterior intradural location of the cyst was confirmed by preoperative magnetic resonance imaging. Complete excision of the cyst was achieved through the anterior central corpectomy approach. The vertebral defect was reconstructed with autogenous fibular graft. The child made a complete neurological recovery without a mechanical problem either at the neck or at the graft donor site.

Foetus in foetu--a case report

A three-month old baby presented to the Paediatric Department with a problem of abdominal distension. Clinically, he had a large right abdominal mass which on investigations suggested a teratomatous lesion. At operation, a foetus-like tumour mass was located in the retroperitoneal space. A diagnosis of foetus in foetu was made. A close differential of a retroperitoneal teratoma is discussed and comparison with confirmed cases made.

Prevalence and Distribution of Campylobacter jejuni and Campylobacter coli in Retail Meats

Nine cooperating laboratories, distributed throughout the United States, determined the interlaboratory reproducibility of a sensitive, selective method for isolation of Campylobacter jejuni and Campylobacter coli from foods, and determined the prevalence and distribution of the organism in retail meats. A double-blind inoculated/recovery experiment demonstrated the ability to detect two cells of C. jejuni and C. coli per g of meat at a rate of 96% among the cooperating laboratories. However, a 7.5% false-positive rate for the presumptive detection of the organism was also reported. Samples of ground beef, beef flank steak, lamb stew meat, broiler chicken, pork sausage (without antimicrobials), and pork chops were selected to assess the presence of campylobacters. Each cooperator purchased five of each of the above samples from the refrigerated case of two retail outlets at quarterly intervals throughout the year. A total of 2,160 retail samples were analyzed for the presence of C. jejuni and C. coli . Results indicated that about 30% of the 360 chickens sampled yielded the organism. Analysis of 1,800 red meat products yielded campylobacters at a rate of about 5.1%. Pork samples yielded C. coli and other meats yielded C. jejuni . Higher numbers of isolations from the red meats were made during June and September (8.6%) as compared with December and March (4.2%). These results provide a baseline, for the prevalence of campylobacters in these selected foods, and also support epidemiologic data associating mishandled foods of animal origin as a potential vehicle in human gastroenteritis.

Development of high heat resistance of Arizona neotype by preincubation at 35 degrees C in media containing NaCl

When cells of Arizona neotype were preincubated at 35 degrees C in a medium containing NaCl (1 to 10%), they were found to be much more heat resistant upon being tested at 57 degrees C in a Trypticase (BBL Microbiology Systems) soy-yeast extract broth medium containing 10% NaCl than cells that had not been preincubated. Although no growth takes place during preincubation in the presence of 10% NaCl, some metabolic activity is necessary, since the presence of 2,4-dinitrophenol during incubation reduced the amount of gain in heat resistance. Incubation in the presence of N2, instead of air, abolished the effect. Chloramphenicol and rifampin, however, had no effect. Preincubated cells were just as heat resistant when separated by centrifugation and suspended in a fresh medium as when suspended in the incubated supernatant liquid. Conversely, the incubated supernatant liquid did not confer increased heat resistance upon unincubated cells. The increase in heat resistance, therefore, is probably a result of the salt osmotically plasmolyzing the cells by removing intracellular water, thus rendering the cellular contents more stable to heat. It is not known, however, why metabolic activity is necessary.

Effect of growth conditions on heat resistance of Arizona bacteria grown in a chemostat

The effects of various growth conditions on the heat resistance of Arizona bacteria grown in a continuous-culture device (chemostat) were studied. Using either glucose, NH4Cl, NaH2PO4, or MgCl2 as the rate-limiting nutrient, it was found that the heat resistance, in all cases depended on the dilution rate and, hence, growth rate of the culture. Cells grown at high dilution rates were less heat resistant than those grown at low dilution rates. If, however, the dilution rate was maintained at a constant rate, the higher the growth temperature, the more heat resistant were the cells. Also at any given dilution rate, the cells were most heat resistant when grown at a near neutral pH. Most survival curves were biphasic in shape, indicating the presence in the population of two fractions of cells, one fraction being more resistant than the other. The size of the more heat-resistant fraction varied from almost 100% in very slow-growing cultures to practically 0% in cultures grown at a dilution rate of 0.67 h-1.

Protection of mice by intraperitoneal vaccination against challenge in the foot pad with Mycobacterium marinum

In a study of local infection of mice with Mycobacterium marinum, heat-killed M. marinum suspended either in Hanks' balanced salt solution or in Freund's incomplete adjuvant was administered i.p. to BALB/c mice. The mice were challenged in the hind foot pad 3, 7, or 14 days thereafter with 5 x 10(3) viable M. marinum. At every time interval, killed M. marinum in the saline medium conferred modest protection against the challenge infection, whereas the antigen suspended in adjuvant conferred protection only when the challenge was administered 14 days after vaccination. Freund's incomplete adjuvant appeared to enhance the infection and to minimize the immune response to the antigen.

Viability of Mycobacterium leprae after multiplication in mice

To measure the rate at which Mycobacterium leprae are killed in the course of the mouse footpad infection after the maximum of multiplication has been achieved, M. leprae were harvested shortly before and at intervals after multiplication had reached the level of 10(6) organisms per footpad, serially diluted, and inoculated into the footpads of passage mice. Beginning 1 year later, foot-by-foot harvests of M. leprae were performed from passage mice, and the proportion of viable organisms in the passage inocula was calculated by means of a most-probable-number calculation. In addition, the proportion of solidly staining M. leprae was measured in the passage inocula. The proportion of viable M. leprae in the passage inocula was found to decrease with the time after multiplication to 10(6) organisms per footpad of donor mice; the half-time of loss of viable M. leprae was 25 days. The proportion of solidly staining organisms appeared to be directly related to the proportion of viable organisms, as measured by mouse passage, and inversely proportional to the time after multiplication to 10(6) organisms per footpad.

Survival of BALB/c mice after intraperitoneal infection with Mycobacterium lepraemurium

In an attempt to develop a single, quantitative method of studying the disease that follows infection of susceptible mice with Mycobacterium lepraemurium, survival of BALB/c mice was measured as a function of time following i.p. inoculation with the organisms. Survival was found to be inversely related to the challenge dose of M. lepraemurium and unrelated to the organ-source of the organisms; survival was prolonged by treatment with isoniazid. Mice infected with M. lepraemurium were protected against i.v. challenge with M. marinum administered early in the disease, whereas they demonstrated enhanced susceptibility to the same challenge administered later. Conversely, prior M. marinum infection of mice in the hindfoot pad conferred protection against subsequent challenge with M. lepraemurium.

A combined defect of three mitochondrial carboxylases presenting as biotin-responsive 3-methylcrotonyl glycinuria and 3-hydroxyisovaleric aciduria

A child with a history of episodes of metabolic acidosis was found to excrete 3-hydroxyisovaleric acid and 3-methylcrotonylglycine. These metabolites disappeared following the administration of biotin. The specific activities of propionyl CoA carboxylase, 3-methylcrotonyl CoA carboxylase and pyruvate carboxylase were found to be low in skin fibroblasts cultured in the absence of added biotin. With the addition of biotin, the specific activity of all three carboxylases returned to normal, that of 3-methylcrotonyl CoA carboxylase ahowing the greatest sensitivity to biotin.

Pasteurization of salted whole egg inoculated with Arizona or Salmonella

Recently, Arizona bacteria, close relatives of Salmonella, were recovered from salted whole egg that had been pasteurized by the presently recommended process of 63.3 degrees C (146 degrees F) for 3.5 min. Because of this and the fact that the heat resistance of Arizona in salted whole egg had not been determined, the present study was undertaken. Arizona or Salmonella, grown in Trypticase soy broth supplemented with 2% yeast extract in Fernbach flasks covered with aluminum foil over cotton and guaze at 35 degrees C with shaking at 176 rpm for about 96 h, were found to have the greatest degree of heat resistance. As expected, these cells, when inoculated into salted whole egg at 10(7) cells per ml, survived heating at 63.3 degrees C (146 degrees F) for 3.5 min in a two-phase slug flow heat exchanger. To consistently achieve a 7-log kill of typical Salmonella or Arizona, a treatment of 67 degrees C (152.6 degrees F) for 3.5 min was required. However, if a 7-log kill is mandatory, it remains to be determined whether this process affect the functional properties of this product.

The interactions of thrombin with borosilicate glass surfaces

Borosilicate glass (G) and commercial poly(methyl methacrylate) (PMM) surfaces were examined at pH 7, monovalent ionic strength 0.14 and 22 degrees C. Thrombin concentrations ranged from 6 X 10(-9) to 5.2 X 10(-8)M. Decreases in thrombin concentration in 10 ml vessles were determined by clotting time assay. Adsorption to PMM vessels is small. These were examined to establish the validity of the method. For G-vessels, the terminations of initial rapid decreases, associated with adsorption equilibrium, are accounted for mainly by an average isotherm having an association constant of 1.8 X 10(7) l./mol. Adsorption equilibrium is accompanied by a slower rate of decrease consistent with the surface denaturation of 2.5%/min of adsorbed molecules. Molecules remaining adsorbed to the surfaces of 1 mm i.d. G-capillaries were examined using the sequence of thrombin adsorption, buffer washing for times tw, removal of buffer and introduction of a fibrinogen aliquot for determination of effective surface thrombin concentration by a capillary clotting time. Most adsorbed molecules (less than 90%) essentially desorb within tw = 2 min, a second class (greater than 8%) desorb in tw similar to 30 min, and members of additional classes are still present after tw = 1440 min. For all of the properties examined, there is a small variance between vessels taken at the same time from the same batch, and a larger variance between groups of vessels taken at different times from the same batch or from different batches.

Death of Staphylococcus aureus in liquid whole egg near pH 8

Incubating and shaking Staphylococcus aureus in liquid whole egg causes a decline in viability. During the period of agitation, the natural pH of the egg rises from about 7.2 to between 8.0 and 8.2 as a result of a loss of carbon dioxide. However, if the pH of the egg is prevented from rising, either by not shaking or by addition of a buffer, S. aureus will grow. The cause of death is traced to the presence of lysozyme of egg white. Interestingly, the action of lysozyme is not attributable to its bacterial lytic property but, instead, to the basicity of the lysozyme molecule. This conclusion is supported by the fact that the lytic property of lysozyme is known to have its optimal activity near neutrality and by the finding that protamine sulfate, a nonenzymatic basic polypeptide, also caused death of S. aureus at pH 8.0 but not at 7.0. It was postulated that the rise in pH renders the bacterial cells more negatively charged, so that in the presence of positively charged molecules like lysozyme or protamine sulfate a complex is formed, agglutinating the cells.

Susceptibility of thymectomized and irradiated mice to challenge with several organisms and the effect of dapsone on infection with Mycobacterium leprae

B6C3F1 mice that had been thymectomized at 8 to 12 weeks of age, subjected to 950 R of whole-body X irradiation, and transfused with syngeneic bone marrow were challenged in a footpad with Mycobacterium leprae or M. marinum, or intravenously or intraperitioneally with Listeria monocytogenes. Also, mice inoculated with M. leprae in a hind footpad were administered dapsone in the mouse chow. The thymectomized-irradiated (T + R) mice did not survive as well as non-thymectomized mice when housed in the vivarium with no special precautions, but survived sufficiently well to permit the completion of some long-term experiments. M. leprae multiplied to a higher "ceiling" and survived longer in the T + R mice than in the non-thymectomized controls. But a ceiling to multiplication of M. leprae was imposed, and finally the organisms were killed. The histopathological appearance of the footpad tissues, studied by electron microscopy, was consistent with the measurements of bacterial numbers and viability. Swelling of the footpad after local inoculation with M. marinum was greater in T + R mice than in non-thymectomized controls. Similarly, the number of L. monocytogenes following intravenous challenge was greater in the spleens of T + R than of non-thymectomized mice, and the survival of the T + R mice was impaired after intraperitoneal challenge with L.monocytogenes, compared to the survival of non-thymectomized mice. None of these differences was striking, suggesting that these T + R mice had retained or regained some immune competence. The effects of dapsone treatment of T + R mice inoculated with M. leprae were much the same as those of treatment of non-thymectomized mice. Because these T + R mice were not greatly immunosuppressed, they would not have provided a model of human lepromatous leprosy suitable for chemotherapeutic studies.