Rapid disintegration and weakening of ice shelves in North Greenland

The glaciers of North Greenland are hosting enough ice to raise sea level by 2.1 m, and have long considered to be stable. This part of Greenland is buttressed by the last remaining ice shelves of the ice sheet. Here, we show that since 1978, ice shelves in North Greenland have lost more than 35% of their total volume, three of them collapsing completely. For the floating ice shelves that remain we observe a widespread increase in ice shelf mass losses, that are dominated by enhanced basal melting rates. Between 2000 and 2020, there was a widespread increase in basal melt rates that closely follows a rise in the ocean temperature. These glaciers are showing a direct dynamical response to ice shelf changes with retreating grounding lines and increased ice discharge. These results suggest that, under future projections of ocean thermal forcing, basal melting rates will continue to rise or remain at high level, which may have dramatic consequences for the stability of Greenlandic glaciers.

Understanding discrimination faced by transgender people in the health and social care settings

Background

This session reports on a literature review from a study aiming to identify whether there is a positive correlation between inclusive legal gender recognition procedures, and well-being of transgender people within the EU. The review explores socio-demographic/economic profiles of transgender people, and forms of discrimination faced.

Methods

The review is based on 47 peer-reviewed articles and 11 grey literature reports, provides analysis concerning sociodemographic/economic positions of transgender people, and an overview of discrimination faced.

Results

The focus is discrimination within health & social care, how this leads to unmet health needs and a lower sense of wellbeing within the trans population. Due to actual, or expected, discrimination, some trans individuals will not disclose their gender identity in a healthcare context, or may avoid using such services altogether. Mental health was a focus of many of the studies, with prevalence of depression, self-injury, and suicidal thoughts being higher for this group. Fewer studies reported on the physical health status, with some studies finding that transgender people had low health status. Studies suggest that professionals may treat trans people in an insensitive or inappropriate way, largely due to a lack of knowledge/ignorance, for example health & social care staff often had little knowledge of trans people and their health & wellbeing, how to appropriately address them, and how to support their care. Trans individuals may also be treated in a discriminatory way in the context of trans-specific healthcare, for e.g within a gender unit due to a non-binary gender identity.

Conclusions

Discrimination has a negative impact on health & wellbeing, specifically mental health, mainly due to discrimination trans people face.This has a negative effect on actual/future health & well-being, as it translates into fear of seeking care, and postponing/avoiding care, due to actual or expected poor treatment.

Key messages

The review contributes to an evidence base to address discrimination faced by transgender people, however there is a lack of evidence found in the area of EU transgender health and wellbeing issues. The study seeks to confirm a positive correlation between inclusive LGR and well-being of transgender people in the EU, which can help contribute to improving their quality of life.

Publisher's Note: Hydrogen Bonds in Excited State Proton Transfer [Phys. Rev. Lett. 117, 163002 (2016)]

This corrects the article DOI: 10.1103/PhysRevLett.117.163002.

Hydrogen Bonds in Excited State Proton Transfer

Hydrogen bonding interactions between biological chromophores and their surrounding protein and solvent environment significantly affect the photochemical pathways of the chromophore and its biological function. A common first step in the dynamics of these systems is excited state proton transfer between the noncovalently bound molecules, which stabilizes the system against dissociation and principally alters relaxation pathways. Despite such fundamental importance, studying excited state proton transfer across a hydrogen bond has proven difficult, leaving uncertainties about the mechanism. Through time-resolved photoelectron imaging measurements, we demonstrate how the addition of a single hydrogen bond and the opening of an excited state proton transfer channel dramatically changes the outcome of a photochemical reaction, from rapid dissociation in the isolated chromophore to efficient stabilization and ground state recovery in the hydrogen bonded case, and uncover the mechanism of excited state proton transfer at a hydrogen bond, which follows sequential hydrogen and charge transfer processes.

[Hygiene in otorhinolaryngology: Requirements and reality]

Considering the physiological contamination of skin and mucous membranes in the ear, nose, and throat region by facultative pathogen microorganisms, as well as the increase in multidrug resistant organisms (MDRO), it is mandatory that hygienic procedures be observed in ENT institutions, in order to prevent transmission of bacteria and infections in patients. General guidelines for hygiene in otorhinolaryngology are presented based on the recommendations published by the German Commission on Hospital Hygiene and Infection Prevention (KRINKO). These encompass hand hygiene, surface disinfection, and reprocessing of medical devices. The correct reprocessing of the various components of ENT treatment units (including endoscopes, water bearing systems) is reported. Although law requires and KRINKO recommends that manufacturers of medical devices publish instructions for reprocessing their products, these reprocessing recommendations are often insufficient. Manufacturers should thus be called upon to improve their recommendations. In this paper, the requirements for handling of ENT treatment units are compared with the observations made by the Public Health Department in 7 ENT clinics and 32 ENT practices in Frankfurt/Main, Germany, in 2014.

[Hygiene in endoscopy in clinic and practice 2013 in comparison with 2003--structure and process quality]

BACKGROUND

Endoscopy is an important part of modern medical diagnostics and therapy. The invasive procedures are however associated with a risk to transmit infections. Against this background the KRINKO has published the "Hygienic requirements for the reprocessing of flexible endoscopes and endoscopic accessories" in 2002 and has updated these recommendations in 2012. In 2003 and 2013 all gastroenterological facilities in Frankfurt am Main using flexible endoscopes were monitored for compliance with the recommendations.

METHODS

The inspections were performed after prior notice by a staff member of the health authority using a checklist which had been developed on the basis of the current KRINKO recommendations.

RESULTS

In both years all institutions performing endoscopic procedures were visited: 2003 15 hospitals and 23 practices; 2013 14 clinics and 10 practices. In 2013 (data for 2003 in brackets) 100 % (93 %) of the hospitals and 60 % (22 %) of practices reprocessed their endoscopes by automated methods. The appropriate reprocessing and filling of water bottles for rinsing the scope channels with sterile water and the sterilisation of accessories were satisfactorily performed in 2003 and 2013 by all hospitals. However in 2013 only 90 % (2003: 74 %) of the practices correctly reprocessed water bottles and 80 % (52 %) used sterile water for filling the bottle. In 2013 100 % (2003: 57 %) of the practices correctly sterilised accessory instruments, while 2 practices used disposable, i. e., single-use materials. In 2013 all institutions performed microbiological tests according to KRINKO recommendations, while in 2003 all hospitals but only 43 % of the practices could present such tests.

DISCUSSION

While the gastroenterological departments of Frankfurt hospitals already complied with the KRINKO recommendations in 2003, the inspection of several practices in 2003 had revealed considerable shortcomings in the implementation of these recommendations. Subsequently the practices have improved their hygiene management.

[Hygiene in intensive care units in Frankfurt am Main, Germany]

: The German Commission on Hospital Hygiene and Infection Prevention has published several recommendations regarding hygiene in the intensive care unit. Compliance with these recommendations was surveyed.

METHODS

In 2005 and 2011, the intensive care units of all hospitals in Frankfurt am Main, Germany, were examined by members of the public health department, using a checklist based on the respective recommendations.

RESULTS

Recommendations on the architecture and function of intensive care wards were almost fully complied with, except for the stipulated amount of space and nursing personnel. Compliance with recommendations for prevention of ventilator-associated pneumonia and for prevention of catheter-related bloodstream infections was excellent, with only some minor exceptions. Regarding hand hygiene, in 2011 fewer faults were documented than in 2005. All hospitals took part in the German project of the world-wide campaign "clean care is safer care." In 2005, device-associated infections were surveyed in 92% intensive care units, and in 2011 in all of them. By 2011, screening of methicillin-resistant Staphylococcus aureus had been established in all intensive care units.

CONCLUSION

Most problems that were observed regarded a scarcity of space and of facilities for isolation of patients and of nursing personnel. Improvements were seen in hand hygiene and in screening for multidrug resistant organisms (MDRO).

The clinical benefit of pegylated liposomal doxorubicin in patients with metastatic breast cancer previously treated with conventional anthracyclines: a multicentre phase II trial

This study evaluates the clinical benefit of pegylated liposomal doxorubicin (PLD) in patients with metastatic breast cancer (MBC), previously treated with conventional anthracyclines. Seventy-nine women with MBC previously treated with anthracyclines received PLD 50 mg m⁻² every 4 weeks. All patients were previously treated with chemotherapy and 30% of patients had ⩾3 prior chemotherapies for metastatic disease. Patients were considered anthracycline resistant when they had disease progression on anthracycline therapy for MBC or within 6 months of adjuvant therapy. The overall clinical benefit rate (objective response+stable disease ⩾24 weeks) was 24% (16.1% in patients with documented anthracycline resistance vs 29% in patients classified as having non-anthracycline-resistant disease). There was no difference with respect to the clinical benefit between patients who received PLD >12 months and those who received PLD ⩽12 months since last anthracycline treatment for metastatic disease (clinical benefit 25 vs 24.1%, respectively). Median time to progression and overall survival were 3.6 and 12.3 months, respectively. The median duration of response was 12 months, and the median time to progression in patients with stable disease (any) was 9.5 months. Fourteen patients (17.7%) had a prolonged clinical benefit lasting ⩾12 months. In conclusion, PLD was associated with an evident clinical benefit in anthracycline-pretreated patients with MBC.

Induction chemotherapy (ICT) followed by pre-operative chemoradiotherapy in locally advanced rectal cancer

13531

Background: Preoperative radiotherapy (RT)with or without chemotherapy (CRT) for patients (ptns) with T3,4 rectal carcinoma is increasingly accepted.We presented, 3 yrs ago, our experience with Cisplatin-5FU-Folonic(FA)regimen (FOLFC) in patns with metastatic CR carcinoma.We proved it is comparable to other regimens with lower cost. Methods: Between 10/99 & 8/04, 104 ptns between 18 and 65 year old (PS 0–1) were assessed retrospectively (24 T3 & 80 T4). Ptns received 2 months of ICT Cis(40mg/m2 D1)+FA(200mg/m2 2hrs infusion D1,2)followed by 5FU bolus(400 mg/m2 D1,2)+5FU cont inf(1200 mg/m2 D1–2)this cycle repeated q 2 wks for 8 wks. Starting on wk 9, 5 FU-FA was given as in Mayo-clinic regimen (D1–5, D21–25) with concomitant RT 45Gy in 25 fractions followed by 9 Gy boost to primary tumor. TME was planned at 4–6 wks from completion of ICT. 2 more cycles of FOLFC was given post-operatively. Results: All ptns (104) undergoing CRT completed therapy as planned, with no treatment-related interruptions. No GIII-IV toxicity. The radiological RR (after ICT) was 75% and (4 wks after CRT) was 89% (20CRs, 73PRs). 92% of ptns had subjective R in a median of 24 days from start of ICT in terms of improvement of diarrhea/constipation (90.4%), in obstructive symptoms (40/ 50 ptns)&weight gain in 100% of ptns.Reduced rectal bleeding (100%) & pelvic pain (100%). 17 of 20 ptns who were considered to be inoperable prior to the treatment underwent TME with negative radial margins. Anastomotic leakage occurred in 8 ptns (7.7%). Wound infection occurred in 4 ptns (3.8%). Delayed complications occurred in 3 ptns one required surgery for a stomal stricture. All ptns underwent R0 resection with clear CRM. Pathological CR was found in 32 ptns and in an additional 41 ptns, only microscopic tumor foci were found on surgical specimens. After a median follow-up of 16 months, two ptns had developed LR. Conclusions: ICT followed by synchronous CRT and TME results in marked tumor regression, rapid symptomatic response and achievement of R0 resection. The majority of ptns considered inoperable prior to receiving this treatment underwent successful excision. Given the low toxicity and promising activity, this regimen is being compared to standard synchronous 5FU- pelvic chemoradiation in a randomized study.

No significant financial relationships to disclose.

A Systemic Hyperthermia Oncologic Working Group trial. Ifosfamide, carboplatin, and etoposide combined with 41.8 degrees C whole-body hyperthermia for metastatic soft tissue sarcoma

BACKGROUND

Based on earlier clinical and preclinical studies, we conducted a phase II trial in metastatic sarcoma patients of the combination of 41.8 degrees C (x60 min) radiant heat (Aquatherm) whole-body hyperthermia (WBH) with 'ICE' chemotherapy. The ICE regimen consists of ifosfamide (5 g/m(2)), carboplatin (300 mg/m(2)) and etoposide (100 mg/m(2)), concurrent with WBH, with etoposide also on days 2 and 3 post-WBH.

METHODS

Therapy was delivered every 4 weeks for a maximum of 4 cycles. All patients received filgrastim or lenograstim.

RESULTS

Of 108 patients enrolled as of September 2001, 95 are evaluable for response. Of the evaluable patients (mean ECOG performance status approximately 1; mean age 42.3; 58% male) 33 had no prior therapy for metastatic disease, and 62 were pretreated (mean: 1.5 prior regimens). The overall response rate was 28.4% (4 complete remissions and 23 partial remissions) with stable disease (SD) in 31 patients. For no prior therapy, the response rate was 36%; in pretreated patients it was 24%. The median overall survival by Kaplan-Meier estimates was 393 days (95% CI 327, 496); the median time to treatment failure was 123 days (95% CI 77, 164). The major toxicity (287 cycles) was grade 3 or 4 neutropenia and thrombocytopenia seen in 79.7 and 60.6% of treatments respectively; there were 7 episodes of infection (grade 3/4) with 2 treatment-related deaths, bot involving disease progression and ureteral obstruction.

CONCLUSION

These results are consistent with continued clinical investigation of this combined modality approach.

Strategy for monitoring T cell responses to NY-ESO-1 in patients with any HLA class I allele

NY-ESO-1 elicits frequent antibody responses in cancer patients, accompanied by strong CD8(+) T cell responses against HLA-A2-restricted epitopes. To broaden the range of cancer patients who can be assessed for immunity to NY-ESO-1, a general method was devised to detect T cell reactivity independent of prior characterization of epitopes. A recombinant adenoviral vector encoding the full cDNA sequence of NY-ESO-1 was used to transduce CD8-depleted peripheral blood lymphocytes as antigen-presenting cells. These modified antigen-presenting cells were then used to restimulate memory effector cells against NY-ESO-1 from the peripheral blood of cancer patients. Specific CD8(+) T cells thus sensitized were assayed on autologous B cell targets infected with a recombinant vaccinia virus encoding NY-ESO-1. Strong polyclonal responses were observed against NY-ESO-1 in antibody-positive patients, regardless of their HLA profile. Because the vectors do not cross-react immunologically, only responses to NY-ESO-1 were detected. The approach described here allows monitoring of CD8(+) T cell responses to NY-ESO-1 in the context of various HLA alleles and has led to the definition of NY-ESO-1 peptides presented by HLA-Cw3 and HLA-Cw6 molecules.

['Microbial air pollutants'. Emission sources and preventive measures]

Already in the planning or monitoring phase, measures have to be realized for the reduction in emissions of bio-aerosols in biological waste treatment plants. For this purpose, operation-related measures (in open and partially closed plants) and technology-related measures (in closed plants with automatic ventilation) can be taken. A survey on the currently feasible measures for reduction is submitted. The realization has to be adapted to the individual site and type of plant. An enormous demand for examinations is envisaged in order to enable a qualified assessment of the emission behaviour of diverse waste air systems or process steps.

A probabilistic model for the failure frequency of underground gas pipelines

A model is constructed for the failure frequency of underground pipelines per kilometer year, as a function of pipe and environmental characteristics. The parameters in the model were quantified, with uncertainty, using historical data and structured expert judgment. Fifteen experts from institutes in The Netherlands, the United Kingdom, Italy, France, Germany, Belgium, Denmark, and Canada participated in the study.

Vincristine, doxorubicin, cyclophosphamide, prednisone and etoposide (VACPE) in high-grade non-Hodgkin's lymphoma--a multicenter phase II study

BACKGROUND

Patients with high-grade non-Hodgkin's lymphoma (NHL) can potentially be cured by intensive chemotherapy. However, many patients still die of their disease, which underscores the need to define patient groups with different long-term prognoses and for more effective and possibly risk-adapted treatment approaches.

PATIENTS AND METHODS

In this phase II study we investigated the feasibility and efficacy of a polychemotherapy consisting of 2 mg vincristine (V) on day 1, 25 mg/m2 doxorubicin (A) days 1-3, 800 mg cyclophosphamide (C) day 1, 60 mg/m2 prednisone (P) days 1-7 and 120 mg/m2 etoposide (E) days 1-3. This cycle (VACPE) was repeated on day 22 for up to 5 cycles in stages I-III and 6 cycles in stage IV, respectively, followed by consolidating radiotherapy in 38/73 patients. A total of 75 patients with high-grade NHLs according to the Kiel classification were eligible, and 73 patients are evaluable for response. The predominant histological subtypes were centroblastic, pleomorphic T-cell and large-cell anaplastic lymphomas, 60% of the patients presented with stage III/IV, 55% with a poor performance status (ECOG > or = 2), 53% with B symptoms and 60% with a LDH level >200 U/l.

RESULTS

57/73 patients achieved CR (78%), and the overall response rate (CR-PR) was 95%. The median observation time is 40 months (10+-74+). The 1-, 3- and 5-year overall survivals for the entire VACPE group were 79%, 64% and 61%, respectively. Forty-one patients are in ongoing CR with a continuous complete remission rate (CCR) of 67%. Fourteen of the 16 patients who relapsed (88%) did so within the first 24 months. The predicted 1-, 3- and 5-year DFS for those patients who achieved CR is 83%, 67% and 67%, respectively. The early mortality was 3/73 (4.1%). In patients with reduced performance status the overall survival (OS) (ECOG > or = 2) was significantly reduced, with a predicted 1-, 3- and 5-year survival of 62%, 49% and 49% versus 100%, 84% and 77% in patients with favorable performance status, respectively (p = 0.001). The predicted overall survival in stages III/IV is worse than in early stages with a 1-, 3- and 5-year probability of 73%, 52% and 52% versus 90%, 86% and 78%, respectively (p = 0.02). Comparison of patient groups with cumulative risk factors shows a significant decrease in overall survival. Especially in patients with 0-2 risk factors versus those presenting with >2 risk factors, there is a significantly better 3- and 5-year survival (p = 0.002). In contrast to overall survival, there were no differences between the listed risk groups concerning the disease-free survival of complete responders.

CONCLUSION

In conclusion, the VACPE regime is feasible and effective in high-grade NHLs and may also be administered on an outpatient basis. Despite encouraging data, however, a prospective randomized trial is warranted to define a possible superiority to standard CHOP. However, this regimen may be the basis for further randomized and risk adapted innovative approaches for high-grade NHLs.

[Air microbial burden at garbage sorting facilities]

At two german garbage sorting facilities, germ concentrations in the air were analyzed at different working environments (waste reception, manual sorting). At plant A, maximum concentrations of total bacteria (14700 CFU/m3), gram-negative bacteria (7279 CFU/m3) and moulds (> 84806 CFU/m3) occurred in the air at the final manual sorting belts. Referring to concentrations of total bacteria and moulds, concentrations in the air at the final sorting belts were significantly higher (p < 0.001) than at the other working environments. At plant B, the counts of total bacteria reached 7173 CFU/m3 in the air at the waste reception site and 5512 CFU/m3 at the manual sorting belt. Maximum concentrations for gram-negative bacteria were 247 resp. 206 CFU/m3 and 70919 resp. 60848 CFU/m3 for moulds. At the waste reception site, the aerial concentrations of total bacteria lay highly significantly (p < 0.001) and of moulds significantly (p < 0.05) above aerial concentrations at the manual sorting belt. As causes, an intensive mechanical pretreatment of recycle material at plant A and whirling up of sedimentary dust of the floor during manual sweeping of the material on to the transportation at plant B are discussed.

[Composting facilities. 2. Aerogenic microorganism content at different working areas of composting facilities]

At two composting facilities (plants D and E), contamination of the air with total bacteria and mould fungi, and in addition with gram-negative bacteria (only at plant D) was analyzed at different indoor sites and outdoor in the vicinity. Statistical validity of the determination of contents of microorganisms in air samples was guaranteed by the collection and analysis of 30 parallel samples. At plant D, total bacteria concentrations in outdoor air ranged from 106 to 15,618 CFU/m3 air (median: 495 CFU/m3 air), gram-negative bacteria concentrations ranged up to 71 CFU/m3 air (median: below the detection limit of 35 CFU/m3 air), and mould fungi reached 7,138 CFU/m3 air (median: 141 CFU/m3 air). Highest concentrations of total bacteria above the upper detection limit (> 84,806 CFU/m3 air, sample volume: 28.3 l) and of mould fungi (38,940 CFU/m3 air) occurred at the place where three months old compost was mixed, highest concentrations of gram-negative bacteria (14,134 CFU/m3 air) were measured during mixing of fresh compost (younger than 8 days). Maximum and median values of the examined microorganisms ranged so high that special protective means for personnel working directly beneath the mixing process seem to be necessary under hygienic aspects. Raw and clean air at the composting filter at plant D showed highly significant differences concerning air concentration of gram-negative bacteria and mould fungi, indicating a good separation efficiency for these types of microorganisms. Maximum and median values of gram-negative bacteria and mould fungi concentrations (all < 1,000 CFU/m3 air) measured in clean air behind the composting filter lie in the range of normal outdoor air. Merely total bacteria show statistical significant differences to outdoor air with median values of clean air of 1,979 CFU/m3 air (edge of filter) resp. 3,110 CFU/m3 air (upside the filter) and with maximum values of above 30,000 CFU/m3 air in each case. In the outdoor air at plant E, total bacteria concentrations ranged from 362 to 7,633 CFU/m3 air (median: 1,312 CFU/m3 air), mould fungi ranged from 115 to 4,072 CFU/m3 air (median: 345 CFU/m3 air). Highest concentrations of total bacteria and mould fungi (all analyses above the upper detection limit of 21,201 CFU/m3 air; sample volume: 113,2 l) occurred during shredding of a mixture of kitchen and green wastes and of shrubs. During experimental shredding of separately collected panty diapers air concentrations of total bacteria ranged from about 19,000 CFU/m3 air to > 21,201 CFU/m3 air.(ABSTRACT TRUNCATED AT 400 WORDS)

[Composting facilities. 1. Microbiological quality of compost with special regard to disposable diapers]

At three different composting facilities, co-composting of used panty diapers with an addition of 10% (weight) to the usual plant input was investigated for various hygienic and microbiological parameters. In nearly any case, a sufficient degree of germ reduction above 99.9% could be observed by determination of reduction rates of B. subtilis spores. The concentrations of "total microorganisms" ranged from 3.9 x 10(5) to 3.3 x 10(11) colony forming units per gram compost (CFU/g) in composts without and from 3.3 x 10(5) to 4.7 x 10(9) CFU/g in composts with panty diapers in the input. The concentrations of "gram-negative bacteria" ranged from 3.3 x 10(4) to 1.3 x 10(9) CFU/g (without panty diapers) resp. from 3.3 x 10(5) to 3.5 x 10(8) CFU/g (with panty diapers), the concentrations of "fecal streptococci" from 1.7 x 10(3) to 7.7 x 10(7) CFU/g (without panty diapers) resp. from 1.4 x 10(4) to 1.4 x 10(8) CFU/g (with panty diapers). Facultatively pathogenic microorganisms showed a broad variety, but no common trend in composts with and without panty diapers in the input. Statistical validity of the determination of contents of microorganisms in compost samples was guaranteed by the collection and analysis of 20 parallel samples with an average sample mass of 10 to 15 kg. From the analyzed quantitative and qualitative hygienic-microbiological parameters, it can be concluded that no negative hygienic-microbiological effects, caused by the addition of 10% (weight) of used panty diapers in the input, have to be expected. Under the aspects of epidemiologic hygiene, composting of used panty diapers together with usual input materials seems to cause no increased risks under the tested conditions. Under the aspect of consumer protection, there is no increase in the risk of infection when using compost produced with addition of panty diapers, compared to compost produced without panty diaper addition to the input.

[Medical wastes. 2. Comparative studies of the microbial contamination of wastes from medical practices of different disciplines and household garbage]

Medical consulting room wastes of 7 disciplines were investigated quantitatively and qualitatively for nosocomial infective agents. 20-25 samples from each consulting room were examined for 3 months. The results were compared with those of household refuse and hospital wastes. The whole content of a waste bag was suspended without a preceding sorting and the eluate was microbiologically examined. The results of the investigations proved, that the germ concentration of the medical consulting room wastes was less than that of household refuse. The median for all investigated germ groups was less than 1 log(10)-step compared-to household refuse. The statistical analyses confirmed highly significant differences (p less than 0.001) for total germ concentration, thermoresistant obligate aerobic and facultative anaerobic bacteria and bacteria spores. Exceptionally the paediatric consulting room wastes show smaller differences (p less than 0.01) between the household refuse for obligate and facultative anaerobic bacteria, thermoresistant obligate and facultative anaerobic bacteria and bacteria spores and D-streptococci. From the comparison of total germ concentration for medical wastes from conservative disciplines and household refuse resulted that wastes from medical consulting rooms are less contaminated with nosocomial infective agents than household refuse and hospital wastes. In conclusion wastes from medical consulting rooms can, similar to hospital wastes, be disposed together with household refuse.

[Medical waste. 1. Microbiologic studies of wastes of various specialties at a large and small hospital in comparison to housekeeping waste]

Hospital wastes, similar to household refuse, from normal and high risk areas of a big and a smaller hospital were tested quantitatively and qualitatively for nosocomial infective agents. The results were compared with those of household refuse. 20-25 samples from care and operating wards were examined each for 3 months. The whole content of a waste bag was suspended without a preceding sorting. After this treatment the eluat was microbiologically examined. The results of the test proved that the germ concentration of the hospital waste was less or similar than that of household refuse. The median for gram negative rods in household refuse was e.g. 4 log10-steps higher than in wastes from operating wards. The statistical analysis confirmed these highly significant differences between the wastes from the high risk operating areas of the big and smaller hospital and the household refuse for all investigated bacteria groups. There are nearly no differences between the wastes from normal wards and from household refuse regarding germ concentration for different groups, e.g. gram negative rods or D-streptococci, and no higher germ concentration in any case. In conclusion hospital wastes must be disposed with special hygienic measures inside the hospital, outside the hospital they can be disposed together with household refuse.

Chloramphenicol/thiamphenicol and cycloheximide as tools for the measurement of mitochondrial protein synthesis in vitro during organogenesis of rat embryos

1. A test system was developed to allow the measurement of protein synthesis in vitro in mitochondria from tissues which were accessible only in small quantities. The subcellular fractions which could be isolated are not purely mitochondrial but contain other particles as well, mainly microsomal, which are also active in protein synthesis. The following differences between mitochondrial and microsomal protein synthesis in vitro were used to measure selectively the mitochondrial portion in cell fractions sedimenting between 600 and 10000 X g: selective inhibition of mitochondrial protein synthesis by chloramphenicol/thiamphenicol selective inhibition of microsomal protein synthesis by cycloheximide kinetics of amino acid incorporation a medium favoring mitochondrial protein synthesis Activity of mitochondrial protein synthesis was based on measurements of cytochrome oxidase, a mitochondrial marker enzyme. 2. The technique developed was used for the evaluation of mitochondrial protein synthesis in mammalian embryonic tissues. It may equally well be applied to other tissues available in small amounts and in cases where the isolation of highly purified mitochondrial fractions is met with difficulty. 3. Comparing the rate of 14C-phenylalanine incorporation into mitochondrial protein from rat embryos at different stages of gestation, it was found that mitochondria from 11=day-old rat embryos exhibit an approximately 30-fold higher capacity for protein synthesis than those of day 13-16. On day 12 the capacity is 6 times higher than on the following days.