Immune Profiling of Patients with Systemic Sclerosis through Targeted Proteomic Analysis

High-throughput proteomic analysis could offer new insights into the pathogenesis of systemic sclerosis (SSc) and reveal non-invasive biomarkers for diagnosis and severity. This study aimed to assess the protein signature of patients with SSc compared to that of healthy volunteers, decipher various disease endotypes using circulating proteins, and determine the diagnostic performance of significantly expressed plasma analytes. We performed targeted proteomic profiling in a cohort of fifteen patients with SSc and eighteen controls using the Olink® (Olink Bioscience, Uppsala, Sweden)Target 96 Inflammation Panels. Seventeen upregulated proteins involved in angiogenesis, innate immunity, and co-stimulatory pathways discriminated between patients with SSc and healthy controls (HCs) and further classified them into two clusters, a low-inflammatory and a high-inflammatory endotype. Younger age, shorter disease duration, and lack of reflux esophagitis characterized patients in the low-inflammatory endotype. TNF, CXCL9, TNFRSF9, and CXCL10 positively correlated with disease progression, while the four-protein panel comprising TNF, CXCL9, CXCL10, and CX3CL1 showed high diagnostic performance. Collectively, this study identified a distinct inflammatory signature in patients with SSc that reflects a persistent T helper type 1 (Th 1) immune response irrespective of disease duration, while the multi-protein panel might improve early diagnosis in SSc.

Prospective randomized controlled trial comparing the effect of Monocryl versus nylon sutures on patient- and observer-assessed outcomes following carpal tunnel surgery

Controversy remains regarding the optimal technique and suture type for wound closure after carpal tunnel surgery. Adult patients undergoing open carpal tunnel release were prospectively randomized to receive either interrupted, buried Monocryl sutures or traditional nylon horizontal mattress sutures for their wound closures. At the 2-week and 6-week postoperative visits, Patient and Observer Scar Assessment Scale questionnaires were completed. At 2 weeks, patients and observers had a significantly better opinion of incisions closed with Monocryl. By 6 weeks, neither patients nor observers found a difference between suture types in any category. Scars of wounds closed with Monocryl did not change appreciably in appearance between 2 and 6 weeks. However, patients and observers noted significant improvement in scar appearance in the nylon group over time. Monocryl suture represents an effective method for carpal tunnel closure that leads to improved patient- and observer-reported outcome scores in the early postoperative period compared with nylon.Level of evidence: II.

Enhanced Innate and Acquired Immune Responses in Systemic Sclerosis Primary Peripheral Blood Mononuclear Cells (PBMCs)

Chronic immune activation in systemic sclerosis is supported by the production of a plethora of cytokines with proven regulatory activities of the immune responses. This study aimed to explore PBMCs' cytokine profiles in SSc patients versus controls, as well as to investigate the balance between pro- and anti-inflammatory cytokines in association with disease duration. PBMCs were isolated from 18 SSc patients and 17 controls and further subjected to in vitro stimulation with lipopolysaccharide and heat-killed Candida albicans. Cytokine production was measured after 24 h and 7 days, respectively, using ELISA kits for interleukin (IL)-1β, IL-1 receptor antagonist (IL-1Ra), IL-6, tumor necrosis factor (TNF), IL-10, IL-17, and interferon-gamma (IFN-gamma). IL-1 β, IL-6, and TNF levels were increased in SSc patients compared with healthy volunteers irrespective of the stimulus used. IL-1Ra and Il-17 concentrations were not statistically different between groups, even though a trend toward higher levels in patients compared with their matched controls was also observed. Most cytokines demonstrated a stable course with disease progression, except for IL-10 levels, which declined over time. In conclusion, the results of this pilot study reveal that in patients with SSc a persistently enhanced immune response is established and maintained regardless of stimulus or disease duration.

Comparative study on the deamidation of three recombinant human insulins using capillary electrophoresis

The applicability of capillary zone electrophoresis (CZE) for the separation of different recombinant human insulins and their deamidated isoforms was studied. The high resolving power of CZE is demonstrated by its ability to separate insulin isoforms differing only by 0.984 Da (different-fold deamidated forms) and even components having the exacts same mass but slightly different shapes (same-fold deamidated forms). From among the several insulins available, humulin, glargine and glulisine were selected for our study because their sequences and chemical parameters are quite similar, however, the small differences present in their amino acid sequences influence the deamidation processes. Using a background electrolyte with basic pH was favourable not only for the separation of the different types of insulin but also for the separation of deamidated protein forms even in a bare fused silica capillary. The LOD values ranged between 0.6 - 0.93 mg/L and 2.17 - 4.37 mg/L for UV and ESI-MS detection, respectively. At -20 - -80 °C, the deamidation is minimal, but at temperatures above +5 °C deamidation is accelerated. At +5 °C only 1-fold deamidation forms could be observed for each insulin. Acidified samples incubated for 1-month at room temperature showed varying levels of deamidation: 1-fold, 1-2-fold and 1-2-3-fold forms for glargine, glulisine and humulin, respectively.

New data regarding the identification of critical raw materials recoverable from raw, processed and the waste mining industry materials from Romania

Several EU initiatives focused on renewable energy, sustainable infrastructure and green transport require a sustainable supply of a wide range of raw materials. The increase in the population and, implicitly, the increasing demand for necessary resources led to accelerated degradation of the environment, a pressing issue which the contemporary world faces. The mining activities produced huge amounts of waste, which may now become a potential secondary raw materials source that offer the potential to extract critical mineral elements of current interest. This study is intended as a historical literature data processing combined with recent analyses according to modern test methods to confirm the presence of selected critical raw materials (CRMs). The aim of the work was an integrated approach to identify the presence of Ga, In, Ge, Bi, Co and Te in ore, ore concentrates, tailing ponds and ore dumps from some Romanian historical mining regions: Apuseni Mountains (5 deposits) and the northern part of the Eastern Carpathians (Baia Mare area 2 deposits and Fundu Moldovei area 1 deposit). The consulted literature data highlighted that the tailing ponds and dumps from Romania contain a noticeable quantity of secondary resources of critical elements, respectively, an average of 2172 mg/kg Bi, 1737 mg/kg Co, 691 mg/kg Ga, 667 mg/kg In, 74 mg/kg Ge and 108 mg/kg Te in ore and 1331 mg/kg Ga, 1093 mg/kg Co, 180 mg/kg Bi, 72 mg/kg In and 35 mg/kg Ge in tailings. The overall statistics for the 2008-2018 period show a decrease in the amount of hazardous waste produced by the extractive industry in Romania. The older literature data (from about 50 years ago) for the investigated deposits was confirmed by the laboratory analysis of selected CRMs from several samples collected from known former and current mining activities. Furthermore, the optical microscopy investigations coupled with modern electronic microscopy and quantitative and semi-quantitative techniques have provided further details regarding the sample nature and constituents. High levels of Bi (35,490 mg/kg) and Sb (15,930 mg/kg) were determined in samples from Băița Bihor and Coranda-Hondol ore deposits (Apuseni Mountains), and the presence of some rare elements such as Te was also detected. The recovery of critical elements present in the mining waste significantly contributes to the transition to a circular economy that is essential for the development of a sustainable and resource-efficient economy. This study enables future research focused on the recovery of critical elements present in the mining waste, with benefits for the environment, economy and society.

Hyperferritinemia, Low Circulating Iron and Elevated Hepcidin May Negatively Impact Outcome in COVID-19 Patients: A Pilot Study

Inflammation in COVID-19 produces intracellular iron overload with low circulating iron available for metabolic processes. The accumulated intracellular iron generates reactive species of oxygen and results in ferroptosis, a non-programmed cell death. Since no organ is spared, iron dysmetabolism increases the mortality and morbidity. Hepcidin and the mediator interleukin 6 are believed to play a role in the process. Our aim is to evaluate the predictive values of serologic iron and inflammatory parameters in COVID-19 critically ill patients. Hence, 24 patients were included. Hepcidin and interleukin 6, along with routine blood parameters, were determined and outcomes, such as death, multiple organ damage (MOD), anemia, and need for transfusions, were assessed. The results of this pilot study indicate that iron metabolism parameters individually, as well as models consisting of multiple laboratory and clinical variables, may predict the outcomes. Further larger studies are needed to validate the results of this pilot stud. However, this paper identifies a new direction for research.

Ultrasound-based assessment of hyomental distances in neutral, ramped, and maximum hyperextended positions, and derived ratios, for the prediction of difficult airway in the obese population: a pilot diagnostic accuracy study

BACKGROUND

Ultrasonography-assessed hyomental distance (HMD) ratio has been found to discriminate between obese patients with Cormack-Lehane grades 1 or 2 vs. those with grades 3 or 4. The aim of our study is to evaluate the performance of the HMD evaluated ultrasonographically in neutral, ramped, and maximum hyperextended positions, as well as for the ratios obtained by dividing the HMD in the ramped position to that in the neutral position (HMDR1) and by dividing the HMD in maximum hyperextension to that in the neutral position (HMDR2), in order to predict the occurrence of Cormack-Lehane grades 3 or 4 during direct laryngoscopy.

METHODS

Ultrasound measurements were performed preoperatively in 25 patients with morbid obesity, measuring the HMD in the neutral, ramped, and maximum hyperextended positions. Pre-epyglotic soft tissue thickness, Mallampati and upper lip bite test scores were recorded. Cormack-Lehane grading was considered as an outcome variable in the Receiver Operating Characteristics curve analysis.

RESULTS

HMD in the neutral, ramped and maximum hyperextended positions presented similar sensitivities, 100% [39.8-100.0]. For HMD, specificity was 42.86% [21.8-66.0] in the neutral position, 61.9% [38.4-81.9] in the ramped postion, and 71.4% [47.8-88.7] in the maximum hyperextended position. For HMDR1, the cut-off value was 1.12. This threshold provides 75% [19.4-99.4] sensitivity and 76.2% [52.8-91.8] specificity. For HMDR2, a cut-off value of 1.23 provides 100% [39.8-100.0] sensitivity and 90.5% [69.6-98.8] specificity.

CONCLUSION

HMDR2 seems to have superior diagnostic accuracy in predicting difficult laryngoscopy in the obese population compared to HMDR1, as well as compared to the HMD in the neutral, ramped, and maximum hyperextended positions.

Acute poisoning due to ingestion of Datura stramonium - a case report

Datura stramonium (DS) is a widespread annual plant, containing atropine, hyoscyamine, and scopolamine, which can produce poisoning with a severe anticholinergic syndrome. Teenagers ingest the roots, seeds or the entire plant to obtain its hallucinogenic and euphoric effects. We presented the case of a 22 year old male who was admitted to the Emergency Room in a coma after consuming Datura stramonium, 2 hours earlier. The patient presented with fever, tachycardia with right bundle branch block, and urinary retention. Rapid sequence induction and intubation was performed immediately, with sedation and assisted-control mechanical ventilation, after being transferred to the Intensive Care Unit. The patient received activated charcoal, in repeated doses, external and internal cooling was applied, and an infusion of neostigmine was started. The biological assessment revealed rhabdomyolysis and prevention of renal failure was initiated. After a proper neurological evaluation, 36 hours after using Datura stramonium, the patient was extubated and transferred to the Psychiatric ward for further assessment and care.

Passenger mutations and aberrant gene expression in congenic tissue plasminogen activator-deficient mouse strains

Essentials C57BL/6J-tissue plasminogen activator (tPA)-deficient mice are widely used to study tPA function. Congenic C57BL/6J-tPA-deficient mice harbor large 129-derived chromosomal segments. The 129-derived chromosomal segments contain gene mutations that may confound data interpretation. Passenger mutation-free isogenic tPA-deficient mice were generated for study of tPA function.

SUMMARY

Background The ability to generate defined null mutations in mice revolutionized the analysis of gene function in mammals. However, gene-deficient mice generated by using 129-derived embryonic stem cells may carry large segments of 129 DNA, even when extensively backcrossed to reference strains, such as C57BL/6J, and this may confound interpretation of experiments performed in these mice. Tissue plasminogen activator (tPA), encoded by the PLAT gene, is a fibrinolytic serine protease that is widely expressed in the brain. A number of neurological abnormalities have been reported in tPA-deficient mice. Objectives To study genetic contamination of tPA-deficient mice. Materials and methods Whole genome expression array analysis, RNAseq expression profiling, low- and high-density single nucleotide polymorphism (SNP) analysis, bioinformatics and genome editing were used to analyze gene expression in tPA-deficient mouse brains. Results and conclusions Genes differentially expressed in the brain of Plat(-/-) mice from two independent colonies highly backcrossed onto the C57BL/6J strain clustered near Plat on chromosome 8. SNP analysis attributed this anomaly to about 20 Mbp of DNA flanking Plat being of 129 origin in both strains. Bioinformatic analysis of these 129-derived chromosomal segments identified a significant number of mutations in genes co-segregating with the targeted Plat allele, including several potential null mutations. Using zinc finger nuclease technology, we generated novel 'passenger mutation'-free isogenic C57BL/6J-Plat(-/-) and FVB/NJ-Plat(-/-) mouse strains by introducing an 11 bp deletion into the exon encoding the signal peptide. These novel mouse strains will be a useful community resource for further exploration of tPA function in physiological and pathological processes.

Carpal tunnel syndrome: assessment of surgeon and patient preferences and priorities for decision-making

PURPOSE

This study tested the null hypothesis that there are no differences between the preferences of hand surgeons and those patients with carpal tunnel syndrome (CTS) facing decisions about management of CTS (ie, the preferred content of a decision aid).

METHODS

One hundred three hand surgeons of the Science of Variation Group and 79 patients with CTS completed a survey about their priorities and preferences in decision making regarding the management of CTS. The questionnaire was structured according the Ottawa Decision Support Framework for the development of a decision aid.

RESULTS

Important areas on which patient and hand surgeon interests differed included a preference for nonpainful, nonoperative treatment and confirmation of the diagnosis with electrodiagnostic testing. For patients, the main disadvantage of nonoperative treatment was that it was likely to be only palliative and temporary. Patients preferred, on average, to take the lead in decision making, whereas physicians preferred shared decision making. Patients and physicians agreed on the value of support from family and other physicians in the decision-making process.

CONCLUSIONS

There were some differences between patient and surgeon priorities and preferences regarding decision making for CTS, particularly the risks and benefits of diagnostic and therapeutic procedures.

CLINICAL RELEVANCE

Information that helps inform patients of their options based on current best evidence might help patients understand their own preferences and values, reduce decisional conflict, limit surgeon-to-surgeon variations, and improve health.

Potent and specific inhibition of the biological activity of the type-II transmembrane serine protease matriptase by the cyclic microprotein MCoTI-II

Matriptase is a type-II transmembrane serine protease involved in epithelial homeostasis in both health and disease, and is implicated in the development and progression of a variety of cancers. Matriptase mediates its biological effects both via as yet undefined substrates and pathways, and also by proteolytic cleavage of a variety of well-defined protein substrates, several of which it shares with the closely-related protease hepsin. Development of targeted therapeutic strategies will require discrimination between these proteases. Here we have investigated cyclic microproteins of the squash Momordica cochinchinensis trypsin-inhibitor family (generated by total chemical synthesis) and found MCoTI-II to be a high-affinity (Ki 9 nM) and highly selective (> 1,000-fold) inhibitor of matriptase. MCoTI-II efficiently inhibited the proteolytic activation of pro-hepatocyte growth factor (HGF) by matriptase but not by hepsin, in both purified and cell-based systems, and inhibited HGF-dependent cell scattering. MCoTI-II also selectively inhibited the invasion of matriptase-expressing prostate cancer cells. Using a model of epithelial cell tight junction assembly, we also found that MCoTI-II could effectively inhibit the re-establishment of tight junctions and epithelial barrier function in MDCK-I cells after disruption, consistent with the role of matriptase in regulating epithelial integrity. Surprisingly, MCoTI-II was unable to inhibit matriptase-dependent proteolytic activation of prostasin, a GPI-anchored serine protease also implicated in epithelial homeostasis. These observations suggest that the unusually high selectivity afforded by MCoTI-II and its biological effectiveness might represent a useful starting point for the development of therapeutic inhibitors, and further highlight the role of matriptase in epithelial maintenance.

Non-hematopoietic PAR-2 is essential for matriptase-driven pre-malignant progression and potentiation of ras-mediated squamous cell carcinogenesis

The membrane-anchored serine protease, matriptase, is consistently dysregulated in a range of human carcinomas, and high matriptase activity correlates with poor prognosis. Furthermore, matriptase is unique among tumor-associated proteases in that epithelial stem cell expression of the protease suffices to induce malignant transformation. Here, we use genetic epistasis analysis to identify proteinase-activated receptor (PAR)-2-dependent inflammatory signaling as an essential component of matriptase-mediated oncogenesis. In cell-based assays, matriptase was a potent activator of PAR-2, and PAR-2 activation by matriptase caused robust induction of nuclear factor (NF)κB through Gαi. Importantly, genetic elimination of PAR-2 from mice completely prevented matriptase-induced pre-malignant progression, including inflammatory cytokine production, inflammatory cell recruitment, epidermal hyperplasia and dermal fibrosis. Selective ablation of PAR-2 from bone marrow-derived cells did not prevent matriptase-driven pre-malignant progression, indicating that matriptase activates keratinocyte stem cell PAR-2 to elicit its pro-inflammatory and pro-tumorigenic effects. When combined with previous studies, our data suggest that dual induction of PAR-2-NFκB inflammatory signaling and PI3K-Akt-mTor survival/proliferative signaling underlies the transforming potential of matriptase and may contribute to pro-tumorigenic signaling in human epithelial carcinogenesis.

Suppression of Tumorigenicity-14, encoding matriptase, is a critical suppressor of colitis and colitis-associated colon carcinogenesis

Colitis-associated colorectal cancers are an etiologically distinct subgroup of colon cancers that occur in individuals suffering from inflammatory bowel disease and arise as a consequence of persistent exposure of hyperproliferative epithelial stem cells to an inflammatory microenvironment. An intrinsic defect in the intestinal epithelial barrier has been proposed to be one of several factors that contribute to the inappropriate immune response to the commensal microbiota that underlies inflammatory bowel disease. Matriptase is a membrane-anchored serine protease encoded by Suppression of Tumorigenicity-14 (ST14) that strengthens the intestinal epithelial barrier by promoting tight junction formation. Here we show that intestinal epithelial-specific ablation of St14 in mice causes formation of colon adenocarcinoma with very early onset and high penetrance. Neoplastic progression is preceded by a chronic inflammation of the colon that resembles human inflammatory bowel disease and is promoted by the commensal microbiota. This study demonstrates that inflammation-associated colon carcinogenesis can be initiated and promoted solely by an intrinsic intestinal permeability barrier perturbation, establishes St14 as a critical tumor suppressor gene in the mouse gastrointestinal tract, and adds matriptase to the expanding list of pericellular proteases with tumor suppressive functions.

Matriptase inhibition by hepatocyte growth factor activator inhibitor-1 is essential for placental development

Hepatocyte growth factor activator inhibitor-1 (HAI-1) is a Kunitz-type transmembrane serine protease inhibitor that forms inhibitor complexes with several trypsin-like serine proteases and is required for mouse placental development and embryo survival. Here we show that the essential function of HAI-1 in placentation and all other embryonic processes is to restrict the activity of the type II transmembrane serine protease, matriptase. Enzymatic gene trapping of matriptase combined with HAI-1 immunohistochemistry revealed that matriptase is co-expressed with HAI-1 in both extraembryonic and embryonic tissues. As early as embryonic day 8.5, matriptase and HAI-1 were expressed in a population of chorionic trophoblasts. Ablation of HAI-1 disrupted the epithelial integrity of this cell population, causing disorganized laminin deposition and altered expression of E-cadherin and beta-catenin. This led to a complete loss of undifferentiated chorionic trophoblasts after embryonic day 9.5 and prevented the formation of the placental labyrinth. Genetic ablation of matriptase activity in HAI-1-deficient embryos, however, restored the integrity of chorionic trophoblasts and enabled placental labyrinth formation and development to term. Furthermore, matriptase/HAI-1 double-deficient mice were phenotypically indistinguishable from matriptase single-deficient littermates.

Cla4 protein kinase is essential for filament formation and invasive growth of Yarrowia lipolytica

The non-conventional yeast Yarrowia lipolytica is a suitable model for the study of yeast dimorphism. In order to identify genes that may be involved in the regulation of this process, random mutagenesis was performed. This led to the isolation of monomorphic mutants that had lost the ability to grow in a hyphal form both in liquid and on solid medium. Filamentation was restored to one of the mutants by transformation with a fragment of Y. lipolytica genomic DNA containing a single 2766-bp ORF. The predicted protein has a molecular weight of 99.6 kDa and is highly homologous to the protein kinases Cla4 of Candida albicans and Saccharomyces cerevisiae, which are members of the p21-activated kinase (PAK) family. Analysis of the putative protein sequence identified conserved C-terminal catalytic, and internal Cdc42p-binding regions, as well as a pleckstrin homology domain typical of PAK kinases. The results indicate that CLA4 is a single-copy gene located on the chromosome V of Y. lipolytica. Deletion of CLA4 is not lethal, but completely eliminates the ability to form filaments and to invade agar. A strain lacking a functional CLA4 gene exhibits an aberrant distribution of chitin in the cell wall, indicating a possible role for the Cla4 protein kinase in the maintenance of cell polarity in Y. lipolytica.

The respiratory complex I in yeast: isolation of a gene NUO51 coding for the nucleotide-binding subunit of NADH:ubiquinone oxidoreductase from the obligately aerobic yeast Yarrowia lipolytica

We have isolated a gene NUO51 coding for a homologue of the nucleotide-binding subunit of mitochondrial respiratory chain linked NADH:ubiquinone oxidoreductase from the obligately aerobic yeast Yarrowia lipolytica. DNA sequencing revealed a 1464 bp open reading frame encoding a protein with predicted molar mass of about 53.7 kDa. The sequence is highly conserved with its counterparts from filamentous fungi and represents the first yeast homologue of the NADH-binding subunit (51 kDa) of the respiratory complex 1. In addition, PFGE and Southern hybridization analysis indicate that NUO51 is a single copy gene in the genome of Y. lipolytica. The expression of NUO51 by Northern blot analysis was also examined.

Dimorphism in Yarrowia lipolytica: filament formation is suppressed by nitrogen starvation and inhibition of respiration

In contrast to Saccharomyces cerevisiae, nitrogen starvation inhibited formation of hyphae in liquid cultures of Y. lipolytica, while carbon source did not seem to be important for filament formation. Inhibitors of mitochondrial respiration strongly suppressed the development of hyphae, indicating that energy conversion processes, and thus carbon metabolism, may be involved. pH of the medium also strongly affected the morphology, but only in the presence of a complex nitrogen source, implying that the cells respond to altered nutrition in media with different pH rather than to pH itself. The results suggest that the XPR2 gene encoding Y. lipolytica alkaline extracellular proteinase is involved in the regulation of dimorphism in this species.

Localized amyloid tumor of the tongue. A case report and review of the literature

Amyloid is usually deposited in the tongue, as a part of generalized amyloidosis. Isolated localized amyloidosis of the tongue is relatively rare. We report such a case which presented with glossodynia and glossopyrosis and was thought clinically to represent median rhomboid glossitis. Histologically the amyloid stained positively with Congo-red giving green birefringence under polarized light, was not abolished after permanganate pretreatment and did not react immunohistochemically for amyloid A, beta 2 microglobulin and transthyretin.

Increased sensitivity of the rapid hydrophobic grid membrane filter enzyme-labeled antibody procedure for Escherichia coli O157 detection in foods and bovine feces

Several strains of Escherichia coli O157:H7 artificially inoculated into vegetables and dairy products were recovered on hydrophobic grid membrane filters and enumerated by an enzyme-labeled antibody assay. The mean of the recoveries from 12 fresh vegetables was 108.8%, whereas that from 10 dairy products was 93.2%. Modified tryptic soy broth at 43 degrees C with shaking at 100 rpm provided optimum recovery of the organism from meat, with a sensitivity of less than or equal to 1 CFU/g, which is 10 times more sensitive than direct plating. The method performed equally well with vegetable and dairy products. Tryptic soy broth, however, under the same conditions gave the best results for fecal samples. Of 22 asymptomatic dairy cattle, reported as having positive Brucella titers when assayed with polyclonal antibodies, eight were found to contain E. coli O157 in their feces as demonstrated by the enzyme-labeled antibody assay by using monoclonal antibodies. This finding may explain some of the false-positive Brucella tests.

Thermal Stability of Staphylococcal Enterotoxins A, B and C in a Buffered System

The heat stability of staphylococcal enterotoxins A, B and C (SEA, SEB, SEC) in phosphate buffered saline solution at a concentration of 100 ng per ml indicated that normal cooking times and temperatures are unlikely to completely inactivate the toxins. The order of heat resistance of the three toxins was SEC>SEB>SEA.

Evaluation of the reversed passive latex agglutination (RPLA) test kits for detection of staphylococcal enterotoxins A, B, C, and D in foods

Four lots of the SET-RPLA kit (Denka Seiken Co. Ltd., Tokyo), a commercial reverse passive latex agglutination test kit for the detection of staphylococcal enterotoxins A, B, C, and D in foods, have been evaluated for their efficacy. The kits showed high specificity and sensitivity with a detection limit of 0.75 ng enterotoxin/g of food. The test is simple, is completed within 24 h, and does not require complicated extraction or concentration procedures nor expensive equipment. In addition, the assay is semiquantitative. However, as in any other immunological system, routine verification of the specificity of the latex reagents against standard enterotoxins and toxin-free food extracts is necessary.

Hydrophobic Grid Membrane Filter Method for Aerobic Plate Count in Foods: Collaborative Study

Twenty-one laboratories participated in a collaborative study to validate a hydrophobic grid membrane filter (HGMF) method for aerobic plate count by comparing its performance against the AOAC/APHA pour plate method. Raw milk, raw poultry, whole egg powder, flours, and spices were included in the study. Counts obtained by the HGMF and pour plate methods did not differ significantly, except in the case of whole egg powder, for which the HGMF method produced significantly higher counts. The hydrophobic grid membrane filter method for aerobic plate count in foods has been adopted official first action.

Staphylococcus aureus Growth and Thermostable Nuclease and Enterotoxin Production in Canned Salmon and Sardines

Staphylococcus aureus growth, thermostable nuclease (TNase) and enterotoxin production in inoculated canned salmon incubated at 22 ± 1°C for 4 d were dependent on the size of inoculum, and on the amount of oxygen present in the headspace; under nitrogen with an inoculum of 7 cfu/can, 10²-10³ cfu/g, no TNase and traces of enterotoxins (A, B, C₂) were observed; under oxygen with the same inoculum ≥10⁹ cfu/g, ≥6.0 μg TNase and up to 5.2 μg total enterotoxins (A, B, and C₂)/100 g of salmon were observed. Values were intermediate under atmospheric air. After 1 week, 2 months and 4-24 months of incubation of salmon under nitrogen, S. aureus cfus were 10⁸, 10⁶ and 10⁴-10⁵ per g; TNase ranged from trace amounts to 20 μg/100 g and total enterotoxins from <1.0 μg to 6.2 μg/100 g. In canned sardines stored from 1 d to 12 months at 22 ± 1°C, levels were 10⁹ cfu/g and 3.7-3.9 μg total enterotoxins/100 g; after 1 week, counts declined to 10⁵ cfu/g but total enterotoxins remained relatively stable in some cans with up to 6.2 μg/100 g of sardines after 12 months. TNase varied from <1.0 μg to 20 μg/100 g of salmon with 10⁹ and 10⁵ cfu/g, respectively. In sardines, similar variation in TNase was observed and there was no correlation between TNase, enterotoxins and cfu/g. After 2 d to 24 months, carbon dioxide, an acidic smell and unacceptable odors were detectable over the headspace of S. aureus contaminated salmon and sardines, but not all persons who sniffed the contaminated products could recognize off-odors that would warn them against consuming the food. To prevent canned foods from causing staphylococcal illness, the conditions allowing post-process contamination should be eliminated by the producer and distributor of the products.

Donairs (Gyros) - Potential Hazards and Control

Because of concerns that meat in donairs could allow growth of pathogens during cooking and overnight cooling of leftovers, 34 donairs from eleven establishments had temperatures taken and were examined microbiologically. Temperatures varied depending on depth of measurement and stage from the raw product to reheated leftovers. These were frequently >4 or <60°C and could be considered at temperatures favorable for growth of pathogens. Although aerobic colony counts were high (mean of 10⁵ to 10⁷ CFU/g), counts tended to decrease the longer the donair remained cooking on the spit. Staphylococcus aureus , Bacillus cereus , Clostridium perfringens and Escherichia coli were never more than 10⁴/g despite some abusive practices, such as leaving donairs on the spit with the heat source turned off because the demand was low. Salmonella was found only in raw chicken slices to be used in donairs. It is recommended that good hygienic practices be encouraged at donair establishments and temperature measurements of donairs taken to verify these. Only if meat is <50°C at 1 cm below the surface during cooking or >5°C for the raw product or cooled leftovers, should samples be considered for microbiological analysis unless abusive practices have been observed. Because temperatures may vary over a short period of time during cooking, at least five measurements are recommended for each stage of the donair life (raw product, cooking donair, cooled leftovers and reheating donairs).

Cost of orthopedic injuries sustained in motorcycle accidents

Fifty-one serial admissions to the orthopedic services at the University of California, Davis, Medical Center, Sacramento, for motorcycle accident trauma with open fractures were reviewed. Fifty-five percent of those tested were alcohol intoxicated at the time of admission. Seventy-five percent carried no insurance of any kind, and for the total group, 72% of the cost of acute hospitalization (+17,704 per patient) was paid by the state of California, with an additional 10% paid by other tax-based sources. Care of motorcycle trauma consumes a substantial portion of public health care funds in California. This could be reduced by legislative action concerning helmet use, licensing, and rigid enforcement of compulsory insurance.

Hydrocele following internal spermatic vein ligation: a retrospective study and review of the literature

We reviewed 82 consecutive infertile men with varicoceles and 1 teenage boy with a painful varicocele, all of whom underwent a total of 111 internal spermatic vein ligations (55 unilateral and 28 bilateral) by the suprainguinal approach (Palomo method). Of these patients 3 who underwent unilateral and 3 bilateral internal spermatic vein ligations subsequently suffered a total of 8 hydroceles after an average postoperative interval of 18.2 months. The protein concentration of the hydrocele fluid in the 2 most recent patients was consistent with lymphatic obstruction.

A vascular necrosis of the lunate and sickle cell anemia. A case report

Sickle cell anemia and Kienböck's disease occurred in an 18-year-old man. The association of the two conditions seems not to have been previously reported.

Computed tomography of the normal radioulnar joints

Computed tomography followed by sectional radiography and photography as performed on eight cadaveric specimens in order to define the anatomy and normal motion of both the proximal and the distal radioulnar articulations. Osseous landmarks were defined that allowed measurement of rotation at the glenohumeral, proximal radioulnar and distal radioulnar joints as well as rotation between humerus and radius and between humerus and ulna. Findings included the absence of independent ulnar rotation and the presence of normal translatory motion at the distal radioulnar articulation that may be misinterpreted as evidence of subluxation of the distal ulna.

Computed tomography of the normal soft tissues of the wrist

Computed tomography and sectional radiography and photography were performed on eight cadaveric wrist specimens in order to define the soft tissue structures of the normal wrist. Three specific levels were analyzed in detail: the levels of the distal radioulnar joint, of the pisotriquetral joint, and of the hook of the hamate. All soft tissues, with the exception of arteries and veins, were well demonstrated with computed tomography. In particular, the contents of both Guyon's canal and the carpal tunnel could be delineated. The position of the extensor carpi ulnaris tendon and sheath could also be evaluated. Contrast opacification of the flexor tendon sheaths and palmar synovial sacs did not contribute to the analysis. Computed tomography appears to be an important imaging modality in the evaluation of significant clinical problems, including the carpal tunnel and ulnar tunnel syndromes and subluxation of the extensor carpi ulnaris tendon.

Variation in Counts, Enterotoxin Levels and TNase in Swiss-Type Cheese Contaminated with Staphylococcus aureus

In 1977, a number of staphylococcal intoxications occurred as a result of several lots of Swiss-type cheese being contaminated with Staphylococcus aureus . Blocks of cheese representing 59 of the recalled lots manufactured between January 5 and April 25, 1977, were examined for S. aureus counts and for staphylococcal thermonuclease (TNase), enterotoxin and pH. Counts ranged from <25 to 10⁸ S. aureus /g, with most blocks containing between 10⁴ and 10⁶/g. Enterotoxin B was present in 72.6% of 186 samples and TNase in 52.5% of 122 samples tested. The pH was generally between 5.5 and 5.7 with some samples as high as 6.2; normal pH for Swiss-type cheese is 5.7. Variations in levels of these parameters occurred within lots and even within blocks, as well as between lots. Within blocks there seemed to be differences between samples at the center and the periphery. The activity and degree of contamination of the starter cultures, temperatures of cooking and ripening and the speed of salt penetration could be factors causing these variations. TNase was not detectable in all samples containing enterotoxin, especially those with <0.5 μg/100 g. Therefore, cheese suspected of being a health hazard, such as being manufactured under unsanitary conditions or suspected of being contaminated with S. aureus , should be sampled at the center and periphery of blocks, if these are available, and analyzed for S. aureus counts, TNase and enterotoxin.

Discrimination between schizophrenic and control subjects by means of plasma dehydroepiandrosterone measurements

In this study we were able to distinguish 10 schizophrenic subjects from 10 control subjects with 100% accuracy by measuring plasma dehydroepiandrosterone (DHEA) diurnal rhythms and analyzing the data using a linear function equation. Discrimination with this high level of accuracy is in contrast to most studies of altered biological functioning in schizophrenia which have yielded inconsistent results. These findings are regarded as preliminary; further study is necessary to elicit any consistent DHEA disturbance in schizophrenics and to discover the significance for the pathophysiology of the illness. Measurements of plasma cortisol, aldosterone, DHEA-SO4, and testosterone did not provide such a basis for discrimination.

Selective enrichment of Shigella in the presence of Escherichia coli by use of 4-chloro-2-cyclopentylphenyl beta-D-galactopyranoside

A procedure involving the use of citrate-buffered lactose broth (pH 6.5) containing an analogue of a beta-galactoside (4-chloro-2-cyclopentylphenyl beta-D-galactopyranoside) has been developed for the enrichment of Shigella in competition with a 100-fold higher population of Escherichia coli. The system makes use of the beta-galactosidase activity of E. coli which hydrolyzes the phenolic derivative of beta-galactoside to galactose and an aglycone moiety (4-chloro-2-cyclopentylphenol) which is toxic to E. coli but is tolerated by Shigella. The procedure is particularly effective in the enrichment of S. sonnei and S. flexneri; S. dynsenteriae and S. boydii are enriched to a lesser extent.

Decrease of serotonin N-acetyltransferase activity in rat pineal organs after treatment with prostaglandin synthesis inhibitor indomethacin

Administration of indomethacin to rats abolished the cyclic AMP dependent, dark induced rise in serotonin N-acetyltransferase, presumably by inhibiting prostaglandin synthesis.