Aftereffects of entrainment on the period of the pacemaker in the eye of the mollusk Bulla gouldiana

The authors examined the "aftereffects" of entrainment of Bulla gouldiana to 11 h light:11 h dark (LD 11:11) (T22) or LD 13:13 (T26) on the period (tau) of the circadian rhythm of impulse activity recorded in vitro from the eye in constant darkness. When both eyes remained attached to the cerebral ganglion, the average period was 23.9 +/- 0.62 h (mean +/- SD, n = 6) for animals from T22 and 24.9 +/- 0.54 h for animals from T26. The 1-h difference between the periods of the T26 and the T22 animals was significant (p < .01, t test). When eyes were isolated from the cerebral ganglion by severing the optic nerve, the difference in average period between eyes from T22 and eyes from T26 animals was 2.2 h (23.3 +/- 0.72 h [n = 7] vs. 25.5 +/- 0.62 [n = 6], p < .001). When eyes remained attached to the brain but uncoupled from the contralateral eye, the aftereffect of entrainment to non-24-h light cycles was intermediate. For T22 animals, tau was 23.9 +/- 0.29 h (n = 6), whereas for the T26 animals, tau = 25.2 +/- 0.48 h (n = 7). The results show that isolated eyes can express aftereffects and indicate that coupling between ocular pacemakers and efferent signals from the cerebral ganglion diminish the effects of entrainment on the free-running period of the rhythm from the eye.

Engraftment and molecular monitoring of CD34+ peripheral-blood stem-cell transplants for follicular lymphoma: a pilot study

PURPOSE

A pilot study to validate the use of CD34+ selection (Ceprate SC) of blood stem-cell collection in patients with advanced follicular lymphoma receiving myeloablative chemoradiotherapy.

PATIENTS AND METHODS

Seventeen patients were entered onto the protocol. Thirteen of 17 patients have undergone transplantation; the median age is 42.5 years (range, 33 to 51), seven of 13 are stage IVB, two stage IVA, three stage IIIB, and one stage IIB. All except two patients were treated after first or subsequent relapses after receiving cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy to achieve a good partial (six of 13) or complete (seven of 13) response before stem-cell mobilization with cyclophosphamide 3 g/m2 and filgrastim 300 microg once daily.

RESULTS

Eleven of 13 patients had a detectable t(14;18) by nested polymerase chain reaction (PCR). Median CD34+ count before selection was 2.9 x 10(6)/kg (range, 1.17 to 11.3) and after CD34+ selection was 1.54 x 10(6)/kg (range, 0.88 to 7.6) with a median CD34+ yield of 62.4% (range, 17% to 95%) and purity of 60% (range, 39.3% to 73%). Of the 11 patients known to have t(14;18), 10 had PCR-detectable contamination of stem-cell harvests that became PCR negative in six of the 10 after CD34+ selection. Engraftment was rapid with a median day to absolute neutrophil count (ANC) greater than 0.5 x 10(9)/L of 13 days (range, 11 to 21) and platelet count greater than 20 x 10(9)/L of 14 days (range, 10 to 44). With a median follow-up duration of 15 months, three patients have remained persistently PCR-positive, two of whom received PCR-positive stem cells. Two have relapsed. Of the seven patients who received PCR-negative stem cells, five have had no PCR-detectable disease in posttransplant bone marrow samples.

CONCLUSION

Longer follow-up duration is required to determine the significance of these findings, but we have confirmed the feasibility of CD34+ selected cells to deplete peripheral-blood stem cells of tumor cells from patients undergoing high-dose therapy for follicular lymphoma.

Helical computed tomography in the assessment of abdominal aortic pathology

A pilot study was undertaken to evaluate the role of helical computed tomography in the assessment of abdominal aortic pathology. A total of 17 patients underwent intra-arterial digital subtraction of angiography (IADSA) and helical computed tomography, with eight patients undergoing subsequent operative intervention. A comparison of radiological findings between IADSA and helical computed tomography (CT) was made and, where applicable, a comparison was made with operative findings. Pathology included abdominal aortic aneurysm (AAA) (n = 12), thoraco-abdominal aneurysm (n = 2) and dissection (n = 1), graft distension following AAA repair (n = 1) and plaque haemorrhage in the distal aorta following percutaneous transluminal angioplasty (PTA) of the iliac artery (n = 1). Planned operative management as based on pre-operative helical CT imaging findings, in particular with reference to the type of graft used (straight or bifurcated) was not changed at operation. Our findings on helical CT in regards to AAA, thoroco-abdominal aneurysm and dissection correlated well with angiography and surgery findings.

Molecular characterization of a gene encoding a membrane protein of Spiroplasma citri

A 9.6-kb genomic DNA segment, previously cloned from the phytopathogen Spiroplasma citri BR3-3X [Fletcher et al. (1981) Phytopathology 71, 1073-1080], contained several open reading frames including one encoding a 58-kDa protein. In this work, the transcription initiation site of the P58 mRNA was mapped and part of the gene was expressed in Escherichia coli as a fusion protein. A synthetic peptide, whose sequence is included in the fusion protein, was produced. Antibodies against both the fusion protein and the peptide reacted with a 60-kDa protein in a S. citri total protein extract. Hydrophobicity characteristics of this protein and its fractionation into the detergent phase indicated that P58, which shares limited sequence similarity with the adhesin of Mycoplasma hominis and the attachment protein of M. genitalium, is an integral membrane protein.

Reviews

PRESSURE SORE PREVENTION

RESEARCH MINDEDNESS FOR PRACTICE: AN INTERACTIVE APPROACH FOR NURSING AND HEALTH CARE

Pressure-relieving equipment: criteria and selection

The selection of equipment for pressure sore prevention and management is extremely complex, with many variables to consider. There is a considerable lack of data to support the use of individual pieces of equipment, and so additional criteria need to be considered. A logical approach, taking into account the objectives of treatment, the modality of action, and the resources available, enables an optimal choice to be reached which should satisfy both the patient and the staff involved.

Accessory lung lobe torsion and chylothorax in an Afghan hound

Torsion of the accessory lung lobe is extremely rare and has been reported only in one human. Accessory lung lobe torsion (LLT) and chylothorax occurred in a 3.5-year-old, male Afghan hound. An exploratory thoracotomy was used to remove the torsed lung lobe. When medical management of the chylous effusion failed, thoracic duct ligation was performed, resulting in resolution of the effusion. The dog remains clinically healthy 29 months postoperatively.

Do nurses really care? An agenda for higher education following recent mergers

This paper considers how the mergers of colleges of nursing into higher education may offer an opportunity to address the situation revealed in a previous paper, which suggested that nursing as practised, rather than as theorized, fails to live up to its claim to be regarded consistently as a caring profession. The economic position in which higher education currently finds itself, and which impacts on mergers, is summarized before reforms to nurse education are considered, in terms of their implications for students, staff, research, and the courses themselves. The agenda for change is substantial and urgent. The paper concludes by maintaining that the absorption of colleges of nursing into higher education is to be seen, not as a threat, but as an unprecedented opportunity for nursing to begin to realize fully its professional aspirations.

Interactions between periodontopathogenic bacteria and cytokines

Cytokines produced in response to plaque bacteria clearly play a key role in the periodontal diseases. However, we know very little about the interactions between cytokines and periodontopathogenic bacteria. The aims of this study were to determine whether the key pro-inflammatory cytokines interleukin-1 beta (IL-1 beta) and IL-6 could affect the growth of Actinobacillus actinomycetemcomitans or Porphyromonas gingivalis and to determine whether these organisms could hydrolyse IL-1 beta, IL-6 or the anti-inflammatory IL-1 receptor antagonist (IL-1ra). Culture medium containing up to 100 ng/ml of IL-1 beta or IL-6 was inoculated with A. actinomycetemcomitans (serotypes a, b and c) or P. gingivalis and growth was monitored by measuring changes in electrical conductivity every 3 min for up to 48 h. IL-1 beta, IL-6 or IL-1ra were added to culture supernatants and incubated for up to 24 h. Samples were taken at various times, analysed by SDS-PAGE and the separated proteins transferred by Western blotting to PVDF membranes and probed with anti-cytokine antibodies. None of the cytokines tested had any effect on the rate of growth or yield of A. actinomycetemcomitans or P. gingivalis. Supernatants from P. gingivalis cultures, but not those from A. actinomycetemcomitans, hydrolysed IL-1 beta, IL-6 and IL-1ra. The hydrolysate from the P. gingivalis supernatant-treated IL-1 beta was unable to stimulate the release of IL-6 from human gingival fibroblasts showing that it had lost biological activity. These results suggest that P. gingivalis can perturb the cytokine network, not only by stimulating the release of cytokines from host cells, but also by removing them from its local environment.

Phonological processing skills in speech and language impaired children

Phonological processing has been shown by many researchers to be strongly related to the acquisition of reading and spelling skills. Children with speech and language impairment appear to be at increased risk for phonological processing problems and hence literary difficulties. However, not all children with speech and language impairment experience difficulties: the literature is not clear as to which groups of speech and language impaired children are most severely affected nor which aspects of phonological processing are most likely to be impaired. Rigorous subject selection was employed to compare the performance of four groups of 20 children, aged approximately 6 years: speech-impaired (Speech); language-impaired (Language); speech and language impaired (Mixed); and children with normally developing language (Normal), by use of a battery of phonological processing tasks. The results supported the research that has shown speech and language impaired children to have weaker phonological processing skills than the general population. All the subjects in this sample appeared to be at risk: the Mixed children demonstrated the most difficulty, followed by the Language group, with the Normal group performing the best. Whilst the Speech group as a whole performed significantly more poorly than the Normal group, it consisted of two levels of performance which, on post hoc analysis were shown to relate to the pattern of speech impairment exhibited by the child.

Ex vivo neutrophil function in response to three different doses of glycosylated rHuG-CSF (Lenograstim)

Granulocyte colony-stimulating factor (G-CSF) is being considered as adjuvant treatment for infections in non-neutropenic patients. Normal healthy donors were given rHuG-CSF (Lenograstim) at 2.5, 5.0 and 7.5 micrograms/kg subcutaneously daily for 5 d. Polymorphonuclear leucocyte (PMN) function tests were carried out on peripheral blood PMN before the first injection and at 24 h and 96 h. Circulating PMN levels were also measured at these time intervals and found to be significantly increased with all doses by 24 and 96 h. Investigation of cell surface antigen expression revealed no changes in beta 2 integrin (CD11b/ CD18) expression. L-selectin (CD62L) expression was reduced with all doses by 96 h, this being significant with the 7.5 micrograms/kg dose. Fc gamma RI (CD64) levels were significantly up-regulated with the 7.5 micrograms/kg dose by 96 h whereas Fc gamma RIII (CD16) expression was found to be reduced during G-CSF treatment. Superoxide anion production was significantly increased in response to N-formylmethionyl-leucylphenylalanine (FMLP) and opsonized Staphylococcus epidermidis stimulation at 24 h and 96 h with the 5.0 and 7.5 micrograms/kg doses. The initial rate of phagocytosis (0-2 min) appeared to have increased with the 7.5 and 5.0 micrograms/kg doses at 96 and 24 h compared with PMN responses pretreatment, although these increases were not statistically significant. These results show that G-CSF enhances the functional responses of PMN stimulated by physiological agnonists and may help in the treatment of infections.

Do nurses really care? Some unwelcome findings from recent research and inquiry

This paper examines the position of nursing as a caring profession, in terms of an ethical code that stresses collegial relationships, a sense of obligation to a clientele that is realized in terms of expert service, and a clearly defined body of research-derived knowledge as the basis for practice. It also investigates the substance of the claim that nursing has tended to arrogate to itself another operational distinction-its exclusive capacity to blend physical and emotional support into care. A review of recent research and investigation, undertaken in a number of countries, suggests that nursing as practiced, rather than as theorized, fails to fulfil its wider professional aspirations, and to fulfil its caring rhetoric. A related paper will consider how the absorption of nursing into higher education might begin to play a part in developing and consolidating the professionalization of nursing.

Auditory selective attention: an fMRI investigation

In the present experiment, 25 adult subjects discriminated speech tokens ([ba]/[da]) or made pitch judgments on tone stimuli (rising/falling) under both binaural and dichotic listening conditions. We observed that when listeners performed tasks under the dichotic conditions, during which greater demands are made on auditory selective attention, activation within the posterior (parietal) attention system and at primary processing sites in the superior temporal and inferior frontal regions was increased. The cingulate gyrus within the anterior attention system was not influenced by this manipulation. Hemispheric differences between speech and nonspeech tasks were also observed, both at Broca's Area within the inferior frontal gyrus and in the middle temporal gyrus.

A phase I trial to assess the value of recombinant human granulocyte colony stimulating factor (R-MeTHuG-CSF, filgrastim) in accelerating the dose rate of chemotherapy for intermediate and high-grade non-Hodgkin's lymphoma (NHL). The Central Lymphoma Group

In a multi-centre phase I study we investigated the possibility of reducing the interval between courses of standard CHOP (cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, vincristine 2 mgs day 1, and prednisolone 40 mg/m2 days 1-8) from 21 days to 15 days and then 10 days using granulocyte colony stimulating factor (r-MetHuG-CSF (Amgen)-filgrastim) to accelerate neutrophil recovery. Patients received CHOP followed by G-CSF 5 micrograms/kg s.c. from day 2 to the day before the next course (e.g. days 2-14 for the 15-day interval). A total of 28 patients with newly diagnosed intermediate grade or high grade NHL were studied. Four patients were studied at a 21-day interval, six patients were treated at a 15-day interval and subsequently six patients at a 10-day interval. Following analysis of this initial cohort, a further 12 patients were evaluated; four at the 15-day interval, and eight at the 10-day interval. No dose-limiting toxicity was seen in the four patients receiving 21-day CHOP. Dose-limiting toxicity was seen in 4/10 patients treated at the 15-day interval (M:F 7:3, median age 55.5, range 39-67 years). This consisted of infection in two patients, recurrent infection and debility in a third, and mucositis in a fourth. Seven patients experienced one or more infectious episodes requiring antibiotics (median number of episodes: 2, range 1-4). Fourteen patients (M:F 4:3, median age 47.5, range 25-63 years) were treated at the 10-day interval. Dose-limiting toxicity was seen in six patients. This consisted of severe mucositis in three patients, neutropenia and thrombocytopenia on two separate occasions in one patient, and steroid-induced gastritis in two patients. Nine patients had one or more documented infections (median: 2, range 1-3) requiring antibiotics, of which six were severe (WHO grade 3 or 4). One patient died of Pneumocystis carinii (PCP) pneumonia. In summary, G-CSF (filgrastim) will facilitate the shortening of the dosage interval between cycles of CHOP chemotherapy due to accelerated hematological recovery. However, non-hematological toxicity due to the shorter dosage interval is increased and infective episodes are frequent.

Day surgery and community health services work load: a descriptive study

This prospective descriptive study of primary health care workload in the five days after day surgery is based on a questionnaire to patients who received day surgery in a specialist unit in Oxford. Half of all patients received health care, the mean consultation time was 16 minutes, and half the consultations were within two days of surgery.

Hydrogen peroxide generation by polymorphonuclear leukocytes exposed to peritoneal dialysis effluent

In the presence of peritoneal dialysis effluent (PDE), human polymorphonuclear leukocytes (PMN) showed reduced production of hydrogen peroxide and hypochlorous acid (H2O2 and HOCl, respectively) when at rest and when stimulated with both soluble (formylmethionyl-leucyl-phenylalanine and phorbol myristate acetate) and particulate (Staphylococcus epidermidis) agonists. This effect occurred in a concentration-dependent manner between 0 and 70%. (vol/vol) dialysis effluent. The inhibition of H2O2 and HOCl observed in resting, formy-methionylleucyphenyalanine-stimulated, and S. epidermidis-stimulated PMN was confined to a low-molecular-mass (< 10,000-Da) fraction of PDE, whereas the inhibition of the PMA response was equally dispersed throughout both low (< 10,000-Da)- and high-molecular-mass (> 10,000-Da) fractions. Human serum albumin, a major component of PDE, also inhibited H2O2 and HOCl production by PMN; however, results from cell-free systems suggested that human serum albumin was not wholly responsible for the inhibition of PMN function seen with PDE. The solute(s) responsible did not affect myloperoxidase but very rapidly scavenged H2O2 and HOCl. These data suggest that the factors capable of affecting H2O2 and HOCl production by PMN accumulate in uremia and are removed from the circulation into dialysis effluent.

Extensive chromosome aberrations in Spiroplasma citri Strain BR3

Genetic variations in the plant pathogen, Spiroplasma citri strain BR3, were characterized through physical genome mapping of the original isolate, BR3-3X, and two derivatives, BR3-T and BR3-G, obtained after several years of different maintenance conditions. BR3-T was transmitted from plant to plant via its natural insect vector, the leafhopper Circulifer tenellus, while BR3-G was maintained only in plants by periodic grafting and has lost its ability to be insect transmitted. By pulsed field gel electrophoresis (PFGE) analysis and DNA hybridization, extensive changes in chromosomal DNA restriction patterns relative to the parent, BR3-3X, were observed in both BR3-T and BR3-G, each of which also had a larger genome size than the parent line. Genetic organization was relatively conserved between BR3-T and BR3-3X. In contrast, a large chromosomal inversion and deletions of approximately 10 kb near each of the inversion borders were observed in BR3-G. One of the deletions, which included several possibly functional genes, was closely linked to a SpV1-related transposase gene. The locations of the deletion borders were also determined. The results of this study demonstrated remarkable genome instability of spiroplasmas.

Types of pressure-relieving equipment available: 2

This is the second article in a two-part series. The first article reviewed the mode of action of the different types of equipment. This article examines some of the evidence behind the design and suggests selection criteria to assist when choosing individual items of pressure-relieving equipment. By presenting a broader view it is hoped to guide the reader through a logical approach considering all of the variables, thus enabling the selection of the optimum piece of equipment.

The principles of pressure sore prevention

This article describes the main causes of pressure sore development and discusses the principles of pressure sore prevention. It relates to UKCC Professional Development categories: Reducing risk and Care enhancement.

Types of pressure-relieving equipment available: 1

This is the first of two articles which consider the practical difficulties in selecting pressure-relieving devices for patients. The selection of pressure-relieving equipment has become increasingly difficult as the number of commercially available products rises. This article reviews the modes of action of the equipment, including alternating pressure and constant low pressure, outlining the differences between individual pieces of equipment. It will also include a brief summary of the factors which are important to acknowledge when selecting seating.