Clostridium perfringens sepsis and liver abscess following laparoscopic cholecystectomy

Clostridium perfringens sepsis with intravascular haemolysis is a catastrophic process with a reported mortality of between 90 to 100%. We successfully treated a case of severe clostridial infection with a liver abscess following laparoscopic cholecystectomy, the first to our knowledge. A 59-year-old man presented one week after an uneventful laparoscopic cholecystectomy with jaundice, peritonism, sepsis and acute renal failure. He was found to have a haemolytic anaemia, unconjugated hyperbilirubinemia and blood cultures grew Clostridium perfringens. A CT revealed a large gas forming abscess in the gallbladder fossa and right lobe of liver. He was treated with directed antibiotic therapy and underwent emergency laparotomy, drainage of the abscess and peritoneal washout. He required intensive care support, parenteral nutrition and inotropic support for a limited period. CT liver angiogram post op was normal. Continued renal dysfunction necessitated protracted haemofiltration. This resolved and the patient was discharged home at 2 months.

A new technique for assessing renal transplant perfusion preoperatively using contrast-enhanced ultrasound (CEUS) and three-dimensional ultrasound (3DUS)--a porcine model pilot study

PURPOSE

This pilot study aims to assess the viability of using contrast-enhanced ultrasound (CEUS) in renal grafts while they are on hypothermic perfusion machines prior to transplantation. We assessed the vascularity and renal perfusion of machine-perfused porcine kidneys (Maastricht category II) using CEUS.

MATERIALS AND METHODS

Five kidneys were placed on hypothermic machine perfusion for up to 24 hours after retrieval. The kidneys were then scanned with a low MI contrast-specific preset and a bolus of 0.5 ml of Sonovue contrast agent was administered. Contrast-specific ultrasound images of the kidney were acquired in 2D and 3D.

RESULTS

The five kidneys demonstrated variable flow rates on the perfusion machine (10 - 37 ml/min at 30 mmHg). The CEUS technique demonstrated good perfusion and flow patterns, similar to those seen in vivo, in four kidneys. One kidney had patent arteries up to the interlobar region but no contrast filling in the cortex or medulla. Small perfusion defects were seen in two of the perfused kidneys.

CONCLUSION

CEUS appears to be a viable technique for assessing global perfusion and small defects within kidneys prior to transplantation. The flow patterns seen in vitro appear to correspond to those seen in vivo. Further work is required to evaluate the relevance of the flow dynamics measured.

Real-time monitoring of the Bragg-peak position in ion therapy by means of single photon detection

For real-time monitoring of the longitudinal position of the Bragg-peak during an ion therapy treatment, a novel non-invasive technique has been recently proposed that exploits the detection of prompt gamma-rays issued from nuclear fragmentation. Two series of experiments have been performed at the GANIL and GSI facilities with 95 and 305 MeV/u (12)C(6+) ion beams stopped in PMMA and water phantoms. In both experiments, a clear correlation was obtained between the carbon ion range and the prompt photon profile. Additionally, an extensive study has been performed to investigate whether a prompt neutron component may be correlated with the carbon ion range. No such correlation was found. The present paper demonstrates that a collimated set-up can be used to detect single photons by means of time-of-flight measurements, at those high energies typical for ion therapy. Moreover, the applicability of the technique both at cyclotron and at synchrotron facilities is shown. It is concluded that the detected photon count rates provide sufficiently high statistics to allow real-time control of the longitudinal position of the Bragg-peak under clinical conditions.

D-Cycloserine and Early Ethanol Exposure in Developing Rats

Pregnant rats were exposed to one of the following treatments: 20% aqueous sucrose (w/v; Control), 20% aqueous sucrose with 20 mg D-cycloser-ine (DCS), 20% aqueous sucrose with 5% ethanol (ETH), or 20% aqueous sucrose with both 20 mg DCS and 5% ethanol (DCS + ETH). Treatments were delivered in 20 ml of drinking water provided daily, as pilot work had determined that this was the average daily water consumption for female rats. Treatments began on Day 10 or 11 of pregnancy and terminated on postnatal Day 10. As juveniles, offspring were tested for activity in an open field and motor coordination using a rotating rod. Ethanol and DCS+ Ethanol groups were the most active groups in the open field, and DCS and DCS+ Ethanol groups had fewer falls than the Control and Ethanol groups on the rod test. Results suggest that DCS might provide protection from ethanol's adverse effects on some developmental behaviors.

The role of parents' sense of coherence in irregular meal pattern and food intake pattern of children aged 10-11 in Finland

BACKGROUND

Among adults, a stronger sense of coherence (SOC) seems to promote a better coping with strain and is associated with healthier behaviours, including eating patterns. The parents' SOC may also have a wider effect on the health behaviour of their children. The aim of this study is to determine whether there are associations between parents' SOC and the eating patterns of their children and if this can be explained by mediating factors.

METHODS

Cross-sectional. In 2006, 1268 (response rate 79%) 10- and 11-year-old children in southern Finland, in a classroom situation, filled in a questionnaire assessing meal pattern and food frequency intake. Parents, 816 (response rate 64%), filled in a questionnaire assessing SOC (13 items) and eating patterns. Matching data were found from 772 child-parent pairs. chi(2) tests, factor analysis, univariate analysis of variance and logistic regression analyses were used as statistical methods.

RESULTS

A weaker parental SOC was associated with children's irregular meal pattern (p = 0.004), more frequent intake of energy-rich foods (p = 0.002) and less frequent intake of nutrient-rich foods (p = 0.051). Mediating factors, such as availability and accessibility of fruit and vegetables at home, parent's nutrition knowledge, parents' own fruit and vegetable intake and an irregular meal pattern, explained the association between parents' SOC and children's intake of nutrient-dense foods, but not the association with energy-rich foods.

CONCLUSIONS

Parents' weaker SOC was associated with children's unhealthier eating patterns. More research is needed on the associations between parents' SOC and other health-related behaviours in their children.

Fission time measurements: a new probe into superheavy element stability

Reaction mechanism analyses performed with a 4pi detector for the systems 208Pb + Ge, 238U + Ni and 238U + Ge, combined with analyses of the associated reaction time distributions, provide us with evidence for nuclei with Z=120 and 124 living longer than 10(-18) s and arising from highly excited compound nuclei. By contrast, the neutron deficient nuclei with Z=114 possibly formed in 208Pb + Ge reactions have shorter lifetimes, close to or below the sensitivity limit of the experiment.

Temporal and spatial patterns of Bartonella infection in black-tailed prairie dogs (Cynomys ludovicianus)

We describe the temporal dynamics and spatial distribution of Bartonella in black-tailed prairie dogs (Cynomys ludovicianus) based on a longitudinal study conducted in 20 black-tailed prairie dog (BTPD) colonies in Boulder County, CO from 2003 to 2005. Bartonella infection was widely distributed in all colonies with an overall prevalence of 23.1%, but varied by colony from 4.8% to 42.5% and by year from 9.1 to 39.0%, with a marked increase in Bartonella activity in 2005. Levels of bacteremia varied from 40 to 12,000 colony forming units (CFU) per milliliter of BTPD blood, but were highly skewed with a median of 240 CFU. Bartonella infection rates were unimodal with respect to BTPD body mass, first increasing among growing juveniles, then declining among adults. Infection rates exhibited a sigmoidal response to body mass, such that 700g may prove to be a useful threshold value to evaluate the likelihood of Bartonella infection in BTPDs. Bartonella prevalence increased throughout the testing season for each year, as newly emerged juveniles developed bacteremia. Data from recaptured animals suggest that Bartonella infections did not persist in individual BTPDs, which may explain the relatively low prevalence of Bartonella in BTPDs compared to other rodent species. No association was found between Bartonella prevalence and host population density. Prevalence did not differ between males and females. The spatio-temporal pattern of Bartonella infection among colonies suggests epizootic spread from northern to central and southern portions of the study area. The potential significance of the BTPD-associated Bartonella for public health needs to be further investigated.

Movement of bromacil in a Hawaii soil under pineapple cultivation - a field study

Recent discovery of low concentrations of bromacil in drinking water prompted the State of Hawaii to examine the leaching behavior of bromacil in pineapple fields. This study is a follow up to earlier work on bromacil concentrations in soil profiles in a pineapple field in central Oahu, Hawaii. Soil samples were collected for bromacil analysis at different times prior to and after application from a pineapple field that was previously surveyed by other research workers. The leaching pattern of bromacil was further investigated at two different application rates (2.25 and 1.8 kg ha(-1)). The concentration of bromacil in the topsoil about 100 days after bromacil application (1.8 kg ha(-1)) was substantially higher in 2002 compared to 1999. The distribution profiles were generally consistent with the one presented in the previous study. Residual bromacil was present in the entire sampled zone (3m deep) about 18 months after the previous bromacil application. Over a period of 9 months, there was substantial dissipation of bromacil residue present in the topsoil. The residual concentration of bromacil in the area that received the reduced application rate (1.8 kg ha(-1)) were lower than those receiving the current application rate (2.25 kg ha(-1)) and the depth of penetration of the bromacil front was shallower at the reduced application rate. Because of the common practice of placing plastic mulch around the base of the pineapple plants to retain volatile nematicides, the applied bromacil was found to be concentrated in the areas between the plastic mulch, transported by runoff from the plastic. The study results encourage the use of less than the label led rate of application of bromacil for pineapple fields.

Climate-driven spatial dynamics of plague among prairie dog colonies

We present a Bayesian hierarchical model for the joint spatial dynamics of a host-parasite system. The model was fitted to long-term data on regional plague dynamics and metapopulation dynamics of the black-tailed prairie dog, a declining keystone species of North American prairies. The rate of plague transmission between colonies increases with increasing precipitation, while the rate of infection from unknown sources decreases in response to hot weather. The mean annual dispersal distance of plague is about 10 km, and topographic relief reduces the transmission rate. Larger colonies are more likely to become infected, but colony area does not affect the infectiousness of colonies. The results suggest that prairie dog movements do not drive the spread of plague through the landscape. Instead, prairie dogs are useful sentinels of plague epizootics. Simulations suggest that this model can be used for predicting long-term colony and plague dynamics as well as for identifying which colonies are most likely to become infected in a specific year.

Tobacco and tuberculosis: a qualitative systematic review and meta-analysis

OBJECTIVES

To assess the strength of evidence in published articles for an association between smoking and passive exposure to tobacco smoke and various manifestations and outcomes of tuberculosis (TB). Clinicians and public health workers working to fight TB may not see a role for themselves in tobacco control because the association between tobacco and TB has not been widely accepted. A qualitative review and meta-analysis was therefore undertaken.

METHODS

Reference lists, PubMed, the database of the International Union Against Tuberculosis and Lung Disease and Google Scholar were searched for a final inclusion of 42 articles in English containing 53 outcomes for data extraction. A quality score was attributed to each study to classify the strength of evidence according to each TB outcome. A meta-analysis was then performed on results from included studies.

RESULTS

Despite the limitations in the data available, the evidence was rated as strong for an association between smoking and TB disease, moderate for the association between second-hand smoke exposure and TB disease and between smoking and retreatment TB disease, and limited for the association between smoking and tuberculous infection and between smoking and TB mortality. There was insufficient evidence to support an association of smoking and delay, default, slower smear conversion, greater severity of disease or drug-resistant TB or of second-hand tobacco smoke exposure and infection.

CONCLUSIONS

The association between smoking and TB disease appears to be causal. Smoking can have an important impact on many aspects of TB. Clinicians can confidently advise patients that quitting smoking and avoiding exposure to others' tobacco smoke are important measures in TB control.

Lemierre's syndrome complicating pregnancy

Lemierre's syndrome is an anaerobic suppurative thrombophlebitis involving the internal jugular vein secondary to oropharyngeal infection. There is only one previous case report in pregnancy which was complicated by premature delivery of an infant that suffered significant neurological damage. We present an atypical case diagnosed in the second trimester with a live birth at term. By reporting this case, we hope to increase the awareness of obstetricians to the possibility of Lemierre's syndrome when patients present with signs of unabating oropharyngeal infection and pulmonary symptoms.

Biomedical engineering degrees at Lyon 1 University

Biomedical diploma degrees have a long tradition at Lyon 1, Claude Bernard University. Since 2004, the transition towards the LMD system leaded to a unified Bachelor and Master Degree in Biomedical Engineering. A next evolution plans the creation of a Biomedical Engineering Department in the future Polytechnic School of Claude Bernard University. This department will form professionals in Biomedical Engineering, Medical Physics and for academic employment in Universities and research structures.

The role of medial prefrontal cortex in context-specific inhibition during reversal learning of a visual discrimination

Rats with medial prefrontal cortex or sham lesions were trained on a visual discrimination task designed for the eight-arm radial maze. After reaching asymptotic performance on this task, both groups were divided into sub-groups that would experience reversal learning in the same or different context from original training. The results showed that both groups reversed in the different context had accelerated learning compared to the groups reversed in the same context. Reversal learning in rats with medial prefrontal cortex damage was faster than sham animals in the same context. These and other results from a transfer test suggest that the medial prefrontal cortex participates in the behavioral effects of a context-specific inhibitory association acquired during visual discrimination learning.

Microwave endometrial ablation for menorrhagia: outcome at 2 years--experience of a district general hospital

One hundred and twenty-three women underwent microwave endometrial ablation (MEA) for the treatment of dysfunctional uterine bleeding (DUB). The mean age at treatment was 40.2 years and the average treatment time was 2 minutes 50 seconds. All patients stayed as day cases, except for two who stayed overnight, one due to pain and the other due to urinary retention. The follow-up was carried out at 6 months, 1 and 2 years, respectively. The success rate was 80%, 76% and 70% at 6 months and 1-year and 2-year follow-up. The patient satisfaction rate was 80%, 75% and 68% at 6 months, 1 year and 2 years, respectively. However, in women 45 years old and over the success rate was more than 90%, suggesting that MEA could be a preferred procedure for treatment of DUB in this age group compared to younger women, especially in those who do not benefit from the mirena intrauterine system or decline it. Approximately 70% of patients, who underwent hysterectomy due to the failure of treatment, had uterine/pelvic pathology in the form of adenomyosis, fibroid uterus or endometriosis; therefore prior to MEA, proper patient selection is vital. There were a few minor complications but no uterine perforation or emergency hysterectomies in the group studied.

Reduction of hematotoxicity and augmentation of antitumor efficacy of cyclophosphamide by dopamine

Modulatory effects of dopamine (DA) on hematotoxicity and antitumor efficacy of cyclophosphamide (CY) were studied in Swiss mice bearing transplantable Ehrlich ascites carcinoma (EAC). DA was administered i.p. at a dose of 50 mg/kg/day for 5 consecutive days beginning day 3 after tumor transplantation. CY (200 mg/kg i.p.) was injected 24 hour after completion of DA treatment. DA pretreatment reduced the suppressive effects of CY on hemoglobin, RBC, total WBC, neutrophil, platelet, and bone marrow nucleated cell counts. Likewise, DA partially prevented the CY-induced fall in pluripotent (CFU-S12) and lineage-specific stem cells for granulocytes (CFU-C) in bone marrow. Moreover, mice receiving a combination of DA and CY illustrated greater reduction in tumor volume, viable tumor cell count and mitotic index along with upregulation of tumor cell apoptosis than CY-only group. As a result, the former group demonstrated prolonged hosts survival. Thus, DA protected to a great extent the hematopoietic cells of tumor bearing hosts from the suppressive action of CY and concomitantly augmented its antitumor efficacy resulting in improved hosts survival.

Metal-insulator transitions in an expanding metallic fluid: particle formation kinetics

Core-level photoemission spectroscopy provides a local probe of expansion dynamics and associated transient chemical properties as a highly pressurized, metallic fluid expands into vacuum following impulsive heating of a semiconductor by an intense, ultrashort laser pulse. Transient photoemission peak shifts reveal that metal-insulator transitions occur rapidly following laser heating. These experiments probe constituents species and solidification kinetics occurring in the early moments of material ejection and provide insight into how particles arise in the current laser ablation regime.

Measurement of vacuum-assisted photoionization at 1 GeV for Au and Ag targets

We report a measurement of photon impact ionization of K and L shell of Au and K shell of Ag targets in the 1-GeV energy range. We show that the cross section is dominated by a contribution from a new channel called vacuum-assisted photoionization. In this process the energy-momentum balance associated with the removal of the innershell electron is obtained by conversion of a high-energy photon into an electron-positron pair. This measurement is consistent with the theoretical prediction that vacuum-assisted photoionization is the most probable ionization mechanism at very high energies.

Decrease in platelet serotonin level in uterine cervix cancer patients

Platelet serotonin (5-HT) concentration was measured by HPLC with electrochemical detection in 46 women suffering from cancer of the uterine cervix and 16 matched controls. About 53% reduction (p < 0.05) was recorded in platelet 5-HT level in cancer patients against a control value of 1.29 +/- 0.16 (mean +/- S.E.) nmol per 10(9) platelets. Depletion of intraplatelet 5-HT was positively correlated with clinical stage of the disease although a modest rise (p > 0.05) in platelet 5-HT was observed in patients at stage I. Serotonin release from platelets following activation with thrombin was considerably increased in cancer patients (38.2% compared to 17.4% in controls). The results demonstrate progressive depletion of intraplatelet 5-HT in cervical cancer patients. In addition, their platelets release more 5-HT than the controls upon activation by thrombin.