Optimization of environmental factors for the biological treatment of trinitrotoluene-contaminated soil

In earlier studies (Boopathy et al. 1994a, 1994b), soil bacteria present in a TNT-contaminated site removed 2,4,6-trinitrotoluene (TNT). In this study the optimum conditions for the most efficient removal of TNT is discussed. The results suggest that the soil bacterial consortium has an optimal pH range of 6-7. Maximum growth was observed at pH 7. However, the TNT removal rate was higher at pH 6. Studies of the effects of temperature showed that the bacterial consortium had maximum metabolic activity at 20 to 22 degrees C (ambient temperature). At a higher temperature (37 degrees C) the TNT removal rate dropped significantly. The consortium could not use TNT as a nitrogen source but required the addition of ammonium. Optimal growth occurred with 0.25 g/L of ammonium chloride. Growing cells removed TNT significantly faster rates than resting cells or cell-free extract. The operation of soil slurry reactors with the optimal conditions suggested that TNT can be removed effectively from the contaminated sites. These environmental conditions established as optimal can be used to improve the efficiency of large-scale soil slurry reactors for the treatment of soil contaminated with TNT.

Selective cytotoxicity of lithium gamma-linolenic acid in human T cells chronically and productively infected with HIV

We sought to extend observations of lithium gamma-linolenic acid (LiGLA)-associated selective cytotoxicity in different models of chronic HIV infection in vitro. In our initial experiments, 8E5, 8E5L and A3.01 cells were allowed to proliferate in the presence of 0-20 microg/ml LiGLA for 4 days. Similarly, OM-10.1 cells (with or without prior stimulation with tumour necrosis factor-alpha (TNF-alpha)) were grown with 0-5 microg/ml LiGLA for 10 days. Significant cytotoxicity was observed in productively infected 8E5 cells (100% cell death by day 2 at the highest concentration) as compared with latently infected 8E5L cells (50% cell death on days 2-4) and uninfected A3.01 cells. No drug-induced viral stimulation was observed in surviving cells. In fact, a mild direct antiviral effect may be present, independent of cytotoxicity. Maximum cytotoxicity to OM-10.1 cells was only observed when active viral replication was induced by TNF-alpha. Our preliminary results are encouraging and suggest that LiGLA should be retained as a candidate antiretroviral agent. Further work is underway to identify the specific mechanism underlying our observations.

Increased nailfold capillary dimensions in primary Raynaud's phenomenon and systemic sclerosis

The aim of the study was to measure nailfold capillary dimensions and capillary density in patients with primary Raynaud's phenomenon (PRP) and systemic sclerosis (SSc) compared to control subjects. Ten controls, nine patients with PRP and 10 patients with SSc were studied. All dimensions other than distance between limbs were significantly increased in both the PRP and SSc groups compared to controls (P < 0.01), with the SSc group showing the most marked increases (SSc vs PRP, P < 0.05 for all dimensions). Capillary density was significantly reduced in the SSc group compared to controls (P = 0.004). These results suggest that structural vascular changes occur in PRP as well as in SSc, and that PRP may, therefore, not be entirely benign.

Health across the life span: raising nursing student awareness in Australia

Quality nursing practice depends on knowledgeable and sensitive professional nurses. Nursing students, and ultimately the public they serve, benefit from learning experiences that enhance understanding of the physical and psychoemotional effects of aging and health dysfunctions across the life span. The Friends of the School of Nursing Program at The University of South Australia, City Campus, is a coalition between students and volunteers that provides students with the opportunity to participate in a variety of learning situations involving people of all ages and representing different health, social, and cultural backgrounds.

Intrathecal narcotics: new approach for labor analgesia

Injection of narcotics in the subarachnoid space is the most recent advancement in managing pain during childbirth. This article reviews the history of labor pain control and discusses the introduction of intrathecal narcotics (ITNs), including administration, side effects, and nursing care, in one birthing center. The responses of clients and nurses to ITNs are discussed.

Extramedullary plasmacytoma mimicking primary colonic carcinoma in a patient with Crohn's disease. Case report and literature review

We present the case of a 45-year-old man who underwent segmental resection for what was considered clinically to be a primary colonic carcinoma. Histopathologic evaluation revealed the tumor to be a malignant plasmacytoma of the colon. Additionally, the entire segment of distal ileum and colon was involved by an inflammatory process with the features of Crohn's disease, accompanied by focal glandular dyplasia of the colonic mucosa. This case reemphasizes that plasmacytoma of the colon can closely mimic carcinoma of the colon in its presentation. The association between plasmacytoma of the colon and Crohn's disease has not, to our knowledge, been described previously.

Australian registered nurse medical device education: a comparison of simple vs. complex devices

As the primary users of medical devices in direct patient care, registered nurses must be competent both with simple and complex devices because any device improperly used can have serious consequences. Results of a cross-sectional survey of registered nurses (n = 238) working at a large South Australian tertiary care centre on units with high usage both of indwelling urethral (Foley) catheters and intravenous infusion pumps revealed that participants were significantly more likely to have learned to use the indwelling urethral (Foley) catheter in nursing school than they were to have learned how to use an intravenous infusion pump. Participants differed significantly on most (13 of 17) items about what they learned, with nurses being more likely to learn various factors about the indwelling urethral catheter than the infusion pump. Registered nurses were more likely to feel stressed when using an intravenous infusion pump than when using an indwelling urethral catheter, but were more likely to have used an indwelling urethral catheter that caused a patient harm than an intravenous infusion pump that caused a patient harm. The most frequently identified reasons for incidents of patient harm resulting from use of an intravenous infusion pump were user error and inadequate device education. The most frequently identified reasons for incidents of patient harm resulting from use of an indwelling urethral catheter were the patient's condition, particularly confusion, user error, equipment malfunction, and inadequate device education.

Sustained-release transdermal glyceryl trinitrate patches as a treatment for primary and secondary Raynaud's phenomenon

A randomized, double-blind, placebo controlled, cross-over study was conducted to determine the clinical efficacy of and patient tolerance to sustained-release glyceryl trinitrate (GTN) patches in the treatment of Raynaud's phenomenon. The patients studied were those with primary Raynaud's disease (n = 21) and patients with Raynaud's phenomenon secondary to systemic sclerosis (n = 21). GTN patches (0.2 mg/h) were found to be effective in reducing the number (P < 0.05) and severity of Raynaud's attacks (P < 0.05) in both groups of patients. Objective assessments by infrared thermography did not show any significant improvement when the patients were on GTN patches (P > 0.05). Headaches, refractory to treatment, led to the withdrawal of eight patients from the study and occurred in approximately 80% of the remaining patients. Thus, in spite of the subjective efficacy, the frequent headaches will limit the use of GTN patches in Raynaud's phenomenon. Elucidating the mechanism of action of the beneficial and adverse effects of GTN at the molecular level may shed light on the pathogenesis of Raynaud's phenomenon and its treatment.

Reality based scenarios facilitate knowledge network development

The challenge in nursing education is to create a learning environment that enables students to learn new knowledge, access previously acquired information from a variety of disciplines, and apply this newly constructed knowledge to the complex and constantly changing world of practice. Faculty at the University of South Australia, School of Nursing, City Campus describe the use of reality based scenarios to acquire domain-specific knowledge and develop well connected associative knowledge networks, both of which facilitate theory based practice and the student's transition to the role of registered nurse.

Single-dose and steady-state pharmacokinetics of fosinopril and fosinoprilat in patients with hepatic impairment

The single-dose and steady-state pharmacokinetics of the angiotensin-converting enzyme (ACE) inhibitor fosinopril and its active diacid, fosinoprilat, were evaluated in 6 healthy volunteers and 12 patients with alcoholic cirrhosis. Fosinopril was administered at a dosage of 10 mg once daily for 14 days. Results in the two groups were similar, with no evidence of accumulation of fosinoprilat in hepatically impaired patients. Mean (+/- SD) maximum observed plasma concentrations of fosinoprilat in the healthy subjects were 112.0 +/- 67.2 ng/mL after the first dose and 144.1 +/- 61.7 ng/mL at steady-state. Corresponding values for the hepatically impaired patients were 111.4 +/- 40.1 ng/mL and 140.2 +/- 50.9 ng/mL. The area under the serum concentration versus time curve for healthy volunteers was 790.7 +/- 431.0 ng.hr/mL after the first dose and 940.3 +/- 400.4 ng.hr/mL at steady-state. Similar values were noted in hepatically impaired patients: 926.0 +/- 293.9 ng.hr/mL and 1,255.4 +/- 434.0 ng.hr/mL for first dose and steady-state, respectively. No statistically significant differences were detected in fosinoprilat pharmacokinetic values between healthy and hepatically impaired subjects. Absence of accumulation can be attributed to the dual route of elimination of fosinoprilat reported in previous studies. Renal excretion of fosinoprilat in hepatically impaired patients prevents increased accumulation. The present findings suggest that the starting dose of fosinopril used in hypertensive patients with normal renal and hepatic function can also be used in patients with hepatic impairment secondary to cirrhosis.

Effects of ankle braces upon agility course performance in high school athletes

The purpose of this study was to compare the effects of wearing the Aircast(TM) Sports Stirrup, Aircast(TM) Training brace, Swede-O(TM) brace, and DonJoy(TM) Ankle Ligament Protector while running an agility course. Eighty-five high school athletes with no history of ankle injury and no experience in wearing any ankle support served as subjects. Each subject participated in four separate testing sessions. During sessions 1 and 4, subjects ran the agility course under the control (unbraced) conditions. Sessions 2 and 3 consisted of randomly wearing the ankle braces while running the agility course. A questionnaire concerning support, comfort, and restriction was completed by each subject after wearing each of the braces. An analysis of variance (ANOVA) with repeated measures revealed that a significant difference existed between the agility times. Tukey's post hoc test indicated that a significant difference existed between each ankle brace and the control 2 agility times as well as a control 1 and control 2 time difference. The control time difference was attributed to a learning effect. An ANOVA with repeated measures of only the four braces revealed that a significant difference existed between the agility times. Tukey's post hoc test showed the only difference was between the DonJoy Ankle Ligament Protector and the Aircast Training brace. We concluded: 1) there is limited practical performance effect upon agility while wearing an ankle brace; and 2) an athlete's perceived comfort, support, and performance restriction are contributing factors that may directly influence the effectiveness of ankle bracing.

Inactivation of nitric oxide synthase after prolonged incubation of mouse macrophages with IFN-gamma and bacterial lipopolysaccharide

Large amounts of nitric oxide (NO) are produced by the inducible isoform of NO synthase (iNOS) in many cell types once the iNOS gene is transcriptionally activated. In primary mouse peritoneal macrophages elicited by thioglycolate broth, expression of iNOS follows treatment with IFN-gamma and is synergistically increased by the addition of bacterial LPS. Expression of iNOS is suppressible at transcriptional and translational levels by certain cytokines and microbial products. The present study describes a novel form of inactivation of iNOS that is post-translational and nondegradative. Mouse peritoneal macrophages cultured in the presence of IFN-gamma alone or IFN-gamma plus LPS rapidly depleted the medium of L-arginine, a substrate for iNOS, and stopped producing NO. Repletion of L-arginine permitted cells treated with IFN-gamma alone to resume NO production for at least 5 days, leading to the release of more NO than macrophages were previously believed capable of generating. L-Arginine repletion also boosted NO production by macrophages cultured for up to 2 to 3 days in the presence of IFN-gamma plus LPS, but thereafter, iNOS was inactive in these cells whether or not L-arginine was repleted. Activity of iNOS could be restored by adding both L-arginine and fresh IFN-gamma with or without LPS, likely reflecting the synthesis of new enzyme. However, the inactivation of iNOS seen late in culture with a single application of IFN-gamma plus LPS could be attributed neither to loss of iNOS protein nor to its autoinactivation by NO. Thus, LPS, a co-inducer of iNOS, causes macrophages to inactivate iNOS about 3 days after the onset of its induction. The mechanism, which remains to be identified, is novel for iNOS, in that it decreases neither its amount nor its apparent molecular mass.

Inactivation of nitric oxide synthase after prolonged incubation of mouse macrophages with IFN-gamma and bacterial lipopolysaccharide

Large amounts of nitric oxide (NO) are produced by the inducible isoform of NO synthase (iNOS) in many cell types once the iNOS gene is transcriptionally activated. In primary mouse peritoneal macrophages elicited by thioglycolate broth, expression of iNOS follows treatment with IFN-gamma and is synergistically increased by the addition of bacterial LPS. Expression of iNOS is suppressible at transcriptional and translational levels by certain cytokines and microbial products. The present study describes a novel form of inactivation of iNOS that is post-translational and nondegradative. Mouse peritoneal macrophages cultured in the presence of IFN-gamma alone or IFN-gamma plus LPS rapidly depleted the medium of L-arginine, a substrate for iNOS, and stopped producing NO. Repletion of L-arginine permitted cells treated with IFN-gamma alone to resume NO production for at least 5 days, leading to the release of more NO than macrophages were previously believed capable of generating. L-Arginine repletion also boosted NO production by macrophages cultured for up to 2 to 3 days in the presence of IFN-gamma plus LPS, but thereafter, iNOS was inactive in these cells whether or not L-arginine was repleted. Activity of iNOS could be restored by adding both L-arginine and fresh IFN-gamma with or without LPS, likely reflecting the synthesis of new enzyme. However, the inactivation of iNOS seen late in culture with a single application of IFN-gamma plus LPS could be attributed neither to loss of iNOS protein nor to its autoinactivation by NO. Thus, LPS, a co-inducer of iNOS, causes macrophages to inactivate iNOS about 3 days after the onset of its induction. The mechanism, which remains to be identified, is novel for iNOS, in that it decreases neither its amount nor its apparent molecular mass.

Fatty acid composition of low-density lipoprotein influences its susceptibility to autoxidation

Low-density lipoprotein (LDL) oxidation was studied using copper or the water-soluble initiator azobis(2-amidinopropane) dihydrochloride (ABAP) to catalyze the reaction. These studies were carried out with purified, native LDLs that had a well-defined composition and which contained different concentrations of polyunsaturated fatty acids (PUFA) and alpha-tocopherol. The LDL was obtained from nonhuman primates fed diets enriched in cholesterol and one of four types of fatty acids: saturated (Sat), monounsaturated (Mono), omega-6 (omega-6FA), or omega-3 (omega-3FA) fatty acids. The PUFA concentration of the LDLs depended upon the diet and had the following order: omega-6FA > Sat approximately Mono approximately omega-3FA. Linoleic acid was the predominant PUFA in all of the LDLs. The rates of oxidation were linearly dependent upon the concentration of PUFA. When ABAP was used to initiate oxidation the lag time was linearly related to the amount of alpha-tocopherol. However, with copper catalysis no linear correlation was evident. If the different enrichments were analyzed independently, it was found that copper-catalyzed oxidation of LDLs enriched with omega-6 and omega-3 fatty acids showed a linear correlation between the lag time and the amount of alpha-tocopherol but that LDLs enriched with Sat or Mono fatty acids did not show a correlation. These results demonstrate that the rate of oxidation is dependent upon PUFA concentration and that the ability of alpha-tocopherol to inhibit oxidation depends upon the lipid environment and the mode of initiation.

Proliferating cell nuclear antigen (PCNA) expression in chronic lymphocytic leukemia (CLL)

Chronic Lymphocytic Leukemia (CLL) is usually an indolent disorder which in some patients assumes an aggressive clinical course. In order to assess at presentation the prognosis of a given patient, several staging systems and prognostic variables have been proposed including the expression of the Proliferating Cell Nuclear Antigen (PCNA). PCNA is a 36 kd nuclear protein, the regulation of which is cell cycle-dependent. In CLL, PCNA levels correlate with cell proliferation, clinical stage and the lymphocyte doubling time (LDT). Furthermore, preliminary data suggests that PCNA expression may also predict response to Fludarabine-based chemotherapy. Since PCNA is a cofactor for Delta DNA polymerase, PCNA overexpression in CLL may also reflect the intrinsic DNA repair activity of the leukemic cells and thus their resistance to chemotherapy. Further studies aiming at modulation of PCNA expression in CLL cells may clarify this issue and may offer a future new therapeutic strategy with which to treat this disorder.

Technology assessment applied: a comparison of ophthalmic diagnostic techniques to detect diabetic retinopathy among Aboriginal people in central Australia

Diabetes mellitus is one of the non-communicable diseases that has accompanied Aboriginal exposure to Western life style. The prevalence of diabetes mellitus is higher in the Aboriginal population than in non-Aboriginal Australians (Holding, 1985) and many Aboriginals who have diabetes mellitus develop diabetic retinopathy. Early detection facilitates treatment and prevention of blindness, a sequela of diabetic retinopathy. This paper describes the use of technology assessment as a framework for comparing two diagnostic technologies, fundal camera and ophthalmoscope, for use with Aboriginal people in central Australia.

Prognostic value of proliferating cell nuclear antigen expression in chronic lymphoid leukemia

Chronic lymphocytic leukemia (CLL) is a usually indolent disease that can assume an aggressive clinical course in some patients. To develop assays that would be predictive of how a particular patient's disease would evolve, we studied the expression of proliferating cell nuclear antigen (PCNA) by Western blotting in 40 patients with CLL. The concentration of PCNA, a cofactor for delta DNA-dependent DNA polymerase, is indicative of the proliferative state of the cell. Significantly lower PCNA levels were observed in earlier stage CLL when compared with more advanced disease. The leukemic cell proliferative rate, assessed by lymphocyte doubling time and flow cytometry, also correlated significantly with the level of PCNA expression. These results suggest that a high level of PCNA in the cells of CLL patients at presentation identifies a subgroup of patients whose CLL cells have a higher proliferative activity and who may, therefore, have a potentially shorter survival.

Are gamma delta T cells important for the elimination of virus-infected cells?

Rhesus monkeys (Macaca mulatta) gamma delta T cells were identified using a monoclonal antibody. The relative representation of gamma delta T lymphocytes in the peripheral blood, lymph nodes, and spleen resembles that of Homo sapiens. The analysis of function and specificity revealed further significant similarities between the simian and human gamma delta T-cell systems. Since both human and monkey gamma delta T lymphocytes can effectively lyse cells infected with immunodeficiency viruses, it is possible that the primate gamma delta T-cell systems contribute to antiviral immunosurveillance.

A Comparison of Skin Interface Temperature Response Between the ProHeat Instant Reusable Hot Pack and the Standard Hydrocollator Steam Pack

The ProHeat(trade mark) reusable hot pack is being used increasingly as a substitute for the standard hydrocollator steam pack. This study evaluated the effects of these two modalities on skin temperature. Seventeen subjects were studied during separate 30-minute applications of a ProHeat pack with a wet barrier, a ProHeat pack with a dry barrier, a hydrocollator pack, and a control pack on their nondominant calf. We measured the skin interface temperature and pack surface temperature during each application with surface thermocouples. The skin interface temperature rise time to the minimum therapeutic temperature (104 degrees F) and the total time at and above the minimum therapeutic temperature, for each application, were analyzed using an analysis of variance (ANOVA) with repeated measures (p<.05). The ProHeat pack application, with one layer of wet toweling as a barrier, was not significantly different from the hydrocollator steam pack application. We conclude that the ProHeat pack, prepared with a wet barrier, can be considered a viable alternative to the standard hydrocollator steam pack.

Effect of anaerobic cecal microflora and dietary lactose on colonization resistance of layer chicks to invasive Salmonella enteritidis

The effect of oral inoculation with anaerobic cultures of cecal microflora and providing lactose in the feed on colonization resistance to invasive Salmonella enteritidis was evaluated in newly hatched leghorn chicks. Salmonella colonization of the ceca, tissue invasion and organ colonization, horizontal transmission, and seroconversion were significantly decreased (P less than 0.01) in chicks inoculated with cecal flora. The addition of lactose to the feed, in the absence of cecal microflora, failed to provide protection. Dietary lactose enhanced colonization resistance in chicks that were inoculated with anaerobic cultures of cecal flora. The results indicated that establishment of normal cecal flora in layer chicks together with the addition of lactose to the diet markedly increases resistance to cecal colonization and organ invasion, and decreases horizontal transmission of S. enteritidis.

Cytomorphologic, immunocytochemical, and nucleic acid flow cytometric study of 50 lymph nodes by fine-needle aspiration. Comparison with results obtained by subsequent excisional biopsy

Fifty patients with clinically suspected or previous diagnosis of lymphoma underwent fine-needle aspiration (FNA) and subsequent excisional biopsy of their lymph nodes. Results of cytologic diagnosis made from the direct smears in conjunction with immunocytochemical study of cytospin preparations and nucleic acid flow cytometric study (FCM) were compared with the results obtained from histologic sections, cryostat-immunohistochemical study, and nucleic acid FCM performed on resected lymph nodes. This study demonstrates (1) results of immunocytochemical and DNA-FCM analysis of FNA-derived material are comparable in the majority of cases to those obtained from surgical specimens, (2) immunostaining of cytospin preparations for immunoglobulin (Ig) gives less background staining and in certain cases is easier to interpret than when performed on frozen sections, and (3) monotypia in FNA in conjunction with cytomorphologic study is 100% specific for lymphoma, and polytypic staining for Ig does not exclude HD, T-cell lymphoma, or B-cell malignancy focally involving a lymph node.