The effect of surgical excision and grafting procedures on postburn lymphocyte suppression

Previous reports have stressed the immunosuppressive effects of major surgical procedures. In this study, 30 adult patients with a mean burn size of 42.8% TBSA and a mean age of 31.9 years underwent 78 surgical excision and grafting (E/G) procedures. The mean surface area excised was 2,373 cm2, with a mean blood transfusion requirement per E/G of 3,355 cc or 1.4 cc/cm2. The suppressive effect of burn serum was assayed in mixed lymphocyte cultures. Before E/G, burn serum caused a mean 42.2 +/- 3.3% suppression of normal lymphocyte blastogenesis; serum suppressive activity following E/G was reduced to 29.1 +/- 2.9% (p less than 0.005). The mean duration of improvement in lymphocyte function was 5.0 days. E/G procedures which achieved complete burn wound closure were more effective in restoring lymphocyte immunocompetence. E/G has a significant beneficial effect on restoring lymphocyte responsiveness in burn patients. Preliminary evidence suggests that this effect is related to blood transfusions.

Hemolysis and suppression of neutrophil chemotaxis by a low molecular weight component of human burn patient sera

During the past year, we have reported the isolation and characterization of a low molecular mass (less than 5000 Da) complex (SAP), having profound immunosuppressive activity, found in the plasma of patients with major thermal injuries. Our continued studies have revealed that non-cytotoxic inhibition of neutrophil chemotaxis by SAP is paralleled by erythrocyte hemolysis by the same compound. Both neutrophil inhibitory and hemolytic activities appear to be a function of the peptide portion of SAP (determined by sensitivity to trypsin and pronase), which is augmented by the presence of sialic acid in the complex (activity eliminated by the addition of neuraminidase). The lipid portion of SAP, which is critical to its neutrophil immunosuppressive activity, does not appear to participate in erythrocyte hemolysis. Hemolytic activity of SAP is not due to protease activity, and does not appear to be receptor dependent. However, it is completely dependent upon the presence of calcium. The hemolytic activity of SAP appears to be abrogated by the addition of cerium nitrate, leading to a hypothesized relationship of SAP to the immunological activity of "burn toxin", previously described in detail (Schoenenberger, G.A. (1975) Monogr. Allergy 9, 72-139).

Lasers in endoscopic gastrointestinal surgery

Lasers have been used for endoscopic gastrointestinal surgery at our institution since 1977. The argon and Nd-YAG lasers are valuable for coagulating upper gastrointestinal hemorrhage, arteriovenous malformations, and benign and malignant lesions, as well as a variety of anatomic anomalies. Between December 1977 and September 1983, 222 procedures were performed in 122 patients. Hospital charts were reviewed and a scale constructed to assess the results of treatment. When information was available, a comparison of transfusion requirements before and after laser therapy was made. Success was achieved in 84 percent of the patients regardless of initial diagnosis. Laser therapy was not effective in 12 patients (10 percent). In 27 patients with gastrointestinal atrioventricular malformations, transfusion requirements fell from a mean of 17 +/- 5.9 units in the year before laser therapy to 1 +/- 0.8 units in the year after laser phototherapy (p less than 0.01). Complications rarely occurred (6 percent of all procedures). There were no perforations of the gastrointestinal tract and only one death (0.8 percent) partially attributable to laser application. Endoscopic laser surgery is minimally invasive and can be performed on an outpatient basis without anesthesia. It is especially valuable in patients with a high operative risk.

Evaluation of two seminal collection regimens for mature Holstein bulls

Twenty mature Holstein bulls (3 to 10 yr old) were used to test the effect of two semen collection regimens on spermatozoal output, post-thaw percentage spermatozoal motility, and time needed to make the collections/week. For both regimens, six ejaculates/wk were collected using either three ejaculates/d, 2 d/wk, or two ejaculates/d, 3 d/wk. A three-period switchback experimental design was used. Each collection period for which measurements were taken was 3 wk and was preceded by a 2 wk period of acclimation. The total number of spermatozoa harvested per week was not significantly different (P greater than .05): 33.2 X 10(9) when the bulls were collected two ejaculates 3 d/wk, compared with 33.9 X 10(9) three ejaculates 2 d/wk. Post-thaw progressive spermatozoal motility was 50.3 and 52.1% (P greater than .05), respectively. The average time per week to collect each bull was 73.6 and 83.7 min (P less than .05), respectively.

Fine structural abnormalities of spermatozoa from a subfertile bull: A case report

Spermatozoa from a nine-year-old subfertile Holstein bull were evaluated by light and electron microscopy. Morphological abnormalities observed included cytoplasmic droplet-like structures, constriction of the midpiece, missing axial filaments and abnormal spermatozoal head shapes.

Enzymatic transformation of PSP toxins in the littleneck clam (Protothaca staminea)

Stemming from investigations into the relationship between toxins produced by Gonyaulax sp. and accumulated in shellfish, we wish to report enzymatic transformations of the PSP toxins to decarbamoyl derivatives in the littleneck clam (Protothaca staminea). No toxin transformations were observed in either mussels (Mytilus edulis) or in butter clams (Saxidomus giganteus). In addition, littleneck clam samples from the natural environment contained predominantly the decarbamoyl derivatives, while other shellfish species collected from the same vicinity contained the previously reported PSP toxins.

High pressure liquid chromatographic determination of toxins associated with paralytic shellfish poisoning

A high pressure liquid chromatographic procedure is described for assay of toxins associated with paralytic shellfish poisoning (PSP). The method is applicable to saxitoxin, neosaxitoxin, gonyautoxins I through IV, and their sulfocarbamoyl derivatives. Toxins are separated on a bonded phase cyano column and detected by fluorescence following alkaline oxidation (NH+4 and periodic acid). The utility of the HPLC procedure for research and monitoring is discussed.

A critique of Theory Z

Ouchi's Theory Z prescribes how employees should be motivated for increased productivity. Based on the theoretical work of Emile Durkheim, it views the modern large corporation as a communal alternative to the shortcomings of other institutions in industrial mass society. Ouchi's assertion that Japan is the industrial society in which Theory Z has flourished received limited support from research findings. Moreover, Ouchi's grounding of the theory in humanistic management seem unwarranted.

Metacyclogenesis of Trypanosoma cruzi in vitro: a simplified procedure

A simplified procedure for obtaining high levels of infective, metacyclic trypomastigotes of a Brazilian strain of Trypanosoma cruzi in vitro is described. Epimastigotes cultured in Yaeger's Liver Infusion Tryptose Medium, when transferred to Grace's Insect Tissue Culture Medium (GMA) supplemented with 10% foetal bovine serum, yielded over 90% metacyclic forms. Decreasing or eliminating the serum from GMA adversely affected growth but did not decrease levels of transformation, thus providing a chemically defined culture system for analysing factors influencing metacyclogenesis of T. cruzi.

Effect of pH and ammonium ions on mutagenic activity in cooked beef

Controversy surrounding the extraction procedure commonly used for isolating and concentrating mutagens from foods has resulted in a need for the re-examination of the reported mutagenicity in fried hamburgers. Using a procedure in which Na2SO4 and NaOH are substituted for (NH4)2SO4 and NH4OH respectively, mutagenic activity in extracts of hamburgers fried for 5 min appeared to be unchanged. However, when organic extractions are performed at pH conditions more moderate than those generally employed to isolate mutagens from foods, a 30-50% decrease in mutagenicity is observed.

A source of error in mutagen testing of foods

Mutagenic compounds reported to be present in foods may be forming during the extraction process rather than during cooking or baking. In this study, the formation of mutagenic substances in biscuits was examined using in the extraction procedure either ammonium sulfate and ammonium hydroxide or sodium sulfate and sodium hydroxide. Compounds producing high mutagenic activity in Salmonella strains 1538 and TA 98 obtained from aqueous biscuit extracts containing ammonium ions. No mutagenic activity was observed in extracts from aqueous biscuit extracts containing sodium ions until some ammonium ions (NH4OH) were added. We suggest that ammonium sulfate and ammonium hydroxide not be used in the extraction procedure of food when studying mutagen formation.

Serologic and parasitologic studies of Entamoeba histolytica in El Salvador, 1974-1978

Serologic and parasitologic studies were done in El Salvador, C.A., from 1974-1978 to examine the reliability of the diagnosis of Entamoeba histolytica infection in an endemic area and to confirm the estimates of morbidity and mortality due to amebiasis. The results suggest that infection with E. histolytica is common, but the estimated prevalence is too high. Misdiagnosis occurring in hospital and public health laboratories was documented. Data collected from examining family members of persons with E. histolytica infection and disease indicate that most infections are asymptomatic, and support the hypothesis that estimates of morbidity and mortality rates are excessive.

Purification and properties of the pyrrolidonecarboxylate peptidase of Streptococcus faecium

Pyrrolidonecarboxylate peptidase (EC 3.4.11.8) from Streptococcus faecium was purified by fractionation with streptomycin sulphate and ammonium sulphate, by chromatography on Sephadex G200 and DEAE-cellulose, and by preparative electrophoresis on Sephadex G25. The purified enzyme on acrylamide gel showed a strong protein band which contained enzyme activity and a very faint band which had no activity. The subunit molecular weight of the purified enzyme was estimated by acrylamide gel electrophoresis in sodium dodecyl sulphate to be 42,000 +/- 1,000. The enzyme showed optimum activity at pH 7.6 and was unstable in the absence of 2-mercaptoethanol. The sensitivity of the enzyme to alkylating agents (N-ethylmaleimide and iodoacetamide) suggested that free sulphydryl groups were essential for enzyme activity. The enzyme was rapidly inactivated above 45 degrees C. The values of the Michaelis constants (Km) obtained with various L-pyrrolidonecarboxylyl dipeptides were similar although there was a 10-fold range in the maximal rates of hydrolysis of these substrates. Inhibition studies showed that the substrate analogues 2-pyrrolidone and pyrrolidonecarboxylate are competitive inhibitors of the enzyme. The binding of substrates and inhibitors to the active site of the enzyme is discussed.

Predicting infant apgar scores

This study identified psychologic and sociologic phenomena that affect a woman during pregnancy which, when associated with physical factors, result in poor neonatal outcome for the infant, as measured by the Apgar score at five minutes after birth. The Utah Test Appraising Health (UTAH) was administered to 51 pregnant women during the second or third trimester of pregnancy. Data measuring maternal and infant outcomes were collected postdelivery. A significant correlation was found between maternal stress up to six months before administration of the UTAH questionnaire and the five-minute infant Apgar score (r = -.2787, p less than or equal to .05). The stress score was combined with past pregnancy complications, pregnancy symptoms during the first and third trimesters, and illness-proneness in a regression equation. The total multiple correlation coefficient was .8979, with stress X past pregnancy complications contributing most to the prediction equation. When stress and past pregnancy complications were controlled, the partial correlation value was -.8001. The data were consistent with the hypothesis that stress during pregnancy is an activator of physical illness processes in the mother, and, when combined with these variables, is related to neonatal outcome, as measured by the infant Apgar score at five minutes.

Secretory (juvenile) carcinoma of the breast

A case of secretory (juvenile) carcinoma of the breast is reported in a 26-year-old multiparous woman who had been taking oral contraceptives for 7 months. The tumour recurred 8 months after local resection and axillary metastases were found at radical mastectomy. No further recurrence has been detected but the follow-up period is only 8 months. It is emphasized that secretory carcinoma of the breast originally described in children occurs also in adults. Early reports stressed the slow rate of growth, often with intervals of many years before recurrence, and the small risk of metastatic spread, many cases being cured by local resection. However, axillary metastases have been found in approximately 15% of the recorded cases. Consequently it is recommended that the initial treatment should be simple mastectomy with at least a low axillary resection.

Fibrin-bound tumour cells on a sclerosed mitral valve

The association of fibrin and tumour cells on a sclerosed mitral valve in a 62-year-old woman is described. This was the first indication of malignant disease but bilateral ovarian cancer was proved two months later. ino further tumour deposits have been found in fifteen months. The tumour deposit on the valve was most likely a metastasis but primary heart valve sarcoma has not been positively excluded. If the lesion was a secondary deposit this has possible implications for the role of fibrin in metastasis in humans.

Parapleurogonius brevicecum gen. et sp. n. (Trematoda: Pronocephalidae) from a freshwater turtle in peninsular Malaysia

Parapleurogonius brevicecum gen. et sp. n. is described from the freshwater turtle, Kachuga trivittata, in Selangor, Malaysia. Parapleurogonius is most closely related to Pleurogonius Looss, 1901, but from which it can be distinguished by the termination of the ceca at or just overlapping the anterior border of the testes and the pretesticular position of the excretory pore. Additionally, Parapleurogonius is described from a freshwater turtle, whereas Pleurogonius is only known from marine hosts.

Antibiotic penetrance of ascitic fluid in dogs

Antibiotic concentrations in ascitic fluid after parenteral therapy may be important in the treatment of peritonitis. We have created ascites in dogs by partial ligation of the inferior vena cava. Ascitic fluid volume was measured at the time each antibiotic was administered. Nine antibiotics were studied in the same three dogs. Antibiotic concentration in ascitic fluid was found to vary inversely with ascites volume. Percentage of penetration (ratio of ascites peak to serum peak x100) ranged from 5.8 to 65% among the drugs studied. Only metronidazole showed a statistically significant higher percentage of penetration than other antimicrobials. Concentrations in ascitic fluid after single doses of cephalothin (15 mg/kg) and the aminoglycosides (2 mg/kg, gentamicin and tobramycin; 7.5 mg/kg, amikacin and kanamycin) did not exceed the minimum inhibitory concentration of many gram-negative rods and may justify the use of higher than usual initial parenteral doses, or possibly initial intraperitoneal administration in seriously ill patients.

Infective larvae of Brugia: escape from mosquitoes into water and subsequent oral infectivity in jirds

Published work showed that third-stage larvae (L-3s) escape into water from dead or dying, Brugia pahangi-infected, Aedes aegypti. The present study revealed the same escape phenomenon among B. pahangi-infected Armigeres subalbatus, Anopheles quadrimaculatus, and Aedes togoi, and among Brugia malayi-infected Ae. aegypti and Ae. togoi. L-3s maintained in water or in Lum's solution for 3 hours retained infectivity when tested in orally or subcutaneously exposed jirds; furthermore, L-3s recovered from mosquitoes dead for 24 to 48 hours were also infective by either portal of entry in jirds. Since L-3s may escape and remain infective in the field, it is conceivable that natural filarial infections might thus be acquired orally by definitive hosts.

Thyroid suppression tests during drug treatment of hyperthyroidism

In fifteen hyperthyroid patients treated for 5 or more consecutive years with propylthiouracil four or more yearly prognostic 'suppression' tests (Cassidy & VanderLaan, 1960) were done. In nine of the fifteen patients there was a progressive diminution over a period of 3-6 years in the values of these suppressed uptakes to 20% or below. Eight of these nine patients have remained euthyroid off therapy for 1-8 years (average 3-1 years). None have become hypothyroid. The data suggest a gradual continuing change in thyroid function over the course of years in some hyperthyroid patients on antithyroid therapy. This may be a long-term effect of the drug and may have prognostic significance.