Antibiotic pharmacokinetics in the inflamed prostate

We hypothesized that altered pharmacokinetics in the inflamed prostate gland might account for the treatment failure of clinically diagnosed chronic bacterial prostatitis. We employed a rat model of chronic bacterial prostatitis to investigate any pharmacokinetic differences that may exist between uninflamed and inflamed prostate glands. Four groups of animals were studied (treated and untreated control and prostatitis groups). Seven days of norfloxacin therapy cured 60% of the animals with well-established bacterial prostatitis compared with a spontaneous cure rate of 10% in the nontreated prostatitis animals. Norfloxacin levels did not change significantly between the infected and noninfected prostate glands. We conclude that failure of antibiotic therapy in chronic bacterial prostatitis is not due to significantly altered norfloxacin pharmacokinetics in the chronically inflamed prostate gland but rather to the difficulty of eradicating protected bacterial microcolonies within an infection-induced altered microenvironment deep within the prostate gland.

Bacterial biofilms: influence on the pathogenesis, diagnosis and treatment of urinary tract infections

The bacterial biofilm theory which describes bacterial populations in natural and pathogenic ecological systems in terms of a free-floating or 'planktonic' population of bacteria interacting with a more important matrix enclosed 'sessile' population of bacteria associated with or adherent to a surface, may help explain some of the problems linked to our understanding the nature of urinary tract infections. This paper reviews the role of bacterial biofilm formation in catheter-associated infection, prostatitis and struvite (infected stone) calculogenesis stressing, the importance of bacterial biofilms in the pathogenesis, persistence and hence the treatment of urinary tract infection.

Treatment of ABO hemolytic disease with synthetic blood group trisaccharides

Thirteen infants, 10 with A-O and 3 with B-O hemolytic disease of the newborn (ABO-HDN), were treated with synthetic A or B blood group trisaccharides (ATS, BTS) which cause dissociation of maternal antibody bound to infant red cells. The clinical outcome was compared with that of a control group of 21 infants treated with phototherapy during the preceding year. Exchange transfusion was required in 2 out of 13 infants in the experimental group and in 7 in the control group. A randomized prospective controlled study is necessary to confirm these results.

Willingness to perform euthanasia. A survey of physician attitudes

BACKGROUND

In the United States, few studies have examined important variables in physician attitudes toward the practice of euthanasia, such as the patient's underlying disease, mental capacity, and age, and the physician's specialty and religion. We administered a case-based survey to analyze the impact of such specific variables on physician attitudes toward the practice.

METHODS

A four-section survey solicited (1) physician responses to three hypothetical cases in which patients requested euthanasia; (2) physicians' general opinions about euthanasia and how its legalization might affect them personally and professionally; and (3) demographic information. Analysis focused on physicians' characteristics as they related to their responses to the various aspects of euthanasia elicited in the survey. Univariate and multivariate analyses, using logistic regression, were performed.

RESULTS

Completed and analyzable surveys were returned by 740 physicians. We found that physicians felt more comfortable with euthanasia requests from nondecisional, nonterminal patients who had left advance directives than they did with requests from decisional patients suffering from grave illnesses or injuries, or from decisional patients who had early signs of a progressive but nonlethal neurologic disease. We also found that physicians' specialties and religions correlated with their responses to the hypothetical cases and with their generalized attitudes toward euthanasia.

CONCLUSIONS

Given the disparity in responding physicians' attitudes toward euthanasia, along with the fact that values based on religious affiliation or profession may underlie many physicians' opposition to the practice, we conclude that if euthanasia is to be legalized, safeguards protective of patients and physicians must be incorporated.

Life satisfaction, life review, and near-death experiences in the elderly

When 145 senior citizens living independently in the community were surveyed for incidence of near-death experiences (NDEs), 46 of the seniors believed they had had a "close call" with death. Twelve of those reported that they had had an unusual experience during their close call and were subsequently interviewed. Their stories were evaluated using research criteria to document sufficient number of characteristics of an NDE for inclusion in research data and if that set of characteristics of the NDE included a life review component. They were also compared to a non-NDE group on the Life Satisfaction Index, to determine if life review in the context of an NDE helped older people feel more satisfied with life. There was no correlation, because surprisingly, although older people do have NDEs at least as often as other groups, the life review does not seem to be a part of it. So the reasons for scores on the LSI-A are not attributable to the life review. Reasons for this finding are discussed.

Effect of enamel bleaching on the bonding strength of orthodontic brackets

Various whitening/bleaching systems have been introduced on the market, including an over-the-counter external bleaching material, containing carbamide peroxide. It has been suggested that the process might alter the enamel surface structure in a manner similar to acid etching. Orthodontists are interested in determining whether the process will alter the adhesive characteristics of orthodontic bonding systems. The results of this study indicate that the use of 10% carbamide peroxide did not result in significant changes in the shear debonding strength of orthodontic brackets.

Inferior mesenteric artery branch avulsion from blunt trauma--CT findings. Case report

Mesenteric arterial injuries are uncommon following blunt abdominal trauma. We describe the computed tomography (CT) findings of a patient with avulsion of a branch of the inferior mesenteric artery following a low-speed motor vehicle accident.

Viscoelastic influence on wall and baroreceptors of rabbit carotid sinus

This study examined multifiber baroreceptor nerve activity (BNA) as a function of carotid sinus wall distension in 19 rabbits. Analysis estimated mechanical or viscoelastic properties of the sinus wall and their influence on BNA. In six sinuses, properties were altered by treatment with the enzyme protease to remove the endothelium and with nifedipine to passively relax smooth muscle. Properties were estimated from dynamic and steady state wall response to a 45 mm Hg step increase and decrease in intrasinus pressure (ISP) of 20 min. Control wall response had fast and slow (creep) portions with a viscosity increase from 1,370 N(s)/m to 17,864 N(s)/m during step-up in ISP. Wall elasticity averaged 77 N/m; which estimated the relationship of force and change in steady state response. Control BNA response also had fast and slow (resetting) portions. A BNA and wall response relationship (BNA/m) was defined as transduction-gain (T-G) with proportional and dynamic components. In the subgroup, wall creep and baroreceptor resetting were abolished by protease treatment, suggesting an endothelial mediator which influenced sinus smooth muscle. Histology data indicated enzyme damage was limited to tunica intima tissues, and nifedipine did not block Ca2+ channels on neural structures. By comparison of responses before and after treatments the proportional component of T-G was equated to an elastic influence (1/E), with E = 7.5 x 10(-6) m/BNA, while the dynamic component was equated to a viscous influence (1/V), with V = 1.53 x 10(-4) m(s)/BNA. A simple but fundamental relationship for baroreceptor-tissue linkages was estimated by BNA/m = 1/(Vs + E), a first-order transfer function.

Therapeutic touch and post-Hurricane Hugo stress

This repeated-session design sought to answer questions about the effectiveness of therapeutic touch in reduction of stress for 23 individuals following a natural disaster. In addition, methodological issues related to the average length of time for a therapeutic-touch treatment and a method of documenting the nonverbal interaction between subject and toucher were investigated. Findings indicate that stressed people report themselves to be less stressed following therapeutic touch (p = .05). Time of therapeutic-touch intervention varied significantly between the touchers, with a range of 6.8 to 20 minutes. Qualitative data examining the interaction of toucher and subject raised a number of questions that require further study.

Variations of broncho-alveolar lavage techniques affect cell recoveries

Broncho-alveolar lavage (BAL) has become a routine method of sampling airway and alveolar milieu. Variations of BAL techniques, such as application of chest massage, may have an effect on cell yields. We compared numbers and composition of cells obtained by BAL with and without chest massage from naive rats and from rats infected 7 days earlier with 3,000 larvae of Nippostrongylus brasiliensis. Both techniques revealed significant increases in numbers of agranulocytes and granulocytes after N. brasiliensis infection, but the total yield of cells was 4-5 times greater when massage was used. The use of massage consistently increased the yield of macrophages, but did not result in consistently greater yields of lymphocytes or granulocytes.

Organization of the 5S rRNA genes in the soybean Glycine max (L.) Merrill and conservation of the 5S rDNA repeat structure in higher plants

The 5S rRNA gene of the soybean Glycine max (L.) Merr. has been cloned on a 556-bp fragment of DNA and sequenced. This fragment contains two copies of the soybean 5S rDNA sequence, one intact and one truncated, separated by noncoding DNA. We have used this clone to investigate the organization of the 5S genes within the soybean genome and the extent of their methylation. Our results demonstrate that soybean 5S genes are clustered, organized into tandem repeats of 330 bp, and extensively methylated. Hybridization of the 5S sequence to Southern transfers of soybean DNA digested with BamHI reveals a striking ladderlike pattern. Hybridization of the soybean 5S sequence to a wide variety of plant DNAs results in similar patterns, suggesting that the 5S rDNA sequence, gene organization, and methylation pattern are conserved in many higher plants.

Teaching home health aides the use of Life Review

Life Review is presented as a therapeutic nursing intervention for the elderly. This article describes a class on life review for home health aides and shows the ease with which these aides managed life review. The description of this class may serve as a model for inservice educators to teach nurse aides the use of life review.

CT characteristics of a hyperdense renal mass due to Richter syndrome

A case of Richter syndrome (histiocytic lymphoma or Hodgkin disease complicating chronic lymphocytic leukemia) presented as a hyperdense renal mass on CT.

Hyperphosphorylation of N-60, a protein structurally and immunologically related to nucleolin after tumour-promoter treatment

Okadaic acid, a non-TPA-type tumour promoter, induces hyperphosphorylation of a 60-kd protein in primary human fibroblasts. Treatment with TPA-type tumour promoters (e.g. TPA and teleocidin) did not cause this hyperphosphorylation. Phosphorylation of this protein was not seen at times earlier than 90 min after the addition of 75 ng/ml okadaic acid to the proliferating cell cultures. The presence of inhibitors such as actinomycin D and cycloheximide, did not significantly influence the level of hyperphosphorylation induced by okadaic acid treatment. By immunoblotting using an antibody anti-nucleolin, the 60-kd protein was identified as a fragment of nucleolar protein, nucleolin. Similarly, antibodies against the 60-kd protein cross-reacted with nucleolin. Furthermore peptide mapping, using staphylococcal V8 protease, showed that the 60-kd protein phosphorylated by casein kinase II in vitro and the okadaic-acid-induced hyperphosphorylated 60-kd protein exhibited identical phosphopeptide maps, indicating that there is also structural relatedness between N-60 and nucleolin. Hyperphosphorylation of the nucleolin fragment (N-60) was suppressed by anti-tumour promoter retinoic acid.