Dynamics of airborne fungal populations in a large office building

The increasing concern with bioaerosols in large office buildings prompted this prospective study of airborne fungal concentrations in a newly constructed building on the Gulf coast. We collected volumetric culture plate air samples on 14 occasions over the 18-month period immediately following building occupancy. On each sampling occasion, we collected duplicate samples from three sites on three floors of this six-story building, and an outdoor sample. Fungal concentrations indoors were consistently below those outdoors, and no sample clearly indicated fungal contamination in the building, although visible growth appeared in the ventilation system during the course of the study. We conclude that modern mechanically ventilated buildings prevent the intrusion of most of the outdoor fungal aerosol, and that even relatively extensive air sampling protocols may not sufficiently document the microbial status of buildings.

Differential block by troglitazone and rosiglitazone of glibenclamide-sensitive K(+) current in rat aorta myocytes

Thiazolidinediones are insulin-sensitising agents effective in controlling type II diabetes. These compounds also cause vasodilation. We evaluated the effects of the thiazolidinediones troglitazone and rosiglitazone on the glibenclamide-sensitive K(+) current in freshly isolated rat aorta myocytes. Troglitazone inhibited this current in a concentration-dependent manner (IC(50) approximately 1 microM). Rosiglitazone had a similar, but much less potent (IC(50) approximately 20 microM) action. Block of the glibenclamide-sensitive K(+) channels, in particular by troglitazone, may potentially affect the response of arteries to hypoxia and to certain endogenous and exogenous vasodilators.

A role for a glibenclamide-sensitive, relatively ATP-insensitive K+ current in regulating membrane potential and current in rat aorta

OBJECTIVE

ATP-sensitive K+ channels have been classified based on their inhibition by cytoplasmic ATP. Recent evidence in vascular smooth muscle has suggested that these channels show weak sensitivity to intracellular ATP. However, it is not known whether these channels regulate the resting K+ conductance in vascular smooth muscles. Therefore, the aim of the present investigation was to characterize this current in rat aorta myocytes and to examine whether it contributes to setting the membrane potential.

METHODS

The conventional and nystatin-permeablised whole cell patch clamp techniques were used to characterize the effect of glibenclamide on membrane potential and K+ current in enzymatically dispersed rat aorta myocytes.

RESULTS

The mean resting potential measured in current clamp mode using the permeabilized patch approach was -54 +/- 5 mV (n = 8). Glibenclamide (10 microM) caused a reversible 24-mV depolarization in these cells. In symmetrical K+ (135 mM) solution an inward glibenclamide-sensitive (10 microM) current (-4.1 +/- 0.7 pA/pF; n = 5), hereafter termed Iglib, was observed at a membrane potential of -80 mV when cells held at -60 mV were ramped from -80 to +80 mV. In the absence of any nucleotide in the pipette solution, Iglib measured by the conventional whole-cell method was -23.69 +/- 4.65 pA/pF (n = 9). With 1 and 3 mM ATP in the pipette, the average current density was -25 +/- 6.3 pA/pF (n = 8), and -9.4 +/- 2.7 pA/pF (n = 9), respectively. In the absence of ATP, 1 mM GDP significantly (P < 0.01) increased Iglib (-44.8 +/- 8.4 pA/pF; n = 13). Inclusion of 1 mM ATP in the GDP-containing pipette solution had no significant effect on the current amplitude (-56.4 +/- 10.7 pA/pF; n = 7). Iglib fell to -11.0 +/- 2.9 pA/pF (n = 10) if 1 mM GDP and 3 mM ATP were present. In symmetrical K+, the Iglib observed in the presence of 1 mM ATP in the pipette was increased by more than two-fold in the presence of 10 microM levcromakalim. In PSS containing 5 mM K+, a significant glibenclamide-sensitive current was observed at -45 mV membrane potential when cells dialyzed with 1 mM ATP were ramped between -80 to 30 mV.

CONCLUSION

These results demonstrate that Iglib channels in rat aorta myocytes differ from classical KATP channels, being relatively insensitive to intracellular ATP. Iglib therefore appears to have an important role in contributing to the maintenance of the resting potential in rat aortic smooth muscle.

Safety and efficacy of total thyroidectomy in hands of endocrine surgery trainees

BACKGROUND

Fear of a high complication rate of total thyroidectomy, especially in the hands of less experienced surgeons, limits its routine use. The results of total thyroidectomy in the hands of endocrine surgery trainees and consultants were compared to know whether this procedure can be performed effectively and safely by trainees.

METHODS

Medical records of 232 patients who underwent total thyroidectomy from 1990 to 1997 were reviewed. Patients were put into groups A (operated by consultants) and B (trainees). Safety (postoperative hypoparathyroidism, recurrent laryngeal nerve palsy, and hemorrhage) and efficacy (postoperative radioactive iodine uptake) in the two groups were compared.

RESULTS

There were 127 patients in group A and 105 in group B. Rates of occurrence of permanent hypoparathyroidism and recurrent laryngeal nerve palsy were comparable in the two groups. Postoperative radioactive iodine uptake in the two groups was not significantly different.

CONCLUSIONS

Total thyroidectomy can be safely and effectively performed by endocrine surgical trainees.

Posttranscriptional control in the expression of the genes coding for high-light-regulated HL#2 proteins

An antibody was raised against the protein HL#2 which is a nuclear-encoded light-stress-induced protein of barley (Hordeum vulgare L.). The expression of the mRNA and the protein of HL#2 was determined under the influence of high light and methyl jasmonate. The mRNA of HL#2 was induced by high light (1800 &mgr;mol m(-2) s(-1) and 25 degrees C) and the steady-state levels remained elevated for up to 48 h of exposure to high-light stress. In contrast, using an antibody against HL#2 there was no observable change in the level of HL#2 proteins of 18 kDa and 15.5 kDa during the same treatment. These data indicate a pronounced stress-induced control of HL#2 expression at a post-transcriptional level. In the presence of methyl jasmonate (45 &mgr;M), the induction of HL#2 occurred together with that of the two most closely related jasmonate-inducible proteins (JIPs) of 32.6 and 32.7 kDa, as judged by their cross-reactivity with the antibody against HL#2. In contrast to the mRNA and protein levels of early light-inducible proteins (ELIPs) in green barley, those of HL#2 appeared not to be influenced by low temperatures. Therefore, the control of ELIPs and HL#2 by high light fluxes may be measured via the same photoreceptor but must, at least partially, be under the control of two divergent signal transduction chains.

Hospital staff do not know how much drugs cost

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Evaluation of the activity of receptor-operated Ca2+ channels in rat portal vein in induced hyperthyroidism

The activity of receptor-operated Ca2+ channels (ROCCs) was studied in rat portal vein in L-thyroxine-induced experimental hyperthyroidism. The following parameters were evaluated: 1. NE-stimulated 45Ca influx. 2. CaCl2-induced contractile responses in Ca2+ free NE-stimulated tissues to calculate EC50 value of CaCl2. The NE (10(-6)mol) stimulated 45Ca influx and the mean EC50 value of CaCl2 did not differ significantly in portal veins isolated from hyperthyroid rats as compared to those of euthyroid control rats. The study revealed no significant change in the functional status of ROCCs in experimental hyperthyroidism.

Correlation of cell counts and indices in testicular FNAC with histology in male infertility

OBJECTIVE

To evaluate the value of percentage cell counts and cell indices in testicular fine needle aspiration cytology (FNAC) in male infertility and their correlation with histologic categories as seen in open testicular biopsies.

STUDY DESIGN

Differential cell counts were performed, and cell indices, including spermatic index, Sertoli cell index and sperm-Sertoli cell index, were calculated in testicular fine needle aspiration (FNA) smears in 30 azoospermic males whose open testicular biopsies were classified as normal spermatogenesis in 10 cases, maturation arrest in 5, hypospermatogenesis in 6, Sertoli cell only syndrome in 5 and tubular/peritubular sclerosis in 4.

RESULTS

In normal spermatogenesis, FNA smears showed up to 40% Sertoli cells, and spermatozoa were the predominant spermatogenetic cell type. There was a progressive increase in Sertoli cell percentage and Sertoli cell index and reduction in spermatozon percentage, spermatic index and sperm-Sertoli cell index with increasing severity of reduction in spermatogenesis in different histologic categories. The differences between mean counts and indices in normal spermatogenesis and other histologic categories were statistically significant (P < .01).

CONCLUSION

The percent cell counts and cell indices in testicular FNAC correlate with histologic categories and are useful in evaluating male infertility.

Distribution of Candida albicans genotypes among family members

Thirty-three families (71 subjects) were screened for the presence of Candida albicans in mouthwash or stool specimens; 12 families (28 subjects) were culture-positive for this yeast. An enrichment procedure provided a twofold increase in the recovery of C. albicans from mouthwash specimens. Nine of the twelve culture-positive families had two positive members each, two families had three positive members each, and one family had four positive members. Genetic profiles were obtained by three methods: pulsed-field gel electrophoresis; restriction endonuclease analysis, and random amplification of polymorphic DNA analysis. DNA fingerprinting of C. albicans isolated from one body site three consecutive times revealed that each of the 12 families carried a distinct genotype. No two families shared the same strain, and two or more members of a family commonly shared the same strain. Intrafamily genotypic identity (i.e., each member within the family harbored the same strain) was demonstrated in six families. Genotypes of isolates from husband and wife differed from one another in five families. All three methods were satisfactory in determining genotypes; however, we concluded that restriction endonuclease analysis provided adequate resolving power.

Adjuvant therapy in invasive thymoma: an audit of cases treated over an 8 year period

Invasive thymomas comprise 0.1%-0.2% of all malignancies in India. This report is an audit of 11 cases (10 males and 1 female) at a mean age of 36.6 years (range 25-52 years) of invasive thymoma accrued over an eight year period treated by combined modality treatment. Nine of these presented with myaesthenia gravis. All patients underwent initial surgery (3 partial and 8 total resections) and postoperative radiotherapy. Two of the three partially resected patients received one course of chemotherapy prior to radiotherapy consisting of cyclophosphamide, vincristine, procarbazine and prednisolone. At a median follow up of 28 months (range 2-87) there have been no local relapses, one distant metastasis and one death due to uncontrolled myaesthenia. The treatment strategies with invasive thymomas would depend upon the extent of resection. Postoperative radiotherapy appears to be indicated in all cases, however the role of chemotherapy may be limited to those with partial resection.

Differential effects of insulin-sensitizers troglitazone and rosiglitazone on ion currents in rat vascular myocytes

Insulin-sensitizing thiazolidinediones such as troglitazone and pioglitazone have been shown to lower blood pressure in vivo and cause vasorelaxation in vitro. Rosiglitazone (BRL 49653) is a novel thiazolidinedione which has been reported not to cause vasoleraxation. We therefore compared the effects of troglitazone and rosiglitazone on Ca2+ and K+ currents in rat aorta and pulmonary artery smooth muscle cells. Currents were recorded with the conventional whole cell patch clamp technique. Both drugs reduced the voltage-gated (L-type) Ca2+ current in rat aorta cells, with half-maximal current inhibition by troglitazone and rosiglitazone at 2 and 10 microM, respectively. Troglitazone, 2 microM and rosiglitazone, 20 microM caused a similar hyperpolarizing shift of 12 mV in the potential-dependence of Ca2+ current availability. Troglitazone (20 microM) produced a marked block of the tetraethylammonium- and paxilline-sensitive Ca2+ activated K+ current, while rosiglitazone (20 microM and 60 microM) slightly enhanced this current. Rat pulmonary artery smooth muscle cells have a prominent delayed rectifier K+ current. Troglitazone produced a potent block of this current (half-maximal inhibition at <1 microM), while rosiglitazone caused a smaller inhibition at 10 and 60 microM. These results show that troglitazone has relatively potent blocking effects on a wide variety of ion currents in vascular smooth muscle cells. Rosiglitazone exerts less potent, but similar effects on the Ca2+ current and delayed rectifier K+ current, but it enhances the Ca2+ activated K+ current. reserved.

Immunochromatographic test for the diagnosis of Falciparum malaria

The diagnosis of malaria poses great difficulty at times due to non-availability of microscope, trained personnel or laboratory set up. We undertook the immunochromatographic test in 98 suspected cases of malaria for the detection of antigen of P. falciparum in the blood and to assess its sensitivity and positive predictive value. The sensitivity was 87.06% (confidence interval 77.57 to 92.55%) and the positive predictive value was 93.67%. This is a simple, sensitive and convenient test which can be performed in remote areas.

Sparfloxacin in the treatment of purulent sinusitis-a multicentric study in Indian patients

Sparfloxacin, a new quinolone antibacterial was used to treat one hundred and thirty two patients with acute purulent sinusitis, at a dosage of 400 mg on the first day followed by 200 mg once daily for a further four days. A clinically successful outcome (defined as disappearance of nasal discharge, fever, pain, tenderness over the sinuses and headache) was recorded in 122 ( 95.3%) patients. Sparfloxacin was well tolerated. Fourteen adverse experiences were reported in 7 patients ( 5.3%); they were mainly gastrointestinal and mild. No phototoxic or cardiological adverse events occurred. An unusual feature was that Staphylococcus aureus and Pseudomonas spp. were the most common bacterial species isolated from middle meatal was of patients in this study.

Risk factors for duodenal ulcer in north India

OBJECTIVES

The present study was designed to evalutate the association of various risk factors such as smoking, alcohol, NSAIDs, inadequate dietary intake of fibres and consumption of spicy foods with chronic duodenal ulcer using a case-control design and to establish the association of Helicobacter pylori and duodenal ulcer using different diagnostic techniques in Indian subjects.

MATERIALS

A total of 16 consecutive patients with endoscopically proven duodenal ulcer (DU) constituted the test group while 160 subjects with non-ulcer dyspepsia (NUD) were recruited as controls.

METHODS

All subjects were interviewed based on a standard questionnaire and underwent an upper gastrointestinal endsocopy wherein multiple biopsies were taken for rapid urease test (RUT), histology and culture for detection of H. pylori. The serum samples of all the subjects were tested for the presence of antibodies against H. pylori using ELISA.

RESULTS

There were significantly greater number of smokers (80%) and alcoholics (58%) in the male population of DU group as compared to the controls (49% smokers & 15% alcoholics). Similar trend was seen in relation to history of chronic exposure to NSAIDs (29% in DU & 11% in NUD) and inadequate intake of fibre in diet (66% and 39% respectively). The overall prevalence of H. pylori was 82.5% in DU and 50.6% in NUD [p < 0.001].

CONCLUSIONS

In North Indian subjects, alcohol consumption, smoking, inadequate intake of fibre in diet and use of NSAIDs are the risk factors associated with doudenal ulcer disease. Further, infection with H. pylori is strongly associated with DU in the North Indian population.

Risperidone in Indian patients with schizophrenia

Conventional antipsychotic agents are not effective against negative symptoms of schizophrenia and are also noted for their extrapyramidal side effects. Risperidone is a noval antipsychotic agent whose dual antagonism of dopamine and serotonin receptors is believed to underlie its efficacy against negative symptoms and the low incidence of extrapyramidal side effects. An open, non-comparative study of seven weeks duration was performed to evaluate risperidone in the treatment of schizophrenia in Indian patients. Previous antipsychotic therapy was discontinued for a week before risperidone therapy was initiated. At the end of six weeks of risperidone therapy, clinical improvement (≥ 20% reduction in total score on positive and negative syndrome scale for schizophrenia (PANSS;; was shown by 128 (87.7%) of the 146 evaluable patients. Statistically significant reduction (p < 0.05) occurred in the total score of this scale and in the subscale scores for positive, negative and general psychopathology symptoms and in the clinical global impression severity score. The number of patients with adverse experiences were 108 (65.5%) at baseline and 120 (72.7%) at the end of risperidone therapy. Extrapyramidal symptoms, seen in 65 (39.4%) patients compared to 22 (13.3%) patients at baseline, were largely mild to moderate in intensity.

Ectopic ACTH syndrome due to bronchial carcinoid tumour--a case report

A patient is reported who had Cushing's syndrome and carcinoid tumour of the bronchus. The case illustrates the difficulty in preoperative localization of the ectopic ACTH source and the surgical management of such patients.

Basal nitric oxide release differentially modulates vasodilations by pinacidil and levcromakalim in goat coronary artery

In the current investigation, the role of basal nitric oxide (NO) in modulating the vasorelaxant responses to pinacidil and levcromakalim was examined in goat isolated coronary artery. Pinacidil (10(-8) 10(-4) M) elicited concentration-dependent relaxations of the coronary artery ring segments (with intact endothelium) constricted with 30 mM K+ saline solution. The EC50 of the vasodilator was 2.57 x 10(-6) M (95% CL, 1.9-3.46 x 10(-6) M). The removal of endothelium by mechanical rubbing caused a rightward shift in the concentration-response curve of pinacidil with a corresponding increase in EC50 value (1.90 x 10(-5) M; 95% CL, 1.12-3.23 x 10(-5) M). Similar to endothelium removal, treatment of endothelium-intact rings either with the NO synthesis inhibitor L-NAME (NG-nitro-L-arginine methyl ester; 3 x 10(-5) M) or the guanylate cyclase inhibitor, methylene blue (3 x 10(-6) M) resulted in a marked inhibition in the relaxant responses to pinacidil. Hence, the EC50 values of the potassium channel opener were significantly higher in tissues treated either with L-NAME (7.41 x 10(-6) M; 95% CL, 6.02-9.12 x 10(-6) M) or methylene blue (2.29 x 10(-5) M; 95% CL, 1.58-3.31 x 109-5) M) as compared to untreated controls. The ATP-sensitive potassium (KATP) channel blocker glibenclamide, which caused a significant rightward shift in the concentration-relaxation curve of pinacidil in control tissues, was found to be less potent in antagonising the relaxant responses of the KATP channel opener in endothelium-denuded rings and in rings with intact endothelium but treated with either L-NAME or methylene blue. In contrast to the observations made with pinacidil, the vasodilator responses to another KATP channel opener, levcromakalim, were potentiated in the absence of basal NO. Thus, the EC50 of levcromakalim was 1.33 x 10(-8) M (95% CL, 0.8-2.21 x 10(-8) M) in control tissues with intact endothelium, which was significantly higher than those obtained in endothelium-deprived rings (4.81 x 10(-9) M; 95% CL, 4.04-5.73 x 10(-9) M) or endothelium intact rings treated either with L-NAME (2.63 x 10(-9) M; 95% CL, 1.58-4.36 x 10(-9) M) or methylene blue (2.82 x 10(-9) M; 95% CL, 1.7-4.68 x 10(-9) M). The selective modulation by basal NO of the arterial relaxations elicited with the KATP channel openers was evident from the findings that papaverine-induced relaxations were not affected in the absence of basal NO. Taken together, the results of the present study suggest that basal NO differentially modulates the interaction of pinacidil and levcromakalim with the KATP channels in goat coronary artery through a cGMP-dependent pathway.

Acute suppurative thyroiditis with demonstrable distant primary focus: a report of two cases

Two cases of acute suppurative thyroiditis occurring in a normal thyroid gland secondary to a demonstrable primary focus at a distant site are described and the role of interventional radiology in the management is discussed.

Micropropagation of nodal explants from adult trees of Cleistanthus collinus

The micropropagation of adult Cleistanthus collinus was accomplished. The nodal segments from terminal twigs of a 15-year-old tree and basal sprouts of a comparable chronological age were used for initiating shoot bud cultures. Washing explants with sterile mixtures of citric acid (520.5 µM) and PVP 40 (3.75 µM) three to four times controlled the leaching of brown inhibitory substances into the establishment medium. Axillary shoots proliferated best on MS medium containing citric acid (104.1 µM), and PVP 40 (12.5 or 25 µM) supplemented with 0.44 µM BA. The number of new shoots from nodal segments of explants placed on MS medium supplemented with 0.44 µM BA increased when the remaining lengths of nodal segments were transferred to fresh medium after the longer microshoots were harvested. The microshoots derived from basal sprouts rooted best (50%) when treated with 11.4 mM IAA for 2 min, whereas only 40% of the microshoots derived from terminal twigs produced roots after a 2-min exposure to 28.5 mM IAA. The placement of BA-soaked agar cubes on the apex-decapitated shoots controlled shoot-tip necrosis considerably. In general, explants from basal sprouts were more suitable than terminal twig explants for the micropropagation of adult trees of C. collinus.

Fungal colonization of air filters and insulation in a multi-story office building: production of volatile organics

Secondary air filters in the air-handling units on four floors of a multi-story office building with a history of fungal colonization of insulation within the air distribution system were examined for the presence of growing fungi and production of volatile organic compounds. Fungal mycelium and conidia of Cladosporium and Penicillium spp. were observed on insulation from all floors and both sides of the air filters from one floor. Lower concentrations of volatile organics were released from air filter medium colonized with fungi as compared with noncolonized filter medium. However, the volatiles from the colonized filter medium included fungal metabolites such as acetone and a carbonyl sulfide-like compound that were not released from noncolonized filter medium. The growth of fungi in air distribution systems may affect the content of volatile organics in indoor air.

Effect of simulated microgravity and shear stress on microcin B17 production by Escherichia coli and on its excretion into the medium

Production of the antibacterial polypeptide microcin B17 (MccB17) by Escherichia coli ZK650 was inhibited by simulated microgravity. The site of MccB17 accumulation was found to be different, depending on whether the organism was grown in shaking flasks or in rotating bioreactors designed to establish a simulated microgravity environment. In flasks, the accumulation was cellular, but in the reactors, virtually all the microcin was found in the medium. The change from a cellular site to an extracellular one was apparently not a function of gravity, since extracellular production occurred in these bioreactors, irrespective of whether they were operated in the simulated microgravity or normal gravity mode. More probably, excretion is due to the much lower degree of shear stress in the bioreactors. Addition of even a single glass bead to the 50-ml medium volume in the bioreactor created enough shear to change the site of MccB17 accumulation from the medium to the cells.

Development of an antimicrobial susceptibility testing method suitable for performance during space flight

Very little is known regarding the effects of the microgravity environment of space flight upon the action of antimicrobial agents on bacterial pathogens. This study was undertaken to develop a simple method for conducting antibacterial susceptibility tests during a space shuttle mission. Specially prepared susceptibility test research cards (bioMérieux Vitek, Hazelwood, Mo.) were designed to include 6 to 11 serial twofold dilutions of 14 antimicrobial agents, including penicillins, cephalosporins, a beta-lactamase inhibitor, vancomycin, erythromycin, tetracycline, gentamicin, ciprofloxacin, and trimethoprim-sulfamethoxazole. MICs of the drugs were determined by visual reading of color end points in the Vitek research cards made possible by incorporation of a colorimetric growth indicator (alamarBlue; Accumed International, Westlake, Ohio). This study has demonstrated reproducible susceptibility results in the testing of isolates of Staphylococcus aureus, group A Streptococcus species, Enterococcus faecalis, Escherichia coli (beta-lactamase-positive and -negative strains), Klebsiella pneumoniae, Enterobacter cloacae, and Pseudomonas aeruginosa. In some instances, the MICs were comparable to those determined by a standard broth microdilution method, while in some cases the unique test media and format yielded slightly different values that were themselves reproducible. The proposed in-flight experiment will include inoculation of the Vitek cards on the ground prior to launch of the space shuttle, storage of inoculated cards at refrigeration temperature aboard the space shuttle until experiment initiation, and then incubation of the cards for 18 to 48 h prior to visual interpretation of MICs by the mission's astronauts. Ground-based studies have shown reproducible MICs following storage of inoculated cards for 7 days at 4 to 8 degrees C to accommodate the mission's time schedule and the astronaut's activities. For comparison, ground-based control (normal gravity) MIC values will be generated by simultaneous inoculation and incubation of a second set of test cards in a laboratory at the launch site. This procedure can provide for a safe and compact experiment that should yield new information on the effects of microgravity on the biological activities of various classes of antibiotics.

Pioglitazone and metformin reverse insulin resistance induced by tumor necrosis factor-alpha in liver cells

Tumor necrosis factor-alpha (TNF-alpha) has recently been implicated as a cause of insulin resistance (IR) in obesity and non-insulin dependent diabetes mellitus (NIDDM). To examine mechanisms involved, we induced IR induced IR in H-411 E cells with graded doses of TNF-alpha and measured the ability of insulin (INS) to stimulate both calmodulin (CaM) mRNA and glucose utilization. With TNF-alpha concentration at 1 ng/ml and 10(4) muU/ml INS, metformin 10 microM and pioglitazone 1.5 microM, reversed the IR induced by TNF-alpha restoring biologic response to 100% of INS effect alone. Furthermore, comparable results were obtained with glucose utilization/oxidation experiments in the H-411 E cells using glucose U-14C, trapping 14CO2 release in a hyamine filter and extracting 14C labelled lipids with Dole's reagent. In condusion, these data add scientific support for the use of both metformin and pioglitazone in treatment of IR in NIDDM patients and support a rationale for use of use of these drugs alone, and in conjuction with oral agents and/or INS treatment.

Identification of specific sites in the TNF-alpha molecule promoting insulin resistance in H-411E cells

Data from a number of laboratories support a potential role for tumor necrosis factor-alpha (TNF-alpha) in the loss of insulin sensitivity and the pathogenesis of insulin resistance (IR) in diabetic animal models and human patients. We designed experiments to establish a dose-response relationship for TNF-alpha and IR in H-411E cells in culture. IR was measured by inhibition of the ability of graded amounts of insulin to stimulate expression of calmodulin (CaM) mRNA in these cells. This was assessed by autoradiographs of Northern blot(s) of CaM mRNA probed with labeled oligonucleotide cDNA for rat CaM. We found that TNF-alpha at 0.1, 1.0, and 10.0 ng/ml opposed 10,000 microU/ml insulin (i.e., %IR = 20%, 67%, and 88%, respectively). At 1.0 ng/ml TNF-alpha, insulin at the concentration of 1000 microU/ml (0.006 micromol/L) stimulated CaM mRNA at a 41% level and at 10,000 microU/ml (0.06 micromol/L) at a 63% level. Furthermore, oligopeptide TNF-alpha homologs (at 1000 x the molar concentration of TNF-alpha) TNF-alpha 69-100 and TNF-alpha 133-157 conferred 66% and 101% IR, respectively, while all other peptide fragments of TNF-alpha were essentially without effect. Studies done with both monoclonal and polyclonal antibodies to the TNF-alpha receptor demonstrated blocking activity by polyclonal but not by monoclonal anti TNF-alpha receptor antibody. This supports the concept that the activity of the peptide fragments occurs through the TNF-alpha receptor and not through nonspecific translocation across the plasma membrane. These data suggest that the epitopes on TNF-alpha that mediate IR reside in two regions of the molecule spanning amino acid residues 69-100 and 133-157.

K(ATP) channels do not mediate vasodilation by 3-morpholinosydnonimine in goat coronary artery

The present study investigated the role of ATP-sensitive potassium (K(ATP)) channels in mediating relaxation to the nitric oxide (NO) donor, 3-morpholinosydnonimine (SIN-1) in goat coronary arteries. SIN-1 (10(-8)-10(-5) M) caused concentration-dependent relaxations of the coronary artery ring segments contracted with K+ (30 mM) with an EC50 of 6.61 x 10(-7) M. Methylene blue (3 x 10(-6) M) caused a rightward shift in the concentration-response curve of SIN-1 (10(-8)-3 X 10(-5) M) with a corresponding increase in the EC50 (3.62 x 10(-6) M) of the nitrovasodilator. While the K(ATP) channel blocker, glibenclamide (1 and 3 x 10(-6) M) caused dose-dependent inhibition of vasorelaxations produced by pinacidil (10(-8)-10(-4) M), it had no effect on the vasodilations elicited by SIN-1 (10(-8)-10(-5) M) in the coronary arterial smooth muscle. Increasing the extracellular K+ concentration from 30 mM to 80 mM to reduce the K+ gradient across the cell membrane, inhibited the relaxations elicited by pinacidil (10(-8)-10(-4) M). On the other hand, SIN-1 (10(-8)-10(-5) M)-induced relaxations were potentiated in high K+ (80 mM) compared to those observed at K+ (30 mM). These results suggest that goat coronary artery vasodilations caused by the NO donor, SIN-1, do not involve K(ATP) channels.

Post-thyroidectomy haemorrhage: an analysis of critical factors in successful management

Haemorrhage following thyroidectomy is a well known complication and early intervention is advocated to avoid fatality. Traditionally more emphasis has been given to the amount of drainage, increasing size of the swelling and obvious signs of respiratory obstruction as indications of re-exploration leading to delay, and subtle features of hypoxia like tachycardia, sweating, irritability and confusion resulting from upper airway oedema are usually ignored. The authors described their experience of post-thyroidectomy haemorrhage in 396 thyroidectomies performed during a 6-year period (1989-1995) for various thyroid disorders. All these patients were detected early in the postoperative course based on subtle signs of hypoxia and re-explored. There were 10 cases of post-thyroidectomy haemorrhage and they were successfully managed early in the postoperative period with excellent outcome. Close postoperative monitoring for features of hypoxia rather than external evidence of haemorrhage is the key factor in early detection and successful management of such a fatal complication.

alpha, beta-Arteether for the treatment of complicated falciparum malaria

alpha, beta-Arteether is an ethyl ether derivative of artemisinin which is an efficient schizontocidal drug in mild falciparum malaria. The present study reports the efficacy of the drug in severe falciparum malaria. Fifty patients with severe falciparum malaria were given intramuscular arteether, 150 mg, once daily on 3 consecutive days. The median fever clearance time was 72 h (range 12-120 h) and the median parasite clearance time was 2 d (range 1-4 d). Rapid recovery from coma was observed in cerebral malaria patients (after a median of 18 h, range 6-72 h). The recovery from other complications was also faster and complete. Two patients died; both had cerebral malaria and haemolytic jaundice, one had respiratory distress needing ventilatory support and the other had severe anaemia. Recrudescence within 28 d was observed in 7 patients. Drug toxicity or significant side effects were not noticed in any patient.

Intraoperative ultrasonography for insulinoma: a preliminary experience

BACKGROUND

A majority of insulinomas are benign and intrapancreatic. Because surgery is curative in 90% of cases, and almost 60% are not detected by preoperative imaging studies, precise intraoperative localization is essential. Recently, the use of high-resolution real-time ultrasonography has facilitated intraoperative detection.

METHODS

Intraoperative ultrasonography using a high-frequency probe was performed in four patients with biochemically proven insulinomas.

RESULTS

Ultrasonography helped to localize the insulinomas, and also helped in surgical decision-making by accurately documenting the relationship of the tumor to vital structures.

CONCLUSION

Besides its ability to find islet cell tumors, intraoperative ultrasonography also affects surgical decision-making.

Gramicidin S production by Bacillus brevis in simulated microgravity

In a continuing study of microbial secondary metabolism in simulated microgravity, we have examined gramicidin S (GS) production by Bacillus brevis strain Nagano in NASA High Aspect Rotating Vessels (HARVs), which are designed to simulate some aspects of microgravity. Growth and GS production were found to occur under simulated microgravity. When performance under simulated microgravity was compared with that under normal gravity conditions in the bioreactors, GS production was found to be unaffected by simulated microgravity. The repressive effect of glycerol in flask fermentations was not observed in the HARV. Thus the negative effect of glycerol on specific GS formation is dependent on shear and/or vessel geometry, not gravity.

Secondary metabolism in simulated microgravity: beta-lactam production by Streptomyces clavuligerus

Rotating bioreactors designed at NASA's Johnson Space Center were used to simulate a microgravity environment in which to study secondary metabolism. The system examined was beta-lactam antibiotic production by Streptomyces clavuligerus. Both growth and beta-lactam production occurred in simulated microgravity. Stimulatory effects of phosphate and L-lysine, previously detected in normal gravity, also occurred in simulated microgravity. The degree of beta-lactam antibiotic production was markedly inhibited by simulated microgravity.

Pulse oximetry for the assessment of autonomic neuropathy in diabetic patients

Altered vascular responses to various thermal stimuli correlate well with the changes of autonomic neuropathy. These responses were assessed by the use of pulse oximetry. Standard cardiac autonomic function tests were performed in normal subjects (n = 12), diabetic patients without autonomic neuropathy (n = 8), and diabetic patients with autonomic neuropathy (n = 7). Autonomic functions in the same patients then were assessed by estimating the severity of vasospasm in response to cold stimulus with the help of pulse oximetry. Percentage fall in oxygen saturation at 15, 30, 60, 90, and 120 sec of exposure to cold stimulus was recorded on pulse oximeter. Time required for recovery and presence or absence of rebound rise following removal of cold stimulus were noted. In diabetics with autonomic neuropathy, the rate of fall in percentage oxygen saturation was significantly slower (p < 0.0001), less intense (p < 0.0001) and with delayed subsequent recovery (p = 0.013), compared to normal subjects. Rebound rise in oxygen saturation was absent in all the diabetics with autonomic neuropathy, compared to 2 of 12 normal subjects (p < 0.0001). We conclude that pulse oximetry may be a potentially useful, simple, and noninvasive bedside method for assessment of diabetic autonomic neuropathy.

Epidemiology of Staphylococcus aureus during space flight

Staphylococcus aureus was isolated over 2 years from Space Shuttle mission crewmembers to determine dissemination and retention of bacteria. Samples before and after each mission were from nasal, throat, urine, and feces and from air and surface sampling of the Space Shuttle. DNA fingerprinting of samples by digestion of DNA with SmaI restriction endonuclease followed by pulsed-field gel electrophoresis showed S. aureus from each crewmember had a unique fingerprint and usually only one strain was carried by an individual. There was only one instance of transfer between crewmembers. Strains from interior surfaces after flight matched those of crewmembers, suggesting microbial fingerprinting may have forensic application.

Evaluation of the Biolog MicroStation system for yeast identification

One hundred and fifty-nine isolates representing 16 genera and 53 species of yeasts were processed with the Biolog MicroStation System for yeast identification. Thirteen genera and 38 species were included in the Biolog database. For these 129 isolates, correct identifications to the species level were 13.2, 39.5 and 48.8% after 24, 48 and 72 hours incubation at 30 degrees C, respectively. Three genera and 15 species which were not included in the Biolog database were also tested. Of the 30 isolates studied, 16.7, 53.3 and 56.7% of the isolates were given incorrect names from the system's database after 24,48 and 72 h incubation at 30 degrees C, respectively. The remaining isolates of this group were not identified.

Modulation of vascular KATP channels in hypothyroidism

The role of vascular KATP channels in hypothyroidism-induced decrease in myogenic activity of rat portal vein was examined by using pharmacologically relevant concentrations of K+ channel ligands. As compared to controls, a significant decrease in the myogenic tone and noradrenaline (10(-9)-10(-5) M)-induced contractions was observed in portal veins from hypothyroid rats. In both euthyroid and hypothyroid states, pinacidil (10(-9)-10(-5) M) and cromakalim (10(-9)-10(-5) M) caused concentration-related inhibition of the myogenic tone (frequency and amplitude). However, hypothyroidism caused a leftward shift in the concentration-response curves of the K+ channel openers with a corresponding decrease in their IC50 values both in the absence and presence of the KATP channel blocker, glibenclamide (10(-7) M). Further, concentration-dependent increase in the frequency of myogenic tone by glibenclamide (10(-8)-3 x 10(-6) M) was greater in tissues from hypothyroid rats (EC50 = 2.07 x 10(-7) M; 95% CL, 1.06-4.05 x 10(-7) M) in comparison to controls (EC50 = 8.07 x 10(-7) M; 95% CL, 0.53-1.22 x 10(-6) M). These results suggest that a decrease in the myogenic tone of rat portal vein may possibly be related to an enhanced opening of the KATP channels in hypothyroidism.

Functional and morphometric study of cryopreserved human parathyroid tissue transplanted into nude mice

As part of an ongoing study of the characteristics of transplanted fresh normal and pathologic parathyroid tissues, we transplanted cryopreserved human parathyroid tissue into nude mice. Hyperplastic glands cryopreserved for various lengths of time (<2 weeks and >1 year) were transplanted into the gluteus muscle of nude mice. Specimens grafted were of two sizes: 10 mg and 30 mg. Serum human parathyroid hormone (hPTH) concentration was estimated by a double-antibody immunoradiometric assay prior to transplantation and 2, 4, and 8 weeks after transplantation. A low-calcium diet was given to some mice to evaluate any effects on the grafts of low serum concentrations of calcium. All mice were killed 4 hours after injection of bromodeoxyuridine (Brd U) for assessment of the cell proliferation in grafted parathyroid tissue. Although hPTH secretion of cryopreserved tissue was only half that of fresh tissue, the cryopreserved tissue released hPTH, as did fresh tissue. hPTH secretion was accelerated by stimulation of a low-calcium diet, and PTH secretion was positively correlated with the volume of transplanted tissue. The number of Brd U-immunoreactive cells was correlated with the serum concentration of hPTH (r = 0.95), which indicates that cell proliferation is closely related to PTH secretion under the condition of successful transplantation. The experimental transplantation of cryopreserved tissue into nude mice, coupled with a concise immunohistochemical study of the grafts conducted prior to their transplantation into humans, can contribute to the evaluation of PTH secretion and cell proliferation.

Completion total thyroidectomy in the management of differentiated thyroid carcinoma

BACKGROUND

Completion thyroidectomy is the removal of any thyroid tissue that remains after a less than total thyroidectomy. This procedure has been commonly performed when the final histopathology of the excised ipsilateral thyroid lobe reveals papillary or follicular carcinoma of the thyroid. Complete thyroidectomy carries little morbidity if performed by experienced surgeons using a lateral approach. The purpose of this study is to reinforce the usefulness of a lateral approach.

METHODS

A retrospective analysis over a 5 year period at the Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) yielded 19 patients who underwent completion thyroidectomy. This group represents 23% of 82 patients who underwent total thyroidectomy for differentiated thyroid cancer (DTC) during that period. The residual thyroid tissue was excised through a lateral approach and could be resected safely, preserving the recurrent laryngeal nerve (RLN) and the parathyroid glands.

RESULTS

A lateral approach dissection could be performed with ease in a virgin area. Excision of residual thyroid tissue could be performed safely even in cases with prior partial lobectomy or bilateral subtotal resection. Tumour was found in 52% of the re-operative specimens: in three out of four of those after a previous partial lobectomy, in six out of 12 of those after a total lobectomy, and in one out of three of those after a prior bilateral (although incomplete) thyroid resection. Postoperative complications included transient RLN palsy (n = 2) and transient hypoparathyroidism (n = 4).

CONCLUSIONS

Completion thyroidectomy using a lateral approach is safe in re-operative thyroid surgery.

Fungal colonization of fiberglass insulation in the air distribution system of a multi-story office building: VOC production and possible relationship to a sick building syndrome

Complaints characteristic of those for sick building syndrome prompted mycological investigations of a modern multi-story office building on the Gulf coast in the Southeastern United States (Houston-Galveston area). The air handling units and fiberglass duct liner of the heating, ventilating and air conditioning system of the building, without a history of catastrophic or chronic water damage, demonstrated extensive colonization with Penicillium spp and Cladosporium herbarum. Although dense fungal growth was observed on surfaces within the heating-cooling system, most air samples yielded fewer than 200 CFU m-3. Several volatile compounds found in the building air were released also from colonized fiberglass. Removal of colonized insulation from the floor receiving the majority of complaints of mouldy air and continuous operation of the units supplying this floor resulted in a reduction in the number of complaints.

Evaluation of three portable samplers for monitoring airborne fungi

Airborne fungi were monitored at five sample sites with the Burkard portable, the RCS Plus, and the SAS Super 90 air samplers; the Andersen 2-stage impactor was used for comparison. All samplers were calibrated before being used simultaneously to collect 100-liter samples at each site. The Andersen and Burkard samplers retrieved equivalent volumes of airborne fungi; the SAS Super 90 and RCS Plus measurements did not differ from each other but were significantly lower than those obtained with the Andersen or Burkard samplers. Total fungal counts correlated linearly with Cladosporium and Penicillium counts. Alternaria species, although present at all sites, did not correlate with total count or with amounts of any other fungal genera. Sampler and location significantly influenced fungal counts, but no interactions between samplers and locations were found.

Delivery practices in west Uttar Pradesh

The present study has been planned to identify healthy and unhealthy delivery practices in rural U.P. specially with reference to five cleans recommended under national C.S.S.M. programme. A total 120 women who had delivered in recent past were interviewed. Only in 3.1 percent deliveries, proper washing of floor was done, in 43 percent deliveries the cord cutting instrument was not sterilized and in about 65 percent deliveries mustard oil and ghee was used as first cord applicant.

Index, comprehensive microsatellite, and unified linkage maps of human chromosome 14 with cytogenetic tie points and a telomere microsatellite marker

Three sets of linkage maps (index, comprehensive microsatellite, and unified) have been constructed for human chromosome 14 based on genotypes from the CEPH reference pedigrees. The index maps consist of 18 microsatellite markers, with heterozygosities of at least 68% and intermarker spacing no greater than 11 cM. The sex-average comprehensive microsatellite map is 125 cM in length and includes 115 markers with 54 loci uniquely placed with odds for marker order of at least 1000:1. The sex-average index map length is 121 cM, and the female- and male-specific maps are 143 and 101 cM, respectively. A unified map was also constructed from 147 loci (162 marker systems), which includes 32 RFLP markers in addition to the 115 microsatellites. The sex-average length of the unified map is 128 cM with 69 loci uniquely placed. Our maps are anchored by a microsatellite telomere marker sCAW1 (D14S826), developed from a telomere YAC clone TYAC196, which extends the linkage map to the physical terminus of the long arm of chromosome 14. Furthermore, we have also physically mapped seven of the loci by fluorescence in situ hybridization of cosmid clones or Alu-PCR products amplified from YACs containing the marker sequences. Together with previously established cytogenetic map designations for other loci, our maps display links between genetic markers for 10 of 13 cytogenetic bands of chromosome 14 at the 550 genome band resolution.

Carcinoma in Graves' disease

Association of thyroid carcinoma in thyrotoxicosis is uncommon. Preoperative diagnosis of such association is difficult. In a retrospective study of 49 operated cases of Graves' disease (GD) such an association was found in four patients. Findings of a palpable nodule, calcification and a cold nodule on scanning in Graves' disease should increase suspicion for such an association and a frozen section study should be underken in all these cases during surgery to exclude possible co-existing malignancy.