G-quadruplex structures bind to EZ-Tn5 transposase

Next generation DNA sequencing and analysis of amplicons spanning the pharmacogene CYP2D6 suggested that the Nextera transposase used for fragmenting and providing sequencing priming sites displayed a targeting bias. This manifested as dramatically lower sequencing coverage at sites in the amplicon that appeared likely to form G-quadruplex structures. Since secondary DNA structures such as G-quadruplexes are abundant in the human genome, and are known to interact with many other proteins, we further investigated these sites of low coverage. Our investigation revealed that G-quadruplex structures are formed in vitro within the CYP2D6 pharmacogene at these sites, and G-quadruplexes can interact with the hyperactive Tn5 transposase (EZ-Tn5) with high affinity. These findings indicate that secondary DNA structures such as G-quadruplexes may represent preferential transposon integration sites and provide additional evidence for the role of G-quadruplex structures in transposition or viral integration processes.

Neurenteric cyst presenting with stridor and dysphagia: case report and literature review

OBJECTIVE

Neurenteric cysts are rare lesions that account for 0.7-1.3% of all spinal cord tumours. We report the first ever case of a neurenteric cyst presenting with stridor and dysphagia. A literature review on the presentation and management of these lesions is also included.

METHODS

A MEDLINE search of articles using the terms 'neurenteric cyst', 'intraspinal cyst', 'enterogenous cyst', 'intramedullary cyst' along with diagnosis, presentation and management was performed. Suitable references from these articles were also reviewed.

RESULTS

All published evidence on neurenteric cysts are either case series or case reports (level IV/V) with the largest case series reporting 23 patients from a single institution.

CONCLUSION

Neurenteric cysts are rare spinal cord lesions that usually present with focal neurological signs and managed within neurosurgical units. This is the first reported case of a neurenteric cyst presenting with upper aerodigestive tract symptoms warranting specialist ear, nose and throat input.

Within herd transmission and evaluation of the performance of clinical and serological diagnosis of foot-and-mouth disease in partially immune cattle herds

The control of foot-and-mouth disease (FMD) in vaccinated populations relies upon surveillance activities such as clinical inspections (CI) and serological monitoring. New evidence to refine current surveillance guidelines has been provided by evaluating (1) the diagnostic performance of CI and serological tests for detection of FMD virus (FMDV) non-structural proteins (NSP), and (2) the within-herd transmission of the virus in partially immune cattle. Data came from 23 affected herds during an epidemic of FMDV type O in Bolivia, in 2007. All cattle (n=957) in these herds were clinically inspected and serum samples were collected one month after the last animal with clinical signs was detected. Samples were tested for the presence of antibodies against NSP using the PANAFTOSA 3ABC-ELISA test and a subset of samples were tested using the enzyme-linked immunoelectrotransfer blot assay (EITB). Data from clinical and serological diagnoses were analysed using a Bayesian model. The sensitivity Se and specificity Sp of the tests, as well as the prevalence and the within-herd reproduction ratio R of FMDV were estimated. In addition, risk factors for infection were identified. The Se of CI, the 3ABC-ELISA and the EITB tests were estimated to be 0.30, 0.88 and 0.96 respectively. The estimated Sp, in the same order, were 0.88, 0.93 and 0.97. The within-herd prevalence of infected animals ranged from 0.04 to 0.91 and R ranged from 1.02 to 2.68. It was observed that cattle coming from areas with high vaccination coverage had a lower risk of becoming infected than home-bred cattle from the affected herds, where vaccination coverage was thought to be low. Although these estimates come from herds kept under specific conditions, they provide a reference for future surveillance design and can inform simulation models for surveillance and control of FMD in similar cattle populations.

Palliative care for dementia--time to think again?

It is estimated that there are 35.6 million people with dementia worldwide and this is projected to increase to over 115 million by the year 2050. Dementia is a progressive neurodegenerative disease that significantly reduces survival. End-of-life care received by this group is often poor and does not equate to that offered in other life limiting illnesses. This review highlights results from a large UK study of informal carers of people with dementia to explore what are determinants of care for people with dementia and their family carers. New perspectives as to models of care for end-of-life care for patients with dementia are discussed together with how these may be implemented and delivered within wider community settings and contexts, where many people with dementia may be cared for in the future.

The safety profile of a retrospective Accessory Postero-Lateral hind foot portal: the risk of sural nerve damage during visualisation of the Achilles tendon insertion

INTRODUCTION

The Accessory Postero-Lateral (AccPL) portal has recently been described to improve the visualisation for the endoscopic debridement of Haglund's tubercle. The safety of using this portal has been considered previously for posterior ankle arthroscopy. We performed a study to determine the proximity of the AccPL portal to the sural nerve.

METHODS

We compared the distances between AccPL and PL portals to the sural nerve in 17 cadaveric specimens.

RESULTS

The AccPL portal was significantly closer (mean 12.0mm, range 6-19 mm, SD=3.64) to the sural nerve than the PL portal (mean 14.1mm, range 11-18 mm, SD=2.34) (t(16)=-2.34, p=0.03). In two cases the sural nerve was in contact with the clip but on close inspection, the nerve had not been damaged in any of the specimens.

CONCLUSIONS

We conclude that the AccPL portal is a safe method to allow visualisation during endoscopic debridement of the Achilles tendon insertion. We also recommend that the portal is used for visualisation rather than instrumentation.

Microbial water pollution: a screening tool for initial catchment-scale assessment and source apportionment

The European Union Water Framework Directive requires that Management Plans are developed for individual River Basin Districts. From the point of view of faecal indicator organisms (FIOs), there is a critical need for screening tools that can provide a rapid assessment of the likely FIO concentrations and fluxes within catchments under base- and high-flow conditions, and of the balance ('source apportionment') between agriculture- and sewage-derived sources. Accordingly, the present paper reports on: (1) the development of preliminary generic models, using water quality and land cover data from previous UK catchment studies for assessing FIO concentrations, fluxes and source apportionment within catchments during the summer bathing season; (2) the calibration of national land use data, against data previously used in the models; and (3) provisional FIO concentration and source-apportionment assessments for England and Wales. The models clearly highlighted the crucial importance of high-flow conditions for the flux of FIOs within catchments. At high flow, improved grassland (and associated livestock) was the key FIO source; FIO loadings derived from catchments with high proportions of improved grassland were shown to be as high as from urbanized catchments; and in many rural catchments, especially in NW and SW England and Wales, which are important areas of lowland livestock (especially dairy) farming, ≥ 40% of FIOs was assessed to be derived from agricultural sources. In contrast, under base-flow conditions, when there was little or no runoff from agricultural land, urban (i.e. sewerage-related) sources were assessed to dominate, and even in rural areas the majority of FIOs were attributed to urban sources. The results of the study demonstrate the potential of this type of approach, particularly in light of climate change and the likelihood of more high-flow events, in underpinning informed policy development and prioritization of investment.

Quantitative catchment profiling to apportion faecal indicator organism budgets for the Ribble system, the UK's sentinel drainage basin for Water Framework Directive research

Under the EU Water Framework Directive (WFD) 20/60/EC and the US Federal Water Pollution Control Act 2002 management of water quality within river drainage basins has shifted from traditional point-source control to a holistic approach whereby the overall contribution of point and diffuse sources of pollutants has to be considered. Consequently, there is a requirement to undertake source-apportionment studies of pollutant fluxes within catchments. The inclusion of the Bathing Water Directive (BWD), under the list of 'protected areas' in the WFD places a requirement to control sources of faecal indicator organisms within catchments in order to achieve the objectives of both the BWD (and its revision - 2006/7/EC) and the WFD. This study was therefore initiated to quantify catchment-derived fluxes of faecal indicator compliance parameters originating from both point and diffuse sources. The Ribble drainage basin is the single UK sentinel WFD research catchment and discharges to the south of the Fylde coast, which includes a number of high profile, historically non-compliant, bathing waters. Faecal indicator concentrations (faecal coliform concentrations are reported herein) were measured at 41 riverine locations, the 15 largest wastewater treatment works (WwTWs) and 15 combined sewer overflows (CSOs) across the Ribble basin over a 44-day period during the 2002 bathing season. The sampling programme included targeting rainfall-induced high flow events and sample results were categorised as either base flow or high flow. At the riverine sites, geometric mean faecal coliform concentrations showed statistically significant elevation at high flow compared to base flow. The resultant faecal coliform flux estimates revealed that over 90% of the total organism load to the Ribble Estuary was discharged by sewage related sources during high flow events. These sewage sources were largely related to the urban areas to the south and east of the Ribble basin, with over half the load associated with the relatively small subcatchment of the River Douglas. The majority of this load was attributed to two WwTWs that discharge through a common outfall close to the tidal limit of this catchment. Budgets adjusted to accommodate the impact of proposed UV disinfection of these effluents showed that the load from these sources would be reduced significantly during base flow conditions. However, during high flow events loads would still remain high due to the operation of storm sewage overflows from stormwater retention tanks. The study identified untreated storm sewage spills from urban infrastructure and WwTW stormwater retention tanks as the dominant component of the high flow flux of faecal indicators to receiving waters of the Fylde coast and the associated bathing waters.

Faecal indicator organism concentrations and catchment export coefficients in the UK

Characterisation of faecal indicator organism (FIO) concentrations and export coefficients for catchments with particular combinations of land use and under specific climatic regimes is critical in developing models to predict daily loads and apportion sources of the microbial parameters used to regulate water quality. Accordingly, this paper presents a synthesis of FIO concentration and export coefficient data for the summer bathing season, with some comparative winter data, for 205 river/stream sampling points widely distributed across mainland UK. In terms of both geometric mean (GM) FIO concentrations and export coefficients (expressed as cfu km(-2) h(-1)), the results reveal (1) statistically significant elevations at high flow compared with base flow, with concentrations typically increasing by more than an order of magnitude and export coefficients by about two orders; (2) significantly higher values in summer than in winter under high-flow conditions; and (3) extremely wide variability between the catchments (e.g. four orders of magnitude range for GM faecal coliform concentrations), which closely reflects land use-with urban areas and improved pastures identified as key FIO sources. Generally, these two most polluting land uses are concentrated in lowland areas where runoff (m3 km(-2) h(-1)) is low compared with upland areas, which in the UK are dominated by rough grazing and forestry. Consequently, contrasts in export coefficients between land use types are less than for FIO concentrations. The GMs reported for most land use categories are based on 13 sites and exhibit quite narrow confidence intervals. They may therefore be applied with some confidence to other catchments in the UK and similar geographical regions elsewhere. Examples are presented to illustrate how the results can be used to estimate daily summer base- and high-flow FIO loads for catchments with different land use types, and to assess the likely effectiveness of certain strategies for reducing FIO pollutant loadings in areas with extensive areas of lowland improved pasture.

Faecal indicator organism concentrations in sewage and treated effluents

The importance of faecal indicator organism (FIO) fluxes within drainage basins is increasing as the European Union (EU) Water Framework Directive and the United States Clean Water Act place requirements on regulators to manage point and diffuse sources of microbial pollution causing non-compliance (EU) or impairment (US) of receiving waters. Central to this management task is knowledge of the likely FIO concentrations in raw sewage and treated effluents, but few empirical data have been published in the peer-reviewed literature. Accordingly, this paper presents results for 1933 samples from 162 different sewage discharge sites in the UK and Jersey, which encompass 12 types of sewage-related discharge, representative of untreated sewage and primary-, secondary- and tertiary-treated effluents. Geometric means (GMs) and 95% confidence intervals (CIs) have been used to characterise base- and high-flow FIO concentrations. The data sets and sub-sets are mostly quite large (n 40) and may therefore be applied with some confidence to comparable discharge sites in similar geographical regions. Very marked, statistically significant reductions in GM FIO concentrations result from secondary and tertiary treatment, and there are statistically significant differences between some secondary and some tertiary treatments. Flow conditions are also shown to be important: untreated sewage and effluent from primary treatment plant have lower concentrations at high flow, due to dilution within combined sewerage systems, whereas some treated effluents (e.g. from activated sludge plant) have higher concentrations at high flow because of the shorter residence time within the plant. Under base-flow conditions, secondary treatments result in estimated GM FIO reductions of 95.22-99.29% (cf. primary-treated effluent). Corresponding figures for tertiary treatment plants (cf. secondary-treated effluent) are 93.24-96.59% for reedbed/grass plots and 99.71-99.92% for UV disinfection. Results suggest that secondary and tertiary treatment plants are less effective under high-flow conditions, but further high-flow sampling is required to confirm this.

Reducing fluxes of faecal indicator compliance parameters to bathing waters from diffuse agricultural sources: the Brighouse Bay study, Scotland

The European Water Framework Directive requires the integrated management of point and diffuse pollution to achieve 'good' water quality in 'protected areas'. These include bathing waters, which are regulated using faecal indicator organisms as compliance parameters. Thus, for the first time, European regulators are faced with the control of faecal indicator fluxes from agricultural sources where these impact on bathing water compliance locations. Concurrently, reforms to the European Union (EU) Common Agricultural Policy offer scope for supporting on-farm measures producing environmental benefits through the new 'single farm payments' and the concept of 'cross-compliance'. This paper reports the first UK study involving remedial measures, principally stream bank fencing, designed to reduce faecal indicator fluxes at the catchment scale. Considerable reduction in faecal indicator flux was observed, but this was insufficient to ensure bathing water compliance with either Directive 76/160/EEC standards or new health-evidence-based criteria proposed by WHO and the European Commission.

The International Atomic Energy Agency (IAEA) experience in the development of validation systems leading to the OIE certification of diagnostic assays

For the past 15 years, the International Atomic Energy Agency (IAEA) has had a major interest in helping its member states to diagnose livestock diseases through the development and validation of diagnostic tests for trans-boundary animal diseases. In November, 2007, an IAEA consultants meeting attended by experts, OIE members and producers reviewed the OIE process for the recognition of tests to date. Conclusions concerning the application procedure were tabled by the general meeting and then specific producer recommendations were made. Both are shown below, along with conclusions regarding referencing in general. Some of the points brought up suggest major changes in the idea of trade prescription and test status.

Decay of intestinal enterococci concentrations in high-energy estuarine and coastal waters: towards real-time T90 values for modelling faecal indicators in recreational waters

Intestinal enterococci are the principal 'health-evidence-based' parameter recommended by WHO for the assessment of marine recreational water compliance. Understanding the survival characteristics of these organisms in nearshore waters is central to public health protection using robust modelling to effect real-time prediction of water quality at recreation sites as recently suggested by WHO and the Commission of the European Communities Previous models have more often focused on the coliform parameters and assumed two static day-time and night-time T90 values to characterise the decay process. The principal driver for enterococci survival is the received dose of irradiance from sunlight. In the water column, transmission of irradiance is determined by turbidity produced by suspended material. This paper reports the results of irradiated microcosm experiments using simulated sunlight to investigate the decay of intestinal enterococci in relatively turbid estuarine and coastal waters collected from the Severn Estuary and Bristol Channel, UK. High-turbidity estuarine waters produced a T90 value of 39.5 h. Low-turbidity coastal waters produced a much shorter T90 value of 6.6 h. In experiments receiving no irradiation, high-turbidity estuarine waters also produced a longer T90 of 65.1 h compared with corresponding low-turbidity coastal waters, T90 24.8 h. Irradiated T90 values were correlated with salinity, turbidity and suspended solids (r>0.8, p<0.001). The results suggest that enterococci decay in irradiated experiments with turbidity >200 NTU is similar to decay observed under dark conditions. Most significantly, these results suggest that modelling turbidity and or suspended solids offers a potential means of predicting T90 values in 'real-time' for discrete cells of a hydrodynamic model.

Estimation of diffuse and point source microbial pollution in the ribble catchment discharging to bathing waters in the north west of England

Achieving compliance with the mandatory standards of the 1976 Bathing Water Directive (76/160/EEC) is required at all U.K. identified bathing waters. In recent years, the Fylde coast has been an area of significant investments in 'point source' control, which have not proven, in isolation, to satisfactorily achieve compliance with the mandatory, let alone the guide, levels of water quality in the Directive. The potential impact of riverine sources of pollution was first confirmed after a study in 1997. The completion of sewerage system enhancements offered the potential for the study of faecal indicator delivery from upstream sources comprising both point sources and diffuse agricultural sources. A research project to define these elements commenced in 2001. Initially, a desk study reported here, estimated the principal infrastructure contributions within the Ribble catchment. A second phase of this investigation has involved acquisition of empirical water quality and hydrological data from the catchment during the 2002 bathing season. These data have been used further to calibrate the 'budgets' and 'delivery' modelling and these data are still being analysed. This paper reports the initial desk study approach to faecal indicator budget estimation using available data from the sewerage infrastructure and catchment sources of faecal indicators.

The use of ITS1 rDNA PCR in detecting pathogenic African trypanosomes

There are 11 different pathogenic trypanosomes in trypanosomiasis endemic regions of Africa. Their detection and characterisation by molecular methods relies on species-specific primers; consequently several PCR tests have to be made on each sample. Primers ITS1 CF and ITS1 BR, previously designed to amplify the internal transcribed spacer (ITS1) of rDNA, have been evaluated for use in a universal diagnostic test for all pathogenic trypanosomes. Blood was collected from 373 cattle and 185 camels. The primers gave constant PCR products with the stocks of each taxon tested. Members of subgenus Trypanozoon (T. brucei brucei, T. evansi, T. b. rhodesiense and T. b. gambiense) gave a constant product of approximately 480 bp; T. congolense, savannah 700 bp, T. congolense kilifi 620 bp and T. congolense forest 710 bp: T. simiae 400 bp, T. simiae tsavo 370 bp, T. godfreyi 300 bp and T. vivax 250 bp. The sensitivity of the test ranged from 10 pg for Trypanozoon, T. congolense clade and T. vivax to 100 pg for T. simiae and T. godfreyi. The primers detected cases of multi-taxa samples, although the sensitivity was reduced with an increase in the combinations. A better detection rate of trypanosome DNA was recorded with buffy coats than from direct blood. With the field samples, the diagnostic sensitivity was close to the sensitivity obtained using single reactions with species-specific primers for Trypanozoon 38/40 (95%) and T. congolense savannah 30/33 (90.9%) but was lower with T. vivax 25/31 (77.4%). The primers offer promise as a routine diagnostic tool through the use of a single PCR; however, further evaluation is recommended.

Modelling faecal indicator concentrations in large rural catchments using land use and topographic data

AIMS

To characterize and model spatial variations in faecal-indicator organism concentrations in watercourses draining a large rural catchment during the bathing season.

METHODS AND RESULTS

Presumptive coliform (PC), presumptive Eschericia coli (PE) and presumptive enterococci (PEnt) concentrations were determined under base- and high-flow conditions at 24 monitoring points in the Rheidol/Ystwyth catchment, Wales. Relationships with land use and topographic variables within their 'subcatchments' were investigated. Geometric mean (GM) concentrations typically increase more than 10-fold at high flow. The proportion of improved pasture within subcatchments explains 81.6, 73.0 and 85.8%, respectively, of the variance in high-flow GM PC, PE and PEnt concentrations. Distributed modelling suggests that organisms derived from more distant parts of subcatchments may be lost through die-off and sedimentation along watercourses at base flow, although not at high flow. Reductions in concentrations are also evident downstream of reservoir impoundments.

CONCLUSIONS

Large rural catchments may contribute substantially to faecal indicator loadings in coastal waters. Indicator concentrations can be modelled successfully using land use and topographic data.

SIGNIFICANCE AND IMPACT OF THE STUDY

Development of a modelling approach that provides valuable insight into faecal indicator sources and the transport and survival of these organisms within large catchments.

Relationships between microbial water quality and environmental conditions in coastal recreational waters: the Fylde coast, UK

This paper explores ways in which the analysis of microbial data from routine compliance monitoring, in combination with basic environmental data, can provide insight into the factors affecting faecal-indicator organism concentrations in coastal waters. In the case study presented, eight designated bathing waters on the Fylde coast are continuing to exhibit unreliable compliance with the Imperative standards for total coliform (TC) and faecal coliform (FC) concentrations specified in the EU Bathing Water Directive (76/160/EEC), despite significant reductions in geometric mean concentrations following recent major investment in the sewerage infrastructure. Faecal streptococci (FS) concentrations have remained high and have not been improved by the new sewerage schemes. The results suggest that, prior to the schemes, higher bacterial concentrations were strongly associated with rainfall; and sewage sources were important for TC and FC, but less important for FS, which may have been more strongly affected by diffuse catchment sources. In the post-schemes period, catchment sources appear to be of greater significance; rainfall remains as a significant, though less important, predictor; and tide height at time of sampling, together with variables such as sunshine and the proportion of onshore winds (which affect the survival and movement of bacteria that have already entered the coastal waters), assume greater significance. The approach used here provides a cost-effective management tool for the exploratory investigation of any monitoring point that is failing to meet recreational water quality standards.

Insular carcinoma of thyroid presenting as cervical cord compression

Insular carcinoma of thyroid is a very rare subtype of thyroid carcinoma which is characterized by its advanced stage at presentation and aggressive clinical course. We describe a case of insular carcinoma of the thyroid presenting in an unusual fashion with cervical cord compression at initial presentation. Cord compression is shown to be due to spinal metastases from vascular spread of the tumour and this typifies the high metastatic potential of this tumour subtype.

Identification of a human olfactory ensheathing cell that can effect transplant-mediated remyelination of demyelinated CNS axons

The olfactory ensheathing cell (OEC) has attracted much interest recently because of its potential for transplantation-based therapy of CNS disease. Rat OECs are able to remyelinate demyelinated axons and support regeneration of damaged axons. Although OECs can be grown readily from the rat, a macrosmatic species, it has been uncertain whether it would be similarly straightforward to obtain these cells from the human, a microsmatic species with a relatively poorly developed olfactory system. In this study, we have identified a human OEC which shares many properties with its rat counterpart, including expression of the low-affinity nerve growth factor receptor (L-NGFr) and similar growth factor requirements. Purified populations of human OECs obtained by selection with L-NGFr antibodies have extremely high viability in tissue culture, and are capable of remyelinating persistently demyelinated CNS axons following transplantation into experimentally induced demyelinating lesions in the rat spinal cord. Thus, the human OEC represents an important new cell for the development of transplant therapy of CNS diseases.

Study of the effect of gamma-irradiation on bovine serum samples on the ability of monoclonal antibodies to detect invariant antigens of Trypanosoma congolense, T. vivax and T. brucei in enzyme-linked immunosorbent assays

Samples of bovine serum from uninfected and African trypanosomes-infected animals were tested before and after gamma-irradiation, using three sandwich enzyme-linked immunosorbent assays (ELISA). Each test system utilized a different monoclonal antibody, reputedly allowing the specific detection of conserved-invariant cytoplasmic antigens of trypanonosomes, T. congolense, T. vivax, and T. brucei, respectively. Results have identified two groups of samples. The first contained samples where there were unequivocal ELISA results indicating positivity and negativity, for non-irradiated samples. In this group, irradiation had no effect on the diagnostic sensitivity of the assays. All samples shown to be positive before irradiation remained positive and those shown to be negative, remained negative. There was, however, a statistically significant reduction in signal in each of the ELISAs following irradiation. The second group contained samples identified before irradiation as flanking the diagnostic negative/positive threshold of OD > or =0.05. These showed a negative bias after irradiation of the order of OD -0.01, which was shown to be statistically significant by paired t-statistics. Without correction of the given diagnostic negative/positive threshold, bovine sera with OD values around the threshold were expected to deliver more false negative test results upon irradiation. This was confirmed when serological data were compared with parasitological findings; where three times more false negative test results were found from irradiated serum samples. Consequently, for this group of irradiated bovine samples tested by ELISA, the re-adjustment of the diagnostic negative/positive threshold of the ELISAs using defined irradiated serum samples is recommended; otherwise, the frequency of false negative results might be increased.

Analysis of CT scanning referrals for chronic rhinosinusitis

The principal role of computed tomography (CT) scanning in rhinosinusitis is as a planning investigation for patients requiring functional endoscopic sinus surgery (FESS). The pre-operative scan is used to highlight any potential surgical hazards, and to delineate the extent of disease reducing unnecessary intervention in disease-free areas. It is inappropriate for CT to be used purely as a diagnostic investigation for chronic rhinosinusitis. As concern has been expressed over the steady rise in the referrals for CT of the sinuses, we conducted a retrospective review of all patients having these scans at two CT scanner sites in Scotland during 1993. Of the 162 scans performed for rhinosinusitis, 58 patients (36 per cent) had not had nasendoscopy performed or had a trial of medical treatment. Subsequently, only 61 patients (38 per cent) went on to FESS. The inappropriate use of CT for these patients can be reduced by insisting that nasendoscopy is performed prior to scanning. Furthermore, radiologists and surgeons should audit the number of patients not having FESS after scanning.

Chimeric hepatitis B virus core particles as probes for studying peptide-integrin interactions

An RGD-containing epitope from the foot-and-mouth disease virus (FMDV) VP1 protein was inserted into the e1 loop of the hepatitis B virus core (HBc) protein. This chimeric protein was expressed at high levels in Escherichia coli and spontaneously assembled into virus-like particles which could be readily purified. These fusion particles elicited high levels of both enzyme-linked immunosorbent assay- and FMDV-neutralizing antibodies in guinea pigs. The chimeric particles bound specifically to cultured eukaryotic cells. Mutant particles carrying the tripeptide sequence RGE in place of RGD and the use of a competitive peptide, GRGDS, confirmed the critical involvement of the RGD sequence in this binding. The chimeric particles also bound to purified integrins, and inhibition by chain-specific anti-integrin monoclonal antibodies implicated alpha 5 beta 1 as a candidate cell receptor for both the chimeric particle and FMDV. Some serotypes of FMDV bound to beta 1 integrins in solid- phase assays, and the chimeric particles competed with FMDV for binding to susceptible eukaryotic cells. Thus, HBc particles may provide a simple, general system for exploring the interactions of specific peptide sequences with cellular receptors.

Growth of microorganisms in propofol, thiopental, and a 1:1 mixture of propofol and thiopental

To assess and compare the growth of four microorganisms in solutions of intravenous anesthetics, known quanta of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans were inoculated into propofol, thiopental, a 1:1 mixture of propofol and thiopental, and normal saline. All microorganisms were taken from standard stock cultures and incubated for 24 h (48 h for C. albicans). Growth of microorganism in each drug was compared by counting the number of colony forming units (CFUs) grown from a subculture of each inoculated anesthetic at 0, 3, 6, 12, and 24 h. The study shows that propofol strongly supports the growth of E. coli and C. albicans but is bacteriostatic toward S. aureus and weakly bactericidal toward P. aeruginosa. In contrast, both thiopental and the 1:1 mixture of propofol and thiopental behaved differently, exhibiting markedly bactericidal properties toward E. coli, S. aureus, and P. aeruginosa and a bacteriostatic effect on C. albicans. This finding supports recommendations that a strict aseptic technique should be used when handling propofol and that the contents of an ampoule should be used within 6 h of aspirating. The measured high pH of both thiopental and the 1:1 mixture of propofol and thiopental compared to propofol alone suggests pH to be a major factor in determining whether a given drug will support microbial growth.

Pharmacokinetics and toxicokinetics of an orally active tripeptide, IRI-695, in animals

Pharmacokinetics and toxicokinetics of IRI-695, a tripeptide, were investigated in the rat, rabbit, dog, and monkey. Tissue distribution and excretion of [14C]IRI-695 were determined in the rat. Following a single intravenous (IV) injection, the elimination half-life (t1/2) of IRI-695 in the rabbit, dog, and monkey was similar (about 65 min) and approximately four times that in the rat (15 min). This difference in t1/2 can be attributed to about four times higher clearance of the drug in rats (11.2 mL min-1 kg-1). The volume of distribution (Vss) in these four species, 132-234 mL kg-1, suggested negligible preferential distribution of IRI-695 to body tissue. After a 5 mg kg-1 oral dose, the absolute bioavailability of IRI-695 was 2.0% in rats and 3.1% in dogs. However, systemic drug exposure in the dog was about five to 10 times that in the rat, which is related to the slower clearance of the peptide in the dog. Toxicokinetic studies in the rat and dog indicated linear kinetics and systemic exposure of IRI-695 up to 300 mg kg-1 d-1 oral doses throughout the 28 d toxicity study. Accumulation of the drug after the repeated oral dosing was negligible. After a single 0.10 mg kg-1 [14C]IRI-695 IV injection in rats, almost all of the radioactivity administered was excreted in urine within 24 h postdose.

Determination of nanogram levels of peptide drug in rabbit and human plasma using high-performance liquid chromatography coupled with electrospray ionization mass spectrometry

High-performance liquid chromatography (HPLC) coupled to mass spectrometry (MS) using an electrospray ionization (ESI) interface provides a sensitive method for the quantitative analysis of peptide drugs in complex biological matrixes. ESI HPLC-MS was applied to the analysis of a pentapeptide drug (IRI-514) in rabbit and human plasma. Prior to analysis, the plasma samples were prepared using protein precipitation followed by solid-phase extraction. The lower limit of quantitation using selected ion monitoring was determined to be 2 ng/mL, when 8 mL of human plasma spiked with 1-40 ng/mL was extracted. Rabbit plasma (1 mL) samples spiked with 10-40,000 ng of authentic drug/mL gave a linear response when a deuterated peptide analog was employed as an internal standard. A commercial ESI interface was modified to permit higher flow rates (10-20 microL/min) to enter the mass spectrometer source. The revised interface provided a 10-fold increase in sensitivities and permitted the use of standard HPLC columns (2.0-mm i.d.) and HPLC instrumentation. ESI HPLC-MS analysis was automated to provide unattended, precise, and sensitive detection of small peptides in both human and rabbit plasma. Using this methodology, a toxicokinetic study of intravenously administered IRI-514 at three dose levels indicated that the area under the curve values were dose proportional.

Isolation, identification, and characterization of a palladium complex in the catalytic deprotection of a protected peptide

The final catalytic deprotection in the large scale synthesis of thymopentin (Arg-Lys-Asp-Val-Tyr) produced an impurity which had not previously been observed. Isolation by preparative HPLC and spectroscopic characterization led to a postulated structure of the impurity as the 1:1 thymopentin-palladium complex. A complex corresponding to the proposed structure was independently synthesized and shown to have identical chromatographic and spectroscopic properties with the isolated material. Proton and carbon (13) NMR were used to determine the coordination sites of the peptide with palladium. The susceptibility of the complex to hydrogenation indicated a possible source for its formation.

Effect of electrical stimulation on middle latency response in the guinea pig

A temporary threshold shift (TTS) has been demonstrated in the electrically evoked middle latency response (EMLR) following exposure to moderate levels of continuous electrical stimulation via a cochlear implant. The threshold at which the EMLR was elicited in chronically implanted guinea pigs was elevated by approximately 100% following 30 minutes of moderate intensity (200 microA or more) sinusoidal electrical stimulation of the cochlea. Results obtained under anesthesia varied unacceptably. In awake animals, EMLR thresholds were stable over time and consistent TTSs were observed. The threshold returned to prestimulation levels within 4 hours following termination of the stimulation. The possibility of histopathologic changes and the relevance of these findings in setting safe output levels for cochlear implant processors are discussed.

Anesthesia effects on the electrically evoked middle latency response in guinea pigs

Recent data indicate that the electrically evoked middle latency response (EMLR) is useful for patient selection for cochlear implantation and may provide a test for determining safe levels of electrical stimulation in cochlear implant recipients. Some anesthetic agents have been reported to alter the auditory evoked middle latency response. The aim of our study was to examine the effects of ketamine and xylazine anesthesia on the EMLR in guinea pigs. A consistent, reproducible, and significant depression in the EMLR was observed after anesthesia. Response latencies were increased and the suprathreshold amplitudes were depressed initially, but later increased above preanesthetic values. Changes followed a predictable time course of depression and overshoot, which allows the investigator to compensate for these effects of anesthesia. No change in threshold was observed. The lack of threshold change and the predictable course of suprathreshold depression indicates that the EMLR may be useful to evaluate responsiveness of the auditory system to electrical stimulation in the anesthetized animal.

The effectiveness of adenoidectomy in the treatment of glue ear: a randomized controlled trial

One hundred children with glue ear, in whom surgical treatment was indicated, were randomly allocated to 1 of 4 treatment groups. Children in 2 of the groups underwent adenoidectomy plus various combinations of ear operations while in the other 2 groups surgery was confined to the ears. The effect of adenoidectomy was assessed 6 weeks, 6 months and 1 year after surgery by means of audiometry, impedance tympanometry and parental opinion. Improvements in hearing were greater in those children who underwent an adenoidectomy than in those who did not (4.0 dB at 6 weeks; 2.4 dB at 6 months; 0.7 dB at 1 year). However, these differences are of little clinical significance and were only statistically significant (P less than 0.05) 6 weeks after surgery. Middle ear function, measured by tympanometry, revealed a similar pattern of response to treatment. Despite this, 6 months after surgery a higher proportion of parents were satisfied with their child's condition if an adenoidectomy had been performed. Possible explanations of this discrepancy between clinical and parental assessments of outcome are discussed.

Prospective research with vulnerable children and the risky art of preventive intervention

The Vermont Vulnerable Child Development Project is presented as an example of community based preventive intervention research employing multiple control groups and prospective epidemiology. Discussion emphasizes both methodological issues and the pragmatics involved in choosing to use community institutions in order to study preventive interventions for very young multi-risk children living with their mentally disturbed parents. Further, a rationale is provided for anticipating and coping with the political, sociological and personality conflicts which are probably inescapable in this type of mental health research.