Measurement of rivaroxaban concentrations demonstrates lack of clinical utility of a PT, dPT and APTT test in estimating levels

INTRODUCTION

Rivaroxaban concentrations were measured in 127 inpatient samples using an HPLC-MS/MS assay.

METHODS

We compared this measurement with a calibrated anti-Xa assay and performed PT, aPTT and dilute PT tests to assess the value of clot-based assays in clinical decision-making.

RESULTS

The correlation between the anti-Xa assay and the HPLC-MS/MS at therapeutic concentrations was strong (R²  = 0.98). The PT, RecombiPlasTin 2G, and aPTT, Actin FS, showed a linear dose-response but poor correlation (R²  = 0.32 and 0.44, respectively) and at dilutions of 1 in 150 to 1 in 750 the dilute PT assay also showed poor correlation with rivaroxaban concentrations measured by specific assays. A normal PT or aPTT alone did not identify a likely safe rivaroxaban concentration to allow surgery or invasive procedures, but the combination of normal PT and aPTT identified a group of patients with rivaroxaban levels less than 90 ng/mL. Combined normal PT and aPTT had specificity and sensitivity of 0.97 (95% CI 0.92-0.99) and 0.37 (95% CI 0.1-0.74) for a rivaroxaban concentration < 32 ng/mL.

CONCLUSIONS

The PT and aPTT show poor correlation with rivaroxaban levels measured by calibrated anti-Xa and HPLC-MS/MS assays. A normal combined PT and APTT identified low rivaroxaban levels with high specificity but lacked sensitivity. The dPT assay at several dilutions could not be used to quantify rivaroxaban in clinical samples. The utility of these PT, aPTT and dilute PT assays in a clinical setting is very limited, and results generated must be interpreted with caution.

An allogeneic 'off the shelf' therapeutic strategy for peripheral nerve tissue engineering using clinical grade human neural stem cells

Artificial tissues constructed from therapeutic cells offer a promising approach for improving the treatment of severe peripheral nerve injuries. In this study the effectiveness of using CTX0E03, a conditionally immortalised human neural stem cell line, as a source of allogeneic cells for constructing living artificial nerve repair tissue was tested. CTX0E03 cells were differentiated then combined with collagen to form engineered neural tissue (EngNT-CTX), stable aligned sheets of cellular hydrogel. EngNT-CTX sheets were delivered within collagen tubes to repair a 12 mm sciatic nerve injury model in athymic nude rats. Autologous nerve grafts (autografts) and empty tubes were used for comparison. After 8 weeks functional repair was assessed using electrophysiology. Further, detailed histological and electron microscopic analysis of the repaired nerves was performed. Results indicated that EngNT-CTX supported growth of neurites and vasculature through the injury site and facilitated reinnervation of the target muscle. These findings indicate for the first time that a clinically validated allogeneic neural stem cell line can be used to construct EngNT. This provides a potential 'off the shelf' tissue engineering solution for the treatment of nerve injury, overcoming the limitations associated with nerve autografts or the reliance on autologous cells for populating repair constructs.

The effectiveness of television advertising campaigns on generating calls to a national Quitline by Māori

OBJECTIVE

To examine the effectiveness of four mass media campaigns on calls to a national Quitline by Māori (the indigenous people of New Zealand).

METHODS

Monthly Quitline call data and calls within one hour of a television commercial (TVC) being shown were analysed for the 2002-2003 period. Data on target audience rating points (TARPs) and expenditure on TVCs were also used (n = 2319 TVC placements).

RESULTS

Māori were found to register with the Quitline at higher rates during the most intense six campaign months (15% more registrations compared to less intense months). The most effective campaign generated 115 calls per 100 TARPs by Māori callers within one hour of TVC airing (the "Every cigarette" campaign). A more Māori orientated campaign with both health and cultural themes generated 91 calls per 100 TARPs from Māori callers. For these two campaigns combined, the advertising cost per new registration with the Quitline by a Māori caller was NZD 30-48. Two second hand smoke campaigns that did not show the Quitline number were much less effective at 25 and 45 calls per 100 TARPs.

CONCLUSIONS

These television advertising campaigns were effective and cost effective in generating calls to a national Quitline by Māori. Health authorities should continue to explore the use of both "threat appeal" style media campaigns and culturally appropriate campaigns to support Quitline use by indigenous peoples.

Ensembl 2005

The Ensembl (http://www.ensembl.org/) project provides a comprehensive and integrated source of annotation of large genome sequences. Over the last year the number of genomes available from the Ensembl site has increased by 7 to 16, with the addition of the six vertebrate genomes of chimpanzee, dog, cow, chicken, tetraodon and frog and the insect genome of honeybee. The majority have been annotated automatically using the Ensembl gene build system, showing its flexibility to reliably annotate a wide variety of genomes. With the increased number of vertebrate genomes, the comparative analysis provided to users has been greatly improved, with new website interfaces allowing annotation of different genomes to be directly compared. The Ensembl software system is being increasingly widely reused in different projects showing the benefits of a completely open approach to software development and distribution.

Ensembl 2004

The Ensembl (http://www.ensembl.org/) database project provides a bioinformatics framework to organize biology around the sequences of large genomes. It is a comprehensive and integrated source of annotation of large genome sequences, available via interactive website, web services or flat files. As well as being one of the leading sources of genome annotation, Ensembl is an open source software engineering project to develop a portable system able to handle very large genomes and associated requirements. The facilities of the system range from sequence analysis to data storage and visualization and installations exist around the world both in companies and at academic sites. With a total of nine genome sequences available from Ensembl and more genomes to follow, recent developments have focused mainly on closer integration between genomes and external data.

CML leukapheresis products can be enriched for CD34+ cells and simultaneously depleted of CD15+ cells using a simple Ab cocktail

BACKGROUND

CML progenitor-cell studies would be greatly facilitated if samples could be repeatedly accessed from a source of well-characterized cells. The present study was designed to develop a simple, inexpensive Ab cocktail that would provide subpopulations of cells enriched for CD34+ cells and simultaneously depleted of CD15+ mature myeloid cells.

METHODS

Cells from leukapheresis products from CML patients at diagnosis were incubated with each of two Ab cocktails. The standard cocktail (debulking, DB), containing 11 Abs, is recommended for obtaining a highly enriched population of CD34+ cells. The efficacy of an alternative, simpler cocktail (CML custom, CC), containing only four Abs was tested. The recoveries of CD34+ cells, CD15+ cells, colony-forming unit granulocyte-macrophage, and LTCIC were monitored. The samples were then cryopreserved, thawed, and the recoveries remeasured.

RESULTS

The purity of CD34+ cells was significantly superior using the DB cocktail than with the CC cocktail. Conversely, using the CC cocktail, the yield of CD34+ cells was significantly higher compared to the DB cocktail. These results were maintained even when the amount of Ab was reduced 10-fold. Both Ab cocktails consistently removed > 99% of the CD15+ cells. Consistent with the CD34+ cell-enrichment data, higher colony-forming cell (CFC) frequencies were obtained with the DB cocktail, although superior yields of CFC were obtained with the CC cocktail. After cryopreservation and thawing the yield of CD34+ cells remained high, and a further reduction in the number of CD15+ cells was obtained.

DISCUSSION

A method is described that allows the rapid and efficient debulking of large CML samples. This strategy will provide a source of well-characterized CML stem/progenitor cells that can be repeatedly accessed.

Ensembl 2002: accommodating comparative genomics

The Ensembl (http://www.ensembl.org/) database project provides a bioinformatics framework to organise biology around the sequences of large genomes. It is a comprehensive source of stable automatic annotation of human, mouse and other genome sequences, available as either an interactive web site or as flat files. Ensembl also integrates manually annotated gene structures from external sources where available. As well as being one of the leading sources of genome annotation, Ensembl is an open source software engineering project to develop a portable system able to handle very large genomes and associated requirements. These range from sequence analysis to data storage and visualisation and installations exist around the world in both companies and at academic sites. With both human and mouse genome sequences available and more vertebrate sequences to follow, many of the recent developments in Ensembl have focusing on developing automatic comparative genome analysis and visualisation.

The Ensembl genome database project

The Ensembl (http://www.ensembl.org/) database project provides a bioinformatics framework to organise biology around the sequences of large genomes. It is a comprehensive source of stable automatic annotation of the human genome sequence, with confirmed gene predictions that have been integrated with external data sources, and is available as either an interactive web site or as flat files. It is also an open source software engineering project to develop a portable system able to handle very large genomes and associated requirements from sequence analysis to data storage and visualisation. The Ensembl site is one of the leading sources of human genome sequence annotation and provided much of the analysis for publication by the international human genome project of the draft genome. The Ensembl system is being installed around the world in both companies and academic sites on machines ranging from supercomputers to laptops.

Fostering empowering participation in prevention programs for disadvantaged children and families: lessons from ten demonstration sites

Empowering participation is relevant to many prevention programs. Yet many attempts at empowerment proceed without any clear understanding of the nature of empowerment or the practical requirements of an empowering process. This paper draws on the extensive program-development research for two Canadian prevention projects for disadvantaged children and families: the Parent Mutual Aid Organizations in Child Welfare Project and the Better Beginnings. Better Futures Prevention Project. The lessons learned in these projects about fostering empowering participation are summarized. The paper emphasizes the necessity to respect the demanding and complex requirements of successful empowering participation as well as the need to balance empowering participation with other priorities in prevention programs and projects.

Reconstructing organizational culture: a process using multiple perspectives

Transformational leadership was an integral part of the process of changing organizational values in a Continuing Care Program. The management team engaged the staff members in a process of reflection-on-action where they told stories from practice to define and describe their organizational values. Then the Continuing Care staff solicited feedback from clients and agency personnel about whether or not they experienced the staff "walking their talk." This was followed by staff participation in problem solving and decision making to find solutions to the issues that arose from the feedback.

Clinical characteristics of essential tremor: data from a community-based study

BACKGROUND

99.5% of individuals with essential tremor (ET) who live in the community have mild tremor and do not attend clinics. Clinic-based studies of ET have not allowed investigators to characterize the full clinical spectrum of this disorder. In community-based studies of ET, the primary focus has been the prevalence rather than the clinical characteristics of ET.

OBJECTIVE

To describe the clinical characteristics of ET as seen in a community-based study.

METHODS

73 subjects with ET, identified in a community-based study of ET in Washington Heights-Inwood, New York, underwent a standardized 84-item physician-administered tremor interview and a 26-item videotaped tremor examination which included 12 bedside tests for ET. Two neurologists who specialized in movement disorders and who demonstrated excellent interrater agreement rated the severity of tremor using a 0 to +3 clinical rating scale and assigned a total tremor score (range, 0-36) and a diagnosis of ET.

RESULTS

Diagnoses in the 73 cases were: definite ET (18, 24.7%), probable ET (32, 43.8%), and possible ET (23, 31.5%). The mean total tremor score was 17.8 of 36. Thirty-six of 73 (49.3%) were asymptomatic, answering "no" to the question "do you often have shaking or tremor that you can't control?" Sixty-seven of 73 (91.8%) had not been prescribed medication for tremor. On average, subjects received tremor ratings of > or =+2 on only 5.4 of the 12 bedside tests for ET. Kinetic tremor was rated as more severe than postural tremor in 72 (98.6%) of 73 cases.

CONCLUSIONS

We present the clinical findings of a group of largely untreated, unselected cases of ET that would not otherwise have come to neurologic attention. The tremor was mild, often asymptomatic, and not uniformly present throughout the examination. It was rarely treated. The kinetic component of the tremor was more severe than the postural component. These clinical data further our understanding of the clinical spectrum of ET.

Diagnostic criteria for essential tremor: a population perspective

BACKGROUND

Prevalence estimates vary 2750-fold among the 20 studies of essential tremor (ET). It is not clear how the choice of diagnostic criteria affects research results.

OBJECTIVE

To determine the impact of alternative sets of diagnostic criteria on the diagnosis of ET.

METHODS

As part of the Washington Heights-Inwood Genetic Study of ET (WHIGET), a population-based study of ET, 285 subjects who include 36 case subjects with probable or definite ET, 34 case subjects with possible ET, and 215 normal subjects were interviewed and examined. All diagnoses in WHIGET were assigned by 2 neurologists. Ten of the 20 published prevalence studies of ET provided diagnostic criteria for ET. Criteria differed in terms of requirements for the distribution, duration, and severity of tremor. These 10 sets of criteria were then each separately applied to the subjects in the WHIGET cohort to determine their impact on the diagnosis of ET.

RESULTS

Depending on which diagnostic criteria were applied to the WHIGET cohort, the proportion of WHIGET case subjects with definite or probable ET who would have been diagnosed as having ET was as low as 14% and the proportion of WHIGET normal subjects who would have been diagnosed as having ET was as high as 51%. Diagnostic criteria that included a positive family history of ET or a lengthy duration of tremor would have classified many WHIGET case subjects with ET as normal, whereas criteria that did not specify a minimal tremor severity would have classified many WHIGET normal subjects as having ET.

CONCLUSIONS

Alternative sets of diagnostic criteria for ET greatly impact on the diagnosis of ET. For population-based studies, information on tremor type and severity rather than family history should be included in diagnostic criteria.

Expression of bcl-2 in lichen planus, acute graft-versus-host disease, and erythema multiforme

The bcl-2 gene family plays a significant role in the propagation of cell survival and tissue modeling. Bcl-2 was originally described in follicular lymphomas and is associated with the suppresion of cellular apoptosis. Evaluation for this protein has been performed for a variety of benign and malignant cutaneous tumors but not to any significant extent on inflammatory disorders. Therefore, we stained biopsy specimens from diseases with interface inflammation (lichen planus, acute graft-versus-host disease, and erythema multiforme) for Bcl-2. Epidermal expression of this protein was minimal for all three diseases; however, lymphocytes stained prominently in lichen planus. The data suggest that Bcl-2 is not prominently involved in the epidermal changes in these diseases. The role of other members of this oncogene family in interface dermatitis still needs to be elucidated.

Type B lactic acidosis following cardiopulmonary bypass

OBJECTIVE

To describe, characterize, and identify the associations of postcardiac surgical lactic acidosis occurring in the absence of clinical evidence of tissue hypoperfusion.

DESIGN

The preliminary study is a report of a series of observations in 12 patients. The prospective study is also observational, involving the structured collection of hemodynamic and metabolic variables in a prescribed series of patients.

SETTING

Cardiac surgical intensive care unit of a university teaching hospital.

PATIENTS

Twelve patients who developed an unexplained lactic acidosis after cardiac surgery are reported in the preliminary study. The prospective study involved observations in 112 consecutive patients undergoing cardiopulmonary bypass for cardiac surgery.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Preliminary study: Cardiac index was increased before, during and after recovery from lactic acidosis. Recovery from lactic acidosis was associated with a decrease in oxygen transport index and significant increases in oxygen consumption index and oxygen extraction ratio.

PROSPECTIVE STUDY

Hemodynamic, oxygen transport, and oxygen consumption variables, together with arterial blood gas and lactate concentrations, were assessed every 6 hrs for 24 hrs after surgery. Sixteen patients developed lactic acidosis (peak lactate concentration > 5.0 mmol/L). Compared with the remainder of the patients, this subgroup had longer duration of cardiopulmonary bypass (116 +/- 31 vs. 76 +/- 31 mins, p < .01), greater intraoperative hypothermia (24.9 +/- 2.0 degrees vs. 26.6 +/- 2.3 degrees C, p < .01), more frequent requirement for vasopressor agents (14/16 vs. 35/96, p < .05) and a higher frequency of hyperglycemia (15/16 vs. 28/96, p < .01). Hemodynamic variables, including cardiac index, were remarkably similar in the acidotic and nonacidotic groups. All of the acidotic patients, in both parts of this study, recovered from their acidosis. Eleven of the patients in the preliminary study and all of the 16 acidotic patients in the prospective study were ultimately discharged from the hospital.

CONCLUSIONS

This report documents the occurrence of lactic acidosis in a subgroup of patients undergoing cardiopulmonary bypass. The pathogenesis of this disorder is uncertain, but it appears to not relate to inadequate oxygen delivery. Systemic vasodilation and reduced oxygen extraction appear to be features of this disorder, which has an excellent prognosis.

Button-pexy fixation for repair of ileostomy and colostomy prolapse

Intestinal stomas are used in the surgical management of a number of congenital and acquired gastrointestinal conditions. Minor stomal complications are relatively common and are often well managed with nonoperative measures. Stomal prolapse may not represent a serious problem, but occasionally it requires surgical correction because of severe skin excoriation, bleeding, or incarceration of the bowel. The authors describe the treatment of stomal prolapse with the technique of button-pexy fixation, as originally described by C.W. Mayo.

Resident participation in the Better Beginnings, Better Futures prevention project: Part II--Factors that facilitate and hinder involvement

Resident participation is the cornerstone of any community-based prevention program. However, many challenges exist which make it difficult to involve residents in a meaningful way in the development of such programs. How can programs be organized so as to provide for significant participation of community residents in the process of program development? This article outlines the procedures that were utilized in seven community-based prevention programs established under the Better Beginnings, Better Futures initiative of the Government of Ontario to enlist the participation of community residents in program decision making and implementation.

Resident participation in the Better Beginnings, Better Futures prevention project: Part I--The impacts of involvement

What impact does the involvement of community residents in developing prevention programs have on the residents themselves, the programs they help to create, and the communities in which they live? The research literature suggests that resident involvement in program decision making can enhance residents' sense of control or empowerment, improve programs and services, and provide a better match between the needs of the community and the kinds of services provided. Much of this literature, however, has focused on relatively few of the benefits and costs that residents can experience as a result of their involvement. The investigation reported in this paper utilized a qualitative research methodology to discover the outcomes, both positive and negative, that residents derive from their involvement. Prevention programs operating in seven Ontario communities under the auspices of the Better Beginnings, Better Futures primary prevention initiative are featured in the discussion.

The planning and implementation of government-sponsored community-based primary prevention: a case study

Governments at all levels have become increasingly involved in initiating and funding projects within which community residents work collaboratively with local service providers in the development of programs for the betterment of themselves, their families, and their community. Inherent in these initiatives, however, are a number of possible sources of tension which, left unresolved, may hamper the intentions of governments to seed grass-roots solutions to community problems. A qualitative research methodology was used to examine the nature of the relationship between government and community representatives (both residents and local service providers) in establishing community-based primary prevention programs under the auspices of the Better Beginnings, Better Futures initiative of the Government of Ontario. We examine a number of issues and tensions that have arisen from this project, both during the development of the program model by the government, and through to its implementation in several communities in the province.

Human in vivo phosphorus 31 magnetic resonance spectroscopy of psoriasis. A noninvasive tool to monitor response to treatment and to study pathophysiology of the disease

BACKGROUND

There is no objective laboratory technique to measure and to monitor disease activity in psoriasis.

OBJECTIVE

We assessed the effectiveness of using phosphorus 31 (31P) magnetic resonance spectroscopy (MRS) to noninvasively monitor metabolism in psoriasis and to compare these spectroscopic data with chromatographic analysis.

METHODS

Fourteen persons were enrolled in the study. 31P magnetic resonance spectra were obtained from skin of persons without skin disease, uninvolved psoriatic skin, nonpsoriatic erythroderma, and from skin of patients with psoriasis. In three patients with psoriasis 31P magnetic resonance spectra were repeated after treatment with methotrexate, UVB, etretinate, and topical steroids. Finally, shave biopsy specimens were obtained from two patients with psoriasis and submitted for chromatographic evaluation.

RESULTS

In patients with severe psoriasis, in comparison with the control group, elevations in phosphomonoester concentrations and in the phosphomonoester/phosphodiester ratio were observed. These appear to be useful markers to monitor treatment response in patients with psoriasis. Finally, 31P MRS data in conjunction with chromatographic analysis indicated a defect in phosphometabolism in psoriatic skin. However, it is unclear whether this defect is a cause or an epiphenomenon of the disease.

CONCLUSION

31P MRS appears to be a sensitive, noninvasive technique to monitor disease activity in psoriasis. Further studies to characterize the defect in phosphometabolism in psoriatic skin are warranted.

The effects of World Health Organization chemotherapy on imported leprosy in Auckland, New Zealand, 1983-90

Between January 1983 and December 1990 in Auckland, New Zealand, 87 patients (28 paucibacillary disease (PBD) and 59 multibacillary disease (MBD)) commenced WHO multidrug therapy (MDT). All were immigrants from the Pacific Islands (65) or Asia (22). A total of 57 patients had already received non-WHO regimens, some continuously, but often intermittently, for many years; 30 patients received WHO MDT only. By December 1990, 50 had completed treatment, with 1 relapse and 1 late reaction, both in patients with PBD treated with WHO MDT only. There have been no relapses in those treated with WHO MDT after prior leprosy treatment. In those with MBD, type II leprosy reactions were less common (16%) in those treated only with WHO MDT than in those treated continuously before 1983 with older regimens (64%). Type I leprosy reactions occurred in about 20% of both these groups. The bacterial index fell faster in those who had had a prolonged prior treatment beginning WHO MDT than in those starting WHO MDT as their initial leprosy chemotherapy. Overall we found WHO MDT was well accepted and the compliance good, but 13 patients (15%) left Auckland before treatment was completed and 6 (7%) during follow up.

New services of the EMBL Data Library

The existing services of the EMBL Data Library for external users have been improved and extended in several ways. The EMBL File Server has been reorganised, and many new databases and other information relevant to biologists are now accessible via global computer networks. A broad range of software for molecular biology is freely available for different popular computer systems, including the EMBL enhancements to the Wisconsin (GCG) Package. The new Mail-Quicksearch and Mail-FastA services give access to the latest sequence data for database searches by ordinary electronic mail.

Mechanisms of asbestos-induced squamous metaplasia in tracheobronchial epithelial cells

Within 1 to 4 weeks after exposure to asbestos, differentiated rodent and human tracheobronchial epithelial cells in organ culture undergo squamous metaplasia, a putative preneoplastic lesion characterized by conversion of mucociliary cell types to keratinizing cells. The exogenous addition of retinal acetate (RA) to culture medium of hamster tracheal organ cultures reverses preestablished, asbestos-induced squamous metaplasia, although data suggest that the effectiveness of RA decreases as the length of time between exposure to asbestos and initial application of RA increases. alpha-Difluoromethylornithine (DFMO), an irreversible inhibitor of ornithine decarboxylase (ODC), inhibits squamous metaplasia caused by asbestos or vitamin A deficiency, whereas addition of methylglyoxal bis(guanylhydrazone) (MGBG), a structural analog of spermidine and inhibitor of S-adenosylmethionine decarboxylase, causes an enhancement of metaplasia under both circumstances. Basal cell hyperplasia and increased incorporation of 3H-thymidine by tracheal epithelial cells also are seen after addition of the polyamines, putrescine or spermidine, to tracheal organ cultures, an observation supporting the importance of polyamines in the development of this lesion. The use of retinoids and inhibitors of ODC could be promising as preventive and/or therapeutic approaches for individuals at high risk for development of asbestos-associated diseases.

Muscle and bone in paraplegic patients, and the effect of functional electrical stimulation

1. Four paraplegic men volunteered for an exercise programme in which their paralysed quadriceps muscles were stimulated by means of computer-regulated electrical impulses applied through external electrodes. The first exercise regimen consisted of leg raising against a graded load, and during the second regimen exercise took the form of cycling on a modified bicycle ergometer. Each subject exercised five times weekly for 10 weeks during the first regimen and 32 weeks during the second regimen. 2. Whole-body protein turnover determined by L-[1-13C]leucine during feeding remained constant during both exercise regimens, when expressed either in terms of body weight or fat-free mass derived from measurements of total body potassium. 3. Quadriceps muscle protein synthetic rate increased during the study, from 0.0712 to 0.0985%/h (P less than 0.05), as did quadriceps muscle area assessed by computed tomography. 4. Bone mineral content for lumbar vertebrae was normal in all four patients, but for the femoral mid-shaft bone mineral content averaged only 66% of normal for three of the patients. Trabecular bone density in the distal tibia ranged from normal to 2% of normal for the men with the shortest and longest periods of disability, respectively. No changes in bone mineral content or bone density occurred during the exercise period.

Stress-relief osteoporosis of the anterior femoral condyles in total knee replacement. A study of 185 patients

A study has been conducted to examine anterior femoral condylar osteoporosis. A series of 65 ICLH knees with a more than four-year follow-up and a series of 120 Tricon P knees were examined radiologically. It was found that almost all cases showed anterior femoral condylar osteoporosis beginning at three months and stabilizing at two years. It was more severe in those with rheumatoid arthritis than in those with osteoarthritis. This type of osteoporosis can be prevented by using a layer of cement more than 7 mm thick or by using reinforcing screws in the condyles. Femoral component loosening leads to regression of the changes. This osteoporosis does not give rise to for revision arise in a case of this type, bone should be available for grafting the anterior femoral condyles.

CT guided percutaneous decompression of a rectal duplication cyst in a child

We report an 18-month-old girl who was referred with urinary tract and colonic obstructions secondary to a large spherical rectal duplication cyst. Computed tomographic guided percutaneous drainage provided temporary relief of both urinary and colonic obstructions prior to definitive surgery.

Locating peptides generated by limited proteolysis in known protein sequences by means of computer search

A computational method is presented for locating peptides on known protein sequences using their molecular weights (estimated by SDS polyacrylamide gel electrophoresis) and their composition (obtained by amino acid analysis from eluted gel bands). The technique is easy and rapid, and appears particularly valuable if recoveries of peptides are low, or if they are heterogeneous due to secondary proteolytic degradation. An analysis of limited proteolysis of maltoporin (Schenkman, S. et al. [1984] J. Biol. Chem. 259, 7570-7576) is used to illustrate applicability and reliability of the method, which can also be applied to confirm gene-derived sequences.

Two epizootics of lymphocytic choriomeningitis virus occurring in laboratory mice despite intensive monitoring programs

Two epizootics of lymphocytic choriomeningitis virus in mice occurred within two months in one research facility consisting of several widely separated rooms. These outbreaks developed despite intensive institutional monitoring policies designed to prevent introduction and spread of lymphocytic choriomeningitis virus. Evidence derived from serological and virological assays and interviews with the concerned investigators suggested that a single transplantable tumor carried in mice may have been responsible for spread of the virus. However, the tumor was not contaminated with lymphocytic choriomeningitis virus at the time of its introduction into the mouse facility. The origin of the virus responsible for the outbreaks was not definitively established although data supported an hypothesis that the virus was introduced into the research facility by a wild or feral mouse. Virus spread from infected mice to humans did not occur, as measured by serological tests. However, a large and valuable animal facility was depopulated for safety reasons. Absorption of sera with lymphocytic choriomeningitis virus antigen proved a necessary and reliable method for confirming specificity of lymphocytic choriomeningitis virus fluorescence-positive reactions.

Central venous catheters for out-patient management of malignant disorders

The use of tunnelled central venous catheters in children with malignant disorders is an effective and safe way of giving out-patient chemotherapy and supportive care. The benefits include ready venous access, ease of administration of chemotherapy, decreased time spent in the out-patient clinic, and less anticipatory vomiting and emotional trauma for patients, parents, and staff.

Primate disease and breeding rates

33 species were compared for 12 disease categories over 3 years of laboratory housing. There were low correlations between popularity, birth, death, and illness rates. Highest rates were: birth, Macaca nemestrina; illness, Pongo pygmaeus; death, Cercopithecus aethiops. Lowest rates were: birth, Lemur catta; illness, Sanguinus mystax; death, Galago crassicaudatus. Galago crassicaudatus and Macaca fasicularus had low disease and high birth rates.