Calculation of decision threshold and detection limit in radiometric measurements using a Monte Carlo Method

Calculation of the decision threshold and detection limit of a measurement, or measurement method, are crucial in order to decide if an analyte is present or not and with what confidence it can be quantified. That decision is important in view of possible actions if something would be detected. In this work, a method for calculating these limits using a Monte Carlo method is presented. In the Monte Carlo method any a priori distribution (e.g. normal distribution, rectangular distribution, triangular distribution) of an input quantity can be selected. Differences between the Monte Carlo calculated characteristic limits and the ones calculated according to ISO 11929:2010 is presented. Moreover, suggestions how to calculate the detection limit when it can not be calculated according to the ISO 11929:2010 are given.

RADIATION PROTECTION MEASUREMENTS WITH THE VARIANCE-COVARIANCE METHOD IN THE STRAY RADIATION FIELDS FROM PHOTON AND PROTON THERAPY FACILITIES

The microdosimetric variance-covariance method was used to study the stray radiation fields from the photon therapy facility at the Technical University of Denmark and the scanned proton therapy beam at the Skandion Clinic in Uppsala, Sweden. Two TEPCs were used to determine the absorbed dose, the dose-average lineal energy, the dose-average quality factor and the dose equivalent. The neutron component measured by the detectors at the proton beam was studied through Monte Carlo simulations using the code MCNP6. In the photon beam the stray absorbed dose ranged between 0.3 and 2.4 μGy per monitor unit, and the dose equivalent between 0.4 and 9 μSv per monitor unit, depending on beam energy and measurement position. In the proton beam the stray absorbed dose ranged between 3 and 135 μGy per prescribed Gy, depending on detector position and primary proton energy.

Manipulation of the energetic state of Atlantic salmon Salmo salar juveniles and the effect on migration speed

Atlantic salmon Salmo salar smolts were produced with similar energetic states as wild S. salar and the effect of low energetic state on smolt migration was tested. The total energetic state of the fish (body lipids and proteins) in the spring was correlated with Fulton's condition factor (K). Fish at a low energetic state swam slower but migrated further than fish at a higher energetic state when tested in two experimental streams. During a period of starvation throughout the winter and spring, fish conserved their body-lipid reserves at 1·5% by using more protein as an energy source and the metabolic shift occurred between 3·5 and 1·5% body lipids. An energetic state of approximately 3·5 kJ g^-1 (K ≈ 0·65) appeared to be the critical limit for survival.

The effect of shelter on welfare of juvenile Atlantic salmon Salmo salar reared under a feed restriction regimen

This study investigated whether shelter (presence or absence) affected the frequency of fin damage in Atlantic salmon Salmo salar exposed to feed restrictions (0·73 or 0·33% of body mass day(-1) ). The presence of shelter had a positive effect on the pectoral fins at both feed ration levels and on the dorsal fin at the higher ration level but it had a negative effect on survival. The reduced feed rations resulted in fish of the same size and nutritional status as wild fish. The provision of shelter has potential to mitigate the negative effects of feed restrictions on fin quality, but the optimal shelter design requires some additional investigation.

Root Rot of Pea and Faba Bean in Southern Sweden Caused by Phytophthora pisi sp. nov

A root rot disease of pea and faba bean caused by a Phytophthora sp. was observed in fields and field soil samples in southern Sweden. Observations of the disease in pea root rot greenhouse assays were systematically recorded, and incidence and geographic distribution data were compared with the pea root rot caused by Aphanomyces euteiches. Following one successful isolation of the pathogen, isolation procedures and selective media were optimized to retrieve more isolates. Phylogenetic analysis showed that the isolates belong to a novel lineage, closely related to Phytophthora sojae, and proposed here as a new species, P. pisi sp. nov. In a collection of 13 isolates from separate fields, intraspecific variation was detected in both nuclear and mitochondrial loci. Pathogenicity tests on a range of crop plants and wild legumes suggest that the host range of the pathogen is restricted to a group of legumes closely related to pea which, in addition to pea, include the crop species faba bean, lentil, common vetch, and chickpea. Morphology, growth requirements, and pathogenicity traits indicate that the species may be identical to the organism previously described as P. erythroseptica var. pisi. The work characterizes a novel Phytophthora sp. causing root rot of legume crops.

FACTORS INFLUENCING CONDOM USE AMONG NIGERIAN UNDERGRADUATES: A MIXED METHOD STUDY

OBJECTIVE

This study's objective was to explore and assess the factors influencing condom use among Nigerian undergraduates within the age group 16-34 years.

SETTING

The University of Lagos, a federal University in the commercial capital of Nigeria.

STUDY DESIGN

Both qualitative (focus group discussions) and quantitative (cross-sectional survey) methods were utilised for this study.

SUBJECTS

A total of 101 subjects were recruited with age range 18 to 34 years as against 100 years, with a mean age of 21 years. Data collection was conducted in July and August 2011 at the University of Lagos.

SUBJECTS

A total of 820 students from University of Lagos in four faculties participated in the cross-sectional survey, and we organised four focus group discussions with six students each.

RESULTS

Students were of the perception that various socio-economic and environmental factors influenced condom use during sexual intercourse. Factors identified as having great influence on condom use include: "adequate sex education" and "unplanned/ unanticipated sexual intercourse". Conversely, the influence of alcohol/social drugs on condom use was ranked low.

CONCLUSION

The study showed that students had the perception that various factors influenced condom use but these perceptions varied between young men and women. It may therefore be rewarding to have customised messages based on specific needs when reaching out to different groups stratified based on gender.

Novel Pt(II) and Pd(II) complexes with polyamine analogues: synthesis and vibrational analysis

A vibrational spectroscopy study (infrared and Raman) is reported for the biogenic polyamine analogues norspermidine (NSpd), N(1),N(11)-bis(ethyl)norspermine (BENSpm) and N(1)-cyclo-propylmethyl-N(11)-ethylnorspermine (CPENSpm), as well as for their newly synthesised Pt(II) and Pd(II) complexes. Attending to the potential antineoplastic properties of this kind of systems, their full conformational characterization is essential for understanding the molecular basis of their cytotoxic activity and the mechanisms through which they are transported into the cell. The all-trans geometry was found to be favoured for all the alkylated polyamines, in their totally protonated state, while their polynuclear complexes presented a stable geometry very similar to that previously obtained for the analogous chelates with spermidine (M(3)Spd(2)) and spermine (M(2)Spm), comprising two or three cisplatin-like (MCl(2)NH(2)) moieties.

A small skull from Flores dated to the 20th century

A human skull with mandible from the Ngada District on the island of Flores, Indonesia, is described in order to contribute to the knowledge of variation in cranial architecture, which is important in interpretations of evolutionary cerebralisation. The skull was excavated in 1924 and sent to the National Museum in Copenhagen. The "Copenhagen Flores" (CF) male skull is radiocarbon-dated and of modern age. The cranium is small, but larger than e.g. Liang Bua skull (LB1) in every measurement. The (CT-scan based) cranial capacity of 1258 ml is normal for modern humans, but somewhat lower than values from the middle or upper Palaeolithics. The metric cranial data analysed in FORDISC, characterize the skull as a male Vietnamese rather than a Chinese or White individual. Tooth morphology shows the sundadont pattern and tooth size corresponds to that of teeth from Bali, Java and Malayan Orang Asli. Remarkable are the marked asymmetries in the dentition with rotation of an upper premolar and congenital absence of a third molar. In these respects the CF skull is similar to dentitions belonging to the pygmoid villagers of Rampasasa, a village not far from the Liang Bua cave, and to LB1.

Alteration of the colonization pattern of coagulase-negative staphylococci in patients undergoing treatment for hematological malignancy

The aim was to prospectively describe the colonization pattern of coagulase-negative staphylococci (CoNS) and the relationship between colonizing and invasive CoNS isolates among patients undergoing treatment for hematological malignancy. Fourteen newly diagnosed patients were included with either multiple myeloma or acute leukemia. Patients were repeatedly sampled from nares, throat, axillae, and perineum, and the CoNS isolates obtained were phenotypically characterized together with blood isolates of CoNS using the PhenePlate system (PhP). During the treatment a gradual reduction in the heterogeneity of colonizing CoNS was observed as well as an inter-patient accumulation of phenotypically related and multi-drug-resistant CoNS. These clusters of CoNS persisted for 2-3 months after the end of therapy. Ten positive blood cultures of CoNS were obtained and in the majority of these cases CoNS of the same PhP type were found in superficial cultures collected prior to the blood culture sampling. In conclusion, the study shows that therapy for hematological malignancy is associated with a homogenization of colonizing CoNS isolates and that this acquired flora of CoNS is persistent several months after the end of therapy. Furthermore, the results suggest that the source of bloodstream infections of CoNS in hematological patients is colonizing CoNS of the skin and mucosa.

Prevalence of the ica operon and insertion sequence IS256 among Staphylococcus epidermidis prosthetic joint infection isolates

Joint replacement surgery has improved the quality of life for hundreds of thousands of patients. However, the infection of a joint implant is an important and serious complication, though the prevalence is low. Staphylococcus epidermidis is the most important pathogen involved in foreign-body infections. S. epidermidis is also a commensal that comprises a substantial part of the normal skin flora of humans. The possibility to demonstrate potential specific virulence markers may facilitate the interpretation of the bacteriological findings, as well as the clinical decision. The prevalence of the ica locus and insertion sequence IS256 by using polymerase chain reaction (PCR) among 32 clinical S. epidermidis isolates from prosthetic joint infections (PJIs) and 24 commensal isolates from nares and skin was investigated. Sixteen (50%) of the 32 PJI isolates harbored the ica operon compared with one-third of the commensal isolates obtained from the samples of the skin and nares of healthy individuals. The IS256 was demonstrated in 26 (81%) out of 32 PJI isolates. By contrast, IS256 was found in one of 24 commensal isolates. In conclusion, IS256 may be superior to the ica operon as a marker of the invasive capacity of S. epidermidis, since it was found in most of the PJI isolates, but rarely among commensals.

Stage-specific predator species help each other to persist while competing for a single prey

Prey in natural communities are usually shared by many predator species. How predators coexist while competing for the same prey is one of the fundamental questions in ecology. Here, we show that competing predator species may not only coexist on a single prey but even help each other to persist if they specialize on different life history stages of the prey. By changing the prey size distribution, a predator species may in fact increase the amount of prey available for its competitor. Surprisingly, a predator may not be able to persist at all unless its competitor is also present. The competitor thus significantly increases the range of conditions for which a particular predator can persist. This "emergent facilitation" is a long-term, population-level effect that results from asymmetric increases in the rate of prey maturation and reproduction when predation relaxes competition among prey. Emergent facilitation explains observations of correlated increases of predators on small and large conspecific prey as well as concordance in their distribution patterns. Our results suggest that emergent facilitation may promote the occurrence of complex, stable, community food webs and that persistence of these communities could critically depend on diversity within predator guilds.

Diagnostics of Human Body Cavities Using Diode Laser Gas Spectroscopy

We have developed a technique to measure gas non-intrusive in scattering media, such as human tissue. The technique was first demonstrated for test samples in 2001 by our group and utilizes diode laser absorption spectroscopy to monitor molecular oxygen and water vapor. The focus of medical application has been on sinuses, both maxillary and frontal sinuses and the potential of the technique has been shown on volunteers. A spin-off company named GasPorOx AB has been formed with the aim to develop a product used to improve the diagnosis of the sinus infections. A portable fiber-guided system has been developed and is used in an ongoing initial clinical trial in collaboration with the Ear, Nose and Throat Clinic, the Oncology and Diagnostic radiology clinics at the Lund University Hospital.

Angler numerical response across landscapes and the collapse of freshwater fisheries

Recreational angling opportunities in lakes are distributed across landscapes and attract anglers based on the combination of angling quality, travel distance, and availability of facilities. The relationship between angler density and fishing quality, as measured by catch rate, represents a numerical response that is analogous to a predator numerical response to variability in prey abundance. We quantified this numerical response of anglers to rainbow trout, Oncorhynchus mykiss, populations distributed over a large lake district in south-central British Columbia, Canada. We developed a harvest dynamics model by linking this empirical description of the spatial numerical response of anglers to a logistic population growth rate model. The model was parameterized for rainbow trout and simulated spatial patterns of angler density and catch rates over a landscape. At locations distant from urban centers, angler density is low and catch rate high, suggesting near pristine conditions; at intermediate distances angler density is higher while catch rates are lower and approximate maximum sustainable levels; and at short distances angler density is sufficiently high to harvest to local extirpation. We extrapolated the model to other lake districts varying in human population size using an empirically derived angling participation rate relationship. Extrapolation to lake districts with one-tenth the human population maintained viable fisheries close to the urban area, and districts with 10 times the human populations could not maintain viable fisheries across much of their lake district. Landscape-scale spatial patterns differed quantitatively for species varying in rates of intrinsic population growth and carrying capacity, but the qualitative spatial patterns were consistent among species, demonstrating the pervasive impacts of the angler numerical response. To achieve a management goal of sustaining fisheries across landscapes, a change in management perspective is necessary, from that of individual lakes to one of dynamic harvest processes across landscapes. This new approach makes it clear that a one-size-fits-all management approach must be replaced with a mosaic of approaches cognizant of landscape-scale processes.

Population feedback after successful invasion leads to ecological suicide in seasonal environments

For most consumer species, winter represents a period of harsh food conditions in addition to the physiological strain that results from the low ambient temperatures. In size-structured populations, larger-bodied individuals do better during winter as they have larger energy reserves to buffer starvation periods. In contrast, smaller-bodied individuals do better under growing conditions, as they have lower maintenance costs. We study how the interplay between size-dependent life-history processes and seasonal changes in temperature and food availability shape the long-term dynamics of a size-structured consumer population and its unstructured resource. We show that the size dependence of maintenance requirements translates into a minimum body size that is needed for surviving starvation when consumers can adapt only to a limited extent to the low food densities in winter. This size threshold can lead to population extinction because adult individuals suffer only a little during winter and hence produce large numbers of offspring. Due to population feedback on the resource and intense intra-cohort competition, newborn consumers then fail to reach the size threshold for survival. Under these conditions, small numbers of individuals can survive, increase in density, and build up a population, which will subsequently go extinct due to its feedback on the resource. High juvenile mortality may prevent this ecological suicide from occurring, as it releases resource competition among newborns and speeds up their growth. In size-structured populations, annual fluctuations in temperature and food availability may thus lead to a conflict between individual fitness and population persistence.

Targeting the polyamine biosynthetic enzymes: a promising approach to therapy of African sleeping sickness, Chagas' disease, and leishmaniasis

Trypanosomatids depend on spermidine for growth and survival. Consequently, enzymes involved in spermidine synthesis and utilization, i.e. arginase, ornithine decarboxylase (ODC), S-adenosylmethionine decarboxylase (AdoMetDC), spermidine synthase, trypanothione synthetase (TryS), and trypanothione reductase (TryR), are promising targets for drug development. The ODC inhibitor alpha-difluoromethylornithine (DFMO) is about to become a first-line drug against human late-stage gambiense sleeping sickness. Another ODC inhibitor, 3-aminooxy-1-aminopropane (APA), is considerably more effective than DFMO against Leishmania promastigotes and amastigotes multiplying in macrophages. AdoMetDC inhibitors can cure animals infected with isolates from patients with rhodesiense sleeping sickness and leishmaniasis, but have not been tested on humans. The antiparasitic effects of inhibitors of polyamine and trypanothione formation, reviewed here, emphasize the relevance of these enzymes as drug targets. By taking advantage of the differences in enzyme structure between parasite and host, it should be possible to design new drugs that can selectively kill the parasites.

Sequence elements essential for the rapid turnover of Crithidia fasciculata ornithine decarboxylase

Ornithine decarboxylase (ODC) has a very fast turnover in mammalian cells, but is a stable enzyme in T. brucei and other trypanosmatid parasites like Leishmania donovani. However, Crithidia fasciculata, which is a phylogenetically closely related trypanosomatid to L. donovani, has an ODC with a rapid turnover. Interestingly, C. fasciculata ODC, but not L. donovani ODC, is rapidly degraded also in mammalian systems. In order to obtain information on what sequences are important for the rapid degradation of C. fasciculata ODC, we produced a variety of C. fasciculata/L. donovani ODC hybrid proteins and characterized their turnover using two different mammalian expression systems. The results obtained indicate that C. fasciculata ODC contains several sequence elements essential for the rapid turnover of the protein and that these regions are mainly located in the central part of the enzyme.

Ornithine decarboxylase and S-adenosylmethionine decarboxylase in trypanosomatids

The production of polyamines has been shown to be an effective target for a drug against the West African form of sleeping sickness caused by Trypanosoma brucei gambiense. T. brucei belongs to the group of protozoan parasites classed as trypanosomatids. Parasitic species of this group are the causative agents of various tropical diseases besides African sleeping sickness, e.g. Chagas' disease (Trypanosoma cruzi), cutaneous (Lesihmania spp.) and visceral (Leishmania donovani) leishmaniasis. The metabolism of polyamines in the parasites is a potential target for the development of new drugs for treatment of these diseases. The key steps in polyamine synthesis are catalysed by ODC (ornithine decarboxylase) and AdoMetDC (S-adenosylmethionine decarboxylase). In the present paper, some of the available information on ODC and AdoMetDC in trypanosomatids will be described and discussed.

Size-dependent interactions inhibit coexistence in intraguild predation systems with life-history omnivory

Growth in body size during ontogeny often results in changes in diet, leading to life-history omnivory. In addition, growth is often dependent on food density. Using a physiologically structured population model, we investigated the effects of these two aspects of individual growth in a system consisting of two size-structured populations, an omnivorous top predator and an intermediate consumer. With a single shared resource for both populations, we found that life-history omnivory decreases the likelihood of coexistence between top predator and intermediate consumer in this intraguild predation (IGP) system. This result contrasts with previous unstructured models and stage-structured models without food-dependent development. Food-dependent development and size-dependent foraging abilities of the predator resulted in a positive feedback between foraging success on the shared resource at an early life stage and foraging success on the intermediate consumer later in life. By phenomenologically incorporating this feedback in an unstructured IGP model, we show that it also demotes coexistence in this simple setting, demonstrating the robustness of the negative effect of this feedback.

Phenotypic and genotypic characterization of coagulase-negative staphylococci isolated in blood cultures from patients with haematological malignancies

Coagulase-negative staphylococci are the predominant aetiological agents in bacteraemic patients hospitalized for haematological malignancies. The aim of this study was to determine whether differences exist in the prevalence of icaAB genes and in the phenotypic and/or genotypic pattern between blood isolates of coagulase-negative staphylococci, interpreted as representing true bacteraemia, and contaminant isolates from patients with haematological malignancies. Eighty-two isolates representing true bacteraemia and 47 contaminant isolates were found among 76 patients. The most prevalent species in both groups of patients was Staphylococcus epidermidis (n=103; 80%). Biochemical typing using the Phene Plate system and genotyping using pulsed-field gel electrophoresis showed a tendency towards a more homogeneous pattern among isolates causing true bacteraemia compared with contaminant isolates. Two major genotypic groups of S. epidermidis were found in both the true bacteraemia group and the contaminant group, with concordant pulsotypes found as well. These groups may comprise isolates carrying specific virulence factors, but the prevalence of the icaAB genes did not differ between the true bacteraemia group and the contaminant group. No significant difference was seen between the two study groups regarding clinical symptoms or complications, use of central venous catheter, and levels of absolute neutrophil count or C-reactive protein.

Immunoglobulin treatment reduces atherosclerosis in apolipoprotein E-/- low-density lipoprotein receptor-/- mice via the complement system

Atherosclerosis is associated with activation of the immune system. Intravenously applied normal polyclonal immunoglobulins (IVIg) have broad therapeutic applications in the treatment of autoimmune and systemic inflammatory diseases. Recently, IVIg have been shown to inhibit atherogenesis in experimental animal models. To investigate the role of the complement system in this process, we used third complement component-deficient (C3(-/-)) and control atherosclerosis-prone apolipoprotein E (ApoE) and low-density lipoprotein receptor (LDLR) double knock-out mice fed a normal diet. IVIg treatment reduced lesion fraction area in the aortic root of complement-sufficient mice whereas the lesion fraction area of C3(-/-) mice was not affected. Thus, complement activation plays a role in the anti-atherosclerotic effects of IVIg, possibly by C3-derived fragments generated through Fc-dependent complement activation.

Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects

OBJECTIVE

To investigate the potential of acetic acid supplementation as a means of lowering the glycaemic index (GI) of a bread meal, and to evaluate the possible dose-response effect on postprandial glycaemia, insulinaemia and satiety.

SUBJECTS AND SETTING

In all, 12 healthy volunteers participated and the tests were performed at Applied Nutrition and Food Chemistry, Lund University, Sweden.

INTERVENTION

Three levels of vinegar (18, 23 and 28 mmol acetic acid) were served with a portion of white wheat bread containing 50 g available carbohydrates as breakfast in randomized order after an overnight fast. Bread served without vinegar was used as a reference meal. Blood samples were taken during 120 min for analysis of glucose and insulin. Satiety was measured with a subjective rating scale.

RESULTS

A significant dose-response relation was seen at 30 min for blood glucose and serum insulin responses; the higher the acetic acid level, the lower the metabolic responses. Furthermore, the rating of satiety was directly related to the acetic acid level. Compared with the reference meal, the highest level of vinegar significantly lowered the blood glucose response at 30 and 45 min, the insulin response at 15 and 30 min as well as increased the satiety score at 30, 90 and 120 min postprandially. The low and intermediate levels of vinegar also lowered the 30 min glucose and the 15 min insulin responses significantly compared with the reference meal. When GI and II (insulinaemic indices) were calculated using the 90 min incremental area, a significant lowering was found for the highest amount of acetic acid, although the corresponding values calculated at 120 min did not differ from the reference meal.

CONCLUSION

Supplementation of a meal based on white wheat bread with vinegar reduced postprandial responses of blood glucose and insulin, and increased the subjective rating of satiety. There was an inverse dose-response relation between the level of acetic acid and glucose and insulin responses and a linear dose-response relation between acetic acid and satiety rating. The results indicate an interesting potential of fermented and pickled products containing acetic acid.

Childhood abuse in Swedish female users of psychiatric services

INTRODUCTION

The aims of this study were to investigate: (1) the prevalence of childhood abuse in women admitted to psychiatric services in a county in the south of Sweden; (2) who the perpetrators were; and (3) the women's self-reported consequences of childhood abuse.

METHOD

The study had a cross-sectional design and was a part of a more comprehensive study. An anonymous self-reported questionnaire was used which included both closed and open-ended questions. The data material were analysed by means of descriptive statistics, Mann-Whitney U-test and manifest content analysis.

RESULTS

The total number of women who participated in the study was 259, 51% of whom reported experiences of abuse during childhood, with 53% of these having been exposed to more than one type of abuse. The most frequent perpetrator was the woman's parents; mainly the fathers but also the mothers turned out to be frequent perpetrators of abuse. Some 75% of the women reported current psychological problems in adulthood related to abuse in childhood. According to a manifest content analysis, five themes of self-reported psychological problems emerged: psychiatric problems, shortcomings in social relations, poor self-confidence, fears and bad memories.

The establishment of endovascular aneurysm coiling at a neurovascular unit: report of experience during early years

The treatment of cerebral aneurysms is changing from surgical clipping to endovascular coiling (EVC) in many neurovascular centres. The aim of this study was to evaluate the technical results and clinical outcome at 6 months in a consecutive series of subarachnoid hemorrhage (SAH) patients treated with EVC, in a situation when the EVC had been established very rapidly as the first line of treatment at a neurovascular centre. The patient material comprised 239 SAH patients (155 women and 84 men, mean age 55 years, age range 16-81) allocated to EVC as the first line of treatment in the acute stage (within 3 weeks of rupture) between September 1996 and December 2000. Clinical grade on admission was Hunt & Hess (H&H) I and II in 42%, H&H III in 25% and H&H grade IV and V in 33% of the patients. The aneurysm was located in the anterior circulation in 82% of the cases. EVC was performed on days 0-3 in 77% of the cases. EVC of the target aneurysm was able to be completed in 222 patients (93%). Complete occlusion was achieved in 126 patients (53%). Procedural complications occurred in 39 patients (16%). Favourable clinical outcome was observed in 57%, severe disability in 28% and poor outcome in 14% of the patients. Favourable outcome was achieved in 77% of H&H I and II patients and in 43% of H&H III-V patients. The multivariate logistic regression analysis revealed that younger age, good neurological grade on admission, absence of intracerebral hematoma and intraventricular hematoma respectively, ICA-PcomA aneurysm location, later treatment and absence of complications were significant predictors of favourable outcome. After interventional training and installation of the X-ray system, the introduction and establishment of EVC at a neurovascular unit can be done in a short period of time and with favourable results. Future studies must concentrate on identifying factors of importance for the choice of interventional or surgical therapy. The results of this study indicate that endovascular therapy may be particularly beneficial in poor-grade patients and in patients with aneurysms in the ICA-PcomA territory.

Histamine and histidine decarboxylase are hallmark features of ECL cells but not G cells in rat stomach

The oxyntic mucosa of the rat stomach is rich in ECL cells which produce and secrete histamine in response to gastrin. Histamine and the histamine-forming enzyme histidine decarboxylase (HDC) have been claimed to occur also in the gastrin-secreting G cells in the antrum. In the present study, we used a panel of five HDC antisera and one histamine antiserum to investigate whether histamine and HDC are exclusive to the ECL cells. By immunocytochemistry, we could show that the ECL cells were stained with the histamine antiserum and all five HDC antisera. The G cells, however, were not stained with the histamine antiserum, but with three of the five HDC antisera. Thus, histamine and HDC coexist in the ECL cells (oxyntic mucosa) but not in G cells (antral mucosa). Western blot analysis revealed a typical pattern of HDC-immunoreactive bands (74, 63 and 54 kDa) in oxyntic mucosa extracts with all five antisera. In antral extracts, immunoreactive bands were detected with three of the five HDC antisera (same as above); the pattern of immunoreactivity differed from that in oxyntic mucosa. Food intake of fasted rats or treatment with the proton pump inhibitor omeprazole raised the HDC activity and the HDC protein content of the oxyntic mucosa but not of the antral mucosa; the HDC activity in the antrum was barely detectable. We suggest that the HDC-like immunoreactivity in the antrum represents a cross-reaction with non-HDC proteins and conclude that histamine and HDC are hallmark features of ECL cells but not of G cells.

Haemodynamic and metabolic disturbances in the acute stage of subarachnoid haemorrhage demonstrated by PET

OBJECTIVE

To investigate the occurrence of early haemodynamic and metabolic changes in the acute stage of subarachnoid haemorrhage (SAH).

MATERIAL AND METHODS

Eleven SAH patients were studied. Regional cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2) and oxygen extraction ratio (OER) were measured with positron emission tomography (PET) 22-53 h after haemorrhage, utilizing 15O-labelled water bolus and the 15O-inhalation technique. Ten volumes of interest (VOIs) representing vascular territories were outlined in each patient according to a standardized procedure. The occurrence of irreversible ischaemia, penumbra, oligaemia, hyperperfusion and normal haemodynamics according to PET criteria was investigated. These pathophysiological categories were related to final tissue outcome as determined by follow-up computed tomography (CT).

RESULTS

All five tissue subtypes were represented in the vascular region VOIs; oligaemia was the predominant pathophysiological pattern. When global changes were analysed, blood flow was reduced in three, oxygen metabolism was reduced in four, and OER was increased in four of seven unsedated patients, respectively. The sedated patients all had markedly reduced CBF and CMRO2 and OER in the high or supranormal range.

CONCLUSION

Haemodynamic and metabolic disturbances proved to be common after SAH. These abnormalities probably reflect the primary brain injury caused by the initial haemorrhage. The impact of secondary insults such as acute hydrocephalus, brain oedema, vasospasm, seizures, hypotension and hypoxaemia are likely to be dependent on the degree of primary injury, which can be assessed by PET.

Human cytomegalovirus, human herpesvirus-6 and human herpesvirus-7 in neutropenic patients with fever of unknown origin

OBJECTIVE

To investigate the appearance of cytomegalovirus (CMV) DNA, human herpesvirus-6 (HHV-6) DNA and human herpesvirus-7 (HHV-7) DNA in plasma as a sign of reactivation and possible causes of fever of unknown origin (FUO) during neutropenia.

METHODS

From 134 patients with febrile neutropenia following cytotoxic chemotherapy during the years 1996-2000, 20 severely neutropenic patients (granulocyte count < 0.1 x 109/L) were selected. Ten were patients with bacteremia and ten were patients with FUO. Five samples from each patient were selected at the start of chemotherapy, at the time of blood culture and fever, after 24 and 48 hours of fever, and, finally, after two to three days without fever. Virus DNA was detected by real-time quantitative and nested polymerase chain reaction (PCR).

RESULTS

CMV-DNA was detected in two out of ten FUO-patients in all samples drawn during fever. From another FUO and during two bacteremia episodes, CMV-DNA was detected after 48 hours of fever. DNA from HHV-6 and HHV-7 was not detected in any of the 20 febrile episodes.

CONCLUSIONS

HHV-6 and HHV-7 as a possible explanation for FUO in severely neutropenic patients treated with cytotoxic chemotherapy seems not be very likely. However, CMV was identified in 5/20 patients and the febrile episodes in the two FUO-patients with constant DNA-emia may have been caused by a reactivation of CMV. This implies that CMV infection can be expected not only in transplant patients but also in chemotherapy-treated neutropenic patients.

Rat stomach ECL cells: mode of activation of histidine decarboxylase

Histidine decarboxylase (HDC) occurs in ECL cells in the oxyntic mucosa of rat stomach. It is activated by gastrin. Refeeding of fasted rats or treatment with the proton pump inhibitor omeprazole promptly raised the serum gastrin concentration and consequently the HDC activity and the HDC protein content of the oxyntic mucosa. The food- and omeprazole-induced increase in HDC mRNA expression in the oxyntic mucosa was modest by comparison. Blockade of translation (cycloheximide) but not transcription (actinomycin D) prevented the postprandial rise in HDC activity. The half-life of HDC activity (after blockade of translation) was 94 min in omeprazole-treated rats and 55 min in fasted controls. The rate of enzyme synthesis was estimated to be 15 times higher in omeprazole-treated rats than in fasted controls. Inhibition of histamine uptake into ECL-cell granules by reserpine, a blocker of the vesicular monoamine transporter type-2, lowered the HDC activity and prevented the gastrin-induced HDC activation. We suggest that HDC activation reflects enhanced transcription, translation and/or posttranslational enzyme activation as well as stabilization, and that a high cytosolic histamine concentration suppresses HDC activation.

Turnover of trypanosomal ornithine decarboxylases

Interestingly, there is a major difference in turnover rate between ornithine decarboxylases (ODCs) from various trypanosomatids. ODCs from Trypanosoma brucei and Leishmania donovani are both stable proteins, whereas ODC from Crithidia fasciculata is a metabolically unstable protein in the parasite. C. fasciculata ODC is also rapidly degraded in mammalian systems, whereas the closely related L. donovani ODC is not. The degradation of C. fasciculata ODC in the mammalian systems is shown to be dependent on a functional 26 S proteasome. However, in contrast to the degradation of mammalian ODC, the degradation of C. fasciculata ODC does not involve antizyme. Instead, it appears the degradation of C. fasciculata ODC may be associated with poly-ubiquitination of the enzyme.

Early cerebral hyperglycolysis after subarachnoid haemorrhage correlates with favourable outcome

BACKGROUND

Intracerebral microdialysis (MD) was applied in patients with severe subarachnoid haemorrhage treated in a neurosurgical intensive care unit in order to explore their cerebral energy metabolism.

METHOD

Brain MD fluid levels of glucose, lactate and pyruvate were measured for 3 to 12 days in 20 patients and 2,635 hourly samples were analysed. The MD data were related to computerized tomography and clinical outcome, assessed by the Glasgow Outcome Scale.

FINDINGS

The study showed that most patients who made a good recovery had a specific curve pattern when plotting the studied metabolites over time, characterised by a distinct decrease in MD-glucose and a parallel increase in both MD-lactate and pyruvate. Patients who had an unfavourable outcome lacked this distinct curve pattern and exhibited more irregular changes, including increased levels of both MD-glucose and lactate and low MD-pyruvate levels.

INTERPRETATION

This exploratory study suggests that accumulation of interstitial lactate and pyruvate, together with decreasing levels of glucose is a favourable prognostic pattern presumably reflecting increased glucose metabolism. Such hyperglycolysis may be elicited in patients with recovery potential to cope with an extreme metabolic demand set in motion by a brain insult to restore brain cell homeostasis and integrity.

The common -675 4G/5G polymorphism in the plasminogen activator inhibitor -1 gene is strongly associated with obesity

AIMS/HYPOTHESIS

Plasminogen activator inhibitor 1 (PAI-1) increases in several insulin-resistant conditions such as obesity. We tested the hypothesis that the PAI-1 gene might be a candidate for obesity and Type II (non-insulin-dependent) diabetes mellitus.

METHODS

We investigated the frequency of a common and functional -675 4G/5G promoter polymorphism in the PAI-1 gene in 188 lean, 70 overweight (BMI 25-30 kg/m(2)) and 247 obese otherwise healthy Scandinavian subjects.

RESULTS

The genotypic ( p = 0.002), or allelic ( p = 0.0004) distribution differed markedly between the three groups. Homozygosity for 4G was more common among obese people, whereas homozygosity for 5G was more common among lean subjects. Heterozygosity was evenly distributed. The lean and overweight groups did not differ in frequency distribution. The relative risk for being obese in comparison to being lean for 4G/4G was threefold higher ( p = 0.0003). Also, carriers of the 4G allele in the heterozygous or homozygous form were distributed differently between the three groups ( p = 0.006). The 4G carriers were more common among the obese than the lean group. The latter group did not differ from the overweight group. The relative risk of being obese in comparison with lean was twofold increased in 4G carriers ( p = 0.0015). Similar results were obtained in men and women.

CONCLUSION/INTERPRETATION

Thus, the common -675 4G/5G polymorphism in the PAI-1 gene is strongly linked to obesity and a markedly increased risk for obesity is associated with the 4G allele in its homozygous form.

Increased incidence of bacteraemia due to viridans streptococci in an unselected population of patients with acute myeloid leukaemia

The aetiology, clinical characteristics and outcome of bacteraemia in patients with acute myeloid leukaemia were studied. All positive blood cultures collected at a haematological ward during 2 7-y periods were evaluated. Altogether, 274 episodes of bacteraemia in 152 patients were recorded, 80 episodes during 1980-86 and 194 during 1990-96. During the 2 periods, trimethoprim-sulfamethoxazol in combination with amikacin was the first-line empirical therapy in patients with neutropaenia and fever. In 1990, antimicrobial prophylaxis with ciprofloxacin and fluconazole was introduced. The incidence of bacteraemia due to viridans streptococci or coagulase-negative staphylococci increased from the first period to the second, whereas the incidence of Enterobacteriaceae decreased. In granulocytopaenic patients during 1990-96, viridans streptococci accounted for 21% of the isolates and in patients treated prophylactically with fluoroquinolone, viridans streptococci accounted for 31%. All viridans streptococci were sensitive to penicillin. At the time of the positive blood cultures, the patients of the second period were granulocytopaenic in 83% of the episodes. The mortality related to septicaemia during the later period was 13% and only 1 of 33 (3%) of the patients with viridans streptococci died. Eight patients (9%) died in relation to septicaemia following curative antileukaemic therapy.

Changes in intervention and outcome in elderly patients with subarachnoid hemorrhage

BACKGROUND AND PURPOSE

The elderly constitute a significant and increasing proportion of the population. The aim of this investigation was to study time trends in clinical management and outcome in elderly patients with subarachnoid hemorrhage.

METHODS

Two hundred eighty-one patients >/=65 years of age with aneurysmal subarachnoid hemorrhage who were accepted for treatment at the Uppsala University Hospital neurosurgery clinic during 1981 to 1998 were included. Hunt and Hess grades on admission, specific management components, and clinical outcomes were recorded. Three periods were compared: A, 1981 to 1986 (before neurointensive care); B, 1987 to 1992; and C, 1993 to 1998.

RESULTS

The volume of elderly patients (>/=65 years of age) increased with time, especially patients >/=70 years of age. Furthermore the proportion of patients with more severe clinical conditions increased. A greater proportion of patients had a favorable outcome (A, 45%; B, 61%; C, 58%) despite older ages and more severe neurological and clinical conditions. In period C, Hunt and Hess I to II patients had a favorable outcome in 85% of cases compared with 64% in period A. This was achieved without any increase in the number of severely disabled patients.

CONCLUSIONS

Elderly patients with subarachnoid hemorrhage can be treated successfully, and results are still improving. The introduction of neurointensive care may have contributed to the improved outcome without increasing the proportion of severely disabled patients. A defeatist attitude toward elderly patients with this otherwise devastating disease is not justified.

Contribution of ICP-IDMS to the certification of antimony implanted in a silicon wafer--comparison with RBS and INAA results

A thin-layer reference material for surface and near-surface analytical methods was produced and certified. The surface density of the implanted Sb layer was determined by Rutherford backscattering spectrometry (RBS), instrumental neutron activation analysis (INAA), and inductively coupled plasma isotope dilution mass spectrometry (ICP-IDMS) equipped with a multi-collector. The isotopic abundances of Sb (121Sb and 123Sb) were determined by multi-collector ICP-MS and INAA. ICP-IDMS measurements are discussed in detail in this paper. All methods produced values traceable to the SI and are accompanied by a complete uncertainty budget. The homogeneity of the material was measured with RBS. From these measurements the standard uncertainty due to possible inhomogeneities was estimated to be less than 0.78% for fractions of the area increments down to 0.75 mm2 in size. Excellent agreement between the results of the three different methods was found. For the surface density of implanted Sb atoms the unweighted mean value of the means of four data sets is 4.81 x 10(16) cm(-2) with an expanded uncertainty (coverage factor k = 2) of 0.09 x 10(16) cm(-2). For the isotope amount ratio R (121Sb/123Sb) the unweighted mean value of the means of two data sets is 1.435 with an expanded uncertainty (coverage factor k = 2) of 0.006.