Upper gastrointestinal training in the UK and Ireland: a Roux Group Study

INTRODUCTION

Surgical training programmes in the United Kingdom and Ireland (UK&I) are in a state of flux. This study aims to report the contemporary opinions of trainee and consultant surgeons on the current upper gastrointestinal (UGI) training model in the UK&I.

METHODS

A questionnaire was developed and distributed via national UGI societies. Questions pertained to demographics, current training evaluation, perceived requirements and availability.

RESULTS

A total of 241 responses were received with representation from all UK&I postgraduate training regions. The biggest discrepancies between rotation demand and national availability related to advanced/therapeutic endoscopy and robotic surgery, with 91.7% of respondents stating they would welcome greater geographical flexibility in training. The median suggested academic targets were 3-5 publications (trainee vs consultant <3 vs 3-5, p<0.001); <3 presentations (<3 vs 3-5, p=0.002); and 3-5 audits/quality improvement projects (<3 vs 3-5, p<0.001). Current operative requirements were considered achievable (87.6%) but inadequate for day one consultant practice (74.7%). Reassuringly, 76.3% deemed there was role for on-the-job operative training following consultant appointment. Proficiency in diagnostic endoscopy was considered a minimum requirement for Certificate of Completion of Training (CCT) yet the majority regarded therapeutic endoscopy competency as non-essential. The median numbers of index UGI operations suggested were comparable with the current curriculum requirements. Post-CCT fellowships were not considered necessary; however, the majority (73.6%) recognised their advantage.

CONCLUSIONS

Current CCT requirements are largely consistent with the opinions of the UGI community. Areas for improvement include flexibility in geographical working and increasing national provisions for high-quality endoscopy training.

Biocompatibility of Antifogging SiO-doped Diamond-Like Carbon Laparoscope Coatings

Laparoscopes can suffer from fogging and contamination difficulties, resulting in a reduced field of view during surgery. A series of diamond-like carbon films, doped with SiO, were produced by pulsed laser deposition for evaluation as biocompatible, antifogging coatings. DLC films doped with SiO demonstrated hydrophilic properties with water contact angles under 40°. Samples subjected to plasma cleaning had improved contact angle results, with values under 5°. Doping the DLC films with SiO led to an average 40% decrease in modulus and 60% decrease in hardness. Hardness of the doped films, 12.0 - 13.2 GPa, was greater than that of the uncoated fused silica substrate, 9.2 GPa. The biocompatibility was assessed through CellTiter-Glo assays, with the films demonstrating statistically similar levels of cell viability when compared to the control media. The absence of ATP released by blood platelets in contact with the DLC coatings suggests in vivo hemocompatibility. The SiO doped films displayed improved transparency levels in comparison to undoped films, achieving up to an average of 80% transmission over the visible spectrum and an attenuation coefficient of 1.1 × 10⁴ cm^-1 at the 450 nm wavelength. The SiO doped DLC films show promise as a method of fog prevention for laparoscopes.

The impact of age on long-term survival following gastrectomy for gastric cancer

INTRODUCTION

Gastrectomy remains the primary curative treatment modality for patients with gastric cancer. Concerns exist about offering surgery with a high associated morbidity and mortality to elderly patients. The study aimed to evaluate the long-term survival of patients with gastric cancer who underwent gastrectomy comparing patients aged <70 years with patients aged ≥70 years.

METHODS

Consecutive patients who underwent gastrectomy for adenocarcinoma with curative intent between January 2000 and December 2017 at a single centre were included. Patients were stratified by age with a cut-off of 70 years used to create two cohorts. Log rank test was used to compare overall survival and Cox multivariable regression used to identify predictors of long-term survival.

RESULTS

During the study period, 959 patients underwent gastrectomy, 520 of whom (54%) were aged ≥70 years. Those aged <70 years had significantly lower American Society of Anesthesiologists grades (p<0.001) and were more likely to receive neoadjuvant chemotherapy (39% vs 21%; p<0.001). Overall complication rate (p=0.001) and 30-day postoperative mortality (p=0.007) were lower in those aged <70 years. Long-term survival (median 54 vs 73 months; p<0.001) was also favourable in the younger cohort. Following adjustment for confounding variables, age ≥70 years remained a predictor of poorer long-term survival following gastrectomy (hazard ratio 1.35, 95% confidence interval 1.09, 1.67; p=0.006).

CONCLUSIONS

Low postoperative mortality and good long-term survival were demonstrated for both age groups following gastrectomy. Age ≥70 years was, however, associated with poorer outcomes. This should be regarded as important factor when counselling patients regarding treatment options.

The junior doctor changeover effect: does it exist in general surgery?

INTRODUCTION

Junior doctor changeover has been perceived as a period of increased risk to patients. However, there is a paucity of contemporary evidence of this 'changeover effect'. The aim of this study was to evaluate the presence of an adverse patient effect during periods of junior doctor changeover.

METHODS

Data were requested on all patients aged 18 years or older admitted acutely under General Surgery in the North of England between 2005 and 2016. This included patient characteristics, diagnoses, comorbidities, procedure codes, mortality and length of stay. Patients were included in the study if they were admitted during the 'changeover week'; defined as the first day of the changeover followed by the six subsequent days. For junior trainees (FY1-CT2), this is the first Wednesday of August, December and April each year. For higher surgical trainees (ST3-ST8), it is the first Wednesday in October. Another week, four weeks prior, was chosen as a historical comparator.

RESULTS

In total, 61,714 patients were included in this study. Patient characteristics did not vary between the cohorts. There was no difference in 30-day mortality between changeover and non-changeover groups (2.5% vs 2.6%, p = 0.280) or length of stay (5.3 vs 5.2, p = 0.613). Changeover week was not a predictor of increased mortality (OR 1.06, p = 0.302) following multivariable adjustment. Further analysis of the first junior and higher specialty trainee periods, August and October, respectively, showed no significant difference for measured outcomes.

CONCLUSIONS

This retrospective cohort study provides contemporary evidence that the 'changeover effect' does not exist in acute general surgical admissions in the UK.

Patient Outcomes Following Emergency Bowel Resection for Inflammatory Bowel Disease and the Impact of Surgical Subspecialisation in the North of England: A Retrospective Cohort Study

BACKGROUND

Management of inflammatory bowel disease (IBD) has changed considerably over recent years, which has coincided with increased subspecialisation amongst general surgeons. This study evaluated the demographics and outcomes of patients with IBD undergoing bowel resection and assessed for the potential impact of surgical subspecialisation.

METHODS

Patient demographic, operative and outcome data were collected for patients undergoing a bowel resection secondary to IBD, admitted acutely to NHS trusts in the North of England between 2002 and 2016. The primary outcome of interest was 30-day post-operative mortality, with secondary outcomes: length of stay, stoma and anastomosis rates.

RESULTS

A total of 913 patients were included in the study cohort. A reduction in the number of resections was noted over time (2002-2006: 361 vs. 2012-2016: 262). No change was observed for 30-day mortality over the study period (3.9%, p = 0.233). Length of stay was also unchanged (p = 0.949). Laparoscopic surgery was increasingly utilised (0.6% vs. 17.2%, p < 0.001) in recent years, and by colorectal subspecialists (p = 0.003). More patients were managed by a colorectal consultant latterly (2002-2006: 45.4% vs. 2012-2016: 63.7%, p < 0.001). There was no difference between colorectal and other subspecialists in mortality (p = 0.156), length of stay (p = 0.201), stoma (p = 0.629) or anastomosis (p = 0.659) rates, including following multivariable adjustment.

CONCLUSION

The study demonstrated a significant reduction in the number of resections over time, increased utilisation of a laparoscopic approach and a shift towards the care of IBD surgical patients being by a colorectal subspecialist. However, these changes do not correspond with improved surgical outcomes.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Perforated diverticulitis in the North of England: trends in patient outcomes, management approach and the influence of subspecialisation

INTRODUCTION

In recent years, several management options have been used in the management of perforated diverticulitis, ranging from conservative treatment to laparotomy. General surgery has also become increasingly specialised over time. This retrospective cohort study investigated changes in patient outcomes following perforated diverticulitis, management approach and the influence of consultant subspecialisation over time.

MATERIALS AND METHODS

Data was collected on patients admitted with perforated diverticulitis in the North of England between 2002 and 2016. Subspecialisation was categorised as colorectal or other general subspecialties. The primary outcome of interest was overall 30-day mortality; secondary outcomes included surgical approach, stoma and anastomosis rate.

RESULTS

A total of 3394 cases of perforated diverticulitis were analysed (colorectal, n = 1290 and other subspecialists, n = 2104) with a 30-day mortality of 11.6%. There was a significant reduction in mortality over time (2002-2006: 18.6% to 2012-2016: 6.8, P < 0.001).There was a significant reduction in open surgery (60% to 25.3%, P < 0.001) with increased conservative management (37.4% to 63.5%, P < 0.001), laparoscopic resection (0.1% to 4.9%, P < 0.001) and laparoscopic washout (0.1% to 5.7%, P < 0.001).Patients admitted under colorectal surgeons had lower mortality than other subspecialists (9.9% vs 12.4%, P = 0.027), which remained significant following multivariate adjustment (hazard ratio 1.44, P = 0.039). These patients had fewer stomas (13.9% vs. 21.0%, P = 0.001) and higher anastomosis rates (22.1% vs 15.8%, P = 0.004).

CONCLUSION

This study demonstrated considerable improvements in the management of perforated diverticulitis alongside the positive impact of subspecialisation on patient outcomes.

Soil color indicates carbon and wetlands: developing a color-proxy for soil organic carbon and wetland boundaries on sandy coastal plains in South Africa

A relationship between soil organic carbon and soil color is acknowledged-albeit not a direct one. Since heightened carbon contents can be an indicator of wetlands, a quantifiable relationship between color and carbon might assist in determining wetland boundaries by rapid, field-based appraisal. The overarching aim of this initial study was to determine the potential of top soil color to indicate soil organic carbon, and by extension wetland boundaries, on a sandy coastal plain in South Africa. Data were collected from four wetland types in northern KwaZulu-Natal in South Africa. Soil samples were taken to a depth of 300 mm in three transects in each wetland type and analyzed for soil organic carbon. The matrix color was described using a Munsell soil color chart. Various color indices were correlated with soil organic carbon. The relationship between color and carbon were further elucidated using segmented quantile regression. This showed that potentially maximal carbon contents will occur at values of low color indices, and predictably minimal carbon contents will occur at values of low or high color indices. Threshold values can thus be used to make deductions such as "when the sum of dry and wet Value and Chroma values is 9 or more, carbon content will be 4.79% and less." These threshold values can then be used to differentiate between wetland and non-wetland sites with a 70 to 100% certainty. This study successfully developed a quantifiable correlation between color and carbon and showed that wetland boundaries can be determined based thereon.

Toxicity of four sulfonamide antibiotics to the freshwater amphipod Hyalella azteca

Sulfonamides are a widely used class of antibiotics; however, there are few toxicological data available with which to conduct environmental risk assessments for these compounds. Therefore, the toxicity of four sulfonamides (sulfaguanidine, sulfathiazole, sulfamerazine, and sulfasalazine) to Hyalella azteca was assessed in chronic (four-week), water-only exposures. Survival was evaluated weekly, and growth was measured at the end of the test. Four-week lethal concentrations associated with 50% mortality (LC50s) for sulfaguanidine, sulfathiazole, and sulfamerazine were 0.90, 1.6, and 3.9 µM, respectively. Sulfaguanidine caused effects on survival more quickly and at lower concentrations than sulfathiazole or sulfamerazine. These differences were more pronounced at week 1 than week 4, when sulfaguanidine LC50s were 8 to 20 times lower and 2 to 4 times lower, respectively. Growth was affected by sulfathiazole but was a less sensitive end point than survival, with an effective concentration associated with 50% reduction in growth (EC50) of 13 µM, whereas sulfaguanidine and sulfamerazine caused negligible effects on growth. Sulfasalazine had no effect on survival or growth at any concentration tested, up to 13 µM. The effects observed in the present study occurred at concentrations exceeding those typically found in environmental waters. However, given that LC50s decreased with exposure duration (except for sulfasalazine), the present study demonstrates the importance of conducting longer-term tests to adequately assess the environmental toxicity of sulfonamides.

Causes of toxicity to Hyalella azteca in a stormwater management facility receiving highway runoff and snowmelt. Part I: polycyclic aromatic hydrocarbons and metals

The Terraview-Willowfield Stormwater Management Facility (TWSMF) receives inputs of multiple contaminants, including metals, polycyclic aromatic hydrocarbons (PAHs), road salt, and nutrients, via highway and residential runoff. Contaminant concentrations in runoff are seasonally dependent, and are typically high in early spring, coinciding with the snowmelt. In order to investigate the seasonal fluctuations of contaminant loading and related changes in toxicity to benthic invertebrates, overlying water and sediment samples were collected in the fall and spring, reflecting low and high contaminant loading, respectively, and four-week sediment toxicity tests were conducted with Hyalella azteca. The effects of metals and PAHs are discussed here; the effects of salts, nutrients, and water quality are discussed in a companion paper. Survival and growth of Hyalella after exposure to fall samples were variable: survival was significantly reduced (64-74% of controls) at three out of four sites, but there were no significant growth effects. More dramatic effects were observed after Hyalella were exposed to spring samples: survival was significantly reduced at the two sites furthest downstream (0-75% of controls), and growth was significantly lower in four out of five sites when comparing Hyalella exposed to site sediment with overlying site water versus site sediment with overlying control water. These seasonal changes in toxicity were not related to metals or PAHs: 1. levels of bioavailable metals were below those expected to cause toxicity, and 2. levels of PAHs in sediment were lowest at sites with the greatest toxicity and highest in water and sediment at sites with no toxicity. Although not associated with toxicity, some metals and PAHs exceeded probable and severe effect levels, and could be a cause for concern if contaminant bioavailability changes. Toxicity in the TWSMF appeared to be primarily associated with water-borne contaminants. The cause(s) of these effects are discussed in our companion manuscript.

Causes of toxicity to Hyalella azteca in a stormwater management facility receiving highway runoff and snowmelt. Part II: salts, nutrients, and water quality

The Terraview-Willowfield Stormwater Management Facility (TWSMF) features a tandem of stormwater management ponds, which receive inputs of multiple contaminants from highway and residential runoff. Previous research determined that benthic communities in the ponds were impacted by poor habitat quality, due to elevated sediment concentrations of metals and polycyclic aromatic hydrocarbons (PAHS), and salinity in the overlying water, but did not address seasonal changes, including those caused by the influx of contaminants with the snowmelt. In order to address this issue, water and sediment samples were collected from the TWSMF during the fall and spring, and four-week sediment toxicity tests were conducted with Hyalella azteca. The effects of metals and PAHs are discussed in a companion paper; the effects of road salt, nutrients, and water quality are discussed here. After exposure to fall samples, survival of Hyalella was reduced (64-74% of controls) at three out of four sites, but growth was not negatively affected. After exposure to spring samples, survival was 0-75% of controls at the two sites furthest downstream, and growth was significantly lower in four out of five sites when comparing Hyalella exposed to site water overlying site sediment versus control water overlying site sediment. Toxicity appeared to be related to chloride concentrations: little or no toxicity occurred in fall samples (200 mg Cl(-)/L), and significant effects on survival and growth occurred in spring samples above 1550 mg Cl(-)/L and 380 mg Cl(-)/L, respectively. Sodium chloride toxicity tests showed similar results: four-week LC50s and EC25s (growth) were 1200 and 420 mg Cl(-)/L, respectively. Although water quality and nutrients were associated with effects observed in the TWSMF, chloride from road salt was the primary cause of toxicity in this study. Chloride persists during much of the year at concentrations representing a significant threat to benthic communities in the TWSMF.

Maternal influences on thiamine status of walleye Sander vitreus ova

Concentrations of the various forms of thiamine (vitamin B(1) ) were determined in walleye Sander vitreus ova from three central North American lakes. Total thiamine concentrations in ova from Lake Winnipeg S. vitreus were approximately three times greater (mean 12 nmol g(-1) ) than in those from Lakes Erie or Ontario. The percentage of thiamine in the active form (thiamine pyrophosphate, TPP) was highest in Lake Ontario ova (mean 88%) and lowest in those from Lake Winnipeg (mean 70%). Neither ova total thiamine concentration nor per cent ova thiamine as TPP showed any consistent relationships with maternal age, size, morphometric condition, somatic lipid concentrations or liver lipid concentrations. Ova total thiamine concentration, however, was negatively related to ovum size in some populations, as well as among populations, and was positively related to liver total thiamine concentration. Maternal transfer of thiamine to ova appears to be independent of female ontogenetic or conditional state in S. vitreus.

Vaccination--knowledge and attitudes of school children

Low vaccine up-take in Ireland resulted in the measles epidemic of 2000-2001, and more recent outbreaks of mumps in many schools and colleges. Forty-five schools were selected from a list of secondary schools in Ireland using a table of random numbers, and teachers were requested to distribute self-administered questionnaires to their 4th year students. The questionnaires were analysed using Epi-Info and chi-square test. 86% (n=675) of students considered themselves inadequately informed about vaccines and vaccine-preventable diseases. 67.9% (n=532) wanted the topic added to the science syllabus. 88.3% (n=692) agreed that they would vaccinate their own children against all childhood diseases. It is recommended that the topic of vaccination be covered more completely by the Junior Certificate Science syllabus. It is concluded that the vaccination up-take rates in the Ireland should rise with the next generation.

Methanogenesis under acidic pH conditions in a semi-continuous reactor system

Operating an anaerobic digester at low pH could offer several advantages over operation at neutral pH. Most wastewater streams targeted for anaerobic digestion are inherently acidic, requiring alkalinity supplementation (at added expense) to buffer the pH at neutral. Additionally, previously published work completed by the authors using batch systems suggested that lowering the system pH could increase methane production by as much as 30%. The goal of this research was to evaluate the feasibility of sustaining methanogenesis at low pH in a semi-continuous laboratory-scale fermentor. Significant methane production was achieved in a system ranging in pH from approximately 4.0-5.3. Results show that, if the consortium is allowed to sufficiently acclimate to acidic conditions, methanogenesis can be maintained under acidic pH conditions, resulting in overall chemical oxygen demand (COD) reduction and methane production comparable to that achieved in a neutral pH system.

Development and comparisons of efficient gas-cultivation systems for anaerobic carbon monoxide-utilizing microorganisms

We describe a system for the cultivation of gaseous substrate utilizing microorganisms that overcomes some of the limitations of fixed volume culture vessels and the costs associated with sparging. Cali-5-Bond gas-sampling bag was used as the culture vessel. The bags contain approximately six times more mass of CO than the 40 mL vials at 1 atm of pressure and performed equally to the 40 mL vials in terms of their ability to maintain the composition of the gas over extended incubation times. Experiments using Clostridium ljungdahlii and CO as the sole carbon and energy source in both the gas sampling bag cultivation system and the traditional vial system demonstrated that this culture had a 15x increase in optical density in 24 h of incubation. The gas-sampling bags offer a viable alternative to gas sparging while overcoming the limitations of fixed volume culture vessels.

Geomicrobiology

The ever increasing demand for oil, coupled with the reduction in reserves, is increasing emphasis on finding new oil deposits and recovering more oil from known reserves since half to two thirds of all of the oil discovered to date is still in the ground and not recoverable by present technology. There are, however, microbiological techniques that could be of value in extending the time before alternatives to oil as the major energy source are required. Two will be discussed here ? geomicrobiological prospecting and microbial enhanced oil recovery (MEOR).

Feasibility of methanogenic digestion applied to a low pH acetic acid solution

This paper discusses the methanogenic digestion of a synthetic acetic acid wastewater inoculated using a mixed culture obtained from an anaerobic digester at a municipal wastewater treatment facility. Experiments were conducted in 500mL batch reactors containing an unbuffered acetic acid solution. Test conditions compared methane production and acetic acid degradation at both acidic (pH 4.5) and neutral (pH 7.0) initial system conditions. Results showed that methane production increased by 30% when the initial pH was decreased from 7.0 to 4.5.

Isopropanol and acetone induces vinyl chloride degradation in Rhodococcus rhodochrous

In situ bioremediation of vinyl chloride (VC)-contaminated waste sites requires a microorganism capable of degrading VC. While propane will induce an oxygenase to accomplish this goal, its use as a primary substrate in bioremediation is complicated by its flammability and low water solubility. This study demonstrates that two degradation products of propane, isoproponal and acetone, can induce the enzymes in Rhodococcus rhodochrous that degrade VC. Additionally, a reasonable number of cells for bioremediation can be grown on conventional solid bacteriological media (nutrient agar, tryptic soy agar, plate count agar) in an average microbiological laboratory and then induced to produce the necessary enzymes by incubation of a resting cell suspension with isopropanol or acetone. Since acetone is more volatile than isopropanol and has other undesirable characteristics, isopropanol is the inducer of choice. It offers a non-toxic, water-soluble, relatively inexpensive alternative to propane for in situ bioremediation of waste sites contaminated with VC.

Effects of n-hexadecane and PM-100 clay on trichloroethylene degradation by Burkholderia cepacia

Trichloroethylene (TCE) is a non-flammable, volatile organochlorine compound which was a widely used degreasing agent, anesthetic, and coolant prior to 1960, but has since been placed on the Environmental Protection Agency's (EPA) list of priority pollutants. The inadequate disposal practices for TCE have created numerous TCE-contaminated superfund sites. The most commonly employed practice for remediating TCE-contaminated sites is to purge the contaminant from the source and trap it onto an adsorbent which is disposed of in a landfill or by incineration. This investigation was undertaken to evaluate the effectiveness of Burkholderia cepacia strain G4 (G4) to regenerate used sorbents by degrading TCE from the sorbent directly or indirectly. The results of this investigation showed that G4 was capable of reducing TCE attached to PM-100 clay but at significantly reduced rate due to the slow desorption rate. Conversely, it was shown that G4 was capable of degrading TCE dissolved in n-hexadecane at the same rate as systems without n-hexadecane present. The reduction in TCE degradation when the TCE is attached to the PM-100 clay could be overcome by solvent rinsing the TCE from the clay with subsequent removal of the TCE from the n-hexadecane by G4.

Radiographic measurements of cardiac size as predictors of outcome in patients with dilated cardiomyopathy

BACKGROUND

Cardiac dilatation is a predictor of poor outcome in patients with dilated cardiomyopathy. Whereas cardiac chamber dimensions or volumes can be assessed by various noninvasive and invasive techniques, simple chest radiography also may provide a valuable assessment of cardiac size.

METHODS AND RESULTS

To determine the relative power of radiographic heart measurements for predicting outcome in dilated cardiomyopathy, we retrospectively studied 88 adult patients with chest radiographs obtained within 35 days of echocardiography. Standard radiographic variables were measured for each patient, and the cardiothoracic (CT) ratio, frontal cardiac area, and volume were calculated. During a mean 4.1-year follow-up, 62 of the 88 (71%) patients died. CT ratio was the best predictor of mortality among the radiographic cardiac measurements. By multivariate analysis, a model including echocardiographic ejection fraction, New York Heart Association (NYHA) functional class, and history of heart failure was highly predictive of survival. When added to this model, CT ratio also was independently associated with mortality, but not radiographic cardiac area or volume. When radiographic variables were each added to CT ratio, they did not add incremental predictive value to the model that included CT ratio alone. Echocardiographic measurement of left ventricular (LV) size, especially when indexed for body size, was independently predictive of outcome, but it did not supersede the predictive power of CT ratio.

CONCLUSION

The simply derived radiographic CT ratio is a useful predictor of outcome in patients with dilated cardiomyopathy and compares favorably with other clinical and selected echocardiographic variables.

How water scarcity will shape the new century

Water resources are increasingly being overexploited, such that current food production, which relies heavily on irrigation schemes, is unsustainable. Many steps, including improved irrigation techniques, more water-efficient crops and animal protein production, etc., will be needed to raise water productivity across the board. Water must in future be recognised as a scarce resource and not taken for granted.

Line Positions and Intensities in the 2nu(2)/nu(4) Vibrational System of (14)NH(3) near 5-7 µm

Line positions and intensities belonging to the vibrational system 2nu(2)/nu(4) of ammonia (14)NH(3) are measured and analyzed between 1200 and 2200 cm(-1) in order to improve the molecular database. For this, laboratory spectra are obtained at 0.006 and 0.011 cm(-1) unapodized resolution and with 4% precisions for the intensities using Fourier transform spectrometers located at the Kitt Peak National Observatory and the Jet Propulsion Laboratory. The observed data contain transitions of the nu(4) fundamental band near 1626.276(1) and 1627.375(2) cm(-1) (for s and a inversion upper states, respectively) and the 2nu(2) overtone band near 1597.470(3) and 1882.179(5) cm(-1) (for s and a inversion states, respectively). A total of 2345 lines with J' </= 15 is assigned from which 2114 line positions with J' </= 15 are fitted using an effective rotation-inversion-rotation Hamiltonian to achieve an rms of 0.003 cm(-1) with 57 molecular parameters. Over 1200 intensity measurements are modeled to +/-4.7% using 16 terms of the dipole moment expansion. A dyad model is used in order to model all the interactions expected within the 2nu(2)/nu(4) system. The bandstrengths of 2nu(2) (s <-- a), 2nu(2) (a <-- s), and nu(4) (s <-- s and a <-- a) are estimated to be 6.68(24), 0.201(5), and 116(3) cm(-2) atm(-1), respectively, at 296 K. The prediction generated by this study is available for planetary studies. Copyright 2000 Academic Press.

The Intensities of Methane in the 3-5 µm Region Revisited

The analysis of the linestrengths of the infrared spectrum of methane (12 and 13) in the 3-5 µm region has been revisited on the basis of new measurements from Fourier transform spectra recorded at Kitt Peak under various optical densities. A simultaneous fit of these new data with previously reported tunable difference-frequency laser data has been done. An effective transition moment model in tensorial form up to the third order of approximation within the Pentad scheme has been used. The standard deviations achieved are very close to the experimental precision: 3 and 1.5%, respectively, for the two sets of data for the (12)CH(4) molecule, representing a substantial improvement with respect to earlier studies. The integrated bandstrengths obtained in the present work differ from previously reported values by factors ranging from -5 to +6%. The correction for the nu(3) band, the strongest band of the Pentad system, is +2% with respect to the study of Hilico et al. [J. C. Hilico, J. P. Champion, S. Toumi, V. G. Tyuterev, and S. A. Tashkun, J. Mol. Spectrosc. 168, 455-476 (1994)]. Copyright 2000 Academic Press.

The NMR solution structure of the ion channel peptaibol chrysospermin C bound to dodecylphosphocholine micelles

Chrysospermin C is a 19-residue peptaibol capable of forming transmembrane ion channels in phospholipid bilayers. The conformation of chrysospermin C bound to dodecylphosphocholine micelles has been solved using heteronuclear NMR spectroscopy. Selective 15N-labeling and 13C-labeling of specific alpha-aminoisobutyric acid residues was used to obtain complete stereospecific assignments for all eight alpha-aminoisobutyric acid residues. Structures were calculated using 339 distance constraints and 40 angle constraints obtained from NMR data. The NMR structures superimpose with mean global rmsd values to the mean structure of 0. 27 A (backbone heavy atoms) and 0.42 A (all heavy atoms). Chrysospermin C bound to decylphosphocholine micelles displays two well-defined helices at the N-terminus (residues Phe1-Aib9) and C-terminus (Aib13-Trp-ol19). A slight bend preceding Pro14, i.e. encompassing residues 10-12, results in an angle of approximately 38 degrees between the mean axes of the two helical regions. The bend structure observed for chrysospermin C is compatible with the sequences of all 18 long peptaibols and may represent a common 'active' conformation. The structure of chrysospermin C shows clear hydrophobic and hydrophilic surfaces which would be appropriate for the formation of oligomeric ion channels.

Dominant sensitization variants of human O(6)-methylguanine-DNA-methyltransferase obtained by a mutational screen of surface residues

A scanning mutagenesis experiment was performed on human O(6)-methylguanine methyltransferase (hMGMT), directed largely at non-conserved surface residues that have not previously been studied. Variants typically contained two or more substitutions. Two of the 16 variants characterized in detail are inactive for methyltransfer, but increase the cytotoxicity and mutagenic effects of methylating agents. This phenotype is reminiscent of a variant (C145A) that has a mutation in the methyl-accepting cysteine. C145A is inactive, but reportedly binds methylated DNA and confers sensitivity to methylating agents. The sensitization phenotype of the two new variants is more striking in strains that are wild-type for DNA repair than in strains that are deficient for repair, suggesting that these proteins inhibit functional DNA repair proteins by competitively binding to methylated DNA. Both variants have multiple substitutions in the last helix of the protein. These results suggest that the C-terminal helix is necessary for methyltransfer activity, but not for methylguanine-specific binding.

Experimental Line Parameters of the Oxygen A Band at 760 nm

To support atmospheric remote sensing applications, line positions, intensities, self- and nitrogen-broadened linewidths and their temperature dependences and pressure-induced shifts in line positions at room temperature were measured up to J' and N' = 22 for the oxygen A band at 13 122 cm(-1). Line intensities were obtained with 1% precisions and 2% absolute accuracies using absorption spectra recorded at Doppler-limited (0.02 cm(-1)) resolution with the McMath Fourier transform spectrometer (FTS) located at Kitt Peak National Observatory/National Solar Observatory in Arizona. The oxygen line positions were calibrated using near-infrared transitions of the 2-0 and 3-0 bands of CO as secondary standards. The intensities and positions of seven H(2)O lines near 13 900 cm(-1) were also remeasured to validate the FTS performance. The O(2) intensities fell within 1% of the values currently assumed for the molecular databases, but it was found that broadening coefficients and line positions should be revised for the A band of molecular oxygen. Copyright 2000 Academic Press.

Use of sublimation to prepare solid microbial media with water-insoluble substrates

A method was developed to deposit a visible layer of water-insoluble compounds via sublimation onto the surface of solid media. The compound is sublimed from a heated aluminum dish containing the compound onto the surface of an inverted, ice-cooled, inoculated agar petri dish. The method results in the deposition of a thin, even layer on the agar surface without the use of solvent. After incubation, clearing zones around colonies indicate the presence of compound-degrading microorganisms.

The NMR structure of the 5S rRNA E-domain-protein L25 complex shows preformed and induced recognition

The structure of the complex between ribosomal protein L25 and a 37 nucleotide RNA molecule, which contains the E-loop and helix IV regions of the E-domain of Escherichia coli 5S rRNA, has been determined to an overall r.m.s. displacement of 1.08 A (backbone heavy atoms) by heteronuclear NMR spectroscopy (Protein Databank code 1d6k). The interacting molecular surfaces are bipartite for both the RNA and the protein. One side of the six-stranded beta-barrel of L25 recognizes the minor groove of the E-loop with very little change in the conformations of either the protein or the RNA and with the RNA-protein interactions occurring mainly along one strand of the E-loop duplex. This minor groove recognition module includes two parallel beta-strands of L25, a hitherto unknown RNA binding topology. Binding of the RNA also induces conversion of a flexible loop to an alpha-helix in L25, the N-terminal tip of which interacts with the widened major groove at the E-loop/helix IV junction of the RNA. The structure of the complex reveals that the E-domain RNA serves as a preformed docking partner, while the L25 protein has one preformed and one induced recognition module.

Triple-resonance experiments for correlation of H5 and exchangeable pyrimidine base hydrogens in (13)C,(15)N-labeled RNA

Triple-resonance two-dimensional H5(C5C4N)H experiments are described that provide through-bond H5 to imino/amino connectivities in uridines and cytidines in (13)C, (15)N-labeled RNAs. The experiments employ selective INEPT steps for transferring magnetization from the H5 hydrogens through the intervening C5, C4, and N3/N4 nuclei to the imino/amino hydrogens. The improved sensitivity of these experiments for assignments in a large 43-nucleotide RNA is demonstrated.

Direct identification of NH...N hydrogen bonds in non-canonical base pairs of RNA by NMR spectroscopy

It is shown that the recently developed quantitative J(NN)HNN-COSY experiment can be used for the direct identification of hydrogen bonds in non-canonical base pairs in RNA. Scalar(2h)J(NN)couplings across NH.N hydrogen bonds are observed in imino hydrogen bonded GA base pairs of the hpGA RNA molecule, which contains a tandem GA mismatch, and in the reverse Hoogsteen AU base pairs of the E-loop of Escherichia coli 5S rRNA. These scalar couplings correlate the imino donor(15)N nucleus of guanine or uridine with the acceptor N1 or N7 nucleus of adenine. The values of the corresponding(2h)J(NN)coupling constants are similar in size to those observed in Watson-Crick base pairs. The reverse Hoogsteen base pairs could be directly detected for the E-loop of E.coli 5S rRNA both in the free form and in a complex with the ribosomal protein L25. This supports the notion that the E-loop is a pre-folded RNA recognition site that is not subject to significant induced conformational changes. Since Watson-Crick GC and AU base pairs are also readily detected the HNN-COSY experiment provides a useful and sensitive tool for the rapid identification of RNA secondary structure elements.

Positions and Intensities in the 2nu4/nu1/nu3 Vibrational System of 14NH3 Near 3 µm

Line positions and line intensities of the nu1, nu3, and 2nu4 bands of 14NH3 were analyzed using line positions from 0.0054 cm-1 apodized resolution FT spectra recorded at Orsay and using line intensities from 0.011 cm-1 unapodized resolution FT spectra recorded at Kitt Peak National Observatory. About 2110 lines with J' </= 10 were assigned from which 1832 line positions were fitted using an effective rotation-inversion Hamiltonian to achieve an rms of 0.085 cm-1. Nearly 1000 line intensities were measured with an accuracy of 6% or better and modeled to 11 terms of dipole moment expansion to +/-9.4%. The bandstrengths of the nu1, nu3, and 2nu4 bands (determined for the first time in the case of the 2nu4 band) are, respectively, 23.6(2), 11.8(1), and 2.82(4) cm-2/atm at 296 K. A prediction of the line positions and intensities was generated for some approximately 2700 lines with intensities calculated greater than 1 x 10(-4) cm-2 atm-1 at 296 K, suitable for planetological purposes. Tentative assignments involving 22 upper state levels of 4nus2 were identified, but these were not included in the modeling at the present stage. The theoretical model and the set of programs developed for treating the infrared system nu1/nu3/2nu4 of ammonia are briefly discussed. Copyright 1999 Academic Press.

The NMR structure of Escherichia coli ribosomal protein L25 shows homology to general stress proteins and glutaminyl-tRNA synthetases

The structure of the Escherichia coli ribosomal protein L25 has been determined to an r.m.s. displacement of backbone heavy atoms of 0.62 +/- 0.14 A by multi-dimensional heteronuclear NMR spectroscopy on protein samples uniformly labeled with 15N or 15N/13C. L25 shows a new topology for RNA-binding proteins consisting of a six-stranded beta-barrel and two alpha-helices. A putative RNA-binding surface for L25 has been obtained by comparison of backbone 15N chemical shifts for L25 with and without a bound cognate RNA containing the eubacterial E-loop that is the site for binding of L25 to 5S ribosomal RNA. Sequence comparisons with related proteins, including the general stress protein, CTC, show that the residues involved in RNA binding are highly conserved, thereby providing further confirmation of the binding surface. Tertiary structure comparisons indicate that the six-stranded beta-barrels of L25 and of the tRNA anticodon-binding domain of glutaminyl-tRNA synthetase are similar.

Conformational analysis of protein and nucleic acid fragments with the new grid search algorithm FOUND

The new computer algorithm FOUND, which is implemented as an integrated module of the DYANA structure calculation program, is capable of performing systematic local conformation analyses by exhaustive grid searches for arbitrary contiguous fragments of proteins and nucleic acids. It uses torsion angles as the only degrees of freedom to identify all conformations that fulfill the steric and NMR-derived conformational restraints within a contiguous molecular fragment, as defined either by limits on the maximal restraint violations or by the fragment-based DYANA target function value. Sets of mutually dependent torsion angles, for example in ribose rings, are treated as a single degree of freedom. The results of the local conformation analysis include allowed torsion angle ranges and stereospecific assignments for diastereotopic substituents, which are then included in the input of a subsequent structure calculation. FOUND can be used for grid searches comprising up to 13 torsion angles, such as the backbone of a complete alpha-helical turn or dinucleotide fragments in nucleic acids, and yields a significantly higher number of stereospecific assignments than the precursor grid search algorithm HABAS.

The NO Vibrational Fundamental Band: O2-Broadening Coefficients

The first measurements of O2 broadening of NO lines is reported. For the NO fundamental vibration-rotation band, polynomial representations for this broadening at 299 K are given for Omega = 32 and Omega = (1/2) e and f transitions, respectively: gamma3/2(|m|) = 0.06463 - 0.00262|m| + 0.000147|m|2 - 0.00000327|m|3, gammaf1/2 (|m|) = 0.06515 - 0.00381|m| + 0.000271|m|2 - 0.00000665|m|3, and gammae1/2(|m|) = 0.06433 - 0.00343|m| + 0.000214|m|2 - 0.00000497|m|3. These broadening coefficients are on the order of 17% smaller than the comparable coefficients found for N2 broadening of NO. Copyright 1998 Academic Press.

Methyl Chloride nu5 Region Lineshape Parameters and Rotational Constants for the nu2, nu5, and 2nu3 Vibrational Bands

Fourier spectra of methyl chloride have been obtained at ambient laboratory temperature under self-broadening conditions. Five thousand two hundred and sixty rovibrational transitions of the (nu2, nu5, 2nu3)-vibrational-band triad have been assigned, and new ground and excited state rotational constants for CH335Cl and CH327Cl have been determined. The nu5 and nu2 vibrational-band intensities are determined to be, respectively, 42(1.2) and 31.7(0.9) cm-2 atm-1. Self-broadening coefficients of individual rovibrational lines are determined for the nu5 band of CH335Cl and CH337Cl at 296 K. The self-broadening coefficients peak broadly close to the maximum in the Boltzmann rotational population; no specific trends of the broadening coefficients are observed with the rotational quantum number K. With the exception of the RQ(J, 0) branch, the 1260-1650 cm-1 spectral region can be well modeled by the superposition of overlapping Voigt line profiles. To adequately model the densely packed RQ(J, 0) branch, however, we included collisional line mixing with A+ to A- in addition to A- to A- and A+ to A+ |DeltaJ| >/= 1, DeltaK = 0 collisional transitions allowed. Copyright 1998 Academic Press.

Nuclear magnetic resonance solution structure of the plasminogen-activator protein staphylokinase

Staphylokinase, a 15.5 kDa protein from Staphylococcus aureus, is a plasminogen activator which is currently undergoing clinical trials for the therapy of myocardial infarction and peripheral thrombosis. The three-dimensional (3D) NMR solution structure has been determined by multidimensional heteronuclear NMR spectroscopy on uniformly 15N- and 15N,13C-labeled samples of staphylokinase. Structural constraints were obtained from 82 3JHNH alpha as well as 22 3JNH beta scalar coupling constants and 2345 NOE cross-peaks, derived from 15N-edited and 13C-edited 3D NOE spectra. NOE cross-peak assignments were confirmed by analysis of ¿15N,13C¿-edited and ¿13C,13C¿-edited 4D NOE spectra. The structure is presented as a family of 20 conformers which show an average rmsd of 1.02 +/- 0.15 A from the mean structure for the backbone atoms. The tertiary structure of staphylokinase shows a well-defined global structure consisting of a central 13-residue alpha-helix flanked by a two-stranded beta-sheet, both of which are located above a five-stranded beta-sheet. Two of the connecting loops exhibit a higher conformational heterogeneity. Overall, staphylokinase shows a strong asymmetry of hydrophilic and hydrophobic surfaces. The N-terminal sequence, including Lys10 which is the site of the initial proteolytic cleavage during activation of plasminogen, folds back onto the protein core, thereby shielding amino acids with functional importance in the plasminogen activation process. From a comparison of the structure with mutational studies, a binding region for plasminogen is proposed.

A solution NMR study of the selectively 13C, 15N-labeled peptaibol chrysospermin C in methanol

The conformation of the 19-residue peptaibol chrysospermin C in methanol has been investigated by NMR spectroscopy using selective 15N and 13C labeling of the alpha-aminoisobutyric acid (Aib) residues. Complete 1H and 13C sequential assignments, including stereospecific assignments for the heavily overlapped resonances from the two Cbeta methyl groups of the eight Aib residues, are reported for a peptaibol for the first time. An Aib residue followed by a Pro is an exception to previous suggestions regarding stereospecific assignment of the two Cbeta methyl groups of Aib residues. Local nuclear Overhauser effects and 3J(HNC') and 3J(HNCbeta) scalar couplings indicate that the phi angles of the Aib residues are restricted sterically to local conformations consistent with right-handed helices. Despite these constraints on the eight Aib residues, the NMR data for chrysospermin C in methanol are generally most consistent with an ensemble of transient conformations, including backbone conformations inconsistent with helical structures. Initial NMR measurements for chrysospermin C bound to micelles suggest structural and dynamic differences relative to alamethicin bound to micelles which may be related to differences in gating voltages for formation of ion channels.

Advanced multiple beam equalization radiography: receiver operating characteristic comparison with screen-film chest radiography

OBJECTIVE

To test the hypothesis that the advanced multiple beam equalization radiography (AMBER) imaging system is superior to conventional chest radiography in the demonstration of diffuse infiltrative lung disease, emphysema, pulmonary nodules, calcification within nodules, and mediastinal or hilar masses and lymphadenopathy.

MATERIAL AND METHODS

The study involved 115 patients, each of whom underwent chest computed tomography (CT), AMBER, posteroanterior chest radiography, and conventional posteroanterior stereoscopic chest radiography (two films). All radiographs were obtained with the InSight Thoracic Imaging System. Four chest radiologists independently analyzed the 115 AMBER studies, 115 unpaired single conventional radiographs (a single film from a stereoscopic pair), and 115 stereoscopic conventional radiographs (2 films) for the presence of diffuse infiltrative lung disease, emphysema, pulmonary nodules, calcification within nodules, and mediastinal or hilar masses and lymphadenopathy. For each abnormality detected, the radiologists described their level of confidence based on a scale of 1 to 5. The 115 CT examinations were interpreted by consensus among 3 of the chest radiologists. The CT results were considered the standard. Receiver operating characteristic (ROC) techniques were used for statistical analysis.

RESULTS

No statistically significant differences were found with ROC techniques between the AMBER system and single or stereoscopic conventional screen-film radiography for the abnormalities studied.

CONCLUSION

We noted no clinically significant difference between AMBER and either single or stereoscopic conventional screen-film radiography in this prospective study of 115 patients in which CT (performed within 1 week of both radiographic examinations) was the standard.

NMR investigations of recombinant 15N/13C/2H-labeled bradykinin bound to a Fab mimic of the B2 receptor

NMR spectroscopy has been used to obtain structural information on the bioactive conformation of the nonapeptide hormone bradykinin (Arg-Pro-Pro-Gly-Ser-Pro-Phe-Arg, BK) bound to the Fab-fragment of an antibody that mimics the hormone binding site of the natural bradykinin B2-receptor. Using 15N or 15N,13C, 60% 2H isotope labelled bradykinin, complete 1H, 13C and 15N assignments for bradykinin bound to the Fab-fragment have been obtained. Preliminary interpretation of 15N edited NOE spectra indicates that the conformation of bradykinin bound to the model receptor differs substantially from previous computer models of the bioactive conformation of bradykinin.

The Absorption Spectrum of H2S Between 2150 and 4260 cm-1: Analysis of the Positions and Intensities in the First (2nu2, nu1, and nu3) and Second (3nu2, nu1 + nu2, and nu2 + nu3) Triad Regions

The two triad systems of hydrogen sulfide (2nu2, nu1, and nu3 near 4 µm and 3nu2, nu1 + nu2, and nu2 + nu3 near 2.7 µm) were analyzed using 14 spectra recorded at 0.0056 and 0.011 cm-1 resolution with the McMath Fourier transform spectrometer located at Kitt Peak National Observatory. Experimental upper state levels of H232S, H234S, and H233S were obtained from assigned positions (as high as J = 20 and Ka = 15 for the main isotope). These were fitted to the A-reduced Watson Hamiltonian to determine precise sets of rotational constants through J10 and up to nine Fermi and Coriolis coupling parameters. Intensities of the two H232S triads were modeled with rms values of 2.5%, using the transformed transition moment expansion with 19 terms for 568 intensities of the first triad and 11 terms for the 526 intensities of the second triad. The second derivatives of the dipole moment with respect to normal coordinates were estimated in Debye to be: 22µx = -0.004873 (90); 12µx = 0.01372 (30); and 23µz = 0.01578 (30). This confirmed that for hydrogen sulfide some of the second derivatives are larger than the first derivatives. The calculated line intensities were summed yielding integrated band strengths (in cm-2/atm at 296 K) as follows: 0.3315 for 2nu2, 0.4522 for nu1, 0.1201 for nu3, 0.0303 for 3nu2, 1.820 for nu1 + nu2, and 2.869 for nu2 + nu3. In addition, the hot band transitions were identified in both regions. Finally, a composite database of hydrogen sulfide line parameters was predicted for the 5- to 2.5-µm region. Copyright 1998 Academic Press.

Detection of subtle abnormalities on chest radiographs after irreversible compression

PURPOSE

To assess the effect of wavelet-based compression of posteroanterior chest radiographs on detection of small uncalcified pulmonary nodules and fibrosis.

MATERIALS AND METHODS

Computed tomography (CT) of the chest was used to identify 20 patients with normal posteroanterior chest radiographs, 20 with a solitary uncalcified pulmonary nodule 1-2 cm in diameter, and 20 with fibrotic disease. A double-blind protocol for readings of original images and images compressed at 40:1 and 80:1 was analyzed by using the nonparametric receiver operating characteristic to measure differences in diagnostic accuracy and their statistical significance.

RESULTS

There was no substantial difference in the overall diagnostic accuracy (measured by the area under the curve index) for both nodules and fibrosis between images compressed at 40:1 and 80:1 and uncompressed images. Readers tended to perform better on images compressed at 40:1 compared with uncompressed images. The "high-sensitivity" portion of the 80:1 compression curve for nodules was below that for the uncompressed curve, although this was not statistically significant.

CONCLUSION

Lossy compression of chest radiographs at 40:1 can be used without decreased diagnostic accuracy for detection of pulmonary nodules and fibrosis. There is no statistically significant difference in diagnostic accuracy at 80:1 compression, but detection ability is decreased.

Structure of an RNA hairpin loop with a 5'-CGUUUCG-3' loop motif by heteronuclear NMR spectroscopy and distance geometry

Structural features of a 19-nucleotide RNA hairpin loop (5'-GGCGUACGUUUCGUACGCC-3'), a loop motif which occurs in eukaryotic 18S rRNA, have been derived using multidimensional heteronuclear NMR spectroscopy in combination with local conformational analysis and torsion angle distance geometry followed by restrained energy minimization. A method to obtain both the 3JC4'P3' and 3JC4'P5' coupling constants from a set of spin-echo difference constant time HSQC spectra is introduced, and it is shown how these couplings can be assigned to the backbone angles beta and epsilon. A total of 280 distance constraints as well as 132 homo- and heteronuclear three-bond scalar coupling constants were derived from the NMR data. The structure which has been determined is a pentaloop rather than a triloop with no base pairing between G8 and C12. G8 is pointed to the minor groove where it forms a base triplet with C7-G13 that is further stabilized by hydrogen bonding to the 2'-hydroxyl group of C7. C12 is directed to the major groove where its conformation is stabilized by hydrogen bonding between O2 and HO2'. The NMR data suggest two possible, interconverting conformations with stacking of bases U10-G8 or U11-C7. Overall, the loop provides a variety of interaction sites for RNA or protein interactions.

Concentrations of chlorinated organic compounds in biota and bed sediment in streams of the San Joaquin Valley, California

Samples of resident biota and bed sediments were collected in 1992 from 18 sites on or near the floor of the San Joaquin Valley, California, for analysis of 33 organochlorine compounds. The sites were divided into five groups on the basis of physiographic region and land use. Ten compounds were detected in tissue, and 15 compounds were detected in bed sediment. The most frequently detected compound in both media was p,p'-DDE. Concentrations of SigmaDDT (sum of o,p'- and p, p' forms of DDD, DDE, and DDT) were statistically different among groups of sites for both tissue and sediment (Kruskal-Wallis, p < 0.05). Concentrations in both media were highest in streams draining the west side of the valley. Concentrations of SigmaDDT in tissue were significantly correlated with specific conductance, pH, and total alkalinity (p < 0.05), which are indicators of the proportion of irrigation return flows in stream discharge. Concentrations in sediment on a dry-weight basis were not correlated with these water-quality parameters, but total organic carbon (TOC) normalized concentrations were significantly correlated with specific conductance and pH (p < 0.05). Regressions of the concentration of SigmaDDT in tissue, as a function of SigmaDDT in bed sediment, were significant and explained up to 76% of the variance in the data. The concentration of SigmaDDT in sediment may be related to mechanisms of soil transport to surface water with bioavailability of compounds related to the concentration of TOC in sediment. The results of this study did not indicate any clear advantage to using either bed sediment or tissues in studies of organochlorine chemicals in the environment. Some guidelines for protection of fish and wildlife were exceeded. Concentrations of organochlorine chemicals in biota, and perhaps sediment, have declined from concentrations measured in the 1970s and 1980s, but remain high compared to other regions of the United States.