Benzimidazole resistance in cyathostomes in horses in the Ukraine

The efficacy of treatment with cambendazole was tested in 1-year-old horses on a farm in Dubrovka, Ukraine. Thirty-five horses were treated. Their egg output was compared on the day of treatment and 14 days later with that of 33 untreated horses. Before treatment the mean number of eggs g-1 faeces was 614 in the controls and 766 in horses that had been treated. After 14 days the mean egg output in the controls was 580 and in the treated horses 369. This means a reduction of 54.5%. Only cyathostome larvae could be cultured from faeces collected after treatment. It can be concluded that benzimidazole resistance in cyathostomes is present in the Ukraine.     

Fractures in childhood in Khartoum

A prospective study of fractures in 231 children received at Khartoum North Teaching Hospital(KNTH) was carried out for a period of six months. The incidence of child fracture rated as one per day, then it increased from the age of 5 years onwards in boys and between 6 and 8 years in girls. Most injuries were sustained during the day time, especially between late afternoon and sunset. 82% of injured children presented to a medical facility, while 18% were taken to native healers first. Non-road traffic accidents accounted for 84% of the fractures mainly due to sports, domestic injuries and falls; whereas road traffic accidents were 16% and occurred mainly in pedestrians. Forty three percent of the fractures needed only first aid and splintage while 42% needed closed reduction. Thirty one percent of all patients were treated as inpatients. The long bones were affected in 91% of all fractures, the commonest site being the distal end of the forearm (26%), followed by supracondylar fracture of the humerus (15.6%). In the upper limb, left-sided fractures predominated. The epiphyseal injuries were 3.5% of all fractures, mainly at the distal radial epiphysis. Boys were commonly affected between 13-15 years of age. Open fractures constituted 9.8% of the series and were mainly due to traffic accidents in town dwellers, the most vulnerable bones were those of the leg and foot. Pathological fractures accounted for 2.2% and were due to bone cysts and osteogenesis imperfecta. The problem of child safety and the preventive measures need to be more stressed.     

Problems in falling in love

Certain patients enter psychoanalysis because of their inability to love another person. Often they report a repetitive erotic pursuit of desired partners, without being able to experience or maintain loving feelings. Kernberg has understood such difficulties as representing effects of early narcissistic disappointments and/or of difficulties in resolving oedipal conflicts. In this paper, Lacanian concepts of the mirror phase and symbolic love are employed to develop these issues. Sexualization of problems in mirroring may be fused with oedipal conflicts in some cases. An extended vignette is presented to illustrate the technical and theoretical issues.     

Apoptosis in experimental myocardial infarction in situ and in the perfused heart in vitro

We report the appearance of apoptotic cells in experimental myocardial infarction (rabbit heart) in in situ and in vitro preparations. Apoptosis was recognized by intravital staining with Hoechst 33342 (Ho342), by nick-end labeling (TUNEL) and by DNA laddering. A steady rise in the relative number of apoptotic cardiomyocytes (apoptotic index) was noted in in situ preparations. Apoptosis was first noted 6 h after the onset of ischemia with its highest value occurring after 72 h. Apoptotic nuclei were absent in remote areas of the left and right ventricles. Apoptotic nuclei within the infarcted area showed diminished intensity of Ho342 fluorescence. Three days after ischemia, a border zone adjacent to the infarcted area consisting of apoptotic macrophages was recognized. A novel finding was the appearance of apoptotic cardiomyocytes in the isolated perfused ischemic heart. Occurring as early as 50 min after the onset of ischemia, a high apoptotic index was present adjacent to the ligature placed around the coronary artery. This observation provides the opportunity to selectively examine factors leading to apoptosis in the ischemic heart under controlled experimental conditions.     

Botulism in Poland in 1996

A model is presented in which ion translocation through the F0 part of the ATP synthase drives the rotation of the ring of c subunits (rotor) versus the a subunit (stator). The coupling ion binding sites on the rotor are accessible from the cytoplasm of a bacterial cell except for the c subunit at the interface to the stator. Here, the binding site is accessible from the periplasm through a channel formed by subunit a. In the ATP synthesis mode, a coupling ion is anticipated to pass through the stator channel into the binding site of the adjacent rotor subunit, following the electrical potential. Occupation of this site triggers, probably by electrostatic forces, the rotation of the ring. This makes the binding site accessible to the cytoplasm, where the coupling ion dissociates. Simultaneously, this rotation moves again an empty rotor subunit into the contact site with the stator, where its binding site becomes loaded and rotation continues.     

Heatstroke in runners in Oklahoma

It is a common opinion that general surgery is the first step for whoever approaches a surgical discipline, and that whoever practices training in general surgery should learn the rudiments of each surgical branch. The role of microsurgery in the training of the general surgeon has not been well-established. Clinical applications of microsurgery in general surgery are few and are rarely required, and have been connected strictly to restricted indications. However, we think that microsurgery could be very useful to the general surgeon because it allows the execution of experimental research on rats, the only possibility permitted by law. In these studies the microsurgeon can perform many times and in a short time the same surgical operation, thus improving his skill, and easily getting familiarity with surgical instruments and sutures.     

The change in laser usage in gastroenterology--the status in 1997

Since the establishing of laser technology in gastroenterology there has been a change in the indications for laser therapy and numerous new laser systems have been introduced in basic and clinical research. First the argon laser and later on the Nd:YAG laser were used mainly for bleeding peptic lesions, today emphasis is on palliative desobliteration of advanced esophageal and rectosigmoidal carcinoma. Moreover, in selected cases it is used for curative ablation of early carcinoma and dysplasia. A new field of application is photocoagulation of the "watermelon stomach". Despite of promising ablation results the erbium:YAG and holmium:YAG laser became not yet established in gastroenterology. Also the KTP laser is rarely used e.g. for treatment of telangiectasia. Difficult bile duct stones can be highly effective fragmented intracorporally by means of laser lithotripsy; an automatic stone-tissue discrimination system avoids uncontrolled injury of the bile ducts. The hitherto experimental interstitial laser therapy of primary and secondary liver malignancies shows excellent results, but online monitoring of the expansion of the necrosis is still a problem. Thermal probes, MRT technology and duplex sonography are under current evaluation. Photodynamic therapy (PDT) is now, after numerous pilot studies, investigated with larger numbers of patients. First results show a marked effectiveness in ablation of dysplasia and mucosal carcinoma. The photosensitizer 5-aminolaevulinic acid seems to be particularly effective for ablation of Barrett's mucosa and m-THPC for treatment of local carcinoma. Palliative PDT of bile duct cancer may help to avoid repeated endoprosthetic treatment. The possibilities and limitations of light induced fluorescence diagnostics of severe dysplasia and carcinoma in situ is now being evaluated intensively. This method might in future facilitate the endoscopic diagnosis of dysplasia in Barrett's esophagus and chronic inflammatory bowel disease.     

Epstein-Barr virus in malignancies in renal transplant recipients in Japan

A role for Epstein-Barr virus (EBV) in the development of malignancies including lymphomas, and carcinoma of the stomach, nasopharynx, thymus and salivary gland is suggested. It is indicated that EBV evokes polyclonal-B-cell-proliferative diseases in immunocompromised hosts, such as transplant patients, which results in monoclonal malignant lymphomas. The suppression of immune functions in these patients is thought to lead to incomplete elimination of the cells expressing EBV latent infection genes. To examine the etiological role of EBV in the development of malignancies following renal transplant in Japan, 42 malignancies in 1744 cases of renal transplant were studied for the presence and type of EBV. The polymerase chain reaction revealed that 5 malignancies were positive for EBV, all type A: 2 of 2 cases of non-Hodgkin's lymphoma (NHL), 2 of 8 cases of gastric adenocarcinoma of the common type, and 1 of 2 cases of gastric plasmacytoma. In situ hybridization revealed positive signals in the nucleus of tumor cells in 2 cases of NHL and 1 of plasmacytoma. Positive signals were found in the small lymphoid cells but not in the tumor cells in 2 cases of gastric carcinoma. On the basis of these findings, a role for EBV in the development of malignancies in renal transplant patients is unlikely except for lymphoid neoplasias.     

Sex differences in ethanol-induced dopamine release in nucleus accumbens and in ethanol consumption in rats

In vivo microdialysis was used to examine changes in nucleus accumbens and striatal dopamine, dihydrophenylacetic acid (DOPAC), and homovanillic acid (HVA) following acute administration of ethanol (0.0, 0.25, 0.5, 1.0, or 2.0 g/kg) in male and female Long-Evans rats. Following dialysis, rats were trained to bar-press for oral ethanol reinforcement. In nucleus accumbens, females showed significant increases in extracellular dopamine following 0.25 or 0.5 g/kg ethanol, but did not show significant increases over baseline at the higher doses. Males showed slight increases in dopamine at the lower doses and decreased dopamine at 2.0 g/kg. In striatum, both sexes showed increased dopamine at the lower doses and decreased dopamine at 2.0 g/kg. There were slight increases in nucleus accumbens DOPAC and HVA at some doses in both sexes, but no changes in striatal metabolite levels. In addition to showing increased responsiveness to ethanol-induced mesolimbic dopamine stimulation, females consumed more ethanol than males during behavioral testing. The pattern of both greater ethanol-induced nucleus accumbens dopamine release and greater ethanol consumption in females supports the hypothesis that ethanol reward is mediated, at least in part, by the mesolimbic dopamine system.     

Seasonal variations in sperm abnormalities in bulls in a tropical climate

A case of anicteric idiopathic intrahepatic cholestasis in association with ankylosing spondylitis is described. No primary cause for the cholestatic syndrome was found and the liver histology was repeatedly normal. Results of treatment with clofibrate (2 g daily) were very satisfactory, as the symptoms and signs of cholestasis had gradually subsided. Discontinuation of the treatment was followed rapidly by a recurrence of the cholestasis with a new improvement after restarting treatment. The beneficial mechanism of action of clofibrate on the intrahepatic cholestasis in the case described remains speculative.     

Changes in medical education in Spain

In Spain, the lack of homogeneous criteria among medical institutions has led to gaps between medical school, residency, and continuing medical education. The authors describe the background and early history of the Spanish medical education system, early reforms, and the start of modern postgraduate medical education. They discuss the current system, highlighting ongoing concerns about how physicians are trained, including the emphasis on lectures and traditional assessment methods; the focus of faculty on research activities rather than teaching; inadequate assessment of residents; and the lack of coordination among providers of continuing medical education. However, they also highlight ongoing reform efforts, most notably the development of a new medical curriculum that has just begun to be implemented. They conclude with a discussion of the future direction of medical education in Spain, in which the growing movement toward greater unity among European nations is likely to play a large role.     

Human Herpesviridae in acute necrotizing ulcerative gingivitis in children in Nigeria

Currently, much nursing practice is based on limited evidence, for example, small-scale research, case studies and clinical experience. In a mature science this would be undesirable, but nursing is in the early stages of development as a science, and many of its practices depend on relatively informal knowledge. To encourage the spread of potentially valuable ideas, nurses must be willing to share their clinical experience and journal editors should consider publishing this information. High-quality research is essential to the long-term development of 'evidence-based practice', but it is crucial at the present stage of nursing science that we do not become too concerned with perfect research methodology at the expense of good ideas. This particularly applies to tests of statistical significance. If we accept only information that has demonstrated statistical significance, we risk the dismissal of qualitative research and other information which may be extremely valuable but which have not yet been fully investigated. The aim of this paper is to convince practitioners and journal editors that statistical significance is not the only way to judge clinical importance and to suggest that decisions on what should be submitted and accepted for publication should be based on potential clinical relevance as well as statistical analysis.     

Hypoglycaemia in paediatric admissions in Mozambique

We studied the incidence and clinical associations of hypoglycaemia in an acute medical paediatric service in Maputo, Mozambique. Of 603 children, 43 (7.1%) were hypoglycaemic. 16 of these with Plasmodium falciparum malaria had a shorter illness, and a higher incidence of convulsions and focal neurological signs than those with other diagnoses, but were less likely to die. Hypoglycaemia also complicated protein energy malnutrition, pneumonia, encephalitis, intestinal parasite infection, and nephrotic syndrome. 25 of the 603 children died: 7 (16.3%) of 43 with hypoglycaemia and 18 (3.2%) of 560 who were normoglycaemic, (relative risk of death 5.8 [95% confidence interval 2.25 to 14.93]). Hypoglycaemia is common in children in hospital in Mozambique, and should be suspected in any acutely-ill child regardless of the primary disease.     

Role of clozapine in the occurrence of chromosomal abnormalities in human bone-marrow cells in vivo and in cultured lymphocytes in vitro

Bone-marrow chromosomes were examined from 38 mentally and physically retarded and two psychiatric patients who were being treated with a variety of neuropharmacologic drugs. Twenty of these patients used clozapine (Leponex). The clastogenic effects of clozapine in vitro were studied in the lymphocyte cultures of three patients--one free of hematologic disease and two who 6 months earlier had had agranulocytosis attributed to the use of clozapine. The mean frequency of cytogenetic abnormalities in the bone-marrow cells of patients who used clozapine was significantly increased (P less than 0.05). The two patients who had had agranulocytosis had a greater frequency of cytogenetic abnormalities in their cultured lymphocytes in vivo and in vitro than the patient free of hematologic disease. A clone with a 13/14 chromosome translocation was detected in one of the patients. As all patients received a number of drugs during the in vivo and in vitro studies no definite conclusions could be drawn regarding the role played by clozapine in the occurrence of chromosomal abnormalities.     

Severe malaria in children in Togo

BACKGROUND: The definition of severe malaria is no longer limited to cerebral malaria, but is as well extended to other clinical forms of the disease. This work analyses epidemiological, clinical and evolutive aspects of severe malaria in Togo. PATIENTS AND METHODS: This study included 549 children, aged from 0 to 15 years, hospitalized in 1994-5 in the pediatric department of the Lome-Tokoin University Teaching Hospital for severe malaria as defined by World Health Organization (WHO) criteria. RESULTS: The hospitalization frequency was 7.44%; the maximum frequency was from 1 to 5 years of age, but 6.56% of patients were more than 10 years old. The most frequent clinical form was that of severe anemia, followed by cerebral complications, as seen in many African countries. The death rate was 18.94% and the proportional mortality was 8.21%; 2.73% of the patients had neurological sequelae (behaviour disturbances in five cases, aphasia in four, hemiplegia in three, mumbling in one, oculomotor paralysis in one, and cerebellar ataxia in one). Hypoglycemia was fairly frequent (11.6%) and was associated with a poor prognosis. CONCLUSION: It is possible to improve severe malaria prognosis in Africa by insisting not only on better equipment in intensive care wards, but also on improved and early management of hypoglycemia.     

Cardiac interventions in Switzerland in 1994

As in the previous seven years, a survey of cardiac invasive, interventional and surgical procedures among the 25 Swiss centers was carried out in 1994 by a detailed questionnaire. The resulting data are presented per individual center and per university, private or public sector. The outstanding findings of the 1994 survey are: There is an ongoing increase in the use of coronary angioplasty. The rapid evolution of coronary angioplasty is predominantly due to an extension of indications towards simple cases since the percentage of multivessel angioplasties has remained low. More than half of all angioplasties have been performed immediately after the respective coronary angiography (ad hoc angioplasty). The use of coronary stents has increased steeply over the past three years. Other new devices like directional coronary atherectomy, rotablation and transluminal extraction have lost further ground. PTCA for ongoing infarction has remained exceptional, probably due to logistical problems. Among the diagnostic tools, only coronary ultrasound has been used regularly. Coronary as well as non-coronary surgery seem to plateau. Percutaneous balloon valvuloplasties remained rather rare interventions. Catheter closure of congenital shunt defects has joined the routine interventional procedures. The majority of interventional catheter procedures have been performed at the five university centers whereas the majority of coronary artery bypass graft interventions have been carried out at private institutions.     

Photoreactivation in bacteria and in skin

In many procaryotic and eucaryotic cells, photoreactivating enzyme mediates light-dependent repair of UV-induced damage: the enzyme binds to a pyrimidine dimer in DNA, and, on absorption of a photon (300-600 nm), specifically monomerizes the dimer, thus repairing the DNA. Photoreactivating enzyme has been found in human tissues and human cells in culture; human cells in culture can photoreactivate cellular dimers, and can mediate photoreactivation of Herpes (human fibroblasts) and Epstein-Barr virus (human leukocytes). Measurements of pyrimidine dimer formation and repair in human skin indicate that detectable numbers of dimers are formed at 1 minimal erythemal dose, that the dimers are rapidly removed in skin kept in the absence of light, and they are more rapidly removed when the skin is exposed to visible light.