Hand-assisted laparoscopic vertical banded gastroplasty. Initial report

Laparoscopic approaches to surgery for morbid obesity offer to reduce the morbidity associated with conventional weight reduction surgery. This paper describes a hand-assisted laparoscopic technique for vertical banded gastroplasty, a method which shortens and simplifies the laparoscopic approach to this established open surgical procedure.     

Chemokine networks in vivo: involvement of C-X-C and C-C chemokines in neutrophil extravasation in vivo in response to TNF-alpha

In this study, we have evaluated the role of specific chemotactic cytokines in leukocyte recruitment to s.c. tissue in response to TNF-alpha in vivo. Injection of TNF-alpha into s.c. air pouches led to a rapid, transient accumulation of leukocytes. Maximal accumulation of leukocytes in the air pouch was observed at between 2 and 4 h after injection of TNF-alpha. The cellular exudate comprised predominantly neutrophils, with smaller numbers of eosinophils and mononuclear phagocytes also being recruited. However, lymphocyte recruitment was not observed. TNF-alpha injection induced a time-dependent increase in the levels of immunoreactive macrophage inflammatory protein (MIP)-2, MIP-1alpha, and JE in the pouch exudate as well as increased steady-state mRNA levels of KC, MIP-2, MIP-1alpha, and JE in the tissue lining the s.c. pouch and of MIP-2, MIP-1alpha, and JE in the exudate cell population. Passive immunization with specific Abs directed against each of these chemokines significantly inhibited the accumulation of neutrophils, mononuclear phagocytes, and eosinophils in response to TNF-alpha. Taken together, these data demonstrate the existence of a chemokine network in vivo involving at least four individual chemokines that regulates recruitment of the major peripheral blood granulocytes and mononuclear phagocytes to s.c. sites during acute inflammation. To our knowledge, these data are also the first demonstration that the C-C chemokine JE is involved in neutrophil recruitment in a physiologic system in vivo.     

The predictability of periodontal treatment as measured by tooth loss: a retrospective study

OBJECTIVE: To analyse the validity of the Micraltest and Microbumintest semi-quantitative methods for microalbuminuria screening in type 2 diabetes mellitus in primary care clinics. DESIGN: Crossover study to validate diagnostic tests. SETTING: Three general practices at an urban health centre. PATIENTS: Consecutive sample of 64 diabetics not dependent on insulin. MEASUREMENTS AND MAIN RESULTS: Each patient's own doctor performed in the consultation the semi-quantitative determinations in a simple sample of the morning's first urine. As standard, a rate of albumin excretion above 20 micrograms/min, determined by immunonephelometry in a 2-hour controlled time sample, was used. The prevalence of Microalbuminuria was 25% (C.I. 95%, 14.4-35.6). The sensitivity of Micraltest was 69% (CI, 42-88), and its specificity 52% (CI, 37-67), corresponding to the cut-off point of 10 mg/L. The sensitivity of Microbumintest was 63% (CI, 36-84), and its specificity 67% (CI, 52-79). The combination of both tests in one sample had 75% sensitivity (CI, 47-92) and 44% specificity (CI, 30-59). Negative predictive values ranged between 84 and 85%. CONCLUSIONS: The semi-quantitative microalbuminuria detection tests are of limited use in the primary care clinic. Their sensitivity and the negative predictive value obtained in an isolated sample do not seem acceptable for a screening method.     

Perinatal asphyxia and heart problems

New bisantrene analogues were synthesized, bearing one or two 4,5-dihydro-1H-imidazol-2-yl hydrazone side chains at positions 1,4 or 9 of the anthracene ring system. A 10-azabioisostere was also prepared. The position of substituents in structurally isomeric drugs modulates topoisomerase II poisoning and specificity, along with cytotoxicity.     

Severe anaphylaxis to a new disinfectant: polyhexanide, a chlorhexidine polymer

We describe the cases of an 18-year-old female and a 15-year-old male who developed severe anaphylaxis following contact of surgical wounds with the disinfectant Lavasept, containing polyhexanide, a polymerised form of chlorhexidine, during orthopaedic interventions. According to the manufacturer, this product is the only polyhexanide containing medical disinfectant, has recently been commercialised and is only available in Switzerland. One of the patients denied previous contact with this compound but both patients were previously exposed to chlorhexidine. Immediate-type hypersensitivity to polyhexanide was suggested by positive skin prick tests in the two patients and by negative skin tests in control individuals. Skin tests with chlorhexidine in the patients remained negative. We conclude that contact with the new disinfectant Lavasept can trigger anaphylactic reactions, even in the absence of previous history of exposure to this compound. It remains to be established whether this new disinfectant is a frequent anaphylactogen.     

Atypical mycobacterial infection in childhood: a "surgical disease''

Frequency data for the STR system HumFGA were obtained from a North Italian population sample (Milano area) of 201 unrelated individuals. PCR products were detected by horizontal polyacrylamide gel electrophoresis and a total of 15 alleles were identified by side-by-side comparison with a commercially available sequenced allelic ladder. The observed genotype distribution showed no significant deviation from Hardy-Weinberg equilibrium. The high information content (discrimination power > 0.96, polymorphism information content > 0.84) render this system a useful tool in forensic routine casework both in criminal and paternity cases.     

Three-dimensional reconstruction of the membranous vestibular labyrinth in the toadfish, Opsanus tau

Membranous vestibular labyrinths from the oyster toadfish, Opsanus tau, were fixed, dissected from the animal, stained, and embedded in rectangular blocks of clear histological resin. Photomicrographs of complete embedded labyrinths were taken from six orthogonal directions and used to construct three-dimensional (3D) geometrical models of the semicircular canals, ampullae, utricular vestibule and common crus. Membraneous ducts and ampullae were modeled using a set of cross-sectional elliptical curves laced together to generate curved tubular models of each structure. The ensemble of these curved tubes was used to generate a complete 3D reconstruction of the outside surface of the membranous labyrinth. When viewed from six orthogonal directions, reconstructions closely matched the embedded tissue. Dimensions of the reconstruction and histological sections were compared to measurements of fresh tissue taken from the same animals prior to fixation and used to correct the reconstructions for tissue shrinkage. Results provide estimates of the endolymphatic volumes, local cross-sectional areas and elliptical eccentricities as well as 3D orientations of the geometric canal planes relative to the skull. Ten micrometer histological sections of the material were also prepared to measure wall thickness in various regions of the labyrinth.     

Home visitors'' beliefs and practices regarding childhood injury prevention

Although the discriminative properties of cocaine have been examined extensively in rats, and to a lesser extent in other species, there are currently no reports on cocaine discrimination by mice. In one of our experiments, C57BL/6 (C57) mice acquired cocaine discrimination (10 mg/kg training dose) and exhibited dose responsive generalization to lower doses of the drug, which was similar to previous reports using rats. In addition, mazindol, a general monoamine uptake inhibitor similar to cocaine, and nomifensine, which is relatively specific for the dopamine transporter, substituted completely for cocaine, as described for rats. In contrast, there was little substitution evidenced by monoamine uptake inhibitors relatively specific for the norepinephrine transporter (nisoxetine) or for the serotonin transporter (fluoxetine), or by the local anesthetics procaine or lidocaine. In our second experiment, neither cocaine nor mazindol substituted for procaine in animals trained to discriminate the local anesthetic (100 mg/kg) although lidocaine substituted completely for the procaine cue. These experiments emphasize the importance of the dopamine transporter in mediating the discriminative stimulus effects of cocaine in C57 mice. The lack of cross generalization between cocaine and procaine suggests that the anesthetic properties of cocaine contribute little toward its discrimination by this mouse strain.