In situ hybridization analysis of leucomyosuppressin mRNA expression in the cockroach, Diploptera punctata

In the cockroach Diploptera punctata, sequencing of the cDNA for the insect myoinhibitory neuropeptide, leucomyosuppressin (LMS), has demonstrated that LMS is the only Phe-Met-Arg-Phe-amide (NH2) (FMRFamide)-related peptide to be encoded by this gene (Donly et al. [1996] Insect Biochem. Mol. Biol. 26:627-637). However, in the present study, high performance liquid chromatography analysis of brain extracts showed six discrete FMRFamide-like immunoreactive fractions, one of which co-eluted with LMS. This study compared the distribution of FMRFamide-related peptides visualized by immunohistochemistry with LMS mRNA expression demonstrated by in situ hybridization in D. punctata. Immunohistochemistry with a polyclonal antiserum generated against FMRFamide, but which recognizes extended RFamide peptides, demonstrated numerous RFamide-like immunoreactive cells and processes in both nervous and nonnervous tissues. RFamide-like immunoreactivity was found in cells and processes of the brain and optic lobes, the stomatogastric nervous system, including the frontal and ingluvial ganglia, and the suboesophageal ganglion. Immunoreactivity was also present in all ganglia of the ventral nerve cord and in the alimentary canal. Within the alimentary canal, positively stained processes were found in the crop, midgut, and hindgut, and immunoreactive endocrinelike cells were located in the midgut. In situ hybridization with a digoxigenin-labeled RNA probe spanning the entire LMS coding region showed cell bodies containing LMS mRNA in all ganglia studied, other than the ingluvial ganglion. Expression was most abundant in the brain and optic lobes and in the frontal and suboesophageal ganglia. LMS mRNA was also apparent, although less intensely, in all other ganglia of the ventral nerve cord. Within the alimentary canal, LMS mRNA-positive cells were only visible in the anterior portion of the midgut, in the endocrinelike cells. The appearance of LMS mRNA in the central nervous system, stomatogastric nervous system, and midgut suggests that LMS may play a central role in Diploptera and may be associated with feeding and digestion.     

Ganglion cysts of the knee: articular communication revealed by delayed radiography and CT after arthrography

OBJECTIVE: The diagnosis of ganglion cysts of articular origin may sometimes be uncertain when communication with the joint is not evident. Because we have observed that opacification of ganglion cysts revealed by arthrography can be significantly delayed, the purpose of this study was to determine retrospectively in 20 cases the time delay needed to show with arthrography a communication between the articular cavity and ganglion cysts of the knee. CONCLUSION: Arthrographic evidence of a communication between the articular cavity of the knee and communicating ganglion cysts requires delayed radiography performed at least 1 hr after intraarticular injection of contrast material. The best results are obtained with additional CT performed 1-2 hr after injection.     

Syntheses of D- and L-myo-inositol 1,2,4,5-tetrakisphosphate and stereoselectivity of the I(1,4,5)P3 receptor binding

D- and L-myo-Inositol 1,2,4,5-tetrakisphosphate [D- & L-I(1,2,4,5)P4], which are analogues of D-myo-Inositol 1,4,5-trisphosphate [D-I(1,4,5)P3], a calcium mobilizing second messenger, were synthesized via resolution of the camphanate ester of a myo-inositol derivative, and the binding affinities to I(1,4,5)P3 receptor were measured.     

Development and evaluation of a procedure for fitting multi-channel compression hearing aids

Hearing aids with multi-channel compression are often fitted on the basis of loudness scaling data obtained using narrow bands of noise or tones. Here, we report the development and evaluation of an alternative fitting procedure based on the use of speech signals. The parameters of the hearing aid (the gains in each channel for high and low input levels) are adjusted adaptively under computer control on the basis of the listener's responses. The goal is that speech at 85 dB SPL should be judged as 'loud', speech at 60 dB SPL should be judged as 'quiet', and speech at both levels should be judged as 'neither tinny nor boomy'. The procedure was evaluated using a two-channel compression hearing aid, the remote control of which allowed two programs to be stored. One program was based on our fitting procedure. The other was either based on the manufacturer's recommended full fitting procedure (which included loudness scaling with bands of noise), or was based on the audiogram alone, using the manufacturer's algorithm. After an acclimatization period of at least two weeks, subjects were then asked to fill in a questionnaire about their experiences with the two programs in different listening situations. The results generally indicated a preference for the program based on our adaptive fitting procedure. We also conducted laboratory measurements of speech intelligibility, in quiet and in a background of a single competing talker. These showed no clear difference between programs, although scores overall were very high. We conclude that our adaptive procedure gives very satisfactory results in everyday life. Parameter values giving good comfort also give good intelligibility. The procedure typically takes between five and 10 minutes per ear, which is quicker than most loudness scaling procedures.     

Strategies in the treatment of penicillin-resistant Streptococcus pneumoniae

The epidemiology, resistance mechanisms, susceptibility testing, treatment, prevention, and clinical importance of penicillin-resistant Streptococcus pneumoniae (PRSP) infection are discussed. PRSP is an established presence in the United States, with some geographic areas reporting decreased susceptibility in up to half of isolates. The mechanism of resistance to beta-lactam antibiotics in S. pneumoniae is genetic changes resulting in decreased binding of drug to the bacterial cell wall. Emerging PRSP strains have necessitated testing as a tool in selecting drugs for treating life-threatening infections. Opinions differ on how to treat these infections empirically. Non-life-threatening infections, such as otitis media, are still often treated successfully with amoxicillin, amoxicillin-clavulanate potassium, or a third-generation cephalosporin. Currently recommended initial treatment of pneumococcal pneumonia in otherwise healthy patients requiring hospitalization consists of cefuroxime, ceftriaxone, or cefotaxime; some authors continue to emphasize injectable penicillin. Once the mainstay of empirical treatment of pneumococcal meningitis, penicillin has largely been abandoned in favor of cefotaxime or ceftriaxone. Vaccination remains an underutilized strategy in atrisk populations. The clinical importance of penicillin resistance among pneumococci is still uncertain. Changing patterns in the susceptibility of S. pneumoniae to penicillin make selection of appropriate therapy increasingly difficult. Key considerations are the site of infection and the level of resistance.     

Changes over time in optimal duplex threshold for the identification of patients eligible for carotid endarterectomy

BACKGROUND AND PURPOSE: Two surgical trials established that carotid endarterectomy is beneficial to symptomatic patients who have a severe internal carotid artery (ICA) stenosis on angiograms. Duplex ultrasonography-derived hemodynamic parameters show a good correlation with angiography and are often used for detecting severe ICA stenoses. However, duplex performance is ultrasound machine and operator dependent. Over time both may change, possibly affecting duplex performance. We compared duplex performance of 2 time periods in 1 specific vascular laboratory using angiography as the gold standard. METHODS: Consecutive patients who underwent both angiography and duplex examinations of the ICA were evaluated (first period, 60 patients; second period, 61 patients). Peak systolic velocity and several other hemodynamic parameters and ratios were analyzed by receiver operating characteristic curves in their ability to detect severe ICA stenoses. The optimal parameter and threshold were determined for each period. Subsequently, duplex test characteristics were compared after the optimal thresholds of both the first and the second periods were applied in the second period. RESULTS: In both periods peak systolic velocity of the ICA was the best test parameter; areas under the receiver operating characteristic curve were similar (0.957 and 0.954, respectively). However, the optimal threshold was different. The optimal threshold in the second period was 270 cm/s. When the optimal threshold of 210 cm/s of the first period was applied in the second period, test characteristics changed significantly. Sensitivity increased from 98% to 100%, and specificity decreased from 85% to 71% (P=0.004). CONCLUSIONS: The optimal threshold for detecting severe ICA stenoses with duplex ultrasonography in our laboratory changed over time. Individual laboratories should assess duplex accuracy regularly and adjust adopted criteria if necessary to keep diagnostic performance optimal.     

Urinary deoxypyridinoline is a useful biochemical bone marker for the management of postmenopausal osteoporosis

Fecal nematode egg counts and serum pepsinogen concentrations of cattle were determined in six Provinces of the northern (Chiangrai and Lampang), north-eastern (Khonkaen, Mahasarakham and Nakhonratchasima) and eastern (Chonburi) parts of Thailand in the dry season. Nematode eggs were detected in 82% of animals examined. Serum pepsinogen concentrations ranged from 78 to 2,951 (mean 934) mU tyrosine. Animals in Chonburi Province had higher mean values for both egg counts and serum pepsinogen concentrations than animals in the other Provinces. Two calves in Khonkaen and Mahasarakham Provinces were found to be heavily infected with Strongyloides papillosus, with 10,840 and 9,593 eggs/g feces. The source and route of S. papillosus infections remained unknown.     

A clinical prediction rule for renal artery stenosis

BACKGROUND: Renal artery stenosis is a rare cause of hypertension. The gold standard for diagnosing renal artery stenosis, renal angiography, is invasive and costly. OBJECTIVE: To develop a prediction rule for renal artery stenosis from clinical characteristics that can be used to select patients for renal angiography. DESIGN: Logistic regression analysis of data from a prospective cohort of patients suspected of having renal artery stenosis. A prediction rule was derived from the regression model for use in clinical practice. SETTING: 26 hypertension clinics in The Netherlands. PATIENTS: 477 hypertensive patients who underwent renal angiography because they had drug-resistant hypertension or an increase in serum creatinine concentration during therapy with angiotensin-converting enzyme inhibitors. RESULTS: Age, sex, atherosclerotic vascular disease, recent onset of hypertension, smoking history, body mass index, presence of an abdominal bruit, serum creatinine concentration, and serum cholesterol level were selected as predictors. The regression model was reliable (goodness-of-fit test, P > 0.2) and discriminated well between patients with stenosis and those with essential hypertension (area under the receiver-operating characteristic curve, 0.84). The diagnostic accuracy of the regression model was similar to that of renal scintigraphy, which had a sensitivity of 72% and a specificity of 90%. CONCLUSIONS: In the diagnostic workup of patients suspected of having renal artery stenosis, the clinical prediction rule can be considered as an alternative to renal scintigraphy. It can help to select patients for renal angiography in an efficient manner by reducing the number of angiographic procedures without the risk for missing many renal artery stenoses.     

Nutrient Intake Report: a coordination of patient dietary assessment between physicians and registered dietitians

The Nutrient Intake Report (NIR) is based on a 7-day dietary recall questionnaire used previously in research for dietary assessment and adapted for clinical use. Used to provide information and counseling as part of total patient care, the NIR acts as a cornerstone for dietary education and interaction between physician, registered dietitian, and patient. The NIR is ordered by physicians or registered dietitians, scanned and assessed by a registered dietitian, and incorporated into the laboratory section of the medical record. It documents the patient's dietary intake in the context of his or her diagnosis and general health status. The NIR also opens a dialogue between physicians and registered dietitians. Incorporation of the NIR into the medical record makes the work of the registered dietitian available to other health practitioners, which is welcome in an era when licensing and reimbursement are contingent on systematic documentation of dietary assessment and its role in patient care.     

Thrombogenesis of different cell types seeded on vascular grafts and studied under blood-flow conditions

BACKGROUND: Small-diameter vascular grafts tend to have an early and high occlusion rate. Cell seeding on the luminal surfaces of small-diameter vascular prostheses may provide an antithrombotic lining and improve both the short-term and the long-term patency rates. We studied the net results of procoagulant and anticoagulant properties of seeded grafts under blood-flow conditions, and we compared the different available types of donor cells. METHODS: Monolayers of liposuction-derived cultured human microvascular endothelial cells (MVECs), human adult endothelial cells (HAECs), human umbilical vein endothelial cells (HUVECs), and human mesothelial cells (MCs) that had been seeded on expanded polytetrafluoroethylene (ePTFE) grafts were perfused with marginally anticoagulated blood (20 U/mL low molecular weight heparin; shear rate, 400/s, 10 minutes) or with non-anticoagulated blood (shear rate, 100/s, 5 minutes). The thrombin and fibrin generation in time was studied with the measurement of the plasma levels of prothrombin fragment 1 and 2 (F 1+2) and of fibrinopeptide A (FPA). The plain ePTFE graft was taken as a control. RESULTS: When the seeded MCs were perfused with recirculating anticoagulated blood, a linear generation of F 1+2 in time was seen, with high levels of F 1+2 and FPA after 10 minutes (4.38 nmol/L and 362 ng/mL, respectively). Allopurinol was added, and the MCs generated less F 1+2 than the HAECs (0.7 nmol/L vs 1.86 nmol/L; P <.05). No fibrin formation was seen. The MVECs generated low amounts of F 1+2 (0.7 nmol/L; 10 minutes), and the HUVECs and the plain ePTFE graft generated the lowest amounts of F 1+2 (0.26 and 0.25 nmol/L, respectively). When the MCs were perfused with non-anticoagulated blood, high amounts of thrombin and fibrin were generated immediately and constantly and could not be decreased with allopurinol. The perfusion of the plain ePTFE graft showed a dramatic increase in F 1+2 and FPA levels towards the end of the experiments. The seeded HAECs, HUVECs, and MVECs inhibited this increase. These results were confirmed by means of scanning electron microscopy. CONCLUSION: Vascular prostheses that are seeded with cultured MCs are highly procoagulant. Standard ePTFE graft prostheses also initiate coagulation, which supports the idea of cell seeding. The endothelial cells, of which the MVECs are the most readily available, seem to preserve their anticoagulant properties after being seeded on vascular grafts.