Isolation, structure elucidation, and biological activity of the steroid oligoglycosides and polyhydroxysteroids from the Antarctic starfish Acodontaster conspicuus

A total of 19 steroids, of which 13 steroidal oligoglycosides (nine new and four known) and six polyhydroxylated steroids (four new and two known), has been isolated from the Antarctic starfish Acodontaster conspicuus. The mixture is dominated by glycosides composed of steroidal aglycons having the hydroxyl groups typically disposed on one side of the tetracyclic nucleus, i.e., 3 beta,4 beta,6 alpha,8,15 beta-, with some having a sulfate at C-6, and differing in the side chains and/or in the disaccharide moieties that are usually attached at C-26, with some at C-28 and C-29. Those compounds are accompanied by minute amounts of glycosides with a delta 8(14)-double bond in the steroid, which is a structural feature not previously found among polyhydroxysteroids derived from starfish. Small amounts of six related unglycosidated polyhydroxysteroids and three higher-molecular-weight asterosaponins complete the composition of the mixture. The structures of the new compounds were determined by interpretation of their spectral data and by comparison with spectral data of known compounds. Eighteen of these compounds were evaluated for their ability to inhibit growth in Antarctic marine bacteria isolated from either the water column or the surfaces of benthic marine invertebrates. Of these compounds, 50% were active against at least one Antarctic marine bacterium. This suggests that these compounds may play an important role in deterring microbial fouling.     

Management of ingested foreign bodies within the appendix: a case report with review of the literature

A case is reported of an elective appendectomy in a patient with known ingestion of a sharp foreign body. The metal drill bit was ingested unintentionally 3 months before presentation at our institution. Plain abdominal films demonstrated the foreign body in the right lower abdominal quadrant. Because the gold dental drill bit was sharp and thought to be lodged in the terminal ileum or cecum, an attempt was made to remove the object during colonoscopy. This attempt was unsuccessful because no drill bit could be detected in the colon or terminal ileum. A laparoscopic exploration was performed, and the foreign body was found to lie in the appendix, after bowel manipulation under fluoroscopic guidance and with direct laparoscopic visualization. A laparoscopic assisted appendectomy was performed. On pathologic examination the drill bit was embedded in the tip of the appendix with signs of intramucosal acute inflammation. Management and indication for surgery of foreign bodies in the appendix are discussed, and we review the related literature. This is the second reported case of a dental drill bit in the appendix causing appendicitis.     

Epilepsy, learning disability and anti-convulsant drug status

We describe the isolation of crotoxin, a presynaptic B-neurotoxin, as well as its subunits B (crotactine) and A (crotapotin) from lyophilized Crotalus durissus terrificus venom by a single-step preparative isoelectric focusing procedure. From 98 mg of dried venom protein 20.1 mg of crotactine and 13.1 mg of crotapotin were recovered in the first step of focalization and 4.2 mg in a second run. These values correspond to 35.7% of the total venom protein applied. Crotactine separated in the 9.3-7.0 pH range (tubes 1-6) and crotapotin in the 1.8-2.8 pH range (tubes 15-19) and both were homogeneous by SDS-PAGE and N-terminal amino acid analysis. Crotactine, a 12-kDA protein, presented hemolytic and phospholipase A2 activity. Thus, using isoelectric focusing we simultaneously purified both toxins in high yields. This method can be used as an alternative for the purification and characterization of proteins from other snake venoms under conditions in which biological activity is retained.     

Spinal injuries in New Zealand rugby and rugby league--a twenty year survey

AIMS: To establish trends in frequency of serious spinal cord injuries in rugby and rugby league over a 20 year period and to elucidate patterns of injury from retrospective analysis of cases admitted to New Zealand's two spinal injuries units. METHODS: A detailed survey of unit records with follow-up of selected patients; statistical analysis of data. RESULTS: During the 20 years 1976 to 1995, 119 rugby and 22 rugby league players (total 141) were admitted to New Zealand's two spinal injuries units suffering serious spinal injuries and 47 of these became permanently confined to wheelchairs. There was a steady increase in frequency throughout the period studied. Of the injuries 83% occurred in forwards and 17% in backs. In rugby it was the scrum which produced most injuries, and in rugby league it was the tackle. The early season month of April produced most spinal injuries. In the eighteen months since intense compulsory educational programmes on safety were introduced by the New Zealand Rugby Union there have been no serious spinal cord injuries from rugby scrums. CONCLUSION: Contrary to widespread belief, there has not been a decrease in spinal cord injuries in rugby following rule changes in the mid 1980s. The information produced by this retrospective study has been an effective educational platform to make rugby and rugby league safer.     

Assisted suicide: implications for nurses and nursing

Assisted suicide is an issue of great importance to nurses. This issue reflects our values and beliefs as a society, calls for a clear and precise response as a profession, and challenges individual nurses to think about their own moral views. The history of the debate and the compelling moral arguments on both sides attest to the complexity of the issue and also suggest that it will not soon be resolved. The current position of the profession, as expressed in the ANA Code for Nurses and a specific position statement, were reviewed. The dilemma faced by the individual nurse who perceives an obligation to adhere to the guidelines specified by his or her profession's code and yet whose conscience dictates an act in violation of this code has been discussed as an instance of conscientious objection. While this analysis has been necessarily brief, it was intended to illustrate the importance of being clear about one's personal moral views and equally clear about one's duty to fulfil the obligations stemming from the profession's public statements. It is essential that the profession continue to explore the moral issues involved in requests for assistance in dying and provide additional guidelines for practicing nurses, with sound rationale for the profession's position.