The utility of video-assisted thoracic surgery in the diagnosis of pulmonary metastases from renal cell carcinoma

To assess the clinical usefulness of serum pro-gastrin-releasing peptide (Pro-GRP) as a tumor marker for small cell lung carcinoma (SCLC), we measured serum levels of Pro-GRP with a newly developed ELISA and measured serum levels of neuron-specific enolase (NSE) in 44 patients with untreated SCLC and 77 patients with untreated non-SCLC. We prospectively measured serum levels of Pro-GRP and NSE in SCLC patients after initial treatment until relapse. The sensitivity (70%) and specificity (91%) of Pro-GRP were similar to those of NSE (70 and 86%). Thirty-nine % of patients who had a partial response still had elevated serum levels of Pro-GRP at the time of restaging after initial treatment. In follow-up study, 94% of patients had elevated serum levels of Pro-GRP again at the time of relapse, whereas 37% of patients showed elevated levels of NSE. Levels of Pro-GRP increased a median of 35 (-95 to 151) days before clinical evidence of relapse was detected with successive physical examinations and imaging studies, whereas levels of NSE increased 20 (-85 to 124) days after relapse was detected (P < 0.05). Pro-GRP was helpful as a diagnostic aid and a marker for therapeutic effect and relapse in patients with SCLC, supplemented to serum NSE.     

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.     

Glutathione synthetase is dispensable for growth under both normal and oxidative stress conditions in the yeast Saccharomyces cerevisiae due to an accumulation of the dipeptide gamma-glutamylcysteine

Glutathione (GSH) synthetase (Gsh2) catalyzes the ATP-dependent synthesis of GSH from gamma-glutamylcysteine (gamma-Glu-Cys) and glycine. GSH2, encoding the Saccharomyces cerevisiae enzyme, was isolated and used to construct strains that either lack or overproduce Gsh2. The identity of GSH2 was confirmed by the following criteria: 1) the predicted Gsh2 protein shared 37-39% identity and 58-60% similarity with GSH synthetases from other eukaryotes, 2) increased gene dosage of GSH2 resulted in elevated Gsh2 enzyme activity, 3) a strain deleted for GSH2 was dependent on exogenous GSH for wild-type growth rates, and 4) the gsh2 mutant lacked GSH and accumulated the dipeptide gamma-Glu-Cys intermediate in GSH biosynthesis. Overexpression of GSH2 had no effect on cellular GSH levels, whereas overexpression of GSH1, encoding the enzyme for the first step in GSH biosynthesis, lead to an approximately twofold increase in GSH levels, consistent with Gsh1 catalyzing the rate-limiting step in GSH biosynthesis. In contrast to a strain deleted for GSH1, which lacks both GSH and gamma-Glu-Cys, the strain deleted for GSH2 was found to be unaffected in mitochondrial function as well as resistance to oxidative stress induced by hydrogen peroxide, tert-butyl hydroperoxide, and the superoxide anion. Furthermore, gamma-Glu-Cys was at least as good as GSH in protecting yeast cells against an oxidant challenge, providing the first evidence that gamma-Glu-Cys can act as an antioxidant and substitute for GSH in a eukaryotic cell. However, the dipeptide could not fully substitute for the essential function of GSH in the cell as shown by the poor growth of the gsh2 mutant on minimal medium. We suggest that this function may be the detoxification of harmful intermediates that are generated during normal cellular metabolism.     

Arrhythmia detection and response in a monitoring technician and pocket paging system

Technologically advanced telemetry systems have begun to produce alternatives to the need for continuous visual observation of the electrocardiogram (ECG). Few studies have been conducted to determine the efficacy of these systems in the clinical setting. The purpose of this study was to describe two different approaches to communication of arrhythmia events and corresponding nurse response. One approach, on a cardiac medical unit, utilized a monitoring technician to continuously observe ECGs at a central monitoring technician station (MTS) and notify the nurse of changes. The other approach, on a general medical unit, eliminated the use of the monitoring technician and utilized a pocket paging system (PPS). The PPS interfaced with the computerized arrhythmia detection system from the ECG monitor, which directly alerted the nurse to arrhythmia events. A quasi-experimental comparative post-test design was used. The sample consisted of 50 randomly selected, 2-hour observation periods on each unit during a 3-month period. Data collectors recorded the interaction of the monitoring technician with the arrhythmia detection system and the nurse on the MTS unit, or the nurse using the PPS. Results of this study revealed all arrhythmia events activated an alarm by the computerized arrhythmia detection system. Length of time to notify the nurse was within 0 to 1 minute for both systems. This study demonstrated that the PPS is a viable approach to arrhythmia detection and communication in the medical/cardiac patient population.     

Multiple phases of expression and regulation of mouse Hoxc8 during early embryogenesis

Hox genes are expressed in dynamic patterns during embryogenesis consistent with their role in axial specifications. To study the distribution of mouse Hoxc8, a homeodomain containing protein, we raised monoclonal antibodies against the least conserved portion of Hoxc8. Using these antibodies, we have examined early and mid-gestation embryos for the distribution of the protein. At the end of gastrulation Hoxc8 is expressed in the caudal portion of the embryo. In the neural tube, an early phase when all cells express Hoxc8 is distinguished from a late phase with predominant expression in differentiating neurons. A comparison of this expression pattern with that of a reporter gene under the control of the early Hoxc8 enhancer demarcates three separate regulatory components: (1) initiation and establishment; (2) maintenance; and (3) downregulation. We propose that Hoxc8 expression during embryogenesis is established in multiple phases. Possible regulatory mechanisms involved in generating such a complex domain of Hox gene expression are discussed.     

Asthma health status measurement in clinical practice: validity of a new short and simple instrument

Health status (Quality of Life) questionnaires for use in asthma are generally too long or complex for routine use. A new short and simple measure of health status in asthma has been developed for this purpose. There are two versions, one containing 30 items (AQ30) and the other 20 items (AQ20). This study examined their cross-sectional and longitudinal properties and compared them with those of two established measures--the St. George's Respiratory Questionnaire (SGRQ) and the Asthma Quality of Life Questionnaire (AQLQ). Ninety asthmatic patients (mean age 46 years) participated. Mean post-bronchodilator forced expiratory volume in one second (FEV1) was 73 +/- 25 (SD)% predicted at baseline. Questionnaire data were collected twice, 12 weeks apart. Diary records of peak expiratory flow rate (PEFR) and daily asthma were kept for 14 days. The new questionnaires each took 3 min or less to complete. At baseline they correlated well with the SGRQ and AQLQ and showed the same pattern of correlations with clinical measures of asthma. Change scores for the new questionnaires correlated with those for the established measures. There was no advantage of the AQ30 over the AQ20. The AQ20 provides a simple method for obtaining valid health status estimates of asthmatics in routine clinical practice and has properties similar to more complex research instruments.     

Cariogenicity depends more on diet than the prevailing mutans streptococcal species

This review aims to compare the occurrence and distribution of mutans streptococci in Africa, Europe, and North America and in addition will try to offer explanations for existing relationships among salivary mutans streptococci counts, dietary patterns, and dental caries. The literature reveals that salivary mutans streptococci counts in child populations of the three continents are comparable. The distribution of mutans streptococci species, with a predominance of S. mutans followed by S. sobrinus, and the virtual absence of other mutans streptococci species are also comparable. Although it is widely believed that diet has an important effect on mutans streptococci counts, this review provides evidence that this does not hold true when variations in dietary patterns are moderate, as they normally are in real-life situations. Since the diets of the child populations in the three continents vary moderately, a strong dietary-induced effect on salivary mutans streptococci counts cannot be expected. The observed analogous salivary mutans streptococci counts in these child populations are thus 'not surprising' but are in accordance with the conceptual expectation. The differences in caries experience in children of the three continents cannot be explained by the prevailing mutans streptococci species but instead should be attributed to differences in the cariogenicity of the various diets. The fact that the cariogenicity of the diet determines the development of dental caries while hardly affecting the mutans streptococci counts explains the limited value of the latter as an indicator of dental caries. The reviewed literature shows that mutans streptococci are ubiquitous in children aged 7 years and older in Africa, Europe, and North America. Mutans streptococci should therefore be considered as belonging to the indigenous microflora of the human mouth.