Major abdominal surgery and the clearance of lipid emulsions

Reaction of bacterial adhesins with complementary receptors on the surfaces of mucosal respiratory, gastrointestinal and genitourinary cells leads to bacterial adhesion to the human body. This is the first step in the sequence of events leading to infection. It has been observed that subinhibitory concentrations (sub-MICs) of some antibiotics are able to reduce bacterial adhesion. The pharmacokinetic curves of antibiotics show that these sub-MICs are present in tissues during a typical course of therapy. This study investigated the ability of sub-MICs of seven macrolides and four fluoroquinolones to reduce adhesiveness of Staphylococcus aureus to human buccal cells. The literature generally reports data for only one antibiotic at a time. To obtain an overall view of the findings of eleven antibiotics together, the data have been normalized according to the molecular weight of each antibiotic and the dose-effect curves determined.     

Differential expression of two fibroblast growth factor-receptor genes is associated with malignant progression in human astrocytomas

Malignant astrocytomas, which are highly invasive, vascular neoplasms, compose the majority of nervous system tumors in humans. Elevated expression of fibroblast growth factors (FGFs) in astrocytomas has implicated the FGF family of mitogens in the initiation and progression of astrocyte-derived tumors. In this study, we demonstrated that human astrocytomas undergo parallel changes in FGF-receptor (FGFR) expression during their progression from a benign to a malignant phenotype. FGFR type 2 (BEK) expression was abundant in normal white matter and in all low-grade astrocytomas but was not seen in malignant astrocytomas. Conversely, FGFR type 1 (FLG) expression was absent or barely detectable in normal white matter but was significantly elevated in malignant astrocytomas. Malignant astrocytomas also expressed an alternatively spliced form of FGFR-1 (FGFR-1 beta) containing two immunoglobulin-like disulfide loops, whereas normal human adult and fetal brains expressed a receptor form (FGFR-1 alpha) containing three immunoglobulin-like disulfide loops. Intermediate grades of astrocytic tumors exhibited a gradual loss of FGFR-2 and a shift in expression from FGFR-1 alpha to FGFR-1 beta as they progressed from benign to malignant phenotype. These results suggest that differential expression and alternative splicing of FGFRs may be critical in the malignant progression of astrocytic tumors.     

Prevalence of metaplasia at the gastro-oesophageal junction

Specialised columnar epithelium (SCE), a form of intestinal metaplasia usually found in Barrett's oesophagus, cannot be distinguished endoscopically from normal gastric epithelium. Endoscopists seldom obtain biopsy specimens from a normal-appearing gastro-oesophageal junction, and therefore short segments of SCE in this region may go unrecognised. We studied patients who had short segments of SCE at the gastro-oesophageal junction. All patients scheduled for elective endoscopic examinations in our general endoscopy unit, irrespective of indication, were questioned for symptoms of gastro-oesophageal reflux disease. At endoscopy, severity of oesophagitis was graded, and biopsy specimens obtained from the squamocolumnar junction, irrespective of its appearance or location in the oesophagus. Among 142 patients without endoscopically apparent Barrett's oesophagus, 26 (18%) were found to have SCE. All patients with SCE were white, and the male/female ratio was 1.9. In contrast, non-whites accounted for 14% of the 114 patients without SCE and the male/female ratio was 0.8. The groups did not differ significantly in the frequency of symptoms and endoscopic signs of gastrooesophageal reflux. We conclude that adults frequently have unrecognised segments of SCE at the gastro-oesophageal junction; this may underlie the rising frequency of cancer of the gastrooesophageal junction in the USA and Europe.     

Frequency of molecular alterations in heterozygous beta-thalassemia in southern Spain and their relation to the hematologic phenotype

INTRODUCTION: Heterozygous beta-thalassemia manifests hematologically with microcytosis, reduced red blood cell hemoglobin concentration and high hemoglobin A2 levels. Almost all molecular alterations are due to point mutations. We attempt to determinate the frequency of that mutations in the Oriental Andalusia Area, and its relationship with the hematological phenotype. PATIENTS AND METHODS: We have studied 45 heterozygous patients. DNA samples were amplified by PCR, using the printers CD7 and HI1. A 16 Kb fragment corresponding to beta globin gene was obtained and analyzed by Dot Blot assay and hybridized with allelic specific oligonucleotide (ASO) probes to detect the 6 more frequent mutations found in the South of Spain. RESULTS: Codon 39 nonsense mutation (31.1%) was the most frequent finding followed by IVS-1 NT 110 (26.7%). The relationship between hematological parameters and molecular mutations concluded that IVS-I NT 6 mutation developed a minimal anemia. DISCUSSION: From the practical point of view, this study indicates that we were able to detect more than 90% of heterozygous beta-tal. with 5 out of 6 ASO probes used in this work. Thus, our data also provides a further implication in prenatal diagnosis.     

Exercise VO2 estimation using recovery sampling

Various situations present a challenge to determine oxygen uptake (VO2) accurately simply because of the restrictions imposed by the equipment employed. This investigation was undertaken to 1) compare a select number of recovery VO2 measurements with respect to their accuracy in estimating actual exercise VO2 and 2) to determine whether absolute workload or VO2max affect this relationship. Fifteen subjects [8 highly trained (HT), VO2max +/- SD = 70.2 +/- 3.5 ml/kg . min-1 and 7 untrained (UT), VO2max = 49.7 +/- 3.8 ml/kg . min-1] completed a number of 5 min workbouts on a bicycle ergometer at 25-70% VO2max (VO2 = .899--3.879 l . min-1). VO2 and VCO2 (l . min-1) were monitored continuously throughout the exercise and for 5 min of recovery via a breath-by-breath system. The results indicated that 1) exercise VO2 +/- Sy.x can be estimated from several recovery collection periods, the first breath y = .953X + .441 +/- .319, the first two breaths y = 1.046X + .327 +/- .270, the first three breaths y = 1.089X + .260 +/- .241, and the second three breaths y = 1.101X + .387 +/- .234, and 2) VO2max does not affect this relationship (p greater than 0.05) while increasing absolute workload produces a greater exercise VO2 underestimation (p less than 0.05). It was concluded that using this method exercise VO2 can be estimated with reasonable accuracy (Sy.x = .234--.319, r = .92--.94, p less than 0.01).     

Chlamydial pneumonia of infancy: further clinical observations

Two patients with chlamydial pneumonia of infancy are described. One recovered spontaneously without any specific antichlamydial treatment. The other, prior to a belated antimicrobial therapy, developed a persistent and protracted respiratory illness characterized by wheezing. Our observations suggest that: (1) untreated chlamydial pneumonia of infancy may spontaneously resolve, or may become a persistent and protracted disease, and (2) wheezing may be a very prominent manifestation of the disease and should be differentiated from wheezing due to bronchiolitis and bronchial asthma.