Combined use of laparoscopic cholecystectomy and endoscopic retrograde cholangiography (ERC) and papillotomy (ERCP) in management of cholecysto-choledocholithiasis

In a review of 328 cases the combination of laparoscopic cholecystectomy with specific use of endoscopic retrograde cholangiography (pre- and postoperatively) proved to be a riskless, secure and time-saving procedure. In our opinion this is a minimal invasive method of treatment for patients with cholecysto-/choledocholithiasis.     

Inactivation of FhuA at the cell surface of Escherichia coli K-12 by a phage T5 lipoprotein at the periplasmic face of the outer membrane

Inactivation of phage T5 by lysed cells after phage multiplication is prevented by a phage-encoded lipoprotein (Llp) that inactivates the FhuA outer membrane receptor protein (K. Decker, V. Krauel, A. Meesmann, and K. Heller, Mol. Microbiol. 12:321-332, 1994). Using FhuA derivatives carrying insertions of 4 and 16 amino acid residues and point mutations, we determined whether FhuA inactivation is caused by binding of Llp to FhuA and which regions of FhuA are important for inactivation by Llp. Cells expressing Llp were resistant not only to phage T5 but to all FhuA ligands tested, such as phage phi 80, colicin M, and albomycin, and they were strongly reduced in the uptake of ferrichrome. Most of the FhuA derivatives which were not affected by Llp were, according to a previously published FhuA transmembrane topology model, located in periplasmic turns and in the TonB box close to the periplasm. Since the ligands bind to the cell surface, interaction of FhuA with Llp in the periplasm may induce a FhuA conformation which impairs binding of the ligands. This conclusion was supported by the increase rather than decrease of colicin M sensitivity of two mutants in the presence of Llp. The only Llp-resistant FhuA derivatives with mutations at the cell surface contained insertions of 16 residues in the loop that determines the permeability of the FhuA channel and serves as the principal binding site for all FhuA ligands. This region may be inactivated by steric hindrance in that a portion of Llp penetrates into the channel. Outer membranes prepared with 0.25% Triton X-100 from cells expressing Llp contained inactivated FhuA, suggesting Llp to be an outer membrane protein whose interaction with FhuA was not abolished by Triton X-100. Llp solubilized in 1.1% octylglucoside prevented T5 inactivation by FhuA dissolved in octylglucoside.     

Prenatal determination of human platelet antigen type using DNA amplification following amniocentesis

OBJECTIVE: To assess the effectiveness of a newly developed individualised birthweight ratio (IBR), which corrects for physiological birthweight determinants, in identifying infants at risk from the complications of macrosomia. DESIGN: Prospective observational study. SETTING: Obstetric unit, Nottingham City Hospital. SUBJECTS: 2835 women delivered between December 1991 and July 1992 and the infants of 624 of these, selected by virtue of their birthweight for gestation and IBR centile positions. MAIN OUTCOME MEASURES: Skinfold thickness and ponderal index measurements, operative delivery, shoulder dystocia, fetal trauma, impaired glucose tolerance. RESULTS: Using an IBR above the 90th centile as a cut off results in 2.4% of infants being reclassified as normally grown and 3.1% are reclassified as large. The IBR does not result in the identification of any more infants with abnormal ponderal indices or skinfold thicknesses than birthweight for gestation. It does, however, identify more of the infants at risk of operative delivery, shoulder dystocia, fetal trauma and impaired glucose tolerance. CONCLUSION: The IBR significantly improves upon birthweight for gestation in identifying infants who suffer from the complications of relative macrosomia.     

Impairment, disability, and handicap in multiple sclerosis. A cross-sectional study in an incident cohort in M?re and Romsdal County, Norway

Non-submerged ITI Bonefit implants (ITI Dental Implant System) were inserted in edentulous lower jaws of 46 patients. The patients were provided with either a fixed prosthesis or an overdenture, and has been followed during a 2-year-period. At the 1-year examination, the suprastructures were removed permitting test of the individual implant stability. Radiographic examinations were performed in connection with the loading of the implants and at the 1-year examination. In total 216 implants were inserted. 4 implants were lost before loading and 4 during the 2nd year of function, which gives a survival rate after 1 year 98% and after 2 years of 96%. The mean marginal bone loss during the first year of function was 0.1 mm. However, the marginal bone changes had a high degree of variation and four implants showed a severe bone loss. The intention is to follow this patient group with annual examinations during 5 years.     

Site-directed mutagenesis of recombinant human beta 2-glycoprotein I identifies a cluster of lysine residues that are critical for phospholipid binding and anti-cardiolipin antibody activity

beta2-Glycoprotein I (beta2GPI) is a phospholipid-binding serum protein with anticoagulant properties. It plays a vital role in the binding of anti-cardiolipin Abs purified from patients with autoimmune disease when assayed in a cardiolipin (CL) ELISA. Based on a three-dimensional model of beta2GPI, electrostatic calculations, and earlier peptide studies, a highly positively charged amino acid sequence, Lys282-Asn-Lys-Glu-Lys-Lys287, located in the fifth domain of beta2GPI, has been predicted to be the phospholipid binding site. We tested this hypothesis by site-directed mutagenesis of residues in the predicted phospholipid binding site and by assessing the mutants for phospholipid binding and anti-beta2GPI activity. A single amino acid change from Lys286 to Glu significantly decreased the binding of beta2GPI to CL. Double and triple mutants 2k (from Lys286, 287 to Glu286, 287), 2ka (from Lys284, 287 to Glu284, 287), and 3k (from Lys284, 286, 287 to Glu284, 286, 287) possessed no binding of Ab to beta2GPI in a CL ELISA, as well as no inhibitory activity on the binding of iodinated native beta2GPI to CL. These results indicate that the residues Lys284, Lys286, and Lys287 in the fifth domain of beta2GPI are critical for its binding to anionic phospholipids and its subsequent capture for binding of anti-beta2GPI Abs.     

Structural modelling of coprecipitated VTiO catalysts

A statistical study of the particle shape and size of pure V₂O₅ and TiO₂, and samples of coprecipitated V₂O₅---TiO₂ catalysts with different V/Ti ratios, has been performed. They were also characterized by XRD, EDAX, SEM and XPS. The results showed that pure vanadium pentoxide is compose by large square or needle-shaped particles, while pure titanium dioxide has small and rounded ones. VTiO samples presented an area and shape, depending on the V/Ti ratio.

These results and the spectroscopical characterization conducted to a particle model of the catalysts. Those VOTi samples with high V/Ti ratio would have large V₂O₅ crystals acting as support of a V/TiO₂ solid solution. In contrast, those samples with a low V/Ti ratio, would have the solid solution supporting vanadium pentoxide crystals.