Identification and characterization of a two-component regulatory system involved in invasion of eukaryotic cells and heavy-metal resistance in Burkholderia pseudomallei

Burkholderia pseudomallei is the causative agent of melioidosis, a disease increasingly recognized as an important cause of morbidity and mortality in many regions of the world. B. pseudomallei is a facultative intracellular pathogen capable of invading eukaryotic cells. We used Tn5-OT182 mutagenesis to generate mutants deficient in the ability to invade a human type II pneumocyte cell line (A549 cells). One of these mutants, AJ1D8, exhibited approximately 10% of the ability of the parental strain, 1026b, to invade A549 cells. There was no difference in the abilities of 1026b and AJ1D8 to resist killing by RAW macrophages or the human defensin HNP-1. The nucleotide sequence flanking the Tn5-OT182 integration in AJ1D8 was determined, and two open reading frames were identified. The predicted proteins shared considerable homology with two-component regulatory systems involved in the regulation of heavy-metal resistance in other organisms. AJ1D8 was 16-fold more sensitive to Cd2+ and twofold more sensitive to Zn2+ than was 1026b but was not sensitive to any of the other heavy metals examined. The B. pseudomallei two-component regulatory system, termed irlRS, complemented the invasion-deficient and heavy-metal-sensitive phenotype of AJ1D8 in trans. There was no significant difference between the virulence of AJ1D8 and that of 1026b in infant diabetic rats and Syrian hamsters, suggesting that the irlRS locus is probably not a virulence determinant in these animal models of acute B. pseudomallei infection.     

The impact of pre-clerking clinics on surgical operation cancellations: a prospective audit

Pre-clerking of all patients undergoing elective general surgical operations was introduced at our hospital in an attempt to reduce an unacceptably high operation cancellation rate. A prospective audit has been performed on the effect of this policy on the cancellation rate. Before the introduction of pre-clerking there was a marked seasonal variation in the number of patients who failed to attend for surgery, which could be explained by absence on holiday. This seasonal variation disappeared after the start of pre-clerking clinics, but there has been no reduction in the number of cancellations for medical reasons.     

Investigation of driving performance, vection, postural sway, and simulator sickness in a fixed-based driving simulator

This paper reports the results of a pilot study conducted to determine whether there is a relationship between simulator sickness and measures of driver inputs, vection, and postural sway, in a fixed base driving simulator. Seven males and four females performed a series of alternating left and right turns (20 each), with straigth-aways inbetween. The task was designed to promote experiences of circular and linear vection, and associated sway. It was hypothesized that greater driver inputs (i.e., steering wheel and braking activity; deviation from the centerline) would correlate: with reports of vection and measures of postural sway. Ten of the eleven subjects reported moderate sickness, which precluded any statistical comparisons between “sick” and “not sick” however, there was a significant tendency for persons who reported vection to also report sickness. There were no gender differences in reported incidence of vection or sickness, however, males tended to exhibit greater lateral velocity. The next phase of investigation will necessitate reducing the strength of the stimulus (i.e., require less turns) to increase variability of sickness scores amongst subjects and permit comparisons between “sick” and “not sick.” Measurement considerations include increasing the sensitivity of vection ratings, and examination of the timecourse for the development of postural sway.     

Pharmacokinetics of ethanol in saliva: comparison with blood and breath alcohol profiles, subjective feelings of intoxication, and diminished performance

The concentration-time profiles of ethanol were determined for capillary blood, end-expired breath, and saliva after 21 healthy men ingested ethanol at 0.68 g/kg body weight. Near the time of obtaining body fluids, the volunteers estimated their feelings of intoxication, and body sway (with open and closed eyes), hand tremor, positional alcohol nystagmus (PAN), and roving ocular movements (ROM) were quantitatively recorded. The concentration-time profiles of ethanol in blood, breath, and saliva agreed well within individuals but there were large variations between subjects. The mean saliva-ethanol profiles ran slightly above those for blood and breath. Subjective ratings of intoxication and impairment of body function (standing steadiness and hand steadiness) were highest at the time of reaching the peak concentrations of ethanol in body fluids. PAN was evident in most subjects between 60 and 120 min after the start of drinking, whereas ROM appeared mainly during the postabsorptive phase of ethanol kinetics (120-420 min). The blood ethanol concentration thresholds were between 500 and 700 mg/L (50-70 mg/dL) when the diminished performance had recovered to baseline values.     

Human cholesterol synthesis measurement using deuterated water. Theoretical and procedural considerations

Creation of a dynamic levator aponeurosis fold or double eye adds to the beauty of the East Asian. The eyes are larger and less puffy, and the eyelashes appear longer and curve up and out instead of down. The distance from the ciliary border to the eyebrow is decreased and more in proportion. The Mongolian trait is preserved.     

The COMMIT dental model: tobacco control practices and attitudes

The National Cancer Institute's program to help dentists reduce tobacco use among their patients is part of the Community Intervention Trial for Smoking Cessation, a 22-community, randomly controlled trial of an intervention program for smoking cessation. Results of COMMIT baseline surveys of dentists in the 11 intervention communities are presented.     

A paradigm for single-case research: The time series study of a long-term psychotherapy for depression.

Articulates a paradigm for single-case research in psychotherapy. A patient diagnosed as having major depressive disorder was seen in an intensive, twice-weekly psychodynamic psychotherapy for 2.5 years. Each session was videotaped, and assessments of patient change were obtained at regular intervals. A time-series analysis was used to model fluctuations in the therapy process to take into account time and the effect of previous events on subsequent changes, thereby preserving the context-determined meaning for therapist and patient actions. A bidirectional analysis of causal effects shows that the influence processes between therapist and patient are mutual and reciprocal and suggests that the effect of the patient on the therapist and on the process has not been made sufficiently explicit in previous models of process and change. The potential of intensive single-case designs for uncovering causal effects in psychotherapy is demonstrated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Survey of dirofilariasis in Arkansas

A card survey was sent to 340 veterinarians in the Urban, Delta, Highland and Coastal Plain regions of Arkansas. Veterinarians were asked to indicate numbers of dogs tested, confirmed Dirofilaria immitis positive, diagnostic techniques, frequency and period tested. A significantly greater percentage of dogs tested D. immitis positive in the Delta region as compared with the Urban region. There were no significant differences in the percentage of treated dogs on prophylaxis or the types of diagnostic tests among regions.     

Prospective, randomized trial comparing blood and oxygenated crystalloid cardioplegia in reoperative coronary artery bypass grafting

OBJECTIVES: Reoperative coronary artery bypass grafting presents unique challenges for myocardial preservation. The purpose of this study was to compare oxygenated blood cardioplegia with oxygenated crystalloid cardioplegia during reoperative coronary artery bypass grafting using transesophageal echocardiography to assess regional wall motion of the left ventricle before and after cardiopulmonary bypass. METHODS: Sixty-one patients undergoing reoperative coronary artery bypass grafting were prospectively randomized to receive oxygenated blood cardioplegia or oxygenated crystalloid cardioplegia delivered with a combined antegrade-retrograde technique. Transgastric short axis views of the left ventricle were made with transesophageal echocardiography during the operation before cardiopulmonary bypass and immediately after cardiopulmonary bypass. Regional wall motion was graded by a blinded observer, and before cardiopulmonary bypass scores were compared with after cardiopulmonary bypass scores. RESULTS: No significant differences were found in the change in regional wall motion score from before cardiopulmonary bypass to after cardiopulmonary bypass between the blood and crystalloid cardioplegia groups. CONCLUSIONS: This study found blood and crystalloid cardioplegia to be equally efficacious for myocardial preservation during reoperative coronary artery bypass grafting.