Effects of preliminary muscular exercise on body temperature, water loss and physical performance

We investigated the effects of preliminary exercise (muscular warm-up) on body temperature, water loss and physical performance during consecutive sustained exercise. Thirty-one untrained men aged 21 to 30 years old (mean 25.12 +/- 2.92) were subjected to two physical trial tests at 75% Pma. One trial. (T - PE) was performed without preliminary exercise (PE) and the other (T + PE) was preceded by 15 minutes of preliminary exercise performed at 50% Pma. The trials involved pedaling an ergocycle until exhaustion, followed by a 30 minutes period of inactive recovery. The rate of increase of body temperature during the work consecutive to preliminary exercise (T + PE) was lower than that of the work without preliminary exercise (T - PE). The energy output and water loss during T + PE were significantly (P < 0.01) greater than during T - PE. However, the body temperatures at the end of the two tests were identical. The rate of decrease of body temperature, measured after 30 minutes of recovery, was higher for T + PE than T - PE. The duration of work was increased by PE for 25 (80.65%) subjects and decreased for 6 (19.35%). We conclude that preliminary exercise allows better adjustment of thermohydric regulation by moderating the rise in body temperature and increasing water loss during physical work. For most subjects, these adjustments allow improved endurance.     

Methodology of serial ECG classification using an adaptation of the NOVACODE for Q wave myocardial infarction in the Bypass Angioplasty Revascularization Investigation (BARI)

Serial electrocardiographic (ECG) changes are a critical component of the diagnostic algorithm for classification of myocardial ischemic events in large-scale clinical trials. This study describes a computerized serial ECG classification program developed at the St. Louis University Core ECG Laboratory for use in the Bypass Angioplasty Revascularization Investigation (BARI) trial, in which patients with multivessel coronary artery disease were randomized to receive either coronary artery bypass grafting or percutaneous transluminal coronary angioplasty. The St. Louis University program detects and codes serial changes in Q, ST, and T wave items according to Minnesota code (MC) criteria using a modified NOVACODE hierarchical classification system. Measurements using a seven-power calibrated coding loupe are used to generate the MC from a customized software program. Significant minor or major changes are detected by the serial comparison program and referred to a physician coder for verification. Serial comparison coding rules are used to adjust for weaknesses in the standard MC classification system resulting from instability at decision boundaries. Of 4,244 BARI randomized and registry study participants with follow-up ECGs received at the Core ECG Laboratory as of March 1995, a grade 2 MC Q wave progression was noted in 568 participants (13.4%) using MC criteria alone, as compared with 367 (8.6%) after the St. Louis University coding rules were applied. The incidence of grade 1 MC Q wave progressions was 16.4% (697/4,244) versus 6.1% (259/4,244) when the St. Louis University program was applied. Intraobserver variability for grade 2 Q wave progression codes determined from a sample of 812 serial.     

Recombinant expression and characterization of the major beta-lactamase of Mycobacterium tuberculosis

New antibiotic regimens are needed for the treatment of multidrug-resistant tuberculosis. Mycobacterium tuberculosis has a thick peptidoglycan layer, and the penicillin-binding proteins involved in its biosynthesis are inhibited by clinically relevant concentrations of beta-lactam antibiotics. beta-Lactamase production appears to be the major mechanism by which M. tuberculosis expresses beta-lactam resistance. beta-Lactamases from the broth supernatant of 3- to 4-week-old cultures of M. tuberculosis H37Ra were partially purified by sequential gel filtration chromatography and chromatofocusing. Three peaks of beta-lactamase activity with pI values of 5.1, 4.9, and 4.5, respectively, and which accounted for 10, 78, and 12% of the total postchromatofocusing beta-lactamase activity, respectively, were identified. The beta-lactamases with pI values of 5.1 and 4.9 were kinetically indistinguishable and exhibited predominant penicillinase activity. In contrast, the beta-lactamase with a pI value of 4.5 showed relatively greater cephalosporinase activity. An open reading frame in cosmid Y49 of the DNA library of M. tuberculosis H37Rv with homology to known class A beta-lactamases was amplified from chromosomal DNA of M. tuberculosis H37Ra by PCR and was overexpressed in Escherichia coli. The recombinant enzyme was kinetically similar to the pI 5.1 and 4.9 enzymes purified directly from M. tuberculosis. It exhibited predominant penicillinase activity and was especially active against azlocillin. It was inhibited by clavulanic acid and m-aminophenylboronic acid but not by EDTA. We conclude that the major beta-lactamase of M. tuberculosis is a class A beta-lactamase with predominant penicillinase activity. A second, minor beta-lactamase with relatively greater cephalosporinase activity is also present.     

A death certificate-based study of occupation and mortality from reproductive cancers among women in 24 US states

We conducted a study of occupation and mortality from reproductive cancers among women, based on death certificates from 24 US states for the period 1984-1993. There were 9,523 cervical cancer deaths, 12,335 endometrial cancer deaths, and 25,212 ovarian cancer deaths. Usual occupation and industry, which were obtained from death certificates, were coded using the 1980 Bureau of Census classification system. Mortality odds ratios (MORs) and 95% confidence intervals (CIs) were calculated, using all non-cancer deaths as the referent disease category. In general, jobs involving professional or administrative occupations were related to increased risk of mortality from endometrial and ovarian cancer, while cervical cancer mortality was increased among women employed in manufacturing, service, farm work, and health care technician and aide occupations. Associations with some occupations involving exposure to chemicals and metals, such as the associations between cervical cancer and employment in printing, typesetting, and machine operating occupations, deserve further attention. Similarly, further investigations should be made into the excess of ovarian cancer observed in several occupations in health care, an industry that has numerous hazardous exposures, including radiation, chemotherapeutic drugs, and viruses. The study results reflect, in part, socioeconomic factors and reproductive patterns but may also indicate a possible etiologic role for occupational chemical exposures.     

CT features of calcifications in abdominal malignant fibrous histiocytoma

Driven by the need for a readily available, non-immunological tissue that possesses many of the characteristics of normal human skin, tissue-engineered skin has been developed. For over a decade, laboratory grown or processed skin has been under investigation and, in some cases, available as an alternative to autologous grafts. Apligraf, derived from neonatal foreskin and bovine type I collagen, is the first bi-layered living skin equivalent approved in the US and other countries for use in venous ulcers. Apligraf is effective both in the treatment of refractory venous ulcers and for acute wounds such as surgical excision sites and split thickness donor sites. Apligraf is safe and is not clinically rejected. Its ultimate fate is not known, so it may well work to aid healing in a variety of ways including graft 'take' and as a stimulus for healing.     

Microsurgical thumb reconstruction with toe transfer: selection of various techniques

Microsurgical toe transfer is an established method for reconstruction of missing thumbs. However, there is little agreement on which of the various techniques represents the ideal transfer. Basically, selection of technique requires balancing the patient's functional needs, appearance of the reconstructed thumb, and donor-site cosmesis. Based on our experience with 103 toe-to-thumb transfers performed over the past 9 years, this paper attempts to provide guidelines for appropriate selection among the four most commonly employed toe transfer techniques (e.g., second toe, total great toe, great toe wrap-around, trimmed great toe) so that optimal results and patient's acceptance can both be achieved.     

Gray-scale ultrasound: utility preoperatively and postoperatively in a patient with obstructive jaundice

We present a case of obstructing calculi of the common bile duct diagnosed by ultrasonography. Postoperatively, a sterile abscess due to bile leakage at the distal common bile duct developed, and was also diagnosed by ultrasound Ultrasonography was useful in following the course of clearing of the bile collection. Preoperative ultrasound evaluation of the jaundiced patient should be followed by postoperative sonography, especially if complications occur.