Long-term follow-up of immunosuppressive treatment for obstructive airways disease after allogeneic bone marrow transplantation

BACKGROUND: Locally advanced thyroid cancer invading the tracheal cartilage represents a difficult treatment dilemma during thyroidectomy. METHODS: A retrospective chart review was performed to determine the results of laryngotracheal resection or tracheal cartilage shave with adjuvant radiotherapy in patients with locally advanced thyroid cancer invading the upper airway. RESULTS: Of 597 patients undergoing thyroidectomy for thyroid cancer, 40 were found to have laryngotracheal invasion. Thirty-five patients with superficial invasion underwent cartilage shave procedures with adjuvant radiotherapy; five with full-thickness invasion underwent radical resection, including tracheal sleeve resection (n = 3) or total laryngectomy (n = 2). Histologic subtypes included papillary (n = 32), follicular (n = 2), Hurthle cell (n = 1), medullary (n = 3), and anaplastic (n = 2). Of the cartilage shave group, 25 are currently alive with no evidence of disease at a mean follow-up of 81 months (range 1-290). Six developed isolated local/regional recurrence and were managed with total laryngectomy (n = 1), tracheal resection (n = 1), cervical lymphadenectomy (n = 1), or repeat radiotherapy (n = 3). All six patients remain free of disease at a mean follow-up of 5 years. Of those who underwent initial laryngotracheal resection, four remain free of disease at a mean follow-up of 5 years. The rates of 10-year disease-free survival and overall survival for all patients were 47.9% (95% confidence interval [CI] 24.8, 71.0) and 83.9% (95% CI 70.3, 97.5), respectively. CONCLUSIONS: These data suggest that adequate management of thyroid cancer with laryngotracheal invasion can be achieved with a more conservative surgical approach and adjuvant radiotherapy, reserving more radical resections for extensive primary lesions or locally recurrent disease.     

Coupling GIS with Hydrologic and Hydraulic Flood Modelling

Geographic Information Systems (GIS) have been recognised as a powerful means to integrate and analyse data from various sources in the context of comprehensive floodplain management. As part of this comprehensive approach to floodplain management, it is very important to be able to predict the consequences of different scenarios in terms of flooded areas and associated risk. Hydrologic and hydraulic modelling plays a crucial role and there is much to gain in incorporating these modelling capabilities in GIS. This is still a rather complex task and research is being done on the full integration of these models. Interfacing between these models and GIS may be a very efficient way of overcoming the difficulties and getting very good results in terms of engineering practice. This paper presents results based on the use of Intergraph GIS coupled with Idrisi GIS. Using these two systems substantially increased the flexibility of using GIS as a tool for flood studies. A lumped (XSRAIN) and a distributed (OMEGA) hydrologic models were used to simulate flood hydrographs. The well known HEC-2 Hydraulic model was used to compute flooded areas. These models were applied in the Livramento catchment with very good results. The computation of flooded areas for different flood scenarios, and its representation in GIS, can be used in the assessment of affected property and associated damages. This is a very useful GIS-based approach to floodplain management.     

secG and temperature modulate expression of azide-resistant and signal sequence suppressor phenotypes of Escherichia coli secA mutants

SecA is a dynamic protein that undergoes ATP-dependent membrane cycling to drive protein translocation across the Escherichia coli inner membrane. To understand more about this process, azide-resistant (azi) and signal sequence suppressor (prlD) alleles of secA were studied. We found that azide resistance is cold sensitive because of a direct effect on protein export, suggesting that SecA-membrane interaction is regulated by an endothermic step that is azide inhibitable. secG function is required for expression of azide-resistant and signal sequence suppressor activities of azi and prlD alleles, and in turn, these alleles suppress cold-sensitive and export-defective phenotypes of a secG null mutant. These remarkable genetic observations support biochemical data indicating that SecG promotes SecA membrane cycling and that this process is dependent on an endothermic change in SecA conformation.     

Minimal inhibition concentrations of selected antibiotics for strains of Staphylococcus aureus

Minimal inhibition concentrations (MIC) of gentamycin (Ge), neomycin (Neo), rifampicin (Rif), ampicillin (Amp), lincomycin (Lin), erythromycin (Ery), and streptomycin (STM) were determined by the agar dilution technique using 46, 130, 131, 125, 140, 139 and 142 strains of Staphylococcus aureus, respectively. The strains, selected from the collection of the authors' laboratory, were isolated from mammary gland secretions of cows affected with clinical or subclinical mastitis. The following ranges of MIC (micrograms/ml) were assessed for the antibiotics under study: Ge 0.125-0.50, Neo 0.06-0.50, Rif 0.0039-0.030, Amp 0.015-1.00, Lin 0.25-1.00, Ery 0.06-0.25, STM 0.50-64.0. Modal MIC (micrograms/ml) were as follows; Ery 0.125 (86%), Lin 0.5 (71.4%), Rif 0.007 (68.7%), Ge 0.25 (56.5%), STM 1.00 (54.2%), Neo 0.25 (53.8%), Amp 0.06 (41.6%). The order of efficiency expressed in MIC 90 (micrograms/ml) was as follows: Rif (0.015), Ery (0.125), Ge (0.25), Neo (0.25), Amp (0.5), STM (4.0).     

Synthesis and release of ATP by soluble mitochondrial F1 in complex with its inhibitor protein during dimethylsulfoxide-water transitions

Soluble mitochondrial F1 and F1 in complex with the natural ATPase inhibitor protein (F1-IP) catalyze the spontaneous synthesis of [gamma-32P]ATP from medium [32P]phosphate and enzyme-bound ADP when incubated in media with dimethylsulfoxide (Me2SO); under these conditions, the synthesized [gamma-32P]ATP is not released into the media, it remains tightly bound to the enzymes [Gómez-Puyou, A., Tuena de Gómez-Puyou, M. & de Meis, L. (1986) Eur. J. Biochem. 159, 133-140]. Some of the characteristics of the synthesized [gamma-32P]ATP were studied in F1 and F1-IP (ATPase activities of 70 and 1-3 micromol x min(-1) x mg(-1), respectively). In Me2SO media, gamma-phosphate of synthesized ATP in F1 or F1-IP exchanges with medium phosphate. From the rates of the exchange reaction, the half-times for hydrolysis of the synthesized ATP in F1 and F1-IP were calculated: 45 min and 58 min for F1 and F1-IP, respectively. The course that synthesized [gamma-32P]ATP follows after dilution of the Me2SO synthetic mixture with aqueous buffer was determined. After dilution, the half-life of synthesized ATP in F1 was less than 1 min. In F1-IP, ATP was also hydrolyzed, but at significantly lower rates. In F1-IP, dilution also produced release of the synthesized [gamma-32P]ATP. This was assayed by the accessibility of [gamma-32P]ATP to hexokinase. About 25% of [gamma-32P]ATP synthesized in F1-IP, but not in F1, was released into the media after dilution with aqueous buffer that contained 20 mM phosphate. Release of tightly bound ATP required the binding energy of phosphate and solvation of F1-IP, however, the particular kinetics of F1-IP were also central for medium ATP synthesis in the absence of electrochemical H+ gradients.     

Helicobacter pylori and gastric lymphoma]

BACKGROUND: Continent urinary diversion may be necessary in a range of urological abnormalities. In circumstances where the standard techniques are not possible, alternative innovative techniques may be used. METHODS: In a female patient with bladder exstrophy, a continent diversion was recommended. The appendix was not available, the ureters were not suitable and a continent stoma was fashioned from an isolated segment of colon. RESULTS: The stoma proved to be continent, although it was somewhat stenotic. However, clean intermittent catheterization maintained its patency. CONCLUSIONS: A continent catheterizable stoma may be constructed from a segment of colon. The technique may be considered when other well recognized methods are not feasible.