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Biomedical subjects

J M Nagy

Publications and source records attributed to J M Nagy.

At least 19 recordsLinked to original sources

Does the cleaning technique influence the durability of the <9F flexible ureteroscope?

BACKGROUND AND PURPOSE: The fragility of the <9F flexible ureteroscope limits its availability to general urology practice. The purpose of this study was to determine whether the technique used to clean the flexible ureteroscope or the number of persons handling the instrument during the cleaning process influenced endoscope breakage or deterioration during regular endourologic use. PATIENTS AND METHODS: A new Olympus URF/P3 flexible 7.5F ureteroscope was used for each of two 30-day study periods during which a single surgeon used the endoscope for a variety of upper urinary tract procedures. During the first 30-day period (Group 1), the endoscope was leak-proof-pressure tested and cleaned by the endourology support team using the Steris 20 (peroxyacetic acid 35%) technique. During the second 30-day period (Group 2), the endoscope was leak-proof tested and cleaned only by the surgeon using the Cidex (glutaraldehyde 2.4%) technique. A record was kept for each ureteroscopic case to document the patient position, access technique, time the endoscope was in the urinary tract, instruments passed through the ureteroscope, and the maximum irrigant pressure used. In addition, a record was made of the number of broken fibers, the degree of flexion and deflexion of the endoscope, and the problems encountered with the endoscope during the case. RESULTS: The two study groups were similar in terms of the total number of cases performed, the mean time the endoscope was in the urinary tract per case, the access approach used, and the use of the ureteral access sheath and ancillary equipment. In Group 2, the endoscope was used for a longer total time (618 minutes v 457 minutes), and access to a lower pole calix was more than twice as common as in Group 1. This may explain why more broken fibers were noted in the instrument used in Group 2 over the study period (eight v four broken fibers) than in Group 1. The only breakage occurred as a result of the surgeon accidentally activating the laser probe inside the working channel of the endoscope in Group 2. CONCLUSION: The technique and number of personnel involved in the maintenance and cleaning of the flexible ureteroscope does not have a significant effect on the durability and function of these instruments. It is the arduous demands of the endourologic procedure that influence the durability of these fragile endoscopes.

Disinfectants↗

Purification and characterization of recombinant catalase-peroxidase, which confers isoniazid sensitivity in Mycobacterium tuberculosis.

The Mycobacterium tuberculosis katG gene encodes a dual-function enzyme called catalase-peroxidase, which confers sensitivity in M. tuberculosis to isonicotinic acid hydrazide. We have constructed a system for the high level expression of a recombinant form of this enzyme by amplifying the katG gene from the pYZ56 construct (1) and subcloning into a vector suitable for expression in Escherichia coli. The resulting plasmid, pTBCP, produced the catalase-peroxidase in large quantities, corresponding to 30% of total cell protein. The enzyme has been purified to homogeneity and appears to be a dimer in the native form. Using either hydrogen peroxide or t-butyl hydroperoxide and 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) as substrates, kcat and Km values have been obtained for both catalatic and peroxidatic activities, respectively. The availability of significant quantities of an active, folded, recombinant form of M. tuberculosis catalase-peroxidase should thus facilitate future studies of its role in drug activation and antibiotic resistance.

Bacterial Proteins↗

The effect of smoking cessation on pulmonary function: a 30-month follow-up of two smoking cessation clinics.

To obtain further information about the effects of cessation of smoking on pulmonary function, we followed subjects who attended 2 smoking cessation clinics during a period of 30 months. This paper reports the results from 15 persons who succeeded in stopping smoking for the full 30-month period and from 42 who did not succeed for more than one month. Testing included a respiratory questionnaire, spirometry, and the single-breath N2 test. Standardized methods, the same equipment, and the same experienced personnel were used throughout the study. We found that forced vital capacity, one-second forced expiratory volume, closing volume as a percentage of vital capacity, closing capacity as a percentage of total lung capacity, and the slope of the alveolar plateau of the single-breath N2 test all improved significantly in the subjects who stopped smoking. This improvement continued for as long as 6 to 8 months, and then remained stable. There was no sex difference in the response to smoking cessation, nor could we find a threshold of function below which cessation did not result in improvement. On the contrary, those subjects with the greatest impairment initially showed the greatest improvement. Respiratory symptoms virtually disappeared in those who stopped smoking. Subjects who continued to smoke showed an initial improvement in some function tests, probably due to a marked decrease in consumption, but no significant improvement during the whole period. We concluded from this study that cessation of smoking results in definite improvement in pulmonary function, that there is greater improvement in persons who begin with impaired function than in those whose function is initially normal, that respiratory symptoms disappear rapidly.

Adult↗

The effect of smoking cessation and modification on lung function.

The purpose of this study was to obtain more information about the effect on lung function of stopping smoking or of modifying the smoking habit and to determine the time course of change. We followed a group of 75 cigarette smokers who attended a smoking cessation clinic in May 1973, using a respiratory symptom questionnaire, spirometry, closing volumes, and the slope of the alveolar plateau of the single-breath nitrogen test. Subjects were tested before stopping smoking and at 1, 3, 6, and 12 months after the initial testing. We found a significant (P less than 0.05) improvement in closing volume as a percentage of vital capacity and closing capacity as a percentage of total lung capacity at 6 and 12 months and in the slope of the alveolar plateau at 1, 6, and 12 months in those who stopped smoking. There was also a dramatic decrease in respiratory symptoms in those who stopped smoking, a moderate decrease in those who reduced their consumption by at least 25 per cent, and very little change in those who did not appreciably modify their smoking consumption.

Adult↗