Multi-drug resistant escherichia coli with extended-spectrum beta-lactamase activity and fluoroquinolone resistance isolated from clinical infections in dogs.
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Animals↗
Biomedical subjects
T King
Publications and source records attributed to T King.
Gastrointestinal stromal tumors of the equine cecum.
Ten cecal tumors were identified during the postmortem examination of seven horse carcasses at slaughter (one horse had three tumors). The multinodular and hemorrhagic tumors ranged from 1 to 10 cm in diameter and consisted of spindle cells arranged in thin, interconnected trabeculae that were often separated by sinuses filled with mucinous fluid, erythrocytes, and siderophages. Spindle cells of all tumors were immunopositive for vimentin, neuron-specific enolase, and c-kit protein but lacked reactivity with antibodies to glial fibrillary acidic protein, S100 protein, and desmin. In one tumor, spindle cells diffusely bound antibodies to synaptophysin. Most tumors contained focal reactivity to smooth muscle actin antibodies; one tumor reacted diffusely. Ultrastructurally, tumor cells were connected by desmosome-like structures and exhibited extended cell processes; some contained dense core neurosecretory granules. These equine stromal tumors appeared to share some characteristics with human gastrointestinal stromal tumors.
Animals↗
Securing cochlear implants to the skull: two alternate methods.
In view of the various problems encountered with the traditional methods of securing cochlear implants--including dural tear and suture dissolution following infection--we devised two alternate methods of performing this procedure. We use a titanium mesh or a Gore-Tex patch secured with two 4-mm screws to fix the receiver to the skull. No patient who has undergone either of these procedures at our institution has experienced any of the complications that are associated with the older silk, nylon, and Dacron sutures. Moreover, our two alternate methods are less technically difficult and can be performed in a shorter period of time.
Cochlear Implantation↗
New opportunities in animal breeding and production - an introductory remark.
New opportunities in animal breeding and production will be offered by methods for embryo production and the introduction of precise genetic changes in livestock species. A review of current procedures shows that they have been improved during the last 4 years, but still have significant limitations. In the light of experience over the past 50 years it seems likely that these methods will contribute to animal health and productivity, but at some unknown time in the future and in ways that cannot be predicted precisely. When looking to the future, delegates to this meeting should take pride in what science continues to contribute.
Animal Husbandry↗
Fetal heart rate monitoring: is it salvageable?
Fetal heart rate monitoring was introduced in the 1960s. After a number of randomized controlled trials in the mid 1980s, doubt arose regarding the efficacy of fetal heart rate monitoring in improving fetal outcome. The potential reasons why fetal heart rate monitoring has not been shown to be efficacious are (1) use of an outcome measure that is not related to variant fetal heart rate monitoring patterns, (2) lack of standardized interpretation of fetal heart rate patterns, (3) disagreement regarding algorithms for intervention of specific fetal heart rate patterns, and (4) the inability to demonstrate the reliability, validity, and ability of fetal heart rate monitoring to allow timely intervention. A recent National Institutes of Health committee proposed detailed, quantitative, standardized definitions of fetal heart rate patterns, which can serve as a basis for determining whether fetal heart rate monitoring is reliable and valid. In this article we examine reasons why fetal heart rate monitoring did not live up to its original expectations and why the randomized controlled trials did not demonstrate efficacy, and we make suggestions for determining whether electronic fetal heart rate monitoring should be abandoned.
Asphyxia Neonatorum↗
The physiology of fetal heart rate patterns and perinatal asphyxia.
The purpose of electronic fetal heart rate (FHR) monitoring is the ongoing assessment of fetal oxygenation. FHR tracings are analyzed for characteristic patterns that signify specific hypoxic or nonhypoxic events. A working knowledge of fetal physiology and the fetal response to hypoxia can aid and refine clinical interpretation of FHR patterns during labor. This article reviews the fetal response to decreased oxygenation, the physiology of subsequent FHR patterns and the clinical presentation of asphyxia in the newborn.
Asphyxia Neonatorum↗
Developmental biology. Antagonists on the left flank.
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Activins↗
Immune responses and protection induced by DNA vaccines encoding bovine parainfluenza virus type 3 glycoproteins.
This study was designed to assess the parameters influencing the magnitude and type of immune responses generated to plasmids encoding the hemagglutinin/neuraminidase (HN) and fusion (F) proteins of bovine parainfluenzavirus type 3 (BPIV3). Mice immunized with plasmids expressing HN or F under control of the Rous sarcoma virus long terminal repeat promoter were primed, but they did not develop measurable immune responses. In contrast, strong humoral and cellular immune responses were induced with constructs containing the human cytomegalovirus immediate-early promoter and intron A. After immunization with both HN- and F-encoding plasmids, enhanced responses were observed. Analysis of in vitro protein synthesis confirmed that the presence of the intron is crucial for the expression of the BPIV3 HN gene. Plasmid encoding HN induced significantly higher serum antibody titers by intradermal injection than by intramuscular delivery, whereas antigen-specific T cell proliferation was stronger in intramuscularly injected mice. Both the isotype ratios and the cytokine profiles indicated a Th1-type response after intramuscular immunization and a mixed to Th2-type response in intradermally immunized mice. A plasmid encoding a truncated, secreted form of HN induced a Th2-type immune response, regardless of the route of delivery. In cotton rats, HN- and F-encoding plasmids conferred protection from BPIV3 challenge.
Animals↗
Embryonic asymmetry: the left side gets all the best genes.
The origin of left-right developmental asymmetry is a continuing puzzle, but some recent results provide new insights into the steps leading to organ asymmetry - implicating the homeobox protein Pitz-2 in one key step - and others support a model of symmetry-breaking that involves the chirality of microtubules.
Animals↗
Effect of taphonomic processes on dental microwear.
Taphonomic processes have the potential to affect microscopic wear on teeth and to modify the wear patterns so as to confound dietary reconstructions based on dental microwear which was formed during the lifetime of an animal. This study describes a series of experiments which were conducted to simulate various taphonomic agents and to record their effect on dental microwear. Three types of experiment were carried out in order to explain anomalous microscopic wear that had been found on the dentition of several hominoid specimens from the 15 M.a. site of Pasalar in Turkey. The effect of two different acids-citric and hydrochloric acid-on dental microwear was investigated. Modification to microscopic wear caused by alkali (carbonatite ash) was examined in the second set of experiments. Lastly, the effect of abrasion by three different size classes of sediment from the site of Pasalar-quartz pebbles (grain size varied from 2,000-11,000 microm), coarse sand (grain size ranged from 500-1,000 microm), and medium-sized sand (grain diameters were between 250 and 500 microm)-was investigated. Results confirm previous findings that the taphonomic modification of dental microwear is readily identifiable and causes the obliteration rather than secondary alteration of microwear features. The experiments show that both citric and hydrochloric acid affect dental microwear but to varying degrees, whereas alkali did not cause any modification of microscopic features. The different size classes of sediment also had different effects on the dental microwear. The largest size sediment (quartz pebbles) polished the enamel and removed finer microwear features. The coarse sand, however, did not have any effect on the microwear. The greatest amount of abrasion was caused by the smallest sediment particles -the medium-sized sand. Several hominoid dental specimens from Pasalar display similar microscopic wear to the two types of acid erosion and the abrasion caused by the medium-sized sands.
Animals↗
Dental microwear of Griphopithecus alpani.
The examination of microscopic dental wear allows inferences to be made about diet in extinct species. This study reconstructs the diet of Griphopithecus alpani, a 15 Ma fossil hominoid from the Miocene site of Paşalar in north-western Turkey, using scanning electron microscopy (SEM) to examine the microscopic wear on its molar teeth. The microwear patterns of Griphopithecus are compared with those of three extant hominoid taxa-Gorilla gorilla gorilla, Pan troglodytes verus, and Pongo pygmaeus pygmaeus. The microwear on three occlusal wear surfaces is examined in this study, and sex and age differences are also included. Analysis of variance is performed on the following microwear variables-feature density, pit density, striation density, the ratio of pits relative to striations, pit widths, and striation widths. Griphopithecus has significantly higher microwear feature densities and higher percentages of pits than Gorilla. It also has larger pit frequencies and narrower striations than both Pan and Gorilla. There are no significant differences between the microwear patterns of Griphopithecus and Pongo. This suggests that the diet of Gripho-pithecus was more similar to that of Pongo, which consumes mainly fruit, and occasionally hard and unripe fruits and nuts, than to that of Pan and Gorilla. In addition, the high percentage of pits displayed by Griphopithecus may indicate that it was ingesting harder fruits and/or objects than the extant hominoids, although this is not a significant difference. There also are consistent variations in the microwear present on the three different wear facets examined in the study-Phase II facets display more microwear and pitting than the Phase I surface examined. The results of this study do not indicate variation in dental microwear according to sex or age.
Age Factors↗
Glucocorticoid metabolism in proximal tubules modulates angiotensin II-induced electrolyte transport.
The hormonal interactions that regulate electrolyte transport in the proximal tubule are complex and incompletely understood. Since endogenous glucocorticoids and angiotensin II each can affect electrolyte transport in this renal segment, we hypothesized that local metabolism of glucocorticoids by the enzyme 11beta-hydroxysteroid dehydrogenase (11beta-HSD) might alter the response to angiotensin II. Studies were conducted in cultured origin defective SV-40 transformed immortalized renal proximal tubule cells (IRPTC) derived from weanling Wistar rat kidney. The 11beta-HSD contained in these cells uses NADP+, has an apparent Km for corticosterone of 1.6 microM, but functions only as a dehydrogenase (corticosterone --> 11-dehydro-corticosterone). When mounted in modified Ussing chambers, IRPTC generate a transmembrane current, and angiotensin II (10 pM to 10 microM) increases this sodium-dependent current. Cells incubated with corticosterone (100 nM) and the 11beta-HSD inhibitor carbenoxolone (CBX) (1 microM) for 24 hr and then acutely stimulated with angiotensin (10 nM) show a greater rise in current than do cells exposed to corticosterone alone and stimulated with angiotensin (corticosterone + CBX: 64.2% +/- 20.5% vs. corticosterone: 18.8% +/- 5.9%; P < 0.02 at 180 min)[mean +/- SE percentage above baseline, n = 8/group]. Cells exposed to corticosterone (100 nM) or CBX (1 microM) alone for 24 hr and then stimulated with angiotensin II (10 nM) had responses similar to controls. Thus glucocorticoids can enhance angiotensin II-induced electrolyte transport in proximal tubule epithelial cells when local 11beta-HSD is inhibited.
11-beta-Hydroxysteroid Dehydrogenases↗
Clinical validity of a self-test fructosamine in outpatient diabetic management.
BACKGROUND: Measurement of glycated hemoglobin and hemoglobin A1c (HbA1c) is now well established as the best means of measuring overall glucose control in managing diabetes. Other glycated serum protein assays reflecting recent glycemic control, e.g., glycated albumin and glycated protein (fructosamine), have also been validated in clinical studies. Regardless of the method, the expense and inconvenience of laboratory testing of blood samples may contribute to the well-documented underutilization of clinical glycated protein assessment. Accordingly, a rapid, inexpensive fingerstick test of fructosamine has been developed. This study cross-sectionally and prospectively assesses the clinical validity of fingerstick fructosamine versus laboratory determination. METHODS: Fifty-one subjects (18 control, 33 with diabetes) participated in a cross-sectional study and 20 subjects with type 2 diabetes participated in a prospective, 6-week study with clinical intervention consisting of glipizide gits or metformin in mono- and combination therapy. Subjects had weekly laboratory determination of serum fructosamine, glycated hemoglobin, and fasting glucose; fingerstick fructosamine was obtained at each clinic visit. RESULTS: Fingerstick fructosamine was shown to correlate highly to laboratory fructosamine (r = 0.80, p < 0.001) and glycated hemoglobin (r = 0.81, p < 0.001). In the clinical intervention study subjects, significant decreases in fasting glucose (p < 0.001), laboratory fructosamine (p < 0.001), and fingerstick fructosamine (p < 0.001) were noted compared to baseline. The subject's self-test fingerstick fructosamine mirrored laboratory testing of fructosamine in detection of changes in clinical glucose control. CONCLUSIONS: This study demonstrates that fingerstick fructosamine correlates well to laboratory assessment of fructosamine and glycated hemoglobin. The patient self-test fructosamine provides the same clinical information as laboratory assessment.
Adult↗
A 12-month randomized controlled trial of patient education on radiographic changes and quality of life in early rheumatoid arthritis.
OBJECTIVE: In rheumatoid arthritis, education programmes successfully impart knowledge but, notwithstanding issues of empowerment, this knowledge has to be translated into behavioural change to have a chance of improving disease outcome. Arguably, behavioural change must also occur early if outcomes are to be improved. For these reasons, we planned a study of patient education in early disease, with radiological damage and quality of life as the main outcome variables. METHODS: We performed a randomized controlled trial in people with rheumatoid arthritis of < 5 yr duration. The main intervention was a 4 week education programme, each weekly session lasting 2 h. Assessments were made at entry, at 4 weeks and at 12 months. The main outcome variables were the modified Larsen radiological score for the hands and the SF-36 quality of life questionnaire. Secondary outcome variables were the Health Assessment Questionnaire (HAQ), Ritchie Articular Index (RAI), Patient Knowledge Questionnaire (PKQ), Compliance Questionnaire (CQ), plasma viscosity (PV), pharmaceutical changes and consulting behaviour. RESULTS: The patient numbers were 34 (10 male, 24 female) for the control group and 43 (16 male, 27 female) for the education group. The groups were matched for age (56.5 yr for control, 55 yr for education), disease duration (3.5 yr vs 3.0 yr) and duration of second-line drug therapy (14 months vs 12 months). We found no significant difference between the groups for Larsen scores at 12 months, although scores for the education group were lower (39.5 vs 43.0, P = 0.13). The 'social functioning' and 'general health perception' subscales of the SF-36 showed a significant improvement in the education group, but no significant differences between groups were seen. No significant differences were found for the HAQ, RAI, PV and CQ, but the education group had more disease-specific knowledge than the control group at 12 months (PKQ scores: 17 vs 21, P = 0.0002). No differences were found for out-patient visits and in-patient admissions, but the education group had slightly more changes in second-line drugs during the study (0.43 changes/person in the control group, 0.51 changes/person in the education group). CONCLUSIONS: We found no significant difference between the groups in our primary outcome measures, but a trend in favour of the education group was found in radiological progression. Further studies of this kind, using larger patient numbers, are required since the difference may result from improved self-care, better compliance with joint protection strategies and, possibly, improved drug compliance.
Adult↗
Misclassification of susceptible strains of Staphylococcus aureus as methicillin-resistant S. aureus By a rapid automated susceptibility testing system.
Eight Staphylococcus aureus strains initially identified by Vitek GPS-BS or GPS-SA cards as resistant to oxacillin, but susceptible to most non-beta-lactam antibiotics, were found on further testing to be susceptible to oxacillin and ceftizoxime by disk diffusion tests. For all these strains, the MICs of oxacillin were </=0.5 microg/ml by agar dilution tests, and the strains were oxacillin susceptible when tested by the BBL Crystal MRSA ID and a Vitek machine with GPS-101 cards. None grew on oxacillin-salt agar screening plates. None were positive for mecA gene sequences by PCR. When S. aureus strains tested by Vitek GPS-SA or GPS-BS cards appear resistant to only penicillin and oxacillin, a confirmatory test such as the oxacillin-salt agar screening method should be performed.
Methicillin Resistance↗
Point mutations in yeast CBF5 can abolish in vivo pseudouridylation of rRNA.
In budding yeast (Saccharomyces cerevisiae), the majority of box H/ACA small nucleolar RNPs (snoRNPs) have been shown to direct site-specific pseudouridylation of rRNA. Among the known protein components of H/ACA snoRNPs, the essential nucleolar protein Cbf5p is the most likely pseudouridine (Psi) synthase. Cbf5p has considerable sequence similarity to Escherichia coli TruBp, a known Psi synthase, and shares the "KP" and "XLD" conserved sequence motifs found in the catalytic domains of three distinct families of known and putative Psi synthases. To gain additional evidence on the role of Cbf5p in rRNA biosynthesis, we have used in vitro mutagenesis techniques to introduce various alanine substitutions into the putative Psi synthase domain of Cbf5p. Yeast strains expressing these mutated cbf5 genes in a cbf5Delta null background are viable at 25 degrees C but display pronounced cold- and heat-sensitive growth phenotypes. Most of the mutants contain reduced levels of Psi in rRNA at extreme temperatures. Substitution of alanine for an aspartic acid residue in the conserved XLD motif of Cbf5p (mutant cbf5D95A) abolishes in vivo pseudouridylation of rRNA. Some of the mutants are temperature sensitive both for growth and for formation of Psi in the rRNA. In most cases, the impaired growth phenotypes are not relieved by transcription of the rRNA from a polymerase II-driven promoter, indicating the absence of polymerase I-related transcriptional defects. There is little or no abnormal accumulation of pre-rRNAs in these mutants, although preferential inhibition of 18S rRNA synthesis is seen in mutant cbf5D95A, which lacks Psi in rRNA. A subset of mutations in the Psi synthase domain impairs association of the altered Cbf5p proteins with selected box H/ACA snoRNAs, suggesting that the functional catalytic domain is essential for that interaction. Our results provide additional evidence that Cbf5p is the Psi synthase component of box H/ACA snoRNPs and suggest that the pseudouridylation of rRNA, although not absolutely required for cell survival, is essential for the formation of fully functional ribosomes.
Amino Acid Sequence↗
Paclitaxel and concurrent radiation therapy for locally advanced adenocarcinomas of the pancreas, stomach, and gastroesophageal junction.
An effective locoregional therapy is needed for adenocarcinomas of the pancreas, stomach, and gastroesophageal junction. Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) may enhance the effect of radiation therapy (RT). Paclitaxel synchronizes cells at G2/M, a relatively radiosensitive phase of the cell cycle. We have shown that response to paclitaxel and concurrent RT (paclitaxel/RT) was not affected by p53 mutations in non-small cell lung cancer. This finding suggested that paclitaxel/RT was a rational treatment approach for other malignancies that frequently harbor p53 mutations, such as upper gastrointestinal malignancies. We completed a phase I study of paclitaxel/RT for locally advanced pancreatic and gastric cancer. The maximum tolerated dose of paclitaxel was 50 mg/m2/wk for 6 weeks with abdominal RT. The dose-limiting toxicities were abdominal pain within the radiation field, nausea, and anorexia. Phase II studies are now under way. Twenty-five patients with locally advanced pancreatic cancer have been entered at the phase II dose level of paclitaxel 50 mg/m2/wk with concurrent RT (total dose, 50 Gy). Thus far, the only grade 3/4 toxicities have been hypersensitivity reactions (n = 2), asymptomatic grade 4 neutropenia (n = 3), and nonneutropenic biliary sepsis (n = 1). Of the first 18 assessable patients with pancreatic cancer treated on the phase II study, six obtained a partial response, for a preliminary response rate of 33%. In the phase II study for locally advanced gastric cancer, 20 patients have been enrolled. Of the first 19 patients who have completed treatment, nine (47%) had grade 3/4 toxicities, including nausea, anorexia, esophagitis, and gastritis. Of the first 16 patients with gastric cancer, complete and partial responses have been observed in one and eight patients, respectively, for a preliminary response rate of 56%. We have also completed treatment on 24 patients with potentially resectable adenocarcinomas of the gastroesophageal junction with neoadjuvant paclitaxel 60 mg/m2 and cisplatin 25 mg/m2, weekly for 4 weeks, with concurrent RT (total dose, 40 Gy) followed by surgical resection. Ten patients (41%) had grade 3/4 toxicities, including neutropenia, nausea, and dehydration. Of 24 patients, four complete responses (17%) and 14 partial responses (58%) were observed, for an overall response rate of 75%. Severe esophagitis was uncommon, making this a well-tolerated outpatient regimen for adenocarcinomas of the distal esophagus. These findings demonstrate that paclitaxel-based chemoradiation for locally advanced upper gastrointestinal malignancies is well-tolerated with substantial activity.
Adenocarcinoma↗
Left-right development: mammalian phenotypes and conceptual models.
Consistent left-right asymmetry in a population requires a special kind of developmental specification. Models of this process must account for the complex phenotypes seen when left-right is abnormal. In some human and mouse mutations, there appears to be a randomisation of global situs to either solitus or inversus, whereas in the inv/inv mouse essentially all are inversus. However, in these and all additional examples there are frequently other anomalies, including symmetry (isomerism) and discordance between organs (heterotaxia). Current models invoke a molecular chiral referent as the source of the primary handed information. We describe a new two-gradient model which accommodates all defects of situs whilst leaving the primary asymmetry unaltered.
Animals↗