Some observations on the detection of cholera carriers.
Explore the source record for details and available documents.
Bacteriological Techniques↗
SEARCH · Search PubMed
Results for “Azurin”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Cholera incidence in a population offered cholera vaccination: comparison of cooperative and uncooperative groups.
From May 1964 to December 1965, a controlled field trial of the effectiveness of cholera and cholera El Tor vaccines was conducted in Negros Occidental, Philippines. Some people did not volunteer for vaccination, and of those who did some received cholera vaccine and others a control (typhoid) vaccine. After analysing he incidence of cholera among these three groups it was found that the morbidity and mortality rates were significantly higher in the unvaccinated group than in either the control vaccine group or the cholera vaccine group. This would indicate that the unvaccinated group is basically different from the vaccinated control group. The clinical course of the disease was the same whether the patient had been vaccinated or not. The reasons for non-vaccination were investigated and should be taken into account by public health agencies when immunization programmes are being planned.
Adolescent↗
The role of health in an efficient public service.
Explore the source record for details and available documents.
Nursing↗
A controlled field trial of the effectiveness of cholera and cholera El Tor vaccines in the Philippines.
A controlled field trial on some 584 000 people in an endemic cholera El Tor area in the Philippines demonstrated that cholera vaccines gave moderate protection of short duration. Injection of a single dose of vaccine prepared from either Vibrio cholerae or El Tor vibrios gave over 50% protection for the first 2 months. The immunity conferred by the V. cholerae vaccine declined rapidly after 3 to 4 months. The effectiveness of the El Tor vaccine continued for 6 months. An oil-adjuvant vaccine prepared from V. cholerae conferred an equally high degree of protection for a longer period of time, but, owing to severe vaccination reactions, its use could not be recommended.
Adjuvants, Immunologic↗
Studies on cholera carriers.
Cholera carrier studies in the Philippines in 1964-66 showed a prevalence rate of 21.7% among household contacts of cholera patients, and 8.4% in occupants of houses next door to one where a cholera patient lived, as opposed to 0.34% in the general population. The duration of the carrier state among 19 household carriers isolated for examination varied from 5 to 19 days. The vibrio concentration in the stool of contact carriers was 10(2)-15(5) per gram, as compared with 10(6)-19(9) per ml of rice-water stool in cholera cases.The agglutinin titre increased with time for carriers, as it does for patients. It declined to a very low level 8-12 weeks after recovery, with the exception of one proved long-term carrier.The strains isolated from carriers were identical in all respects, including virulence in infant rabbits, with strains isolated from patients-except that 3 carrier strains were rough.
Adolescent↗
A long-term carrier of cholera: cholera Dolores.
The first known long-term carrier of cholera, found in the Philippines, is described. The carrier, Dolores M., who had suffered from El Tor cholera in August 1962, continued intermittently to excrete vibrios of the same characteristics as the original isolates until the date of reporting (1966). Duodenal intubation proved that the vibrios are lodged in her biliary tract. Her serum antibody titre continued to remain high in the absence of vaccination against cholera.
Biliary Tract↗
[Structure of type I copper proteins].
Explore the source record for details and available documents.
Amino Acid Sequence↗
Kinetics of copper(II) uptake by apoazurin in complexing media.
We have studied the kinetics of copper uptake by apoazurin in imidazole and 1-methylimidazole buffers in the pH range of 7-9 with mu = 0.5 M and copper(II) in large excess. The reaction has been monitored by measuring the visible absorbance and circular dichroism as a function of time. The uptake occurs in a stepwise fashion, and at least two intermediates are implicated. Overall, the rate of uptake varies inversely with the concentration of the proton and the (complexing) buffer, but depends directly on the copper concentration. A model involving a weakly absorbing intermediate is proposed to rationalize the data taken at the lower end of the pH range. According to the model the intermediate forms with a second order rate constant of about 30 M-1 S-1 and is probably described as a ternary complex of copper, buffer, and one or more of the histidine ligands of the binding site. This then decays by a pH-dependent process to give product. At higher pH values there is evidence that relaxation to product occurs via a second intermediate form in which the cysteine ligand is bound to copper. The relevance of these results to the question of how copper is selectively incorporated into the protein is considered. Finally, a milder, more reliable route to the preparation of apoazurin is described.
Apoproteins↗
Nursing assertiveness in primary health care.
Explore the source record for details and available documents.
Assertiveness↗
A divide and conquer approach to multiple alignment.
We present a report on work in progress on a divide and conquer approach to multiple alignment. The algorithm makes use of the costs calculated from applying the standard dynamic programming scheme to all pairs of sequences. The resulting cost matrices for pairwise alignment give rise to secondary matrices containing the additional costs imposed by fixing the path through the dynamic programming graph at a particular vertex. Such a constraint corresponds to a division of the problem obtained by slicing both sequences between two particular positions, and aligning the two sequences on the left and the two sequences on the right, charging for gaps introduced at the slicing point. To obtain an estimate for the additional cost imposed by forcing the multiple alignment through a particular vertex in the whole hypercube, we will take a (weighted) sum of secondary costs over all pairwise projections of the division of the problem, as defined by this vertex, that is, by slicing all sequences at the points suggested by the vertex. We then use that partition of every single sequence under consideration into two 'halfs' which imposes a minimal (weighted) sum of pairwise additional costs, making sure that one of the sequences is divided somewhere close to its midpoint. Hence, each iteration can cut the problem size in half. As the enumeration of all possible partitions may restrict this approach to small-size problems, we eliminate futile partitions, and organize their enumeration in a way that starts with the most promising ones.(ABSTRACT TRUNCATED AT 250 WORDS)
Algorithms↗
Trocar site herniation following laparoscopic cholecystectomy and the significance of an incidental preexisting umbilical hernia.
With the expansion of both laparoendoscopic surgery and the number of those performing it, the surgeon must remain cognizant of the uncommon complication of herniation through a previous trocar site. Herniation through laparoscopic trocar defects most often occurs as a Richter's hernia, hence its presentation can be insidious and can lead to significant morbidity. A retrospective chart review of 1300 consecutive laparoscopic cholecystectomies over 5 years was performed. An incidence of 0.77 per cent for trocar site herniations was found. All of the trocar site hernias occurred through large (> or = 10 mm) defects at the umbilical site. Ninety per cent of those patients with trocar site herniations had an umbilical hernia or midline incisional hernia found incidentally upon entrance into the peritoneal cavity. All of the herniations occurred despite primary fascial closure of the trocar sites. One trocar site hernia resulted in a small bowel obstruction secondary to an incarcerated Richter's hernia. This required a small bowel resection. Consequently, we now close trocar fascial defects in patients with preexisting hernias in a formal fashion. We recommend that trocar ports be removed under direct vision and that large fascial defects (> or = 10mm) be primarily closed. Furthermore, we recommend in those patients with incidentally found umbilical hernias that both the fascial edge and complete extent of the hernia defect be defined and then closed as a formal herniorrhaphy with interrupted nonabsorbable suture and a synthetic patch if necessary.
Abdominal Muscles↗
Safety, accuracy, and diagnostic yield of needle localization biopsy of the breast performed using local anesthesia.
BACKGROUND: In changing our technique to performing needle localization breast biopsies (NLBB) using local anesthesia in an outpatient setting, we investigated whether or not our complication rates with local anesthesia were acceptable when compared with complications from a cohort of biopsies of the breast performed for palpable masses. We were also interested in determining whether or not our rate of missed biopsies was within acceptable ranges. STUDY DESIGN: Complications occurring in 283 patients who underwent 301 NLBB using local anesthesia between 1983 and 1991 were compared with complications occurring after excision of 249 palpable masses of the breast excised using local anesthesia during this period. RESULTS: Complications associated with NLBB were missed lesions, six (1.99 percent) of 301; hematoma, 12 (3.99 percent) of 301; abscess, three (0.99 percent) of 301; seroma, one (0.33 percent) of 301, and wound separation, two (0.66 percent) of 301, for a total of 24 complications (7.96 percent). These rates were not statistically different from the rates of complication after biopsies of palpable lesions using local anesthesia (p < 0.49). The 301 NLBB revealed 87 carcinomas (28.9 percent); 50 invasive and 37 in situ. Of the nonpalpable carcinomas, 43 percent were in situ. Only 11 percent carcinomas, 43 percent were in situ. Only 11 percent of the palpable lesions were in situ (p < 0.001). Forty-four patients with nonpalpable invasive carcinoma had a 25 percent rate of positive axillary lymph nodes. CONCLUSIONS: Needle localization breast biopsies can be performed using local anesthesia exclusively with less than a 2 percent chance of missed lesions and complication rates similar to those associated with biopsies of palpable lesions. The biology of these lesions varies. Although there is a high rate of in situ carcinoma, there is a significant rate of node positivity in the patients with nonpalpable invasive carcinoma.
Adolescent↗
Pulmonary risk factors of elective abdominal aortic surgery.
PURPOSE: The purpose of this study was to retrospectively identify risk factors for postoperative pulmonary complications in patients undergoing elective abdominal aortic surgery via a midline incision. METHODS: We reviewed 181 consecutive patients who underwent operation between July 1986 to December 1992. Preoperative factors analyzed included age, sex, diabetes mellitus, history of smoking, chronic obstructive pulmonary disease, obesity, indication for surgery (aneurysm [126] or aortoiliac occlusive disease [AIOD] [55]), history of coronary artery disease, length of preoperative hospital stay, American Society of Anaesthesiologists class, and pulmonary function tests. Intraoperative factors analyzed included endotracheal tube diameter, percent of inspired oxygen, blood loss, blood and crystalloid replacement, total operative time, epidural analgesia, and stress ulcer prophylaxis. RESULTS: Although the operative mortality rate was only 1.7% (3 of 181), major pulmonary complications occurred in 29 (16%) patients, including two lung-related deaths. Pneumonia occurred in 17 (9%) patients, prolonged intubation greater than 24 hours occurred in nine (5%), and reintubation caused by pulmonary insufficiency occurred in three (2%). On univariate analysis, the following were associated with major pulmonary complications (p < 00.05): American Society of Anaesthesiologists class IV, age greater than 70 years, ideal body weight greater than 150%, forced vital capacity of 80% or less predicted, forced expiratory flow rate (25 to 75) of 60% or less predicted, crystalloid replacement greater than 6 L, and total operative time greater than 5 hours. CONCLUSIONS: The presence of these pulmonary risk factors, notably increased age and weight, decreased forced vital capacity and forced expiratory flow rate (25 to 75), and expected prolonged operative time, influences our decision not to proceed with surgery for small aortic aneurysms or for AIOD causing claudication. Patients at high pulmonary risk with AIOD who require revascularization for limb salvage would be more likely to undergo extraanatomic bypass. Pulmonary risk factors may play as important a role as cardiac factors in elective aortic surgery.
Age Factors↗
Palliative gastric transposition following pharyngolaryngoesophagectomy.
Extensive extirpative resection of advanced head and neck tumors followed by functional reconstruction is a formidable undertaking. Poor long-term survival and substantial morbidity and mortality have often conferred a nihilistic approach toward these patients. We reviewed our experience with transhiatal gastric transposition with pharyngogastric anastomosis for reconstruction of pharyngoesophageal defects to assess the value of undertaking such a formidable surgical intervention. A retrospective analysis (1990-1994) of 20 consecutive patients with advanced head and neck tumors who underwent pharyngolaryngoesophagectomy followed by transhiatal gastric transposition with pharyngogastric anastomosis was performed. Morbidity was 35 per cent; mortality was 10 per cent. Pharyngogastric leaks occurred in 10 per cent of patients. The median postoperative stay was 19 days. Ninety-four per cent of patients had good to excellent palliation. Follow-up averaged 14.3 months. Late stricture occurred in two patients that was easily amenable to dilatation. Tumor recurrence caused dysphagia in one patient; otherwise, all patients are swallowing well or have died without dysphagia. Gastric transposition without thoracotomy is a versatile and reliable method for reconstruction of large pharyngoesophageal defects and is associated with an acceptable morbidity and mortality, thus allowing good palliation in a patient population with an extremely poor prognosis and an otherwise poor quality of life.
Aged↗
Thoracoscopic vagotomy as a safe adjunct to remedial gastric surgery.
Patients who have had prior subdiaphragmatic dissection with an incomplete vagotomy or Nissen fundoplication present added challenges when they require vagotomy and gastric resection. In this setting, thoracoscopic vagotomy offers significant advantages. A second attempt at vagotomy in a previously dissected field can be prolonged and frustrating. In addition to these concerns, repeat dissection can also lead to failure to find the vagal trunks, perforation of the esophagus, hemorrhage, and/or splenic injury. In our experience, three patients requiring gastrectomy or resection of a marginal ulcer have undergone thoracoscopic vagotomy at the time of transabdominal gastric surgery. The thoracoscopic approach avoided either a thoracoabdominal incision or combined thoracic and abdominal incisions while allowing dissection of the vagal trunks to be performed in normal tissue planes. The minimally invasive approach afforded decreased postoperative pain and excellent clinical results. Thoracoscopic vagotomy offers a welcome alternative to re-exploration of a previously dissected distal esophagus in search of vagal trunks, especially when they have been missed at the time of the first operation. Further application of this approach is recommended.
Adult↗
Comparison of the time-resolved absorption and phosphorescence from the tryptophan triplet state in proteins in solution.
Measurement of the room temperature Trp triplet state lifetime in proteins by time-resolved phosphorescence can provide valuable information on the structure and dynamics of proteins in solution. Our time-resolved absorption measurements on the long-lived states resulting from electronic excitation of the chromophore demonstrate the presence of more complex behavior than revealed by time-resolved phosphorescence. To provide additional insight into this behavior, a comparative study of time-resolved transient absorption and time-resolved phosphorescence of proteins in solution was carried out. The results show that the time evolution of the long-lived states observed through transient absorption often differs considerably from that observed in time-resolved phosphorescence. In some proteins, the presence of competing reactions complicates the interpretation of the transient absorption measurements (which may affect the phosphorescence yield). A more complete characterization of these processes will likely prove useful in the study of protein structure and dynamics in solution.
Alkaline Phosphatase↗
[Intrinsic UV-fluorescence of proteins as a tool for studying their dynamics].
A review of literature and our own data on intramolecular mobility of aromatic amino acids in proteins are presented. The necessity to take into account a possible existence of the nanosecond intramolecular mobility with the rotational relaxation time independent of solvent viscosity is pointed out. A comparison of spectral and polarizational characteristics of a number of proteins allowed to solve the problem of the mobility of tryptophan residues localized in the inner regions of macromolecules. According to experimental data, such tryptophan residues can be even more mobile than those located closer to the surface but in the surrounding of polar groups. It is most evident when comparing the intramolecular mobility of tryptophan residues of native proteins and some proteins in the intermediate state of the "molten globule" type. The comparison of experimental data with molecular dynamic simulations contributes substantially to the concepts of tryptophan residue mobility in proteins.
Amino Acids↗