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Evaluation of donor arm disinfection techniques.

BACKGROUND AND OBJECTIVE: To validate a standardized optimal national procedure for donor arm disinfection. MATERIALS AND METHODS: A direct swabbing and plating technique was used to enumerate bacteria present on the arm pre- and postdisinfection. Twelve donor arm disinfection techniques were evaluated. RESULTS: The Medi-Flex Adapted method, consisting of a two-stage process with an initial application of isopropyl alcohol followed by tincture of iodine, produced the best arm disinfection. A percentage reduction in bacterial counts of 99.79% (logarithmic reduction of 2.67) was obtained. Postdisinfection, 70% of donors had bacterial counts of zero, and 98% had counts of 10 or less. CONCLUSION: The Medi-Flex disinfection method offers the English National Blood Service a validated, optimal 'best practice' disinfection technique and should contribute significantly to the reduction in risk of transmission of bacteria by transfusion.

2-Propanol↗

Analysis of spatial patterns at a geographical scale over north-western Europe from point-referenced aphid count data.

The spatial analysis by distance indices (SADIE) technique was developed to evaluate the spatial pattern of point-referenced count data as well as the spatial association between two sets of data sharing the same point locations. This paper presents an analysis of spatial patterns in aphid count data and the association of these data with climate across north-west Europe. The paper tests the applicability of the technique to large geographical areas. Aggregation and cluster indices were calculated for the total annual abundance of the peach-potato aphid Myzus persicae (Sulzer) and for the annual mean rainfall and temperature at aphid monitoring sites. Association indices demonstrated the stability in time of aphid spatial structures and the correlation between aphid density and climate patterns. Groups of relatively large numbers of aphids, termed patches, and groups of relatively small numbers of aphids, termed gaps, were located and their mean size estimated. The aphid patterns were quite stable in time and the spatial patterns of temperature and rainfall were weakly associated with M. persicae annual abundance. Similarities were observed between the results of SADIE and those from the more widely used technique of spatial autocorrelation (SAC). However, the SADIE association index has the advantage of quantifying the possible associations between aphid data and the factors that determine population distribution. Thus, high temperature and low rainfall were identified as environmental factors that were positively associated with aphid abundance across north-west Europe.

Animals↗

Effects of maxillary protraction determined by laser metrology.

In this work we studied some of the main effects of the maxillary protraction orthopedic device. The initial dento-craniofacial reactions induced by maxillary protraction similar to that commonly employed in clinical practice are reported. The fringe counting holographic interferometry technique is used to measure displacements. The experiments were performed on a dried human skull; traction application points were situated over the permanent lateral incisors or over the first permanent molars. The results fundamentally reveal an anterior rotation of the dentomaxillary complex, more intense when traction is applied to the lateral incisors, as shown by a more marked extrusion of the molars in this case. Moreover, major deformation patterns could be observed in inner hard structures of the skull base when applying orthopaedic forces.

Child↗

Capecitabine treatment results in increased mean corpuscular volume of red blood cells in patients with advanced solid malignancies.

Capecitabine is a novel fluoropyrimidine carbamate which is selectively activated after oral administration to 5-fluorouracil (5-FU) by a sequential triple enzyme pathway in liver and tumor cells. The cytotoxic activity of the metabolized 5-FU depends on thymidylate synthase (TS) inhibition, leading to defective DNA synthesis. Capecitabine has shown promising activity in all tumor types sensitive to 5-FU and is therefore investigated in many clinical trials. Since we observed an increase of mean corpuscular volume (MCV) of red blood cells under therapy with capecitabine, the current investigation aimed to quantitate this effect and to elucidate the underlying mechanisms. A total of 154 patients suffering from advanced cancer received capecitabine (2500 mg/m2/day for 14 days every 21 days) either as monotherapy, or in combination with other antineoplastic agents or biological response modifiers. During 3 consecutive cycles of therapy a complete blood cell count including the red cell indices MCV, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration was performed before each application of capecitabine. In addition, vitamin B12, folic acid and homocysteine were determined to define their role in increasing MCV. Restaging was performed after 9 weeks. Within 9 weeks, a statistically significant increase of MCV (without other hematologic abnormalities or clinical symptoms) could be observed (p<0.0001). Vitamin B12, folic acid and homocysteine levels did not change significantly during the observation period. When comparing the different increases of MCV during 9 weeks (deltaMCV) with respect to tumor response, deltaMCV tended to higher values in patients with tumor remission or stable disease than in patients with tumor progression. We conclude that serum levels within the normal range rule out severe deficiencies of vitamin B12, folic acid or homocysteine as an account of macrocytemia. We therefore hypothesize that an increased MCV (without concomitant anemia) in patients receiving capecitabine might be due to the 5-FU-induced TS inhibition also in erythroid precursor cells. Whether this increase in MCV might serve as a surrogate marker for tumor response has to be evaluated in further investigations.

Antimetabolites, Antineoplastic↗

Approximate Bayesian evaluation of multiple treatment effects.

We propose an approximate Bayesian method for comparing an experimental treatment to a control based on a randomized clinical trial with multivariate patient outcomes. Overall treatment effect is characterized by a vector of parameters corresponding to effects on the individual patient outcomes. We partition the parameter space into four sets where, respectively, the experimental treatment is superior to the control, the control is superior to the experimental, the two treatments are equivalent, and the treatment effects are discordant. We compute posterior probabilities of the parameter sets by treating an estimator of the parameter vector like a random variable in the Bayesian paradigm. The approximation may be used in any setting where a consistent, asymptotically normal estimator of the parameter vector is available. The method is illustrated by application to a breast cancer data set consisting of multiple time-to-event outcomes with covariates and to count data arising from a cross-classification of response, infection, and treatment in an acute leukemia trial.

Antineoplastic Agents↗

Detection of platelet antibody using rosette technique with anti-IgG antibody-coated polyacrylamide gel: a preliminary report.

Paraformaldehyde-fixed platelets from normal donors were used for detection of antibody to platelet by in vitro sensitization (indirect method) utilizing rabbit anti-human IgG heavy chain specific antibody-coated polyacrylamide gels (Immunobeads). The sensitized platelets formed rosettes with Immunobeads and the positive rosette count was over 30%, while control showed less than 8% when normal sera were used. This method was also applicable for detecting antibody-sensitized platelets in vivo (direct method) in patients with autoimmune thrombocytopenia. This method is simple, rapid and reproducible for clinical use. Direct and indirect immunofluorescent antibody tests and a blocking test with anti-human serum also supported the results of Immunobead rosetting technique.

Blood Platelets↗

Measurement of marine picoplankton cell size by using a cooled, charge-coupled device camera with image-analyzed fluorescence microscopy.

Accurate measurement of the biomass and size distribution of picoplankton cells (0.2 to 2.0 microns) is paramount in characterizing their contribution to the oceanic food web and global biogeochemical cycling. Image-analyzed fluorescence microscopy, usually based on video camera technology, allows detailed measurements of individual cells to be taken. The application of an imaging system employing a cooled, slow-scan charge-coupled device (CCD) camera to automated counting and sizing of individual picoplankton cells from natural marine samples is described. A slow-scan CCD-based camera was compared to a video camera and was superior for detecting and sizing very small, dim particles such as fluorochrome-stained bacteria. Several edge detection methods for accurately measuring picoplankton cells were evaluated. Standard fluorescent microspheres and a Sargasso Sea surface water picoplankton population were used in the evaluation. Global thresholding was inappropriate for these samples. Methods used previously in image analysis of nanoplankton cells (2 to 20 microns) also did not work well with the smaller picoplankton cells. A method combining an edge detector and an adaptive edge strength operator worked best for rapidly generating accurate cell sizes. A complete sample analysis of more than 1,000 cells averages about 50 min and yields size, shape, and fluorescence data for each cell. With this system, the entire size range of picoplankton can be counted and measured.

Algorithms↗

Caries trends 1992-1998 in two low-fluoride Finnish towns formerly with and without fluoridation.

Water fluoridation in Kuopio, Finland, was stopped at the end of 1992. In our previous study, no increase in caries was found in Kuopio 3 years after the discontinuation of water fluoridation. The aim of the present study was to further observe the occurrence and distribution of caries in Kuopio and Jyväskylä, which was used as the reference town for Kuopio. In 1992, 1995 and 1998 independent random samples of all children aged 3, 6, 9, 12 and 15 years were drawn in Kuopio and Jyväskylä. The total numbers of subjects examined were 688, 1,484 and 1,530 in 1992, 1995 and 1998, respectively. Calibrated dentists registered caries clinically and radiographically. No indication of increasing caries could be found in the previously fluoridated town during 1992-1998. In both towns the mean dmfs and DMFS values either decreased or remained about the same during the observation period. When all study years and both towns were pooled, 25% of the 12- and 15-year-olds with the highest DMFS counts accounted for 79 and 67%, respectively, of all affected surfaces. The mean numbers of fluoride varnish and sealant applications had markedly decreased in 1993-1998 compared to 1990-1992. The fact that no increase in caries was found in Kuopio despite discontinuation of water fluoridation and decrease in preventive procedures suggests that not all of these measures were necessary for each child.

Adolescent↗

Deficient production of hexadecenoic acid in the skin is associated in part with the vulnerability of atopic dermatitis patients to colonization by Staphylococcus aureus.

BACKGROUND AND OBJECTIVES: As one of the major skin fatty acids, cis-6-hexadecenoic acid (C16:1Delta6) exhibits a specific antibacterial activity and might play a specific role in the defense mechanism against Staphylococcus aureus, in healthy subjects whereas S. aureus frequently colonizes the skin of patients with atopic dermatitis (AD). METHODS: Fatty acid composition of sebum at the recovery level was analyzed by gas chromatography and S. aureus colonizing the skin was assessed by the 'cup-scrub' method (9 patients and 10 healthy controls). To evaluate in vivo effect of C16:1Delta6 on colonization, C16:1Delta6 was applied for 2 weeks on the upper arm skin of another group of AD patients (11 patients). RESULTS: Analysis of sebum lipids revealed that there is a significant lower free C16:1Delta6 content in nonlesional skin from AD patients compared with healthy controls. This lower content is also accompanied by a significantly lower level of C16:1Delta6 in the total fatty acid composition of sebum (analyzed following hydrolysis). The lower level of free C16:1Delta6 correlated significantly (R(2) = 0.41, p < 0.01) with the numbers of S. aureus colonizing nonlesional skin. Topical application of free C16:1Delta6 on the skin of AD patients for 2 weeks abolished the markedly increased bacterial count in 6 out of the 8 AD patients tested. CONCLUSIONS: Free C16:1Delta6 may be involved in the defense mechanism against S. aureus in healthy skin and this deficit triggers the susceptibility of the skin to colonization by S. aureus in AD.

Adult↗

Use of peptide nucleic acid probes for rapid detection and enumeration of viable bacteria in recreational waters and beach sand.

Environmental monitoring and public health risk assessments require methods that are rapid and quantitative with defined sensitivity and specificity thresholds. Although several molecular techniques have been developed to rapidly detect bacteria in complex matrices, the challenge to simultaneously detect and enumerate only viable cells remains a limiting factor to their routine application. This chapter describes the use of peroxidase-labeled peptide nucleic acid (PNA) probes to simultaneously detect and count live Staphylococcus aureus, a human pathogen in sea water and beach sand. Mixed bacteria from the environmental sample were immobilized on polyvinylidene difluoride membrane filters and allowed to form microcolonies during a 5-h incubation on Tryptic soy agar plates. PNA probes targeting species-specific regions of the 16S rRNA sequences of S. aureus were then used to hybridize the target bacteria in situ. Probes were detected by capturing chemiluminiscence on instant (e.g., Polaroid) films. Each viable cell (i.e., rRNA producing) is detected as a light spot from its microcolony on the film after scanning the image into a computer. This rapid in situ hybridization technique is simple and highly sensitive and could be developed into portable kits for monitoring pathogens and indicators in the environment.

Bathing Beaches↗

Isoelectric focusing of pure rat pancreatic juice in polyacrylamide gel : possibility of concomitant estimation of radioactivity incorporated into single identified protein constituents.

A method is described for the isoelectric focusing of rat pancreatic juice on columns of polyacrylamide gel containing urea. Twenty-six bands were separated, and 6 were identified. Application of this method of separation to in vivo radioactively labelled pancreatic juice resulted in bands which could be counted with precision. This procedure allowed also the expression of radioactivity of one constituent relative to any single band, or relative to total radioactivity, concomitantly.

Acrylamides↗

Toxic effect of lead of mice testicles after its administration with drinking water.

The experiments were carried out with male mice of the strain CBA x C57BL/10. Lead dinitrate was added to drinking water to obtain the final lead concentration of 0.05 g/l. The material was removed on the 1st, 2nd, 3rd, 4th and 5th week. Testicles were removed fixed in the mixture of neutral formol and 3% K2Cr2O7. Tissue samples were processed by routine procedure and stained with HE and PAS. A relative volume proportion of seminiferous tubules and of interstitial tissue of the testicles was determined by the method of point counting. The first changes in the germinal epithelium of seminiferous tubules were found on the 2nd week after the application. Atypical cells varying in size up to large multinuclear cells were present. With a prolonged time of exposition they multiplied and various dystrophic changes up to disintegration of cells of the germinal epithelium occurred. The experimental groups showed (compared to controls) an increased volume of interstitial tissue. A prolonged exposition led to a marked enlargement of the interstitial tissue.

Animals↗

A selective angiotensin receptor antagonist, Valsartan, produced regression of left ventricular hypertrophy associated with a reduction of arterial stiffness.

We investigated whether a selective angiotensin II receptor blocker (ARB) would have a regressive effect on left ventricular hypertrophy (LVH) in patients on continuous ambulatory peritoneal dialysis (CAPD). In a double-blind study, 24 CAPD patients with LVH [left ventricular mass index (LVMi) > 110 g/m2 for women and LVMi > 137 g/m2 for men] were randomized to 12 months' administration of either the ARB valsartan (n = 14) or a placebo (n = 10). The target blood pressure (BP) was 140/90 mmHg or lower in both groups. The following parameters were measured before and at the end of the study: aortic and large-artery compliance and arterial wave reflections [pulse wave velocity (PWV) and augmentation index (AI) application tonometry] and cardiac echocardiography. Periodically recorded were body weight, BP (mercury sphygmomanometer), serum creatinine, electrolytes, complete blood cell counts, urine volume, drainage volume, and weekly creatinine clearance. Two-way analysis of variance for repeated measurements was used for statistical analysis. Systolic and diastolic BP were both reduced in patients treated with ARB. The LVMi was significantly reduced in patients treated with ARB (to 121 +/- 4 from 145 +/- 5) but not in those receiving placebo (to 137 +/- 3 from 152 +/- 3, p < 0.05). The decrease in LVMi was associated with a reduction in PWV and AI. In CAPD patients with LVH, ARB reduced LVMi in association with alterations in arterial hemodynamics.

Angiotensin II Type 1 Receptor Blockers↗

The influence of hyperoxia on cough reflex intensity in guinea pigs treated with bleomycin.

Inhalation of high concentration of oxygen produces a lung injury in men and experimental animals. In our previous experiment we have found suppression of cough reflex in healthy guinea pigs after an exposure to 100% O2 for 60 hours. This study was designed to find the effect of hyperoxia on cough reflex in guinea pigs with lungs damaged by bleomycin. We used 48 animals (300-400 g) in two separated experiments. 32 of them were intratracheally injected with 1.5 mg bleomycin (Bleocin, Nippon Kayaku Co., Ltd., Tokyo, Japan) for induction of lung damage according to the method described by Parizada et al (20). 16 animals were given saline, only (control). Animals of experimental group were divided into two subgroups according to the lapse of time from bleomycin application. 13 days after bleomycin application animals of the 1st subgroup (16) were exposed to 100% O2 (8) or to room air (8) for 48 h. Similarly, 20 days after bleomycin application guinea pigs of the 2nd subgroup (16) were exposed to 100% O2 (8) or air (8), respectively. Cough was provoked in conscious animals placed in bodyplethysmograph box by inhalation of citric acid aerosol (0.3 mol/L) before, then 13 or 20 days after bleomycin application, and finally at the end of 48-h exposition to 100% O2 (air). The number of coughs was counted from airflow trace recorded by pneumotachograph. Cough was also induced by mechanical stimulation of laryngopharyngeal (LPh) and tracheobronchial (TBr) region in anaesthetized animals (Urethane, 1.1 g/kg, i.p.) just after the end of oxygen exposition and was evaluated from the interpleural pressure record. The results have shown a tendency to inhibition of citric acid cough reflex in animals 13 days treated with bleomycin and exposed to 100% O2, and significant decrease in citric acid induced cough in animals 20 days treated with bleomycin and exposed to 100% O2. Significant changes were present in cough intensity induced by mechanical stimulation of TBr region of the guinea pigs airway treated with bleomycin and exposed to oxygen, too. (Tab. 1, Fig. 3, Ref: 29.)

Animals↗

The perivascular cell populations in human skin after topical application of leukotriene B4.

Fifteen timed biopsies of human skin were performed after application of 100 nanograms of leukotriene B4 in a Finnchamber for six hours. The number of inflammatory cells were counted per high power perivascular field and compared to three control biopsies. At 24 hours a peak of neutrophiles was observed and subsequently lymphocytes predominated. Eosinophils were never prominent. This pattern of successive cell populations has been described in inflammatory and whealing skin disease.

Administration, Topical↗

Dose response relationships of anticoagulant activities after subcutaneous administration of two low molecular weight heparins in healthy individuals.

This study was performed to estimate appropriate dosages of two low molecular weight heparins (LMWH) for clinical trials on subcutaneous perioperative thrombosis prophylaxis. Anticoagulatory activities and platelet function were investigated after single doses of two LMWH and of unfractionated sodium heparin (UFH) in 24 healthy individuals. Twelve subjects received subcutaneous injections of 1000, 1500, and 2500 i.u. (aPTT) of LMHW 1, and the other 12 received LMWH 2 at same dosages. The following parameters were determined before 30 min, 1 h, 90 min, 2 h, 3 h, 4 h, 6 h, 8 h, and 10 h after either LMWH or 5000 i.u. (aPTT) UFH: aPTT, thrombin time, anti-Xa activity (S 2222, Coatest heparin), and anti-IIa activity (Chromozym TH). Bleeding time, platelet count, and adrenalin-, collagen-, and ADP-induced platelet aggregation were assessed before and 3 h after administration. After application of 1500 i.u. LMWH 1 and LMWH 2, the anti-Xa and anti-IIa levels were already significantly higher than after 5000 i.u. UFH. 2500 i.u. LMWH 1 and LMWH 2 evoked significantly greater prolongations of aPTT and thrombin time values than did 5000 i.u. UFH. This was not the case after 1000 and 1500 i.u. LMWH. The half-lives of anticoagulatory effects after LMWH were markedly longer than after UFH. Platelet function was not altered by any of the heparins tested. Our results indicate that LMWH cause anticoagulatory effects in vivo that cannot be predicted by in vitro studies and that the appropriate single dosages of LMWH in subcutaneous perioperative thrombosis prophylaxis have to be estimated by dosage determinations in healthy subjects.

Adult↗

[Optimization of the decision-making guidelines for the diagnosis of cerebrovascular diseases].

The problem to optimize decision rules and the number of informative signs for the automated diagnosis of the cerebrovascular pathology is analysed. A double application of the algorithm to subdivide the set into clusters makes it possible to decrease the number of informative counts and to rearrange separate signs thus decreasing the dimensionality of the sum dividing subspace and improving a recognition quality for a newly designed classifier even though the number of classes being diagnosed increases.

Cerebrovascular Disorders↗

[Clinical applications of bone scintigraphy in patients with benign bone diseases].

Detection and staging of metastatic diseases and follow up study by bone scintigraphy are used ordinarily in every hospitals, although various applications to benign bone diseases are seen in a type of hospital. The number of bone scan cases was counted in three hospitals (general hospital = g-hosp, university hospital = un-hosp, cancer center hospital = ca-hosp). The number of bone scan cases in patients with benign bone diseases was 182 in one year in g-hosp, 235 in one year in un-hosp, 30 in one year ca-hosp. Its ratio to total bone scan cases was higher in g-hosp (51.9%) and in un-hosp (23.1%), lower in ca-hosp (3.1%). Interpretation of scintigraphic findings and comments on indication to each diseases (bone and joints diseases, rheumatic syndrome, trauma, inflammation, metabolic bone diseases and muscle disorders) were written.

Bone Diseases↗