Evaluation of Enoxaparin Given before and after Operation to Prevent Venous Thromboembolism during Digestive Surgery: Play-the-Winner Designed Study

A total of 316 patients were included in a play-the-winner (PTW) designed study comparing the safety of enoxaprain started preoperatively versus postoperatively as prophylaxis against venous thromboembolism for digestive surgery. In a PTW-designed study the treatment of any next patient depends on the outcome of the previous patient. If successful, the next patient receives the same treatment, if not, the comparative regimen is given. Excessive bleeding according to specified criteria, severe adverse reactions, clinically detected deep venous thrombosis (DVT), or pulmonary embolism (PE) were criteria for classification as “loser.” The PTW design allocates most patients to the superior treatment. The main variable in PTW studies is the number of consecutive patients receiving the same treatment. In this study 163 patients were allocated to postoperatively started and 153 to preoperatively started prophylaxis with enoxaparin. The frequency of “winners” was found to be 82.8% and 78.4% in the post- and preoperatively treated groups, respectively. No significant differences were found between the groups with regard to frequency of “winners” or the number of consecutive patients before change of treatment. The percentile of survival distribution did not detect superiority of any group. Prophylaxis against postoperative venous thromboembolism for digestive surgery using enoxaparin can safely be started preoperatively.     

Reactions in rat gluteal muscle to titanium implants

A new approach to the analysis of tissue-implant interaction is presented using rat gluteal muscle as implantation site and using monoclonal antibodies to identify and quantify cells around the implant. The method can be used for comparative studies on biocompatibility. In this methodological investigation, pure titanium (Ti) was studied, revealing an initial response of macrophages, followed by the formation of a fibrous membrane, in which, even at 50 and 70 d, la-expressing cells and suppressor T-lymphocytes were present.     

The significance of HIV antigen and HIV antibodies specific against envelope and core proteins in serum of HIV-infected hemophiliacs

Serial serum samples from the 21 HIV-infected Norwegian hemophiliacs have been assayed for the presence of HIV antigen and antibodies to HIV specific for the core protein p24 and the envelope protein gp41. HIV antigen was detected in 4 patients, of whom 3 have developed AIDS to date. HIV antigen appeared in serum 10 to 24 months before the diagnosis in these patients. Antibodies to gp41 was a constant finding. Antibodies to p24 disappeared from the serum in 1 patient who developed AIDS and from 3 persons free of symptoms related to the HIV infection. The detection of HIV antigen in HIV antibody-positive hemophiliacs appears to be of considerable prognostic significance.     

The cellulose-binding domain of the major cellobiohydrolase of Trichoderma reesei exhibits true reversibility and a high exchange rate on crystalline cellulose.

Cellulose-binding domains (CBDs) bind specifically to cellulose, and form distinct domains of most cellulose degrading enzymes. The CBD-mediated binding of the enzyme has a fundamental role in the hydrolysis of the solid cellulose substrate. In this work we have investigated the reversibility and kinetics of the binding of the CBD from Trichoderma reesei cellobiohydrolase I on microcrystalline cellulose. The CBD was produced in Escherichia coli, purified, and radioactively labeled by reductive alkylation with 3H. Sensitive detection of the labeled CBD allowed more detailed analysis of its behavior than has been possible before, and important novel features were resolved. Binding of the CBD was found to be temperature sensitive, with an increased affinity at lower temperatures. The interaction of the CBD with cellulose was shown to be fully reversible and the CBD could be eluted from cellulose by simple dilution. The rate of exchange measured for the CBD-cellulose interaction compares well with the hydrolysis rate of cellobiohydrolase I, which is consistent with its proposed mode of action as a processive exoglucanase.     

Preliminary evaluation of cyto-rich: An improved automated cytology preparation

A new cervical cytology monolayer preparation system called Cyto-Rich was evaluated. Using samples from 557 patients, Cyto-Rich monolayers were compared to matched conventional smears. After conventional smears were prepared and spray fixed, residual exfoliated cells were transferred to preservative fluid. The cell suspensions were gently disaggregated and the epithelial component enriched with gradient centrifugal sedimentation. The batched samples were then placed on the Cyto-Rich work station where slides are automatically prepared and stained. The results demonstrate that Cyto-Rich prepared monolayers are vastly superior to the conventional smears for cell presentation. While the study showed 99% overall concordance, Cyto-Rich improved the detection of low-grade cervical intraepithelial lesions.     

Nature and mechanism of action of the CAMP protein of group B streptococci.

The extracellular product of group B streptococci responsible for the CAMP reaction was purified to near homogeneity. It is a relatively thermostable protein having a molecular weight of 23,500 and an isoelectric pH of 8.3. It was found that the CAMP reaction could be simulated by substituting [14C]glucose-containing liposomes prepared from sphingomyelin, cholesterol, and dicetyl phosphate for sheep erythrocytes. In the belief that the liposome system is a valid model, the mechanism of the CAMP reaction was further investigated by using liposomes in which N-acylsphingosine (ceramide) was substituted for sphingomyelin. In this system disruption of liposomes, as measured by release of trapped [14C]glucose, was effected by CAMP protein alone. As judged from thin-layer chromatography, CAMP protein caused no reduction in the amount of ceramide present in ceramide-containing liposomes, nor were split products demonstrable. However, binding of CAMP protein to ceramide-containing liposomes could be shown. It is inferred that in sheep erythrocytes CAMP protein reacts nonenzymatically with membrane ceramide formed by the prior action of staphylococcal sphingomyelinase and that binding of CAMP protein to ceramide disorganizes the lipid bilayer to an extent that results in cell lysis.