Legacy AdvanTec and Sovereign WhiteStar: a wound temperature study

PURPOSE: To assess the wound temperature of the Sovereign WhiteStar (S-WS) (AMO) and Legacy AdvanTec (L-ADV) (Alcon) phacoemulsification systems. SETTING: John A. Moran Eye Center, Health Sciences Center, University of Utah, Salt Lake City, Utah, USA. METHODS: Phacoemulsification using 20-gauge, 30-degree straight tips with the L-ADV and S-WS systems was performed in fresh cadaver eyes. The power was set at 50%, and aspiration was 12 mL/min; the L-ADV was run at 15 pulses per second (pps) and the S-WS at WS CF (6 milliseconds on, 12 milliseconds off). Temperature was measured at 5-second intervals for 60 seconds using a microthermistor placed in the wound. The phaco tip was angled 30 degrees to increase wound-tissue contact. At 10 seconds, the flow was clamped to simulate occlusion. Five runs, sleeved and unsleeved, were averaged for the phaco tip. RESULTS: The mean temperature was significantly higher with L-ADV than with S-WS (from 10 seconds on in the sleeved condition and from 5 seconds on in the unsleeved condition after the aspiration line was clamped). In 2 of 5 sleeved runs and 4 of 5 unsleeved runs, the L-ADV handpiece decreased power as the temperature increased. One run with the L-ADV with sleeve showed signs of wound burn. There were no signs of wound burn with the S-WS. The highest temperature recorded was 57.5 degrees C with the L-ADV and 38.6 degrees C with the S-WS. Power tests showed L-ADV protected the stroke length and S-WS had constant power except in air where it increased power. CONCLUSIONS: There was less increase in wound temperature over time with the S-WS than with the L-ADV system in sleeved and unsleeved simulated surgery in human eye-bank eyes. Because the ultrasound handpieces respond differently under different load scenarios, meaningful comparisons of pulsing features are difficult to create.     

Speech intelligibility rating of cochlear implanted children: inter-rater reliability

The Speech Intelligibility Rating (SIR) scale was designed to classify children's global speech production according to one of five hierarchical categories. Individuals rating the scale need to judge which category is appropriate, giving the possibility that different raters could use different scores in their assessments. The aim of this study was to determine the inter-rater reliability of the scale, i.e. whether judges agree as to the category membership for the assessed behaviour. Inexperienced ('naive') judges rated videotape excerpts of implanted children in communication with a known adult according to the scale. Each judge rated four children sequentially from one of four videos: there were two videos of different sets of children, each recorded with two different orders. Both subsets of subjects ranked children in the same order of intelligibility (Kendall's W = 0.86 and W = 0.98 respectively, both p < 0.01). There was agreement on the category membership for each child (Kappa's K = 0.45 and K = 0.68 respectively, both p < 0.001). The intra-class correlation coefficient showed that agreement between raters was high (ICC(2,1) values = 0.80 and 0.81, both p < 0.001), and that ratings were consistent (ICC(3,1) values = 0.82 and 0.97, both p < 0.001). This study indicated that the scale demonstrates good inter-rater reliability. It can be used confidently by cochlear implant teams to monitor the progress of implanted children's speech intelligibility.     

Associations between smoking and adenocarcinomas and squamous cell carcinomas of the uterine cervix (United States)

Objectives: Few studies of smoking and cervical carcinoma have addressed the rare cervical adenocarcinomas or used DNA-based tests to control for human papillomavirus (HPV) infection. Methods: This multicenter case–control study included 124 adenocarcinoma cases, 307 community controls (matched on age, race, and residence to adenocarcinoma cases), and 139 squamous carcinoma cases (matched on age, diagnosis date, clinic, and disease stage to adenocarcinoma cases). Participants completed risk-factor interviews and volunteered cervical samples for PCR-based HPV testing. Polychotomous logistic regression generated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for both histologic types. Results: Eighteen percent of adenocarcinoma cases, 43% of squamous carcinoma cases, and 22% of controls were current smokers. After control for HPV and other questionnaire data, adenocarcinomas were consistently inversely associated with smoking (e.g. current: OR = 0.6, 95% CI 0.3–1.1; 1 pack per day: OR = 0.7, 95% CI 0.4–1.3), while squamous carcinomas were positively associated with smoking (e.g. current: OR = 1.6, 95% CI 0.9–2.9; 1 pack per day: OR = 1.8, 95% CI 1.0–3.3). Results in analyses restricted to HPV-positive controls were similar. Conclusion: Smoking has opposite associations with cervical adenocarcinomas and squamous carcinomas. Although both histologic types are caused by HPV and arise in the cervix, etiologic co-factors for these tumors may differ.     

Prolonged QT interval and cardiac arrhythmias in two neonates: sudden infant death syndrome in one case

Two neonates with arrhythmias and the long QT syndrome are described. The arrhythmias were detected in utero and both infants were apparently well after birth. The first infant, although well, had a bradycardia for the first 9 days of life. A normal heart rate was documented at 10 days but a prolonged QT interval was not appreciated on the ECG. He was discharged from hospital but died suddenly and unexpectedly 3 days later. A post-mortem examination failed to find a cause for his death which therefore fell into the category of the sudden infant death syndrome (SIDS). A retrospective analysis of the perinatal electrocardiogram showed a probable junctional rhythm with 2:1 conduction to the ventricle; the QT interval was prolonged at 0.52 seconds (QTC = 0.63). The second infant had a QT interval of 0.52 seconds (QTC = 0.54) and frequent ventricular premature beats on a 24-hour electrocardiogram. She was treated with propranolol and remains well 2 years later. Sudden infant death has often been described in the siblings of children with the long QT syndrome and one other report described a case of SIDS which was said to have had a prolonged QT interval on the perinatal ECG. This report, however, provides unquestionable evidence, in one case, of an association between the long QT syndrome and SIDS.     

Modulation of implantation-associated integrin expression but not uteroglobin by steroid hormones in an endometrial cell line

In order to test the hypothesis that integrin and uteroglobin (UG) expression in cultured endometrial cells are affected by hormone treatment, Ishikawa-CH endometrial cancer cells were cultured and exposed to oestradiol or oestradiol and progesterone regimens and assayed using immunohistochemistry. We evaluated the intensity of immunohistochemical staining for the integrin monomers alpha(v) and beta1, the dimers alpha(v)beta3 and alpha(v)beta6, and for the secretory protein uteroglobin under various experimental conditions. Cells grown in control media stained positively for the integrin monomers alpha(v) and beta1, the dimer alpha(v)beta3, and for UG. Oestradiol and sequential oestradiol/progesterone reversibly suppressed staining for the dimer alpha(v)beta3. Hormone treatment had no effect on the staining of the beta1 and alpha(v) monomers or UG. The alpha(v)beta6 dimer antibody did not stain under any experimental treatment conditions. These data indicate that expression of the integrin complex alpha(v)beta3 is reversibly suppressed by oestradiol in Ishikawa cells and that these cells may be a good model for studying hormone-driven molecular changes in endometrium.      

The Flvr-encoded murine oligoadenylate synthetase 1b (Oas1b) suppresses 2-5A synthesis in intact cells

Resistance to flavivirus-induced disease in mice is conferred by the autosomal gene Flv, identified as 2′-5′ oligoadenylate synthetase 1b (Oas1b). Resistant mice express a full-length Oas1b protein while susceptible mice express the truncated Oas1btr. In this study, Oas1b was shown to be an inactive synthetase. Although the Oas/RNase L pathway was previously shown to have an antiviral role during flavivirus infections, Oas1b protein inhibited Oas1a in vitro synthetase activity in a dose-dependent manner and reduced 2-5A production in vivo in response to poly(I:C). These findings suggest that negative regulation of 2-5A by inactive Oas1 proteins may fine tune the RNase L response that if not tightly controlled could cause significant damage in cells. The results also indicate that flavivirus resistance conferred by Oas1b is not mediated by 2-5A. Instead, Oas1b inhibits flavivirus replication by an alternative mechanism that overrides the proviral effect of reducing 2-5A accumulation and RNase L activation.     

Kell blood group activity of gram-negative bacteria

To understand better the relationships between blood-group antigens and bacterial constituents, examples of 23 gram-negative bacteria (representing the 10 genera Citrobacter, Edwardsiella, Enterobacter, Escherichia, Klebsiella, Proteus, Pseudomonas, Salmonella, Serratia, and Shigella) were tested for the presence of Kl-like antigens by hemagglutination-inhibition (HAI) assays against both IgG and IgM anti-Kl. Saline-suspended whole organisms, cell-free culture media, and disrupted organisms were used to test for such antigens in, on, and secreted by the microorganisms examined. Disrupted organisms of an isolate of Shigella sonnei nonspecifically inhibited IgG anti-Kl as well as IgG antibodies of the specificities Kpb, Fya, S, and c. However, only Escherichia coli 0125:B15, subtype 12808, had specific K1-like activity (no activity with other IgG [(k, Kpb, Jka, Fya, S, c] and IgM [A, B, M, P1] antibodies). Disrupted organisms inhibited IgM but not IgG anti-K1 in the HAI assay. A second subtype, E. coli 0125:B15, subtype 12809, exhibited no K1-like activity. These findings support the report of K1 activity in cell-free broth cultures of E. coli 0125:B15 (subtype unspecified). Thus, although not all E. coli 0125:B15 possesses K1-like activity, the finding of such activity in at least one E. coli subtype confirms the idea that bacterial components may play a role in the production of naturally occurring antibodies directed against non-ABO red cell antigens.     

Detection of viral-specific nucleic acid and intracellular virions in ventral horn neurons of lactate dehydrogenase-elevating virus infected C58 mice

C58 mice which have been immunosuppressed by treatment with cyclophosphamide (200 mg/kg) one day prior to infection with the C strain of lactate dehydrogenase-elevating virus (LDV-C) develop poliomyelitis. Using in situ hybridisation, we found that some ventral horn neurons in these mice contain cytoplasmic viral-specific nucleic acid. Viral-specific nucleic acid was also found within a few small cells located near inflammatory foci. In addition, mature virus particles were observed by electron microscopy in some ventral horn neurons, indicating that these cells are productively infected in C58 mice. Neither viral nucleic acid nor virions were found in the ventral horn neurons of poliomyelitis-resistant mouse strains or C58 mice that were not immunosuppressed prior to infection. Ventral horn neurons which contained viral nucleic acid or virions within cytoplasmic vesicles generally were normal in appearance and were not located within poliomyelitis inflammatory foci. Our data are consistent with the hypothesis that infected neurons first replicate virus and subsequently are attacked and cleared by inflammatory cells.     

Expression of pertussis toxin adenosine diphosphate-ribosyltransferase in a T-cell hybridoma reduces metastatic capacity

T-cell hybridomas are highly metastatic, and their in vitro invasiveness correlates with metastatic capacity. Invasion is blocked by pertussis toxin (PT), which adenosine diphosphate (ADP)-ribosylates G1-proteins, and we have provided evidence that the PT-sensitive signal stimulates leukocyte function-associated antigen-1 (LFA-1)-mediated adhesion required for invasion. PT pretreatment of TAM2D2 T-cell hybridoma cells reduced metastasis, but only to a limited extent. In the present study, we have transfected the cDNA of the PT ADP- ribosyltransferase S1 subunit into TAM2D2 cells to abrogate G1-protein function permanently. We report here a substantial reduction in the metastatic capacity of two transfectants, S05 and S09, in which 88% and 95% of the G1-proteins was ADP-ribosylated. Two-thirds of the mice injected with S09 cells were tumor-free. Metastasis to the liver was almost completely prevented and less metastases were formed in the spleen and kidneys. Metastasis formation by S05 cells in liver and spleen was much reduced, but in lymph nodes and peritoneal tissues, metastases occurred with a frequency similar to that of controls. We conclude that G1-proteins play an important role in T-cell hybridoma metastasis. We propose that the reduction in metastasis is due to diminished entry of tumor cells from the blood into tissues.