Induction for overseas qualified doctors

This study describes a strategy for the integration of overseas doctors with different professional and cultural backgrounds. A central induction course, complementing local trust-based induction programmes, was developed and evaluated by the London Deanery. Most participants found the course helpful, and their comments were used to further improve it.     

Lysosomal Ca(2+) stores in bovine corneal endothelium

PURPOSE: Acidic organelles, including Golgi bodies and lysosomes, are known to operate as Ca(2+) storage sites in many cell types. This study demonstrates the presence of Ca(2+) stores in lysosomes of bovine corneal endothelial cells (BCECs) and examines their interaction with Ins(1,4,5)P(3)-sensitive Ca(2+) stores. METHODS: Glycyl-L-phenylalanine-beta-naphthylamide (GPN) was used to release Ca(2+) from lysosomes by inducing their selective osmotic swelling. Ca(2+) released into the cytoplasm was measured with fura-2 or fura-PE3 fluorescent dyes. Fluorescence of acridine orange (AO), which selectively sequesters into acidic organelles, was used to establish swelling of lysosomes in response to GPN. RESULTS: Exposure to GPN (100-200 microM) in cultured BCECs produced an increase in free cytosolic Ca(2+) ([Ca(2+)](i)) equivalent to approximately 79% of the peak response to uridine triphosphate (UTP), a P2Y agonist (n = 19). The endothelium of the freshly isolated cornea also produced [Ca(2+)](i) transients similar to those in cultured BCECs; however, the peak [Ca(2+)](i) increase was smaller ( approximately 43% of the peak response to UTP; n = 13). In cultured BCECs, the response to UTP was unaffected by pretreatment with GPN with extracellular calcium ([Ca(2+)](o)) at 0 and 1.2 mM (n = 10). Neither pretreatment with thapsigargin (5 microM) nor with U73122 (a phospholipase C inhibitor; 10 microM) blocked the peak GPN response (n = 6). Exposure to 20 microM monensin produced a [Ca(2+)](i) increase with [Ca(2+)](o) at 0 and 1.2 mM and also reduced the subsequent peak response to GPN (n = 6). CONCLUSIONS: GPN-sensitive lysosomal Ca(2+) stores, distinct from Ins(1,4,5)P(3)-sensitive Ca(2+) stores, are found in both cultured cells and fresh tissue. These stores are susceptible to depletion by the loss of the pH gradient across lysosomes and P2 agonists. The latter occurs through mechanisms independent of phospholipase C (PLC) activation or Ins(1,4,5)P(3). The GPN stores also induce [Ca(2+)](o) influx in response to their depletion.     

Gap velocity measurements of a blood pump model

This paper presents the velocity measurements in the gap between the impeller and the pump casing of a 5:1 enlarged centrifugal blood pump model at operating condition. Both the radial and tangential velocity at the gap were measured. It was found that there was no cross flow in both the radial and tangential velocity distributions at the seven radial locations. This implies that the 0.2 mm gap in the prototype should be the optimal clearance of the pump. The vector plot of the resultant velocity showed that the double volute design of the pump, especially the splitter plate that started at theta; = 180 degrees, has created a washout mechanism in the clearance gap; that is, a sector of flow ranging from theta; = 100 degrees to theta; = 190 degrees has directed strongly toward the eye while the rest of the flow in the gap is in a tangential direction. It is important that the blood should flow out of the gap through the eye instead of continuing to circulate in the clearance gap. This explains why the pump has minimum hemolysis and thrombus formation and is able to function with nominal efficiency as compared to other centrifugal pumps.     

BpeAB-OprB, a multidrug efflux pump in Burkholderia pseudomallei

Burkholderia pseudomallei, the causative agent of melioidosis, is intrinsically resistant to a wide range of antimicrobial agents, including beta-lactams, aminoglycosides, macrolides, and polymyxins. An operon, bpeR-bpeA-bpeB-oprB, which encodes a putative repressor, a membrane fusion protein, an inner membrane protein, and an outer membrane protein, respectively, of a multidrug efflux pump of the resistance-nodulation-division family was identified in B. pseudomallei. The divergently transcribed bpeR gene encodes a putative repressor protein of the TetR family which probably regulates the expression of the bpeAB-oprB gene cluster. Comparison of the MICs and minimal bactericidal concentrations of antimicrobials for bpeAB deletion mutant KHW Delta bpeAB and its isogenic wild-type parent, KHW, showed that the B. pseudomallei BpeAB-OprB pump is responsible for the efflux of the aminoglycosides gentamicin and streptomycin, the macrolide erythromycin, and the dye acriflavine. Antibiotic efflux by the BpeAB-OprB pump was dependent on a proton gradient and differs from that by the AmrAB-OprA pump in that it did not efflux the aminoglycoside spectinomycin or the macrolide clarithromycin. The broad-spectrum efflux pump inhibitor MC-207,110 did not potentiate the effectiveness of the antimicrobials erythromycin and streptomycin in B. pseudomallei.     

Oxygen consumption is increased relative to work rate in patients with McArdle's disease

BACKGROUND: Patients with McArdle's disease suffer exercise incapacity as a result of myophosphorylase deficiency, and for a given work rate have excessive circulatory and ventilatory responses. We hypothesized that the rate of increase of oxygen consumption with work rate (DeltaVO2-DeltaWR slope) would also be elevated in such patients as a result of these excessive responses. PATIENTS AND METHODS: Five patients with McArdle's disease and five matched controls carried out a maximal incremental cardiopulmonary exercise test. Controls then carried out a second test matched to the maximal test of a paired patient. Venous blood was sampled at rest, peak exercise and recovery. RESULTS: During the matched test, the DeltaVO2-DeltaWR slope was higher in the patients than in the controls [19.9 (15.0-24.6) vs. 11.7 (9.2-13.5) mL min(-1) W(-1); mean (range); P = 0.022], and the peak-achieved VO2 was also greater in the patient group [1201 (890-1575) vs. 918 (599-1248) mL min(-1); P = 0.003]. A similar pattern was observed for heart rate [173 (165-182) vs. 108 (105-134) b.p.m.; P = 0.001] and plasma norepinephrine levels [12.6 (9.2-19.9) vs. 2.9 (2.2-4.9) nmol l(-1); P = 0.003]. CONCLUSION: There is an increased rate of rise in VO2 relative to work rate during exercise in patients with McArdle's disease. There is also a greater rise in catecholamines, which may be the result of a physiological response to substrate starvation, and is likely to contribute to the increase in VO2.     

Changes in GABA transporters in the rat hippocampus after kainate-induced neuronal injury: decrease in GAT-1 and GAT-3 but upregulation of betaine/GABA transporter BGT-1

The gamma-aminobutyric acid (GABA) transporters GAT-1, GAT-2, GAT-3, and BGT-1 have been cloned and identified according to their differential amino acid sequences and pharmacologic properties. In contrast to GAT-1, -2, or -3, BGT-1 is capable of utilizing both GABA and betaine as substrates. Betaine has been suggested to be a protective osmolyte in the brain. Because changes in expression of GABA transporters/BGT-1 might result in alterations in levels of GABA/betaine in the extracellular space, with consequent effects on neuronal excitability or osmolarity, the present study was carried out to explore expression of GABA transporters in the rat hippocampus after kainate-induced neuronal injury. A decrease in GAT-1 and GAT-3 immunostaining but no change in GAT-2 staining was observed in the degenerating CA subfields. In contrast, increased BGT-1 immunoreactivity was observed in astrocytes after kainate injection. BGT-1 is a weak transporter of GABA in comparison to other GABA transporters and the increased expression of BGT-1 in astrocytes might be a protective mechanism against increased osmotic stress known to occur after excitotoxic injury. On the other hand, excessive or prolonged BGT-1 expression might be a factor contributing to astrocytic swelling after brain injury.