Cardiovascular effects of agmatine within the rostral ventrolateral medulla are similar to those of clonidine in anesthetized rats

Agmatine was isolated from bovine brain in 1994. It exhibits various functions, as a consequence of which it meets the criteria for an endogenous brain neurotransmitter. However, its physiological action on the cardiovascular system remains unclear. This study was designed to clarify its cardiovascular effects when administered into the rostral ventrolateral medulla （RVLM） in anesthetized and paralyzed rats. Unilateral injection of clonidine （5 nmol） into the RVLM significantly decreased mean arterial pressure （MAP） and heart rate （HR）.     

Molecular phenotype of a human lymphoblastoid cell-line homoplasmic for the np 7445 deafness-associated mitochondrial mutation

We have studied mitochondrial gene expression and metabolic function in a human lymphoblastoid cell-line homoplasmic for the np 7445, deafness- associated mitochondrial DNA mutation. The mutation maps to the 3' termini of the oppositely oriented genes encoding cytochrome oxidase subunit I (COI) and tRNA-ser(UCN). In comparison with control lymphoblastoid cells, we detected a marked depletion (> 60%) of tRNA- ser(UCN). There was, however, no significant impairment of respiratory function, no alteration to the structure or abundance of COI mRNA or its precursors, and no detectable abnormality of mitochondrial protein synthesis. We also found considerable tissue-variation in the abundance of tRNA-ser(UCN). We propose that the tissue-specific phenotype associated with this mutation results from an inherent deficiency in the processing of the mutant pre-tRNA, that becomes limiting for protein synthesis only in a restricted set of cells of the auditory system in which the tRNA is, for other reasons, already at a critically low level.      

Increased risk of squamous cell carcinoma in junctional epidermolysis bullosa

Non-Herlitz junctional epidermolysis bullosa (JEB) is an autosomal recessive genodermatosis characterized by skin fragility and blistering. It is usually caused by mutations in the genes encoding the basement membrane proteins laminin 5 or type XVII collagen. Clinically, impaired wound healing and chronic erosions cause major morbidity in affected patients. Previously it was thought that these individuals, unlike patients with dystrophic EB, did not have an increased risk of developing skin cancer. However, we describe three patients with non-Herlitz JEB (aged 42, 56 and 75 years) who developed cutaneous squamous cell carcinomas (SCCs). The tumours were well-differentiated in two cases, but one patient had multiple primary SCCs that were either well- or moderately differentiated. Most cases of SCC in non-Herlitz JEB described have occurred in those with laminin 5 defects and on the lower limbs. These clinicopathological observations have important implications for the management of patients with this mechanobullous disorder as well as providing further insight into the biology of skin cancer associated with chronic inflammation and scarring.     

Evaluation of the Effects of Cypermethrin on Female Reproductive Function by Using Rabbit Model and of the Protective Role of Chinese Propolis

正The prophylactic effects of Chinese propolis against cypermethrin toxicity were evaluated by performing ovary and uterus histopathology,as well as by characterizing ovarian function,embryos,and litters.Cypermethrin induced atypia in the ovary and uterus,and decreased the ovulation sites and the number of embryos.Cypermethrin-induced oxidative stress during pregnancy,decreased the parturition rate as well as the number and weight     

A novel system for providing compatible blood to patients during surgery: "self-service" electronic blood banking by nursing staff

BACKGROUND: A good blood bank must be able to provide compatible blood units promptly to operating room patients with minimal wastage. A "self- service" by nursing staff blood banking system that is safe, efficient, and well-accepted has been developed. STUDY DESIGN AND METHODS: Specific blood units are no longer assigned to surgical patients who have a negative pretransfusion antibody screen, irrespective of the type of surgery. A computer-generated list of the serial numbers of all group-identical blood units currently in the blood bank inventory is provided for each patient. The units themselves are not labeled with a patient's name. The group O list will be provided for group O patients, the group A list for group A patients, and so forth. Should the patient require transfusion during surgery, the operating room nurses go to the refrigerator, remove any group-identical unit, and check the serial number of the unit against the serial numbers on the patient's list. If the serial number is on that list, the blood bank will accept responsibility for compatibility. The system was implemented in 1995. RESULTS: Since implementation, a total of 2154 patients have undergone operations at this hospital. Thirty-two patients received more than 10 units of red cells each. There were no transfusion errors. The crossmatch-to-transfusion ratio was reduced from 1.67 to 1.12. Turnaround time for supplying additional or urgent units to patients in operating room was shortened from 33 to 2.5 minutes. There was no incidence of a blood unit's serial number not being on the list. Work by nurses and technical staff was reduced by nearly 50 percent. CONCLUSION: The "self-service" (by nursing staff) blood banking system described is safe and efficient. It saves staff time and can be easily set up.     

Critical Care nurses' understanding of the NHS Knowledge and Skills Framework. An Interpretative Phenomenological Analysis

Aims: This small‐scale research study aimed to explore Critical Care nurses' understanding of the National Health Service (NHS) Knowledge and Skills Framework (KSF) in relationship to its challenges and their nursing role. Background: The NHS KSF is central to the professional development of nurses in Critical Care and supports the effective delivery of health care in the UK. KSF was implemented in 2004 yet engagement seems lacking with challenges often identified. Design: This qualitative study adopted an Interpretative Phenomenological Analysis framework. Method: Data were collected from five Critical Care nurses using semi‐structured interviews that were transcribed for analysis. Results: Two super‐ordinate themes of ‘engagement’ and ‘theory‐practice gap’ were identified. Six subthemes of ‘fluency’, ‘transparency’, ‘self‐assessment', ‘achieving for whom’, ‘reflection’ and ‘the nursing role’ further explained the super‐ordinate themes. Critical Care nurses demonstrated layers of understanding about KSF. Challenges identified were primarily concerned with complex language, an unclear process and the use of reflective and self‐assessment skills. Conclusions: Two theory‐practice gaps were found. Critical Care nurses understood the principles of KSF but they either did not apply or did not realize they applied these principles. They struggled to relate KSF to Critical Care practice and felt it did not capture the ‘essence’ of their nursing role in Critical Care. Relevance to clinical practice: Recommendations were made for embedding KSF into Critical Care practice, using education and taking a flexible approach to KSF to support the development and care delivery of Critical Care nurses.     

A comparative study of the diagnostic capabilities of 2D plain radiograph and 3D cone beam CT sialography

Objective

The aim of this study was to compare the diagnostic capabilities of two-dimensional sialography with a novel three-dimensional technique using cone beam CT (CBCT).

Methods

47 subjects underwent parotid or submandibular gland sialography over a 2 year period using both plain imaging and CBCT. Both image sets were anonymized and independently reviewed by three certified oral and maxillofacial radiologists blinded to the clinical data. McNemar''s χ² test was used to determine differences between the two modalities for feature visualization and interpretation.

Results

CBCT outperformed plain imaging with respect to visualization of the gland parenchyma (p < 0.001) and identification of sialoliths (p = 0.02). Plain imaging outperformed CBCT for the identification of strictures (p = 0.04); however, the negative per cent agreement (“specificity”) between the two imaging modalities was 100%. Although both imaging modalities performed equally in identifying normal and abnormal sialographic examinations, CBCT demonstrated a high negative per cent agreement for normal glands and a high positive per cent agreement (“sensitivity”) for abnormal glands with inflammatory changes.

Conclusion

CBCT sialography allowed better visualization of gland parenchyma and identification of sialoliths. The high negative per cent agreement for strictures suggests that, if strictures are identified on CBCT images, then obstruction can be ruled in. Relative to plain images, the high negative per cent agreement for normal glands suggests that, if an abnormal finding is detected on CBCT images, then disease can be ruled in, and the high positive per cent agreement for glands with inflammatory changes suggests that inflammation can be ruled out if these changes are not seen on CBCT images.     

Tap water versus sterile saline solution in the colonisation of skin wounds

Irrigating wounds with tap water does not increase colonisation, but controlled studies are required for further evidence. Microbial colonisation was assessed in skin wounds, before and after irrigation with tap water, and was compared with irrigation using 0·9% sodium chloride sterile solution. The study included 120 subjects with chronic, traumatic, vascular, pressure or neuropathic wounds. A total of 60 wounds were randomly assigned to be irrigated with tap water (tap water group) and another 60 to be irrigated with 0·9% sodium chloride sterile solution (saline group), at a pressure of 0·46–0·54 PSI. Samples were collected from the centre of each wound using Levine's technique, before and after irrigation, and cultivated in thioglycollate, hypertonic mannitol agar, eosin methylene blue (EMB) agar, blood agar and Sabouraud agar at 37°C for 72 hours. There was concordance (kappa test) and discordance (McNemar test) regarding the count of positive and/or negative samples before and after irrigation in each group. The proportion of reduction of positive samples was similar for both groups in all cultures. Colony‐forming unit count before and after irrigation was similar in both groups and in all cultures, except for the culture in hypertonic mannitol agar from the tap water group, for which the count was lower after irrigation (Wilcoxon z = 2·05, P = 0·041). It is concluded that skin wound irrigation with tap water leads to further reduction of Gram‐positive bacteria compared with 0·9% sodium chloride sterile solution, with no difference in colonisation of haemolytic bacteria, Gram‐negative bacteria and fungi.