Consecutive salmonella outbreaks traced to the same bakery.

Two consecutive community outbreaks of Salmonella enteritidis phage type 4 (PT4) traced to the same bakery occurred in Cardiff, Wales during August-September 1992. In the first outbreak, illness was associated with eating custard slices (odds ratio 23.8, 95% confidence interval 6.5-94.4, P < 0.0001), and in the second, with eating fresh cream cakes (odds ratio 15.8, 95% confidence interval 1.6-374, P = 0.004). Environmental investigations implicated cross-contamination during preparation of the cold-custard mix as the cause of the first outbreak, and inadequate cleaning and disinfection of nozzles used for piping cream in the second outbreak. S. enteritidis PT4 was isolated from fresh cream sponge cake retained by a case and from two fresh cream cakes and four environmental swabs obtained at the bakery. This incident illustrates the hazard of widespread environmental contamination with salmonella and the need for thorough environmental cleansing for any premises implicated in an outbreak of food poisoning.     

A central odontogenic fibroma exhibiting pleomorphic fibroblasts and numerous calcifications

A case of an odontogenic fibroma with unusual histopathological features is described. The tumour exhibited numerous, plump, stellate fibroblasts, similar to those found in the so-called giant cell fibroma. This finding has not been described previously in odontogenic fibromas. This case also exhibited an unusually large number of calcifications. Neither of these features should affect the biological behavior of this lesion.     

Clinical value of the creatinine clearance before the administration of chemotherapy with cisplatin

The creatinine clearance was calculated in standard fashion from a timed urine specimen (measured creatinine clearance [MCC]) and from a previously published formula (estimated creatinine clearance [ECC]), in 55 instances, in 19 consecutive patients who were admitted to the hospital for treatment with cisplatin. Using creatinine excretion as an index of completeness of urine collection, there were 19 (35%) inaccurate collections. The correlation between creatinine clearances calculated by both methods was excellent (r = 0.684, P less than .001) and improved when inaccurate collections were excluded (r = 0.922, P less than 0.001). A discrepancy between the two methods of 25% or more was found in 19 collections. Using data from patients with two or more collections to test whether or not the two methods produced equally variable results, indicated that the MCC is a more variable, less reliable method than the ECC. In eight of 55 urine collections, the results of MCC were not used as a guide to chemotherapy and, in an additional 16 should have not been used because of inaccuracy in the urine collection. These results suggest that the creatinine clearance as calculated by an alternative method (ECC) should replace the use of MCC when assessment of the renal function is needed before the administration of nephrotoxic agents.     

Fetal Prostate Growth and Development

Normal fetal and newborn prostates were studied to evaluate growth patterns, histogenesis, and secretory activity. Whole cross-sectioned prostates harvested from 107 necropsies of fetuses and newborns ages 20 weeks gestation to 1 month of age were used. Development of the prostate occurred in three stages: bud stage (20-30 weeks gestation), bud-tubule stage (31-36 weeks gestation), and acinotubular stage (37-42 weeks gestation). Squamous metaplasia often appeared in the urethra, utricle, and primary lobular ducts, and occasional microcysts were noted. PAS and alcian blue-PAS positive secretion were present in 65% of the specimens by 20-30 weeks gestation and in over 87% of the specimens by 37 or more weeks gestation. Secretory activity was most prominent in the lateral regions of the peripheral zone. Prostate-specific antigen was only weakly detected throughout the prenatal period and was not related to secretory activity as evidenced by the PAS technique.     

Evaluation of a fiber optic glove for semi-automated goniometric measurements

Normal subjects were used to evaluate a fiber optic instrumented glove for semi-automated goniometric measurement. The glove electronically records and transmits hand and finger position to a host computer by measuring the amount of joint flexion. The glove was put through a series of range-of-motion (ROM) tests with five subjects. Metacarpal (MP) and proximal interphalangeal (PIP) joint angles of the five digits were compared during repetitive standardized motions to evaluate the glove's repeatability. The results showed an overall error of 5.6 degrees, as compared to an error of between 5 and 8 degrees with manual measurement. Additional tests were done to determine factors such as fit, grip force, and wrist motion that may contribute to the overall error. The glove should have applicability to some aspects of hand evaluation as a semi-automated goniometric measurement device.     

Effect of calcium on the vasoactive response of arterioles to light during fluorescent intravital microscopy of the tibialis anterior muscle of the hamster.

Arterioles may undergo a transient vasoactive response when exposed to light during fluorescent intravital microscopy. We hypothesized that the type and frequency of the vasoactive responses by arterioles to light is calcium dependent. In order to test this hypothesis we quantitated the type and frequency of vasoactive responses by arterioles to light in the presence and absence of calcium within the suffusate bathing the muscle. In addition, we determined whether the presence or absence of calcium also influenced the reactivity of these arterioles to adenosine and norepinephrine. In separate experiments, we determined the effect of increases in suffusate calcium concentration on the resting diameter of arterioles. The concentration of calcium in the suffusate significantly influenced the frequency of light-induced vasoactivity of the arterioles of the tibialis anterior muscle: a normal suffusate calcium concentration of 2 x 10(-3) M was associated with an incidence of light-induced vasoreactivity of 77% but decreased significantly to 58% when calcium was removed from the suffusate. Although the frequency of the vasoactive response to light was different for the two experimental conditions, the type of vasoactive response, predominately vasomotion, was similar. The vasoactive responses of arterioles to adenosine and norepinephrine were similar in the presence and absence of calcium in the suffusate. However, the concentration of calcium in the suffusate did significantly influence resting arteriolar diameters: 2 x 10(-3) M calcium CaCl2 caused a mean decrease in the arteriolar diameter of 11.6 (+/- 3.0)%, 4 x 10(-3) M CaCl2 caused a mean decrease of 41.2 (+/- 12)%, and 8 x 10(-3) M CaCl2 caused a mean decrease of 55.4 (+/- 14.4)%. These results show that the concentration of calcium in the suffusate bathing the tibialis anterior muscle during fluorescent intravital microscopy significantly influences the vasoactive response of arterioles to light. Further investigation of the mechanisms of light-induced effects on microcirculation during fluorescent intravital microscopy will become important as this technique is used more widely in the study of the microcirculation of solid tissues and organs.