Diarrhetic Shellfish Poisoning,Washington, USA, 2011

Diarrhetic shellfish poisoning is a gastrointestinal illness caused by consumption of bivalves contaminated with dinophysistoxins. We report an illness cluster in the United States in which toxins were confirmed in shellfish from a commercial harvest area, leading to product recall. Ongoing surveillance is needed to prevent similar illness outbreaks.     

Tissue Distribution of P32-Labeled Parathion

Repeated inhalation of the vapors of bis(chloromethyl) ether and chloromethyl methyl ether at one and two ppm, respectively, and of the aerosol of urethan at approximately 138 ppm, resulted in an increase in incidence of pulmonary adenomas in strain A mice. In addition, the high toxicity of the two haloethers and the general lack of properties irritating to the upper respiratory tract in all three compounds pose an insidious industrial handling hazard.     

Further evidence of construct validity of standardized patient‐based performance examinations

The purpose of this study was to gather additional evidence pertinent to the construct validity of standardized patient‐based clinical performance examinations. Specifically, the study determined whether students who indicated they had previously read about, seen, or worked up a case on the examination performed differently on that case from those students who had not. Overall, it was found that students with previous reading or direct experiences with cases on the test tended to have higher case mean scores on those cases than those who had not. These results demonstrated that scores on standardized patient‐based performance examinations are sensitive to the examinees’ various learning experiences.     

A microcirculatory technique for evaluating intravascular and topical administration of vasoactive agents: Response to AVP in the SHR

A "closed bath" cremaster muscle preparation is described which permits the administration of vasoactive materials to the microvasculature via intraarterial injection and topical suffusion. The technique is evaluated in spontaneously hypertensive (SHR) and Wistar-Kyoto (WKY) rats by comparing arteriolar responses to intraarterial and topically suffused arginine vasopressin. The preparation utilizes a thermostatically heated brass suffusion chamber overlying the cremaster. The chamber is closed with a glass coverslip. Experimental materials are presented to the microvessels via intraarterial injection or suffusion through the chamber. The coverglass permits high optical resolution with both routes of administration. Following vasopressin administration, changes in arteriolar diameter were continuously monitored by image-shearing techniques or variable-resistance calipers. The responses were analyzed by comparing both the peak 5-sec vasoconstriction and a 60-sec integrated response. Intraarterial and topical suffusion of vasopressin (1.25 X 10(-10)-3.75 X 10(-7) M) caused dose-dependent vasoconstriction among 23-microns arterioles. Compared to the WKY, vasoconstriction was greater in the SHR when vasopressin was administered intraarterially. A similar strain difference was not observed with topical suffusion. The dose-response curves with intraarterial vasopressin were shifted approximately 100-fold in concentration to the right relative to those with topically suffused vasopressin. The "closed bath" cremaster muscle preparation described has several distinct advantages: (1) it permits introduction of different vasoactive materials in the most physiological manner in the same animal, and (2) it maintains high optical resolution and clarity for critical observation of the smallest vessels, even with suffusion.     

External auditory canal reconstruction following subtotal auricular resection with a tragal lobule wrap flap

Different etiologies may lead to total auricular and external auditory canal wall ablation. These include burns, tumors, trauma, and malformations. Reconstruction of the canal wall and maintaining its patency pose as a great challenge in plastic surgery. Inability to do so may lead to a serious hearing impairment. To date, different procedures aim at restoring this patency and include skin grafts and local flaps. Unfortunately, skin grafts are associated with a high contracture rate. Local flaps are associated with donor site morbidity. We present a case of an 85-year-old man who underwent auricular ablation due to squamous cell carcinoma which included the external auditory canal. Sparing the tragal and lobular areas within the surgical margins using frozen section-controlled margins, we were able to reconstruct the canal wall. The tragal lobular wrap flap provides a valuable and consistent long-lasting method for auricular canal reconstruction and postauricular amputation wound coverage. Level of evidence: Level V, therapeutic study.     

Nocturia in adults: Etiology and classification

Nocturia is one of the most bothersome of all urologic symptoms, yet even a rudimentary classification does not exist. We herein propose a classification system of nocturia based on a retrospective study. The records of 200 consecutive patients with nocturia were reviewed. Evaluation included history, micturition diary (including day, night, and 24-hr voided volume), postvoid residual urine (PVR), and videourodynamic study (VUDS). Functional bladder capacity (FBC) was determined to be the largest voided volume in a 24-hr period. The etiology of nocturia was thus classified into one of three groups: nocturnal polyuria ([NP] in which voided urine volume during the hours of sleep exceeds 35% of the 24-hr output), nocturnal detrusor overactivity ([NDO] defined as nocturia attributable to diminished bladder capacity during the hours of sleep), and mixed (NP + NDO); polyuria (24-hr urine output >2,500 cc) was classified separately. There were 129 women and 65 men ranging in age from 17 to 94 years (x = 59). Overall 13 (7%) had NP, 111 (57%) NDO, and 70 (36%) had a mixed etiology of their nocturia (both NP and NDO). Forty-five (23%) also had polyuria. These data confirm that the etiology of nocturia is multifactorial and in many instances unrelated to the underlying urologic condition. Nocturnal overproduction of urine is a significant component of nocturia in 43% of patients, most of whom will also have NDO. We believe that treatment should be directed at both conditions. Neurourol. Urodynam. 17:467–472, 1998. © 1998 Wiley-Liss, Inc.     

Effects of blood flow modifiers on tumor metabolism observed in vivo by proton magnetic resonance spectroscopic imaging

Perfusion plays a key role in tumor proliferation and therapeutic response. Tumor heterogeneity necessitates use of the highest spatial resolution to monitor metabolic correlates of blood flow changes. This is best achieved with ¹H NMR spectroscopy, which permits noninvasive acquisition of high resolution spectroscopic images (SI) of subcutaneous tumors in a relatively short scan time (e.g., 12-25 μl voxels with signal-to-noise ratio 7:1 in 30 min at 4.7 T). This study seeks to identify ¹H spectroscopic indices of tumor blood flow. Proton SI of subcutaneous murine RIF-1 tumors were recorded (a) before and after administration of nicotinamide (1 g/kg) to increase blood flow, and (b) before and after hydralazine (10 mg/kg) to decrease flow. Nicotinamide produced a significant decrease in the total choline peak amplitudes, which subsequent high resolution NMR spectroscopy of tumor extracts revealed to be due to decreases in phosphocholine and glycerophosphocholine. The deamidation of nicotinamide to nicotinic acid, which is known to have hypolipidemic effects and to stimulate the formation of prostaglandins, may have sufficiently altered lipid metabolism to affect the in vivo concentration of the NMR-visible choline-containing compounds. The main effect of hydralazine was a significant increase of lactate, which is consistent with a reduction of tumor blood flow.