Prevalence of enterotoxigenic Escherichia coli (ETEC) in hospitalized acute diarrhea patients in Denpasar, Bali, Indonesia

The relationship between enterotoxigenic Escherichia coli (ETEC) and hospitalized patients with acute diarrhea was examined in a study conducted in two hospitals from June 2000 to May 2001 in Denpasar, Bali, Indonesia. A total of 489 hospitalized patients with acute diarrhea were enrolled, and their rectal swabs were screened for enteric bacterial pathogens. Toxins, colonization factor antigens (CFAs), in vitro antimicrobial susceptibility and seasonal distribution patterns associated with ETEC were ascertained. The diagnosis of ETEC infection and CFAs association were performed with GM-1 ELISA and Dot blot immunoassays. Enterotoxigenic Escherichia coli was isolated from the rectal swabs of 14.9% of the patients. The distribution of toxins among the ETEC strains found was ST in 51 (69.9%), while LT and ST/LT were found in 28.8% and 1.3% respectively. The highest isolation rate for ETEC was found among children between the ages of 1 and 15 years. Colonization factor antigens were identified in 28.8% of the ETEC strains. A high prevalence of CFA was found among the rectal swabs of patients with ST isolates. High frequency of resistance to ampicillin, trimethoprim/sulfamethoxazole, chloramphenicol, tetracycline and cephalothin was displayed among the ETEC strains. All ETEC strains were susceptible to norfloxacin, ciprofloxacin and nalidixic acid. The results of this study document the prevalence of ETEC in hospitalized patients with acute diarrhea in Denpasar, Bali, Indonesia. Data generated in this study depicts the prevalence of ETEC diarrhea and CFA types among diarrhea patients in the tourist city of Denpasar, Bali, Indonesia.     

Fluid therapy in acute myocardial infarction: evaluation of predictors of volume responsiveness

Background: Static vascular filling pressures suffer from poor predictive power in identifying the volume-responsive heart. The use of dynamic arterial pressure variables, including pulse pressure variation (PPV) has instead been suggested to guide volume therapy. The aim of the present study was to evaluate the performance of several clinically applicable haemodynamic parameters to predict volume responsiveness in a pig closed chest model of acute left ventricular myocardial infarction.
Methods: Fifteen anaesthetized, mechanically ventilated pigs were studied following acute left myocardial infarction by temporary coronary occlusion. Animals were instrumented to monitor central venous (CVP) and pulmonary artery occlusion (PAOP) pressures and arterial systolic variations (SPV) and PPV. Cardiac output (CO) was measured using the pulmonary artery catheter and by using the PiCCO^® monitor also giving stroke volume variation (SVV). Variations in the velocity time integral by pulsed-wave Doppler echocardiography were determined in the left (ΔVTI_LV) and right (ΔVTI_RV) ventricular outflow tracts. Consecutive boluses of 4 ml/kg hydroxyethyl starch were administered and volume responsiveness was defined as a 10% increase in CO.
Results: Receiver–operator characteristics (ROC) demonstrated the largest area under the curve for ΔVTI_RV [0.81 (0.70–0.93)] followed by PPV [0.76 (0.64–0.88)] [mean (and 95% CI)]. SPV, ΔVTI_LV and SVV did not change significantly during volume loading. CVP and PAOP increased but did not demonstrate significant ROC.
Conclusion: PPV may be used to predict the response to volume administration in the setting of acute left ventricular myocardial infarction.     

EGF促进RPE细胞毒蕈碱受体诱导的磷酸肌醇形成：受体间交互作用分析

对培养人眼视网膜色素上皮（RPE）细胞磷酸肌醇（InsPs）水平的分析表明，Carbachol显著刺激RPE细胞InsPs水平的升高，且该效应可被阿托品所阻断，表明在人眼RPE细胞存在毒蕈碱受体。去甲肾上腺素、5-羟色胺、表皮生长因子（EGF）、异丙肾上腺素和NECA对InsPs基础水平无明显影响。异丙肾上腺素和NECA对Carbachol刺激InsPs的效应也无明显影响；但EGF显著促进Carbacol刺激人眼RPE细胞InsPs水平升高的效应。提示在人眼RPE细胞EGF与毒蕈碱受体之间存在有受体间交互作用。 （中华眼底病杂志，1994，10：220-222）     

Enabling a person with multiple disabilities and minimal motor behaviour to control environmental stimulation with chin movements

Purpose: To assess whether a young man with multiple disabilities and minimal motor behaviour would learn to control environmental stimulation using chin movements and a mechanical microswitch. Method: The study was carried out according to an ABAB design in which A represented baseline and B intervention phases. The chin movements controlled the stimulation only during the intervention phases. A 2-month post-intervention check was conducted. Results: The man increased the frequency of his chin movements, thus increasing the level of environmental stimulation, during the intervention phases. This performance was maintained at the post-intervention check. Conclusion: The use of chin movements is a practical strategy for enabling individuals with minimal motor movements to control environmental stimulation. Future research should examine whether similar types of movements may enable some individuals to control voice-output communication devices.     

Cellular B-2 microglobulin expression as a prognostic indicator in renal cell carcinoma.

The expression of B-2 microglobulin (B-2M) on tumor cells and their normal cell counterparts in 39 patients with renal cell carcinoma was studied and correlated to tumor stage and survival. The median survival time of patients with localized disease (stage I) whose tumors expressed B-2M was 10.2 years while the median survival time for patients whose tumors did not express B-2M was only 3.6 years (p less than 0.001). For patients with more advanced disease (stages II, III, IV) whose tumors expressed B-2M, median survival time was 3.6 years compared to 2.0 years in patients whose tumors did not express B-2M, a non-significant difference. It is suggested that the tumor cell membrane expression of B-2M may serve as an indicator of good prognosis in early renal cell carcinoma.     

芹菜甲素保护脑细胞的作用

以每周定时im马桑内酯0.9～1.5mg/kg三个月为实验性癫痫慢性发作模型。ig芹菜甲素700mg/kg能明显降低大鼠癲痫发作的程度和次数,延长潜伏期。脑形态学结果表明,芹菜甲素对大脑顶叶皮层细胞、胶质细胞和小脑蚓部蒲肯野细胞有一定的保护作用。同时观察的安定1.5～5mg/kg则无此作用。     

U22, a Protocol to Quantify Symptoms Associated with Supraventricular Tachycardia

Background: The main indication for ablation of supraventricular tachyarrhythmias (SVTA) is symptomatic relief. Specific paroxysmal symptoms cannot be quantified with general measures of quality of life, such as with the SF-36 questionnaire. U22 is a new protocol which measures the effects of arrhythmia on well-being, the intensity of discomfort during an episode, the type and temporal characteristics of dominant symptoms, and the duration and frequency of episodes. Discrete 0–10 scales are used. Unlike SF-36, U22 can be used in individual patients.
Methods: U22 and SF-36 protocols were used in the symptomatic evaluation of 88 patients (mean age = 49.6 ± 16.4 years; 43 men), who underwent catheter ablation of SVTA.
Results: The U22 scores (SD) for (a) well-being (10 being best), (b) effects of arrhythmia on well-being (10 being worst), and (c) discomfort during arrhythmia (10 being worst) were 5.6 (2.7), 7.5 (2.8), and 8.0 (2.4), respectively. For comparison, the physical and mental component summaries of SF-36 were 45.3 (11.0) and 45.2 (12.1), respectively, slightly lower than the expected normal of 50. The intensity of dominant symptom scored by U22 was 9.7 (1.2), 10 being worst. In 29% of patients ≥4 symptoms were equally dominant. Multiple dominant symptoms in U22 were associated with a low general well-being in SF-36.
Conclusion: We found U22 useful to quantify symptoms associated with SVTA.