Ia antigen is a differentiation marker on human eosinophils

Evidence suggests that the "la-like" or antigen is a differentiation marker that is expressed on early human hematopoietic precursor cells, but is absent on their mature progeny. The eosinophil precursor cell (CFU-EO) is distinct from the granulocyte-monocyte colon-forming cell (CFU-C). We provide data that indicate that the ia antigen is expressed on the human eosinophil colony-forming cells and is absent on mature eosinophils. All CFU-EO were inhibited in the presence of rabbit la antiserum at a titer of 1:30. Cytotoxicity was complement-dependent. The metamyelocytic eosinophil and more mature eosinophil forms did not express the la antigen.     

Achieving consensus on the definition of conversion to laparotomy: a Delphi study among general surgeons, gynecologists, and urologists

Background

In laparoscopic surgery, conversion to laparotomy is associated with worse clinical outcomes, especially if the conversion is due to a complication. Although apparently important, no commonly used definition of conversion exists. The aim of this study was to achieve multidisciplinary consensus on a uniform definition of conversion.

Methods

On the basis of definitions currently used in the literature, a web-based Delphi consensus study was conducted among members of all four Dutch endoscopic societies. The rate of agreement (RoA) was calculated; a RoA of >70 % suggested consensus.

Results

The survey was completed by 268 respondents in the first Delphi round (response rate, 45.6 %); 43 % were general surgeons, 49 % gynecologists, and 8 % urologists. Average ± standard deviation laparoscopic experience was 12.5 ± 7.2 years. On the basis of the results of round 1, a consensus definition was compiled. Conversion to laparotomy is an intraoperative switch from a laparoscopic to an open abdominal approach that meets the criteria of one of the two subtypes: strategic conversion, a standard laparotomy that is made directly after the assessment of the feasibility of completing the procedure laparoscopically and because of anticipated operative difficulty or logistic considerations; and reactive conversion, the need for a laparotomy because of a complication or (extension of an incision) because of (anticipated) operative difficulty after a considerable amount of dissection (i.e., >15 min in time). A laparotomy after a diagnostic laparoscopy (i.e., to assess the curability of the disease) should not be considered a conversion. In the second Delphi round, a RoA of 90 % was achieved with this definition.

Conclusions

After two Delphi rounds, consensus on a uniform multidisciplinary definition of conversion was achieved within a representative group of general surgeons, gynecologists, and urologists. An unambiguous interpretation will result in a more reliable clinical registration of conversion and scientific evaluation of the feasibility of a laparoscopic procedure.     

Benzodiazepines inhibit the rate of neutrophil apoptosis

Background Benzodiazepines, which are commonly administered perioperatively, can depress immune function. Neutrophil apoptosis plays a central role in the regulation of inflammation. This is particularly important during and after surgery. Aim To examine the effects of benzodiazepines (midazolam and diazepam) on neutrophil apoptosis. Methods Venous blood samples were withdrawn from patients scheduled to undergo elective surgery, (a) immediately prior to, and 10 minutes after administration of midazolam 0.2mg/kg intravenously (n=11) and (b) immediately prior to, and 60 minutes after administration of diazepam 10mg po (n=10). Neutrophil apoptosis was measured by Annexin VFITC after 1 and 12 hours in culture. Results The percentage of apoptotic cells was significantly less after midazolam at 12% (11.9) hours in culture compared to pre-midazolam 29.7% (13.3) (p<0.05). After diazepam, the rates of neutrophil apoptosis were also significantly less after 12 hours in culture (p<0.05). Conclusion Administration of benzodiazepines in clinically relevant doses inhibits neutrophil apoptosis. In the perioperative period, this may influence the inflammatory response to surgery.     

Breath odor evaluation by detection of volatile sulfur compounds – correlation with organoleptic odor ratings

Background:  Detection of oral volatile sulfur compounds (VSC) by gas chromatography (GC) is a widely used method for evaluating breath odor. Air aspirated from the mouth is injected into the GC column for analysis. To eliminate discrepancies caused by variations in operator sampling or injection techniques, a new GC system designed to aspirate breath samples directly into the GC was developed.
Objective:  A clinical study was performed to compare this new automated breath-sampling GC system to organoleptic evaluation by two trained odor judges.
Methods:  A randomized, two-cell, double-blind, parallel design was used in which subjects were tested before and 3 h after using either a mouthrinse containing zinc or a matching placebo rinse. Thirteen subjects used the zinc mouthrinse, and 12 used the placebo. Subjects with a wide range of VSC levels were studied. The average organoleptic ratings for each subject at each time-point were compared with the average VSC measurements made with the GC, and Pearson product–moment correlation coefficients between the corresponding GC and organoleptic measurements were determined.
Results:  The correlation between the GC and organoleptic assessment methods were highly significant ( P  ≤ 0.001) for: total VSC, 0.65; H₂S, 0.63; CH₃SH, 0.61; and (CH₃)₂S, 0.46. The correlation between the two judges was also highly significant (0.823, P  < 0.001).
Conclusion:  These results demonstrate the utility of the automated GC method for evaluating breath odor.