4,4′-Isopropylidine-Bis[2-Isopropyl]Phenol,a New Inhibitor for Cell Wall Formation of Bacillus subtilis

4,4′-Isopropylidine-bis[2-isopropyl]phenol was found to possess antimicrobial activity against gram-positive bacteria and some fungi, whereas it had no effect on gram-negative organisms. The drug has a potent inhibitory action on the synthesis of cell wall mucopeptides of Bacillus subtilis by inhibiting the enzyme d-glutamate ligase, which is responsible for the incorporation of d-glutamic acid into uridine 5′-diphosphate-muramyl-l-alanine. The drug had a weak lytic effect on protoplasts and inhibited protein synthesis, whereas no significant effect on the synthesis of deoxyribonucleic acid and ribonucleic acid was found.     

Cairomycin B, a New Antibiotic

Cairomycin B is a new cyclic peptide antibiotic that was isolated from Streptomyces As-C-19 obtained from the soil of Cairo. The antibiotic had the following empirical formula: C₁₀H₁₅N₃O₃; on acid hydrolysis, it yielded aspartic acid and lysine. Spectral analysis and its chemical characteristics indicated that it was a cyclic peptide. The antibiotic melted at 120 to 121°C and was freely soluble in chloroform, ethyl acetate, and acetone, slightly soluble in alcohols, and rather insoluble in water and petroleum ether. Cairomycin B was mainly active against gram-positive bacteria, with high toxicity to experimental animals and weak serum-binding properties.     

Characterization of multiple membrane progestin receptor (mPR) subtypes from the goldfish ovary and their roles in the induction of oocyte maturation

Oocyte maturation (OM) in goldfish is induced by the maturation inducing hormone (MIH) via its membrane receptor. Previously, we described the cloning of the membrane progesterone receptor alpha (mPRα or paqr7b) cDNA from a goldfish ovarian cDNA library and obtained experimental evidence that the mPRα protein is an intermediary in MIH induction of OM in goldfish. Three mPR subtypes have been identified in fish by cDNA cloning or by in silico analysis of genome sequence databases. In order to investigate the potential roles of the mPR subtypes in oocyte maturation, we cloned additional mPRs from a goldfish ovarian cDNA library. RACE amplification, and screening of the cDNA library identified one β (paqr8) and two γ subtypes (paqr5) (hereafter referred to as γ-1 and γ-2), respectively. Tissue distribution of mPR subtypes showed differential expression pattern. However, in addition to mPRα, the β, γ-1 and γ-2 subtypes were also expressed in follicle-enclosed oocytes. Cell lines expressing the β, γ-1 and γ-2 genes were established and their steroid binding properties compared. The β subtype exhibited higher binding affinity than the γ subtypes for 17,20β-DHP, the MIH in goldfish. Microinjection of goldfish oocytes with a morpholino antisense oligonucleotide to mPRβ blocked the induction of oocyte maturational competence, whereas injection of antisense oliogonucleotides to mPRγ-1 and γ-2 were ineffective. These results suggest that the goldfish mPRβ protein acts as an intermediary during MIH induction of OM in goldfish, in a manner similar to that described previously for mPRα.     

Effective Hepatic Cryoablation: Does It Enhance Tumor Dissemination?

n = 12) were sacrificed after induction of liver tumors at 4 and 6 weeks. The animals in the treatment group (n= 16) underwent cryosurgery 2 weeks after tumor induction and were allowed to recover before sacrifice 2 and 4 weeks later. Pulmonary metastases were identified in 9 of 12 (75%) control animals at postmortem examination (2 and 6 weeks after tumor inoculation) and in 6 of 16 (38%) rats in the treatment group at sacrifice 2 and 4 weeks after cryosurgery (p= 0.11, Fisher's test for unpaired analysis). Peritoneal deposits were observed in 5 of 12 (42%) control animals at postmortem examination and in 8 of 16 (50%) of the treated animals at the time of cryosurgery (p= 0.95, Fisher's test for unpaired analysis). Two other study animals developed deposits after cryosurgery. The prevalence of peritoneal deposits in the study group was not altered by cryosurgery (p= 0.5, McNemar's test for paired analysis). The importance of the final subzero temperature at the edge of the iceball during tumor ablation by cryosurgery was confirmed by the histologic findings. Complete ablation with no residual viable tumor was obtained only when the subzero temperature had reached −38°C or below. The results of this study do not support the suggestion that hepatic cryosurgery enhances tumor dissemination. The findings also confirm that a subzero temperature at the edge of the iceball of −38°C or lower is necessary to ensure complete ablation of tumor.     

Mycétome osseux métatarsien: à propos d’un cas

Actinomycosis of bone or bone mycetoma is an infectious disease caused by a fungal or actinomycotic organism presenting as apseudo-tumour.The condition develops insidiously. It is very unusual to find this infection in the foot. Bone involvement makes medical management more difficult. We report the case of a man aged 26 years, admitted with mycetomatous osteitis of the third metatarsal. This was treated by surgical extirpation and a 12-month course of antibiotic therapy. Progress was satisfactory. The objective of this report is to draw attention to this very rare condition, which is little known by many doctors and can present therapeutic problems.     

L’embrochage centromédullaire antérograde dans les fractures des métatarsiens moyens

Introduction

Despite being common, there are very few articles about metatarsal fractures either concerning surgical techniques or clinical results. This type of fracture may need surgical correction when displaced, especially at an angle. The authors are reporting on the surgical technique and the clinical results of closed anterograde intramedullary pinning of fractures of the neck, diaphysis and the head of the metatarsals.

Equipment and methods

Thirty-one patients with a metatarsal fracture from January 2009 to June 2012 were reviewed retrospectively by the authors. The study included 24 males and 7 females and comprised of 41 fractures of either the diaphysis, the neck or the head of the metatarsal. The technique is described, whereby the pin was introduced from front to back via a small dorsal incision at the base of the metatarsals. The consolidation, the range of movement of the metatarsal phalangeal joint and residual pain were assessed at 6 weeks post surgery and at the final follow-up appointment. The American Orthopaedic Foot and Ankle Society (AOFAS) score was assessed at the last follow-up consultation.

Results

Consolidation was achieved on average after 7.3 weeks (ranging from 6 to 10 weeks). Two patients presented with a moderate limitation to the metatarsal phalangeal joint at 6 weeks, however they had recovered full mobility at the last follow-up appointment. The AOFAS score was 94.7 points (range: 81 to 99).

Conclusion

Due to this simple, reliable and minimally invasive technique, all patients were immediately able to start moving their joint, with partial weight bearing with the help of a rigid boot cast. The overall result is satisfactory and there are very few complications.     

An Unsupervised Neural Network to Predict the Level of Heat Stress

Heat stress is known to induce high mortality rate due to multi-system illness, which demands urgent attention to reduce the fatality rate in such patients. Further, for the diagnosis and supportive therapy, one needs to define the severity of heat stress that can be distinguished as mild, intermediate and severe. The objective of this work is to develop an automated unsupervised artificial system to analyze the clinical outcomes of different levels of heat related illnesses. The Kohonen neural network program written in C++, which has seven normalized values of different clinical symptoms between 0–1 fed to the input layer of the network with 50 Kohonen output neurons, has been presented. The optimized initializing parameters such as neighborhood size and learning rate was set to 50 and 0.7, respectively, to simulate the network for 10 million iterations. The network was found smartly distinguishing all 51 patterns to three different states of heat illnesses. With the advent of these findings, it can be concluded that the Kohonen neural network can be used for automated classification of the severity of heat stress and other related psycho-patho-physiological disorders. However, to replace the expert clinicians with such type of smart diagnostic tool, extensive work is required to optimize the system with variety of known and hidden clinical and pathological parameters. Aggarwal Y, Karan BM, Das BN, Sinha RK. An unsupervised neural network to predict the level of heat stress.     

Implications of Stoma Formation as Part of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Background

Formation of protective stoma as part of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS–HIPEC) may be an effective tool in reducing anastomotic leak incidence. Our aim was to evaluate the incidence and implications of stoma formation during CRS–HIPEC and to examine whether a creation of protective stoma reduces the postoperative morbidity.

Methods

A cohort retrospective analysis of all CRS–HIPEC procedures performed between 2004 and 2016 was conducted. Predicting factors for stoma formation were assessed by comparing all patients who underwent stoma formation to those who did not; both groups were then restricted to cases with ≥2 bowel anastomoses and compared in terms of perioperative outcomes in order to determine whether protective stoma confers a morbidity benefit.

Results

One hundred and ninety-nine CRS–HIPEC procedures were performed on 186 patients. Thirty-four patients (17%) underwent stoma formation, 24 of them as protective stoma. Formation of a stoma was correlated with higher peritoneal carcinomatosis index score (13.6 ± 8 vs. 9.5 ± 7.7, p = 0.007), larger number of organs resected (p < 0.001), greater number of anastomoses (p < 0.001), prolonged operative time (8.1 ± 2.7 vs. 6.6 ± 2.2 h, p = 0.002), and prolonged hospital stay (12 vs. 8.5 days, p = 0.001). In procedures requiring ≥2 anastomoses, formation of protective stoma reduced the anastomotic leak rate (6 vs. 37%, p = 0.025), the morbidity rate (6 vs. 41%, p = 0.017), and reoperation rate (0 vs. 28%, p = 0.03). Overall, 15 patients (44%) underwent stoma reversal, 3 of whom had a complication treated non-operatively.

Conclusions

Protective stoma should be considered in extensive CRS–HIPEC procedures requiring two or more bowel anastomoses in order to reduce the postoperative morbidity rate.