Collection of blood, saliva, and buccal cell samples in a pilot study on the Danish nurse cohort: comparison of the response rate and quality of genomic DNA.

In this study, we compared the response rates of blood, saliva, and buccal cell samples in a pilot study on the Danish nurse cohort and examined the quantity and quality of the purified genomic DNA. Our data show that only 31% of the requested participants delivered a blood sample, whereas 72%, 80%, and 76% delivered a saliva sample, buccal cell sample via mouth swabs, or buccal cell sample on FTA card, respectively. Analysis of purified genomic DNA by NanoDrop and agarose gel electrophoresis revealed that blood and saliva samples resulted in DNA with the best quality, whereas the DNA quality from buccal cells was low. Genotype and PCR analysis showed that DNA from 100% of the blood samples and 72% to 84% of the saliva samples could be genotyped or amplified, whereas none of the DNA from FTA cards and only 23% of the DNA from mouth swabs could be amplified and none of the DNA from swabs and 94% of the DNA from FTA cards could be genotyped. Our study shows that the response rate of self-collection saliva samples and buccal cell samples were much higher than the response rate of blood samples in our group of Danish nurses. However, only the quality of genomic DNA from saliva samples was comparable with blood samples as accessed by purity, genotyping, and PCR amplification. We conclude that the use of saliva samples is a good alternative to blood samples to obtain genomic DNA of high quality and it will increase the response rate considerably in epidemiologic studies.     

Basal cell carcinoma of the vulva

A clinical and histopathologic study of material from a series of 21 patients with basal cell carcinoma treated from 1960 until 1979 are reviewed. In 3 patients 'mixed' tumor was recorded. The histopathologic diagnosis: basosquamous carcinoma and the behavior of this carcinoma are discussed. The mean age of the patients was 76 years. Presenting symptomatology consisted primarily of bleeding, burning or itching, and ulcerations. No case of pure basal cell carcinoma gave metastasis to the regional lymph nodes, in no case could the cause of death be attributed directly to this kind of lesion. A conservative approach consisting of wide local excision is suggested.     

Cluster of African trypanosomiasis in travelers to Tanzanian national parks

Game parks in Tanzania have long been considered to be at low risk for African trypanosomiasis; however, nine cases of the disease associated with these parks were recently reported. The outbreak was detected through TropNetEurop, a sentinel surveillance network of clinical sites throughout Europe.     

Evaluation of referrals from general practice to a neurological department

BACKGROUND: The presence of neurological deficits as obtained from clinical examination increases the likelihood of detecting serious underlying brain disorders. OBJECTIVES: In this study, we assessed the frequency of reported clinical neurological examination in patients referred to neurology. METHODS: We consecutively evaluated referrals to a neurological centre during a 6-month period. RESULTS: From a total of 716 patients, 377 (51%) had an examination reported in the referral letter. Clinical examinations were reported more often in patients with musculo-skeletal disorders compared with others, P = 0.0001. Examination was less likely to be reported in those with a history of disturbed consciousness. CONCLUSION: By showing that only about half of the patients had an examination reported, the study demonstrates that the process of selecting those with a high priority for a secondary neurological service can be improved.     

Enhanced HER-2/neu-specific antitumor immunity by cotransduction of mouse dendritic cells with two genes encoding HER-2/neu and alpha tumor necrosis factor

The present study uses an in vivo murine tumor model expressing the human HER-2/neu antigen to evaluate the potential vaccine using dendritic cells (DCs) infected with adenovirus AdVHER-2. We first investigated whether infected DCs (DC(HER-2)) engineered to express HER-2/neu could induce HER-2/neu-specific immune responses. Our data showed that (i) AdVHER2-infected DC(HER-2) expressed HER-2/neu by Western blot and flow cytometric analysis, and (ii) vaccination of mice with DC(HER-2) induced HER-2/neu-specific cytotoxic T-lymphocyte (CTL) responses, but protected only 25% of vaccinated mice from challenge of 3 x 10(5) MCA26/HER-2 tumor cells. Further, to enhance the efficacy of DC(HER-2) vaccine, we coinfected DCs with both AdVHER-2 and AdVTNF-alpha. The infected DCs (DC(HER-2/TNF-alpha)) displayed the expression of both HER-2/neu and TNF-alpha by flow cytometric and ELISA analysis. We next investigated whether DC(HER-2/TNF-alpha) could induce stronger HER-2/neu-specific immune responses. We found that DC(HER-2/TNF-alpha) displayed up-regulation of immunologically important CD40, CD86, and ICAM-I molecules compared with DC(HER-2), indicating that the former ones are more mature forms of DCs. Vaccination of DC(HER-2/TNF-alpha) induced stronger allogeneic T-cell proliferation and 36% enhanced HER-2/neu-specific T-cell responses in vitro than DC(HER-2) cells. More importantly, it stimulated the significant anti-HER-2/neu immunity in vivo, which protected 8/8 mice from challenge of 3 x 10(5) MCA26/HER-2 tumor cells. Therefore, DCs genetically engineered to express both the tumor antigen and cytokines such as TNF-alpha as an immunoadjuvant are likely to represent a new direction in DC vaccine of cancer.     

Leg wound closure after saphenous vein harvesting in patients undergoing coronary artery bypass grafting: a prospective randomized study comparing intracutaneous,transcutaneous and zipper techniques

OBJECTIVE: Two prospective randomized studies were undertaken to compare different suture closure techniques with respect to postoperative wound infection rates and cosmetic results after saphenous vein harvesting in patients undergoing coronary artery bypass surgery. DESIGN: A total of 166 patients were included in the first study, in which 85 had their leg wounds closed with transcutaneous and 81 with intracutaneous suture. In the second study, 168 patients were selected to a non-invasive surgical zipper (n = 78) or intracutaneous suture (n = 90). RESULTS: In the first study the overall infection rate was 20.5%, 17.6% in the transcutaneous group compared with 23.5% in the intracutaneous group (p = 0.35). In the second study the infection rate was 19.3%, 15.3% in the zipper group vs 23.3% in the intracutaneous group (p = 0.20). On a cosmetic scale from 1 to 10, an average score of 8.0 was obtained in the percutaneous (p.c.) group vs 8.3 in the intracutaneous (i.c.) group (p = 0.35), and 9.0 in the zipper group vs 8.4 in the i.c. group (p = 0.003). CONCLUSION: The incidence of leg wound infection after saphenous vein harvesting in coronary artery bypass graft surgery is high. The zipper closing method may give a lower infection rate and a better cosmetic result compared with the intracutaneous suture.     

Bioavailability and pharmacokinetics of isradipine after oral and intravenous administration: half-life shorter than expected?

Isradipine is a calcium channel-blocking agent of the dihydropyridine type, used in the treatment of hypertension. A terminal half-life of 8-9 hr has been reported, in several pharmacokinetic studies after oral administration of isradipine. In a yet unpublished study a much shorter half-life was observed, and the present trial was therefore conducted in order to estimate the half-life after intravenous administration of isradipine. The bioavailability was estimated as well. In a randomised cross-over design ten healthy young volunteers were given either isradipine orally or an intravenous infusion. The two study periods were separated by at least 3 days. Blood samples for measurement of isradipine concentration were collected for 10-12 hr after administration and half-life and bioavailability were estimated. Mean terminal half-life after intravenous administration was calculated to be 2.8 hr, and the bioavailability to be 0.28. None of the 10 subjects suffered from side effects. In the present intravenous study the half-life of isradipine seems to be of much shorter than demonstrated in previous oral studies.     

Four Weeks’Inhalation Exposure of Rats to p-Cymene Affects Regional and Synaptosomal Neurochemistry

Abstract: Long-lasting effects of inhalation exposure to p-cymene (p-isopropyl-toluene; CAS No. 99-87-6) on regional and subcellular brain neurochemistry were studied. Male Long-Evans rats were exposed to 0, 50, or 250 p.p.m. p-cymene 6 hr/day, 5 days/week for four weeks followed by an exposure-free period of 8 weeks. Synaptosomes were isolated from whole brain minus cerebellum and used as an ex situ model for in situ conditions at the level of the presynaptic nerve terminal. There was no persistent effect on wet weight (regional) or regional noradrenaline (NA), dopamine (DA), or 5-hydroxytryptamine (5-HT) concentrations owing to exposure. Yield of synaptosomal protein was statistically significantly reduced in an exposure concentration-related manner (Control: 16.6±3.1; 50 p.p.m.: 9.2±2.1; 250 p.p.m.: 8.6±1.7 mg protein/g tissue, mean± 1 S.D.). Synaptosomal NA and DA concentrations and acethycholinesterase, butyrylcholinesterase, and lactate dehydrogenase activities were statistically significantly increased when expressed relative to synaptosomal protein. It is hypothesized that a reduced density and number of synapses in situ are functionally compensated for by increased NA and DA release from noradrenergic and dopaminergic presynaptic nerve terminals. The applicability of the synaptosome as an ex situ neurochemical research model for the presynaptic CNS nerve terminal in situ for the study of solvent neurotoxicity in rats was further supported.     

Isokinetic muscle strength and hiking performance in elite sailors

The aim of the present study was to describe the isokinetic strength profile and its relation to hiking performance in male (Sm , n=15) and fmale (Sf , n=6) elite sailors compared to a group of male control subjects (Cm , n=8) similar in age, anthropometry and level of fitness. Eccentric knee extension strength was higher in Sm compared to Cm . (P<0.01). Furthermore, Sm were stronger during trunk extension (P < 0.05), but not during trunk flexion compared to CM. Overall muscle strength was lower in SF compared to SM (P < 0.01) and CM (P < 0.05), except for eccentric knee extension strength, where SF and CM did not differ (P > 0.05). Hiking performance correlated to maximal eccentric and isometric knee extensor strength in SF (r_s= 0.83–0.88, P < 0.05) and in CM (r_s= 0.73-0.77, P < 0.05) and to maximal eccentric knee extensor strength at high velocity in SM (r_s= 0.46-0.54, P < 0.05). For a subgroup of hikers in SM (n= 8), hiking peformance correlated to maximal isometric-eccentric knee extensor strength (r_s=0.67-0.74, P<0.05), whereas no correlations emerged for the non-hikers (n=7). Few correlations were observed between hiking performance and maximal concentric trunk flexor strength (r_s=0.69-0.92, P < 0.05). Unexpectedly, in SM correlations also were observed between hiking performance and maximal strength of the trunk extensors (r_s=0.46-0.53, hike subgroup: r_s=0.64-0.67, P < 0.05). In conclusion, notably high levels of maximal eccentric knee extesor strength were observed for the male and female elite sailors examined in the present study. Furthermore, the present results suggest that hiking performance depends in part on maximal isometric-eccentric knee extensor strength. The maximal strength of the trunk extensors, which potentially stabilizes the lower back and spine, also seems to have some importance for the hiking performance of top-level sailors.