A rapid, 2-well,multiplex real-time polymerase chain reaction assay for the detection of SCCmec types I to V in methicillin-resistant Staphylococcus aureus

For us to assess the spread of methicillin-resistant Staphylococcus aureus (MRSA), typing of the staphylococcal cassette chromosome mec (SCCmec) is a valuable addition to existing typing methods, such as multilocus sequence typing (MLST). Traditional SCCmec typing assays, that is, that of Oliveira et al. and Ito et al., are polymerase chain reaction (PCR) based, requiring electrophoresis. We introduce a rapid, 2-well, multiplex real-time PCR assay that can be used directly on bacterial suspensions and is able to characterize SCCmec type I to V based on the detection of the ccr genes and the mec complex. The assay was evaluated on 212 clinical MRSA isolates from various countries, associated with MLST clonal complexes (CC) 1, 5, 8, 22, 30, and 45, as well as pig-associated CC398. When comparing the real-time PCR assay with traditional methods, the correct SCCmec element was identified in 209 (99%) of the 212 MRSA isolates. The new assay enables high-throughput analyses for SCCmec on large strain collections.     

Body impedance is largely dependent on the intra- and extra-cellular water distribution

Electrical impedance measurements were performed in fasting blood samples and analysed in relation to packed cell volume and calculated intra- and extra-cellular water distribution. The total blood impedance was shown to be strongly dependent on the ratio of intra-cellular water to total water (r = 0.97, P less than 0.0001). In a group of 515 subjects, with a large variation in age and body composition, the relation between the body impedence corrected for fat-free mass and body height (the specific body impedance) and the calculated ratio of intra-cellular water to total body water, was found to be similar to that in blood. From these observations a regression model was developed and applied to body compositional data of several groups of subjects before and after weight loss caused by water losses. It was possible to calculate at a group level the losses of intra- and extra-cellular water, which confirms the applicability of the model. It is concluded that the validity of the predicted fat-free mass or total body water from body impedance is largely dependent on the water distribution in the measured subjects. This means that age- and sex-specific prediction formulas have to be used for the assessment of the body composition and that the bio-electrical impedance method is only with caution applicable in subjects with a disturbed water distribution as in oedema, pregnancy and dehydration.     

Craniosynostosis: diagnostic value of three-dimensional CT reconstruction

Three-dimensional computed tomography (CT) has an important role in determining the presence and extent of congenital and acquired craniofacial deformities. The authors compared the sensitivity and specificity of three-dimensional CT in the detection and characterization of craniosynostosis with that of planar CT and skull radiography. Eighty-two patients with isolated and syndromal synostoses were imaged with CT and three-dimensional CT, and 42 with skull radiography. Three-dimensional CT scan processing was performed by shaded-surface reconstruction, volumetric, and depth-coded methods. Two trained observers read each scan series in a blinded fashion. Diagnostic utility of the images was determined with receiver operating characteristic analysis. The observers ranked three-dimensional shaded images higher than the other types, with three-dimensional volumetric images second and three-dimensional surface images ranked third. Results of this study demonstrate that three-dimensional shaded-surface reconstruction from CT scans is superior to conventional plain radiographs and CT scans in diagnosing craniosynostosis.     

FAILURE OF ADDITION OF LITHIUM TO IMIPRAMINE TO ENHANCE ACTIVITY IN RATS OR MOOD IN NORMAL VOLUNTEERS

Lithium powerfully augments the effects of imipramine in resistant depression. We treated four groups of rats for five weeks with (1) saline alone, (2) saline followed by lithium, (3) imipramine alone, and (4) imipramine followed by lithium. There was no augmentation of activity by lithium. Normal human volunteers took imipramine 75 mg daily for three weeks, followed by imipramine 75 mg daily together with lithium 900 mg daily for another ten days. There was no elevation of mood after the addition of lithium. Lithium augmentation of antidepressants apparently requires a pre-existing neurochemical-behavioral disturbance.     

Visceral fat accumulation measured by magnetic resonance imaging in relation to serum lipids in obese men and women.

In 91 apparently healthy obese subjects (45 premenopausal women and 46 men) the associations between specific fat depots and serum lipids were studied. Magnetic resonance imaging was used to quantify fat depots at abdominal and hip level. In women, an accumulation of visceral fat was associated with a less favourable lipid profile, even after adjustment for age and body fat percentage: higher triglycerides levels (P less than 0.001), lower levels of HDL-cholesterol (P less than 0.01) and a diminished HDL-cholesterol/LDL-cholesterol ratio (P less than 0.01). In men, however, the significant inverse relationship between an abundance of visceral fat and the HDL-cholesterol/LDL-cholesterol ratio and the significant positive correlations with total-, LDL-cholesterol and triglycerides disappeared after adjustment for age and fat percentage. Within each sex, subcutaneous fat neither at abdominal level nor at hip level was significantly related to serum lipids. It is concluded that there are gender differences in the associations between visceral fat accumulation and serum lipids.     

Inactivation of mouse alpha-globin gene by homologous recombination: mouse model of hemoglobin H disease

We have disrupted the 5' locus of the duplicated adult alpha-globin genes by gene targeting in the mouse embryonic stem cells and created mice with alpha-thalassemia syndromes. The heterozygous knockout mice (.alpha/alpha alpha) are asymptomatic like the silent carriers in humans whereas the homozygous knockout mice (.alpha/.alpha) show hemolytic anemia. Mice with three dysfunctional alpha-globin genes generated by breeding the 5' alpha-globin knockouts (.alpha/alpha alpha) and the deletion type alpha-thalassemia mice (../alpha alpha) produce severe hemoglobin H disease and they die in utero. These results indicate that the 5' alpha-globin gene is the predominant locus in mice, and suggest that it is even more dominant than its human homologue.     

MR imaging of the knee. Part II. Chronic disorders

Sixty patients with symptoms of chronic disease of the knee joint were evaluated with high-resolution, thin-section magnetic resonance (MR) imaging. MR imaging depicted a wide variety of knee joint abnormalities including osteochondritis dissecans, medullary infarcts, epiphyseal osteonecrosis, intraarticular osteochondral fragments, synovial cysts, joint effusions, intraarticular soft-tissue tumors, synovial disease, leukemic infiltration of bone marrow, Osgood-Schlatter disease, and nonossifying fibroma. In two cases MR imaging depicted bone infarcts not seen on both radionuclide bone scans and standard radiographs. The highly detailed depiction of the articular cartilage was of particular importance in predicting arthroscopic findings in cases of osteochondritis dissecans. In two cases, a soft-tissue mass (pigmented villonodular synovitis) and a large osteochondral fragment undetected at arthroscopy were accurately localized with MR imaging. The results indicate that MR imaging is capable of providing information that might otherwise require multiple, sometimes invasive diagnostic procedures.