Intraarterial urokinase for acute native arterial occlusion of the limbs

Since 1988, 49 limbs of 47 patients underwent intraarterial urokinase infusion for acute native artery occlusion. The time from the onset of ischemic symptoms ranged from 1 to 45 days (mean = 17.5). The arterial sectors involved were femoropopliteal in 32 cases, followed by aortoiliac in 13 cases, distal in three cases, and subclavian in one case. Treatment consisted of placing a catheter in the clot and the infusion of 4400 U/kg in 20′, followed by a series of 4400 U/kg weight/hour during 6 hours. Clinical evaluation, hemodinamic and coagulation parameters, and angiographical changes were assessed periodically. Infusion time ranged from 6 to 24 hours (mean = 13.2 hours). Improvement of ischemia was achieved in 43 (87.75%) patients. In five patients (12.25%) there was no improvement. Total immediate lysis was achieved in 35 cases (71.5%), and among them, 13 patients (26%) required no associated treatment, 16 (48%) underwent PTA, and four (12%) had surgery of underlying peripheral aneurysms revealed after thrombolysis. Partial lysis was achieved in 13 cases (26.5%), that was enough in four of them, but the remaining nine required further treatment (four PTA, and five arterial surgery). In one case no lysis was achieved, and arterial surgery was carried out. No mortality was recorded, and major complications included one upper gastrointestinal bleeding, and one cerebral hematoma. Late follow-up of successfully treated patients who did not require further surgery shows a cumulative patency rate of 81% at 24 months. (Ann Vasc Surg 1997; 11:565-573.)     

Efficacy of a dish detergent in reducing populations of STI organisms in inoculated female condoms

We assessed the efficacy of dish detergent in removing Neisseria gonorrhoeae, HIV-1, herpes simplex virus type 2 and Chlamydia trachomatis organisms from the surface of inoculated female condoms. The reductions achieved in organism counts with dish detergent were compared with those for household bleach and water. New (out-of-package) and pre-washed/re-lubricated female condoms were used. Dish detergent was as efficacious as bleach in reducing organism counts from the surface of inoculated female condoms. Both bleach and dish detergent performed better than water, although >3 log(10) reductions were achieved with water alone. There was little difference in organism reduction between new and pre-washed condoms. Furthermore, 30 seconds of mechanical agitation (washing) had minimal added impact on organism removal. Reduction in organism counts with water alone suggests that dilution effect may have been as important in organism removal as the microbicidal properties of the detergent.     

Attachment of Neisseria gonorrhoeae to human sperm. Microscopical study of trypsin and iron.

Pilated Neisseria gonorrhoeae of colony type 1 (T1) and non-pilated bacteria of colony type 4 (T4) were observed by transmission (TEM) and scanning electron microscopy (SEM). No pili were observed on T4 gonogocci, but two types of pili--straight, type a, and bent, type b--were seen on T1 by TEM. When incubated with human sperum and examined by either TEM or SEM, T1 gonococci were seen to attach by individual pili, by several pili wound together as a rope, or by direct contact. Gonococci from T4 colonies attached only by direct contact. Treatment with typsin (1 mg/ml) damaged or removed pili from gonococci. After incubation with trypsin, attachment of pilated gonococci to sperm was decreased significantly, but such treatment did not affect attachment of non-pilated gonococci. Incubation of gonococci from either colony type in 0.1 mmol/l ferric nitrate, followed by incubation with sperm, significantly increased attachment of only T4 bacteria. No pili were seen on T4 gonococci treated with ferric nitrate; thus, it appears that factors other than pili alone are concerned in attachment of these gonococci to sperm.     

Important role of interleukin‐3 in the early phase of collagen‐induced arthritis

Objective

Activation of basophils contributes to memory immune responses and results in exacerbation of collagen‐induced arthritis (CIA). We undertook the present study to analyze the production and biologic effects of interleukin‐3 (IL‐3), a strong activator of basophils, in CIA.

Methods

Arthritis was induced by immunization with type II collagen. Mice were treated with blocking monoclonal antibodies against IL‐3 or with recombinant IL‐3. Clinical scoring, histologic analysis, fluorescence‐activated cell sorter analysis, enzyme‐linked immunosorbent assay, and cell culturing were performed to assess disease activity and IL‐3 production.

Results

IL‐3 was produced in large quantities by collagen‐specific CD4+ T cells in the spleen and was present in the synovial tissue during onset of arthritis, but was down‐regulated in paws with severe inflammation. Blockade of IL‐3 during the time of arthritis onset resulted in profound improvement of the disease, with reductions in synovial leukocyte and cytokine levels, peripheral blood basophil levels, and anticollagen antibody titers. Blockade of IL‐3 during the late phase of arthritis had no beneficial effect. Administration of recombinant IL‐3 during onset of arthritis induced a marked exacerbation of the disease, with increased peripheral blood basophil and plasma IL‐6 levels and increased titers of anticollagen antibody. In studies of the regulation of IL‐3 expression in CD4+ T cells, IL‐6 and IL‐4 suppressed the release of IL‐3 by activated CD4+ T cells, whereas lipopolysaccharide and CpG DNA up‐regulated IL‐3 secretion in activated CD4+ T cells by acting on costimulatory cells.

Conclusion

Taken together, the present results demonstrate for the first time that IL‐3 has an important role in the early phase of CIA.

     

Fitness levels of middle aged martial art practitioners

OBJECTIVES: To quantify and compare fitness levels of middle aged practitioners of soo bahk do (SBD; a Korean martial art similar to karate) with those of sedentary subjects. METHODS: Eighteen volunteers, 14 men and four women (aged 40-60 years), participated. Nine sedentary subjects (mean age 46.7 years) and nine SBD practitioners (mean age 46.8 years) were matched for sex and age. All subjects participated in a one day battery of fitness tests. The following dependent variables were tested: body composition, balance, flexibility, quadriceps strength, grip strength, muscle endurance, and aerobic capacity. RESULTS: All dependent variables were analysed using paired t tests. Body composition (% body fat) for the SBD group was 18.9% v 30.8% for the sedentary group (p = 0.004). The SBD group was able to balance for 61.8 seconds v 26.2 seconds for the sedentary group (p = 0.02). The result for the sit and reach flexibility test was 22.3 cm for the SBD group v 10.4 cm for the sedentary group (p = 0.01). The number of push ups performed in one minute was 47.0 for the SBD group v 18.6 for the sedentary group (p = 0.0003), and the number of sit ups performed was 66.1 for the SBD group and 37.3 for the sedentary group (p = 0.00006). Aerobic capacity was 41.0 ml/kg/min v 31.1 ml/kg/min for the sedentary group (p = 0.04). Quadriceps strength was 99.5% (peak torque/body weight) v 83.0% for the sedentary group (p = 0.02). Only grip strength was not significantly different. CONCLUSIONS: There were significant differences between the groups for most of the physical fitness tests. The SBD practitioners displayed greater aerobic capacity, balance, flexibility, muscle endurance, and strength, and less body fat than the sedentary controls matched for age and sex. SBD can be considered an excellent form of exercise for the promotion of fitness in adults. Health professionals should be aware that there are alternative methods to traditional exercise that can increase the physical fitness and health of the middle aged population.     

An appraisal of the psychometric properties of the Clinician version of the Apathy Evaluation Scale (AES-C)

This article examines the psychometric properties of the clinician version of the Apathy Evaluation Scale (AES-C) to determine its ability to characterize, quantify and differentiate apathy. Critical appraisals of the item-reduction processes, effectiveness of the administration, coding and scoring procedures, and the reliability and validity of the scale were carried out. For training, administration and rating of the AES-C, clearer guidelines, including a more standardized list of verbal and non-verbal apathetic cues, are needed. There is evidence of high internal consistency for the scale across studies. In addition, the original study reported good test-retest and inter-rater reliability coefficients. However, there is a lack of replication on these more stable and informative measures of reliability and as such they warrant further investigation. The research evidence confirms that the AES-C shows good discriminant, convergent and criterion validity. However, evidence of its predictive validity is limited. As this aspect of validity refers to the scale's ability to predict future outcomes, which is important for treatment and rehabilitation planning, further assessment of the predictive validity of the AES-C is needed. In conclusion, the AES-C is a reliable and valid measure for the characterization and quantification of apathy.