Chryseobacterium (Flavobacterium) meningosepticum outbreak associated with colonization of water taps in a neonatal intensive care unit

From September 1994 to May 1996, a strain of multi-resistant Chryseobacterium (Flavobacterium) meningosepticum was isolated from eight neonates on a neonatal intensive care unit. The strain was resistant to ampicillin, ceftazidime, imipenem, gentamicin, ciprofloxacin and trimethoprim-sulphamethoxazole, susceptible to piperacillin and amikacin, and had variable susceptibility to rifampicin and vancomycin. Two neonates were infected (one had pneumonia and one septicaemia and meningitis); the remaining six neonates were colonized in the respiratory secretions. Two cases occurred that could not be explained by cross-infection during the outbreak. Environmental screening recovered C. meningosepticum from sink taps. Pulsed-field gel electrophoresis of chromosomal macrorestriction digests of patient and environmental isolates showed them to be representatives of a single strain. The outbreak was controlled after staff were required to use an alcoholic handrub after washing hands, and toiletting of babies was done with sterile water instead of tap-water. Repair and chlorination of the water-tanks and changing the sink-taps resolves the outbreak.     

The double puncture: an effective percutaneous technique for removing complex, multiple renal calculi

Percutaneous nephrostolithotomy, which can require a double puncture, is presently the method of choice in our institution for the removal of renal stones. Patients that underwent this procedure were evaluated to identify the possible reasons for the double puncture. Of 200 patients evaluated, 14 needed a second tract. The three variables that determined whether a second puncture was needed, in order of importance, were number and size of the stones, with second tracts needed in patients with multiple stones and staghorn calculi; anatomical variations of the renal collecting system itself, with bifid systems the most significant anatomic variation; and the dexterity of the radiologist in performing the puncture and the ability of the urologist to extract the stone. Second tracts were needed more frequently in patients who presented with stones in both the lower and middle poles of the collecting systems.     

Lack of impact of a water and sanitation intervention on the nutritional status of children in rural Bangladesh

The nutritional impact of a water and sanitation intervention in a rural community of Bangladesh, comprising the provision of handpumps, construction of latrines and hygiene education was assessed. During 3 years, the quarterly anthropometric measures of about 200 children aged 12-35 months from the intervention community were compared with those of a similar number of children from a control area. The interventions reduced the incidence of diarrhoea by 25 per cent among the children less than 5 years of age. There was no significant difference in nutritional status, however, between the two groups of children. Moreover, within the intervention area, indicators of water and latrine use were not significantly related to the children's nutritional status. This suggests that either the obtained reduction of diarrhoea was not large enough to have an impact on nutritional status or that diarrhoea is not an important cause of malnutrition in this community.     

Cochlear gene delivery through an intact round window membrane in mouse

Cochlear gene transfer studies in animal models have utilized mainly two delivery methods: direct injection through the round window membrane (RWM) or intracochlear infusion through a cochleostomy. However, the surgical trauma, inflammation, and hearing loss associated with these methods lead us to investigate a less invasive delivery method. Herein, we studied the feasibility of a vector transgene-soaked gelatin sponge, Gelfoam, for transgene delivery into the mouse cochlea through an intact RWM. The Gelfoam absorbed with liposomes and adenovirus, but not with adeno-associated virus (AAV), was successful in mediating transgene expression across an intact RWM in a variety of cochlear tissues. The Gelfoam technique proved to be an easy, atraumatic, and effective, but vector-dependent, method of delivering transgenes through an intact RWM. Compared with the more invasive gene delivery methods, this technique represents a safer and a more clinically viable route of cochlear gene delivery in humans.     

言语流畅的测量及其神经生理基础

目的:介绍言语流畅性的测量工具,考察言语流畅性与记忆之间的关系,探讨言语流畅性的神经生理基础。资料来源:应用计算机检索Sciencedirect 1975-07/2005-05中与言语流畅性相关的文献,检索词为“verbal fluency”,限定文章语言种类为英文。资料选择:对资料进行初审,选取文章标题中含有“verbal fluency”的英文文献。纳入标准:①对言语流畅性测量任务的研究。②对言语流畅性与记忆的研究。③对言语流畅性神经生理基础的研究。资料提炼:共收集到651篇关于言语流畅性的文章,纳入30篇用于本综述。资料综合:测量言语流畅性的任务主要分为简单任务(包括音位流畅性任务和语义流畅性任务)与复杂任务(包括可能工作、替代使用、草拟、推断、物品制作以及新的使用方法等)。言语流畅性任务的完成主要涉及到记忆搜索的过程,另外,精细组织的语义网络系统对于言语流畅性任务来说也是非常重要的。言语流畅性的神经生理基础包括了总体基础,前额叶,海马以及大脑两半球的不对称性。结论:言语流畅性作为人类语言基本技能的一项指标,对语言认知研究具有极其重要的意义。它不仅是神经心理研究的一项非常重要的检测和诊断指标,也是一种研究人类心理的非常有用的研究工具,是探索人类语言与认知、创造之迷进而探索人类意识之迷的钥匙。     

Polarized secretion of transgene products from salivary glands in vivo

Previously (Kagami et al. Hum. Gene Ther. 1996;7:2177-2184) we have shown that salivary glands are able to secrete a transgene-encoded protein into serum as well as saliva. This result and other published data suggest that salivary glands may be a useful target site for vectors encoding therapeutic proteins for systemic delivery. The aim of the present study was to assess in vivo if transgene-encoded secretory proteins follow distinct, polarized sorting pathways as has been shown to occur "classically" in cell biological studies in vitro. Four first-generation, E1-, type 5 recombinant adenoviruses were used to deliver different transgenes to a rat submandibular cell line in vitro or to rat submandibular glands in vivo. Subsequently, the secretory distribution of the encoded proteins was determined. Luciferase, which has no signal peptide, served as a cell-associated, negative control and was used to correct for any nonspecific secretory protein release from cells. The three remaining transgene products tested, human tissue kallikrein (hK1), human growth hormone (hGH), and human alpha1-antitrypsin (halpha1AT), were predominantly secreted (>96%) in vitro. Most importantly, in vivo, after a parasympathomimetic secretory stimulus, both hK1 and hGH were secreted primarily in an exocrine manner into saliva. Conversely, halpha1AT was predominantly secreted into the bloodstream, i.e., in an endocrine manner. The aggregate results are consistent with the recognition of signals encoded within the transgenes that result in specific patterns of polarized protein secretion from rat submandibular gland cells in vivo.     

Two-dimensional and Doppler transesophageal echocardiographic delineation and flow characterization of anomalous coronary arteries in adults.

OBJECTIVES: The purpose of this study was to examine the use of transesophageal echocardiography (TEE) in the identification and flow characterization of congenital coronary anomalies. BACKGROUND: Congenital coronary anomalies in adults are rare but may cause serious cardiac complications. The use of TEE in evaluation of this entity has not been well defined. Very little is known regarding flow patterns in anomalous coronaries assessed by Doppler TEE. METHODS: A total of 32 consecutive adult patients were studied using TEE to define the origin, course, and proximal flow pattern of suspected coronary anomalies. RESULTS: Coronary anomalies identified using TEE included anomalous origin from the pulmonary trunk (n = 2), right sinus (n = 18), left sinus (n = 9), single coronary (n = 2), and left main coronary fistula (n = 1). Multiplane TEE performed in 20 cases simplified the delineation of more complex coronary anomalies. The origin was identified in all patients, proximal course delineated in 31, and proximal flow pattern characterized by pulsed Doppler in 23 of 32 patients. In 16 anomalous left main, left anterior descending, or left circumflex coronary arteries, an abnormal systolic flow pattern (ie, systolic/diastolic time-velocity integral ratio >1) occurred exclusively (P <.001) when the anomalous artery had an intermediate (100%; 5/5) versus anterior or posterior course (0%; 0/11) relative to the aortic and pulmonary artery trunks. A systolic flow pattern was also evident in 4 (80%) of 5 patients with an anomalous right coronary artery with an intermediate course. CONCLUSIONS: TEE, particularly with a multiplane probe, has an important complementary role to coronary angiography in delineating the proximal course and pattern of flow in anomalous coronaries. Predominant systolic flow pattern in anatomically left proximal anomalous coronaries signifies an intermediate course between the aorta and the pulmonary trunk and may be clinically useful for risk stratification.