Methods for identification of flavobacteria.

Published reports disagree on the best features for detecting and distinguishing between Flavobacterium meningosepticum (biovar IIa) and Flavobacterium species CDC group IIb (biovar IIb; Flavobacterium indologenes). This report discloses that at least some of these disagreements may reflect the methods used. To detect production of indole, a modified Kovács reagent (not Ehrlich) and a buffered tryptophan medium were optimal, but not all strains of these two biovars produced indole. To distinguish the two biovars, hydrolysis of corn starch was preferable to that of soluble potato starch. Both biovars may hydrolyze DNA; the differentiation achieved varied with the methods used. Both biovars presented pigmented growth; only IIb, however, was obviously pigmented on a 2-day blood agar plate. Acidification of D-arabinose definitively distinguished these two biovars; several additional features were useful but not definitive.     

Pediatric farm injuries involving non-working children injured by a farm work hazard: five priorities for primary prevention

OBJECTIVES: To describe pediatric farm injuries experienced by children who were not engaged in farm work, but were injured by a farm work hazard and to identify priorities for primary prevention. DESIGN: Secondary analysis of data from a novel evaluation of an injury control resource using a retrospective case series. DATA SOURCES: Fatal, hospitalized, and restricted activity farm injuries from Canada and the United States. SUBJECTS: Three hundred and seventy known non-work childhood injuries from a larger case series of 934 injury events covering the full spectrum of pediatric farm injuries. METHODS: Recurrent injury patterns were described by child demographics, external cause of injury, and associated child activities. Factors contributing to pediatric farm injury were described. New priorities for primary prevention were identified. RESULTS: The children involved were mainly resident members of farm families and 233/370 (63.0%) of the children were under the age of 7 years. Leading mechanisms of injury varied by data source but included: bystander and passenger runovers (fatalities); drowning (fatalities); machinery entanglements (hospitalizations); falls from heights (hospitalizations); and animal trauma (hospitalizations, restricted activity injuries). Common activities leading to injury included playing in the worksite (all data sources); being a bystander to or extra rider on farm machinery (all data sources); recreational horseback riding (restricted activity injuries). Five priorities for prevention programs are proposed. CONCLUSIONS: Substantial proportions of pediatric farm injuries are experienced by children who are not engaged in farm work. These injuries occur because farm children are often exposed to an occupational worksite with known hazards. Study findings could lead to more refined and focused pediatric farm injury prevention initiatives.     

Molecular characterization of homozygous variegate porphyria

Variegate porphyria (VP) is a low penetrance, autosomal dominant disorder that results from partial deficiency of protoporphyrinogen oxidase (PPOX) activity caused by mutation in the PPOX gene. The rare homozygous variant of VP is characterized by severe PPOX deficiency, onset of photosensitization by porphyrins in early childhood, skeletal abnormalities of the hand and, less constantly, short stature, mental retardation and convulsions. We have identified PPOX mutations on both alleles of five of the 11 unrelated patients with homozygous VP reported to date. Two patients were homoallelic for missense mutations (D349A and A433P), while three were heteroallelic. Functional analysis by prokaryotic expression showed that the D349A and A433P and one missense mutation in each of the three heteroallelic patients (G358R in two patients and A219KANA) preserved some PPOX activity (9.5-25% of wild-type). Mutations on the other allele of the heteroallelic patients abolished or markedly decreased activity. There was no relation between genotype assessed by functional analysis and the presence or severity of non-cutaneous manifestations. The mutations were absent from 104 unrelated patients with autosomal dominant VP. Our findings define the molecular pathology of homozygous VP and suggest that mild PPOX mutations occur in the general population but have very low or no clinical penetrance in heterozygotes.      

Sleep deprivation and the control of ventilation

Sleep deprivation is common in acutely ill patients because of their underlying disease and can be compounded by aggressive medical care. While sleep deprivation has been shown to produce a number of psychological and physiologic events, the effects on respiration have been minimally evaluated. We therefore studied resting ventilation and ventilatory responses to hypoxia and hypercapnia before and after 24 h of sleeplessness in 13 healthy men. Hypoxic ventilatory responses (HVR) were measured during progressive isocapnic hypoxia, and hypercapnic ventilatory responses (HCVR) were measured using a rebreathing technique. Measures of resting ventilation, i.e., minute ventilation, tidal volume, arterial oxygen saturation, and end-tidal gas concentrations, did not change with short-term sleep deprivation. Both HVR and HCVR, however, decreased significantly after a single night without sleep. The mean hypoxic response decreased 29% from a slope of 1.20 +/- 0.22 (SEM) to 0.85 +/- 0.15 L/min/% saturation (p less than 0.02), and the slope of the HCVR decreased 24% from 2.07 +/- 0.17 to 1.57 +/- 0.15 L/min/mmHg PCO2 (p less than 0.01). These data indicate that ventilatory chemosensitivity may be substantially attenuated by even short-term sleep deprivation. This absence of sleep could therefore contribute to hypoventilation in acutely ill patients.     

Blood use during extracorporeal membrane oxygenation

An analysis of the transfusion records of 91 neonatal patients subjected to extracorporeal membrane oxygenation (ECMO) is reported. Mean daily blood usage was 250 mL of red cells (RBCs), 80 mL of fresh-frozen plasma, and 2 units of platelets. Average time on ECMO was 4.6 days. Group O or ABO type-specific RBCs and group AB or ABO type-specific plasma products and platelets were transfused. RBCs were not washed, and neither RBCs nor other components were tested for anticytomegalovirus (CMV) or irradiated. No cases of posttransfusion CMV infection or graft-versus-host disease were observed. Hemolysis in eight patients was traced to occlusions in the ECMO circuit. All but three patients survived ECMO. Contrary to a previous report, an active ECMO program for neonatal patients imposes a minimal burden on the hospital transfusion service.     

Blood component therapy during the neonatal period: a national survey of red cell transfusion practice, 1985

A questionnaire to determine patterns of neonatal red cell transfusion practice during 1985 was mailed to 2200 blood banks of American Association of Blood Banks (AABB) institutional members and children's hospitals. There were 915 responses (41.6%); 785 responses (86%) contained sufficient data for analysis. The majority (70.6%) of 785 responding hospitals were community/urban institutions. However, more highly specialized, pediatric hospitals were also represented by 92 university/tertiary-care hospitals (11.7% of respondents) and 29 children's hospitals (3.7% of respondents). Two-thirds of hospitals performed a major antiglobulin crossmatch (rather than an abbreviated one) before all neonatal red cell transfusions. The red cell preparation most frequently selected for small-volume transfusions was ABO and Rh group-specific red cell concentrates. When performing only large-volume exchange transfusions, 19.2 percent of hospitals used whole blood; all others prepared reconstituted units of red cells plus fresh-frozen plasma, a practice that frequently causes exposure to two donors per unit. Another practice likely leading to multiple donor exposure is the use of fresh-frozen plasma to adjust the hematocrit of red cell preparations to a predetermined value prior to a small-volume transfusion. Over one-half of hospitals adjusting hematocrits used plasma, presumably from one donor, to dilute packed red cells from another donor, a practice that has no apparent medical benefit. Most hospitals (63.4%) provided red cells with a reduced risk of transmitting cytomegalovirus; blood from seronegative donors was selected by 65 percent of hospitals. The majority of hospitals, including most of the community/urban hospitals, did not irradiate blood products before transfusion.(ABSTRACT TRUNCATED AT 250 WORDS)     

碱性成纤维细胞生长因子对人晶状体上皮细胞增殖及移行作用的影响

目的 探讨碱性成纤维细胞生长因子（bFGF）对体外培养的人晶状体上皮细胞（HLEC）增殖及移行作用的影响.方法 在无血清培养液培养的HLEC中分别加入不同终浓度的bFCF（0.01、0.1、1、10及100 μg/L）,MTT法测定其促细胞增殖的情况;流式细胞仪分析细胞周期;HLEC损伤愈合模型,观察不同终浓度bFGF处理24 h后HLEC的移行情况.结果 bFGF浓度为0.1、1、10、100 μg/L时,其对HLEC细胞有明显的促增殖作用,与阴性对照组比较差异具有统计学意义（P〈0.01）,100 μg/L作用24 h增殖率最大,达112.78%,作用强度呈浓度时间依赖性.bFGF通过促进细胞周期变化,与阴性对照组比较差异具有统计学意义（P〈0.01）,G0/G1期细胞减少,S期和G2/M期细胞增多,通过促进HLEC由G0向G1的转化来促进细胞的增殖;bFGF浓度1、10、100 μg/L作用24 h.可明显促进HLEC的移行,其移行能力分别为27.21%、154.42%、和238.77%,与阴性对照组相比,差异有显著统计学意义（P〈0.01）.结论 bFGF可促进HLEC的增殖和移行,是HLEC强有力的有丝分裂原和促移行因子.     

The road to tuberculosis treatment in rural Nepal: A qualitative assessment of 26 journeys

Background  

The fact that tuberculosis can be treated with the DOTS strategy (Directly Observed Treatment, Short-course) is not enough to control the disease. Patients have to find their way to tuberculosis treatment first. To better understand the route to tuberculosis treatment in rural Nepal we interviewed twenty-six patients under treatment.     

灯盏花中新的酚酸类化合物的结构及活性研究

目的研究中药灯盏花［Erigeron breviscapus (Vant.)Hand-Mazz］的心血管活性成分。方法用各种色谱技术进行分离,用IR,UV,MS,¹HNMR,¹³CNMR,2DNMR光谱鉴定他们的结构。以乳酸脱氢酶(LDH)释放量为指标测定BCMEC(bovinecerebralmicrovascularendothelialcell)损伤,比色法测定药物体外抗氧化和抗活性氧能力。结果从灯盏花中分离得到2个化合物,分别鉴定化合物的结构为：1-O-甲基-3,5-O-双咖啡酰基奎宁酸甲酯(III)和5-O-咖啡酰基奎宁酸丁酯(IV)。结论化合物III,IV为新的酚酸类化合物,化合物III对LPC引起的BCMEC损伤有明显的保护作用。     

不孕妇女子宫内膜中肾上腺髓质素及其受体表达

目的:研究不孕妇女子宫内膜中肾上腺髓质素(ADM)及其相关受体CRLR表达的变化,探讨其与不明原因不孕的关系。方法:通过免疫组化、半定量RT-PCR及实时荧光定量RT-PCR等方法,研究原因不明不孕妇女(n=22名)与正常对照组妇女(n=20名)在种植窗口期(LH+6~LH+8)子宫内膜中ADM、CRLR蛋白表达和基因表达量的变化。结果:在正常对照组,ADM蛋白表达出现在内膜的各个细胞中,而不孕症组中间质细胞表达低于正常对照组(P<0.05);CRLR蛋白在内膜各细胞中的表达两组无差异(P>0.05);不孕妇女内膜中血管密度值为4.00±0.84,明显低于正常妇女的7.84±1.33(P<0.05);ADM mRNA不孕症组高于正常对照组3.99倍,CRLR mRNA两组无明显差异。结论:ADM及其受体CRLR通过影响内膜血管的生成而在内膜的生成、修复中发挥重要作用;在不明原因不孕组中,高表达的ADM mRNA尽管有助于种植窗口期孕卵的着床,但其对内膜血管的低调控作用导致内膜中血管密度降低可能是造成患者不孕的原因之一。