Transformation of a human poliovirus receptor gene into mouse cells.

The first step in poliovirus replication is binding of virus to a cellular receptor. Mouse L cells, which are resistant to poliovirus infection because they do not bear a poliovirus receptor, were transformed with HeLa cell (human) DNA to poliovirus sensitivity at a frequency of approximately 1 in 50,000 transformants. Monoclonal antibody directed against the HeLa cell poliovirus receptor site was used in rosette assays to identify poliovirus-sensitive L-cell transformants in a background of L-cell tk+ transformants. A cloned cell line, CM-1, was isolated that displayed a surface component recognized by the anti-poliovirus receptor antibody. CM-1 cells were susceptible to infection with all three poliovirus serotypes, and infection could be blocked by the antireceptor antibody. Poliovirus formed plaques in CM-1 and HeLa cells with equal efficiency. CM-1 and HeLa cells produced infectious poliovirus at a similar rate, although yield of virus in CM-1 cells was about 33% less than the yield in HeLa cells. These results suggest that DNA encoding the HeLa cell poliovirus receptor has been introduced into mouse cells, resulting in the expression of the receptor and susceptibility to poliovirus infection.     

Antibiotic stewardship an einem Krankenhaus der Grund- und Regelversorgung

Background

In response to the global increase in antibiotic resistance, the concept of antibiotic stewardship (ABS) has become increasingly important in recent years. Several publications have demonstrated the effectiveness of ABS, mainly in university facilities. This retrospective observational study describes the implementation of ABS in a basic care hospital.

Material and methods

Following existing national guidelines, an ABS team was set up and measures were launched. These included: hospital guidelines, teaching, weekly antibiotic ward rounds and the restriction of definite substances. The preinterventional/postinterventional data analysis compared the use of antibiotics and blood culture sets as well as the development of resistance, infection with Clostridium difficile (CDI), costs, mortality and length of hospital stay.

Results

The measures introduced led to a significant and continuous decline in total antibiotic use of initially 43 recommended daily doses (RDD)/100 patient days (PD) to 31 RDD/100 PD (p < 0.001). The largest decrease was observed in second generation (2G) cephalosporins (?67.5%), followed by 3G cephalosporins (?52.7%), carbapenems (?42.0%) and quinolones (?38.5%). The resistance rate of E. coli to 3G cephalosporins in blood cultures decreased from 26% to 9% (p = 0.021). The rate of blood cultures taken increased from 1.8 sets/100 PD to 3.2 sets/100 PD (+77%, p < 0.001). The pathogen detection rate, defined as one count when a minimum of one sample taken in a day is positive, also increased significantly from 4.0/1000 PD to 6.8/1000 PD (p < 0.001). The ABS had no effect on the overall mortality, the mean dwell time, and the preintervention low CDI incidence.

Conclusion

The preinterventional/postinterventional comparison showed a significant reduction in the overall consumption of antibiotics with a redistribution in favor of antibiotics with a lower resistance selection. At the same time, the resistance rate of E. coli decreased. The increase of the blood culture rate indicates the optimization of diagnostic procedures. This ABS program had to be established with reduced resources but this seems to have been compensated by the more personal contact addressing the care takers and short chain of commands, as is possible in smaller hospitals. Presumably, the structure of basic care hospitals is particularly suitable for concepts covering entire hospitals. Further clusters of randomized studies are necessary to confirm this.

     

Treatment procedure in spinal metastases: the orthopedic dimension

Background. The authors have presented the results of the medical treatment of patients with metastatic disease of the spine. The aim of this treatment was to improve the patients quality of life through spinal stabilisation, maintaining neurological functions and the maximum pain relief.
Material and methods. Surgical indications included progressive, neurological deficit, fracture of vertebra, spine instability and histologic diagnosis. The patients underwent anterior, posterior or combined decompression and stabilisation procedures with the use of implants. Neurological examination of the patients has been carried out by means of Frankel grade whereas the tool for measurement of vertebra destruction was Harrington classification.
The results and the treatment for spinal metastatic tumors of the 86 patients were treated from 1997 to 2002.
There were 55 men and 33 women with a median age of 56 years. The mean survival time after surgery was 7,5 months.
Results. The improvement in neurological state of 28 in 59 patients was recorded. 11 patients have died of health conditions during the medical treatment as a consequences of the metastases.
Conclusions. The full decompression and stabilisation of the spine should be carried out in order to avoid the consequences and enable the patients to continue oncological treatment. The early diagnostic and good health conditions have been stressed. The can help in patient's qualification to surgical treatment, improve the general results of the treatment while giving the full satisfaction to the surgeon and the patient, prolonging the patient's life and improving his comfort of life by pain restriction and the protection of neurological consequences.     

Development of a novel resection and cutting guide for mandibular reconstruction using free fibula flap

Introduction

The authors developed a semi-standardised resection and cutting guide for mandibular reconstruction with free fibula flap based on data of mandible sizes and angles.

Distinct forms of Gq-receptor-dependent plasticity of excitatory transmission in the BNST are differentially affected by stress

Long-term depression (LTD) is an important synaptic mechanism for limiting excitatory influence over circuits subserving cognitive and emotional behavior. A major means of LTD induction is through the recruitment of signaling via G_q-linked receptors activated by norepinephrine (NE), acetylcholine, and glutamate. Receptors from these transmitter families have been proposed to converge on a common postsynaptic LTD maintenance mechanism, such that hetero- and homosynaptic induction produce similar alterations in glutamate synapse efficacy. We report that in the dorsolateral and ventrolateral bed nucleus of the stria terminalis (BNST), recruitment of G_q-linked receptors by glutamate or NE initiates mechanistically distinct forms of postsynaptically maintained LTD and these LTDs are differentially regulated by stress exposure. In particular, we show that although both mGluR5- and α₁-adrenergic receptor (AR)-dependent LTDs involve postsynaptic endocytosis, the α₁-AR-initiated LTD exclusively involves modulation of signaling through calcium-permeable AMPA receptors. Further, α₁-AR- but not mGluR5- dependent LTD is disrupted by restraint stress. α₁-AR LTD is also impaired in mice chronically exposed to ethanol. These data thus suggest that in the BNST, NE- and glutamate-activated G_q-linked signaling pathways differentially tune glutamate synapse efficacy in response to stress.