Preliminary studies of nematocysts from the jellyfish Stomolophus meleagris

Nematocysts from the jellyfish Stomolophus meleagris were found to be of the type—heterotrichous microbasic euryteles. The nematocysts were not ruptured by various physical or chemical means, but were disrupted by homogenization in a Braun homogenizing mill. The toxin(s) which contained 11·2 per cent protein and 7·25 per cent nitrogen, had an LD₅₀ in mice of 0·85 μg N₂/g mouse when injected intravenously. The toxin(s) were heat labile and rapidly destroyed when incubated with trypsin, indicating that they were protein.     

Bone tissue content of TGF-β2 changes with time in human heterotopic ossification after total hip arthroplasty

Transforming growth factor beta isoforms (TGF-β₁, TGF-β₂, and TGF-β₃) most likely play a role in bone physiology, but little is known about their relative importance in normal as well as in heterotopic bone. This study focused on possible differences in the localization and relative content of different TGF beta isoforms in heterotopic ossifications (HO) by comparing HOs, which have developed less than 17 months (immature HOs) with those developed 3–9 years (mature HOs). The HOs were harvested after total hip arthroplasty (THA) during revision surgery. The HO samples were decalcified, embedded in paraffin and sectioned. Azan staining was used to evaluate histological structure of the ossifications and immunohistochemical analysis was performed to estimate the localization of three TGF beta isoforms in the HOs. Comparison of different TGF beta isoforms in the immature and the mature ossifications showed that the content of TGF-β₂ was decreased by almost three times in the mature HO as compared to the immature HO (p = 0.0064). The proportions of other isoforms in HOs did not differ significantly. This study shows that the relative importance of TGF betas change with HO development.     

Inter-observer reliability in the assessment of heterotopic ossification: proposal of a combined classification

We applied four published classifications for assessment of heterotopic ossification after total hip arthroplasty (Arcq, Brooker, DeLee and Della Valle [1, 2, 5, 6]. The average incidence of heterotopic ossification varied from 19.8% to 27.7%. The inter-observer reliability of the various classifications was determined by Cohens Kappa statistic. Kappa values ranged from 0.897 for Arcqs to 0.814 for Brookers classification. In order to increase the reliability and consistency, we propose a new classification system combining Brookers and Della Valles classifications. This new classification preserves the high reliability of Della Valles system and is comparable to previous publications since it includes Brookers criteria.

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Résumé Nous avons utilisé quatre classifications publiées pour lestimation des ossifications hétérotopiques après arthroplastie total de la hanche (Arcq, Brooker, DeLee and Della Valle [1, 2, 5, 6]. La fréquence moyenne de ces ossifications variait de 19,8 à 27,7%. La précision inter-observateurs des classifications a été déterminée par le kappa statistique de Cohen. Les valeurs Kappa ont varié de 0.897 pour Arcq à 0.814 pours la classification de Brooker. Pour augmenter la précision et la cohérence, nous proposons un nouveau système qui combine les classifications de Brooker et de Della Valles. Cette nouvelle classification conserve la haute précision du système de Della Valle et est comparable aux publications antérieures puisque elle inclut les critères de Brooker.

     

Evaluation of the Vitek 2 System for Susceptibility Testing of Streptococcus pneumoniae Isolates

 Vitek 2 (bioMérieux, France) is a new commercial system that allows rapid identification and rapid determination of the minimum inhibitory concentration (MIC) of Streptococcus pneumoniae by monitoring the growth kinetics of the organisms in microwells. The accuracy of the Vitek 2 system in susceptibility testing was evaluated by determining the MICs of 50 penicillin-susceptible and 150 intermediate or penicillin-resistant Streptococcus pneumoniae isolates and comparing the results with those obtained using the agar dilution method. The essential agreement between the Vitek 2 system and the reference method was 91% for penicillin, 93% for cefotaxime and ceftriaxone, and more than 94% for amoxicillin, erythromycin, ofloxacin, co-trimoxazole, tetracycline, and imipenem. One very major error (1.1%) and one major error (0.9%) were obtained for tetracycline. The minor error rate for penicillin of 19.3% was mainly due to intermediate category isolates (n=29) being identified as resistant and susceptible isolates (n=6) being identified as intermediate by the commercial system. The minor error rates for amoxicillin, cefotaxime, ceftriaxone, imipenem, and ofloxacin were 25.4%, 25.4%, 29.4%, 19.2%, and 31.5%, respectively. Vancomycin, tetracycline, co-trimoxazole, and erythromycin showed minor error rates of 0–6.1%. In conclusion, Vitek 2 shows good agreement with the reference method, as demonstrated by the low numbers of major errors, but it has a tendency to overestimate MICs, resulting in minor errors.     

3-year results of 'gallstone outpatient clinic' in an academic hospital]

On April 1st 1988 an outpatient clinic solely for patients with gallstones was started. 594 patients visited the gallstone outpatient clinic during the first three years of its existence and the data of all these patients were collected and examined retrospectively. Mean age was 49.0 years (SD: 15; range: 20-88), male-female ratio was 0.34 and the majority of patients were symptomatic (86.9%). 60.3% were referred by their general practitioners, 21.7% by another specialist en 18.0% sought help on their own initiative. In 8.1% of the cases there were acute biliary problems and 2.4% had an increased surgical mortality risk. Cholecystectomy was advised in the majority of patients (51.9%), expectant management in 20.2%, analysis was stopped in 2.5% and the others (25.4%) were advised a treatment alternative to cholecystectomy. Medical, but most of all public interest in the different therapeutic modalities for symptomatic cholelithiasis has a trend-sensitive character which is reflected in patterns of referral, diagnostic procedures and therapeutic advice given.     

Euro-Collins solution versus UW-solution for long-term liver preservation in the isolated rat-liver perfusion model.

To compare UW-solution (UW) and Euro-Collins (EC) for long-term liver preservation we investigated the morphology and metabolic capacity of rat liver after 18 and 42-hours cold-storage in either UW or EC. After harvesting the rat liver was transferred to a perfusion chamber where it was perfused for 10 min with UW or EC at 4 degrees C. Thereafter livers were stored at 4 degrees C in UW or EC for 18 hours (both groups n = 6) or for 42 hours (both groups n = 8). After 18-hr or 42-hr cold-storage a 2-hr warm perfusion (37 degrees C) was started with Krebs-Ringer solution with carbogen to which 125Iodine-triiodothyronine (T3) was added. Control livers (n = 8) were immediately perfused with Krebs-Ringer without cold-storage. The following parameters were assessed: ASAT-levels in the perfusate, T3-metabolites in the bile and the perfusate, the perfusion pressure, the volume of bile secreted and light-microscopical morphology at the end of the warm perfusion period. After cold storage in UW-solution the ASAT-levels in the perfusate were lower than after storage in EC as well as the perfusion pressures. These livers demonstrated a better T3-metabolism and secreted more bile than EC-stored livers. Histological examination showed more tissue damage in the EC-stored livers than in the UW stored livers. We conclude that cold-storage of rat liver in UW-solution resulted in a better morphology and metabolic capacity as compared with EC-solution.     

Cardiac effects of Stomolophus meleagris (cabbage head jellyfish) toxin.

Electrocardiograms recorded from rabbits and rats injected intravenously with toxin from Stomolophus meleagris showed bradycardia followed by inversion of the P and T waves, alterations of the QRS complex, ventricular extrasystoles, atrioventricular block, bizarre ventricular patterns, and fibrillation. Analysis of plasma samples taken after the onset of electrocardiographic abnormalities were characterized by hemolysis, hyponatremia and hyperkalemia when compared to plasma taken before injection of toxin. Sublethal doses of toxin produced an increase in lactate dehydrogenase (LDH) levels in serum, but did not increase creatine phosphokinase levels. Electrophoretic analysis of the serum LDH isoenzymes following injection of toxin did not indicate severe cardiac tissue damage. This toxin appears to disrupt cardiac rhythmicity and myocardial conduction pathways in a manner consistent with other coelenterate toxins. The observed hyperkalemia appears to result from hemolysis and generalized tissue destruction, although the serum enzyme and isoenzyme assays did not suggest severe myocardial infarction.