Impact of enteral nutrition on nitrogen balance in patients of trauma.

BACKGROUND: A prospective study of 50 patients of trauma was carried out at a tertiary level trauma center in Mumbai. The aim was to study the hypermetabolic response to trauma and the effect of early enteral feeding and nutritional supplementation in blunting this response in these patients. METHODS: Early enteral feeding was started within 72 h in most patients. The caloric requirement was calculated as per the body weight and a 150: 1 ratio of nonprotein calories to protein was maintained. A 24-h urinary nitrogen loss was estimated and nitrogen balance was calculated on days 1, 3 and 7. RESULTS: The correlation between the injury severity and the severity of catabolism was also analysed. Urinary nitrogen loss and nitrogen balance were used as parameters to evaluate the hypermetabolic response. CONCLUSIONS: Early (within 72 h) enteral nutritional support blunts this hypermetabolic response to some extent in these trauma patients.

Chemoimmunotherapy with dacarbazine, cisplatin, interferon-alpha2b and interleukin-2 versus two cycles of dacarbazine followed by chemoimmunotherapy in patients with metastatic melanoma: a randomised phase II study of the European Organization for Research and Treatment of Cancer Melanoma Group.

BACKGROUND: Chemoimmunotherapy for patients with metastatic melanoma is associated with high toxicity, and only a subset of patients will benefit. This randomised phase II study was performed with the primary objective of exploring whether two cycles of dacarbazine monotherapy could select the subset of patients that would benefit most from more intensive chemoimmunotherapy. PATIENTS AND METHODS: Patients with metastatic melanoma were randomised to either receive chemoimmunotherapy with dacarbazine, cisplatin, interferon-alpha and interleukin-2 (arm A) or initial treatment with two cycles of dacarbazine monotherapy followed irrespective of response by the same 4-drug regimen of chemoimmunotherapy (arm B). Chemoimmunotherapy was continued in the absence of disease progression for a maximum of four cycles. Primary end-point was the disease stabilisation rate. RESULTS: A total of 93 patients were randomised, and 89 patients were eligible. Disease stabilisation (complete/partial response or stable disease) was achieved in 19 patients (42.2%) in arm A and 9 patients (20.5%) in arm B. In arm B 32 of the 44 patients continued chemoimmunotherapy after two cycles of dacarbazine. Of 20 patients with progressive disease (PD) after two cycles of dacarbazine in arm B, only 2 patients achieved an objective response. Median overall survival (OS) in arms A and B was 10.5 months and 9.5 months, respectively. CONCLUSIONS: Despite a lower initial stabilisation rate, the strategy of starting with 2 courses of DTIC prior to a 4-drug regimen led to comparable median overall survival. Only few transient responses were achieved with the 4-drug regimen in patients with disease progression on DTIC, suggesting frequent cross resistance. Two cycles of dacarbazine monotherapy cannot be recommended to select patients for more intensive chemoimmunotherapy.

Enhanced capacities and selectivities for cholesterol in aqueous media by molecular imprinting: role of novel cross-linkers.

Molecularly imprinted polymers are being increasingly investigated as selective sorbents. For the recovery of cholesterol from aqueous media, the utility of the molecularly imprinted polymers has been limited by modest capacities and selectivities, especially when compared with alternative adsorbents reported for the binding of bile acids [Macromolecules 34 (2001) 1548]. This paper describes the use of cholesterol conjugated monomers and cross-linkers, which bind to the template cholesterol molecule by hydrophobic interactions. This leads to enhanced capacities and selectivities during the recovery of cholesterol from aqueous media. The templating effect is clearly seen in the enhanced capacity and selectivity in the retention of cholesterol vis-a-vis stigmasterol and testosterone.

Recombination within a nucleotide-binding-site/leucine-rich-repeat gene cluster produces new variants conditioning resistance to soybean mosaic virus in soybeans.

The soybean Rsv1 gene for resistance to soybean mosaic virus (SMV; Potyvirus) has previously been described as a single-locus multi-allelic gene mapping to molecular linkage group (MLG) F. Various Rsv1 alleles condition different responses to the seven (G1-G7) described strains of SMV, including extreme resistance, localized and systemic necrosis, and mosaic symptoms. We describe the cloning of a cluster of NBS-LRR resistance gene candidates from MLG F of the virus-resistant soybean line PI96983 and demonstrate that multiple genes within this cluster interact to condition unique responses to SMV strains. In addition to cloning 3gG2, a strong candidate for the major Rsv1 resistance gene from PI96983, we describe various unique resistant and necrotic reactions coincident with the presence or absence of other members of this gene cluster. Responses of recombinant lines from a high-resolution mapping population of PI96983 (resistant) x Lee 68 (susceptible) demonstrate that more than one gene in this region of the PI96983 chromosome conditions resistance and/or necrosis to SMV. In addition, the soybean cultivars Marshall and Ogden, which carry other previously described Rsv1 alleles, are shown to possess the 3gG2 gene in a NBS-LRR gene cluster background distinct from PI96983. These observations suggest that two or more related non-TIR-NBS-LRR gene products are likely involved in the allelic response of several Rsv1-containing lines to SMV.

Mapping tightly linked genes controlling potyvirus infection at the Rsv1 and Rpv1 region in soybean.

Soybean mosaic virus (SMV) and peanut mottle virus (PMV) are two potyviruses that cause yield losses and reduce seed quality in infested soybean (Glycine max (L.) Merr.) fields throughout the world. Rsv1 and Rpv1 are genes that provide soybean with resistance to SMV and PMV, respectively. Isolating and characterizing Rsv1 and Rpv1 are instrumental in providing insight into the molecular mechanism of potyvirus recognition in soybean. A population of 1056 F2 individuals from a cross between SMV- and PMV-resistant line PI 96983 (Rsv1 and Rpv1) and the susceptible cultivar 'Lee 68' (rsv1 and rpv1) was used in this study. Disease reaction and molecular-marker data were collected to determine the linkage relationship between Rsv1, Rpv1, and markers that target candidate disease-resistance genes. F2 lines showing a recombination between two of three Rsv1-flanking microsatellite markers were selected for fine mapping. Over 20 RFLP, RAPD, and microsatellite markers were used to map 38 loci at high-resolution to a 6.8-cM region around Rsv1 and Rpv1. This study demonstrates that Rsv1 and Rpv1 are tightly linked at a distance of 1.1 cM. In addition, resistance-gene candidate sequences were mapped to positions flanking and cosegregating with these resistance loci. Based on comparisons of genetic markers and disease reactions, it appears likely that several tightly linked genes are conditioning a resistance response to SMV. We discuss the specifics of these findings and investigate the utility of two disease resistance related probes for the screening of SMV or PMV resistance in soybean.

Callitrichid nutrition and food sensitivity.

Captive callitrichids are prone to developing intestinal problems. Their captive and natural diets differ enormously, and diet has been suggested to play a major role in wasting marmoset syndrome. Proteins in wheat, soy and milk are included in callitrichid diets of most colonies and have been linked to an immune reaction in Saguinus oedipus and Callithrix jacchus. In the present study of 23 males and females of the two species, wheat protein was tested but soy and milk products were excluded. One group had wheat and the other had rice in their diet. Blood samples and biopsies from the colon were taken. Results showed changes in the colon and an immune reaction to gliadin, a wheat protein related to coeliac disease in humans. A further immune reaction was also observed. Suggestions for further study and exclusion of cereal in the diet of these small, New World primates are discussed.

Gene expression changes associated with cytotoxicity identified using cDNA arrays.

In order to investigate gene expression changes associated with cytotoxicity, we used cDNA arrays to monitor the expression of over 5,000 genes in response to toxic stress in the HepG2 liver cell line. Cells were treated with cytotoxic doses of acetaminophen, caffeine or thioacetamide for nine time points ranging from 1 to 24 h. Samples of mRNA from each time point were used to prepare radiolabeled cDNA, which was hybridized to nylon-membrane-based cDNA arrays. High-stringency washes were applied to reduce cross-hybridization. Analysis of spot intensities revealed that each compound led to approximately 150-250 gene expression changes that were sustained over at least three adjacent time points. The affected genes could be classified into clusters based on their temporal patterns of differential expression. A common set of 44 genes showed similar expression changes in response to all three compounds. Of these changes, 90% could be confirmed by quantitative RT-PCR analysis. The results indicate that detailed array-based time-course studies, coupled with a sensitive and highly specific confirmation assay, provide a powerful means of identifying cytotoxicity-associated gene expression changes.

Screening for novel antimicrobials from encoded combinatorial libraries by using a two-dimensional agar format.

A sensitive lawn-based format has been developed to screen bead-tethered combinatorial chemical libraries for antimicrobial activity. This method has been validated with beads linked to penicillin V via a photocleavable chemical linker in several analyses including a spike-and-recover experiment. The lawn-based screen sensitivity was modified to detect antibacterial compounds of modest potency, and a demonstration experiment with a naive combinatorial library of over 46,000 individual triazines was evaluated for antibacterial activity. Numerous hits were identified, and both active and inactive compounds were resynthesized and confirmed in traditional broth assays. This demonstration experiment suggests that novel antimicrobial compounds can be easily identified from very large combinatorial libraries of small, nonpeptidic compounds.

Attaining dominance in vivo: distinguishing dominant from challenger follicles in humans.

This study provides the first report of local suppression of follicle growth in vivo by the dominant follicle in humans. Analyses were focused on antral follicles > or =6 mm in diameter, classified as dominant (ovulatory) and challenger (large, non-ovulatory) follicles. We examined antral follicle characteristics, interactions and location in the ovary in the follicular phase of natural, ovulatory cycles in humans. Individual antral follicles (> or =2 mm) were identified and monitored using a system, developed by the authors, incorporating mapping and computer modelling from ultrasound imaging of the ovary. Results showed that antral follicle development was not restricted to a particular location in the ovary. The apparent randomization of location may provide a developmental advantage for follicles. The population of challenger follicles peaked at mid follicular phase, suggesting a period when the ovarian environment was supportive of larger antral follicle development. As ovulation date approached, however, challenger follicles did not attain the visible characteristics of dominance: mid-level echogenicity, large size, smooth antral wall, round shape. Furthermore, dominant follicles subsequently appeared to reduce the number of neighbouring challenger follicles. The results strongly suggest that a paracrine secretion of the dominant follicle was the source of this localized effect. This process may provide increased nutrient level and space at a critical growth stage for dominant follicles.

Thermal burns with injury to the intestine in a congenital hernia sac.

It is unusual to have a bowel injury in association with thermal injury. It is even rarer to encounter a patient with cerebral palsy and thermal injury to an intestinal loop in a congenital hernia sac. A case report of such a child is presented and the management is discussed.

Prediction of ovarian cycle outcome by follicular characteristics, stage 1.

Both dominant and subdominant follicles have been identified and individually monitored over the follicular phases of 54 natural cycles in 36 women. Population dynamics of all antral follicles, visible by ultrasonography, in the ovary over the entire cycle have also been characterized for the first time. This has been accomplished by developing a new system of mapping and monitoring follicles, including a three-dimensional computer imaging model and correlation program. The different dominant follicle types were characterized by their ultrasonographic properties. Ovulatory follicles were rounded in shape and mid-range echogenic, with a smooth antral edge by late follicular phase. Luteinized unruptured follicles were round, had low echogenicity and a very smooth antral edge. Atretic follicles were irregular in shape and antral edge and had mid-range echogenicity. A further important finding was that follicle success appears to be related to timing of growth and to the subdominant follicle population present in the ovary. An analysis of follicle population dynamics in ovulatory cycles showed a drastic decrease in number at the end of the luteal phase, followed by a sharp increase at the beginning of the follicular phase. This study has demonstrated that characteristics of individual follicles and population dynamics of both dominant and subdominant follicles are strongly associated with cycle outcome. These findings will contribute towards a predictive model of dominant follicle status and cycle outcome. A new hypothesis of follicle competition has also been proposed.

A comparison of morphometry from captive and free-ranging Macaca mulatta.

The paper addresses the effect of captivity on body size in Macaca mulatta, comparing a captive with the free-ranging population from which it was derived. The captive population, which was housed socially, was smaller in most linear measures and in body mass, particularly in young up to 13 month old animals. Nutritional differences in the diet may be at least partially responsible; the captive population was fed a lower level of total protein. Measurements for captive individuals < 24 hours to 36 months old are discussed in detail.

Laboratory data from the surveillance of a burns ward for the detection of hospital infection.

Nosocomial infection is a major problem affecting many hospital personnel and patients. Surveillance of intensive care areas such as burns wards is important due to the immunocompromised status of the patients. Since infection has been found to be a major cause of death in our burns ward, bacteriological surveillance of the area was carried out over a 1-year period. This indicated the various sources of infection, which included a contaminated container of disinfectant, and transient pathogenic flora on one of the staff members involved in changing dressings. Pseudomonas aeruginosa was the most commonly isolated pathogen from infected wounds as well as from the blood of patients developing sepsis. Autogenous spread of this organism was confirmed by similar pyocin typing results of the strains isolated from wounds, blood and faeces of the patients. Necessary changes were implemented based on these findings and the infection rate was reduced remarkably. The results suggested that strict vigilance by the personnel involved in the care of burns patients reduces the incidence of invasive sepsis and shortens the hospital stay.