Group B Streptococcus (GBS) colonization is dynamic over time, whilst GBS capsular polysaccharides-specific antibody remains stable.

Group B Streptococcus (GBS) is a leading cause of adverse pregnancy outcomes due to invasive infection. This study investigated longitudinal variation in GBS rectovaginal colonization, serum and vaginal GBS capsular polysaccharide (CPS)-specific antibody levels. Non-pregnant women were recruited in the UK and were sampled every 2 weeks over a 12-week period. GBS isolates were taken from recto-vaginal swabs and serotyped by polymerase chain reaction. Serum and vaginal immunoglobulin G (IgG) and nasal immunoglobulin A (IgA) specific to CPS were measured by Luminex, and total IgG/A by ELISA. Seventy women were enrolled, of median age 26. Out of the 66 participants who completed at least three visits: 14/47 (29.8%) women that were GBS negative at screening became positive in follow-up visits and 16/19 (84.2%) women who were GBS positive at screening became negative. There was 50% probability of becoming negative 36 days after the first positive swab. The rate of detectable GBS carriage fluctuated over time, although serum, vaginal, and nasal CPS-specific antibody levels remained constant. Levels of CPS-specific antibodies were higher in the serum of individuals colonized with GBS than in non-colonized, but similar in the vaginal and nasal mucosa. We found correlations between antibody levels in serum and the vaginal and nasal mucosa. Our study demonstrates the feasibility of elution methods to retrieve vaginal and nasal antibodies, and the optimization of immunoassays to measure GBS-CPS-specific antibodies. The difference between the dynamics of colonization and antibody response is interesting and further investigation is required for vaccine development.

Increase of weight-bearing capacity of patients with lesions of the TFCC using a wrist brace.

STUDY DESIGN: Retrospective cross-sectional case series. BACKGROUND: Lesions of the triangular fibrocartilage complex (TFCC) can result in pain during axial load and unstable distal radioulnar joint (DRUJ). Conventional wrist orthoses decrease initial pain sufficiently but also prevent any movement during recovery and do not contribute to the stabilization of the DRUJ. PURPOSE: In this retrospective analysis, we tested if the weight-bearing capacity of patients with lesions of the triangular fibrocartilage complex was increased by wearing a brace that stabilizes the distal radioulnar joint. METHODS: Twenty-three patients had an arthroscopically confirmed TFCC lesion. We compared preoperative dynamic weight-bearing capacity of both hands with and without a commercially available wrist brace (WristWidget). Subgroup analysis was performed for stability of the distal radioulnar joint and etiology of the TFCC lesion. The dynamic ulnar variance was measured in a modified weight bearing test. We used parametric tests for normally distributed values. RESULTS: The weight-bearing capacity of the hand with TFCC lesion was significantly lower than of the control hand (16 verus 36 kg; p <0.001). The relative load of the affected hand compared to the unaffected hand increased from 48 % (CI 37-60, SD 27) to 59 % (CI 47-72, SD 29) with a brace. The device had no effect on the control hand. Twelve patients with unstable DRUJ had a lower weight-bearing capacity compared to the eleven with stable joint. The percentage improvement with bracing was higher for those with unstable joints (versus stable) and traumatic lesions (versus degenrative). CONCLUSION: The use of a wrist brace significantly increases the weight-bearing capacity and therefore the maximum tolerated axial load of patients with a lesion of the TFCC. Patients with traumatic lesion or unstable DRUJ tend to show lower values than with degenerative lesions or stable joints.

Variability in colonization of arbuscular mycorrhizal fungi and its effect on mycorrhizal dependency of improved and unimproved soybean cultivars.

Breeding selection of germplasm under fertilized conditions may reduce the frequency of genes that promote mycorrhizal associations. This study was developed to compare variability in mycorrhizal colonization and its effect on mycorrhizal dependency (MD) in improved soybean genotypes (I-1 and I-2) with differential tolerance to drought stress, and in unimproved soybean genotypes (UI-3 and UI-4). As inoculum, a mixed native arbuscular mycorrhizal fungi (AMF) was isolated from soybean roots, showing spores mostly of the species Funneliformis mosseae. At 20 days, unimproved genotypes followed by I-2, showed an increase in arbuscule formation, but not in I-1. At 40 days, mycorrhizal plants showed an increase in nodulation, this effect being more evident in unimproved genotypes. Mycorrhizal dependency, evaluated as growth and biochemical parameters from oxidative stress was increased in unimproved and I-2 since 20 days, whereas in I-1, MD increased at 40 days. We cannot distinguish significant differences in AMF colonization and MD between unimproved and I-2. However, variability among improved genotypes was observed. Our results suggest that selection for improved soybean genotypes with good and rapid AMF colonization, particularly high arbuscule/hyphae ratio could be a useful strategy for the development of genotypes that optimize AMF contribution to cropping systems.

Enhancement in treatment planning for magnetic nanoparticle hyperthermia: optimization of the heat absorption pattern.

In clinical applications of magnetic nanoparticle hyperthermia for cancer treatment it is very important to ensure a maximum damage to the tumor while protecting the normal tissue. The resultant heating pattern by the nanoparticle distribution in tumor is closely related to the injection parameters. In this study we develop an optimization algorithm to inversely determine the optimum heating patterns induced by multiple nanoparticle injections in tumor models with irregular geometries. The injection site locations, thermal properties of tumor and tissue, and local blood perfusion rates are used as inputs to the algorithm to determine the optimum parameters of the heat sources for all nanoparticle injection sites. The design objective is to elevate the temperature of at least 90% of the tumor above 43 degrees C, and to ensure only less than 10% of the normal tissue is heated to temperatures of 43 degrees C or higher. The efficiency, flexibility and capability of this approach have been demonstrated in a case study of two tumors with simple or complicated geometry. An extensive experimental database should be developed in the future to relate the optimized heating pattern parameters found in this study to their appropriate nanoparticle concentration, injection amount, and injection rate. We believe that the optimization algorithm developed in this study can be used as a guideline for physicians to design an optimal treatment plan in magnetic nanoparticle hyperthermia.

Evaluation of effectiveness of Er,Cr:YSGG laser for root canal disinfection: theoretical simulation of temperature elevations in root dentin.

Erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) lasers are currently being investigated for disinfecting the root canal system. Prior to using laser therapy, it is important to understand the temperature distribution and to assess thermal damage to the surrounding tissue. In this study, a theoretical simulation using the Pennes bioheat equation is conducted to evaluate how heat spreads from the canal surface using an Er,Cr:YSGG laser. Results of the investigation show that some of the proposed treatment protocols for killing bacteria in the deep dentin are ineffective, even for long heating durations. Based on the simulation, an alternative treatment protocol is identified that has improved effectiveness and is less likely to introduce collateral damage to the surrounding tissue. The alternative protocol uses 350 mW laser power with repeating laser tip movement to achieve bacterial disinfection in the deep dentin (800 microm lateral from the canal surface), while avoiding thermal damage to the surrounding tissue (T<47 degrees C). The alternative treatment protocol has the potential to not only achieve bacterial disinfection of deep dentin but also shorten the treatment time, thereby minimizing potential patient discomfort during laser procedures.

Controlling nanoparticle delivery in magnetic nanoparticle hyperthermia for cancer treatment: experimental study in agarose gel.

In magnetic nanoparticle hyperthermia for cancer treatment, controlling the heat distribution and temperature elevations is an immense challenge in clinical applications. In this study we evaluate magnetic nanofluid transport and heat distribution induced by commercially available magnetic nanoparticles injected into the extracellular space of biological tissue using agarose gel with porous structures similar to human tissue. The nanofluid distribution in the gel is examined via digital images of the nanofluid spreading in the gel. A radio-frequency electromagnetic field is applied to the gel following the nanofluid injection and the initial rates of temperature rise at various locations are measured to obtain the specific absorption rate (SAR) distribution. By adjusting the gel concentration and injection flow rate, the results have demonstrated that a relatively low injection rate leads to a spherically shaped nanofluid distribution in the gels which is desirable for controlling temperature elevations. The SAR distribution shows that the nanoparticle distribution in the gel is not uniform with a high concentration of the nanoparticles close to the injection site. We believe that the experimental study is the first step towards providing guidance for designing better treatment protocol for future clinical applications.

Clinical audit: obstetric performance after caesarean section.

The RCOG Clinical Audit Unit has defined two auditable standards in women labouring with a previous caesarean section (LSCS). We found documentation of a discussion in 98% of patient notes on issues relating to delivery, including a trial of vaginal delivery. Excluding patients declining a trial of vaginal delivery, the successful vaginal delivery rate was 36/60 (60%). One in three patients, although suitable, declined a trial of vaginal delivery. This request was invariably made at the booking consultation. Two in three patients required a repeat LSCS for delivery. Women were twice and 2.4 times as likely to have a repeat LSCS delivery when their primary LSCS was for fetal distress and failure to progress, respectively. There was one (1%) case of confirmed scar rupture and one stillbirth of unknown aetiology at 34/40. Recommendations include vigilance and senior supervision at primigravid labours and confident recommendation of trial of vaginal delivery by obstetrics team.

Sorption of 1-naphthol to soil and geologic samples with varying diagenetic properties.

Remediation of contaminated land requires a firm understanding of the processes that occur between xenobiotics and soil colloids. It is currently accepted that the extent of xenobiotic uptake is proportional to the carbon quantity and character of the soil or geologic sample. Previous studies have developed empirical equations to predict the extent of sorption based on the aromatic carbon content. We examined these relationships with an independent set of soil and geologic samples and 1-naphthol. The 1-naphthol sorption coefficients varied significantly (P < 0.01) among sorbents and are consistent with the diagenetic properties of the organic matter in these samples. The cross-polarization magic angle spinning (CPMAS) 13C nuclear magnetic resonance (NMR) and elemental data did not concur with the sorption data for most of the soil samples. We suggest that this contradiction may be due to a third variable, the physical organization of the organic matter. Chemical methods measure the whole sample, whereas short-term sorption occurs on the surface; therefore, only some organic matter domains in the soil are available for interaction with 1-naphthol. Hence, chemical data alone may be insufficient for predicting the sorption behavior of xenobiotics in soil and geologic samples.

Vaginal retropubic urethropexy with intraoperative cystometry for treating urinary stress incontinence.

OBJECTIVE: To determine the effectiveness of a vaginal retropubic urethropexy with intraoperative cystometry in treating urinary stress incontinence. PATIENTS AND METHODS: One hundred patients with genuine stress incontinence on urodynamic examination underwent the procedure and were followed up for 1 year; 96 completed the follow-up (four were lost to follow-up). RESULTS: At 1 year, 91 patients (95%) were cured of their stress incontinence and five (5%) failed, with recurrent stress incontinence developing. The complications were mainly of suture erosion (6%). CONCLUSION: This method of urethropexy has produced excellent results to date, with low complication and morbidity rates, and continues to be our treatment of choice. A randomized control trial comparing it with standard established procedures would be welcomed.

The Hybrid III 10-Year-Old Dummy.

This paper describes the design and development of the Hybrid III 10-year-old crash test dummy. The size of the dummy was chosen to fill the gap between the Hybrid III 6-year-old and the Hybrid III small adult female dummy which is also about the size of a 13-year-old teenager. Characteristic dimensions and segment weights of the dummy are based on the anthropometry of the average 10-year-old. Biofidelity response guidelines for forehead, sternum and knee impacts and for fore/aft neck bending are scaled from the midsize adult male biofidelity guidelines taking into account the effects of differences in size, mass and material properties due to the age difference. The dummy is similar in construction to the other Hybrid III dummies except it has an adjustable lumbar spine which allows the dummy to slouch and its neck structure is aligned with its thoracic spine. Data are given showing the responses of the prototype dummy relative to its biofidelity guidelines. The prototype dummy was evaluated in out-of-position air bag tests and three-point belt tests to evaluate its durability and ease of use. The prototype dummy has demonstrated acceptable biofidelity, repeatability and durability and the design has been approved by the SAE Hybrid III Dummy Family Task Group for production.

Shear stress-induced apoptosis of adherent neutrophils: a mechanism for persistence of cardiovascular device infections.

The mechanisms underlying problematic cardiovascular device-associated infections are not understood. Because the outcome of the acute response to infection is largely dependent on the function of neutrophils, the persistence of these infections suggests that neutrophil function may be compromised because of cellular responses to shear stress. A rotating disk system was used to generate physiologically relevant shear stress levels (0-18 dynes/cm(2); 1 dyne = 10 microN) at the surface of a polyetherurethane urea film. We demonstrate that shear stress diminishes phagocytic ability in neutrophils adherent to a cardiovascular device material, and causes morphological and biochemical alterations that are consistent with those described for apoptosis. Complete neutrophil apoptosis occurred at shear stress levels above 6 dynes/cm(2) after only 1 h. Morphologically, these cells displayed irreversible cytoplasmic and nuclear condensation while maintaining intact membranes. Analysis of neutrophil area and filamentous actin content demonstrated concomitant decreases in both cell area and actin content with increasing levels of shear stress. Neutrophil phagocytosis of adherent bacteria decreased with increasing shear stress. Biochemical alterations included membrane phosphatidylserine exposure and DNA fragmentation, as evaluated by in situ annexin V and terminal deoxynucleotidyltransferase-mediated dUTP end labeling (TUNEL) assays, respectively. The potency of the shear-stress effect was emphasized by comparative inductive studies with adherent neutrophils under static conditions. The combination of tumor necrosis factor-alpha and cycloheximide was ineffective in inducing >21% apoptosis after 3 h. These findings suggest a mechanism through which shear stress plays an important role in the development of bacterial infections at the sites of cardiovascular device implantation.

Study of the effect of using mini-transitional implants as temporary abutments in implant overdenture cases.

In an attempt to improve patient satisfaction during the healing period after placement of implants, mini-transitional implants (MTIs) have been advocated to allow immediate use of temporary dentures and to prevent transmucosal loads over the definitive implants. Twelve edentulous patients received two screw implants each in the predetermined mandibular canine region. At the time of surgery, six patients had two MTIs placed medially to the permanent ones. The flap was repositioned allowing transmucosal penetration of MTIs. Patients left the operating room wearing their relined lower dentures. The results indicated that MTIs integrated sufficiently in bone, giving successful immediate support for the transitional prosthesis and allowing proper mucosal healing. Two of these transitional implants showed mobility three months after phase I surgery. After loading the final implants, patients who had MTI-supported dentures showed bone loss that was not significantly different from the control group.