Ratite eggshells from lanzarote, canary islands.

Struthious and aepyornithoid eggshells from Tertiary calcareous sediments on Lanzarote prove the presence, until about 12 million years ago, of large flightless birds. The calcarenite horizon is recognized as an old land surface. Mesozoic sedimentary rocks in the basement of the volcanic islands of Lanzarote and neighboring Fuerteventura indicate that at least part of the Canary Archipelago is underlain by continental crust. Separation of the eastern Canaries from Africa raight have been by rifting, and a land connection might still have existed in the lower Pliocene.

RNA/DNA co-analysis from human skin and contact traces--results of a sixth collaborative EDNAP exercise.

The European DNA profiling group (EDNAP) organized a sixth collaborative exercise on RNA/DNA co-analysis for body fluid/tissue identification and STR profiling. The task was to identify skin samples/contact traces using specific RNA biomarkers and test three housekeeping genes for their suitability as reference genes. Eight stains, a skin RNA dilution series and, optionally, bona fide or mock casework samples of human or non-human origin were analyzed by 22 participating laboratories using RNA extraction or RNA/DNA co-extraction methods. Two sets of previously described skin-specific markers were used: skin1 pentaplex (LCE1C, LCE1D, LCE2D, IL1F7 and CCL27) and skin2 triplex (LOR, KRT9 and CDSN) in conjunction with a housekeeping gene, HKG, triplex (B2M, UBC and UCE). The laboratories used different chemistries and instrumentation. All laboratories were able to successfully isolate and detect mRNA in contact traces (e.g., human skin, palm-, hand- and fingerprints, clothing, car interiors, computer accessories and electronic devices). The simultaneous extraction of RNA and DNA provides an opportunity for positive identification of the tissue source of origin by mRNA profiling as well as a simultaneous identification of the body fluid donor by STR profiling. The skin markers LCE1C and LOR and the housekeeping gene marker B2M were detected in the majority of contact traces. Detection of the other markers was inconsistent, possibly due to the low amounts and/or poor quality of the genetic material present in shed skin cells. The results of this and the previous collaborative RNA exercises support RNA profiling as a reliable body fluid/tissue identification method that can easily be combined with current STR typing technology.

Lean body mass in twins.

A study of 49 pairs of monozygous (MZ) twins and 38 pairs of same-sexed dizygous (DZ) twins showed that lean body mass (LBM), as determined by potassium 40 counting, is under genetic influence. Intrapair variances for LBM are much smaller than those for body fat, which suggests that LBM has a higher degree of heritability. There is a correlation between the magnitude of intrapair LBM differences and intrapair weight differences for both sets of twins, showing that environment is also an important influence. The effect of weight variation on LBM variation is greater for thin people than for those with appreciable burdens of body fat, an observation previously made on individuals who undergo a nutrition-induced weight change.

Effect of iron limitation on protein composition and ultrastructure of Haemophilus ducreyi.

Protein profiles of whole cells of Haemophilus ducreyi grown in the presence or absence of the iron chelator desferal, were compared by polyacrylamide gel electrophoresis. Each of four strains produced novel proteins in the range 43-160 kDa when cultured under conditions of reduced iron availability. At some sub-inhibitory concentrations, desferal produced enhanced growth, possibly due to it functioning as an exogenous siderophore. Organisms grown under conditions of reduced iron availability ultrastructurally showed also large periplasmic spaces between cytoplasm and outer membrane.

Colonization of burns and the duration of hospital stay of severely burned patients.

In a retrospective study the influence of several factors on the length of hospital stay of severely burned patients (at least 24% total body surface area) has been investigated. The influence of these factors was studied by means of the Cox model survival analysis with time-varying covariates. Seventy-one patients were included in this study. The mean age was 32 years (range 1-82 years), the mean total body surface area burned 40% (range 24-80%) and the mean full-thickness area burned 32% (range 10-70%). The length of hospital stay was positively correlated with the extent of the burned area and with the age of the patient. Wound colonization with Enterobacteriaceae or with a combination of Pseudomonas spp. and Staphylococcus aureus was also associated with a prolonged stay in hospital.

The value of thoracoplasty before extensive unilateral resection for pulmonary tuberculosis.

Among 24 patients who required extensive unilateral resection for tuberculosis, 17 underwent adequate thoracoplasty before resection and seven others received either no thoracoplasty before resection or an inadequate one. These two groups were comparable as to severity of disease and operative risk. The incidence of serious complications was 83 per cent in the latter group compared to 12 per cent in the former. While the number of patients in each group is too small for a statistically valid comparison, the results suggest that an adequate thoracoplasty before resection is of definite value in preventing pleural complications after extensive unilateral resection for tuberculosis.

Disseminated melanomatosis of the central nervous system and other organs: a case report.

This case represents an example of clinically occult, disseminated neoplastic disease with almost asymptomatic but severe involvement of the central nervous system. The only helpful diagnostic investigation appeared to be cerebrospinal fluid cytology. Extensive post mortem examination was inconclusive as to whether the widespread CNS involvement with melanoma was primary or secondary.

[Chronic hypophosphatemic osteopathy (author's transl)]. / Chronische hypophosphatämische Osteopathie.

The process of chronic hypophosphatemic vitamin D-resistant rickets--observation of two cases. With the male patient--our first case--the disease was sporadic and had not been recognized for a long time. In his early adulthood it manifested itself as Umbauzonen (pseudofractures) in the larger context of active osteomalacia. It was possible to observe the pseudofractures before and while the patient was treated with drugs. High doses of vitamin D 3 and dosage of phosphate mitigated the complains although with respect to the radiological, scintigraphic, humoral and histological findings there was only slow improvement or no improvement at all.--The patient's daughter is affected by the disease as well. In her case the pathological signs of her bones became better when treated with vitamin D 3.

[Clinical and experimental investigations with 201tl for noninvasive myocardial scintigraphy (author's transl)]. / Klinishce und experimentelle Untersuchungen mit 201Tl zur nichtinvasiven Myokardszintigraphie

The biological distribution of 201Tl after intravenous injection was studied experimentally in 42 rats. It was found (see figure 1) that the kidneys showed the greatest affinity for 201Th, reaching an activity concentration of 6.6% per gramme of tissue, almost independently of time. Within the first 30 minutes of injection, myocardial activity exceeds that of the surrounding structures (10 min. p.i.: 4.24%/g; 30 min. p.i.: 2.58%/g). During this time the myocardium can be well demonstrated by "image processing". The relatively fast myocardial kinetics of 201Tl (half value time 33 minutes) make it necessary, strictly speaking, to use a scintillation camera. The clinical value of this method is illustrated by a number of case histories.

[Evaluation by means of ECG-gated cardiac blood pool scintigraphy of global and regional left ventricular function at rest and during exercise in patients with coronary artery disease (author's transl)]. / Die Beurteilung der globalen und regionalen linksventrikulären Funktion in Ruhe und während Ergometerbelastung bei Patienten mit koronarer Herzkrankheit mit der EKG-getriggerten Herzbinnenraumszintigraphie.

ECG-gated cardiac blood pool scintigraphy permits a non-invasive determination of the end-diastolic and end-systolic ventricular volumes and of the ejection fraction as well as a qualitative description of regional ventricular wall motion at rest and during excercise. In 6 healthy persons a significant increase of the ejection fraction from 66 +/- 7% at rest to 78 +/- 3% during exercise (p less than 0.01) was observed. In contrast, the ejection fraction decreased in 15 out of 18 patients with coronary artery disease, with a significant (p less than 0.01) difference between patients with and without angina pectoris. Thus, the ejection fraction fell in 12 patients without angina during excercise from 60 +/- 11% to 52 +/- 11% (p less than 0.05) whereas in 6 patients with angina a decrease from 61 +/- 7% to 30 +/- 8% (p less than 0.01) was observed. This non-invasive technique makes it possible to demonstrate in a simple and safe manner changes of cardiac function during excercise in patients with coronary artery disease.

Selective intestinal decontamination for prevention of wound colonization in severely burned patients: a retrospective analysis.

In this study the effect of selective intestinal decontamination of the digestive tract (SDD) on wound colonization was investigated. Ninety-one patients with at least 25 per cent total burned surface area (TBSA) were included in this study. All patients received oral polymyxin. In 63 patients oral co-trimoxazole and amphotericin B were added to the regimen. The addition of co-trimoxazole decreased the incidence of Enterobacteriaceae wound colonization from 71 per cent to 11 per cent (P less than 0.005). Colonization with Proteus was eliminated in patients treated with co-trimoxazole, compared with an incidence of 36 per cent in the group treated with polymyxin alone (P less than 0.001). The addition of amphotericin B decreased yeast colonization of the burn wound from 39 per cent to 10 per cent (P less than 0.005). A close relation was observed between burn wound colonization and colonization of the gastrointestinal tract. No resistant bacterial strains emerged during the period of study. These results suggest that SDD is an effective method for prevention of wound colonization. Further controlled studies are needed to establish the role of SDD in preventing burn wound colonization and wound sepsis.

Successful homografting in an elderly patient with extensive burns using his identical twin brother as skin donor.

A 60-year-old patient with 50 per cent body surface area (BSA) flame burns (of which 46 per cent were full skin thickness loss) was treated successfully with skin grafts taken from his identical twin brother to cover 20 per cent of the wounds. On theoretical grounds, it can be assumed that the period in hospital was reduced by 28 days. Blood for tissue and blood group typing should be taken at an early stage, before the patient is given a blood transfusion.

Attempted suicide by means of burns.

A study was made of the results of treatment of 57 patients who made 68 suicide attempts by means of burns in the period between 1979 and 1987. They formed 14 per cent of the total patient population older than 16 years of age. Attempted suicide was observed most frequently in patients between 20 and 39 years of age. The sex incidence was equal. Most patients were in contact with or had been in contact with mental health care institutions at the time of their attempt, half of the attempts took place in a psychiatric hospital. Twelve patients died, in nine the prognosis was considered to be so poor that in view of the seriousness of the burns or the accompanying injuries no treatment was initiated. Follow-up took place after an average 3.8 years (1-8.25 years). Information was obtained on all 45 surviving patients. Eight patients had died, six of natural causes and two had committed suicide. Eighteen patients were living at home, 13 were residents at a psychiatric hospital, three were living in a protective commune, two were being detained during Her Majesty's pleasure and one was in prison. It appeared to be difficult to incorporate these patients in a closed follow-up regimen.

Selective intestinal decontamination of the digestive tract for infection prophylaxis in severely burned patients.

An oral prophylactic antibiotic regimen aiming at suppression of the gram-negative rods and yeasts of the bowel flora was utilised in 48 severely burned patients to prevent burn wound colonisation. Only 17% of the patients had an actual or potential infection. Only one Pseudomonas infection occurred. The effect of this selective gastro-intestinal decontamination is discussed.

Psychological and social problems in burn patients after discharge. A follow-up study.

Approximately 18 months after discharge we were able to screen 42 burned adult patients for psychological and social problems. Using independent semi-standardized interviews, validated psychological questionnaires and standardized self-reports of the patients, we obtained three separate evaluations. The interreliability between the three different 'judges' varied from poor to moderate. Research suggests that 40% of burned adult patients have psychological problems. The cycle of recovery is dynamic. Only 21% need psychological help 18 months after discharge, but half of these are in danger of becoming 'drop-outs' because they do not receive the necessary treatment. A follow-up consisting of psychological questionnaires six months post-discharge appears to be a good and efficient instrument in limiting the drop-out risk.

Management of fingernail deformities after thermal injury.

Fingernail deformities after thermal injury can be very disfiguring and troublesome. The fingernails may be discoloured, cleft or vertically deviated. From the pathophysiology of the nail growth in general, the specific features of the nail deformities after deep burn can be deduced, as can guidelines for the treatment. Over a two-year period, 153 patients with burned hands were treated in the Groningen Burn Centre. Seven of these patients developed abnormal quality and growth pattern of the fingernails. In two patients an effort was made to correct the deformity by incising the dorsal skin at the base of the nail fold, reflecting the nail fold and covering the acquired defect with a full thickness skin graft. Although the patients were satisfied with the results achieved, one year after the operation little or no improvement in the nail growth was found. A cautious policy should be followed in correcting these deformities, since dislocation of the eponychium together with damage to the nail matrix and the nail bed play a complex role in the process of deformation.

Higher density of mental capacities in the left cerebral hemisphere of man: a quantitative investigation in children with localized cerebral lesions.

51 children with localized cerebral lesions were investigated with the British Ability Scales, Wechsler test, Porteus Mazes, Conners Teacher Rating Scale, and computerized tomography. The extent of the lesions was quantitatively determined. The IQ was 10 points lower in the left hemispheric lesions, although the right hemispheric lesions were larger. When corrected for size of lesions, the IQ is 17 points higher (p less than 0.05) in children with right than with left hemispheric early lesions. The children with left hemispheric lesions had also significantly more behavioural problems (Conners Scale). Children with bilateral lesions had 15 points lower IQ than those with unilateral lesions, although from the slightly larger extent one could expect only 3 points difference. There was no influence of hemiparesis or of epilepsy of the IQ independent of the extent of lesion. There was more plasticity of the hemisphere than of the lobes as shown by Wisconsin Card Sorting data. The higher density of mental capacities in the left cerebral hemisphere of man is explained by more efficient programs, and more dense packing of functions due to more training of the left cerebral hemisphere.

RNA/DNA co-analysis from human menstrual blood and vaginal secretion stains: results of a fourth and fifth collaborative EDNAP exercise.

The European DNA Profiling Group (EDNAP) organized a fourth and fifth collaborative exercise on RNA/DNA co-analysis for body fluid identification and STR profiling. The task was to identify dried menstrual blood and vaginal secretion stains using specific RNA biomarkers, and additionally test 3 housekeeping genes for their suitability as reference genes. Six menstrual blood and six vaginal secretion stains, two dilution series (1/4-1/64 pieces of a menstrual blood/vaginal swab) and, optionally, bona fide or mock casework samples of human or non-human origin were analyzed by 24 participating laboratories, using RNA extraction or RNA/DNA co-extraction methods. Two novel menstrual blood mRNA multiplexes were used: MMP triplex (MMP7, MMP10, MMP11) and MB triplex (MSX1, LEFTY2, SFRP4) in conjunction with a housekeeping gene triplex (B2M, UBC, UCE). Two novel mRNA multiplexes and a HBD1 singleplex were used for the identification of vaginal secretion: Vag triplex (MYOZ1, CYP2B7P1 and MUC4) and a Lactobacillus-specific Lacto triplex (Ljen, Lcris, Lgas). The laboratories used different chemistries and instrumentation and all were able to successfully isolate and detect mRNA in dried stains. The simultaneous extraction of RNA and DNA allowed for positive identification of the tissue/fluid source of origin by mRNA profiling as well as a simultaneous identification of the body fluid donor by STR profiling, also from old and compromised casework samples. The results of this and the previous collaborative RNA exercises support RNA profiling as a reliable body fluid identification method that can easily be combined with current STR typing technology.

RNA/DNA co-analysis from human saliva and semen stains--results of a third collaborative EDNAP exercise.

A third collaborative exercise on RNA/DNA co-analysis for body fluid identification and STR profiling was organized by the European DNA Profiling Group (EDNAP). Twenty saliva and semen stains, four dilution series (10-0.01 µl saliva, 5-0.01 µl semen) and, optionally, bona fide or mock casework samples of human or non-human origin were analyzed by 20 participating laboratories using an RNA extraction or RNA/DNA co-extraction method. Two novel mRNA multiplexes were used: a saliva triplex (HTN3, STATH and MUC7) and a semen pentaplex (PRM1, PRM2, PSA, SEMG1 and TGM4). The laboratories used different chemistries and instrumentation and a majority (16/20) were able to successfully isolate and detect mRNA in dried stains. The simultaneous extraction of RNA and DNA from individual stains not only permitted a confirmation of the presence of saliva/semen (i.e. tissue/fluid source of origin), but allowed an STR profile of the stain donor to be obtained as well. The method proved to be reproducible and sensitive, with as little as 0.05 µl saliva or semen, using different analysis strategies. Additionally, we demonstrated the ability to positively identify the presence of saliva and semen, as well as obtain high quality DNA profiles, from old and compromised casework samples. The results of this collaborative exercise involving an RNA/DNA co-extraction strategy support the potential use of an mRNA based system for the identification of saliva and semen in forensic casework that is compatible with current DNA analysis methodologies.