Molecular analysis and genotyping of methicillin-resistant Staphylococcus aureus strains isolated from different clinical sources.

BACKGROUND: Investigating genetic relatedness between methicillin-resistant Staphylococcus aureus (MRSA) strains from humans and different animal species may clarify the epidemiological characteristic of MRSA infections together. AIM: The aim of the study was to perform genotypic characterization and type strains of MRSA isolated from different clinical sources, by molecular techniques. MATERIALS AND METHODS: The molecular characterization of the strains was performed by polymerase chain reaction (PCR), using several specific oligonucleotides. These were as follows: S. aureus species-specific sau gene, mecA gene coding PBP2a responsible for methicillin resistance, femA gene coding for a protein, which influences the level of methicillin resistance of S. aureus, and is universally present in all MRSA strains; spa gene coding for protein A; coa gene coding for coagulase, and blaZ gene coding for the production of beta-lactamase. To determine the genetic diversity of these strains, random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR) was performed. RESULTS: Among the 415 S. aureus strains, 61 were phenotypically identified as MRSA, and confirmed as S. aureus by amplification of sau gene. However, 90.16% of the strains were mecA positive, while all were negative for femA gene. The presence and polymorphism of coa and spa genes were investigated and 83.60% and 18.03% strains were positive for coa and spa, respectively. While these strains were grouped into six coa-types by PCR, no polymorphism was found for spa gene among strains having only single 190 bp of the band. bla genes were found in 75.40% of strains. These strains were divided into 12 RAPD types. CONCLUSIONS: The results showed the relatively high heterogeneity and variation of coa gene among MRSA strains, while further studies on sequencing of these strains may identify which sequence type is predominant in this region.

Calcium electroporation and electrochemotherapy for cancer treatment: Importance of cell membrane composition investigated by lipidomics, calorimetry and in vitro efficacy.

Calcium electroporation is a novel anti-cancer treatment investigated in clinical trials. We explored cell sensitivity to calcium electroporation and electroporation with bleomycin, using viability assays at different time and temperature points, as well as heat calorimetry, lipidomics, and flow cytometry. Three cell lines: HT29 (colon cancer), MDA-MB231 (breast cancer), and HDF-n (normal fibroblasts) were investigated for; (a) cell survival dependent on time of addition of drug relative to electroporation (1.2 kV/cm, 8 pulses, 99 µs, 1 Hz), at different temperatures (37 °C, 27 °C, 17 °C); (b) heat capacity profiles obtained by differential scanning calorimetry without added calcium; (c) lipid composition by mass spectrometry; (d) phosphatidylserine in the plasma membrane outer leaflet using flow cytometry. Temperature as well as time of drug administration affected treatment efficacy in HT29 and HDF-n cells, but not MDA-MB231 cells. Interestingly the HT29 cell line displayed a higher phase transition temperature (approximately 20 °C) versus 14 °C (HDF-n) and 15 °C (MDA-MB231). Furthermore the HT29 cell membranes had a higher ratio of ethers to esters, and a higher expression of phosphatidylserine in the outer leaflet. In conclusion, lipid composition and heat capacity of the membrane might influence permeabilisation of cells and thereby the effect of calcium electroporation and electrochemotherapy.

Nonlinear analysis of heart rate variability of healthy subjects and patients with chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is one of the causes of mortality worldwide with an increasing prevalence. Heart rate variability (HRV) reflects the regulation mechanism of the cardiac activity by the autonomic nervous system. The assessment of HRV by using nonlinear methods is more sensitive for the detection of complexity when compared to linear methods. This study aims to get information about the autonomic dysfunction occurred in patients with COPD by analysing the complexity of HRV. Electrocardiogram signals recorded from healthy subjects, patients with moderate COPD and severe COPD (eight subjects per group) were analysed. The HRV signals were acquired from ECG signals. Signals were reconstructed in the phase space and largest Lyapunov exponent (LLE), correlation dimension, Hurst exponent and approximate entropy (ApEn) values were calculated. It has seen that for the patients with COPD LLE, correlation dimension, Hurst exponent and ApEn values were less than control group. According to this, HRV complexity decreases in the presence of COPD. However, there is no significant difference between COPD groups and the severity of COPD has no effect on the chaoticity of the system. The results revealed that autonomic dysfunction occurred in patients with COPD is associated with reduced HRV complexity.

Chromosome abnormality incidence in fetuses with cerebral ventriculomegaly.

Ventriculomegaly (VM) is a marker of aneuploidy and warrants a detailed examination of fetal anatomy. Chromosomal abnormalities worsen the fetal and neonatal prognosis significantly and karyotyping of fetuses is critically important when accompanying anomalies are detected. Here, we report the genetic results of 140 fetuses with isolated and non-isolated VM detected during a second trimester ultrasound examination followed by invasive in utero diagnostic procedures for karyotyping. VM was diagnosed in seven (5%) fetuses with abnormal karyotype and the chromosomal abnormality incidence was higher in severe VM (6.8%) than mild (4.2%). Higher chromosomal abnormality rates were detected when VM was isolated (8.6%), rather than associated with any anomaly (3.8%). These results suggest that karyotype analysis should be offered to all patients with any degree of VM, regardless of its association with structural anomalies.

Effect of bauhinia bauhinioides kallikrein inhibitor on endothelial proliferation and intracellular calcium concentration.

OBJECTIVES: Proteinase inhibitors act as a defensive system against predators e.g. insects, in plants. Bauhinia bauhinioides kallikrein inhibitor (BbKI) is a serine proteinase inhibitor, isolated from seeds of Bauhinia bauhinioides and is structurally similar to plant Kunitz-type inhibitors but lacks disulfide bridges. In this study we evaluated the antiproliferative effect of BbKI on endothelial cells and its impact on changes in membrane potential and intracellular calcium. MATERIALS AND METHODS: HUVEC proliferation was significantly reduced by incubation with BbKI 50 and 100 µM 12% and 13%. Furthermore, BbKI (100 µM) exposure caused a significant increase in intracellular Ca2+ concentration by 35% as compared to untreated control. RESULTS: The intracellular rise in calcium was not affected by the absence of extracellular calcium. BBKI also caused a significant change in the cell membrane potential but the antiproliferative effect was independent of changes in membrane potential. CONCLUSIONS: BBKI has an antiproliferative effect on HUVEC, which is independent of the changes in membrane potential, and it causes an increase in intracellular Ca2+.

Which is a better treatment for carotid artery stenosis: stenting or endarterectomy?

Carotid stenosis amenable to surgical or interventional revascularization accounts for 5-12% of all new strokes. Several randomized trials have shown that carotid endarterectomy (CEA) for the treatment of symptomatic and asymptomatic carotid stenosis is superior to medical treatment. Application of a carotid artery stent (CAS) representing a good alternative for many patients. CAS application has become comparatively safe with the use of embolism-preventive systems developed in recent years. Complication rates reported in some randomized trials and case studies in the literature are similar with CEA. CAS may be recommended as the first choice or alternative treatment for patients with symptomatic stenosis carrying high risks for open surgery. However, more randomized studies are necessary to recommend CAS for patients carrying at low surgical risks or patients with asymptomatic stenosis. This is a systematic review of the literature investigating the effectiveness of the treatment methods for carotid artery stenosis.

Assessment of in vivo spinal cord conduction velocity in rats in an experimental model of ischemic spinal cord injury.

STUDY DESIGN: Experimental laboratory investigation of spinal cord conductivity alterations in a rat model of ischemic spinal cord injury (SCI). OBJECTIVE: To observe the epidural spinal cord stimulation-induced electromyography responses, and to investigate the possible alterations of spinal cord conduction velocity (SCCV) and compound muscle action potentials (CMAPs) after ischemic SCI in rats. SETTINGS: Adnan Menderes University, Institute of Health Science, Aydin, Turkey. METHODS: SCI was induced by transient occlusion of the abdominal aorta in male Sprague-Dawley rats. Spinal cord histopathology was examined to determine neuronal damage and Tarlov scale was used to grade locomotor functions. Epidural electrical stimulation of spinal cord was performed by monopolar needle electrodes sequentially at L1-L2 and L5-L6 levels, and CMAPs were recorded from the left gastrocnemius muscle by surface electrodes. Amplitudes and durations of CMAPs were evaluated and SCCVs were calculated by analyzing the latency difference of CMAPs. RESULTS: Ischemia-induced SCI resulted in significant reduction of Tarlov scores and a significant decline in number of viable neurons. Similarly, a significant decrement was observed in SCCV following spinal cord ischemia. CONCLUSION: This study demonstrated that measurement of SCCV via epidural electrical stimulation is possible and displays a significant decline after spinal cord ischemia in rats. We suggest that this method can be beneficial to quantify neuronal damage after experimental ischemic SCI.

Ultrasonography and magnetic resonance imaging findings of abdominal complications of cystic fibrosis.

UNLABELLED: In this study, our aim is to discuss the imaging findings of the abdominal complications seen in Cystic Fibrosis (CF), with ultrasonography (US) and magnetic resonance imaging (MRI). Our first case, a 22 year-old female showed changes characterized by severe biliary involvement such as cholelithiasis and cholangitis. Our second case was a 36 year-old male with severe hepatic manifestations. In this case signs of severe cirrhosis, portal hypertension and marked splenomegaly were seen. Micro-gallbladder, cholecystolithiasis and diffuse fatty infiltration of the pancreas were seen in both cases. IN CONCLUSION: US and MRI are effective and noninvasive imaging techniques to evaluate the abdominal complications of cystic fibrosis.

Effect of different palatal vault shapes on the dimensional stability of glass fiber-reinforced heat-polymerized acrylic resin denture base material.

OBJECTIVE: The aim of this study was to determine the effect of different palatal vault shapes on the dimensional stability of a glass fiber reinforced heat polymerized acrylic resin denture base material. METHODS: Three edentulous maxilla with shallow, deep and medium shaped palatal vaults were selected and elastomeric impressions were obtained. A maxillary cast with four reference points (A, B, C, and D) was prepared to serve as control. Point (A) was marked in the anterior midline of the edentulous ridge in the incisive papillary region, points (B) and (C) were marked in the right and left posterior midlines of the edentulous ridge in the second molar regions, and point (D) was marked in the posterior palatal midline near the fovea palatina media (Figure 2). To determine linear dimensional changes, distances between four reference points (A-B, A-C, A-D and B-C) were initially measured with a metal gauge accurate within 0.1 mm under a binocular stereo light microscope and data (mm) were recorded. RESULTS: No significant difference of interfacial distance was found in sagittal and frontal sections measured 24 h after polymerization and after 30 days of water storage in any of experimental groups (P>.05). Significant difference of linear dimension were found in all experimental groups (P<.01) between measurements made 24 h after polymerization of specimens and 30 days after water storage. CONCLUSION: Palatal vault shape and fiber impregnation into the acrylic resin bases did not affect the magnitude of interfacial gaps between the bases and the stone cast surfaces.

Effects of current provisional restoration materials on the viability of fibroblasts.

OBJECTIVES: The aim of the present study was to evaluate the cytotoxic effects of three different provisional restoration materials on fibroblasts. Two bis-acrylic based [Tempofit Duomix (Detax), Protemp 3 Garant (3M ESPE)] and one urethan dimethacrylate [Revotek LC (GC Corporation)] based provisional restoration materials used. METHODS: Materials were prepared according to the manufacturers' instructions in standard teflon disks (2x5 mm) and four samples were extracted in 7 ml of Basal Medium Eagle with 10% new born calf serum and 100 mg/ml penicillin/streptomycin for 24 hours. The L929 fibroblast cells were plated (25.000 cells/ml) in well plates, and maintained in a CO(2) incubator at 37 degrees C for 24h. After 24 hours, the incubation medium was replaced by the immersed medium in which the samples were stored and the L929 fibroblasts were incubated in contact with eluates for 24 hours at 37 degrees C for 24h. The fibroblast cell viability was analyzed by measuring the mitochondrial activity with the methyltetrazolium test (MTT). Twelve well used for each specimen and experiment repeated for two times. The data was statistically analyzed by Mann-Whitney U tests. RESULTS: The results showed that, Revotek LC and Protemp 3 Garant were not cytotoxic for fibroblast cells when compared to control group (P>.05). However, Tempofit duomix was cytotoxic for L929 fibroblasts when compared to control group and other tested materials (P<.05). CONCLUSIONS: Taking into consideration the limitations of an in vitro study, our study indicate that provisional restoration materials might have cytotoxic effects on fibroblasts and should be selected carefully for clinical applications.

Alteration of nitric oxide production in rats exposed to a prolonged, extremely low-frequency magnetic field.

The purpose of this study is to investigate the possible effect of an extremely low-frequency magnetic field (ELF-MF) on nitric oxide (NO) level. In this study, 27 male Sprague-Dawley rats were used. The rats were divided into three groups: two experimental and one control (sham-exposed). The first and second experimental group (n = 10) were exposed to 100 microT and 500 microT ELF-MF during 10 months, 2 h a day, respectively, and the third (n = 7) group was treated like an experimental group except for ELF-MF exposure in methacrylate boxes. After ELF-MF and sham exposure, serum nitrite levels were measured by Griess reaction. A significant reduction was observed in nitrite levels among the first and second experimental groups of rats and sham-exposed rats after exposure for 10 months, 2 h a day, to ELF-MF of 100 and 500 microT (p < 0.01). These results suggest that prolonged ELF-MF exposure at intensities of exposure limits, determined by ICNIRP for public and occupational, may reduce NO production probably affected by NO generation pathways.

Measurement of selected indoor physical environmental factors in hairdresser salons in a Turkish City.

OBJECTIVES: The purpose of this study was to determine electromagnetic fields, electric fields, humidity, temperature, and illumination levels in hairdresser salons located in the downtown area of Aydin, Turkey. Also some health problems which could be related with the occupational factors are evaluated. MATERIALS AND METHODS: The study was carried out in 30 hairdresser salons, all of which had been registered within the past 5 years. Electric and electromagnetic fields, illumination, temperature and humidity measurements were determined for hairdryers, hood hairdryers and depilatory heaters in the participating salons. A brief questionnaire about characteristics and the health status of hairdressers and workplace conditions was prepared and administered to the hairdressers at the salons. RESULTS: The mean electric fields of hairdryers, hood hairdryers and depilatory heaters were determined as 518 +/- 74, 1,123 +/- 199, and 648 +/- 146 in V/m, respectively, at 5 cm from the surface of each device. These appliances generate mean electromagnetic fields in excess of 0.25 microT at 5 cm: hand-held hairdryers, 5.0 +/- 0.7 microT; hood hairdryers, 1.6 +/- 0.3 microT; and depilatory heaters 1.9 +/- 0.6 microT. Total average of cumulative electric and electromagnetic fields, measured at a distance of 90 cm from the surface of these three devices was calculated to be 98.8 V/m and 0.5 microT, in the participating salons. CONCLUSIONS: This preliminary study suggests that physical environmental factors in the salons may be contributing to the health problems of the hairdressers, and the electrical equipment in the workplaces may have cumulative electric and electromagnetic effects.

Turban pin aspiration: non-asphyxiating tracheobronchial foreign body in young islamic women.

BACKGROUND: Foreign body aspiration is rare in adults. However, in recent years, the aspiration of pins which are used for securing turbans (headscarves) is seen frequently in young women. The aim of this article was to review 105 patients who were admitted to our hospital for turban pin aspiration. METHODS: Chest X-rays were used for diagnosis. Various methods of treatment were performed: laryngoscopy in 6 patients, flexible fiberoptic bronchoscopy in 16, rigid bronchoscopy in 93, and thoracotomy in one patient, while in the other patient the turban pin was spontaneously expectorated. RESULTS: Localization of the pin in the right bronchial system was common (52%). In 6 patients, turban pins located in the larynx were extracted successfully by direct laryngoscopy. Turban pins were successfully removed with a flexible fiberoptic bronchoscope in 4 patients of the 16 (25%) and by rigid bronchoscope in 93 patients of 94 (99%). The average time until discharge was 18 hours and there was no mortality. CONCLUSIONS: Turban pin aspiration is common in Islamic populations and treatment usually requires bronchoscopic procedures. In order to minimize turban pin aspiration frequency, we recommend that turbans should be secured by traditional fastening methods or with an apparatus which cannot be aspirated.

Near-real-time feedback control system for liver thermal ablations based on self-referenced temperature imaging.

Our challenge was to design and implement a dedicated temperature imaging feedback control system to guide and assist in a thermal liver ablation procedure in a double-donut 0.5T open MR scanner. This system has near-real-time feedback capability based on a newly developed "self-referenced" temperature imaging method using "moving-slab" and complex-field-fitting techniques. Two phantom validation studies and one ex vivo experiment were performed to compare the newly developed self-referenced method with the conventional subtraction method and evaluate the ability of the feedback control system in the same MR scanner. The near-real-time feedback system was achieved by integrating the following primary functions: (1) imaging of the moving organ temperature; (2) on-line needle tip tracking; (3) automatic turn-on/off the heating devices; (4) a Windows operating system-based novel user-interfaces. In the first part of the validation studies, microwave heating was applied in an agar phantom using a fast spoiled gradient recalled echo in a steady state sequence. In the second part of the validation and ex vivo study, target visualization, treatment planning and monitoring, and temperature and thermal dose visualization with the graphical user interface of the thermal ablation software were demonstrated. Furthermore, MR imaging with the "self-referenced" temperature imaging method has the ability to localize the hot spot in the heated region and measure temperature elevation during the experiment. In conclusion, we have demonstrated an interactively controllable feedback control system that offers a new method for the guidance of liver thermal ablation procedures, as well as improving the ability to assist ablation procedures in an open MR scanner.

Global analysis of protein activities using proteome chips.

To facilitate studies of the yeast proteome, we cloned 5800 open reading frames and overexpressed and purified their corresponding proteins. The proteins were printed onto slides at high spatial density to form a yeast proteome microarray and screened for their ability to interact with proteins and phospholipids. We identified many new calmodulin- and phospholipid-interacting proteins; a common potential binding motif was identified for many of the calmodulin-binding proteins. Thus, microarrays of an entire eukaryotic proteome can be prepared and screened for diverse biochemical activities. The microarrays can also be used to screen protein-drug interactions and to detect posttranslational modifications.

Extreme Thrombocytosis after Penetrating Femoral Venous Injury.

Lower extremity trauma is an uncommon cause of reactive thrombocytosis. A 17-year-old male patient with an extreme increase in platelet count caused by penetrating femoral venous injury is presented. During his stay in hospital, two thrombotic attacks were observed. Such events should be considered as high risk for thrombosis and anticoagulant therapy administered.

Photosensitization of red blood cell hemolysis by lutetium texaphyrin.

Lutetium (III) texaphyrin photosensitizes postirradiation or "delayed" photohemolysis (DPH) of human and bovine red blood cells at 730 nm by a Type-2 pathway mediated by singlet molecular oxygen. The DPH rate increases with increasing incubation temperature and with the second power of the incident fluence. The experimental DPH curves are in good agreement with a multi-hit kinetics model based on target theory.

Posterior mediastinal goiter.

A patient with chronic cough and recent dysphagia was found to have a retrotracheal mass extending into the mediastinum on chest radiography. A computed tomographic scan confirmed a retrotracheal posterosuperior mediastinal lesion which was believed to have a neurogenic origin. A thyroid 131I scan revealed no uptake of tracer in the chest and results of thyroid function tests were normal. A large retrotracheal colloidal nodular goiter was excised through a right thoracotomy. The diagnostic approach and the safety of surgical access by thoracotomy for thyroid lesions in this unusual site are discussed.