In vitro interactions between probiotic bacteria and milk proteins probed by atomic force microscopy.

Interactions between microbial cells and milk proteins are important for cell location into dairy matrices. In this study, interactions between two probiotic strains, Lactobacillus rhamnosus GG and Lactobacillus rhamnosus GR-1, and milk proteins (micellar casein, native and denatured whey proteins) were studied. The bacterial surface characterization was realized with X-ray photoelectron spectroscopy (XPS) to evaluate surface composition (in terms of proteins, polysaccharides and lipid-like compounds) and electrophoretic mobility that provide information on surface charge of both bacteria and proteins along the 3-7 pH range. In addition, atomic force microscopy (AFM) enabled the identification of specific interactions between bacteria and whey proteins, in contrast to the observed nonspecific interactions with micellar casein. These specific events appeared to be more important for the GG strain than for the GR-1 strain, showing that matrix interaction is strain-specific. Furthermore, our study highlighted that in addition to the nature of the strains, many other factors influence the bacterial interaction with dairy matrix including the nature of the proteins and the pH of the media.

The effect of calcium channel blockers on outcome following the surgical treatment of phaeochromocytomas and paragangliomas.

The peri-operative management of patients undergoing surgery for phaeochromocytoma or paraganglioma with calcium channel blockers (CCB) and their impact on postoperative morbidity and mortality were studied. The medical records of 105 patients undergoing surgery between 1991 and 2002 were analysed retrospectively. In all patients, the calcium channel blocker nicardipine was used for the peri-operative management of haemodynamic changes. Sixty-five patients (61.9%) showed transient intra-operative hypertension. Systolic blood pressure (SBP) > 220 mmHg and SBP > 180 mmHg for > 10 consecutive minutes was observed in 14 (13%) and four patients (2.8%), respectively. SBP < 80 mmHg for > 10 consecutive minutes occurred in 13 patients (12.3%). Eleven patients (10.4%) developed postoperative complications and three patients died (2.8%). The median (range) ICU and hospital length of stay were, respectively, 1 (0-7) day and 10 (2-35) days. The sole use of calcium channel blockers for the peri-operative management of phaeochromocytoma and paraganglioma resection does not prevent all haemodynamic changes; however, its use was associated with a low morbidity and mortality.

[Interest of mannequin based simulator to evaluate anaesthesia residents]. / Intérêt du simulateur d'anesthésie pour l'évaluation des internes d'anesthésie-réanimation.

OBJECTIVE: The aim of this study was to test simulator validity to evaluate the ability of anaesthesia residents to solve two simulated scenarios. STUDY DESIGN: Monocentre, prospective, randomized study. POPULATION: Anaesthesia residents. METHODS: All anaesthesia residents were invited to participate into the study but were free to decline to take part. The authors developed grading forms to evaluate preoperative preparation of anaesthesia room and two simulated scenarios which had been previously validated. All residents were evaluated on the preoperative preparation of anaesthesia room. A randomization was performed to select half of the residents to be tested on one of the simulated scenario. Two experienced anaesthesiologists scored the residents' performance. At the end of the simulated session, residents rated the realism of the scenarios. RESULTS: Among 72 training residents in our institution, 48 participated with 24 beginning and 24 advanced residents. Median scores were similar between beginning (first and second year) and advanced residenced (third and fourth year) for the preoperative preparation of anaesthesia room (17 vs 17 for a maximal score of 25) while scores tended to be higher in advanced residents for simulated scenarios (scenario 1 [34 vs 19 for a maximal score of 55; p = 0.0009], scenario 2 [17 vs 13 for a maximal score of 45; p = 0.58]). However, numerous management errors were observed and some of them did not improve with training. Anaesthesia residents rated the simulator scenarios as realistic. CONCLUSION: This study suggests that mannequin-based simulator appears as a reliable and valid tool to test the performance of anaesthesia residents during critical situations.

Can sonography diagnose acute colonic diverticulitis in patients with acute intestinal inflammation? A prospective study.

In a prospective study of 123 patients with clinical signs of acute intestinal inflammation, the sensitivity of ultrasonography in diagnosing acute colonic diverticulitis was 84.6% and the specificity 80.3%. The predictive value of a positive and a negative sonogram was 76.0% and 87.7%, respectively. Of the 52 patients with subsequently proven acute colonic diverticulitis, 44 presented sonographically with a thickened (greater than 4 mm) hypoechoic bowel wall. In 15 patients, enlarged fluid-filled bowel loops were also present. Air-containing diverticula were demonstrated in 3 patients, abscesses in 8 patients, and colovesical fistulae in 2 patients. Eight large abscesses were successfully treated without emergency surgery by percutaneous sonographically guided evacuation. The described sonographic abnormalities strongly suggest acute colonic diverticulitis, particularly when localized in the left lower abdomen.

Use of topical ketanserin in the treatment of skin ulcers: a double-blind study.

The use of a 2% ointment formulation of ketanserin, an S2-serotoninergic blocking agent, was investigated in a randomized double-blind clinical trial for its effect on the healing of wounds of patients with decubitus, venous, and ischemic skin ulcers. The result demonstrates a significant difference in favor of the ketanserin-treated group (35 patients) versus the placebo-treated group (37 patients) on the basis of two factors: formation of granulation tissue and epithelialization. In addition, a significant difference of 150% in the initial velocity of wound closure was observed in favor of the patients treated with ketanserin. This effect was persistent during the entire study period.

[Multiple tumors in the midline of the brain with endocrine dysfunction]. / Multipele tumoren in het mediane vlak van de hersenen met endocriene uitval.

A patient is reported with hypothalamic-pituitary dysfunction due to multiple cerebral midline tumours of germinoma type. The symptomatology and differential diagnosis are reviewed. The necessity of stereotactic biopsy is discussed. The treatment of these tumours as proposed in recent literature is mentioned, with special reference to radiotherapy (cranial and spinal) and chemotherapy.

The impact of routine admission abdominal sonography on patient care.

In a prospective study of 1000 consecutive patients, abdominal sonography added diagnostic information to that available by history and physical examination in 8.9%. The yield ranged from a high of 27.4% in patients with acute abdominal symptoms to a low of 2.7% in screening sonograms of patients without abdominal symptoms. Sonographically guided biopsy-proven diagnoses were obtained in 6.6% of the patients and were clinically not suspected in 4.4%. The percentage of false-positive and false-negative sonographic studies was 0.5% and 1.1%, respectively. Sonography shortened the duration of hospitalization in 15.3%.

Inversions of chromosome 12 in human malignancies.

We present four cases with a malignant hematologic disorder and an inversion (peri- or paracentric) involving chromosome #12. Two cases of myelodysplastic syndrome showed an identical acquired pericentric inv(12)(p12q23). The pertinent literature on constitutional and acquired inversions of chromosome #12 has been revised.

Partial splenoportal and superior mesenteric venous thrombosis. Early sonographic diagnosis and successful conservative management.

A 61-yr-old woman presented with acute severe pain in the upper abdomen. Within a few hours after admission, diagnosis of partial splenoportal and superior mesenteric venous thrombosis was made by ultrasonography. This thrombosis appeared to be the first sign of a previously unsuspected essential thrombocythemia. Early sonographic diagnosis made possible the prompt institution of conservative treatment. Total thrombosis of the splenoportal system could be prevented. Major surgery was avoided and the outcome was uneventful.