Effect of Heat-treatment on Accuracy of Infrared Spectroscopy and Digital and Optical Brix Refractometers for Measuring Immunoglobulin G Concentration in Bovine Colostrum.

BACKGROUND: Heat-treatment of colostrum is a method developed to reduce calf exposure to pathogens. Infrared (IR) spectroscopy and Brix refractometers can be used for measuring colostral IgG concentration and assessing colostrum quality. OBJECTIVES: To determine the impact of heat-treatment on accuracy of IR spectroscopy and Brix refractometers for measuring colostral IgG concentration and assessing colostrum quality before and after heat-treatment. ANIMALS: A total of 60 Holstein dairy cows on 8 commercial dairy farms. METHODS: A cross-sectional study was designed to determine the effect of heat-treatment at 60°C and 63°C each for 30 and 60 minutes duration on colostral IgG concentration measured by the reference radial immunodiffusion (RID) assay, IR spectroscopy, and digital and optical refractometers. RESULTS: Colostrum IgG concentration significantly decreased after heat-treatment at 63°C for 30 or 60 minutes as measured by RID, but the IgG values remained unchanged when measured by IR spectroscopy and refractometers. The lowest correlation coefficient found between IR spectroscopy (r = 0.70) and RID results was in colostrum heat-treated at 63°C for 60 minutes. For digital (r = 0.48) and optical (r = 0.50) refractometers, the lowest correlation coefficient was at 63°C for 30 minutes when compared to RID. The accuracy of the IR spectroscopy, digital and optical Brix refractometers was decreased from 91.7 to 80%, 81.7 to 45%, and 80 to 45%, respectively, when colostrum heat-treated at 63°C for 60 minutes. CONCLUSIONS AND CLINICAL IMPORTANCE: Radial immunodiffusion, IR spectroscopy, and Brix refractometers exhibit utility for measuring IgG concentration when colostrum heat-treated at 60°C but does not detect decrease IgG concentrations when heat-treated at 63°C.

The significance of interactions between organic compounds on low pressure membrane fouling.

Fouling of hollow fibre microfiltration and ultrafiltration membranes by solutions of pure organic compounds and mixtures of these compounds was studied with a backwashable membrane filtration apparatus. Small molecular weight compounds resulted in little fouling, while their polymeric analogues resulted in more severe fouling. Neutrally charged dextran resulted in minor, irreversible fouling, that was considered to be associated with blocking of small pores. Cationically charged chitosan produced gross fouling for which the extent of reversibility increased with salt addition. Anionically charged alginic acid resulted in gross irreversible fouling, except when being filtered by a hydrophilic membrane in the absence of calcium where a high degree of flux recovery was observed. Calcium addition to the alginic acid solutions resulted in gross fouling of all membranes and calcium bridging was considered to be responsible for this behaviour. Greater fouling occurred on the hydrophilic membrane compared to the hydrophobic membranes for bovine serum albumin (BSA) solutions, and this was considered to be due to physical blocking of pores, because addition of calcium resulted in lower flux declines. Addition of BSA and calcium to alginic acid solutions resulted in lower flux recoveries for the alginic acid system, consistent with the proposition that interactions between polysaccharide and other compounds are required for irreversible fouling on hydrophilic membranes.

Missing cyclists.

OBJECTIVES: (1) For crashes on a public road, to compare serious cyclist crashes involving a motor vehicle with cyclist crashes not involving a motor vehicle, in terms of threat to life and length of stay in hospital. (2) To determine the proportion of all serious crashes involving cyclists on public roads which are recorded by the police. (3) To determine the degree to which under-reporting of serious crashes involving cyclists and motor vehicles on public roads is associated with various demographic, environmental, and injury factors. STUDY DESIGN: Records for the period 1995-99, of cyclists seriously injured on a public road and hospitalised were linked to the traffic crash report (TCR) database maintained by Land Transport Safety Authority (LTSA). RESULTS: Of the 2925 cyclist crashes on public roads, only 652 (22%) could be linked to a TCR. Of the crashes involving motor vehicles (n = 1033), only 562 (54%) could be linked to the LTSA database. Age, ethnicity, injury severity, and cumulative length of stay were the only variables that predicted whether hospitalised cycle crash cases were more likely to have a corresponding TCR. There were substantial numbers of cyclist only crashes which typically are not captured in the TCR database. Nine percent of these resulted in serious or worse injury (that is, International Classification of Diseases/abbreviated injury scale score of 3+) and 7% resulted in hospital stays greater than seven days. CONCLUSION: Greater effort and precision needs to be applied to routinely document the burden of cyclist crashes, especially cyclist only crashes.

How many children remain fracture-free during growth? a longitudinal study of children and adolescents participating in the Dunedin Multidisciplinary Health and Development Study.

While much is known regarding the incidence and pattern of fractures during growth, information is sparse as to how many children fracture repeatedly and how many remain fracture-free during growth. The Dunedin Multidisciplinary Health and Development Study, a birth cohort, whose members were questioned regularly throughout growth (at ages 5, 7, 9, 11, 13, 15 and 18 years) concerning injuries including fractures, has provided a unique opportunity to answer these questions. Life-table analysis showed that approximately half the children remained fracture-free throughout growth [girls 60.1%, (95% CI 54.7-65.0) and boys 49.3% (95% CI 44.0-54.4)]. Data on fracture history, for participants seen at every phase, was available for 601 members through to the age of 18 years (61.1% of the cohort seen at age 5 years). Two hundred and ninety-one of these 601 participants reported 498 fractures, with 172 sustaining a single fracture, and 119 more than one fracture (15.8% girls and 23.4% boys). The most common site of fracture was the wrist/forearm (24.1% of all fractures). We conclude that although bone fractures are a common adverse event in childhood, half of all children remain fracture-free throughout growth.

Herpes virus infections occur frequently following treatment with fludarabine: results of a prospective natural history study.

We performed a prospective infectious natural history study of 21 patients with low-grade lymphoproliferative disorders receiving fludarabine as initial (n = 5) or salvage (n = 16) therapy. 12 (57%) of these patients developed herpes zoster (n = 9), herpes simplex I (n = 1) or herpes simplex II (n = 2) infections at a median of 8 (range 1-17) months following initiation of fludarabine, with 75% of these having completed therapy. All patients with herpes zoster developed severe post-herpetic neuralgia. Factors differentiating patients developing these infections included older age and low serum IgG or IgA. Based upon these prospective data, we conclude that herpes virus infections frequently occur following fludarabine treatment, necessitating aggressive patient education and new prophylactic strategies.

The "dural tail sign": not always a meningioma.

Periorbital masses are often referred to oculoplastic surgeons. We report a 20-year-old patient presenting with a tender supertemporal mass that on gadolinium-enhanced magnetic resonance imaging (MRI) demonstrated a prominent dural enhancement adjacent to the mass, the so-called "dural tail sign." This sign has been reported to be highly specific for a meningioma; however recent literature challenges this view. In this case as well, the "dural tail sign" was not produced by a meningioma.

Leukemic thyroiditis as the initial relapsing sign in a patient with acute lymphocytic leukemia and blast expression of the neural cell adhesion molecule.

We report a patient with a history of T-cell ALL in remission who presented with symptoms and laboratory values consistent with subacute thyroiditis but was found to have leukemic thyroiditis as the first clinical manifestation of leukemic relapse. Bone marrow examination at this time demonstrated recurrent ALL. After successful re-induction with chemotherapy and an allogeneic bone marrow transplant this patient developed an isolated recurrence of her ALL manifested by symptomatic thyromegaly and a new mediastinal mass that was treated with irradiation. Despite no medullary recurrence of ALL, the patient developed pleuritic chest pain and shortness of breath and succumbed to pericardial extramedullary leukemia 9 months later. This to our knowledge is the third reported case of symptomatic ALL involvement of the thyroid gland and the first to be confirmed histologically. Furthermore, this patient had blast expression of the neural cell adhesion molecule (CD56), a cell surface marker that has not been studied in ALL but has previously been identified as a risk factor for extramedullary leukemia (EML) in acute non-lymphocytic leukemia. The authors hypothesize that CD56 expression in this patient might have contributed to her predisposition to EML.

Desialylation of peripheral blood mononuclear cells promotes growth of HIV-1.

Activation of peripheral blood CD4+ helper T lymphocytes establishes a permissive state for growth of HIV-1. Activated T lymphocytes expressed increased sialidase (neuraminidase) activity and were hyposialylated. Treatment of freshly isolated peripheral blood mononuclear cells (PBMCs) with microbial neuraminidase (NANase) or phytohemagglutinin (PHA) prior to infection at low multiplicity with T cell line-adapted HIV-1IIIB resulted in production of large amounts of p24 antigen and reverse transcriptase. In contrast, neither viral component was detected in the medium of mock-treated cells infected at a similar multiplicity through 21 days in culture. The titer of a stock solution of HIV-1IIIB was 1.4 +/- 0.18 log10 greater in NANase-treated PBMCs than in mock-treated cells; the titer was similarly raised 1.5 to 1.76 +/- 0.18 log10 in PHA-treated cells. Growth of the primary isolate HIV-1(91/US/056) was also enhanced in NANase-treated PBMCs; the titer of a stock solution of HIV-1(91/US/056 was 1.0 +/- 0.16 log10 greater in NANase-treated PBMCs than in mock-treated cells 7 days after infection. No enhancement of viral growth in PBMCs was detected when NANase was heat-inactivated or specifically inhibited with 2,3-dehydro-2-desoxy-N-acetyl-neuraminic acid prior to use. Treatment of PBMCs with NANase did not alter the distribution of lymphocyte subsets nor change the density of CD4 antigen per cell after 7 days in culture. Whereas PHA treatment of PBMCs was mitogenic, pretreatment with NANase was not; the amount of [3H]thymidine incorporated into DNA and culture growth characteristics were similar for NANase- and mock-treated cells. Thus, desialylation of PBMCs promoted a permissive state for growth of HIV-1 without affecting the rate of DNA synthesis or relative number of target CD4+ cells.

Extramedullary myeloid cell tumors in myelodysplastic-syndromes: not a true indication of impending acute myeloid leukemia.

The purpose of this report is to record a patient with myelodysplastic syndrome (MDS) associated acute myelogenous leukemia (AML) and leukemia cutis who had blast expression of the neural cell adhesion molecule (NCAM) and to review the world literature on prognostic implications of extramedullary myeloid cell tumors (granulocytic sarcoma, myeloblastoma, chloroma and leukemia cutis) in MDS and MDS associated AML. Case report and world literature from January 1965-January 1994 for all cases of MDS-associated extramedullary myeloid cell tumors (EMT) is reviewed, and the first patient with EMT, MDS associated AML and blast expression of NCAM is described. There have been 46 cases of MDS associated EMT previously reported. 32 cases occurred in the absence of AML. AML developed in 47% of these patients at a mean of 38 weeks from initial EMT. Of the patients not developing AML, median survival from initial EMT was 11 weeks. Nine patients received chemotherapy at the time of EMT and had a median survival of 36 weeks. The median survival for patients receiving conservative therapy for EMT was 48 weeks. Patients (n = 15) with EMT and MDS associated AML had a poor outcome regardless of therapy with a median survival of 11 weeks. Unlike other forms of isolated EMT, MDS associated EMT is not always a forerunner of AML. Premature induction therapy for MDS associated EMT does not appear to prolong survival. EMT in the setting of MDS associated AML is associated with a poor prognosis despite aggressive chemotherapy. Blast expression of NCAM may prove to be a risk factor for EMT in MDS associated AML.

A flow cytometric method for phenotyping recipient red cells following transfusion.

BACKGROUND: Reticulocyte phenotyping is used for transfused patients, who have red cell antibodies, to match blood for subsequent transfusion. Current methods are labor-intensive and require a significant amount of sample. STUDY DESIGN AND METHODS: A simple dual-color flow cytometry method developed for antigen typing of reticulocytes in mixed red cell populations is reported. Antigens were labeled by an indirect immunofluorescence technique using undiluted reagent sera as the primary label, biotinylated goat anti-human IgG as the secondary label, and avidin-phycoerythrin as the fluorescent stain. Reticulocytes were labeled with a thiazole orange fluorescent stain. Reticulocyte identification and antigen typing were performed on 319 samples to establish the validity of the procedure. Mixed red cells were prepared in all possible c antigen combinations to simulate transfusion concentrations of 25, 50, and 75 percent. RESULTS: The anti-c flow cytometry profiles readily distinguished between antigen-positive and antigen-negative populations and allowed the detection of reticulocytes at all simulated transfusion concentrations. Similar results were obtained in experiments using C, K, s, Fya, Fyb, Jka, or Jkb sera against equal volumes of antigen-positive and -negative cells. Anti-S gave inconsistent results. The in vitro results were confirmed in 19 transfused patients who had received red cells antigenically different from their own as well as cells from 1 chimera blood donor. CONCLUSION: This method provides a simpler, safer, less labor-intensive, and less subjective technique requiring far less sample volume than current methods for antigen typing of reticulocytes in mixed red cell samples from recently transfused patients.

Tributo de Mudanca com o TRO e o Rorschach num Caso de Tratamento Psicanalitico

Trata-se de um estudo psicanalitico de um paciente com impotencia sexual e depressao.

Respiratory failure in rapidly progressing pulmonary lymphoma. Role of immunophenotyping in diagnosis.

An asymptomatic man was found to have bilateral small pulmonary infiltrates on a preoperative chest roentgenogram. Over a 4-wk period there was rapid progression of the infiltrates with a clinical picture suggestive of adult respiratory distress syndrome. Open lung biopsy showed a high grade lymphoma filling and distorting the pulmonary parenchyma. Flow cytometry of pleural fluid showed an aberrant phenotype consistent with T cell lymphoma. The patient died of progressive respiratory failure 6 wk after the first radiographic abnormalities were detected. With further experience, immunophenotyping of pleural fluid may secure definitive diagnoses in certain clinical situations, obviating more invasive procedures.

Hairy cell leukemia in two siblings. A human leukocyte antigen-linked disease?

Shared haplotypes have been documented in three of the four previously reported families with familial hairy cell leukemia (HCL). Human leukocyte antigen (HLA) typing was done on a four-member sibship in which two siblings had hairy cell leukemia. The two affected siblings share the haplotype A2; Bw6, Bw62(15); Cw1; DR4, DRw53; DQw3. No one HLA antigen or haplotype is common among the five families reported at this time. These limited data suggest HCL is not associated with a specific HLA antigen. HLA typing of a larger collection of cases of familial HCL may help better define what role, if any, inheritance plays in the occurrence of this rare disorder among numerous first degree relatives.

Primary omental leiomyosarcoma masquerading as hemorrhagic ascites.

An 85-year-old man with unexplained hemorrhagic pseudoascites of four years' duration was discovered to have a primary omental leiomyosarcoma. Neoplasms arising in the greater omentum are rare. To date, only three primary omental leiomyosarcomas have been described. Clinical and pathologic findings of this case are presented and the topic of primary omental neoplasms is reviewed.