Rapid detection of Group B streptococcus directly from vaginal-rectal specimens using liquid swabs and the BD Max GBS assay.

OBJECTIVE: We adapted the BD Max GBS assay, an automated platform for the detection of Group B streptococcus (GBS) DNA in vaginal-rectal swab specimens after LIM broth enrichment, to directly detect GBS in specimens collected using cellular foam swabs in Amies liquid medium. We compared the BD Max GBS assay performance to that of enriched culture and the BD GeneOhm StrepB assay. METHODS: Seventy-two reference vaginal-rectal specimens were employed to determine the limit of GBS detection and the preferred test volume for direct detection of GBS. A total of 304 clinical specimens were then tested by the optimized BD Max GBS assay, both by direct testing and following broth enrichment. RESULTS: The limit of GBS detection was 75 CFU/mL and the preferred test volume was 100 µL. Of 304 clinical specimens tested, GBS was detected in 62 specimens by enriched culture (20.4%); 61 of these yielded GBS by the BD Max GBS assay when performed directly from the liquid swab (sensitivity 98.4%). All 242 culture-negative specimens also yielded negative results by the BD Max GBS assay (specificity 100%). When this assay was performed following broth enrichment, GBS was detected in all 62 culture-positive specimens (100% sensitivity). The sensitivity and specificity of the BD GeneOhm StrepB assay was 90.3% and 99%, respectively. CONCLUSIONS: The BD Max GBS assay is highly sensitive, requires minimal technical skill with <2 min required to set-up, and results are available in under 80 min (versus 24-48 h for culture). It is configured for 'on demand' testing and vaginal-rectal specimens can be rapidly screened for GBS without the need for enrichment. The results obtained in this study demonstrate that rapid GBS screening using the BD Max GBS assay at the time of delivery is a viable alternative to the current recommended screening at 35-37 weeks of gestation with pre-enrichment testing methods.

Selective immobilization of Acinetobacter junii on the natural zeolitized tuff in municipal wastewater.

The immobilization of desired bacteria onto material was usually performed in synthetic media. The aim of this study was to test the immobilization of phosphate (P)-accumulating bacteria Acinetobacter junii onto natural zeolitized tuff (NZ) in the raw or sterilized municipal wastewater containing the common bacteria Escherichia coli and Enterococcus faecalis and the performance of immobilized A. junii in the same type of wastewater. In the sterilized wastewater which contained the mixture of A. junii, E. coli and E. faecalis, the A. junii was selectively immobilized onto NZ in significantly higher numbers than E. coli and E. faecalis. The A. junii added in the form of bioparticles to the wastewater containing E. coli and E. faecalis, multiplied and removed P from wastewater. The P removal from wastewater was a function of biomass of P-accumulating bacteria and not the amount of NZ or bioparticles used. The performance of A. junii was significantly better in membrane filtered than in autoclaved wastewater. The experiments that were performed in raw non sterilized wastewater showed that A. junii can be successfully immobilized onto NZ in competition with natively present heterotrophic bacteria, retain its metabolic activity and successfully remove P from such water, which makes this technology feasible from biotechnological aspect.

Identification and characterization of potential autochthonous starter cultures from a Croatian "brand" product "Slavonski kulen".

The microbial population of a traditional Croatian fermented sausage "Slavonski kulen" was isolated, identified and subjected to technological and functional characterization in order to select potential autochthonous functional starter cultures. Dominant microflora were lactic acid bacteria (LAB), followed by staphylococci. Identification of isolated lactobacilli showed domination of Leuconostoc mesenteroides and Lactobacillus acidophilus while Staphylococcus xylosus and Staphylococcus warneri outnumbered the staphylococcal microbiota. Most of the isolated LAB and Staphylococcus species displayed good growth in the presence of 5% of NaCl and at 12, 18 and 22°C. All LAB and most of the staphylococci possess proteolytic activity and only Staphylococcus xylosus had lipolytic activity. All lactobacilli and staphylococci isolates produced significant concentrations of lactic acid (as determined by HPLC) and showed antimicrobial activity against pathogenic test microorganisms. Dominant LAB and Staphylococcus species displayed growth in the presence of 1% bile. Most of the staphylococci and all of lactobacilli showed sensitivity to all antibiotics tested.

[An interesting case: recovery of a transmurally penetrated abdominal pad by the means of laparoscopy]. / Der interessante Fall: Laparoskopisch unterstützte Bergung eines transmural penetrierten Bauchtuches.

Lymphangiomas are rare benign tumors. In most cases, resection is necessary to obtain a precise histopathological analysis. There are capillary, caverous and cystic lymphangiomas. The therapy of choice is a complete excision. Recurrence has been reported after incomplete resection. We present the case of a 45-year-old man with a lymphangioma of the omentum minus and -review the literature.

Primary extranodal marginal zone lymphoma of the uvea associated with massive diffuse epibulbar extension and focal infiltration of the optic nerve and meninges, clinically presented as uveitis masquerade syndrome: a case report.

To report a clinical, histopathological and immunohistochemical findings in a case of primary extranodal marginal zone lymphoma of the uvea associated with massive diffuse extraocular episcleral extension and focal infiltration of the optic nerve and meninges, clinically presented as longstanding uveitis masquerade syndrome. Interventional case reports with histopathological correlation. We describe a 80-year-old male patient with a 3-year history of chronic recurrent hypertensive (pan) uveitis associated with ocular pain, unresponsive to topical and systemic anti-inflammatory, immunosuppressive, antibiotic/antiviral and antiglaucomatous therapy. Because the eye was not salvageable with conservative treatment, enucleation of blind and painful eye was performed. Findings from histopathological and immunohistochemistry examination of the enucleated eye showed an extranodal marginal zone lymphoma of the uveal tract with massive epibulbar extension and optic nerve and meningeal penetration. During almost 3 years of clinical course and 6 months after the enucleation, there were no systemic manifestations of lymphoma, and patient has not required subsequent treatment. Primary lymphoproliferative lesions of the uvea, comprising the iris, ciliary body and choroid are very rare, associated with epibulbar extension extremely and with optic nerve and menigeal penetration exceptionally. Despite its rarity, primary lymphoma of the uvea should be included in the differential diagnosis particularly in older patients with longstanding recurrent uveitis.

Cardiac memory (t-wave memory) after ablation of posteroseptal accessory pathway.

BACKGROUND: Cardiac memory is a phenomenon characterized by transient T-wave abnormalities occurring during normal sinus rhythm, after a period of altered ventricular depolarization, where the T-wave vector has the same direction as the vector of the previously altered QRS complex (T-wave inversion). It is a form of electrical remodelling of the ventricular, where the T-wave follows ("remembers") a previously altered QRS vector. METHODS AND RESULTS: Over a 5-year period (2002-2006), 525 consecutive patients underwent electrophysiological study. One hundred and one patients underwent ablation of the atrioventricular reentry tachycardia (AVRT) with an accessory pathway (AP). Forty-two of them were without delta wave on the electrocardiogram (concealed accessory pathway), and 58 patients had an open form of accessory pathways, with delta wave on EKG (Wolff-Parkinson-White syndrome) and only one patient had an accessory pathway between the right atrium and right bundle branch (Mahaim form). According to the location of the accessory pathway, 17 patients (29.3 %) had an accessory pathway in the right posteroseptal region. There was the highest percentage of the appearance of inversion of the T-wave in patients with this position of accessory pathway. T-wave changes were followed in the frontal plane (leads II, III, and aVF). Electrocardiogram (ECG) signs of cardiac memory were present in 16 of 17 (94.1 %) patients within one day after the ablation. The post-ablation T-wave vector had the same direction as the vector of the pre-excited QRS complex (and delta wave) creating inferior T-wave inversions. There was no correlation between the number or duration of energy applications and the extent of cardiac memory post ablation. A majority (90% of cases) of ECGs recorded 3 months after the procedure showed complete or almost complete normalization. None of the patients with T-wave inversion after ablation had a recurrence of preexcitation or tachycardia during the follow-up period of 12 +/- 4 months. CONCLUSIONS: T-wave inversion in leads II, III and aVF with the disappearance of the delta wave after ablation of the accessory pathway in patients with Wolff-Parkinson-White syndrome (accessory pathway in the right posteroseptal region of the heart), is the most powerful marker of successful ablation.

Radiofrequency current catheter ablation of accessory atrioventricular pathways.

BACKGROUND: The purpose of this study was to evaluate the safety and efficacy of a radiofrequency catheter ablation in the patients with the Wolff-Parkinson-White syndrome or paroxysmal supraventricular tachycardia involving a concealed accessory atrio ventricular connection. METHODS AND RESULTS: During a 45 month period (1st January 2002 until 30th September 2005) 373 consecutive patients underwent electrophysiological study in our electrophysiological lab at the Institute for Heart Diseases. Of all the patients 171 (45.8%) were ablated for junction depend tachycardia. Ninety-five patients had undergone ablation of atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reentry tachycardia (AVRT) with accessory pathway (AP) 76 patients. Ablation of the atrioventricular node (AVN) was performed in 59 patients, because of uncontrolled atrial fibrillation with implantation of pacemakers. Ablation was successful in 206 patients (89.3%), partial successful was achieved in 21 patient (9.4%), and no successful only in 3 patients (1.3%). Ablation successful outcome rate was 98.7% (without clinical supraventricular arrhythmia in the follow up period until September 2005). There was a need for performing a re-do ablation in 11 patients (4.8%). A complication occurred in 8 patients, 4.9% (only one major complication, complete atrioventricular block with narrow QRS complex in the AVNRT group). In the group with accessory pathways (atrio ventricular reentry tachycardia (AVRT), there were 76 patients, 28 without delta way on the electrocardiogram (concealed accessory pathways), 47 patients were with open form of accessory pathways, with delta way on EKG (Wolff-Parkinson-White syndrome) and only in one patient with accessory pathway between right atrio and right bundle branch (Mahaim form of concealed accessory pathway). In two patients with AVRT, another circle movement tachycardia was found after the ablation of the accessory pathways, bystander arrhythmia of AVNRT: CONCLUSIONS: The success and safety of catheter accessory pathway ablation is so great that we recommend this nonpharmacological approach as an initial option to any patient with AVRT who has recurrent symptomatic arrhythmias.

The role of zeolites in wastewater treatment of printing inks.

The adsorption of residual organic pollutants from flocculated printing ink wastewater onto several synthetic zeolites was investigated as a finishing method for additional reduction of TOC. The nonselective removal of total organic content was studied. The amount of adsorbed organics was largest for ZSM-5 and NH4-Beta while the other zeolites studied showed lower efficiency, suggesting that adsorption is independent of pore structure. The adsorption rates of organic pollutants were fast. Although the TOC removal increases with increasing amount of zeolite, because of the necessity of additional filtration to lower turbidity to required levels, 5.0 g/L of zeolite was found to be optimum. The 88% reduction of TOC obtained with a single flocculation treatment was improved with the combination of flocculation and adsorption with ZSM-5 which resulted in the overall TOC efficiency of 95%. The addition of zeolites in decantated supernatant water, obtained after flocculation, was also studied in order to assess the effect of floc on zeolite capacity. A decrease in adsorption capacity occurred only if a coagulant concentration less than optimal was applied. Removal efficiency then decreased by around 10%. It was concluded that flocculation followed by adsorption with zeolites is an effective treatment method for this kind of wastewater.

Changes in left ventricular morphology and function in end-stage dilated cardiomyopathy after reductive annuloplasty of double mitral and tricuspid orifices.

BACKGROUND AND AIM: The aim of this study is to show the changes in left ventricular morphology and function after reductive annuloplasty of double mitral and tricuspid orifices (RADO) in ischemic dilated cardiomyopathy (IDCM) and primary dilated cardiomyopathy (PDCM) analyzed by intraoperative transesophageal echocardiography (TEE). METHODS: There were 274 patients, mean age 50.1 years, 188 operated due to IDCM with ejection fraction under 30%, and 86 patients due to PDCM. Mitral annuloplasty according to A. Carpentier and our own procedure was done in 49 and 225 patients, respectively. In 265 cases (97%) our modified De Vega's tricuspid annuloplasty was performed. CONCLUSION: RADO significantly changes left ventricular morphology, reverses remodeling of the heart, decreases sphericity of the left heart, improves hemodynamic function of both ventricles, and slows down progression of cardiac failure. We recommend RADO in the early stage of PDCM, immediately after the first decompensation, and as an important associated procedure in IDCM.

Three-month change in the radiodensity of alveolar bone supporting partial-denture abutment teeth.

This study uses the intraoral microdensitometric method to examine the impact of masticatory pressure on the alveolar bone around the abutment teeth clasp. Two retroalveolar radiographs were carried out on all 30 subjects over a period of 3 months using a copper calibration stepwedge. The dental radiographs were digitized and converted into positive. Grey level values on dental radiographs in the alveolar bone area in 7 region of interest (ROI) were measured. They were converted into the equivalent thickness of the calibration stepwedge using mathematical methods and the difference of the bone density between the two radiographs was calculated. The results demonstrated that there were no statistically significant differences between the 1st and 2nd radiographs in any of ROI (p > 0.05).

Spectroscopic analysis of desiccation-induced alterations of the chlorophyllide transformation pathway in etiolated barley leaves.

Effects of water deficit on the chlorophyllide (Chlide) transformation pathway were studied in etiolated barley (Hordeum vulgare) leaves by analyzing absorption spectra and 77-K fluorescence spectra deconvoluted in components. Chlide transformations were examined in dehydrated leaves exposed to a 35-ms saturating flash triggering protochlorophyllide (Pchlide) and Chlide transformation processes. During the 90 min following the flash, we found that dehydration induced modifications of Chlide transformations, but no effect on Pchlide phototransformation into Chlide was observed. During this time, content of NADPH-Pchlide oxydoreductase in leaves did not change. Chlide transformation process in dehydrated leaves was characterized by the alteration of the Shibata shift process, by the appearance of a new Chlide species emitting at 692 nm, and by the favored formation of Chl(ide) A(668)F(676). The formation of Chl(ide) A(668)F(676), so-called "free Chlide," was probably induced by disaggregation of highly aggregated Chlide complexes. Here, we offer evidence for the alteration of photoactive Pchlide regeneration process, which may be caused by the desiccation-induced inhibition of Pchlide synthesis.

Loss of heterozygosity of DPC4 tumor suppressor gene in human sporadic colon cancer.

We investigated the prevalence of DPC4 loss of heterozygosity in sporadic colorectal cancer. Thirty-six cases of human sporadic colon carcinoma and corresponding normal tissue samples were examined to evaluate loss of heterozygosity at the DPC4 tumor suppressor locus using variable nucleotide tandem repeat (VNTR) analysis and three polymorphic markers. From 36 analyzed samples 35 (97%) were heterozygous or informative. Loss of heterozygosity at the DPC4 locus was detected in 18 (51%) of informative tumor DNAs. The DPC4 LOH was more frequent in smaller tumors (<5 cm) than in larger ones. There was no correlation between DPC4 LOH and age or sex of patients. There was a negative correlation between DPC4 LOH and histological grade or Dukes' stage of tumors, but without statistic significance. Observed results are in agreement with the view that malignant progression is consequence of many genetic changes. It can be concluded that inactivation of the DPC4 gene plays a role in a multistep process of outgrowth and progression of colon cancer.

Effect of the nonsteroidal anti-inflammatory drug indomethacin on proliferation and apoptosis of colon carcinoma cells.

PURPOSE: Nonsteroidal anti-inflammatory drugs lower the incidence of and mortality from colon cancer. In this paper, we present the effect of indomethacin on growth inhibition and alterations in the expression of several genes involved in cell cycle and apoptosis in CaCo-2 colon adenocarcinoma cells. METHODS: We used the MTT test to evaluate the effect of indomethacin on the proliferation rate of colon cancer and normal fibroblast cells in vitro. The expression of c-myc oncoprotein and p53 and p27 suppressor proteins was examined using the immunocytochemical method. RESULTS: We have shown that indomethacin reduces the proliferation rate of CaCo-2 colon cancer cells (up to 60% at the concentration of 4 x 10(-4) M), alters their morphology, and induces cell death by apoptosis. The most pronounced inhibitory effect was observed at the concentration of 6 x 10(-4) M where the growth was completely suppressed. However, the growth of normal fibroblasts (Hef 522) was much less inhibited (about 30% of inhibition at the concentration of 6 x 10(-4) M). Indomethacin reduces the proliferation rate and induces apoptosis in CaCo-2 colon cancer cells through enhanced expression of c-myc, p53, and p27 proteins. CONCLUSIONS: This is the first report about p27-increased expression in colon carcinoma cells induced by indomethacin treatment. Increased expression of p27 represents a new mechanism of apoptosis in cells treated with NSAIDs (indomethacin). This effect probably contributes to the anti-proliferative effect on colon cancer cells in vitro.

Syndroma: glaucoma pigmentatum primarium--pigmented glaucoma.

In this study pigmented glaucoma was diagnosed in 29 out of 4350 patients suffering from glaucoma. In clinical analysis of those cases main attention was put on Krukenberg spindle with emphasis on the process and reason of its development. In all cases of Krukenberg spindle moderate myopia and myopic astigmatism were present. The main axis of the spindle lies in the principal meridian of corneal astigmatism. The principal meridian of the anterior cornea surface corresponds with the axis of the principal meridian of the posterior corneal surface. The higher degree of astigmatism more pronounced Krukenberg spindle. This corresponds to a number of cases in which the spindle is hardly recognisable in the astigmatism, of only +/- 0.25 to +/- 0.50 Dcyl. The axis of meridian corresponds to direct astigmatism (from 110 degrees to 70 degrees). The authors conclude that there is no pigmented Krukenberg spindle without myopic astigmatism. It is for this reason and because of the inheritance factor that this type of glaucoma should be considered primary glaucoma and a separate clinical entity.

Complications of pneumatic retinopexy.

Twenty-eight patients with rhegmatogenous retinal detachment were treated by pneumatic retinopexy using intravitreal perfluorpropane (C3F8) gas. Reattachment was successfully achieved in 22 eyes (78.6%) after one treatment. Most of the eyes were myopic and had a single retinal break or group of breaks within one o'clock hour. All retinal complications developed in the inferior retinal quadrants with postoperative proliferative vitreoretinopathy (PVR) as one of the most serious complications, occurring in 3 (10.7%) eyes. New retinal breaks developed in 2 (7.1%) eyes.

[Magnesium in cardiology]. / Magnezijum u kardiologiji.

INTRODUCTION: Magnesium is an oligo-element which has an important effect on the myocardial function and peripheral vascular system. MATERIAL AND METHODS: The experiences of other authors as well as other papers have been analyzed. RESULTS: Magnesium participates in over 300 enzymatic reactions in the human organism. It may be found in drinking water and food through which it is substituted. According to WHO, there is a good correlation between Ca++/Mg++ ratio in drinking water and frequency of cardiac events. Higher Mg++ quantity reduces coronary disease. Decreased Mg++ quantity in plasma has been registered in patients with acute myocardial infarction (AMI), coronary patients and patients with heart failure. Various rhythm disturbances, particularly Torsade de points are related to hypomagnesemia. Diuretics and some cytostatics, and antibiotics decrease Mg++ in plasma, erythrocytes and muscles. Decreased Mg++ have been found in alcoholics, diabetics and Crohn disease, which are in certain cases related to existing heart rhythm disturbances. In cardiology it is proved that Mg++ are beneficial in AMI, protection during open heart surgery and treatment and prevention of heart surgery and heart rhythm disturbances. The use of Mg++ in vasospastic angina pectoris, Raynaud's disease and cardiomyopathies due to cytostatics is still in the process of investigation. It is still a matter of discussion whether Mg++ should be administered in these conditions or only when its quantities are reduced. Do Mg++ values in plasma indicate its total presence in the organism? Where should Mg++ be administered as therapy, in which doses and how rapidly? Should preventive addition of Mg++ in drinking water reduce heart disease and prolong life? There are neither many answers nor real conclusions on Mg++ significance in cardiology. However, some encouraging results about its use indicate the significance of further investigations. DISCUSSION: It has been accepted by the authors all over the world that the role of magnesium is of great importance in prevention and treatment of cardiac patients. CONCLUSION: Our first experiences are in accordance with other studies.

Kineziographic research of patients with cross bite.

The paper describes the use of an objective method for the quantitative analysis of the relationship between the posterior cross-bite and the occurrence of occlusive interferences and damages to the mandible muscle elevator. Two groups of subjects were selected for the analysis: 10 patients with unilateral cross-bite and 10 students without any symptoms of temporomandibular disorders (TMD). By means of the Robert Jenkelson K5A kinesiograph we measured maximal opening velocity of the mandible (mm/s), maximal-closing velocity (mm/s), first tooth contact velocity and displacement in the vertical plane at the maximal intercuspidation (mm). The following values were obtained: maximal-opening velocity in the first group was 349 mm/s and 380 mm/s in the control group. This difference was incidental. The maximal closing velocity in the study group was 204.9 and 345.2 in the control group (p < 0.05). The first tooth contact velocity in the study group was 75.93 and 325 in the control group (p < 0.01). Displacements in the vertical plane at the maximal intercuspidation in the investigated group was 0.24 +/- 0.01 mm, while in control group that value was 0.12 +/- 0.012 mm.

[Arrhythmogenic right ventricular dysplasia]. / Aritmogena displazija desnog ventrikla.

INTRODUCTION: Arrhythmogenic right ventricular dysplasia (ARVD), disease of uncertain etiology, is characterized by fibrofatty collections in the right ventricular myocardium, premature ventricular complexes with left bundle branch block (LBBB) morphology, ventricular tachycardia and fibrillation. GOALS: To point out diagnostic methods for this progressive disease and to analyze differential diagnosis and significance of arrhythmogenic right ventricular dysplasia in young, active athletes. RESULTS: Arrhythmogenic right ventricular disease can be asymptomatic or manifested (syncope). It is not uncommon that the first evidence of the disease is ventricular tachycardia/fibrillation or sudden cardiac death. Results of electrocardiography, echocardiography, invasive and other methods can, even after few years, be negative for ARVD. The most significant ECG features are inverese T wave in precordial V1-V3 leads and widened QRS complex (> 120 ms) in V1 lead. Significant echocardiographic features and data obtained by invasive hemodynamic examinations are: dilated right ventricle, left and right ventricular end-diastolic diameter ratio less then 0.5, hypokinetic/akinetic areas involving the wall of the right ventricle, predominantly inferobasal, apical and wall of the left ventricular outflow tract. Findings may also include deep fissures among hypertrophied trabeculae. Biopsy may reveal fibrofatty tissue in hypo/akinetic regions of the right ventricular myocardium. DISCUSSION AND CONCLUSION: Since arrhythmogenic right ventricular dysplasia is diagnosed in predominantly young population, not uncommonly athletes, and since it may be cause of sudden cardiac death, there must be a high degree of suspicion in cases with activity related VT/VF and positive family history (it is proposed that it is a hereditary disease).