Endoscopic treatment of Zenker's diverticulum.

BACKGROUND: The most important aspect of the surgical management of Zenker's diverticulum is probably the cricopharyngeal myotomy. Endoscopic diverticulotomy can be performed with a needle-knife papillotome, which allows simultaneous myotomy of the upper esophageal sphincter. METHODS: Since 1978, 47 patients (28 men and 19 women 51 to 81 years of age) underwent endoscopic diverticulotomy. Most patients underwent more than one treatment session (mean value 2.2). The procedure was performed with sedation. Tubes were not used, and oral intake of food was begun the first day after the operation. RESULTS: Forty-five (95.74%) patients had no dysphagia or only occasional, mild dysphagia during the postoperative course. No fistula, no recurrent laryngeal paralysis, and no deaths occurred. CONCLUSION: Endoscopic diverticulotomy seems to be a good choice of therapy at least for patients with associated diseases that increase surgical risk.

Chemical and immunological characterization of a low molecular weight outer membrane protein of Salmonella typhi.

A new immunogenic outer membrane protein, Omp-28 (MW 28,000 and pI 4.6), was isolated from smooth Salmonella typhi cells by the use of an extracting medium containing 6 M urea, 1% deoxycholate and 5 mM EDTA. The purification of Omp-28 was performed by gel filtration and fast ion exchange chromatography. This protein showed to be the prevalent component isolated by the latter methodology. Omp-28 is formed by three identical subunits (MW 9,000), not linked by disulfide bonds. The partial N-terminal amino acid sequence of Omp-28 presented great homology with part of the sequence of an Escherichia coli protein found in a precursor whose sequence was predicted by c-DNA. ELISA and Western blotting identified Omp-28 as the major antigenic protein present in the outer membrane protein fraction, isolated by gel filtration. Antibodies against Omp-28 were detected by ELISA in 43% of 28 sera from typhoid fever convalescent patients. The antisera from mice immunized with Omp-28 and the highest positive typhoid fever convalescent serum gave a positive bactericidal test, killing 50% of Salmonella typhi cells in serum dilutions of 1/80 and 1/320, respectively. These results indicate the immunogenic importance of Omp-28 isolated from Salmonella typhi outer membrane and strongly suggest it should be used in further studies of animal protection against the disease caused by this pathogenic bacteria.

Amino acid sequence of a new 2S albumin from Ricinus communis which is part of a 29-kDa precursor protein.

The isolation and sequence determination of a new 2S albumin storage protein from Ricinus communis seeds denoted 2S ASP-Ib are described. The fragment approach using selective enzymatic cleavage, Edman degradation, and mass spectrometry was used to demonstrate that the 11-kDa heterodimer protein linked by disulfide bridges has the following structure: short chain, GEREGSSSQQCRQEVQRKDLSSCERYLRQSSS; long chain,

[Effect of H2 blockers on the surgical indications for peptic ulcer]. / Influência dos bloqueadores H2 na indicação da cirurgia para úlcera péptica.

The effects of introduction of cimetidine therapy were studied by an analysis of all cases of peptic ulcer who came to be operated at the Hospital das Clinicas of the University of São Paulo in the period between 1966 and 1985. A reduction in the frequency of surgical interventions especially after 1978, was verified. Ten percent of all cases operated between 1973 and 1985 and chosen at random were studied in a more detailed way. A reduction in the number of operations for gastric and duodenal ulcers was found. There was a greater interval between diagnosis and surgery, an increased number of operations for stenosis and hemorrhagic peptic ulcers and a reduction in frequency of operations for perforated peptic ulcer. There were no significant differences as to the sex and age of patients, except in cases of perforated peptic ulcer, with a larger number of female patients.

Energy balance for ethyl alcohol production from crops.

Energy requirements to produce ethyl alcohol from three different crops in Brazil (sugarcane, cassava, and sweet sorghum) were calculated. Figures are presented for the agricultural and industrial phases. The industrial phase is always more energy-intensive, consuming from 60 to 75 percent of the total energy. Sugarcane is the more efficient crop for ethyl alcohol production, followed by sweet sorghum and cassava from a net energy viewpoint. The utilization of sweet sorghum stems might increase the total energy gain from this crop to almost the same level as sugarcane. Cassava has a lower energy gain at the present state of agriculture in Brazil.