Determination of antimicrobial activity of Achatina reticulata slime.

BACKGROUNDS: Snails (Gastropoda) have a mechanism for the production of a significant amount of slime and substances contained therein they use to protect themselves against bacterial or fungal pathogens. These active substances are involved in both humoral and cellular immune responses of the gastropods. The antibacterial or antifungal effect of the humoral immune component of slime lies in cytotoxic and haemagglutination activity against potential microbial pathogens. The activity of antibacterial agents present in Achatina reticulata slime against bacterial strains of Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa was tested. MATERIAL AND METHODS: A total of five samples of slime from laboratory reared Achatina reticulata were tested. To eliminate potential microbial contamination, slime samples were sterilized by UV radiation. To screen slime samples for antibacterial activity, the simple diffusion method on Mueller-Hinton agar was used. Samples diluted in guaiacol glycerol ether were used in the testing. RESULTS: The results show that the biologically active substances present in Achatina reticulata slime have an antimicrobial activity which is almost commensurate with that of the conventional antibiotics used to treat bacterial infections. The results of the determination of the antimicrobial effects of Achatina reticulata slime also highlighted viridation (partial hemolysis of erythrocytes after 24 hours of slime cultivation exposed to UV light for 60 minutes on Columbia blood agar. CONCLUSIONS: The results of the antimicrobial activity testing of selected Achatina reticulata slime samples show that the gastropod slime contains biologically active substances with a relatively significant antimicrobial activity.

[Arthroscopic Treatment of Chronic Retrocalcaneal Bursitis - Endoscopic Calcaneoplasty]. / Artroskopická terapie chronické retrokalkaneární burzitidy ­ endoskopická kalkaneoplastika.

INTRODUCTION The authors evaluate the results of endoscopic treatment and analyse the causes of persisting difficulties in retrocalcaneal bursitis unresponsive to conservative treatment. Stated as one of the causes is the possible chronic irritation of minor/partial tears of anterior parts of the distal portion of the Achilles tendon, which have no chance to heal due to continued overload and impingement syndrome of the superior prominence of the calcaneal tubercle. MATERIAL AND METHODS The authors evaluate the group of 24 patients (10 women and 14 men) diagnosed with retrocalcaneal bursitis, who reported more than 12 months of difficulties and in whom the conservative therapy options have already been exhausted. The decision to perform a revision arthroscopy was made by the authors based on chronic long-lasting difficulties, clinical examination, calcaneus radiograph, ultrasound examination and negative response to the performed conservative treatment. The MRI scan was obtained in 4 patients. In 11 patients during arthroscopy the Achilles tendon was intact, in 13 patients (54.2%) minor tears were detected on the anterior aspect of the distal Achilles tendon, not diagnosed preoperatively (by ultrasound examination). In all the patients, resection of the prominence of the calcaneal tubercle was performed, whereas in patients with affected Achilles tendon also the loose tendon fragments were resected. RESULTS A total of 23 patients reported an improvement of their condition, the pain subsided at 21-43 days. Altogether 21 patients returned to activities carried out before the onset of pain. The AOFAS score values measured preoperatively in patients with an intact tendon were 59.5 ± 15.0, in patients with an injured tendon it was 45.57 ± 9.6, while 6 months after the surgery the values were 95.7 ± 6.2, or 88.71 ± 7.8 respectively. In 1 female patient, with one prior surgery, diagnosed with a partial tear of the Achilles tendon, the effect of the surgery was unsatisfactory. After six months the patient underwent an open revision surgery and the Achilles tendon reinsertion. No intraoperative or postoperative complications were observed. DISCUSSION The endoscopic technique facilitates a more visible bone resection, with better control of resection, which is less invasive than the open technique. The source of irritation can be removed, which is not always only the prominence of the calcaneal tubercle, but another cause of persisting problems can also be a microtrauma affecting the anterior portion of the Achilles tendon, with a reactive hyperaemia in bursal tissue. Compared to literature and also based on the results of the authors of this retrospective study, the endoscopic calcaneoplasty is less invasive than the open surgery. It is always necessary to properly diagnose the causes of difficulties and to timely respond to persisting symptoms in patients, not responding satisfactorily to conservative therapy. CONCLUSIONS The findings presented by the authors provide a new perspective on the causes of chronic problems such as the "posterior heel pain" and tend to give preference to the active endoscopic approach in patients with persisting problems, not responding to conservative treatment, predisposed based on the radiological examination and with a positive finding on ultrasound or MRI scan. Key words:retrocalcaneal bursitis, endoscopic calcaneoplasty, arthroscopy.

[Treatment of Extensive Chondral Defects of the Patella after Patellar Dislocation]. / Terapie rozsáhlých chondrálních defektu pately po akutní luxaci pately.

PURPOSE OF THE STUDY Patellar dislocation is a fairly frequent knee joint injury in young patients. In most cases, this injury can be treated conservatively or surgically. In many cases, patellar cartilage or lateral femoral condyle or both these parts of articular surface are injured, and in conservative treatment this chondral damage very often remains undiagnosed. The purpose of this study is to evaluate the outcomes of treatment in patients who underwent surgery for patellar dislocation and in whom extensive traumatic cartilage lesions of the patella were found. MATERIAL AND METHODS The authors carry out a retrospective evaluation of outcomes in 34 patients from the period 2005-2014, in whom extensive chondral defect of the posterior side of the patella after its traumatic dislocation with the mean size of 4.1 cm2 (the maximum size was 28x18 mm) was found, namely in 21 women and 13 men aged 13-28 years. The patients were indicated for arthroscopic surgery based on the clinical examination which revealed a clear traumatic patellar dislocation. In 2 radiographs only, an osteochondral fragment was found, and in these patients a CT scan of the injured knee was made. The patients were retrospectively broken down into 3 sub-groups by the method of treatment of the chondral defect. The mean size of the defect in the debridement group was 2.7 cm2 compared to 4.6 cm2 in the group with cartilage fixation. In group I reinsertion through MiniSynthes 2.0 screws (5 patients) was performed, in group II reinsertion of the chondral fragment was done using transosseous PDS sutures (19 patients), in group III debridement of injured cartilage was carried out (10 patients). RESULTS The patients were assessed postoperatively using Kujala score and IKDC score. The mean age of patients at the time of injury was 19.6 years, with mean follow-up of 30.2 months. No group reported limitations of range of motion at the time of evaluation. Knee pain under load was present in 3 patients in group I, in 1 patient in group II and in 7 patients in group III. No patient suffered from another patellar dislocation. The mean Kujala score was 84.7 (group I), 89.3 (group II), and 78.5 (group III). The IKDC was 84.6 in group I, 87.2 in group II, and 74.3 in group III. At the time of evaluation, pre-injury activities were resumed by 72% of patients from group I, 82% of patients from group II, and 69% of patients from group III. DISCUSSION Treatment of primary patellar dislocation is still subject to discussions on whether to pursue conservative or surgical treatment. The main topic of studies is the subsequent rate of patellar re-dislocation and the rate of cartilage damage in patellofemoral joint, examined is also the scope of performed surgery, while only very few papers focus on treating the injured cartilage of the patella. Despite numerous studies, the optimal method of treatment of this injury has been identified as yet. CONCLUSIONS Where a serious, extensive fragment of patellar cartilage is found, the fixation of cartilage with the use of transosseous PDS sutures brings very good and good results, without the necessity of another surgery, while the simultaneous treatment of medial patellar retinacula considerably decreases the risk of patellar re-dislocation, thus reducing the risk of further damage to cartilage of patelofemoral joint. The use of transosseous suture fixation is considered by the authors to be more appropriate than the use of screws, mostly because no further surgery to remove fixation screws is necessary. Key words: acute patellar dislocations, chondral lesions, chondral repair, arthroscopy.

[Diaries for critically ill patients]. / Tagebücher für kritisch kranke Patienten.

After a stay on an intensive care unit (ICU), patients and relatives may be affected by psychological consequences such as anxiety, depression or posttraumatic stress disorder. ICU diaries written for patients during the stay by clinicians and relatives can alleviate the consequences. Diaries can contribute to the humanization of intensive care through the person-centered approach. A case report illustrates the perspective and benefits from a patient's perspective.

Breast cancer: induction of differentiation by embryonic tissue.

A mouse mammary tumor, adenocarcinoma BW 10232, was maintained in vitro for 14 days, separated from embryonic mammary mesenchyme by a Millipore filter. Tubules developed in the tumor; deoxyibonucleic acid synthisis declined; and a presumptive acid mucopolysaccharide matrix, not evident in the controls, appeared.

Abscisic acid signaling through cyclic ADP-ribose in plants.

Abscisic acid (ABA) is the primary hormone that mediates plant responses to stresses such as cold, drought, and salinity. Single-cell microinjection experiments in tomato were used to identify possible intermediates involved in ABA signal transduction. Cyclic ADP-ribose (cADPR) was identified as a signaling molecule in the ABA response and was shown to exert its effects by way of calcium. Bioassay experiments showed that the amounts of cADPR in Arabidopsis thaliana plants increased in response to ABA treatment and before ABA-induced gene expression.

Embryonic inductive tissues that cause histologic differentiation of murine mammary carcinoma in vitro.

A murine mammary tumor was cultured in vitro for 14 days, either in direct combination with various embryonic murine inductive tissues or separated by a Millipore filter from these tissues. From 456 test cultures and 269 control cultures of tumor alone, morphologic, histochemical, and autoradiographic evidence for cytodifferentiation was obtained in the tumor after exposure to inductive tissues directly or through the filter. There appeared to be a gradient in potency of the inductive tissues; embryonic mammary mesenchyme was the most active of the tissues tested. Tumor growth was not different from that of controls, however, when the cultured, inductive tissue-exposed neoplasm was returned to the murine host.

Mortality among California Seventh-Day Adventists for selected cancer sites.

In previous reports concerning cancer among Seventh-Day Adventists (SDA), comparisons were made only with the general population. This report compared California SDA to a sample of non-SDA who were demographically similar to SDA. The study consisted of 17 years of follow-up (1960--76) on 22,940 white California SDA and 13 years of follow-up (1960--72) on 112,725 white California non-SDA. Both groups completed the same base-line questionnaire in 1960. Deaths were ascertained by annual contacts with each study member and by computer-assisted record linkage with the California State death certificate file. Results indicated that, with the exception of colon-rectal cancer and smoking-related cancers, the difference in risk of fatal cancer between SDA and non-SDA was substantially reduced when SDA were compared with a more socioeconomically similar population. The persistence of the low risk for colon-rectal cancer can probably be attributed to some aspect of the diet or life-style of the SDA.

Leaf Isoprene Emission Rate Is Dependent on Leaf Development and the Level of Isoprene Synthase.

Isoprene (2-methyl-1,3-butadiene) is a major volatile hydrocarbon produced by many plant species. Here we report that in velvet bean (Mucuna sp.), isoprene emission is strongly dependent on leaf developmental state and that changes in extractable isoprene synthase activity parallel isoprene emission rates during leaf development. Both leaf emission and enzyme activity exhibit over 100-fold increases from leaf emergence to leaf age 14 d and exhibit similar patterns to 23 d. This suggests that the enzyme, isoprene synthase, is responsible for the in vivo production of isoprene and that the level of the enzyme regulates the pattern of isoprene emission in response to leaf development.

Coronary heart disease mortality among Seventh-Day Adventists with differing dietary habits: a preliminary report.

Seventh-Day Adventists (SDAs) are a conservative religious denomination who abstain from tobacco and alcohol; approximately one-half follow a lacto-ovo-vegetarian diet. In this 6-year prospective study of 24,044 California SDAs age 35 and over, coronary heart disease (CHD) mortality rates for ages 35 to 64 and 65+ are 28% and 50% respectively, of the rates for the same age groups of the total California population. This reduced risk of CHD mortality among SDAs is partially due to abstinence from smoking; however, at least half the low risk among SDAs is likely attributable to other characteristics of the SDA lifestyle. The risk of fatal CHD among nonvegetarian SDA males, ages 35 to 64, is three times greater than vegetarian SDA males of comparable age (P less than 0.01), suggesting that the SDA diet may account for a large share of their low risk. This differential was much smaller for older SDA males and SDA females. Although the differential in risk of fatal CHD for male nonvegetarians versus vegetarians may be partially accounted for by other CHD risk factors, which are more frequent among nonvegetarians, a significant differential persists after adjustment for each of six other CHD risk factors.

Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies.

We combined data from 5 prospective studies to compare the death rates from common diseases of vegetarians with those of nonvegetarians with similar lifestyles. A summary of these results was reported previously; we report here more details of the findings. Data for 76172 men and women were available. Vegetarians were those who did not eat any meat or fish (n = 27808). Death rate ratios at ages 16-89 y were calculated by Poisson regression and all results were adjusted for age, sex, and smoking status. A random-effects model was used to calculate pooled estimates of effect for all studies combined. There were 8330 deaths after a mean of 10.6 y of follow-up. Mortality from ischemic heart disease was 24% lower in vegetarians than in nonvegetarians (death rate ratio: 0.76; 95% CI: 0.62, 0.94; P<0.01). The lower mortality from ischemic heart disease among vegetarians was greater at younger ages and was restricted to those who had followed their current diet for >5 y. Further categorization of diets showed that, in comparison with regular meat eaters, mortality from ischemic heart disease was 20% lower in occasional meat eaters, 34% lower in people who ate fish but not meat, 34% lower in lactoovovegetarians, and 26% lower in vegans. There were no significant differences between vegetarians and nonvegetarians in mortality from cerebrovascular disease, stomach cancer, colorectal cancer, lung cancer, breast cancer, prostate cancer, or all other causes combined.

Self-report of physical activity and patterns of mortality in Seventh-Day Adventist men.

The Adventist Mortality Study provides 26-year follow-up through 1985 for 9484 males who completed a lifestyle questionnaire in 1960. The relationship of self-reported physical activity and all cause and disease-specific mortality was examined by survival analysis and with the Cox proportional hazards model, controlling for demographic and lifestyle characteristics. Moderate activity was associated with a protective effect on cardiovascular and all cause mortality in both analyses. In the Cox model, age-specific estimates of relative risk (RR) were obtained for several endpoints due to a significant interaction between level of physical activity and attained age (age at death or end of follow-up). This model permits calculation of the age at which the RR = 1.0, or the age at crossover of risk. For moderate activity, this age was 95.6 years (95% confidence intervals, 81.7-109.4 years) for all cause mortality and 91.5 years (95% confidence intervals, 79.0-104.0 years) for cardiovascular mortality. While the protective effect on mortality associated with moderate activity decreased with increasing age, it remained significant to the verge of the present life span.

Coffee consumption and cause-specific mortality. Association with age at death and compression of mortality.

The relationship between reported coffee consumption and specific causes of death was examined in 9484 males enrolled in the Adventist Mortality Study in 1960 and followed through 1985. Coffee consumption was divided into three levels: less than 1 cup per day, 1-2 cups per day, and greater than or equal to 3 cups per day. Approximately one third of the subjects did not drink coffee. Cause-specific mortality rates were compared using survival analysis including Cox's proportional hazard model, and controlling for potential confounders such as body mass index, heart disease and hypertension at baseline, race, physical activity, marital status, educational level, smoking history, and dietary pattern. Inclusion of interaction terms between coffee consumption and attained age as time-dependent covariates allowed the hazard ratio to vary with age. Univariate analyses showed a statistically significant association (p less than 0.05) for coffee consumption and mortality for most endpoints. Multivariate analyses showed a small but statistically significant association between coffee consumption and mortality from ischemic heart disease, other cardiovascular diseases, all cardiovascular diseases, and all causes of death. For the major causes of death, the hazard ratios decreased from about 2.5 at 30 years of age to 1.0 around 95 years of age. These results indicate that abstinence from coffee leads to compression of mortality rather than an increase in lifespan.

Significant determinants of susceptibility to alcohol teratogenicity.

Typically, the rate of abusive drinking during pregnancy considerably exceeds the rates of fetal alcohol syndrome (FAS) and alcohol-related birth defects, suggesting that other factors may modify the impact of alcohol on the developing organism. Data in the literature supporting this susceptibility hypothesis are sparse. In this paper, two studies in different samples, using different analytic strategies to examine susceptibility to different adverse outcomes are presented. Among 176 pregnancies in which lowered birth weight for gestational age was detected as an effect attributable to frequent beer drinking, 27 infants weighted less than 2,700 grams and 149 weighed more. Using discriminant analysis to contrast these groups, lowered birth weight for gestational age was associated with black race and lower maternal weight and weight gain. The effects of these factors were additive with that of persistent alcohol exposure; no interactions were detected, but pregnancies with risks in addition to alcohol were more likely to yield growth-retarded infants. In a second study, pregnancies resulting in 25 FAS cases were contrasted with 50 controls. A four-factor model accounted for nearly two-thirds of the explainable variance in the occurrence of FAS. Adjusted for frequency of maternal drinking, chronic alcohol problems and parity, there was a sevenfold increase in risk for FAS among black infants. The findings from both studies are consistent with the susceptibility hypothesis and have potentially important implications for public health and clinical approaches to prevention, as well as for future research.

Effect of ascorbic acid on rectal polyps of patients with familial polyposis.

Evidence for dehydrogenation by fecal bacteria in the genesis of colon cancer suggested that an antioxidant might modify these mechanisms. Ascorbic acid, 3 Gm. daily, was given to five patients who had active rectal adenomatous polyp formation long after ileorectal anastomosis for familial polyposis. During a 4 to 13 month study, rectal polyps disappeared in two, regressed partially in two, and increased in one. Among three additional treated patients with rectal polyps, one had a reduction in polyps and two were unaffected.

Implantation of the Melbourne/Cochlear multiple-electrode extracochlear prosthesis.

The Melbourne/Cochlear multiple-electrode extracochlear implant is designed for deaf patients who are unsuited to multiple-electrode intracochlear implantation. The implant consists of a receiver-stimulator package connected via a lead wire assembly to six individual stimulating electrodes. There is a choice of two alternative surgical procedures, both of which are via a combined middle ear approach using anterior and posterior tympanotomies. Four active electrodes shaped into compressible platinum-iridium soft-balls are fed through the mastoid cavity and across the facial recess, and placed into cavities that are made over the cochlear turns that project to the medial wall of the middle ear. One hard-ball active electrode is placed into the round window niche. One hard-ball reference electrode is placed into the hypotympanum. An additional electrode wrapped around the lead wire assembly can be used as an alternative reference electrode. A specially designed insertion needle facilitates the placement and the fixation of the soft-ball electrodes.

Cytologic detection of early Paget's disease of breast with improved cellular collection method.

Improved cellular collection method and cytologic criteria for diagnosis of Paget's disease of the breast are presented. When indicated, the cytologic test is highly recommended for the early detection and pre-operative diagnosis of the minimal breast cancer10.

New Clarion electrode with positioner: insertion studies.

A new straight thin electrode array (universal electrode) was designed to be used together with a positioner, which will place the electrode array at the medial wall (modiolus) of the cochlea. The study objectives were to demonstrate safety and ease of insertion, tissue trauma, electrode position, and depth for universal and standard electrodes in human temporal bones; to test functional properties in cats; and to determine the surgical procedure and electrophysiological benefits in a clinical study. The cadaver study demonstrated the ease of insertion for the universal electrode and the positioner without tissue damage. An average gain of insertion depth of 180 degrees was achieved with the positioner. Animal studies demonstrated a reduction in threshold of 6 dB for the electrical auditory brain stem response (EABR). Neither additional cochlear damage nor additional connective tissue formation was found. The intraoperative human study findings showed a marked reduction of threshold for both EABR and stapedius reflex thresholds. Impedances were increased. Plain x-rays demonstrated modiolus proximity of the electrode with the positioner. The new Clarion electrode with positioner is a relatively safe design for providing modiolus proximity. The electrophysiological benefits include reduction of threshold and power consumption.

A multi-channel hearing prosthesis for profound-to-total hearing loss.

A multi-channel cochlear implant hearing prosthesis providing 22 separate channels of stimulation has been developed. The electronics for the implantable receiver-stimulator have been incorporated on a single chip, using digital circuits and employing CMOS technology. The chip is enclosed in a titanium capsule with platinum/ceramic electrode feed-throughs. A pocket-sized speech processor and directional microphone extract the following speech parameters: signal amplitude, fundamental frequency and formant frequency. The fundamental frequency is coded as electric pulse rate, and formant frequency by electrode position. The speech processor has been realized using hybrid circuits and CMOS gate arrays. The multi-channel prosthesis has undergone a clinical trial on four postlingually deaf patients with profound-total hearing losses. The speech perception results indicate that they were able to obtain open-set speech recognition scores for phonetically balanced words, CID sentences and spondees. In all cases the tests showed significant improvements when using the cochlear prosthesis combined with lipreading compared to lipreading alone.