Comparison of Methods for Cleaning Enteral Feeding Tube Junctions of the New International Standard (ISO 80369-3).

INTRODUCTION: International standards for enteral feeding involving the use of feeding tubes with junctions have been introduced. If these junctions are not properly cleaned, they can become contaminated, leading to microbial infections. We aimed to compare the ease and effectiveness of cleaning of four methods using the number of bacteria. METHODS: We compared enteral nutrition tube junctions cleaned using four methods such as water, toothbrush, cotton swab, and EnClean® brush with an uncleaned control. Once daily for 7 days, the tubes were injected with nutrients, cleaned, and incubated at 37°C. Samples for bacterial culture were collected before injections on days 7, 14, 21, and 28. The culture samples were incubated at 37°C for 48 h, and the number of colonies was counted. RESULTS: The number of residual bacteria on day 28 did not differ between the four cleaning methods and the control group. Moreover, no significant difference was observed in bacterial counts among the four wash methods. The number of washes did not differ among cleaning methods. CONCLUSION: The bacterial count in the ISO-standardized tube junction increased, and none of the cleaning methods decreased the counts.

A dust-parallax distance of 19 megaparsecs to the supermassive black hole in NGC 4151.

The active galaxy NGC 4151 has a crucial role as one of only two active galactic nuclei for which black hole mass measurements based on emission line reverberation mapping can be calibrated against other dynamical techniques. Unfortunately, effective calibration requires accurate knowledge of the distance to NGC 4151, which is not at present available. Recently reported distances range from 4 to 29 megaparsecs. Strong peculiar motions make a redshift-based distance very uncertain, and the geometry of the galaxy and its nucleus prohibit accurate measurements using other techniques. Here we report a dust-parallax distance to NGC 4151 of 19.0(+2.4)(-2.6) megaparsecs. The measurement is based on an adaptation of a geometric method that uses the emission line regions of active galaxies. Because these regions are too small to be imaged with present technology, we use instead the ratio of the physical and angular sizes of the more extended hot-dust emission as determined from time delays and infrared interferometry. This distance leads to an approximately 1.4-fold increase in the dynamical black hole mass, implying a corresponding correction to emission line reverberation masses of black holes if they are calibrated against the two objects with additional dynamical masses.

The characteristic blue spectra of accretion disks in quasars as uncovered in the infrared.

Quasars are thought to be powered by supermassive black holes accreting surrounding gas. Central to this picture is a putative accretion disk which is believed to be the source of the majority of the radiative output. It is well known, however, that the most extensively studied disk model-an optically thick disk which is heated locally by the dissipation of gravitational binding energy-is apparently contradicted by observations in a few major respects. In particular, the model predicts a specific blue spectral shape asymptotically from the visible to the near-infrared, but this is not generally seen in the visible wavelength region where the disk spectrum is observable. A crucial difficulty has been that, towards the infrared, the disk spectrum starts to be hidden under strong, hot dust emission from much larger but hitherto unresolved scales, and thus has essentially been impossible to observe. Here we report observations of polarized light interior to the dust-emitting region that enable us to uncover this near-infrared disk spectrum in several quasars. The revealed spectra show that the near-infrared disk spectrum is indeed as blue as predicted. This indicates that, at least for the outer near-infrared-emitting radii, the standard picture of the locally heated disk is approximately correct.

A 5-22-year follow-up study of stemmed alumina ceramic total elbow arthroplasties with cement fixation for patients with rheumatoid arthritis.

BACKGROUND: We determined mid to long-term results of total elbow arthroplasty (TEA) by use of unlinked elbow prostheses with solid alumina ceramic trochleae, and ceramic ulnar stems (stemmed Kyocera type I; SKC-I) for patients with rheumatoid arthritis. PATIENTS AND METHODS: Fifty-four elbows of 39 patients were available for detailed clinical and radiographic review after a follow-up period of at least 5 years. The mean follow-up period was 12.6 years (range 5-22 years). Clinical condition before and after surgery was assessed by use of a modified version of the Mayo Elbow Performance Score (MEPS; 0-100 points) and a Japan Orthopaedic Association Elbow score (JOA score; 0-100 points). The radiographs were reviewed and loosening was defined as a progressive radiolucent line >1 mm wide that was completely circumferential around the prosthesis. Clinical records of post-operative events affecting the elbows were used for survival analysis of the prostheses using the Kaplan-Meier method. RESULTS: The average modified MEPS and JOA scores improved significantly from 39.7 ± 14.3 to 44.7 ± 9.4, respectively, pre-operatively, to 89.7 ± 15.4 and 83.1 ± 12.8, respectively, post-operatively (P < 0.0001). The functional assessment score also improved from 4.9 ± 2.8 to 8.5 ± 3.3 points (P < 0.0001). With loosening or implant revision defined as end points, the likelihood of survival of the prosthesis for up to 20 years was 92.6% (95% confidence interval (CI), 85.6-100.0) or 86.3 % (95 % CI 75.0-97.6), respectively. CONCLUSION: Satisfactory clinical results were obtained after TEA using SKC-I prostheses, which provided excellent pain relief and functional range of motion. The results of our study reveal the high reliability over a long period of the cemented SKC-I prosthesis with an alumina ceramic component.

Effects of Sho-saiko-to extract and its components, Baicalin, baicalein, glycyrrhizin and glycyrrhetic acid, on pharmacokinetic behavior of salicylamide in carbon tetrachloride intoxicated rats.

To elucidate the effects of Sho-saiko-to extract and its components, baicalin, baicalein, glycyrrhizin and glycyrrhetic acid, against the effects of longer periods of acute hepatic injury induced by CCl4, we measured serum ALT activity in male Wistar rats for five days after ip administration of CCl4 (0.2 ml/kg), and examined the daily changes of the pharmacokinetic behavior of salicylamide (SAM) for five days. Serum ALT activity rose to a maximum level within a day after administration of CCl4 and then decreased to the control level after three. Sho-saiko-to extract and its components could suppress this acute change in serum ALT activity to less than 50% of CCl4 alone. However, the pharmacokinetics of SAM showed that liver function recovers in a biphasic manner, so that plasma clearance (CL) decreased significantly at days 1 and 3 after administration of CCl4 (P<0.05). We concluded that the CL change at day 1 corresponds to the acute action of CCl4 intoxication, and that the change at day 3 is effect of physiologically reduced liver function due to the liver regeneration for tissue repair after the CCl4 hepatic injury. Sho-saiko-to extract and its components were shown to suppress acute hepatic injury induced by CCl4, and to bring about an early recovery in liver function.