Bismuth toxicity in patients treated with bismuth iodoform paraffin packs.

Bismuth is a heavy metal used in bismuth iodoform paraffin paste (BIPP) antiseptic dressings and in a number of other medical preparations. It can be absorbed systemically and cause toxicity. We report 2 cases of such neurotoxicity after it was used in operations on the jaws.

Heat stress tolerance in relation to oxidative stress and antioxidants in Brassica juncea.

In the present study fifty genotypes of Brassica juncea were evaluated for heat stress tolerance in terms of biochemical components, in four day old seedlings. Heat shock was given at 45 degrees C for 4.5 hr and thereafter survival percentage, electrolyte leakage and chlorophyll content were estimated. Tolerant genotypes (10) registered survival greater than 65%, moderately tolerant (20) between 35-65% and susceptible (20) less than 35%. Electrolyte leakage was significantly (p < 0.001) higher in susceptible genotypes than in tolerant ones with respect to control seedlings. Chlorophyll content showed no significant variation among the tolerant, moderately tolerant and susceptible genotypes, although it registered a decline in response to heat stress. Lipid peroxidation, assessed by malondialdehyde (MDA) in stressed conditions was 4.66 (MDA g(-1) f. wt. of tissue) in tolerant genotypes, 7.44 (MDA g(-1) f. wt. of tissue) in susceptible genotypes and correlated significantly (r = 0.563) with electrolyte leakage. Increase in POD activity under heat stress was maximum in tolerant class with respect to control. CAT activity showed decrease after heat shock treatment in all the three classes but the decrease was 1.3 fold in tolerant genotypes as compared to 1.6 fold in susceptible genotypes. The non-enzymatic antioxidants glutathione and proline registered a significantly (< 0.01) high value in tolerant genotypes on heat shock treatment in comparison to susceptible genotypes corroborating the role of antioxidants in mitigating the effect of heat stress in Bjuncea. The antioxidants and proline seemed to play role in mitigating the effect of heat stress.

A role for near infrared spectroscopy in the assessment of intermittent claudication.

BACKGROUND: Near infrared spectroscopy (NIRS) can be used to monitor muscle oxyhemoglobin (HbO2), deoxyhemoglobin (Hb) and cytochrome oxidase (CytOx) oxidation. We evaluated the changes in NIRS in patients with intermittent claudication (IC) pre- and postexercise. Microalbuminuria is an index of endothelial dysfunction. Therefore, we also assessed whether the urinary excretion of albumin increased postexercise in patients with IC. METHODS: Each participant (14 patients with IC and 10 controls) underwent a treadmill test; NIRS was continuously recorded. The urinary albumin:creatinine ratio (ACR) and ankle: brachial systolic pressure index (ABPI) were measured pre- and postexercise. RESULTS: The ABPI in the claudicants dropped significantly (p<0.001) postexercise. The pre-exercise ACR did not differ between claudicants and controls but postexercise, the ACR increased significantly (p<0.001) in the claudicants. There was a significant (p<0.001) difference in the degree of HbO2 deoxygenation between claudicants and controls; the rate of deoxygenation was significantly higher in claudicants than in controls (-8.4 vs. -3.4 mol/L.min, p=0.024). The period of recovery of HbO2 postexercise was also significantly slower in claudicants (192 vs 68 sec, p=0.003). There was a significant correlation between the increase in the ACR and time of recovery of HbO2 levels postexercise (r=0.86, p<0.001, n=24). A similar pattern was seen with CytOx. CONCLUSIONS: NIRS may provide a simple, non-invasive assessment of the severity of IC. Furthermore, because the ACR is a marker of endothelial damage, it is possible that NIRS changes also reflect endothelial integrity. These applications of NIRS technique should be assessed in a larger study.

Modern management of pulmonary embolism.

BACKGROUND: Pulmonary embolism is a significant cause of morbidity and death after operation. The introduction of new technologies in the diagnosis, and thrombolysis in the treatment, of pulmonary embolism has led to a need to reappraise the management of this condition. METHODS: This review encompasses a comprehensive discussion of diagnostic modalities and therapeutic strategies used in the current management of pulmonary embolism. Relevant papers on the diagnosis and treatment of pulmonary embolism were identified from a Medline search for the period 1967-1998. Additional papers were derived from the reference lists of retrieved articles. Articles presenting prospectively gathered data have been referenced preferentially. RESULTS AND CONCLUSION: Algorithms for the diagnosis and treatment of pulmonary embolism are presented.

Vascular surgical society of great britain and ireland: caval filters are an underexploited therapy for acute pulmonary embolism

BACKGROUND: Inferior vena caval filters are a recognized intervention for recurrent pulmonary embolism (PE). Filter utilization in the UK is considerably less than in Europe; this may partly be due to omission of referral of appropriate patients. METHODS: A cohort with the prospect of benefit from caval filter insertion was identified by retrospective study of inpatients who died within 30 days of a positive ventilation-perfusion (V/Q) scan over 2 years. The number of actively managed patients in this group who fulfilled the recognized criteria for caval filter insertion was determined. RESULTS: Fifty-two of 606 patients died within 30 days of scanning. Information was available on 38 (73 per cent) of 52 who had 39 scans (14 positive, 22 negative, three indeterminate). Six of 14 patients (two men and four women, aged 46-84 years) with a positive scan had strong indications for caval filter deployment including contraindication to anticoagulation (three), recurrent PE despite adequate anticoagulation (two) and complications arising from anticoagulation (one). All six died following continuing embolism or complications from anticoagulation. CONCLUSION: Six of 14 patients who died following acute PE required caval filtration but were not offered this intervention. Failure to refer patients who would benefit from filtration may partially account for the disparity in utilization of caval filters between the UK and Europe. Furthermore, because of the choice of death as outcome marker, this study underestimated the value of caval filter utilization.

Effects of protein source and amino acid supplementation on plasma cholesterol in guinea pigs.

The effects of three dietary protein treatments were compared on cholesterol content of plasma lipoprotein fractions and oxidative status of liver lipids in adult guinea pigs. All diets were adequate in soluble dietary fiber and well-balanced in fatty acids providing 30% of total energy. After seven weeks dietary treatments, casein compared to soy protein increased cholesterol in a sub-fraction of LDL (low density lipoprotein) with larger molecular weight and in a combination of this sub-fraction of LDL plus VLDL (very low density lipoprotein) taken together. Supplementation of casein diet with glycine, alanine, arginine and cystine tended to decrease cholesterol in the sub-fraction of LDL with larger molecular weight. There was no effect of dietary treatments on thiobarbituric acid reactive substances in lipids extracted from guinea pig liver likely due to the very high vitamin E and C content of the diets. In addition to counteracting the serum cholesterol elevating effects of dietary cholesterol soy protein also appears to attenuate the hypercholesterolemic effects of dietary saturated fatty acids.

Increased milk production of cows in early lactation fed chemically treated soybean meal.

Holstein cows in early lactation and producing about 35 kg/d of milk were fed TMR for ad libitum intake and 1 kg/d of long alfalfa hay. Soybean meal and soybean meal treated by a novel technique were compared in diets of 15 and 17% CP in a 2 x 2 factorial design. Digestibilities of DM, CP, and ADF were significantly lower for treated soybean meal diets. Mean DMI was about 21 kg/d and was unaffected by treatment. Milk production was significantly increased during wk 7 to 16 of lactation for cows fed treated soybean meal diets. The production of SCM and milk components was greater for cows fed treated soybean meal than for cows fed soybean meal, but the differences were not significant. By wk 16, compared with wk 3 of lactation, the persistency of production of milk and lactose was markedly increased by treated soybean meal. The persistency of milk protein production was 100.5% for cows fed the diet containing treated soybean meal at 17% CP and about 97% for the other diets. The hypothesis that Met supply was limiting secretion of milk protein in cows fed treated soybean meal is discussed.

Determination of formaldehyde in fresh and retail milk by liquid column chromatography.

A quantitative method is described for the determination of formaldehyde (CH2O) in milk by liquid chromatography. Aldehyde derivatization-extraction was carried out in situ with 2,4-dinitrophenylhydrazine in 2-phase reaction medium. Average recovery of added CH2O (0.1 microgram/mL) was 89.9 +/- 3.9% with an estimated detection limit of 0.009 mg/kg. The technique was used for the determination of CH2O in commercial 2% milk and in fresh milk of cows fed on a typical North American dairy diet. The average concentrations of CH2O in fresh and commercial milk were 0.027 and 0.164 mg/kg, respectively. Several methods for CH2O determination in milk are compared.

Antimicrobial activity of 2-aminophenoxazin-3-one under anaerobic conditions.

Potential toxicity of 2-aminophenoxazin-3-one to 20 bacterial species and two fungi and its inactivation under anaerobic conditions were investigated. Minimum inhibitory concentration for cellulolytic bacteria was in the range of 50-100 micrograms.mL-1, but at 100 micrograms.mL-1 of 2-aminophenoxazin-3-one, there was no effect on the growth of any of the noncellulolytic bacteria. Four noncellulolytic bacterial strains showed no inhibition of growth, even at 200 micrograms.mL-1 of this compound. Under anaerobic conditions and in the presence of cysteine, the long wavelength absorption band of this compound slowly shifted from about 434 to 320 nm, and its inhibitory effect on RNA synthesis was relieved after one-half of a generation time in cultures of cellulolytic ruminal bacteria. A similar shift of absorption band was observed in rumen fluid filtered through a 0.22-microns Millipore filter. It was concluded that protonation of 2-aminophenoxazin-3-one under anaerobic conditions present in the rumen would considerably reduce its potential toxicity to cellulolytic bacteria.

Effects of feeding fish meal to cows on digestibility, milk production, and milk composition.

Holstein cows in early lactation, producing about 30 kg/d of milk, were fed high energy diets containing 5% Megalac. Three protein treatments, soybean meal diet (16% CP), fish meal diet (16% CP), and soybean meal-fish meal diet (20% CP) were compared in a change-over design. Digestibilities of DM, gross energy, CP, and ADF were not affected significantly by protein treatments. The fish meal diet decreased DMI but increased milk and SCM production compared with the soybean meal diet. Daily production of milk, SCM, and milk components (fat, protein, and lactose) were highest and BW gain lowest for the high protein soybean meal-fish meal diet. The fish meal and soybean meal-fish meal diets increased fat percentage but decreased lactose percentage of milk compared with soybean meal diet. This suggests that, for each diet, the energy supply was adequate, and the observed changes were the effects of protein (i.e., AA) supply to the cows. Thus, there seems to be good reason to feed a good quality undegradable protein like fish meal to cows producing more than 30 kg/d of milk.

Effect of intraperitoneally injected tocopherol on vitamin E status of dairy cow.

The effect of intraperitoneal (IP) administration of vitamin E on the concentration of tocopherol in the blood and milk of cows was studied. Two trials were carried out using a total of twenty-four Holstein cows. In the first trial, two doses of dl-alpha-tocopherol (1 g and 5 g) were given to six cows in each treatment. Administration of 1 g caused a small increase in blood and milk concentrations; dosing with 5 g IP caused appreciable increases in both plasma and milk concentrations. Plasma and milk concentrations peaked 1 d after dosing with a maximum value of 10.7 micrograms/ml plasma and 1.39 micrograms/ml milk. Then there was a continuous decline during the 14 d experimental period. In the 2nd trial, twelve cows were dosed IP with the acetate form of vitamin E. Six cows were given 5 g and six others 10 g of dl-alpha-tocopherol acetate. Maximum plasma vitamin E concentrations occurred at d 2 (7.4 micrograms/ml) and d 1 (10.9 micrograms/ml) for the cows dosed with 5 and 10 g of the ester form, respectively. Milk vitamin E concentrations were significantly higher (P less than .05) during the first 4 d for cows dosed with 10 compared to those given 5 g. During the 14 d experimental period, maximum milk vitamin E concentration for the 10 g group was 141 micrograms vitamin E/g fat 2 d after dosing and for the 5 g group 62 micrograms vitamin E/mg fat also at 2 d after dosing. The technique of dosing cows with vitamin E by IP proved to be an effective way for increasing vitamin E status. These treatments had no effect on cholesterol content of milk fat. However, it was noted that cholesterol level was lower in PM milking as compared to AM milking.

Growth and feed efficiency of pureline and crossline dairy heifers.

Data on 3957 heifers from the Holstein H line, Ayrshire-based A line, and C line (crossbreds between H and A lines) were used. Growth, feed consumption, and feed efficiency from 26 to 34 wk were examined. The full model included the fixed effects of herd, year of birth, season of birth, and additive, maternal, and heterotic genetic effects with 26-wk weight as a covariate. Heterotic and maternal effects were not significant. Adjusted for the 26-wk weight covariate, H line heifers gained 3 kg more than A line heifers with C line heifers intermediate. Adjusted for 26 and 34-wk weight covariates, H line heifers ate 2 kg less TDN than A line heifers and, hence, were more efficient. Correlations among traits were estimated using the residual variance-covariance matrix from the full model. Body weight at 34 wk was correlated with 26-wk weight (r = .88) but essentially independent of rate of gain (r = .02). It was correlated with feed consumed (r = .51) and negatively associated with gain/feed consumed (r = -.25). Gain was correlated (r = .84) with gain/feed consumed but mildly so (r = .28) with feed consumed. Feed consumption was negatively correlated (r = -.25) with gain/feed consumed when the 26-wk weight covariate was included but became much larger (r = -.95) when both 26 and 34 wk weight covariates were included. Although genetic differences in feed consumption and feed efficiency of growing heifers exist, these are small and closely associated with weights and weight gains.

Differences between the activities of human monoclonal IgG1 and IgG3 subclasses of anti-D(Rh) antibody in their ability to mediate red cell-binding to macrophages.

Four IgG1 and three IgG3 human monoclonal antibodies specific for the blood group D(Rh) antigen were tested for their ability to mediate red cell-binding to macrophages in vitro. The IgG3 monoclonals were found to opsonize at a density of approximately 100 molecules per red cell, whereas the IgG1 antibodies were only active at a level of 10,000 molecules per cell. There was no substantial difference between the two IgG subclasses in their ability to bind to Fc receptors on macrophages and it is suggested that the more potent opsonic activity of IgG3 is the result of the relatively long hinge, leading to greater accessibility to the Fc receptor binding site on the Fc piece.

The use of FEIBA (factor eight inhibitor bypassing activity) in cataract extraction in hemophilia A patient with inhibitor.

A 34-year-old patient, with severe factor VIII deficiency (anti-hemophilic factor deficiency) and inhibitor against factor VIII, underwent a phacoemulsification with posterior capsulatomy and thermal iridectomy under general anesthesia. FEIBA (Factor Eight Inhibitor Bypassing Activity) was used to achieve hemostasis. The surgical procedure was successful and no complication was ensued. A brief management of hemophilia A patient requiring surgery is discussed.

Isolation and characterization of phospholipase D from fababeans.

An enzyme activity in crude extract of fababeans hydrolyzed phosphatidylcholine-U-14C to produce choline and phosphatidic acid. This enzyme, phospholipase D, was stable at 50 C in the presence of 5 mM DTT but was inactivated at 55 C. The enzyme was precipitated with cold acetone, concentrated between 30% saturation to 40% saturation with ammonium sulphate, absorbed on calcium phosphate gel and eluted with 0.2 M phosphate buffer. This procedure resulted in a 20-fold increase in specific activity. The activity of fababean phospholipase D was much higher when assayed at 38 C than that at room temperature. There was an obligatory requirement for calcium, and for maximal activity 40 mM calcium was required. A narrow pH optimum of about pH 5.7 was observed. The enzyme activity was extremely dependent on substrate dispersion. When 5 mM phosphatidylcholine (PC) was sonicated with increasing levels of sodium dodecyl sulphate (1 mM to 4 mM), the enzyme activity kept increasing. By using equimolar concentrations of PC and sodium dodecyl sulphate (1 mM to 5 mM), the Michaelis constant (Km) was estimated to be 1.74 mM. Addition of choline and serine at 10 mM concentration reduced phospholipase D activity by 31% and 22%, respectively.