[Hybrid NOS appendectomy (NA): clinical assessment of a new surgical technique]. / Hybrid-NOS-Appendektomie (NA), eine neue Operationsmethode - eine klinische Evaluation.

UNLABELLED: INTRODUCTION, AIM AND METHOD: Consecutive female patients undergoing hybrid NOS appendectomy (NA - with prospectively collected data) and laparoscopic appendectomy (LA - with retrospectively registered data) were compared by means of a matched-pair analysis according to selected criteria such as patient age, BMI, ASA and previous operations showing a near-perfect congruence with the following aims to: 1) demonstrate the feasibility of NA and to estimate its general costs, and 2) elucidate the outcome of the two techniques using available perioperative parameters from daily clinical practice. In particular, operating time, complications, histopathological findings, postoperative hospital stay and analgesic scores were used for comparison. A gynaecological follow-up investigation was carried out on the day of discharge and after a medium-term time period of 4 weeks in the NA group, and 6 months postoperatively, patients of both groups were interviewed using a standardised questionnaire. RESULTS: From 05/01/2008 to 02/28/2010, transvaginal NA (n = 30) was compared with the results of the conventional LA (n = 30) in 60 female patients with regard to the operative outcome. Overall, matched-pair analysis of LA with NA, the novel technique resulted in the assessment of basically comparable surgical procedures with regard to perioperative routine parameters and outcome. There were no intraoperative complications in either of the two approaches; conversion was not required in both techniques. In addition, there were no significant differences in operating time (p = 0.099), postoperative complications (p = 0.72) and analgesic scores (p = 0.33/0.46). Postoperative hospital stay was even slightly shorter in the NA group (p = 0.02). The costs of the two methods are almost identical if the same instruments are used. Patient interviews suggested a slightly faster recovery, greater satisfaction with the better cosmetic outcome as well as a reduced pain intensity in favour of transvaginal NA. CONCLUSION: Provided that a well developed laparoscopic expertise exists, it turned out i) that there are no serious reasons to resist a quick inauguration and establishment of NA for selected cases as well as ii) even to facilitate further clinical distribution of NA. Further systematic data collection appears to be indicated to analyse long-term outcome as parameters of an appropriate quality assurance.

Pyrogenic toxin superantigen site specificity in toxic shock syndrome and food poisoning in animals.

Staphylococcus aureus and Streptococcus pyogenes express pyrogenic toxin superantigens (PTSAgs) that are associated with toxic shock syndrome (TSS) and staphylococcal food poisoning (SFP). Most PTSAgs cause TSS in deep-tissue infections, whereas only TSS toxin 1 (TSST-1) is associated with menstrual, vaginal TSS. In contrast, SFP has been linked only with staphylococcal enterotoxins (SEs). Because of the differential abilities of PTSAgs to cause systemic or localized symptoms in a site-dependent manner, the present study was undertaken to assess the toxins' abilities to cross mucosal barriers. The activity of three PTSAgs when delivered orally, vaginally, or intravenously to rabbits and orally to monkeys was investigated. TSST-1 induced shock via all three routes in rabbits. Although active when administered intravenously, SEC1 and streptococcal pyrogenic exotoxin A (SPEA) did not cause symptoms when administered orally or vaginally. Only SEC1 induced emesis in the monkey feeding assay. TSST-1, albeit less stable than SEC1 and SPEA to pepsin, induced diarrhea in monkeys. Our results may explain the unique association of TSST-1 with menstrual TSS and why SPEA is only rarely associated with TSS after pharyngitis, despite being highly associated with TSS after subcutaneous infections. Finally, our studies indicate that enterotoxicity in SFP is not the result of superantigenicity.

[The department of occupational medicine of the State School of Occupational Medicine at the National Institute of Occupational Medicine in Warsaw in 1926-1939]. / Oddzial Higieny Pracy Panstwowej Szkoly Higieny przy Panstwowym Zakladzie Higieny w Warszawie, w latach 1926-1939.

The Department of Occupational Hygiene, State School of Hygiene at the National Institute of Hygiene was established in 1926/27. Prof. Brunon Nowakowski was its founder and the first Director. Teaching and providing of highly qualified personnel for occupational medicine institutions was the main area of the Department's activity. The Department also carried out scientific research focusing on organisation of labour hygiene in Poland, and occupational diseases, lead poisoning in particular. The results of studies carried out by the Department provided the basis for the elaboration of numerous legal regulations in the area of occupational medicine.

Plasmids for efficient single-copy gene cloning into gdh2 and trpC of Bacillus megaterium DSM319 and QM B1551.

We constructed integrative plasmids to place xylA-lacZ indicator gene fusions into two different loci of the Bacillus megaterium chromosome, gdh2 and trpC, in lac mutants of strains DSM 319 and QM B1551, which differ markedly. Single-crossover integration was achieved in all cases while double crossovers occurred only in gdh2 of DSM 319 and QM B1551 and in trpC of QM B1551. Neither of the loci affected regulation of the xylA-lacZ fusions. These results confirm the suitability of the two gene loci for single-copy cloning.

Molecular structure of staphylococcus and streptococcus superantigens.

Staphylococcus aureus and streptococci, notably those belonging to group A, make up a large family of true exotoxins referred to as pyrogenic toxin superantigens. These toxins cause toxic shock-like syndromes and have been implicated in several allergic and autoimmune diseases. Included within this group of proteins are the staphylococcal enterotoxins, designated serotypes A, B, Cn, D, E, and G; two forms of toxic shock syndrome toxin-1 also made by Staphylococcus aureus; the group A streptococcal pyrogenic exotoxins, serotypes A, B, and C; and recently described toxins associated with groups B, C, F, and G streptococci. The nucleotide sequences of the genes for all of the toxins except those from the groups B, C, F, and G streptococcal strains have been sequenced. The sequencing studies indicate that staphylococcal enterotoxins B and C and streptococcal pyrogenic exotoxin A share highly significant sequence similarity; staphylococcal enterotoxins A, D, and E share highly significant sequence similarity; and toxic shock syndrome toxin-1 and streptococcal pyrogenic exotoxin B and C share little, if any, sequence similarity with any of the toxins. Despite the dissimilarities seen in primary amino acid sequence among some members of the toxin family, it was hypothesized that there was likely to be significant three-dimensional structure similarity among all the toxins. The three-dimensional structures of three of the pyrogenic toxin superantigens have been determined recently. The structural features of two of these, toxic shock syndrome toxin-1 and enterotoxin C3, are presented. Toxic shock syndrome-1 exists as a protein with two major domains, referred to as A and B. The molecule begins with a short N-terminal alpha-helix that then leads into a clawshaped structure in domain B that is made up of beta strands.

Predictions of T-cell receptor- and major histocompatibility complex-binding sites on staphylococcal enterotoxin C1.

We have focused on regions of staphylococcal enterotoxin C1 (SEC1) causing immunomodulation. N-terminal deletion mutants lacking residues 6 through 13 induced T-cell proliferation similar to that induced by native toxin. However, mutants with residues deleted between positions 19 and 33, although nonmitogenic themselves, were able to inhibit both SEC1-induced T-cell proliferation and binding of the native toxin to major histocompatibility complex (MHC) class II. Presumably, these deletions define a part of SEC1 that interacts with the T-cell receptor. Three synthetic peptides containing residues located in a region analogous to the alpha 5 groove of SEC3 had residual mitogenic activity or blocked T-cell proliferation induced by SEC1 and appear to recognize the same site as SEC1 on a receptor for the toxin, presumably MHC class II. We conclude that isolated portions of the SEC1 molecule can retain residual mitogenic activity but that the entire protein is needed to achieve maximal superantigenic stimulation. Our results, together with the results of other investigators, support a model in which SEC1 binds to an alpha helix of MHC class II through a central groove in the toxin and thereby promotes or stabilizes the interaction between antigen-presenting cells and T cells.

Conditions for transformation of Pasteurella multocida by electroporation.

Conditions for electroporation of plasmid DNA into Pasteurella multocida were determined for use in developing a cloning system to study virulence factors of P. multocida. The highest efficiency of transformation (1.25 x 10(7) cfu/micrograms DNA) was obtained when 7.6 x 10(10) cells of P. multocida strain R473 were electroporated at 12.5 kV/cm (10 ms, 5 ng of pVM109). Transformation efficiencies of cells prepared at mid-log-phase were approximately 0.5 log10 lower than early, late, or stationary phases. Neither pBR322 nor pUC-19 were able to transform strain R473 under these conditions, even when DNA concentrations were increased to 1 microgram. When pBR322 was ligated with a Pasteurella plasmid, pLAR-1, the hybrid was able to transform strain R473 at an efficiency between 4.5 x 10(2) and 8 x 10(4) cfu/micrograms DNA. Six strains of P. multocida including serotypes A, B, D, and E were transformed successfully.

[Caries prevalence in people aged over 50 years living in the province of Lublin]. / Wystepowanie próchnicy zbów u osób po 50 roku zycia zamieszkalych w wojewodztwie lubelskim.

A group of 2022 people aged over 50 years were examined in a search for possible effects of various social features on the condition of teeth. Each feature was recorded in a special inquiry and then all data were put in order, and subjected to statistical and epidemiological-demographic analysis. The examination demonstrated a very bad condition of teeth in males and females. Thus the greatest number of carietic teeth, that is 2.21 per 14.92% of complete denture was in the group aged 50-55 years. A very high proportion of carietic teeth (21.55%) was in the individuals never receiving stomatological services and those who had never had proper stomatological care (1.11%). The obtained results show a considerable relationship between the persisting teeth and the availability of stomatological treatment, distance from the place of residence to specialist outpatient clinic, and the need for teeth treatment which was not felt by a high proportion of these people. Most of them came to the dentist only with strong pain. The bad condition of teeth in this group was caused by lack of adequate stomatological health education, lack of adequate prophylactic care, and lack of early treatment of stomatognathic system.

Viral hepatitis among the hospital staff.

The paper compares the incidence of viral hepatitis, the frequency of occurrence of antigen HBs, as well as the clinical course of the disease in medical staff in relation to patients in the general population. The analysis has shown that the incidence rate in the Lublin district in the years 1979-1984 was 453.7 per 100,000 medical employees, and was 3.4 times higher than in the general population. No differences, however, were stated in the severity of the clinical course of the illness and in the activity of selected index enzymes indicating impaired liver functions among the medical staff and the other patients.

Occupational biohazards: a review.

There are at least 193 important biological agents that show infectious, allergenic, toxic, or carcinogenic activities in the working population. These agents are viruses, bacteria, fungi, plant substances, invertebrate animals (mostly arthropods), and substances derived from vertebrate animals. At least 20 large occupational groups are exposed to these biohazards. The risk is greatest among health care and laboratory workers who are threatened by human pathogens and among agricultural workers who are at risk from dust-borne biological allergens and toxins and by parasitic worms in warm climates. There is growing evidence that biohazards are also important risk factors for many other professions, including woodworkers, workers of textile plants, sewage and compost workers, miners and renovators. Some suggestions for research and prevention for reducing the occupational risks from biohazards are discussed.

Nosocomial infection in a children's hospital. A retrospective study.

The investigations the frequency of the occurrences of hospital infections were carried in a General Pediatric Ward. Most of the infections (77 per cent) appeared in children up to one year of age. The hospital infections mostly affected children residing in rural areas. The etiological agent was E. coli (36 per cent), Proteus (22.7 per cent) Klebsiella and Staphylococcus. The infections caused by E. coli mainly appeared in girls, others- in boys. The frequency of the occurrences of hospital infections was also analysed with respect to the primary disease of a child. In most cases of additional infections were found in children with upper respiratory tract infections, pneumonia and bronchitis. The above differences are statistically valid.