Electromechanical cell lysis using a portable audio device: enabling challenging sample preparation at the point-of-care.

Audio sources are ubiquitously available on portable electronic devices, including cell phones. Here we demonstrate lysis of Mycobacterium marinum and Staphylococcus epidermidis bacteria utilizing a portable audio device coupled with a simple and inexpensive electromagnetic coil. The resulting alternating magnetic field rotates a magnet in a tube with the sample and glass beads, lysing the cells and enabling sample preparation for these bacteria anywhere there is a cell phone, mp3 player, laptop, or other device with a headphone jack.

Skin temperature measurements during intense pulsed light emission.

BACKGROUND: Although lasers and intense pulsed light sources have improved the capability of injuring veins without affecting the overlying skin, work is needed to improve the procedure. OBJECTIVE: To create a method for predicting skin reaction to pulsed light. METHODS: Twenty patients were divided into four groups according to skin type (I-IV). An industrial thermometer equipped with a laser-aiming system was adapted to the intense pulsed light source handpiece. Patients received shots of increasing intensity while the skin temperature was measured. RESULTS: Fluence and temperature data were analyzed by logistic regression to evaluate possible injury. The stepwise method selected skin type and temperature variation as predictors of skin injury. Logistic curves indicated the maximum temperature variation tolerable for each skin type. More pigmented skin types tolerated less temperature increase. CONCLUSION: Skin type can predict cutaneous reaction to intense pulsed light through measurements of temperature variation. This method may help achieve successful selective photothermolysis.

Diagnosis of limbs and neck arterial trauma using duplex ultrasonography.

OBJECTIVE: To evaluate duplex ultrasonography for diagnosis of arterial trauma in limbs and neck. METHOD: Fifty-one wounds in 47 patients, with indication for arteriography, were prospectively studied and grouped according to the presence (PCS group: 21 wounds, 41.2%) or absence (ACS group: 30 wounds, 58.8%) of clinical signs of arterial injury. All underwent duplex ultrasonography and arteriography. RESULTS: Arteriography disclosed arterial injury in 21 wounds, of which 19 were visualized by duplex ultrasonography. In the other 30 wounds neither methods disclosed any arterial injury. The sensitivity of duplex ultrasonography was 90.5%, the specificity was 100% and the accuracy was 96.1%. In PCS group duplex ultrasonography showed 14 injuries (93.3%) and one false-negative result, and in ACS group, five injuries (83.3%) and one false-negative result in the ACS group. CONCLUSIONS: Duplex ultrasonography reproduces the results of arteriography as a non-invasive diagnostic method in trauma of the limbs and neck.

Endovascular grafting of a popliteal aneurysm using the saphenous vein.

PURPOSE: To report the successful endovascular exclusion of a popliteal aneurysm using a saphenous vein stent-graft. METHODS AND RESULTS: A 1.9-cm popliteal aneurysm in a 75-year-old man was excluded by an endovascular stent-graft constructed from a segment of a greater saphenous vein to which a Palmaz stent was attached at its proximal end. The operation was performed through an open posterior approach to the distal popliteal artery. The stent-graft was introduced in retrograde fashion and passed up to the superficial femoral artery, where the proximal stent was deployed. Distally, a conventional anastomosis was performed with standard suture technique. Follow-up at 2 months shows continued exclusion of the aneurysm and patency of the bypass. CONCLUSIONS: Saphenous stent-grafting is a promising technique in the less invasive treatment of popliteal aneurysms. Further experience and longer follow-up are required before this technique can replace open surgery in clinical practice.

[Evaluation of middle cerebral artery blood flow velocity with transcranial Doppler in carotid endarterectomy]. / Avaliação da velocidade de fluxo sangüíneo na artéria cerebral média, pelo Doppler transcraniano, na cirurgia de endarterectomia da carótida.

Thirty patients, submitted to 34 carotid endarterectomies, from September, 1992 to April, 1996, on Hospital Albert Einstein, São Paulo, have been studied. In these surgeries, Middle Cerebral Artery (MCA) was miniaturized with Transcranial Doppler (TCD). The purpose of this study were to verify the relationship between MCA blood flow velocity with postoperative neurologic complications: studying the velocity variations with risk of cerebral low perfusion and carotid stump back pressure, during carotid clamping; confirming that the TCD information, could show when it is necessary to use shunting, and its efficiency; and to know whether the method could detect intraoperative embolization. The equipment used was a Transpect TCD-EME 2000. During surgery, when carotid stump back pressure was bellow of 54.4 mmHg, Pruitt-Inahara shunt was applied. The flow velocity value observed with TCD was divided in 3 parts: phase 1, basal, since anesthesy induction until carotid clamping; phase 2, clamping, during the period when the carotid artery was occluded; phase 3, post-declamping, from the time the carotid artery was declamping until the end of surgery. The MCA flow velocity was available on three phases, in cm/s and percentually on phases 2 and 3, in relation to basal phase. The embolizations, detected by TCD, were classified in: a) a few embolizations in less than 10 second period, b) many embolizations in more than 10 second period. Based on the results obtained, its possible to conclude that the MCA flow velocity is related to the risk of cerebral low perfusion during carotid clamping; it was not possible to stablish any relation of MCA flow velocity to carotid stump back pressure; the TCD informs when the use of shunt is necessary and its efficiency; the postoperative neurologic complications were caused by embolizations. The conclusion is that the TCD is useful and easily applicated on carotid endarterectomy.

Distribution of Heterodera glycines in Ohio.

A 4-year systematic survey for the presence of soybean cyst nematode Heterodera glycines in Ohio soybean fields was initiated in 1992. A total of 667 soybean fields in 63 counties was sampled. Heterodera glycines was present in 91 fields in 40 counties based on soil samples collected, and in one field in each of three additional counties based on soil samples submitted to the Plant and Pest Diagnostic Clinic or through a preliminary survey conducted in 1991. Soybean hectarage in the 43 counties with at least one field known to be infested with H. glycines accounts for 79% of the total Ohio soybean production area. Eight races of H. glycines were identified in 33 samples from 18 counties. The most common was race 3, identified in 15 samples; others were races 1, 2, 4, 5, 6, 10, and 14.

[Preoperative localization of parathyroid adenomas. Role of cervical ultrasonography]. / Localisation pré-opératoire des adénomes parathyroidiens. Place de l'échographie cervicale.

OBJECTIVES: We evaluated the sensitivity and specificity of cervical ultrasonography for the detection of primary parathyroid adenomas. METHODS: From January 1990 to May 1992, ultrasonography was performed before exploratory cervicotomy in 30 patients (10 males, 20 females, mean age 56.3 yr) whose diagnosis was primary hyperparathyroidism based on radioimmunoassay of parathyroid hormone. The same trained operator performed all the ultrasonographic examinations. RESULTS: Twenty-six parathyroid tumours were detected in 23 of the 30 patients examined by ultrasonography. The four standard localizations and one ectopic tumour were visualized. At surgery 37 tumours were found in 30 patients. Among the 11 false negatives, the operator had identified an abnormal tumour incorrectly as a cervical lymph node in 2. Most of the false negatives occurred early in the study. The sensitivity of ultrasonography was thus 70 % with a 100% specificity. CONCLUSIONS: Cervical ultrasonography is a reliable, non-invasive and relatively inexpensive examination which should be used as a first-line test for the aetiological assessment of hyperparathyroidism.

Ischemic rest pain of the lower extremities. Treatment with peripheral nerve crush.

The authors report the results obtained from peripheral nerve crushing in the treatment of ischemic rest pain and/or trophic lesions of toes and feet. They studied retrospectively 102 patients who were submitted to peripheral nerve crushing at the "Hospital das Clínicas da Universidade de São Paulo" during a sixteen-year period, from March 1971 to April 1987. These patients had no other choice, either clinical or surgical. The results were evaluated under three aspects: elimination of pain, evolution of trophic lesions and postoperative complications. The follow-up period varied from 1 month to 6 years (mean of 18 months). The results showed immediate elimination of pain in 94% of the patients. The remaining 6% were reoperated on within 24 to 48 hours, due to technical failure in identifying some of the nerves during the first operation. Regarding the trophic lesions, in 71% of the patients the results were good and the remaining underwent amputation at leg or thigh. The worst results were obtained in patients with necrotic lesions (p < 0.05). Three patients presented surgical wound dehiscence. The authors conclude that peripheral nerve crushing constitutes a valid alternative for a select group of patients with uncontrollable ischemic rest pain in the feet.

[Diagnosis of deep venous thrombosis of the lower limbs by computed tomography]. / Diagnóstico de trombose venosa profunda de membros inferiores por tomografia computadorizada.

In the CT scan of a patient with knee tumor and deep vein thrombosis confirmed by phlebography, the casual observation of a thrombus image in the vein was made, characterized by wall contrastation in opposition to a lack of luminar contrastation. Then, CT scans of the lower limbs and the pelvic region were performed in 14 patients with suspected DVT, who were followed consecutively. Diagnosis of ruptured Baker cyst was made in one patient and DVT in 13 patients. DVT was demonstrated in both lower limbs of three patients. Diagnosis of DVT was confirmed in six of seven exams involving the legs. CT scan could detect thrombi in muscular veins and in deep femoral and internal iliac veins. In six patients with suspected pulmonary embolism, CT scan was also made of the thoracic region and showed pleuropulmonary involvement concomitant with lower limb DVT. The characteristic image of DVT in CT is that of a contrasted ring. Its brightness may be due to contrastation of the venous wall through its vasa vasorum, whereas the thrombus obstructs the luminar flow of the contrast medium. Reproducibility of the characteristic image of thrombus presence in the vein at different levels of the lower limbs and pelvic region gives CT the status of alternative diagnosis means for DVT. False negatives and false positives should be evaluated.

[Unusual complication of surgery of popliteal artery aneurysm: report of a case and considerations on the surgical technique]. / Complicação rara da cirurgia do aneurisma da artéria poplítea: relato de caso e considerações sobre a técnica cirúrgica.

A popliteal artery aneurysm was submitted to an exclusion surgery and autologous reversed saphenous vein bypass. The proximal ligation of the popliteal artery was performed 3cm above the aneurysm. A large branch of the artery below this point remained patent maintaining a communication with a branch of deep femoral artery. Due to this fact residual circulation inside the aneurysm was observed. The patient was reoperated in order to ligate the collateral branch and resect part of the aneurysm. This kind of complication of the technique proposed by Edwards is not common and does not invalidate this technique preferred by most surgeons.

[Arterial reconstruction of the iliofemoral segment by eversion endarterectomy]. / Reconstrução arterial do segmento iliacofemoral através de endarterectomia de eversão.

From October 1985 to December 1988, 31 iliofemoral eversion endarterectomies were performed in 29 patients with arteriosclerosis. The surgical procedure was carried out for trophic lesions in 74% of the patients and for ischemic rest pain in the remaining 26%. In 11 operations the endarterectomy was associated with profundoplasty, and in eight with saphenous vein femoropopliteal bypass. There were six immediate failures, four of them submitted to successful reoperations, and two to above knee amputations. In cases with good immediate patency no complications occurred during the follow-up periods which ranged from one to 34 months. With one post-operative death the mortality rate was 3.2%. Two patients displayed later severe ischemic manifestations in the opposite limbs and were both submitted to the same type of operation with good result. It may be concluded that iliofemoral eversion endarterectomy is an appropriate alternative procedure to the aortoiliofemoral reconstruction surgery in patients with severe ischemia of the lower limbs.

Enzyme immunoassay for detection of Drosophila melanogaster antigens in the juice of various foods.

An enzyme immunoassay (EIA) was developed to identify and quantitate soluble antigens originating from Drosophila melanogaster eggs. Polystyrene microtiter plates were coated with anti-egg antibody. Egg antigen standards or samples were reacted with the sensitized wells. The immobilized antigen was reacted with biotinylated antibody, and the complex was quantitated by an avidin-horseradish peroxidase conjugate. The assay can detect egg antigens equivalent to 0.03 eggs/mL. The antibody was directed against a number of antigens and cross-reacted with extracts of adult Drosophila melanogaster flies. Homogenized eggs diluted in various juice samples were detectable by EIA. Heating the antigen diluted in buffer or juice at a temperature used in processing of juice reduced the immunological response approximately 40-45%. Brine separated from fresh-packed sauerkraut showed EIA responses equivalent to 0.3-3 eggs/mL. Electrophoretic, chromatographic, and immunological analyses suggested that the EIA responses for sauerkraut brine were related to the Drosophila melanogaster egg antigens.

Comparison of immune status and 1,2-dimethylhydrazine induced tumorigenesis in brown--Norway and Fischer rats. Emphasis on splenic and colonic lymphocyte function.

Sym 1,2-dimethylhydrazine (DMH)-induced colon tumorigenesis was studied in immunologically different strains of rat: the Brown--Norway which is known to be immunologically a low-responder and the Fischer a high-responder. Brown--Norway rats received a total dose of 75, 150 or 225 mg DMH/kg or vehicle and Fischer rats received 150 mg DMH/kg or vehicle over a 3-week period. Rats were killed 5 months after the final treatment. Lymphocytes were isolated from the spleen and colon from rats treated with 150 mg DMH/kg or vehicle. Natural killer (NK) cell activity and the autologous mixed lymphocyte response (AMLR) as well as colon tumor incidence were compared between the two strains. Splenic and colonic intraperithelial lymphocytes (IEL) from the Brown--Norway strain demonstrated low NK activity and reduced splenic T lymphocyte proliferation in response to autologous non-T lymphocytes. As well, colonic lamina propria lymphocyte (LPL) proliferation was low and Brown--Norway rats had a low incidence of DMH-induced colon neoplasms (7%). In comparison, the Fischer rats had more effective splenic and IEL NK killing, enhanced splenic AMLR, enhanced LPL proliferation and a higher incidence of colon tumors (20%).

Comparacao das curvas de diluicao do tempo de protrombina e do tempo de tromboplastina parcial ativada para controle do efeito das antivitaminas K. / Comparison between the dilution curves of prothrombin time and activated partial thromboplastin time for the control of the effect of anti-vitamins K

O tempo de tromboplastina parcial ativada (TTPA) vem sendo utilizado com metodo alternativo ao tempo de protrombina (TP) para controle do uso clinico das antivitaminas K. No caso do TP considera-se como sendo a faixa da seguranca as atividades protrombinicas entre 15 e 30% do normal.Com relacao ao TTPA considera-se qualquer valor acima do limite superior a normalidade como indicativo de hipocoagulacao nao existindo referencias sobre uma faixa de seguranca para controle do uso das antivitaminas K. Neste trabalho adotou-se para o TTPA o mesmo procedimento de avaliacao da atividade protrombinica, ou seja, obtencao de TTPA de diluicoes de plasma normal com solucao fisiologica e com plasma adsorvido Para tanto, foram estudadas 16 curvas de diluicao em cada solvente, a partir de misturas com quatro plasmas de individuos normais. Obteve-se os valores de TTPA correspondentes as diluicoes que determinam a faixa de seruganca do TP. Embora devam ser considesiderados anticoagulantes todos os doentes com TTPA acima do limite superior da normalidade e possivel que a faixa de seguranca quando se utiliza este metodo, esteja entre 1,35 e 1,90 utilizando-se a relacao: TTPA das diluicoes entre 10 a 30% do normal/TTPA normal (100%)

Aneurismas aterioscleroticos da arteria poplitea. / Arteriosclerotic aneurysms of the popliteal artery

Os autores estudam 37 casos de aneurisma arteriosclerotico de poplitea, observados em 27 doentes do sexo masculino que foram tratados cirurgicamente. Em 20 membros havia sinais de isquemia; em 6 sintomas compressivos de veia e/ou nervo e, em 4, sinais de rotura do aneurisma; em 7, nao havia qualquer manifestacao sintomatologica.Em 33 membros, o aneurisma foi ressecado ou excluido da circulacao e o transito arterial foi restaurado por meio de implante venoso em 31, protese de dacron em 1 e P.T.F.E. em outro; em 3 casos, a simpatectomia lombar foi o unico tratamento cirurgico adotado e, em 1, alem desta cirurgia, foram feitas ligaduras proximal e distal da arteria. Os resultados do tratamento cirurgico foram excelentes em 26, bons em 7 e maus en 4. Um paciente faleceu por complicacoes pulmonares