Accessing packaged food and beverages in hospital. Exploring experiences of patients and staff.

Food and beverage packaging has been identified as a contributing factor to malnutrition among elderly patients in hospitals. The focus of this research was to describe the types of food and beverage packaging used in NSW hospitals, determine the 'problematic' packaging from the users' perspective, investigate the effect of hand strength on the ability to open the packaging and to survey users' (patients and staff) views on the 'accessibility' of the packaging. The study was conducted in the Illawarra region of NSW, Australia. Participants (140 mostly elderly inpatients and 64 staff members) were recruited from four local public hospitals. Data were collected using interviews, questionnaires, observations and grip strength testing. Several food and beverage packages were found difficult to open by at least 40% of patients. These included milk and juices (52%), cereal (49%), condiments (46%), tetra packs (40%) and water bottles (40%). The difficulties were attributed to 'fiddly' packaging, hand strength and vision; however, only tetra packs demonstrated a relationship between time taken to open and hand strength, suggesting other aspects of hand function may be more important than strength when opening food and beverage packages.

Proteomic comparison of nasopharyngeal cancer cell lines C666-1 and NP69 identifies down-regulation of annexin II and beta2-tubulin for nasopharyngeal carcinoma.

CONTEXT: Nasopharyngeal carcinoma (NPC), common in southern China and North Africa, has a complex etiology involving interplay between viral, environmental, and hereditary factors and is almost constantly associated with the Epstein-Barr virus. Since the prognosis of locally advanced and metastatic diseases is poor, increased understanding of the pathogenesis of NPC would be important for discovering novel markers for patients' management. OBJECTIVES: To compare the proteomic expression profile between an Epstein-Barr virus-associated NPC cell line (C666-1) and a normal NP cell line (NP69). The proteins with differential expression were analyzed in 40 undifferentiated NPC paraffin-embedded specimens. DESIGN: Differentially expressed proteins discovered between the two cell lines were identified by mass spectrometry. After confirmation by immunocytochemical staining, their expression in patient samples was measured using 40 pairs of undifferentiated NPCs together with their adjacent normal epithelia. RESULTS: Proteomic findings indicated that adenosine triphosphate synthase alpha chain was up-regulated, whereas annexin II, annexin V, beta(2)-tubulin, and profilin 1 were down-regulated. After confirming the results in agar-processed cell lines, annexin II and beta(2)-tubulin expression were found to be lower in tumor cells than in adjacent normal epithelial cells in 100% and 90% of the patients' specimens, respectively. Finally, annexin II down-regulation was positively associated with lymph node metastasis, suggesting that it may be a prognostic factor in NPC. CONCLUSIONS: The results suggest that annexin II and beta(2)-tubulin down-regulation is important in NPC formation and may represent potential targets for further investigations.

The contribution of bifunctional SkipDewax pretreatment solution, rabbit monoclonal antibodies, and polymer detection systems in immunohistochemistry.

CONTEXT: In immunohistochemistry, nonstandardized antigen retrieval protocols and fluids, poor-quality antibodies, and the presence of endogenous biotin frequently lead to incorrect results. Recently, advanced reagents including bifunctional SkipDewax pretreatment solution (BSPS), rabbit monoclonal (RM) antibodies, and biotin-free polymer detection systems (PDSs) have been developed, which, it is claimed, resolve these problems. OBJECTIVES: To determine whether BSPS, RM antibodies, and biotin-free PDSs improve the accuracy of immunohistochemistry; to optimize a new protocol consisting of a combination of BSPS, RM antibodies, and PDSs; and to compare it with a conventional protocol. DESIGN: The efficacies of BSPS, RM antibodies, and PDSs were compared with those of their respective conventional reagents using multitissue spring-roll sections. The new protocol was compared with a conventional protocol using Ki-67 immunostaining of 49 colorectal carcinoma specimens. RESULTS: For antigen retrieval, BSPS resulted in similar or better tissue staining than an EDTA solution, but the efficacy of BSPS decreased when it was reused. Most RM antibodies resulted in a greater proportion of positive cells than the corresponding non-RM antibodies, which did not produce satisfactory results in the absence of antigen retrieval. The PDSs Bond, ChemMate, and SuperPicture resulted in a high percentage of positive cells, good staining intensities, and low backgrounds. Other PDSs, except that from Ventana, resulted in high backgrounds and false positivity. The new combined protocol resulted in better Ki-67 staining than the conventional assay. CONCLUSIONS: Bifunctional SkipDewax pretreatment solution, RM antibodies, and PDSs improve staining quality and diagnostic accuracy of immunohistochemistry assays and provide a foundation for standardization.

Follicular dendritic cell sarcoma: a rare tumor presenting as an abdominal mass.

Follicular dendritic cell (FDC) sarcoma is a rare and probably even underreported entity. Only approximately some 50 cases have been described in the literature, the majority of which had a lymph node origin. The authors report a case of FDC sarcoma arising within the soft tissues of the abdominal cavity. As FDC markers are often not routinely included in antibody panels, awareness of this sarcoma is important, as it can be confused with other tumors, especially when occurring extranodally.

The Bub2p spindle checkpoint links nuclear migration with mitotic exit.

Bfa1p and Bub2p are spindle checkpoint proteins that likely have GTPase activation activity and are associated with the budding yeast spindle pole body (SPB). Here, we show that Bfa1p and Bub2p bind the Ras-like GTPase Tem1p, a component of the mitotic exit network, to the cytoplasmic face of the SPB that enters the bud, whereas the GDP/GTP exchange factor Lte1p is associated with the cortex of the bud. Migration of the SPB into the bud probably allows activation of Tem1p through Lte1p, thereby linking nuclear migration with mitotic exit. Since components of the Bub2p checkpoint are conserved in other organisms, we propose that the position of the SPB or mammalian centrosome controls the timing of mitotic exit.

Sclerosing epithelioid fibrosarcoma: a study of five cases emphasizing diagnostic criteria.

AIMS: To study the clinical and histopathological features of sclerosing epithelioid fibrosarcoma, and to define diagnostic criteria for this uncommon soft-tissue tumour. METHODS AND RESULTS: Standard histological, immunohistochemical and ultrastructural techniques were applied to five tumours from head and neck, chest wall and groin. Tumours consisted of groups of monomorphic rounded/epithelioid cells surrounded by a prominent collagenous stroma. Tumour cells showed positive vimentin staining but were negative for other markers. They contained prominent rough endoplasmic reticulum and a large Golgi apparatus which in one case was producing collagen secretion granules, an ultrastructural marker for collagen production. Three patients had medium to long-term survival (3-7 years). Of these, one was disease-free for 3 years, and two experienced multiple recurrences: one of the latter died of metastatic disease. CONCLUSION: Criteria for diagnosing this uncommon tumour include: small to medium cell size, clear or pale cytoplasm, cellular arrangement in cords and strands, dense collagenous stroma; vimentin staining; rough endoplasmic reticulum and a Golgi apparatus producing, in well preserved examples, collagen secretion granules. The paper emphasizes the value of electron microscopy, supporting an appropriate histological picture and immunophenotype, in identifying these relatively low-grade sarcomas.

Neuroendocrine differentiation and prognosis in prostatic adenocarcinoma.

OBJECTIVES: To assess the prognostic importance of neuroendocrine differentiation in conventional (non-small cell) prostatic adenocarcinoma. MATERIALS AND METHODS: Ninety-two samples from patients with prostatic adenocarcinoma were studied retrospectively. The immunohistochemical analysis of chromogranin A and neuron-specific enolase in formalin-fixed, paraffin wax embedded prostatic tissue chips was related to other prognostic variables and patient survival. RESULTS: Neuroendocrine differentiation was detected in 48 cases; there was a significant correlation with worsening tumour differentiation, the presence of bone metastases and with worsening survival, but no independent effect of neuroendocrine differentiation on survival. CONCLUSION: The detection of neuroendocrine differentiation in conventional prostatic adenocarcinoma is not an independent indicator of prognosis.

AIDS orphans -- how fares Zimbabwe?

PIP: The author spent 2 weeks in Zimbabwe during May 1997 partly in Harare and the rest in rural areas. He found Harare to be a very clean and vibrant city with no signs of decay. Nongovernmental organizations (NGOs) involved with children in distress explained that they try to keep AIDS orphans in the community, not necessarily in the city, but in their communities of origin which are largely in rural areas. Orphans who end up in the rural areas may benefit from the cultivation of collectively owned land and the occasional visit from field workers who may provide very basic material assistance. However, no government grants are available to either foster or adopt orphans, and the only possible tangible financial assistance will come from NGOs or churches. Children left in urban areas tend to gravitate toward informal settlements or be absorbed by fellow city dwellers. Those who end up in informal settlements are often child-headed households highly vulnerable to economic and sexual exploitation. Harare has a number of organizations which provide services to street children.^ieng

Post-operative spindle cell nodule of the vulva.

A case of post-operative spindle cell nodule arising in the vulva of a 33-year old woman is reported and the relevant literature reviewed. This is an uncommon, benign lesion which develops soon after a surgical procedure and which is composed of mitotically active spindle cells, causing possible confusion with sarcoma. Knowledge of the clinical history and an awareness of the existence of such lesions is necessary in order to avoid misinterpretation.

Binding of acyl-CoA to liver fatty acid binding protein: effect on acyl-CoA synthesis.

The ability of purified rat liver and heart fatty acid binding proteins to bind oleoyl-CoA and modulate acyl-CoA synthesis by microsomal membranes was investigated. Using binding assays employing either Lipidex 1000 or multilamellar liposomes to sequester unbound ligand, rat liver but not rat heart fatty acid binding protein was shown to bind radiolabeled acyl CoA. Binding studies suggest that liver fatty acid binding protein has a single binding site acyl-CoA which is separate from the two binding sites for fatty acids. Experiments were then performed to determine how binding may influence acyl-CoA metabolism by liver microsomes or heart sarcoplasmic reticulum. Using liposomes as fatty acid donors, liver fatty acid binding protein stimulated acyl-CoA production, whereas that from heart did not stimulate production over control values. 14C-labeled fatty acid-fatty acid binding protein complexes were prepared, incubated with membranes, and acyl-CoA synthetase activity was determined. Up to 70% of the fatty acid could be converted to acyl-CoA in the presence of liver fatty acid binding protein but in the presence of heart fatty acid binding protein, only 45% of the fatty acid was converted. Liver but not heart fatty acid binding protein bound the acyl-CoA formed and removed it from the membranes. The amount of product formed was not changed by additional membrane, enzyme cofactors, or incubation time. Additional liver fatty acid binding protein was the only factor found that stimulated product formation. Acyl-CoA hydrolase activity was also shown in the absence of ATP and CoA. These studies suggest that liver fatty acid binding protein can increase the amount of acyl-CoA by binding this ligand, thereby removing it from the membrane and possibly aiding transport within the cell.

The kinetics of mutagen excretion in the urine of cigarette smokers.

The excretion of mutagens in the urine of cigarette smokers was studied as a model for absorption and elimination of complex carcinogenic and mutagenic mixtures in humans. Urine was collected from an occasional smoker who smoked 1 cigarette (17 mg tar/cigarette) and from a heavy smoker (smokes approximately 20 cigarettes/day) who quit for 2 days and then resumed smoking. Urine samples were collected for 6 days, including a 2-day pre-smoking period for the occasional smoker and pre-abstention period for the heavy smoker, respectively. Mutagen excretion patterns were determined by extracting the mutagens in each urine sample with XAD-2 resin and testing the extract in a microsuspension modification of the Salmonella/microsome liquid-incubation assay using bacterial strain TA98 with metabolic activation. Peak mutagenic activity of the urine collected from the two smokers appeared 4-5 h after the beginning of smoking. Activity decreased to pre-smoking "baseline' levels in approximately 12 h for the occasional smoker, and the activity for the heavy smoker approached the occasional smoker's 'baseline' in approximately 18 h after the cessation of smoking. The mutagen excretion patterns of the occasional smoker after smoking a single cigarette suggests that, the mutagens, as detected by the Salmonella assay, are absorbed rapidly (3-5 h) and are eliminated from the body following first order kinetics. The excretion rate constant for the occasional smoker was approximately 0.1 h-1 and the half-life (T1/2) was approximately 7 h.

Regulation of phenylalanine oxidase synthesis in Proteus mirabilis.

Cells of Proteus mirabilis could oxidize L-phenylalanine to phenylpyruvate only when grown in the presence of a number of amino acids, particularly, L-alanine, L-asparagine, L-glutamate, and L-glutamine. Production of phenylalanine oxidase was slowly lost upon growth in a minimal medium containing ammonium ions as a nitrogen source but was reversed by the addition of casein hydrolysate. Oxidase activity as well as a phenylalanine-dichlorophenolindophenol (DCIP) reductase activity increased in P. mirabilis only during cell multiplication. Both rifampin and nalidixic acid caused inhibition of oxidase synthesis. A phenylalanine-active transport was found to be operative when bacteria were grown in the absence of added amino acids. After anaerobic growth, cells of P. mirabilis had lost their ability to carry the phenylalanine oxidase reaction when assayed in the presence of air, and nitrate could not be used as an electron acceptor for the oxidation of phenylalanine. However, some phenylalanine-dichlorophenolindophenol reductase activity was still present in anaerobic bacteria at the early stage of cell multiplication.