Analysis of metals leached from smoked cigarette litter.

BACKGROUND: Littered cigarette butts represent potential point sources for environmental contamination. In areas with substantial amounts of cigarette litter, environmental hazards may arise as chemical components are leached from the filters and smoked tobacco. OBJECTIVE: The three main aims of this study were: (1) to quantify the amount of Al, Ba, Cd, Cr, Cu, Fe, Pb, Mn, Ni, Sr, Ti and Zn leached from cigarette butts, (2) to determine the relationship between the pH of the aqueous soaking solution and metal concentration leached and (3) to determine the relationship between the period of soaking in aqueous solution and metal concentration leached. METHODS: Smoked cigarette butts and unsmoked cigarettes were added to phials containing aqueous solutions of pH 4.00, 5.00 and 6.00 (± 0.05). The metal concentration of the resultant leachates was measured via inductively coupled plasma optical emission spectroscopy (ICP-OES) 1 day, 7 days and 34 days after sample addition. RESULTS: All metals were detected in leachates 1 day after sample addition (with the exception of Cd) and were released at varying rates. No clear relationship between pH within the range typical of precipitation and metal concentration leached was observed. CONCLUSIONS: Based on the gradual release of multiple metals over the full 34-day study period, cigarette litter was found to be a point source for metal contamination. The apparent rapid leaching of other metals may increase the risk of acute harm to local organisms.

Observation of two-photon speckle patterns.

We report the observation of speckle patterns in quantum correlations within light that is scattered by a disordered medium. The random medium is illuminated with spatially entangled photon pairs, and fourth-order speckle patterns are spatially resolved by two independently scanning detectors. Spatial entanglement gives two-photon speckle a much richer structure than ordinary one-photon speckle. Our experiments demonstrate that two-photon speckle from a surface scatterer and a volume scatterer look entirely different.

Safety of alternative medicines reconsidered: lead-induced anaemia caused by an indian ayurvedic formulation.

We report two cases of Belgian women diagnose with a lead poisoning. Both patients presented with abdominal pain and a normochromic normocytic anaemia. The diagnosis was based on the clinical symptoms, the anaemia, the basophilic stippling of erythrocytes and the elevated blood lead level Upon further questioning, both patients reported the use of Ayurvedic medications. Toxicological analysis of the different pills revealed that, in both, the same orange-red pills contained a remarkably high amount of lead. Cases of lead poisoning associated with the use ofAyurvedic formulations are emerging around the world. However, to our knowledge, these are the first reported cases in Belgium.

Coexistence of light chain disease and chronic lymphocytic leukaemia, a complex karyotype with a rapid fatal outcome.

We report on a 48-year-old man with concomitantly diagnosed kappa expressing chronic lymphocytic leukaemia (CLL) and lambda light chain disease with highly complex chromosomal aberrations. The clinical course of the disease was very aggressive with survival of only 1 month. We demonstrate the distinct clonal origin by cytogenetic data and immunoglobulin rearrangement studies. To our knowledge this is the first report of a light chain disease associated with CLL.

Oxazolidinones: new antibacterial agents.

The oxazolidinones are a new chemical class of synthetic antibacterial agents that are active orally or intravenously against multidrug-resistant Gram-positive bacteria. Their unique mechanism of action and activity against bacteria that pose therapeutic problems in hospital and community treatments make them promising candidates for antimicrobial agents.

In vivo activities of U-100592 and U-100766, novel oxazolidinone antimicrobial agents, against experimental bacterial infections.

The Upjohn oxazolidinones, U-100592 and U-100766, are orally bioavailable synthetic antimicrobial agents with spectra of activity against antibiotic-susceptible and -resistant gram-positive pathogens. In several mouse models of methicillin-resistant Staphylococcus aureus infection, U-100592 and U-100766 yielded oral 50% effective doses (ED50) ranging from 1.9 to 8.0 mg/kg of body weight, which compared favorably with vancomycin subcutaneous ED50 values of 1.1 to 4.4 mg/kg. Similarly, both compounds were active versus a Staphylococcus epidermidis experimental systemic infection. U-100592 and U-100766 effectively cured an Enterococcus faecalis systemic infection, with ED50 values of 1.3 and 10.0 mg/kg, and versus a vancomycin-resistant Enterococcus faecium infection in immunocompromised mice, both drugs effected cures at 12.5 and 24.0 mg/kg. Both compounds were exceptionally active in vivo against penicillin- and cephalosporin-resistant Streptococcus pneumoniae, with ED50 values ranging from 1.2 to 11.7 mg/kg in systemic infection models. In soft tissue infection models with S. aureus and E. faecalis, both compounds exhibited acceptable curative activities in the range of 11.0 to 39.0 mg/kg. U-100766 was also very active versus the Bacteroides fragilis soft tissue infection model (ED50 = 46.3 mg/kg). In combination-therapy studies, both U-100592 and U-100766 were indifferent or additive in vivo against a monomicrobic S. aureus infection in combination with other antibiotics active against gram-positive bacteria and combined as readily as vancomycin with gentamicin in the treatment of a polymicrobic S. aureus-Escherichia coli infection. U-100592 and U-100766 are potent oxazolidinones active against antibiotic-susceptible and -resistant gram-positive pathogens in experimental systemic and soft tissue infections.

Intramedullary fixation of forearm fractures in adults.

The authors present a retrospective study of acute fractures of the diaphysis of the radius or ulna, or both, in adults treated by intramedullary nailing. Seventy diaphyseal fractures in 38 patients (30 men and 8 women) were treated by intramedullary fixation. The mean age of the patients was 31.5 years. Union occurred in 66 fractures (94%). The average union-time was 73 days. Compared with the results published by other authors, using the same evaluation criteria, union-time with the intramedullary technique was shorter than with other techniques. Union-rates and functional results were similar to those in comparable studies. Closed nailing does have many advantages, including early union, low incidence of infection, small scars, less blood loss, and short operating time with minimal surgical trauma.

Treatment of unstable fractures, dislocations and fracture-dislocations of the cervical spine with Senegas plate fixation.

The results of the anterior approach to the cervical spine for the treatment of fractures and dislocations by arthrodesis and Senegas plate fixation are described. Twenty-two patients underwent a one- or two-level arthrodesis of the cervical spine. Their mean age was 42 years. The injuries were subdivided using the radiological classification described by Harris. In the group of patients who presented with a complete neurological deficit below the level of injury, there was only one patient who deteriorated. X ray examination 1 year after surgery showed fusion in 17 patients (100%). In contrast to some recent cadaveric and animal studies in which the anterior approach and fixation were found to be less stable than posterior fusion, our results obtained with this method are excellent, despite the fact that post-operative immobilization was limited. Problems with the anterior approach did not arise in these 22 patients. Alignment was always acceptable and fusion was achieved within one year in all cases.

Treatment of tibial shaft fractures by interlocking nailing.

Between 1982 and 1986, 60 tibial shaft fractures were treated by interlocking nailing. Of these, 10 were complicated by a pseudarthrosis. The results were assessed after a minimum follow-up of 2 years and were found to be good both in patients with fresh fractures and with pseudarthroses; in only 3 out of 60 cases was the outcome poor. The advantages of the techniques include: its suitability for virtually all types of shaft fractures ease of surgery early mobilization and weightbearing, with a low risk of infection rapid consolidation. Relative drawbacks are: radiation exposure longer preoperative preparation involvement of the entire shaft if infection develops irritation of the patellar tendon.

Kashin-Beck's disease.

A case of Kashin-Beck's disease is presented. It is an acquired, disabling, polyarthritic, degenerative condition of early onset, sometimes leading to a variable degree of dwarfism. It occurs endemically in certain Asian areas. Treatment is, if possible, preventive. In the established disease the therapy is that of any other form of secondary osteoarthritis. Reconstructive surgery and removal of loose bodies may be needed in severe cases (11). Early detection, facilitated by careful family history taking, is a prime requisite, especially in non-endemic areas (7).

Prosthetic versus tendon allograft replacement of ACL-deficient knees.

ACL reconstruction is still controversial. Between November 1985 and October 1987, 57 ACL reconstructions were performed using a Dacron graft. Evaluation was done using the Lysholm rating system and Tegner scale. The Lysholm score averaged 84.2. Regarding the level of performance, the patients had lost an average of 2.1 points on the Tegner scale. 18 of the 57 patients developed a synovitis. In 11 patients (19 per cent) the implant had to be removed. CT scan of the operated knee proved the Dacron graft to be nonfunctioning in as many as 40 per cent of the patients. Because of this high complication rate, the authors started to use deep-frozen (-70 degrees C) tendon allograft material. Both Achilles and Tibialis Posterior tendons were implanted using the over-the-top technique with or without an additional extra-articular procedure. Complications as seen with the rigid synthetic ligaments were absent. The preliminary results seem satisfactory in that the functional demands placed on the knee are not restricted.

Acetabular bone stock reconstruction with frozen femoral head allografts and the use of a cementless screw cup in total hip revision surgery. A 5 years' clinical, radiologic and scintigraphic follow-up.

This prospective study reviews the behaviour of a cementless conical screw cup in total hip revision surgery with or without the use of bone grafts to reconstruct acetabular bone stock. Clinical and radiologic results are given. For proper radiographic interpretation a new classification system is suggested, based on histologic features, the principles of which are explained. The results of auto- or allografts for the treatment of the same pathological condition are compared. The difference between both grafts successively in bone incorporation, biochemical behaviour, morbidity and mortality rate is discussed. The difference between a cancellous and a cortical bone transplant in the mechanism of repair is discussed. This study also analyzes acetabular bone graft activity using serial technetium-99m bone scans. Some guidelines for rehabilitation programs can be deduced from these observations. Finally, a correlation between graft incorporation and the acetabular deficiency to be reconstructed can be postulated.

Significance of Clostridium difficile and its cytotoxin in children.

Stools of 147 children belonging to different age groups were examined for the presence of Clostridium difficile, its cytotoxin and other enteric pathogens. None of the 31 full-term neonates, 5 (16%) of the 32 premature neonates, 27 (46%) of the 59 infants and 1 (4%) of the 25 older children excreted C. difficile in their stools. Faecal cytotoxin was only detected in four infants (7%). There was no correlation with diarrhoea, previous antibiotic therapy, type of diet, or the concomitant presence of other intestinal pathogens. We conclude that colonisation of the intestine by C. difficile is probably acquired from environmental sources and that it cannot be regarded as a significant cause of diarrhoea in children.