Acute Brucellosis Following Accidental Exposure to Brucella melitensis Rev 1 Vaccine.

Brucellosis is mainly transmitted to humans by direct contact with infected animals, consumption of non-pasteurized dairy products or through inhalation of aerosols. However, the disease may also be transmitted by exposure to Brucella vaccination that is used in veterinary medicine. In the literature, there were a few case reports of persons who developed brucellosis after unintentional inoculation or conjunctival exposure to the live Brucella vaccine. Here, we describe a sheep farmer with acute brucellosis that occurred as a result of unintentional percutaneous exposure to Brucella melitensis Rev 1 animal vaccine while vaccinating lambs.

Comparison of four methods for rapid identification of Staphylococcus aureus directly from BACTEC 9240 blood culture system.

PURPOSE: Differentiation of Staphylococcus aureus (S. aureus) from coagulase-negative staphylococci is very important in blood stream infections. Identification of S. aureus and coagulase-negative staphylococci (CoNS) from blood cultures takes generally 18-24 h after positive signaling on continuously monitored automated blood culture system. In this study, we evaluated the performance of tube coagulase test (TCT), slide agglutination test (Dry Spot Staphytect Plus), conventional polymerase chain reaction (PCR) and LightCycler Staphylococcus MGrade kit directly from blood culture bottles to achieve rapid identification of S. aureus by using the BACTEC 9240 blood culture system. MATERIALS AND METHODS: A total of 129 BACTEC 9240 bottles growing gram-positive cocci suggesting Staphylococci were tested directly from blood culture broths (BCBs) with TCT, Dry Spot Staphytect Plus, conventional PCR and LightCycler Staphylococcus MGrade kit for rapid identification of S. aureus. RESULTS: The sensitivities of the tests were 99, 68, 99 and 100%, respectively. CONCLUSION: Our results suggested that 2 h TCT was found to be simple and inexpensive method for the rapid identification of S. aureus directly from positive blood cultures.

Predictive value of relative changes in serum total sialic acid level for response to neoadjuvant chemotherapy in patients with locally advanced breast carcinoma.

The aim of this study was to determine whether relative changes in total serum sialic acid (TSA) levels are associated with response to neoadjuvant chemotherapy in locally advanced breast carcinoma (LABC) patients. Forty-seven patients with stage III-B breast carcinoma and 20 healthy subjects (controls) were included to the study. TSA levels were determined in serum from patients at baseline and after completion of preoperative chemotherapy. Pathological responses to chemotherapy were determined on specimens of modified radical mastectomy underwent in responders. Association between the relative changes in serum TSA levels and the pathological response to chemotherapy was investigated. The baseline mean serum TSA level of LABC patients was 88.6+/-0.6 mg/dl and 66.9+/-0.7 mg/dl for the control group (p<0.0001). After 3 cycles chemotherapy, the serum levels of TSA were markedly decreased with pathological partial response (pPR) (73.8+/-1.0 mg/dl) and complete response (pCR) (68.1+/-1.9 mg/dl) compared to baseline values (p<0.05). In 8 non-responders, mean TSA value was 88.9+/-1.1 mg/dl (p=0.9 for pretreatment vs posttreatment TSA levels). Of 39 responders, 6 had pathological complete response (pCR) and remaining had pathological partial response (pPR). TSA levels derived from patients with pCR and from those with pPR were 68.1+/-1.9 mg/dl and 73.8+/-1.0 mg/dl, respectively (p=0.03). While TSA levels from pCR were not different from those of controls (p=0.4), there was a significant difference between TSA levels from pPR and from controls (p<0.0001). A significant correlation was demonstrated between the relative changes in TSA levels and pathological response (p<0.0001, coefficient of correlation [rs]=0.81). The ROC analysis showed that the discriminating ability was satisfactory and relative decrease by more than 21% in TSA levels indicated a pCR with the sensitivity by 83%, specificity by 76%. In conclusion, there is a significant correlation between the relative changes in TSA levels by chemotherapy and clinical/ pathological response to neoadjuvant chemotherapy in LABC patients.

Contrast-enhanced power Doppler US in the diagnosis of acute appendicitis.

INTRODUCTION/OBJECTIVE: To determine the value of power Doppler (PD) ultrasonography (US) and contrast-enhanced power Doppler (CEPD) US in the diagnosis of acute appendicitis and the prediction of histopathologic stages. METHODS AND MATERIAL: 50 patients with suspected acute appendicitis were evaluated by the same radiologist with PD US and CEPD US. Air micro bubbles stabilized by a granulate of "galactose and palmitic acid" were used as a contrast medium for sonography with the concentration of 400 mg/ml. PD US and CEPD US results were later correlated with the surgical and histopathologic findings. PD US and CEPD US findings were considered positive for appendicitis; if there was depiction of hyperemia in the wall of the appendix or if there was depiction of prominent peripheral vascularity when compared with normal soft tissues; and negative if both hyperemia and peripheral hyperemia were not prominent. RESULTS AND DISCUSSIONS: Of the 50 patients, 35 patients had histopathologically proven acute appendicitis. CEPD US showed prominent hyperemia in the appendiceal vessels or feeding vessels of the inflamed appendix, and resistance index (RI) calculations were easier. There was statistically significant difference between mean RI values of the normal appendix, suppurative appendicitis and gangrenous appendicitis. PD US has accuracy of 80%, sensitivity of 74% and CEPD US has 98%, and 100% in the diagnosis of acute appendicitis. CEPD US identified 100% of suppurative appendicitis and gangrenous appendicitis. CONCLUSION: CEPD US is a promising method in the diagnosis of acute appendicitis and determination of the inflammation stage.

Are percutaneous transgastric biopsies using 14-, 16- and 18-G Tru-Cut needles safe? An experimental study in the rabbit.

We evaluated perforation, peritonitis and bleeding after 14-, 16-, 18-G Tru-Cut needles were passed through the stomach in an animal model. Insertions were performed on seven anaesthetized rabbits with 18-, 16- and 14-G needles simulating the clinical technique. Diluted contrast medium with methylene blue (60 mL) was administered through a nasogastric tube after the biopsy. Computed tomography (CT) scanning of the upper abdomen was performed 10 min after the insertion for leakage. The abdominal contents were inspected by laparotomy. There was no contrast medium leakage outside the gastrointestinal tract on CT images. Neither methylene blue nor other stomach content leakage was identified by laparotomy, even with manual squeezing. A tiny spot of blood was observed on the serosal surface of the stomach with the 18-G needle passes (five cases), whereas a relatively large haematoma was present with 14-G needle (four cases). Six of the rabbits survived and one died due to an inadvertant aortic injury. The results of the study show that transgastric route with an 18-G cutting needle can be used without fear of peritonitis and bleeding.

Trace elements in hydatid disease.

The serum and cyst fluid levels of selenium, zinc and copper were investigated both in patients and sheep with hydatid cysts. Results were compared with those of healthy subjects in both species. The serum values of Se, Zn and Cu in healthy subjects were 60.24 +/- 1.96 micrograms/L, 0.59 +/- 0.07 mg/L, and 1.01 +/- 0.08 mg/L, respectively. The corresponding serum values of the three trace elements in patients with hydatidosis were 41.30 +/- 1.94 micrograms/L, 1.27 +/- 0.08 mg/L, and 0.89 +/- 0.09 mg/L. These results show a decrease in Se and Zn, and a rise in Cu in sera of patients with hydatid disease. Similar results were obtained in infested sheep as related to the healthy control animals. Our results on the three trace elements were found to correlate well with the incidence of cirrhosis, malignant and infectious diseases and arthritis. Se was not detectable in cyst fluid, while Cu and Zn levels were found significantly lower than serum levels. Cu and Zn levels in cyst fluid showed no difference in both species. Variations in serum Cu, Zn and Se levels were insignificant with regard to the genus of the host and the fertile capacity of the hydatid cyst.

Research note: utilizing hazelnut kernel oil meal in layer diets.

The present study was conducted in order to investigate the possibility of utilizing hazelnut kernel oil meal (HKOM) in layer diets as a replacement for soybean oil meal (SBM). Two hundred and sixteen brown egg layers raised in contiguous wire cages were used. The duration of the experiment was 24 wk consisting of six periods of 4 wk. In the trial, six diets containing different levels of HKOM replacing 0, 20, 40, 60, 80, and 100% of SBM protein, respectively, were utilized as the treatments. Differences among the diets in terms of egg yield, feed consumption, feed efficiency ratio, egg weight, egg yolk and albumen ratios, shell thickness, shell weight, and Roche color values of the yolk were not statistically significant (P greater than .01). Results indicated that SBM could be replaced totally by HKOM in layer diets. However, replacement of more than 40% of SBM with HKOM is not recommended.

Effect of appendicectomy on development of right inguinal hernia.

The effect of appendicectomy on the subsequent development of right inguinal hernia was investigated in 583 patients with hernias, 42 of whom had previously had appendicectomies. The incidence of right sided hernias was no greater among these patients than among those who had not had their appendixes removed. Neither sex was more prone to develop an inguinal hernia after appendicectomy, and no type of hernia (direct or indirect) predominated. The cause of right sided inguinal herniation after appendicectomy has been thought to be damage to the nerve supply of the inguinal muscles during the appendicectomy incision. All our 42 cases except two had had their appendicectomies through classic McBurney incisions, which were some distance away from the most common areas of nerve damage. We conclude that development of a right inguinal hernia is an unlikely complication of appendicectomy if a classic McBurney incision was used.

Regulation of rat liver phosphatidylethanolamine N-methyltransferase by cytosolic factors. Examination of a role for reversible protein phosphorylation.

The nature of cytosolic factors which modulate the activity of rat liver phosphatidylethanolamine (PE) methyltransferase was investigated. The combined additions of cytosol, Mg X ATP, and NaF to incubations with rat liver microsomes produced a 1.6-fold activation of the methyltransferase at pH 9.2 and a 1.3-fold stimulation at pH 7.0. Nonhydrolyzable 5'-adenylylimidodiphosphate could not substitute for ATP, although GTP could. The activation was time dependent, stable to reisolation of the microsomes by ultracentrifugation, and partially preventable by other cytosolic components. Despite these indications that PE methyltransferase might be a substrate for cytosolic protein kinases, cAMP and Ca2+-calmodulin exerted little influence on the activation reaction. Furthermore, microsomal PE methyltransferase activity was unaffected by purified preparations of cAMP-dependent protein kinase, calmodulin-dependent protein kinase, and casein kinase II, nor was methyltransferase activity influenced by the purified catalytic subunits of protein phosphatases 1 and 2A. Cytosol also contained inhibitors of PE methyltransferase which could overcome the Mg X ATP X NaF-mediated activation of the enzyme, but were not affected by the thermostable phosphatase inhibitors 1 and 2. Part of this inhibitory activity (apparent molecular mass of 15 X 10(3) daltons) was insensitive to trypsin and chymotrypsin, stimulated by Mn2+, and partly inhibited by NaF. Therefore, regulation of methyltransferase by reversible phosphorylation, while still a tenable hypothesis, is apparently more complex than previously proposed.