Attitude of Iranian nephrologists toward living unrelated kidney donation.

Living unrelated kidney donation (LURD) is increasing worldwide due to the shortage of cadaveric kidneys. In our country an LURD program has been practiced since 1988. This study sought to evaluate the attitude of Iranian nephrologists towards various aspects of the program. Questionnaires including 20 queries were sent to nephrologists. Among 100 randomly selected nephrologists, 50 completed and returned the questionnaires. Forty six (92%) and 45 (90%) believed that LURD has potential minor short- and long-term complications, respectively. Forty two percent assumed renal failure was a potential complication. Ninety two percent used to inform donors about the complications, all verbally. Thirty four percent and 72% assumed inhalational opium addiction and heroin addiction were contraindications to LURD, respectively. Twenty eight percent and 68% believed that the amount of recipients' gift and the governmental award are not sufficient, respectively. Thirty two percent believed that all compensation should be paid by the government. Sixty six percent believed that donors should be given social advantages, and 26% believed that they should not, in order to not enhance persuasion of nonaltruistic donation. Eighty eight percent claimed that donor follow-up is not regularly done and should be organized. Finally, 30 agreed and 19 disagreed with LURD. We conclude that despite the success of our LURD program in elimination of the transplant waiting list, most Iranian nephrologists believe that there should be some revisions. Verbal information about complications may not be sufficient to help the donors to make a correct decision. We should reconsider the method and amount of financial compensation and organize a regular follow-up program.

Concordance between tumour cell activation by epidermal growth factor and alteration of cell sensitivity to cisplatin and lymphokine-activated killer cell activity.

In this study the impact of epidermal growth factor (EGF) on chemosensitivity and susceptibility to lymphokine-activated killer (LAK) cytolysis on six cell lines (one super expressing EGFr i.e. HN5, three high expressing i.e. Hep2, KB and MCF-7 and two low expressing i.e. Fen and HN15) was investigated using the tetrazolium salt reduction assay (MTT) as measured by optical density (OD). Hep2, KB, MCF-7 and Fen lines showed a dose-related inhibition to cisplatin (from 19% to 80%). Treatment of EGFr positive cell lines, Hep2, KB and MCF-7 but not EGFr negative Fen by EGF prior to exposure to cisplatin inhibited the cells by between 10-15% (p<0.05). Exposure of HN5 line to EGF (0.1 ng/ml) prior to LAK assay, led to a decrease in tumour killing (13%, p<0.05). However, at 0.01 ng/ml the pre-treatment enhanced tumour sensitivity. These data indicated that pre-exposure of tumour cells to EGF altered their response to cisplatin and LAK killing and this depended on the degree of EGFr expression. These data may prove helpful for pre-selection of patients for an appropriate therapy.

In vitro studies of the loss of antibacterial activity of oxytetracycline in presence of Ca(II) or Mg(II) ions.

The results of a comparative study, which evaluated the in vitro effect on the antibacterial activity of oxytetracycline (OTC, CAS 79-57-2) in presence of Ca(II)/Mg(II) ions suggest that susceptibility of Staphylococcus aureus, Bacillus pumilis and Bacillus subtilis to OTC is reduced in presence of Ca(II)/Mg(II) ions. As the ratio of concentration of Ca(II)/Mg(II) to OTC was increased, antibacterial activity of OTC declined. In addition to the difference observed between the antibacterial effect of pure OTC and its Ca(II)/Mg(II) complexes, it was found that decline in antibacterial activity is greater for Mg(II)-OTC complex than Ca(II)-OTC complex for the same concentration of Ca(II)/Mg(II) ions.

Nosocomial outbreak of respiratory tract colonization with Mycobacterium fortuitum: demonstration of the usefulness of pulsed-field gel electrophoresis in an epidemiologic investigation.

Between August 1989 and January 1990, 16 patients on an alcoholism rehabilitation ward (ARW) developed positive sputum cultures for Mycobacterium fortuitum. During a 2-wk surveillance period, six of 43 ARW patients but none of 20 staff members had positive sputum cultures. In addition, none of 54 patients and staff on an adjacent ward sharing the same ice machine and water supply had positive cultures, and none of 92 acid-fast bacilli cultures performed on all sputum specimens from all other inpatient sources during the same 2-wk period were positive. The only exposure factor common to all cases was the use of one or both of the ward showers. Compared with 36 ARW control patients, cases were more likely to report clinical criteria for chronic bronchitis (odds ratio, 6.6; 95% confidence interval, 1.5 to 28.6; p = 0.02). Using phenotype analysis, plasmid profiles, and pulsed-field gel electrophoresis of large genomic DNA restriction enzyme fragments, the 16 case isolates were found to be identical. This strain of M. fortuitum was also cultured from a tap connected to the water line supplying the ARW showers, but not from the showers themselves. No further cases were identified after the showers were disconnected and decontaminated. To our knowledge, this is the first clinical use of pulsed-field gel electrophoresis for genetic comparison of mycobacterial strains. It demonstrates the important potential of this technique for studying the epidemiology of mycobacterial infections. Showers should be considered a possible source of nosocomial respiratory tract colonization with M. fortuitum.

Simple spot test for rapid detection of urease activity.

A spot test for the detection of urease activity was developed and evaluated with 761 strains of gram-negative bacteria. The test was compared with the conventional Christensen urea agar slants and urease test on the Vitek Enterobacteriaceae card (Vitek Systems, Inc., St. Ana, Mo.). Of the 348 strains of the Proteus-Providencia-Morganella group that were urease positive, 327 (94%) yielded positive results within 1 min, and all strains yielded positive results within 2 min. All these organisms also gave a positive urease reaction on the Vitek Enterobacteriaceae card test within 5 h and on the Christensen urea agar slants in 4 to 48 h. All the bacteria that did not hydrolyze urea by these two tests also remained negative by the spot test.

Rapid test for determination of urea hydrolysis.

A urease test for the rapid determination of urea hydrolysis is described in which diluted urea agar concentrate was used in small amounts with dense inoculum of the test organisms. The method was evaluated and compared with Christensen's urea agar slants by using 728 clinical isolates of gram-negative bacteria. Of the 325 strains of urease-positive Proteus-Providencia-Morganella, 282 (87%) gave positive results within 5 min with the rapid test. Urease activity of 97% of these organisms became evident within 30 min. All 287 isolates which showed no urease activity on Christensen's urea agar also remained negative by this test.

Comparison of spot esculin hydrolysis with the PathoTec strip test for rapid differentiation of anaerobic bacteria.

The ability of several anaerobic bacteria to hydrolyze esculin to esculetin is used by clinical microbiologists and taxonomists in the differentiation and identification of both gram-positive and gram-negative microorganisms. Conventional methods used for determining esculin hydrolysis by anaerobic bacteria require 24 to 48 h for completion. In this paper we evaluate two procedures which yield rapid results. A total of 738 anaerobic bacteria were used in this study. A total of 99% of the esculin-hydrolyzing anaerobic bacteria gave positive results with the spot test in 1 h, whereas the other test method, the PathoTec strip test (General Diagnostics, Morris Plains, N.J.), required 4 h for 96% of the strains tested to yield positive reactions. Both tests showed a 100% specificity when compared with the standard broth test and are easy to perform, accurate, and economical. The spot test is superior to the PathoTec strip test in yielding results more rapidly.

Esculin hydrolysis by Gram positive bacteria. A rapid test and it's comparison with other methods.

A number of bacteria hydrolyze esculin enzymatically to esculetin. This characteristic is used by taxonomists and clinical microbiologists in the differentiation and identification of bacteria, especially to distinguish Lance-field group D streptococci from non-group D organisms and Listeria monocytogenes from morphologically similar Erysipelothrix rhusipoathiae and diphtheroids. Conventional methods used for esculin hydrolysis require 4--48 h for completion. We developed and evaluated a medium which gives positive results more rapidly. The 2,330 isolates used in this study consisted of 1,680 esculin positive and 650 esculin negative organisms. The sensitivity and specificity of this method were compared with the PathoTec esculin hydrolysis strip and the procedure of Vaughn and Levine (VL). Of the 1,680 esculin positive organisms, 97% gave positive reactions within 30 minutes with the rapid test whereas PathoTec required 3--4 h incubation for the same number of organisms to yield a positive reaction.

Rapid test for determination of esculin hydrolysis.

An esculin hydrolysis test is described which distinguishes over 97% of bacteria that can convert esculin to esculetin in a buffered solution, from those that cannot, within an hour.