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Spontaneous rupture of the popliteus tendon has not previously been reported. We report the case of a 74-year-old patient, discuss its diagnosis and management, and review the current literature on isolated popliteus lesions. A multi-database electronic literature review suggests that the injury is invariably traumatic and has essentially been reported only in young, active individuals. It should be suspected in a patient with acute lateral knee pain who, on examination, has a hemarthrosis and a stable, possibly locked knee. The diagnosis is readily made using arthroscopy. While both conservative treatment with physiotherapy and open repair have been advocated, we describe a successful outcome of arthroscopic resection in an elderly patient and propose that popliteus injury is not confined to a younger age group. The balance of opinion in the current literature is that acute traumatic rupture in the young patient is managed by primary surgical repair, but successful outcome is also reported with nonoperative treatment.

Elevated temperatures jeopardize plant disease resistance, as mediated by salicylic acid (SA). SA potentiates heat-induced expression of the 70-kDa heat shock protein (Hsp70) in tomato cells. In mammalian cells, Hsp70 suppresses apoptosis. We hypothesized that potentiation of heat-induced Hsp70 by SA contributes to a reduction in apoptosis in tobacco protoplasts.Tobacco protoplasts (Nicotiana tabacum) were exposed to SA (70 microM) at normal temperatures or in combination with heat shock. Hsp70/Hsc70 accumulation and phosphatidylserine (PS) exposure, DNA fragmentation, as well as loss of mitochondrial membrane potential were quantified by flow cytometry.SA at normal temperatures did not influence Hsp70/Hsc70 accumulation, but were found to induce apoptosis. In contrast, SA in combination with HS potentiated heat-induced Hsp70/Hsc70 accumulation in tobacco protoplasts that correlated negatively with apoptosis, illustrated by decreased PS exposure and DNA fragmentation and enhanced mitochondrial membrane potential. We propose that this correlation supports a possible role for apoptosis suppression by Hsp70 under elevated temperatures during pathogen infection.

Study Objectives: To identify factors before a trial of nasal continuous positive airway pressure (CPAP) treatment that are associated with lower compliance. Design: A prospective cohort study. Initial Hospital Anxiety and Depression Scale scores and other demographic data were noted. Machine use was recorded by clock timer after a 1-month trial of treatment. Setting: District General Hospital sleep-disordered breathing clinic. Patients or Participants: Eighty consecutive patients with symptoms of sleep apnea-hypopnea syndrome and a 4% Sao2 desaturation index greater than 10 events per hour. Interventions: N/A. Measurements and Results: Those reporting 'initial problems' with CPAP went on to have an average of 2.4 hours of on time per night, while those not reporting initial problems had an on time of 5.0 hours per night (P

Background We present evidence that in plant cells DNA damage induced by the topoisomerase trapping drug camptothecin induces oxidative stress via the mitochondrial respiratory chain. Methods Flow cytometry was used to analyse mitochondrial respiratory chain activity by simultaneous measurement of mitochondrial generation of reactive oxygen intermediates (ROI) and mitochondrial membrane potential (ΔΨm), in live functioning sugarbeet protoplasts. The mitochondrial respiratory chain function was assessed by the addition of substrate and inhibitors to the digitonin-permeabilised protoplasts. Mitochondrial activity was also measured in protoplasts at different stages of induced apoptosis by camptothecin. Results The addition of camptothecin to sugarbeet protoplasts resulted in increased mitochondrial generation of ROI, occurring concurrently with the hyperpolarisation of the mitochondrial inner membrane. Subsequently, there was a decrease in mitochondrial-generated ROI, in association with a decrease in ΔΨm. These camptothecin-treated digitonin-permeabilised protoplasts could be re-energised and ROI decreased by the addition of malic acid in the early stages of apoptosis induction, but not in the latter stages. There was a depolarisation of the mitochondrial inner membrane in the final stages of apoptosis. Conclusions These results are consistent with impaired adenine nucleotide exchange across the mitochondrial membrane, suggesting that similar mechanisms regulate plant apoptosis as those described for mammalian apoptosis. Cytometry Part A 54A:109–117, 2003. © 2003 Wiley-Liss, Inc.

Publisher Summary Apoptosis is programmed cell death characterized by specific transformations such as membrane-enclosed. Apoptosis, by comparison, involves an ordered set of events. The morphological properties of apoptotic cells are (1) a rapid shrinkage of the cell as it becomes dehydrated, followed by a detachment from its neighboring cells, (2) condensation of the chromatin, (3) systematic DNA cleavage with disintegration of the nucleus and fragmentation into discrete apoptotic bodies, and (4) a late loss of plasma membrane integrity. In plants, apoptosis is involved in a variety of situations. These include responses to environmental stresses, the hypersensitive response to pathogen attack, and plant senescence and fruit ripening. In addition, genetically controlled cell death is also likely to be involved in pollen tube growth down the style of flowers, in xylem development, and in other processes where cells die as part of normal development and differentiation processes.

A total of 1,116 clinically isolated strains belonging to Staphylococcus aureus (200), Staphylococcus epidermidis (200), Streptococcus pneumoniae (20), Escherchia coli (200), Klebsiella spp. (177), Serratia marcescens (22), Pseudomonas aeruginosa (224), Haemophilus influenzae (35) and Salmonella (38) from the Department of Infectious Diseases, La Sapienza University in Rome (Italy) were tested against three fluoroquinolones (ofloxacin, ciprofloxacin and levofloxacin) and 10 other antibiotics (augmentin, ampicillin, cefaclor, cefixime, cefotaxime, cotrimoxazole, gentamicin, minocycline, oxacillin and vancomycin). Fluoroquinolones inhibited essentially about 100% of H. influenzae, Salmonella and S. pneumoniae, more than 75% of Staphylococcus including methicillin-resistant strains, and about 90% of Enterobacteriaceae and 50% of P. aeruginosa. Minimal inhibitory concentration values ranged from0.015 to32 micrograms/ml for Klebsiella, S. aureus and epidermidis, E. coli and P. aeruginosa; from0.015 to 2 micrograms/ml for Salmonella; from 0.03 to 16 micrograms/ml for Serratia; from0.015 to 1 microgram/ml for Haemophilus; and from 0.5 to 2 micrograms/ml for S. pneumoniae. Levofloxacin and to a lesser extent ofloxacin and ciprofloxacin, generally exhibited a greater activity than the other agents against both Gram-positive and Gram-negative bacteria. Regarding the distribution of resistant strains in Italy, we found a peculiar pattern of resistance as far as E. coli and P. aeruginosa were concerned. Quality control parameters are also summarized. S. epidermidis resulted as a new emergent pathogen especially in immunocompromised patients and its level of sensitivity has been modified over the last few years. In fact, the percentage of resistant strains to antibiotics or the percentage of methicillin-resistant isolates (in our study 35%), has gradually increased. Levofloxacin and ofloxacin showed good activity against staphylococcal strains compared with the majority of other antibiotics. These results suggest that the newer quinolones are promising antimicrobial agents for various infections.

Forty-four Mycobacterium-spp. were isolated in 33 patients from an infectious diseases ward. All patients were HIV-positive and most of them were drug-abusers. M. avium-intracellulare was the most common type of MOTT (Mycobacteria other than tuberculosis) detected and the only microorganism isolated in patients with mycobacteriaemia. The radiometric method performed by the Bactec system enhanced the isolation rate of mycobacteria, especially from the bloodstream. The Gen-probe DNA hybridization system proved to be rapid diagnostic tool for the identification of strains.

We described a technique of measuring the flexibility of the rib prominence clinically before surgery, and aimed to analyse the results in patients with adolescent idiopathic scoliosis who underwent posterior correction with pedicle screw instrumentation. This prospective study investigated the magnitude of rib humps before and after the operation when the patient was in Adam9s forward bending posture. Also preoperatively, a flexion and derotation manoeuvre was performed and the corrected rib prominence was measured. This is compared to the magnitude of the rib hump present postoperatively at three months9 follow up. Seven consecutive patients with adolescent idiopathic scoliosis that underwent posterior surgical correction. Clinical measurement of rib prominence using scoliometer. The magnitude of the curve improved from a mean preoperative Cobb angle of 53.6+/−11.2° (range 45.3–72.5°) to a mean postoperative Cobb angle of 7.8+/−9.3° (range 0.4–17.6°). The mean preoperative magnitude of the rib hump was 12.3+/−6.9° (range 5-20°) which was then corrected to a mean magnitude of 1.3+/−2.2° (range 0-5°) by performing the above described flexion derotation manoeuvre. The mean postoperative magnitude of the rib hump was 3.0+/−3.1° (range 0-8°) with the patient in Adam9s forward bend position. There was positive correlation between the postoperative residual rib hump and the reduced rib hump measured preoperatively using our described technique (r=0.8,p=0.05). This flexion derotation test is a useful in assessing the amount of postoperative persistent rib hump after posterior correction of adolescent idiopathic scoliosis using pedicle screw instrumentation with derotation technique.

The authors have compared the antimicrobial resistance patterns and plasmid profiles of Gram-negative isolates in an intensive care unit over a 7-month period in order to identify epidemiologically related isolates. Bacterial plasmids were found to be valuable markers for the comparison of strains of nosocomial Gram-negative bacilli. Thirty-nine mechanically ventilated patients in an ICU were included. From bronchoaspiratus, the authors isolated 58 strains of Gram-negative bacilli (24 Ps. aeruginosa and 34 Enterobacteria). Common plasmids were found in most Enterobacteria. The interspecies plasmid exchange suggests that interstate spread of these strains may have occurred. Twenty-six Enterobacteria carried plasmids, 11 of which proved transmissible. The R-factors were transferred to other genera that were isolated in the hospital, thereby adding to the pool of multiresistant nosocomial isolates. Larger plasmids transferred ampicillin and carbenicillin resistance, while gentamycin and cephalotin resistance was carried by smaller plasmids. Only 4 Ps. aeruginosa carried plasmids, one of which was transmissible. Pseudomonas plasmid DNA is extracted with difficulty by the simple lysis method, due to the roughness of the colonies. All Pseudomonas isolates belonged to the same biotype which can be regarded as an epidemiological marker. Therefore, plasmid profiling is a useful tool for epidemiological surveillance of Enterobacteria and is a good method for determining the relatedness of isolates in a nosocomial environment.

HIV infection is thought to exacerbate the virulence of normal saprophytic vaginal microflora. We studied the vaginal ecosystem of HIV patients to detect the quantitative and qualitative variation of vaginal microorganisms. 15 patients (5 with AIDS and 10 with ARC) were investigated. Vaginal candidiasis was more frequent in this group than in the control groups. Gardnerella was present in 60% of patients generally in association with anaerobic bacteria and Mycoplasma. Among anaerobia, Bacteroides sp and other Gram-negative rods were the most common bacteria. Neisseria gonorrhoeae was absent in all patients tested. Chlamydia trachomatis was recovered in two out of the 15 HIV-positive patients. Aerobic Gram-negative flora was 100-fold that of the control group and anaerobic Gram-negative flora 10-fold.

The early growth responses of apple fruit to temperature were studied under controlled environment conditions. Growth of fruit on young trees of `Fuji'/M.9 `Golden Delicious'/M.9, and `Harold Red Delicious'/M.9 was frequently measured, over a 30-day period commencing 10 days after full bloom, under daily maximum/minimum temperatures of 22/12, 19/9, 16/6 and 13/3C. All other environmental conditions were maintained constant across all temperature treatments. Fruitlet diameter growth rate was approximately constant over the treatment period within each temperature regime and ranged from 0.24 mm day-1 at 13/3C to 0.85 mm day-1 at 22/12C. The growth responses to temperature were similar among cultivars but expansion rates were highest for `Fuji' and lowest for `Golden Delicious'. Cell division rates and durations, using flow cytometry, were measured over the treatment period and could be related to diameter growth rates. The impacts of temperature-induced differences in early fruit growth rates on final fruit sire will be described.