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Escherichia coli are widely used as indicators of fecal contamination, and in some cases to identify host sources of fecal contamination in surface water. Prevalence, genetic diversity and antimicrobial susceptibility were determined for 600 generic E. coli isolates obtained from surface water and sediment from creeks and channels along the middle Santa Ana River (MSAR) watershed of southern California, USA, after a 12 month study. Evaluation of E. coli populations along the creeks and channels showed that E. coli were more prevalent in sediment compared to surface water. E. coli populations were not significantly different (P = 0.05) between urban runoff sources and agricultural sources, however, E. coli genotypes determined by pulsed-field gel electrophoresis (PFGE) were less diverse in the agricultural sources than in urban runoff sources. PFGE also showed that E. coli populations in surface water were more diverse than in the sediment, suggesting isolates in sediment may be dominated by clonal populations.Twenty four percent (144 isolates) of the 600 isolates exhibited resistance to more than one antimicrobial agent. Most multiple resistances were associated with inputs from urban runoff and involved the antimicrobials rifampicin, tetracycline, and erythromycin. The occurrence of a greater number of E. coli with multiple antibiotic resistances from urban runoff sources than agricultural sources in this watershed provides useful evidence in planning strategies for water quality management and public health protection.

Fluoroquinolones were discovered in the 1960s as a derivative of the antimalarial drug chloroquine. Over the past 40 years, many fluoroquinolones have been developed for use in human and veterinary medicine. As with all classes of antibiotics, resistance to fluoroquinolones is a serious concern, and multiple avenues for resistance are being investigated. Resistance-associated point mutations in bacterial DNA and, more recently, plasmid-mediated resistance have been reported in both human and veterinary bacterial isolates. This article reviews the history and most current literature on fluoroquinolones approved for use in dogs and cats and the spectra of activity, mechanisms of action, resistance patterns, and recommendations for appropriate clinical use of these drugs.

The high concentration of swine production in southeastern North Carolina generates public health concerns regarding the potential transport of pathogens from these production systems to nearby surface waters. The microbial source tracking (MST) tool, antibiotic resistance analysis (ARA), was used to identify sources of E. coli in a segment of Six Runs Creek in Sampson County, North Carolina. Among 52 water samples, fecal coliform (FC) counts averaged 272.1 ± 181.6 CFU/100 mL. Comparisons of isolates from water samples to an ARA library with an average rate of correct classification (ARCC) of 94.3% indicated an average of 64% and 27.1% of 1,961 isolates from Six Runs Creek were associated with lagoon effluent and cattle manure respectively. The potential for aerosol transport of bacteria during lagoon spray events, as well as, the potential for wildlife to serve as a vehicle of transport for bacteria from fields and lagoons to nearby surface waters should be investigated further.

Antimicrobial peptides (AMPs) are small proteins involved in defense against pathogenic organisms. Defensins and cathelicidin are the most frequently studied human AMPs. Our goals were to determine the distribution of AMPs and evaluate their mRNA expression in normal canine skin. Skin biopsies were taken from six healthy beagles. The relative transcript level of canine cathelicidin (cCath) and β-defensin (cBD)-1, cBD2 and cBD3 mRNA was quantified using quantitative real-time polymerase chain reaction. Indirect immunofluorescence (IIF), using polyclonal antibodies against cBD2, cBD3 and cCath, was used to evaluate protein localization in the skin of healthy dogs. The Pfaffl method, using experimentally determined primer efficiencies of amplification, was used to determine the expression level of cCath, cBD1 and cDB3 relative to cDB2. The levels of cCath, cBD3 and cBD1 mRNA were 358, 296 and 177 times higher than those of cBD2, respectively. Using IIF, cBD2 and cBD3 protein fluorescence was detected in all layers of the epidermis, whereas cCath was detected predominantly in the stratum granulosum and corneum. In addition, antimicrobial peptide detection was limited to the infundibular portion of the pilosebaceous units. We have validated useful methods to evaluate AMPs in canine skin. Further studies are needed to compare AMP expression in healthy dogs with that of dogs with inflammatory skin conditions.

Insulin detemir and insulin glargine are synthetic long-acting insulin analogs. In people, insulin glargine is longer acting and has a relatively flat time-action profile, while insulin detemir has significantly less within-subject variability. Insulin detemir is also associated with less undesired weight gain and decreased frequency of hypoglycemic events.To compare the pharmacodynamics of insulin detemir and insulin glargine in healthy cats.Ten young, healthy, neutered, purpose-bred cats.Randomized, cross-over design. Pharmacodynamics of insulin detemir and insulin glargine were determined by the isoglycemic clamp method after a 0.5 U/kg SC injection.The only significant difference in the pharmacodynamics of insulin detemir and insulin glargine was onset of action (1.8+/-0.8 and 1.3+/-0.5 hours for insulin detemir and insulin glargine, respectively, P=.03). End of action of insulin detemir was reached at 13.5+/-3.5 hours and for insulin glargine at 11.3+/-4.5 hours (P=.18). Time-to-peak action of insulin detemir was reached at 6.9+/-3.1 hours and for insulin glargine at 5.3+/-3.8 hours (P=.7). The time-action curves of both insulin analogs varied between relatively flat curves in some cats and peaked curves in others.Insulin detemir and insulin glargine have shorter durations of action than in people when assessed by the clamp method, but in some cats these insulin analogs could be useful as once-a-day drugs. Peak effects of both insulin analogs are pronounced in some cats.

A 56-year-old woman was evaluated for dyspnea in the emergency department. She had no risk factors for venous thromboembolism except hormone replacement therapy; however, pulmonary embolism was suspected and subsequently confirmed via computed tomographic angiogram. An echocardiogram was conducted to further assess right ventricular function, revealing marked right ventricular enlargement and a mobile mass in the left atrium (initially suspected to be an atrial myxoma). After subsequent embolization to the left axillary artery, thrombolysis was administered, and embolectomy confirmed this to be thrombus. A repeat echocardiogram showed resolution. This case highlights that although echocardiography can be helpful in risk stratification when assessing patients with pulmonary embolism, unexpected findings may be encountered. When clinicians identify multiple clinical findings, Occam's razor suggests that these multiple findings are most likely related.

An 86-year-old man underwent pacemaker implantation for symptomatic atrio-ventricular block grade 2 Mobitz II. The patient suffered repeated admissions for iterative sterile wound necrosis, leading to two generator re-implantations. No bacterial infection was detected in the microbiological screening tests. The skin patch testing to titanium was negative. Nevertheless, we decided to remove the pacemaker system and to implant a gold-plated generator with polyurethane leads. Since then, there has been no recurrence of wound complications. Gold-plated generator and polyurethane leads are effective in treating allergic reactions to pacemaker system components in selected cases. Negative skin patch testing to titanium does not exclude allergic reaction to this pacemaker component.

Serum fructosamine (SF) concentrations depend on plasma glucose concentrations and are used to evaluate glycemic control in animals with diabetes mellitus (DM). Despite the strong association between obesity and DM, the effects of body weight (BW) and body condition on SF concentrations in clinically healthy cats have not been reported.The aim of the study was to evaluate the effects of BW, body condition score (BCS), sex, and age on SF concentrations in healthy cats.BW, BCS, and SF concentrations were determined in 84 clinically healthy client-owned cats (50 neutered males, 33 spayed females, and 1 intact female) of known age. The cats were enrolled prospectively in the study.Mean BW, median BCS, and mean SF concentrations for the 84 cats were 5.4 kg, 5/9, and 268.7 ± 45.5 μmol/L (range 197-399), respectively. BW was weakly but significantly correlated with SF (r=.26; P=.02), whereas BCS was not. Cats weighing5.4 kg and cats with BCS5/9 had higher mean SF concentrations compared with cats weighing5.4 kg and cats with BCS5/9, respectively. Cats categorized as normal weight to obese by BW (BW ≥ 4.0 kg) had higher mean SF concentrations compared with cats categorized as lean (BW4.0 kg). For domestic shorthair cats, the same was true for BCS: cats with BCS ≥ 4/9 had higher mean fructosamine concentrations than those with BCS4/9. Male cats had significantly higher mean SF concentrations compared with female cats (285.1 ± 45.3 vs 244.5 ± 33.9 μmol/L, P.001). Age did not affect mean SF concentrations.BW is positively correlated with SF concentration, and lean cats have lower SF concentrations than normal and obese cats. In contrast to previous reports, mean SF concentrations were higher in male cats than in female cats, even when males and females were matched based on BW, BCS, and age.

Childhood obesity, which is due in part to lack of physical activity, is a serious concern that requires the attention of the behavioral community. Although excessive video game play has been noted in the literature as a contributor to childhood obesity, newer video gaming technology, called exergaming, has been designed to capitalize on the reinforcing effects of video games to increase physical activity in children. This study evaluated the effects of exergaming on physical activity among 4 inactive children in a physical education (PE) classroom. Results showed that exergaming produced substantially more minutes of physical activity and more minutes of opportunity to engage in physical activity than did the standard PE program. In addition, exergaming was socially acceptable to both the students and the PE teacher. Exergaming appears to hold promise as a method for increasing physical activity among inactive children and might be a possible intervention for childhood obesity.

Aims: The aim of this study was to identify and characterize the population of Enterococcus sp. in domestic wastewater as it flows through a constructed wetland. Methods and Results: Four hundred and eighty-four Enterococcus isolates were collected from the inlet, various sites within and from the outlet of a plastic lined constructed wetland in College Station, TX. The wetland treated septic tank effluent that passed sequentially through two 1·89 m3 septic tanks and a 1·89 m3 pump tank allowing 48 l doses at a 24 l min−1 rate. The Enterococcus isolates were identified to species using the commercial Biolog system. The 484 Enterococcus isolates were comprised of ten different species, including Enterococcus faecalis (30·6%), Enterococcus pseudoavium (24·0%), Enterococcus casseliflavus (12·8%), Enterococcus faecium (11·2%), Enterococcus mundtii (7·9%), Enterococcus gallinarum (6·2%), Enterococcus dispar (3·7%), Enterococcus hirae (2·1%), Enterococcus durans and Enterococcus flavescens both 0·8%. Of the 88 isolates collected from the inlet, only 9·1% of the isolates were identified as Ent. faecalis and Ent. pseudoavium (36·4%) was identified as the predominant species. Whereas of the 74 isolates collected from the outlet, the predominant species were identified as Ent. faecalis (29·7%). Species identification varied among sites within the wetland, but often Ent. faecalis was the predominant species. Conclusions: Our data suggest that while Ent. faecalis is the predominant species of Enterococcus found in domestic wastewater, the populations may shift during treatment as the wastewater flows through the constructed wetland. Significance and Impact of the Study: We found that shifts in Enterococcus species composition occurred during domestic wastewater treatment. This has implications for the identification of faecal pollution based on the presence of specific bacterial types associated with domestic wastewater.

Fourteen cats received either daily prednisolone (4.4 mg/kg per os [PO]) or dexamethasone (0.55 mg/kg PO) for 56 days. These doses were clinically equipotent. Serum fructosamine and urine glucose were measured on days 0, 28, and 56. Insulin sensitivity, glucose tolerance, and peak insulin secretion were measured in each group prior to and at the end of the courses of glucocorticoid administration. On day 56, the prevalence of glucosuria was significantly greater (P=0.027), and a trend was seen toward greater fructosamine concentrations (P=0.083) in dexamethasone-treated cats compared to prednisolone-treated cats. The results of this pilot study also showed a trend toward a greater decrease in insulin sensitivity (P=0.061) and a significantly lower compensatory increase in insulin secretion (P=0.081) in the dexamethasone-treated cats than in cats administered prednisolone. These preliminary data suggest that dexamethasone exhibits greater diabetogenic effects in cats than equipotent doses of prednisolone. Further study is justified to support this hypothesis.

Aortic complications are very rare during off-pump coronary artery bypass grafting (OPCAB). When they occur, the mortality is high. We report a case of perforation of the posterior aortic wall after punching out the hole in the ascending aorta with an automatic aortic cutter to avoid clamping for the proximal anastomosis during a routine OPCAB procedure. The consequence was a massive hemorrhage, emergency conversion to cardiopulmonary bypass and replacement of the aortic valve and of the ascending aorta.

The objective of the present study was to measure the differences in body composition, adipose tissue gene expression, blood metabolite and hormone concentrations, and insulin sensitivity in kittens exposed to high-protein (HP) or high-carbohydrate (HC) nutritionin uteroand through the growth period. Eight dams were randomised onto two test diets, and fed the diets throughout gestation and lactation. Male offspring were evaluated for 9 months. Kittens were weaned at 2 months of age onto the same treatment diet as the dam and were allowed to consume dietsad libitum. The HC diet contained 34·3 % crude protein (CP), 19·2 % fat and 30·8 % digestible carbohydrate, while the HP diet contained 52·9 % CP, 23·5 % fat and 10·8 % digestible carbohydrate. Blood samples were collected at 6 months after birth. Body composition was determined at 2 and 8 months of age and an intravenous glucose tolerance test, neutering and adipose tissue biopsy conducted at 8 months of age. Physical activity was quantified at 6 and 9 months. Energy intake, DM intake and body weight were not different between groups. At 2 months, blood TAG were greater (P P P

OBJECTIVE: We examined the incidence of perioperative fever and its relationship to outcome among patients enrolled in the Intraoperative Hypothermia for Aneurysm Surgery Trial. METHODS: One thousand patients with initial World Federation of Neurological Surgeons grades of I to III undergoing clipping of intracranial aneurysms after subarachnoid hemorrhage were randomized to intraoperative normothermia (36 degrees C-37 degrees C) or hypothermia (32.5 degrees C-33.5 degrees C). Fever (> or =38.5 degrees C) and other complications (including infections) occurring between admission and discharge (or death) were recorded. Functional and neuropsychologic outcomes were assessed 3 months postoperatively. The primary outcome variable for the trial was dichotomized Glasgow Outcome Scale (good outcome versus all others). RESULTS: Fever was reported in 41% of patients. In 97% of these, fever occurred in the postoperative period. The median time from surgery to first fever was 3 days. All measures of outcome were worse in patients who developed fever, even in those without infections or who were World Federation of Neurological Surgeons grade I. Logistic regression analyses were performed to adjust for differences in preoperative factors (e.g., age, Fisher grade, initial neurological status). This demonstrated that fever continued to be significantly associated with most outcome measures, even when infection was added to the model. An alternative stepwise model selection process including all fever-related measures from the preoperative and intraoperative period (e.g., hydrocephalus, duration of surgery, intraoperative blood loss) resulted in the loss of significance for dichotomized Glasgow Outcome Scale, but significant associations between fever and several other outcome measures remained. After adding postoperative delayed ischemic neurological deficits to the model, only worsened National Institutes of Health Stroke Scale score, Barthel Activities of Daily Living index, and discharge destination (home versus other) remained independently associated with fever. CONCLUSION: These findings suggest that fever is associated with worsened outcome in surgical subarachnoid hemorrhage patients, although, because the association between fever and the primary outcome measure for the trial is dependent on the covariates used in the analysis (particularly operative events and delayed ischemic neurological deficits), we cannot rule out the possibility that fever is a marker for other events. Only a formal trial of fever treatment or prevention can address this issue.

We measured dopamine, norepinephrine, serotonin and epinephrine concentrations in the paraventricular nucleus and median eminence, and corticotrophin-releasing factor levels in the paraventricular nucleus. Tissue was isolated by micropunch technique from hypothalami of normal dogs, dogs treated for one week with dexamethasone (1 mg/kg/day) and dogs with spontaneous pituitary-dependent hyperadrenocorticism. Concentrations of corticotrophin-releasing factor and most of the neurotransmitters were found to be similar between our three groups of dogs. However, we found the mean dopamine concentration in the median eminence tissue to be significantly decreased in dogs with Cushing's disease and in steroid-treated dogs. Epinephrine levels were elevated in the hypothalamic paraventricular nucleus of steroid-treated dogs.

Dimerization among transcription factors has become a recurrent theme in the regulation of eukaryotic gene expression. Hepatocyte nuclear factor-1 alpha (HNF-1 alpha) is a homeodomain-containing protein that functions as a dimer. A dimerization cofactor of HNF-1 alpha (DCoH) was identified that displayed a restricted tissue distribution and did not bind to DNA, but, rather, selectively stabilized HNF-1 alpha dimers. The formation of a stable tetrameric DCoH-HNF-1 alpha complex, which required the dimerization domain of HNF-1 alpha, did not change the DNA binding characteristics of HNF-1 alpha, but enhanced its transcriptional activity. However, DCoH did not confer transcriptional activation to the GAL4 DNA binding domain. These results indicate that DCoH regulates formation of transcriptionally active tetrameric complexes and may contribute to the developmental specificity of the complex.

HNF-1 alpha (previously referred to as HNF-1, LPB1, and APF) is a vertebrate transcription factor that contains a divergent homeo domain and plays a prominent role in regulating genes that have the common characteristic of being expressed in hepatocytes and a complex group of endodermally and mesodermally derived tissues. HNF-1 alpha is unique among the vertebrate homeo domain-containing proteins in that it dimerizes in the absence of its DNA recognition sequence, suggesting the possibility that the function of HNF-1 alpha may be diversified by forming heterodimers with other related proteins. We report the initial characterization of HNF-1 beta, which is closely related to HNF-1 alpha and is able to form heterodimers with HNF-1 alpha in vitro. Although HNF-1 alpha, but not HNF-1 beta, is expressed in the liver, HNF-1 alpha and HNF-1 beta are coexpressed in the murine Hepa1A cell line and in the mammalian kidney where a subset of hepatocyte genes are expressed. In contrast, exclusive expression of HNF-1 beta is associated with repression of a subset of hepatocyte-specific genes in the dedifferentiated hepatocyte cell line C2, differentiated F9 cells, in somatic hybrids between hepatocytes and fibroblasts, and in the lung. The extent of heterodimerization may be regulated in a tissue-specific way because freely exchangeable heterodimers are formed in Jurkat T cells transfected with HNF-1 alpha and HNF-1 beta, whereas in liver cells stable homodimers are present. These studies define a pair of homeo domain proteins that have the potential to interact to produce an embryologically complex pattern of gene expression.

The mechanisms contributing to BW gain following ovariohysterectomy in domestic cats are poorly understood. Moreover, the effects of food restriction to maintain BW following spaying have been poorly studied. Thus, our primary objective was to determine the effects of spaying and food restriction to maintain BW on adipose and skeletal muscle mRNA abundance and activity levels in cats. After a 4-wk baseline period (wk 0), 8 adult (approximately 1.5 yr old) domestic shorthair cats were spayed and fed to maintain BW for 12 wk. After 12 wk, cats were fed ad libitum for an additional 12 wk. Body composition was determined, activity levels were measured, and adipose and muscle biopsies were collected at wk 0, 12, and 24. Fasting blood samples were collected at wk 0, 6, 12, 18, and 24. To maintain BW post-spay, food intake was decreased (P0.05) by 30%. During this phase, mRNA abundance of adipose tissue lipoprotein lipase and leptin was decreased (P0.05), representing only 52 and 23% of baseline expression, respectively. Interleukin-6 mRNA, however, was increased (P0.05) 2-fold. Physical activity was decreased (P0.05) by wk 12, most dramatically during the dark period (approximately 20% of baseline activity). During ad libitum feeding (wk 12 to 24), food intake, BW, body fat percentage, and total fat mass were greatly increased (P0.05). Compared with wk 0, circulating leptin concentrations tended to increase (P0.10) by wk 18 and 24 (4.45 vs. 10.02 and 9.14 ng/mL, respectively), whereas glucose (91 vs. 162 mg/dL) and triacylglyceride (30 vs. 48 mg/dL) concentrations were increased (P0.05) by wk 24. Adipose tissue lipoprotein lipase, hormone sensitive lipase, and adiponectin mRNA were decreased (P0.05) at wk 24. Adipose interleukin-6 mRNA was increased (P0.05) at 24 wk. Physical activity was further decreased (P0.05) by wk 24, during the light (60% of baseline) and dark (33% of baseline) periods. In summary, spaying and food restriction affect physical activity levels and several genes associated with lipid metabolism (decreased lipoprotein lipase), food intake (decreased leptin expression), and insulin insensitivity (increased interleukin-6). By identifying these changes, targets for nutritional intervention or lifestyle management have been identified that may curb the risk of obesity and related disorders in spayed cats.

The purpose of this study was to develop a T3 suppression test to help in the diagnosis of mild hyperthyroidism in cats. We evaluated the response in circulating T4 concentrations to exogenous T3 (liothyronine) administration in 44 clinically normal cats, 77 cats with hyperthyroidism, and 22 cats with nonthyroidal disease. The test was performed by first collecting blood samples for basal serum T4 and T3 determinations, administering liothyronine at an oral dosage of 25 micrograms three times daily for seven doses, and, on the morning of the third day, again collecting serum samples for T4 and T3 determinations 2 to 4 hours after the seventh dose of liothyronine. The mean basal serum concentrations of T4 (53.1 nmol/L) and T3 (1.8 nmol/L) were significantly higher in the cats with hyperthyroidism than in the normal cats (T4 = 25.3 nmol/L, T3 = 1.3 nmol/L) and the cats with nonthyroidal disease (T4 = 29.5 nmol/L, T3 = 1.4 nmol/L); however, there was a great deal of overlap of basal values between the three groups of cats. Of the 77 cats with mild hyperthyroidism, 41 (53%) had serum T4 values and 55 (71%) had T3 values that were within the established normal ranges. After administration of liothyronine, mean serum T4 concentrations fell much more markedly in the normal cats and the cats with nonthyroidal disease than in the hyperthyroid cats.(ABSTRACT TRUNCATED AT 250 WORDS)

The Doppler ultrasonic recording technique was used to measure systolic and diastolic blood pressures indirectly in 28 cats with naturally occurring renal failure, 39 cats with hyperthyroidism, and 33 clinically normal cats. The mean systolic and diastolic blood pressures in the normal cats were 118.4 +/- 10.6 mm Hg and 83.8 +/- 12.2 mm Hg, respectively. In the cats with chronic renal failure, both the systolic (146.6 +/- 25.4 mm Hg) and diastolic (96.6 +/- 15.2 mm Hg) blood pressures were significantly higher (P less than 0.0001 and P less than 0.01, respectively) than in the normal cats. Elevations in systolic and/or diastolic blood pressure were recorded in 17 (61%) of the 28 cats with chronic renal failure. In the 39 untreated hyperthyroid cats, both the mean systolic (167.9 +/- 28.9 mm Hg) and diastolic (111.6 +/- 21.5 mm Hg) pressures also were significantly higher (P less than 0.0001) than normal. Increased systolic and/or diastolic blood pressure was recorded in 34 (87%) of the 39 hyperthyroid cats. In seven cats with hyperthyroidism that were reevaluated two to four months after successful treatment of the hyperthyroid state, there was a significant fall in mean systolic pressure (P less than 0.05) from a pretreatment value of 159.5 +/- 15.4 mm Hg to a posttreatment value of 132.0 +/- 1.62 mm Hg. Overall, the results of this study indicate that mild to moderate hypertension is common in cats with chronic renal failure and in cats with untreated hyperthyroidism. In addition, the hypertension appears to be reversible following successful treatment of the hyperthyroid state.

To determine if routine pre-treatment clinical data can be used to predict the development of overt renal insufficiency following treatment of feline hyperthyroidism, we studied retrospectively all non-azotemic cats undergoing treatment for hyperthyroidism at our hospital. Medical records were reviewed for signalment, clinical signs, and serum biochemical, hematologic and urinalysis parameters before and after treatment for hyperthyroidism. Two groups – cats that developed post-treatment renal insufficiency, and those that did not – were compared. No significant differences could be detected between the groups with respect to the parameters measured. Our study suggests that the results of routine pre-treatment clinical data cannot be used to reliably predict renal function after treatment for hyperthyroidism, validating the necessity of a methimazole trial prior to definitive therapy. The widely held belief that cats with pre-treatment urine specific gravity>1.035 are at less risk for development of renal azotemia after treatment of hyperthyroidism seems unwarranted.

This article is a complete review of all reported therapies for hyperadrenocorticism in dogs. Both medical and surgical options for treating pituitary-dependent hyperadrenocorticism and adrenal tumor-related disease are discussed, and the efficacy, safety, and use of these treatments are compared.

Dairyland Power Cooperative is installing a new distribution automation/telecommunications system that will provide secure collection of substation meter readings, load profile billing information, real-time meter data, local alarms, and a secure communications path for member Automatic Meter Reading (AMR) systems. Dairyland Power is a generation and transmission cooperative located in La Crosse, WI that provides wholesale power to 25-member cooperatives and 19-member municipal electric systems. Dairyland Power was experiencing diminished analog cellular service with limited bandwidth, minimal security, and no guarantee of service beyond February of 2008. As a result, a comprehensive distribution automation and telecommunications project was approved in December 2004. Expansion of the existing digital microwave network, installation of point-to-multipoint I/P-capable spread spectrum radios, and installation of custom-designed metering, communications, and automation cabinets provides secure serial and I/P connections for real-time and billing metering data, distribution SCADA, load management, and AMR traffic.

Commentary on : Carrier M, Lazo-Langner A, Shivakumar S, et al., SOME Investigators. Screening for occult cancer in unprovoked venous thromboembolism. N Engl J Med 2015;373:697–704.[OpenUrl][1][CrossRef][2][PubMed][3] In patients with unprovoked venous thromboembolism, occult malignancy is of concern. Studies have shown that more than 60% of occult cancers are diagnosed following unprovoked venous thromboembolism and up to 10% of patients with unprovoked venous thromboembolism are diagnosed with cancer within the following year.1 Despite this, the approach to evaluating patients for occult malignancy varies widely. Studies have described a limited technique of history, physical examination and laboratory tests, as well as utilising multimodal imaging techniques to detect cancer in these patients.2 ,3 Carrier and colleagues compared comprehensive and limited occult-cancer screening strategies in patients with unprovoked venous thromboembolism. This multicentre, randomised trial … [1]: {openurl}?query=rft.jtitle%253DN%2BEngl%2BJ%2BMed%26rft.volume%253D373%26rft.spage%253D697%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJMoa1506623%26rft_id%253Dinfo%253Apmid%252F26095467%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1056/NEJMoa1506623&link_type=DOI [3]: /lookup/external-ref?access_num=26095467&link_type=MED&atom=%2Febmed%2F21%2F1%2F19.atom

The kaolin-based activated clotting time (ACT) is commonly used for monitoring heparin-induced anticoagulation alone and combined with aprotinin during cardiopulmonary bypass. However, aprotinin prolongs ACT measurements. Recently, a new so-called 'aprotinin-insensitive' ACT test (SaiACT) has been developed for the SONOCLOT analyzer. In this study we evaluated and compared this new test for the SONOCLOT analyzer in vitro with an established kaolin-based ACT from HEMOCHRON (HkACT). Twenty-five patients undergoing elective valve surgery donated 80 mL of blood after induction of anesthesia. The blood was withdrawn in citrated tubes and processed to analyze effects of heparin (0, 1, 2, and 3 U x mL(-1)), aprotinin (0, 200 kIU x mL(-1)), and 25% hemodilution with calcium-free lactated Ringer's solution on ACT measurements. A total of 400 blood samples were analyzed and ACT was measured in a wide, clinically relevant range in duplicate with SaiACT and HkACT. Addition of aprotinin to heparinized blood samples induced no significant changes of SaiACT measurements. By contrast, HkACT readings increased significantly: aprotinin prolonged HkACT in heparinized blood samples by 20% +/- 37% (2 U x mL(-1)) and 24% +/- 18% (3 U x mL(-1)), respectively, and in vitro hemodilution increased this effect.Current standard techniques to measure heparin-induced anticoagulation during cardiopulmonary bypass are affected by aprotinin, a drug widely used in this setting. The aim of this study was to investigate in vitro a new, so-called 'aprotinin-insensitive' test from SONOCLOT to measure heparin-induced anticoagulation more reliably in combination with aprotinin.

Myoepithelium is an integral part of the mammary ductal and lobular architecture, positioned between luminal cells and the basement membrane. We describe the first report on cytogenetic findings in an adenomyoepithelioma of the breast with a balanced t(8;16)(p23;q21), and provide gene expression profile using Affymetrix GeneChip U95AV2 (Affymetrix, Santa Clara, CA). Differential analysis identified 857 genes with 2-fold or more mRNA change in comparison to pooled normal breast control; immunohistochemical analysis was used to confirm these results in a limited number of genes. Expression results were grouped based on the chromosomal location of the genes and associated protein function, and identified several potential pathogenetic mechanisms (autocrine and paracrine growth stimuli) in the development of myoepithelial tumors.

C . H A G E D O R N , J . B . C R O Z I E R , K . A . M E N T Z , A . M . B O O T H , A . K . G R A V E S , N . J . N E L S O N A N D R . B . R E N E A U J R . 2003. Aims: Carbon source utilization profiles as a phenotypic fingerprinting methodology for determining sources of faecal pollution in water were evaluated. Methods and Results: Three hundred and sixty-five Enterococcus isolates were collected from known faecal sources in four different geographical regions and were identified to species with the commercial Biolog system. Discriminant analysis (DA) was used to identify the substrate-containing wells that best classified the 365 isolates by source. By using 30 of the 95 wells for the analysis, the average rate of correct classification (ARCC) by source was 92AE7% for a human vs non-human two-way classification when isolates from all regions were combined into one library. Corresponding ARCCs for other classification schemes were 81AE9% for a four-way classification of human vs livestock vs wildlife vs domestic pets, and 85AE7% for a three-way classification without human isolates. When three individual libraries were made based on classification of sources within Enterococcus species, the ARCC was 95AE3% for the Ent. faecalis library, 95AE8% for the Ent. gallinarum library and 94AE7% for the Ent. mundtii library. Thirty Enterococcus isolates (unknown sources) were obtained from each of three stream sites where a specific source of pollution was apparent; 90AE0% of the isolates from a human-suspected source were classified as human, 86AE6% were classified as livestock from a livestock-suspected site, and 93AE3% were classified as wildlife from a wildlife-suspected site. Conclusions: Phenotypic fingerprinting with carbon source utilization profiles provided levels of correct classification by sources from an Enterococcus library that were in the upper range of those reported in the literature. ARCCs for three Enterococcus species-specific libraries were very high and may be the best approach for further developing this concept and methodology. Significance and Impact of the Study: The results, based on a modest Enterococcus library and a preliminary field validation test, demonstrated the potential for carbon source utilization profiles to be employed as a phenotypic method for determining sources of faecal pollution in water.

We measured plasma concentrations of cortisol and aldosterone before and after administration of adrenocorticotropin (ACTH) in dogs with trichuriasis. These dogs had physical examination, historical, and serum electrolyte findings suggestive of hypoadrenocorticism; trichuriasis-associated pseudohypoadrenocorticism has been reported previously. We found normal basal and ACTH-stimulated plasma cortisol concentrations. Basal and ACTH-stimulated plasma aldosterone concentrations were normal in 2 dogs and increased in 3 dogs, suggesting that the electrolyte abnormalities seen in this clinical syndrome are not due to aldosterone deficiency.

The major themes of our research include the creation of mobile robot systems that are robust and adaptive in rapidly changing environments and the view of integration as a basic research issue. Where reasonable, we try to use the same representations to allow different components to work more readily together and to allow better and more natural integration of and communication between these components. In this paper, we summarize our recent work in integrated mobile robot exploration, localization, and navigation.

Continuous localization is a technique that allows a robot to maintain an accurate estimate of its location by performing regular small corrections to its odometry. Continuous localization uses an evidence grid representation, a common representation scheme that is used by other map-dependent processes, such as path planning. Although techniques exist for building evidence grid maps, most are not adaptive to changes in the environment. In this research, we extend the continuous localization technique by adding a learning component. This allows continuous localization to update the long-term map (evidence grid) with current sensor readings. Results show that the addition of the learning behavior to continuous localization allows the system to adapt to changes in its environment without a loss in its ability to remain localized. This system was tested on a Nomad 200 mobile robot.

Mathematical co-registration of functional image data (e.g., positron emission tomography, PET) to anatomical magnetic resonance (MR) imaging data allows for objective associations between function and anatomy. Baboons are often used as non-human primate models for functional neuroimaging studies. In this work, a digital MR-based high-resolution atlas of the baboon brain was generated and evaluated for PET. The atlas was generated from six SPGR-MR datasets (centered at mid-sagittal line, AC-PC orientation) that were transformed into the space of one representative MR, averaged and resampled into PET space. The atlas was evaluated by comparing blood flow and dopamine receptor and serotonin transporter binding measures determined using regions-of-interest (ROIs) generated on each individual co-registered MR (ROIi) and the atlas-defined ROI template (ROIATLAS). Common ROIs applied to all data included frontal cortex, temporal cortex, thalamus, caudate, putamen and cerebellum. High correlations (r2>0.87) were found between the ROIi and ROIATLAS data for all radiotracers (linear regression across ROIs for each baboon). The average regression slope values ranged from 0.95 to 1.02 across radiotracers. Lastly, use of the atlas for statistical parametric mapping (SPM) of [ 15 O ]water data yielded good agreement with previous ROIi results. Overall, the digital MR-based atlas allowed for automatic co-registration, proved useful across a range of PET Studies, and is accessible electronically via the Internet.

Antibiotic resistance analysis (ARA) was used to determine if enterococci of human origin were present in a stream (Spout Run) that passes through a rural nonsewered community (Millwood, VA). Millwood consists of 82 homes, all served by individual septic systems, and Spout Run drains a 5,800-ha karst topography watershed that contains large populations of livestock and wildlife. Periodic monitoring by state regulatory officials had resulted in Spout Run being placed on the Virginia impaired stream list and Millwood being categorized as an at-risk community. Stream samples were collected monthly and analyzed for fecal coliforms and enterococci (May 1999-May 2000); ARA was performed on enterococci stream isolates on a quarterly basis. All 117 stream samples were positive for fecal coliforms, and 32% exceeded the Virginia recreational water standard (1,000 fecal coliforms/100 mL). A library of 1,174 known source Enterococcus isolate antibiotic resistance profiles was constructed, and yielded correct classification rates of 94.6% for 203 human isolates, 93.7% for 734 livestock isolates, and 87.8% for 237 wildlife isolates. Antibiotic resistance analysis of 2,012 enterococcal isolates recovered from stream samples indicated isolates of human origin appeared throughout the stream as it passed through Millwood, with a yearly average of approximately 10% human, 40% wildlife, and 50% livestock. There were no human origin isolates in samples collected upstream from Millwood, and the percent human origin isolates declined downstream from Millwood. While a human signature was found in Spout Run, it was small compared with the proportion of isolates from livestock and wildlife.

In some individuals with autosomal dominant isolated growth hormone deficiency, one copy of growth hormone lacks amino acids 32-71 and is severely misfolded. We transfected COS7 cells with either wild-type human growth hormone or Delta 32-71 growth hormone and investigated subcellular localization of growth hormone and other proteins. Delta 32-71 growth hormone was retained in the endoplasmic reticulum, whereas wild-type hormone accumulated in the Golgi apparatus. When cells transfected with wild-type or Delta 32-71 growth hormone were dually stained for growth hormone and the Golgi markers beta-COP, membrin or 58K, wild-type growth hormone was colocalized with the Golgi markers, but beta-COP, membrin and 58K immunoreactivity was highly dispersed or undetectable in cells expressing Delta 32-71 growth hormone. Examination of alpha-tubulin immunostaining showed that the cytoplasmic microtubular arrangement was normal in cells expressing wild-type growth hormone, but microtubule-organizing centers were absent in nearly all cells expressing Delta 32-71 growth hormone. To determine whether Delta 32-71 growth hormone would alter trafficking of a plasma membrane protein, we cotransfected the cells with the thyrotropin-releasing hormone (TRH) receptor and either wild-type or Delta 32-71 growth hormone. Cells expressing Delta 32-71 growth hormone, unlike those expressing wild-type growth hormone, failed to show normal TRH receptor localization or binding. Expression of Delta 32-71 growth hormone also disrupted the trafficking of two secretory proteins, prolactin and secreted alkaline phosphatase. Delta 32-71 growth hormone only weakly elicited the unfolded protein response as indicated by induction of BiP mRNA. Pharmacological induction of the unfolded protein response partially prevented deletion mutant-induced Golgi fragmentation and partially restored normal TRH receptor trafficking. The ability of some misfolded proteins to block endoplasmic reticulum-to-Golgi traffic may explain their toxic effects on host cells and suggests possible strategies for therapeutic interventions.

Prosthetic mitral valve replacement (MVR) is associated with paravalvular leak in up to 12.5% of patients. The influence of the morphology and location of paravalvular leaks on clinical symptoms and degree of leak-related hemolysis is unknown.Morphology, size, location and number of paravalvular leaks were analyzed in 96 consecutive patients with primary mitral paravalvular leaks.Mitral leak was diagnosed a median of 119 days after primary MVR. A small (1-2 mm) paravalvular leak was found in 41 patients (43%), an intermediate leak (3-5 mm) in 26 (27%), and a large leak (6-15 mm) in 29 (30%). Single leaks were observed in 70 patients (73%), whilst 26 (27%) had multiple leaks. Paravalvular leaks occurred around the entire prosthetic circumference, but were seen predominantly around the mitral commissural areas (76%). The larger the size of the leak, the more symptomatic the patient (p = 0.006); 80% of patients with small leaks were in NYHA classes I and II, whilst 62% with intermediate/large leaks were in NYHA classes III and IV. The number of leaks was not correlated with severity of clinical symptoms. Multiple leaks were more likely to cause significant hemolysis. Patients with preoperative chronic renal insufficiency, postoperative infection or large (5 cm) left atria were more likely to develop multiple leaks. The size and location of the leaks was surgeon-dependent.Intraoperative transesophageal echocardiography is mandatory to detect possible small leaks and technical errors. Strict monitoring of all MVR patients is necessary for prolonged periods, as the appearance of paravalvular leaks is not necessarily correlated with clinical symptoms. Small paravalvular leaks, in particular, may go unnoticed. As the location and size of the leaks were significantly surgeon-dependent, self-monitoring should be mandatory for all surgeons.

To determine the combined role of in situ hybridization (ISH) and immunohistochemistry (IHC) in the detection of human papilloma virus (HPV) infection in cases of diagnostic uncertainty.A retrospective study.Department of Histopathology at the University of Zimbabwe and Department of Pathology at the University of Texas Medical Branch at Galveston in Texas, both teaching referral hospitals.23 patients with a diagnosis suggestive but not diagnostic of HPV infection on routine histology sections of uterine cervical biopsies, in which 20 had enough material to complete the study.Surgical pathology records of cases with morphologic features suggestive but not diagnostic of HPV cases were identified. Representative sections of each case were investigated with ISH and IHC for HPV infection.HPV DNA was detected in 12 cases. The bovine papilloma virus (BPV) antibody immunoreacted with six of the cases and two of these had not been detected by ISH resulting in a combined ISH and IHC, HPV detection of 14 cases.This preliminary data seems to support the validity of combining IHC and ISH, even though IHC is less sensitive compared to ISH, it may detect certain HPV types not represented in the DNA probe.

Using web-based discussion as a teaching strategy: bioethics as an exemplar Nurses are required to be competent in the area of bioethics based on several accreditation standards. Bioethics courses are one strategy to develop such a competency. Bioethics education itself has various goals including the need to engage in discussion and the ability to debate diverse issues. Providing an educational experience that meets both disciplinary and topic needs can be challenging. On-line conferencing through WebBoard 3·0, a web-based discussion software program, within a graduate level bioethics course successfully contributed to meeting these needs. A technical description of the WebBoard is provided in the following discussion along with a description of the integration of this device into a bioethics course. The WebBoard conferencing allowed all students to enter the class discussion and especially facilitated discussion for reticent speakers and distance learners. Evaluations of the bioethics course from both the faculty and students’ perspectives were generally positive. Most students found the technique easy to use and liked the asynchronous format that allowed them to read and contribute at any hour of the day or night. Despite the labour intensive nature of this experience, the strategy ensured participation by every student, a major goal of the project. Developing an interdisciplinary situation would increase the value of such an experience.

Tc-99m HDP bone scintigraphy is used primarily for skeletal imaging to detect abnormalities of bone. However, soft tissue abnormalities can be detected through accumulation of Tc-99m HDP at these sites. A 45-year-old man with a history of performing squatting exercises 1 week prior had increased HDP uptake in the adductor magnus muscles of the gluteal region in association with the use of this muscle in squatting exercises.