An arresting injury.
Three cases of branchial plexus injury due to handcuffing with the hands behind the back are presented.
Adult↗
Biomedical subjects
M A Lambert
Publications and source records attributed to M A Lambert.
Total pancreatectomy for chronic pancreatitis.
The operation of total pancreatectomy is performed rarely. Its role in the management of patients with chronic pancreatitis remains to be elucidated. We have reviewed our series of 29 total pancreatectomies for benign disease [14 women median age 39 years; 15 men median age 34 years]. Twelve underwent standard total pancreatectomy, in 17 duodenum preserving total pancreatectomy (DPTP) was performed. There was one death (mortality 3.4%). In no patient was the total pancreatectomy the first operative procedure. The patients were compared with age and sex matched diabetic control subjects selected on a best fit basis from the diabetic clinic database. The aetiology of the pancreatitis was idiopathic nine, pancreas divisum nine, alcohol eight and other causes three. The indication for surgery was pain 27, acute pancreatitis one and cholangitis with pancreatitis one. The complications of the procedures were mainly caused by infection [wound three, chest six and central line sepsis four] and in two there was a leak from the duodenum; no patient required re-operation. The postoperative stay [standard total, median 21 days (range 13-98) DPTP median 31 days (range 17-49)] has lengthened over the period due to greater attention to analgesic, diabetic and enzyme deficiency control before discharge. In standard total pancreatectomy there were five major hypoglycaemic episodes with only two in 17 DPTP patients. The per cent ideal body weight, the insulin requirement and the HbAl compared less well in standard total pancreatectomy group compared with controls than did DPTP. With both groups large doses of enzyme replacement were required, and this proved of importance in diabetic control. Our experience with total pancreatectomy suggests that pain will be improved in over 80% of patients and that the results of surgery will improve with prolonged follow up provided attention is given to analgesic abuse, enzyme deficiency and diabetes.
Adult↗
Duodenum-preserving total pancreatectomy for end stage chronic pancreatitis.
The classical Whipple procedure for chronic pancreatitis has been associated with significant long term postoperative morbidity. The pylorus-preserving procedure of Longmire has reduced but not eliminated the long-term morbidity. Preservation of the whole duodenum with total pancreatectomy has been introduced for the treatment of patients with end-stage chronic pancreatitis after favourable experience with this procedure in infants for nesidioblastosis. Fourteen patients with chronic pancreatitis have had a total pancreatectomy with preservation of the duodenum and the bile duct. All patients are still alive (median follow-up 9.5 months) and none suffered major complications in the perioperative period. One patient developed a biliary stricture at 3 months, requiring biliary reconstruction. Six of the patients have returned to full-time work; nine require no analgesia. All patients require pancreatic enzyme replacement, and all patients have gained weight postoperatively. Diabetic control is satisfactory with a twice daily insulin regime. Duodenum-preserving total pancreatectomy is feasible in the adult without mortality or high morbidity; early experience suggests that preserving the duodenum improves gastrointestinal function with easier control of the diabetes.
Adult↗
Campylobacter hyointestinalis associated with human gastrointestinal disease in the United States.
Campylobacter hyointestinalis was isolated from stool specimens of four persons, all of whom were experiencing nonbloody, watery diarrhea. The youngest (8 months of age) and the oldest (79 years of age) individuals were females, and the other two were homosexual men. C. hyointestinalis was the only clinically significant pathogen isolated from stool specimens for three of the individuals. In case 3 (involving a 37-year-old homosexual man), Entamoeba histolytica and Shigella sonnei were also present in the stool. The identification of all C. hyointestinalis strains was made biochemically and confirmed by DNA hybridization. This study documented the isolation of C. hyointestinalis from four patients with diarrhea, and our findings suggest that the clinical significance of Campylobacter species must be expanded to include C. hyointestinalis as a potential cause of human gastrointestinal disease.
Adult↗
Differentiation of Campylobacter and Campylobacter-like organisms by cellular fatty acid composition.
The cellular fatty acid compositions of 368 strains of Campylobacter species or Campylobacter-like organisms were determined by gas-liquid chromatography. Most of the strains (339) were placed in one of three groups based on differences in fatty acid profiles. Group A contained Campylobacter jejuni (97%) and most C. coli (83%) strains and was characterized by the presence of a 19-carbon cyclopropane fatty acid (19:0 cyc) and 3-hydroxytetradecanoic acid (3-OH-14:0). Group B included all C. laridis and some C. coli (17%) strains; its profile was similar to that of group A, except that 19:0 cyc was absent. Group C contained C. fetus subsp. fetus and C. fetus subsp. veneralis and was characterized by the presence of 3-OH-14:0 and 3-hydroxyhexadecanoic acid (3-OH-16:0) and the absence of 19:0 cyc. Twenty-nine isolates were placed in four additional groups. Group D included the type strain of "C. cinaedi" and 14 other isolates, which were differentiated by the presence of dodecanoic acid (12:0), 3-hydroxydodecanoic acid (3-OH-12:0), and 3-OH-16:0 and the absence of hexadecenoic acid (16:1) and 3-OH-14:0. Group E contained the type strain of "C. fennelliae" and two additional isolates, which were differentiated by the presence of a 16-carbon aldehyde and a 16-carbon dimethylacetyl and the absence of 16:1. Group F included the type strain and one reference strain of C. cryaerophila and six human isolates whose phenotypic characteristics were similar to those of this species; this group was distinguished by the presence of two isomers of 16:1, tetradecenoic acid (14:1), and 3-OH-14:0. Group G included three stains of C. pyloridis and was characterized by the presence of 19:0 cyc, 3-OH-16:0, and 3-hydroxyoctadecanoic acid (3-OH-18:0) and by the absence of 16:1 and 3-OH-14:0.
Animals↗
Analysis of mycolic acid cleavage products and cellular fatty acids of Mycobacterium species by capillary gas chromatography.
After growth and experimental conditions were established, the mycolic acid cleavage products, constituent fatty acids, and alcohols of representative strains of Mycobacterium tuberculosis, M. smegmatis, M. fortuitum complex, M. kansasii, M. gordonae, and M. avium complex were determined by capillary gas chromatography. Reproducible cleavage of mycolic acid methyl esters to tetracosanoic (24:0) or hexacosanoic (26:0) acid methyl esters was achieved by heating the sample in a high-temperature muffle furnace. The major constituent fatty acids in all species were hexadecanoic (16:0) and octadecenoic (18:1 omega 9-c, oleic) acids. With the exception of M. gordonae, 10-methyloctadecanoic acid was found in all species; moreover, M. gordonae was the only species tested which contained 2-methyltetradecanoic acid. M. kansasii was characterized by the presence of 2,4-dimethyltetradecanoic acid, M. avium complex by 2-eicosanol, and M. tuberculosis by 26:0 mycolic acid cleavage product. The mycolic acid cleavage product in the other five species tested was 24:0. Although a limited number of strains and species were tested, preliminary results indicate that this gas chromatographic method can be used to characterize mycobacterial cultures by their mycolic acid cleavage products and constituent fatty acid and alcohol content.
Alcohols↗
Molecular cloning of cDNA for rat argininosuccinate lyase and its expression in rat hepatoma cell lines.
Using antibody and plaque hybridization screening, we isolated rat argininosuccinate lyase (AS lyase) cDNA clones from a liver cDNA library prepared in the phage expression vector lambda gt11. Five overlapping cDNAs covering 1.7 kilobases of the estimated 2.0-kilobase AS lyase mRNA were characterized and confirmed as AS lyase sequences by hybrid selection. We examined the differential expression of AS lyase in rat liver and four rat hepatoma cell lines (7800C1, H4, HTC, and MH1C1). These cells exhibited a 60-fold range of AS lyase enzyme activity, with a direct correlation between activity, amount of AS lyase immunoreactive protein, and quantity of specific AS lyase mRNA. These observations suggest that the differences in AS lyase expression between rat liver and the hepatoma cell lines result from variations in AS lyase transcriptional activity or alterations in nuclear processing of AS lyase RNA.
Animals↗
Fine needle aspiration biopsy: a cautionary tale.
Explore the source record for details and available documents.
Adrenal Gland Neoplasms↗
Legionella sainthelensi: a new species of Legionella isolated from water near Mt. St. Helens.
Six strains of a new species, Legionella sainthelensi, were isolated from freshwater in areas affected by the volcanic eruptions of Mt. St. Helens in the state of Washington. Strains of L. sainthelensi are culturally and biochemically similar to other legionellae. They grow on buffered charcoal yeast agar but not on media that lack cysteine. They are gram-negative, nonsporeforming, motile rods that are positive in reactions for catalase, oxidase, gelatin liquefaction, and beta-lactamase. They are negative in reactions for urease, hydrolysis of hippurate, reduction of nitrates, fermentation of glucose, and blue-white autofluorescence. Their cell wall fatty acid composition is qualitatively similar to those of other legionellae, with 50 to 62% branched-chain fatty acids. They contain the isobranched-chain 14- and 16-carbon acids and anteisobranched-chain 15- and 17-carbon acids and relatively large amounts of straight-chain 16-carbon acid. All strains of L. sainthelensi contain approximately equal amounts of ubiquinones Q9, Q10, Q11, and Q12, a pattern similar to those of Legionella bozemanii, Legionella dumoffi, and Legionella longbeachae. Serological cross-reactions were observed between L. sainthelensi, both serogroups of L. longbeachae, and Legionella oakridgensis. Three strains of L. sainthelensi were greater than 90% related by DNA hybridization. The type strain of L. sainthelensi, Mt. St. Helens 4, was 36% related to the type strain of L. longbeachae and 3 to 14% related to the other nine described Legionella species.
Disasters↗
Isoprenoid quinone content and cellular fatty acid composition of Campylobacter species.
A total of 36 strains of Campylobacter species were examined for isoprenoid quinones and cellular fatty acids. The isoprenoid quinone content was determined by reverse-phase high-pressure liquid chromatography, and the fatty acids were determined by capillary gas-liquid chromatography. All Campylobacter species contained menaquinone-6 (2-methyl-3-farnesyl-farnesyl-1,4-naphthoquinone) and a methyl-substituted menaquinone-6 (2,[5 or 8]-dimethyl-3-farnesyl-farnesyl-1,4-napthoquinone) as the major isoprenoid quinones. The latter menaquinone has not been reported in other bacteria and may prove to be a useful chemical marker of Campylobacter species. Campylobacter jejuni and most Campylobacter coli were distinguished from other campylobacteria by the presence of a C19 cyclopropane acid, and Campylobacter sputorum subsp. mucosalis differed from other species by the presence of lauric acid.
Campylobacter↗
Legionella oakridgensis: unusual new species isolated from cooling tower water.
We describe a new species of Legionella represented by 10 strains isolated from industrial cooling towers. Legionella oakridgensis differed genetically from the other seven species of Legionella in DNA hybridization studies and differed serologically in direct fluorescent-antibody tests. The new species, unlike all other species except L. jordanis, did not require added L-cysteine for growth in serial transfer on charcoal-yeast extract agar. L. oakridgensis, as well as three other species tested, required L-cysteine for primary isolation from animal tissues. L. oakridgensis was the only species of Legionella that failed to produce alkaline phosphatase at pH 8.5. In all other respects, it resembled other species of Legionella, including having a high content of branched-chain cellular fatty acids and being pathogenic for guinea pigs. These bacteria have not yet been associated with human disease, but they are potential causes of legionellosis.
Air Conditioning↗
Cellular fatty acid composition and ubiquinone content of Legionella feeleii sp. nov.
The cellular fatty acid composition of Legionella feeleii was determined by capillary gas-liquid chromatography, and the ubiquinone content was determined by reverse-phase high-pressure liquid chromatography. As in other Legionella species, this new species is characterized by relatively large amounts of branched-chain fatty acids and by major amounts of ubiquinones with more than 10 isoprene units in the side chain.
Chromatography, Gas↗
Comparison of the effects of acid and base hydrolyses on hydroxy and cyclopropane fatty acids in bacteria.
The cellular fatty acid compositions of Legionella oakridgensis, Brucella suis, Pseudomonas aeruginosa, and Francisella tularensis were compared after base hydrolysis (saponification), acid hydrolysis, and acid methanolysis procedures were used to release the fatty acids. The branched-chain, unsaturated, saturated, and ester-linked hydroxy acids were released as effectively with saponification at 100 degrees C for 30 min as with acid hydrolysis or acid methanolysis at 85 degrees C for 16 h. Although the amide-linked hydroxy acids were released more effectively by acid hydrolysis or acid methanolysis, these methods degraded the cyclopropane fatty acids, producing a number of new peaks or artifacts in the chromatograms. Cyclopropane fatty acids were not degraded by saponification, and at least 50% of the hydroxy acids were released when the cells were saponified with 15% NaOH in 50% aqueous methanol. Thus, the results show that saponification for 30 min at 100 degrees C with 15% NaOH, followed by methylation is an excellent method for routine fatty acid analysis of bacteria and for screening cultures whose identity and fatty acid composition are unknown.
Bacteria↗
30 years of campylobacters: biochemical characteristics and a biotyping proposal for Campylobacter jejuni.
Several biochemical test systems were studied for their potential usefulness for the examination of strains of Campylobacter species. Most (81%) of the C. jejuni strains hydrolyzed sodium hippurate, but strains of C. fetus, C. sputorum, and C. fecalis did not. Some (46%) of the C. jejuni strains and all of the C. sputorum subsp. sputorum, C. sputorum subsp. bubulus, and C. fecalis strains hydrolyzed DNA, but the C. fetus and C. sputorum subsp. mucosalis strains did not. Strains of all species of Campylobacter grew on charcoal-yeast extract agar, but 47% of the C. jejuni strains did not. Alkaline phosphatase activity was recorded for some strains of C. jejuni, but all other species were negative for this activity. Aryl sulfatase activity was detected in 7% of the C. jejuni, 15% of the C. fetus subsp. fetus, and all of the C. sputorum subsp. sputorum, C. sputorum subsp. bubulus, and C. fecalis strains, but it was not detected in the C. fetus subsp. venerealis and C. sputorum subsp. mucosalis strains. Most (93%) of the C. jejuni but none of the other Campylobacter strains contained lactobacillic acid when examined for cellular fatty acids. On the basis of results from three of these tests (hippurate hydrolysis, DNA hydrolysis, and growth on charcoal-yeast extract agar), clinical strains of C. jejuni were placed in eight biotypes.
Alkaline Phosphatase↗
Analysis of short-chain acids from anaerobic bacteria by high-performance liquid chromatography.
A standard mixture of 25 short-chain fatty acids was resolved by high-performance liquid chromatography, using an Aminex HPX-87 column. The acids produced in culture media by anaerobic bacteria were analyzed by high-performance liquid chromatography after extraction with ether and reextraction into a small volume of 0.1 N NaOH. The presence of fumaric acid in culture extracts of Peptostreptococcus anaerobius was confirmed by gas chromatography-mass spectrometry analysis of the trapped eluent fractions from the high-performance liquid chromatography column.
Bacteroides fragilis↗
Gas-chromatographic analysis of mycolic acid cleavage products in mycobacteria.
Mycolic acids were detected in both reference strains and clinical isolates of mycobacteria using gas chromatography of fatty acid methyl esters prepared by acid methanolysis. The methyl esters were extracted with hexane, concentrated, and analyzed with a gas chromatograph by using two different injector temperatures. When the samples were analyzed at high injector temperatures of 300 to 350 degrees C, characteristic thermal cleavage products from mycolic acids, C22:0, C24:0, or C26:0 fatty acid methyl esters, were detected. When analyzed at injector temperatures of 235 degrees C or lower, the mycolic acids were heat stable and the characteristic methyl ester cleavage products were not observed.
Chromatography, Gas↗
Production of phenylacetic and hydroxyphenylacetic acids by clostridium botulinum type G.
Phenylacetic and hydroxyphenylacetic acids were present as major acids in spent growth medium from Clostridium botulinum type G. These aromatic acids were identified by gas-liquid chromatography and mass spectrometry.
Chromatography, Gas↗
Production of p-hydroxyhydrocinnamic acid from tyrosine by Peptostreptococcus anaerobius.
Peptostreptococcus anaerobius was found to metabolize tyrosine to p-hydroxyhydrocinnamic acid [3-(p-hydroxyphenyl)propionic acid]. This acid was detected in spent growth media by gas-liquid chromatography, and its identity was confirmed by mass spectrometry.
Culture Media↗