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[Comparison of host water wash and trimming of pork carcasses for reducing the level of bacterial contamination].

This study was carried out to evaluate the microbial contamination on pork carcasses after they had fallen on the floor in the cooler and also to evaluate the effectiveness of trimming and hot, high-pressure water washing (55 degrees C). A bacteriological analysis was done on 2 groups of 40 carcasses before and after trimming or washing, along with a group of 10 control carcasses. Results showed that the bacterial total count was higher (P = 0.01) on carcasses after they had fallen, but, in this study, no significant difference (P = 0.76) was found for total coliform contamination. Also, no significant difference was observed between total count for aerobic bacteria, total coliforms, and Escherichia coli before and after decontamination, no matter which technique was used. Neither trimming nor washing carcasses showed, in this study, a significant difference (P = 0.37) in the reduction of the total aerobic bacterial count on the pork carcasses analyzed (P = 0.65).

Animals↗

Peritoneal washings cytology combined with immunocytochemical staining in pancreatic cancer.

BACKGROUND/AIMS: Peritoneal washings from patients with pancreatic cancer demonstrate malignant cells in 0-58% of patients. But the significance of their potential for implantation and growth after radical surgery has not been clarified. METHODOLOGY: Peritoneal washings were collected from 74 consecutive pancreatic cancer patients during a 5-year period and studied by conventional staining and immunocytochemical staining using anti-CEA and anti-CA 19-9. Fifty of the 74 patients were resectable and the others were nonresectable. RESULTS: Seven out of 8 patients with macroscopic peritoneal metastasis were positive in conventional staining, but all 8 patients were positive in immunocytochemical staining. Five of the 66 (8%) patients without macroscopic peritoneal metastasis were positive in conventional staining, but the positive rate increased to 14 of 66 (22%) in immunocytochemical staining. There was no statistically significant difference in post-operative cumulative survival rate between the 13 positive cytology patients and 37 negative cytology patients without macroscopic peritoneal metastasis. CONCLUSIONS: The positive rate of peritoneal washings cytology was increased in this study by the use of immunocytochemical staining in addition to conventional staining. No statistically significant difference in post-operative cumulative survival rate between positive cytology patients and negative cytology patients without macroscopic peritoneal metastasis was observed.

Adenocarcinoma↗

Removal of hepatocarcinoma cells from blood via cell washing and filtration techniques.

Utilization of autotransfusion during tumor resection remains controversial due to viability of carcinoma cells remaining in collected blood. The purpose of this study was to evaluate autotransfusion techniques combined with leukocyte depleting filters (LDF) for removal of hepatocarcinoma cells from autotransfusate. An in vitro model was created by contaminating expired human erythrocytes with cultured hepatocarcinoma (HEP G2) cells. Autotransfusion devices evaluated were Cobe BRAT2, Sorin STAT-P, and Fresenius CATS. Autotransfusate collected from varying processing conditions were filtered using the Pall Leukoguard RS or Pall Purecell RCQ LDF. Carcinoma concentrations were quantified via Coulter Counter technology. The CATS exhibited higher concentrations of cancer cells in the autotransfusate prior to washing, a 449% increase. This was significantly higher than either the BRAT2 or STAT-P, 350% and 315% respectively. Post washing HEP G2 concentrations in the BRAT2 were significantly higher than the STAT-P and CATS. Doubled wash volumes removed more HEP G2 cells in all trials, reaching statistical significance only in the CATS. LDF resulted in a significant 75% reduction of HEP G2 cells, with no difference between filters. While combination use of autotransfusion devices and leukocyte depleting filters did result in a product with concentrated hematocrit, no technique removed all hepatocarcinoma cells.

Blood Transfusion, Autologous↗

Tissue-washing tank for histologic preparations.

A small tank made of plexiglass was designed to wash tissues for histologic preparations. The tank was divided into 16 compartments in 2 rows to wash 16 tissue samples at one time. The compartments in the same row alternately intercommunicated by rows of holes in the upper or lower halves. The arrangement of holes at 2 water levels in the partition appeared to create silent water waves, making the tank more efficient for washing tissues.

Histological Techniques↗

Washing of new microscopic glass slides in dichromate solution does not influence sputum AFB smear results.

SETTING: Microscopy centres in Tiruvallur District, Tamil Nadu, India, implementing DOTS. OBJECTIVE: To know whether washing new glass slides in dichromate solution is essential for effective sputum acid-fast bacilli microscopy. METHODS: Two direct smears were prepared from each of 1750 sputum samples. One was made on dichromate solution-cleaned new glass slides and the other was made on unwashed new glass slides. The smears were blinded and examined. RESULTS: Of the 1750 specimens, 13.5% and 13.08% were positive for AFB using washed and unwashed slides, respectively (P = 0.12). The concordance between these two (including one grade above and one below) was 98.7%. CONCLUSION: Washing of new glass slides in dichromate solution is not essential for AFB microscopy.

Caustics↗

Simultaneous removal of cadmium and turbidity in contaminated soil-washing water by DAF and electroflotation.

The removal of cadmium and turbidity from contaminated soil-washing water was studied by dissolved air flotation (DAF) and electroflotation at laboratory scale by using sodium lauryl sulfate (SLS) as an anionic surfactant, and calcium hydroxide (Ca(OH)2) as a coagulant. Using DAF, and in the presence of SLS or Ca(OH)2, the maximum recovery rate of cadmium obtained at a stoichiometric cadmium to collector and coagulant ratio of 1:4.5 was 51.1% and 80.8%, while the removal rate of turbidity was 18.4% and 19.2%. However, satisfactory cadmium and turbidity removal was not obtained by DAF. Much more significant removal of cadmium (100%, not detected in the residual) and turbidity (95.7%) was obtained by electroflotation using an aluminium metal plate as electrode, which generated hydroxide and aluminum ion. As a consequence, electroflotation is considered an effective method to separate cadmium and turbidity from contaminated soil-washing water. The electroflotation process may have practical applications for the removal of other hazardous metals from contaminated soil-washing water.

Air↗

Relations between monophasic action potential duration and refractoriness after cardioversion of persistent atrial fibrillation: results in wash-out and amiodarone-treated patients.

BACKGROUND: The relation between repolarization and refractoriness has been clinically evaluated both in the atrium and ventricle. However, this relation has not been carefully investigated in the atria of patients with persistent atrial fibrillation after cardioversion. METHODS: We determined the refractoriness and monophasic action potential duration at 90% of repolarization (MAP90), at 5 pacing cycle lengths (300 to 700 ms) and in 5 right atrial sites after internal cardioversion of persistent atrial fibrillation in 27 patients. RESULTS: The effective refractory periods (ERPs) were longer in amiodarone-treated patients (group 1) than in wash-out patients (group 2) (211.3 +/- 26.4 vs 199.1 +/- 24.3 ms, p < 0.002) as well as the MAP90 (243.6 +/- 36.8 vs 223.1 +/- 29.2 ms, p < 0.001). Linear regression analysis showed a direct relation between the MAP90 and ERP changes induced by different pacing cycle lengths (r = 0.77 and r = 0.92 in the amiodarone and wash-out patients, respectively). The ERP/MAP90 ratio was similar at all pacing cycle lengths in both wash-out and amiodarone groups and was always < 1. The mean ERP and MAP90 were shorter in the lateral right atrial sites than in the atrial roof and septum in both group 1 and group 2 patients (p < 0.001). CONCLUSIONS: A linear correlation was found between ERP and MAP90 in response to changes in pacing cycle lengths. Postrepolarization refractoriness was not observed after cardioversion of persistent atrial fibrillation. Pretreatment with oral amiodarone does not affect these electrophysiological features or the dispersion of ERP and MAP90 in the right atrium after sinus rhythm restoration.

Action Potentials↗

Carcinoembryonic antigen levels in peritoneal washes: a potential prognostic marker for patients with colorectal cancer.

BACKGROUND/AIMS: This study was conducted to define the clinical significance of intraoperative determination of carcinoembryonic antigen levels in peritoneal washes from patients undergoing surgery for colorectal cancer. METHODOLOGY: The correlation of carcinoembryonic antigen levels in peritoneal washes (pCEA) with several clinicopathological factors and the long-term surgical outcome in 54 patients with resectable colorectal cancer was determined retrospectively. RESULTS: Among several clinicopathological factors, the depth of tumor invasion significantly and independently correlated with pCEA levels as revealed by multivariate stepwise logistic regression analysis. A significant difference in overall survival rates was observed between pCEA-positive and pCEA-negative groups: five-year survival rates were 97.1% in pCEA-negative patients and 78.9% in pCEA-positive patients (p = 0.0274). CONCLUSIONS: Intraoperative determination of carcinoembryonic antigen levels in peritoneal washes could be a potentially predictive factor of a poor prognosis in patients with colorectal cancer.

Adult↗

[Effectiveness of intraoperative cytological examination of peritoneal washings for patients with pancreatic cancer].

To confirm the effectiveness of cytological examination of peritoneal washings for detecting invisible micro-peritoneal dissemination in patients with pancreatic cancer, results were analyzed with the survival and the background factors of the patients. Cytological examination of peritoneal washings or ascitic fluid at recto-vesical pouch or pouch of Douglas was performed in 37 patients with primary pancreatic cancer. Positive results for cancer cells were obtained in five of 9 patients (55.6%) who received cytological examination of ascitic fluid and in seven of 28 patients (25.0%) who received that of peritoneal washings. Four of 6 patients (66.7%) with visible peritoneal dissemination showed positive results. These 6 patients died of peritoneal dissemination with about 10 months. Eight of 31 patients (25.8%) without visible peritoneal dissemination showed positive results of the cytological examination. Two of the 8 patients received resection of the tumor. Other 6 patients without resection developed clinically evident peritoneal carcinomatosis. A high positive rate (66.7%) of cytological examination of the patients with visible peritoneal dissemination and a high incidence of appearance of peritoneal carcinomatosis in patients with positive cytological results but without visible peritoneal dissemination (75.0%; positive vs 26.1%; negative) indicate a high reliability of the cytological examination to detect invisible micro-peritoneal dissemination.

Ascitic Fluid↗

Efficacy of bronchial wash cytology and its correlation with biopsy in lung tumours.

OBJECTIVE: To evaluate bronchial wash cytology with histology in our set up. METHODS: Seventy three specimens were obtained by flexible fiberoptic bronchoscope at pulmonology department of Military Hospital Rawalpindi. All the preserved samples were processed under standard conditions. The slides were stained with Papanicolaou and Haematoxylin and Eosin stains. RESULTS: A total of 73 patients were studied. The age range was 21 to 80 years. Male to female ratio was 8:1. Complete cytological and biopsy consensus was found in 55 (77.4%) cases. Cytology revealed 24 cases as malignant and nine as atypical/suspicious. Benign and inadequate were 29 and 2 respectively. Histopathology of these cases confirmed 24 (32.9%) as malignant and 29 (39.8%) as benign. True positive alongwith suspicious/atypical were 33 and true negative cases were 29. False positive was one case only whereas false negative cases were eight. The bronchial wash cytology showed sensitivity (80.5%), specificity (96.6%) and accuracy (87.3%). Positive predictive value and negative predictive value were 97% and 78.4% respectively. The commonest types of tumours were squamous cell carcinoma and small cell carcinoma. CONCLUSION: It is concluded that bronchial wash cytology is a valuable tool and yields almost same information as biopsy. It is useful in patients with evidence of obstruction or risk of haemorrhage.

Adult↗

Cytology and DNA flow cytometry of peritoneal washings in gynecologic patients.

Peritoneal washing cytology, widely used in the management of gynecologic malignancy, entails several difficulties in interpretation. Quantitative DNA analysis by flow cytometry (FCM) holds promise as a more objective method fo diagnosis of malignancy. We performed traditional cytologic examination and single-parameter FCM DNA analysis on peritoneal washings from 136 gynecologic laparotomies, compared these results with the final pathologic findings, and analyzed sources of error. A total of 50 laparotomies were performed for benign disease. Another 86 were performed for cervical, endometrial, and ovarian carcinomas and various other cancers. In the benign group, cytology had one false suspicious but no false positive results, and FCM showed only diploid cells. In the cancer cases, cytology had five suspicious and 13 positive results and one false negative from laboratory error. On review, 16 washings contained confirmed cancer cells. FCM, performed in 13 of these cases, was diploid in 10 and aneuploid in only 3. In six of the diploid cases, visual cell counts showed that tumor cells were present in concentrations of 2.5% or less of total cells. In the remaining four diploid cases, a second DNA determination was obtained by FCM of nuclei retrieved from paraffin blocks of the tumors. These nuclei were diploid by FCM in three of the tumors and aneuploid in only one. Single-parameter DNA FCM was too insensitive to be helpful in our material.

DNA↗

A comprehensive system for washing, pre-disinfecting and sterilizing of dental and surgical instruments.

PURPOSE: The purpose of this study was to test and describe in detail a newly developed comprehensive system for washing, pre-disinfecting and sterilizing of dental and surgical instruments. MATERIALS AND METHODS: The system consists of a combined washing and steam-operated pre-disinfection apparatus and newly developed trays, in which assorted instruments can be washed and disinfected without handling individual instruments. The system was subjected to a large number of tests. RESULTS: The cleaning efficiency of blood-soiled instruments was found to be excellent. The disinfection of dental instruments contaminated with bacteria, yeast and non-enveloped virus showed decimal reduction factors that were equivalent to sterilization. The trays had optimal sealing qualities. Their steam permeability was perfect even after prolonged use in N-, S- and B-type autoclaves. However, long-term tests in a clinic revealed shortcomings with regard to insufficient drying of instruments in the wash/disinfection apparatus. Furthermore, the mechanical stability of the polysulfonate tray covers needs to be improved. Occasionally, after extended use, the fit of the filters in metal trays became inadequate, in particular when trays were sterilized for 18 min at 134 degrees C for a prolonged period of time. CONCLUSION: In spite of the above-mentioned shortcomings, the system shows great labor and cost-saving potential, allowing a new approach to instrument recirculation and workflow in the dental office.

Dental Instruments↗

The usefulness of immunostaining in washed cell cytological smears for differential diagnosis of B cell type malignant lymphoma.

We investigated the usefulness of immunostaining on washed cell cytological smears for the differential diagnosis of B-cell type malignant lymphoma. Twenty-eight cases with possible malignant lymphoma were examined. The tissues were squashed in a test tube of isotonic saline. The cell suspensions were then washed to remove non-specific soluble immmunoglobulin, and were smeared. Immunocytochemical staining for IgG, IgA, IgM, kappa and lambda was performed on the smears. As seen in the results, all cases of B cell lymphoma have a positive rate of 20% or over for kappa or lambda, and a kappa/lambda ratio of over 4.5 or a ratio of over 2.0 lambda/kappa, in the washed cell smears. Thus, it is possible to distinguish B cell lymphoma from the others by means of the results use as cut off scores. In addition, the rapid staining protocol in the present study was able to provide the results within 15 min. Therefore, it might be the most suitable method for the detection of immunoglobulin monoclonality in general laboratories.

Diagnosis, Differential↗

Evidence-based recommendations for antimicrobial nasal washes in chronic rhinosinusitis.

BACKGROUND: Chronic rhinosinusitis (CRS) refractory to medical and surgical therapy is a difficult problem for patients and physicians. Topical antimicrobial nasal irrigations are commonly used for treatment with great variation in methodology and without clear scientific support for current treatment formulations. The purpose of this study was to develop a scientific rationale for creating standardized recommendations for clinical practice in the use of topical antimicrobial washes for CRS. METHODS: An extensive review of basic science and clinical literature on the treatment of CRS with topical antimicrobial washes was completed. Pharmacokinetics of and organism susceptibility to appropriate topically applied antimicrobial agents were reviewed. RESULTS: The most common organisms associated with CRS were identified. The relevant pharmacokinetics of drugs targeted at these organisms are presented. Susceptibility breakpoints set by the National Committee for Clinical Laboratory Standards are identified to help establish the most effective concentration of the identified drugs. Recommendations for agent selection, agent concentration, length of treatment, dosing schedule, and methods of irrigation are presented. CONCLUSION: Antimicrobial nasal washes provide a potentially effective treatment for the growing population of patients who remain symptomatic after appropriate medical and surgical intervention. This study establishes the basic principles supporting this treatment option and offers rational, evidence-based treatment guidelines. The study has identified additional areas that need to be investigated before prospective clinical trials can be effectively undertaken.

Administration, Intranasal↗

Cytokines in the nasal washes of children with respiratory syncytial virus bronchiolitis.

Although respiratory syncytial (RS) virus is the major cause of bronchiolitis and pneumonia in young children, the factors that regulate the associated lung inflammation have not been defined. The levels of interleukin (IL)10, IL-12, and interferon (IFN) were determined in the nasal wash samples from 20 infants with a clinical diagnosis of bronchiolitis, seven with confirmed RS virus infections and 9 control children without respiratory illnesses. IL-10 levels were significantly higher in acute nasal wash samples (1-4 d post hospitalization) from RS virus-infected infants than in convalescent samples from these children (14-21 d post-hospitalization), from children with other forms of bronchiolitis and from control children. In contrast, only one RS virus-infected infant had detectable IL-12 in an acute nasal wash sample. IFN activity was not detected in any samples from RS virus-infected children. RS virus infection stimulates IL-10 expression but not IL-12 and IFN, possibly contributing to an ineffective cell-mediated immune response.

Acute Disease↗

Routine intrauterine insemination and the effect of spermatozoal washing as assessed by computer-assisted semen analyzer.

We present the results from 283 cycles of intrauterine insemination (IUI) performed on 237 patients. Their indications for treatment included cervical factor infertility, spermatozoal antibodies, idiopathy, poor postcoital test, and oligozoospermia. Pregnancies arose in all groups, with 28 pregnancies from natural cycles, and 17 from clomiphene citrate-supplemented cycles. A live birth rate per cycle of 12.7% (36/283) was achieved following nine miscarriages. A further 133 patients, with only cervical factor or idiopathic infertility, underwent 144 cycles of IUI in natural cycles; this more homogeneous group had their spermatozoal performance monitored by a computer-assisted semen analyzer (CASA) before and after spermatozoal washing for IUI. All factors in the spermatozoal profile changed significantly after washing. Twelve clinical pregnancies resulted from these 144 cycles of IUI, and a comparison was made between the spermatozoal profiles, as assessed by CASA, of conceptual and nonconceptual cycles. Post-wash spermatozoal concentration was slightly greater (P less than .1) in the conceptual cycles, whilst spermatozoal velocity was significantly less (P less than .005). The relevance of these findings to the definition of a "hyperactivational" state for human spermatozoa is discussed, and the general applicability of IUI as a "frontline" treatment for nontubal infertility is proposed.

Adult↗

[Influence of pulmonary artery perfusion with solution of washed red blood cells on lung injury after cardiopulmonary bypass].

OBJECTIVE: To observe the influence of intra-operative pulmonary artery perfusion with hypothermic washed red blood cell (RBC) solution on lung injury after cardiopulmonary bypass (CPB). METHODS: Thirty patients of mitral disease with pulmonary hypertension undergoing mitral valve replacement were randomly divided into 2 equal groups: control group, and perfusion group (with the pulmonary artery infused with 4 degrees C washed RBC protective solution during CPB). The blood cell count, pulmonary vascular resistance (PVR), white blood cell (WBC) ratio (venous blood/arterial blood), plasma malonyldialdehyde (MDA), and oxygenation index (OI), were measured and the time of mechanical ventilation was obtained as well. RESULTS: (1) The PVR at the end of CPB, and 12 h and 24 h after CPB of the perfusion group were 46.4 kPa.s.L(-1) +/- 8.1 kPa.s.L(-1), 48.5 kPa.s.L(-1) +/- 7.0 kPa.s.L(-1), and 36.1 kPa.s.L(-1) +/- 6.3 kPa.s.L(-1) respectively, all significantly lower than those of the control group (65.7 kPa.s.L(-1) +/- 5.3 kPa.s.L(-1), 79.8 kPa.s.L(-1) +/- 8.7 kPa.s.L(-1), and 47.9 kPa.s.L(-1) +/- 7.1 kPa.s.L(-1) respectively, all P < 0.05). (2) The levels of MDA at the end of CPB, and 12 h and 24 h after CPB of the perfusion group were 14.3 mmol/L +/- 0.8 mmol/L, 16.1 mmol/L +/- 0.7 mmol/L, and 13.3 mmol/L +/- 0.5 mmol/L respectively, all significantly lower than those of the control group (18.9 mmol/L +/- 0.9 mmol/L, 21.6 mmol/L +/- 0.4 mmol/L, and 22.5 mmol/L +/- 0.7 mmol/L respectively, all P < 0.05). (3) The WBC ratios of vein and artery (V/A) a the end of CPB and 12 h after CPB of the perfusion group were 1.16 +/- 0.05 and 1.20 +/- 0.05 respectively, both significantly lower than those of the control group (1.53 +/- 0.07 and 1.68 +/- 0.25 respectively (both P < 0.01). (4) The OI at the end of CPB, and 12 h and 24 h after CPB of the perfusion group were 370 +/- 33, 388 +/- 41, and 414 +/- 39 respectively, all significantly higher than those of the control group (217 +/- 30, 210 +/- 36, and 222 +/- 33 respectively (all P < 0.05). (5) The time of mechanical ventilation the perfusion group was 13 h +/- 4 h, significantly shorter than that of the control group (27 h +/- 6 h, P < 0.01). CONCLUSION: Pulmonary artery perfusion with hypothermic washed RBC protective solution alleviates the lung injury after cardiopulmonary bypass.

Adult↗

[Effects of blood washing and autotransfusion during cardiopulmonary bypass on erythrocyte immune and kidney function].

OBJECTIVE: To study changes of erythrocyte immune and kidney function after autotransfusion washed red blood cells during cardiopulmonary bypass (CPB). METHODS: Thirty-two patients undergoing valve replacement with CPB were randomly divided into study group and control group (16 in each group). In study group, the blood in operative field and the residual blood in the extracorporal machine were collected, centrifuged, washed and retransfused to patients. Patients in control group were transfused with the residual blood in the extracorporal machine without any disposal or banked blood. All patients were used with membrane oxygenator. Before CPB, 12 h, 24 h, 72 h and 7 d after CPB, whole blood were taken, then the erythrocyte immune function (C3bRR, RICR) and level of plasma free hemoglobin (FHB) were assayed, and post-operation renal function was compared between the two groups. Moreover, total volume of banked blood transfused to patients after CPB was recorded. RESULTS: (1) After 12 hours, 24 hours, 72 hours, 7 days of CPB, the RBC-C3bRR (14.3% +/- 4.7%, 15.9% +/- 3.6%, 16.6% +/- 2.8%, 19.9% +/- 4.1%) and RBC-ICR (8.7% +/- 1.9%, 9.2% +/- 2.0%, 9.5% +/- 2.6%, 12.0% +/- 2.0%) in study group were significantly elevated than that in control group (RBC-C3bRR 10.7% +/- 2.4%, 11.3% +/- 3.0%, 12.3% +/- 3.5%, 14.5% +/- 2.0%, RBC-ICR 5.9% +/- 1.4%, 6.0% +/- 1.8%, 7.0% +/- 1.7%, 8.7% +/- 2.7%). The erythrocyte immune function after CPB was better and restored faster in study group than that in control group (P < 0.05 in all). (2) After 12 hours, 24 hours of CPB, the levels of FHB (0.41 g/L +/- 0.13 g/L, 0.03 g/L +/- 0.02 g/L) in study group were significantly lower than that in control group (1.02 g/L +/- 0.23 g/L, 0.54 g/L +/- 0.09 g/L) (P < 0.01). After 24 hours of CPB, the level of urinary protein excretion (0.19 g/d +/- 0.08 g/d) in study group was significantly lower than that in control group (0.32 g/d +/- 0.07 g/d) (P < 0.05). (3) After 24 hours of CPB, the level of 24 h creatinine clearance was significantly elevated in study group (68 ml x min(-1) x 1.73 m(-2) +/- 10 ml x min(-1) x 1.73 m(-2)) than that in control group (45 ml x min(-1) x 1.73 m(-2) +/- 4 ml x min(-1) x 1.73 m(-2)) (P < 0.01). (4) The total volume of banked RBCs transfused after CPB were fewer in study group (2.0 U +/- 1.1 U) than that in control group (7.4 U +/- 2.3 U) (P < 0.01). CONCLUSION: Autotransfusion of washed red blood cells during CPB may improve significantly the erythrocyte immune function and protect kidney function better than transfusion of residual blood in the extracorporal machine or banked blood.

Adult↗