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Objectives: In the mid-1990s, fluoroquinolones were introduced in Indonesia for the management of gonorrhea and are now part of the national recommended treatment guidelines. We recently documented introduction of ciprofloxacin-resistant Neisseria gonorrhoeae strains in female sex workers (FSWs) in Timika, Indonesia, 5 years after treating gonococcal cervicitis with ciprofloxacin and periodically monitoring antimicrobial susceptibility of isolates. To assess the importance of this observation, we determined antimicrobial susceptibilities and strain types of N. gonorrhoeae isolates from FSWs seen in a sexually transmitted infection (STI) clinic in Denpasar, Bali, Indonesia. Goal: The goal of this study was to determine antimicrobial susceptibilities and strain types among N. gonorrhoeae isolated from FSWs in Denpasar, Bali. Study Design: FSWs in Denpasar were screened for N. gonorrhoeae by standard culture. Endocervical isolates were frozen in Microbank tubes and sent to the University of California at San Francisco on dry ice. Antimicrobial susceptibility testing using a Clinical Laboratory Standards Institute-recommended agar dilution method was performed at the Centers for Disease Control and Prevention. Isolates were characterized by [beta]-lactamase production, antimicrobial resistance phenotypes, and auxotype/serovar class. Results: One hundred forty-seven N. gonorrhoeae isolates were characterized. All isolates were highly resistant to tetracycline (minimum inhibitory concentration, [greater than or equal to] 16.0 pg/mL): 117 (79.1%) were [beta]-lactamase-positive (PP-TR), 3 (2.0%) exhibited chromosomally mediated resistance to penicillin (PenR-TRNG), and 27 (18.2%) were susceptible to penicillin (TRNG). All isolates were susceptible to ceftriaxone, cefixime, and spectinomycin; lack of interpretive criteria do not allow interpretation of susceptibilities of cefoxitin, cefpodoxime, or azithromycin. Fifty-nine (40.1%) isolates were ciprofloxacin-resistant; 35 (59.3%) of the ciprofloxacin-resistant isolates exhibited high-level resistance to ciprofloxacin (Cip-HLR; minimum inhibitory concentration, [greater than or equal to] 4.0 pg/mL of ciprofloxacin). Three (2.0%) isolates were intermediate to ciprofloxacin. Twenty-two strain types were identified among these isolates: small clusters were identified with 3 strain types. Conclusions: N. gonorrhoeae isolates from FSWs in Denpasar were resistant to penicillin and tetracycline; 40.1% of the isolates were fluoroquinolone-resistant. With gonorrhea prevalence of 35% at this clinic (by nucleic acid amplified tests), ongoing surveillance for antimicrobial resistance will be needed to appropriately choose treatment for infections caused by these resistant organisms.

BackgroundStudies comparing the clinical outcomes of second-generation biodegradable polymer drug-eluting stents (BP-DES) and second-generation durable polymer drug-eluting stents (DP-DES) in patients with ST-segment elevation myocardial infarction (STEMI) with follow-up duration of more than 1 year are still limited.ObjectiveThis study aimed to compare the 2-year clinical outcome of BP-DES with second-generation DP-DES in patients undergoing primary percutaneous coronary intervention (PPCI).MethodsThis is a retrospective cohort study in patients with STEMI, the primary endpoint was major adverse cardiac events (MACE) defined as recurrent myocardial infarction, total repeat revascularisation and cardiac death. The secondary endpoint was stent thrombosis (ST) defined as definite, probable or possible.ResultsA total of 400 patients were analysed (197 BP-DES groups and 203 DP-DES groups). BP-DES were independently associated with lower incidence of MACE (adjusted HR 0.67, 95% CI 0.21 to 0.91, p=0.005) and ST (adjusted HR 0.62, 95% CI 0.19 to 0.73, p<0.016) within 2 years of follow-up. Subgroup analysis of MACE individual components showed that BP-DES were associated with lower cardiac deaths (HR 0.35; 95% CI 0.18 to 0.94; p<0.001) compared to DP-DES, but not recurrent myocardial infarction and total repeat revascularisation.ConclusionsBP-DES were associated with better clinical outcomes compared to second-generation DP-DES in patients with STEMI undergoing PPCI.

Ohne Zusammenfassung:

Vitello-intestinal ducts anomalies has been described extensively in literatures, however - a prolapsed vitello-intestinal duct with prolapsed ileum is extremely rare and might be challenging diagnostically. We describe a baby boy who was born with a reddish mass arising from the abdominal wall. He had early surgical correction, and the diagnosis was confirmed intra operatively. The vitello-intestinal duct was resected as well as some part of the edematous ileum, and ileal anastomosis was performed. He had uneventful recovery.

Very high molecular weight (Mnup to 700 000) and narrowly polydispersed (PDI 1.1−1.4) hyperbranched polyglycerols (HPG) were synthesized by ring-opening multibranching polymerization of glycidol using dioxane as an emulsifying agent. Broader molecular weight distributions with low molecular weight fractions were obtained when diglyme was used as the emulsifying agent. But the low molecular weight fractions could be removed by dialysis. Isolated yields in both the cases were 70−90%. The different result in the case of dioxane may be due to faster cation exchange which leads to low polydispersites. HPGs of various molecular weights were characterized by a GPC system coupled with a multiangle laser light scattering detector and a triple detector array. The intrinsic viscosities were low for these polymers and did not increase with molecular weight. The dimensions of these polymers (Rg, Rh, R) and their dependence on molecular weights are described. The hydrodynamic radii were very small with dimensions similar to those of dendrimers. Our results show that these polymers are very compact and have spherical conformations in water with no indications of aggregate formation. The melt viscoelastic properties were also studied. Despite their self-similar structures, depending on the type of solvent used to synthesize them (diglyme vs dioxane), topologically restricted configurations are produced that result in completely different entanglement dynamics.

In this paper we studied the melt fracture behaviour in capillary flow of a number of polyethylenes produced by various technologies. The critical shear rates for the onset of both sharkskin and gross melt fractures were found to correlate with the high-rate extensional flow behaviour of the polymers. These findings were found to mechanistically support the generally accepted observations of melt fracture occurring at the exit (sharkskin) and entrance (gross) regions of the capillary die. In addition, it was found that boron nitride (BN) behaves as an energy dissipater that suppresses the rapid increase of extensional stress associated with gross melt fracture. This enables BN to act as an effective processing aid in postponing gross melt fracture in the extrusion of polyethylenes.

The flow curves of linear (linear-low and high density) and branched polyethylenes are known to differ significantly. At increasing shear rates, the linear polymers exhibit a surface melt fracture or sharkskin region that is followed by an unstable oscillating or stick-slip flow regime when a constant piston speed capillary rheometer is used. At even higher shear rates, gross melt fracture appears. Unlike their linear counterparts, branched polyethylenes rarely exhibit sharkskin melt fracture and although gross melt fracture appears at high shear rates there is no discontinuity in their flow curve. The various flow regimes of these two types of polyethylenes are examined by performing experiments in the melt state using a unique extensional rheometer (the SER by Xpansion Instruments) that is capable of performing accurate extensional flow and peel experiments at very high rates not previously realized. The peel strength curves of these linear and branched polyethylenes exhibit all of the distinct flow regimes exhibited in their respective flow curves, thereby providing a fingerprint of their melt flow behavior. Moreover, these extensional flow and peel results in the melt state provide insight into the origins and mechanisms by which these melt flow phenomena may occur with regard to rapid tensile stress growth, melt rupture, and adhesive failure at the polymer wall interface.

Zusammenfassung Im akuten Tierversuch mit Änderung des Saure-Basenhaushaltes wurde die kontinuierlich messende pH-Elektrode der Fa. ROCHE auf ihre Ansprechbarkeit und Meßgenauigkeit geprüft. Bei anästhesierten Hunden wurde die Elektrode in dem Subkutangewebe des Kopfes, des Halses und der Axilla befestigt. Simultan zur kontinuierlichen pH-Messung wurden über arterielle und venöse Katheter diskontinuierlich in Abständen von 5 min sämtliche Parameter des Säure-Basenhaushaltes bestimmt. Verschiedene Formen der Acidose und Hypoxie wurden erzeugt und die Ansprechbarkeit und Meßgenauigkeit der pH-Elektrode, auch in bezug auf ihre Lokalisation, geprüft.

Zusammenfassung Die kontinuierlich messende ROCHE-pH-Elektrode wurde klinisch bei 20 Feten unter der Geburt und einem nicht lebensfähigen Neugeborenen mit schwerer Mißbildung eingesetzt.

Zusammenfassung Die ROCHE pH-Elektrode muß chemisch (mitKorsolin oderCitex) oder Gas-sterilisiert werden (Formaldehyd oder Äthylen-Oxyd-Gas). Die Sterilisationsdauer mit Korsolin wurde mit E. coli und β-Streptokokken kontraminierten Elektroden geprüft. Erst nach 3 Std Korsolin-Bad ist kein Bakterienwachstum mehr nachweisbar. Die in vitro-Charakteristik der pH-Elektrode wird durch ein 3stündiges Korsolin-Badnicht beeinträchtigt.

Ohne Zusammenfassung:

The use of exhalation of ethane and n-pentane in experimental animals as parameters of lipid peroxidation led to an examination of pharmacokinetics of both compounds in rats. When rats were exposed, in a closed desiccator jar chamber, to a wide range of ethane concentrations, linear elimination pharmacokinetics were observed. n-Pentane, when concentrations higher than 100 ppm were applied, displayed saturation kinetics. These were formally explained by action of two competing metabolizing pathways or enzymes. Application of preexisting models could describe exhalation of both ethane and n-pentane by untreated control rats. Stimulation of lipid peroxidation by ferrous ions or by carbon tetrachloride resulted in dissimilar quantitative behaviours of ethane and n-pentane. Ethane production rates were enhanced after application of both compounds. Because of relatively slow metabolic eliminations this led to markedly elevated concentrations of ethane in the gas phase of the system. Pentane production rates were simultaneously enhanced. However, difficulties in interpretation arise because of rapid metabolic elimination of n-pentane. Compounds that diminish pentane metabolism are shown to evoke higher pentane concentrations in the system than compounds which only enhance the pentane production rate. Determinations of ethane exhalation should provide a more favourable parameter of lipid peroxidation than exhalation of pentane.

Isolated rat hepatocytes (1×107 cells/ml) were aerobically incubated in Eagle's Minimum Essential Medium which contained 2.0% albumin. As potential parameters of lipid peroxidation ethane and n-pentane formed were measured in samples obtained from the gas phase above the incubation mixture. 15–30 nmol ethane or n-pentane were produced by 107 hepatocytes within 90 min. Carbon tetrachloride (CCl4) or ADP-complexed ferrous ions stimulated ethane and n-pentane formation considerably, depending on the concentrations of the compounds. With CCl4 107 cells formed max 180 nmol ethane and 140 nmol n-pentane within 90 min incubation, whereas with Fe(II) max 130 nmol ethane and 220 nmol n-pentane could be detected.

Bleomycin was injected i.p. in rats, and the amount of expired ethane which indicateds lipid peroxidation was followed up for 78 h. Compared to controls neither 1x30 mg/kg and 2x30 mg/kg nor 1x70 mg/kg bleomycin led to increased ethane expiration, although body weight loss indicated toxicity. That pulmonary toxicity had been developed due to the acute bleomycin treatment could be demonstrated by histological examinations of lungs of the animals of the highest dosage group.

Zusammenfassung Es wird ein neues Applikationsinstrument beschrieben, durch welches die Applikation der pH-Elektrode fast ebenso leicht ist wie die Anbringung der herkömmlichen EKG-Scalp-Elektrode [3]. Visuelle Kontrolle und Steinschnittlagerung sind nicht mehr erforderlich. Die verschiedenen Teile des Applikationsinstrumentes sind aneinander so angepaßt, daß die Elektrodenspitze automatisch in die vorher angelegte Hautinzision eingeführt wird. Die ersten Ergebnisse mit diesem neuen Applikationsinstrument sind erfolgversprechend. Die Applikationszeit ist kurz, die Stabilität der pH-Elektrode ist gut und die Anwendung für den Patienten nicht mehr beschwerlich.

Ethane evolution was measured in rats breathing pure oxygen. Animals injected i.p. with a lethal dose of paraquat (50 mg/kg) developed signs of pulmonary insufficiency within 3 hours and died within 24 hours. Ethane evolution, a parameter of lipid peroxidation in vivo, was increased over control levels only by 26% after 4 hours. It is concluded that this increase is too small to support the theory that lipid peroxidation is the biochemical mechanism of paraquat toxicity.