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Economic changes are happening at a bewildering rate these days in the national economy. What's causing this? How is Florida doing? How can businesses cope? Recently, the U.S. Dept. of [...]

For too long, Florida's economy has relied on theme parks and beaches. Cities and counties should step up their own efforts to encourage diversified economic development. It is of compelling [...]

The levering of U.S. corporations: the debt binge's implications As the United States endures a year of slow economic growth, it is important to realize that one crucial aspect of [...]

A Clinton White House carries with it renewed prospects for broad-scale bank reform proposals and actual legislation within the next two years. The banking industry is only now digesting the [...]

A systematic review was undertaken to assess the safety and efficacy of laparoscopic live-donor nephrectomy (LLDN) compared with open live-donor nephrectomy (OLDN).

The aim of this systematic review was to compare the safety and efficacy of laparoscopic live donor nephrectomy with the “gold” standard of open live donor nephrectomy.

Serine-dependent carboxylesterases (EC 3.1.1.1) are found in a variety of tissues with high activity detected in the liver. Carboxylesterases (CaE) hydrolyze aliphatic and aromatic esters, and aromatic amides, and play an important role in the detoxification of xenobiotic chemicals that contain organophosphate (OP) compounds. The detoxifying ability of CaE is limited by its low concentration in serum where it encounters OP compounds. Studies in our laboratory have shown that a pRC/CMV-hCaE plasmid construct, stably integrated into 293T cells, expresses a human liver CaE in culture. However, the enzyme remained inside the cell and reached a low steady-state level of expression. The goals of this study were to overexpress a functional human liver CaE from a recombinant cDNA in a human cell line and to isolate and purify the recombinant protein. To accomplish these goals, a single amino acid change was made in the C-terminal retrieval signal, HIEL (His-Ile-Glu-Leu), of human liver CaE. The mutation produced a unique Eco47III restriction site, which aided in clone selection. The recombinant plasmid, pRc/CMV-mhCaE, was isolated and stably integrated into human 293T cells. Expression of the altered cDNA resulted in secretion of an active CaE up to levels of 500 enzyme units per liter of growth medium. Secretory CaE displayed isoelectric focusing patterns similar to those of the native enzyme with no observable changes in activity. The secreted enzyme was partially purified by hydrophobic interaction chromatography and Cibacron blue affinity chromatography. Partial enzyme purification was achieved, and CaE retained a high level of enzymatic activity.

Over a 12-year period, 290 aortofemoral reconstructions were performed for intermittent claudication involving 449 legs in 262 patients. The accumulative patency rate in surviving patients was 79 per cent at 5 years. The patency rate was significantly better in patients who stopped smoking after operation, and in men compared with women. Dacron grafts were significantly more successful than endarterectomy in men. If there was no associated superficial femoral artery occlusion, endarterectomy and Dacron bypass grafts were equally successful, but Dacron bypass grafts were significantly superior to endarterectomy if the superficial femoral artery was severely stenosed or occluded.The success rates for improving the patients' intermittent claudication were 90 per cent at 3 months and 72 per cent at 3 years. The success rate at 3 years was 80 per cent if the superficial femoral artery was patent but only 62 per cent if the superficial femoral artery was severely stenosed or occluded. Mortality and morbidity rates fell markedly in the last 6 years of the study.

Femoropopliteal vein grafts were performed for intermittent claudication in 160 patients (182 legs) over a 12-year period. The accumulative patency rate was 67 per cent at 5 years. However, patency rates improved significantly in the latter 6 years of the study, to 75 per cent at 5 years. Early postoperative occlusion and morbidity rates also markedly declined in this latter period. Patency rates were significantly better in males than in females, in patients who were able to stop smoking after operation and in legs with a three-vessel run-off compared with those with a two- or one-vessel run-off. The patients' age did not influence graft patency rates.

Multivariate Cox regression analysis of patency rates for 750 consecutive femorodistal autogenous vein graftings for chronic lower limb ischemia showed that significant independent prognostic covariates were the type of graft (long saphenous or arm vein), presence of diabetes, and absence of a past history of myocardial ischemia. Analysis assumes that patients withdrawn with patent grafts due to death or loss to follow-up would have followed the same course as those who remain, and the degree to which this could distort results was studied. Patients who died with patent grafts were more likely to have had past myocardial ischemia and critical lower limb ischemia. Cox regression analysis for 600 operations after excluding patients who died with patent grafts then showed that significant independent covariates were the type of graft (long saphenous or arm vein) and indication (claudication or critical ischemia); then age, sex, hypertension, diabetes, myocardial ischemia, date of operation, surgeon, site of distal anastomosis, or first compared to repeat operations had no significant influence. Cox regression analysis helps determine which covariates influence graft patency rates, but results are affected by censored data, particularly from patients who die with patent grafts.

This report describes the results of 290 aortoiliac reconstructions performed for intermittent claudication and particularly analyzes the results for different techniques of operation and their indications. The accumulative patency rate for all operations was 79% at 5 years in surviving patients. The patency rate was significantly better in patients who stopped smoking after the operation. Dacron®grafts had a significantly higher patency rate than endarterectomy in men. Dacron®grafts and endarterectomy had equal patency rates in patients who had patent superficial femoral arteries, but Dacron®grafts had a significantly higher patency rate than endarterectomy if the superficial femoral arteries were occluded or severely stenosed. If the success rate for relieving intermittent claudication is considered rather than the patency rate, then Dacron®grafts gave even better results than endarterectomy in patients with severe superficial femoral artery disease. Limited unilateral extraperitoneal operations gave satisfactory long-term results in selected patients, as did extra-anatomical operations in patients in whom conventional reconstructions seemed inappropriate. Cet article fait état de 290 greffes aorto-iliaques pratiquées pour claudication intermittente et analyse plus précisément les indications et les résultats des différentes techniques opératoires. Le taux de perméabilité à 5 ans chez les survivants est de 79%. Il est meilleur, de faÇon significative, chez les sujets qui ne fument plus. Les greffes en dacron ont un taux global de perméabilité supérieur chez les hommes. En effet, si le taux de perméabilité est identique pour la greffe en dacron et l'endartériectomie lorsque l'intervention est pratiquée sur une artère encore perméable, celui de la greffe en dacron est supérieur au taux de l'endartériectomie quand l'artère est très sténosée ou obstruée. Si l'on prend en ligne de compte le taux de guérison de la claudication intermittente plutÔt que le taux de perméabilité, la greffe en dacron donne de meilleurs résultats que l'endartériectomie chez les malades qui présentent une atteinte sévère de l'artère fémorale superficielle. Les interventions extrapéritonéales limitées ont donné des résultats satisfaisants à long terme chez les malades sélectionnés comme l'avaient fait les opérations extra-anatomiques chez les malades pour lesquels les méthodes de reconstruction conventionnelle semblaient inappropriées. Este informe describe los resultados de 290 reconstrucciones aorto-ilíacas realizadas por claudicación intermitente, y analiza en particular los resultados con las diferentes técnicas operatorias y sus indicaciones. La tasa de permeabilidad para el total de operaciones fue de 79 por ciento a los 5 años en los pacientes que sobrevivieron. La tasa de permeabilidad fue significativamente mejor en los pacientes que dejaron de fumar después de la operación. En los hombres los injertos de dacrón tuvieron una tasa de permeabilidad significativamente más alta que la endarterectomía. Los injertos de dacrón y la endarterectomía tuvieron tasas de permeabilidad iguales en pacientes con arterias femorales superficiales permeables, pero los injertos de dacrón tuvieron una tasa de permeabilidad significativamente más alta que la endarterectomía si las arterias femorales superficiales se hallaban ocluídas o severamente estenosadas. Al considerar la tasa de éxito en el control de la claudicación intermitente en vez de la tasa de permeabilidad, se encuentra que los injertos de dacrón dieron resultados aÚn mejores que la endarterectomía en pacientes con enfermedad severa de la arteria femoral superficial. Las operaciones extraperitoneales unilaterales dieron resultados satisfactorios a largo plazo en pacientes seleccionados, así como los dieron operaciones extra-anatómicas en pacientes en quienes las reconstrucciones convencionales parecían ser inapropiadas.

Six clinical isolates of Staphylococcus aureuswere compared for their relative susceptibilities to the killing effects of oxacillin. Three of the strains had minimum bactericidal concentrations which were >10 times the minimum bacteriostatic concentration for this antibiotic and were designated tolerant (Tol+). The other strains had minimum bactericidal concentrations which were comparable to the minimum bacteriostatic concentration (Tol−). Lysis curves of these strains revealed that the Tol+strains exhibited a diminished rate of lysis when inhibited by oxacillin. This reduced rate of lysis was reflected also in a reduced rate of viability loss when the cells were exposed to oxacillin. During log growth the uptake of [14C]glycerol by Tol+cells was 1.5-fold greater than that by Tol−cells. Glycerol-labeled cells of each phenotype secreted radioactivity when inhibited by oxacillin. However, the Tol+strains released over twice as much label as the Tol−strains. No difference in the proportion of lipid secreted by the two phenotypes was found. The behavior of 60 to 65% of the labeled material released by inhibited cells during both sodium dodecyl sulfate gel electrophoresis and Sepharose 6B chromatography corresponded to that of lipoteichoic acid. When the major component of secreted material was added to oxacillin-inhibited Tol−strains, an inhibition of the lytic response was observed. These results suggest that oxacillin tolerance in S. aureuscould be related to the enhanced secretion of an autolysin inhibitor, such as lipoteichoic acid.

Three clinical isolates of Staphylococcus aureus, which were previously shown to contain a 50S plasmid conferring resistance to several aminoglycosides, were examined for modifying enzymes. Both the wild-type and heat-cured derivatives of the isolates were screened for acetyl-, adenylyl-, and phosphotransferase activities. The substrates were gentamicin, amikacin, and netilmicin; the results indicated that even though all three activites were present, the phosphotransferase reaction was most responsible for resistance to these antibiotics. The absence of any of the modifying activites in cured derivatives of the three isolates supports the conclusion that aminoglycoside resistance in these strains is conferred by a plasmid.

A study was conducted on a randomised sample (2006) of patients on waiting lists for surgery in Victorian public hospitals with the largest lists. Information was obtained from the hospitals' waiting lists, patients were interviewed and surgeons' opinions sought on particular patients. The results indicated that the waiting lists were inaccurate, with approximately one in five patients inappropriately included on the lists. The remaining 80% of patients, however, were genuinely in need of surgery. Twenty per cent of arranged admissions did not eventuate, the main reasons for this being failure of the patient to aUend or a shortage of surgical beds. Of 206 patients interviewed, 56 considered that their condition had deteriorated whilst on the waiting list and this was verified by surgeons in 29 cases, that is, in 14% of all patients interviewed. The study suggests that the provision of surgical services in Victorian public hospitals is not satisfactory, waiting lists require regular administrative and clinical review, efforts to reduce the waiting lists should continue and the need for an Increased number of surgical beds is a matter of urgency. There is also a need for some hospitals to improve their “call for admission” practices.

The effectiveness of passive immunization was assessed in an infection model of toxic shock syndrome (TSS) in which monoclonal antibody to TSS toxin 1 (TSST-l) was administered intravenously to rabbits. Previously implanted infection chambers were inoculated with Staphylococcus aureus strains RN4710 and D4508. The former strain carries the TSST-l gene on plasmid pRN6201; the latter is a TSST-l-negative clinical isolate obtained from a patient with nonmenstrual TSS. Purified monoclonal antibody, MAb 8-5-7 (IgG), was administered in two doses of ~ 1.25 mg each 24 hours before and 24 hours after infection. MAb 8-5-7 provided complete protection against both the TSS-like syndrome and the mortality that occurred in unprotected rabbits infected with strain RN4710 but did not provide complete protection in rabbits infected with strain D4508; three of the five rabbits either displayed signs of illness or died despite treatment. Western-blot analyses of the extracellular proteins produced by strains RN4710 and D4508 that used MAb 8-5-7 as a probe revealed that only TSST-l produced by RN4710 reacted with the antibody. Thus, if MAb 8-5-7 partially protected animals against infections with strain D4508, the protection appears to have been nonspecific.

Opinion. Focuses on the discussion of the luring of Tampa Bay Bucs to the Orlando area. Witnessing of one of the strangest approach to economic development; Scarity of pro football franshises.

Discusses various aspects of the business cycles. Interest rates' impact on the housing construction industry; Description of business cycles; Expansions and contractions; Average lengths of expansions and recessions; Financial reserves; Currency intervention; Inflation indexes.

Elaborates on economic expansion in the United States. Inflation rates; Percent growth of gross domestic product in 1992 and 1993; Unemployment rate; Monthly employment generation average; Contributing factors to uncertainties in the economy 1n 1993.

Opinion. Focuses on the job growth performance of Jacksonville, Florida for 1995. Breakdown of statistics; Comparison with other metro areas; Implications; Expectations.