Disseminated Mycobacterium chimaera Presenting as Vertebral Osteomyelitis.

PubMed

Moutsoglou, Daphne M; Merritt, Frank; Cumbler, Ethan

2017-01-01

Mycobacterium chimaera , a member of the Mycobacterium avium complex, is a slow-growing, nontuberculous mycobacterium associated with outbreaks in cardiac-surgery patients supported on heart-lung machines. We report a case of an elderly woman on chronic prednisone who presented with a six-month history of worsening chronic back pain, recurrent low-grade fevers, and weight loss. Imaging identified multilevel vertebral osteomyelitis and lumbar soft-tissue abscess. Abscess culture identified M. chimaera .

Total Teacher Effectiveness: Implication for Curriculum Change (TOC) in Hong Kong.

ERIC Educational Resources Information Center

Tsui, Kwok Tung; Cheng, Yin Cheong

This paper introduces the concept of total teacher effectiveness for facilitating educational reform and improvement, using target oriented curriculum (TOC) change in Hong Kong as an example. TOC change is a complex process that involves preparing, changing, and reinforcing teachers in multiple domains at multiple levels. Teacher effectiveness…

How to and how not to develop a theory of change to evaluate a complex intervention: reflections on an experience in the Democratic Republic of Congo.

PubMed

Maini, Rishma; Mounier-Jack, Sandra; Borghi, Josephine

2018-01-01

Theories of change (ToCs) describe how interventions can bring about long-term outcomes through a logical sequence of intermediate outcomes and have been used to design and measure the impact of public health programmes in several countries. In recognition of their capacity to provide a framework for monitoring and evaluation, they are being increasingly employed in the development sector. The construction of a ToC typically occurs through a consultative process, requiring stakeholders to reflect on how their programmes can bring about change. ToCs help make explicit any underlying assumptions, acknowledge the role of context and provide evidence to justify the chain of causal pathways. However, while much literature exists on how to develop a ToC with respect to interventions in theory, there is comparatively little reflection on applying it in practice to complex interventions in the health sector. This paper describes the initial process of developing a ToC to inform the design of an evaluation of a complex intervention aiming to improve government payments to health workers in the Democratic Republic of Congo. Lessons learnt include: the need for the ToC to understand how the intervention produces effects on the wider system and having broad stakeholder engagement at the outset to maximise chances of the intervention's success and ensure ownership. Power relationships between stakeholders may also affect the ToC discourse but can be minimised by having an independent facilitator. We hope these insights are of use to other global public health practitioners using this approach to evaluate complex interventions.

The Arabidopsis ppi1 Mutant Is Specifically Defective in the Expression, Chloroplast Import, and Accumulation of Photosynthetic ProteinsW⃞

PubMed Central

Kubis, Sybille; Baldwin, Amy; Patel, Ramesh; Razzaq, Azam; Dupree, Paul; Lilley, Kathryn; Kurth, Joachim; Leister, Dario; Jarvis, Paul

2003-01-01

The import of nucleus-encoded proteins into chloroplasts is mediated by translocon complexes in the envelope membranes. A component of the translocon in the outer envelope membrane, Toc34, is encoded in Arabidopsis by two homologous genes, atTOC33 and atTOC34. Whereas atTOC34 displays relatively uniform expression throughout development, atTOC33 is strongly upregulated in rapidly growing, photosynthetic tissues. To understand the reason for the existence of these two related genes, we characterized the atTOC33 knockout mutant ppi1. Immunoblotting and proteomics revealed that components of the photosynthetic apparatus are deficient in ppi1 chloroplasts and that nonphotosynthetic chloroplast proteins are unchanged or enriched slightly. Furthermore, DNA array analysis of 3292 transcripts revealed that photosynthetic genes are moderately, but specifically, downregulated in ppi1. Proteome differences in ppi1 could be correlated with protein import rates: ppi1 chloroplasts imported the ribulose-1,5-bisphosphate carboxylase/oxygenase small subunit and 33-kD oxygen-evolving complex precursors at significantly reduced rates, but the import of a 50S ribosomal subunit precursor was largely unaffected. The ppi1 import defect occurred at the level of preprotein binding, which is consistent with a role for atToc33 during preprotein recognition. The data suggest that atToc33 is involved preferentially in the import of photosynthetic proteins and, by extension, that atToc34 is involved in the import of nonphotosynthetic chloroplast proteins. PMID:12897258

Modifications at the A-domain of the chloroplast import receptor Toc159.

PubMed

Agne, Birgit; Kessler, Felix

2010-11-01

Two families of GTPases, the Toc34 and Toc159 GTPase families, take on the task of preprotein recognition at the translocon at the outer membrane of chloroplasts (TOC translocon). The major Toc159 family members have highly acidic N-terminal domains (A-domains) that are non-essential and so far have escaped functional characterization. But recently, interest in the role of the A-domain has strongly increased. The new data of three independent studies provide evidence that the Toc159 A-domain I) participates in preprotein selectivity, II) has typical features of intrinsically unfolded proteins and III) is highly phosphorylated and possibly released from the rest of the protein by a proteolytic event. This hints to a complex regulation of A-domain function that is important for the maintenance of the preprotein selectivity at the TOC translocons.

Nano-scale characterization of the dynamics of the chloroplast Toc translocon.

PubMed

Reddick, L Evan; Chotewutmontri, Prakitchai; Crenshaw, Will; Dave, Ashita; Vaughn, Michael; Bruce, Barry D

2008-01-01

Translocons are macromolecular nano-scale machines that facilitate the selective translocation of proteins across membranes. Although common in function, different translocons have evolved diverse molecular mechanisms for protein translocation. Subcellular organelles of endosymbiotic origin such as the chloroplast and mitochondria had to evolve/acquire translocons capable of importing proteins whose genes were transferred to the host genome. These gene products are expressed on cytosolic ribosomes as precursor proteins and targeted back to the organelle by an N-terminal extension called the transit peptide or presequence. In chloroplasts the transit peptide is specifically recognized by the Translocon of the Outer Chloroplast membrane (Toc) which is composed of receptor GTPases that potentially function as gate-like switches, where GTP binding and hydrolysis somehow facilitate preprotein binding and translocation. Compared to other translocons, the dynamics of the Toc translocon are probably more complex and certainly less understood. We have developed biochemical/biophysical, imaging, and computational techniques to probe the dynamics of the Toc translocon at the nanoscale. In this chapter we provide detailed protocols for kinetic and binding analysis of precursor interactions in organeller, measurement of the activity and nucleotide binding of the Toc GTPases, native electrophoretic analysis of the assembly/organization of the Toc complex, visualization of the distribution and mobility of Toc apparatus on the surface of chloroplasts, and conclude with the identification and molecular modeling Toc75 POTRA domains. With these new methodologies we discuss future directions of the field.

A Role for the TOC Complex in Arabidopsis Root Gravitropism1[W][OA

PubMed Central

Stanga, John P.; Boonsirichai, Kanokporn; Sedbrook, John C.; Otegui, Marisa S.; Masson, Patrick H.

2009-01-01

Arabidopsis (Arabidopsis thaliana) roots perceive gravity and reorient their growth accordingly. Starch-dense amyloplasts within the columella cells of the root cap are important for gravitropism, and starchless mutants such as pgm1 display an attenuated response to gravistimulation. The altered response to gravity1 (arg1) mutant is known to be involved with the early phases of gravity signal transduction. arg1 responds slowly to gravistimulation and is in a genetically distinct pathway from pgm1, as pgm1 mutants enhance the gravitropic defect of arg1. arg1 seeds were mutagenized with ethylmethane sulfonate to identify new mutants that enhance the gravitropic defect of arg1. Two modifier of arg1 mutants (mar1 and mar2) grow in random directions only when arg1 is present, do not affect phototropism, and respond like the wild type to application of phytohormones. Both have mutations affecting different components of the Translocon of Outer Membrane of Chloroplasts (TOC) complex. mar1 possesses a mutation in the TOC75-III gene; mar2 possesses a mutation in the TOC132 gene. Overexpression of TOC132 rescues the random growth phenotype of mar2 arg1 roots. Root cap amyloplasts in mar2 arg1 appear ultrastructurally normal. They saltate like the wild type and sediment at wild-type rates upon gravistimulation. These data point to a role for the plastidic TOC complex in gravity signal transduction within the statocytes. PMID:19211693

A role for the TOC complex in Arabidopsis root gravitropism.

PubMed

Stanga, John P; Boonsirichai, Kanokporn; Sedbrook, John C; Otegui, Marisa S; Masson, Patrick H

2009-04-01

Arabidopsis (Arabidopsis thaliana) roots perceive gravity and reorient their growth accordingly. Starch-dense amyloplasts within the columella cells of the root cap are important for gravitropism, and starchless mutants such as pgm1 display an attenuated response to gravistimulation. The altered response to gravity1 (arg1) mutant is known to be involved with the early phases of gravity signal transduction. arg1 responds slowly to gravistimulation and is in a genetically distinct pathway from pgm1, as pgm1 mutants enhance the gravitropic defect of arg1. arg1 seeds were mutagenized with ethylmethane sulfonate to identify new mutants that enhance the gravitropic defect of arg1. Two modifier of arg1 mutants (mar1 and mar2) grow in random directions only when arg1 is present, do not affect phototropism, and respond like the wild type to application of phytohormones. Both have mutations affecting different components of the Translocon of Outer Membrane of Chloroplasts (TOC) complex. mar1 possesses a mutation in the TOC75-III gene; mar2 possesses a mutation in the TOC132 gene. Overexpression of TOC132 rescues the random growth phenotype of mar2 arg1 roots. Root cap amyloplasts in mar2 arg1 appear ultrastructurally normal. They saltate like the wild type and sediment at wild-type rates upon gravistimulation. These data point to a role for the plastidic TOC complex in gravity signal transduction within the statocytes.

Mercury in fish from Norwegian lakes: The complex influence of aqueous organic carbon.

PubMed

Braaten, Hans Fredrik Veiteberg; de Wit, Heleen A; Larssen, Thorjørn; Poste, Amanda E

2018-06-15

Mercury (Hg) concentrations in water and biota are often positively correlated to organic matter (OM), typically measured as total or dissolved organic carbon (TOC/DOC). However, recent evidence suggests that higher OM concentrations inhibit bioaccumulation of Hg. Here, we test how TOC impacts the Hg accumulation in fish in a synoptic study of Methyl-Hg (MeHg) in water and total Hg (THg) in perch (Perca fluviatilis) in 34 boreal lakes in southern Norway. We found that aqueous MeHg (r 2  = 0.49, p < 0.0001) and THg (r 2  = 0.69, p < 0.0001), and fish THg (r 2  = 0.26, p < 0.01) were all positively related with TOC. However, we found declining MeHg bioaccumulation factors (BAF MeHg ) for fish with increasing TOC concentrations. The significant correlation between fish THg concentrations and aqueous TOC suggests that elevated fish Hg levels in boreal regions are associated with humic lakes. The declining BAF MeHg with increasing TOC suggest that increased OM promotes increased aqueous Hg concentrations, but lowers relative MeHg bioaccumulation. A mechanistic understanding of the response from OM on BAF MeHg might be found in the metal-complexation properties of OM, where OM complexation of metals reduces their bioavailability. Hence, suggesting that MeHg bioaccumulation becomes less effective at higher TOC, which is particularly relevant when assessing potential responses of fish Hg to predicted future changes in OM inputs to boreal ecosystems. Increased browning of waters may affect fish Hg in opposite directions: an increase of food web exposure to aqueous Hg, and reduced bioavailability of Hg species. However, the negative relationship between BAF MeHg and TOC is challenging to interpret, and carries a great deal of uncertainty, since this relationship may be driven by the underlying correlation between TOC and MeHg (i.e. spurious correlations). Our results suggest that the trade-off between Hg exposure and accumulation will have important implications for the effects of lake browning on Hg transport, bioavailability, and trophodynamics. Copyright © 2018 Elsevier B.V. All rights reserved.

Molecular Characterization and Expression Analysis of Chloroplast Protein Import Components in Tomato (Solanum lycopersicum)

PubMed Central

Yan, Jianmin; Campbell, James H.; Glick, Bernard R.; Smith, Matthew D.; Liang, Yan

2014-01-01

The translocon at the outer envelope membrane of chloroplasts (Toc) mediates the recognition and initial import into the organelle of thousands of nucleus-encoded proteins. These proteins are translated in the cytosol as precursor proteins with cleavable amino-terminal targeting sequences called transit peptides. The majority of the known Toc components that mediate chloroplast protein import were originally identified in pea, and more recently have been studied most extensively in Arabidopsis. With the completion of the tomato genome sequencing project, it is now possible to identify putative homologues of the chloroplast import components in tomato. In the work reported here, the Toc GTPase cDNAs from tomato were identified, cloned and analyzed. The analysis revealed that there are four Toc159 homologues (slToc159-1, -2, -3 and -4) and two Toc34 homologues (slToc34-1 and -2) in tomato, and it was shown that tomato Toc159 and Toc34 homologues share high sequence similarity with the comparable import apparatus components from Arabidopsis and pea. Thus, tomato is a valid model for further study of this system. The expression level of Toc complex components was also investigated in different tissues during tomato development. The two tomato Toc34 homologues are expressed at higher levels in non-photosynthetic tissues, whereas, the expression of two tomato Toc159 homologues, slToc159-1 and slToc159-4, were higher in photosynthetic tissues, and the expression patterns of slToc159-2 was not significantly different in photosynthetic and non-photosynthetic tissues, and slToc159-3 expression was limited to a few select tissues. PMID:24751891

Treatment of elbow osteomyelitis with an interposition arthroplasty using a rectus abdominis free flap.

PubMed

Jaiswal, Rohit; Busse, Brittany; Allen, Robert; Sahar, David

2015-05-01

Osteomyelitis of the elbow may be a complex clinical problem. Treatment goals include the eradication of infection and preservation of maximal joint function. Bony debridement may be necessary in addition to elbow joint arthroplasty. The use of synthetic material or allograft as the arthroplasty material may be contraindicated in the setting of infection. The use of free muscle transfer as an arthroplasty medium has not been well described. A 22-year-old paraplegic man developed recurrent osteomyelitis of the right elbow, necessitating extensive bony debridement by the orthopedic surgery team. Reconstruction arthroplasty was performed using a free rectus abdominis muscle flap as the arthroplasty material to serve as a source of biologically active, well-vascularized arthroplasty medium in the presence of ongoing infection. A successful free muscle flap arthroplasty was performed. External fixation and physical therapy were implemented postoperatively. The patient had resolution of osteomyelitis and excellent functional use of the elbow for activities of daily living and wheelchair motion. Elbow arthroplasty in the setting of active infection may be accomplished by means of free tissue muscle transfer. Elimination of infection and acceptable joint function may be possible with this form of reconstruction.

Treatment options for diabetic foot osteomyelitis.

PubMed

Senneville, Eric; Robineau, Olivier

2017-06-01

Diabetic foot osteomyelitis therapeutical options are based on antibiotic therapy and surgical resection of the infected bone(s). Surgical and medical approaches of patients suffering from a diabetic foot osteomyelitis do not oppose but are complementary and need to be discussed as a tailored manner. Areas covered: The aim of the present article is to discuss data issued from the most recent guidelines of the Infectious Diseases Society of America and the International Working Group on the Diabetic Foot on the management of the diabetic foot infection and from a search in the current literature using the terms diabetic foot osteomyelitis and treatment/therapy/therapeutical in both PubMed and Medline, restricted to the last five years. Expert opinion: Surgical removal of the entire infected bone(s) has been considered in the past as the standard treatment but medical approach of these patients has now proven efficacy in selected situations. The current emergence of bacteria, especially among Gram negative rods, resistant to almost all the available antibiotics gradually augments the complexity of the management of these patients and is likely to decrease the place of the medical approach and to worsen the outcome of these infections in the next future.

Using a theory driven approach to develop and evaluate a complex mental health intervention: the friendship bench project in Zimbabwe.

PubMed

Chibanda, Dixon; Verhey, Ruth; Munetsi, Epiphany; Cowan, Frances M; Lund, Crick

2016-01-01

There is a paucity of data on how to deliver complex interventions that seek to reduce the treatment gap for mental disorders, particularly in sub-Saharan Africa. The need for well-documented protocols which clearly describe the development and the scale-up of programs and interventions is necessary if such interventions are to be replicated elsewhere. This article describes the use of a theory of change (ToC) model to develop a brief psychological intervention for common mental disorders and its' evaluation through a cluster randomized controlled trial in Zimbabwe. A total of eight ToC workshops were held with a range of stakeholders over a 6-month period with a focus on four key components of the program: formative work, piloting, evaluation and scale-up. A ToC map was developed as part of the process with defined causal pathways leading to the desired impact. Interventions, indicators, assumptions and rationale for each point along the causal pathway were considered. Political buy-in from stakeholders together with key resources, which included human, facility/infrastructure, communication and supervision were identified as critical needs using the ToC approach. Ten (10) key interventions with specific indicators, assumptions and rationale formed part of the final ToC map, which graphically illustrated the causal pathway leading to the development of a psychological intervention and the successful implementation of a cluster randomized controlled trial. ToC workshops can enhance stakeholder engagement through an iterative process leading to a shared vision that can improve outcomes of complex mental health interventions particularly where scaling up of the intervention is desired.

Border control: selectivity of chloroplast protein import and regulation at the TOC-complex

PubMed Central

Demarsy, Emilie; Lakshmanan, Ashok M.; Kessler, Felix

2014-01-01

Plants have evolved complex and sophisticated molecular mechanisms to regulate their development and adapt to their surrounding environment. Particularly the development of their specific organelles, chloroplasts and other plastid-types, is finely tuned in accordance with the metabolic needs of the cell. The normal development and functioning of plastids require import of particular subsets of nuclear encoded proteins. Most preproteins contain a cleavable sequence at their N terminal (transit peptide) serving as a signal for targeting to the organelle and recognition by the translocation machinery TOC–TIC (translocon of outer membrane complex–translocon of inner membrane complex) spanning the dual membrane envelope. The plastid proteome needs constant remodeling in response to developmental and environmental factors. Therefore selective regulation of preprotein import plays a crucial role in plant development. In this review we describe the diversity of transit peptides and TOC receptor complexes, and summarize the current knowledge and potential directions for future research concerning regulation of the different Toc isoforms. PMID:25278954

Integrated Transitions of Care for Patients With Rare Pulmonary Diseases.

PubMed

Moreo, Kathleen; Lattimer, Cheri; Lett, James E; Heggen-Peay, Cherilyn L; Simone, Laura

Many continuing education (CE) resources are available to support case management professionals in developing competencies in transitions of care (TOC) that apply generally across disease areas. However, CE programs and tools are lacking for advanced TOC competencies in specific disease areas. This article describes 2 projects in which leading TOC, case management, and CE organizations collaborated to develop CE-accredited interdisciplinary pathways for promoting safe and effective TOC for patients with rare pulmonary diseases, including pulmonary arterial hypertension (PAH) and idiopathic pulmonary fibrosis (IPF). The interdisciplinary pathways apply to PAH and IPF case management practice and TOC across settings that include community-based primary care and specialty care, PAH or IPF centers of expertise, acute care and post-acute settings, long-term care, rehabilitation and skilled nursing facilities, and patients' homes. Both PAH and IPF are chronic, progressive respiratory diseases that are associated with severe morbidity and mortality, along with high health care costs. Because they are relatively rare diseases with nonspecific symptoms and many comorbidities, PAH and IPF are difficult to diagnose. Early diagnosis, referral to centers of expertise, and aggressive treatment initiation are essential for slowing disease progression and maintaining quality of life and function. Both the rarity and complexity of PAH and IPF pose unique challenges to ensuring effective and safe TOC. Expert consensus and evidence-based approaches to meeting these challenges, and thereby improving PAH and IPF patient outcomes, are presented in the 2 interdisciplinary TOC pathways that are described in this article. In coordinating care for patients with complex pulmonary diseases such as PAH and IPF, case managers across practice settings can play key roles in improving workflow processes and communication, transition planning, coordinating TOC with centers of expertise, coordinating care and TOC for patients with comorbidities, providing patient and caregiver education, promoting engagement between patients and the team, advancing the care plan, and improving ongoing adherence to treatment in order to maximize the patient's pulmonary function. Details regarding these interprofessional roles and responsibilities are provided in the full interdisciplinary TOC pathways for PAH and IPF.

An Overview of Internal and External Fixation Methods for the Diabetic Charcot Foot and Ankle.

PubMed

Ramanujam, Crystal L; Zgonis, Thomas

2017-01-01

Diabetic Charcot neuroarthropathy (DCN) of the foot and ankle is a challenging disease with regard to clinical presentation, pathogenesis, and prognosis. Its surgical management is equally difficult to interpret based on the wide array of options available. In the presence of an ulceration or concomitant osteomyelitis, internal fixation by means of screws, plates, or intramedullary nailing needs to be avoided when feasible. External fixation becomes a great surgical tool when managing DCN with concomitant osteomyelitis. This article describes internal and external fixation methods along with available literature to enlighten surgeons faced with treating this complex condition. Copyright © 2016 Elsevier Inc. All rights reserved.

Chloroplast Omp85 proteins change orientation during evolution

PubMed Central

Sommer, Maik S.; Daum, Bertram; Gross, Lucia E.; Weis, Benjamin L. M.; Mirus, Oliver; Abram, Lars; Maier, Uwe-G.; Kühlbrandt, Werner; Schleiff, Enrico

2011-01-01

The majority of outer membrane proteins (OMPs) from Gram-negative bacteria and many of mitochondria and chloroplasts are β-barrels. Insertion and assembly of these proteins are catalyzed by the Omp85 protein family in a seemingly conserved process. All members of this family exhibit a characteristic N-terminal polypeptide-transport–associated (POTRA) and a C-terminal 16-stranded β-barrel domain. In plants, two phylogenetically distinct and essential Omp85's exist in the chloroplast outer membrane, namely Toc75-III and Toc75-V. Whereas Toc75-V, similar to the mitochondrial Sam50, is thought to possess the original bacterial function, its homolog, Toc75-III, evolved to the pore-forming unit of the TOC translocon for preprotein import. In all current models of OMP biogenesis and preprotein translocation, a topology of Omp85 with the POTRA domain in the periplasm or intermembrane space is assumed. Using self-assembly GFP-based in vivo experiments and in situ topology studies by electron cryotomography, we show that the POTRA domains of both Toc75-III and Toc75-V are exposed to the cytoplasm. This unexpected finding explains many experimental observations and requires a reevaluation of current models of OMP biogenesis and TOC complex function. PMID:21825140

Osteomyelitis of the head and neck: sequential radionuclide scanning in diagnosis and therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Strauss, M.; Kaufman, R.A.; Baum, S.

1985-01-01

Sequential technetium and gallium scans of the head and neck were used to confirm the diagnosis of osteomyelitis and as an important therapeutic aid to delineate the transformation of active osteomyelitis to inactive osteomyelitis in 11 cases involving sites in the head and neck. Illustrative cases are presented of frontal sinus and cervical spine osteomyelitis and laryngeal osteochondritis.

The pore structure and fractal characteristics of shales with low thermal maturity from the Yuqia Coalfield, northern Qaidam Basin, northwestern China

NASA Astrophysics Data System (ADS)

Hou, Haihai; Shao, Longyi; Li, Yonghong; Li, Zhen; Zhang, Wenlong; Wen, Huaijun

2018-03-01

The continental shales from the Middle Jurassic Shimengou Formation of the northern Qaidam Basin, northwestern China, have been investigated in recent years because of their shale gas potential. In this study, a total of twenty-two shale samples were collected from the YQ-1 borehole in the Yuqia Coalfield, northern Qaidam Basin. The total organic carbon (TOC) contents, pore structure parameters, and fractal characteristics of the samples were investigated using TOC analysis, low-temperature nitrogen adsorption experiments, and fractal analysis. The results show that the average pore size of the Shimengou shales varied from 8.149 nm to 20.635 nm with a mean value of 10.74 nm, which is considered mesopore-sized. The pores of the shales are mainly inkbottle- and slit-shaped. The sedimentary environment plays an essential role in controlling the TOC contents of the low maturity shales, with the TOC values of shales from deep to semi-deep lake facies (mean: 5.23%) being notably higher than those of the shore-shallow lake facies (mean: 0.65%). The fractal dimensions range from 2.4639 to 2.6857 with a mean of 2.6122, higher than those of marine shales, which indicates that the pore surface was rougher and the pore structure more complex in these continental shales. The fractal dimensions increase with increasing total pore volume and total specific surface area, and with decreasing average pore size. With increasing TOC contents in shales, the fractal dimensions increase first and then decrease, with the highest value occurring at 2% of TOC content, which is in accordance with the trends between the TOC and both total specific surface area and total pore volume. The pore structure complexity and pore surface roughness of these low-maturity shales would be controlled by the combined effects of both sedimentary environments and the TOC contents.

Non-contiguous multifocal vertebral osteomyelitis caused by Serratia marcescens.

PubMed

Lau, Jen Xin; Li, Jordan Yuanzhi; Yong, Tuck Yean

2015-03-01

Serratia marcescens is a common nosocomial infection but a rare cause of osteomyelitis and more so of vertebral osteomyelitis. Vertebral osteomyelitis caused by this organism has been reported in few studies. We report a case of S. marcescens vertebral discitis and osteomyelitis affecting multiple non-contiguous vertebras. Although Staphylococcus aureus is the most common cause of vertebral osteomyelitis, rare causes, such as S. marcescens, need to be considered, especially when risk factors such as intravenous heroin use, post-spinal surgery and immunosuppression are present. Therefore, blood culture and where necessary biopsy of the infected region should be undertaken to establish the causative organism and determine appropriate antibiotic susceptibility. Prompt diagnosis of S. marcescens vertebral osteomyelitis followed by the appropriate treatment can achieve successful outcomes.

Osteomyelitis

MedlinePlus

... to need IV or oral (taken by mouth) antibiotics at home for several more weeks. Most teens recover completely from osteomyelitis. Can I Prevent Osteomyelitis? The easiest way to prevent yourself from getting osteomyelitis is to practice good hygiene. If you get a cut or a ...

Dynamic generation of a table of contents with consumer-friendly labels.

PubMed

Miller, Trudi; Leroy, Gondy; Wood, Elizabeth

2006-01-01

Consumers increasingly look to the Internet for health information, but available resources are too difficult for the majority to understand. Interactive tables of contents (TOC) can help consumers access health information by providing an easy to understand structure. Using natural language processing and the Unified Medical Language System (UMLS), we have automatically generated TOCs for consumer health information. The TOC are categorized according to consumer-friendly labels for the UMLS semantic types and semantic groups. Categorizing phrases by semantic types is significantly more correct and relevant. Greater correctness and relevance was achieved with documents that are difficult to read than those at an easier reading level. Pruning TOCs to use categories that consumers favor further increases relevancy and correctness while reducing structural complexity.

Nanocidals therapy for osteomyelitis

NASA Astrophysics Data System (ADS)

Qadri, Shahnaz Majid

Infection is a major medical problem that causes serious complications including patient death. The mortality rate of invasive infection has reduced significantly since the introduction of antibiotherapy. However, the resistance to antibiotic is becoming a serious medical problem that resulted in high medical cost. The overall aim of this study is to evaluate a potential inorganic route (metalo-antibiotic) to treat localized infections that require long-term antibiotic treatment combined with medical and surgical intervention. In this study osteomyelitis (bone infection) was selected as a model to evaluate the inorganic route to treat infection. Osteomyelitis is a progressive infection that could result in amputation and patient death. The metalo-antibiotics are faster to develop than antibiotics and have shown great efficacy against a wide range of bacterial infection. A unique composition of particles with ability to extend their residual efficacy on bacteria for an extended time compared to conventional antibiotics was synthesized and evaluated in this study. The in vitro experiments demonstrated the metalo-antibiotics to treat cellular internal infections without damaging the home cell. The in vivo toxicity experiments demonstrated a tolerance of the particles for doses that are 20 times higher than the anticipated treatment dose. A murine mouse model for osteomyelitis was developed. The efficacy of the metalo-antibiotics on the induced osteomyelitis was evaluated. A significant decrease in infection in the bones treated with nanoparticles was observed. By delivering optimal concentration of nanoparticles in mouse models there was no sign of pathology seen in mouse. Overall, this study has two main impacts: a) creation of inorganic routes to fight against bacterial infection particularly those requiring long-term antibiotic or surgical treatment b) reduction of critical technical risk through generation of pre-clinical data of the employment of inorganic antibacterial complexes.

Histopathologic characteristics of bone infection complicating foot ulcers in diabetic patients.

PubMed

Cecilia-Matilla, Almudena; Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; García-Morales, Esther; García-Álvarez, Yolanda; Beneit-Montesinos, Juan Vicente

2013-01-01

A universally accepted histopathologic classification of diabetic foot osteomyelitis does not currently exist. We sought to evaluate the histopathologic characteristics of bone infection found in the feet of diabetic patients and to analyze the clinical variables related to each type of bone infection. We conducted an observational prospective study of 165 diabetic patients with foot ulcers who underwent surgery for bone infection. Samples for microbiological and histopathologic analyses were collected in the operating room under sterile conditions. We found four histopathologic types of osteomyelitis: acute osteomyelitis (n = 46; 27.9%), chronic osteomyelitis (n = 73; 44.2%), chronic acute osteomyelitis (n = 14; 8.5%), and fibrosis (n =32; 19.4%). The mean ± SD time between the initial detection of ulcer and surgery was 15.4 ± 23 weeks for acute osteomyelitis, 28.6 ± 22.4 weeks for chronic osteomyelitis, 35 ± 31.3 weeks for chronic acute osteomyelitis, and 27.5 ± 27.3 weeks for the fibrosis stage (analysis of variance: P = .03). Bacteria were isolated and identified in 40 of 46 patients (87.0%) with acute osteomyelitis, 61 of 73 (83.5%) with chronic osteomyelitis, 11 of 14 (78.6%) with chronic acute osteomyelitis, and 25 of 32 (78.1%) with fibrosis. Histopathologic categorization of bone infections in the feet of diabetic patients should include four groups: acute, chronic, chronic acute, and fibrosis. We suggest that new studies should identify cases of fibrosis to allow comparison with the present results.

Evaluations of Structural Interventions for HIV Prevention: A Review of Approaches and Methods.

PubMed

Iskarpatyoti, Brittany S; Lebov, Jill; Hart, Lauren; Thomas, Jim; Mandal, Mahua

2018-04-01

Structural interventions alter the social, economic, legal, political, and built environments that underlie processes affecting population health. We conducted a systematic review of evaluations of structural interventions for HIV prevention in low- and middle-income countries (LMICs) to better understand methodological and other challenges and identify effective evaluation strategies. We included 27 peer-reviewed articles on interventions related to economic empowerment, education, and substance abuse in LMICs. Twenty-one evaluations included clearly articulated theories of change (TOCs); 14 of these assessed the TOC by measuring intermediary variables in the causal pathway between the intervention and HIV outcomes. Although structural interventions address complex interactions, no evaluation included methods designed to evaluate complex systems. To strengthen evaluations of structural interventions, we recommend clearly articulating a TOC and measuring intermediate variables between the predictor and outcome. We additionally recommend adapting study designs and analytic methods outside traditional epidemiology to better capture complex results, influences external to the intervention, and unintended consequences.

An Overview of the Percutaneous Antibiotic Delivery Technique for Osteomyelitis Treatment and a Case Study of Calcaneal Osteomyelitis.

PubMed

Karr, Jeffrey C

2017-11-01

A percutaneous antibiotic delivery technique (PAD-T) used for the adjunctive management of osteomyelitis is presented. This surgical technique incorporates a calcium sulfate and hydroxyapatite (calcium phosphate) bone void filler acting as a carrier vehicle with either an antibiotic or an antifungal medicine, delivering this combination directly into the area of osteomyelitis. The benefit of the PAD-T is reviewed with a case presentation of a successfully treated calcaneal osteomyelitis. No previously reported PAD-T using a simple bone cortex incision in the adjunctive treatment of osteomyelitis has been reported. The PAD-T safely and effectively uses a calcium sulfate and hydroxyapatite bone void filler carrier vehicle to deliver either an antibiotic or an antifungal medicine directly into the area of osteomyelitis.

Tandem duplications of a degenerated GTP-binding domain at the origin of GTPase receptors Toc159 and thylakoidal SRP

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hernandez Torres, Jorge; Maldonado, Monica Alexandra Arias; Chomilier, Jacques

2007-12-14

The evolutionary origin of some nuclear encoded proteins that translocate proteins across the chloroplast envelope remains unknown. Therefore, sequences of GTPase proteins constituting the Arabidopsis thaliana translocon at the outer membrane of chloroplast (atToc) complexes were analyzed by means of HCA. In particular, atToc159 and related proteins (atToc132, atToc120, and atToc90) do not have proven homologues of prokaryotic or eukaryotic ancestry. We established that the three domains commonly referred to as A, G, and M originate from the GTPase G domain, tandemly repeated, and probably evolving toward an unstructured conformation in the case of the A domain. It resulted frommore » this study a putative common ancestor for these proteins and a new domain definition, in particular the splitting of A into three domains (A1, A2, and A3), has been proposed. The family of Toc159, previously containing A. thaliana and Pisum sativum, has been extended to Medicago truncatula and Populus trichocarpa and it has been revised for Oryza sativa. They have also been compared to GTPase subunits involved in the cpSRP system. A distant homology has been revealed among Toc and cpSRP GTP-hydrolyzing proteins of A. thaliana, and repetitions of a GTPase domain were also found in cpSRP protein receptors, by means of HCA analysis.« less

Approach to osteomyelitis treatment with antibiotic loaded PMMA.

PubMed

Wentao, Zhang; Lei, Guangyu; Liu, Yang; Wang, Wei; Song, Tao; Fan, Jinzhu

2017-01-01

To reduce the incidence of osteomyelitis infection, local antibiotic impregnated delivery systems are commonly used as a promising and effective approach to deliver high antibiotic concentrations at the infection site. The objective of this review was to provide a literature review regarding approach to osteomyelitis treatment with antibiotic loaded PMMA. Literature study regarding osteomyelitis treatment with antibiotic loaded carriers using key terms Antibiotic, osteomyelitis, biodegradable PMMA through published articles. Hands searching of bibliographies of identified articles were also undertaken. We concluded that Antibiotic-impregnated PMMA beads are useful options for the treatment of osteomyelitis for prolonged drug therapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Aspergillus vertebral osteomyelitis and ureteral obstruction after liver transplantation.

PubMed

Zhu, L-P; Chen, X-S; Wu, J-Q; Yang, F-F; Weng, X-H

2011-04-01

Aspergillus osteomyelitis has been reported as a result of dissemination in solid organ transplant recipients. Vertebral osteomyelitis is one of the most common forms of Aspergillus osteomyelitis. An Aspergillus fungal ball is a rare cause of ureteral obstruction. We describe an unusual case of simultaneous vertebral osteomyelitis and ureteral obstruction caused by A. flavus in a hepatic transplant recipient, who was successfully treated with sequential intravenous and oral itraconazole solution. © 2011 John Wiley & Sons A/S.

Twinning "Practices of Change" with "Theory of Change": Room for Emergence in Advocacy Evaluation

ERIC Educational Resources Information Center

Arensman, Bodille; van Waegeningh, Cornelie; van Wessel, Margit

2018-01-01

Theory of change (ToC) is currently "the" approach for the evaluation and planning of international development programs. This approach is considered especially suitable for complex interventions. We question this assumption and argue that ToC's focus on cause-effect logic and intended outcomes does not do justice to the recursive nature…

A possible case of Garre's sclerosing osteomyelitis from Medieval Tuscany (11th-12th centuries).

PubMed

Giuffra, Valentina; Vitiello, Angelica; Giusiani, Sara; Caramella, Davide; Fornaciari, Gino

2015-12-01

Archaeological excavations carried out at the castle of Monte di Croce near Florence brought to light a small cemetery complex belonging to the castle church, dated back to the 11th-12th centuries. An elite stone tomb contained the skeletal remains of a male aged 35-45 years with obvious pathology of the right tibia. The proximal metaphysis and the upper half of the diaphysis appear massively enlarged as a result of severe chronic periostitis. A transverse section illustrates complete obliteration of the medullary cavity by new spongy bone, with some large cavitations. The primary, but completely remodeled tibial shaft is still recognizable. This finding and the strong sclerotic reaction with some central cavitations rule out any form of bone tumor and indicate a chronic inflammatory disease. The morphological and radiological picture and the tibial localization suggest a diagnosis of chronic sclerosing osteomyelitis of Garré, a rare form of chronic osteomyelitis characterized by an intense periosteal reaction with little or no suppuration. Copyright © 2015. Published by Elsevier Inc.

Complexing agent and heavy metal removals from metal plating effluent by electrocoagulation with stainless steel electrodes.

PubMed

Kabdaşli, Işik; Arslan, Tülin; Olmez-Hanci, Tuğba; Arslan-Alaton, Idil; Tünay, Olcay

2009-06-15

In the present study, the treatability of a metal plating wastewater containing complexed metals originating from the nickel and zinc plating process by electrocoagulation using stainless steel electrodes was experimentally investigated. The study focused on the effect of important operation parameters on electrocoagulation process performance in terms of organic complex former, nickel and zinc removals as well as sludge production and specific energy consumption. The results indicated that increasing the applied current density from 2.25 to 9.0 mA/cm(2) appreciably enhanced TOC removal efficiency from 20% to 66%, but a further increase in the applied current density to 56.25 mA/cm(2) did not accelerate TOC removal rates. Electrolyte concentration did not affect the process performance significantly and the highest TOC reduction (66%) accompanied with complete heavy metal removals were achieved at the original chloride content ( approximately 1500 mg Cl/L) of the wastewater sample. Nickel removal performance was adversely affected by the decrease of initial pH from its original value of 6. Optimum working conditions for electrocoagulation of metal plating effluent were established as follows: an applied current density of 9 mA/cm(2), the effluent's original electrolyte concentration and pH of the composite sample. TOC removal rates obtained for all electrocoagulation runs fitted pseudo-first-order kinetics very well (R(2)>92-99).

38 CFR 4.43 - Osteomyelitis.

Code of Federal Regulations, 2013 CFR

2013-07-01

... DISABILITIES Disability Ratings The Musculoskeletal System § 4.43 Osteomyelitis. Chronic, or recurring, suppurative osteomyelitis, once clinically identified, including chronic inflammation of bone marrow, cortex...

38 CFR 4.43 - Osteomyelitis.

Code of Federal Regulations, 2012 CFR

2012-07-01

... DISABILITIES Disability Ratings The Musculoskeletal System § 4.43 Osteomyelitis. Chronic, or recurring, suppurative osteomyelitis, once clinically identified, including chronic inflammation of bone marrow, cortex...

38 CFR 4.43 - Osteomyelitis.

Code of Federal Regulations, 2011 CFR

2011-07-01

... DISABILITIES Disability Ratings The Musculoskeletal System § 4.43 Osteomyelitis. Chronic, or recurring, suppurative osteomyelitis, once clinically identified, including chronic inflammation of bone marrow, cortex...

38 CFR 4.43 - Osteomyelitis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... DISABILITIES Disability Ratings The Musculoskeletal System § 4.43 Osteomyelitis. Chronic, or recurring, suppurative osteomyelitis, once clinically identified, including chronic inflammation of bone marrow, cortex...

38 CFR 4.43 - Osteomyelitis.

Code of Federal Regulations, 2014 CFR

2014-07-01

... DISABILITIES Disability Ratings The Musculoskeletal System § 4.43 Osteomyelitis. Chronic, or recurring, suppurative osteomyelitis, once clinically identified, including chronic inflammation of bone marrow, cortex...

Developing a mental health care plan in a low resource setting: the theory of change approach.

PubMed

Hailemariam, Maji; Fekadu, Abebaw; Selamu, Medhin; Alem, Atalay; Medhin, Girmay; Giorgis, Tedla Wolde; DeSilva, Mary; Breuer, Erica

2015-09-28

Scaling up mental healthcare through integration into primary care remains the main strategy to address the extensive unmet mental health need in low-income countries. For integrated care to achieve its goal, a clear understanding of the organisational processes that can promote and hinder the integration and delivery of mental health care is essential. Theory of Change (ToC), a method employed in the planning, implementation and evaluation of complex community initiatives, is an innovative approach that has the potential to assist in the development of a comprehensive mental health care plan (MHCP), which can inform the delivery of integrated care. We used the ToC approach to develop a MHCP in a rural district in Ethiopia. The work was part of a cross-country study, the Programme for Improving Mental Health Care (PRIME) which focuses on developing evidence on the integration of mental health in to primary care. An iterative ToC development process was undertaken involving multiple workshops with stakeholders from diverse backgrounds that included representatives from the community, faith and traditional healers, community associations, non-governmental organisations, Zonal, Regional and Federal level government offices, higher education institutions, social work and mental health specialists (psychiatrists and psychiatric nurses). The objective of this study is to report the process of implementing the ToC approach in developing mental health care plan. A total of 46 persons participated in four ToC workshops. Four critical path dimensions were identified: community, health facility, administrative and higher level care organisation. The ToC participants were actively engaged in the process and the ToC encouraged strong commitment among participants. Key opportunities and barriers to implementation and how to overcome these were suggested. During the workshops, a map incorporating the key agreed outcomes and outcome indicators was developed and finalized later. The ToC approach was found to be an important component in the development of the MHCP and to encourage broad political support for the integration of mental health services into primary care. The method may have broader applicability in planning complex health interventions in low resource settings.

Acute osteomyelitis complicating a simple fracture. A case report.

PubMed

Drummond-Webb, J J; Schnaid, E

1983-11-26

Osteomyelitis complicating a simple fracture is unusual, but the reason for its rarity is unknown. We report on a 9-year-old Black boy who developed acute osteomyelitis after sustaining an acute simple fracture of the femur. The causative role of trauma in acute osteomyelitis is discussed and 'the relative resistance of healthy bone' questioned.

Case report 834: Chronic sclerosing osteomyelitis of the mandible with long bone periostitis.

PubMed

Stewart, A; Carneiro, R; Pollock, L; Shaw, D

1994-04-01

We present the case of a patient with primary chronic osteomyelitis of the mandible, the radiological appearance of which is compatible with a diagnosis of chronic sclerosing osteomyelitis. The accompanying femoral and tibial periosteal reactive new bone formation and the benign clinical course suggest that this presentation may represent a form of chronic multifocal osteomyelitis.

Critical Limb Ischemia in Association with Charcot Neuroarthropathy: Complex Endovascular Therapy for Limb Salvage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palena, Luis Mariano, E-mail: marianopalena@hotmail.com; Brocco, Enrico; Manzi, Marco

2013-05-09

Charcot neuroarthropathy is a low-incidence complication of diabetic foot and is associated with ankle and hind foot deformity. Patients who have not developed deep ulcers are managed with offloading and supportive bracing or orthopedic arthrodesis. In patients who have developed ulcers and severe ankle instability and deformity, below-the-knee amputation is often indicated, especially when deformity and cutaneous involvement result in osteomyelitis. Ischemic association has not been described but can be present as a part of peripheral arterial disease in the diabetic population. In this extreme and advanced stage of combined neuroischemic diabetic foot disease, revascularization strategies can support surgical andmore » orthopedic therapy, thus preventing osteomyelitis and leading to limb and foot salvage.« less

The reverse sural artery fasciomusculocutaneous flap for small lower-limb defects: the use of the gastrocnemius muscle cuff as a plug for small bony defects following debridement of infected/necrotic bone.

PubMed

Al-Qattan, M M

2007-09-01

The reverse sural artery fasciomusculocutaneous flap is a modification of the original fasciocutaneous flap in which a midline gastrocnemius muscle cuff around the buried sural pedicle is included in the flap. This modification was done to improve the blood supply of the distal part of the flap, which is harvested from the upper leg. The aim of this paper is to demonstrate that there is another important advantage of the modified flap: the use of the muscle cuff as a "plug" for small lower limb defects following debridement of infected/necrotic bone. A total of 10 male adult patients with small complex lower-limb defects with underlying bone pathology were treated with the modified flap using the muscle component to fill up the small bony defects. The bony pathology included necrotic exposed bone without evidence of osteomyelitis or wound infection (n = 1), an underlying neglected tibial fracture with wound infection (n = 4), and a sinus at the heel with underlying calcaneal osteomyelitis (n = 5). Primary wound healing of the flap into the defect was noted in all patients. No recurrence of calcaneal osteomyelitis was seen and all tibial fractures united following appropriate orthopedic fixation. It was concluded that the reverse sural artery fasciomusculocutaneous flap is well suited for small complex lower-limb defects with underlying bone pathology.

Osteomyelitis - children

MedlinePlus

... 13th ed. Philadelphia, PA: Elsevier; 2017:chap 21. Kaplan SL. Osteomyelitis. In: Kliegman RM, Stanton BF, St. ... Krogstad P. Osteomyelitis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and ...

Utility of unenhanced fat-suppressed T1-weighted MRI in children with sickle cell disease -- can it differentiate bone infarcts from acute osteomyelitis?

PubMed

Delgado, Jorge; Bedoya, Maria A; Green, Abby M; Jaramillo, Diego; Ho-Fung, Victor

2015-12-01

Children with sickle cell disease (SCD) are at risk of bone infarcts and acute osteomyelitis. The clinical differentiation between a bone infarct and acute osteomyelitis is a diagnostic challenge. Unenhanced T1-W fat-saturated MR images have been proposed as a potential tool to differentiate bone infarcts from osteomyelitis. To evaluate the reliability of unenhanced T1-W fat-saturated MRI for differentiation between bone infarcts and acute osteomyelitis in children with SCD. We retrospectively reviewed the records of 31 children (20 boys, 11 girls; mean age 10.6 years, range 1.1-17.9 years) with SCD and acute bone pain who underwent MR imaging including unenhanced T1-W fat-saturated images from 2005 to 2010. Complete clinical charts were reviewed by a pediatric hematologist with training in infectious diseases to determine a clinical standard to define the presence or absence of osteomyelitis. A pediatric radiologist reviewed all MR imaging and was blinded to clinical information. Based on the signal intensity in T1-W fat-saturated images, the children were further classified as positive for osteomyelitis (low bone marrow signal intensity) or positive for bone infarct (high bone marrow signal intensity). Based on the clinical standard, 5 children were classified as positive for osteomyelitis and 26 children as positive for bone infarct (negative for osteomyelitis). The bone marrow signal intensity on T1-W fat-saturated imaging was not significant for the differentiation between bone infarct and osteomyelitis (P = 0.56). None of the additional evaluated imaging parameters on unenhanced MRI proved reliable in differentiating these diagnoses. The bone marrow signal intensity on unenhanced T1-W fat-saturated MR images is not a reliable criterion to differentiate bone infarcts from osteomyelitis in children.

[Definition of the Diagnosis Osteomyelitis-Osteomyelitis Diagnosis Score (ODS)].

PubMed

Schmidt, H G K; Tiemann, A H; Braunschweig, R; Diefenbeck, M; Bühler, M; Abitzsch, D; Haustedt, N; Walter, G; Schoop, R; Heppert, V; Hofmann, G O; Glombitza, M; Grimme, C; Gerlach, U-J; Flesch, I

2011-08-01

The disease "osteomyelitis" is characterised by different symptoms and parameters. Decisive roles in the development of the disease are played by the causative bacteria, the route of infection and the individual defense mechanisms of the host. The diagnosis is based on different symptoms and findings from the clinical history, clinical symptoms, laboratory results, diagnostic imaging, microbiological and histopathological analyses. While different osteomyelitis classifications have been published, there is to the best of our knowledge no score that gives information how sure the diagnosis "osteomyelitis" is in general. For any scientific study of a disease a valid definition is essential. We have developed a special osteomyelitis diagnosis score for the reliable classification of clinical, laboratory and technical findings. The score is based on five diagnostic procedures: 1) clinical history and risk factors, 2) clinical examination and laboratory results, 3) diagnostic imaging (ultrasound, radiology, CT, MRI, nuclear medicine and hybrid methods), 4) microbiology, and 5) histopathology. Each diagnostic procedure is related to many individual findings, which are weighted by a score system, in order to achieve a relevant value for each assessment. If the sum of the five diagnostic criteria is 18 or more points, the diagnosis of osteomyelitis can be viewed as "safe" (diagnosis class A). Between 8-17 points the diagnosis is "probable" (diagnosis class B). Less than 8 points means that the diagnosis is "possible, but unlikely" (class C diagnosis). Since each parameter can score six points at a maximum, a reliable diagnosis can only be achieved if at least 3 parameters are scored with 6 points. The osteomyelitis diagnosis score should help to avoid the false description of a clinical presentation as "osteomyelitis". A safe diagnosis is essential for the aetiology, treatment and outcome studies of osteomyelitis. © Georg Thieme Verlag KG Stuttgart · New York.

Clinical outcomes of osteomyelitis patients infected with methicillin-resistant Staphylococcus aureus USA-300 strains.

PubMed

Peyrani, P; Allen, M; Seligson, D; Roberts, C; Chen, A; Haque, N; Zervos, M; Wiemken, T; Harting, J; Christensen, D; Ramirez, R

2012-03-01

Methicillin-resistant Staphylococcus aureus (MRSA) USA-300 strains have emerged as an important cause of community-acquired infections. These strains have been recognized as an etiology of osteomyelitis but data on their incidence and outcomes are limited. We retrospectively studied the incidence and clinical outcomes of MRSA USA-300 osteomyelitis in patients at the University of Louisville Hospital and the Henry Ford Health System between January 2007 and March 2008. Pulsed-field gel electrophoresis was used to determine USA type. Clinical outcomes were defined as management success versus failure at 12 months. Chi-square tests, Fisher exact tests, and Mann-Whitney tests were used to compare patient characteristics on the basis of clinical outcomes and USA type. Of the 50 patients with MRSA osteomyelitis, 27 (54%) had the USA-300 strain. Clinical failure was identified in 22% (6/27) of the patients with MRSA USA-300 and in 30% (7/23) of the patients with MRSA non-USA-300 osteomyelitis (P = .509). Our results showed that MRSA USA-300 is a significant etiology of MRSA osteomyelitis. With current surgical and medical management, outcomes of patients with MRSA USA-300 osteomyelitis are similar to those of patients with MRSA non-USA-300 osteomyelitis.

Management of osteomyelitis of the skull base

DOE Office of Scientific and Technical Information (OSTI.GOV)

Benecke, J.E. Jr.

1989-12-01

Osteomyelitis of the skull base is the most severe form of malignant otitis externa. As a result of having treated 13 patients with skull base osteomyelitis over a 4-year period, we have developed a method of staging and monitoring this malady using gallium and technetium scanning techniques. Stage I is localized to soft tissues, stage II is limited osteomyelitis, and stage III represents extensive skull base osteomyelitis. All stages are treated with appropriate antipseudomonal antibiotics. The duration of therapy depends upon the clearing of inflammation as shown on the gallium scan. Each case must be looked at independently and notmore » subjected to an arbitrary treatment protocol.« less

Osteomyelitis: A Context for Wound Management.

PubMed

Groll, Mary E; Woods, Timothy; Salcido, Richard

2018-06-01

To provide an overview of osteomyelitis. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After completing this continuing education activity, you should be able to:1. Distinguish the pathogenesis of osteomyelitis in children and adults.2. Identify practical considerations for diagnosis and evidence-based treatment of osteomyelitis. This educational activity reviews the pathogenesis of osteomyelitis and discusses practical considerations for diagnosis, treatment, and functional rehabilitation of pediatric and adult patients with osteomyelitic wounds. Antibiotic, surgical, and adjunctive treatments will be addressed. Emphasis is placed on consulting with infectious disease specialists and using evidence-based guidelines for antibiotic prescribing.

Speechreading development in deaf and hearing children: introducing a new Test of Child Speechreading (ToCS)

PubMed Central

Kyle, Fiona Elizabeth; Campbell, Ruth; Mohammed, Tara; Coleman, Mike; MacSweeney, Mairéad

2016-01-01

Purpose We describe the development of a new Test of Child Speechreading (ToCS) specifically designed for use with deaf and hearing children. Speechreading is a skill which is required for deaf children to access the language of the hearing community. ToCS is a deaf-friendly, computer-based test that measures child speechreading (silent lipreading) at three psycholinguistic levels: words, sentences and short stories. The aims of the study were to standardize ToCS with deaf and hearing children and investigate the effects of hearing status, age and linguistic complexity on speechreading ability. Method 86 severely and profoundly deaf and 91 hearing children aged between 5 and 14 years participated. The deaf children were from a range of language and communication backgrounds and their preferred mode of communication varied. Results: Speechreading skills significantly improved with age for both deaf and hearing children. There was no effect of hearing status on speechreading ability and deaf and hearing showed similar performance across all subtests on ToCS. Conclusions The Test of Child Speechreading (ToCS) is a valid and reliable assessment of speechreading ability in school-aged children that can be used to measure individual differences in performance in speechreading ability. PMID:23275416

Direct analysis of δ13C and concentration of dissolved organic carbon (DOC) in environmental samples by TOC-IRMS

NASA Astrophysics Data System (ADS)

Kirkels, Frédérique; Cerli, Chiara; Federherr, Eugen; Kalbitz, Karsten

2014-05-01

Dissolved organic carbon (DOC) plays an important role in carbon cycling in terrestrial and aquatic systems. Stable isotope analysis (delta 13C) of DOC could provide valuable insights in its origin, fluxes and environmental fate. Precise and routine analysis of delta 13C and DOC concentration are therefore highly desirable. A promising, new system has been developed for this purpose, linking a high-temperature combustion TOC analyzer trough an interface with a continuous flow isotope ratio mass spectrometer (Elementar group, Hanau, Germany). This TOC-IRMS system enables simultaneous stable isotope (bulk delta 13C) and concentration analysis of DOC, with high oxidation efficiency by high-temperature combustion for complex mixtures as natural DOC. To give delta 13C analysis by TOC-IRMS the necessary impulse for broad-scale application, we present a detailed evaluation of its analytical performance for realistic and challenging conditions inclusive low DOC concentrations and environmental samples. High precision (standard deviation, SD predominantly < 0.15 permil) and accuracy (R2 = 0.9997, i.e. comparison TOC-IRMS and conventional EA-IRMS) were achieved by TOC-IRMS for a broad diversity of DOC solutions. This precision is comparable or even slightly better than that typically reported for EA-IRMS systems, and improves previous techniques for δ13C analysis of DOC. Simultaneously, very good precision was obtained for DOC concentration measurements. Assessment of natural abundance and slightly 13C enriched DOC, a wide range of concentrations (0.2-150 mgC/L) and injection volumes (0.05-3 ml), demonstrated good analytical performance with negligible memory effects, no concentration/volume effects and a wide linearity. Low DOC concentrations (< 2 mgC/L), were correctly analyzed without any pre-concentration. Moreover, TOC-IRMS was successfully applied to analyze DOC from diverse terrestrial, freshwater and marine environments (SD < 0.23 permil). In summary, the TOC-IRMS performs fast and reliable analysis of DOC concentration and δ13C in aqueous samples, without any pre-concentration/freeze-drying. Flexible usage is highlighted by automated, online analysis, a variable injection volume, high throughput and no extensive maintenance. Sample analysis is simple, using small aliquots and with minimal sample preparation. Further investigations should focus on complex, saline matrices and very low DOC concentrations, to achieve a potential lower limit of 0.2 mgC/L. High-resolution, routine delta 13C analysis of DOC by TOC-IRMS offers opportunities for wide-scale application in terrestrial, freshwater and marine research to elucidate the role of DOC in biogeochemical processes and ecosystem functioning.

Free intra-osseous muscle transfer for treatment of chronic osteomyelitis.

PubMed

Lê Thua, Trung-Hau; Boeckx, Willy D; Zirak, Christophe; De Mey, Albert

2015-06-10

Chronic osteomyelitis is still a big reconstructive challenge. Even with standard care, therapeutic failures and recurrences are common. Multiple techniques of tissue transfer have increased the success rate. This study recommends free muscle transfers into the intramedullary bone cavities for treatment of chronic osteomyelitis. The review included 29 patients that were treated for chronic osteomyelitis. Osteomyelitis was located at the femur in four patients, the tibia in 22 patients, and the foot in three patients. Dead bone and scar tissue were replaced with durable free muscle flap with special attention to fill the dead space. The average age of these patients was 48.5 years old (range = 23-70 years old). The average duration of osteomyelitis was 8.2 years (range = 1-45 years). Gracilis was applied in 20 cases (69%), latissimus dorsi was used in five cases (17.2%), and rectus abdominis was performed in four cases (13.8%). There was one flap failure, one partial superficial flap necrosis, two arterial thrombosis, and one venous thrombosis. All the remaining 28 muscle flaps survived. From 1-10 years follow-up, there was one recurrence of the osteomyelitis in the distal end of the intra-medullary cavity of a femur after reconstructing using the gracilis flap. The present study demonstrated that free intramedullary muscle transfers are effective in providing a high rate of success in the treatment of chronic osteomyelitis. The secondary filling of the intramedullary cavity after extensive removal of all infected bony sequesters has proven to give a long-term arrest of chronic osteomyelitis.

The novel chloroplast outer membrane kinase KOC1 is a required component of the plastid protein import machinery.

PubMed

Zufferey, Mónica; Montandon, Cyrille; Douet, Véronique; Demarsy, Emilie; Agne, Birgit; Baginsky, Sacha; Kessler, Felix

2017-04-28

The biogenesis and maintenance of cell organelles such as mitochondria and chloroplasts require the import of many proteins from the cytosol, a process that is controlled by phosphorylation. In the case of chloroplasts, the import of hundreds of different proteins depends on translocons at the outer and inner chloroplast membrane (TOC and TIC, respectively) complexes. The essential protein TOC159 functions thereby as an import receptor. It has an N-terminal acidic (A-) domain that extends into the cytosol, controls receptor specificity, and is highly phosphorylated in vivo However, kinases that phosphorylate the TOC159 A-domain to enable protein import have remained elusive. Here, using co-purification with TOC159 from Arabidopsis , we discovered a novel component of the chloroplast import machinery, the regulatory kinase at the outer chloroplast membrane 1 (KOC1). We found that KOC1 is an integral membrane protein facing the cytosol and stably associates with TOC. Moreover, KOC1 phosphorylated the A-domain of TOC159 in vitro , and in mutant koc1 chloroplasts, preprotein import efficiency was diminished. koc1 Arabidopsis seedlings had reduced survival rates after transfer from the dark to the light in which protein import into plastids is required to rapidly complete chloroplast biogenesis. In summary, our data indicate that KOC1 is a functional component of the TOC machinery that phosphorylates import receptors, supports preprotein import, and contributes to efficient chloroplast biogenesis. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

The novel chloroplast outer membrane kinase KOC1 is a required component of the plastid protein import machinery

PubMed Central

Zufferey, Mónica; Montandon, Cyrille; Douet, Véronique; Demarsy, Emilie; Agne, Birgit; Baginsky, Sacha; Kessler, Felix

2017-01-01

The biogenesis and maintenance of cell organelles such as mitochondria and chloroplasts require the import of many proteins from the cytosol, a process that is controlled by phosphorylation. In the case of chloroplasts, the import of hundreds of different proteins depends on translocons at the outer and inner chloroplast membrane (TOC and TIC, respectively) complexes. The essential protein TOC159 functions thereby as an import receptor. It has an N-terminal acidic (A-) domain that extends into the cytosol, controls receptor specificity, and is highly phosphorylated in vivo. However, kinases that phosphorylate the TOC159 A-domain to enable protein import have remained elusive. Here, using co-purification with TOC159 from Arabidopsis, we discovered a novel component of the chloroplast import machinery, the regulatory kinase at the outer chloroplast membrane 1 (KOC1). We found that KOC1 is an integral membrane protein facing the cytosol and stably associates with TOC. Moreover, KOC1 phosphorylated the A-domain of TOC159 in vitro, and in mutant koc1 chloroplasts, preprotein import efficiency was diminished. koc1 Arabidopsis seedlings had reduced survival rates after transfer from the dark to the light in which protein import into plastids is required to rapidly complete chloroplast biogenesis. In summary, our data indicate that KOC1 is a functional component of the TOC machinery that phosphorylates import receptors, supports preprotein import, and contributes to efficient chloroplast biogenesis. PMID:28283569

Differentiating osteomyelitis from bone infarction in sickle cell disease.

PubMed

Wong, A L; Sakamoto, K M; Johnson, E E

2001-02-01

This brief review discusses one possible approach to evaluating the sickle cell patient with bone pain. The major differential diagnoses include osteomyelitis and bone infarction. Based on previous studies, we provide an approach to assessing and treating patients with the possible diagnosis of osteomyelitis. An algorithm has been provided, which emphasizes the importance of the initial history and physical examination. Specific radiographic studies are recommended to aid in making the initial assessment and to determine whether the patient has an infarct or osteomyelitis. Differentiating osteomyelitis from infarction in sickle cell patients remains a challenge for the pediatrician. This algorithm can be used as a guide for physicians who evaluate such patients in the acute care setting.

Oral Rehabilitation of an Osteopetrosis Patient with Osteomyelitis

PubMed Central

Celakil, Tamer; Dogan, Merve; Rohlig, Bilge Gokcen; Evlioglu, Gulumser; Keskin, Haluk

2016-01-01

Osteopetrosis is a congenital disorder characterized by increasing osteoclastic function resulting in osteomyelitis in the jaws. Orofacial findings in osteopetrosis patients are unerupted, malformed, or delayed teeth and many dental caries due to vulnerable enamel and dentin and osteomyelitis. Many reports have described that maxilla is an uncommon site of occurrence for osteomyelitis due to cortical bone morphology and collateral circulation. This report aims to discuss clinical features and prosthodontic management of a patient with clinical features of adult form of osteopetrosis and osteomyelitis in both jaws. The patient has reported better masticatory and speech efficiency with removable dentures in maxillary and mandibular jaw and also self-esteem improvement and family interaction. PMID:27148461

Oral Rehabilitation of an Osteopetrosis Patient with Osteomyelitis.

PubMed

Celakil, Tamer; Dogan, Merve; Rohlig, Bilge Gokcen; Evlioglu, Gulumser; Keskin, Haluk

2016-01-01

Osteopetrosis is a congenital disorder characterized by increasing osteoclastic function resulting in osteomyelitis in the jaws. Orofacial findings in osteopetrosis patients are unerupted, malformed, or delayed teeth and many dental caries due to vulnerable enamel and dentin and osteomyelitis. Many reports have described that maxilla is an uncommon site of occurrence for osteomyelitis due to cortical bone morphology and collateral circulation. This report aims to discuss clinical features and prosthodontic management of a patient with clinical features of adult form of osteopetrosis and osteomyelitis in both jaws. The patient has reported better masticatory and speech efficiency with removable dentures in maxillary and mandibular jaw and also self-esteem improvement and family interaction.

Criterion-related validity of the Test of Children's Speech sentence intelligibility measure for children with cerebral palsy and dysarthria.

PubMed

Hodge, Megan; Gotzke, Carrie Lynne

2014-08-01

To evaluate the criterion-related validity of the TOCS+ sentence measure (TOCS+, Hodge, Daniels & Gotzke, 2009 ) for children with dysarthria and CP by comparing intelligibility and rate scores obtained concurrently from the TOCS+ and from a conversational sample. Twenty children (3 to 10 years old) diagnosed with spastic cerebral palsy (CP) participated. Nineteen children also had a confirmed diagnosis of dysarthria. Children's intelligibility and speaking rate scores obtained from the TOCS+, which uses imitation of sets of randomly selected items ranging from 2-7 words (80 words in total) and from a contiguous 100-word conversational speech were compared. Mean intelligibility scores were 46.5% (SD = 26.4%) and 50.9% (SD = 19.1%) and mean rates in words per minute (WPM) were 90.2 (SD = 22.3) and 94.1 (SD = 25.6), respectively, for the TOCS+ and conversational samples. No significant differences were found between the two conditions for intelligibility or rate scores. Strong correlations were found between the TOCS+ and conversational samples for intelligibility (r = 0.86; p < 0.001) and WPM (r = 0.77; p < 0.001), supporting the criterion validity of the TOCS+ sentence task as a time efficient procedure for measuring intelligibility and rate in children with CP, with and without confirmed dysarthria. The results support the criterion validity of the TOCS+ sentence task as a time efficient procedure for measuring intelligibility and rate in children with CP, with and without confirmed dysarthria. Children varied in their relative performance on the two speaking tasks, reflecting the complexity of factors that influence intelligibility and rate scores.

Analysis of the cochlear amplifier fluid pump hypothesis.

PubMed

Zagadou, Brissi Franck; Mountain, David C

2012-04-01

We use analysis of a realistic three-dimensional finite-element model of the tunnel of Corti (ToC) in the middle turn of the gerbil cochlea tuned to the characteristic frequency (CF) of 4 kHz to show that the anatomical structure of the organ of Corti (OC) is consistent with the hypothesis that the cochlear amplifier functions as a fluid pump. The experimental evidence for the fluid pump is that outer hair cell (OHC) contraction and expansion induce oscillatory flow in the ToC. We show that this oscillatory flow can produce a fluid wave traveling in the ToC and that the outer pillar cells (OPC) do not present a significant barrier to fluid flow into the ToC. The wavelength of the resulting fluid wave launched into the tunnel at the CF is 1.5 mm, which is somewhat longer than the wavelength estimated for the classical traveling wave. This fluid wave propagates at least one wavelength before being significantly attenuated. We also investigated the effect of OPC spacing on fluid flow into the ToC and found that, for physiologically relevant spacing between the OPCs, the impedance estimate is similar to that of the underlying basilar membrane. We conclude that the row of OPCs does not significantly impede fluid exchange between ToC and the space between the row of OPC and the first row of OHC-Dieter's cells complex, and hence does not lead to excessive power loss. The BM displacement resulting from the fluid pumped into the ToC is significant for motion amplification. Our results support the hypothesis that there is an additional source of longitudinal coupling, provided by the ToC, as required in many non-classical models of the cochlear amplifier.

Chronic osteomyelitis correlates with increased risk of acute pancreatitis in a case-control study in Taiwan.

PubMed

Lai, Shih-Wei; Lai, Hsueh-Chou; Lin, Cheng-Li; Liao, Kuan-Fu; Tseng, Chun-Hung

2015-07-01

The objective of this study was to examine the relationship between chronic osteomyelitis and acute pancreatitis in Taiwan. This was a population-based case-control study utilizing the database of the Taiwan National Health Insurance Program. We identified 7678 cases aged 20-84 with newly diagnosed acute pancreatitis during the period of 1998 to 2011. From the same database, 30,712 subjects without diagnosis of acute pancreatitis were selected as controls. The cases and controls were matched with sex, age and index year of diagnosing acute pancreatitis. The odds ratio with 95% confidence interval of acute pancreatitis associated with chronic osteomyelitis was examined by the multivariable unconditional logistic regression analysis. After adjustment for multiple confounders, the multivariable analysis showed that the adjusted odds ratio of acute pancreatitis was 1.93 for subjects with chronic osteomyelitis (95% confidence interval 1.01, 3.69), when compared with subjects without chronic osteomyelitis. Chronic osteomyelitis correlates with increased risk of acute pancreatitis. Patients with chronic osteomyelitis should be carefully monitored about the risk of acute pancreatitis. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

[Acute osteomyelitis of the clavicle in the newborn infant: a case report].

PubMed

Allagui, M; Bellaaj, Z; Zrig, M; Abid, A; Koubaa, M

2014-02-01

Acute osteomyelitis of the clavicle accounts for less than 3% of osteomyelitis cases, with its usual location in the middle third. It may be hematogenous, due to contiguity, or secondary to catheterization of the subclavian vein or neck surgery. The diagnosis is often delayed, and clinical symptoms may simulate obstetric brachial plexus palsy in young children. We report a new case of osteomyelitis of the clavicle in a 30-day-old newborn. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Two hit hypothesis: an unusual complication following supra-pubic catheter insertion.

PubMed

Nason, G J; Looney, A T; Kelly, M E; McGuire, B B; Mulvin, D W

2014-01-01

Osteomyelitis is an inflammation of the bone caused by an infection. Though bone is normally resistant to bacterial infection, events including trauma, presence of foreign bodies including prosthesis can act as a nidus for infection. Osteomyelitis is a rare but recognised complication of radiotherapy. Osteomyelitis of the pubis has scarcely been reported as a complication following urological procedures- prostatectomy, sling surgery and catheterisation. We report a rare complication of a gentleman post radiotherapy presenting with delayed osteomyelitis of the pubis following supra-pubic catheterisation.

Does osteomyelitis in the feet of patients with diabetes really recur after surgical treatment? Natural history of a surgical series.

PubMed

Aragón-Sánchez, J; Lázaro-Martínez, J L; Hernández-Herrero, C; Campillo-Vilorio, N; Quintana-Marrero, Y; García-Morales, E; Hernández-Herrero, M J

2012-06-01

The aim of this study was to determine the rate of recurrence, reulceration and new episodes of osteomyelitis and the duration of postoperative antibiotic treatment in a prospective cohort of patients with diabetes who underwent conservative surgery for osteomyelitis. The prospective cohort included patients with diabetes and a definitive diagnosis of osteomyelitis who were admitted to the Diabetic Foot Unit (Surgery Department, La Paloma Hospital, Las Palmas de Gran Canaria, Spain) and underwent surgical treatment from 1 November 2007 to 30 May 2010. Eighty-one patients were operated on for osteomyelitis during the study period. Seven patients were lost to follow-up at different stages of the study. The median duration of follow-up was 101.8 weeks (quartile 1 = 56.6, quartile 3 = 126.7). Forty-eight patients (59.3%) underwent conservative surgery, 32 (39.5%) had minor amputations and there was one (1.2%) major amputation. Twenty patients (24.7%) required reoperation because of persistent infection. Postoperative antibiotic treatment over a median period of 36 days was provided. Wound healing was achieved by secondary intention for a median of 8 weeks. Sixty-five patients were available for follow-up after healing. The percentage of recurrence, reulceration, and new episodes of osteomyelitis was 4.6% (3/65), 43% (28/65) and 16.9% (11/65), respectively. Mortality during follow-up (excluding in-hospital deaths and patients lost to follow-up) was 13% (9/69). A low rate of recurrence of osteomyelitis after surgical treatment for osteomyelitis was achieved. Despite new episodes, our approach to managing this cohort of patients with diabetes and foot osteomyelitis achieved 98.8% limb salvage. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME)

PubMed Central

2014-01-01

Background The Theory of Change (ToC) approach has been used to develop and evaluate complex health initiatives in a participatory way in high income countries. Little is known about its use to develop mental health care plans in low and middle income countries where mental health services remain inadequate. Aims ToC workshops were held as part of formative phase of the Programme for Improving Mental Health Care (PRIME) in order 1) to develop a structured logical and evidence-based ToC map as a basis for a mental health care plan in each district; (2) to contextualise the plans; and (3) to obtain stakeholder buy-in in Ethiopia, India, Nepal, South Africa and Uganda. This study describes the structure and facilitator’s experiences of ToC workshops. Methods The facilitators of the ToC workshops were interviewed and the interviews were recorded, transcribed and analysed together with process documentation from the workshops using a framework analysis approach. Results Thirteen workshops were held in the five PRIME countries at different levels of the health system. The ToC workshops achieved their stated goals with the contributions of different stakeholders. District health planners, mental health specialists, and researchers contributed the most to the development of the ToC while service providers provided detailed contextual information. Buy-in was achieved from all stakeholders but valued more from those in control of resources. Conclusions ToC workshops are a useful approach for developing ToCs as a basis for mental health care plans because they facilitate logical, evidence based and contextualised plans, while promoting stakeholder buy in. Because of the existing hierarchies within some health systems, strategies such as limiting the types of participants and stratifying the workshops can be used to ensure productive workshops. PMID:24808923

Lumbar Aspergillus osteomyelitis mimicking pyogenic osteomyelitis in an immunocompetent adult.

PubMed

Yoon, Kyeong-Wook; Kim, Young-Jin

2015-04-01

Spinal Aspergillus osteomyelitis is rare and occurs mostly in immunocompromised patients, but especially very rare in immunocompetent adult. This report presents a case of lumbar vertebral osteomyelitis in immunocompetent adult. A 53-year-old male who had no significant medical history was admitted due to complaints of back pain radiating to the flank for the last 3 months, followed by a progressive motor weakness of both lower limbs. Lumbar magnetic resonance imaging (MRI) demonstrated osteomyelitis and diskitis, suspected to be a pyogenic condition rather than a tuberculosis infection. Despite antibiotic treatment for several weeks, the symptoms worsened, and finally, open surgery was performed. Surgical biopsy revealed an Aspergillus infection and medical treatment with amphotericin B was started. It can be diagnosed early through an MRI; biopsy is very important but difficult, and making the correct differential diagnosis is essential for avoiding unexpected complications. The authors report a case of lumbar Aspergillus osteomyelitis in an immunocompetent adult and reviewed previously described cases of spinal aspergillosis.

Rare case of Isolated Aspergillus Osteomyelitis of Toe: Presentation and Management.

PubMed

Pattanashetty, O B; B B, Dayanand; Bhavi, Shushrut B; Bami, Monish

2013-01-01

Fungal osteomyelitis is an uncommon diseases and generally present in an indolent fashion. Isolated bone affection due to fungi are rare and we present one such case with fungal osteomyelitis of terminal phalanx of second toe. We present a rare case of fungal osteomyelitis of right second toe in a 30 year old Indian female who presented with swelling of 8 months duration. Diagnosis was based on the histo-pathological report and culture showing Aspergillus growth. The patient was treated with surgical debridement and amphotericin-B was given for 6 weeks after debridement. There was no recurrence one year post surgery. Isolated Aspergillus osteomyelitis of the bone are very rare and mostly seen in immunocompromised patients and larger bones like spine, femur and tibia. Treatment with wound debridement and subsequently followed up with a course of Amphotericin-B for 6 weeks provided good results. There was no recurrence noted at 1 year follow up. Fungi should be kept in mind for differential diagnosis of osteomyelitis and culture should be appropriately ordered.

A secreted bacterial protease tailors the Staphylococcus aureus virulence repertoire to modulate bone remodeling during osteomyelitis

PubMed Central

Cassat, James E.; Hammer, Neal D.; Campbell, J. Preston; Benson, Meredith A.; Perrien, Daniel S.; Mrak, Lara N.; Smeltzer, Mark S.; Torres, Victor J.; Skaar, Eric P.

2013-01-01

Summary Osteomyelitis is a common manifestation of invasive Staphylococcus aureus infection. Pathogen-induced bone destruction limits antimicrobial penetration to the infectious focus and compromises treatment of osteomyelitis. To investigate mechanisms of S. aureus-induced bone destruction, we developed a murine model of osteomyelitis. Micro-computed tomography of infected femurs revealed that S. aureus triggers profound alterations in bone turnover. The bacterial regulatory locus sae was found to be critical for osteomyelitis pathogenesis, as Sae-regulated factors promote pathologic bone remodeling and intraosseous bacterial survival. Exoproteome analyses revealed the Sae-regulated protease aureolysin as a major determinant of the S. aureus secretome and identified the phenol soluble modulins as aureolysin-degraded, osteolytic peptides that trigger osteoblast cell death and bone destruction. These studies establish a murine model for pathogen-induced bone remodeling, define Sae as critical for osteomyelitis pathogenesis, and identify protease-dependent exoproteome remodeling as a major determinant of the staphylococcal virulence repertoire. PMID:23768499

Acute bacterial sternoclavicular osteomyelitis in a long-term renal transplant recipient

PubMed Central

Dounousi, Evangelia; Duni, Anila; Xiromeriti, Sofia; Pappas, Charalambos; Siamopoulos, Kostas C

2016-01-01

Kidney transplantation is the treatment of choice for a significant number of patients with end-stage renal disease. Although immunosuppression therapy improves graft and patient’s survival, it is a major risk factor for infection following kidney transplantation altering clinical manifestations of the infectious diseases and complicating both the diagnosis and management of renal transplant recipients (RTRs). Existing literature is very limited regarding osteomyelitis in RTRs. Sternoclavicular osteomyelitis is rare and has been mainly reported after contiguous spread of infection or direct traumatic seeding of the bacteria. We present an interesting case of acute, bacterial sternoclavicular osteomyelitis in a long-term RTR. Blood cultures were positive for Streptococcus mitis, while the portal entry site was not identified. Magnetic resonance imaging of the sternoclavicluar region and a three-phase bone scan were positive for sternoclavicular osteomyelitis. Eventually, the patient was successfully treated with Daptomycin as monotherapy. In the presence of immunosuppression, the transplant physician should always remain alert for opportunistic pathogens or unusual location of osteomyelitis. PMID:27358791

Acute bacterial sternoclavicular osteomyelitis in a long-term renal transplant recipient.

PubMed

Dounousi, Evangelia; Duni, Anila; Xiromeriti, Sofia; Pappas, Charalambos; Siamopoulos, Kostas C

2016-06-24

Kidney transplantation is the treatment of choice for a significant number of patients with end-stage renal disease. Although immunosuppression therapy improves graft and patient's survival, it is a major risk factor for infection following kidney transplantation altering clinical manifestations of the infectious diseases and complicating both the diagnosis and management of renal transplant recipients (RTRs). Existing literature is very limited regarding osteomyelitis in RTRs. Sternoclavicular osteomyelitis is rare and has been mainly reported after contiguous spread of infection or direct traumatic seeding of the bacteria. We present an interesting case of acute, bacterial sternoclavicular osteomyelitis in a long-term RTR. Blood cultures were positive for Streptococcus mitis, while the portal entry site was not identified. Magnetic resonance imaging of the sternoclavicluar region and a three-phase bone scan were positive for sternoclavicular osteomyelitis. Eventually, the patient was successfully treated with Daptomycin as monotherapy. In the presence of immunosuppression, the transplant physician should always remain alert for opportunistic pathogens or unusual location of osteomyelitis.

Analysis of accumulation of 99mTc-octreotide and 99mTc-EDDA/HYNIC-Tyr3-octreotide in the rat kidneys.

PubMed

Kopecky, Martin; Semecky, Vladimir; Trejtnar, Frantisek; Laznicek, Milan; Laznickova, Alice; Nachtigal, Petr; Decristoforo, Clemens; Mather, Stephen J; Mäcke, Helmut R

2004-02-01

The aim of this study was to compare renal handling and distribution of (99m)Tc-octreotide and (99m)Tc-EDDA/HYNIC-Tyr(3)-octreotide (HYNIC-TOC) in rats. In kidney perfusion experiments, the renal clearance value of (99m)Tc-octreotide was three times lower than that of (99m)Tc-EDDA/HYNIC-TOC. The predominant renal excretion of (99m)Tc-EDDA/HYNIC-TOC was associated with a high and long-term renal accumulation up to 48 hrs. Microautoradiographic results indicated that (99m)Tc-EDDA/HYNIC-TOC was retained mainly in the renal medulla within the cells of the collecting ducts and in the surrounding tissue. Lower positivity was found in the proximal and distal tubular cells. We conclude that the mechanism of renal accumulation of somatostatin analogues renal accumulation is complex and that proximal tubular reabsorption is probably not the main mechanism for uptake of (99m)Tc-EDDA/HYNIC-TOC in the kidneys. The presence of the somatostatin receptors, differences in the tonicity level within kidneys and other possible mechanisms could participate in their renal accumulation.

A simple approach to estimate daily loads of total, refractory, and labile organic carbon from their seasonal loads in a watershed.

PubMed

Ouyang, Ying; Grace, Johnny M; Zipperer, Wayne C; Hatten, Jeff; Dewey, Janet

2018-05-22

Loads of naturally occurring total organic carbons (TOC), refractory organic carbon (ROC), and labile organic carbon (LOC) in streams control the availability of nutrients and the solubility and toxicity of contaminants and affect biological activities through absorption of light and complex metals with production of carcinogenic compounds. Although computer models have become increasingly popular in understanding and management of TOC, ROC, and LOC loads in streams, the usefulness of these models hinges on the availability of daily data for model calibration and validation. Unfortunately, these daily data are usually insufficient and/or unavailable for most watersheds due to a variety of reasons, such as budget and time constraints. A simple approach was developed here to calculate daily loads of TOC, ROC, and LOC in streams based on their seasonal loads. We concluded that the predictions from our approach adequately match field measurements based on statistical comparisons between model calculations and field measurements. Our approach demonstrates that an increase in stream discharge results in increased stream TOC, ROC, and LOC concentrations and loads, although high peak discharge did not necessarily result in high peaks of TOC, ROC, and LOC concentrations and loads. The approach developed herein is a useful tool to convert seasonal loads of TOC, ROC, and LOC into daily loads in the absence of measured daily load data.

Osteomyelitis associated with Nocardiopsis composta in a dog.

PubMed

Salas, Elisa N; Royal, Debra; Kurz, Lance; Loy, J Dustin

2015-05-01

We report the first detection of Nocardiopsis composta in association with osteomyelitis in a young male miniature Australian shepherd dog. Findings included suppurative osteomyelitis containing intralesional Fite's acid fast bacilli, aerobic culture of branching Gram-positive rods, and positive identification via phenotypic analysis and 16S rDNA sequencing.

Is there a simple, definitive, and cost-effective way to diagnose osteomyelitis in the pressure ulcer patient?

PubMed

Larson, David L; Gilstrap, Jarom; Simonelic, Kevin; Carrera, Guillermo F

2011-02-01

Despite advances in managing pressure ulcers, there is still no definitive way to diagnose bone infection (osteomyelitis) short of open biopsy. An effective, less invasive diagnostic method might result in cost savings and improved care; however, needle aspiration, computed tomography scan, magnetic resonance imaging, ultrasound, and bone scans have proven unsatisfactory in predicting osteomyelitis. The authors reviewed preoperative radiologic studies of stage IV pressure ulcer patients and their bone biopsy results to determine which radiologic studies are most diagnostic for osteomyelitis. Patients (n = 44) having surgical débridement of stage IV ulcers with open bone biopsy after prior radiographic imaging (plain films, ultrasound, computed tomography, magnetic resonance imaging, and/or nuclear bone scans) were included. Studies were interpreted by a single musculoskeletal radiologist blinded to information from the medical record and following standard radiologic criteria for the diagnosis of osteomyelitis. The percentage of patients with biopsy-proven osteomyelitis identified with imaging was 50 percent using a computed tomography scan and 88 percent using a plain film of the bony area of involvement. The overall sensitivity of either radiologic study was 61 percent. The percentage of patients without osteomyelitis identified as not having the condition by imaging was 85 percent for the computed tomography scan and 32 percent for the plain film. Overall specificity of both studies was 69 percent. Preoperative radiologic studies for osteomyelitis in a pressure ulcer are far from definitive; however, if a radiologic study is used to make that diagnosis in a stage IV pressure ulcer, it would appear that a plain film would suffice.

Osteomyelitis associated with Nocardiopsis composta in a dog

PubMed Central

Salas, Elisa N.; Royal, Debra; Kurz, Lance; Loy, J. Dustin

2015-01-01

We report the first detection of Nocardiopsis composta in association with osteomyelitis in a young male miniature Australian shepherd dog. Findings included suppurative osteomyelitis containing intralesional Fite’s acid fast bacilli, aerobic culture of branching Gram-positive rods, and positive identification via phenotypic analysis and 16S rDNA sequencing. PMID:25969577

Rare case of Isolated Aspergillus Osteomyelitis of Toe: Presentation and Management

PubMed Central

Pattanashetty, O.B.; B.B., Dayanand; Bhavi, Shushrut B; Bami, Monish

2013-01-01

Introduction: Fungal osteomyelitis is an uncommon diseases and generally present in an indolent fashion. Isolated bone affection due to fungi are rare and we present one such case with fungal osteomyelitis of terminal phalanx of second toe. Case Report: We present a rare case of fungal osteomyelitis of right second toe in a 30 year old Indian female who presented with swelling of 8 months duration. Diagnosis was based on the histo-pathological report and culture showing Aspergillus growth. The patient was treated with surgical debridement and amphotericin-B was given for 6 weeks after debridement. There was no recurrence one year post surgery. Conclusion: Isolated Aspergillus osteomyelitis of the bone are very rare and mostly seen in immunocompromised patients and larger bones like spine, femur and tibia. Treatment with wound debridement and subsequently followed up with a course of Amphotericin-B for 6 weeks provided good results. There was no recurrence noted at 1 year follow up. Fungi should be kept in mind for differential diagnosis of osteomyelitis and culture should be appropriately ordered. PMID:27298903

Trichophyton rubrum osteomyelitis after calcaneus external fixation pin stabilization of a pilon fracture.

PubMed

Waryasz, Gregory R; Bariteau, Jason T

2014-01-01

Fungal organisms are an uncommon cause of osteomyelitis, and no dermatophyte osteomyelitis infections have been reported in published studies. We present the case of Trichophyton rubrum osteomyelitis of the calcaneus. Our patient initially presented with a pilon fracture requiring temporary external fixation while awaiting definitive fixation. From our review of the published data, the present case is the first of this type of fungal osteomyelitis to be reported. The patient was evaluated for a left neck mass during his hospitalization that was later found to be consistent with salivary duct carcinoma of the tail of the parotid gland. A left neck dissection and superficial excision of the parotid gland was performed after fixation of his pilon fracture. Subsequently, he developed an increasing lucency in the calcaneus and symptoms of pain and erythema months after the calcaneus pin had been removed. The osteomyelitis was treated with surgical debridement and 3 months of itraconazole once cultures had definitively grown T. rubrum. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Gentamicin-loaded borate bioactive glass eradicates osteomyelitis due to Escherichia coli in a rabbit model.

PubMed

Xie, Zongping; Cui, Xu; Zhao, Cunju; Huang, Wenhai; Wang, Jianqiang; Zhang, Changqing

2013-07-01

The treatment of osteomyelitis induced by Gram-negative bacilli is rarely reported in the literature. This study established a rabbit tibia model of osteomyelitis induced by the Gram-negative bacillus Escherichia coli. Using this model, pellets composed of a chitosan-bonded mixture of borate bioactive glass and gentamicin were evaluated in vitro and in vivo for the treatment of osteomyelitis induced by Escherichia coli. Our results showed that the pellets in phosphate-buffered saline released gentamicin continuously over 26 days. Without the simultaneous use of a systemic antibiotic, the implantation of the gentamicin-loaded pellets into the osteomyelitis region of the tibia resulted in the eradication of 81.82% of infections, as determined by microbiological, histological and radiographic evaluation, and supported the ingrowth of new bone into the tibia defects after 6 weeks of implantation. The results indicate that the gentamicin-loaded borate bioactive glass implant, combining sustained drug release with the ability to support new bone formation, could provide a method for treating osteomyelitis induced by Gram-negative bacilli.

Gentamicin-Loaded Borate Bioactive Glass Eradicates Osteomyelitis Due to Escherichia coli in a Rabbit Model

PubMed Central

Xie, Zongping; Cui, Xu; Zhao, Cunju; Huang, Wenhai; Wang, Jianqiang

2013-01-01

The treatment of osteomyelitis induced by Gram-negative bacilli is rarely reported in the literature. This study established a rabbit tibia model of osteomyelitis induced by the Gram-negative bacillus Escherichia coli. Using this model, pellets composed of a chitosan-bonded mixture of borate bioactive glass and gentamicin were evaluated in vitro and in vivo for the treatment of osteomyelitis induced by Escherichia coli. Our results showed that the pellets in phosphate-buffered saline released gentamicin continuously over 26 days. Without the simultaneous use of a systemic antibiotic, the implantation of the gentamicin-loaded pellets into the osteomyelitis region of the tibia resulted in the eradication of 81.82% of infections, as determined by microbiological, histological and radiographic evaluation, and supported the ingrowth of new bone into the tibia defects after 6 weeks of implantation. The results indicate that the gentamicin-loaded borate bioactive glass implant, combining sustained drug release with the ability to support new bone formation, could provide a method for treating osteomyelitis induced by Gram-negative bacilli. PMID:23629702

Aspergillus osteomyelitis: epidemiology, clinical manifestations, management, and outcome.

PubMed

Gamaletsou, Maria N; Rammaert, Blandine; Bueno, Marimelle A; Moriyama, Brad; Sipsas, Nikolaos V; Kontoyiannis, Dimitrios P; Roilides, Emmanuel; Zeller, Valerie; Prinapori, Roberta; Taj-Aldeen, Saad J; Brause, Barry; Lortholary, Olivier; Walsh, Thomas J

2014-05-01

The epidemiology, pathogenesis, diagnosis, and management of Aspergillus osteomyelitis are not well understood. Protocol-defined cases of Aspergillus osteomyelitis published in the English literature were reviewed for comorbidities, microbiology, mechanisms of infection, clinical manifestations, radiological findings, inflammatory biomarkers, antifungal therapy, and outcome. Among 180 evaluable patients, 127 (71%) were males. Possible predisposing medical conditions in 103 (57%) included pharmacological immunosuppression, primary immunodeficiency, and neutropenia. Seventy-three others (41%) had prior open fracture, trauma or surgery. Eighty (44%) followed a hematogenous mechanism, 58 (32%) contiguous infections, and 42 (23%) direct inoculation. Aspergillus osteomyelitis was the first manifestation of aspergillosis in 77%. Pain and tenderness were present in 80%. The most frequently infected sites were vertebrae (46%), cranium (23%), ribs (16%), and long bones (13%). Patients with vertebral Aspergillus osteomyelitis had more previous orthopedic surgery (19% vs 0%; P = 0.02), while those with cranial osteomyelitis had more diabetes mellitus (32% vs 8%; P = 0.002) and prior head/neck surgery (12% vs 0%; P = 0.02). Radiologic findings included osteolysis, soft-tissue extension, and uptake on T2-weighted images. Vertebral body Aspergillus osteomyelitis was complicated by spinal-cord compression in 47% and neurological deficits in 41%. Forty-four patients (24%) received only antifungal therapy, while 121 (67%) were managed with surgery and antifungal therapy. Overall mortality was 25%. Median duration of therapy was 90 days (range, 10-772 days). There were fewer relapses in patients managed with surgery plus antifungal therapy in comparison to those managed with antifungal therapy alone (8% vs 30%; P = 0.006). Aspergillus osteomyelitis is a debilitating infection affecting both immunocompromised and immunocompetent patients. The most common sites are vertebrae, ribs, and cranium. Based upon this comprehensive review, management of Aspergillus osteomyelitis optimally includes antifungal therapy and selective surgery to avoid relapse and to achieve a complete response. Copyright © 2013 The British Infection Association. All rights reserved.

Aspergillus Osteomyelitis: Epidemiology, Clinical Manifestations, Management, and Outcome

PubMed Central

Gamaletsou, Maria N.; Rammaert, Blandine; Bueno, Marimelle A.; Moriyama, Brad; Sipsas, Nikolaos V.; Kontoyiannis, Dimitrios P.; Roilides, Emmanuel; Zeller, Valerie; Prinapori, Roberta; Tajaldeen, Saad Jaber; Brause, Barry; Lortholary, Olivier; Walsh, Thomas J.

2014-01-01

Background The epidemiology, pathogenesis, diagnosis, and management of Aspergillus osteomyelitis are not well understood. Methods Protocol-defined cases of Aspergillus osteomyelitis published in the English literature were reviewed for comorbidities, microbiology, mechanisms of infection, clinical manifestations, radiological findings, inflammatory biomarkers, antifungal therapy, and outcome. Results Among 180 evaluable patients, 127 (71%) were males. Possible predisposing medical conditions in 103 (57%) included pharmacological immunosuppression, primary immunodeficiency, and neutropenia. Seventy-three others (41%) had prior open fracture, trauma or surgery. Eighty (44%) followed a hematogenous mechanism, 58 (32%) contiguous infections, and 42 (23%) direct inoculation. Aspergillus osteomyelitis was the first manifestation of aspergillosis in 77%. Pain and tenderness were present in 80%. The most frequently infected sites were vertebrae (46%), cranium (23%), ribs (16%), and long bones (13%). Patients with vertebral Aspergillus osteomyelitis had more previous orthopedic surgery (19% vs 0%; P=0.02), while those with cranial osteomyelitis had more diabetes mellitus (32% vs 8%; P=0.002) and prior head/neck surgery (12% vs 0%; P=0.02). Radiologic findings included osteolysis, soft-tissue extension, and uptake on T2-weighted images. Vertebral body Aspergillus osteomyelitis was complicated by spinal-cord compression in 47% and neurological deficits in 41%. Forty-four patients (24%) received only antifungal therapy, while 121(67%) were managed with surgery and antifungal therapy. Overall mortality was 25%. Median duration of therapy was 90 days (range, 10–772 days). There were fewer relapses in patients managed with surgery plus antifungal therapy in comparison to those managed with antifungal therapy alone (8% vs 30%; P=0.006). Conclusions Aspergillus osteomyelitis is a debilitating infection affecting both immunocompromised and immunocompetent patients. The most common sites are vertebrae, ribs, and cranium. Based upon this comprehensive review, management of Aspergillus osteomyelitis optimally includes antifungal therapy and selective surgery to avoid relapse and to achieve a complete response. PMID:24378282

Cryptococcal osteomyelitis: a report of 5 cases and a review of the recent literature.

PubMed

Medaris, Leigh Ann; Ponce, Brent; Hyde, Zane; Delgado, Dennis; Ennis, David; Lapidus, William; Larrison, Matthew; Pappas, Peter G

2016-06-01

Cryptococcus neoformans is a fungal pathogen associated with advanced HIV disease and other disorders associated with immune dysfunction. The pulmonary and the central nervous system are the most common manifestations of the disease. Localised osteomyelitis as the sole manifestation of extrapulmonary disease is rare. Herein, we present five cases of Cryptococcus osteomyelitis as the only manifestation of extrapulmonary disease. We also identified 84 additional cases of isolated cryptococcal osteomyelitis in the literature. Using these data, we have made some general recommendations regarding an approach to treatment of this uncommon clinical entity. © 2016 Blackwell Verlag GmbH.

Speechreading development in deaf and hearing children: introducing the test of child speechreading.

PubMed

Kyle, Fiona E; Campbell, Ruth; Mohammed, Tara; Coleman, Mike; Macsweeney, Mairéad

2013-04-01

In this article, the authors describe the development of a new instrument, the Test of Child Speechreading (ToCS), which was specifically designed for use with deaf and hearing children. Speechreading is a skill that is required for deaf children to access the language of the hearing community. ToCS is a deaf-friendly, computer-based test that measures child speechreading (silent lipreading) at 3 psycholinguistic levels: (a) Words, (b) Sentences, and (c) Short Stories. The aims of the study were to standardize the ToCS with deaf and hearing children and to investigate the effects of hearing status, age, and linguistic complexity on speechreading ability. Eighty-six severely and profoundly deaf children and 91 hearing children participated. All children were between the ages of 5 and 14 years. The deaf children were from a range of language and communication backgrounds, and their preferred mode of communication varied. Speechreading skills significantly improved with age for both groups of children. There was no effect of hearing status on speechreading ability, and children from both groups showed similar performance across all subtests of the ToCS. The ToCS is a valid and reliable assessment of speechreading ability in school-age children that can be used to measure individual differences in performance in speechreading ability.

Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran?

PubMed Central

Izadi, Morteza; Zamani, Mohammad Mahdi; Mousavi, Seyed Ahmad; Sadat, Seyed Mir Mostafa; Siami, Zeinab; Vais Ahmadi, Noushin; Jonaidi Jafari, Nematollah; Shirvani, Shahram; Majidi Fard, Mojgan; Imani Fooladi, Abbas Ali

2012-01-01

Background Pyogenic bacteria and especially Staphylococcus aurous (S. aurous) are the most common cause of chronic osteomyelitis. Not only treatment protocol of chronic osteomyelitis occasionally is amiss but also this malady responds to treatment difficultly. Objectives This study investigates antibiotic resistance pattern of S. aurous isolated from Iranian patients who suffer from chronic osteomyelitis by two methods: disk diffusion (Kirby bauyer) and E-test (Epsilometer test) to find Vancomycin susceptibility and MIC (Minimum inhibitory concentration). Patients and Methods One hundred and thirty one patients who suffer from chronic osteomyelitis which have been referred to both governmental and private hospitals at 2010 were tried out for culturing of osteomyelitis site (sites). Antibiotic susceptibility and MIC of isolated bacteria were investigated by Kirby bauyer and E-test respectively. Results Samples were collected from bone (73.4%), surrounding tissue (14.6%) and wound discharge (12%). S. aureus was isolated from 49.6% of the samples. According to disc diffusion, methicillin resistance S. aureus (MRSA) was 75% and Vancomycin resistance S. aurous (VRSA) was 0% and based on MIC, MRSA was 68.5% and VRSA was 0%. According to MIC experiments, maximum sensitivity was against to Vancomycin (90.2%) and ciprofloxacin (54.4%) respectively but based on disc diffusion, maximum sensitivity was against to Vancomycin (97.7%) and ciprofloxacin (43.2%), respectively (P = 0.001). E-test (9.8%) in comparison with Disc diffusion (2.3%) showed higher percent of intermediate susceptibility to Vancomycin (P = 0.017). Conclusions Comparison of antibiograms and MICs showed that Kirby bauyer technique especially for detection of VISA strains is not reliable comparison with E-test. Already VRSA strains have not detected in Iranian chronic osteomyelitis, Thus Vancomycin is the first choice for chronic osteomyelitis empirical therapy in Iran yet. PMID:23483042

Genetic Analysis of Gravity Signal Transduction in Arabidopsis Roots

NASA Astrophysics Data System (ADS)

Masson, Patrick; Strohm, Allison; Barker, Richard; Su, Shih-Heng

Like most other plant organs, roots use gravity as a directional guide for growth. Specialized cells within the columella region of the root cap (the statocytes) sense the direction of gravity through the sedimentation of starch-filled plastids (amyloplasts). Amyloplast movement and/or pressure on sensitive membranes triggers a gravity signal transduction pathway within these cells, which leads to a fast transcytotic relocalization of plasma-membrane associated auxin-efflux carrier proteins of the PIN family (PIN3 and PIN7) toward the bottom membrane. This leads to a polar transport of auxin toward the bottom flank of the cap. The resulting lateral auxin gradient is then transmitted toward the elongation zones where it triggers a curvature that ultimately leads to a restoration of vertical downward growth. Our laboratory is using strategies derived from genetics and systems biology to elucidate the molecular mechanisms that modulate gravity sensing and signal transduction in the columella cells of the root cap. Our previous research uncovered two J-domain-containing proteins, ARG1 and ARL2, as contributing to this process. Mutations in the corresponding paralogous genes led to alterations of root and hypocotyl gravitropism accompanied by an inability for the statocytes to develop a cytoplasmic alkalinization, relocalize PIN3, and transport auxin laterally, in response to gravistimulation. Both proteins are associated peripherally to membranes belonging to various compartments of the vesicular trafficking pathway, potentially modulating the trafficking of defined proteins between plasma membrane and endosomes. MAR1 and MAR2, on the other end, are distinct proteins of the plastidic outer envelope protein import TOC complex (the transmembrane channel TOC75 and the receptor TOC132, respectively). Mutations in the corresponding genes enhance the gravitropic defects of arg1. Using transformation-rescue experiments with truncated versions of TOC132 (MAR2), we have shown that the protein-import function of the complex, not the presence of a large acidic domain of TOC132 within the cytoplasm, is needed for gravity signal transduction. Furthermore, mutations in several genes encoding distinct members of the TOC complex also enhanced the gravitropic defect of arg1. Together, these data suggest that the TOC complex works indirectly in gravity signal transduction through its ability to target specific cytoplasmically synthesized proteins, possibly gravity signal transducers, into the plastid. We have used a proteomic strategy to identify root-tip proteins that are differentially expressed between wild type and mar2 mutant plants. The corresponding list of differentially expressed proteins, which includes a surprisingly small number of plastid-targeted molecules, mainly contains proteins that are predicted to be associated with distinct cellular compartments. Several of the corresponding genes were found to also be differentially expressed between wild type and mar2 mutant root tips at the transcriptional level, suggesting cross-talk between amyloplasts and nucleus in these cells. Some of the differentially represented proteins are encoded by genes that are differentially expressed in the root tip in response to gravistimulation, further suggesting their contribution to gravity signal transduction. Work in underway to elucidate their function and potential contribution to this pathway. This work was funded by grants from the National Science Foundation.

Treatment of Calcaneal Fracture With Severe Soft Tissue Injury and Osteomyelitis: A Case Report.

PubMed

Karns, Michael; Dailey, Steven K; Archdeacon, Michael T

2015-01-01

Advancements in surgical technique have resulted in the ability to reconstruct lower extremity injuries that would have previously been treated by amputation. Currently, a paucity of data is available specifically addressing limb amputation versus reconstruction for calcaneal fractures with severe soft tissue compromise. Reconstruction leaves the patient with their native limb; however, multiple surgeries, infections, chronic pain, and a poor functional outcome are very real possibilities. We present the case of a complex calcaneal fracture complicated by soft tissue injury and osteomyelitis that highlights the importance of shared decision-making between patient and surgeon when considering reconstruction versus amputation. This case exemplifies the need for open communication concerning the risks and benefits of treatment modalities while simultaneously considering the patient's expectations and desired outcomes. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Bone scintigraphy for neonatal osteomyelitis: simulation by extravasation of intravenous calcium

DOE Office of Scientific and Technical Information (OSTI.GOV)

Balsam, D.; Goldfarb, C.R.; Stringer, B.

Intravenously administered calcium gluconate has become increasingly popular in the treatment of neonatal tetany. Occasionally, extravasation results in cellulitis, leading to a clinical diagnosis of superimposed osteomyelitis. Osseous scintigraphy, as the accepted modality in the early detection of osteomyelitis, would tend to be used in this circumstance. This case illustrates a false-positive result, probably due to soft-tissue calcification.

Aspergillus vertebral osteomyelitis in immunocompetent patients.

PubMed

Sethi, Somika; Siraj, Fouzia; Kalra, Kl; Chopra, P

2012-03-01

Fungal infections are one of the important cause of morbidity and mortality in immunocompromised patients. Aspergillus vertebral osteomyelitis is extremely rare. We report two cases of aspergillus vertebral osteomyelitis in immunocompetent men in the absence of an underlying disorder. The clinical and radiological findings were suggestive of Pott's spine. The absolute CD4, CD8 counts and their ratio were normal. The HIV status was negative in both patients. Both patients underwent surgical decompression. The histopathology of tissue obtained were suggestive of aspergillus osteomyelitis. One patient had antifungal treatment for 3 months and was doing well at 1 year followup, whereas other patient did not turnup after 2 months.

Aspergillus vertebral osteomyelitis in immunocompetent patients

PubMed Central

Sethi, Somika; Siraj, Fouzia; Kalra, KL; Chopra, P

2012-01-01

Fungal infections are one of the important cause of morbidity and mortality in immunocompromised patients. Aspergillus vertebral osteomyelitis is extremely rare. We report two cases of aspergillus vertebral osteomyelitis in immunocompetent men in the absence of an underlying disorder. The clinical and radiological findings were suggestive of Pott's spine. The absolute CD4, CD8 counts and their ratio were normal. The HIV status was negative in both patients. Both patients underwent surgical decompression. The histopathology of tissue obtained were suggestive of aspergillus osteomyelitis. One patient had antifungal treatment for 3 months and was doing well at 1 year followup, whereas other patient did not turnup after 2 months. PMID:22448068

Mandibular osteomyelitis in children mimicking juvenile recurrent parotitis.

PubMed

Saarinen, Riitta T; Kolho, Kaija-Leena; Kontio, Risto; Saat, Riste; Salo, Eeva; Pitkäranta, Anne

2011-06-01

To describe pediatric cases with mandibular osteomyelitis initially diagnosed and treated as juvenile recurrent parotitis. We reviewed the patient data of all our pediatric patients treated at Helsinki University Central Hospital, a tertiary care hospital, between 1998 and 2010 who had the initial diagnosis of recurrent parotitis which in fact was osteomyelitis. Over a period of 12 years, six children (aged 5-17 years, five girls) presented with mandibular osteomyelitis primarily diagnosed as recurrent parotitis. Diagnostic delay ranged from 1.5 months to 6.0 years before the final diagnosis of mandibular osteomyelitis confirmed in MRI. Of the six cases undergoing biopsies, bacterial culture showed Actinomyces or Streptococcus viridans in four cases. All patients received antimicrobial treatment. Two received hyperbaric oxygen therapy with no resolution of symptoms. Debridement was performed in these two cases as well, and in the second case persistent symptoms led to bisphosphonate treatment. Juvenile parotitis is in most cases a clinical diagnosis, and treatment is symptomatic. In contrast, mandibular osteomyelitis is a severe disease requiring lengthy treatment. Because symptoms of these two entities may mimic each other, unclear cases require MRI. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Sternoclavicular Osteomyelitis in an Immunosuppressed Patient: A Case Report and Review of the Literature

PubMed Central

Khan, Kamran; Wozniak, Susan E.; Mehrabi, Erfan; Giannone, Anna Lucia; Dave, Mitul

2015-01-01

Patient: Male, 62 Final Diagnosis: Sternoclavicular osteomyelitis Symptoms: — Medication: — Clinical Procedure: Debridement Specialty: Infectious Diseases Objective: Rare disease Background: Sternoclavicular osteomyelitis is a rare disease, with less than 250 cases identified in the past 50 years. We present a rare case of sternoclavicular osteomyelitis in an immunosuppressed patient that developed from a conservatively treated dislocation. Case Report: A 62-year-old white man with a history of metastatic renal cell carcinoma presented to the emergency department (ED) with a dislocated left sternoclavicular joint. He was managed conservatively and subsequently discharged. However, over subsequent days he began to experience pain, fever, chills, and night sweats. He presented to the ED again and imaging revealed osteomyelitis. In the operating room, the wound was aggressively debrided and a wound vac (vacuum-assisted closure) was placed. He was diagnosed with sternoclavicular osteomyelitis and placed on a 6-week course of intravenous Nafcillin. Conclusions: Chemotherapy patients who sustain joint trauma normally associated with a low risk of infection should be monitored thoroughly, and the option to discontinue immunosuppressive therapy should be considered if signs of infection develop. PMID:26708708

Functional Specialization amongst the Arabidopsis Toc159 Family of Chloroplast Protein Import ReceptorsW⃞

PubMed Central

Kubis, Sybille; Patel, Ramesh; Combe, Jonathan; Bédard, Jocelyn; Kovacheva, Sabina; Lilley, Kathryn; Biehl, Alexander; Leister, Dario; Ríos, Gabino; Koncz, Csaba; Jarvis, Paul

2004-01-01

The initial stages of preprotein import into chloroplasts are mediated by the receptor GTPase Toc159. In Arabidopsis thaliana, Toc159 is encoded by a small gene family: atTOC159, atTOC132, atTOC120, and atTOC90. Phylogenetic analysis suggested that at least two distinct Toc159 subtypes, characterized by atToc159 and atToc132/atToc120, exist in plants. atTOC159 was strongly expressed in young, photosynthetic tissues, whereas atTOC132 and atTOC120 were expressed at a uniformly low level and so were relatively prominent in nonphotosynthetic tissues. Based on the albino phenotype of its knockout mutant, atToc159 was previously proposed to be a receptor with specificity for photosynthetic preproteins. To elucidate the roles of the other isoforms, we characterized Arabidopsis knockout mutants for each one. None of the single mutants had strong visible phenotypes, but toc132 toc120 double homozygotes appeared similar to toc159, indicating redundancy between atToc132 and atToc120. Transgenic complementation studies confirmed this redundancy but revealed little functional overlap between atToc132/atToc120 and atToc159 or atToc90. Unlike toc159, toc132 toc120 caused structural abnormalities in root plastids. Furthermore, when proteomics and transcriptomics were used to compare toc132 with ppi1 (a receptor mutant that is specifically defective in the expression, import, and accumulation of photosynthetic proteins), major differences were observed, suggesting that atToc132 (and atToc120) has specificity for nonphotosynthetic proteins. When both atToc159 and the major isoform of the other subtype, atToc132, were absent, an embryo-lethal phenotype resulted, demonstrating the essential role of Toc159 in the import mechanism. PMID:15273297

Repurposing the Nonsteroidal Anti-inflammatory Drug Diflunisal as an Osteoprotective, Antivirulence Therapy for Staphylococcus aureus Osteomyelitis.

PubMed

Hendrix, Andrew S; Spoonmore, Thomas J; Wilde, Aimee D; Putnam, Nicole E; Hammer, Neal D; Snyder, Daniel J; Guelcher, Scott A; Skaar, Eric P; Cassat, James E

2016-09-01

Staphylococcus aureus osteomyelitis is a common and debilitating invasive infection of bone. Treatment of osteomyelitis is confounded by widespread antimicrobial resistance and the propensity of bacteria to trigger pathological changes in bone remodeling that limit antimicrobial penetration to the infectious focus. Adjunctive therapies that limit pathogen-induced bone destruction could therefore limit morbidity and enhance traditional antimicrobial therapies. In this study, we evaluate the efficacy of the U.S. Food and Drug Administration-approved, nonsteroidal anti-inflammatory (NSAID) compound diflunisal in limiting S. aureus cytotoxicity toward skeletal cells and in preventing bone destruction during staphylococcal osteomyelitis. Diflunisal is known to inhibit S. aureus virulence factor production by the accessory gene regulator (agr) locus, and we have previously demonstrated that the Agr system plays a substantial role in pathological bone remodeling during staphylococcal osteomyelitis. Consistent with these observations, we find that diflunisal potently inhibits osteoblast cytotoxicity caused by S. aureus secreted toxins independently of effects on bacterial growth. Compared to commonly used NSAIDs, diflunisal is uniquely potent in the inhibition of skeletal cell death in vitro Moreover, local delivery of diflunisal by means of a drug-eluting, bioresorbable foam significantly limits bone destruction during S. aureus osteomyelitis in vivo Collectively, these data demonstrate that diflunisal potently inhibits skeletal cell death and bone destruction associated with S. aureus infection and may therefore be a useful adjunctive therapy for osteomyelitis. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Microbiology and management of joint and bone infections due to anaerobic bacteria.

PubMed

Brook, Itzhak

2008-03-01

To describes the microbiology, diagnosis, and management of septic arthritis and osteomyelitis due to anaerobic bacteria. The predominant anaerobes in arthritis are anaerobic Gram-negative bacilli (AGNB) including the Bacteroides fragilis group, Fusobacterium spp., Peptostreptococcus spp., and Propionibacterium acnes. Infection with P. acnes is associated with a prosthetic joint, previous surgery, and trauma. B. fragilis group is associated with distant infection, Clostridium spp. with trauma, and Fusobacterium spp. with oropharyngeal infection. Most cases of anaerobic arthritis, in contrast to anaerobic osteomyelitis, involved a single isolate, and most cases are secondary to hematogenous spread. The predominant anaerobes in osteomyelitis are Bacteroides, Peptostreptococcus, Fusobacterium, and Clostridium spp. as well as P. acnes. Conditions predisposing to bone infections are vascular disease, bites, contiguous infection, peripheral neuropathy, hematogenous spread, and trauma. Pigmented Prevotella and Porphyromonas spp. are mostly isolated in skull and bite infections, members of the B. fragilis group in hand and feet infections, and Fusobacterium spp. in skull, bite, and hematogenous long bone infections. Many patients with osteomyelitis due to anaerobic bacteria have evidence of an anaerobic infection elsewhere in the body that is the source of the organisms involved in the osteomyelitis. Treatment of arthritis and osteomyelitis involving anaerobic bacteria includes symptomatic therapy, immobilization in some cases, adequate drainage of purulent material, and antibiotic therapy effective against these organisms. Anaerobic bacteria can cause septic arthritis and osteomyelitis. Correct diagnosis and appropriate therapy are important contributor to successful outcome.

Acute hematogenous osteomyelitis of the odontoid process in a child with torticollis.

PubMed

Nolting, Laura; Singer, Jonathan; Hackett, Russell; Kleiner, Laurence

2010-09-01

Acute vertebral osteomyelitis is rare in the pediatric population. Its presentation may be subtle and without constitutional manifestations. We present a case of osteomyelitis of the odontoid process. The disease was not considered in the initial evaluation of an afebrile, nontoxic child who presented for evaluation of neck stiffness. Although there was a delay in diagnosis and treatment, the outcome was favorable.

Comparative in vitro activities of dalbavancin and seven comparator agents against 41 Staphylococcus species cultured from osteomyelitis infections and 18 VISA and hVISA strains.

PubMed

Citron, Diane M; Tyrrell, Kerin L; Goldstein, Ellie J C

2014-08-01

Due to a high rate of relapse, osteomyelitis remains difficult to treat, requiring prolonged parenteral therapy. MICs for 41 consecutive Staphylococcus species recovered from patients with osteomyelitis were determined for dalbavancin, daptomycin, doxycycline, levofloxacin, linezolid, vancomycin, trimethoprim-sulfamethoxazole, rifampin, and vancomycin. Strains of vancomycin-intermediate Staphylococcus aureus (VISA) and heteroresistant VISA were included for additional comparison. Except for rifampin, dalbavancin was the most active agent tested. Dalbavancin is given once a week, making treatment of infections such as osteomyelitis potentially more convenient and thus could help reduce the rate of hospitalizations and outpatient costs. Copyright © 2014 Elsevier Inc. All rights reserved.

Chronic osteomyelitis of the clavicle

DOE Office of Scientific and Technical Information (OSTI.GOV)

Granick, M.S.; Ramasastry, S.S.; Goodman, M.A.

1989-07-01

Osteomyelitis of the clavicle is an uncommon disease, but it should be considered in patients who present with pain, cellulitis, or drainage in the sternoclavicular area following head and neck surgery, irradiation, subclavian vein catheterization, or immunosuppression. An idiopathic presentation is possible. In contrast to primary osteomyelitis of the clavicle, which is occasionally seen in children, secondary osteomyelitis is quite rare. It is often mistaken for a fracture or a possible neoplasm on plain x-rays. Tomograms and CT scanning are confirmatory, and in early cases, technetium-99m bone scanning can be helpful. Treatment must include early, aggressive surgical debridement of allmore » affected tissues, followed by wound coverage with a well-vascularized flap and perioperative antibiotics.« less

Rebuilding Iraq: DoD and State Department Have Improved Oversight and Coordination of Private Security Contractors in Iraq, but Further Actions are Needed to Sustain Improvements

DTIC Science & Technology

2008-07-01

MNC-I Multi-National Corps-Iraq MNF-I Multi-National Force-Iraq PSC private security contractor RSO Regional Security Office TOC tactical...maritime and territorial jurisdiction’ to include a housing complex leased by the U.S. military on a military base in Germany where a sexual assault...and monitored by RSO personnel in the RSO TOC . Motorcade vehicles are equipped with video cameras that record and document motorcade movements and

Juvenile Gaucher disease simulating osteomyelitis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, J.H.; Ortega, J.A.; Heisel, M.A.

1981-10-01

A case in which several imaging procedures suggested juvenile Gaucher disease in a child who presented with symptomatology of osteomyelitis is discussed. The 20-month girl was given a Technetium-99m radionuclide skeletal examination which revealed intense uptake of tracer agents along the shaft of the right femur. It was also found that the liver and spleen were dramatically Ga-67 avid. The bone pain symptomatology suggested an osteomyelitis of the femur, but skeletal scintigraphy with Tc-99m-labeled bone tracer demonstrated photopenic areas involving the femur, suggesting that the bone pain may have been due to marrow packed with Gaucher cells. This overexpansion ofmore » the marrow may lead to microfractures with remodeling seen radiographically as periosteal new bone and scintigraphically as increased periosteal deposition of tracer agent. The radiogallium study was useful to exclude an underlying osteomyelitis in the involved femurs. Although juvenile Gaucher disease is unusual, it should be considered in any child who presents with the constellation of hepatosplenomegaly and bone pain simulating osteomyelitis.« less

A model of Staphylococcus aureus bacteremia, septic arthritis, and osteomyelitis in chickens.

PubMed

Daum, R S; Davis, W H; Farris, K B; Campeau, R J; Mulvihill, D M; Shane, S M

1990-11-01

We studied the occurrence, magnitude, and kinetics of bacteremia and the resultant osteomyelitis and septic arthritis in an avian model of Staphylococcus aureus infection. Thirty-day-old male broiler chicks were inoculated i.v. with 10(5), 10(6), or 10(7) cfu of strain Duntravis, a beta-hemolytic, coagulase-producing, capsular type 8 isolate from the synovial fluid of a 2-year-old black boy. Bacteremia occurred in 80%, 90%, and 100% of animals inoculated with 10(5), 10(6), or 10(7) cfu, respectively. The magnitude of bacteremia in surviving, bacteremic animals increased for 96 hours after inoculation and then decreased after a plateau phase. Osteomyelitis and septic arthritis occurred only in chicks that were continuously bacteremic. The occurrence of osteomyelitis was uniform among continuously bacteremic animals and developed 1 to 23 hours after inoculation. Chickens are susceptible to systemic infections with S. aureus. Bacteremia, osteomyelitis, and septic arthritis may be induced in healthy chickens without prior manipulations that depress their resistance.

Sternoclavicular Osteomyelitis in an Immunosuppressed Patient: A Case Report and Review of the Literature.

PubMed

Khan, Kamran; Wozniak, Susan E; Mehrabi, Erfan; Giannone, Anna Lucia; Dave, Mitul

2015-12-28

BACKGROUND Sternoclavicular osteomyelitis is a rare disease, with less than 250 cases identified in the past 50 years. We present a rare case of sternoclavicular osteomyelitis in an immunosuppressed patient that developed from a conservatively treated dislocation. CASE REPORT A 62-year-old white man with a history of metastatic renal cell carcinoma presented to the emergency department (ED) with a dislocated left sternoclavicular joint. He was managed conservatively and subsequently discharged. However, over subsequent days he began to experience pain, fever, chills, and night sweats. He presented to the ED again and imaging revealed osteomyelitis. In the operating room, the wound was aggressively debrided and a wound vac (vacuum-assisted closure) was placed. He was diagnosed with sternoclavicular osteomyelitis and placed on a 6-week course of intravenous Nafcillin. CONCLUSIONS Chemotherapy patients who sustain joint trauma normally associated with a low risk of infection should be monitored thoroughly, and the option to discontinue immunosuppressive therapy should be considered if signs of infection develop.

A novel injectable borate bioactive glass cement for local delivery of vancomycin to cure osteomyelitis and regenerate bone.

PubMed

Cui, Xu; Zhao, Cunju; Gu, Yifei; Li, Le; Wang, Hui; Huang, Wenhai; Zhou, Nai; Wang, Deping; Zhu, Yi; Xu, Jun; Luo, Shihua; Zhang, Changqing; Rahaman, Mohamed N

2014-03-01

Osteomyelitis (bone infection) is often difficult to cure. The commonly-used treatment of surgical debridement to remove the infected bone combined with prolonged systemic and local antibiotic treatment has limitations. In the present study, an injectable borate bioactive glass cement was developed as a carrier for the antibiotic vancomycin, characterized in vitro, and evaluated for its capacity to cure osteomyelitis in a rabbit tibial model. The cement (initial setting time = 5.8 ± 0.6 min; compressive strength = 25.6 ± 0.3 MPa) released vancomycin over ~25 days in phosphate-buffered saline, during which time the borate glass converted to hydroxyapatite (HA). When implanted in rabbit tibial defects infected with methicillin-resistant Staphylococcus aureus (MRSA)-induced osteomyelitis, the vancomycin-loaded cement converted to HA and supported new bone formation in the defects within 8 weeks. Osteomyelitis was cured in 87 % of the defects implanted with the vancomycin-loaded borate glass cement, compared to 71 % for the defects implanted with vancomycin-loaded calcium sulfate cement. The injectable borate bioactive glass cement developed in this study is a promising treatment for curing osteomyelitis and for regenerating bone in the defects following cure of the infection.

Systematic review of duration and choice of systemic antibiotic therapy for acute haematogenous bacterial osteomyelitis in children.

PubMed

Howard-Jones, Annaleise R; Isaacs, David

2013-09-01

Historically, children with acute osteomyelitis received 4-6 weeks of parenteral antibiotics; however, evidence to guide optimal duration of therapy is limited. This study aims to summarise the available evidence on the duration and choice of antimicrobial therapy for acute haematogenous osteomyelitis in children. We systematically reviewed the literature on children with acute osteomyelitis to determine if shorter durations of antibiotic treatment compared with protracted treatment gave different cure rates. We also analysed studies for choice of antibiotics to determine differences in success rates. Randomised controlled trials, cohort studies, case-control studies and case series were eligible for inclusion. We identified six randomised controlled trials, three of which addressed duration of antibiotic use and three choice of antibiotic for acute osteomyelitis in children. We found 28 observational studies, 20 of which focused on duration and 22 of which allowed analysis of choice of antibiotic. A range of therapy durations and types of antibiotics were assessed. Only one small study looked at treatment of neonates. The quality of evidence on antibiotic treatment for acute osteomyelitis is limited, allowing only weak (GRADE 2B) recommendations. Our review suggests that early transition from intravenous to oral therapy, after 3-4 days in patients responding well, followed by oral therapy to a total of 3 weeks may be as effective as longer courses for uncomplicated acute osteomyelitis. This recommendation does not apply to neonates. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Aggregatibacter actinomycetemcomitans osteomyelitis in a 12 year old boy: case report emphasizing the importance of tissue culture, and review of literature.

PubMed

Sharma, Ketaki; Mudgil, Poonam; Whitehall, John S; Gosbell, Iain

2017-03-14

Aggregatibacter actinomycetemcomitans most commonly causes periodontitis but has been reported to infect heart valves, soft tissue, brain and lungs, and distal bones. Osteomyelitis distal to the jaw is rarely described. We report an unusual and rare case of chronic osteomyelitis caused by A. actinomycetemcomitans in the toe of a paediatric patient, and review the available literature. The infection was managed with intravenous antibiotics followed by oral antibiotics. This is an unusual presentation of A. actinomycetemcomitans causing chronic osteomyelitis presumed due to nidation in a minimally damaged bone, associated with bacteraemia of an oral commensal. It occurred in the toe, without obvious dental predisposition; associated with minimal clinical disturbance and with muted immune response.

Arthritis and osteomyelitis associated with Enterococcus cecorum infection in broiler and broiler breeder chickens in Ontario, Canada.

PubMed

Stalker, Margaret J; Brash, Marina L; Weisz, Alexandru; Ouckama, Rachel M; Slavic, Durda

2010-07-01

In August 2008, an Ontario broiler chicken flock experienced an outbreak of lameness in 4-week-old birds, with morbidity reaching 7% by day 3. Necropsy examination and histopathology revealed arthritis of the hock, stifle, and coxofemoral joints, and femoral and vertebral osteomyelitis. Enterococcus cecorum was isolated from the lesions and identified by 16S ribosomal RNA sequencing. In October 2008, a second case of E. cecorum osteomyelitis involved a flock of 9-week-old broiler breeder chickens, with 2% of the male birds showing reluctance to walk. Necropsy examination revealed osteomyelitis and abscessation of the body of the caudal thoracic vertebra in affected birds, with impingement on the overlying spinal cord.

Finding of synergistic and cancel effects on the aroxyl radical-scavenging rate and suppression of prooxidant effect for coexistence of α-tocopherol with β-, γ-, and δ-tocopherols (or -tocotrienols).

PubMed

Ouchi, Aya; Nagaoka, Shin-ichi; Suzuki, Tomomi; Izumisawa, Katsuhiro; Koike, Taisuke; Mukai, Kazuo

2014-08-13

Measurements of aroxyl radical (ArO•)-scavenging rate constants (k(s)(AOH)) of antioxidants (AOHs) [α-, β-, γ-, and δ-tocopherols (TocHs) and -tocotrienols (Toc-3Hs)] were performed in ethanol solution via stopped-flow spectrophotometry. k(s)(AOH) values of α-, β-, γ-, and δ-Toc-3Hs showed good agreement with those of the corresponding α-, β-, γ-, and δ- TocHs. k(s)(AOH) values were measured not only for each antioxidant but also for mixtures of two antioxidants: (i) α-TocH with β-, γ-, or δ-TocH and (ii) α-TocH with α-, β-, γ-, or δ-Toc-3H. A synergistic effect in which the k(s)(AOH) value increases by 12% for γ-TocH (or by 12% for γ-Toc-3H) was observed for solutions including α-TocH and γ-TocH (or γ-Toc-3H). On the other hand, a cancel effect in which the k(s)(AOH) value decreases (a) by 7% for β-TocH (or 11% for β-Toc-3H) and (b) by 24% for δ-TocH (or 25% for δ-Toc-3H) was observed for solutions including two kinds of antioxidants. However, only a synergistic effect may function in edible oils, because contents of β- and δ-TocHs (and β- and δ-Toc-3Hs) are much less than those of α- and γ-TocHs (and α- and γ-Toc-3Hs) in many edible oils. UV-vis absorption of α-Toc•, which was produced by reaction of α-TocH with ArO•, decreased remarkably for coexistence of α-TocH with β-, γ-, or δ-TocH (or β-, γ-, or δ-Toc-3H), indicating that the prooxidant effect of α-Toc• is suppressed by the coexistence of other TocHs and Toc-3Hs.

Expressed parental concern regarding childhood stuttering and the Test of Childhood Stuttering.

PubMed

Tumanova, Victoria; Choi, Dahye; Conture, Edward G; Walden, Tedra A

The purpose of the present study was to determine whether the Test of Childhood Stuttering observational rating scales (TOCS; Gillam et al., 2009) (1) differed between parents who did versus did not express concern (independent from the TOCS) about their child's speech fluency; (2) correlated with children's frequency of stuttering measured during a child-examiner conversation; and (3) correlated with the length and complexity of children's utterances, as indexed by mean length of utterance (MLU). Participants were 183 young children ages 3:0-5:11. Ninety-one had parents who reported concern about their child's stuttering (65 boys, 26 girls) and 92 had parents who reported no such concern (50 boys, 42 girls). Participants' conversational speech during a child-examiner conversation was analyzed for (a) frequency of occurrence of stuttered and non-stuttered disfluencies, and (b) MLU. Besides expressing concern or lack thereof about their child's speech fluency, parents completed the TOCS observational rating scales documenting how often they observe different disfluency types in speech of their children, as well as disfluency-related consequences. There were three main findings. First, parents who expressed concern (independently from the TOCS) about their child's stuttering reported significantly higher scores on the TOCS Speech Fluency and Disfluency-Related Consequences rating scales. Second, children whose parents rated them higher on the TOCS Speech Fluency rating scale produced more stuttered disfluencies during a child-examiner conversation. Third, children with higher scores on the TOCS Disfluency-Related Consequences rating scale had shorter MLU during child-examiner conversation, across age and level of language ability. Findings support the use of the TOCS observational rating scales as one documentable, objective means to determine parental perception of and concern about their child's stuttering. Findings also support the notion that parents are reasonably accurate, if not reliable, judges of the quantity and quality (i.e., stuttered vs. non-stuttered) of their child's speech disfluencies. Lastly, findings that some children may decrease their verbal output in attempts to minimize instances of stuttering - as indexed by relatively low MLU and a high TOCS Disfluency-Related Consequences scores - provides strong support for sampling young children's speech and language across various situations to obtain the most representative index possible of the child's MLU and associated instances of stuttering. Copyright © 2018 Elsevier Inc. All rights reserved.

Organic carbon accumulation in modern sediments of the Angola basin influenced by the Congo deep-sea fan

NASA Astrophysics Data System (ADS)

Baudin, François; Martinez, Philippe; Dennielou, Bernard; Charlier, Karine; Marsset, Tania; Droz, Laurence; Rabouille, Christophe

2017-08-01

Geochemical data (total organic carbon-TOC content, δ13Corg, C:N, Rock-Eval analyses) were obtained on 150 core tops from the Angola basin, with a special focus on the Congo deep-sea fan. Combined with the previously published data, the resulting dataset (322 stations) shows a good spatial and bathymetric representativeness. TOC content and δ13Corg maps of the Angola basin were generated using this enhanced dataset. The main difference in our map with previously published ones is the high terrestrial organic matter content observed downslope along the active turbidite channel of the Congo deep-sea fan till the distal lobe complex near 5000 m of water-depth. Interpretation of downslope trends in TOC content and organic matter composition indicates that lateral particle transport by turbidity currents is the primary mechanism controlling supply and burial of organic matter in the bathypelagic depths.

Major Histopathologic Diagnoses of Chronic Wounds.

PubMed

Turi, George K; Donovan, Virginia; DiGregorio, Julie; Criscitelli, Theresa M; Kashan, Benjamin; Barrientos, Stephan; Balingcongan, Jose Ramon; Gorenstein, Scott; Brem, Harold

2016-08-01

To clarify the histopathology of acute osteomyelitis, chronic osteomyelitis, primary vasculitis, and secondary-type vasculitis. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Describe the parameters and significance of this study.2. Identify chronic wound diagnosis and treatment.3. Differentiate the histopathology of osteomyelitis and vasculitis. The presence of a chronic wound can result in significant morbidity/mortality. Understanding the pathological alterations of wound tissue that are refractory to standard wound therapy is essential for effective wound management and healing. The authors describe 4 wound etiologies, specifically, acute osteomyelitis, chronic osteomyelitis, primary vasculitis, and secondary-type vasculitis. A tertiary care hospital. A retrospective review of 1392 wound operations performed during a 24-month period at a tertiary care hospital was conducted. Tissue specimens reviewed included soft tissue infections of the lower extremity, sacrum, hip/pelvis, trunk, perineum, and buttocks. Acute osteomyelitis is defined as bone tissue with a predominance of polymorphonuclear leukocytes, evidence of osteoclast bone resorption with scalloping of the cortical bone edges, and bone detritus. Chronic osteomyelitis is defined as bone tissue with a significant amount of fibrosis surrounding devitalized tissue and heavy infiltration of lymphocytes and plasma cells. Primary-type vasculitis is defined primarily as inflammation and necrosis of blood vessel walls. In cutaneous lesions of granulomatosis with polyangiitis, ulceration with numerous inflammatory granulomas is seen in the papillary dermis. Secondary vasculitis is defined by vessel wall infiltration by inflammatory cells and fibrinoid necrosis of the small vessel wall. Pathologies of these 4 types of wounds can complicate standard algorithms designed for diagnosis and treatment, and accurate diagnosis through histopathologic analysis can help tailor targeted treatment.

Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol

PubMed Central

2013-01-01

Background Pediatric osteomyelitis is a bacterial infection of bones requiring prolonged antibiotic treatment using parenteral followed by enteral agents. Major complications of pediatric osteomyelitis include transition to chronic osteomyelitis, formation of subperiosteal abscesses, extension of infection into the joint, and permanent bony deformity or limb shortening. Historically, osteomyelitis has been treated with long durations of antibiotics to avoid these complications. However, with improvements in management and antibiotic treatment, standard of care is moving towards short durations of intravenous antibiotics prior to enteral antibiotics. Methods/Design The authors will perform a systematic review based on PRISMA guidelines in order to evaluate the literature, looking for evidence to support the optimal duration of parenteral and enteral therapy. The main goals are to see if literature supports shorter durations of either parenteral antibiotics and/or enteral antibiotics. Multiple databases will be investigated using a thorough search strategy. Databases include Medline, Cochrane, EMBASE, SCOPUS, Dissertation Abstracts, CINAHL, Web of Science, African Index Medicus and LILACS. Search stream will include medical subject heading for pediatric patients with osteomyelitis and antibiotic therapy. We will search for published or unpublished randomized and quasi-randomized controlled trials. Two authors will independently select articles, extract data and assess risk of bias by standard Cochrane methodologies. We will analyze comparisons between dichotomous outcomes using risk ratios and continuous outcomes using mean differences. 95% confidence intervals will be computed. Discussion One of the major dilemmas of management of this disease is the duration of parenteral therapy. Long parenteral therapy has increased risk of serious complications and the necessity for long therapy has been called into question. Our study aims to review the currently available evidence from randomized trials regarding duration of both parenteral and oral therapy for pediatric acute osteomyelitis. Trial registration CRD42013002320 PMID:24099135

Diagnosing diabetic foot osteomyelitis: is the combination of probe-to-bone test and plain radiography sufficient for high-risk inpatients?

PubMed

Aragón-Sánchez, J; Lipsky, Benjamin A; Lázaro-Martínez, J L

2011-02-01

To investigate the accuracy of the sequential combination of the probe-to-bone test and plain X-rays for diagnosing osteomyelitis in the foot of patients with diabetes. We prospectively compiled data on a series of 338 patients with diabetes with 356 episodes of foot infection who were hospitalized in the Diabetic Foot Unit of La Paloma Hospital from 1 October 2002 to 31 April 2010. For each patient we did a probe-to-bone test at the time of the initial evaluation and then obtained plain X-rays of the involved foot. All patients with positive results on either the probe-to-bone test or plain X-ray underwent an appropriate surgical procedure, which included obtaining a bone specimen that was processed for histology and culture. We calculated the sensitivity, specificity, predictive values and likelihood ratios of the procedures, using the histopathological diagnosis of osteomyelitis as the criterion standard. Overall, 72.4% of patients had histologically proven osteomyelitis, 85.2% of whom had positive bone culture. The performance characteristics of both the probe-to-bone test and plain X-rays were excellent. The sequential diagnostic approach had a sensitivity of 0.97, specificity of 0.92, positive predictive value of 0.97, negative predictive value of 0.93, positive likelihood ratio of 12.8 and negative likelihood ratio of 0.02. Only 6.6% of patients with negative results on both diagnostic studies had osteomyelitis. Clinicians seeing patients in a setting similar to ours (specialized diabetic foot unit with a high prevalence of osteomyelitis) can confidently diagnose diabetic foot osteomyelitis when either the probe-to-bone test or a plain X-ray, or especially both, are positive. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

Pressure Ulcer-Related Pelvic Osteomyelitis: A Neglected Disease?

PubMed Central

Bodavula, Phani; Liang, Stephen Y.; Wu, Jiami; VanTassell, Paige; Marschall, Jonas

2015-01-01

Background. Decubitus ulcers can become complicated by pelvic osteomyelitis. Little is known about the epidemiology of pressure ulcer-related pelvic osteomyelitis. Methods. We performed a retrospective cohort study of adult patients with pressure ulcer and pelvic osteomyelitis admitted to an academic center from 2006 to 2011. Data on clinical presentation, diagnostic evaluation, and treatment during the index admission were collected. Outcome measures included length of hospital stay and number of readmissions in the subsequent year. Results. Two hundred twenty patients were included: 163 (74%) were para/quadriplegic and 148 (67%) were male (148; 67%). Mean age was 50 (±18) years. Pelvic osteomyelitis was the primary admission diagnosis for 117 (53%). Fifty-six (26%) patients had concurrent febrile urinary tract infection. Wound cultures collected for 113 patients (51%) were notable for methicillin-resistant Staphylococcus aureus (37; 33%), Streptococci (19; 17%), and Pseudomonas spp (20; 18%). Plain films were obtained in 89 (40%) patients, computed tomography scans were obtained for 81 (37%) patients, and magnetic resonance images were obtained for 40 (18%) patients. Most patients received osteomyelitis-directed antibiotics (153; 70%), 134 of 153 (88%) of which were scheduled to receive ≥6 weeks of treatment. Fifty-five (25%) patients underwent surgery during the index admission; 48 (22%) patients received a combined medical-surgical approach. One third of patients had ≥2 readmissions during the subsequent year. Patients treated with a combined approach were less likely to be readmitted than those who received antibiotics alone (0 [range, 0–4] vs 1 [0–7] readmissions; P = .04). Conclusions. This is one of the largest cohort studies of pressure ulcer-related pelvic osteomyelitis to date. Significant variations existed in diagnostic approach. Most patients received antibiotics; those treated with a combined medical-surgical approach had fewer hospital readmissions. PMID:26322317

Methicillin-Resistant Staphylococcus aureus in Foot Osteomyelitis.

PubMed

Ashong, Chester N; Raheem, Shazia A; Hunter, Andrew S; Mindru, Cezarina; Barshes, Neal R

Conflicting studies exist regarding the impact of methicillin-resistant Staphylococcus aureus (MRSA) on increased time to wound healing, future need for surgical procedures, and likelihood of treatment failure in patients with diabetic foot osteomyelitis. The purpose of this study is to determine the overall significance of MRSA in predicting treatment failure in bone infections of the foot and to determine an appropriate pre-operative and empiric post-operative antibiotic regimen. Patients presenting with an initial episode of "probable" or "definite" foot osteomyelitis were included for review and analysis if the following criteria were met: (1) Osteomyelitis occurred in the foot (i.e., distal to the malleoli of the ankle); episodes occurring above the ankle were excluded. (2) Patients received either no antibiotics or only oral antibiotics for long-term treatment; episodes managed with long-term parenteral antibiotics were excluded. (3) The infection was managed initially with medical therapy or conservative surgical therapy; episodes managed with major (above-ankle) amputation as the initial treatment were excluded. The primary objective of this study was to assess whether episodes of foot osteomyelitis associated with MRSA resulted in treatment failure more frequently than not. Of 178 episodes included in the study, 50 (28.1%) episodes had treatment failure. Median time-to-treatment failure was 60 days (range 7-598 days). In 28.1% (9/32 episodes) in which treatment failure occurred and 39.0% (41/105) episodes in which no treatment failure occurred, MRSA was present. The presence of MRSA was not significantly associated with treatment failure (p = 0.99). The presence of MRSA in bone culture and whether antibiotic use had anti-MRSA activity was not associated with increased treatment failure of diabetic foot osteomyelitis in our institution. Empiric antibiotic coverage of MRSA may not be necessary for many patients presenting with foot osteomyelitis.

Dynamics of organic and inorganic carbon in surface sediments of the Yellow River Estuary

NASA Astrophysics Data System (ADS)

Yu, Z.; Wang, X.; Liu, X.; Zhang, E.; Hang, F.

2017-12-01

Estuarine sediment is an important carbon reservoir thus may play an important role in the global carbon cycle. However, little is known on the dynamics of organic carbon (OC) and inorganic carbon (IC) in the surface sediment of the Yellow River Estuary, a large estuary in northern China. In this study, we applied element analyses and isotopic approach to study spatial distribution and sources of OC and IC in the Yellow River Estuary. We found that TIC concentration (6.3-20.1 g kg-1) was much higher than TOC (0.2-4.4 g kg-1) in the surface sediment. There showed a large spatial variability in TOC and TIC and their stable isotopes. Both TOC and TIC were higher to the north (2.6 and 14.5 g kg-1) than to the south (1.6 and 12.2 g kg-1), except in the southern bay where TOC and TIC reached 2.7 and 15.4 g kg-1, respectively. Generally, TOC and TIC in our study area was mainly autochthonous. The lower TOC values in the south section were due to relatively higher kinetic energy level whereas the higher values in the bay was attributable to terrigenous matters accumulation and lower kinetic energy level. However, the southern bay revealed the most negative δ13Corg and δ13Ccarb, suggesting that there might exist some transfer of OC to IC in the section. Our study points out that the dynamics of sedimentary carbon in the Yellow River Estuary is influenced by multiple and complex processes, and highlights the importance of carbonate in carbon sequstration.

Acute bacterial prostatitis with osteomyelitis

PubMed Central

Nargund, V H; Stewart, P A Hamilton

1995-01-01

This short case presentation concerns the simultaneous occurrence of acute bacterial prostatitis and osteomyelitis due to staphylococcal bacteraemia hitherto unrecorded in the literature. ImagesFigure 1Figure 2 PMID:7629772

A Molecular-Genetic Study of the Arabidopsis Toc75 Gene Family1

PubMed Central

Baldwin, Amy; Wardle, Anthony; Patel, Ramesh; Dudley, Penny; Park, Soon Ki; Twell, David; Inoue, Kentaro; Jarvis, Paul

2005-01-01

Toc75 (translocon at the outer envelope membrane of chloroplasts, 75 kD) is the protein translocation channel at the outer envelope membrane of plastids and was first identified in pea (Pisum sativum) using biochemical approaches. The Arabidopsis (Arabidopsis thaliana) genome contains three Toc75-related sequences, termed atTOC75-I, atTOC75-III, and atTOC75-IV, which we studied using a range of molecular, genetic, and biochemical techniques. Expression of atTOC75-III is strongly regulated and at its highest level in young, rapidly expanding tissues. By contrast, atTOC75-IV is expressed uniformly throughout development and at a much lower level than atTOC75-III. The third sequence, atTOC75-I, is a pseudogene that is not expressed due to a gypsy/Ty3 transposon insertion in exon 1, and numerous nonsense, frame-shift, and splice-junction mutations. The expressed genes, atTOC75-III and atTOC75-IV, both encode integral envelope membrane proteins. Unlike atToc75-III, the smaller atToc75-IV protein is not processed upon targeting to the envelope, and its insertion does not require ATP at high concentrations. The atTOC75-III gene is essential for viability, since homozygous atToc75-III knockout mutants (termed toc75-III) could not be identified, and aborted seeds were observed at a frequency of approximately 25% in the siliques of self-pollinated toc75-III heterozygotes. Homozygous toc75-III embryos were found to abort at the two-cell stage. Homozygous atToc75-IV knockout plants (termed toc75-IV) displayed no obvious visible phenotypes. However, structural abnormalities were observed in the etioplasts of toc75-IV seedlings and atTOC75-IV overexpressing lines, and toc75-IV plants were less efficient at deetiolation than wild type. These results suggest some role for atToc75-IV during growth in the dark. PMID:15908591

Thoracic osteomyelitis and epidural abscess formation due to cat scratch disease: case report.

PubMed

Dornbos, David; Morin, Jocelyn; Watson, Joshua R; Pindrik, Jonathan

2016-12-01

Osteomyelitis of the spine with associated spinal epidural abscess represents an uncommon entity in the pediatric population, requiring prompt evaluation and diagnosis to prevent neurological compromise. Cat scratch disease, caused by the pathogen Bartonella henselae, encompasses a wide spectrum of clinical presentations; however, an association with osteomyelitis and epidural abscess has been reported in only 4 other instances in the literature. The authors report a rare case of multifocal thoracic osteomyelitis with an epidural abscess in a patient with a biopsy-proven pathogen of cat scratch disease. A 5-year-old girl, who initially presented with vague constitutional symptoms, was diagnosed with cat scratch disease following biopsy of an inguinal lymph node. Despite appropriate antibiotics, she presented several weeks later with recurrent symptoms and back pain. Magnetic resonance imaging revealed 2 foci of osteomyelitis at T-8 and T-11 with an associated anterior epidural abscess from T-9 to T-12. Percutaneous image-guided vertebral biopsy revealed B. henselae by polymerase chain reaction analysis, and she was treated conservatively with doxycycline and rifampin with favorable clinical outcome.

Ulcer osteoma and periosteal reactions to chronic leg ulcers.

PubMed

Karasick, D; Schweitzer, M E; Deely, D M

1997-01-01

The purpose of this study was to describe the types of periosteal reaction seen in response to long-standing leg ulcers and to differentiate the types associated with osteomyelitis. Over a 10-year span, we retrospectively evaluated the radiographs of 20 patients with lower leg soft-tissue ulceration and adjacent periosteal bone reaction of the tibia or fibula. Two of us evaluated the location and appearance of periosteal reaction, and one of us evaluated the patients' medical records for evidence of peripheral vascular disease, systemic illnesses, and osteomyelitis. Twelve patients had organized periosteal reactions that resulted in the appearance of ulcer osteoma. None of these patients subsequently developed osteomyelitis. Eight patients had interrupted lamellar nodular periosteal reactions; six of the eight patients had superimposed osteomyelitis. Our study showed two types of periosteal response to chronic leg ulcers: a solid organized type that over time formed an ulcer osteoma and a lamellar nodular type that was often associated with osteomyelitis. Both types of ulcers were seen in patients with peripheral vascular disease, IV drug abuse, sickle cell disease, and neurologic impairment.

Osteomyelitis Caused by Moraxella osloensis

PubMed Central

Sugarman, Barrett; Clarridge, Jill

1982-01-01

Moraxella osloensis osteomyelitis of the femur developed in a paraplegic man. He responded to treatment with oral ampicillin. Disease in humans caused by this unusual clinical isolate is reviewed. PMID:7107844

Treatment of chronic heel osteomyelitis in vasculopathic patients. Can the combined use of Integra® , skin graft and negative pressure wound therapy be considered a valid therapeutic approach after partial tangential calcanectomy?

PubMed

Fraccalvieri, Marco; Pristerà, Giuseppe; Zingarelli, Enrico; Ruka, Erind; Bruschi, Stefano

2012-04-01

Osteomyelitis of the calcaneus is a difficult problem to manage. Patients affected by osteomyelitis of the calcaneus often have a below-the-knee amputation because of their comorbidity. In this article, we present seven cases of heel ulcerations with chronic osteomyelitis treated with Integra(®) Dermal Regeneration Template, skin graft and negative pressure wound therapy after partial tangential calcanectomy, discussing the surgical and functional results. In this casuistic of patients, all wounds healed after skin grating of the neodermis generated by Integra(®), with no patient requiring a below-knee amputation. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

Vertebral Osteomyelitis and Acinetobacter Spp. Paravertebral Soft Tissue Infection in a 4-Year-Old Boy With X-Linked Chronic Granulomatous Disease.

PubMed

Vignesh, Pandiarajan; Bhattad, Sagar; Shandilya, Jitendra-Kumar; Vyas, Sameer; Garg, Rashi; Rawat, Amit

2016-09-01

Vertebral osteomyelitis is known to occur in chronic granulomatous disease, a phagocytic disorder and the etiology is usually a fungus. Indolent spread of fungal infection from lungs to adjacent ribs and vertebra often results in persistent pneumonia and vertebral deformities. We report a 4-year-old boy with chronic cough and kyphosis, who had a fungal vertebral osteomyelitis and Acinetobacter spp. paravertebral soft tissue infection related to X-linked chronic granulomatous disease.

Surgical treatment of hematogenous vertebral Aspergillus osteomyelitis.

PubMed

Bridwell, K H; Campbell, J W; Barenkamp, S J

1990-04-01

Three cases of Aspergillus fumigatas vertebral osteomyelitis failed courses of medical treatment. Each was subsequently treated with anterior vertebral debridement and posterior segmental spinal instrumentation. Despite poor nutritional and immune systems, resolution of the infection and subsequent anterior ankylosis occurred in each patient, with follow-up ranging from 1 to 3 years. If patients with aspergillus vertebral osteomyelitis do not respond to medical treatment, early surgical debridement and stabilization in combination with intravenous amphotericin B can lead to resolution and bony ankylosis.

Primary tuberculous petrositis.

PubMed

Sethi, Ashwani; Sabherwal, Anup; Gulati, Achal; Sareen, Deepika

2005-11-01

Tuberculous osteomyelitis of the temporal bone is a rare and dangerous entity that should be included in the differential diagnosis of infectious processes of the base of the skull. We present the case of an 11-year-old child who presented with diplopia, ear discharge and hearing loss. The radiological and histopathological findings revealed tuberculous otitis with osteomyelitis and an abscess in the petrous apex. The child responded to anti-tuberculous chemotherapy. The diagnosis and management of tuberculous osteomyelitis are discussed and a brief review of the literature is presented.

Different tocopherol isoforms vary in capacity to scavenge free radicals, prevent inflammatory response, and induce apoptosis in both adult- and fetal-derived intestinal epithelial cells.

PubMed

Elisia, Ingrid; Kitts, David D

2013-01-01

Gamma-tocopherol (γ-Toc) and δ-Toc are two vitamin E isoforms for which biological activities are not well established, yet these isoforms are present in many different sources of vegetable oils and, therefore, contribute significantly to the total dietary intake of vitamin E. Infant formula also contains relatively high amounts of γ-Toc and δ-Toc, compared with that found in human milk. The efficacy of γ-Toc and δ-Toc to modulate cellular events that include oxidative stress, inflammatory response, and apoptosis-mediated cytotoxicity, relative to α-Toc, was determined using differentiated Caco-2 and primary FHs 74 Int cells intestinal epithelial cell lines. Antioxidant capacity of Toc-isoforms followed the order of δ-Toc > γ-Toc > α-Toc against peroxyl radical-induced membrane oxidation in both Caco-2 and FHs 74 Int cells, respectively. The different Toc-isoforms suppressed inflammatory response in interferon (IFN) γ/phorbol myristate acetate (PMA)-induced Caco-2 adult-derived intestinal epithelial cells, but exacerbated both IL8 and PGE2 secretion in fetal-derived FHs 74 Int intestinal epithelial cells. Lastly, Toc exhibited an isoform-dependent apoptosis-mediated cytotoxicity, whereby δ-Toc elicited the greatest apoptosis followed by γ-Toc, whereas α-Toc was not cytotoxic. Cellular uptake of non-α-Toc isoforms were greater (P < 0.05) than that observed for α-Toc in both intestinal epithelial cell lines which in part explains the superior bioactive function observed for both γ-Toc and δ-Toc, compared with α-Toc. We conclude that the non-α-Toc isoforms of vitamin E have distinct roles that influence oxidative stress and inflammatory responses in both adult and fetal-derived intestinal epithelial cell lines. © 2013 International Union of Biochemistry and Molecular Biology.

Aspergillosis with Aspergillus osteomyelitis and diskitis after heart transplantation: surgical and medical management.

PubMed

Hummel, M; Schüler, S; Weber, U; Schwertlick, G; Hempel, S; Theiss, D; Rees, W; Mueller, J; Hetzer, R

1993-01-01

This is the report of a 49-year-old man, who could be cured of aspergillosis with Aspergillus osteomyelitis and diskitis of the lumbar spine by medical and surgical therapy after heart retransplantation. Aspergillus osteomyelitis and diskitis is a rare complication of invasive aspergillosis. Lumbar involvement is the main manifestation, followed by rare locations in the tibia, ribs, wrist, sternum, pelvis, and knee. It is nearly always secondary to pulmonary aspergillosis, which occurs in about 6% to 14% of patients after heart transplantation. For treatment, a combined surgical and medical approach is recommended, which enables quick pain relief for the patient and histologic and microbiologic diagnosis and stabilization of the spine. Because of definitive cure of osteomyelitis cannot be guaranteed by removal of the abscess, medical therapy after surgery is necessary for years.

Biomaterials approaches to treating implant-associated osteomyelitis

PubMed Central

Inzana, Jason A.; Schwarz, Edward M.; Kates, Stephen L.; Awad, Hani A.

2016-01-01

Orthopaedic devices are the most common surgical devices associated with implant-related infections and Staphylococcus aureus (S. aureus) is the most common causative pathogen in chronic bone infections (osteomyelitis). Treatment of these chronic bone infections often involves combinations of antibiotics given systemically and locally to the affected site via a biomaterial spacer. The gold standard biomaterial for local antibiotic delivery against osteomyelitis, poly(methyl methacrylate) (PMMA) bone cement, bears many limitations. Such shortcomings include limited antibiotic release, incompatibility with many antimicrobial agents, and the need for follow-up surgeries to remove the non-biodegradable cement before surgical reconstruction of the lost bone. Therefore, extensive research pursuits are targeting alternative, biodegradable materials to replace PMMA in osteomyelitis applications. Herein, we provide an overview of the primary clinical treatment strategies and emerging biodegradable materials that may be employed for management of implant-related osteomyelitis. We performed a systematic review of experimental biomaterials systems that have been evaluated for treating established S. aureus osteomyelitis in an animal model. Many experimental biomaterials were not decisively more efficacious for infection management than PMMA when delivering the same antibiotic. However, alternative biomaterials have reduced the number of follow-up surgeries, enhanced the antimicrobial efficacy by delivering agents that are incompatible with PMMA, and regenerated bone in an infected defect. Understanding the advantages, limitations, and potential for clinical translation of each biomaterial, along with the conditions under which it was evaluated (e.g. animal model), is critical for surgeons and researchers to navigate the plethora of options for local antibiotic delivery. PMID:26724454

Antibiotic-eluting hydrophilized PMMA bone cement with prolonged bactericidal effect for the treatment of osteomyelitis.

PubMed

Oh, Eun Jo; Oh, Se Heang; Lee, In Soo; Kwon, Oh Soo; Lee, Jin Ho

2016-05-01

Osteomyelitis is still considered to be one of the major challenges for orthopedic surgeons despite advanced antiseptic surgical procedures and pharmaceutical therapeutics. In this study, hydrophilized poly(methyl methacrylate) (PMMA) bone cements containing Pluronic F68 (EG79PG28EG79) as a hydrophilic additive and vancomycin (F68-VAcements) were prepared to allow the sustained release of the antibiotic for adequate periods of time without any significant loss of mechanical properties. The compressive strengths of the bone cements with Pluronic F68 compositions less than 7 wt% were not significantly different compared with the control vancomycin-loaded bone cement (VAcement). TheF68 (7 wt%)-VAcement showed sustained release of the antibiotic for up to 11 weeks and almost 100% release from the bone cement. It also prohibited the growth ofS. aureus(zone of inhibition) over six weeks (the required period to treat osteomyelitis), and it did not show any notable cytotoxicity. From an animal study using a femoral osteomyelitis rat model, it was observed that theF68 (7 wt%)-VAcement was effective for the treatment of osteomyelitis, probably as a result of the prolonged release of antibiotic from the PMMA bone cement. On the basis of these findings, it can be suggested that the use of Pluronic F68 as a hydrophilic additive for antibiotic-eluting PMMA bone cement can be a promising strategy for the treatment of osteomyelitis. © The Author(s) 2016.

A link between osteomyelitis and IL1RN and IL1B polymorphisms—a study in patients from Northeast Brazil

PubMed Central

Alves De Souza, Clinio; Queiroz Alves De Souza, Argos; Queiroz Alves De Souza, Maria do Socorro; Dias Leite, José Alberto; Silva De Morais, Maíra; Barem Rabenhorst, Sílvia Helena

2017-01-01

Background and purpose Treatment failure of osteomyelitis can result from genetic susceptibility, highlighting polymorphisms of the interleukin-1 (IL-1) family members, central mediators of innate immunity and inflammation. Polymorphisms are DNA sequence variations that are common in the population (1% or more) and represent multiple forms of a single gene. We investigated the association of IL1RNVNTR (rs2234663) and IL1B-511C > T (rs16944) polymorphisms with osteomyelitis development in patients operated on because of bone trauma. Patients and methods 153 patients who fulfilled the inclusion criteria were enrolled from a referral public hospital for trauma. All the patients were followed up daily until hospital discharge and, after this, on an outpatient basis. Patients were treated with prophylactic antimicrobials and surgery according to traumatology service protocol. The IL1RNVNTR and the IL1B-511C > T polymorphisms were determined by PCR and PCR-RFLP, respectively. Results The IL1RN*2/*2 genotype was associated (OR: 7; p < 0.001) with a higher risk of osteomyelitis and was also significantly associated with Staphylococcus aureus infection. The haplotypes (combination of different markers) *2-C and *2-T were also associated with osteomyelitis development. Interpretation IL1B-511C > T and IL1RNVNTR polymorphisms were associated with osteomyelitis development, which may have implications for patients with bone traumas. These data may be relevant for new therapeutic strategies for this disease. PMID:28682145

A link between osteomyelitis and IL1RN and IL1B polymorphisms-a study in patients from Northeast Brazil.

PubMed

Alves De Souza, Clinio; Queiroz Alves De Souza, Argos; Queiroz Alves De Souza, Maria do Socorro; Dias Leite, José Alberto; Silva De Morais, Maíra; Barem Rabenhorst, Sílvia Helena

2017-10-01

Background and purpose - Treatment failure of osteomyelitis can result from genetic susceptibility, highlighting polymorphisms of the interleukin-1 (IL-1) family members, central mediators of innate immunity and inflammation. Polymorphisms are DNA sequence variations that are common in the population (1% or more) and represent multiple forms of a single gene. We investigated the association of IL1RNVNTR (rs2234663) and IL1B-511C > T (rs16944) polymorphisms with osteomyelitis development in patients operated on because of bone trauma. Patients and methods - 153 patients who fulfilled the inclusion criteria were enrolled from a referral public hospital for trauma. All the patients were followed up daily until hospital discharge and, after this, on an outpatient basis. Patients were treated with prophylactic antimicrobials and surgery according to traumatology service protocol. The IL1RNVNTR and the IL1B-511C > T polymorphisms were determined by PCR and PCR-RFLP, respectively. Results - The IL1RN*2/*2 genotype was associated (OR: 7; p < 0.001) with a higher risk of osteomyelitis and was also significantly associated with Staphylococcus aureus infection. The haplotypes (combination of different markers) *2-C and *2-T were also associated with osteomyelitis development. Interpretation - IL1B-511C > T and IL1RNVNTR polymorphisms were associated with osteomyelitis development, which may have implications for patients with bone traumas. These data may be relevant for new therapeutic strategies for this disease.

Testing the efficacy of antimicrobial peptides in the topical treatment of induced osteomyelitis in rats.

PubMed

Melicherčík, Pavel; Čeřovský, Václav; Nešuta, Ondřej; Jahoda, David; Landor, Ivan; Ballay, Rastislav; Fulín, Petr

2018-01-01

Joint replacement infections and osteomyelitis are among the most serious complications in orthopaedics and traumatology. The risk factors for these infections are often bacterial resistance to antimicrobials. One of the few solutions available to control bacterial resistance involves antimicrobials, which have a different mechanism of action from traditional antibiotics. Antimicrobial peptides (AMP) appear to be highly promising candidates in the treatment of resistant infections. We have identified several AMP in the venom of various wild bees and designed analogues that show potent antimicrobial activity and low toxicity against eukaryotic cells. The aim of the present study was to test the efficacy of one of those synthetic peptide analogues for the treatment of acute osteomyelitis invoked in laboratory rats. Femoral cavities of 20 laboratory Wistar rats were infected with Staphylococcus aureus. After 1 week, eight rats received an injectable calcium phosphate carrier alone, another eight rats were treated with a calcium phosphate mixed with AMP, and four rats were left without any further treatment. After another week, all rats were euthanized and radiographs were made of both the operated and healthy limbs. The animals with the carrier alone exhibited more severe acute osteomyelitis on radiographs in comparison to the recipients of the calcium phosphate carrier loaded AMP and untreated infected individuals. Based on the results of the above mentioned experiment, it was concluded that when injected directly into the site of femoral acute osteomyelitis, the calcium phosphate carrier mixed with AMP reduced osteomyelitis signs visible on radiographs.

Total organic carbon and humus fractions in restored soils from limestone quarries in semiarid climate, SE Spain

NASA Astrophysics Data System (ADS)

Luna Ramos, Lourdes; Miralles Mellado, Isabel; Ángel Domene Ruiz, Miguel; Solé Benet, Albert

2016-04-01

Mining activities generate erosion and loss of plant cover and soil organic matter (SOM), especially in arid and semiarid Mediterranean regions. A precondition for ecosystem restoration in such highly disturbed areas is the development of functional soils with sufficient organic matter. But the SOM quality is also important to long-term C stabilization. The resistance to biodegradation of recalcitrant organic matter fractions has been reported to depend on some intrinsic structural factors of humic acid substances and formation of amorphous organo-mineral recalcitrant complexes. In an experimental soil restoration in limestone quarries in the Sierra de Gádor (Almería), SE Spain, several combinations of organic amendments (sewage sludge and compost from domestic organic waste) and mulches (gravel and woodchip) were added in experimental plots using a factorial design. In each plot, 75 native plants (Anthyllis cytisoides, A. terniflora and Macrochloa tenacissima) were planted and five years after the start of the experiment total organic carbon (TOC), physico-chemical soil properties and organic C fractions (particulate organic matter, H3PO4-fulvic fraction, fulvic acids (FA), humic acids (HA) and humin) were analyzed. We observed significant differences between treatments related to the TOC content and the HA/FA ratio. Compost amendments increased the TOC, HA content and HA/FA ratio, even higher than in natural undisturbed soils, indicating an effective clay humus-complex pointing to progressively increasing organic matter quality. Soils with sewage sludge showed the lowest TOC and HA/FA ratio and accumulated a lower HA proportion indicating poorer organic matter quality and comparatively lower resilience than in natural soils and soils amended with compost.

Vertebral osteomyelitis and epidural abscess due to Aspergillus nidulans resulting in spinal cord compression: case report and literature review.

PubMed

Jiang, Zheng; Wang, Yunyan; Jiang, Yuquan; Xu, Yonghao; Meng, Bin

2013-04-01

Vertebral osteomyelitis caused by Aspergillus nidulans is rare and usually affects immunocompromised patients. This report presents a case of thoracic vertebral osteomyelitis with epidural abscesses due to A. nidulans in a 40-year-old immunocompetent female who presented with back pain, numbness and weakness of both lower limbs. Magnetic resonance imaging demonstrated osteomyelitis involving the thoracic (T)1-T3 vertebral bodies with epidural abscesses, resulting in spinal compression. The patient underwent a decompression laminectomy of T1-T3 and debridement of the thoracic epidural inflammatory granuloma. Histopathology revealed fungal granulomatous inflammation. The patient received 6 mg/kg voriconazole every 12 h (loading dose on day 1) followed by 4 mg/kg voriconazole twice daily for 1 month, administered intravenously. The patient returned with recurrent back pain 16 months after initial presentation. A. nidulans was identified by fungal culture and polymerase chain reaction. The patient showed no evidence of recurrence 1 year after a 6-month course of oral voriconazole. The key to the effective treatment of Aspergillus osteomyelitis is not to excise the abscess, but to administer systemic antifungal drug therapy.

Teicoplanin-loaded borate bioactive glass implants for treating chronic bone infection in a rabbit tibia osteomyelitis model.

PubMed

Zhang, Xin; Jia, Weitao; Gu, Yifei; Xiao, Wei; Liu, Xin; Wang, Deping; Zhang, Changqing; Huang, Wenhai; Rahaman, Mohamed N; Day, Delbert E; Zhou, Nai

2010-08-01

The treatment of chronic osteomyelitis (bone infection) remains a clinical challenge. In this work, pellets composed of a chitosan-bonded mixture of borate bioactive glass particles (<50microm) and teicoplanin powder (antibiotic), were evaluated in vitro and in vivo for treating chronic osteomyelitis induced by methicillin-resistant Staphylococcus aureus (MRSA) in a rabbit model. When immersed in phosphate-buffered saline, the pellets showed sustained release of teicoplanin over 20-30 days, while the bioactive glass converted to hydroxyapatite (HA) within 7 days, eventually forming a porous HA structure. Implantation of the teicoplanin-loaded pellets in a rabbit tibia osteomyelitis model resulted in the detection of teicoplanin in the blood for about 9 days. The implants converted to a bone-like HA graft, and supported the ingrowth of new bone into the tibia defects within 12 weeks of implantation. Microbiological, histological and scanning electron microscopy techniques showed that the implants provided a cure for the bone infection. The results indicate that the teicoplanin-loaded borate bioactive glass implant, combining sustained drug release with the ability to support new bone ingrowth, could provide a method for treating chronic osteomyelitis. Copyright 2010 Elsevier Ltd. All rights reserved.

Use of alpha-tocopherol esters for topical vitamin E treatment: evaluation of their skin permeation and metabolism.

PubMed

Ben-Shabat, Shimon; Kazdan, Yolia; Beit-Yannai, Elie; Sintov, Amnon C

2013-05-01

The aim of this work was to investigate new pro-vitamins based on α-tocopherol (α-Toc) and fatty acids, and to compare their properties with those of α-tocopherol acetate (α-TAc). Skin levels of α-Toc-fatty acid ester conjugates, total α-Toc and endogenous α-Toc were measured in skin samples taken from separate groups of treated and untreated rats. Multiple and extensive treatment with α-Toc oleate and α-TAc was also carried out to assess the skin accumulation and safety of these esters. The in-vivo studies revealed that α-Toc-fatty acid conjugates penetrated into the skin quantitatively while being comparable with the permeation of α-TAc. Differences were found between the levels of total α-Toc and endogenous α-Toc after application of α-TAc, α-Toc oleate, α-Toc linoleate, α-Toc-α linolenate and α-Toc palmitate, indicating that α-Toc conjugates of these fatty acids, but not α-Toc γ-linolenate or α-Toc stearate, were hydrolysed to free α-Toc. In long-term and extensive treatment, α-TAc was found to be lethal to rats treated with 1.15 mg/kg of this agent, which had been spread over 16 cm(2) of skin. Similar treatment with α-Toc oleate did not produce any side effects. This study suggests that α-Toc conjugates with unsaturated fatty acids may be a good alternative as stable vitamin E derivatives, rather than the α-TAc ester. © 2013 The Authors. JPP © 2013 Royal Pharmaceutical Society.

Update: Cytokine Dysregulation in Chronic Nonbacterial Osteomyelitis (CNO)

PubMed Central

Hofmann, Sigrun R.; Roesen-Wolff, Angela; Hahn, Gabriele; Hedrich, Christian M.

2012-01-01

Chronic nonbacterial osteomyelitis (CNO) with its most severe form chronic recurrent multifocal osteomyelitis (CRMO) is a non-bacterial osteitis of yet unknown origin. Secondary to the absence of both high-titer autoantibodies and autoreactive T lymphocytes, and the association with other autoimmune diseases, it was recently reclassified as an autoinflammatory disorder of the musculoskeletal system. Since its etiology is largely unknown, the diagnosis is based on clinical criteria, and treatment is empiric and not always successful. In this paper, we summarize recent advances in the understanding of possible etiopathogenetic mechanisms in CNO. PMID:22685464

Gentamicin coating of plasma chemical oxidized titanium alloy prevents implant-related osteomyelitis in rats.

PubMed

Diefenbeck, M; Schrader, C; Gras, F; Mückley, T; Schmidt, J; Zankovych, S; Bossert, J; Jandt, K D; Völpel, A; Sigusch, B W; Schubert, H; Bischoff, S; Pfister, W; Edel, B; Faucon, M; Finger, U

2016-09-01

Implant related infection is one of the most feared and devastating complication associated with the use of orthopaedic implant devices. Development of anti-infective surfaces is the main strategy to prevent implant contamination, biofilm formation and implant related osteomyelitis. A second concern in orthopaedics is insufficient osseointegration of uncemented implant devices. Recently, we reported on a macroporous titanium-oxide surface (bioactive TiOB) which increases osseointegration and implant fixation. To combine enhanced osseointegration and antibacterial function, the TiOB surfaces were, in addition, modified with a gentamicin coating. A rat osteomyelitis model with bilateral placement of titanium alloy implants was employed to analyse the prophylactic effect of gentamicin-sodiumdodecylsulfate (SDS) and gentamicin-tannic acid coatings in vivo. 20 rats were randomly assigned to four groups: (A) titanium alloy; PBS inoculum (negative control), (B) titanium alloy, Staphylococcus aureus inoculum (positive control), (C) bioactive TiOB with gentamicin-SDS and (D) bioactive TiOB plus gentamicin-tannic acid coating. Contamination of implants, bacterial load of bone powder and radiographic as well as histological signs of implant-related osteomyelitis were evaluated after four weeks. Gentamicin-SDS coating prevented implant contamination in 10 of 10 tibiae and gentamicin-tannic acid coating in 9 of 10 tibiae (infection prophylaxis rate 100% and 90% of cases, respectively). In Group (D) one implant showed colonisation of bacteria (swab of entry point and roll-out test positive for S. aureus). The interobserver reliability showed no difference in the histologic and radiographic osteomyelitis scores. In both gentamicin coated groups, a significant reduction of the histological osteomyelitis score (geometric mean values: C = 0.111 ± 0.023; D = 0.056 ± 0.006) compared to the positive control group (B: 0.244 ± 0.015; p < 0.05) was observed. The radiographic osteomyelitis scores confirmed these histological findings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Treatment of osteomyelitis defects by a vancomycin-loaded gelatin/β-tricalcium phosphate composite scaffold

PubMed Central

Zhou, J.; Zhou, X. G.; Wang, J. W.; Zhou, H.; Dong, J.

2018-01-01

Objective In the present study, we aimed to assess whether gelatin/β-tricalcium phosphate (β-TCP) composite porous scaffolds could be used as a local controlled release system for vancomycin. We also investigated the efficiency of the scaffolds in eliminating infections and repairing osteomyelitis defects in rabbits. Methods The gelatin scaffolds containing differing amounts of of β-TCP (0%, 10%, 30% and 50%) were prepared for controlled release of vancomycin and were labelled G-TCP0, G-TCP1, G-TCP3 and G-TCP5, respectively. The Kirby-Bauer method was used to examine the release profile. Chronic osteomyelitis models of rabbits were established. After thorough debridement, the osteomyelitis defects were implanted with the scaffolds. Radiographs and histological examinations were carried out to investigate the efficiency of eliminating infections and repairing bone defects. Results The prepared gelatin/β-TCP scaffolds exhibited a homogeneously interconnected 3D porous structure. The G-TCP0 scaffold exhibited the longest duration of vancomycin release with a release duration of eight weeks. With the increase of β-TCP contents, the release duration of the β-TCP-containing composite scaffolds was decreased. The complete release of vancomycin from the G-TCP5 scaffold was achieved within three weeks. In the treatment of osteomyelitis defects in rabbits, the G-TCP3 scaffold showed the most efficacious performance in eliminating infections and repairing bone defects. Conclusions The composite scaffolds could achieve local therapeutic drug levels over an extended duration. The G-TCP3 scaffold possessed the optimal porosity, interconnection and controlled release performance. Therefore, this scaffold could potentially be used in the treatment of chronic osteomyelitis defects. Cite this article: J. Zhou, X. G. Zhou, J. W. Wang, H. Zhou, J. Dong. Treatment of osteomyelitis defects by a vancomycin-loaded gelatin/β-tricalcium phosphate composite scaffold. Bone Joint Res 2018;7:46–57. DOI: 10.1302/2046-3758.71.BJR-2017-0129.R2. PMID:29330343

The performance of serum inflammatory markers for the diagnosis and follow-up of patients with osteomyelitis.

PubMed

Michail, Marios; Jude, Edward; Liaskos, Christos; Karamagiolis, Spyridon; Makrilakis, Konstantinos; Dimitroulis, Dimitrios; Michail, Othon; Tentolouris, Nicholas

2013-06-01

Serum inflammatory markers, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBC), and procalcitonin (PCT), have been used for the diagnosis of foot infections in patients with diabetes. However, little is known about their changes during treatment of patients with foot infections. The aim of this prospective study was to examine the performance of serum inflammatory markers for the diagnosis and follow-up of patients with osteomyelitis. A total of 61 patients (age 63.1 ± 7.0 years, 45 men and 16 women, 7 with type 1 and 54 with type 2 diabetes) with untreated foot infection (34 with soft-tissue infection and 27 with osteomyelitis) were recruited. Diagnosis of osteomyelitis was based on clinical examination and was confirmed by imaging studies (X-ray, scintigraphy, magnetic resonance imaging). Determination of the inflammatory markers was performed at baseline, after 1 week, after 3 weeks, and after 3 months of treatment. At baseline, the values of CRP, ESR, WBC, and PCT were significantly higher in patients with osteomyelitis than in those with soft-tissue infections. The sensitivity and specificity for the diagnosis of osteomyelitis of CRP (cutoff value >14 mg/L) were 0.85 and 0.83, of ESR (cutoff value >67 mm/h) 0.84 and 0.75, of WBC (cutoff value >14 × 10(9)/L) 0.75 and 0.79, and of PCT (cutoff value >0.30 ng/mL) 0.81 and 0.71, respectively. All values declined after initiation of treatment with antibiotics; the WBC, CRP, and PCT values returned to near-normal levels at day 7, whereas the values of ESR remained high until month 3 only in patients with bone infection. From the inflammatory markers, ESR is recommended to be used for the follow-up of patients with osteomyelitis.

Implementation of Recommendations from the One System Comparative Evaluation of the Hanford Tank Farms and Waste Treatment Plant Safety Bases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Garrett, Richard L.; Niemi, Belinda J.; Paik, Ingle K.

2013-11-07

A Comparative Evaluation was conducted for One System Integrated Project Team to compare the safety bases for the Hanford Waste Treatment and Immobilization Plant Project (WTP) and Tank Operations Contract (TOC) (i.e., Tank Farms) by an Expert Review Team. The evaluation had an overarching purpose to facilitate effective integration between WTP and TOC safety bases. It was to provide One System management with an objective evaluation of identified differences in safety basis process requirements, guidance, direction, procedures, and products (including safety controls, key safety basis inputs and assumptions, and consequence calculation methodologies) between WTP and TOC. The evaluation identified 25more » recommendations (Opportunities for Integration). The resolution of these recommendations resulted in 16 implementation plans. The completion of these implementation plans will help ensure consistent safety bases for WTP and TOC along with consistent safety basis processes. procedures, and analyses. and should increase the likelihood of a successful startup of the WTP. This early integration will result in long-term cost savings and significant operational improvements. In addition, the implementation plans lead to the development of eight new safety analysis methodologies that can be used at other U.S. Department of Energy (US DOE) complex sites where URS Corporation is involved.« less

Maxillary Chronic Osteomyelitis Caused by Domestic Violence: A Diagnostic Challenge

PubMed Central

Oliveira, Tamyris Inácio; de Carli, Marina Lara; Ribeiro Junior, Noé Vital; Pereira, Alessandro Antônio Costa; Tatakis, Dimitris N.; Hanemann, João Adolfo Costa

2014-01-01

Maxillary osteomyelitis is a rare condition defined as inflammation of the bone primarily caused by odontogenic bacteria, with trauma being the second leading cause. The present report documents a rare case of maxillary osteomyelitis in a 38-year-old female who was the victim of domestic violence approximately a year prior to presentation. Intraoral examination revealed a lesion appearing as exposed bony sequestrum, with significant destruction of gingiva and alveolar mucosa in the maxillary right quadrant, accompanied by significant pain, local edema, and continued purulence. Teeth numbers 11, 12, 13, 14, and 15 were mobile, not responsive to percussion, and nonvital. Treatment included antibiotic therapy for seven days followed by total enucleation of the necrotic bone tissue and extraction of the involved teeth. Microscopic findings confirmed the clinical diagnosis of chronic suppurative osteomyelitis. Six months postoperatively, the treated area presented complete healing and there was no sign of recurrence of the lesion. PMID:25610667

Anterior decompression and fusion for Aspergillus osteomyelitis of the lumbar spine associated with paraparesis.

PubMed

Korovessis, P; Repanti, M; Katsardis, T; Stamatakis, M

1994-12-01

A very rare case of Aspergillus fumigatus osteomyelitis of the spine is described. The differential diagnosis, medical and operative treatment, and follow-up evaluation are reported. To increase knowledge about the pathogenesis and treatment of vertebral osteomyelitis resulting from Aspergillus and to emphasize that such cases still exist. Vertebral osteomyelitis from Aspergillus species is an infrequently described disease in Europe and only few cases have been previously reported. A 48-year-old woman with Aspergillus fumigatus spondylitis in the lumbar spine and tuberculosis-lung infection and concomitant debilitating systemic disease was afflicted with incomplete paraplegia and underwent successful combined operative and medical treatment. Early anterior decompression with spinal fusion, combined with Amphotericin B therapy, was crucial in bringing about complete neurologic recovery and maintaining the sagittal lumbar profile. Excellent clinical and radiologic results were shown in the 42-month follow-up period.

Orbital necrotizing fasciitis and osteomyelitis caused by arcanobacterium haemolyticum: a case report.

PubMed

Stone, Lindsay A; Harshbarger, Raymond J

2015-01-01

The facial region is infrequently affected by necrotizing infections. Orbital necrotizing infections are even rarer, seen following trauma, local skin infection, and sinusitis. The authors report a unique case of orbital necrotizing fasciitis and osteomyelitis resulting from Arcanobacterium Haemolyticum ethmoid sinusitis. No prior occurrences of Arcanobacterial species orbital necrotizing fasciitis/osteomyelitis have been reported.A 16-year-old boy presented to the ER with a 3-day history of fever, chills, headache, and sinus pressure. CT scan revealed soft tissue swelling of the right orbit, forehead, and ethmoid sinusitis. Within 24 hours of admission, he suffered rapidly progressive swelling and erythema of the right orbit and forehead with diminished visual acuity, despite broad-spectrum antibiotics. Orbital exploration revealed frankly necrotic fascia and periosteum along the superior aspect. Lateral canthotomy, cantholysis, decompression of the optic nerve, and soft tissue debridement with bone biopsy was performed. Operative specimens isolated Arcanobacterium Haemolyticum. Pathologic examination revealed right orbital osteomyelitis.

Concomitant Suppurative Parotitis and Condylar Osteomyelitis.

PubMed

Vorrasi, John; Zinberg, Geoffrey

2017-03-01

Parotitis is a common occurrence in the immunocompromised, dehydrated, and malnourished patient as a result of dysfunctional ductal and parotid cells. Inflammation can be acute or chronic based on clinical history, and it can be suppurative based on the presence of micro or macro abscess formation within the substance of the gland. This report presents a case of concomitant condylar osteomyelitis and chronic suppurative parotitis in the setting of previous methicillin-susceptible Staphylococcus aureus foot infection. Ultimately, resection of osteomyelitis, drainage of parotid infection, and intravenous antibiotic therapy led to full resolution of the infection and symptoms. The final pathology of osteomyelitis of the temporomandibular joint and methicillin-resistant S aureus infection is an unusual consequence of chronic parotitis. The patient was restored with a total joint replacement approximately 3 months after resection with no recurrence of infection after 24 months. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Chronic osteomyelitis of the tibia in a runner: catastrophic consequences of shin splints.

PubMed

Hammad, Yunes Nadim; Johnson, Abigail; Norrish, Alan

2018-03-01

Medial tibial stress syndrome and chronic osteomyelitis are conditions that are traditionally thought to affect very different patient groups. We present a case of shin splints in a recreational long-distance runner, complicated by chronic osteomyelitis of the tibia. This is a unique case in which the microtrauma resulting from shin splints was implicated as an entry point for bacterial infection into the bone. Clinical evaluation and bone biopsy culture results indicated haematogenous spread of bacteria originating from the oral cavity. The patient required surgical resection of the affected bone and a prolonged course of intravenous antibiotic treatment. We illustrate that when shin splints show signs of acute inflammation with delayed recovery, the possibility of osteomyelitis should be kept in mind. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Vertebral osteomyelitis caused by Prevotella (Bacteroides) melaninogenicus.

PubMed

Mukhopadhyay, Surabhi; Rose, Fredrick; Frechette, Vincent

2005-02-01

A 35-year-old, previously healthy female presented with severe low back pain, fever, and a high erythrocyte sedimentation rate 1 week after a routine dental cleaning. Technetium-labeled leukocyte scanning and magnetic resonance imaging scan of the spine were negative for osteomyelitis. The patient underwent biopsy, cultures from which grew Prevotella (Bacteroides) melaninogenicus. Appropriate antibiotic therapy resulted in resolution of symptoms. P. melaninogenicus is a gram-negative anaerobic bacillus that is part of the indigenous oral flora. It may cause dental, sinus, skin, and soft tissue infections. Infection of bone is rare. Only three cases of vertebral osteomyelitis due to P. melaninogenicus have been reported in the literature. The early diagnosis of vertebral osteomyelitis requires a high index of clinical suspicion and cannot be excluded by negative imaging tests alone. The recovery of this unusual organism highlights the importance of requesting anaerobic cultures of biopsy specimens.

Successful limb salvage through staged bypass combined with free gracilis muscle transfer for critical limb ischemia with osteomyelitis after failed endovascular therapy.

PubMed

Miyake, Keisuke; Kikuchi, Shinsuke; Okuda, Hiroko; Koya, Atsuhiro; Abe, Satomi; Sawa, Yoshiki; Ota, Tetsuo; Azuma, Nobuyoshi

2018-05-02

Critical limb ischemia with osteomyelitis is so difficult to treat that even appropriate revascularization and wound therapy cannot achieve limb salvage because of uncontrollable infection. It is still difficult to judge the possibility of limb salvage before revascularization. A 73-year-old male complained of a small ulcer on his left toe, which was treated with multiple endovascular therapy. After failed endovascular therapy, he suffered extensive tissue loss with tibial osteomyelitis. We carried out staged surgery that was composed of dual bypass to the sural artery and posterior tibial artery. After intensive debridement and wound care, insertion of a subsequent free gracilis muscle flap to cover the exposed tibial bone was performed, achieving functional limb salvage. Even in the threatened limb with extensive tissue loss and osteomyelitis, intensive and multidisciplinary treatment with staged revascularization, muscle transfer, and appropriate wound care achieved functional limb salvage.

Aspergillus fumigatus Empyema, Arthritis, and Calcaneal Osteomyelitis in a Lung Transplant Patient Successfully Treated with Posaconazole

PubMed Central

Lodge, Barbara Alexander; Ashley, Elizabeth Dodds; Steele, Mark P.; Perfect, John R.

2004-01-01

A 64-year-old male with Aspergillus fumigatus infection that had disseminated from the lung to the ankle and adjacent bone was treated successfully with posaconazole after therapy with itraconazole and amphotericin B lipid complex failed. Marked clinical improvement occurred within 6 weeks of initiation of posaconazole therapy; after 6 months, infection had resolved at all sites. The patient has had no recurrence of infection. PMID:15004125

Noninvasive Thermal Ablation of Osteomyelitis-Causing Bacteria using Functionalized Nanoparticles

DTIC Science & Technology

2012-03-01

2008). One alternative approach to antibiotics includes the use of near infrared ( IR ) radiation to thermally kill pathogenic organisms (Kam, 2005...Zharov, 2006). Whereas near IR wavelengths pass harmlessly through the human body, they are known to heat gold nanoshells to high temperatures (>70°C...nanoparticles both alone and complexed with PlyCB (Fig. 8). Task 3. Determine depth of IR radiation penetration and range of thermal damage. (months 11- 15

Surgical management of maxillary and premaxillary osteomyelitis in a reticulated python (Python reticulatus).

PubMed

Latney, La'Toya V; McDermott, Colin; Scott, Gregory; Soltero-Rivera, Maria M; Beguesse, Kyla; Sánchez, Melissa D; Lewis, John R

2016-05-01

CASE DESCRIPTION A 1-year-old reticulated python (Python reticulatus) was evaluated because of a 2-week history of wheezing and hissing. CLINICAL FINDINGS Rostral facial cellulitis and deep gingival pockets associated with missing rostral maxillary teeth were evident. Tissues of the nares were swollen, resulting in an audible wheeze during respiration. Multiple scars and superficial facial wounds attributed to biting by live prey were apparent. Radiographic examination revealed bilateral, focal, rostral maxillary osteomyelitis. TREATMENT AND OUTCOME Wound irrigation, antimicrobials, and anti-inflammatory drug treatment resulted in reduced cellulitis. A 3-week regimen that included empirical antimicrobial treatment and improved husbandry resulted in resolution of the respiratory sounds and partial healing of bite wounds, but radiographic evaluation revealed progressive maxillary osteomyelitis. Microbial culture of blood yielded scant gram-positive cocci and Bacillus spp, which were suspected sample contaminants. Bilateral partial maxillectomies were performed; microbial culture and histologic examination of resected bone confirmed osteomyelitis with gram-positive cocci. Treatment with trimethoprim-sulfamethoxazole was initiated on the basis of microbial susceptibility tests. Four months later, follow-up radiography revealed premaxillary osteomyelitis; surgery was declined, and treatment with trimethoprim-sulfamethoxazole was reinstituted. Eight months after surgery, the patient was reevaluated because of recurrent clinical signs; premaxillectomy was performed, and treatment with trimethoprim-sulfamethoxazole was prescribed on the basis of microbial culture of bone and microbial susceptibility testing. Resolution of osteomyelitis was confirmed by CT 11 months after the initial surgery. CONCLUSIONS AND CLINICAL RELEVANCE Focal maxillectomies and premaxillectomy were successfully performed in a large python. Surgical management and appropriate antimicrobial treatment resulted in a good outcome.

Surgical treatment strategy for diabetic forefoot osteomyelitis.

PubMed

Fujii, Miki; Terashi, Hiroto; Yokono, Koichi

2016-03-01

The aim of this study was to propose an appropriate surgical treatment for diabetic forefoot osteomyelitis (DFO) involving ischemia or moderate to severe soft tissue infection. The records of 28 patients with osteomyelitis from 2009 to 2015 were retrospectively studied. All patients had undergone surgery based on preoperative magnetic resonance imaging examinations and histopathological or culture analyses confirming the surgical bone margin. The appropriate surgical margin, crucial factors for early healing, and prognosis after complete resection of osteomyelitis were examined. After healing, patients were followed up to assess prognosis (range 32-1,910 days, median 546 days). The healing rate of nonischemic cases of DFO with negative surgical margins was 100% and that of ischemic cases was 84.6%; the ambulatory rates for both types of cases were 100%. No wound (and/or osteomyelitis) recurrence was observed. Nine new cases of DFO developed in six patients (21.4%; eight were due to vascular stenosis, and one was due to biomechanical changes in the foot. After complete resection of osteomyelitis, preoperative and postoperative C-reactive protein levels and the size of the ulcer were significant predictors of early healing (p < 0.05, 0.01, and 0.05, respectively). The appropriate surgical margin should be set in the area of bone marrow edema, based on magnetic resonance imaging examinations after revascularization. In cases with high preoperative or postoperative C-reactive protein levels, long-term antibiotic therapy is recommended, and surgery should be planned after the C-reactive protein levels decrease, except in emergencies. © 2016 by the Wound Healing Society.

Biomaterials approaches to treating implant-associated osteomyelitis.

PubMed

Inzana, Jason A; Schwarz, Edward M; Kates, Stephen L; Awad, Hani A

2016-03-01

Orthopaedic devices are the most common surgical devices associated with implant-related infections and Staphylococcus aureus (S. aureus) is the most common causative pathogen in chronic bone infections (osteomyelitis). Treatment of these chronic bone infections often involves combinations of antibiotics given systemically and locally to the affected site via a biomaterial spacer. The gold standard biomaterial for local antibiotic delivery against osteomyelitis, poly(methyl methacrylate) (PMMA) bone cement, bears many limitations. Such shortcomings include limited antibiotic release, incompatibility with many antimicrobial agents, and the need for follow-up surgeries to remove the non-biodegradable cement before surgical reconstruction of the lost bone. Therefore, extensive research pursuits are targeting alternative, biodegradable materials to replace PMMA in osteomyelitis applications. Herein, we provide an overview of the primary clinical treatment strategies and emerging biodegradable materials that may be employed for management of implant-related osteomyelitis. We performed a systematic review of experimental biomaterials systems that have been evaluated for treating established S. aureus osteomyelitis in an animal model. Many experimental biomaterials were not decisively more efficacious for infection management than PMMA when delivering the same antibiotic. However, alternative biomaterials have reduced the number of follow-up surgeries, enhanced the antimicrobial efficacy by delivering agents that are incompatible with PMMA, and regenerated bone in an infected defect. Understanding the advantages, limitations, and potential for clinical translation of each biomaterial, along with the conditions under which it was evaluated (e.g. animal model), is critical for surgeons and researchers to navigate the plethora of options for local antibiotic delivery. Copyright © 2015 Elsevier Ltd. All rights reserved.

Combined application of latissimus dorsi myocutaneous flap and iliac bone flap in the treatment of chronic osteomyelitis of the lower extremity.

PubMed

Ju, Jihui; Li, Lei; Zhou, Rong; Hou, Ruixing

2018-05-18

To evaluate the clinical efficacy and safety of latissimus dorsi myocutaneous flap (stage I) combined with iliac bone flap (stage II) in the treatment of chronic osteomyelitis of the lower extremity. Clinical data of 18 patients undergoing latissimus dorsi myocutaneous flap in combination with iliac bone flap grafting were retrospectively analyzed. Among them, 2 patients developed chronic osteomyelitis of the lower segment of the femur, 4 were diagnosed with chronic osteomyelitis of the tibial plateau, and 12 with chronic osteomyelitis of the lower segment of the tibia. All the latissimus dorsi myocutaneous flaps survived in 18 patients. After the corresponding surgery, primary wound healing was achieved in 11 patients, and delayed wound healing was obtained in 7 cases. All wounds were completely healed with postoperative 2 months. Following the iliac bone flap grafting, primary would healing was accomplished in all cases. All dorsal window chambers survived. The bone defects were properly restored within 4-12 postoperative months. Functional training was performed after removal of the internal and external fixators. Postoperative follow-up was endured from 6 months to 10 years. All patients were satisfied with the bone healing and flap texture without the incidence of osteomyelitis and sinus tract. No contraction was observed in the grafting area of 2 patients receiving latissimus dorsi myocutaneous flap grafting. Residual linear scars were noted in the dorsal and iliac donor sites. Combined usage of stage I latissimus dorsi myocutaneous flap and stage II iliac bone flap grafting is an efficacious and safe surgical technique in clinical practice.

40 CFR Table 20 to Subpart Uuu of... - Continuous Compliance With Organic HAP Emission Limits for Catalytic Reforming Units

Code of Federal Regulations, 2010 CFR

2010-07-01

... uncontrolled emissions of total organic compounds (TOC) or nonmethane TOC from your process vent by 98 percent... of TOC or nonmethane TOC; or maintaining a TOC or nonmethane TOC concentration of not more than 20...

A Case of Aerococcus Urinae Vertebral Osteomyelitis

PubMed Central

Jerome, Michael; Slim, Jihad; Sison, Raymund; Marton, Randy

2015-01-01

Aerococcus urinae is an aerobic, alpha hemolytic gram positive coccus bacterium that grows in pairs or clusters. We report the first case of vertebral osteomyelitis due to A. urinae. This has not been previously reported in the literature. PMID:26069429

Plasma and Tissue Concentrations of α-Tocopherol and δ-Tocopherol Following High Dose Dietary Supplementation in Mice

PubMed Central

Baxter, Laura L.; Marugan, Juan J.; Xiao, Jingbo; Incao, Art; McKew, John C.; Zheng, Wei; Pavan, William J.

2012-01-01

Vitamin E isoforms are essential nutrients that are widely used as dietary supplements and therapeutic agents for a variety of diseases. However, their pharmacokinetic (PK) properties remain poorly characterized, and high dosage animal studies may provide further information on their in vivo functions and pharmacological effects. In this study, alpha-tocopherol (α-toc) and delta-tocopherol (δ-toc) levels were measured in mouse plasma and tissues following their high dosage dietary supplementation. Average α-toc levels at 5, 10 and 20 g α-toc/kg diet increased over baseline levels 6-fold in plasma, 1.6-fold in brain, and 4.9-fold in liver. These elevated α-toc concentrations remained constant from 5 to 20 g α-toc/kg diet, rather than showing further increases across these dosages. No α-toc-related toxicity occurred at these high dosages, and strain-specific differences in liver and brain α-toc levels between Balb/cJ and C57Bl/6J mice were observed. Relatively high-dosage administration of dietary δ-toc for 1 or 4 weeks resulted in 6–30-fold increases in plasma and liver levels between dosages of 0.33 and 1.67 g δ-toc/kg diet. Co-administration of sesamin with δ-toc further increased δ-toc levels between 1.3- and 14-fold in plasma, liver, and brain. These results provide valuable PK information on high dosage α-toc and δ-toc in mouse and show that supplementation of sesamin with δ-toc further increases δ-toc levels over those seen with δ-toc supplementation alone. PMID:22822447

Aspergillus vertebral osteomyelitis after simultaneous kidney-pancreas transplantation.

PubMed

Salvalaggio, P R O; Bassetti, M; Lorber, M I; Micheletto, G C; Friedman, A L; Andriole, V T; Basadonna, G P

2003-12-01

Aspergillus osteomyelitis is a rare complication of invasive aspergillosis after organ transplantation. This is the report of a 46-year-old man who underwent a simultaneous pancreas and kidney transplantation, complicated by an Aspergillus osteomyelitis and diskitis of the lumbar spine. Prompt diagnosis with needle biopsy, followed by antifungal therapy using caspofungin, a new antifungal agent recommended for the treatment of refractory aspergillosis, in combination with amphotericin B and an early surgical intervention led to clinical resolution of the infection. Reported cases of spinal aspergillosis after transplantation are reviewed in terms of clinical presentation, risk factors, therapeutic options, and outcome.

Mycobacterium tuberculosis osteomyelitis in a patient with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS): a case report.

PubMed

Mannepalli, Supriya; Mitchell-Samon, Levonne; Guzman, Nilmarie; Relan, Manish; McCarter, Yvette S

2010-02-23

The incidence of tuberculosis is increasing in the United States. Extra-pulmonary involvement is more common in patients with HIV/AIDS. The diagnosis of Tuberculosis osteomyelitis requires a high degree of suspicion for accurate and timely diagnosis.We present a case of a 49 year old Caucasian male with HIV/AIDS who presented with a four-month history of soft tissue swelling in the left proximal thigh unresponsive to various broad spectrum antibiotics who was eventually diagnosed with Mycobacterium tuberculosis osteomyelitis of the left proximal femur.

Diabetic charcot neuroarthropathy of the foot and ankle with osteomyelitis.

PubMed

Ramanujam, Crystal L; Stapleton, John J; Zgonis, Thomas

2014-10-01

One of the most devastating foot and/or ankle complications in the diabetic population with peripheral neuropathy is the presence of Charcot neuroarthropathy (CN). In recent years, diabetic limb salvage has been attempted more frequently as opposed to major lower extremity amputation for CN of the foot and ankle with ulceration and/or deep infection. Treatment strategies for osteomyelitis in the diabetic population have evolved. This article reviews some of the most common surgical strategies recommended for the diabetic patient with CN of the foot and/or ankle and concomitant osteomyelitis. Copyright © 2014 Elsevier Inc. All rights reserved.

The diagnostic value of 18F-FDG-PET/CT and MRI in suspected vertebral osteomyelitis - a prospective study.

PubMed

Kouijzer, Ilse J E; Scheper, Henk; de Rooy, Jacky W J; Bloem, Johan L; Janssen, Marcel J R; van den Hoven, Leon; Hosman, Allard J F; Visser, Leo G; Oyen, Wim J G; Bleeker-Rovers, Chantal P; de Geus-Oei, Lioe-Fee

2018-05-01

The aim of this study was to determine the diagnostic value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) and magnetic resonance imaging (MRI) in diagnosing vertebral osteomyelitis. From November 2015 until December 2016, 32 patients with suspected vertebral osteomyelitis were prospectively included. All patients underwent both 18 F-FDG-PET/CT and MRI within 48 h. All images were independently reevaluated by two radiologists and two nuclear medicine physicians who were blinded to each others' image interpretation. 18 F-FDG-PET/CT and MRI were compared to the clinical diagnosis according to international guidelines. For 18 F-FDG-PET/CT, sensitivity, specificity, PPV, and NPV in diagnosing vertebral osteomyelitis were 100%, 83.3%, 90.9%, and 100%, respectively. For MRI, sensitivity, specificity, PPV, and NPV were 100%, 91.7%, 95.2%, and 100%, respectively. MRI detected more epidural/spinal abscesses. An important advantage of 18 F-FDG-PET/CT is the detection of metastatic infection (16 patients, 50.0%). 18 F-FDG-PET/CT and MRI are both necessary techniques in diagnosing vertebral osteomyelitis. An important advantage of 18 F-FDG-PET/CT is the visualization of metastatic infection, especially in patients with bacteremia. MRI is more sensitive in detection of small epidural abscesses.

Cohort study of somatostatin-based radiopeptide therapy with [(90)Y-DOTA]-TOC versus [(90)Y-DOTA]-TOC plus [(177)Lu-DOTA]-TOC in neuroendocrine cancers.

PubMed

Villard, Linda; Romer, Anna; Marincek, Nicolas; Brunner, Philippe; Koller, Michael T; Schindler, Christian; Ng, Quinn K T; Mäcke, Helmut R; Müller-Brand, Jan; Rochlitz, Christoph; Briel, Matthias; Walter, Martin A

2012-04-01

Radiopeptide therapy is commonly performed with a single radioisotope. We aimed to compare the effectiveness of somatostatin-based radiopeptide therapy with a single versus a combination of radioisotopes. In a cohort study, patients with metastasized neuroendocrine cancer were treated with repeated cycles of (90)yttrium-labeled tetraazacyclododecane-tetraacetic acid modified Tyr-octreotide ([(90)Y-DOTA]-TOC) or with cycles alternating between [(90)Y-DOTA]-TOC and (177)lutetium-labeled DOTA-TOC ([(177)Lu-DOTA]-TOC) until tumor progression or permanent toxicity. Multivariable Cox regression and competing risk regression were used to study predictors of survival and renal toxicity in patients completing three or more treatment cycles. A total of 486 patients completed three or more treatment cycles; 237 patients received [(90)Y-DOTA]-TOC and 249 patients received [(90)Y-DOTA]-TOC + [(177)Lu-DOTA]-TOC. Patients receiving [(90)Y-DOTA]-TOC + [(177)Lu-DOTA]-TOC had a significantly longer survival than patients receiving [(90)Y-DOTA]-TOC alone (5.51 v 3.96 years; hazard ratio, 0.64; 95% CI, 0.47 to 0.88; P = .006). The rates of severe hematologic toxicities (6.3% v 4.4%; P = .25) and severe renal toxicity (8.9% v 11.2%; P = .47) were comparable in both groups. [(90)Y-DOTA]-TOC + [(177)Lu-DOTA]-TOC was associated with improved overall survival compared with [(90)Y-DOTA]-TOC alone in patients completing three or more cycles of treatment. Contrary to the current practice in radiopeptide therapy, our results suggest an advantage of using a combination of radioisotopes.

Efficient bioremediation of total organic carbon (TOC) in integrated aquaculture system by marine sponge Hymeniacidon perleve.

PubMed

Fu, Wantao; Wu, Yichun; Sun, Liming; Zhang, Wei

2007-08-15

The aim of this study is to investigate the potential of using marine sponge Hymeniacidon perleve to remove total organic carbon (TOC) in integrated aquaculture ecosystems. In sterilized natural seawater (SNSW) with different concentrations of TOC, H. perleve removed approximately 44-61% TOC during 24 h, with retention rates of ca. 0.19-1.06 mg/h .g-fresh sponge, however no particulate selectivity was observed. The highest initial TOC concentration, in which about 2.7 g fresh sponges could remove TOC effectively in 0.5-L SNSW, is 214.3-256.9 mg/L. The highest capacity of TOC removal and clearance rate (CR) by H. perleve is ca. 25.50 mg-TOC/g-fresh sponge and 7.64 mL/h . g-fresh sponge within 24 h, respectively. Until reaching the highest TOC removal capacity, the TOC removal capacity and clearance rate of H. perleve increased with initial TOC concentration, and dropped dramatically thereafter. After reaching the highest removal capacity, H. perleve could only remove relatively lower TOC concentration in seawater in subsequent run. The TOC removal kinetics in SNSW by H. perleve fitted very well with a S-shaped curve and a Logistic model equation (R(2) = 0.999). In different volumes of SNSW with a fixed initial TOC concentration, the weight/volume ratio of sponge biomass and SFNSW was optimized at 1.46 g-fresh sponge/1-L SNSW to achieve the maximum TOC removal. When co-cultured with marine fish Fugu rubripes for 15 days, H. perleve removed TOC excreted by F. rubripes with similar retention rates of ca. 0.15 mg/h . g-fresh sponge, and the sponge biomass increased by 22.8%. (c) 2007 Wiley Periodicals, Inc.

Somatostatin-based radiopeptide therapy with [177Lu-DOTA]-TOC versus [90Y-DOTA]-TOC in neuroendocrine tumours.

PubMed

Romer, A; Seiler, D; Marincek, N; Brunner, P; Koller, M T; Ng, Q K T; Maecke, H R; Müller-Brand, J; Rochlitz, C; Briel, M; Schindler, C; Walter, M A

2014-02-01

Somatostatin-based radiopeptide treatment is generally performed using the β-emitting radionuclides (90)Y or (177)Lu. The present study aimed at comparing benefits and harms of both therapeutic approaches. In a comparative cohort study, patients with advanced neuroendocrine tumours underwent repeated cycles of [(90)Y-DOTA]-TOC or [(177)Lu-DOTA]-TOC until progression of disease or permanent adverse events. Multivariable Cox regression and competing risks regression were employed to examine predictors of survival and adverse events for both treatment groups. Overall, 910 patients underwent 1,804 cycles of [(90)Y-DOTA]-TOC and 141 patients underwent 259 cycles of [(177)Lu-DOTA]-TOC. The median survival after [(177)Lu-DOTA]-TOC and after [(90)Y-DOTA]-TOC was comparable (45.5 months versus 35.9 months, hazard ratio 0.91, 95% confidence interval 0.63-1.30, p = 0.49). Subgroup analyses revealed a significantly longer survival for [(177)Lu-DOTA]-TOC over [(90)Y-DOTA]-TOC in patients with low tumour uptake, solitary lesions and extra-hepatic lesions. The rate of severe transient haematotoxicities was lower after [(177)Lu-DOTA]-TOC treatment (1.4 vs 10.1%, p = 0.001), while the rate of severe permanent renal toxicities was similar in both treatment groups (9.2 vs 7.8%, p = 0.32). The present results revealed no difference in median overall survival after [(177)Lu-DOTA]-TOC and [(90)Y-DOTA]-TOC. Furthermore, [(177)Lu-DOTA]-TOC was less haematotoxic than [(90)Y-DOTA]-TOC.

Diagnostic value of MRI signs in differentiating Ewing sarcoma from osteomyelitis.

PubMed

Kasalak, Ömer; Overbosch, Jelle; Adams, Hugo Ja; Dammann, Amelie; Dierckx, Rudi Ajo; Jutte, Paul C; Kwee, Thomas C

2018-01-01

Background The value of magnetic resonance imaging (MRI) signs in differentiating Ewing sarcoma from osteomyelitis has not be thoroughly investigated. Purpose To investigate the value of various MRI signs in differentiating Ewing sarcoma from osteomyelitis. Material and Methods Forty-one patients who underwent MRI because of a bone lesion of unknown nature with a differential diagnosis that included both Ewing sarcoma and osteomyelitis were included. Two observers assessed several MRI signs, including the transition zone of the bone lesion, the presence of a soft-tissue mass, intramedullary and extramedullary fat globules, and the penumbra sign. Results Diagnostic accuracies for discriminating Ewing sarcoma from osteomyelitis were 82.4% and 79.4% for the presence of a soft-tissue mass, and 64.7% and 58.8% for a sharp transition zone of the bone lesion, for readers 1 and 2 respectively. Inter-observer agreement with regard to the presence of a soft-tissue mass and the transition zone of the bone lesion were moderate (κ = 0.470) and fair (κ = 0.307), respectively. Areas under the receiver operating characteristic curve of the diameter of the soft-tissue mass (if present) were 0.829 and 0.833, for readers 1 and 2 respectively. Mean inter-observer difference in soft-tissue mass diameter measurement ± limits of agreement was 35.0 ± 75.0 mm. Diagnostic accuracies of all other MRI signs were all < 50%. Conclusion Presence and size of a soft-tissue mass, and sharpness of the transition zone, are useful MRI signs to differentiate Ewing sarcoma from osteomyelitis, but inter-observer agreement is relatively low. Other MRI signs are of no value in this setting.

Clinical significance of the isolation of Staphylococcus epidermidis from bone biopsy in diabetic foot osteomyelitis.

PubMed

Aragón-Sánchez, Javier; Lázaro-Martínez, Jose Luis; Hernández-Herrero, María José; Quintana-Marrero, Yurena; Cabrera-Galván, Juan J

2010-01-01

Coagulase-negative staphylococci are considered as microorganisms with little virulence and usually as contaminants. In order to establish the role of Staphylococcus epidermidis as a pathogen in diabetic foot osteomyelitis, in addition to the isolation of the sole bacterium from the bone it will be necessary to demonstrate the histopathological changes caused by the infection. A consecutive series of 222 diabetic patients with foot osteomyelitis treated surgically in the Diabetic Foot Unit at La Paloma Hospital (Las Palmas de Gran Canaria, Canary Islands, Spain) between 1 October 2002 and 31 October 2008. From the entire series including 213 bone cultures with 241 isolated organisms, we have analyzed only the 139 cases where Staphylococci were found. We analyzed several variables between the two groups: Staphylococcus aureus versus Staphylococcus epidermidis. Of the 134 patients included in this study, Staphlylococcus epidermidis was found as the sole bacterium isolated in 11 cases and accompanied by other bacteria in 12 cases. Staphlylococcus aureus was found as the sole bacterium isolated in 72 cases and accompanied by other bacteria in 39 cases. Histopathological changes were found in the cases of osteomyelitis where Staphylococcus epidermidis was the sole bacterium isolated. Acute osteomyelitis was found to a lesser extent when Staphylococcus epidermidis was the sole bacterium isolated but without significant differences with the cases where Staphylococcus aureus was the sole bacterium isolated. Staphylococcus epidermidis should be considered as a real pathogen, not only a contaminant, in diabetic patients with foot osteomyelitis when the bacterium is isolated from the bone. No differences in the outcomes of surgical treatment have been found with cases which Staphlylococcus aureus was isolated.

Clinical significance of the isolation of Staphylococcus epidermidis from bone biopsy in diabetic foot osteomyelitis

PubMed Central

Aragón-Sánchez, Javier; Lázaro-Martínez, Jose Luis; Hernández-Herrero, María José; Quintana-Marrero, Yurena; Cabrera-Galván, Juan J.

2010-01-01

Introduction Coagulase-negative staphylococci are considered as microorganisms with little virulence and usually as contaminants. In order to establish the role of Staphylococcus epidermidis as a pathogen in diabetic foot osteomyelitis, in addition to the isolation of the sole bacterium from the bone it will be necessary to demonstrate the histopathological changes caused by the infection. Methods A consecutive series of 222 diabetic patients with foot osteomyelitis treated surgically in the Diabetic Foot Unit at La Paloma Hospital (Las Palmas de Gran Canaria, Canary Islands, Spain) between 1 October 2002 and 31 October 2008. From the entire series including 213 bone cultures with 241 isolated organisms, we have analyzed only the 139 cases where Staphylococci were found. We analyzed several variables between the two groups: Staphylococcus aureus versus Staphylococcus epidermidis. Results Of the 134 patients included in this study, Staphlylococcus epidermidis was found as the sole bacterium isolated in 11 cases and accompanied by other bacteria in 12 cases. Staphlylococcus aureus was found as the sole bacterium isolated in 72 cases and accompanied by other bacteria in 39 cases. Histopathological changes were found in the cases of osteomyelitis where Staphylococcus epidermidis was the sole bacterium isolated. Acute osteomyelitis was found to a lesser extent when Staphylococcus epidermidis was the sole bacterium isolated but without significant differences with the cases where Staphylococcus aureus was the sole bacterium isolated. Conclusion Staphylococcus epidermidis should be considered as a real pathogen, not only a contaminant, in diabetic patients with foot osteomyelitis when the bacterium is isolated from the bone. No differences in the outcomes of surgical treatment have been found with cases which Staphlylococcus aureus was isolated. PMID:22396808

Diagnostic usefulness of the QuantiFERON-TB gold in-tube test (QFT-GIT) for tuberculous vertebral osteomyelitis.

PubMed

Choi, Sungim; Jung, Kyung Hwa; Son, Hyo-Ju; Lee, Seung Hyun; Hong, Jung Min; Kim, Min Chul; Kim, Min Jae; Chong, Yong Pil; Sung, Heungsup; Lee, Sang-Oh; Choi, Sang-Ho; Kim, Yang Soo; Woo, Jun Hee; Kim, Sung-Han

2018-05-01

Interferon (IFN)-γ-releasing assay for diagnosing tuberculosis (TB) has shown promise; however, there are only a few reports on usefulness of the QuantiFERON-TB Gold In-Tube test (QFT-GIT) for diagnosing TB vertebral osteomyelitis. All patients presenting at a tertiary hospital between January 2010 and July 2016 with suspected TB vertebral osteomyelitis were retrospectively enrolled to evaluate the diagnostic performance of QFT-GIT. We used QFT-GIT to measure the IFN-γ response to ESAT-6, CFP-10 and TB7.7. A total of 141 patients were enrolled; 32 (23%) were categorized as having confirmed TB, (1%) as probable TB, 14 (10%) as possible TB and 93 (66%) as not TB. Of these, 16 patients with probable and possible TB were excluded from the final analysis. Chronic granulomas with/without necrosis, acid-fast bacilli stain, M. tuberculosis polymerase chain reaction and cultures for M. tuberculosis were positive in 14 (44%), 12 (38%), 22 (69%) and 28 (88%) patients, respectively, among the 32 patients with confirmed TB. The overall sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive result, and likelihood ratio for a negative result of the QFT-GIT for TB vertebral osteomyelitis were 91% (95% confidence interval [CI], 75-98%), 65% (95% CI, 54-75%), 50% (95% CI, 42-58%), 95% (95% CI, 86-98%), 2.59 (95% CI, 1.89-3.55) and 0.14 (95% CI, 0.05-0.43), respectively. The QFT-GIT appears to be a useful adjunct test for diagnosing TB vertebral osteomyelitis because the negative test results may be useful for excluding a diagnosis of active TB vertebral osteomyelitis.

Clinical, Morphological, and Molecular Characterization of Penicillium canis sp. nov., Isolated from a Dog with Osteomyelitis

PubMed Central

Sutton, Deanna A.; Swenson, Cheryl L.; Bailey, Chris J.; Wiederhold, Nathan P.; Nelson, Nathan C.; Thompson, Elizabeth H.; Wickes, Brian L.; French, Stephanie; Fu, Jianmin; Vilar-Saavedra, Paulo

2014-01-01

Infections caused by Penicillium species are rare in dogs, and the prognosis in these cases is poor. An unknown species of Penicillium was isolated from a bone lesion in a young dog with osteomyelitis of the right ilium. Extensive diagnostic evaluation did not reveal evidence of dissemination. Resolution of lameness and clinical stability of disease were achieved with intravenous phospholipid-complexed amphotericin B initially, followed by long-term combination therapy with terbinafine and ketoconazole. A detailed morphological and molecular characterization of the mold was undertaken. Sequence analysis of the internal transcribed spacer revealed the isolate to be closely related to Penicillium menonorum and Penicillium pimiteouiense. Additional sequence analysis of β-tubulin, calmodulin, minichromosome maintenance factor, DNA-dependent RNA polymerase, and pre-rRNA processing protein revealed the isolate to be a novel species; the name Penicillium canis sp. nov. is proposed. Morphologically, smooth, ovoid conidia, a greenish gray colony color, slow growth on all media, and a failure to form ascomata distinguish this species from closely related Penicillium species. PMID:24789186

Clinical, morphological, and molecular characterization of Penicillium canis sp. nov., isolated from a dog with osteomyelitis.

PubMed

Langlois, Daniel K; Sutton, Deanna A; Swenson, Cheryl L; Bailey, Chris J; Wiederhold, Nathan P; Nelson, Nathan C; Thompson, Elizabeth H; Wickes, Brian L; French, Stephanie; Fu, Jianmin; Vilar-Saavedra, Paulo; Peterson, Stephen W

2014-07-01

Infections caused by Penicillium species are rare in dogs, and the prognosis in these cases is poor. An unknown species of Penicillium was isolated from a bone lesion in a young dog with osteomyelitis of the right ilium. Extensive diagnostic evaluation did not reveal evidence of dissemination. Resolution of lameness and clinical stability of disease were achieved with intravenous phospholipid-complexed amphotericin B initially, followed by long-term combination therapy with terbinafine and ketoconazole. A detailed morphological and molecular characterization of the mold was undertaken. Sequence analysis of the internal transcribed spacer revealed the isolate to be closely related to Penicillium menonorum and Penicillium pimiteouiense. Additional sequence analysis of β-tubulin, calmodulin, minichromosome maintenance factor, DNA-dependent RNA polymerase, and pre-rRNA processing protein revealed the isolate to be a novel species; the name Penicillium canis sp. nov. is proposed. Morphologically, smooth, ovoid conidia, a greenish gray colony color, slow growth on all media, and a failure to form ascomata distinguish this species from closely related Penicillium species. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

A case of relapsing Salmonella osteomyelitis in a thalassaemia trait patient

PubMed Central

Mukundan, C.; Shukla, D. D.

2008-01-01

We report a case of chronic relapsing osteomyelitis caused by Salmonella Stanley in a β-thalassaemia trait patient who is otherwise normal. The importance of obtaining definitive bacteriological diagnosis and timely intervention to treat bone infection effectively is emphasised here. PMID:19384633

Candida albicans osteomyelitis of the spine: progressive clinical and radiological features and surgical management in three cases.

PubMed

Khazim, Rabi M; Debnath, Ujjwal K; Fares, Youssef

2006-09-01

Candida albicans vertebral osteomyelitis is rare. Three cases are presented. Without antifungal treatment, they developed spinal collapse and neurological deterioration within 3-6 months from the onset of symptoms. There was a delay of 4.5 and 7.5 months between the onset of symptoms and surgery. All patients were managed with surgical debridement and reconstruction and 12-week fluconazole treatment. The neurological deficits resolved completely. The infection has not recurred clinically or radiologically at 5-6 years follow-up. Although rare, Candida should be suspected as a causative pathogen in cases of spinal osteomyelitis. Without treatment the disease is progressive. As soon as osteomyelitis is suspected, investigations with MRI and percutaneous biopsy should be performed followed by medical therapy. This may prevent the need for surgery. However, if vertebral collapse and spinal cord compression occurs, surgical debridement, fusion and stabilisation combined with antifungal medications can successfully eradicate the infection and resolve the neurological deficits.

Candida albicans osteomyelitis of the spine: progressive clinical and radiological features and surgical management in three cases

PubMed Central

Debnath, Ujjwal K; Fares, Youssef

2006-01-01

Candida albicans vertebral osteomyelitis is rare. Three cases are presented. Without antifungal treatment, they developed spinal collapse and neurological deterioration within 3–6 months from the onset of symptoms. There was a delay of 4.5 and 7.5 months between the onset of symptoms and surgery. All patients were managed with surgical debridement and reconstruction and 12-week fluconazole treatment. The neurological deficits resolved completely. The infection has not recurred clinically or radiologically at 5–6 years follow-up. Although rare, Candida should be suspected as a causative pathogen in cases of spinal osteomyelitis. Without treatment the disease is progressive. As soon as osteomyelitis is suspected, investigations with MRI and percutaneous biopsy should be performed followed by medical therapy. This may prevent the need for surgery. However, if vertebral collapse and spinal cord compression occurs, surgical debridement, fusion and stabilisation combined with antifungal medications can successfully eradicate the infection and resolve the neurological deficits. PMID:16429290

A paradoxical presentation of rickets and secondary osteomyelitis of the jaw in Type II autosomal dominant osteopetrosis: Rare case reports.

PubMed

Jayachandran, S; Kumar, M Suresh

2016-01-01

Osteopetrosis is a rare genetic bone disorder arising due to a defect in the differentiation or function of osteoclast which results in a generalized increase in bone mass. Osteomyelitis is one of the most common complications because of decreased bone marrow function and compromised blood supply. Radiologist plays a vital role in diagnosing osteopetrosis. Here, we present two cases of autosomal dominant osteopetrosis Type II (ADO II) with secondary osteomyelitis changes which were reported to our department. One of these two cases presented with secondary osteomyelitis in both maxilla and mandible and features of rickets, which is very rarely seen in ADO II. To the best of our knowledge, the presentation of rickets with ADO is the first of its kind to be reported. In this paper, we describe the clinical and radiological features leading to the diagnosis of ADO in these two patients. Further, a review of the literature regarding ADO is discussed.

Limb salvage in Charcot foot and ankle osteomyelitis: combined use single stage/double stage of arthrodesis and external fixation.

PubMed

Dalla Paola, Luca; Brocco, Enrico; Ceccacci, Tanja; Ninkovic, Sasa; Sorgentone, Sara; Marinescu, Maria Grazia; Volpe, Antonio

2009-11-01

Charcot neuroarthropathy of the foot/ankle is a devastating complication of diabetes. Along with neuroarthropathy, osteomyelitis can occur which can result in amputation. This prospective study evaluated a limb salvage procedure as an alternative to amputation through surgical treatment of osteomyelitis of the midfoot or the ankle and stabilization with external fixation. Forty-five patients with Charcot arthropathy and osteomyelitis underwent debridement and attempted fusion with an external fixator. Chart and radiograph review was performed to assess the success of the fusion and eradication of infection. Out of 45 patients, 39 patients healed using emergent surgery to drain an acute manifestation of the infection while maintaining the fixation for an average of 25.7 weeks. Two patients were treated with intramedullary nail in a subsequent surgical procedure. In four patients, the infection could not be controlled, therefore a major amputation was carried out. For select patients, external fixation proved to be a reasonable alternative to below-knee amputation.

Osteomyelitis as the only manifestation of late latent syphilis: case report and literature review.

PubMed

Liu, Z-Y; Zhang, Y; Qiu, K-F; Du, S-X

2011-06-01

Bone infection, particularly of the skull and the long bones of the legs and arms, despite being a common characteristic of tertiary stage syphilis and congenital syphilis in the past, is seldom encountered clinically due to effective antibiotic therapy. We report a case of a 62-year-old man who presented with one-month acute pain in the left leg. Treponema pallidum particle agglutination test was positive, and radiography showed a pathological fracture of the left tibiofibula. Surgical debridement and biopsy of the bone marrow were performed and a pathological diagnosis of syphilis osteomyelitis was entertained. The patient's symptoms resolved completely after a six-week course of penicillin. We identified 17 previously published cases of bone lesions of syphilis, eight of which had syphilitic osteomyelitis, seven were syphilitic osteitis and two had syphilitic periostitis. We suggest that bone lesions such as osteomyelitis caused by syphilis can be the only manifestation of late latent syphilis.

The potential role of newer gram-positive antibiotics in the setting of osteomyelitis of adults.

PubMed

Moenster, Ryan P; Linneman, Travis W; Call, William B; Kay, Chad L; McEvoy, Theresa A; Sanders, Jamie L

2013-04-01

To summarize available literature regarding the potential role of linezolid, daptomycin, telavancin, tigecycline and ceftaroline for the treatment of osteomyelitis caused by resistant gram-positive organisms. Literature was obtained through PubMed searches from January 1980 to October 2011 using the terms osteomyelitis, bone, linezolid, daptomycin, telavancin, tigecycline and ceftaroline. Results were limited to those published in English. All articles identified from the PubMed searches were evaluated. Any published data related to bone penetration (animal or human) or clinical outcomes in adult osteomyelitis of these agents were included in the review. Animal models report bone concentrations of 2·3 mcg/dL (vertebral) for linezolid, 0·45 mcg/mL (tibiae) for daptomycin, 0·78 mcg/mL (tibiae) for tigecycline and 0·27 mcg/mL (tibiae) for telavancin; no data are available for ceftaroline. Human studies demonstrate bone concentrations of 4·6, 17·0 and 3·9 mcg/mL (sternal, metatarsal and cancellous bone respectively) for linezolid, 4·7 mcg/mL (metatarsal) for daptomycin and 0·078 mcg/mL (unspecified) for tigecycline; no data are available for telavancin and ceftaroline. Retrospective cohort data, and prospective/retrospective case series support the use of linezolid in this setting; however, side-effects may limit use. Retrospective and prospective cohort data support daptomycin use. A retrospective case series is available supporting the use of telavancin. No data are available supporting clinical effectiveness for ceftaroline or tigecycline in the setting of osteomyelitis. Limited data are available evaluating the safety and efficacy of these agents in osteomyelitis in adults. Daptomycin and telavancin may be potential alternatives or second-line agents to vancomycin in selected patients. Linezolid, because of an increase in clinically important ADRs with prolonged use, should be reserved as a second- or third-line agent. Due to a lack of clinical data and poor bone penetration, along with concerns regarding outcomes in severe infections, tigecycline's potential is limited. Little data exist regarding ceftaroline use in osteomyelitis. © 2013 Blackwell Publishing Ltd.

Scedosporium prolificans Osteomyelitis in an Immunocompetent Child Treated with Voriconazole and Caspofungin, as Well as Locally Applied Polyhexamethylene Biguanide

PubMed Central

Steinbach, William J.; Schell, Wiley A.; Miller, Jackie L.; Perfect, John R.

2003-01-01

Scedosporium species are increasingly isolated from immunocompromised and immunocompetent patients. Unfortunately, Scedosporium infections are generally resistant to amphotericin B, and Scedosporium prolificans strains are particularly resistant to the antifungal agents now in use. We report here on an immunocompetent child with S. prolificans-associated osteomyelitis successfully treated with debridement, local irrigation with polyhexamethylene biguanide, and the systemic administration of voriconazole and caspofungin despite poor in vitro activity of voriconazole alone against the isolate. We also review the treatments and outcomes of 28 reported cases of osteomyelitis or septic arthritis caused by Scedosporium species in immunocompetent patients. PMID:12904435

[In Process Citation].

PubMed

Scherrer, Beat; Della Chiesa, Andrea; Polska, Elzbieta; Kutten Berger, Johannes J

Inflammation of bone is caused either by bacterial infection or occasionally by physical stimulus. Primary chronic osteomyelitis of mandibular bone is a chronic inflammation of an unknown cause. Pain, swelling, limited mouth opening, regional lymphadenopathy and hypaesthesia are clinical symptoms at initial presentation. Results of biopsy, computed tomography and scintigraphy reveal the diagnosis of a primary chronic osteomyelitis. Its management is long-term antibiotic therapy, hyperbaric oxygen and surgical therapy, even bisphophonate treatement may be a good option. The case report presents a primary progressive chronic osteomyelitis of the manibular bone of a ten year old boy. Clinical and radiological signs are discussed as well as diagnosis, management and follow-up.

Unusual presentation of calcaneal osteomyelitis. Twenty-five years after inoculation.

PubMed

Rogoff, R S; Tinkle, J D; Bartis, D G

1997-03-01

An unusual presentation of calcaneal osteomyelitis is described, where-by the infection remained undiagnosed for 25 years. The 36-year-old patient recently sought medical treatment for a reported ankle sprain, but the pain was recalcitrant to conservative care. Further investigation yielded a history significant for stepping on a chicken bone as a child, which entered the inferior lateral heel. Magnetic resonance imaging revealed what plain radiographs did not: a well demarcated lytic lesion in the body of the calcaneus. Intraoperative findings were consistent with an abscess of chronic osteomyelitis. The treatment included incision and drainage, antibiotic beads, and a tricortical bone graft.

[Studies on the factors responsible for low erythrocyte alpha-tocopherol concentrations in patients on maintenance hemodialysis].

PubMed

Mori, K

1989-03-01

The present study was undertaken to clarify the low erythrocyte (RBC) alpha-tocopherol (TOC) concentrations in patients on maintenance hemodialysis (HD) using in vivo and in vitro experiments. 15 age-matched male controls and HD patients were evaluated. The experimental designs and the results were as follows: 1) Changes in fasting stage; TOC levels of plasma, high density lipoproteins (HDL) and RBC, especially RBC, were lower in HD-patients than in controls. The ratio of RBC to plasma and HDL showed more significant changes between HD-patients and controls. In controls, RBC-TOC was noted to have a positive correlation with HDL-TOC and a negative correlation with non HDL-(plasma--HDL)-TOC, whereas a reverse correlation was observed in HD-patients. 2) In vivo experiments: Each 7 of HD-patients and controls were orally given TOC 600 mg after meal at early morning; the blood was sampled at 0, 3, 6, 10 and 24 hr. Poor increase of RBC-TOC in HD-patients was observed. In contrast, HDL-TOC was significantly higher at all measurement times than in controls. The change of plasma-TOC was similar to that of non HDL-TOC. 3) In vitro experiment:RBC from patients or controls showing various concentrations of RBC-TOC and plasma from controls were incubated at 37 degrees C or 4 degrees C. The inactivated plasma from controls was prepared by incubation at 56 degrees C, 30 min or by supplement of 2 mM parachloromerucuric benzonic sulfonate. The ratio of RBC and plasma was at 2:3 close to physiological conditions. No difference between patient and control RBCs as an acceptor of TOC and no appreciable transfer of TOC between RBC to plasma at 4 degrees C were observed. When RBC-TOC was low, transfer volume of TOC from plasma to RBC was increased and TOC was supplied from mainly non HDL fractions; in contrast, when it was high, the main source of TOC was due to the transfer from HDL fractions which was reduced when lecithin: cholesterol acyltransferase (LCAT) reaction was inhibited. From above in vivo and in vitro studies, it was concluded that low levels of RBC-TOC in HD-patients may be due to an insufficiency of TOC transfer from HDL fractions affected by low LCAT activity.

[Chronic recurrent multifocal osteomyelitis of the mandible: report of three cases].

PubMed

Paim, Luciana B; Liphaus, Bernadete Lourdes; Rocha, André C; Castellanos, Aura Ligia Z; Silva, Clovis Artur A

2003-01-01

To report three cases of chronic recurrent multifocal osteomyelitis of the mandible, an inflammatory disease affecting one or more bones with absence of isolated microorganisms in affected areas. The first case is a 13 year-old female presenting with pain and fever after dental treatment. The patient received antibiotic treatment for osteomyelitis, but developed progressive enlargement of the mandible and palmoplantar pustulosis. Bone scintigraphy showed intense and diffuse uptake in the mandible. The swelling decreased after indomethacin and hyperbaric oxygen therapy. Case 2 is a 9 year-old female patient with recurrent pain and edema of the right mandible for three years. The diagnosis of osteomyelitis was established and amoxicillin introduced. After three months, tomography showed diffuse mandible osteolysis. Indomethacin and hyperbaric oxygen therapy were introduced, however the patient presented a relapse and was treated with prednisone, rofecoxib and methotrexate. Patient 3, a 10 year-old male, had palmoplantar pustulosis and recurrent enlargement of the mandible. Tomography showed diffuse mandible osteolysis and scintigraphy revealed intense and diffuse uptake in the mandible. The patient was treated with prednisone. Rofecoxib was replaced after two relapses. Chronic recurrent multifocal osteomyelitis of the mandible is often associated with prolonged pain periods and periods of activity and remission of the inflammatory process. Its recognition is important to prevent the patient from being submitted to prolonged antibiotic therapy and unnecessary invasive procedures.

TOC-39, a novel parenteral broad-spectrum cephalosporin with excellent activity against methicillin-resistant Staphylococcus aureus.

PubMed Central

Hanaki, H; Akagi, H; Masaru, Y; Otani, T; Hyodo, A; Hiramatsu, K

1995-01-01

TOC-39, a new parenteral cephalosporin, is a hydroxyimino-type cephem antibiotic with vinylthio-pyridyl moiety at the 3 position. TOC-39 was evaluated for antibacterial activity against various clinically isolated strains. TOC-39 had excellent activity, stronger than that of methicillin, oxacillin, the cephalosporins tested, imipenem, gentamicin, minocycline, tobramycin, ofloxacin, and ciprofloxacin against methicillin-resistant Staphylococcus aureus (MRSA) and had an MIC comparable to that of vancomycin (the MICs of TOC-39 and vancomycin for 90% of the strains tested were 3.13 and 1.56 micrograms/ml, respectively). Against Enterococcus faecalis strains, which are resistant to cephalosporins, TOC-39 was twice as active as ampicillin. Against methicillin-susceptible S. aureus, coagulase-negative Staphylococcus spp., and Streptococcus pneumoniae, TOC-39 was twice as active as or more active than cefotiam, ceftazidime, flomoxef, and cefpirome. Against Streptococcus pyogenes, TOC-39 was superior to cefotiam, ceftazidime, and flomoxef and was similar to cefpirome. In addition, the activity of TOC-39 was equal to or greater than that of cefotiam, ceftazidime, flomoxef, and cefpirome against Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Morganella morganii. In terms of bactericidal effect against MRSA, TOC-39 was superior to vancomycin. No mutant resistant to TOC-39 or vancomycin was obtained from susceptible MRSA strains. In murine systemic infection models, TOC-39 showed potent activity against S. aureus and E. coli. Against highly MRSA, the activity of TOC-39 was comparable to that of vancomycin. PMID:7625799

[Age-related change in the alpha-tocopherolquinone/alpha-tocopherol ratio in the rat erythrocyte membrane].

PubMed

Yanagawa, K; Takeda, H; Matsumiya, T; Takasaki, M

1999-05-01

alpha-Tocopherol (alpha-Toc), a lipophilic phenolic antioxidant that is localized mainly in the biomembrane, protects cells against oxidation-associated cytotoxicity by prevention of membrane lipid peroxidation, maintenance of the redox balance intracellular thiols and stabilization of the membrane structure. We investigated the age-related changes in redox dynamics of alpha-Toc in plasma and erythrocyte membrane of an elderly (66 weeks old) and young group (10 weeks old). Total, alpha-, beta + gamma-, delta-Toc and alpha-tocopherolquinone (alpha-TocQ) in plasma and erythrocyte membrane were determined by high-performance liquid chromatography (HPLC) with a series of multiple coulometric working electrodes (CWE). Rat venous blood sample was divided into plasma and erythrocyte layers by centrifugation, and then erythrocyte membrane sample was prepared according to the method of Dodge et al. under a stream of nitrogen. In plasma, total and alpha-Toc concentrations were increased, and beta + gamma-, delta-Toc and alpha-TocQ concentrations were decreased age-dependently. In the erythrocyte membrane, total, alpha-TocQ concentrations and three fractions of tocopherols decreased age-dependently. Also, a decrease in the alpha-TocQ/alpha-Toc ratio in erythrocyte membrane was observed in the elderly group. These findings suggest that the alpha-Toc uptake in erythrocyte membrane and utilization rate of alpha-Toc in erythrocyte membrane decline age-dependently. This decline may promote membrane lipid peroxidation. alpha-Toc redox dynamics in erythrocyte membrane were useful to investigate the pathophysiology of aging mechanisms related to oxidative stress.

Saksenaea vasiformis osteomyelitis.

PubMed Central

Pierce, P F; Wood, M B; Roberts, G D; Fitzgerald, R H; Robertson, C; Edson, R S

1987-01-01

A 24-year-old man sustained a crush injury to the tibia, which subsequently became infected with Saksenaea vasiformis. He was treated with debridement and a free myocutaneous flap, but amputation was necessary because of mycotic osteomyelitis. S. vasiformis was recovered and identified on the basis of its characteristic morphology on cornmeal agar. Images PMID:3584430

Origin and distribution of hydrocarbons and organic matter in the surficial sediments of the Sfax-Kerkennah channel (Tunisia, Southern Mediterranean Sea).

PubMed

Zaghden, Hatem; Tedetti, Marc; Sayadi, Sami; Serbaji, Mohamed Moncef; Elleuch, Boubaker; Saliot, Alain

2017-04-15

We investigated the origin and distribution of aliphatic and polycyclic aromatic hydrocarbons (AHs and PAHs) and organic matter (OM) in surficial sediments of the Sfax-Kerkennah channel in the Gulf of Gabès (Tunisia, Southern Mediterranean Sea). TOC, AH and PAH concentrations ranged 2.3-11.7%, 8-174μgg -1 sed.dw and 175-10,769ngg -1 sed.dw, respectively. The lowest concentrations were recorded in the channel (medium sand sediment) and the highest ones in the Sfax harbor (very fine sand sediment). AHs, PAHs and TOC were not correlated for most of the stations. TOC/N and δ 13 C values revealed a mixed origin of OM with both marine and terrestrial sources. Hydrocarbon molecular composition highlighted the dominance of petrogenic AHs and the presence of both petrogenic and pyrogenic PAHs, associated with petroleum products and combustion processes. This work underscores the complex distribution patterns and the multiple sources of OM and hydrocarbons in this highly anthropogenized coastal environment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Solubility of lead and copper in biochar-amended small arms range soils: influence of soil organic carbon and pH.

PubMed

Uchimiya, Minori; Bannon, Desmond I

2013-08-14

Biochar is often considered a strong heavy metal stabilizing agent. However, biochar in some cases had no effects on, or increased the soluble concentrations of, heavy metals in soil. The objective of this study was to determine the factors causing some biochars to stabilize and others to dissolve heavy metals in soil. Seven small arms range soils with known total organic carbon (TOC), cation exchange capacity, pH, and total Pb and Cu contents were first screened for soluble Pb and Cu concentrations. Over 2 weeks successive equilibrations using weak acid (pH 4.5 sulfuric acid) and acetate buffer (0.1 M at pH 4.9), Alaska soil containing disproportionately high (31.6%) TOC had nearly 100% residual (insoluble) Pb and Cu. This soil was then compared with sandy soils from Maryland containing significantly lower (0.5-2.0%) TOC in the presence of 10 wt % (i) plant biochar activated to increase the surface-bound carboxyl and phosphate ligands (PS450A), (ii) manure biochar enriched with soluble P (BL700), and (iii) unactivated plant biochars produced at 350 °C (CH350) and 700 °C (CH500) and by flash carbonization (corn). In weak acid, the pH was set by soil and biochar, and the biochars increasingly stabilized Pb with repeated extractions. In pH 4.9 acetate buffer, PS450A and BL700 stabilized Pb, and only PS450A stabilized Cu. Surface ligands of PS450A likely complexed and stabilized Pb and Cu even under acidic pH in the presence of competing acetate ligand. Oppositely, unactivated plant biochars (CH350, CH500, and corn) mobilized Pb and Cu in sandy soils; the putative mechanism is the formation of soluble complexes with biochar-borne dissolved organic carbon. In summary, unactivated plant biochars can inadvertently increase dissolved Pb and Cu concentrations of sandy, low TOC soils when used to stabilize other contaminants.

Multimeric complement component C9 is necessary for killing of Escherichia coli J5 by terminal attack complex C5b-9

DOE Office of Scientific and Technical Information (OSTI.GOV)

Joiner, K.A.; Schmetz, M.A.; Sanders, M.E.

The authors studied the molecular composition of the complement C5b-9 complex required for optimal killing of Escherichia coli strain J5. J5 cells were incubated in 3.3%, 6.6%, or 10.0% C8-deficient serum previously absorbed to remove specific antibody and lysozyme. This resulted in the stable deposition after washing of 310, 560, and 890 C5b67 molecules per colony-forming unit, respectively, as determined by binding of /sup 125/I-labeled C7. Organisms were then incubated with excess C8 and various amounts of /sup 131/I-labeled C9. Plots of the logarithm (base 10) of E. coli J5 cells killed (log kill) vs. C9 input were sigmoidal, confirmingmore » the multihit nature of the lethal process. When C9 was supplied in excess, 3300, 5700, and 9600 molecules of C9 were bound per organism for cells bearing 310, 560, and 890 C5b-8 complexes, respectively, leading to C9-to-C7 ratios of 11.0:1, 10.8:1, and 11.4:1 and to log kill values of 1.3, 2.1, and 3.9. However, at low inputs of C9 that lead to C9-to-C7 ratios of less than 3.3:1, no killing occurred, and this was independent of the number of C5b-9 complexes bound. Formation of multimeric C9 at C9-to-C7 ratios permissive for killing was confirmed by electron microscopy and by binding of /sup 125/I-labeled antibody with specificity for multimeric but not monomeric C9. These experiments are the first to demonstrate a biological function for C9 polymerization and suggest that multimeric C9 is necessary for optimal killing of E. coli J5 cells by C5b-9.« less

Robust labeling and comparative preclinical characterization of DOTA-TOC and DOTA-TATE.

PubMed

Velikyan, Irina; Xu, Hui; Nair, Manoj; Hall, Håkan

2012-07-01

Various radionuclide-labeled somatostatin analogues are used currently for diagnosis and therapy of neuroendocrine tumors. In particular, [68Ga]Ga-DOTA-TOC is commonly used for diagnosis, while [177Lu]Lu-DOTA-TATE is used for therapy. With the development of theranostics and personalized medicine where the imaging diagnosis is tailored to the subsequent radiotherapy, it is of paramount importance to investigate the relevance of the ligand exchange. The aim of this study was to compare binding capacity of [67/68Ga]Ga-DOTA-TOC ([67/68Ga]Ga-N-(4,7,10-(tris(carboxymethyl)-1,4,7,10-tetraazacyclododecan-1-yl)acetyl-D-Phe-c[Cys-D-Tyr-Trp-Lys-Thr-Cys]-Thr(ol)) and [67/68Ga]Ga-DOTA-TATE ([67/68Ga]Ga-N-(4,7,10-(tris(carboxymethyl)-1,4,7,10-tetraazacyclododecan-1-yl)acetyl-D-Phe-c[Cys-D-Tyr-Trp-Lys-Thr-Cys]-Thr) in vitro in monkey brain cryosections and in vivo in the rat, where, in contrast to transfected cell lines, there is a heterogeneous distribution of somatostatin receptor (SSTR) subtypes. The influence of various production methods of [68Ga]Ga-DOTA-TOC and [68Ga]Ga-DOTA-TATE on the biological performance of the tracers was also studied. [67Ga]Ga-DOTA-TOC, [68Ga]Ga-DOTA-TOC, [67Ga]Ga-DOTA-TATE and [68Ga]Ga-DOTA-TATE were synthesized including preconcentration and purification of the generator eluate. The binding of the radioligands was assessed in vitro using autoradiography on cryosections of Rhesus monkey brains and in vivo/ex vivo using organ distribution studies in rats. The tracer production method was improved in terms of higher robustness, simplification and good manufacturing practice (GMP) relevance. The synthesis variation did not influence the biological performance of the tracers. There was no statistically significant difference observed in the binding of [67/68Ga]Ga-DOTA-TOC and [67/68Ga]Ga-DOTA-TATE either in brain cortex in vitro or in rat biodistribution and uptake in SSTR-positive tissues such as pancreas, adrenals and pituitary. The uptake in these organs was precluded by the excess of octreotide (Sandostatin). The 10-fold higher affinity to SSTR2 of DOTA-TATE as compared to DOTA-TOC known from studies in transfected cells was reflected in a slightly more intense binding of [67/68Ga]Ga-DOTA-TATE than of [67/68Ga]Ga-DOTA-TOC in the monkey brain sections in vitro, but not in vivo in the rat. A robust 68Ga-labeling method was introduced. The difference in the uptake of [67/68Ga]Ga-DOTA-TOC and [67/68Ga]Ga-DOTA-TATE in SSTR2-positive organs was not statistically significant either in vitro in tissue studies or in vivo/ex vivo in rat experiments. The results indicate that the more complex environment in vitro and in vivo diminishes the difference observed in transfected cell line binding. Copyright © 2012 Elsevier Inc. All rights reserved.

Total Organic Carbon Distribution and Bacterial Cycling Across A Geostrophic Front In Mediterranean Sea. Implications For The Western Basin Carbon Cycle

NASA Astrophysics Data System (ADS)

Sempere, R.; van Wambeke, F.; Bianchi, M.; Dafner, E.; Lefevre, D.; Bruyant, F.; Prieur, L.

We investigated the dynamic of the total organic carbon (TOC) pool and the role it played in the carbon cycle during winter 1997-1998 in the Almeria-Oran jet-front (AOF) system resulting from the spreading of Atlantic surface water through the Gibraltar Strait in the Alboran Sea (Southwestern Mediterranean Sea). We determined TOC by using high temperature combustion technique (HTC) and bacterial produc- tion (BP; via [3H] leucine incorporation) during two legs in the frontal area. We also estimated labile TOC (l-TOC) and bacterial growth efficiency (BGE) by performing TOC biodegradation experiments on board during the cruise whereas water column semi-labile (sl-TOC), and refractory-TOC were determined from TOC profile exami- nation. These results are discussed in relation with current velocity measured by using accoustic doppler current profiler (ADCP). Lowest TOC stocks (6330-6853 mmol C m-2) over 0-100 m were measured in the northern side of the geostrophic Jet which is also the highest dynamic area (horizontal speed of 80 cm s-1 in the first 100 m di- rected eastward). Our results indicated variable turnover times of sl-TOC across the Jet-Front system, which might be explained by different coupling of primary produc- tion and bacterial production observed in these areas. We also estimated TOC and sl-TOC transports within the Jet core off the Alboran Sea as well as potential CO2 production through bacterial respiration produced from sl-TOC assimilation by het- erotrophic bacteria.

Technetium-99m-labeled ceftizoxime loaded long-circulating and pH-sensitive liposomes used to identify osteomyelitis.

PubMed

Ferreira, Soraya Maria Zandim Maciel Dias; Domingos, Giselle Pires; Ferreira, Diego dos Santos; Rocha, Talita Guieiro Ribeiro; Serakides, Rogéria; de Faria Rezende, Cleuza Maria; Cardoso, Valbert Nascimento; Fernandes, Simone Odília Antunes; Oliveira, Mônica Cristina

2012-07-15

Osteomyelitis is an infectious disease located in the bone or bone marrow. Long-circulating and pH-sensitive liposomes containing a technetium-99m-labeled antibiotic, ceftizoxime, (SpHL-(99m)Tc-CF) were developed to identify osteomyelitis foci. Biodistribution studies and scintigraphic images of bone infection or non infection-bearing rats that had been treated with these liposomes were performed. A high accumulation in infectious foci and high values in the target-non target ratio could be observed. These results indicate the potential of SpHL-(99m)Tc-CF as a potential agent for the diagnosis of bone infections. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Pseudotumoral subacute osteomyelitis: a series of 41 children].

PubMed

Chau, E; Kohler, R; Cottalorda, J; Rosenberg, D; Bouvier, R

2000-02-01

To confirm that subacute osteomyelitis in children is a real entity, and give the main characteristics of this disease We reviewed 41 cases as well as the litterature. Pain without fever was the only constant symptom. The erythrocyte sedimentation rate was increased slightly. XRays were the most important investigation, showing a geode in the metaphysis or more rarely in the epiphysis evoking a benign bone tumor in a child. The treatment was most often surgical: scraping permits the isolation of the microbe in 50 per cent of cases (staphylococcus most often) and usualy leady to recovery. This form of osteomyelitis is relatively frequent and must be discussed in front of a cystic tumoral image of the child's long bone.

Case report of Aspergillus osteomyelitis of the ribs in an immunocompetent patient.

PubMed

D'sa, Shilpa Reynal; Singh, Suvir; Satyendra, Sowmya; Mathews, Prasad

2013-07-01

Aspergillus is a saprophytic fungus which is universally found in the environment. Most people breathe in the spores of Aspergillus every day without development of disease. It commonly affects immunocompromised hosts. There are only few reported cases in an immunocompetent host. It most commonly affects the respiratory system, causing superficial or invasive disease. It also affects the skin, brain and eye in severely immunocompromised patients. Aspergillosis of the bone is extremely rare. Amongst all the reported cases of invasive aspergillosis the incidence of osteomyelitis is less than three percent. In these cases commonly of the spine is reported. We present a case of Aspergillus osteomyelitis of the ribs in an immunocompetent host.

Case Report of Aspergillus Osteomyelitis of the Ribs in an Immunocompetent Patient

PubMed Central

D’sa, Shilpa Reynal; Singh, Suvir; Satyendra, Sowmya; Mathews, Prasad

2013-01-01

Aspergillus is a saprophytic fungus which is universally found in the environment. Most people breathe in the spores of Aspergillus every day without development of disease. It commonly affects immunocompromised hosts. There are only few reported cases in an immunocompetent host. It most commonly affects the respiratory system, causing superficial or invasive disease. It also affects the skin, brain and eye in severely immunocompromised patients. Aspergillosis of the bone is extremely rare. Amongst all the reported cases of invasive aspergillosis the incidence of osteomyelitis is less than three percent. In these cases commonly of the spine is reported. We present a case of Aspergillus osteomyelitis of the ribs in an immunocompetent host. PMID:24049367

Vertebral Osteomyelitis Caused by Helicobacter cinaedi Identified Using Broad-range Polymerase Chain Reaction with Sequencing of the Biopsied Specimen.

PubMed

Hase, Ryota; Hirooka, Takuya; Itabashi, Takashi; Endo, Yasunobu; Otsuka, Yoshihito

2018-05-15

A 65-year-old man presented with gradually exacerbating low back pain. Magnetic resonance imaging revealed vertebral osteomyelitis in the Th11-L2 vertebral bodies and discs. The patient showed negative findings on conventional cultures. Direct broad-range polymerase chain reaction (PCR) with sequencing of the biopsied specimen had the highest similarity to the 16S rRNA gene of Helicobacter cinaedi. This case suggests that direct broad-range PCR with sequencing should be considered when conventional cultures cannot identify the causative organism of vertebral osteomyelitis, and that this method may be particularly useful when the pathogen is a fastidious organism, such as H. cinaedi.

Spinal osteomyelitis due to Aspergillus flavus in a child: a rare complication after haematopoietic stem cell transplantation.

PubMed

Beluffi, Giampiero; Bernardo, Maria Ester; Meloni, Giulia; Spinazzola, Angelo; Locatelli, Franco

2008-06-01

We report the case of a child affected by acute myeloid leukaemia who was treated with allogeneic haematopoietic stem cell transplantation and developed cervicothoracic spinal osteomyelitis due to Aspergillus flavus. The diagnosis was difficult on a clinical basis, but made possible by conventional radiography and MRI.

[The application of laser therapy for the medical rehabilitation of the children presenting with chronic osteomyelitis].

PubMed

Trunova, O V; Mashkov, A E; Khan, M A; Prikuls, V F; Nazarenko, N N; Supova, M V; Smirnova, S N; Larionov, K S

2015-01-01

The objective of the present study was to develop a scientifically sound rationale for the application of infrared laser radiation (IRLR) either separately or in the combination with fluctuation magnetic therapy in the medical rehabilitation of the children presenting with chronic hematogenous osteomyelitis. Another objective was to evaluate the clinical effectiveness of this therapeutic modality. Two achieve these goals, the clinical observations and special research studies were conducted in two directions with the participation of 95 patients at the age varying from 1 to 15 years. The study has demonstrated the effectiveness of the inclusion of IRLR in the medical rehabilitation program for the children with chronic hematogenous osteomyelitis in different periods of the disease. It was shown that the transcutaneous infrared irradiation of the affected area during the exacerbation of chronic osteomyelitis had a well apparent immunostimulatory effect and reduced the activity of the inflammatory process. The application of IRLR in combination with fluctuation magnetic therapy during the period of partial remission, had a more pronounced influence on the microcirculation and stimulated the regenerative and trophic processes.

Rare Case of Aspergillus ochraceus Osteomyelitis of Calcaneus Bone in a Patient with Diabetic Foot Ulcers.

PubMed

Babamahmoodi, Farhang; Shokohi, Tahereh; Ahangarkani, Fatemeh; Nabili, Mojtaba; Afzalian Ashkezari, Elham; Alinezhad, Sosan

2015-01-01

Diabetes is the most common metabolic disease in humans. One of the major complications of the disease is foot ulcer that is prone to infection. The most common causes of infection which have been reported in these patients are bacteria and fungi such as Candida, Aspergillus, and Rhizopus species. We report one such rare case with calcaneal osteomyelitis caused by Aspergillus ochraceus in a patient with diabetic foot osteomyelitis. The case was a 68-year-old male with a history of type II diabetes for 2 years. The patient had two ulcers on the right heel bones for the past 6 months with no significant improvement. One of the most important predisposing factors to infectious diseases, especially opportunistic fungal infection, is diabetes mellitus. Aspergillus species can involve bony tissue through vascular system, direct infection, and trauma. Proper and early diagnosis and treatment of diabetic foot infection can reduce or prevent complications, such as osteomyelitis and amputation. The annual examination of feet for skin and nail lesion, sensation, anatomical changes, and vascular circulation can be useful for prevention and control of infection.

Rare Case of Aspergillus ochraceus Osteomyelitis of Calcaneus Bone in a Patient with Diabetic Foot Ulcers

PubMed Central

Babamahmoodi, Farhang; Shokohi, Tahereh; Ahangarkani, Fatemeh; Nabili, Mojtaba; Afzalian Ashkezari, Elham; Alinezhad, Sosan

2015-01-01

Diabetes is the most common metabolic disease in humans. One of the major complications of the disease is foot ulcer that is prone to infection. The most common causes of infection which have been reported in these patients are bacteria and fungi such as Candida, Aspergillus, and Rhizopus species. We report one such rare case with calcaneal osteomyelitis caused by Aspergillus ochraceus in a patient with diabetic foot osteomyelitis. The case was a 68-year-old male with a history of type II diabetes for 2 years. The patient had two ulcers on the right heel bones for the past 6 months with no significant improvement. One of the most important predisposing factors to infectious diseases, especially opportunistic fungal infection, is diabetes mellitus. Aspergillus species can involve bony tissue through vascular system, direct infection, and trauma. Proper and early diagnosis and treatment of diabetic foot infection can reduce or prevent complications, such as osteomyelitis and amputation. The annual examination of feet for skin and nail lesion, sensation, anatomical changes, and vascular circulation can be useful for prevention and control of infection. PMID:26064128

[Streptococcus milleri: An unusual cause of skull extensive osteomyelitis in an immunocompetent patient].

PubMed

Duquenne, C; Dernis, E; Zehrouni, A; Bizon, A; Duquenne, M

2017-09-01

Streptococcus milleri (Streptococcus anginosus, intermedius and constellatus) are commensal organisms, which can become pathogenic and cause infection with frequent abscess formation, local or metastatic extension. Osteomyelitis of the skull has been rarely reported in this type of infection. Skull osteomyelitis due to Streptococcus milleri is reported in a 61-year-old immunocompetent man without any medical history, occurring 10 months after a head injury without any wound or complication at initial presentation. A progressive right parieto-occipital headache with worsening and increased acute phase reactants evoked a giant cell arteritis. After few days of corticosteroid therapy (0.5 mg/kg/day), diagnosis of subcutaneous abscess associated to an extensive osteomyelitis of the skull due to Streptococcus milleri was diagnosed. The outcome was favorable after drainage of one liter of pus, irrigation, debridement and antibiotherapy by amoxicillin for 8 weeks. It is necessary to discuss the differential diagnosis of giant cell arteritis particularly when symptoms are unusual. Even a short-term corticosteroid therapy may dramatically exacerbate an undetected infection. Copyright © 2017. Published by Elsevier SAS.

Second Generation International Space Station (ISS) Total Organic Carbon Analyzer (TOCA) Verification Testing and On-Orbit Performance Results

NASA Technical Reports Server (NTRS)

Bentley, Nicole L.; Thomas, Evan A.; VanWie, Michael; Morrison, Chad; Stinson, Richard G.

2010-01-01

The Total Organic Carbon Analyzer (TOGA) is designed to autonomously determine recovered water quality as a function of TOC. The current TOGA has been on the International Space Station since November 2008. Functional checkout and operations revealed complex operating considerations. Specifically, failure of the hydrogen catalyst resulted in the development of an innovative oxidation analysis method. This method reduces the activation time and limits the hydrogen produced during analysis, while retaining the ability to indicate TOC concentrations within 25% accuracy. Subsequent testing and comparison to archived samples returned from the Station and tested on the ground yield high confidence in this method, and in the quality of the recovered water.

In-vivo neutrophil migration and nitroblue tetrazolium reduction in sickle cell disease.

PubMed

Akinyanju, O O

1985-01-01

In order to determine the contribution of neutrophil malfunction to the phenomenon of enhanced susceptibility of sickle cell disease patients to bacterial infection, the in-vivo neutrophil migration capacity in 23 sickle cell patients and in 14 normal controls; and the neutrophil reduction of nitroblue tetrazolium dye in 74 sickle cell patients and in 78 normal controls were studied. Secondarily the usefulness of the NBT test in distinguishing between osteomyelitis and uncomplicated bone pain was examined. No impairment of neutrophil migratory capacity was evident as no significant difference was observed between the mean migrated neutrophil count in the sickle cell subjects (1.99 X 10(9)/1) and that in normal controls (2.08 X 10(9)/1). The mean NBT scores were 19.9 +/- 8.9% in non-infected controls and 41.3 +/- 14.6% in infected controls (P less than 0.001). In sickle cell disease they were 23.6 +/- 6% in steady state subjects, 29.2 +/- 16.4% in sterile painful crises, 42.9 +/- 15% in non-osteomyelitic bacterial infection (P less than 0.001) and 18.9 +/- 4.2% during osteomyelitis. Thus all sickle cell subjects apart from those with osteomyelitis showed significant increases in the NBT scores during bacterial infection. The low score in sickle cell osteomyelitis is possibly associated with a relative neutrophil phagocytic defect which requires further elucidation. The NBT test was not useful in distinguishing uncomplicated painful crisis from early osteomyelitis in sickle cell disease.

The first human clinical case of chronic osteomyelitis caused by Clostridium hydrogeniformans.

PubMed

Hirai, Jun; Sakanashi, Daisuke; Huh, Ji Young; Suematsu, Hiroyuki; Hagihara, Mao; Kato, Hideo; Yamagishi, Yuka; Fujita, Jiro; Mikamo, Hiroshige

2017-06-01

We present the first case report of osteomyelitis due to Clostridium hydrogeniformans in a previously healthy 18-year-old male. He was admitted to our hospital because of an open contaminated fracture of the right arm after being blown into a drain in a motorbike accident. He underwent surgical debridement and treatment course of cefazolin. Although he responded well to these initial treatments, subcutaneous abscess and ulnar osteomyelitis developed 1 month after discharge. Second debridement was performed and specimens were collected from both the abscess and bone tissues. Only anaerobic culture showed a gas-producing Gam-positive rod. Conventional methods and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry could not accurately identify this organism. However, 16S rRNA gene sequence analysis determined the isolate as C. hydrogeniformans with 99.79% homology. The patient recovered after 90 days of antibiotic treatment, and had no evidence of recurrence. Anaerobic bacteria are more common as causative pathogens in osteomyelitis related to traumatic wounds and Clostridium spp. are particularly associated with open fractures, which is consistent with our case. Although the epidemiology and clinical characteristics of C. hydrogeniformans infection is poorly understood because of the limitations of currently available conventional methods of identification, clinicians need to consider this organism as a causative pathogen in a patient with osteomyelitis in traumatic wounds, especially contaminated by sewer water. Copyright © 2017 Elsevier Ltd. All rights reserved.

Response of seed tocopherols in oilseed rape to nitrogen fertilizer sources and application rates* #

PubMed Central

Hussain, Nazim; Li, Hui; Jiang, Yu-xiao; Jabeen, Zahra; Shamsi, Imran Haider; Ali, Essa; Jiang, Li-xi

2014-01-01

Tocopherols (Tocs) are vital scavengers of reactive oxygen species (ROS) and important seed oil quality indicators. Nitrogen (N) is one of the most important fertilizers in promoting biomass and grain yield in crop production. However, the effect of different sources and application rates of N on seed Toc contents in oilseed rape is poorly understood. In this study, pot trials were conducted to evaluate the effect of two sources of N fertilizer (urea and ammonium nitrate). Each source was applied to five oilseed rape genotypes (Zheshuang 72, Jiu-Er-1358, Zheshuang 758, Shiralee, and Pakola) at three different application rates (0.41 g/pot (N1), 0.81 g/pot (N2), and 1.20 g/pot (N3)). Results indicated that urea increased α-, γ-, and total Toc (T-Toc) more than did ammonium nitrate. N3 was proven as the most efficient application rate, which yielded high contents of γ-Toc and T-Toc. Highly significant correlations were observed between Toc isomers, T-Toc, and α-/γ-Toc ratio. These results clearly demonstrate that N sources and application rates significantly affect seed Toc contents in oilseed rape. PMID:24510711

Carbon Burn-Down in a Greenhouse World: Wildfires and Soil Carbon Loss across the Paleocene-Eocene Thermal Maximum (PETM)

NASA Astrophysics Data System (ADS)

Denis, E. H.; Foreman, B.; Maibauer, B.; Bowen, G. J.; Collinson, M. E.; Belcher, C.; Freeman, K. H.

2014-12-01

Projections for Earth's future suggest that wildfire activity will increase with global warming, but the factors controlling fire are complex. The Paleocene-Eocene Thermal Maximum (PETM) was a geologically abrupt global warming event that had profound effects on vegetation and hydrologic patterns and serves as an analog for modern climate change. Carbon burn-down (i.e., oxidation of organic matter) could amplify feedbacks with warming through release of carbon to the atmosphere. To assess relationships between climate, fire and soil respiration, we evaluated biomarkers, including polycyclic aromatic hydrocarbons (PAHs), charcoal and total organic carbon (TOC) for three paleo-floodplain depositional sites in the Western USA. Samples were selected from Bighorn Basin Coring Project cores in the Bighorn Basin, Wyoming (at Basin Substation and Polecat Bench) and from an outcrop section in the Piceance Basin, Colorado. In general, the Paleocene had higher PAH concentrations (μg/g TOC) than the Eocene, but there was no clear trend during the onset (~20 kyr) or through the PETM (~200 kyr). Median %TOC decreased through the PETM, then increased in the Eocene, but did not return to Paleocene values. At Basin Substation, PAH concentrations decreased by an order of magnitude during the PETM interval, concurrent with a decline in TOC and charcoal. High molecular weight (MW) PAHs tend to dominate, especially in low TOC samples; this suggests preferential loss of low MW PAHs, which are relatively more susceptible to post-depositional processes. Lithology, TOC and the relative proportion of PAHs help discern the signals of carbon oxidation, by fire and by soil respiration. Despite climate conditions that tend to promote fire, there is no evidence for increased fires at the onset or throughout the PETM. Biomarker and petrographic data suggest decreased organic carbon preservation, including loss of refractory carbon, at Basin Substation during the PETM. This suggests soil carbon loss, possibly due to higher rates of organic matter decay associated with a hotter and more seasonal climate during the PETM. We propose that higher carbon burn-down, due to accelerated decay rates, outpaced terrestrial productivity during the hyperthermal event, which hindered soil carbon sequestration and enhanced the atmospheric greenhouse.

Modulation of NF-κB and Nrf2 control of inflammatory responses in FHs 74 Int cell line is tocopherol isoform-specific

PubMed Central

Elisia, Ingrid

2013-01-01

The present study investigates the relative ability of α-, γ-, and δ-tocopherol (Toc) to modulate cell signaling events that are associated with inflammatory responses in fetal-derived intestinal (FHs 74 Int) cells. Secretion of the proinflammatory cytokine IL-8 in FHs 74 Int cells was stimulated in the following order: α-Toc < γ-Toc < δ-Toc. A similar proinflammatory response was observed when inflammation was induced in FHs 74 Int cells. Modulation of IL-8 expression by Toc corresponded to an isoform-specific modulation of NF-κB and nuclear factor-erythroid 2-related factor 2 (Nrf2) cell signaling pathways involved in expression of proinflammatory cytokines and antioxidant enzymes, respectively. δ-Toc and, to a lesser extent, γ-Toc activated NF-κB and Nrf2 signaling, as indicated by the greater nuclear translocation of transcription factors. Activation of NF-κB signaling by γ- and δ-Toc was accompanied by upregulation of NF-κB target genes, such as IL-8 and prostaglandin-endoperoxide synthase 2, with and without a prior IFNγ-PMA challenge. Nevertheless, γ- and δ-Toc, particularly δ-Toc, concurrently downregulated glutamate-cysteine ligase, a Nrf2 target gene that encodes for glutathione biosynthesis. This observation was substantiated by confirmation that γ- and δ-Toc were effective at decreasing glutamate-cysteine ligase protein expression and cellular glutathione content. Downregulation of glutathione content in fetal intestinal cells corresponded to induction of apoptosis-mediated cytotoxicity. In conclusion, γ- and δ-Toc are biologically active isoforms of vitamin E and show superior bioactivity to α-Toc in modulating cell signaling events that contribute to a proinflammatory response in fetal-derived intestinal cells. PMID:24136788

Using theory of change to design and evaluate public health interventions: a systematic review.

PubMed

Breuer, Erica; Lee, Lucy; De Silva, Mary; Lund, Crick

2016-05-06

Despite the increasing popularity of the theory of change (ToC) approach, little is known about the extent to which ToC has been used in the design and evaluation of public health interventions. This review aims to determine how ToCs have been developed and used in the development and evaluation of public health interventions globally. We searched for papers reporting the use of "theory of change" in the development or evaluation of public health interventions in databases of peer-reviewed journal articles such as Scopus, Pubmed, PsychInfo, grey literature databases, Google and websites of development funders. We included papers of any date, language or study design. Both abstracts and full text papers were double screened. Data were extracted and narratively and quantitatively summarised. A total of 62 papers were included in the review. Forty-nine (79 %) described the development of ToC, 18 (29 %) described the use of ToC in the development of the intervention and 49 (79 %) described the use of ToC in the evaluation of the intervention. Although a large number of papers were included in the review, their descriptions of the ToC development and use in intervention design and evaluation lacked detail. The use of the ToC approach is widespread in the public health literature. Clear reporting of the ToC process and outputs is important to strengthen the body of literature on practical application of ToC in order to develop our understanding of the benefits and advantages of using ToC. We also propose a checklist for reporting on the use of ToC to ensure transparent reporting and recommend that our checklist is used and refined by authors reporting the ToC approach.

Alendronate-coated long-circulating liposomes containing 99mtechnetium-ceftizoxime used to identify osteomyelitis

PubMed Central

Ferreira, Diego dos Santos; Boratto, Fernanda Alves; Cardoso, Valbert Nascimento; Serakides, Rogéria; Fernandes, Simone Odília; Ferreira, Lucas Antônio Miranda; Oliveira, Mônica Cristina

2015-01-01

Osteomyelitis is a progressive destruction of bones caused by microorganisms. Inadequate or absent treatment increases the risk of bone growth inhibition, fractures, and sepsis. Among the diagnostic techniques, functional images are the most sensitive in detecting osteomyelitis in its early stages. However, these techniques do not have adequate specificity. By contrast, radiolabeled antibiotics could improve selectivity, since they are specifically recognized by the bacteria. The incorporation of these radiopharmaceuticals in drug-delivery systems with high affinity for bones could improve the overall uptake. In this work, long-circulating and alendronate-coated liposomes containing 99mtechnetium-radiolabeled ceftizoxime were prepared and their ability to identify infectious foci (osteomyelitis) in animal models was evaluated. The effect of the presence of PEGylated lipids and surface-attached alendronate was evaluated. The bone-targeted long-circulating liposomal 99mtechnetium–ceftizoxime showed higher uptake in regions of septic inflammation than did the non-long-circulating and/or alendronate-non-coated liposomes, showing that both the presence of PEGylated lipids and alendronate coating are important to optimize the bone targeting. Scintigraphic images of septic or aseptic inflammation-bearing Wistar rats, as well as healthy rats, were acquired at different time intervals after the intravenous administration of these liposomes. The target-to-non-target ratio proved to be significantly higher in the osteomyelitis-bearing animals for all investigated time intervals. Biodistribution studies were also performed after the intravenous administration of the formulation in osteomyelitis-bearing animals. A significant amount of liposomes were taken up by the organs of the mononuclear phagocyte system (liver and spleen). Intense renal excretion was also observed during the entire experiment period. Moreover, the liposome uptake by the infectious focus was significantly high. These results show that long-circulating and alendronate-coated liposomes containing 99mtechnetium-radiolabeled ceftizoxime have a tropism for infectious foci. PMID:25848262

Candida Osteomyelitis: Analysis of 207 Pediatric and Adult Cases (1970–2011)

PubMed Central

Gamaletsou, Maria N.; Kontoyiannis, Dimitrios P.; Sipsas, Nikolaos V.; Moriyama, Brad; Alexander, Elizabeth; Roilides, Emmanuel; Brause, Barry; Walsh, Thomas J.

2012-01-01

Background. The epidemiology, pathogenesis, clinical manifestations, management, and outcome of Candida osteomyelitis are not well understood. Methods. Cases of Candida osteomyelitis from 1970 through 2011 were reviewed. Underlying conditions, microbiology, mechanisms of infection, clinical manifestations, antifungal therapy, and outcome were studied in 207 evaluable cases. Results. Median age was 30 years (range, ≤ 1 month to 88 years) with a >2:1 male:female ratio. Most patients (90%) were not neutropenic. Localizing pain, tenderness, and/or edema were present in 90% of patients. Mechanisms of bone infection followed a pattern of hematogenous dissemination (67%), direct inoculation (25%), and contiguous infection (9%). Coinciding with hematogenous infection, most patients had ≥2 infected bones. When analyzed by age, the most common distribution of infected sites for adults was vertebra (odds ratio [OR], 0.09; 95% confidence interval [CI], .04–.25), rib, and sternum; for pediatric patients (≤18 years) the pattern was femur (OR, 20.6; 95% CI, 8.4–48.1), humerus, then vertebra/ribs. Non-albicans Candida species caused 35% of cases. Bacteria were recovered concomitantly from 12% of cases, underscoring the need for biopsy and/or culture. Candida septic arthritis occurred concomitantly in 21%. Combined surgery and antifungal therapy were used in 48% of cases. The overall complete response rate of Candida osteomyelitis of 32% reflects the difficulty in treating this infection. Relapsed infection, possibly related to inadequate duration of therapy, occurred among 32% who ultimately achieved complete response. Conclusions. Candida osteomyelitis is being reported with increasing frequency. Localizing symptoms are usually present. Vertebrae are the most common sites in adults vs femora in children. Timely diagnosis of Candida osteomyelitis with extended courses of 6–12 months of antifungal therapy, and surgical intervention, when indicated, may improve outcome. PMID:22911646

Pressure ulcer-related pelvic osteomyelitis: evaluation of a two-stage surgical strategy (debridement, negative pressure therapy and flap coverage) with prolonged antimicrobial therapy.

PubMed

Andrianasolo, Johan; Ferry, Tristan; Boucher, Fabien; Chateau, Joseph; Shipkov, Hristo; Daoud, Fatiha; Braun, Evelyne; Triffault-Fillit, Claire; Perpoint, Thomas; Laurent, Frédéric; Mojallal, Alain-Ali; Chidiac, Christian; Valour, Florent

2018-04-10

A two-stage surgical strategy (debridement-negative pressure therapy (NPT) and flap coverage) with prolonged antimicrobial therapy is usually proposed in pressure ulcer-related pelvic osteomyelitis but has not been widely evaluated. Adult patients with pressure ulcer-related pelvic osteomyelitis treated by a two-stage surgical strategy were included in a retrospective cohort study. Determinants of superinfection (i.e., additional microbiological findings at reconstruction) and treatment failure were assessed using binary logistic regression and Kaplan-Meier curve analysis. Sixty-four pressure ulcer-related pelvic osteomyelitis in 61 patients (age, 47 (IQR, 36-63)) were included. Osteomyelitis was mostly polymicrobial (73%), with a predominance of S. aureus (47%), Enterobacteriaceae spp. (44%) and anaerobes (44%). Flap coverage was performed after 7 (IQR, 5-10) weeks of NPT, with 43 (68%) positive bone samples among which 39 (91%) were superinfections, associated with a high ASA score (OR, 5.8; p = 0.022). An increased prevalence of coagulase negative staphylococci (p = 0.017) and Candida spp. (p = 0.003) was observed at time of flap coverage. An ESBL Enterobacteriaceae spp. was found in 5 (12%) patients, associated with fluoroquinolone consumption (OR, 32.4; p = 0.005). Treatment duration was as 20 (IQR, 14-27) weeks, including 11 (IQR, 8-15) after reconstruction. After a follow-up of 54 (IQR, 27-102) weeks, 15 (23%) failures were observed, associated with previous pressure ulcer (OR, 5.7; p = 0.025) and Actinomyces spp. infection (OR, 9.5; p = 0.027). Pressure ulcer-related pelvic osteomyelitis is a difficult-to-treat clinical condition, generating an important consumption of broad-spectrum antibiotics. The lack of correlation between outcome and the debridement-to-reconstruction interval argue for a short sequence to limit the total duration of treatment.

[Dynamics of total organic carbon (TOC) in hydrological processes in coniferous and broad-leaved mixed forest of Dinghushan].

PubMed

Yin, Guangcai; Zhou, Guoyi; Zhang, Deqiang; Wang, Xu; Chu, Guowei; Liu, Yan

2005-09-01

The total flux and concentration of total organic carbon (TOC) in hydrological processes in coniferous and broad-leaved mixed forest of Dinghushan were measured from July 2002 to July 2003. The results showed that the TOC input by precipitation was 41.80 kg x hm(-2) x yr(-1), while its output by surface runoff and groundwater (soil solution at 50 cm depth) was 17.54 and 1.80 kg x hm(-2) x yr(-1), respectively. The difference between input and output was 22.46 kg x hm(-2) x yr(-1), indicating that the ecosystem TOC was in positive balance. The monthly variation of TOC flux in hydrological processes was very similar to that in precipitation. The mean TOC concentration in precipitation was 3.64 mg x L(-1), while that in throughfall and stemflow increased 6.10 and 7.39 times after rain passed through the tree canopies and barks. The mean TOC concentration in surface runoff and in soil solution at 25 and 50 cm depths was 12.72, 7.905 and 3.06 mg x L(-1), respectively. The monthly TOC concentration in throughfall and stemflow had a similar changing tendency, showing an increase at the beginning of growth season (March), a decrease after September, and a little increase in December. The TOC concentration in runoff was much higher during high precipitation months. No obvious monthly variation was observed in soil solution TOC concentration (25 and 50 cm below the surface). Stemflow TOC concentration differed greatly between different tree species. The TOC concentration in precipitation, throughfall, and soil solution (25 and 50 cm depths) decreased with increasing precipitation, and no significant relationship existed between the TOC concentrations in stemflow, surface runoff and precipitation. The TOC concentrations in the hydrological processes fluctuated with precipitation intensity, except for that in stemflow and soil solutions.

Simulation of the induction of oxidation of low-density lipoprotein by high copper concentrations: evidence for a nonconstant rate of initiation.

PubMed

Abuja, P M; Albertini, R; Esterbauer, H

1997-06-01

Kinetic simulation can help obtain deeper insight into the molecular mechanisms of complex processes, such as lipid peroxidation (LPO) in low-density lipoprotein (LDL). We have previously set up a single-compartment model of this process, initiating with radicals generated externally at a constant rate to show the interplay of radical scavenging and chain propagation. Here we focus on the initiating events, substituting constant rate of initiation (Ri) by redox cycling of Cu2+ and Cu+. Our simulation reveals that early events in copper-mediated LDL oxidation include (1) the reduction of Cu2+ by tocopherol (TocOH) which generates tocopheroxyl radical (TocO.), (2) the fate of TocO. which either is recycled or recombines with lipid peroxyl radical (LOO.), and (3) the reoxidation of Cu+ by lipid hydroperoxide which results in alkoxyl radical (LO.) formation. So TocO., LOO., and LO. can be regarded as primordial radicals, and the sum of their formation rates is the total rate of initiation, Ri. As experimental information of these initiating events cannot be obtained experimentally, the whole model was validated experimentally by comparison of LDL oxidation in the presence and absence of bathocuproine as predicted by simulation. Simulation predicts that Ri decreases by 2 orders of magnitude during lag time. This has important consequences for the estimation of oxidation resistance in copper-mediated LDL oxidation: after consumption of tocopherol, even small amounts of antioxidants may prolong the lag phase for a considerable time.

40 CFR Table 19 to Subpart Uuu of... - Initial Compliance With Organic HAP Emission Limits for Catalytic Reforming Units

Code of Federal Regulations, 2010 CFR

2010-07-01

... compounds (TOC) or nonmethane TOC from your process vent by 98 percent by weight using a control device or... stringent The mass emission reduction of nonmethane TOC measured by Method 25 over the period of the... mass emission reduction of TOC measured by Method 25A (or nonmethane TOC measured by Methods 25A and 18...

Complex sacral abscess 8 years after abdominal sacral colpopexy.

PubMed

Collins, Sarah A; Tulikangas, Paul K; LaSala, Christine A; Lind, Lawrence R

2011-08-01

Sacral colpopexy is an effective, durable repair for women with apical vaginal or uterovaginal prolapse. There are few reports of serious complications diagnosed in the remote postoperative period. A 74-year-old woman presented 8 years after undergoing posthysterectomy abdominal sacral colpopexy using polypropylene mesh. Posterior vaginal mesh erosion had been diagnosed several months before presentation. She suffered severe infectious complications including an infected thrombus in the inferior vena cava, sacral osteomyelitis, and a complex abscess with presacral and epidural components. Surgical exploration revealed an abscess cavity surrounding the mesh. Although minor complications commonly occur after sacral colpopexy using abdominal mesh, serious and rare postoperative infectious complications may occur years postoperatively.

Clinical, morphological, and molecular characterization of Penicillium canis, sp. nov., isolated from a dog with osteomyelitis

USDA-ARS?s Scientific Manuscript database

Infections caused by Penicillium spp. are rare in dogs, and the prognosis in these cases is poor. An unknown species of Penicillium was isolated from a bone lesion in a young dog with osteomyelitis of the right ilium. Extensive diagnostic evaluation did not reveal evidence of dissemination. Resoluti...

Treatment of Aspergillus infection of the proximal aortic prosthetic graft with associated vertebral osteomyelitis.

PubMed

Anderson, J; Kron, I L

1984-07-01

This is a case report of an unusual vascular graft infection involving an invasive Aspergillus species with associated vertebral osteomyelitis. Successful treatment was obtained by graft incision, extra-anatomic bypass, and prolonged antibiotic therapy. To our knowledge this is the first successful treatment of invasive Aspergillus of an aortic prosthetic graft.

Fusarium Osteomyelitis in a Patient With Pearson Syndrome: Case Report and Review of the Literature.

PubMed

Hiebert, Rachael M; Welliver, Robert C; Yu, Zhongxin

2016-10-01

Fusarium species are ubiquitous fungi causing a wide array of infections, including invasive disease in the immunosuppressed. We present a fusarium bone infection in a child with Pearson syndrome and review the literature. Ten cases of fusarium osteomyelitis were reported in the past 40 years, and we review the treatments.

Aspergillus discitis with acute disc abscess.

PubMed

Assaad, W; Nuchikat, P S; Cohen, L; Esguerra, J V; Whittier, F C

1994-10-01

Aspergillus osteomyelitis of the vertebral body and disc space is rare. This report discusses a case that occurred in an immunosuppressed 29-year-old man and reviews the pertinent medical literature. To review the management and treatment of Aspergillus osteomyelitis of the vertebral body and disc space. The patient presented with acute neurologic compromise resulting from L5-S1 discitis and a large epidural soft tissue component secondary to the Aspergillus infection. The patient underwent aggressive surgical debridement along with treatment with amphotericin B and had a complete clinical recovery. The authors recommend a combined medical-surgical approach in most cases of vertebral Aspergillus osteomyelitis. Early surgery with vigorous surgical debridement along with antifungal treatment seems to yield a good outcome.

Chronic recurrent multifocal osteomyelitis exhibiting predominance of periosteal reaction.

PubMed

Queiroz, Rodolfo Mendes; Rocha, Pedro Henrique Pereira; Lauar, Lara Zupelli; Costa, Mauro José Brandão da; Laguna, Claudio Benedini; Oliveira, Rafael Gouvêa Gomes de

2017-04-01

Chronic recurrent multifocal osteomyelitis is an idiopathic nonpyogenic autoinflammatory bone disorder involving multiple sites, with clinical progression persisting for more than 6 months and which may have episodes of remission and exacerbation in the long term. It represents up to 2-5% of the cases of osteomyelitis, with an approximate incidence of up to 4/1,000,000 individuals, and average age of disease onset estimated between 8-11 years, predominantly in females. The legs are the most affected, with a predilection for metaphyseal regions along the growth plate. We describe the case of a female patient, aged 2 years and 5 months, with involvement of the left ulna, right jaw and left tibia, showing a predominance of periosteal reaction as main finding.

Chronic suppurative osteomyelitis of subcondylar region: a case report.

PubMed

Kumar, G Ravi; Syed, Basheer Ahmed; Prasad, N; Praveen, Sp

2013-05-01

Chronic suppurative osteomyelitis (CSO) of the maxillofacial region is primarily caused by infections of odontogenic microorganisms. It may also arise as a complication of dental extractions, maxillofacial trauma, inadequate treatment of a fracture and irradiation to the mandible. This condition is characterized by areas of devitalized bone (sequestra) which serves as a nidus for recurrent episodes of infection. This case report describes a case of CSO in an untreated right subcondylar fracture of the mandible which was successfully treated with a combination of antibiotic therapy and surgical debridement in an 8-year-old boy. How to cite this article: Kumar GR, Syed BA, Prasad N, Praveen SP. Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report. Int J Clin Pediatr Dent 2013;6(2): 119-123.

Chloroplast Preproteins Bind to the Dimer Interface of the Toc159 Receptor during Import1[OPEN

PubMed Central

Chen, Lih-Jen; Yeh, Yi-Hung; Hsiao, Chwan-Deng

2017-01-01

Most chloroplast proteins are synthesized in the cytosol as higher molecular weight preproteins and imported via the translocons in the outer (TOC) and inner (TIC) envelope membranes of chloroplasts. Toc159 functions as a primary receptor and directly binds preproteins through its dimeric GTPase domain. As a first step toward a molecular understanding of how Toc159 mediates preprotein import, we mapped the preprotein-binding regions on the Toc159 GTPase domain (Toc159G) of pea (Pisum sativum) using cleavage by bound preproteins conjugated with the artificial protease FeBABE and cysteine-cysteine cross-linking. Our results show that residues at the dimer interface and the switch II region of Toc159G are in close proximity to preproteins. The mature portion of preproteins was observed preferentially at the dimer interface, whereas the transit peptide was found at both regions equally. Chloroplasts from transgenic plants expressing engineered Toc159 with a cysteine placed at the dimer interface showed increased cross-linking to bound preproteins. Our data suggest that, during preprotein import, the Toc159G dimer disengages and the dimer interface contacts translocating preproteins, which is consistent with a model in which conformational changes induced by dimer-monomer conversion in Toc159 play a direct role in facilitating preprotein import. PMID:28250068

C-TOC (Cognitive Testing on Computer): investigating the usability and validity of a novel self-administered cognitive assessment tool in aging and early dementia.

PubMed

Jacova, Claudia; McGrenere, Joanna; Lee, Hyunsoo S; Wang, William W; Le Huray, Sarah; Corenblith, Emily F; Brehmer, Matthew; Tang, Charlotte; Hayden, Sherri; Beattie, B Lynn; Hsiung, Ging-Yuek R

2015-01-01

Cognitive Testing on Computer (C-TOC) is a novel computer-based test battery developed to improve both usability and validity in the computerized assessment of cognitive function in older adults. C-TOC's usability was evaluated concurrently with its iterative development to version 4 in subjects with and without cognitive impairment, and health professional advisors representing different ethnocultural groups. C-TOC version 4 was then validated against neuropsychological tests (NPTs), and by comparing performance scores of subjects with normal cognition, Cognitive Impairment Not Dementia (CIND) and Alzheimer disease. C-TOC's language tests were validated in subjects with aphasic disorders. The most important usability issue that emerged from consultations with 27 older adults and with 8 cultural advisors was the test-takers' understanding of the task, particularly executive function tasks. User interface features did not pose significant problems. C-TOC version 4 tests correlated with comparator NPT (r=0.4 to 0.7). C-TOC test scores were normal (n=16)>CIND (n=16)>Alzheimer disease (n=6). All normal/CIND NPT performance differences were detected on C-TOC. Low computer knowledge adversely affected test performance, particularly in CIND. C-TOC detected impairments in aphasic disorders (n=11). In general, C-TOC had good validity in detecting cognitive impairment. Ensuring test-takers' understanding of the tasks, and considering their computer knowledge appear important steps towards C-TOC's implementation.

Replacement of chemical oxygen demand (COD) with total organic carbon (TOC) for monitoring wastewater treatment performance to minimize disposal of toxic analytical waste.

PubMed

Dubber, Donata; Gray, Nicholas F

2010-10-01

Chemical oxygen demand (COD) is widely used for wastewater monitoring, design, modeling and plant operational analysis. However this method results in the production of hazardous wastes including mercury and hexavalent chromium. The study examined the replacement of COD with total organic carbon (TOC) for general performance monitoring by comparing their relationship with influent and effluent samples from 11 wastewater treatment plants. Biochemical oxygen demand (BOD5) was also included in the comparison as a control. The results show significant linear relationships between TOC, COD and BOD5 in settled (influent) domestic and municipal wastewaters, but only between COD and TOC in treated effluents. The study concludes that TOC can be reliably used for the generic replacement of both COD (COD=49.2+3.00*TOC) and BOD5 (BOD5=23.7+1.68*TOC) in influent wastewaters but only for COD (COD=7.25+2.99*TOC) in final effluents.

Resident learning across the full range of core competencies through a transitions of care curriculum.

PubMed

Pavon, Juliessa M; Pinheiro, Sandro O; Buhr, Gwendolen T

2018-01-01

The authors developed a Transitions of Care (TOC) curriculum to teach and measure learner competence in performing TOC tasks for older adults. Internal medicine interns at an academic residency program received the curriculum, which consisted of experiential learning, self-study, and small group discussion. Interns completed retrospective pre/post surveys rating their confidence in performing five TOC tasks, qualitative open-ended survey questions, and a self-reflection essay. A subset of interns also completed follow-up assessments. For all five TOC tasks, the interns' confidence improved following completion of the TOC curriculum. Self-confidence persisted for up to 3 months later for some but not all tasks. According to the qualitative responses, the TOC curriculum provided interns with learning experiences and skills integral to performing safe care transitions. The TOC curriculum and a mixed-method assessment approach effectively teaches and measures learner competency in TOC across all six Accreditation Council for Graduate Medical Education competency domains.

Changes of tocopherols, tocotrienols, γ-oryzanol, and γ-aminobutyric acid levels in the germinated brown rice of pigmented and nonpigmented cultivars.

PubMed

Ng, Lean-Teik; Huang, Shao-Hua; Chen, Yen-Ting; Su, Chun-Han

2013-12-26

This study examined the changes of tocopherols (Toc), tocotrienols (T3), γ-oryzanol (GO), and γ-aminobutyric acid (GABA) contents in germinated brown rice (GBR) of pigmented and nonpigmented cultivars under different germination conditions. Results showed that the Toc and T3 contents in GBR were significantly different between treatments in both rice cultivars. The pigmented GBR possessed higher total vitamin E, total Toc, total T3, and GO contents than the nonpigmented GBR; however, its level of GABA was lower. The order of the three highest vitamin E homologues in pigmented and nonpigmented GBR was γ-T3 > γ-Toc > α-Toc and α-Toc > γ-T3 > α-T3, respectively; β-Toc, β-T3, δ-Toc, and δ-T3 were present in only small amounts (≤1.0 mg/kg) in GBR of both cultivars. Although both cultivars showed an increase in GABA contents with increasing germination time, the GABA content in nonpigmented GBR was higher.

Comparison of Bone Preserving and Radical Surgical Treatment in 32 Cases of Calcaneal Osteomyelitis.

PubMed

Babiak, Ireneusz; Pędzisz, Piotr; Kulig, Mateusz; Janowicz, Jakub; Małdyk, Paweł

2016-01-01

Introduction. Radical procedures like calcanectomy and amputation performed for calcaneal osteomyelitis are regarded as effective in eradication of infection even though potentially functionally disabling. Bone sparing procedures offer better functional result at the expense of potentially worse infection control. The aim of the study has been to assess the influence of the surgical radicalism as much as the extent of bone infection on the final outcome in the surgical therapy of chronic calcaneal osteomyelitis (CO). Material and method. 32 patients with chronic CO have comprised the group under study: 8 with superficial type, 12 localised type and 12 with diffuse type according to Cierny-Mader classification. The aim of the treatment was to heal infection, preserve the heel shape and achieve good skin coverage over the calcaneus. The therapy consisted of 9 debridement surgeries with or without flaps, 8 drilling-operations of the calcaneus with application of collagen-gentamicin-sponge in bore holes, 15 partial and 2 total calcanectomies, and 4 below-the knee amputations. Results. The healing of infection and wound has been achieved after 7 of 9 debridements, 6 of 8 drilling-operations, 13 of 15 partial and all total calcanectomies. Conclusion. Bone preserving operations in chronic calcaneal osteomyelitis provided inferior infection control (76,47% vs 88,24%) and worse patient satisfaction (88,24% vs 100%) and almost camparable ambulation (100% vs 93,33%). Drilling of the calcaneus with application of collagen sponge containing gentamicin performed in chronic diffuse calcaneal osteomyelitis seems to offer a viable alternative to partial or radical calcanectomy. V.

Comparison of Bone Preserving and Radical Surgical Treatment in 32 Cases of Calcaneal Osteomyelitis

PubMed Central

Babiak, Ireneusz; Pędzisz, Piotr; Kulig, Mateusz; Janowicz, Jakub; Małdyk, Paweł

2016-01-01

Introduction. Radical procedures like calcanectomy and amputation performed for calcaneal osteomyelitis are regarded as effective in eradication of infection even though potentially functionally disabling. Bone sparing procedures offer better functional result at the expense of potentially worse infection control. The aim of the study has been to assess the influence of the surgical radicalism as much as the extent of bone infection on the final outcome in the surgical therapy of chronic calcaneal osteomyelitis (CO). Material and method. 32 patients with chronic CO have comprised the group under study: 8 with superficial type, 12 localised type and 12 with diffuse type according to Cierny-Mader classification. The aim of the treatment was to heal infection, preserve the heel shape and achieve good skin coverage over the calcaneus. The therapy consisted of 9 debridement surgeries with or without flaps, 8 drilling-operations of the calcaneus with application of collagen-gentamicin-sponge in bore holes, 15 partial and 2 total calcanectomies, and 4 below-the knee amputations. Results. The healing of infection and wound has been achieved after 7 of 9 debridements, 6 of 8 drilling-operations, 13 of 15 partial and all total calcanectomies. Conclusion. Bone preserving operations in chronic calcaneal osteomyelitis provided inferior infection control (76,47% vs 88,24%) and worse patient satisfaction (88,24% vs 100%) and almost camparable ambulation (100% vs 93,33%). Drilling of the calcaneus with application of collagen sponge containing gentamicin performed in chronic diffuse calcaneal osteomyelitis seems to offer a viable alternative to partial or radical calcanectomy. Level of evidence: V. PMID:28529846

Severe skull base osteomyelitis caused by Pseudomonas aeruginosa with successful outcome after prolonged outpatient therapy with continuous infusion of ceftazidime and oral ciprofloxacin: a case report.

PubMed

Conde-Díaz, Cristina; Llenas-García, Jara; Parra Grande, Mónica; Terol Esclapez, Gertrudis; Masiá, Mar; Gutiérrez, Félix

2017-02-21

Skull base osteomyelitis is an uncommon disease that usually complicates a malignant external otitis with temporal bone involvement. It affects predominantly diabetic and immunocompromised males and has a high mortality rate. Pseudomonas aeruginosa is the most common causative organism. Currently, there is no consensus about the best therapeutic option. Here we describe a case of severe skull base osteomyelitis caused by Pseudomonas aeruginosa with progressive palsy of cranial nerves that was successfully managed with prolonged outpatient continuous infusion of ceftazidime plus oral ciprofloxacin. A 69-year-old Caucasian man presented with dysphagia, headache, and weight loss. He complained of left earache and purulent otorrhea. Over the following weeks he developed progressive palsy of IX, X, VI, and XII cranial nerves and papilledema. A petrous bone computed tomography scan showed a mass in the left jugular foramen with a strong lytic component that expanded to the cavum. A biopsy was then performed and microbiological cultures grew Pseudomonas aeruginosa. After 6 weeks of parenteral antibiotic treatment, our patient was discharged and treatment was continued with a domiciliary continuous infusion of a beta-lactam through a peripherally inserted central catheter, along with an oral fluoroquinolone for 10 months. Both radiological and clinical responses were excellent. Skull base osteomyelitis is a life-threating condition; clinical suspicion and correct microbiological identification are key to achieve an accurate and timely diagnosis. Due to the poor outcome of Pseudomonas aeruginosa skull base osteomyelitis, prolonged outpatient parenteral antibiotic therapy administered by continuous infusion could be a valuable option for these patients.

Novel borate glass/chitosan composite as a delivery vehicle for teicoplanin in the treatment of chronic osteomyelitis.

PubMed

Jia, Wei-Tao; Zhang, Xin; Luo, Shi-Hua; Liu, Xin; Huang, Wen-Hai; Rahaman, Mohamed N; Day, Delbert E; Zhang, Chang-Qing; Xie, Zong-Ping; Wang, Jian-Qiang

2010-03-01

Composite materials composed of borate bioactive glass and chitosan (designated BGC) were investigated in vitro and in vivo as a new delivery system for teicoplanin in the treatment of chronic osteomyelitis induced by methicillin-resistant Staphylococcus aureus (MRSA). In vitro, the release of teicoplanin from BGC pellets into phosphate-buffered saline (PBS), as well as its antibacterial activity, were determined. The compressive strength of the pellets was measured after specific immersion times, and the structure of the pellets was characterized using scanning electron microscopy and X-ray diffraction. In vivo, the tibial cavity of New Zealand White rabbits was injected with MRSA strain to induce chronic osteomyelitis, treated by debridement after 4weeks, implanted with teicoplanin-loaded BGC pellets (designated TBGC) or BGC pellets, or injected intravenously with teicoplanin. After 12weeks' implantation, the efficacy of the TBGC pellets for treating osteomyelitis was evaluated using hematological, radiological, microbiological and histological techniques. When immersed in PBS, the TBGC pellets provided a sustained release of teicoplanin, while the surface of the pellets was converted to hydroxyapatite (HA). In vivo, the best therapeutic effect was observed in animals implanted with TBGC pellets, resulting in significantly lower radiological and histological scores, a lower positive rate of MRSA culture, and an excellent bone defect repair, without local or systemic side effects. The results indicate that TBGC pellets are effective in treating chronic osteomyelitis by providing a sustained release of teicoplanin, in addition to participating in bone regeneration. Copyright 2009 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Using Theories of Change to inform implementation of health systems research and innovation: experiences of Future Health Systems consortium partners in Bangladesh, India and Uganda.

PubMed

Paina, Ligia; Wilkinson, Annie; Tetui, Moses; Ekirapa-Kiracho, Elizabeth; Barman, Debjani; Ahmed, Tanvir; Mahmood, Shehrin Shaila; Bloom, Gerry; Knezovich, Jeff; George, Asha; Bennett, Sara

2017-12-28

The Theory of Change (ToC) is a management and evaluation tool supporting critical thinking in the design, implementation and evaluation of development programmes. We document the experience of Future Health Systems (FHS) Consortium research teams in Bangladesh, India and Uganda with using ToC. We seek to understand how and why ToCs were applied and to clarify how they facilitate the implementation of iterative intervention designs and stakeholder engagement in health systems research and strengthening. This paper combines literature on ToC, with a summary of reflections by FHS research members on the motivation, development, revision and use of the ToC, as well as on the benefits and challenges of the process. We describe three FHS teams' experiences along four potential uses of ToCs, namely planning, communication, learning and accountability. The three teams developed ToCs for planning and evaluation purposes as required for their initial plans for FHS in 2011 and revised them half-way through the project, based on assumptions informed by and adjusted through the teams' experiences during the previous 2 years of implementation. All teams found that the revised ToCs and their accompanying narratives recognised greater feedback among intervention components and among key stakeholders. The ToC development and revision fostered channels for both internal and external communication, among research team members and with key stakeholders, respectively. The process of revising the ToCs challenged the teams' initial assumptions based on new evidence and experience. In contrast, the ToCs were only minimally used for accountability purposes. The ToC development and revision process helped FHS research teams, and occasionally key local stakeholders, to reflect on and make their assumptions and mental models about their respective interventions explicit. Other projects using the ToC should allow time for revising and reflecting upon the ToCs, to recognise and document the adaptive nature of health systems, and to foster the time, space and flexibility that health systems strengthening programmes must have to learn from implementation and stakeholder engagement.

Municipal Leachate Treatment by Fenton Process: Effect of Some Variable and Kinetics

PubMed Central

Ahmadian, Mohammad; Reshadat, Sohyla; Yousefi, Nader; Mirhossieni, Seyed Hamed; Zare, Mohammad Reza; Ghasemi, Seyed Ramin; Rajabi Gilan, Nader; Khamutian, Razieh; Fatehizadeh, Ali

2013-01-01

Due to complex composition of leachate, the comprehensive leachate treatment methods have been not demonstrated. Moreover, the improper management of leachate can lead to many environmental problems. The aim of this study was application of Fenton process for decreasing the major pollutants of landfill leachate on Kermanshah city. The leachate was collected from Kermanshah landfill site and treated by Fenton process. The effect of various parameters including solution pH, Fe2+ and H2O2 dosage, Fe2+/H2O2 molar ratio, and reaction time was investigated. The result showed that with increasing Fe2+ and H2O2 dosage, Fe2+/H2O2 molar ratio, and reaction time, the COD, TOC, TSS, and color removal increased. The maximum COD, TOC, TSS, and color removal were obtained at low pH (pH: 3). The kinetic data were analyzed in term of zero-order, first-order, and second-order expressions. First-order kinetic model described the removal of COD, TOC, TSS, and color from leachate better than two other kinetic models. In spite of extremely difficulty of leachate treatment, the previous results seem rather encouraging on the application of Fenton's oxidation. PMID:23840229

Aspergillus terreus infection of pseudoaneurysm of aortofemoral vascular graft with contiguous vertebral osteomyelitis.

PubMed

Glotzbach, R E

1982-02-01

This is a case report of a patient who developed several unusual complications of an aortofemoral vascular graft. These were thrombosis, pseudoaneurysm, and infection. There was an Aspergillus terreus infection of the pseudoaneurysm of the vascular prosthesis. A contiguous vertebral osteomyelitis due to A. terreus subsequently developed. This represented a localized, invasive form of aspergillosis.

Chronic mandibular osteomyelitis with suspected underlying synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome: a case report

PubMed Central

Mochizuki, Yumi; Omura, Ken; Hirai, Hideaki; Kugimoto, Takuma; Osako, Toshimitu; Taguchi, Takahide

2012-01-01

Chronic mandibular osteomyelitis is an intractable disease. In recent years, some case reports have related this disease process to synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, which is chronic with frequent remissions and exacerbations. This report describes a case of chronic mandibular osteomyelitis suspected to be SAPHO syndrome. A 68-year-old woman presented with pain on the left side of the mandible. On the basis of clinical and radiological findings, chronic mandibular diffuse sclerosing osteomyelitis was initially diagnosed. We administrated oral clarithromycin (400 mg daily) and levofloxacin (500 mg daily), and her pain subsequently resolved. On 99mTc-labeled methylene diphosphonate scintigraphy, tracer uptake in the asymptomatic mandible was unchanged, but there was increasing tracer uptake in the sternocostal and sternoclavicular joints, compared with 99mTc-labeled methylene diphosphonate scintigraphic findings of the first visit. We diagnosed SAPHO syndrome and administrated oral sodium risedronate hydrate (2.5 mg daily). Although there has been no pain or swelling in the area of the left mandibular lesion, we have followed up on other skin and osteoarticular manifestations in conjunction with other medical departments. PMID:22427727

A systematic review of animal models for Staphylococcus aureus osteomyelitis

PubMed Central

Reizner, W.; Hunter, J.G.; O’Malley, N.T.; Southgate, R.D.; Schwarz, E.M.; Kates, S.L.

2015-01-01

Staphylococcus aureus (S. aureus) osteomyelitis is a significant complication for orthopaedic patients undergoing surgery, particularly with fracture fixation and arthroplasty. Given the difficulty in studying S. aureus infections in human subjects, animal models serve an integral role in exploring the pathogenesis of osteomyelitis, and aid in determining the efficacy of prophylactic and therapeutic treatments. Animal models should mimic the clinical scenarios seen in patients as closely as possible to permit the experimental results to be translated to the corresponding clinical care. To help understand existing animal models of S. aureus, we conducted a systematic search of PubMed & Ovid MEDLINE to identify in vivo animal experiments that have investigated the management of S. aureus osteomyelitis in the context of fractures and metallic implants. In this review, experimental studies are categorized by animal species and are further classified by the setting of the infection. Study methods are summarized and the relevant advantages and disadvantages of each species and model are discussed. While no ideal animal model exists, the understanding of a model’s strengths and limitations should assist clinicians and researchers to appropriately select an animal model to translate the conclusions to the clinical setting. PMID:24668594

Osteomyelitis in the diabetic foot: diagnosis and management.

PubMed

Game, Frances L

2013-09-01

Although osteomyelitis of the foot in diabetes remains common in specialist foot clinics across the world, the quality of published work to guide clinicians in the diagnosis and management is generally poor. Diagnosis should be based primarily on clinical signs supported by results of pathologic and radiologic investigations. Although the gold standard comes from the histologic and microbiological examination of bone, clinicians should be aware of the problems of sampling error. This lack of standardization of diagnostic criteria and of consensus on the choice of outcome measures poses further difficulties when seeking evidence to support management decisions. Experts have traditionally recommended surgical removal of infected bone but available evidence suggests that in many cases (excepting those in whom immediate surgery is required to save life or limb) a nonsurgical approach to management of osteomyelitis may be effective for many, if not most, patients with osteomyelitis of the diabetic foot. The benefits and limitations of both approaches need, however, to be established in prospective trials so that appropriate therapy can be offered to appropriate patients at the appropriate time, with the patients' views taken fully into account. Copyright © 2013 Elsevier Inc. All rights reserved.

Determining TOC in Waters

ERIC Educational Resources Information Center

Kehoe, Thomas J.

1977-01-01

The instrumental method for detecting total organic carbon (TOC) in water samples is detailed. The method's limitations are discussed and certain precautions that must be taken are emphasized. The subject of TOC versus COD and BOD is investigated and TOC is determined to be a valid indication of biological demand. (BT)

78 FR 63279 - Third Meeting: RTCA Tactical Operations Committee (TOC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-23

... Operations Committee (TOC) AGENCY: Federal Aviation Administration (FAA), U.S. Department of Transportation... hereby given for a meeting of the Tactical Operations Committee (TOC). The agenda will include the following: November 19, 2013 Opening of Meeting/Introduction of TOC Members Official Statement of Designated...

68Ga-DOTA-TOC Uptake in Pleomorphic Adenoma.

PubMed

Laurens, S Tom; Netea-Maier, Romana T; Aarntzen, Erik J H G

2018-07-01

A 56-year-old man who was recently diagnosed with a carcinoid tumor of the os petrosum was referred for a Ga-DOTA-TOC PET/CT scan. Besides the moderately increased Ga-DOTA-TOC accumulation in the carcinoid tumor, the scan showed strongly increased and focal Ga-DOTA-TOC uptake in an additional lesion in the right parotid gland. The markedly different Ga-DOTA-TOC avidity suggested a different etiology, and histological examination demonstrated a pleomorphic adenoma.

Evaluating the Role of Total Organic Carbon in Predicting the Treatment Efficacy of Biosand Filters for the Removal of Vibrio cholerae in Drinking Water During Startup.

PubMed

Danley-Thomson, Ashley A; Huang, Ellen C; Worley-Morse, Thomas; Gunsch, Claudia K

2018-05-09

In biosand filters (BSF), treatment is largely driven by the development of a biolayer (schmutzdecke) which establishes itself during the startup phase. In the present study, the effect of changing influent total organic carbon (TOC) loading on the removal efficiency of Vibrio cholerae in laboratory-operated BSFs was quantified. BSFs were charged with high, medium or low TOC influents and removal efficacy and schmutzdecke composition was monitored over two months. The highest V. cholerae removal efficiencies were observed in the BSF receiving the lowest TOC. Schmutzdecke composition was found to be influenced by influent TOC, in terms of microbial community structure and amount of extracellular polymeric substance (EPS). Physical/chemical attachment was shown to be important during startup. The BSF receiving influent water with lower TOC had a higher attachment coefficient than the BSF receiving high TOC water, suggesting more physical/chemical treatment in the lower TOC BSF. The high TOC BSF had more EPS than did the biofilm from the low TOC BSF, suggesting that schmutzdecke effects may be more significant at high TOC. Overall, this study confirms that influent water characteristics will affect BSF treatment efficacy of V. cholerae especially during the startup phase. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Elevated plasma γ-tocopherol and decreased α-tocopherol in men are associated with inflammatory markers and decreased plasma 25-OH vitamin D

PubMed Central

Cooney, Robert V.; Franke, Adrian A; Wilkens, Lynne R.; Gill, Jasmeet; Kolonel, Laurence N.

2010-01-01

Chronic inflammation is a risk factor for many diseases of aging. Endogenous oxidants are thought to mediate the effects of inflammation and γ-Tocopherol (γ-Toc) may mitigate damage from nitrogen-based oxidants, however, no physiological requirement for γ-Toc has been established. Regulation of tocopherols and their functional significance are poorly defined, thereby limiting their application in prevention. Using stored plasma samples from 657 male control subjects in a previous study of prostate cancer we have analyzed associations of the tocopherols, inflammation markers, and 25-OH vitamin D. Plasma α-Toc and γ-Toc were inversely correlated, whereas δ-Toc and α-Toc levels were positively correlated, suggesting a unique regulatory mechanism. γ-Toc levels were positively and α-Toc negatively associated with plasma C-reactive protein (CRP) and urinary isoprostane F2t, which are markers of inflammation and oxidation. Ethnic variability in tocopherols was observed, however, this may be explained by differences in plasma 25-OH vitamin D, as γ-Toc levels varied inversely and α-Toc positively with 25-OH vitamin D. In these data all-cause mortality appeared to be positively associated with CRP and inversely with 25-OH vitamin D. We hypothesize that plasma levels of tocopherols may serve as markers of systemic inflammation, complicating epidemiologic assessment of their role in cancer etiology. PMID:19003577

Quantitative geochemical modeling along a transect off Peru: Carbon cycling in time and space, and the triggering factors for carbon loss and storage

NASA Astrophysics Data System (ADS)

Arning, Esther T.; van Berk, Wolfgang; Schulz, Hans-Martin

2012-12-01

Early diagenetic processes in Peruvian shelf and slope sediments are numerically reproduced by applying chemical thermodynamics in a complex, universal approach using the PHREEQC (version 2) computer code. The reaction kinetics of organic carbon remineralization are integrated into a set of equilibrium reactions by defining the type and the amount of converted organic matter in a certain time step. We calculate the most intense remineralization of organic carbon for present-day shelf sites, and the final carbon pool is dominated by secondary carbonates. This serves to highlight the influence of organic matter degradation and anaerobic oxidation of methane (AOM) on diagenetic mineral formation. The enrichment of aqueous methane and the formation of methane hydrate only takes place in slope sediments with high sedimentation rates that prevent diffusive loss of methane (e.g., Sites 682 and 688). Moreover, AOM prevents the diffusion of dissolved methane into overlying seawater. Throughout the Miocene period, these sites were located on a former shelf and the total carbon loss from the sediments was significantly higher in comparison with the present-day. Compared with the present-day shelf site, organic matter remineralization is high, and methane is produced but not stored within the sediments. Our model calculations rule out the possibility of present-day and former shelf site sediments off the coast of Peru as methane reservoirs. Remineralized TOC has to be considered, particularly in older sediments, when interpreting TOC profiles and calculating mass accumulation rates of total organic carbon (MARTOC). The more organic matter has been remineralized during the depositional history, the larger the difference between MARTOC calculated from measured TOC data, and from the sum of modeled and measured TOC data. Consequently, most reliable primary productivity calculations are based on the sum of measured relict TOC and the amount of remineralized organic carbon determined by modeling.

Optimizing care transitions: the role of the community pharmacist

PubMed Central

Melody, Karleen T; McCartney, Elizabeth; Sen, Sanchita; Duenas, Gladys

2016-01-01

Transitions of care (TOC) refer to the movement of patients across institutions, among providers, between different levels of care, and to and from home. Medication errors that occur during TOC have the potential to result in medical complications that are serious for the patient and costly to the health care system. Positive outcomes have been demonstrated when pharmacists are involved in providing TOC services, including reducing preventable adverse drug reactions, medication-related problems, and rehospitalizations, as well as improving the discharge process. This review explores TOC models involving community pharmacy practice, the current impact of pharmacist interventions in TOC, and patient satisfaction with TOC services provided by community pharmacists. Common barriers and potential solutions to TOC services provided in the community pharmacy, such as patient identification, information gathering, standardization of services, administrative support, reimbursement, and time restraints, are also discussed. PMID:29354539

Chronic Osteomyelitis of the Distal Femur Treated with Resection and Delayed Endoprosthetic Reconstruction: A Report of Three Cases.

PubMed

Ryan, Sean; Eward, William; Brigman, Brian; Zura, Robert

2017-01-01

Chronic osteomyelitis involving the distal femur often results in amputation or arthrodesis. This article presents three cases of chronic osteomyelitis treated with a staged approach culminating in endoprosthetic reconstruction. Stage one involved resection of infected bone and placement of an intramedullary nail spanning the bony defect between proximal femur and tibia, with antibiotic cement packed around the nail. Patients were then placed on long-term IV +/- oral antibiotics to clear the infection. A "cooldown" period was then used between stages where patients were off antibiotics and inflammatory markers were monitored for signs of remaining infection. Stage two then involved reconstruction of the distal femur and knee with an endoprosthesis. In the appropriate patient, this treatment strategy offers another option in this challenging population.

Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report

PubMed Central

Syed, Basheer Ahmed; Prasad, N; Praveen, SP

2013-01-01

ABSTRACT Chronic suppurative osteomyelitis (CSO) of the maxillofacial region is primarily caused by infections of odontogenic microorganisms. It may also arise as a complication of dental extractions, maxillofacial trauma, inadequate treatment of a fracture and irradiation to the mandible. This condition is characterized by areas of devitalized bone (sequestra) which serves as a nidus for recurrent episodes of infection. This case report describes a case of CSO in an untreated right subcondylar fracture of the mandible which was successfully treated with a combination of antibiotic therapy and surgical debridement in an 8-year-old boy. How to cite this article: Kumar GR, Syed BA, Prasad N, Praveen SP. Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report. Int J Clin Pediatr Dent 2013;6(2): 119-123. PMID:25206205

40 CFR 65.64 - Group determination procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... used to determine group status. (b)(1) Sampling site. For purposes of determining TOC or HAP... inches) in nominal inside diameter. (c) TOC or HAP concentration. The TOC or HAP concentrations used for... appropriate concentration in table 1 of this subpart, TOC or HAP concentration shall be determined based on...

Mid-Holocene paleoclimatic changes and solar activity in San'in District, mid-latitude North Pacific Region

NASA Astrophysics Data System (ADS)

Okazaki, Y.; Seto, K.; Sakai, T.; Ooki, A.; yamada, K.; Dettman, D. L.

2011-12-01

Evidence shows that solar activity influences climate on a global scale. In the mid-latitude region, climate change is expected to change precipitation patterns. Concurrently, variation in solar activity may influence phytoplankton productivity. It seems that these changes should be recorded in sediment and organic matter deposits in coastal lagoons. In this study, we discuss the relationship between climate change and solar activity in the mid-Holocene in the northern hemisphere mid-latitude region based on grain size analysis, total organic carbon (TOC) content and organic carbon accumulation rates (Corg A.R.) in coastal lagoon sediment core samples. The INB core was drilled to produce a high resolution record of Holocene paleoenvironmental change in the San'in District, western Japan. The core is 19.17m in total length and is divided into Unit I~VII by lithofacies. Holocene sediment, primarily organic silt, forms Unit III and above in this core. Unit III was deposited from 8.4 to 5.4 ka, when sea level rose during the Jomon transgression; its depositional environment is a coastal lagoon. Progradation of the river mouth during the sea level rise lead to an increase in the C/N ratio of organic matter. Unit IV contains the volcanic Shigaku pyroclastic flow (the sixth stage of volcanic activity of the Sanbe volcano), and Unit V reflects deposition in a freshwater lake or swamp. Above this aggredational sediments were deposited by small rivers. This study focused on the coastal lagoon sediments of Unit III (8.4 to 5.4 ka); we carried out CNS elemental analysis and grain size analysis with a resolution of approximately five years. TOC content is variable and increases from 0.5 to 5%. Variation in TOC content is relatively well correlated with atmospheric radiocarbon 14C (Delta 14C) and therefore with solar activity, although the relationship is unclear in the upper portion of Unit III. The trend in Corg A.R. is different than TOC contents, about 40g/m/yr at ~8ka and about 20g/m/yr at 6-7 ka. This trend is also observed in a sediment core of Nakaumi Lagoon in San'in District, where it is due to a dilution effect caused by increased precipitation and high productivity because of a higher nutrient load during a warm interval (Sampei et al.,1997). It seems that the correspondence between TOC content and Delta 14C in this core is caused by similar factors. That is, a positive peak of Delta 14C indicating low solar activity and a cold period shows high TOC content because of concentration of TOC. On the other hand, a negative peak in Delta 14C indicates a warm period, and has a low TOC content because of clastic dilution. In the upper portion this relationship becomes complex because of changes in the terrestrial plant input due to river mouth progradation. Using these relationships, we may be able to estimate precipitation change based on the change in TOC content, and discuss its implications for global climate change.

Integration of biofiltration and advanced oxidation processes for tertiary treatment of an oil refinery wastewater aiming at water reuse.

PubMed

Nogueira, A A; Bassin, J P; Cerqueira, A C; Dezotti, M

2016-05-01

The combination of biological and chemical oxidation processes is an interesting approach to remove ready, poor, and non-biodegradable compounds from complex industrial wastewaters. In this study, biofiltration followed by H2O2/UV oxidation (or microfiltration) and final reverse osmosis (RO) step was employed for tertiary treatment of an oil refinery wastewater. Biofiltration alone allowed obtaining total organic carbon (TOC), chemical oxygen demand (COD), UV absorbance at 254 nm (UV254), ammonium, and turbidity removal of around 46, 46, 23, 50, and 61 %, respectively. After the combined biological-chemical oxidation treatment, TOC and UV254 removal amounted to 88 and 79 %, respectively. Whereas, the treatment performance achieved with different UV lamp powers (55 and 95 W) and therefore distinct irradiance levels (26.8 and 46.3 mW/cm(2), respectively) were very similar and TOC and UV254 removal rates were highly affected by the applied C/H2O2 ratio. Silt density index (SDI) was effectively reduced by H2O2/UV oxidation, favoring further RO application. C/H2O2 ratio of 1:4, 55 W UV lamp, and 20-min oxidation reaction corresponded to the experimental condition which provided the best cost/benefit ratio for TOC, UV254, and SDI reduction from the biofilter effluent. The array of treatment processes proposed in this study has shown to be adequate for tertiary treatment of the oil refinery wastewater, ensuring the mitigation of membrane fouling problems and producing a final effluent which is suitable for reuse applications.

40 CFR 60.704 - Test methods and procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... sites. The control device inlet sampling site for determination of vent stream molar composition or TOC... compliance with the 20 ppmv limit. The sampling site shall be the same as that of the TOC samples, and the samples shall be taken during the same time that the TOC samples are taken. The TOC concentration...

40 CFR 60.614 - Test methods and procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... or TOC (less methane and ethane) reduction efficiency shall be prior to the inlet of the control... determining compliance with the 20 ppmv limit. The sampling site shall be the same as that of the TOC samples and the samples shall be taken during the same time that the TOC samples are taken. The TOC...

40 CFR 60.664 - Test methods and procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... sites. The control device inlet sampling site for determination of vent stream molar composition or TOC... compliance with the 20 ppmv limit. The sampling site shall be the same as that of the TOC samples, and the samples shall be taken during the same time that the TOC samples are taken. The TOC concentration...

Multi-functional roles for the polypeptide transport associated domains of Toc75 in chloroplast protein import

PubMed Central

Paila, Yamuna D; Richardson, Lynn GL; Inoue, Hitoshi; Parks, Elizabeth S; McMahon, James; Inoue, Kentaro; Schnell, Danny J

2016-01-01

Toc75 plays a central role in chloroplast biogenesis in plants as the membrane channel of the protein import translocon at the outer envelope of chloroplasts (TOC). Toc75 is a member of the Omp85 family of bacterial and organellar membrane insertases, characterized by N-terminal POTRA (polypeptide-transport associated) domains and C-terminal membrane-integrated β-barrels. We demonstrate that the Toc75 POTRA domains are essential for protein import and contribute to interactions with TOC receptors, thereby coupling preprotein recognition at the chloroplast surface with membrane translocation. The POTRA domains also interact with preproteins and mediate the recruitment of molecular chaperones in the intermembrane space to facilitate membrane transport. Our studies are consistent with the multi-functional roles of POTRA domains observed in other Omp85 family members and demonstrate that the domains of Toc75 have evolved unique properties specific to the acquisition of protein import during endosymbiotic evolution of the TOC system in plastids. DOI: http://dx.doi.org/10.7554/eLife.12631.001 PMID:26999824

α-Tocopherol Attenuates the Triglyceride- and Cholesterol-Lowering Effects of Rice Bran Tocotrienol in Rats Fed a Western Diet.

PubMed

Shibata, Akira; Kawakami, Yuki; Kimura, Toshiyuki; Miyazawa, Teruo; Nakagawa, Kiyotaka

2016-07-06

Previous studies demonstrated the ability of tocotrienol (T3) to lower levels of lipids, including cholesterol (Cho) and triglycerides (TG). Although α-tocopherol (α-Toc) reportedly inhibits the hypocholesterolemic effect of T3, there is no information about whether α-Toc influences the TG-lowering effect of T3 in vivo. In this study, we investigated the influence of α-Toc on the antihyperlipidemic effects (Cho- and TG-lowering) of rice bran tocotrienols (RBT3) in F344 rats fed a western diet. α-Toc attenuated both the Cho- and TG-lowering effects of RBT3 in vivo, whereas α-Toc alone exhibited no hypolipidemic effects. RBT3-induced Cpt-1a and Cyp7a1 gene expression was reduced by α-Toc. Furthermore, coadministration of α-Toc decreased liver and adipose tissue concentrations of tocotrienols in F344 rats. These results indicate that α-Toc has almost no antihyperlipidemic effect in vivo, but abrogates the antihyperlipidemic effect of RBT3 by reducing tissue concentrations of tocotrienols and regulating expression of genes involved in lipid metabolism. Understanding the underlying mechanism of the beneficial effects of T3 on lipid metabolism and the interaction with α-Toc will be important for developing T3-based therapeutics.

Conservative management of diabetic foot osteomyelitis.

PubMed

Acharya, S; Soliman, M; Egun, A; Rajbhandari, S M

2013-09-01

In this retrospective study, 130 patients with diabetic foot osteomyelitis were analysed. 66.9% of these healed with antibiotic treatment alone and 13.9% needed amputation, of which 1.5% were major. Presence of MRSA was associated with adverse outcome (53.3% vs 21.1%, p=0.04) which was defined as death, amputation and failure to heal. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Description of osteomyelitis lesions associated with Actinomyces pyogenes infection in the proximal tibia of adult male turkeys.

PubMed

Brinton, M K; Schellberg, L C; Johnson, J B; Frank, R K; Halvorson, D A; Newman, J A

1993-01-01

Actinomyces pyogenes was isolated from osteomyelitis lesions from the proximal tibia of mature tom turkeys. Gram-stained impression smears of the lesions resulted in bacteria that appeared as club-shaped, gram-positive pleomorphic rods. The bacteria grew better in a reduced-oxygen environment. The lesions were well demarcated and cavernous, ranging from purulent to caseous in consistency.

Aspergillus Osteomyelitis of the Ribs in Immunocompetent Hosts: Report of Two Rare Cases

PubMed Central

Menon, Aditya; Rodrigues, Camilla; Soman, Rajeev; Sunavala, Ayesha; Agashe, Vikas M

2017-01-01

Introduction: Osteomyelitis is rarely caused by fungi, most common among them being Candida. Aspergillus is a rare cause of fungal osteomyelitis mimics tuberculous osteomyelitis. Aspergillus osteomyelitis (AO) of the ribs is relatively uncommon, with an incidence rate of only 9% among all reported cases of AO. With mortality rates of almost 25%, AO is on the rise attributed to increasing numbers of immunocompromised individuals. There are very few case reports of AO of ribs in immunocompetent individuals. We report two such cases. Case Report: Case 1: A 51-year-old male developed spontaneous chest pain along right costal margin with a low-grade fever. High-resolution computed tomography chest revealed osteomyelitis of anterolateral chest wall. He did not improve with empirical antitubercular therapy, and subsequent debridement showed polymicrobial pyogenic infection which was managed with appropriate antibiotics elsewhere. Samples were not sent for fungal culture. He presented to us 3 months later, and surgical debridement showed growth of Aspergillus flavus which was managed with oral voriconazole. The lesion healed with no recurrence at 24-month follow-up. Case 2: A 40-year-old male presented to our institute with left-sided chest pain, low-grade fever, and loss of appetite. There was a history of injury with a sharp piece of wood 2 years earlier. Magnetic resonance imaging defined the lesion which was biopsied under ultrasound guidance. Cultures grew A. flavus which was treated with oral voriconazole. He had complete clinical improvement at 16-month follow-up. Conclusion: More number of AO cases are being reported in immunocompetent individuals. Variability in clinical picture, rarity, misdiagnosis, empirical therapy, and failure to send deep tissue samples for fungal cultures are some of the reasons for the high mortality rates. It is paramount in today’s scenario of atypical presentations, to obtain deep tissue for all cultures including fungal culture and histopathology, either surgically or under image guidance to achieve good clinical outcomes. Our study highlights that following the strict protocol of obtaining tissue for fungal culture, systemic antifungal therapy, and surgical debridement where necessary can help to diagnose and treat this rare pathology and ensure the good clinical outcome. PMID:29181357

Treatment of Osteomyelitis: A Case for Disruption of the Affected Adjacent Periosteum.

PubMed

Hudson, John W; Daly, Austin P; Foster, Michael

2017-10-01

To evaluate the response of mandibular osteomyelitis treated by surgical decortication with disruption of the affected adjacent periosteum in concert with long-term targeted antibiotic therapy. The hypothesis is that, by removing the buccal cortical plate and disrupting the hypertrophically inflamed adjacent periosteum, the medullary bone will be brought in contact with bleeding tissue and circulating immunologic factors and antibiotics, which will promote definitive resolution. A retrospective review was conducted of 7 patient charts with associated radiographs from November 2010 to August 2016 treated by the first author at the University of Tennessee Medical Center (Knoxville, TN). Patients with chronic suppurative or nonsuppurative osteomyelitis of the mandible without condylar involvement or pathologic fracture were selected and treated with decortication with periosteal disruption in combination with long-term targeted antibiotic therapy. Seven patients (3 women and 4 men; mean age, 60 yr) underwent decortication with periosteal disruption of the affected area and received at least 6 weeks of targeted intravenous antibiotics. Computed tomography was performed preoperatively and a repeat study was performed after completion of antibiotics. In each case, post-treatment imaging showed definitive resolution after treatment with decortication in concert with disruption of the inflamed hypertrophic periosteum and intravenous antibiotics. Debridement of the infected cortical bone with restoration of the blood supply through disruption of the adjacent periosteum provided definitive resolution of mandibular osteomyelitis in the 7 patients treated. The hypothesis is that disruption of the affected adjacent periosteum reintroduces an immune-mediated response in concert with improved antibiotic delivery to and penetrance of the diseased mandible, aiding in definitive resolution. Decortication with periosteal disruption allows for preservation of the inferior alveolar nerve, maintains mandibular integrity, and obviates reconstructive surgery. Decortication with disruption of the adjacent periosteum, when combined with targeted antimicrobial therapy, produced definitive resolution of osteomyelitis as shown by postoperative imaging. It is the authors' assertion that not only decortication, but also disruption of the adjacent periosteum in combination with targeted antibiotic therapy should be considered a valid and principal therapeutic option for the surgical treatment of osteomyelitis of the mandible. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Spatio-Temporal Variability of the Phase of Total Ozone Quasi-Decennial Oscillations

NASA Astrophysics Data System (ADS)

Visheratin, K. N.

2017-12-01

The SBUV/SBUV2 (65° S-65° N) and Bodeker Scientific (90° S-90° N) satellite databases have been used for composite and cross-wavelet analyses of the spatio-temporal variability of phase relations between a 11-year cycle of solar activity (SA) and quasi-decennial oscillations (QDOs) of total ozone content (TOC). For globally average TOC values, the QDO maxima coincide in phase with the solar-activity maxima, and amplitude variations of TOC correlate with those of the 11-year solar cycle. According to the analysis of amplitude and phase of QDOs for the zonal average TOC fields, a QDO amplitude is about 6-7 Dobson Units (DU) in the high northern and southern latitudes, and it does not exceed 2-3 DU in the tropic regions. The latitudinal TOC variations are distinguished by a delay of the quasi-decennial oscillation phase in the southern latitudes in comparison with the northern latitudes. The TOC maxima phase coincides with the SA maxima phase in the tropic regions; the TOC variations go ahead of the SA variations, on average, in moderate and high latitudes of the Northern Hemisphere; the TOC variations are behind the SA variations in the Southern Hemisphere. The phase delay between TOC QDO maxima in the northern and southern latitudes appears to increase in the course of time, and the TOC quasi-decennial variations in the Arctic and Antarctic subpolar regions occur approximately in an antiphase over the last two decades.

Synchronous response of sedimentary organic carbon accumulation on the inner shelf of the East China Sea to the water impoundment of Three Gorges and Gezhouba Dams

NASA Astrophysics Data System (ADS)

Lin, Jia; Zhu, Qing; Hong, Yuehui; Yuan, Lirong; Liu, Jinzhong; Xu, Xiaoming; Wang, Jianghai

2018-01-01

Coastal seas, located between continents and the open ocean, are an important active carbon pool. The sedimentary total organic carbon (TOC) in these areas is a mixture of terrestrial and marine sources, and can be a powerful proxy for tracing natural processes and human activities. In this study, one fine-grained sediment core (DH5-1) from the inner shelf of the East China Sea was systematically analyzed for TOC and black carbon (BC) contents and TOC stable carbon isotope ratios (δ13C). By combining these data with 210Pb dating, an improved carbon correction model and a two end-member mixing model, we reconstructed century-scale high-resolution sequences of corrected TOC, terrestrial TOC and marine TOC contents and identified two carbon depletion events in the DH5-1 record. The two events, shown as two minima in the TOC profiles, correspond temporally to 1985-1987 AD and 2003-2006 AD, which exactly matches the water impoundment of the Gezhouba Dam and Three Gorges Dam, respectively. In addition, the variations in TOC contents and δ13C values before, during or after the minima demonstrate a relationship between the depletion events and water impoundment of the dams on the Changjiang River. The TOC reductions may represent synchronous responses of sedimentary TOC and resultant ecological effects on the inner shelf of the East China Sea to the water impoundment of the dams. These new TOC records reflect the interaction between natural and anthropogenic processes and, accordingly, provide a deep insight and important references for assessing marine ecological effects resulting from water impoundment of largescale dams.

Temporal and spatial distributions of sediment total organic carbon in an estuary river.

PubMed

Ouyang, Y; Zhang, J E; Ou, L-T

2006-01-01

Understanding temporal and spatial distributions of naturally occurring total organic carbon (TOC) in sediments is critical because TOC is an important feature of surface water quality. This study investigated temporal and spatial distributions of sediment TOC and its relationships to sediment contaminants in the Cedar and Ortega Rivers, Florida, USA, using three-dimensional kriging analysis and field measurement. Analysis of field data showed that large temporal changes in sediment TOC concentrations occurred in the rivers, which reflected changes in the characteristics and magnitude of inputs into the rivers during approximately the last 100 yr. The average concentration of TOC in sediments from the Cedar and Ortega Rivers was 12.7% with a maximum of 22.6% and a minimum of 2.3%. In general, more TOC accumulated at the upper 1.0 m of the sediment in the southern part of the Ortega River although the TOC sedimentation varied with locations and depths. In contrast, high concentrations of sediment contaminants, that is, total polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs), were found in sediments from the Cedar River. There was no correlation between TOC and PAHs or PCBs in these river sediments. This finding is in contradiction to some other studies which reported that the sorption of hydrocarbons is highly related to the organic matter content of sediments. This discrepancy occurred because of the differences in TOC and hydrocarbon source input locations. It was found that more TOC loaded into the southern part of the Ortega River, while almost all of the hydrocarbons entered into the Cedar River. This study suggested that the locations of their input sources as well as the land use patterns should also be considered when relating hydrocarbons to sediment TOC.

Effect of α-Tocopherol on the Microscopic Dynamics of Dimyristoylphosphatidylcholine Membrane

DOE PAGES

Sharma, V. K.; Mamontov, E.; Tyagi, M.; ...

2015-12-16

Vitamin E behaves as an antioxidant and is well known for its protective properties of the lipid membrane. The most biologically active form of vitamin E in the human organism is α-tocopherol (aToc). Recently (Marquardt, D.; et al. J. Am. Chem. Soc. 2014, 136, 203₋210) it has been shown that aToc resides near the center of dimyristoylphosphatidylcholine (DMPC) bilayer, which is in stark contrast with other PC membranes, where aToc is located near the lipid₋water interface. Here we report an unusual effect of this exceptional location of aToc on the dynamical behavior of DMPC membrane probed by incoherent elastic andmore » quasielastic neutron scattering. For pure DMPC vesicles, elastic scan data show two step-like drops in the elastic intensity at 288 and 297 K, which correspond to the pre- and main phase transitions, respectively. However, inclusion of aToc into DMPC membrane inhibits the step-like elastic intensity drops, indicating a significant impact of aToc on the phase behavior of the membrane. This observation is supported by our differential scanning calorimetry data, which shows that inclusion of aToc leads to a significant broadening of the main phase transition peak, whereas the peak corresponding to the pretransition disappears. We have performed quasielastic neutron scattering (QENS) measurements on DMPC vesicles with various concentrations of aToc at 280, 293, and 310 K. We have found that aToc affects both the lateral diffusion and the internal motions of the lipid molecules. Below the main phase transition temperature inclusion of aToc accelerates both the lateral and the internal lipid motions. On the other hand, above the main phase transition temperature the addition of aToc restricts only the internal motion, without a significant influence on the lateral motion. To conclude, our results support the finding that the location of aToc in DMPC membrane is deep within the bilayer.« less

Test of cure, retesting and extragenital testing practices for Chlamydia trachomatis and Neisseria gonorrhoeae among general practitioners in different socioeconomic status areas: A retrospective cohort study, 2011-2016

PubMed Central

van Liere, Geneviève A. F. S.; Cals, Jochen W. L.; Dukers-Muijrers, Nicole H. T. M.

2018-01-01

Background For Chlamydia trachomatis (CT), a test of cure (TOC) within 3–5 weeks is not recommended. International guidelines differ in advising a Neisseria gonorrhoeae (NG) TOC. Retesting CT and NG positives within 3–12 months is recommended in international guidelines. We assessed TOC and retesting practices including extragenital testing in general practitioner (GP) practices located in different socioeconomic status (SES) areas to inform and optimize local test practices. Methods Laboratory data of 48 Dutch GP practices between January 2011 and July 2016 were used. Based on a patient’s first positive CT or NG test, the proportion of TOC (<3 months) and retests (3–12 months) were calculated. Patient- and GP-related factors were assessed using multivariate logistic regression analyses. Results For CT (n = 622), 20% had a TOC and 24% had a retest at the GP practice. GP practices in low SES areas were more likely to perform a CT TOC (OR:1.8;95%CI:1.1–3.1). Younger patients (<25 years) were more likely to have a CT TOC (OR:1.6;95%CI:1.0–2.4). For CT (n = 622), 2.4% had a TOC and 6.1% had a retest at another STI care provider. For NG (n = 73), 25% had a TOC and 15% had a retest at the GP practice. For NG (n = 73), 2.7% had a TOC and 12.3% had a retest at another STI care provider. In only 0.3% of the consultations patients were tested on extragenital sites. Conclusion Almost 20% of the patients returned for a CT TOC, especially at GP practices in low SES areas. For NG, 1 out of 4 patients returned for a TOC. Retesting rates were low for both CT (24%) and NG (15%), (re)infections including extragenital infections may be missed. Efforts are required to focus TOC and increase retesting practices of GPs in order to improve CT/NG control. PMID:29538469

Evaluation of (64)Cu-labeled DOTA-D-Phe(1)-Tyr (3)-octreotide ((64)Cu-DOTA-TOC) for imaging somatostatin receptor-expressing tumors.

PubMed

Hanaoka, Hirofumi; Tominaga, Hideyuki; Yamada, Keiich; Paudyal, Pramila; Iida, Yasuhiko; Watanabe, Shigeki; Paudyal, Bishnuhari; Higuchi, Tetsuya; Oriuchi, Noboru; Endo, Keigo

2009-08-01

In-111 ((111)In)-labeled octreotide has been clinically used for imaging somatostatin receptor-positive tumors, and radiolabeled octreotide analogs for positron emission tomography (PET) have been developed. Cu-64 ((64)Cu; half-life, 12.7 h) is an attractive radionuclide for PET imaging and is produced with high specific activity using a small biomedical cyclotron. The aim of this study is to produce and fundamentally examine a (64)Cu-labeled octreotide analog, (64)Cu-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-D: -Phe(1)-Tyr(3)-octreotide ((64)Cu-DOTA-TOC). (64)Cu produced using a biomedical cyclotron was reacted with DOTA-TOC for 30 min at 45 degrees C. The stability of (64)Cu-DOTA-TOC was evaluated in vitro (incubated with serum) and in vivo (blood collected after administration) by HPLC analysis. Biodistribution studies were performed in normal mice by administration of mixed solution of (64)Cu-DOTA-TOC and (111)In-DOTA-TOC and somatostatin receptor-positive U87MG tumor-bearing mice by administration of (64)Cu-DOTA-TOC or (64)Cu-1,4,8,11-tetraazacyclotetradecane-1,4,8,11-tetraacetic acid-octreotide ((64)Cu-TETA-OC). The tumor was imaged using (64)Cu-DOTA-TOC, (64)Cu-TETA-OC, and FDG with an animal PET scanner. (64)Cu-DOTA-TOC can be produced in amounts sufficient for clinical study with high radiochemical yield. (64)Cu-DOTA-TOC was stable in vitro, but time-dependent transchelation to protein was observed after injection into mice. In biodistribution studies, the radioactivity of (64)Cu was higher than that of (111)In in all organs except kidney. In tumor-bearing mice, (64)Cu-DOTA-TOC showed a high accumulation in the tumor, and the tumor-to-blood ratio reached as high as 8.81 +/- 1.17 at 6 h after administration. (64)Cu-DOTA-TOC showed significantly higher accumulation in the tumor than (64)Cu-TETA-OC. (64)Cu-DOTA-TOC PET showed a very clear image of the tumor, which was comparable to that of (18)F-FDG PET and very similar to that of (64)Cu-TETA-OC. (64)Cu-DOTA-TOC clearly imaged a somatostatin receptor-positive tumor and seemed to be a potential PET tracer in the clinical phase.

A rabbit model of implant-related osteomyelitis inoculated with biofilm after open femoral fracture

PubMed Central

Zhang, Xiang; Ma, Yun-Fei; Wang, Lei; Jiang, Nan; Qin, Cheng-He; Hu, Yan-Jun; Yu, Bin

2017-01-01

Currently, animal models used in research on implant-associated osteomyelitis primarily use intramedullary fixation and initial inoculum of planktonic bacterial cells. However, these techniques have certain limitations, including lack of rotational stability and instable inoculation. To improve these models, the present study aimed to establish a novel rabbit model of implant-associated osteomyelitis using biofilm as the initial inoculum following plate fixation of the femoral fracture. A total of 24 New Zealand White rabbits were randomly divided into two equal groups. Osteotomy was performed at the right femoral shaft using a wire saw following fixation with a 5-hole stainless steel plate. The plates were not colonized with bacteria in group 1, but colonized with a biofilm of Staphylococcus aureus (American Type Culture Collection, 25923) in group 2. All the rabbits were sacrificed after 21 days for clinical, X-ray, micro-computed tomography and histological assessments of the severity of osteomyelitis. Scanning electron microscopy and confocal laser scanning microscopy were used for biofilm assessment. In group 2, pus formation, periosteal reaction, cortical destruction and absorption were observed in all the rabbits and biofilm formation was observed on all the plates. However, no pus formation was observed except for a slight inflammatory response and all the plates appeared clean without infection in group 1. The differences between the two groups were statistically significant regarding histologic scores and semi-quantification of the bacteria on the plates (P<0.001). In the present study, a novel rabbit model of infection following internal plate fixation of open fracture was successfully established, providing a novel tool for the study of implant-associated osteomyelitis. PMID:29201204

Use of antibiotic-loaded polymethyl methacrylate beads in the management of musculoskeletal sepsis--a retrospective study.

PubMed

Mohanty, S P; Kumar, M N; Murthy, N S

2003-06-01

To assess the use of antibiotic-loaded polymethyl methacrylate beads in the management of chronic osteomyelitis of different aetiologies: infected osteosynthesis, infected open fractures, and haematogenous osteomyelitis. Records of 49 patients with chronic osteomyelitis who were treated at Department of Orthopaedics, Kasturba Medical College, from 1995 to 1999 were studied retrospectively. The diagnosis of chronic osteomyelitis was made on the basis of clinical and radiographic features. Of the 49 patients, 4 had haematogenous osteomyelitis, which later proved to be tuberculosis, and were thus excluded. Antibiotic-loaded acrylic beads were implanted in the remaining patients after thorough debridement. The implant was removed primarily in 16 patients with infected osteosynthesis, who then underwent decompression and sequestrectomy. All wounds were closed primarily. Peri-operative antibiotics were given for 7 days. Beads were removed at the end of 3 weeks followed by bone grafting in 26 patients. Patients were followed up for an average period of 3.7 years. The infective organisms were sensitive to gentamycin in 26 cases and resistant in 19 cases; 14 cases were sensitive to cefuroxime, 11 to cloxacillin, 8 to ampicillin, and 5 to cotrimoxazole. Seven cases were resistant to all antibiotics tested. Of the 19 patients with gentamycin-resistant infection, only one had a poor result. No adverse systemic side-effects such as ototoxicity or nephrotoxicity were seen. Infection did not recur in 39 patients, but 6 patients had low-grade persistent infection at the last follow-up visit. In chronic infections, especially those following osteosynthesis, antibiotic beads are a valuable adjuvant. The most valuable advantage is that the wound can be closed primarily, thereby reducing the incidence of nosocomial infections and requirement of nursing care.

A Novel Injectable Borate Bioactive Glass Cement as an Antibiotic Delivery Vehicle for Treating Osteomyelitis

PubMed Central

Cui, Xu; Gu, Yi-Fei; Jia, Wei-Tao; Rahaman, Mohamed N.; Wang, Yang; Huang, Wen-Hai; Zhang, Chang-Qing

2014-01-01

Background A novel injectable cement composed of chitosan-bonded borate bioactive glass (BG) particles was evaluated as a carrier for local delivery of vancomycin in the treatment of osteomyelitis in a rabbit tibial model. Materials and Methods The setting time, injectability, and compressive strength of the borate BG cement, and the release profile of vancomycin from the cement were measured in vitro. The capacity of the vancomycin-loaded BG cement to eradicate methicillin-resistant Staphylococcus aureus (MRSA)-induced osteomyelitis in rabbit tibiae in vivo was evaluated and compared with that for a vancomycin-loaded calcium sulfate (CS) cement and for intravenous injection of vancomycin. Results The BG cement had an injectability of >90% during the first 3 minutes after mixing, hardened within 30 minutes and, after hardening, had a compressive strength of 18±2 MPa. Vancomycin was released from the BG cement into phosphate-buffered saline for up to 36 days, and the cumulative amount of vancomycin released was 86% of the amount initially loaded into the cement. In comparison, vancomycin was released from the CS cement for up 28 days and the cumulative amount released was 89%. Two months post-surgery, radiography and microbiological tests showed that the BG and CS cements had a better ability to eradicate osteomyelitis when compared to intravenous injection of vancomycin, but there was no significant difference between the BG and CS cements in eradicating the infection. Histological examination showed that the BG cement was biocompatible and had a good capacity for regenerating bone in the tibial defects. Conclusions These results indicate that borate BG cement is a promising material both as an injectable carrier for vancomycin in the eradication of osteomyelitis and as an osteoconductive matrix to regenerate bone after the infection is cured. PMID:24427311

Outcomes of osteomyelitis in patients with diabetes: conservative vs. combined surgical management in a community hospital in Puerto Rico.

PubMed

Maldonado-Rodríguez, Miguel; Cajigas-Feliciano, Yanniris; Torres-Torres, Nancy

2011-06-01

Diabetes predisposes patients to multiple complications, such as osteomyelitis, which, if not managed adequately, may result in amputation, sepsis, or death. This study aimed to compare the rates of amputation associated with two different treatment plans for osteomyelitis being utilized with a group of Puerto Ricans with diabetes. We reviewed the medical records of adult patients with diabetes and osteomyelitis who had been admitted to a community hospital within a two-year timeframe; a total of 169 records were reviewed. Data were analyzed using descriptive statistics, chi-square, odds ratios, and multivariate logistic regression to compare the amputation rate of patients receiving conservative management (antibiotics and/or local care alone) with that of patients receiving combined surgical treatment (any modality consisting of an initial surgical treatment plus antibiotics and/or local care). We found a general amputation rate of 34.5%. Amputation was less likely in patients undergoing combined surgical treatment (OR: 0.22; 95% IC: 0.08-0.59) than it was in those patients whose disease management was conservative. In addition, men (OR: 2.09; 95% CI: 1.04-4.23) and non-geriatric patients (OR: 3.38; 95% CI: 1.65-6.94) had higher probabilities of amputation than did women and geriatric patients, respectively. This study revealed an amputation rate among patients with diabetes that is higher than that reported in the United States (34.5% vs. 11.0% to 20.0%). We also found that the probability of amputation secondary to osteomyelitis among patients with diabetes is two times higher for men and three times higher for non-geriatric patients; combined surgical treatment was associated with a significant reduction (78%) of the probability of amputation.

A novel injectable borate bioactive glass cement as an antibiotic delivery vehicle for treating osteomyelitis.

PubMed

Ding, Hao; Zhao, Cun-Ju; Cui, Xu; Gu, Yi-Fei; Jia, Wei-Tao; Rahaman, Mohamed N; Wang, Yang; Huang, Wen-Hai; Zhang, Chang-Qing

2014-01-01

A novel injectable cement composed of chitosan-bonded borate bioactive glass (BG) particles was evaluated as a carrier for local delivery of vancomycin in the treatment of osteomyelitis in a rabbit tibial model. The setting time, injectability, and compressive strength of the borate BG cement, and the release profile of vancomycin from the cement were measured in vitro. The capacity of the vancomycin-loaded BG cement to eradicate methicillin-resistant Staphylococcus aureus (MRSA)-induced osteomyelitis in rabbit tibiae in vivo was evaluated and compared with that for a vancomycin-loaded calcium sulfate (CS) cement and for intravenous injection of vancomycin. The BG cement had an injectability of >90% during the first 3 minutes after mixing, hardened within 30 minutes and, after hardening, had a compressive strength of 18 ± 2 MPa. Vancomycin was released from the BG cement into phosphate-buffered saline for up to 36 days, and the cumulative amount of vancomycin released was 86% of the amount initially loaded into the cement. In comparison, vancomycin was released from the CS cement for up 28 days and the cumulative amount released was 89%. Two months post-surgery, radiography and microbiological tests showed that the BG and CS cements had a better ability to eradicate osteomyelitis when compared to intravenous injection of vancomycin, but there was no significant difference between the BG and CS cements in eradicating the infection. Histological examination showed that the BG cement was biocompatible and had a good capacity for regenerating bone in the tibial defects. These results indicate that borate BG cement is a promising material both as an injectable carrier for vancomycin in the eradication of osteomyelitis and as an osteoconductive matrix to regenerate bone after the infection is cured.

77 FR 10424 - Approval and Promulgation of Implementation Plans; Wisconsin; Volatile Organic Compound Emission...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-22

... organic compounds (TOC) (minus methane and ethane) by 98 weight-percent or to a TOC (minus methane and...- effectiveness) per unit reduction of TOC associated with an individual vent stream, based on vent stream flow rate, emission rate of TOC, net heating value and corrosion properties, whether or not the vent stream...

40 CFR 419.13 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

...), the Regional Administrator may substitute TOC as a parameter in lieu of COD Effluent limitations for TOC shall be based on effluent data from the plant correlating TOC to BOD5. If in the judgment of the Regional Administrator, adequate correlation data are not available, the effluent limitations for TOC shall...

[Scintigraphic findings in a patient with sickle-cell thalassemia and recurrent pain attacks].

PubMed

Mikosch, Peter; Jauk, Barbara; Kaulfersch, Wilhelm; Gallowitsch, Hans-Jürgen; Lind, Peter

2003-01-01

The case of an eight years old African boy who suffers from sickle cell-thalassemia is presented. In the course of the disease frequent pain attacks occurred within the abdomen and extremities, recently also within the trunk. Local pain, at some occasions in combination with local swelling and always positive laboratory parameters for inflammation, hindered a solely clinical differentiation between bone infarcts and osteomyelitis. Bone scintigraphy, eventually in combination with bone marrow scintigraphy, can assist the clinician in the differentiation of aseptic bone infarcts versus secondary osteomyelitis. Based on the presented case scintigraphic results for bone infarcts, osteomyelitis and special scintigraphic pattern seen in sickle cell disease are presented. Furthermore, problems regarding the interpretation of the scintigraphies in relation to the delayed time after the beginning of pain attacks are discussed.

[Resection of a carpal bone row in a Pustertaler Sprinze cow with chronic purulent arthritis of the carpal joint and osteomyelitis].

PubMed

Kofler, J; Peterbauer, C

2014-01-01

This case report describes the clinical and radiographic findings and the surgical treatment of a serofibrinous arthritis of the antebrachiocarpal joint and of a chronic purulent arthritis of the intercarpal and carpometacarpal joints with osteomyelitis of the distal carpal bones and subchondral osteomyelitis of the proximal metacarpal bones in a cow of the breed "Pustertaler Sprinze". The therapy comprised an arthrotomy of both joint spaces and the resection of the distal row of the carpal bones. The right forelimb had been immobilised for 70 days by a full limb cast. After this period, radiographs revealed an ob- vious ankylosis of the carpal joint, and the cow showed only a slight lameness. Six years postoperatively this cow was still in the herd and had produced six calves.

Frontal osteomyelitis (Pott’s puffy tumour) associated with Pasteurella multocida–A case report and review of the literature

PubMed Central

Skomro, Robert; McClean, Karen L

1998-01-01

A 58-year-old woman presented with progressive midforehead swelling and erythema with frontal headache. Investigations revealed erosion of the anterior wall of the frontal sinus with subgaleal abscess formation, establishing a diagnosis of Pott’s puffy tumour. Pasteurella multocida was isolated in pure growth from an aspirate of the abscess. P multocida is a rare cause of sinusitis. It is isolated from the respiratory tract of asymptomatic individuals and, more commonly, patients with chronic respiratory conditions. Although a cause of osteomyelitis associated with animal bites or scratches, P multocida has not previously been implicated as a cause of frontal osteomyelitis or Pott’s puffy tumour. A review of reported cases of Pott’s puffy tumour, including clinical presentation, microbiology, treatment and outcome, is provided. PMID:22451778

Relationships between water quality parameters in rivers and lakes: BOD5, COD, NBOPs, and TOC.

PubMed

Lee, Jaewoong; Lee, Seunghyun; Yu, Soonju; Rhew, Doughee

2016-04-01

Biological oxygen demand (BOD5) or chemical oxygen demand (COD) analysis is widely used to evaluate organic pollutants in water systems as well as the efficiency of wastewater treatment plants. However, both analysis methods have restrictions such as being insensitive, imprecise, time-consuming, and the production of chemical waste. Therefore, total organic carbon (TOC) analysis for organic pollutants has been considered for an alternative analysis instead of BOD5 or COD. Several studies have investigated the replacement of BOD5 or COD with TOC in wastewater samples; however, few studies have investigated the relationships between water quality parameters in rivers and lakes. Therefore, this study evaluated the relationships between BOD5, COD, or NBOPs and TOC by the analysis of national water quality monitoring data of rivers and lakes for 5 years. High correlation coefficients (r) of 0.87 and 0.66 between BOD5 and TOC (p < 0.05) were obtained for rivers and lakes, respectively, and strong correlation coefficients (r) of 0.93 and 0.75 were observed between COD and TOC (p < 0.05) for rivers and lakes, respectively. The correlation coefficient (r) between NBOPs and TOC was 0.93 for rivers and 0.72 for lakes. The coefficients of determination (R 2) were 0.75 and 0.44 between BOD5 and TOC for rivers and lakes as well as were 0.87 and 0.57 between COD and TOC for rivers and lakes, respectively. The coefficient of determination (R 2) between NBOPs and TOC was 0.73 for rivers and 0.52 for lakes.

[Export of Total Organic Carbon (TOC) from Karst Watershed and Its Influencing Factors: An Example from Xueyudong Underground River System, Chongqing].

PubMed

Wang, Qiao-lian; Jiang, Yong-jun; Chen, Yu

2016-05-15

High time-resolution auto-monitoring techniques were used to obtain the data for TOC and hydrogeochemistry of groundwater, and air temperature and precipitation from August 2014 to September 2015 in Xueyu Cave karst watershed, Southwest China, and then the principal component regression model was used to reveal the variation of TOC in groundwater and its influencing factors. The results indicated that there were significant variations of the TOC and hydrogeochemistry of groundwater in seasonal timescale. The temperature and specific conductance (SpC) of groundwater showed higher values in summer and lower values in winter; while an opposite variation pattern for pH in groundwater was observed, and the TOC and turbidity of groundwater showed higher values in winter and summer seasons and lower values in spring and autumn seasons. Meanwhile, high time-resolution data revealed that the TOC of groundwater responded quickly to rainfall events with different intensities. Generally, an increasing trend for TOC in groundwater was observed during raining and a decreasing trend for TOC in groundwater was shown after rainfall events, especially after storm events due to the dilution effect of rainfall. The export and variations of the TOC in groundwater were mainly controlled by the precipitation and discharge of underground river in the study area, as revealed by the principal component regression model. The TOC increased with the increase of the precipitation, discharge and turbidity of groundwater, and declined with the increase of air temperature and pH of groundwater.

Biochemical indicators for the bioavailability of organic carbon in ground water

USGS Publications Warehouse

Chapelle, F.H.; Bradley, P.M.; Goode, D.J.; Tiedeman, C.; Lacombe, P.J.; Kaiser, K.; Benner, R.

2009-01-01

The bioavailability of total organic carbon (TOC) was examined in ground water from two hydrologically distinct aquifers using biochemical indicators widely employed in chemical oceanography. Concentrations of total hydrolyzable neutral sugars (THNS), total hydrolyzable amino acids (THAA), and carbon-normalized percentages of TOC present as THNS and THAA (referred to as "yields") were assessed as indicators of bioavailability. A shallow coastal plain aquifer in Kings Bay, Georgia, was characterized by relatively high concentrations (425 to 1492 ??M; 5.1 to 17.9 mg/L) of TOC but relatively low THNS and THAA yields (???0.2%-1.0%). These low yields are consistent with the highly biodegraded nature of TOC mobilized from relatively ancient (Pleistocene) sediments overlying the aquifer. In contrast, a shallow fractured rock aquifer in West Trenton, New Jersey, exhibited lower TOC concentrations (47 to 325 ??M; 0.6 to 3.9 mg/L) but higher THNS and THAA yields (???1% to 4%). These higher yields were consistent with the younger, and thus more bioavailable, TOC being mobilized from modern soils overlying the aquifer. Consistent with these apparent differences in TOC bioavailability, no significant correlation between TOC and dissolved inorganic carbon (DIC), a product of organic carbon mineralization, was observed at Kings Bay, whereas a strong correlation was observed at West Trenton. In contrast to TOC, THNS and THAA concentrations were observed to correlate with DIC at the Kings Bay site. These observations suggest that biochemical indicators such as THNS and THAA may provide information concerning the bioavailability of organic carbon present in ground water that is not available from TOC measurements alone.

Staphylococcus aureus Biofilms Decrease Osteoblast Viability, Inhibits Osteogenic Differentiation, and Increases Bone Resorption in vitro

DTIC Science & Technology

2013-06-01

severe and often debilitating disease characterized by inflammatory destruction of bone. Despite treatment, chronic infection often develops which is...biofilms may contribute to bone loss during chronic osteomyelitis simultaneously by: (1) reducing osteoblast viability and osteogenic potential thereby...accounting for more than half of all cases [1]. Despite treatment and surgical intervention up to 30% of osteomyelitis cases progress into a chronic

Aspergillus vertebral osteomyelitis and epidural abscess.

PubMed

Tew, C W; Han, F C; Jureen, R; Tey, B H

2009-04-01

We present the first reported case of Aspergillus vertebral osteomyelitis and epidural abscess in Singapore in a 50-year-old man with post-tuberculous bronchiectasis. The patient presented with acute urinary retention and flaccid paraplegia. Despite surgical debridement and treatment with voriconazole, the patient developed multiorgan failure and died two weeks after presentation. Early diagnosis and prompt initiation of treatment are emphasised in the hope of improving the outcome of this aggressive condition.

Aspergillus osteomyelitis of the lumbar spine complicated with orbital apex syndrome: A potential role of the Batson's plexus in disease propagation.

PubMed

Camargo, Jose F; Seriburi, Vimon; Tenner, Michael; El Khoury, Marc Y

2012-01-01

We report a rare case of orbital apex syndrome following epidural steroid injections of the lumbar spine in an immunocompetent individual with osteomyelitis and discitis caused by Aspergillus fumigatus. We suspect that the craniospinal venous system, also known as the Batson's plexus, was the main route for steroid-facilitated disease propagation from the spine to intracranial structures.

Aspergillus osteomyelitis of the spine.

PubMed

Govender, S; Rajoo, R; Goga, I E; Charles, R W

1991-07-01

Aspergillosis involving either the vertebral body or the intervertebral disc is a rare cause of osteomyelitis of the spine. The following is a report of five cases of Aspergillus fumigatus infection of the spine treated successfully with amphotericin B and 5-flucytosine. In three patients, the diagnosis was established at closed-needle biopsy; two patients with paraplegia had an anterior decompression and fusion. The follow-up period ranged from 19 to 48 months.

[Treatment of pubic osteomyelitis secondary to pressure sores].

PubMed

Brunel, Anne-Sophie; Téot, Luc; Lamy, Brigitte; Masson, Raphaël; Morquin, David; Reynes, Jacques; Le Moing, Vincent

2014-01-01

There is no consensus regarding the diagnostic and therapeutic strategy for pubic osteomyelitis secondary to pelvic pressure sores. Diagnosis is often difficult and bone biopsies with microbiological and anatomical-pathological examination remain the gold standard. The rate of cicatrisation of pressure sores is low. Cleansing and negative pressure treatment are key elements of the treatment. Optimising the care management with medical-surgical collaboration is being studied in the Ostear protocol.

Advances in the local and targeted delivery of anti-infective agents for management of osteomyelitis.

PubMed

Ford, Caleb A; Cassat, James E

2017-09-01

Osteomyelitis, a common and debilitating invasive infection of bone, is a frequent complication following orthopedic surgery and causes pathologic destruction of skeletal tissues. Bone destruction during osteomyelitis results in necrotic tissue, which is poorly penetrated by antibiotics and can serve as a nidus for relapsing infection. Osteomyelitis therefore frequently necessitates surgical debridement procedures, which provide a unique opportunity for targeted delivery of antimicrobial and adjunctive therapies. Areas covered: Following surgical debridement, tissue voids require implanted materials to facilitate the healing process. Antibiotic-loaded, non-biodegradable implants have been the standard of care. However, a new generation of biodegradable, osteoconductive materials are being developed. Additionally, in the face of widespread antimicrobial resistance, alternative therapies to traditional antibiotic regimens are being investigated, including bone targeting compounds, antimicrobial surface modifications of orthopedic implants, and anti-virulence strategies. Expert commentary: Recent advances in biodegradable drug delivery scaffolds make this technology an attractive alternative to traditional techniques for orthopedic infection that require secondary operations for removal. Advances in novel treatment methods are expanding the arsenal of viable antimicrobial treatment strategies in the face of widespread drug resistance. Despite a need for large scale clinical investigations, these strategies offer hope for future treatment of this difficult invasive disease.

Advances in the Local and Targeted Delivery of Anti-infective Agents for Management of Osteomyelitis

PubMed Central

Ford, Caleb A.; Cassat, James E.

2018-01-01

Structured Abstract Introduction Osteomyelitis, a common and debilitating invasive infection of bone, is a frequent complication following orthopedic surgery and causes pathologic destruction of skeletal tissues. Bone destruction during osteomyelitis results in necrotic tissue, which is poorly penetrated by antibiotics and can serve as a nidus for relapsing infection. Osteomyelitis therefore frequently necessitates surgical debridement procedures, which provide a unique opportunity for targeted delivery of antimicrobial and adjunctive therapies. Areas Covered Following surgical debridement, tissue voids require implanted materials to facilitate the healing process. Antibiotic-loaded, non-biodegradable implants have been the standard of care. However, a new generation of biodegradable, osteoconductive materials are being developed. Additionally, in the face of widespread antimicrobial resistance, alternative therapies to traditional antibiotic regimens are being investigated, including bone targeting compounds, antimicrobial surface modifications of orthopedic implants, and anti-virulence strategies. Expert Commentary Recent advances in biodegradable drug delivery scaffolds make this technology an attractive alternative to traditional techniques for orthopedic infection that require secondary operations for removal. Advances in novel treatment methods are expanding the arsenal of viable antimicrobial treatment strategies in the face of widespread drug resistance. Despite a need for large scale clinical investigations, these strategies offer hope for future treatment of this difficult invasive disease. PMID:28837368

Efficacy of magnetic resonance imaging in diagnosing diabetic foot osteomyelitis in the presence of ischemia.

PubMed

Fujii, Miki; Armstrong, David G; Armsrong, David G; Terashi, Hiroto

2013-01-01

Magnetic resonance imaging (MRI) has been recognized as the most accurate imaging modality for the detection of diabetic foot osteomyelitis. However, how accurately MRI displays the extent of diabetic foot osteomyelitis in the presence of ischemia is still unclear. We retrospectively compared the preoperative MRI findings with the results of histopathologic examinations of resected bones and studied the efficacy of MRI in the diagnosis of diabetic foot osteomyelitis of different etiologies. A total 104 bones from 18 foot ulcers in 16 diabetic patients (10 men and 6 women; age range 42 to 84 years) treated by surgical intervention from 2008 to 2012 was examined. In 8 neuropathic ulcers, 29 bones were accurately diagnosed in detail using MRI, even those with severe soft tissue infection. Of 75 bones in 10 ischemic ulcers, only 7 bones evaluated by MRI after revascularization were diagnosed accurately; the other 68 could not be diagnosed because of unclear or equivocal MRI findings. On histopathologic examination, all the bones were found to be infected through the bone cortex by the surrounding infected soft tissue, not directly by articulation. Overall, preoperative MRI is effective in the diagnosis of neuropathic ulcers, but less so of ischemic ones. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Biodegradation of total organic carbons (TOC) in Jordanian petroleum sludge.

PubMed

Mrayyan, Bassam; Battikhi, Mohammed N

2005-04-11

Biodegradation is cost-effective, environmentally friendly treatment for oily contaminated sites by the use of microorganisms. In this study, laboratory experiments were conducted to establish the performance of bacterial isolates in degradation of organic compounds contained in oily sludge from the Jordanian Oil Refinery plant. As a result of the laboratory screening, three natural bacterial consortia capable of degrading total organic carbons (TOC) were prepared from isolates enriched from the oil sludge. Experiments were conducted in Erlenmeyer flasks under aerobic conditions, with TOC removal percentage varied from 0.3 to 28% depending on consortia type and concentration. Consortia 7B and 13B exhibited the highest TOC removal percentage of 28 and 22%, respectively, before nutrient addition. TOC removal rate was enhanced after addition of nutrients to incubated flasks. The highest TOC reduction (43%) was estimated after addition of combination of nitrogen, phosphorus and sulphur to consortia 7B. A significant variation (P<0.005) was observed between the effect of consortia type and concentration on TOC% reduction. No significant variation was observed between incubation at 10 and 18 days in TOC% reduction. This is the first report concerning biological treatment of TOC by bacteria isolated from the oil refinery plants, where it lays the ground for full integrated studies recommended for the degradation of organic compounds that assist in solving sludge problems.

Advances in the genetically complex autoinflammatory diseases.

PubMed

Ombrello, Michael J

2015-07-01

Monogenic diseases usually demonstrate Mendelian inheritance and are caused by highly penetrant genetic variants of a single gene. In contrast, genetically complex diseases arise from a combination of multiple genetic and environmental factors. The concept of autoinflammation originally emerged from the identification of individual, activating lesions of the innate immune system as the molecular basis of the hereditary periodic fever syndromes. In addition to these rare, monogenic forms of autoinflammation, genetically complex autoinflammatory diseases like the periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome, chronic recurrent multifocal osteomyelitis (CRMO), Behçet's disease, and systemic arthritis also fulfill the definition of autoinflammatory diseases-namely, the development of apparently unprovoked episodes of inflammation without identifiable exogenous triggers and in the absence of autoimmunity. Interestingly, investigations of these genetically complex autoinflammatory diseases have implicated both innate and adaptive immune abnormalities, blurring the line between autoinflammation and autoimmunity. This reinforces the paradigm of concerted innate and adaptive immune dysfunction leading to genetically complex autoinflammatory phenotypes.

40 CFR 60.700 - Applicability and designation of affected facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... compounds (TOC) (less methane and ethane) in the vent stream less than 300 ppmv as measured by Method 18 or a concentration of TOC in the vent stream less than 150 ppmv as measured by Method 25A is exempt... limits in these standards are expressed in terms of TOC, measured as TOC less methane and ethane. This...

40 CFR 419.33 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... (TOC) based upon an analysis of any single grab or composite sample. (2) If contaminated runoff is... which exceeds 110 mg/l TOC is not commingled or treated with any other type of wastewater, the quantity... (1,000 ppm), the permitting authority may substitute TOC as a parameter in lieu of COD. A TOC...

40 CFR 419.53 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... (TOC) based upon an analysis of any single grab or composite sample. (2) If contaminated runoff is... which exceeds 110 mg/l TOC is not commingled or treated with any other type of wastewater, the quantity... (1,000 ppm), the permitting authority may substitute TOC as a parameter in lieu of COD. A TOC...

78 FR 44424 - Revisions to Page 700 of FERC Form No. 6

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

... original cost (TOC) rate base information provided on line 5 of page 700 by requiring the reporting of the three subparts of the TOC rate base: (1) Rate Base--Original Cost (proposed line 5a); (2) Rate Base... oil pipeline's TOC Rate Base. Consequently, the NOPR proposed to move the TOC rate base from line 5 to...

40 CFR 419.23 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... (TOC) based upon an analysis of any single grab or composite sample. (2) If contaminated runoff is... which exceeds 110 mg/l TOC is not commingled or treated with any other type of wastewater, the quantity... (1,000 ppm), the permitting authority may substitute TOC as a parameter in lieu of COD. A TOC...

40 CFR 63.1566 - What are my requirements for organic HAP emissions from catalytic reforming units?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) through (ii) of this section: (i) You can elect to vent emissions of total organic compounds (TOC) to a... a TOC or nonmethane TOC percent reduction standard or concentration limit, whichever is less... TOC using Equation 1 of this section (if you use Method 25) or Equation 2 of this section (if you use...

Planning and evaluating mental health services in low- and middle-income countries using theory of change

PubMed Central

Breuer, Erica; De Silva, Mary J.; Shidaye, Rahul; Petersen, Inge; Nakku, Juliet; Jordans, Mark J. D.; Fekadu, Abebaw; Lund, Crick

2016-01-01

Background There is little practical guidance on how contextually relevant mental healthcare plans (MHCPs) can be developed in low-resource settings. Aims To describe how theory of change (ToC) was used to plan the development and evaluation of MHCPs as part of the PRogramme for Improving Mental health carE (PRIME). Method ToC development occurred in three stages: (a) development of a cross-country ToC by 15 PRIME consortium members; (b) development of country-specific ToCs in 13 workshops with a median of 15 (interquartile range 13–22) stakeholders per workshop; and (c) review and refinement of the cross-country ToC by 18 PRIME consortium members. Results One cross-country and five district ToCs were developed that outlined the steps required to improve outcomes for people with mental disorders in PRIME districts. Conclusions ToC is a valuable participatory method that can be used to develop MHCPs and plan their evaluation. PMID:26447178

Assessment of bacterial growth and total organic carbon removal on granular activated carbon contactors.

PubMed

Bancroft, K; Maloney, S W; McElhaney, J; Suffet, I H; Pipes, W O

1983-09-01

The overall growth rate of bacteria on granular activated carbon (GAC) contactors at the Philadelphia Torresdale Water Treatment Pilot Plant facility was found to decrease until steady state was reached. The growth rate was found to fluctuate between 6.94 X 10(-3) and 8.68 X 10(-4) doublings per h. The microbiological removal of total organic carbon (TOC) was calculated by considering the GAC contactors as semiclosed continuous culture systems and using growth yield factors determined in laboratory experiments. After ozonation, the average TOC entering the contactors was 1,488 micrograms/liter, and the average effluent TOC was 497 micrograms/liter. Microbiological TOC removal was found to average 240 micrograms/liter on GAC contactors, which was not significantly different from microbiological TOC (220 micrograms/liter) removal across a parallel sand contactor where no adsorption took place. Thus, GAC did not appear to enhance biological TOC removal. Bacterial growth and maintenance was responsible for approximately 24% of the TOC removal on GAC under the conditions of this study.

A simple approach to estimate daily loads of total, refractory, and labile organic carbon from their seasonal loads in a watershed

Treesearch

Ying Ouyang; Johnny M. Grace; Wayne C. Zipperer; Jeff Hatten; Janet Dewey

2018-01-01

Loads of naturally occurring total organic carbons (TOC), refractory organic carbon (ROC), and labile organic carbon (LOC) instreams control the availability of nutrients and the solubility and toxicity of contaminants and affect biological activities throughabsorption of light and complex metals with production of carcinogenic compounds....

Changes in the expression of α-tocopherol-related genes in liver and mammary gland biopsy specimens of peripartum dairy cows.

PubMed

Haga, S; Miyaji, M; Nakano, M; Ishizaki, H; Matsuyama, H; Katoh, K; Roh, S G

2018-03-28

Blood α-tocopherol (α-Toc) concentrations decline gradually throughout the prepartum period, reaching the nadir after calving in dairy cows. The 6 α-Toc-related molecules [α-Toc transfer protein (TTPA); afamin; scavenger receptor class B, Type I; ATP-binding cassette transporter A1; tocopherol-associated protein (SEC14L2); and cytochrome P450 family 4, subfamily F, polypeptide 2 (CYP4F2)] are expressed in liver and other peripheral tissues. These molecules could regulate α-Toc transport, blood concentrations, and metabolism of α-Toc. Therefore, the aim of this study was to evaluate the changes in the expression of α-Toc-related genes in liver and mammary gland tissues of dairy cows around calving, which have remained elusive until now. In experiment (Exp.) 1, 28 multiparous Holstein cows were used (from -5 to 6 wk relative to parturition) to monitor the changes in dietary α-Toc intake, blood concentrations of α-Toc, and lipoproteins; in Exp. 2, 7 peripartum Holstein cows were used (from -4 to 4 wk relative to parturition) for liver tissue biopsy; and in Exp. 3, 10 peripartum Holstein cows were used (from -8 to 6 wk relative to parturition) to carry out the mammary gland tissue biopsy and milk sampling. In Exp. 1, the serum α-Toc concentrations declined gradually with decreasing amount of α-Toc intake and plasma high-density lipoprotein concentrations toward calving time. However, in the early lactation period after calving, serum α-Toc concentrations remained at a lower concentration despite the recovery of α-Toc intake and plasma high-density lipoprotein concentrations. In Exp. 2, just after calving, the TTPA, SEC14L2, afamin, and albumin mRNA expression levels in the liver were temporarily downregulated, and the hepatic mRNA levels of endoplasmic reticulum stress-induced unfolded protein response markers and acute-phase response marker increased at calving. In Exp. 3, the concentrations of α-Toc in colostrum were greater than those in precolostrum (samples were collected at wk -1 relative to parturition) and mature milk. The expression of TTPA, SEC14L2, and CYP4F2 mRNA in bovine mammary gland tissue was detected. However, TTPA and SEC14L2 mRNA expressions showed the opposite trends: the expression levels of TTPA mRNA peaked whereas SEC14L2 mRNA reached a nadir at calving. These results indicate that the expression of α-Toc-related genes involved in specific α-Toc transfer and metabolism in the liver and mammary gland are altered during calving. Moreover, these changes might be associated with the maintenance of lower serum α-Toc concentrations after calving. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Dynamics of stream water TOC concentrations in a boreal headwater catchment: Controlling factors and implications for climate scenarios

NASA Astrophysics Data System (ADS)

Köhler, S. J.; Buffam, I.; Seibert, J.; Bishop, K. H.; Laudon, H.

2009-06-01

SummaryTwo different but complementary modelling approaches for reproducing the observed dynamics of total organic carbon (TOC) in a boreal stream are presented. One is based on a regression analysis, while the other is based on riparian soil conditions using a convolution of flow and concentration. Both approaches are relatively simple to establish and help to identify gaps in the process understanding of the TOC transport from soils to catchments runoff. The largest part of the temporal variation of stream TOC concentrations (4-46 mg L -1) in a forested headwater stream in the boreal zone in northern Sweden may be described using a four-parameter regression equation that has runoff and transformed air temperature as sole input variables. Runoff is assumed to be a proxy for soil wetness conditions and changing flow pathways which in turn caused most of the stream TOC variation. Temperature explained a significant part of the observed inter-annual variability. Long-term riparian hydrochemistry in soil solutions within 4 m of the stream also captures a surprisingly large part of the observed variation of stream TOC and highlights the importance of riparian soils. The riparian zone was used to reproduce stream TOC with the help of a convolution model based on flow and average riparian chemistry as input variables. There is a significant effect of wetting of the riparian soil that translates into a memory effect for subsequent episodes and thus contributes to controlling stream TOC concentrations. Situations with high flow introduce a large amount of variability into stream water TOC that may be related to memory effects, rapid groundwater fluctuations and other processes not identified so far. Two different climate scenarios for the region based on the IPCC scenarios were applied to the regression equation to test what effect the expected increase in precipitation and temperature and resulting changes in runoff would have on stream TOC concentrations assuming that the soil conditions remain unchanged. Both scenarios resulted in a mean increase of stream TOC concentrations of between 1.5 and 2.5 mg L -1 during the snow free season, which amounts to approximately 15% more TOC export compared to present conditions. Wetter and warmer conditions in the late autumn led to a difference of monthly average TOC of up to 5 mg L -1, suggesting that stream TOC may be particularly susceptible to climate variability during this season.

The Current Landscape of Transitions of Care Practice Models: A Scoping Review.

PubMed

Rochester-Eyeguokan, Charmaine D; Pincus, Kathleen J; Patel, Roshni S; Reitz, Shirley J

2016-01-01

Transitions of care (TOC) are a set of actions to ensure patient coordination and continuity of care as patients transfer between different locations or levels. During transitions associated with chronic or acute illness, vulnerable patients may be placed at risk with fragmented systems compromising their health and safety. In addition, poor care transitions also have an enormous impact on health care spending. The primary objective of this scoping review is to summarize the current landscape of practice models that deliver TOC services in the United States. The secondary objective is to use the information to characterize the current state of best practice models. A search of the PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, International Pharmaceutical Abstracts, National Center for Biotechnology Information at the U.S. National Library of Medicine, and Cochrane Library databases (January 1, 2000-April 13, 2015) for articles pertaining to TOC models, limited to U.S. studies published in the English language with human subjects, gleaned 1362 articles. An additional 26 articles were added from the gray literature. Articles meeting inclusion criteria underwent a second review and were categorized into four groups: background information, original TOC research articles not evaluating practice model interventions, original TOC research articles describing practice models, and systematic or Cochrane reviews. The reviewers met weekly to discuss the challenges and resolve disagreements regarding literature reviews with consensus before progressing. A total of 188 articles describing TOC practice models met the inclusion criteria. Despite the strengths of several quality TOC models, none satisfied all the components recommended by leading experts. Multimodal interventions by multidisciplinary teams appear to represent a best practice model for TOC to improve patient outcomes and reduce readmissions, but one size does not fit all. Best model TOC services must include services along the TOC continuum: pretransition and posttransition, as well as at home and in outpatient health care settings. Studies clearly show that single-modal interventions are rarely successful in reducing readmissions and that successful TOC services must be multimodal and multidisciplinary, and continue throughout the care transition. Utilizing best practice TOC models described in this article as a starting point, practitioners interested in developing their own TOC program should test these tools in new practice environments and add to the body of literature by publishing their findings. © 2016 Pharmacotherapy Publications, Inc.

40 CFR 419.12 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... organic carbon (TOC) based upon an analysis of any single grab or composite sample. (2) If contaminated... contaminated runoff which exceeds 15 mg/l oil and grease or 110 mg/l TOC is not commingled or treated with any... substitute TOC as a parameter in lieu of COD. A TOC effluent limitation shall be based on effluent data from...

Effects of organic amendments on the toxicity and bioavailability of cadmium and copper in spiked formulated sediments

USGS Publications Warehouse

Besser, J.M.; Brumbaugh, W.G.; May, T.W.; Ingersoll, C.G.

2003-01-01

We evaluated the partitioning and toxicity of cadmium (Cd) and copper (Cu) spiked into formulated sediments containing two types of organic matter (OM), i.e., cellulose and humus. Amendments of cellulose up to 12.5% total organic carbon (TOC) did not affect partitioning of Cd or Cu between sediment and pore water and did not significantly affect the toxicity of spiked sediments in acute toxicity tests with the amphipod Hyalella azteca. In contrast, amendments of natural humus shifted the partitioning of both Cd and Cu toward greater concentrations in sediment and lesser concentrations in pore water and significantly reduced toxic effects of both metals. Thresholds for toxicity, based on measured metal concentrations in whole sediment, were greater for both Cd and Cu in sediments amended with a low level of humus (2.9% TOC) than in sediments without added OM. Amendments with a high level of humus (8.9% TOC) eliminated toxicity at the highest spike concentrations of both metals (sediment concentrations of 12.4 ??g Cd/g and 493 ??g Cu/g). Concentrations of Cd in pore water associated with acute toxicity were similar between sediments with and without humus amendments, suggesting that toxicity of Cd was reduced primarily by sorption to sediment OM. However, toxic effects of Cu in humus treatments were associated with greater pore-water concentrations than in controls, suggesting that toxicity of Cu was reduced both by sorption and by complexation with soluble ligands. Both sorption and complexation by OM tend to make proposed sediment quality guidelines (SQGs) based on total metal concentrations more protective for high-OM sediments. Our results suggest that the predictive ability of SQGs could be improved by models of metal interactions with natural OM in sediment and pore water.

Effects of organic amendments on the toxicity and bioavailability of cadmium and copper in spiked formulated sediments.

PubMed

Besser, John M; Brumbaugh, William G; May, Thomas W; Ingersoll, Christopher G

2003-04-01

We evaluated the partitioning and toxicity of cadmium (Cd) and copper (Cu) spiked into formulated sediments containing two types of organic matter (OM), i.e., cellulose and humus. Amendments of cellulose up to 12.5% total organic carbon (TOC) did not affect partitioning of Cd or Cu between sediment and pore water and did not significantly affect the toxicity of spiked sediments in acute toxicity tests with the amphipod Hyalella azteca. In contrast, amendments of natural humus shifted the partitioning of hoth Cd and Cu toward greater concentrations in sediment and lesser concentrations in pore water and significantly reduced toxic effects of both metals. Thresholds for toxicity, based on measured metal concentrations in whole sediment, were greater for both Cd and Cu in sediments amended with a low level of humus (2.9% TOC) than in sediments without added OM. Amendments with a high level of humus (8.9% TOC) eliminated toxicity at the highest spike concentrations of both metals (sediment concentrations of 12.4 microg Cd/g and 493 microg Cu/g). Concentrations of Cd in pore water associated with acute toxicity were similar between sediments with and without humus amendments, suggesting that toxicity of Cd was reduced primarily by sorption to sediment OM. However, toxic effects of Cu in humus treatments were associated with greater pore-water concentrations than in controls, suggesting that toxicity of Cu was reduced both by sorption and by complexation with soluble ligands. Both sorption and complexation by OM tend to make proposed sediment quality guidelines (SQGs) based on total metal concentrations more protective for high-OM sediments. Our results suggest that the predictive ability of SQGs could be improved by models of metal interactions with natural OM in sediment and pore water.

Radiofrequency ablation, an effective modality of treatment in tumor-induced osteomalacia: a case series of three patients.

PubMed

Jadhav, Swati; Kasaliwal, Rajeev; Shetty, Nitin S; Kulkarni, Suyash; Rathod, Krantikumar; Popat, Bhavesh; Kakade, Harshal; Bukan, Amol; Khare, Shruti; Budyal, Sweta; Jagtap, Varsha S; Lila, Anurag R; Bandgar, Tushar; Shah, Nalini S

2014-09-01

Tumor-induced osteomalacia is curable if the tumors can be totally excised. However, when the tumors are present in locations that make surgery disproportionately risky, the need for less invasive strategies like radiofrequency ablation (RFA) is realized. We describe three patients with suspected tumor-induced osteomalacia who were treated in our department between 2006 and 2013 with tumors in surgically difficult locations and were subjected to single or multiple sessions of RFA. The response was documented in terms of symptomatic improvement, phosphorus normalization, and follow-up (99m)Technitium-labelled hydrazinonicotinyl-Tyr3-octreotide ((99m)Tc HYNIC TOC) scan. Two of the three individuals, patient A (with a 1.5 × 1.2-cm lesion in the head of the right femur) and patient B (with a 1.3 × 1.2-cm lesion on the endosteal surface of the shaft of the left femur), achieved complete remission with single sessions of RFA. Three months after the procedure, (99m)Tc HYNIC TOC scans revealed the absence of uptake at the previous sites, corroborating with the clinical improvement and phosphorus normalization. Patient C had a large 5.6 × 6.5-cm complex lesion in the lower end of the left femur with irregular margins, loculations, and bone grafts placed in previous surgery. He failed to achieve remission after multiple sessions of RFA due to the complex nature of the lesion, although the tumor burden was reduced significantly as documented on serial (99m)Tc HYNIC TOC scans. Although surgery remains the treatment of choice, RFA could be an effective, less invasive, and safe modality of treatment in judiciously selected patients.

Role of Temperature Stress on Chloroplast Biogenesis and Protein Import in Pea1[OA

PubMed Central

Dutta, Siddhartha; Mohanty, Sasmita; Tripathy, Baishnab C.

2009-01-01

Modulation of photosynthesis and chloroplast biogenesis, by low and high temperatures, was studied in 12-d-old pea (Pisum sativum) plants grown at 25°C and subsequently exposed to 7°C or 40°C up to 48 h. The decline in variable chlorophyll a fluorescence/maximum chlorophyll a fluorescence and estimated electron transport rate in temperature-stressed plants was substantially restored when they were transferred to room temperature. The ATP-driven import of precursor of small subunit of Rubisco (pRSS) into plastids was down-regulated by 67% and 49% in heat-stressed and chill-stressed plants, respectively. Reduction in binding of the pRSS to the chloroplast envelope membranes in heat-stressed plants could be due to the down-regulation of Toc159 gene/protein expression. In addition to impaired binding, reduced protein import into chloroplast in heat-stressed plants was likely due to decreased gene/protein expression of certain components of the TOC complex (Toc75), the TIC complex (Tic20, Tic32, Tic55, and Tic62), stromal Hsp93, and stromal processing peptidase. In chill-stressed plants, the gene/protein expression of most of the components of protein import apparatus other than Tic110 and Tic40 were not affected, suggesting the central role of Tic110 and Tic40 in inhibition of protein import at low temperature. Heating of intact chloroplasts at 35°C for 10 min inhibited protein import, implying a low thermal stability of the protein import apparatus. Results demonstrate that in addition to decreased gene and protein expression, down-regulation of photosynthesis in temperature-stressed plants is caused by reduced posttranslational import of plastidic proteins required for the replacement of impaired proteins coded by nuclear genome. PMID:19403728

Patterns and predictability in the intra-annual organic carbon variability across the boreal and hemiboreal landscape

USGS Publications Warehouse

Hytteborn, Julia K.; Temnerud, Johan; Alexander, Richard B.; Boyer, Elizabeth W.; Futter, Martyn N.; Fröberg, Mats; Dahné, Joel; Bishop, Kevin H.

2015-01-01

Factors affecting total organic carbon (TOC) concentrations in 215 watercourses across Sweden were investigated using parameter parsimonious regression approaches to explain spatial and temporal variabilities of the TOC water quality responses. We systematically quantified the effects of discharge, seasonality, and long-term trend as factors controlling intra-annual (among year) and inter-annual (within year) variabilities of TOC by evaluating the spatial variability in model coefficients and catchment characteristics (e.g. land cover, retention time, soil type).Catchment area (0.18–47,000 km2) and land cover types (forests, agriculture and alpine terrain) are typical for the boreal and hemiboreal zones across Fennoscandia. Watercourses had at least 6 years of monthly water quality observations between 1990 and 2010. Statistically significant models (p < 0.05) describing variation of TOC in streamflow were identified in 209 of 215 watercourses with a mean Nash-Sutcliffe efficiency index of 0.44. Increasing long-term trends were observed in 149 (70%) of the watercourses, and intra-annual variation in TOC far exceeded inter-annual variation. The average influences of the discharge and seasonality terms on intra-annual variations in daily TOC concentration were 1.4 and 1.3 mg l− 1 (13 and 12% of the mean annual TOC), respectively. The average increase in TOC was 0.17 mg l− 1 year− 1 (1.6% year− 1).Multivariate regression with over 90 different catchment characteristics explained 21% of the spatial variation in the linear trend coefficient, less than 20% of the variation in the discharge coefficient and 73% of the spatial variation in mean TOC. Specific discharge, water residence time, the variance of daily precipitation, and lake area, explained 45% of the spatial variation in the amplitude of the TOC seasonality.Because the main drivers of temporal variability in TOC are seasonality and discharge, first-order estimates of the influences of climatic variability and change on TOC concentration should be predictable if the studied catchments continue to respond similarly.

Development of Thresholds and Exceedance Probabilities for Influent Water Quality to Meet Drinking Water Regulations

NASA Astrophysics Data System (ADS)

Reeves, K. L.; Samson, C.; Summers, R. S.; Balaji, R.

2017-12-01

Drinking water treatment utilities (DWTU) are tasked with the challenge of meeting disinfection and disinfection byproduct (DBP) regulations to provide safe, reliable drinking water under changing climate and land surface characteristics. DBPs form in drinking water when disinfectants, commonly chlorine, react with organic matter as measured by total organic carbon (TOC), and physical removal of pathogen microorganisms are achieved by filtration and monitored by turbidity removal. Turbidity and TOC in influent waters to DWTUs are expected to increase due to variable climate and more frequent fires and droughts. Traditional methods for forecasting turbidity and TOC require catchment specific data (i.e. streamflow) and have difficulties predicting them under non-stationary climate. A modelling framework was developed to assist DWTUs with assessing their risk for future compliance with disinfection and DBP regulations under changing climate. A local polynomial method was developed to predict surface water TOC using climate data collected from NOAA, Normalized Difference Vegetation Index (NDVI) data from the IRI Data Library, and historical TOC data from three DWTUs in diverse geographic locations. Characteristics from the DWTUs were used in the EPA Water Treatment Plant model to determine thresholds for influent TOC that resulted in DBP concentrations within compliance. Lastly, extreme value theory was used to predict probabilities of threshold exceedances under the current climate. Results from the utilities were used to produce a generalized TOC threshold approach that only requires water temperature and bromide concentration. The threshold exceedance model will be used to estimate probabilities of exceedances under projected climate scenarios. Initial results show that TOC can be forecasted using widely available data via statistical methods, where temperature, precipitation, Palmer Drought Severity Index, and NDVI with various lags were shown to be important predictors of TOC, and TOC thresholds can be determined using water temperature and bromide concentration. Results include a model to predict influent turbidity and turbidity thresholds, similar to the TOC models, as well as probabilities of threshold exceedances for TOC and turbidity under changing climate.

Sampling trace organic compounds in water: a comparison of a continuous active sampler to continuous passive and discrete sampling methods

USGS Publications Warehouse

Coes, Alissa L.; Paretti, Nicholas V.; Foreman, William T.; Iverson, Jana L.; Alvarez, David A.

2014-01-01

A continuous active sampling method was compared to continuous passive and discrete sampling methods for the sampling of trace organic compounds (TOCs) in water. Results from each method are compared and contrasted in order to provide information for future investigators to use while selecting appropriate sampling methods for their research. The continuous low-level aquatic monitoring (CLAM) sampler (C.I.Agent® Storm-Water Solutions) is a submersible, low flow-rate sampler, that continuously draws water through solid-phase extraction media. CLAM samplers were deployed at two wastewater-dominated stream field sites in conjunction with the deployment of polar organic chemical integrative samplers (POCIS) and the collection of discrete (grab) water samples. All samples were analyzed for a suite of 69 TOCs. The CLAM and POCIS samples represent time-integrated samples that accumulate the TOCs present in the water over the deployment period (19–23 h for CLAM and 29 days for POCIS); the discrete samples represent only the TOCs present in the water at the time and place of sampling. Non-metric multi-dimensional scaling and cluster analysis were used to examine patterns in both TOC detections and relative concentrations between the three sampling methods. A greater number of TOCs were detected in the CLAM samples than in corresponding discrete and POCIS samples, but TOC concentrations in the CLAM samples were significantly lower than in the discrete and (or) POCIS samples. Thirteen TOCs of varying polarity were detected by all of the three methods. TOC detections and concentrations obtained by the three sampling methods, however, are dependent on multiple factors. This study found that stream discharge, constituent loading, and compound type all affected TOC concentrations detected by each method. In addition, TOC detections and concentrations were affected by the reporting limits, bias, recovery, and performance of each method.

Trends in hydrometeorological conditions and stream water organic carbon in boreal forested catchments.

PubMed

Sarkkola, Sakari; Koivusalo, Harri; Laurén, Ari; Kortelainen, Pirkko; Mattsson, Tuija; Palviainen, Marjo; Piirainen, Sirpa; Starr, Mike; Finér, Leena

2009-12-15

Temporal trends in stream water total organic carbon (TOC) concentration and export were studied in 8 forested headwater catchments situated in eastern Finland. The Seasonal Kendall test was conducted to identify the trends and a mixed model regression analysis was used to describe how catchment characteristics and hydrometeorological variables (e.g. precipitation, air and stream water temperatures, and atmospheric deposition) related to the variation in the concentration and export of stream water TOC. The 8 catchments varied in size from 29 to 494 ha and in the proportion of peatland they contained, from 8 to 70%. Runoff and TOC concentration were monitored for 15-29 years (1979-2006). Trends and variation in TOC levels were analysed from annual and seasonal time series. Mean annual TOC concentration increased significantly in seven of the eight catchments. The trends were the strongest in spring and most apparent during the last decade of the study period. The slopes of the trends were generally smaller than the variation in TOC concentration between years and seasons and between catchments. The annual TOC export showed no clear trends and values were largely determined by the temporal variability in runoff. Annual runoff showed a decreasing trend in two of the eight catchments. Mean annual air and stream water temperatures showed increasing trends, most clearly seen in the summer and autumn series. According to our modeling results, stream water temperature, precipitation and peatland percentage were the most important variables explaining annual and most seasonal TOC concentrations. The atmospheric deposition of SO4, NH4, and NO3 decreased significantly over the study period, but no significant link with TOC concentration was found. Precipitation was the main hydrometeorological driver of the TOC export. We concluded that stream water TOC concentrations and exports are mainly driven by catchment characteristics and hydrometeorological factors rather than trends in atmospheric acid deposition.

Sampling trace organic compounds in water: a comparison of a continuous active sampler to continuous passive and discrete sampling methods.

PubMed

Coes, Alissa L; Paretti, Nicholas V; Foreman, William T; Iverson, Jana L; Alvarez, David A

2014-03-01

A continuous active sampling method was compared to continuous passive and discrete sampling methods for the sampling of trace organic compounds (TOCs) in water. Results from each method are compared and contrasted in order to provide information for future investigators to use while selecting appropriate sampling methods for their research. The continuous low-level aquatic monitoring (CLAM) sampler (C.I.Agent® Storm-Water Solutions) is a submersible, low flow-rate sampler, that continuously draws water through solid-phase extraction media. CLAM samplers were deployed at two wastewater-dominated stream field sites in conjunction with the deployment of polar organic chemical integrative samplers (POCIS) and the collection of discrete (grab) water samples. All samples were analyzed for a suite of 69 TOCs. The CLAM and POCIS samples represent time-integrated samples that accumulate the TOCs present in the water over the deployment period (19-23 h for CLAM and 29 days for POCIS); the discrete samples represent only the TOCs present in the water at the time and place of sampling. Non-metric multi-dimensional scaling and cluster analysis were used to examine patterns in both TOC detections and relative concentrations between the three sampling methods. A greater number of TOCs were detected in the CLAM samples than in corresponding discrete and POCIS samples, but TOC concentrations in the CLAM samples were significantly lower than in the discrete and (or) POCIS samples. Thirteen TOCs of varying polarity were detected by all of the three methods. TOC detections and concentrations obtained by the three sampling methods, however, are dependent on multiple factors. This study found that stream discharge, constituent loading, and compound type all affected TOC concentrations detected by each method. In addition, TOC detections and concentrations were affected by the reporting limits, bias, recovery, and performance of each method. Published by Elsevier B.V.

Photocatalytic ozonation under visible light for the remediation of water effluents and its integration with an electro-membrane bioreactor.

PubMed

Toledano Garcia, Diego; Ozer, Lütfiye Y; Parrino, Francesco; Ahmed, Menatalla; Brudecki, Grzegorz Przemyslaw; Hasan, Shadi W; Palmisano, Giovanni

2018-06-06

Photocatalysis and photocatalytic ozonation under visible light have been applied for the purification of a complex aqueous matrix such as the grey water of Masdar City (UAE), by using N-doped brookite-rutile catalysts. Preliminary runs on 4-nitrophenol (4-NP) solutions allowed to test the reaction system in the presence of a model pollutant and to afford the relevant kinetic parameters of the process. Subsequently, the remediation of grey water effluent has been evaluated in terms of the reduction of total organic carbon (TOC) and bacterial counts. The concentration of the most abundant inorganic ionic species in the effluent has been also monitored during reaction. Photocatalytic ozonation under visible light allowed to reduce the TOC content of the grey water by ca. 60% in the optimized experimental conditions and to reduce the total bacterial count by ca. 97%. The extent of TOC mineralization reached ca. 80% when the photocatalytic ozonation occurred downstream to a preliminary electro-membrane bioreactor (eMBR). Coupling the two processes enhanced the global efficiency. In fact, the eMBR treatment lowered the turbidity and the organic load of the effluent entering the photocatalytic ozonation treatment, which in turn enhanced the extent of purification and disinfection. Copyright © 2018 Elsevier Ltd. All rights reserved.

Transcriptome Analysis of Plant Hormone-Related Tomato (Solanum lycopersicum) Genes in a Sunlight-Type Plant Factory.

PubMed

Tanigaki, Yusuke; Higashi, Takanobu; Takayama, Kotaro; Nagano, Atsushi J; Honjo, Mie N; Fukuda, Hirokazu

2015-01-01

In plant factories, measurements of plant conditions are necessary at an early stage of growth to predict harvest times of high value-added crops. Moreover, harvest qualities depend largely on environmental stresses that elicit plant hormone responses. However, the complexities of plant hormone networks have not been characterized under nonstress conditions. In the present study, we determined temporal expression profiles of all genes and then focused on plant hormone pathways using RNA-Seq analyses of gene expression in tomato leaves every 2 h for 48 h. In these experiments, temporally expressed genes were found in the hormone synthesis pathways for salicylic acid, abscisic acid, ethylene, and jasmonic acid. The timing of CAB expression 1 (TOC1) and abscisic acid insensitive 1 (ABA1) and open stomata 1 (OST1) control gating stomata. In this study, compare with tomato and Arabidopsis thaliana, expression patterns of TOC1 have similarity. In contrast, expression patterns of tomato ABI1 and OST1 had expression peak at different time. These findings suggest that the regulation of gating stomata does not depend predominantly on TOC1 and significantly reflects the extracellular environment. The present data provide new insights into relationships between temporally expressed plant hormone-related genes and clock genes under normal sunlight conditions.

Transcriptome Analysis of Plant Hormone-Related Tomato (Solanum lycopersicum) Genes in a Sunlight-Type Plant Factory

PubMed Central

Tanigaki, Yusuke; Higashi, Takanobu; Takayama, Kotaro; Nagano, Atsushi J.; Honjo, Mie N.; Fukuda, Hirokazu

2015-01-01

In plant factories, measurements of plant conditions are necessary at an early stage of growth to predict harvest times of high value-added crops. Moreover, harvest qualities depend largely on environmental stresses that elicit plant hormone responses. However, the complexities of plant hormone networks have not been characterized under nonstress conditions. In the present study, we determined temporal expression profiles of all genes and then focused on plant hormone pathways using RNA-Seq analyses of gene expression in tomato leaves every 2 h for 48 h. In these experiments, temporally expressed genes were found in the hormone synthesis pathways for salicylic acid, abscisic acid, ethylene, and jasmonic acid. The timing of CAB expression 1 (TOC1) and abscisic acid insensitive 1 (ABA1) and open stomata 1 (OST1) control gating stomata. In this study, compare with tomato and Arabidopsis thaliana, expression patterns of TOC1 have similarity. In contrast, expression patterns of tomato ABI1 and OST1 had expression peak at different time. These findings suggest that the regulation of gating stomata does not depend predominantly on TOC1 and significantly reflects the extracellular environment. The present data provide new insights into relationships between temporally expressed plant hormone-related genes and clock genes under normal sunlight conditions. PMID:26624004

Happy@feet application for the management of diabetic foot osteomyelitis.

PubMed

Fiquet, S; Desbiez, F; Tauveron, I; Mrozek, N; Vidal, M; Lesens, O

2016-12-01

We aimed to develop and implement an application that could improve the management of patients presenting with diabetic foot osteomyelitis. Physicians from the multidisciplinary diabetic foot infection team and a software engineer first assessed the needs required for the infection management and application. An experimental version was then designed and progressively improved. A final version was implemented in clinical practice in 2013 by the multidisciplinary diabetic foot infection team of our university hospital. The application, known as Happy@feet, helps gather and allows access to all required data for patient management, dispenses prescriptions (antibiotics, nursing care, blood tests), and helps follow the evolution of the wound. At the end of the consultation, a customizable letter is generated and may be directly sent to the persons concerned. This application also facilitates clinical and economic research. In 2014, Happy@feet was used to follow 83 patients during 271 consultations, 88 of which were day care hospitalizations. The Happy@feet application is useful to manage these complex patients. Once the learning period is over, the time required for data collection is compensated by the rapid dispense of prescriptions and letters. Happy@feet can be used for research projects and will be used in a remote patient management project. Copyright © 2016. Published by Elsevier SAS.

Aspergillus osteomyelitis of the lumbar spine complicated with orbital apex syndrome: A potential role of the Batson's plexus in disease propagation

PubMed Central

Camargo, Jose F.; Seriburi, Vimon; Tenner, Michael; El Khoury, Marc Y.

2012-01-01

We report a rare case of orbital apex syndrome following epidural steroid injections of the lumbar spine in an immunocompetent individual with osteomyelitis and discitis caused by Aspergillus fumigatus. We suspect that the craniospinal venous system, also known as the Batson's plexus, was the main route for steroid-facilitated disease propagation from the spine to intracranial structures. PMID:24371725

Osteomyelitis and Discitis Following Translumbar Repair of a Type II Endoleak

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sella, David M., E-mail: Sella.david@mayo.edu; Frey, Gregory T., E-mail: Frey.gregory@mayo.edu; Giesbrandt, Kirk, E-mail: giesbrandt.kirk@mayo.edu

2016-03-15

Here we present the case of an 80-year-old man who developed a type II endoleak following endovascular abdominal aortic aneurysm repair. Initial attempts at treating the endoleak via a transarterial approach were unsuccessful; therefore the patient underwent percutaneous translumbar endoleak embolization. Approximately 1 month following the translumbar procedure, he developed back pain, with subsequent workup revealing osteomyelitis and discitis as a complication following repair via the translumbar approach.

Postoperative osteomyelitis following implant arthroplasty of the foot: diagnosis with indium-111 white blood cell scintigraphy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bakst, R.H.; Kanat, I.O.

1987-11-01

Many complications can occur following insertion of silicone elastomer implants into the foot. Postoperative infection may be difficult to distinguish from other conditions such as dislodgment, fracture, ectopic and heterotopic new bone formation, synovitis, and bursitis. White blood cell scintigraphy, in conjunction with the clinical scenario, may prove to be an invaluable tool in the diagnosis of postoperative osteomyelitis, subsequent to implant arthroplasties. 32 references.

Magnetic resonance imaging of diabetic foot complications

PubMed Central

Low, Keynes TA; Peh, Wilfred CG

2015-01-01

This pictorial review aims to illustrate the various manifestations of the diabetic foot on magnetic resonance (MR) imaging. The utility of MR imaging and its imaging features in the diagnosis of pedal osteomyelitis are illustrated. There is often difficulty encountered in distinguishing osteomyelitis from neuroarthropathy, both clinically and on imaging. By providing an accurate diagnosis based on imaging, the radiologist plays a significant role in the management of patients with complications of diabetic foot. PMID:25640096

Biodegradable Scaffolds for Bone Regeneration Combined with Drug-Delivery Systems in Osteomyelitis Therapy

PubMed Central

Dorati, Rossella; DeTrizio, Antonella; Modena, Tiziana; Conti, Bice; Benazzo, Francesco; Gastaldi, Giulia; Genta, Ida

2017-01-01

A great deal of research is ongoing in the area of tissue engineering (TE) for bone regeneration. A possible improvement in restoring damaged tissues involves the loading of drugs such as proteins, genes, growth factors, antibiotics, and anti-inflammatory drugs into scaffolds for tissue regeneration. This mini-review is focused on the combination of the local delivery of antibiotic agents with bone regenerative therapy for the treatment of a severe bone infection such as osteomyelitis. The review includes a brief explanation of scaffolds for bone regeneration including scaffolds characteristics and types, a focus on severe bone infections (especially osteomyelitis and its treatment), and a literature review of local antibiotic delivery by the combination of scaffolds and drug-delivery systems. Some examples related to published studies on gentamicin sulfate-loaded drug-delivery systems combined with scaffolds are discussed, and future perspectives are highlighted. PMID:29231857

Vertebral Aspergillus osteomyelitis and acute diskitis in patients with chronic obstructive pulmonary disease.

PubMed

Martinez, M; Lee, A S; Hellinger, W C; Kaplan, J

1999-06-01

Aspergillus osteomyelitis of the spine with acute diskitis has been well documented in immunocompromised hosts but is rare in immunocompetent patients. Predisposing factors to infection are prolonged neutropenia, hematologic malignancies, chemotherapy, history of prior spinal trauma or surgery, allograft transplantation, or any condition requiring the use of long-term immunosuppressive agents or systemic corticosteroids. Patients with chronic obstructive pulmonary disease (COPD) treated with systemic corticosteroids for either long-term management or frequent exacerbations are at potential risk for such infections. Patients with severe COPD treated primarily with inhaled corticosteroids are considered immunocompetent. This report describes 2 cases of Aspergillus osteomyelitis with acute diskitis in apparently immunocompetent patients with COPD who, aside from brief courses of systemic corticosteroids, were using inhaled corticosteroid therapy. One patient was treated with intravenous amphotericin B alone, whereas the other received amphotericin B and underwent surgical debridement. Both have done well and were symptom free at 6-month follow-up.

Arthritis and Osteomyelitis due to Aspergillus fumigatus: A 17 years old boy with chronic granulomatous disease

PubMed Central

Bodur, Hurrem; Ozoran, Kursat; Colpan, Aylin; Balaban, Neriman; Tabak, Yalcın; Kulacoglu, Sezer

2003-01-01

Background Invasive Aspergillus infections are frequently seen in immunocompromised patients but arthritis is a rare complication of Aspergillus infections in the absence of immune suppressive therapy, trauma or surgical intervention. Case presentation A 17 years old male patient with arthritis and patellar osteomyelitis of the left knee whose further investigations revealed chronic granulomatous disease as the underlying disease is followed. Aspergillus fumigatus was isolated from the synovial fluid and the tissue samples cultures. He was treated with Amphotericin B deoxicolate 0.7 mg/kg/day. Also surgical debridement was performed our patient. Amphotericin B nephrotoxicity developed and the therapy switched to itraconazole 400 mg/day. Itraconazole therapy were discontinued at the 6th month. He can perform all the activities of daily living including. Conclusion We think that, chronic granulomatous disease should be investigated in patients who have aspergillar arthritis and osteomyelitis. PMID:12605719

Vertebral osteomyelitis with a rare etiology diagnosed by fine-needle aspiration cytology.

PubMed

B N, Nandeesh; Kini, Usha; Alexander, Betty

2010-05-01

Invasive fungal infections are rare in immunocompromised individuals, but are not uncommon in immunologically compromised patients. Bone involvement by these infections, though exceedingly rare, may occur due to direct extension of the infection from a neighboring organ or due to hematogenous dissemination in critically ill patients. Still rarer is the invasive aspergillosis involving either the vertebral body or the intervertebral disc with extension into the extradural space as an abscess. We report one such case of vertebral osteomyelitis due to Aspergillus diagnosed by FNAC in a well-controlled diabetic patient who presented with nonspecific symptoms and in whom a clinical and radiological diagnosis of Pott's spine was considered. The present case stresses the importance of early cytologic diagnosis of vertebral Aspergillus osteomyelitis, which in conjunction with appropriate timely medical and surgical treatment, offers good recovery without much sequelae or threat to life.

Aspergillus vertebral osteomyelitis in chronic leukocyte leukemia patient diagnosed by a novel panfungal polymerase chain reaction method.

PubMed

Dayan, Lior; Sprecher, Hannah; Hananni, Amos; Rosenbaum, Hana; Milloul, Victor; Oren, Ilana

2007-01-01

Vertebral osteomyelitis and disciitis caused by Aspergillus spp is a rare event. Early diagnosis and early antifungal therapy are critical in improving the prognosis for these patients. The diagnosis of invasive fungal infections is, in many cases, not straightforward and requires invasive procedures so that histological examination and culture can be performed. Furthermore, current traditional microbiological tests (ie, cultures and stains) lack the sensitivity for diagnosis of invasive aspergillosis. To present a case of vertebral osteomyelitis caused by Aspergillus spp diagnosed using a novel polymerase chain reaction (PCR) assay. Case report. Aspergillus DNA was detected in DNA extracted from the necrotic bone tissue by using a "panfungal" PCR novel method. Treatment with voriconazole was started based on the diagnosis. Using this novel technique enabled us to diagnose accurately an unusual bone pathogen that requires a unique treatment.

In vivo evaluation of teicoplanin- and calcium sulfate-loaded PMMA bone cement in preventing implant-related osteomyelitis in rats.

PubMed

Tuzuner, T; Sencan, I; Ozdemir, D; Alper, M; Duman, S; Yavuz, T; Yildirim, M

2006-12-01

The objective of this study was to evaluate the efficacy of teicoplanin- and calcium sulphate-loaded polymethylmethacrylate (PMMA) bone cements in preventing experimental implant-related osteomyelitis in rats. Four groups of antibiotic-loaded rods were prepared and were implanted into the lateral condylus of the rat femur after inoculation of Staphylococcus aureus. The effectiveness of these were assessed microbiologically, radiographically, and histopathologically. Radiographic evaluation revealed a significant reduction of periostal reaction and osteolysis in rats that received calcium sulphate- and teicoplanin-loaded rods. Histopathological evaluation confirmed these results. Acute infection and bone necrosis were found to be significantly lower in rats that had received calcium sulphate- and teicoplanin-loaded rods. The addition of calcium sulfate to teicoplanin-loaded PMMA bone cement appeared satisfactory as an antibiotic-carrying system for prophylaxis of experimental implant-related osteomyelitis, but further investigations are needed to reach definitive statements for clinical applications.

Splendore-Hoeppli phenomenon in a cat with osteomyelitis caused by Streptococcus species.

PubMed

França, Silvia de Araujo; Braga, Juliana Fortes Vilarinho; Moreira, Matheus Vilardo Loes; Silva, Vitor Cesar Martins; Souza, Erick Ferry; Pereira, Luiz Carlos; Rezende, Cleuza Maria de Faria; Ecco, Roselene

2014-02-01

A 9-month-old male neutered mixed-breed cat had a history of chronic lameness of the right hind limb, which was non-responsive to antibiotic treatment. Hematologic analysis revealed marked neutrophilia and mild monocytosis. Radiography revealed extensive loss of cortical bone, and replacement with irregular and disorganized bone. There was loss of the normal cortico-medullary distinction, and the medullary cavity had an irregular radiodensity suggestive of osteomyelitis. Surgical curettage and antibiotics did not improve the clinical condition, and amputation was performed. Grossly, the skin over the right tibia was ulcerated with a viscous and granular exudate. At histopathology, there was marked diffuse pyogranulomatous dermatitis, myositis, periostitis and osteomyelitis associated with Splendore-Hoeppli phenomenon. In addition, there was marrow osteoproliferation and multifocal cortical loss, reabsorption, fibroplasia and endosteal bone formation. Gram staining revealed myriad slightly elongated Gram-positive bacteria, arranged in pairs or single chains, confirmed by polymerase chain reaction as Streptococcus species.

Human Phaeohyphomycotic Osteomyelitis Caused by the Coelomycete Phomopsis Saccardo 1905: Criteria for Identification, Case History, and Therapy

PubMed Central

Sutton, Deanna A.; Timm, William D.; Morgan-Jones, Gareth; Rinaldi, Michael G.

1999-01-01

The Sphaeropsidales, coelomycetous fungi producing asexual conidia within enclosed conidiomata (pycnidia), are saprobic on numerous vascular plants. Despite their ubiquitous nature, only a limited number of genera have been documented as causing human disease. We report what we believe to be the first human case of osteomyelitis due to a Phomopsis species in a chronically immunosuppressed female. The patient developed a subcutaneous abscess on the distal phalanx of the right fourth finger complicated by osteomyelitis. Operative specimens revealed fungal hyphae and a pure culture of mould. The patient was treated with a 6-month course of itraconazole. At 16 months of follow-up, she remained free of recurrence. Phomopsis species differ from the similar, more frequently reported Phoma species by having immersed, thick-walled, multiloculate conidiomata and by the production of alpha (short, ellipsoidal) and beta (long, filamentous) conidia. PMID:9986861

Clavicle fracture with osteomyelitis after neck dissection and post-operative radiotherapy: case report.

PubMed

Shodo, R; Sato, Y; Ota, H; Horii, A

2017-11-01

Non-traumatic bone fractures in cancer patients are usually pathological fractures due to bone metastases. In head and neck cancer patients, clavicle stress fractures may occur as a result of atrophy of the trapezius muscle after neck dissection in which the accessory nerve becomes structurally or functionally damaged. A 71-year-old man underwent modified radical neck dissection with accessory nerve preservation and post-operative radiotherapy for submandibular lymph node metastases of tongue cancer. Four weeks after the radiotherapy, a clavicle fracture, with osteomyelitis and abscess formation in the pectoralis major muscle, occurred. Unlike in simple stress fracture, long-term antibiotic administration and drainage surgery were required to suppress the inflammation. As seen in the present patient, clavicle stress fractures may occur even after neck dissection in which the accessory nerve is preserved, and may be complicated by osteomyelitis and abscess formation owing to risk factors such as radiotherapy, tracheostomy and contiguous infection.

The Toronto Obsessive-Compulsive Scale: Psychometrics of a Dimensional Measure of Obsessive-Compulsive Traits.

PubMed

Park, Laura S; Burton, Christie L; Dupuis, Annie; Shan, Janet; Storch, Eric A; Crosbie, Jennifer; Schachar, Russell J; Arnold, Paul D

2016-04-01

To describe the Toronto Obsessive-Compulsive Scale (TOCS), a novel 21-item parent- or self-report questionnaire that covers wide variation in obsessive-compulsive (OC) traits, and to evaluate its psychometric properties in a community-based pediatric sample. The TOCS was completed for 16,718 children and adolescents between the ages of 6 and 17 years in a community setting. Internal consistency, convergent validity with the Obsessive-Compulsive Scale of the Child Behaviour Checklist (CBCL-OCS), divergent validity with the Strengths and Weaknesses of ADHD (Attention-Deficit/Hyperactivity Disorder) Symptoms and Normal Behaviour Rating Scale (SWAN), interrater reliability, as well as sensitivity and specificity of the TOCS were assessed. The internal consistency of the 21 TOCS items was excellent (Cronbach's α = 0.94). TOCS was moderately correlated with the CBCL-OCS (Spearman correlation = 0.51) and poorly correlated with the SWAN (Pearson correlation = 0.02). Sensitivity and specificity analyses indicated that a TOCS total score of greater than 0 successfully discriminated community-reported obsessive-compulsive disorder (OCD) cases from noncases. OC traits were continuously distributed both at the total score and dimensional level in our pediatric community sample. TOCS is a multidimensional measure of OC traits in children and adolescents with sound psychometric properties. TOCS reveals that OC traits are common and continuously distributed in a community sample. TOCS may be a useful measure for studies of the characteristics and etiology of OC traits. Copyright © 2016. Published by Elsevier Inc.

Quantification of Organic richness through wireline logs: a case study of Roseneath shale formation, Cooper basin, Australia

NASA Astrophysics Data System (ADS)

Ahmad, Maqsood; Iqbal, Omer; Kadir, Askury Abd

2017-10-01

The late Carboniferous-Middle Triassic, intracratonic Cooper basin in northeastern South Australia and southwestern Queensland is Australia's foremost onshore hydrocarbon producing region. The basin compromises Permian carbonaceous shale like lacustrine Roseneath and Murteree shale formation which is acting as source and reservoir rock. The source rock can be distinguished from non-source intervals by lower density, higher transit time, higher gamma ray values, higher porosity and resistivity with increasing organic content. In current dissertation we have attempted to compare the different empirical approaches based on density relation and Δ LogR method through three overlays of sonic/resistivity, neutron/resistivity and density/resistivity to quantify Total organic content (TOC) of Permian lacustrine Roseneath shale formation using open hole wireline log data (DEN, GR, CNL, LLD) of Encounter 1 well. The TOC calculated from fourteen density relations at depth interval between 3174.5-3369 meters is averaged 0.56% while TOC from sonic/resistivity, neutron/resistivity and density/resistivity yielded an average value of 3.84%, 3.68%, 4.40%. The TOC from average of three overlay method is yielded to 3.98%. According to geochemical report in PIRSA the Roseneath shale formation has TOC from 1 - 5 wt %.There is unpromising correlations observed for calculated TOC from fourteen density relations and measured TOC on samples. The TOC from average value of three overlays using Δ LogR method showed good correlation with measured TOC on samples.

Excess total organic carbon in the intermediate water of the South China Sea and its export to the North Pacific

NASA Astrophysics Data System (ADS)

Dai, Minhan; Meng, Feifei; Tang, Tiantian; Kao, Shu-Ji; Lin, Jianrong; Chen, Junhui; Huang-Chuan, Jr.; Tian, Jiwei; Gan, Jianping; Yang, Shuang

2009-12-01

Depth profiles of total organic carbon (TOC) were measured in spring (2005) and winter (2006) in the South China Sea (SCS), the largest marginal sea adjacent to the North Western Pacific (NWP). Compared to TOC profiles in the NWP, excess TOC (3.2 ± 1.1 μmol kg-1) was revealed in the intermediate layer of the SCS at σθ ˜ 27.2-27.6 (˜1000-1500 m). Below the depth of 2000 m, TOC concentrations were identical between the SCS and the NWP. Based on a one-dimensional steady state diffusion advection model constrained by potential temperature, we estimated a net TOC production rate of 0.12 ± 0.04 μmol kg-1 yr-1 to maintain this excess. A positive relationship between TOC and apparent oxygen utilization in the SCS deep water lent support to such a model-derived TOC production. This excess TOC in the out-flowing intermediate water may carry 3.1 ± 2.1 Tg C yr-1 of organic carbon out from the SCS and potentially into the deep open ocean. In light of the short residence time of the SCS deep water, the exported TOC was likely from the recently fixed organic carbon within the SCS. The export of such organic carbon, thereby less likely to return to the atmosphere may therefore contribute significantly to the carbon sequestration in the SCS.

Temporal trends in organic carbon content in the main Swiss rivers, 1974-2010.

PubMed

Rodríguez-Murillo, J C; Zobrist, J; Filella, M

2015-01-01

Increases in dissolved organic carbon (DOC) concentrations have often been reported in rivers and lakes of the Northern Hemisphere over the last few decades. High-quality organic carbon (OC) concentration data have been used to study the change in DOC and total (TOC) organic carbon concentrations in the main rivers of Switzerland (Rhône, Rhine, Thur and Aar) between 1974 and 2010. These rivers are characterized by high discharge regimes (due to their Alpine origin) and by running in populated areas. Small long term trends (a general statistically significant decrease in TOC and a less clear increase in DOC concentrations), on the order of 1% of mean OC concentration per year, have been observed. An upward trend before 1999 reversed direction to a more marked downward trend from 1999 to 2010. Of the potential causes of OC temporal variation analysed (water temperature, dissolved reactive phosphorus and river discharge), only discharge explains a significant, albeit still small, part of TOC variability (8-31%), while accounting for barely 2.5% of DOC variability. Estimated anthropogenic TOC and DOC loads (treated sewage) to the rivers could account for a maximum of 4-20% of the temporal trends. Such low predictability is a good example of the limitations faced when studying causality and drivers behind small variations in complex systems. River export of OC from Switzerland has decreased significantly over the period. Since about 5.5% of estimated NEP of Switzerland is exported by the rivers, riverine OC fluxes should be taken into account in a detailed carbon budget of the country. Copyright © 2014 Elsevier B.V. All rights reserved.

Distribution of surficial sediment in Long Island Sound and adjacent waters: Texture and total organic carbon

USGS Publications Warehouse

Poppe, L.J.; Knebel, H.J.; Mlodzinska, Z.J.; Hastings, M.E.; Seekins, B.A.

2000-01-01

The surficial sediment distribution within Long Island Sound has been mapped and described using bottom samples, photography, and sidescan sonar, combined with information from the geologic literature. The distributions of sediment type and total organic carbon (TOC) reveal several broad trends that are largely related to the sea-floor geology, the bathymetry, and the effects of modern tidal- and wind-driven currents. Sediment types are most heterogeneous in bathymetrically complex and shallow nearshore areas; the heterogeneity diminishes and the texture fines with decreasing bottom-current energy. Lag deposits of gravel and gravelly sand dominate the surficial sediment texture in areas where bottom currents are the strongest (such as where tidal flow is constricted) and where glacial till crops out at the sea floor. Sand is the dominant sediment type in areas characterized by active sediment transport and in shallow areas affected by fine-grained winnowing. Silty sand and sand-silt-clay mark transitions within the basin from higher- to lower-energy environments, suggesting a diminished hydraulic ability to sort and transport sediment. Clayey silt and silty clay are the dominant sediment types accumulating in the central and western basins and in other areas characterized by long-term depositional environments. The amount of TOC in the sediments of Long Island Sound varies inversely with sediment grain size. Concentrations average more than 1.9% (dry weight) in clayey silt, but are less than 0.4% in sand. Generally, values for TOC increase both toward the west in the Sound and from the shallow margins to the deeper parts of the basin floor. Our data also suggest that TOC concentrations can vary seasonally.

Humic acid coated Fe3O4 magnetic nanoparticles as highly efficient Fenton-like catalyst for complete mineralization of sulfathiazole.

PubMed

Niu, Hongyun; Zhang, Di; Zhang, Shengxiao; Zhang, Xiaole; Meng, Zhaofu; Cai, Yaqi

2011-06-15

Humic acid coated Fe(3)O(4) magnetic nanoparticles (Fe(3)O(4)/HA) were prepared for the removal of sulfathiazole from aqueous media. Fe(3)O(4)/HA exhibited high activity to produce hydroxyl (OH) radicals through catalytic decomposition of H(2)O(2). The degradation of sulfathiazole was strongly temperature-dependent and favored in acidic solution. The catalytic rate was increased with Fe(3)O(4)/HA dosage and H(2)O(2) concentration. When 3 g L(-1) of Fe(3)O(4)/HA and 0.39 M of H(2)O(2) were introduced to the aqueous solution, most sulfathiazole was degraded within 1h, and >90% of total organic carbon (TOC) were removed in the reaction period (6h). The major final products were identified as environmentally friendly ions or inorganic molecules (SO(4)(2-), CO(2), and N(2)). The corresponding degradation rate (k) of sulfathiazole and TOC was 0.034 and 0.0048 min(-1), respectively. However, when 3 g L(-1) of bare Fe(3)O(4) were used as catalyst, only 54% of TOC was eliminated, and SO(4)(2-) was not detected within 6h. The corresponding degradation rate for sulfathiazole and TOC was 0.01 and 0.0016 min(-1), respectively. The high catalytic ability of Fe(3)O(4)/HA may be caused by the electron transfer among the complexed Fe(II)-HA or Fe(III)-HA, leading to rapid regeneration of Fe(II) species and production of OH radicals. Copyright © 2011 Elsevier B.V. All rights reserved.

Measuring Transnational Organized Crime Threats to US National Security

DTIC Science & Technology

2016-05-26

typology is not designed to score TOC networks, so it is not an obvious choice, but it could be easily modified by the TMWG to rank-order TOC networks...States Strategy to Combat Transnational Organized Crime (SCTOC). The strategy identified Transnational Organized Crime ( TOC ) as a national security...identify the TOC groups that present the national security threat defined in the SCTOC? A literature review of existing organized crime assessments

40 CFR 419.52 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... mg/l total organic carbon (TOC) based upon an analysis of any single grab or composite sample. (2) If... contaminated runoff which exceeds 15 mg/l oil and grease or 110 mg/l TOC is not commingled or treated with any... substitute TOC as a parameter in lieu of COD. A TOC effluent limitation shall be based on effluent data from...

Employing the therapeutic operating characteristic (TOC) graph for individualised dose prescription.

PubMed

Hoffmann, Aswin L; Huizenga, Henk; Kaanders, Johannes H A M

2013-03-07

In current practice, patients scheduled for radiotherapy are treated according to 'rigid' protocols with predefined dose prescriptions that do not consider risk-taking preferences of individuals. The therapeutic operating characteristic (TOC) graph is applied as a decision-aid to assess the trade-off between treatment benefit and morbidity to facilitate dose prescription customisation. Historical dose-response data from prostate cancer patient cohorts treated with 3D-conformal radiotherapy is used to construct TOC graphs. Next, intensity-modulated (IMRT) plans are generated by optimisation based on dosimetric criteria and dose-response relationships. TOC graphs are constructed for dose-scaling of the optimised IMRT plan and individualised dose prescription. The area under the TOC curve (AUC) is estimated to measure the therapeutic power of these plans. On a continuous scale, the TOC graph directly visualises treatment benefit and morbidity risk of physicians' or patients' choices for dose (de-)escalation. The trade-off between these probabilities facilitates the selection of an individualised dose prescription. TOC graphs show broader therapeutic window and higher AUCs with increasing target dose heterogeneity. The TOC graph gives patients and physicians access to a decision-aid and read-out of the trade-off between treatment benefit and morbidity risks for individualised dose prescription customisation over a continuous range of dose levels.

Employing the therapeutic operating characteristic (TOC) graph for individualised dose prescription

PubMed Central

2013-01-01

Background In current practice, patients scheduled for radiotherapy are treated according to ‘rigid’ protocols with predefined dose prescriptions that do not consider risk-taking preferences of individuals. The therapeutic operating characteristic (TOC) graph is applied as a decision-aid to assess the trade-off between treatment benefit and morbidity to facilitate dose prescription customisation. Methods Historical dose-response data from prostate cancer patient cohorts treated with 3D-conformal radiotherapy is used to construct TOC graphs. Next, intensity-modulated (IMRT) plans are generated by optimisation based on dosimetric criteria and dose-response relationships. TOC graphs are constructed for dose-scaling of the optimised IMRT plan and individualised dose prescription. The area under the TOC curve (AUC) is estimated to measure the therapeutic power of these plans. Results On a continuous scale, the TOC graph directly visualises treatment benefit and morbidity risk of physicians’ or patients’ choices for dose (de-)escalation. The trade-off between these probabilities facilitates the selection of an individualised dose prescription. TOC graphs show broader therapeutic window and higher AUCs with increasing target dose heterogeneity. Conclusions The TOC graph gives patients and physicians access to a decision-aid and read-out of the trade-off between treatment benefit and morbidity risks for individualised dose prescription customisation over a continuous range of dose levels. PMID:23497640

99mTc-HYNIC-TOC scintigraphy is superior to 131I-MIBG imaging in the evaluation of extraadrenal pheochromocytoma.

PubMed

Chen, Libo; Li, Fang; Zhuang, Hongming; Jing, Hongli; Du, Yanrong; Zeng, Zhengpei

2009-03-01

In this investigation, the efficacy of scintigraphy using (99m)Tc-labeled hydrazinonicotinyl-Tyr3-octreotide (HYNIC-TOC) in the evaluation of extraadrenal pheochromocytoma was assessed and compared with (131)I-labeled metaiodobenzylguanidine (MIBG) imaging. Ninety-seven patients who were suspected of having pheochromocytoma but showed no definite adrenal abnormalities on CT were evaluated by both (99m)Tc-HYNIC-TOC scintigraphy and (131)I-MIBG imaging. The results were compared with pathology findings or clinical follow-up. Of 58 patients proven to be without pheochromocytoma, (99m)Tc-HYNIC-TOC and (131)I-MIBG imaging excluded 56 and 58 patients, respectively, rendering a specificity of 96.6% for (99m)Tc-HYNIC-TOC imaging and 100% for (131)I-MIBG imaging. In the evaluation of adrenal pheochromocytoma (14 patients), the sensitivity of (99m)Tc-HYNIC-TOC scintigraphy and (131)I-MIBG imaging was 50% and 85.7%, respectively. However, in the evaluation of extraadrenal pheochromocytomas (25 patients), the sensitivity of (99m)Tc-HYNIC-TOC scintigraphy and (131)I-MIBG imaging was 96.0% and 72.0%, respectively. (99m)Tc-HYNIC-TOC scintigraphy is more sensitive than (131)I-MIBG imaging in the detection of extraadrenal pheochromocytomas.

Prediction of total organic carbon content in shale reservoir based on a new integrated hybrid neural network and conventional well logging curves

NASA Astrophysics Data System (ADS)

Zhu, Linqi; Zhang, Chong; Zhang, Chaomo; Wei, Yang; Zhou, Xueqing; Cheng, Yuan; Huang, Yuyang; Zhang, Le

2018-06-01

There is increasing interest in shale gas reservoirs due to their abundant reserves. As a key evaluation criterion, the total organic carbon content (TOC) of the reservoirs can reflect its hydrocarbon generation potential. The existing TOC calculation model is not very accurate and there is still the possibility for improvement. In this paper, an integrated hybrid neural network (IHNN) model is proposed for predicting the TOC. This is based on the fact that the TOC information on the low TOC reservoir, where the TOC is easy to evaluate, comes from a prediction problem, which is the inherent problem of the existing algorithm. By comparing the prediction models established in 132 rock samples in the shale gas reservoir within the Jiaoshiba area, it can be seen that the accuracy of the proposed IHNN model is much higher than that of the other prediction models. The mean square error of the samples, which were not joined to the established models, was reduced from 0.586 to 0.442. The results show that TOC prediction is easier after logging prediction has been improved. Furthermore, this paper puts forward the next research direction of the prediction model. The IHNN algorithm can help evaluate the TOC of a shale gas reservoir.

Pea chloroplast DnaJ-J8 and Toc12 are encoded by the same gene and localized in the stroma.

PubMed

Chiu, Chi-Chou; Chen, Lih-Jen; Li, Hsou-min

2010-11-01

Toc12 is a novel J domain-containing protein identified in pea (Pisum sativum) chloroplasts. It was shown to be an integral outer membrane protein localizing in the intermembrane space of the chloroplast envelope. Furthermore, Toc12 was shown to associate with an intermembrane space Hsp70, suggesting that Toc12 is important for protein translocation across the chloroplast envelope. Toc12 shares a high degree of sequence similarity with Arabidopsis (Arabidopsis thaliana) DnaJ-J8, which has been suggested to be a soluble protein of the chloroplast stroma. Here, we isolated genes encoding DnaJ-J8 from pea and found that Toc12 is a truncated clone of one of the pea DnaJ-J8s. Protein import analyses indicate that Toc12 and DnaJ-J8s possess a cleavable transit peptide and are localized in the stroma. Arabidopsis mutants with T-DNA insertions in the DnaJ-J8 gene show no defect in chloroplast protein import. Implications of these results in the energetics and mechanisms of chloroplast protein import are discussed.

INVESTIGATION OF RESPONSE DIFFERENCES BETWEEN ...

EPA Pesticide Factsheets

Total organic carbon (TOC) and dissolved organic carbon (DOC) have long been used to estimate the amount of natural organic matter (NOM) found in raw and finished drinking water. In recent years, computer automation and improved instrumental analysis technologies have created a variety of TOC instrument systems. However, the amount of organic carbon (OC) measured in a sample has been found to depend upon the way a specific TOC instrument treats the sample and the way the OC is calculated and reported. Specifically, relative instrument response differences for TOC/DOC, ranging between 15 to 62%, were documented when five different source waters were each analyzed by five different TOC instrument systems operated according to the manufacturer's specifications. Problems and possible solutions for minimizing these differences are discussed. Establish optimum performance criteria for current TOC technologies for application to Stage 2 D/DBP Rule.Develop a TOC and SUVA (incorporating DOC and UV254) method to be published in the Stage 2 D/DBP Rule that will meet requirements as stated in the Stage 1 D/DBP Rule (Revise Method 415.3,

Enhanced coagulation for turbidity and Total Organic Carbon (TOC) removal from river Kansawati water.

PubMed

Narayan, Sumit; Goel, Sudha

2011-01-01

The objective of this study was to determine optimum coagulant doses for turbidity and Total Organic Carbon (TOC) removal and evaluate the extent to which TOC can be removed by enhanced coagulation. Jar tests were conducted in the laboratory to determine optimum doses of alum for the removal of turbidity and Natural Organic Matter (NOM) from river water. Various other water quality parameters were measured before and after thejar tests and included: UV Absorbance (UVA) at 254 nm, microbial concentrations, TDS, conductivity, hardness, alkalinity, and pH. The optimum alum dose for removal of turbidity and TOC was 20 mg/L for the sample collected in November 2009 and 100 mg/L for the sample collected in March 2010. In both cases, the dose for enhanced coagulation was significantly higher than that for conventional coagulation. The gain in TOC removal was insignificant compared to the increase in coagulant dose required. This is usual for low TOC (< 2 mg/L)--high alkalinity water. Other water samples with higher TOC need to be tested to demonstrate the effectiveness of enhanced coagulation.

Assessment of bacterial growth and total organic carbon removal on granular activated carbon contactors.

PubMed Central

Bancroft, K; Maloney, S W; McElhaney, J; Suffet, I H; Pipes, W O

1983-01-01

The overall growth rate of bacteria on granular activated carbon (GAC) contactors at the Philadelphia Torresdale Water Treatment Pilot Plant facility was found to decrease until steady state was reached. The growth rate was found to fluctuate between 6.94 X 10(-3) and 8.68 X 10(-4) doublings per h. The microbiological removal of total organic carbon (TOC) was calculated by considering the GAC contactors as semiclosed continuous culture systems and using growth yield factors determined in laboratory experiments. After ozonation, the average TOC entering the contactors was 1,488 micrograms/liter, and the average effluent TOC was 497 micrograms/liter. Microbiological TOC removal was found to average 240 micrograms/liter on GAC contactors, which was not significantly different from microbiological TOC (220 micrograms/liter) removal across a parallel sand contactor where no adsorption took place. Thus, GAC did not appear to enhance biological TOC removal. Bacterial growth and maintenance was responsible for approximately 24% of the TOC removal on GAC under the conditions of this study. PMID:6639023

Terrestrial carbon is a resource, but not a subsidy, for lake zooplankton

USGS Publications Warehouse

Kelly, Patrick T.; Solomon, Christopher T.; Weidel, Brian C.; Jones, Stuart E.

2014-01-01

Inputs of terrestrial organic carbon (t-OC) into lakes are often considered a resource subsidy for aquatic consumer production. Although there is evidence that terrestrial carbon can be incorporated into the tissues of aquatic consumers, its ability to enhance consumer production has been debated. Our research aims to evaluate the net effect of t-OC input on zooplankton. We used a survey of zooplankton production and resource use in ten lakes along a naturally occurring gradient of t-OC concentration to address these questions. Total and group-specific zooplankton production was negatively related to t-OC. Residual variation in zooplankton production that was not explained by t-OC was negatively related to terrestrial resource use (allochthony) by zooplankton. These results challenge the designation of terrestrial carbon as a resource subsidy; rather, the negative effect of reduced light penetration on the amount of suitable habitat and the low resource quality of t-OC appear to diminish zooplankton production. Our findings suggest that ongoing continental-scale increases in t-OC concentrations of lakes will likely have negative impacts on the productivity of aquatic food webs.

Blood and tissue tocopherol levels in rats following intraperitoneally administered alpha-tocopheryl acetate.

PubMed

McGee, C D; Greenwood, C E; Jeejeebhoy, K N

1990-01-01

The correction or maintenance of blood and tissue alpha-tocopherol (alpha-Toc) levels by intraperitoneally administered all-rac-alpha-tocopheryl acetate (alpha-Tac) was compared with RRR- alpha-tocopherol (alpha-Toc) in vitamin E-depleted and control rats. Rats received 1.3 TE vitamin E daily for 7 days. alpha-Tac was detected in plasma of one-third of alpha-Tac-treated rats 24 hr after the first treatment, although not in subsequent samplings. Both alpha-Tac and alpha-Toc increased tocopherol levels in plasma and liver of E-deprived rats, while little or no change was observed in adipose tissue and brain. Similarly, control rats treated with alpha-Tac or alpha-Toc had significantly greater (p less than 0.05) plasma and liver alpha-Toc levels at day 3 and day 7 than did saline-treated rats. There was no significant difference in adipose alpha-Toc levels among treatment groups of control rats. The results of this study suggest that alpha-Tac is rapidly hydrolyzed to its biologically active alcohol form and results in similar effects to that of intraperitoneally administered alpha-Toc.

Theory of Constraints for Services: Past, Present, and Future

NASA Astrophysics Data System (ADS)

Ricketts, John A.

Theory of constraints (TOC) is a thinking process and a set of management applications based on principles that run counter to conventional wisdom. TOC is best known in the manufacturing and distribution sectors where it originated. Awareness is growing in some service sectors, such as Health Care. And it's been adopted in some high-tech industries, such as Computer Software. Until recently, however, TOC was barely known in the Professional, Scientific, and Technical Services (PSTS) sector. Professional services include law, accounting, and consulting. Scientific services include research and development. And Technical services include development, operation, and support of various technologies. The main reason TOC took longer to reach PSTS is it's much harder to apply TOC principles when services are highly customized. Nevertheless, with the management applications described in this chapter, TOC has been successfully adapted for PSTS. Those applications cover management of resources, projects, processes, and finances.

Mapping the core of the Arabidopsis circadian clock defines the network structure of the oscillator.

PubMed

Huang, W; Pérez-García, P; Pokhilko, A; Millar, A J; Antoshechkin, I; Riechmann, J L; Mas, P

2012-04-06

In many organisms, the circadian clock is composed of functionally coupled morning and evening oscillators. In Arabidopsis, oscillator coupling relies on a core loop in which the evening oscillator component TIMING OF CAB EXPRESSION 1 (TOC1) was proposed to activate a subset of morning-expressed oscillator genes. Here, we show that TOC1 does not function as an activator but rather as a general repressor of oscillator gene expression. Repression occurs through TOC1 rhythmic association to the promoters of the oscillator genes. Hormone-dependent induction of TOC1 and analysis of RNA interference plants show that TOC1 prevents the activation of morning-expressed genes at night. Our study overturns the prevailing model of the Arabidopsis circadian clock, showing that the morning and evening oscillator loops are connected through the repressing activity of TOC1.

The total occlusal convergence of the abutment of a partial fixed dental prosthesis: A definition and a clinical technique for its assessment

PubMed Central

Mamoun, John S.

2013-01-01

The abutment(s) of a partial fixed dental prosthesis (PFDP) should have a minimal total occlusal convergence (TOC), also called a taper, in order to ensure adequate retention of a PFDP that will be made for the abutment(s), given the height of the abutment(s). This article reviews the concept of PFDP abutment TOC and presents an alternative definition of what TOC is, defining it as the extent to which the shape of an abutment differs from an ideal cylinder shape of an abutment. This article also reviews experimental results concerning what is the ideal TOC in degrees and explores clinical techniques of estimating the TOC of a crown abutment. The author suggests that Dentists use high magnification loupes (×6-8 magnification or greater) or a surgical operating microscope when preparing crown abutments, to facilitate creating a minimum abutment TOC. PMID:24932130

Depositional environment and organic matter accumulation of Upper Ordovician–Lower Silurian marine shale in the Upper Yangtze Platform, South China

USGS Publications Warehouse

Li, Yangfang; Zhang, Tongwei; Ellis, Geoffrey S.; Shao, Deyong

2017-01-01

The main controlling factors of organic matter accumulation in the Upper Ordovician Wufeng–Lower Silurian Longmaxi Formations are complex and remain highly controversial. This study investigates the vertical variation of total organic carbon (TOC) content as well as major and trace element concentrations of four Ordovician–Silurian transition sections from the Upper Yangtze Platform of South China to reconstruct the paleoenvironment of these deposits and to improve our understanding of those factors that have influenced organic matter accumulation in these deposits.The residual TOC content of the Wufeng Formation averages 3.2% and ranges from 0.12 to 6.0%. The overlying lower Longmaxi Formation displays higher TOC content (avg. 4.4%), followed upsection by consistent and lower values that average 1.6% in the upper Longmaxi Formation. The concentration and covariation of redox-sensitive trace elements (Mo, U and V) suggest that organic-rich intervals of the Wufeng Formation accumulated under predominantly anoxic conditions. Organic-rich horizons of the lower Longmaxi Formation were deposited under strongly anoxic to euxinic conditions, whereas organic-poor intervals of the upper Longmaxi Formation accumulated under suboxic conditions. Positive correlations between redox proxies and TOC contents suggest that organic matter accumulation was predominantly controlled by preservation. Barium excess (Baxs) values indicate high paleoproductivity throughout the entire depositional sequence, with an increase in the lower Longmaxi Formation. Increased productivity may have been induced by enhanced P recycling, as evidenced by elevated Corg/Ptot ratios. Mo–U covariation and Mo/TOC values reveal that the Wufeng Formation was deposited under extremely restricted conditions, whereas the Longmaxi Formation accumulated under moderately restricted conditions. During the Late Ordovician, the extremely restricted nature of ocean circulation on the Upper Yangtze Platform in tandem with enhanced stratification of the water column promoted anoxic conditions favorable for the preservation of organic matter. During Early Silurian time, organic matter accumulation was principally controlled by changes in sea level, which affected terrigenous flux, redox conditions, and the degree of nutrition recycling.

A Modular Dual-Labeling Scaffold That Retains Agonistic Properties for Somatostatin Receptor Targeting

PubMed Central

Ghosh, Sukhen C.; Rodriguez, Melissa; Carmon, Kendra S.; Voss, Julie; Wilganowski, Nathaniel L.; Schonbrunn, Agnes

2017-01-01

Fluorescence-guided surgery is an emerging imaging technique that can enhance the ability of surgeons to detect tumors when compared with visual observation. To facilitate characterization, fluorescently labeled probes have been dual-labeled with a radionuclide to enable cross-validation with nuclear imaging. In this study, we selected the somatostatin receptor imaging agent DOTATOC as the foundation for developing a dual-labeled analog. We hypothesized that a customized dual-labeling approach with a multimodality chelation (MMC) scaffold would minimize steric effects of dye conjugation and retain agonist properties. Methods: An MMC conjugate (MMC-TOC) was synthesized on solid-phase and compared with an analog prepared using conventional methods (DA-TOC). Both analogs were conjugated to IRDye 800 using copper-free click chemistry. The resulting compounds, MMC(IR800)-TOC and DA(IR800)-TOC, were labeled with Cu and 64Cu and tested in vitro in somatostatin receptor subtype 2–overexpressing HEK-293 cells to assess agonist properties, and in AR42J rat pancreatic cancer cells to determine receptor binding characteristics. Multimodality imaging was performed in AR42J xenografts. Results: Cu-MMC(IR800)-TOC demonstrated higher potency for cyclic adenosine monophosphate inhibition (half maximal effective concentration [EC50]: 0.21 ± 0.18 vs. 1.38 ± 0.54 nM) and receptor internalization (EC50: 41.9 ± 29.8 vs. 455 ± 299 nM) than Cu-DA(IR800)-TOC. Radioactive uptake studies showed that blocking with octreotide caused a dose-dependent reduction in 64Cu-MMC(IR800)-TOC uptake whereas 64Cu-DA(IR800)-TOC was not affected. In vivo studies revealed higher tumor uptake for 64Cu-MMC(IR800)-TOC than 64Cu-DA(IR800)-TOC (5.2 ± 0.2 vs. 3.6 ± 0.4 percentage injected dose per gram). In vivo blocking studies with octreotide reduced tumor uptake of 64Cu-MMC(IR800)-TOC by 66%. Excretion of 64Cu-MMC(IR800)-TOC was primarily through the liver and spleen whereas 64Cu-DA(IR800)-TOC was cleared through the kidneys. Ex vivo analysis at 24 h confirmed PET/CT data by showing near-infrared fluorescence signal in tumors and a tumor-to-muscle ratio of 5.3 ± 0.8 as determined by γ-counting. Conclusion: The findings demonstrate that drug design affected receptor pharmacology and suggest that the MMC scaffold is a useful tool for the development of dual-labeled imaging agents. PMID:28572490

[Osteomyelitis of the temporomaxillary joint (author's transl)].

PubMed

Winiker-Blanck, E; Wittstock, C; Braun, L; Biedermann, F

1978-01-01

Although osteomyelitis of the inferior maxilla is still relatively frequently diagnosed, manifestation of the disease in the temporomaxillary joint is a rare occurrence. The symptomatology, diagnosis, and therapy of this particular arthropathy is discussed by reference to three cases treated in recent years at the Berlin Clinic of Maxillofacial Surgery. The importance of an early diagnosis and therapy is directed attention to because of the danger of serious subsequent diseases that may result in the loss of vital functions.

Periostitis ossificans.

PubMed

VanDoorne, I; Soubry, R; Wackens, G; Goossens, A

1995-09-01

Mandibular periostitis ossificans was assessed in a 18-year-old black boy. This form of chronic osteomyelitis (Garré osteomyelitis) resulted from a periostitis on the 4.8 in association with an infected and ankylosed 4.7. Clinically a firm swelling of the right mandibular angle was noticeable. The diagnosis was confirmed by computed tomography and biopsy. After extraction of the causative teeth, in combination with an antibiotic treatment, a good evolution was obtained. The possible pathogenesis and the differential diagnosis are discussed.

Current data on extremities chronic osteomyelitis in southwest China: epidemiology, microbiology and therapeutic consequences.

PubMed

Wang, Xiaohua; Yu, Shengpeng; Sun, Dong; Fu, Jingshu; Wang, Shulin; Huang, Ke; Xie, Zhao

2017-11-24

The current study was designed to explore the epidemiology of extremities chronic osteomyelitis, its prognosis and the complications of the treatment methods being used in southwest China. The data from osteomyelitis patients treated at the Department of Orthopaedics, Southwest Hospital, China between May 2011 and September 2016 were collected and analysed. The study comprised 503 admitted patients, of which 416 males and 87 were females, with an average age of 40.15 ± 5.64 years. Approximately 356 cases were followed for more than 18 months; the average bone union time was 6.24 ± 0.76 months in 94.1% (335) patients, and infections were almost controlled in 93.8% patients. The rate of infection control with the induced membrane technique was higher than with the I-stage free bone graft. Iliac infection was the main complication of the induced membrane technique, and impaired joint activity was the main complication of I-stage free bone grafts. In southwest China, the incidence of haematogenous osteomyelitis, caused mainly by Staphylococcus aureus, remains very high. The speed of bone defect repair and the rate of infection control with the induced membrane technique were superior to those of I-stage free bone grafts. Internal fixation should be given priority because it offers reduced complications with no increase in the recurrence of infection.

Successful treatment of Pseudomonas aeruginosa osteomyelitis with antibiotic monotherapy of limited duration.

PubMed

Laghmouche, Nadir; Compain, Fabrice; Jannot, Anne-Sophie; Guigui, Pierre; Mainardi, Jean-Luc; Lonjon, Guillaume; Bouyer, Benjamin; Fernandez-Gerlinger, Marie-Paule

2017-09-01

The aim of this study was to present a 15-year experience and provide a comprehensive analysis of a large cohort of patients with Pseudomonas aeruginosa osteomyelitis. We reviewed the medical records of patients admitted to a large French university hospital for P. aeruginosa osteomyelitis over a 15-year period. Patient outcome was assessed at follow-up after at least six months. Sixty-seven patients were included, comprising 57% with chronic osteomyelitis. Polymicrobial infection was predominant (63%), and an infected device was involved in 39% patients. The overall treatment success rate was 79.1%. All but one patient were treated with a combination of surgery and antibiotic therapy. The antibiotic treatment had a mean duration of 45 days (range, 21-90 days). Single-antibiotic therapy was preferred in nearly all cases. Treatment failure was reported for 14 (21%) patients and was due to the persistence of P. aeruginosa in four cases. No significant risk factor for treatment failure was identified, especially when treatment strategies were compared. We advocate optimal surgical debridement combined with initial parenteral antibiotics for a maximum of 15 days, followed by an oral fluoroquinolone. Total treatment duration should not exceed six weeks, and antibiotic treatment with two-drug combinations does not seem necessary. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

SAPHO osteomyelitis and sarcoid dermatitis in a patient with DiGeorge syndrome.

PubMed

Jyonouchi, Harumi; Lien, Kenneth W; Aguila, Helen; Spinnato, Gaetano G; Sabharwal, Sanjeev; Pletcher, Beth A

2006-06-01

We report the development and spontaneous resolution of annular erythematous skin lesions consistent with sarcoid dermatitis in a child with DiGeorge syndrome (DGS) carrying the 22q11.2 microdeletion. The skin lesion developed after she was treated with isoniazid (INH) following exposure to active tuberculosis (TB). After resolution of the skin lesions, this child developed sterile hyperplastic osteomyelitis consistent with SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) osteomyelitis in her right mandible triggered by an odontogenic infection. This child had congenital heart disease, dysmorphic facies, recurrent sinopulmonary infection, gastroesophageal reflux disease, scoliosis, reactive periostitis, and developmental delay. She had a low CD4 and CD8 T cell count with a normal 4/8 ratio, but normal cell proliferation and T cell cytokine production in response to mitogens. When she was presented with sterile osteomyelitis of right mandible, she revealed polyclonal hypergammaglobulinemia with elevated erythrocyte sedimentation rate (ESR)/angiotensin converting enzyme (ACE) levels, but negative CRP. Autoimmune and sarcoidosis workup was negative. Inflammatory parameters gradually normalized following resolution of odontogenic infection and with the use of non-steroidal anti-inflammatory drugs (NSAIDs). The broad clinical spectrum of DGS is further expanded with the development of autoimmune and inflammatory complications later in life. This case suggests that patients with the DGS can present with unusual sterile inflammatory lesions triggered by environmental factors, further broadening the clinical spectrum of this syndrome.

Examination of a novel, specified local antibiotic therapy through polymethylmethacrylate capsules in a rabbit osteomyelitis model.

PubMed

Börzsei, László; Mintál, Tibor; Koós, Zoltán; Kocsis, Béla; Helyes, Zsuzsanna; Kereskai, László; Nyárády, József

2006-01-01

Chronic bone and soft tissue suppurations have become more frequent recently due to the increasing number of high-energy injuries. There are certain antibiotic beads available for local administration, but they cannot always be applied specifically against the pyogenic microorganisms. In the present study, a new technique of local antibiotic therapy for the treatment of infections is described. Polymethylmethacrylate (PMMA) capsules were produced and filled with 0.1 ml Tazocin (0.02 g piperacillin sodium + 0.005 g tazobactam). The efficacy of these Tazocin-filled capsules was examined in vivo using a rabbit osteomyelitis model. Chronic osteomyelitis was induced in rabbit tibia by local injection of Staphylococcus aureus. The treatment included surgical debridement and implantation of Tazocin-containing PMMA capsules into the medullar cavity (n = 12). Simple surgical debridement with no antibiotic implantation was performed in control animals (n = 7). Results were evaluated using microbiological, radiological and histological methods 14 weeks after induction of osteomyelitis. Eight weeks after the implantation of PMMA capsules, complete physical, radiological and histological healing was achieved in 7 animals, initiation of the reparative phase was observed histologically in 3 cases and no reparative signs were detected in 2 rabbits. In the control group, no significant sign of reparation could be seen in any of the cases. Copyright 2006 S. Karger AG, Basel.

Combination of Open Subtotal Calcanectomy and Stabilization With External Fixation as Limb Salvage Procedure in Hindfoot-Infected Diabetic Foot Ulcers.

PubMed

Dalla Paola, Luca; Carone, Anna; Boscarino, Giulio; Scavone, Giuseppe; Vasilache, Lucian

2016-12-01

Diabetic hindfoot ulcers, complicated by osteomyelitis, are associated with a high risk of major amputation. Partial calcanectomy, preceded by an effective management of the infection and of the eventual peripheral artery disease, can be considered as valid therapeutic option. We have evaluated a therapeutic protocol for diabetic hindfoot ulcers complicated by osteomyelitis, which, besides an adequate surgical debridement, considers a reconstructive pathway assisted by the positioning of a circular external fixator. We made a prospective study of a cohort of diabetic patients affected by heel ulcer complicated by osteomyelitis. All patients underwent open partial calcanectomy associated with the positioning of a circular external frame specifically designed for hindfoot stabilization and offloading. A reconstructive procedure was implemented starting with the application of negative pressure wound therapy and coverage with dermal substitute and split thickness skin grafting. From November 2014 to November 2015, 18 consecutive patients were enrolled. Mean follow-up period was 212.3 ± 64.0 days. Healing was achieved in 18 (100%) patients. The mean healing time was 69.0 ± 64.0 days. No major amputation had to be performed during the follow-up. Open partial calcanectomy associated with external fixation and skin reconstruction was as efficient as limb salvage in patients with infected lesions of the hindfoot complicated by calcaneal osteomyelitis.

Resveratrol and its combination with α-tocopherol mediate salt adaptation in citrus seedlings.

PubMed

Kostopoulou, Zacharoula; Therios, Ioannis; Molassiotis, Athanassios

2014-05-01

Resveratrol, a phytoalexin found in red wine, has the potential to impact a variety of human diseases but its function in plants exposed to stressful conditions is still unknown. In the present study the effect of exogenous application of resveratrol (Res), α-tocopherol (α-Toc) and their combination (Res+α-Toc) in salt adaptation of citrus seedlings was investigated. It was found that Res, α-Toc or Res+α-Toc treatments reduced NaCl-derived membrane permeability (EL), lipid peroxidation (MDA) and pigments degradation, whereas companied Res and α-Toc application also reduced H2O2 accumulation in leaves and restored the reduction of photosynthesis induced by NaCl. Application of Res under salinity retained Cl- in roots while Res+α-Toc reduced the translocation of Na+ and Cl- to leaves. Carbohydrates and proline, phenols, total ascorbic acid and glutathione were remarkably affected by NaCl as well as by chemical treatments in leaves and roots of citrus. NaCl treatment increased the activity of superoxide dismutase (SOD), ascorbate peroxidase (APX), peroxidase (POD), glutathione reductase (GR), polyphenol oxidase (PPO) in leaves while SOD and POD activities were decreased in roots by this treatment. Also, Res, α-Toc or Res+α-Toc treatments displayed tissue specific activation or deactivation of the antioxidant enzymes. Overall, this work revealed a new functional role of Res in plants and provided evidence that the interplay of between Res and α-Toc is involved in salinity adaptation. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

The tae-miR408-Mediated Control of TaTOC1 Genes Transcription Is Required for the Regulation of Heading Time in Wheat1[OPEN

PubMed Central

Zhao, Xiang Yu; Hong, Po; Chen, Xiang Bin; Ye, Xing Guo; Pan, Yan You; Wang, Jian

2016-01-01

Timing of flowering is not only an interesting topic in developmental biology, but it also plays a significant role in agriculture for its effects on the maturation time of seed. The hexaploid wheat (Triticum aestivum) is one of the most important crop species whose flowering time, i.e. heading time, greatly influences yield. However, it remains unclear whether and how microRNAs regulate heading time in it. In our current study, we identified the tae-miR408 in wheat and its targets in vivo, including Triticum aestivum TIMING OF CAB EXPRESSION-A1 (TaTOC-A1), TaTOC-B1, and TaTOC-D1. The tae-miR408 levels were reciprocal to those of TaTOC1s under long-day and short-day conditions. Wheat plants with a knockdown of TaTOC1s via RNA interference and overexpression of tae-miR408 showed early-heading phenotype. Furthermore, TaTOC1s expression was down-regulated by the tae-miR408 in the hexaploid wheat. In addition, other important agronomic traits in wheat, such as plant height and flag leaf angle, were regulated by both tae-miR408 and TaTOC1s. Thus, our results suggested that the tae-miR408 functions in the wheat heading time by mediating TaTOC1s expression, and the study provides important new information on the mechanism underlying heading time regulation in wheat. PMID:26768600

The tae-miR408-Mediated Control of TaTOC1 Genes Transcription Is Required for the Regulation of Heading Time in Wheat.

PubMed

Zhao, Xiang Yu; Hong, Po; Wu, Ji Yun; Chen, Xiang Bin; Ye, Xing Guo; Pan, Yan You; Wang, Jian; Zhang, Xian Sheng

2016-03-01

Timing of flowering is not only an interesting topic in developmental biology, but it also plays a significant role in agriculture for its effects on the maturation time of seed. The hexaploid wheat (Triticum aestivum) is one of the most important crop species whose flowering time, i.e. heading time, greatly influences yield. However, it remains unclear whether and how microRNAs regulate heading time in it. In our current study, we identified the tae-miR408 in wheat and its targets in vivo, including Triticum aestivum TIMING OF CAB EXPRESSION-A1 (TaTOC-A1), TaTOC-B1, and TaTOC-D1. The tae-miR408 levels were reciprocal to those of TaTOC1s under long-day and short-day conditions. Wheat plants with a knockdown of TaTOC1s via RNA interference and overexpression of tae-miR408 showed early-heading phenotype. Furthermore, TaTOC1s expression was down-regulated by the tae-miR408 in the hexaploid wheat. In addition, other important agronomic traits in wheat, such as plant height and flag leaf angle, were regulated by both tae-miR408 and TaTOC1s. Thus, our results suggested that the tae-miR408 functions in the wheat heading time by mediating TaTOC1s expression, and the study provides important new information on the mechanism underlying heading time regulation in wheat. © 2016 American Society of Plant Biologists. All Rights Reserved.

[Effects of understory removal on soil labile organic carbon pool in a Cinnamomum camphora plantation].

PubMed

Wu, Ya-Cong; Li, Zheng-Cai; Cheng, Cai-Fang; Liu, Rong-Jie; Wang, Bin; Geri, Le-Tu

2013-12-01

Taking a 48-year-old Cinnamomum camphora plantation in the eastern area of our subtropics as test object, this paper studied the labile organic carbon contents and their ratios to the total organic carbon (TOC) in 0-60 cm soil layer under effects of understory removal (UR). As compared with no understory removal (CK), the soil TOC and easily-oxidized carbon (EOC) contents under UR decreased, with a decrement of 4.8% - 34.1% and 27.1% - 36.2%, respectively, and the TOC and EOC contents had a significant difference in 0-10 cm and 0-20 cm layers, respectively. The water-soluble organic carbon (WSOC) (except in 0-10 cm and 10-20 cm layers) and light fraction organic matter (LFOM) under UR increaesd, but the difference was not significant. The ratio of soil WSOC to soil TOC in UR stand was higher than that in CK stand, while the ratio of soil EOC to soil TOC showed an opposite trend. In the two stands, soil WSOC, EOC, and LFOM had significant or extremely significant correlations with soil TOC, and the correlation coefficients of soil EOC and LFOM with soil TOC were higher in UR stand than in CK, but the correlation coefficient between soil WSOC and TOC was in opposite. The soil EOC, LFOM, and TOC in the two stands were significantly or extremely significantly correlated with soil nutrients, but the soil WSOC in UR stand had no significant correlations with soil hydrolyzable N, available P, exchangeable Ca, and exchangeable Mg.

76 FR 38110 - Announcement of Small, Socially-Disadvantaged Producer Grant (SSDPG) Application Deadlines in...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

... detailed Table of Contents (TOC) immediately following the SF-424B. The TOC must include page numbers for each component of the application. Pagination should begin immediately following the TOC. 5. Executive...

Organic sedimentation in modern lacustrine systems: A case study from Lake Malawi, East Africa

USGS Publications Warehouse

Ellis, Geoffrey S.; Barry J. Katz,; Christopher A. Scholz,; Peter K. Swart,

2015-01-01

This study examines the relationship between depositional environment and sedimentary organic geochemistry in Lake Malawi, East Africa, and evaluates the relative significance of the various processes that control sedimentary organic matter (OM) in lacustrine systems. Total organic carbon (TOC) concentrations in recent sediments from Lake Malawi range from 0.01 to 8.80 wt% and average 2.83 wt% for surface sediments and 2.35 wt% for shallow core sediments. Hydrogen index (HI) values as determined by Rock-Eval pyrolysis range from 0 to 756 mg HC g−1 TOC and average 205 mg HC g−1 TOC for surface sediments and 228 mg HC g−1 TOC for shallow core samples. On average, variations in primary productivity throughout the lake may account for ~33% of the TOC content in Lake Malawi sediments (as much as 1 wt% TOC), and have little or no impact on sedimentary HI values. Similarly, ~33% to 66% of the variation in TOC content in Lake Malawi sediments appears to be controlled by anoxic preservation of OM (~1–2 wt% TOC), although some component of the water depth–TOC relationship may be due to physical sediment transport processes. Furthermore, anoxic preservation has a minimal effect on HI values in Lake Malawi sediments. Dilution of OM by inorganic sediment may account for ~16% of variability in TOC content in Lake Malawi sediments (~0.5 wt% TOC). The effect of inputs of terrestrial sediment on the organic character of surface sediments in these lakes is highly variable, and appears to be more closely related to the local depositional environment than the regional flux of terrestrial OM. Total nitrogen and TOC content in surface sediments collected throughout the lake are found to be highly correlated (r2 = 0.95), indicating a well-homogenized source of OM to the lake bottom. The recurring suspension and deposition of terrestrial sediment may account for significant amounts of OM deposited in offshore regions of the lake. This process effectively separates denser inorganic sediment from less dense OM and allows terrestrial OM to preferentially be transported farther offshore. The conclusion is that for the organic carbon content in these regions to be elevated a mixed terrestrial-lacustrine origin is required. The hydrodynamic separation of mineral and organic constituents is most pronounced in regions with shallow bathymetric gradients, consistent with previous findings from Lake Tanganyika.

Diagnostic performance and impact on patient management of 68Ga-DOTA-TOC PET/CT for detecting osteomalacia-associated tumours.

PubMed

Paquet, Marie; Gauthé, Mathieu; Zhang Yin, Jules; Nataf, Valérie; Bélissant, Ophélie; Orcel, Philippe; Roux, Christian; Talbot, Jean-Noël; Montravers, Françoise

2018-03-12

Oncogenic osteomalacia is an endocrine disorder induced by small benign tumours (TIO) producing excessive fibroblast growth factor-23 (FGF23). The only way of curing oncogenic osteomalacia is surgical resection of the culprit TIO, which is extremely difficult to detect using conventional imaging modalities due to its small size and variable location in the body. Since TIO frequently overexpress somatostatin receptors, a clinical utility of SPECT or PET with radiolabelled somatostatin analogues has been reported. Among them, 68 Ga-DOTA-TOC has recently been granted a marketing authorization, facilitating its routine application. We report here the results of the first series evaluating the diagnostic performance of 68 Ga-DOTA-TOC PET/CT in detecting TIO and its impact on patient management. 68 Ga-DOTA-TOC PET/CT and clinical and imaging data from 15 patients with clinical and biochemical signs of oncogenic osteomalacia were retrospectively reviewed. The 68 Ga-DOTA-TOC PET/CT findings were compared with the results of post-surgical pathology and clinical and biochemical follow-up. 68 Ga-DOTA-TOC PET/CT resulted in the detection of one focus suspicious for TIO in nine of 15 patients (60%), and a tumour was surgically removed in eight. Post-operative pathology confirmed a TIO in those eight patients whose symptoms diminished promptly and biochemical anomalies resolved. 68 Ga-DOTA-TOC PET/CT sensitivity, specificity and accuracy were 73%, 67% and 71%, respectively. 68 Ga-DOTA-TOC PET/CT findings affected patient management in 67% of cases. In particular, 68 Ga-DOTA-TOC PET/CT was able to detect the TIO with a negative or a false-positive result of a previous 111 In-pentetreotide SPECT/CT in 5/8 patients (63%) or a previous FDG PET/CT in 7/11 patients (64%). No close relationship was found between the positivity of 68 Ga-DOTA-TOC PET/CT and the serum level of a biochemical marker. However, a true-positive result of 68 Ga-DOTA-TOC PET/CT was obtained in only one patient with a non-elevated serum level of FGF23. 68 Ga-DOTA-TOC PET/CT is an accurate imaging modality in the detection of TIO; in particular, it is worthwhile after failure of somatostatin receptor SPECT(/CT) or FDG PET/CT.

Physicians’ experience adopting the electronic transfer of care communication tool: barriers and opportunities

PubMed Central

de Grood, Chloe; Eso, Katherine; Santana, Maria Jose

2015-01-01

Purpose The purpose of this study was to assess physicians’ perceptions on a newly developed electronic transfer of care (e-TOC) communication tool and identify barriers and opportunities toward its adoption. Participants and methods The study was conducted in a tertiary care teaching center as part of a randomized controlled trial assessing the efficacy of an e-TOC communication tool. The e-TOC technology was developed through iterative consultation with stakeholders. This e-TOC summary was populated by acute care physicians (AcPs) and communicated electronically to community care physicians (CcPs). The AcPs consisted of attending physicians, resident trainees, and medical students rotating through the Medical Teaching Unit. The CcPs were health care providers caring for patients discharged from hospital to the community. AcPs and CcPs completed validated surveys assessing their experience with the newly developed e-TOC tool. Free text questions were added to gather general comments from both groups of physicians. Units of analysis were individual physicians. Data from the surveys were analyzed using mixed methods. Results AcPs completed 138 linked pre- and post-rotation surveys. At post-rotation, each AcP completed an average of six e-TOC summaries, taking an average of 37 minutes per e-TOC summary. Over 100 CcPs assessed the quality of the TOC summaries, with an overall rating of 8.3 (standard deviation: 1.48; on a scale of 1–10). Thematic analyses revealed barriers and opportunities encountered by physicians toward the adoption of the e-TOC tool. While the AcPs highlighted issues with timeliness, usability, and presentation, the CcPs identified barriers accessing the web-based TOC summaries, emphasizing that the summaries were timely and the quality of information supported continuity of care. Conclusion Despite the barriers identified by both groups of physicians, the e-TOC communication tool was well received. Our experience can serve as a template for other health research teams considering the implementation of e-health technologies into health care systems. PMID:25609977

Preliminary PET/CT Imaging with Somatostatin Analogs [68Ga]DOTAGA-TATE and [68Ga]DOTAGA-TOC.

PubMed

Satpati, Drishty; Shinto, Ajit; Kamaleshwaran, K K; Sarma, Haladhar Dev; Dash, Ashutosh

2017-12-01

Somatostatin receptor positron emission tomography/X-ray computed tomography (SSTR-PET/CT) is a well-established technique for staging and detection of neuroendocrine tumors (NETs). Ga-68-labeled DOTA-conjugated octreotide analogs are the privileged radiotracers for diagnosis and therapeutic monitoring of NETs. Hence, we were interested in assessing the influence of promising, newer variant DOTAGA on the hydrophilicity, pharmacokinetics, and lesion pick-up of somatostatin analogs. Herein, the potential of ([ 68 Ga]DOTAGA, Tyr 3 , Thr 8 ) octreotide ([ 68 Ga]DOTAGA-TATE) and ([ 68 Ga]DOTAGA, Tyr 3 ) octreotide ([ 68 Ga]DOTAGA-TOC) as NET imaging agents has been investigated. Amenability of [ 68 Ga]DOTAGA-(TATE/TOC) to kit-type formulation has been demonstrated. Biodistribution studies were carried out in normal rats at 1 h post-injection (p.i.). [ 68 Ga]DOTAGA-(TATE/TOC) PET/CT scans were carried out in patients (70-170 MBq, 1 h p.i.) with histologically confirmed well-differentiated NETs. [ 68 Ga]DOTAGA-TATE exhibited hydrophilicity similar to [ 68 Ga]DOTA-TATE (log P = -3.51 vs -3.69) whereas [ 68 Ga]DOTAGA-TOC was more hydrophilic than [ 68 Ga]DOTA-TOC (log P = -3.27 vs -2.93). [ 68 Ga]DOTAGA-TATE and [ 68 Ga]DOTA-TATE showed almost identical blood and kidney uptake in normal rats whereas significantly fast clearance (p < 0.05) of [ 68 Ga]DOTAGA-TATE was observed from other non-specific organs (liver, lungs, spleen, intestine). [ 68 Ga]DOTAGA-TOC also demonstrated rapid clearance from blood and kidneys (p < 0.05) in comparison to [ 68 Ga]DOTA-TOC. The metastatic lesions in NET patients were well identified by [ 68 Ga]DOTAGA-TATE and [ 68 Ga]DOTAGA-TOC. The phenomenal analogy was observed between [ 68 Ga]DOTAGA-TATE and [ 68 Ga]DOTA-TATE as well as between [ 68 Ga]DOTAGA-TOC and [ 68 Ga]DOTA-TOC in biodistribution studies in rats. The good lesion detection ability of the two radiotracers indicates their potential as NET imaging radiotracers.

78 FR 40264 - First Meeting: RTCA Tactical Operations Committee (TOC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration First Meeting: RTCA Tactical Operations Committee (TOC) AGENCY: Federal Aviation Administration (FAA), U.S. Department of Transportation..., Leadership Anticipated Issues for TOC consideration and action at the next meeting. Any Other Business...

78 FR 16757 - First Meeting: RTCA Tactical Operations Committee (TOC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-18

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration First Meeting: RTCA Tactical Operations Committee (TOC) AGENCY: Federal Aviation Administration (FAA), U.S. Department of Transportation... FAA Task Groups Discussion Anticipated Issues for TOC consideration and action at the next meeting...

77 FR 24678 - Announcement of Small, Socially-Disadvantaged Producer Grant (SSDPG) Application Deadlines in...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-25

... a detailed Table of Contents (TOC) immediately following the SF-424B. The TOC must include page... the TOC. 5. Executive Summary. A summary of the proposal, not to exceed one page, must briefly...

Functional imaging in differentiating bronchial masses: an initial experience with a combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan.

PubMed

Kumar, Arvind; Jindal, Tarun; Dutta, Roman; Kumar, Rakesh

2009-10-01

To evaluate the role of combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan in differentiating bronchial tumors observed in contrast enhanced computed tomography scan of chest. Prospective observational study. Place of study: All India Institute of Medical Sciences, New Delhi, India. 7 patients with bronchial mass detected in computed tomography scan of the chest were included in this study. All patients underwent (18)F-FDG PET-CT scan, (68)Ga DOTA-TOC PET-CT scan and fiberoptic bronchoscope guided biopsy followed by definitive surgical excision. The results of functional imaging studies were analyzed and the results are correlated with the final histopathology of the tumor. Histopathological examination of 7 bronchial masses revealed carcinoid tumors (2 typical, 1 atypical), inflammatory myofibroblastic tumor (1), mucoepidermoid carcinoma (1), hamartoma (1), and synovial cell sarcoma (1). The typical carcinoids had mild (18)F-FDG uptake and high (68)Ga DOTA-TOC uptake. Atypical carcinoid had moderate uptake of (18)F-FDG and high (68)Ga DOTA-TOC uptake. Inflammatory myofibroblastic tumor showed high uptake of (18)F-FDG and no uptake of (68)Ga DOTA-TOC. Mucoepidermoid carcinoma showed mild (18)F-FDG uptake and no (68)Ga DOTA-TOC uptake. Hamartoma showed no uptake on either scans. Synovial cell sarcoma showed moderate (18)F-FDG uptake and mild focal (68)Ga DOTA-TOC uptake. This initial experience with the combined use of (18)F-FDG and (68)Ga DOTA-TOC PET-CT scan reveals different uptake patterns in various bronchial tumors. Bronchoscopic biopsy will continue to be the gold standard; however, the interesting observations made in this study merits further evaluation of the utility of the combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan in larger number of patients with bronchial masses.

Benthic foraminiferal response to environmental changes across Cenomanian/Turonian boundary (OAE2) in the northeastern Tethys, Kopet-Dagh basin

NASA Astrophysics Data System (ADS)

Kalanat, Behnaz; Vahidinia, Mohammad; Vaziri-Moghaddam, Hossein; Mahmudy-Gharaie, Mohamad Hosein; Kumon, Fujio

2017-10-01

In order to evaluate Oceanic Anoxic Event 2 (OAE2) at the Cenomanian-Turonian boundary and its effects on benthic foraminifera, the Taherabad stratigraphic section in the east of Kopet-Dagh basin was studied for pattern of changes in benthic foraminiferal communities. Total Organic Carbon (TOC) concentration at the Taherabad section shows that black shale was not deposited in this succession but TOC increases up to 0.68 wt% in the three intervals of Rotalipora cushmani, Whiteinella archaeocretacea and Helvetoglobotruncana helvetica Zones. Also, Total Nitrogen (TN) values were measured in our study succession. High TOC/TN ratios (up to 18) occur in the intervals of TOC enrichment. Foraminiferal assemblages, TOC, TOC/TN and Detrital Index (DI, an index for detrital input) changes in the study section allowed us to divided study section into 4 intervals. Interval A and C are associated with low abundance and diversity of benthic assemblages coeval with lack of planktic foraminifera. Benthic assemblages are strongly dominated by shallow and deep infaunal agglutinated foraminifera including Lagenammina, Saccammina, Reophax and Tritaxia. The foraminiferal composition associated with higher TOC, TOC/TN and DI suggest an influx of fresh water to the basin in the warm-wet periods, which diminished hospitable conditions for planktic foraminifera and probably enhanced land-derived organic matter and/or primary productivity. The hyposaline cap led to development of salinity-stratified water and induce bottom water oxygen depletion. By contrast, the assemblages found in the interval B and D are more diverse and contain high abundance of planktic and calcareous benthic foraminifera. Common benthic taxa in these parts are praebuliminids, lenticulinids, gavelinellids and Valvulineria. These assemblages associated with lower TOC, TOC/TN and DI indicate decreased detrital input and more normal marine condition resulted in improved ventilation of sea-floor, which is favorable for planktic and benthic taxa.

Increasing organic C and N fluxes from a northern Boreal river basin - monitoring and modelling suggest climate related controls

NASA Astrophysics Data System (ADS)

Lepistö, A.; Futter, M.; Kortelainen, P.

2012-04-01

Increasing trends in total organic carbon (TOC) concentrations in lakes and streams across northern Europe and North America have been reported. Various hypotheses including enhanced decomposition of organic soils, changes in hydrology and flow paths, decreased acid deposition and land use changes have been put forward to explain the widespread occurrence of this phenomenon. Both observational and modelling studies are needed to identify the most important drivers and relevant processes controlling observed trends in TOC concentrations. Typically, TOC concentrations in Finnish rivers and lakes are high. The Simojoki river basin (3160 km2) is located in the northern Boreal zone of Finland and experiences low, declining sulphate deposition and limited other human impacts. Forest harvest, land drainage and ditch maintenance are the main land management activities in the catchment. Long-term changes (30-40 years) and seasonal trends of total organic nitrogen (TON) and carbon (TOC) concentrations and fluxes in the Simojoki river system were studied. Concentrations of TOC and TON increased particularly during high flows. TOC concentrations are slowly but continuously increasing, fluctuating between droughts and wet periods. The highest concentrations were detected in 1998-2000 during a period of very high flows, after the drought period 1994-1997. Trends in concentrations of TOC and TON in Simojoki were not linked to declines in sulphate deposition but were more related to trends in climate and hydrology. The autumn season is particularly sensitive to climate change impacts. The INCA-C model was applied to simulate TOC dynamics in the catchment. Model results showed that climate change driven patterns in runoff and soil moisture and soil temperature were more important than temporal patterns of sulphate deposition and land management in controlling surface water TOC concentrations. The possible factors behind changes of TOC and TON concentrations and increasing fluxes to the coastal areas are discussed.

Modeling Source Water TOC Using Hydroclimate Variables and Local Polynomial Regression.

PubMed

Samson, Carleigh C; Rajagopalan, Balaji; Summers, R Scott

2016-04-19

To control disinfection byproduct (DBP) formation in drinking water, an understanding of the source water total organic carbon (TOC) concentration variability can be critical. Previously, TOC concentrations in water treatment plant source waters have been modeled using streamflow data. However, the lack of streamflow data or unimpaired flow scenarios makes it difficult to model TOC. In addition, TOC variability under climate change further exacerbates the problem. Here we proposed a modeling approach based on local polynomial regression that uses climate, e.g. temperature, and land surface, e.g., soil moisture, variables as predictors of TOC concentration, obviating the need for streamflow. The local polynomial approach has the ability to capture non-Gaussian and nonlinear features that might be present in the relationships. The utility of the methodology is demonstrated using source water quality and climate data in three case study locations with surface source waters including river and reservoir sources. The models show good predictive skill in general at these locations, with lower skills at locations with the most anthropogenic influences in their streams. Source water TOC predictive models can provide water treatment utilities important information for making treatment decisions for DBP regulation compliance under future climate scenarios.

40 CFR Table 2 to Subpart Bbbbbb... - Applicability Criteria, Emission Limits, and Management Practices for Loading Racks

Code of Federal Regulations, 2010 CFR

2010-07-01

... the TOC vapors displaced from cargo tanks during product loading; and(b) Reduce emissions of TOC to...) Design and operate the vapor collection system to prevent any TOC vapors collected at one loading rack...

Military Review: The Professional Journal of the U.S. Army. Volume 86, Number 4, July-August 2006

DTIC Science & Technology

2006-08-01

center ( TOc ) and an opportunity to synchronize operations, usually drew only token Iraqi attendance. To their credit, the Iraqis almost always made...a TOC shift of 15 officers and soldiers while his Iraqi counterpart typically has 2 radio opera- tors and a cell phone to call the commander. Iraqi... TOc by demanding the same level of information from them that he expects from his own TOc . In spite of these disparities, in less than one year the

[Osteomyelitis due to Yokenella regensburgei following craniotomy in an immunocompetent patient].

PubMed

Penagos, Sara Catalina; Gómez, Sebastián; Villa, Pablo; Estrada, Santiago; Agudelo, Carlos Andrés

2015-01-01

The gram-negative bacillus Yokenella regensburgei (of the Enterobacteriaceae family) can be found in groundwater and foodstuffs, as well as the digestive tracts of insects and reptiles. Although it has been isolated from humans since its original description, it has rarely been reported as a cause of infection, and then, only in immunosuppressed patients. We report the first case of post-surgical secondary osteomyelitis due to Y. regensburgei in an immunocompetent woman who had undergone a craniotomy.

Osteomyelitis Treatment with Nanometer-Sized Hydroxyapatite Particles as a Delivery Vehicle for a Ciprofloxacin- Bisphosphonate Conjugate; New Fluoroquinolone-Bisphosphonate Derivatives Show Similar Binding Affinity to Hydroxyapatite and Improved Antibacterial Activity Against Drug-Resistant Pathogens

DTIC Science & Technology

2008-12-01

1 OSTEOMYELITIS TREATMENT WITH NANOMETER-SIZED HYDROXYAPATITE PARTICLES AS A DELIVERY VEHICLE FOR A CIPROFLOXACIN- BISPHOSPHONATE CONJUGATE; NEW...FLUOROQUINOLONE-BISPHOSPHONATE DERIVATIVES SHOW SIMILAR BINDING AFFINITY TO HYDROXYAPATITE AND IMPROVED ANTIBACTERIAL ACTIVITY AGAINST DRUG-RESISTANT...vivo OM model. Current studies contrast two CP homeostatic bone-substitute particles, nanometer-sized hydroxyapatite NanOss™ (Nan), and µ-sized

[Osteomyelitis and papillary renal adenoma in a red panda (Ailurus fulgens fulgens)].

PubMed

Kummerfeld, M; Knieriem, A; Wohlsein, P

2008-11-01

A 13 year-old female Red Panda (Ailurus fulgens fulgens) kept in a zoological garden was euthanatized due to poor general condition. Pathological examination revealed a chronic bacterial ulcerative to necrotizing dermatitis and osteomyelitis at the lower jaw with subsequent pyogranulomatous pneumonia and diffuse hydropic degeneration of the liver. Additionally, in the kidney a papillary renal adenoma was found. Immunohistochemistry revealed an expression of cytokeratins 8 and/or 19 indicating an origin from the renal tubular epithelium.

Pubic Bone Osteomyelitis after Salvage High-Intensity Focused Ultrasound for Prostate Cancer

PubMed Central

Robison, Christopher M.; Gor, Ronak A.; Metro, Michael J.

2014-01-01

High-intensity focused ultrasound can be used for the primary treatment of prostate cancer and biochemical recurrence after radical prostatectomy or radiation. Complications of high-intensity focused ultrasound include urinary retention, urethral stenosis, stress incontinence, urinary tract infections, dysuria, impotence, and rarely, rectourethral or rectovesicular fistula. We describe a patient presenting with urinary retention, urinary tract infections and intermittent stress incontinence, later found to be associated with pubic bone osteomyelitis stemming from a prostatopubic fistula. PMID:24917777

Actinomycotic osteomyelitis of the cranial vault presenting with headache: an unusual presentation.

PubMed

Roopesh Kumar, V R; Madhugiri, Venkatesh S; Gundamaneni, Sudheer Kumar; Verma, Surendra Kumar

2014-11-24

A case of left parietal calvarial actinomycotic osteomyelitis in a young woman is described. She had no predisposing illnesses. She had delivered a live child at term and presented in the puerperal period. No extracranial focus of infection was identified. She responded well to a combination of surgery and medical therapy and had an excellent outcome. The authors emphasise the importance of establishing a histopathological diagnosis since radiological signs are non-specific and unreliable. 2014 BMJ Publishing Group Ltd.

The use of newly developed real-time PCR for the rapid identification of bacteria in culture-negative osteomyelitis.

PubMed

Kobayashi, Naomi; Bauer, Thomas W; Sakai, Hiroshige; Togawa, Daisuke; Lieberman, Isador H; Fujishiro, Takaaki; Procop, Gary W

2006-12-01

We report a case of a culture-negative osteomyelitis in which our newly developed real-time polymerase chain reaction (PCR) could differentiate Staphylococcus aureus from Staphylococcus epidermidis. This is the first report that described the application of this novel assay to an orthopedics clinical sample. This assay may be useful for other clinical culture-negative cases in a combination with a broad-spectrum assay as a rapid microorganism identification method.

Unique Case of Disseminated Plague With Multifocal Osteomyelitis.

PubMed

Tovar Padua, Leidy; Kamali, Amanda; Kim, Hannah; Green, Nicole M; Civen, Rachel; Schwartz, Benjamin; Krogstad, Paul; Deville, Jaime; Yeganeh, Nava; Lugo, Debra; Baker, Amira; Soni, Priya; Cho, Catherine; Svircic, Natalia; Dry, Sarah; Seeger, Leanne; Lloyd, Jessica; Deukmedjian, Grace; Bowen, Richard; Hale, Gillian; Zaki, Sherif R; Mead, Paul; Nielsen-Saines, Karin

2017-09-01

Plague is a disease caused by Yersinia pestis. Septicemic and pneumonic plague have a high mortality rate if untreated. Here we describe the challenges of accurately diagnosing a nonfatal pediatric case of septicemic plague with involvement of multiple organs; to our knowledge, the first documented case of multifocal plague osteomyelitis. © The Author 2017. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Application of response surface methodology for optimization of natural organic matter degradation by UV/H2O2 advanced oxidation process

PubMed Central

2014-01-01

Background In this research, the removal of natural organic matter from aqueous solutions using advanced oxidation processes (UV/H2O2) was evaluated. Therefore, the response surface methodology and Box-Behnken design matrix were employed to design the experiments and to determine the optimal conditions. The effects of various parameters such as initial concentration of H2O2 (100–180 mg/L), pH (3–11), time (10–30 min) and initial total organic carbon (TOC) concentration (4–10 mg/L) were studied. Results Analysis of variance (ANOVA), revealed a good agreement between experimental data and proposed quadratic polynomial model (R2 = 0.98). Experimental results showed that with increasing H2O2 concentration, time and decreasing in initial TOC concentration, TOC removal efficiency was increased. Neutral and nearly acidic pH values also improved the TOC removal. Accordingly, the TOC removal efficiency of 78.02% in terms of the independent variables including H2O2 concentration (100 mg/L), pH (6.12), time (22.42 min) and initial TOC concentration (4 mg/L) were optimized. Further confirmation tests under optimal conditions showed a 76.50% of TOC removal and confirmed that the model is accordance with the experiments. In addition TOC removal for natural water based on response surface methodology optimum condition was 62.15%. Conclusions This study showed that response surface methodology based on Box-Behnken method is a useful tool for optimizing the operating parameters for TOC removal using UV/H2O2 process. PMID:24735555

Estimating Global Seafloor Total Organic Carbon Using a Machine Learning Technique and Its Relevance to Methane Hydrates

NASA Astrophysics Data System (ADS)

Lee, T. R.; Wood, W. T.; Dale, J.

2017-12-01

Empirical and theoretical models of sub-seafloor organic matter transformation, degradation and methanogenesis require estimates of initial seafloor total organic carbon (TOC). This subsurface methane, under the appropriate geophysical and geochemical conditions may manifest as methane hydrate deposits. Despite the importance of seafloor TOC, actual observations of TOC in the world's oceans are sparse and large regions of the seafloor yet remain unmeasured. To provide an estimate in areas where observations are limited or non-existent, we have implemented interpolation techniques that rely on existing data sets. Recent geospatial analyses have provided accurate accounts of global geophysical and geochemical properties (e.g. crustal heat flow, seafloor biomass, porosity) through machine learning interpolation techniques. These techniques find correlations between the desired quantity (in this case TOC) and other quantities (predictors, e.g. bathymetry, distance from coast, etc.) that are more widely known. Predictions (with uncertainties) of seafloor TOC in regions lacking direct observations are made based on the correlations. Global distribution of seafloor TOC at 1 x 1 arc-degree resolution was estimated from a dataset of seafloor TOC compiled by Seiter et al. [2004] and a non-parametric (i.e. data-driven) machine learning algorithm, specifically k-nearest neighbors (KNN). Built-in predictor selection and a ten-fold validation technique generated statistically optimal estimates of seafloor TOC and uncertainties. In addition, inexperience was estimated. Inexperience is effectively the distance in parameter space to the single nearest neighbor, and it indicates geographic locations where future data collection would most benefit prediction accuracy. These improved geospatial estimates of TOC in data deficient areas will provide new constraints on methane production and subsequent methane hydrate accumulation.

Seismic based characterization of total organic content from the marine Sembar shale, Lower Indus Basin, Pakistan

NASA Astrophysics Data System (ADS)

Aziz, Omer; Hussain, Tahir; Ullah, Matee; Bhatti, Asher Samuel; Ali, Aamir

2018-02-01

The exploration and production of unconventional resources has increased significantly over the past few years around the globe to fulfill growing energy demands. Hydrocarbon potential of these unconventional petroleum systems depends on the presence of significant organic matter; their thermal maturity and the quality of present hydrocarbons i.e. gas or oil shale. In this work, we present a workflow for estimating Total Organic Content (TOC) from seismic reflection data. To achieve the objective of this study, we have chosen a classic potential candidate for exploration of unconventional reserves, the shale of the Sembar Formation, Lower Indus Basin, Pakistan. Our method includes the estimation of TOC from the well data using the Passey's ΔlogR and Schwarzkofp's methods. From seismic data, maps of Relative Acoustic Impedance (RAI) are extracted at maximum and minimum TOC zones within the Sembar Formation. A geostatistical trend with good correlation coefficient (R2) for cross-plots between TOC and RAI at well locations is used for estimation of seismic based TOC at the reservoir scale. Our results suggest a good calibration of TOC values from seismic at well locations. The estimated TOC values range from 1 to 4% showing that the shale of the Sembar Formation lies in the range of good to excellent unconventional oil/gas play within the context of TOC. This methodology of source rock evaluation provides a spatial distribution of TOC at the reservoir scale as compared to the conventional distribution generated from samples collected over sparse wells. The approach presented in this work has wider applications for source rock evaluation in other similar petroliferous basins worldwide.

Influence of organic carbon on estuarine benthic infauna of the US west coast

EPA Science Inventory

Total organic carbon (TOC) is often used as an indicator of eutrophication in estuarine environments. However, the determination of biologically relevant sediment TOC criteria to indicate estuarine condition is complicated by the relationship between TOC and grain size. Both va...

α- tocopherol’s location in membranes is not affected by their composition

DOE PAGES

Marquardt, Drew; Kucerka, Norbert; Katsaras, John; ...

2014-10-15

To this day, α-tocopherol's (aToc) role in humans is not well known. In previous studies, we have tried to connect aToc's biological function with its location in a-lipid bilayer. In the present study, we have determined, by means of small-angle neutron diffraction, that not only is aToc's hydroxyl group located high in the membrane but its tail also resides far from the center of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) bilayers. In addition, we located aToc's hydroxyl group above the lipid backbone in 1-palmitoyl-2-oleoyl- sn-glycero-3-phosphoethanolamine (POPE), 1-palmitoyl-2-oleoyl- sn-glycero-3-phospho-L-serine (POPS), and Sphingomyelin bilayers, suggesting that aToc's location near the lipid water interface may be amore » universal property of vitamin E. Lastly, in light of these data, how aToc efficiently terminates lipid hydroperoxy radicals at the membrane center remains an open question.« less

Advanced oxidation treatment of pulp mill effluent for TOC and toxicity removals.

PubMed

Catalkaya, Ebru Cokay; Kargi, Fikret

2008-05-01

Pulp mill effluent was treated by different advanced oxidation processes (AOPs) consisting of UV, UV/H2O2, TiO2-assisted photo-catalysis (UV/TiO2) and UV/H2O2/TiO2 in lab-scale reactors for total organic carbon (TOC) and toxicity removals. Effects of some operating parameters such as the initial pH, oxidant and catalyst concentrations on TOC and toxicity removals were investigated. Almost every method resulted in some degree of TOC and toxicity removal from the pulp mill effluent. However, the TiO2-assisted photo-catalysis (UV/TiO2) resulted in the highest TOC and toxicity removals under alkaline conditions when compared with the other AOPs tested. Approximately, 79.6% TOC and 94% toxicity removals were obtained by the TiO2-assisted photo-catalysis (UV/TiO2) with a titanium dioxide concentration of 0.75gl(-1) at pH 11 within 60min.

Aircraft Control Using Engine Thrust: A History of Learning TOC Real-Time

NASA Technical Reports Server (NTRS)

Cole, Jennifer H.; Batteas, Frank; Fullerton, Gordon

2006-01-01

A history of learning the operation of Throttles Only Control (TOC) to control an aircraft in real time using engine thrust is shown. The topics include: 1) Past TOC Accidents/Incidents; 2) 1972: DC-10 American Airlines; 3) May 1974: USAF B-52H; 4) April 1975: USAF C-5A; 5) April 1975: USAF C-5A; 6) 1981: USAF B-52G; 7) August 1985: JAL 123 B-747; 8) JAL 123 Survivor Story; 9) JAL 123 Investigation Findings; 10) July 1989: UAL 232 DC-10; 11) UAL 232 DC-10; 12) Eastwind 517 B-737; 13) November 2003: DHL A-300; 14) Historically, TOC has saved lives; 15) Automated Throttles-Only Control; 16) PCA Project; 17) Propulsion-Controlled Aircraft; 18) MD-11 PCA System and Flight Test Envelope; 19) MD-11 Simulation, PCA ILS-Soupled Landing Dispersion; 20) Throttles-Only Pitch and Roll Control Power; 21) PCA in Commercial Fleet; 22) Fall 2005: PCAR Project; 23) PCAR Background - TOC; and 24) PCAR Background - TOC.

Engagement of stakeholders in the development of a Theory of Change for handwashing and sanitation behaviour change.

PubMed

De Buck, Emmy; Hannes, Karin; Cargo, Margaret; Van Remoortel, Hans; Vande Veegaete, Axel; Mosler, Hans-Joachim; Govender, Thashlin; Vandekerckhove, Philippe; Young, Taryn

2018-02-01

A Theory of Change (ToC) is an approach to map programmes aimed at inducing change in a specific context, with the goal of increasing their impact. We applied this approach to the specific case of handwashing and sanitation practices in low- and middle-income countries and developed a ToC as part of a systematic review exercise. Different existing sources of information were used to inform the initial draft of the ToC. In addition, stakeholder involvement occurred and peer review took place. Our stakeholders included methodological (ToC/quantitative and qualitative research) and content experts (WASH (Water, Sanitation, Hygiene)/behaviour change), as well as end-users/practitioners, policy-makers and donors. In conclusion, the development of a ToC, and the involvement of stakeholders in its development, was critical in terms of understanding the context in which the promotional programmes are being implemented. We recommend ToC developers to work with stakeholders to create a ToC relevant for practice.

Mercury speciation and total organic carbon in marine sediments along the Mediterranean coast of Israel.

PubMed

Shoham-Frider, Efrat; Azran, Shlomi; Kress, Nurit

2012-11-01

Along the Israeli Mediterranean Coast, three areas are considered "hot spots" of mercury (Hg) pollution: (1) Northern Haifa Bay (NHB), (2) the lower Qishon River at the southern part of Haifa Bay, and (3) a marine outfall of activated sewage sludge at the southern coast off Palmachim (sewage-sludge disposal site [SDS]). Even though the total Hg (HgT) concentrations in the sediments at the three areas are of the same order of magnitude (250-500 μg kg(-1)), Hg was shown to bioaccumulate in fish and benthic fauna from Haifa Bay but not in benthic fauna or in commercial fish caught along the southern Mediterranean Coast of Israel near the SDS outfall. The primary goal of this study was to measure the concentrations of Hg species (HgT, methyl-Hg [MeHg], and Hg in different biogeochemical fractions)-in conjunction with organic carbon-in sediments of NHB and the lower Qishon River to assess its impact on Hg transitions among the species as characterized by different bioavailability and bioaccessibility. HgT concentrations in NHB and the Qishon River ranged from 249 to 347 and 165 to 667 μg kg(-1), respectively. MeHg was significantly higher in the Qishon River (6.3-34.0 μg kg(-1)) than in NHB (0.22-0.70 μg kg(-1)) as were total organic carbon (TOC) concentrations (average 2.5 vs. 0.13 %). The relative Hg distribution in the biogeochemical fractions in NHB was 2.3 % in the most bioaccessible fractions (F1 + F2), 55 % in the organo-chelated species fraction (F3), 42 % in the strong-complexed species fraction (F4), and 0.7 % in the mercuric-sulfide fraction (F5). In the Qishon River, the bioavailable F1 + F2 and F3 fractions were lower than in NHB (<0.01 and 23 %, respectively) and the more refractory F4 and F5 fractions higher (73 and 3.3 %, respectively). The fractionation of Hg in Qishon River sediments was similar to the distribution found in polluted stations at the SDS. TOC and MeHg were positively and negatively correlated, respectively, in Qishon River and NHB sediments. Methylation depended on TOC availability when its concentration was in the range of 2-4 wt%. It is possible that TOC in the sediment controlled Hg speciation: Hg in F3 decreased and in F4 increased with increasing TOC concentrations. In contrast, MeHg/HgT was significantly positively correlated with TOC and Hg in the stable F4 fraction and negatively correlated with Hg in the F3 fraction. It was therefore assumed that higher TOC concentrations enhanced microbial activity and decomposition of organic matter. Hg was released from the F3 fraction and was either transferred to the F4 fraction or made available for methylation processes.

Hypertrophic Cranial Pachymeningitis and Skull Base Osteomyelitis by Pseudomonas Aeruginosa: Case Report and Review of the Literature

PubMed Central

Caldas, Ana Rita; Brandao, Mariana; Paula, Filipe Seguro; Castro, Elsa; Farinha, Fatima; Marinho, Antonio

2012-01-01

Hypertrophic cranial pachymeningitis (HCP) is an uncommon disorder characterized by localized or diffuse thickening of the dura mater, and it usually presents with multiple cranial neurophaties. It has been associated with a variety of inflammatory, infectious, traumatic, toxic and neoplasic diseases, when no specific cause is found the process is called idiopathic. The infectious cases occur in patients under systemic immunosuppression, which have an evident contiguous source or those who have undergone neurosurgical procedures. We describe a case of a 62-year-old immunosuppressed woman with diabetes and rheumatoid arthritis, which had HCP and osteomyelitis of the skull base caused by pseudomonas aeruginosa, presenting with headache and diplopia. We believe this is the second documented case of pachymeningitis secondary to this microorganism. As a multifactorial disease, it is essencial to determine the specific causative agent of HCP before making treatment decisions, and great care is needed with immunocompromised patients. Keywords Pseudomonas aeruginosa; Hypertrophic pachymeningitis; Ophtalmoplegia, optical neuropathy; Osteomyelitis; Skull base PMID:22505989

An unusual osteomyelitis caused by Moraxella osloensis: A case report.

PubMed

Alkhatib, Nidal J; Younis, Manaf H; Alobaidi, Ahmad S; Shaath, Nebal M

2017-01-01

Moraxella osloensis is a gram-negative coccobacillus, that is saprophytic on skin and mucosa, and rarely causing human infections. Reported cases of human infections usually occur in immunocompromised patients. We report the second case of M. osloensis-caused-osteomyelitis in literature, occurring in a young healthy man. The organism was identified by sequencing analysis of the 16S ribosomal RNA gene. Our patient was treated successfully with surgical debridement and intravenous third-generation cephalosporins. M. osloensis has been rarely reported to cause local or invasive infections. Our case report is the second case in literature and it is different from the previously reported case in that our patient has no chronic medical problems, no history of trauma, with unique presentation and features on the MRI and intraoperative finding. Proper diagnosis is essential for appropriate treatment of osteomyelitis. RNA gene sequence analysis is the primary method of M. osloensis diagnosis. M. osloensis is usually susceptible to simple antibiotics. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Mandibular pseudocarcinomatous hyperplasia.

PubMed

Warter, A; Walter, P; Meyer, C; Barrière, P; Galatir, L; Wilk, A

2000-08-01

Three unusual cases of pseudocarcinomatous (pseudoepitheliomatous) hyperplasia (PH) affecting chronic osteomyelitic mandibular sequestra are reported to highlight the differences with the various squamous neoplasms which occur in that site. In two patients carrying a mandibular graft following the excision of an ameloblastoma, mucosal ulcers resulted in chronic osteomyelitis. In a third patient, an apical dental infection was associated with fistulated osteomyelitis. Histology of the three sequestra showed an intraosseous squamous proliferation. It was characterized by a peripheral involvement of medullary spaces, the more mature epithelial layer covering the bone trabeculae without intervening stroma, and the basal type epithelial layer surrounding a central fibrovascular core. There were no histological or cytological signs of malignancy. PH shows an inverted pattern when compared with the centro-medullary tumoural islands seen in the various oral or odontogenic squamous neoplasms which occur in the jaws. The lack of signs of malignancy distinguish PH from common squamous cell carcinomas. A short clinical course is an important feature in the distinction of PH from the well differentiated squamous cell carcinomas which may develop in fistulated chronic osteomyelitis.

A multi-disciplinary approach to the management of fungal osteomyelitis: current concepts in post-traumatic lower extremity reconstruction: a case report.

PubMed

Cetrulo, Curtis L; Leto Barone, Angelo A; Jordan, Kathleen; Chang, David S; Louie, Kevin; Buntic, Rudolf F; Brooks, Darrell

2012-02-01

Limb salvage in fungal osteomyelitis of the post-traumatic lower extremity represents a difficult clinical problem requiring aggressive management. We report lower extremity salvage by radical bony debridement, free tissue transfer, distraction osteogenesis with bone-docking, and a novel antifungal regimen in a clinical setting of infection with Scedosporium inflatum, historically requiring amputation in 100% of cases. We treated Scedosporium inflatum osteomyelitis of the tibia and calcaneus with radical debridement of infected bone, free partial medial rectus abdominis muscle flap coverage, transport distraction osteogenesis, and combination voriconazole/terbinafine chemotherapy, a novel antifungal regimen. We achieved successful control of the infection, limb salvage, and an excellent functional outcome through aggressive debridement of infected bone and soft tissue, elimination of dead space within the bony defect, the robust perfusion provided by the free flap, the hypervascular state induced by distraction osteogenesis, and the synergism of the novel antifungal regimen.

Malignant transformation in chronic osteomyelitis: recognition and principles of management.

PubMed

Panteli, Michalis; Puttaswamaiah, Ravindra; Lowenberg, David W; Giannoudis, Peter V

2014-09-01

Malignant transformation as a result of chronic osteomyelitis represents a relatively rare and late complication with a declining incidence in the modern world. For most patients, the interval between the occurrence of the original bacterial infection and the transformation to malignant degeneration is several years. The diagnosis of malignant transformation in a chronic discharging sinus requires a high index of clinical suspicion. Wound biopsies should be obtained early, especially with the onset of new clinical signs such as increased pain, a foul smell, and changes in wound drainage. Squamous cell carcinoma is the most common presenting malignancy. Definitive treatment is amputation proximal to the tumor or wide local excision, combined with adjuvant chemotherapy and radiation therapy in selected patients. Early diagnosis may sometimes allow for treatment consisting of en bloc excision and limb salvage techniques. However, the most effective treatment is prevention with definitive treatment of the osteomyelitis, including adequate débridement, wide excision of the affected area, and early reconstruction. Copyright 2014 by the American Academy of Orthopaedic Surgeons.

Influence of sediment organic carbon on estuarine benthic species of the US West Coast

EPA Science Inventory

Total organic carbon (TOC) is often used as an indicator of nutrient enrichment in estuarine environments. However, the determination of biologically relevant TOC criteria to indicate sediment quality is complicated by the relationship between TOC and grain size. Both variables...

Influence of organic carbon on estuarine benthic infauna of the US west coast - March 3

EPA Science Inventory

Total organic carbon (TOC) is often used as an indicator of nutrient enrichment in estuarine environments. However, the determination of biologically relevant TOC criteria to indicate sediment condition is complicated by the relationship between TOC and grain size. Both variabl...

Soft drink wastewater treatment by electrocoagulation-electrooxidation processes.

PubMed

Linares Hernández, Ivonne; Barrera Díaz, Carlos; Valdés Cerecero, Mario; Almazán Sánchez, Perla Tatiana; Castañeda Juárez, Monserrat; Lugo Lugo, Violeta

2017-02-01

The aim of this work was to implement a coupled system, a monopolar Electrocoagulation (EC)-Electrooxidation (EO) processes, for the treatment of soft drink wastewater. For the EC test, Cu-Cu, anode-cathode were used at current densities of 17, 51 and 68 mA cm -2 . Only 37.67% of chemical oxygen demand (COD) and 27% of total organic carbon (TOC) were removed at 20 min with an optimum pH of 8, this low efficiency can be associated with the high concentration of inorganic ions which inhibit the oxidation of organic matter due to their complexation with copper ions. Later EO treatment was performed with boron-doped diamond-Cu electrodes and a current density of 30 Am -2 . The coupled EC-EO system was efficient to reduce organic pollutants from initial values of 1875 mg L -1 TOC and 4300 mg L -1 COD, the removal efficiencies were 75% and 85%, respectively. Electric energy consumption to degrade a kilogram of a pollutant in the soft drink wastewater using EC was 3.19 kWh kg -1 TOC and 6.66 kWh kg -1 COD. It was concluded that the coupled system EC-EO was effective for the soft drink wastewater treatment, reducing operating costs and residence time, and allowing its reuse in indirect contact with humans, thus contributing to the sustainable reuse as an effluent of industrial wastewater.

Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis.

PubMed

Wang, Yicun; Jiang, Hui; Deng, Zhantao; Jin, Jiewen; Meng, Jia; Wang, Jun; Zhao, Jianning; Sun, Guojing; Qian, Hongbo

2017-01-01

To compare the salvage rate and complication between internal fixation and external fixation in patients with small bone defects caused by chronic infectious osteomyelitis debridement. 125 patients with chronic infectious osteomyelitis of tibia fracture who underwent multiple irrigation, debridement procedure, and local/systemic antibiotics were enrolled. Bone defects, which were less than 4 cm, were treated with bone grafting using either internal fixation or monolateral external fixation. 12-month follow-up was conducted with an interval of 3 months to evaluate union of bone defect. Patients who underwent monolateral external fixation had higher body mass index and fasting blood glucose, longer time since injury, and larger bone defect compared with internal fixation. No significant difference was observed in incidence of complications (23.5% versus 19.3%), surgery time (156 ± 23 minutes versus 162 ± 21 minutes), and time to union (11.1 ± 3.0 months versus 10.9 ± 3.1 months) between external fixation and internal fixation. Internal fixation had no significant influence on the occurrence of postoperation complications after multivariate adjustment when compared with external fixation. Furthermore, patients who underwent internal fixation experienced higher level of daily living scales and lower level of anxiety. It was relatively safe to use internal fixation for stabilization in osteomyelitis patients whose bone defects were less than 4 cm and infection was well controlled.

[Diabetic foot osteomyelitis: is conservative treatment possible?].

PubMed

Jordano-Montañez, Queralt; Muñiz-Tatay, Montse; Viadé-Julià, Jordi; Jaen-Manzanera, Angeles; Royo-Serrando, Josep; Cuchí-Burgos, Eva; Anglada-Barceló, Jordi; de la Sierra-Iserte, Alejandro

2014-11-01

The aim of the present study is to determine the proportion of foot ulcers, complicated by osteomyelitis in diabetic patients, that heal without amputation. Furthermore, an attempt is made to analyze the main clinical and microbiological characteristics of episodes, and to identify potential predictive factors leading to the failure of conservative treatment. A prospective observational study was carried out between 2007 and 2009 on diabetic patients with a foot lesion and attending a diabetic foot clinic. A percutaneous bone biopsy was required to be included in the study. A total of 81 episodes of diabetic foot osteomyelitis in 64 patients were evaluated. Staphylococcus aureus (28/81) and coagulase negative Staphylococcus (22/81) were the most frequent organisms isolated. Among the gramnegative group (34/81), non-fermenting gram negative bacteria were the most prevalent organisms isolated (14/81). Conservative treatment was successful in 73% of episodes. After a logistic regression analysis using the most significant prognostic variables, only lesion size greater than 2cm independently predicted failure of conservative treatment. Culture guided antibiotic treatment was associated with a better prognosis. Conservative treatment, including culture-guided antibiotics, is successful without amputation in a large proportion of diabetic patients with diabetic foot osteomyelitis. Considering empiric therapy directed at non-fermenting gramnegative bacteria could be advisable in some cases, because they are frequently isolated in our setting. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Antimicrobial photodynamic therapy in chronic osteomyelitis induced by Staphylococcus aureus: An in vitro and in vivo study

NASA Astrophysics Data System (ADS)

dos Reis Júnior, João Alves; de Assis, Patrícia Nascimento; Paraguassú, Gardênia Matos; de Vieira de Castro, Isabele Cardoso; Trindade, Renan Ferreira; Marques, Aparecida Maria Cordeiro; Almeida, Paulo Fernando; Pinheiro, Antônio Luiz Barbosa

2012-09-01

Osteomyelitis it is an acute or chronic inflammation in the marrow spaces in the superficial or cortical bone, and associated to bacterial infection. Chronic osteomyelitis represents a major health problem due to its difficult treatment and increased morbidity. Antimicrobial photodynamic therapy (APT) by laser is a treatment based on a cytotoxic photochemical reaction in which, a bright light produced by a laser system and an active photosensitizer absorbed by cells leads an activation that induces a series of metabolic reactions that culminates a bacterial killing. The aim of this study was to assess, both in vitro and in vivo, the effect of lethal laser photosensitization on osteomyelitis. On the in vitro study a diode laser (λ660nm; 40mW; o/ = 0.4 cm2; 5 or 10 J/cm2) and 5, 10 and 15μg/mL toluidine blue (TB) were tested and the best parameter chosen for the in vivo study. The concentration of 5μg/mL was selected to perform the decontamination of infected by Staphylococcus aureus tibial bone defects in rats. The results were performed by ANOVA test. On the in vitro studies all PDTs groups in the different concentrations reduced significantly (p<0,001) the amount of bacteria. On the in vivo study PDT group presented a bacterial reduction of 97,4% (P<0,001). The photodynamic therapy using toluidine blue was effective in reducing the staphiloccocus aureus in both in vitro and in vivo studies.

Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis

PubMed Central

Wang, Yicun; Jiang, Hui; Deng, Zhantao; Meng, Jia; Wang, Jun

2017-01-01

Background To compare the salvage rate and complication between internal fixation and external fixation in patients with small bone defects caused by chronic infectious osteomyelitis debridement. Methods 125 patients with chronic infectious osteomyelitis of tibia fracture who underwent multiple irrigation, debridement procedure, and local/systemic antibiotics were enrolled. Bone defects, which were less than 4 cm, were treated with bone grafting using either internal fixation or monolateral external fixation. 12-month follow-up was conducted with an interval of 3 months to evaluate union of bone defect. Results Patients who underwent monolateral external fixation had higher body mass index and fasting blood glucose, longer time since injury, and larger bone defect compared with internal fixation. No significant difference was observed in incidence of complications (23.5% versus 19.3%), surgery time (156 ± 23 minutes versus 162 ± 21 minutes), and time to union (11.1 ± 3.0 months versus 10.9 ± 3.1 months) between external fixation and internal fixation. Internal fixation had no significant influence on the occurrence of postoperation complications after multivariate adjustment when compared with external fixation. Furthermore, patients who underwent internal fixation experienced higher level of daily living scales and lower level of anxiety. Conclusions It was relatively safe to use internal fixation for stabilization in osteomyelitis patients whose bone defects were less than 4 cm and infection was well controlled. PMID:29333448

A Comparative 68Ga-Citrate and 68Ga-Chloride PET/CT Imaging of Staphylococcus aureus Osteomyelitis in the Rat Tibia

PubMed Central

Lankinen, Petteri; Noponen, Tommi; Autio, Anu; Luoto, Pauliina; Löyttyniemi, Eliisa; Hakanen, Antti J.

2018-01-01

There may be some differences in the in vivo behavior of 68Ga-chloride and 68Ga-citrate leading to different accumulation profiles. This study compared 68Ga-citrate and 68Ga-chloride PET/CT imaging under standardized experimental models. Methods. Diffuse Staphylococcus aureus tibial osteomyelitis and uncomplicated bone healing rat models were used (n = 32). Two weeks after surgery, PET/CT imaging was performed on consecutive days using 68Ga-citrate or 68Ga-chloride, and tissue accumulation was confirmed by ex vivo analysis. In addition, peripheral quantitative computed tomography and conventional radiography were performed. Osteomyelitis was verified by microbiological analysis and specimens were also processed for histomorphometry. Results. In PET/CT imaging, the SUVmax of 68Ga-chloride and 68Ga-citrate in the osteomyelitic tibias (3.6 ± 1.4 and 4.7 ± 1.5, resp.) were significantly higher (P = 0.0019 and P = 0.0020, resp.) than in the uncomplicated bone healing (2.7 ± 0.44 and 2.5 ± 0.49, resp.). In osteomyelitic tibias, the SUVmax of 68Ga-citrate was significantly higher than the uptake of 68Ga-chloride (P = 0.0017). In animals with uncomplicated bone healing, no difference in the SUVmax of 68Ga-chloride or 68Ga-citrate was seen in the operated tibias. Conclusions. This study further corroborates the use of 68Ga-citrate for PET imaging of osteomyelitis. PMID:29681785

40 CFR 60.565 - Reporting and recordkeeping requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... emission control efficiency of a combustion device or the outlet concentration of TOC (minus methane and... performance test period, and (ii) The percent reduction of TOC (minus methane and ethane) achieved by the incinerator, the concentration of TOC (minus methane and ethane) (ppmv, by compound) at the outlet of the...

40 CFR 60.565 - Reporting and recordkeeping requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission control efficiency of a combustion device or the outlet concentration of TOC (minus methane and... performance test period, and (ii) The percent reduction of TOC (minus methane and ethane) achieved by the incinerator, the concentration of TOC (minus methane and ethane) (ppmv, by compound) at the outlet of the...

40 CFR 60.565 - Reporting and recordkeeping requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission control efficiency of a combustion device or the outlet concentration of TOC (minus methane and... performance test period, and (ii) The percent reduction of TOC (minus methane and ethane) achieved by the incinerator, the concentration of TOC (minus methane and ethane) (ppmv, by compound) at the outlet of the...

40 CFR 60.565 - Reporting and recordkeeping requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission control efficiency of a combustion device or the outlet concentration of TOC (minus methane and... performance test period, and (ii) The percent reduction of TOC (minus methane and ethane) achieved by the incinerator, the concentration of TOC (minus methane and ethane) (ppmv, by compound) at the outlet of the...

40 CFR 60.565 - Reporting and recordkeeping requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... emission control efficiency of a combustion device or the outlet concentration of TOC (minus methane and... performance test period, and (ii) The percent reduction of TOC (minus methane and ethane) achieved by the incinerator, the concentration of TOC (minus methane and ethane) (ppmv, by compound) at the outlet of the...

Influence of organic carbon on estuarine benthic infauna of the US west coast - March 3, 2011

EPA Science Inventory

Total organic carbon (TOC) is often used as an indicator of eutrophication in estuarine environments. However, the determination of biologically relevant sediment TOC criteria to indicate estuarine condition is complicated by the relationship between TOC and grain size. Both va...

TOC as a regional sediment conditionindicator: Parsing effects of grain size and organic content

EPA Science Inventory

TOC content of sediments is often used as an indicator of benthic condition. Percent TOC is generally positively correlated with sediment percent fines. While sediment grain size may have impacts on benthic organisms independent of organic content, it is often not explicitly co...

TOC as a regional sediment condition indicator: Parsing effects of grain size and organic content

EPA Science Inventory

TOC content of sediments is often used as an indicator of benthic condition. Percent TOC is generally positively correlated with sediment percent fines. While sediment grain size may have impacts on benthic organisms independent of organic content, it is often not explicitly co...

40 CFR 63.1326 - Batch process vents-recordkeeping provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... single highest-HAP recipe. (3) Total annual uncontrolled TOC or organic HAP emissions, determined at the...): (i) For an incinerator or non-combustion control device, the percent reduction of organic HAP or TOC... percent reduction of organic HAP or TOC achieved, as determined using the procedures specified in § 63...

40 CFR 141.132 - Monitoring requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... H system serving at least 10,000 persons which has a source water annual average TOC level, before.... Subpart H system serving from 500 to 9,999 persons which has a source water annual average TOC level... monitoring. (iii) Monitoring requirements for source water TOC. In order to qualify for reduced monitoring...

40 CFR 60.701 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... provided by the primary fuel. Total organic compounds or TOC means those compounds measured according to...), and TOC concentration as required in § 60.705(b)(4) and § 60.705(f)(4), those compounds which the... per unit reduction of TOC associated with a vent stream from an affected reactor process facility...

40 CFR 63.1104 - Process vents from continuous unit operations: applicability assessment procedures and methods.

Code of Federal Regulations, 2010 CFR

2010-07-01

... accordance with the applicable weight-percent, TOC concentration, or organic HAP concentration requirement in... rate, regulated organic HAP concentration, total organic HAP or TOC concentration, heating value, and... volumetric flow rate, regulated organic HAP concentration, total organic HAP or TOC concentration, and any...

40 CFR 141.134 - Reporting and recordkeeping requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... quarterly for TOC under the requirements of § 141.132(d) and required to meet the enhanced coagulation or... period that paired samples were taken, the arithmetic average of the percent reduction of TOC for each paired sample and the required TOC percent removal. (iv) Calculations for determining compliance with the...

Spectroelectrochemical Instrument Measures TOC

NASA Technical Reports Server (NTRS)

Kounaves, Sam

2011-01-01

A spectroelectrochemical instrument has been developed for measuring the total organic carbon (TOC) content of an aqueous solution. Measurements of TOC are frequently performed in environmental, clinical, and industrial settings. Until now, techniques for performing such measurements have included, various ly, the use of hazardous reagents, ultraviolet light, or ovens, to promote reactions in which the carbon contents are oxidized. The instrument now being developed is intended to be a safer, more economical means of oxidizing organic carbon and determining the TOC levels of aqueous solutions and for providing a low power/mass unit for use in planetary missions.

Centennial-scale records of total organic carbon in sediment cores from the South Yellow Sea, China

NASA Astrophysics Data System (ADS)

Zhu, Qing; Lin, Jia; Hong, Yuehui; Yuan, Lirong; Liu, Jinzhong; Xu, Xiaoming; Wang, Jianghai

2018-01-01

Global carbon cycling is a significant factor that controls climate change. The centennial-scale variations in total organic carbon (TOC) contents and its sources in marginal sea sediments may reflect the influence of human activities on global climate change. In this study, two fine-grained sediment cores from the Yellow Sea Cold Water Mass of the South Yellow Sea were used to systematically determine TOC contents and stable carbon isotope ratios. These results were combined with previous data of black carbon and 210Pb dating from which we reconstructed the centennial-scale initial sequences of TOC, terrigenous TOC (TOCter) and marine autogenous TOC (TOCmar) after selecting suitable models to correct the measured TOC (TOCcor). These sequences showed that the TOCter decreased with time in the both cores while the TOCmar increased, particularly the rapid growth in core H43 since the late 1960s. According to the correlation between the Huanghe (Yellow) River discharge and the TOCcor, TOCter, or TOCmar, we found that the TOCter in the two cores mainly derived from the Huanghe River and was transported by it, and that higher Huanghe River discharge could strengthen the decomposition of TOCmar. The newly obtained initial TOC sequences provide important insights into the interaction between human activities and natural processes.

Integration of Community Pharmacists in Transition of Care (TOC) Services: Current Trends and Pharmacist Perceptions.

PubMed

Zeleznikar, Elizabeth A; Kroehl, Miranda E; Perica, Katharine M; Thompson, Angela M; Trinkley, Katy E

2017-01-01

Barriers exist for patients transitioning from one health-care setting to another, or to home, and health-care systems are falling short of meeting patient needs during this time. Community pharmacist incorporation poses a solution to the current communication breakdown and high rates of medication errors during transitions of care (TOC). The purpose of this study was to determine community pharmacists' involvement in and perceptions of TOC services. Cross-sectional study using electronic surveys nationwide to pharmacists employed by a community pharmacy chain. Of 7236 pharmacists surveyed, 546 (7.5%) responded. Only 33 (6%) pharmacists reported their pharmacy participates in TOC services. Most pharmacists (81.5%) reported receiving discharge medication lists. The most common reported barrier to TOC participation is lack of electronic integration with surrounding hospitals (51.1%). Most pharmacists agreed that (1) it is valuable to receive discharge medication lists (83.3%), (2) receiving discharge medication lists is beneficial for patients' health (89.1%), (3) discharge medication list receipt improves medication safety (88.8%). Most pharmacists reported receiving discharge medication lists and reported discharge medication lists are beneficial, but less than half purposefully used medication lists. To close TOC gaps, health-care providers must collaborate to overcome barriers for successful TOC services.

Inter-Comparison of MODIS and VIIRS Vegetation Indices Using One-Year Global Data

NASA Astrophysics Data System (ADS)

Miura, T.; Muratsuchi, J.; Obata, K.; Kato, A.; Vargas, M.; Huete, A. R.

2016-12-01

The Visible Infrared Imaging Radiometer Suite (VIIRS) sensor series of the Joint Polar Satellite System program is slated to continue the highly calibrated data stream initiated with the Earth Observing System Moderate Resolution Imaging Spectroradiometer (MODIS) sensors. A number of geophysical products are being/to be produced from VIIRS data, including the "Top-of-the-Atmosphere (TOA)" Normalized Difference Vegetation Index (NDVI), "Top-of-Canopy (TOC)" Enhanced Vegetation Index (EVI), and TOC NDVI. In this study, we cross-compared vegetation indices (VIs) from the first VIIRS sensor aboard the Suomi National Polar-orbiting Partnership satellite with the Aqua MODIS counterparts using one-year global data. This study was aimed at developing a thorough understanding of radiometric compatibility between the two VI datasets across globe, seasons, a range of viewing angle, and land cover types. VIIRS and MODIS VI data of January-December 2015 were obtained at monthly intervals when their orbital tracks coincided. These data were projected and spatially-aggregated into a .0036-degree grid while screening for cloud and aerosol contaminations using their respective quality flags. VIIRS-MODIS observation pairs with near-identical sun-target-view angles were extracted from each of these monthly image pairs for cross-comparison. The four VIs of TOA NDVI, TOC NDVI, TOC EVI, and TOC EVI2 (a two-band version of the EVI) were analyzed. Between MODIS and VIIRS, TOA NDVI, TOC NDVI, and TOC EVI2 had very small overall mean differences (MD) of .014, .013, and .013 VI units, respectively, whereas TOC EVI had a slightly larger overall MD of 0.023 EVI units attributed to the disparate blue bands of the two sensors. These systematic differences were consistent across the one-year period. With respect to sun-target-viewing geometry, MDs were also consistent across the view zenith angle range, but always lower for forward- than backward-viewing geometry. MDs showed large land cover dependencies for TOA NDVI and TOC NDVI, varying 10 folds from .002 for forests to .02 for sparsely-vegetated areas. They were consistent across land cover types for TOC EVI and TOC EVI2. Future studies should address the impact of sun-target-view geometry on corss-sensor VI comparisons.

Lower extremity manifestations of "skin-popping" an illicit drug use technique: A report of two cases.

PubMed

Canales, Michael; Gerhard, John; Younce, Erin

2015-06-01

Presented is a rare case of tibial and fibular osteomyelitis and a case of fibular periositis, both a direct consequence of a peculiar drug use technique. The osseous manifestations secondary to presentation of necrotic wounds with indurated rim and serous drainage with associated cellulitis, both resulting from "skin popping." Due to the complex treatment plan required, the importance of a motivated patient, a strong social support system, a controlled environment, and a multidisciplinary team cannot be overstated. Despite comprehensive efforts, devastating consequences may be unavoidable as individuals plunge downward, victimized by their addiction. 4. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reconstruction of posterior neck and skull with vertical trapezius musculocutaneous flap

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mathes, S.J.; Stevenson, T.R.

1988-10-01

The vertical trapezius musculocutaneous flap has been successfully utilized for reconstruction in 13 patients with complex posterior skull and neck defects. This flap based on its vascular pedicle, the descending branch of the transverse cervical artery, provides well-vascularized tissue for coverage of defects related to chronic osteomyelitis, tumor extirpation, osteoradionecrosis, and dehisced cervical laminectomy wounds. Emphasis on flap design, including the location of the skin island, allows adequate wound coverage, direct donor site closure, and muscle function preservation. With its large size and wide arc of rotation, the vertical trapezius musculocutaneous flap provides reliable coverage for posterior trunk, cervical, andmore » skull defects.« less

Vancomycin incorporated chitosan/gelatin coatings coupled with TiO2-SrHAP surface modified cp-titanium for osteomyelitis treatment.

PubMed

D, Nancy; N, Rajendran

2018-04-15

Commercially pure Titanium (Cp-Ti) was electrophoretically modified using double layer coatings consisting of TiO 2 -SrHAP as the first layer (TH) followed by vancomycin incorporated Chitosan/Gelatin as the second layer (THV). The nano crystalline phase of coated Strontium incorporated hydroxyapatite (Sr-HAP) confirmed through X-ray diffraction studies (XRD). The polyelectrolyte complex formation between chitosan and gelatin, the stability of the drug, the bonding between chitosan and Sr-HAP were confirmed through infra-red spectroscopic studies (IR). The average roughness (R a ) value calculated from atomic force microscopy (AFM) corroborates with the water contact angle data, which clearly confirms the tuning property of the surface in relation to the surface energy and roughness of the coated samples. The total amount of vancomycin encapsulated was calculated to be 11.5 μg. Antibacterial activity was found against both Staphylococcus aureus strains methicillin resistant Staphylococcus aureus (MRSA) and methicillin sensitive Staphylococcus aureus (MRSA) for a drug concentration of 2.74 μg released after 12 h of immersion. The in-vitro cell culture studies showed enhanced cellular activity for THV samples. Thus, THV samples have a dual action at the surface, by resisting the bacterial adhesion and enhancing cellular interaction at the bio-interface, making it a promising candidate to treat osteomyelitis infection. Copyright © 2018. Published by Elsevier B.V.

Simulation of Shallow Cumuli and Their Transition to Deep Convective Clouds by Cloud-resolving Models with Different Third-order Turbulence Closures

NASA Technical Reports Server (NTRS)

Cheng, Anning; Xu, Kuan-Man

2006-01-01

The abilities of cloud-resolving models (CRMs) with the double-Gaussian based and the single-Gaussian based third-order closures (TOCs) to simulate the shallow cumuli and their transition to deep convective clouds are compared in this study. The single-Gaussian based TOC is fully prognostic (FP), while the double-Gaussian based TOC is partially prognostic (PP). The latter only predicts three important third-order moments while the former predicts all the thirdorder moments. A shallow cumulus case is simulated by single-column versions of the FP and PP TOC models. The PP TOC improves the simulation of shallow cumulus greatly over the FP TOC by producing more realistic cloud structures. Large differences between the FP and PP TOC simulations appear in the cloud layer of the second- and third-order moments, which are related mainly to the underestimate of the cloud height in the FP TOC simulation. Sensitivity experiments and analysis of probability density functions (PDFs) used in the TOCs show that both the turbulence-scale condensation and higher-order moments are important to realistic simulations of the boundary-layer shallow cumuli. A shallow to deep convective cloud transition case is also simulated by the 2-D versions of the FP and PP TOC models. Both CRMs can capture the transition from the shallow cumuli to deep convective clouds. The PP simulations produce more and deeper shallow cumuli than the FP simulations, but the FP simulations produce larger and wider convective clouds than the PP simulations. The temporal evolutions of cloud and precipitation are closely related to the turbulent transport, the cold pool and the cloud-scale circulation. The large amount of turbulent mixing associated with the shallow cumuli slows down the increase of the convective available potential energy and inhibits the early transition to deep convective clouds in the PP simulation. When the deep convective clouds fully develop and the precipitation is produced, the cold pools produced by the evaporation of the precipitation are not favorable to the formation of shallow cumuli.

Protective Effects of Vitamin E Analogs against Carbon Tetrachloride-Induced Fatty Liver in Rats

PubMed Central

Yachi, Rieko; Igarashi, Osamu; Kiyose, Chikako

2010-01-01

Recently, it has been reported that α-tocopherol (α-Toc) is effective for amelioration of liver damage. However, it is unknown whether other vitamin E analogs are effective. In this study, we investigated the effects of γ-tocopherol (γ-Toc) and tocotrienols (T3) in rats with fatty liver. Rats fed a vitamin E-deficient diet for four weeks were divided into eight groups: Control, carbon tetrachloride (CCl4), α-Toc, α-Toc + CCl4, γ-Toc, γ-Toc + CCl4, T3 mix, T3 mix + CCl4. After a 24 h fast, the rats were administered 20 mg of each of the vitamin E analogs, respectively. Moreover, the CCl4 group were given 0.5 ml/kg body weight corn oil preparation containing CCl4 6 h after vitamin E administration. We measured the activities of aspartate aminotransferase and alanine aminotransferase (ALT) in plasma, and the contents of triglyceride (TG), total cholesterol (T-Chol) and vitamin E analogs in the liver. Also, we determined the hepatic expression of mRNA for inflammatory cytokines. The liver TG content in the γ-Toc + CCl4 and T3 mix + CCl4 groups was decreased in comparison with the CCl4 group. Moreover, ALT activity in the T3 mix + CCl4 group was significantly lower than CCl4 group. These findings suggest that γ-Toc and T3 are effective for amelioration of fatty liver. PMID:20838570

40 CFR 60.614 - Test methods and procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... or TOC (less methane and ethane) reduction efficiency shall be prior to the inlet of the control... TOC (minus methane and ethane), dry basis, ppm by volume. %O2d=Concentration of O2, dry basis, percent.... (ii) The emission reduction (R) of TOC (minus methane and ethane) shall be determined using the...

40 CFR 60.661 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... organic compounds (TOC) means those compounds measured according to the procedures in § 60.664(b)(4). For... required in § 60.664(d)(5) and § 60.664(e); and TOC concentration as required in § 60.665(b)(4) and § 60... total resource requirement per unit reduction of TOC associated with an individual distillation vent...

40 CFR 141.133 - Compliance requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... specified by § 141.135(c). Systems may begin monitoring to determine whether Step 1 TOC removals can be met... the Step 1 requirements in § 141.135(b)(2) and must therefore apply for alternate minimum TOC removal (Step 2) requirements, is not eligible for retroactive approval of alternate minimum TOC removal (Step 2...

40 CFR 65.160 - Performance test and TRE index value determination records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... concentration of TOC or regulated material is determined. (1) Nonflare combustion device. Where an owner or... TOC achieved by the incinerator determined as specified in § 65.158(b)(4), as applicable, or the concentration of regulated material or TOC (parts per million by volume, by compound) determined as specified in...

40 CFR 63.997 - Performance test and compliance assessment requirements for control devices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... as TOC minus methane and ethane according to the procedures specified. (i) Selection of sampling... regulated material or TOC, sampling sites shall be located as specified in paragraphs (e)(2)(i)(A)(1) and (e... shall ensure the measurement of total organic regulated material or TOC (minus methane and ethane...

40 CFR 65.66 - Recordkeeping provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... applicable criteria in table 1 to this subpart shall record the organic HAP or TOC concentration as measurement using the sampling site and HAP or TOC concentration determination procedures specified in § 65.64... to § 65.63(f). (2) If the process vent is Group 2B on the basis of organic HAP or TOC concentration...

40 CFR 60.562-1 - Standards: Process emissions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... methane and ethane) (TOC) by 98 weight percent, or to a concentration of 20 parts per million by volume (ppmv) on a dry basis, whichever is less stringent. The TOC is expressed as the sum of the actual... Polypropylene and Polyethylene Affected Facilities Procedure /a/ Applicable TOC weight percent range Control/no...

40 CFR 65.158 - Performance test procedures for control devices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... regulated material or as TOC (minus methane and ethane) according to the procedures specified. (1) Method 1... material or TOC, sampling sites shall be located at the inlet of the control device as specified in the... sampling sites shall ensure the measurement of total regulated material or TOC (minus methane and ethane...

Predicting total organic carbon load with El Nino southern oscillation phase using hybrid and fuzzy logic approaches

USDA-ARS?s Scientific Manuscript database

During drinking water treatment chlorine reacts with total organic carbon (TOC) to form disinfection byproducts (DBP), some of which can be carcinogenic. Additional treatment required to remove TOC before chlorination significantly increases treatment cost. There are two main sources of TOC in a wat...

Destructive bone disease in early syphilis.

PubMed

Dismukes, W E; Delgado, D G; Mallernee, S V; Myers, T C

1976-12-06

Although destructive bone disease is a well-known complication of tertiary syphilis, osteitis or osteomyelitis are not commonly recognized as complications of early (primary or secondary) syphillis. A patient with secondary syphilis characterized by generalized lymphadenopathy, perianal condyloma lata, and positive rapid plasma reagin (RPR) and fluorescent treponemal antibody-absorption (FTA-ABS) tests also complained of headache, right should pain, and right anterior chest pain and swelling. Roentgenograms showed mottled osteolytic lesions consistent with previously described luetic bone disease. Biopsy confirmed the diagnosis of syphilitic osteomyelitis, and treatment with penicillin resulted in prompt resolution of symptoms.

Aspergillus osteomyelitis. Report of a case and review of the literature.

PubMed

Barnwell, P A; Jelsma, L F; Raff, M J

1985-11-01

Aspergillus is a ubiquitous saprophytic fungus seldom pathogenic for normal hosts. Aspergillus osteomyelitis occurs infrequently and is typically limited to patients with predisposing factors, including leukocyte dysfunction, malignancy with neutropenia, steroid or antibiotic therapy, pulmonary aspergillosis, and surgical manipulation. The spine is most frequently affected, and the clinical presentation is nonspecific (50% afebrile). Diagnosis requires demonstration of characteristic, acutely branching, broad, septate hyphae in biopsy material, and culture of Aspergillus. Therapy includes debridement of necrotic bone and loculated purulence combined with amphotericin B and possibly 5-fluorocytosine or rifampin.

Edible solid lipid nanoparticles (SLN) as carrier system for antioxidants of different lipophilicity

PubMed Central

Oehlke, Kathleen; Behsnilian, Diana; Mayer-Miebach, Esther; Weidler, Peter G.; Greiner, Ralf

2017-01-01

Ferulic acid (FA) and tocopherol (Toc) loaded solid lipid nanoparticles (SLN) were prepared by a hot homogenisation method. The particle size distribution, zeta potential and melting behaviour of the SLN as well as the stability, encapsulation efficiency and radical scavenging activity of FA and Toc in the SLN were analysed. The different formulations containing up to 2.8 mg g−1 of FA or Toc were stable during at least 15 weeks of storage at room temperature. Despite partial degradation and / or release of FA and Toc during storage, significant radical scavenging activity was maintained. DSC measurements and radical scavenging tests after different time periods revealed that the re-structuring of the lipid matrix was connected to the enhanced antioxidant activity of Toc but did not affect the activity of FA. PMID:28192494

Comparison of (68)Ga-DOTA-Tyr(3)-octreotide and (18)F-fluoro-L-dihydroxyphenylalanine positron emission tomography in neuroendocrine tumor patients.

PubMed

Putzer, D; Gabriel, M; Kendler, D; Henninger, B; Knoflach, M; Kroiss, A; Vonguggenberg, E; Warwitz, B; Virgolini, I J

2010-02-01

(68)Ga-DOTA-Tyr3-octreotide positron emission tomography ((68)Ga-DOTA-TOC PET) and (18)F-fluoro-L-dihydroxyphenylalanine PET ((18)F-DOPA PET) are emerging modalities for imaging of neuroendocrine tumors. This study reports our initial experiences with these two PET modalities on initial diagnosis, staging and restaging in NET patients. Fifteen patients with NET underwent both (68)Ga-DOTA-TOC and (18)F-DOPA PET as well as computed tomography (CT). Image findings were compared on a patient-basis (pathological uptake: yes/no) as well as on a lesion-basis. Contrast-enhanced CT and histological follow-up served as gold standard. Furthermore, imaging results were matched with tumor marker levels and quantitative tracer uptake by the tumor lesions. When comparing (68)Ga-DOTA-TOC and (18)F-DOPA PET, each modality showed a sensitivity of 64% and a specificity of 100% on a patient-based analysis. (68)Ga-DOTA-TOC PET and (18)F-DOPA PET showed equal findings in 7 out of 15 patients and disagreement in 8 patients. (68)Ga-DOTA-TOC revealed more metastases than (18)F-DOPA PET in 6 patients, while (18)F-DOPA PET detected more metastases than (68)Ga-DOTA-TOC in 4 patients. By (68)Ga-DOTA-TOC PET, 208 malignant lesions were detected, while by (18)F-DOPA only 86 lesions were found, and in CT 124, respectively. (68)Ga-DOTA-TOC and (18)F-DOPA PET are useful tools in the detection and staging of NET lesions. Our initial results allow the conclusion that (68)Ga-DOTA-TOC PET may have a stronger clinical impact in NET patients, as it does not only offer diagnostic information, but is decisive for the further treatment management, i. e. PRRT, as well.

Integration of In-Flight and Post-Flight Water Monitoring Resources in Addressing the U.S. Water Processor Assembly Total Organic Carbon (TOC) Anomaly

NASA Technical Reports Server (NTRS)

Straub, John E., II; McCly, J. Torin

2011-01-01

Beginning in June of 2010, the total organic carbon (TOC) concentration in the U.S. Water Processor Assembly (WPA) product water started to increase. A surprisingly consistent upward TOC trend was observed through weekly ISS total organic carbon analyzer (TOCA) monitoring. As TOC is a general organic compound indicator, return of water archive samples was needed to make better-informed crew health decisions on the specific compounds of concern and to aid in WPA troubleshooting. TOCA-measured TOC was more than halfway to the health-based screening limit of 3,000 g/L before archive samples were returned. Archive samples were returned on 22 Soyuz in September 2010 and on ULF5 in November of 2010. The samples were subjected to extensive analysis. Although TOC was confirmed to be elevated, somewhat surprisingly, none of the typical target compounds were detected at high levels. After some solid detective work, it was confirmed that the TOC was associated with a compound known as dimethylsilanediol (DMSD). DMSD is believed to be a breakdown product of siloxanes which are thought to be ubiquitous in the ISS atmosphere. A toxicological limit was set for DMSD and a forward plan was developed for conducting operations in the context of understanding the composition of the TOC measured in flight. This required careful consideration of existing ISS flight rules, coordination with ISS stakeholders, and development of a novel approach for the blending of inflight TOCA data with archive results to protect crew health. Among other challenges, team members had to determine how to utilize TOCA readings when making decisions about crew consumption of WPA water. This involved balancing very real concerns associated with the assumption that TOC would continue to be comprised of only DMSD. Demonstrated teamwork, multidisciplinary awareness, and innovative problem-solving were required to respond effectively to this anomaly.

c-Kit Mutation and Localization Status as Response Predictors in Mast Cell Tumors in Dogs Treated with Prednisone and Toceranib or Vinblastine.

PubMed

Weishaar, K M; Ehrhart, E J; Avery, A C; Charles, J B; Elmslie, R E; Vail, D M; London, C A; Clifford, C A; Eickhoff, J C; Thamm, D H

2018-01-01

KIT inhibitors, such as toceranib (TOC), and vinblastine (VBL) have not been prospectively compared in the treatment of macroscopic mast cell tumors (MCTs). Also, it is unknown whether VBL or TOC is superior for treating MCT without c-kit mutations. To determine the value of KIT genotyping and localization in treatment decisions for dogs with macroscopic MCT. We hypothesized that c-kit mutated MCT would have a better response to TOC than VBL. Eighty-eight client-owned dogs with macroscopic MCT. Prospective, randomized trial. Dogs were randomized to TOC (2.75 mg/kg EOD) or VBL (2.5 mg/m 2 weekly × 4 then EOW) by KIT localization and c-kit mutation status using an adaptive randomization scheme. Sixty dogs were allocated to TOC and 28 to VBL. Of the dogs receiving TOC, 20% had c-kit mutations, compared to 30% receiving VBL (P = 0.74). Overall response rates were 46% (TOC) and 30% (VBL) (odds ratio = 1.56 [0.62-3.92]; P = 0.28). Median progression-free survival (PFS) for dogs receiving VBL was 78 days (7-1,521) and for TOC 95.5 (14-990); hazard ratio (HR) = 1.34 [0.72-2.50]; P = 0.36. Median overall survival (OS) was 241.5 days (10-1,521) for the VBL group and 159 (20-990) for the TOC group; HR = 0.80 ([0.45-1.41]; P = 0.44). Neither PFS nor OS was significantly different between treatment groups. As the proportion of dogs with c-kit mutations was not different between treatment groups in this population of dogs, c-kit mutation status did not predict treatment response. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Effect of vitamin E on 24(S)-hydroxycholesterol-induced necroptosis-like cell death and apoptosis.

PubMed

Nakazawa, Takaya; Miyanoki, Yuta; Urano, Yasuomi; Uehara, Madoka; Saito, Yoshiro; Noguchi, Noriko

2017-05-01

24(S)-Hydroxycholesterol (24S-OHC) has diverse physiological and pathological functions. In particular, cytotoxic effects of 24S-OHC in neuronal cells are important in development of neurodegenerative diseases. 24S-OHC induces necroptosis-like cell death in SH-SY5Y cells expressing little caspase-8. In the present study, 24S-OHC was found to induce apoptosis as determined by caspase-3 activation in all-trans-retinoic acid (atRA)-treated SH-SY5Y cells in which expression of caspase-8 was induced. 24S-OHC-induced cell death was inhibited by α-tocopherol (α-Toc) but not by α-tocotrienol (α-Toc3) in SH-SY5Y cells regardless of whether cells were treated with atRA. In contrast, cumene hydroperoxide (CumOOH)-induced cell death was significantly inhibited by α-Toc and α-Toc3. In atRA-treated SH-SY5Y cells, generation of reactive oxygen species (ROS) was induced by stimulation with CumOOH but was not induced by stimulation with 24S-OHC. These results suggest that inhibition of 24S-OHC-induced cell death by α-Toc cannot be explained by its radical scavenging antioxidant activity. Esterification of 24S-OHC followed by lipid droplet (LD) formation due to acyl-CoA:cholesterol acyltransferase 1 (ACAT1) are key events in 24S-OHC-induced cell death in atRA-treated SH-SY5Y cells as demonstrated by inhibition of cell death by ACAT1 inhibitor. LD number was not changed by treatment with either α-Toc or α-Toc3. The different physical properties of α-Toc and α-Toc3 may account for their different inhibitory effects on 24S-OHC-induced cell death. Copyright © 2016 Elsevier Ltd. All rights reserved.

Linking sedimentary total organic carbon to 210Pbex chronology from Changshou Lake in the Three Gorges Reservoir Region, China.

PubMed

Anjum, Raheel; Gao, Jinzhang; Tang, Qiang; He, Xiubin; Zhang, Xinbao; Long, Yi; Shi, Zhonglin; Wang, Mingfeng

2017-05-01

The influences of total organic carbon (TOC) and total nitrogen (TN) on Lead-210 ( 210 Pb) dating have recently been of increasing concern in lacustrine research. Sediment core from Changshou Lake in the Longxi catchment was investigated for influence of TOC on 210 Pb dating. Lead-210 excess ( 210 Pb ex ), Cesium-137 ( 137 Cs) activities, TOC, TN, and particle size were measured. We proposed a dating index based on 137 Cs chronology and particle size distribution of the lake sediment profile and rainfall erosivities calculated from Longxi catchment metrological records. Increasing trends in TOC and TN were specifically caused by commercial cage fish farming after 1989. The statistically significant correlation between 210 Pb ex activity, TOC (0.61, p = 0.04) and TN (0.51, p = 0.04), respectively explained post-1989 210 Pb scavenging. The 210 Pb ex activity was closely related with coupled peaks of TOC and TN from mass depth 5-10 g cm -2 . Higher TOC/TN ratio (8.33) indicated submerged macrophytes and native aquatic algal growth as main source of carbon from enhanced primary productivity because of massive fertilizer use and coherent climate warming. The study supported key hypothesis on vital role of fertilizer usage and algal derived TOC in controlling sedimentary 210 Pb ex activity at Changshou Lake sediment. 137 Cs profile and erosive events as time markers provided reliable and consistent sedimentation rate of (1.6 cm y -1 ). 210 Pb ex activity decayed exponentially after peak at mass depth 5.68 g cm -2 . Therefore, violation of 210 Pb dating primary assumptions made it inappropriate for sediment dating at Changshou Lake. TOC content must be considered while using 210 Pb as dating tool for lake sediment profiles. Copyright © 2017 Elsevier Ltd. All rights reserved.

TOC and TRIZ: using a dual-methodological approach to solve a forest harvesting problem

Treesearch

Ian Conradie

2005-01-01

Although cut-to-length forest harvesting with harvesters and forwarders is hardly used in some parts of the world, it has many advantages over conventional harvesting systems. Research has shown that the core reason for the low adoption of CTL in the southeastern USA is the complexity of the equipment to optimize value recovery. In this paper we delve deeper into this...

Discontinuous pH gradient-mediated separation of TiO2-enriched phosphopeptides

PubMed Central

Park, Sung-Soo; Maudsley, Stuart

2010-01-01

Global profiling of phosphoproteomes has proven a great challenge due to the relatively low stoichiometry of protein phosphorylation and poor ionization efficiency in mass spectrometers. Effective, physiologically-relevant, phosphoproteome research relies on the efficient phosphopeptide enrichment from complex samples. Immobilized metal affinity chromatography and titanium dioxide chromatography (TOC) can greatly assist selective phosphopeptide enrichment. However, the complexity of resultant enriched samples is often still high, suggesting that further separation of enriched phosphopeptides is required. We have developed a pH-gradient elution technique for enhanced phosphopeptide identification in conjunction with TOC. Using this process, we have demonstrated its superiority to the traditional ‘one-pot’ strategies for differential protein identification. Our technique generated a highly specific separation of phosphopeptides by an applied pH-gradient between 9.2 and 11.3. The most efficient elution range for high-resolution phosphopeptide separation was between pH 9.2 and 9.4. High-resolution separation of multiply-phosphorylated peptides was primarily achieved using elution ranges > pH 9.4. Investigation of phosphopeptide sequences identified in each pH fraction indicated that phosphopeptides with phosphorylated residues proximal to acidic residues, including glutamic acid, aspartic acid, and other phosphorylated residues, were preferentially eluted at higher pH values. PMID:20946866

Influence of total organic carbon and UV-B radiation on zinc toxicity and bioaccumulation in aquatic communities.

PubMed

Kashian, Donna R; Prusha, Blair A; Clements, William H

2004-12-01

The effects of total organic carbon (TOC) and UV-B radiation on Zn toxicity and bioaccumulation in a Rocky Mountain stream community were assessed in a 10-d microcosm experiment. We predicted that TOC would mitigate Zn toxicity and that the combined effects of Zn and UV-B would be greater than Zn alone. However, TOC did not mitigate Zn toxicity in this study. In fact, treatments with TOC plus Zn had significantly lower community respiration as compared with the controls and Zn concentrations associated with the periphyton increased in the presence of TOC. UV-B had no additive effect on periphyton Zn accumulation or community respiration. Heptageniid mayflies (Ephemeroptera) were particularly sensitive to Zn, and reduced abundances were observed in all Zn treatments. UV-B did not additionally impact Heptageniid abundances; however UV-B did have a greater effect on macroinvertebrate drift than Zn alone. Ephemeroptera, Plecoptera, and Trichoptera (groups typically classified as sensitive to disturbance) were found in highest numbers in the drift of UV-B + Zn treatments. Measures of Zn accumulation in the caddisfly Arctopsyche grandis, periphyton biomass, and total macroinvertebrate abundance were not sufficiently sensitive to differentiate effects of TOC, UV-B, and Zn. These results indicate that UV-B and TOC affect Zn bioavailability and toxicity by impacting species abundance, behavior, and ecosystem processes.

[Relationships of soil organic carbon with its active and non-active components under different land use types in the middle reaches of Heihe River, China].

PubMed

Zhang, Jun-Hua; Li, Guo-Dong; Wang, Yan-Song; Nan, Zhong-Ren; Zhao, Li-Ping

2012-12-01

Taking the seven typical land use types (paddy field, dry land, medium coverage grassland, saline-alkali field, bare land, desert, and sandlot) in the middle reaches of Heihe River as test objects, this paper studied the relationships of soil organic carbon content with its components. In the 0-100 cm soil profile, the contents of soil total organic carbon (TOC) , active organic carbon (AOC), and non-active organic carbon (NOC) decreased with increasing depth. The soil TOC, AOC, and NOC contents differed with land use type. Land use change induced the increase or decrease of soil organic carbon content. The tillage in paddy field was an available way to increase the contents of soil TOC, AOC, and NOC. After land use change, soil NOC rather than AOC contributed more to soil TOC content. For the same land use types, soil AOC and NOC contents increased together with increasing soil TOC content, and the NOC content increased faster than the AOC content. The soil TOC content corresponding to the crossing point of the variation trend lines of soil AOC and NOC contents could be considered as the boundary point of TOC accumulation or loss, and the saturation capacities of soil AOC and NOC could be obtained by the variation trend lines of the AOC and NOC.

Destruction of OPA from munitions demilitarization in supercritical water oxidation: kinetics of total organic carbon disappearance.

PubMed

Veriansyah, Bambang; Kim, Jae-Duck; Lee, Jong-Chol; Hong, Deasik

2006-01-01

The destruction of OPA from munitions demilitarization has been accomplished in supercritical water oxidation (SCWO) with oxygen as oxidant in an isothermal continuous-flow reactor. The experiments were conducted at a temperature of 689-887 K and a fixed pressure of 25 MPa, with a residence time that ranged from 7 s to 14 s. The destruction efficiency was measured by total organic carbon (TOC) conversion. At the reaction condition, the initial TOC concentrations of OPA were varied from 1.41 mmol/L to 19.57 mmol/L and the oxygen concentrations were varied from 15.03 mmol/L to 81.85 mmol/L. Experimental data showed that all the TOC conversions were >80% under the above experimental conditions. The kinetics of TOC disappearance, which is essential for the design, optimization, and control of reliable commercial SCWO reactor was developed by taking into account the dependence of the oxidant and TOC concentration on the reaction rate. A global TOC disappearance rates expression was regressed from the data of 38 experiments, to a 95% confidence level. The resulting activation energy was determined to be 44.01 +/- 1.52 kJ/mol, and the pre-exponential factor was (1.67 +/- 0.45) x 10(2) L(1.14) mmol(-0.14) s(-1). The reaction orders for the TOC and the oxidant were 0.98 +/- 0.01 and 0.16 +/- 0.02, respectively.

The Story Behind the Numbers: Lessons Learned from the Integration of Monitoring Resources in Addressing an ISS Water Quality Anomaly

NASA Technical Reports Server (NTRS)

McCoy, Torin; Flint, Stephanie; Straub, John, II; Gazda, Dan; Schultz, John

2011-01-01

Beginning in June of 2010 an environmental mystery was unfolding on the International Space Station (ISS). The U.S. Water Processor Assembly (WPA) began to produce water with increasing levels of total organic carbon (TOC). A surprisingly consistent upward TOC trend was observed through weekly in-flight total organic carbon analyzer (TOCA) monitoring. As TOC is a general organics indicator, return of water archive samples was needed to make better-informed crew health decisions and to aid in WPA troubleshooting. TOCA-measured TOC was more than halfway to its health-based screening limit before archive samples could be returned on Soyuz 22 and analyzed. Although TOC was confirmed to be elevated, somewhat surprisingly, none of the typical target compounds were the source. After some solid detective work, it was confirmed that the TOC was associated with a compound known as dimethylsilanediol (DMSD). DMSD is believed to be a breakdown product of silicon-containing compounds present on ISS. A toxicological limit was set for DMSD and a forward plan developed for operations given this new understanding of the source of the TOC. This required extensive coordination with ISS stakeholders and innovative use of available in-flight and archive monitoring resources. Behind the numbers and scientific detail surrounding this anomaly, there exists a compelling story of multi-disciplinary awareness, teamwork, and important environmental lessons learned.

40 CFR 60.700 - Applicability and designation of affected facility.

Code of Federal Regulations, 2012 CFR

2012-07-01

... compounds (TOC) (less methane and ethane) in the vent stream less than 300 ppmv as measured by Method 18 or... maximum production rate at which the affected facility will be operated, or 180 days after the initial... limits in these standards are expressed in terms of TOC, measured as TOC less methane and ethane. This...

40 CFR 60.700 - Applicability and designation of affected facility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... compounds (TOC) (less methane and ethane) in the vent stream less than 300 ppmv as measured by Method 18 or... maximum production rate at which the affected facility will be operated, or 180 days after the initial... limits in these standards are expressed in terms of TOC, measured as TOC less methane and ethane. This...

40 CFR 63.772 - Test methods, compliance procedures, and compliance demonstrations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... conduct a performance test to determine percent emission reduction or outlet organic HAP or TOC... intervals in time, such as 15-minute intervals during the run. (B) The mass rate of either TOC (minus... either TOC (minus methane and ethane) or total HAP at the inlet of the control device (Ei) may be...

40 CFR 65.63 - Performance and group status change requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... material or TOC by at least 98 weight-percent or to a concentration of less than 20 parts per million by... recalculate the TRE index value, flow, or TOC or organic hazardous air pollutant (HAP) concentration according.... Engineering assessments shall meet the specifications in § 65.64(i). (2) Concentration. The TOC or organic HAP...

40 CFR Table 8 to Subpart Eeee of... - Continuous Compliance With Emission Limits

Code of Federal Regulations, 2010 CFR

2010-07-01

..., items 1 through 6 a. Reduce total organic HAP (or, upon approval, TOC) emissions from the closed vent... organic HAP (or, upon approval, TOC) in the exhaust of combustion devices i. Performing CMS monitoring and... HAP (or, upon approval, TOC) emissions during the loading of organic liquids from the closed vent...

40 CFR Figure 1 to Subpart G of... - Definitions of Terms Used in Wastewater Equations

Code of Federal Regulations, 2010 CFR

2010-07-01

... wastewater, ppmw. CG=Concentration of TOC (minus methane and ethane) or total organic hazardous air pollutants, in vented gas stream, dry basis, ppmv. CGc=Concentration of TOC or organic hazardous air... flow rate of vented gas stream, dry standard, m3/min. QMG=Mass flowrate of TOC (minus methane and...

40 CFR 63.1281 - Control equipment requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... performance requirements: (A) Reduces the mass content of either TOC or total HAP in the gases vented to the....1282(d); (B) Reduces the concentration of either TOC or total HAP in the exhaust gases at the outlet to... condenser) or other control device that is designed and operated to reduce the mass content of either TOC or...

40 CFR 63.116 - Process vent provisions-performance test methods and procedures to determine compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... conduct a performance test to determine percent emission reduction or outlet organic HAP or TOC... organic HAP concentration and percent reduction may be measured as either total organic HAP or as TOC... measurement of total organic HAP or TOC (minus methane and ethane) concentrations in all vent streams and...

40 CFR 63.1282 - Test methods, compliance procedures, and compliance demonstrations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... organic HAP or TOC concentration when a flare is used. (3) For a performance test conducted to demonstrate... intervals in time, such as 15-minute intervals during the run. (B) The mass rate of either TOC (minus... either TOC (minus methane and ethane) or total HAP at the inlet of the control device (Ei) may be...

75 FR 22358 - Notice of Funding Availability (NOFA) for the Small, Socially-Disadvantaged Producer Grant (SSDPG...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-28

... information, each application must contain a detailed Table of Contents (TOC) immediately following the SF-424B. The TOC must include page numbers for each component of the application. Pagination should begin immediately following the TOC. 5. Executive Summary. A summary of the proposal, not to exceed one page, must...

40 CFR 63.1253 - Standards: Storage tanks.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Reduces emissions to outlet concentrations less than or equal to 20 ppmv as TOC and less than or equal to... equal to 20 ppmv as TOC and less than or equal to 20 ppmv as hydrogen halides and halogens; (3) Is an... control device achieving an outlet TOC concentration, as calibrated on methane or the predominant HAP, of...

40 CFR 60.611 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... recovery device or series of such devices applied to the same process stream. Total organic compounds (TOC...(d)(5) and § 60.614(e) and TOC concentration as required in § 60.615(b)(4) and § 60.615(g)(4), those... requirement per unit reduction of TOC associated with an individual air oxidation vent stream, based on vent...

40 CFR Table 18 to Subpart Uuu of... - Requirements for Performance Tests for Organic HAP Emissions From Catalytic Reforming Units

Code of Federal Regulations, 2010 CFR

2010-07-01

... part 60, appendix A), as applicable c. Measure TOC concentration (for percent reduction standard) Method 25 (40 part 60, appendix A) to measure nonmethane TOC concentration (in carbon equivalents) at inlet and outlet of the control device. If the nonmethane TOC outlet concentration is expected to be...

40 CFR Table 2 to Subpart Eeee of... - Emission Limits

Code of Federal Regulations, 2010 CFR

2010-07-01

... emissions of total organic HAP (or, upon approval, TOC) by at least 95 weight-percent or, as an option, to... organic HAP (or, upon approval, TOC) by at least 95 weight-percent or, as an option, to an exhaust... total organic HAP (or, upon approval, TOC) from the loading of organic liquids either by venting the...

40 CFR 63.1325 - Batch process vents-performance test methods and procedures to determine compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... either total organic HAP or TOC. For purposes of this paragraph (c), the term “batch emission episode... ensure the measurement of total organic HAP or TOC (minus methane and ethane) concentrations in all batch... organic HAP or TOC, as appropriate. Alternatively, any other method or data that has been validated...

40 CFR Table 6 to Subpart Eeee of... - Initial Compliance With Emission Limits

Code of Federal Regulations, 2010 CFR

2010-07-01

... approval, TOC) emissions by at least 95 weight-percent, or as an option for nonflare combustion devices to an exhaust concentration of ≤20 ppmv Total organic HAP (or, upon approval, TOC) emissions, based on..., or new affected source Reduce total organic HAP (or, upon approval, TOC) emissions from the loading...

Tragedy of the commons in Melipona bees.

PubMed Central

Wenseleers, Tom; Ratnieks, Francis L W

2004-01-01

In human society selfish use of common resources can lead to disaster, a situation known as the 'tragedy of the commons' (TOC). Although a TOC is usually prevented by coercion, theory predicts that close kinship ties can also favour reduced exploitation. We test this prediction using data on a TOC occurring in Melipona bee societies. PMID:15504003

Evaluation of Organic Proxies for Quantifying Past Primary Productivity

NASA Astrophysics Data System (ADS)

Raja, M.; Rosell-Melé, A.; Galbraith, E.

2017-12-01

Ocean primary productivity is a key element of the marine carbon cycle. However, its quantitative reconstruction in the past relies on the use of biogeochemical models as the available proxy approaches are qualitative at best. Here, we present an approach that evaluates the use of phytoplanktonic biomarkers (i.e. chlorins and alkenones) as quantitative proxies to reconstruct past changes in marine productivity. We compare biomarkers contents in a global suite of core-top sediments to sea-surface chlorophyll-a abundance estimated by satellites over the last 20 years, and the results are compared to total organic carbon (TOC). We also assess satellite data and detect satellite limitations and biases due to the complexity of optical properties and the actual defined algorithms. Our findings show that sedimentary chlorins can be used to track total sea-surface chlorophyll-a abundance as an indicator for past primary productivity. However, degradation processes restrict the application of this proxy to concentrations below a threshold value (1µg/g). Below this threshold, chlorins are a useful tool to identify reducing conditions when used as part of a multiproxy approach to assess redox sedimentary conditions (e.g. using Re, U). This is based on the link between anoxic/disoxic conditions and the flux of organic matter from the sea-surface to the sediments. We also show that TOC is less accurate than chlorins for estimating sea-surface chlorophyll-a due to the contribution of terrigenous organic matter, and the different degradation pathways of all organic compounds that TOC includes. Alkenones concentration also relates to primary productivity, but they are constrained by different processes in different regions. In conclusion, as lons as specific constraints are taken into account, our study evaluates the use of chlorins and alkenones as quantitative proxies of past primary productivity, with more accuracy than by using TOC.

The Levels and Distribution of TN, TP and TOC in the South China Sea

NASA Astrophysics Data System (ADS)

Wang, H.; Han, D.

2012-04-01

The marine biogeochemistries of carbon, nitrogen and phosphorous have come under increased scrutiny because of their close involvement in climate change and coastal eutrophication. The South China Sea is unique in that located in a subtropical zone, and therefore represents an important regime for biogeochemical studies. However, to our knowledge, few data are available for total nitrogen (TN), total phosphorous (TP) and total organic carbon (TOC) in South Sea, China. The present study aims to contribute to the knowledge of their status through investigating the level and distribution of TN, TP and TOC in South China Sea. A total of 108 seawater samples of 11 sites in south sea, china were collected during August 29- September 4, 2006. An automated and simultaneous method for determination of TN and TOC was applied to all seawater samples. The combined system allowed simultaneous determination for TOC and TN in the same sample using a single injection and provided low detection limits and excellent linear ranges for both TOC and TN. The risk of contamination has been remarkably reduced due to the minimal sample manipulation and automated analyses. And quantitative analyses of TP in seawater were accomplished by a typical chemical method. Concentration ranges of TN and TP were 0.06-0.67, and 0.003-0.071 mg/L, respectively, as well as that of TOC were 0.23-2.51mg/L. The values of TN and TP showed that the status of nutrition is relatively better in south china sea than other marine areas. Moreover, the upright change trend of TN concentration level as well as TP and TOC according to the experimental results at the total 11 sites are simultaneity studied. The concentration of TN initial increases with the increasing of the depth, later the value becomes almost constant. In contrast, the concentration of TOC reduces with the increasing of the depth, later the value becomes almost unchangeable. Compared with the trend of TN and TOC, that of TP appears relatively stable. Thus, TP could be regarded as the key factor about eutrophication. This work should provide some useful information to better understand the environmental status of south china sea. Keywords: Concentration level, distribution, TN, TP, TOC, South China Sea. Acknowledgments The work was supported by The National Natural Science Foundation of China (No. 40976050), and the National Public Benefit (Ocean) Research Foundation of China (201105013).

An intrapatient comparison of 99mTc-EDDA/HYNIC-TOC with 111In-DTPA-octreotide for diagnosis of somatostatin receptor-expressing tumors.

PubMed

Gabriel, Michael; Decristoforo, Clemens; Donnemiller, Eveline; Ulmer, Hanno; Watfah Rychlinski, Christine; Mather, Stephen J; Moncayo, Roy

2003-05-01

The aim of this study was to compare the imaging abilities of the recently developed somatostatin analog, (99m)Tc-hydrazinonicotinyl-Tyr(3)-octreotide ((99m)Tc-HYNIC-TOC [(99m)Tc-TOC]), with (111)In-diethylenediaminepentaacetic acid-D-Phe(1)-octreotide ((111)In-OCT [Octreoscan]) in patients undergoing routine somatostatin receptor (SSTR) scintigraphy. Forty-one patients (20 men, 21 women; age range, 29-75 y; mean age, 56.7 y) with either histologically proven or biologically and clinically suspected endocrine tumors were enrolled in the study. Four groups were distinguished: (a) patients being evaluated for the detection and localization of neuroendocrine tumors (n = 6), (b) tumor staging (n = 19), (c) patients being investigated to determine the SSTR status of tumor lesions (n = 11), and (d) patient follow-up studies (n = 5). Each patient received a mean activity of 150 MBq (111)In-OCT and 350-400 MBq (99m)Tc-TOC. Scintigraphy with (99m)Tc-TOC was performed 4 h after injection and scintigraphy with (111)In-OCT was performed 4 and 24 h after injection. SPECT studies of areas of interest were performed 4 h after injection for both tracers as well as at 24 h after injection for (111)In-OCT. The time interval between the studies using each tracer ranged from 2 to 22 d (mean interval, 9.3 d). (111)In-OCT and (99m)Tc-TOC showed an equivalent scan result in 32 patients (78%), 9 cases showed discrepancies (22%), false-negative results with (111)In-OCT were seen in 6 cases (14.6%), whereas (99m)Tc-TOC was false-positive in 2 cases (4.9%). (111)In-OCT was true-negative in both cases. The false-positive findings of the (99m)Tc-TOC studies were caused by nonspecific uptake in the bowel. In 1 case, (99m)Tc-TOC correctly identified a metastasis in the lumbar spine but both scan results were false-positive because of an inflammatory process. In 21 patients with SSTR-expressing tumors, the semiquantitative region-of-interest analysis showed that (99m)Tc-TOC achieved higher tumor-to-normal tissue ratios than (111)In-OCT. This study revealed a higher sensitivity of (99m)Tc-TOC as compared with (111)In-OCT as an imaging agent for the localization of SSTR-expressing tumors. To avoid false-positive findings with (99m)Tc-OCT due to nonspecific tracer accumulation, additional scanning at 1-2 h after injection should be done.

Treatment of osteitis pubis and osteomyelitis of the pubic symphysis in athletes: a systematic review

PubMed Central

Choi, Haemi; McCartney, Michael; Best, Thomas M

2013-01-01

Objectives The authors examined the most current evidence for treatment options in athletes with osteitis pubis and osteomyelitis pubis, attempting to determine which options provide optimal pain relief with rapid return to sport and prevention of symptom reoccurrence. Methods Three databases—MEDLINE, Cochrane Database of Systematic Reviews and CINAHL—were searched using the OVID interface for all years between 1985 and May 2008. References were analysed from included studies, and additional relevant articles were obtained for inclusion. Inclusion criteria included (1) humans only, (2) subjects had no apparent risk factors for development of osteitis pubis or osteomyelitis of the pubic symphysis other than athletic involvement, (3) both physical exam findings and diagnostic imaging were used to confirm either diagnosis, and (4) a definitive treatment strategy was identifiable for management of osteitis pubis or osteomyelitis of the pubic symphysis. In total, 25 articles were included in the review. Results There were no randomised controlled trials identified with this study’s search strategy. A total of 195 athletes were diagnosed as having osteitis pubis (186 males, nine females) and treated with either conservative measures/physical therapy, local injection with corticosteroids and/or local anaesthetic, dextrose prolotherapy, surgery or antibiotic therapy. Six case reports/series described conservative treatment measures (physical therapy, rest, non-steroid anti-inflammatory drugs). Four case series explored the use of corticosteroid injections in treatment. One case series described the use of dextrose prolotherapy as a treatment modality. Six case series described various surgical techniques (pubic symphysis curettage, polypropylene mesh placement and pubic bone stabilisation) in treatment. Ten case reports/ series (10 subjects) outlined antibiotic treatment of osteomyelitis of the pubic symphysis. Conclusions The current medical literature shows only level 4 evidence of the treatment for osteitis pubis in 24 case reports/series in athletes. Without any direct comparison of treatment modalities, it is difficult to determine which individual treatment option is the most efficacious. Further study comparing the different treatment options is necessary to determine which modality provides the fastest return to sport. PMID:18812419

Acute haematogenous community-acquired methicillin-resistant Staphylococcus aureus osteomyelitis in an adult: Case report and review of literature

PubMed Central

2012-01-01

Background Methicillin-resistant Staphylococcus aureus (MRSA) has of late emerged as a cause of community-acquired infections among immunocompetent adults without risk factors. Skin and soft tissue infections represent the majority of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clinical presentations, whilst invasive and life-threatening illness like necrotizing pneumonia, necrotizing fasciitis, pyomyositis, osteomyelitis and sepsis syndrome are less common. Although more widely described in the pediatric age group, the occurrence of CA-MRSA osteomyelitis in adults is an uncommonly reported entity. Case presentation We describe an invasive CA-MRSA infection in a 28 year-old previously healthy male, manifesting with bacteraemia, osteomyelitis of femur, pyomyositis and septic arthritis of the knee. Initially a preliminary diagnosis of osteosarcoma was suggested by imaging studies and patient underwent a bone biopsy. MRSA was subsequently isolated from blood cultures taken on day of admission, bone, tissue and pus cultures. Incision and drainage of abscess was performed and patient was treated with vancomycin, with fusidic acid added later. It took 6 months for the inflammatory markers to normalize, warranting 6-months of anti-MRSA therapy. Patient was a fervent deer hunter and we speculate that he acquired this infection from extensive direct contact with deer. Molecular characterization of this isolate showed that it belonged to multilocus sequence type (MLST) ST30 and exhibited the staphylococcal chromosome cassette mec (SCCmec) type IV, staphylococcus protein A (spa) type t019, accessory gene regulator (agr) type III and dru type dt10m. This strain harbored Panton-Valentine leukocidin (pvl) genes together with 3 other virulent genes; sei (enterotoxin), hlg (hemolysin) and fnbA (fibronectin binding protein). Conclusion This case study alerts physicians that beyond the most commonly encountered skin and soft tissue infections, pvl positive CA-MRSA can lead to invasive life-threatening disease especially in an immunocompetent adult. Heightened alertness is needed for osteomyelitis of long bones in adults, as it is not uncommon for this disease to mimic primary bone malignancy. Cure is achievable with early appropriate antibiotics guided by inflammatory markers. PMID:23098162

Acute haematogenous community-acquired methicillin-resistant Staphylococcus aureus osteomyelitis in an adult: case report and review of literature.

PubMed

Dhanoa, Amreeta; Singh, Vivek Ajit; Mansor, Azura; Yusof, Mohd Yasim; Lim, King-Ting; Thong, Kwai-Lin

2012-10-25

Methicillin-resistant Staphylococcus aureus (MRSA) has of late emerged as a cause of community-acquired infections among immunocompetent adults without risk factors. Skin and soft tissue infections represent the majority of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clinical presentations, whilst invasive and life-threatening illness like necrotizing pneumonia, necrotizing fasciitis, pyomyositis, osteomyelitis and sepsis syndrome are less common. Although more widely described in the pediatric age group, the occurrence of CA-MRSA osteomyelitis in adults is an uncommonly reported entity. We describe an invasive CA-MRSA infection in a 28 year-old previously healthy male, manifesting with bacteraemia, osteomyelitis of femur, pyomyositis and septic arthritis of the knee. Initially a preliminary diagnosis of osteosarcoma was suggested by imaging studies and patient underwent a bone biopsy. MRSA was subsequently isolated from blood cultures taken on day of admission, bone, tissue and pus cultures. Incision and drainage of abscess was performed and patient was treated with vancomycin, with fusidic acid added later. It took 6 months for the inflammatory markers to normalize, warranting 6-months of anti-MRSA therapy. Patient was a fervent deer hunter and we speculate that he acquired this infection from extensive direct contact with deer.Molecular characterization of this isolate showed that it belonged to multilocus sequence type (MLST) ST30 and exhibited the staphylococcal chromosome cassette mec (SCCmec) type IV, staphylococcus protein A (spa) type t019, accessory gene regulator (agr) type III and dru type dt10m. This strain harbored Panton-Valentine leukocidin (pvl) genes together with 3 other virulent genes; sei (enterotoxin), hlg (hemolysin) and fnbA (fibronectin binding protein). This case study alerts physicians that beyond the most commonly encountered skin and soft tissue infections, pvl positive CA-MRSA can lead to invasive life-threatening disease especially in an immunocompetent adult. Heightened alertness is needed for osteomyelitis of long bones in adults, as it is not uncommon for this disease to mimic primary bone malignancy. Cure is achievable with early appropriate antibiotics guided by inflammatory markers.

Petroleum source potential of the Lower Cretaceous mudstone succession of the NPRA and Colville Delta area, North Slope Alaska, based on sonic and resistivity logs

USGS Publications Warehouse

Keller, Margaret A.; Bird, Kenneth J.

2003-01-01

Resource assessment of the North Slope of Alaska by the U. S. Geological Survey includes evaluation of the petroleum source potential of Mesozoic and Cenozoic rocks using the delta log R technique (Passey and others, 1990). Porosity and resistivity logs are used in combination with thermal maturity data to produce a continuous profile of total organic carbon content in weight % (TOC). From the pattern and amount of TOC in the profile produced, the depositional setting and thus the petroleum source-rock potential (kerogen type) of the organic matter can be inferred and compared to interpretations from other data such as Rock-Eval pyrolysis. TOC profiles determined by this technique for the contiguous interval of pebble shale unit, Hue Shale (including the Gamma Ray Zone or GRZ), and lower part of the Torok Formation indicate important potential for petroleum generation in the Tunalik 1, Inigok 1, N. Inigok 1, Kuyanak 1, Texaco Colville Delta 1, Nechelik 1, and Bergschrund 1 wells of the western North Slope region. TOC profiles suggest that this interval contains both type II and III kerogens – consistent with proposed depositional models -- and is predominantly greater than 2 wt. % TOC (cut-off used for effective source potential). Average TOC for the total effective section of the pebble shale unit + Hue Shale ranges from 2.6 to 4.1 wt % TOC (values predominantly 2-8% TOC) over 192-352 ft. Source potential for the lower Torok Formation, which also has interbedded sandstone and lean mudstone, is good to negligible in these 7 wells.

Prediction of shale prospectivity from seismically-derived reservoir and completion qualities: Application to a shale-gas field, Horn River Basin, Canada

NASA Astrophysics Data System (ADS)

Mo, Cheol Hoon; Lee, Gwang H.; Jeoung, Taek Ju; Ko, Kyung Nam; Kim, Ki Soo; Park, Kyung-sick; Shin, Chang Hoon

2018-04-01

Prospective shale plays require a combination of good reservoir and completion qualities. Total organic carbon (TOC) is an important reservoir quality and brittleness is the most critical condition for completion quality. We analyzed seismically-derived brittleness and TOC to investigate the prospectivity of the Horn River Group shale (the Muskwa, Otter Park, Evie shales) of a shale-gas field in the western Horn River Basin, British Columbia, Canada. We used the λρ-μρ brittleness template, constructed from the mineralogy-based brittleness index (MBI) and elastic logs from two wells, to convert the λρ and μρ volumes from prestack seismic inversion to the volume for the brittleness petrotypes (most brittle, intermediate, and least brittle). The probability maps of the most brittle petrotype for the three shales were generated from Bayesian classification, based on the λρ-μρ template. The relationship between TOC and P-wave and S-wave velocity ratio (VP/VS) at the wells allowed the conversion of the VP/VS volume from prestack inversion to the TOC volume, which in turn was used to construct the TOC maps for the three shales. Increased TOC is correlated with high brittleness, contrasting with the commonly-held understanding. Therefore, the prospectivity of the shales in the study area can be represented by high brittleness and increased TOC. We propose a shale prospectivity index (SPI), computed by the arithmetic average of the normalized probability of the most brittle petrotype and the normalized TOC. The higher SPI corresponds to higher production rates in the Muskwa and Evie shales. The areas of the highest SPI have not been fully tested. The future drilling should be focused on these areas to increase the economic viability of the field.

(99m)Tc-HYNIC-TOC scintigraphy in evaluation of active Graves' ophthalmopathy (GO).

PubMed

Sun, Hua; Jiang, Xu-Feng; Wang, Shu; Chen, Hao-Yan; Sun, Jiao; Li, Pei-Yong; Ning, Guang; Zhao, Yong-Ju

2007-06-01

A promising radiopharmaceutical (99m)Tc-HYNIC-TOC ((99m)Tc-HYNIC-Octreotide) can be applied for somatostatin receptor scintigraphy with the potential to replace Indium-111 labeled somatostatin analogus. Here we evaluate whether orbital (99m)Tc-HYNIC-TOC scintigraphy can be used as a Graves' ophthalmopathy (GO) activity parameter to predict the retrobulbar irradiation response. Orbital (99m)Tc-HYNIC-TOC scintigraphy was performed on 14 consecutive patients demonstrating moderated to severe Graves' ophthalmopathy. The patients were treated with retrobulbar irradiation following the octreoscan and the response to this therapy was assessed at 3 months after the start of treatment. The orbital (99m)Tc-HYNIC-TOC uptake was calculated to assess the effects of treatment. Among the 14 GO patients, eight (57.1%) responded to retrobulbar radiotherapy; six (42.9%) showed no change. We compared the eight responders and six non-responders in terms of orbital (99m)Tc-HYNIC-TOC uptake, using the orbital/occipital ratio. On the 4-h (99m)Tc-HYNIC-TOC scintigraphy, responders had a higher orbital/occipital uptake ratio than the no-responders (P = 0.001). A significant correlation was found between the orbital/occipital ratio and the clinical activity score (CAS) (P = 0.034). The Receiving-Operator-Characteristic curve showed the best threshold for discriminating active and inactive disease was 1.40 (sensitivity, 100%; specificity, 83.3%). In the responders group, all these eight patients had positive scintigraphy. While there were five patients who had negative scintigraphy in the non-responders group. Orbital (99m)Tc-HYNIC-TOC scintigraphy can be a useful method for the estimation of disease activity and prediction the response to subsequent radiotherapy in GO patient. And the patients with positive octreoscan were more likely to respond to irradiation.

Vertebral metastases from neuroendocrine tumours: How to avoid false positives on 68Ga-DOTA-TOC PET using CT pattern analysis?

PubMed

Gauthé, Mathieu; Testart Dardel, Nathalie; Ruiz Santiago, Fernando; Ohnona, Jessica; Nataf, Valérie; Montravers, Françoise; Talbot, Jean-Noël

2018-03-12

To develop criteria to improve discrimination between vertebral metastases from neuroendocrine tumours (NETs) and benign bone lesions on PET combined with CT using DOTA-D-Phe 1 -Tyr 3 -octreotide labelled with gallium-68 ( 68 Ga-DOTA-TOC). In 535 NET patients, 68 Ga-DOTA-TOC PET/CT examinations were reviewed retrospectively for vertebral CT lesions and/or PET foci. For each vertebral PET abnormality, appearance on CT, biological volume (BV), standardized uptake value (SUV max ) and ratios to those of reference organs were determined. All vertebral abnormalities were characterized as a metastasis, a typical vertebral haemangioma (VH) or other benign lesion. In 79 patients (14.8 %), we found 107 metastases, 34 VHs and 31 other benign lesions in the spine. The optimal cut-off values to differentiate metastases from benign lesions were BV ≥0.72 cm 3 , SUVmax ≥2, SUVmax ratio to a reference vertebra ≥2.1, to liver ≥0.28 and to spleen ≥0.14. They corresponded to lesion-based 68 Ga-DOTA-TOC PET/CT sensitivity of 87 %, 98 %, 97 %, 99 % and 94 %, and specificity of 55 %, 100 %, 90 %, 97 %, 100 %, respectively. The high sensitivity of 68 Ga-DOTA-TOC-PET/CT in detecting NET vertebral metastases was confirmed; this study showed that specificity could be improved by combining CT features and quantifying 68 Ga-DOTA-TOC uptake. • Bone metastases in neuroendocrine tumours correlate with prognosis. • Benign bone lesions may mimic metastases on 68 Ga-DOTA-TOC PET/CT imaging. • The specific polka-dot CT pattern may be missing in some vertebral haemangiomas. • Lesion atypical for haemangiomas can be better characterized by quantifying 68 Ga-DOTA-TOC uptake.

The Relationship between TOC and pH with Exchangeable Heavy Metal Levels in Lithuanian Podzols

NASA Astrophysics Data System (ADS)

Khaledian, Yones; Pereira, Paulo; Brevik, Eric C.; Pundyte, Neringa; Paliulis, Dainius

2017-04-01

Heavy metals can have a negative impact on public and environmental health. The objective of this study was to investigate the relationship between total organic carbon (TOC) and pH with exchangeable heavy metals (Pb, Cd, Cu and Zn) in order to predict exchangeable heavy metal content in soils sampled near Panevėžys and Kaunas, Lithuania. Principal component regression (PCR) and nonlinear regression methods were tested to find the statistical relationship between TOC and pH with heavy metals. The results of PCR [R2 = 0.68, RMSE = 0.07] and non-linear regression [R2 = 0.74, RMSE= 0.065] (pH with TOC and exchangeable parameters) were statistically significant. However, this was not observed in the relationships of pH and TOC separately with exchangeable heavy metals. The results indicated that pH had a higher correlation with exchangeable heavy metals (non-linear regression [R2 = 0.72, RMSE= 0.066]) than TOC with heavy metals [R2 = 0.30, RMSE= 0.004]. It can be concluded that even though there was a strong relationship between TOC and pH with exchangeable metals, the metal mobility (exchangeable metals) can be explained by pH better than TOC in this study. Finally, manipulating soil pH could likely be productive to assess and control heavy metals when financial and time limitations exist (Khaledian et al. 2016). Reference(s) Khaledian Y, Pereira P, Brevik E.C, Pundyte N, Paliulis D. 2016. The Influence of Organic Carbon and pH on Heavy Metals, Potassium, and Magnesium Levels in Lithuanian Podzols. Land Degradation and Development. DOI: 10.1002/ldr.2638

A functional genomics approach reveals CHE as a component of the Arabidopsis circadian clock.

PubMed

Pruneda-Paz, Jose L; Breton, Ghislain; Para, Alessia; Kay, Steve A

2009-03-13

Transcriptional feedback loops constitute the molecular circuitry of the plant circadian clock. In Arabidopsis, a core loop is established between CCA1 and TOC1. Although CCA1 directly represses TOC1, the TOC1 protein has no DNA binding domains, which suggests that it cannot directly regulate CCA1. We established a functional genomic strategy that led to the identification of CHE, a TCP transcription factor that binds specifically to the CCA1 promoter. CHE is a clock component partially redundant with LHY in the repression of CCA1. The expression of CHE is regulated by CCA1, thus adding a CCA1/CHE feedback loop to the Arabidopsis circadian network. Because CHE and TOC1 interact, and CHE binds to the CCA1 promoter, a molecular linkage between TOC1 and CCA1 gene regulation is established.

Accessing global data from accelerator devices

DOEpatents

Bertolli, Carlo; O'Brien, John K.; Sallenave, Olivier H.; Sura, Zehra N.

2016-12-06

An aspect includes a table of contents (TOC) that was generated by a compiler being received at an accelerator device. The TOC includes an address of global data in a host memory space. The global data is copied from the address in the host memory space to an address in the device memory space. The address in the host memory space is obtained from the received TOC. The received TOC is updated to indicate that global data is stored at the address in the device memory space. A kernel that accesses the global data from the address in the device memory space is executed. The address in the device memory space is obtained based on contents of the updated TOC. When the executing is completed, the global data from the address in the device memory space is copied to the address in the host memory space.

Solar photo-degradation of a pharmaceutical wastewater effluent in a semi-industrial autonomous plant.

PubMed

Expósito, Antonio J; Durán, Antonio; Monteagudo, José M; Acevedo, Alba

2016-05-01

An industrial wastewater effluent coming from a pharmaceutical laboratory has been treated in a semi-industrial autonomous solar compound parabolic collector (CPC) plant. A photo-Fenton process assisted with ferrioxalate has been used. Up to 79% of TOC can be removed in 2 h depending on initial conditions when treating an aqueous effluent containing up to 400 ppm of initial organic carbon concentration (TOC). An initial ratio of Fe(II)/TOC higher than 0.5 guarantees a high removal. It can be seen that most of TOC removal occurs early in the first hour of reaction. After this time, mineralization was very slow, although H2O2 was still present in solution. Indeed it decomposed to form oxygen in inefficient reactions. It is clear that remaining TOC was mainly due to the presence of acetates which are difficult to degrade. Copyright © 2016 Elsevier Ltd. All rights reserved.

Accessing global data from accelerator devices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bertolli, Carlo; O'Brien, John K.; Sallenave, Olivier H.

2016-12-06

An aspect includes a table of contents (TOC) that was generated by a compiler being received at an accelerator device. The TOC includes an address of global data in a host memory space. The global data is copied from the address in the host memory space to an address in the device memory space. The address in the host memory space is obtained from the received TOC. The received TOC is updated to indicate that global data is stored at the address in the device memory space. A kernel that accesses the global data from the address in the devicemore » memory space is executed. The address in the device memory space is obtained based on contents of the updated TOC. When the executing is completed, the global data from the address in the device memory space is copied to the address in the host memory space.« less

Catalytic wet air oxidation of aniline with nanocasted Mn-Ce-oxide catalyst.

PubMed

Levi, R; Milman, M; Landau, M V; Brenner, A; Herskowitz, M

2008-07-15

The catalytic wet air oxidation of aqueous solution containing 1000 ppm aniline was conducted in a trickle-bed reactor packed with a novel nanocasted Mn-Ce-oxide catalyst (surface area of 300 m2/g) prepared using SBA-15 silica as a hard template. A range of liquid hourly space velocities (5-20 h(-1)) and temperatures (110-140 degrees C) at 10 bar of oxygen were tested. The experiments were conducted to provide the intrinsic performance of the catalysts. Complete aniline conversion, 90% TOC conversion, and 80% nitrogen mineralization were achieved at 140 degrees C and 5 h(-1). Blank experiments yielded relatively low homogeneous aniline (<35%) and negligible TOC conversions. Fast deactivation of the catalysts was experienced due to leaching caused by complexation with aniline. Acidification of the solution with HCI (molar HCI to aniline ratio of 1.2) was necessary to avoid colloidization and leaching of the nanoparticulate catalyst components. The catalyst displayed stable performance for over 200 h on stream.

[Severe infections in children with sickle cell disease: clinical aspects and prevention].

PubMed

Bégué, P; Castello-Herbreteau, B

2001-09-01

Sickle-cell disease (SCD) is associated with frequent and often severe infections as a result of immune function impairment and functional asplenia. Also, infection can trigger a vasoocclusive crisis. Pneumonococcal bacteremia and meningitis due to S. pneumoniae are often lethal and justify the penicillin prophylaxis, which has provided a dramatic decrease in early mortality bacterial pneumonia is common in patients younger than four years, with most cases being due to S. pneumoniae, H. influenzae, Mycoplasma pneumoniae, Chlamydia pneumoniae. Acute chest syndrome is both a difficult differential diagnosis and a common concomitant of bacterial pneumonia, because they are often intricated. Osteomyelitis is generally due to Salmonella, most often S. enteritidis. Multiple foci are common and treatment is difficult, with some patients developing chronic osteomyelitis with sequestration. Osteomyelitis is less frequent in developed countries and must been differentiated with bone infarction by use of bone scintigraphy. Parvovirus B19 infection causes acute erythroblastopenias. Malaria does not result in cerebral malaria, but can lead to severe anaemia or vasoocclusive crisis, and should therefore be effectively prevented. Antimicrobials are generally selected for efficacy against pneumococci (septicemia, meningitis), Salmonella (osteomyelitis, meningitis), and M. pneumoniae (pneumonia). Prophylactic therapy is of paramount importance and relies on long-term or lifelong penicillin therapy started at three months of age and no closely-spaced immunizations, most notably against peumococci, hepatitis B virus, S. typhi and H. influenzae. Resistant pneumococcal strains have not been reported to cause prophylactic treatment failures. New conjugated pneumococcal vaccines are effective in protecting very young infants and should therefore be used in sickle cell patients.

Diagnostic performance of Fluorine-18-Fluorodeoxyglucose positron emission tomography for the diagnosis of osteomyelitis related to diabetic foot: a systematic review and a meta-analysis.

PubMed

Treglia, Giorgio; Sadeghi, Ramin; Annunziata, Salvatore; Zakavi, Seyed Rasoul; Caldarella, Carmelo; Muoio, Barbara; Bertagna, Francesco; Ceriani, Luca; Giovanella, Luca

2013-12-01

To systematically review and meta-analyse published data about the diagnostic performance of Fluorine-18-Fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and PET/computed tomography (PET/CT) in osteomyelitis related to diabetic foot. A comprehensive literature search of studies on (18)F-FDG-PET and PET/CT in patients with diabetic foot was performed. Pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR-) and diagnostic odds ratio (DOR) and area under the summary ROC curve of (18)F-FDG-PET and PET/CT in patients with osteomyelitis related to diabetic foot were calculated. Nine studies comprising 299 patients with diabetic foot were included in the qualitative analysis (systematic review) and discussed. The quantitative analysis (meta-analysis) of four selected studies provided the following results on a per patient-based analysis: sensitivity was 74% [95% confidence interval (95%CI): 60-85%], specificity 91% (95%CI: 85-96%), LR+ 5.56 (95%CI: 2.02-15.27), LR- 0.37 (95%CI: 0.10-1.35), and DOR 16.96 (95%CI: 2.06-139.66). The area under the summary ROC curve was 0.874. In patients with suspected osteomyelitis related to diabetic foot (18)F-FDG-PET and PET/CT demonstrated a high specificity, being potentially useful tools if combined with other imaging methods such as MRI. Nevertheless, the literature focusing on the use of (18)F-FDG-PET and PET/CT in this setting remains still limited. Copyright © 2013 Elsevier Ltd. All rights reserved.

Deep wound cultures correlate well with bone biopsy culture in diabetic foot osteomyelitis.

PubMed

Malone, M; Bowling, F L; Gannass, A; Jude, E B; Boulton, A J M

2013-10-01

Osteomyelitis is a major complication in patients with diabetic foot ulceration. Accurate pathogenic identification of organisms can aid the clinician to a specific antibiotic therapy thereby preventing the need for amputation. All diabetic patients with bone biopsy-confirmed osteomyelitis were included into the study: biopsies were performed either during surgical removal of infected bone or percutaneously under guided fluoroscopy through non-infected tissue. The depth and extent of the ulcer was assessed using a sterile blunt metal probe. Deep wound cultures were taken from the wound base after sharp debridement. Of 66 cases of suspected osteomyelitis in 102 joints, 34 patients had both bone biopsies and deep wound cultures over the study period. Thirty two of 34 (94%), had a history of preceding foot ulceration, and in 25 of the cases a positive probe to bone test was recorded. In a high proportion of patients, at least one similar organism was isolated from both the deep wound culture and bone biopsy procedures (25 of 34 cases, 73.5%, p<0.001). When organisms were isolated from both wound cultures and bone biopsies, the identical strain was identified in both procedures in a significant proportion of cases (16 of 25 cases, 64%, p<0.001, total sample analysis in 16 of 34 cases, 47%). Deep wound cultures correlate well with osseous cultures and provide a sensitive method in assessing and targeting likely pathogens that cause osseous infections. This will help aid the clinician in guiding antibiotic therapy in centers where bone biopsies may not be readily available. Copyright © 2013 John Wiley & Sons, Ltd.

Skull base osteomyelitis: current microbiology and management.

PubMed

Spielmann, P M; Yu, R; Neeff, M

2013-01-01

Skull base osteomyelitis typically presents in an immunocompromised patient with severe otalgia and otorrhoea. Pseudomonas aeruginosa is the commonest pathogenic micro-organism, and reports of resistance to fluoroquinolones are now emerging, complicating management. We reviewed our experience of this condition, and of the local pathogenic organisms. A retrospective review from 2004 to 2011 was performed. Patients were identified by their admission diagnostic code, and computerised records examined. Twenty patients were identified. A facial palsy was present in 12 patients (60 per cent). Blood cultures were uniformly negative, and culture of ear canal granulations was non-diagnostic in 71 per cent of cases. Pseudomonas aeruginosa was isolated in only 10 (50 per cent) cases; one strain was resistant to ciprofloxacin but all were sensitive to ceftazidime. Two cases of fungal skull base osteomyelitis were identified. The mortality rate was 15 per cent. The patients' treatment algorithm is presented. Our treatment algorithm reflects the need for multidisciplinary input, early microbial culture of specimens, appropriate imaging, and prolonged and systemic antimicrobial treatment. Resolution of infection must be confirmed by close follow up and imaging.

Surgical treatment of pyogenic vertebral osteomyelitis with spinal instrumentation

PubMed Central

Chen, Wei-Hua; Jiang, Lei-Sheng

2006-01-01

Pyogenic vertebral osteomyelitis responds well to conservative treatment at early stage, but more complicated and advanced conditions, including mechanical spinal instability, epidural abscess formation, neurologic deficits, and refractoriness to antibiotic therapy, usually require surgical intervention. The subject of using metallic implants in the setting of infection remains controversial, although more and more surgeons acknowledge that instrumentation can help the body to combat the infection rather than to interfere with it. The combination of radical debridement and instrumentation has lots of merits such as, restoration and maintenance of the sagittal alignment of the spine, stabilization of the spinal column and reduction of bed rest period. This issue must be viewed in the context of the overall and detailed health conditions of the subjecting patient. We think the culprit for the recurrence of infection is not the implants itself, but is the compromised general health condition of the patients. In this review, we focus on surgical treatment of pyogenic vertebral osteomyelitis with special attention to the role of spinal instrumentation in the presence of pyogenic infection. PMID:17106664