The Birth and Development of Continuous Ambulatory Peritoneal Dialysis.

Peritoneal dialysis has a long and tortuous history. First done in animals in the late 1800s, it became clinically practical in the early 1960s. Peritoneal access was first achieved by intermittent abdominal puncture, and then through the development of a 'permanent access' when Silastic became available.

Comparison of Contaminant Transport in Agricultural Drainage Water and Urban Stormwater Runoff.

Transport of nitrogen and phosphorus from agricultural and urban landscapes to surface water bodies can cause adverse environmental impacts. The main objective of this long-term study was to quantify and compare contaminant transport in agricultural drainage water and urban stormwater runoff. We measured flow rate and contaminant concentration in stormwater runoff from Willmar, Minnesota, USA, and in drainage water from subsurface-drained fields with surface inlets, namely, Unfertilized and Fertilized Fields.

Telemedicine: the slow revolution.

The use of interactive video has been recognized as a means of delivering medical support to isolated areas since the 1950s. The Department of Defense recognized early the capacity of telemedicine to deliver medical care and support to front-line military personnel. In 1989, the Texas Telemedicine Project received grants and support from the then American Telephone and Telegraph Company (now AT&T) and the Meadows Foundation of Dallas, Texas, to establish and evaluate telemedicine delivery in central Texas.

Acute effects of hemodialysis on nitrite and nitrate: potential cardiovascular implications in dialysis patients.

Cardiovascular mortality in dialysis patients remains a serious problem. It is 10 to 20 times higher than in the general population. No molecular mechanism has been proven to explain this increased mortality, although nitric oxide (NO) has been implicated.

Effects of polymer-coated urea on nitrate leaching and nitrogen uptake by potato.

Increasing groundwater nitrate concentrations in potato (Solanum tuberosum L.) production regions have prompted the need to identify alternative nitrogen management practices. A new type of polymer-coated urea (PCU) called Environmentally Smart Nitrogen (Agrium, Inc.

Why bury the distal end of the peritoneal dialysis catheter.

The first catheters for peritoneal dialysis were made in silicone with a Dacron cuff, which allowed tissue ingrowth, creating a barrier to the entrance of bacteria from the skin surface. However, the interruption of the skin envelope produces recurrent exit site and tunnel infections and peritonitis, which are the leading causes of discontinuing peritoneal dialysis. Experimental evidence suggests that the use of a double cuff silastic catheter and subcutaneous implantation of the distal catheter for 5-6 weeks before exposure reduces such infections, thus improving catheter life.

Tillage and nutrient source effects on water quality and corn grain yield from a flat landscape.

Beneficial effects of leaving residue at the soil surface are well documented for steep lands, but not for flat lands that are drained with surface inlets and tile lines. This study quantified the effects of tillage and nutrient source on tile line and surface inlet water quality under continuous corn (Zea mays L.) from relatively flat lands (<3%).

Rate of fall-applied liquid swine manure: effects on runoff transport of sediment and phosphorus.

Reducing the delivery of phosphorus (P) from land-applied manure to surface water is a priority in many watersheds. Manure application rate can be controlled to manage the risk of water quality degradation. The objective of this study was to evaluate how application rate of liquid swine manure affects the transport of sediment and P in runoff.

Tillage and manure application effects on mineral nitrogen leaching from seasonally frozen soils.

Land application of manure is a common practice in the Upper Midwest of the United States. Recently, there have been concerns regarding the effect of this practice on water quality, especially when manure is applied during winter over frozen soils. A study undertaken on a Rozetta silt loam (fine-silty, mixed, superactive, mesic Typic Hapludalfs) at Lancaster, WI, evaluated the effects of tillage and timing of manure application on surface and subsurface water quality.

Pharmacokinetics of etoricoxib in patients with renal impairment.

The effect of renal insufficiency on the pharmacokinetics of etoricoxib, a selective inhibitor of cyclooxygenase-2, was examined in 23 patients with varying degrees of renal impairment (12 moderate [creatinine clearance between 30 and 50 mL/min/1.73 m2], 5 severe [creatinine clearance below 30 mL/min/1.73 m2], and 6 with end-stage renal disease requiring hemodialysis) following administration of single 120-mg oral doses of etoricoxib.

Role of macropore continuity and tortuosity on solute transport in soils: 1. Effects of initial and boundary conditions.

Models developed for solute transport vary in their assumptions on macropore continuity and tortuosity. It is unclear how much simplification can be made in computer models to characterize macropore effects on water and solute transport through soils. The objectives of this study were to assess how the importance of macropore continuity and tortuosity varies (1) with various initial and boundary conditions (this paper) and (2) with simplifying model assumptions for macropore description (companion paper).

Role of macropore continuity and tortuosity on solute transport in soils: 2. Interactions with model assumptions for macropore description.

The impact of macropore description on solute transport predictions in soils is not well understood. A 2-D Galerkin finite element model was used to compare different approaches for describing macropore flow in soil. The approaches were: a modification of the hydraulic conductivity function (Hydraulic function), the lumping of all macropores into one single straight macropore (Lumping), the use of an exchange factor between microporosities and macroporosities that occupy the same area (Dual porosity), and a detailed description of each macropore (Full description, base case).

An integrative analysis of the role of atmospheric deposition and land management practices on nitrogen in the US agricultural sector.

Additions of anthropogenic nitrogen (N) compounds constitute one of the major classes of air pollutants of significance to human health and the environment. Reliance on wet deposition measurements alone can lead to considerable underestimates (by 40-60%) of the total (wet + dry) atmospheric N deposition. In addition, wet deposition of N are about 20% of the levels that are lost due to volatilization (primarily ammonia).

Herbicide banding and tillage system interactions on runoff losses of alachlor and cyanazine.

Herbicides transported to surface waters by agricultural runoff are partitioned between solution and solid phases. Conservation tillage that reduces upland erosion will also reduce transport of herbicides associated with the solid phase. However, transport of many herbicides occurs predominantly in solution.

Tillage and nutrient source effects on surface and subsurface water quality at corn planting.

This study quantified the effects of tillage (moldboard plowing [MP], ridge tillage [RT]) and nutrient source (manure and commercial fertilizer [urea and triple superphosphate]) on sediment, NH4+ -N, NO3- -N, total P, particulate P, and soluble P losses in surface runoff and subsurface tile drainage from a clay loam soil. Treatment effects were evaluated using simulated rainfall immediately after corn (Zea mays L.) planting, the most vulnerable period for soil erosion and water quality degradation.

Fragilysin, the enterotoxin from Bacteroides fragilis, enhances the serum antibody response to antigen co-administered by the intranasal route.

Fragilysin, an extracellular zinc metalloprotease produced by enterotoxigenic strains of the anaerobic bacterium Bacteroides fragilis, disrupts the paracellular barrier by cleavage of the intercellular proteins between epithelial cells resulting in fluid secretion. Intranasal immunization of mice with fragilysin and co-administered ovalbumin (Ova) resulted in an Ova-specific serum IgG response that was over 18000-fold higher than Ova alone, as well as detectable levels of serum IgA. Serum IgG titers were comparable with those seen when whole cholera toxin was used as the adjuvant, although the responses obtained with fragilysin showed more variability between mice.

Genetic characterization of toxin A-negative, toxin B-positive Clostridium difficile isolates by PCR.

Toxin-specific enzyme immunoassays, cytotoxicity assays, and PCR were used to analyze 48 toxin A-negative, toxin B-positive Clostridium difficile isolates from various geographical sites around the world. All the isolates were negative by the TOX-A TEST and positive by the TOX A/B TEST. A deletion of approximately 1.

Clostridium difficile recombinant toxin A repeating units as a carrier protein for conjugate vaccines: studies of pneumococcal type 14, Escherichia coli K1, and Shigella flexneri type 2a polysaccharides in mice.

Unlike the native protein, a nontoxic peptide (repeating unit of the native toxin designated rARU) from Clostridium difficile toxin A (CDTA) afforded an antigen that could be bound covalently to the surface polysaccharides of pneumococcus type 14, Shigella flexneri type 2a, and Escherichia coli K1. The yields of these polysaccharide-protein conjugates were significantly increased by prior treatment of rARU with succinic anhydride. Conjugates, prepared with rARU or succinylated (rARUsucc), were administered to mice by a clinically relevant dosage and immunization scheme.

Telemedicine in the care of the end-stage renal disease patient.

Interactive video was used to monitor patients undergoing hemodialysis in a rural community over a 55-mile distance. Between April of 1991 and April 1993, the Texas Telemedicine Project sponsored the contact and record management. During this period, 1,500 patient contacts were documented.

Molecular characterization of the fragilysin pathogenicity islet of enterotoxigenic Bacteroides fragilis.

Enterotoxigenic strains of Bacteroides fragilis produce an extracellular metalloprotease toxin (termed fragilysin) which is cytopathic to intestinal epithelial cells and induces fluid secretion and tissue damage in ligated intestinal loops. We report here that the fragilysin gene is contained within a small genetic element termed the fragilysin pathogenicity islet. The pathogenicity islet of B.

Positive regulation of Clostridium difficile toxins.

The toxigenic element of Clostridium difficile VPI 10463 contains a small open reading frame (ORF) immediately upstream of the toxin B gene (G. A. Hammond and J.

Cloning and characterization of the gene for the metalloprotease enterotoxin of Bacteroides fragilis.

The Bacteroides fragilis enterotoxin is an extracellular zinc metalloprotease that has been implicated in diarrheal disease of humans and animals. This toxin causes fluid accumulation in intestinal loops and is cytotoxic for HT-29 cells, an intestinal carcinoma cell line. Here we report the cloning and sequencing of the toxin gene (bftP).