Revalidation: the catalyst for change in continuing professional development?

Remarkably, only five years ago, hospital specialists were under no formal obligation to record participation in Continuing Medical Education (CME). No one seriously doubted that such education took place, but the system had never been challenged. In recent years, and with apparently ever increasing pace, all this is changing.

Purification and characterization of an extracellular feruloyl esterase from the thermophilic anaerobe Clostridium stercorarium.

Feruloyl esterases act as accessory enzymes for the complete saccharification of plant cell wall hemicelluloses. Although many fungal feruloyl esterases have been purified and characterized, few bacterial phenolic acid esterases have been characterized. This study shows the extracellular production of a feruloyl esterase by the thermophilic anaerobe Clostridium stercorarium when grown on birchwood xylan.

Vascular surgical society of great britain and ireland: scottish audit of surgical mortality, 1997.

BACKGROUND: A national audit of surgical deaths can be seen as the final step in what has been termed the 'journey of care' for both the individual patient and for the population as a whole. METHODS: The Scottish Audit of Surgical Mortality (SASM) examines all hospital deaths in Scotland occurring while under the care of a surgical specialist and all deaths within 30 days of an operation. RESULTS: Compliance for the completion of forms relating to vascular deaths during the first 4 years of the SASM (1994-1997) has remained over 92 per cent.

Determinants of tuberculin reactivity among health care workers: Interpretation of positivity following BCG vaccination.

Objective: To determine the extent to which a history of Bacille Calmette-Guerin (BCG) vaccination influences the likelihood of positive tuberculin skin test (TST) results.

Design: Cross-sectional survey using a hospital-based tuberculosis surveillance program.

Setting: Health Sciences Centre, a tertiary care hospital in Winnipeg, Manitoba.

Detection of ferulic acid esterase production by Bacillus spp. and lactobacilli.

The production of feruloyl esterase activity by Bacillus spp. and lactobacilli can be detected in an agarplate assay. The assay involves the substitution of the main carbon source in specific agar with ethyl ferulate.

Purification and characterization of a feruloyl esterase from the fungus Penicillium expansum.

An extracellular phenolic acid esterase produced by the fungus Penicillium expansum in solid state culture released ferulic and rho-coumaric acid from methyl esters of the acids, and from the phenolic-carbohydrate esters O-[5-O-(trans-feruloyl)-alpha-L-arabinofuranosyl]-(1-->3)-O-beta- D-xylopyranosyl-(1-->4)-D-xylopyranose (FAXX) and O-[5-O-((E)-rho-coumaroyl)-alpha-L-arabinofuranosyl]- (1-->3)-O-beta-D-xylopyranosyl-(1-->4)-D-xylopyranose (PAXX). The esterase was purified 360-fold in successive steps involving ultrafiltration and column chromatography by gel filtration, anion exchange and hydrophobic interaction. These chromatographic methods separated the phenolic acid esterase from alpha-L-arabinofuranosidase, pectate and pectin lyase, polygalacturonase, xylanase and beta-D-xylosidase activities.

The growth of Salmonella typhimurium on irradiated, raw, skinless chicken breast.

Salmonella typhimurium was inoculated onto 1 g cubed samples of irradiated, raw, skinless chicken breast, which were then incubated at 30 degrees C under humid conditions. Kinetic growth data was obtained by means of viable counts performed on triplicate samples over a 24 h period. In addition, the spatial arrangement of cells on samples taken 6, 12 and 24 h after inoculation was observed by scanning electron microscopy.

Intraoperative identification of sentinel lymph node in patients with malignant melanoma.

We report our experience with the technique of lymphatic mapping using patent blue V dye in patients with limb malignant melanoma. The technique is based on the hypothesis that embolic metastases occur along lymphatic channels to a 'sentinel' lymph node: the draining lymph node nearest the site of the primary malignant melanoma. Patent blue V dye (0.

Glucose modification of human serum albumin: a structural study.

Structural changes associated with the exposure of human serum albumin (HSA) to glucose with or without the presence of Cu (II) have been characterized using a bank of methods for structural analysis including circular dichroism (CD), amino acid analysis (AAA), fluorescence measurements, SDS-PAGE, and boronate binding (which is a measure of Amadori product formation). We show that in the short-term (10 d) incubation mixtures, HSA is resistant to Cu (II)-mediated oxidative damage and that the early products of glycation of HSA had minimal effects on the folded structure. Amino acid analysis showed that there was no formation of advanced glycation endproducts (AGE), which can be measured by loss of lysine.

Delusions in schizophrenia: a phenomenological and psychological exploration.

The psychopathological basis of delusions in schizophrenia is poorly understood. The most enduring of several early theories has suggested a causal link with formal thought disorder, whereas recent approaches have proposed relationships with a variety of cognitive abnormalities. The correlations of delusions with other schizophrenic symptoms and with cognitive functions including semantic memory, executive function, and also probabilistic reasoning bias, were examined in a series of (overlapping) groups of 43-79 schizophrenic patients.

A comparison of dosimetric methods in isolated limb perfusion with melphalan for malignant melanoma of the lower extremity.

The three dosimetric schedules currently used in isolated limb perfusion with melphalan for malignant melanoma of the lower limb were compared in a series of 51 patients. The doses prescribed by each of the three methods (based on total body weight (TBW), limb tissue volume (LTV) and total blood volume in the perfusion circuit (TBV)) were calculated for all patients and were then compared using Wilcoxon's signed-rank test. This revealed that the method based on TBV consistently prescribed much lower doses of drug than either of the other two methods.

A single centre's 10 year experience with isolated limb perfusion in the treatment of recurrent malignant melanoma of the limb.

The aim of this study was to assess whether isolated limb perfusion can be performed safely and whether it offers improved disease-free survival for patients with limb malignant melanoma. Between August 1983 and July 1993, 103 patients (78 female, 25 male) with recurrent limb melanoma were treated by isolated limb perfusion (ILP) in Glasgow, U.K.

Neuropsychological impairments in unipolar depression: the influence of perceived failure on subsequent performance.

The CANTAB battery of neuropsychological tests was used to compare the performance of 28 patients with unipolar depression with that of 22 age and IQ matched controls. The patients were impaired on almost all tests studied with deficits in pattern and spatial recognition memory, matching to sample, spatial span, spatial working memory and planning. Most of the patients showed at least some impairment and deficits were seen across cognitive domains.

A method for simultaneous recording and assessment of gut contractions and relaxations in vivo.

The normal gut exhibits both contractions and relaxation from a resting tonus. Pathological and pharmacological information may be gleaned from separate measurement of these activities. Methods for recording and analyzing gut contractions have been presented before.

Semantic memory is impaired in schizophrenia.

Memory is emerging as a key area of neuropsychological deficit in schizophrenia, with evidence suggesting that the impairment is restricted to long-term memory. Semantic memory, the component of long-term memory containing stored representations of the meanings of words and knowledge about the world, was examined in 46 schizophrenic patients and 40 normal controls using a recently devised battery of tests. Evidence of semantic memory impairment was found which was wide ranging and substantial; in some cases it approached the levels seen in a group of 22 patients with mild-to-moderate Alzheimer's disease.

Aminoguanidine and its pro-oxidant effects on an experimental model of protein glycation.

Recent reports show a pro-oxidant activity of aminoguanidine. Aminoguanidine is able to generate hydrogen peroxide in the presence of Cu (II). These observations have been confirmed by the present studies in that aminoguanidine is, indeed, able to generate oxidants similar in reactivity to the hydroxyl radical and is also able to fragment BSA in a Cu (II)-dependent manner.

The Scottish Royal Colleges: a prospective survey of continuing medical education undertaken by their examiners.

Objective: To measure the amount and nature of Continuing Medical Education (CME) activity undertaken by the examiners of the three Scottish Royal Colleges. The data obtained to be compared with recommendations for formal CME participation published by the medical Royal Colleges and Faculties.

Design: All examiners in active clinical practice prospectively surveyed over a 12 month period by completing a monthly return from a specially designed loose-leaf diary.

Production of feruloyl/rho-coumaroyl esterase activity by Penicillium expansum, Penicillium brevicompactum and Aspergillus niger.

Extracellular esterase production by Penicillium expansum, Penicillium brevicompactum and Aspergillus niger was determined in both liquid and solid-state culture. Methyl ferulate was used as the main carbon source in liquid culture whereas wheat bran and sugar beet pulp were used in solid-state culture. Extracted enzyme for each fungus showed activity in the presence of ONP butyrate, methyl ferulate, methyl coumarate and two 'natural' feruloylated carbohydrate esters.

A comparison of the effects of exogenous and endogenous prostaglandins on fast and slow contractions of field-stimulated guinea-pig vas deferens.

1. This study has compared the effects of exogenous and endogenous prostaglandins on the two phases of contraction of the guinea-pig vas deferens produced by electrical field stimulation. Prostaglandin E2 (PGE2), sulprostone and arachidonic acid dose-dependently and completely inhibited the first (fast) phase of contraction, with IC50s of 2.

The effect of sodium chloride concentration and pH on the growth of Salmonella typhimurium colonies on solid medium.

The growth of Salmonella typhimurium colonies on a model food system (agar solidified culture medium) was followed. Colony radius, determined using computer image analysis (IA) techniques, and viable cell number per colony were measured as indices of colony growth, and the effect of [NaCl] (0.5-3.

Carbon dioxide laser ablation as an alternative treatment for cutaneous metastases from malignant melanoma.

Surgical excision of cutaneous malignant melanoma metastases is practical only when the number of lesions is small. In some patients isolated limb perfusion is not possible or fails to achieve control, and carbon dioxide laser ablation is then an alternative treatment. Between September 1992 and September 1994, 19 patients aged 45-94 years were treated with carbon dioxide laser.