Detection of the genes encoding botulinum neurotoxin types A to E by the polymerase chain reaction.

The polymerase chain reaction (PCR) was used as the basis for the development of highly sensitive and specific diagnostic tests for organisms harboring botulinum neurotoxin type A through E genes. Synthetic DNA primers were selected from nucleic acid sequence data for Clostridium botulinum neurotoxins. Individual components of the PCR for each serotype (serotypes A through E) were adjusted for optimal amplification of the target fragment.

Characterization of an endo-1,3(4)-beta-D-glucanase gene from Cellvibrio mixtus.

An endo-1,3(4)-beta-D-glucanase gene (cwd2) of Cellvibrio mixtus encoding laminarinase activity was cloned on a 3.9-kb PstI fragment. The Cwd2 enzyme, extracted from recombinant Escherichia coli, degraded both beta-1,3 glucans and beta-1,3-1,4 mixed-linkage glucans, was endohydrolytic and so conformed to the enzyme class 3.

Parameters of anorectal and colonic motility in health and in severe constipation.

Anorectal function and colonic transit was assessed in 17 severely constipated patients and 15 age-matched controls. The constipated patients were divided into those who had "immobile perineum" (perineal descent < or = 1.0 cm during attempted defecation) and those who had a normal descent (> 1.

Relationship between anal canal tone and rectal motor activity.

The anal sphincters facilitate fecal continence by maintaining a pressure barrier; whether proximal contractile events influence this barrier is unknown. The aim of this study was to determine whether a relationship exists between anal canal pressures and rectal motor activity. A fully ambulatory system for prolonged pressure recording was developed.

Fecal short-chain fatty acid concentrations and effect on ileal pouch function.

Random stool samples were obtained from 14 ileal pouch-anal anastomosis (IPAA) patients 43 +/- 5 (mean +/- SEM) months after surgery, and the concentrations of individual short-chain fatty acids (SCFAs) were determined by gas liquid chromatography. Stool frequency was determined from a diary recorded for 15 days prior to stool sampling. The frequency, amplitude, and duration of phasic contractions (PCs) within the pouch following infusion of a physiologic concentration of SCFAs and normal saline randomly into the pouch of six IPAA patients were determined manometrically.

The histological pattern and pathological involvement of the anal transition zone in patients with ulcerative colitis.

Background: The aim was to determine whether the transitional epithelium (TE) of the anal transition zone (ATZ) was involved by chronic ulcerative colitis (CUC) and whether preserving the ATZ preserves the disease.

Methods: Proctocolectomy specimens from 50 CUC patients and 50 patients with rectal cancer serving as controls were stained with alcian-blue to map the ATZ, and biopsy specimens containing adjacent TE and rectal mucosa were examined.

Results: The mean inflammation score (0, none; 4, severe) in TE of controls was 0.

Anorectal dysfunction and rectal prolapse in progressive systemic sclerosis.

Our aim was to characterize the clinical spectrum of anorectal dysfunction among eight patients with progressive systemic sclerosis (PSS) who presented with altered bowel movements with or without fecal incontinence. The anorectum was assessed by physical examination, proctosigmoidoscopy, and anorectal manometry. There was concomitant involvement of the other regions of the digestive tract in all patients as determined by barium studies, endoscopy, or manometry: eight esophageal, three gastric, four small bowel, and two colonic.

[Undetermined colitis].

Indeterminate colitis combines features of chronic ulcerative colitis and Crohn's colitis and contemplates a dilemma for the patient and surgeon contemplating ileal pouch anal anastomosis. Some series have reported a high incidence of failure of pouch procedures in patients with indeterminate colitis. A series reported by the authors in 1989 reported a failure rate on approximately 9% with indeterminate colitis.

Continence disorders.

Strategies to evaluate patients with continence disorders continue to evolve at a rapid pace. These novel methods quantify physiologic events that, in turn, facilitate increasingly accurate discrimination among the causes of incontinence and constipation. This review discusses recent advances in the causes, diagnostic approaches, and management options available for patients with continence disorders.

DNA fingerprinting in non-human populations.

DNA fingerprinting of non-human populations is beginning to fulfill its early promise, and in the past year there has been a flush of papers on mammalian breeding systems. However, many people, particularly field workers, believe that progress in this area has been slow. Attention is now focused on two amenable alternatives: microsatellite polymorphisms and randomly amplified polymorphic DNA.

Long-term functional results and quality of life after ileal pouch-anal anastomosis and cholecystectomy.

Among 971 patients with chronic ulcerative colitis who underwent ileal-pouch anal anastomosis during an 8-year period from January, 1982 to December 1989, 30 patients were randomly selected from each year (total = 240 patients) for an assessment of their long-term functional results and quality of life as of 1990. Patients undergoing cholecystectomy during each of the same years served as "controls" (20 patients/year, total = 160 patients). All 400 patients completed a written questionnaire that measured bowel habits, overall quality of life, general health, and performance in sports/recreation, travel, sex life, family relationship, occupational work, social activities, and household activities.

Dysplasia in chronic ulcerative colitis: implications for colonoscopic surveillance.

Mucosal dysplasia has been used as a marker for patients with chronic ulcerative colitis considered to be most at risk of developing cancer, and its identification is the basis for colonoscopic surveillance programs. To evaluate the reliability of this premise, colectomy specimens from two groups of patients who had undergone surgery for chronic ulcerative colitis (50 with cancer and 50 without) were retrieved. The groups were matched by age, sex, duration of disease, disease extent, and symptoms at the time of surgery.

Results of pouch surgery after ileo-anal anastomosis: the implications of pouchitis.

The ileal pouch-anal operation is the procedure of choice for those suitable patients requiring surgery for chronic ulcerative colitis or familial adenomatous polyposis. The functional results are generally good but pouchitis remains a significant and poorly understood complication. This review encompasses factors relating to pouchitis, e.

DNA fingerprinting: parentage studies in natural populations and the importance of linkage analysis.

It has been suggested that a full linkage analysis is a prerequisite for confident paternity testing, by using DNA fingerprinting, in natural populations. These fears are based on a confusion between linkage and linkage disequilibrium and a misplaced assumption that linkage between bands will necessarily reduce the effective number of paternal-specific bands. Several methods for detecting linkage without resorting to the analysis of large sibships are considered, for example, by analysing half-sibships, by band-association, and by altering the experimental conditions used.

Experience in the surgical management of the hand in dystrophic epidermolysis bullosa.

Between 1981 and 1990, 45 patients (80 hands) underwent 122 hand operations, involving extensive release of contractures and pseudosyndactyly, with split skin grafting of secondary defects. Other procedures included the use of Kirschner wires, tendon release and arthroplasty. A postoperative programme of long term night splintage was employed.

High-frequency electroporation and maintenance of pUC- and pBR-based cloning vectors in Pseudomonas stutzeri.

A number of Escherichia coli cloning vectors, based on ColE1-like replicons, were shown to be maintained in Pseudomonas stutzeri ATCC 17588. A restrictionless mutant of P. stutzeri was isolated, and this strain was used to develop an efficient electroporation system.

The musculoskeletal manifestations of epidermolysis bullosa: an analysis of 19 cases with a review of the literature.

Epidermolysis bullosa encompasses a group of rare disorders characterized by marked skin fragility and blister formation. In patients with dystrophic epidermolysis bullosa, skeletal and soft-tissue abnormalities are an important feature. An analysis of the musculoskeletal manifestations in 19 patients is presented.

Pouchogram: predictor of clinical outcome following ileal pouch-anal anastomosis.

Unlabelled: Among 914 patients undergoing ileal pouch-anal anastomosis (IPAA) between January 1981 and June 1989, 463 (51 percent) had a pouchogram (meglumine diatrizoate [Gastrografin; E.R. Squibb & Sons, Inc.

Role of oxygen free radicals in the etiology of pouchitis.

Transient mucosal ischemia may cause oxygen-derived free radical production by xanthine oxidase, precipitating pouchitis after ileal pouch-anal anastomosis. Our aim, therefore, was to determine the effect of allopurinol, a xanthine oxidase inhibitor, in patients with acute and chronic pouchitis. Acute pouchitis was characterized clinically by sporadic episodes of increased frequency and decreased viscosity of stools, hematochezia, fever, malaise, and pelvic pain, which resolved promptly with treatment.

Analytic study of the Tadoma method: improving performance through the use of supplementary tactual displays.

Although results obtained with the Tadoma method of speechreading have set a new standard for tactual speech communication, they are nevertheless inferior to those obtained in the normal auditory domain. Speech reception through Tadoma is comparable to that of normal-hearing subjects listening to speech under adverse conditions corresponding to a speech-to-noise ratio of roughly 0 dB. The goal of the current study was to demonstrate improvements to speech reception through Tadoma through the use of supplementary tactual information, thus leading to a new standard of performance in the tactual domain.