A comparison of in vivo and in vitro methods for determining availability of iron from meals

A comparison is made between in vitro and human and rat in vivo methods for estimating food iron availability. Complex meals formulated to replicate meals used by Cook and Monsen (Am J Clin Nutr 1976;29:859) in human iron availability trials were used in the comparison. The meals were prepared by substituting pork, fish, cheese, egg, liver, or chicken for beef in two basic test meals and were evaluated for iron availability using in vitro and rat in vivo methods. When the criterion for comparison was the ability to show statistically significant differences between iron availability in the various meals, there was substantial agreement between the in vitro and human in vivo methods. There was less agreement between the human in vivo and the rat in vivo and between the in vivo and the rat in vivo and between the in vitro and the rat in vivo methods. Correlation analysis indicated significant agreement between in vitro and human in vivo methods. Correlation between the rat in vivo and human in vivo methods were also significant but correlations between the in vitro and rat in vivo methods were less significant and, in some cases, not significant. The comparison supports the contention that the in vitro method allows a rapid, inexpensive, and accurate estimation of nonheme iron availability in complex meals.     

What are the trends in cardiovascular pharmacotherapy in recent years in patients after myocardial infarct?

The authors compared the status of pharmacotherapy in 587 patients with myocardial infarction in 1991 according to the MONICA study, in hospitals of six districts in the Czech Republic, age group 25-64 years with data for 1995 assembled by means of questionnaires in 749 patients of the same age group, who were after myocardial infarction in selected spas. Thrombolytic treatment proved quite inadequate in 1988-1993 in six districts of the Czech Republic, although it rose slightly from mere 2.9% in 1988 to 11.1% in 1993. In 1995 25.4% patients with acute myocardial infarction were treated by thrombolytic treatment. Conversely anti-platelet treatment was very satisfactory in 1991 as well as in 1995. Promising was also the increase in treatment with beta-blockers and ACE inhibitors in 1995 as compared with 1991. Also the percentage of patients treated by hypolipidaemic treatment increased in 1995. This work indicates the favourable trends in pharmacotherapy of patients with acute myocardial infarction in the acute stage as well as in patients after myocardial infarction.     

Rapid detection cytomegalovirus pneumonia in recipients of bone marrow transplant: evaluation and comparison of five survey methods for bronchoalveolar lavage fluid

To detect cytomegalovirus-associated interstitial pneumonia (CMV-IP) in recipients of BMT in its earliest stage, five CMV methods were assessed for their usefulness using bronchoalveolar lavage fluid as the test specimen. Of the 43 cases enrolled in the study, PCR was positive in 12 cases, shell vial in eight, culture in eight and cytology in three. There were no positive cases in in situ hybridization. Based on this result, the 43 cases were classified into four groups: Group 1, three cases: positive in PCR, shell vial and cytology; Group 2, five cases: positive in PCR and shell vial; Group 3, four cases: positive only in PCR; and Group 4, 31 cases: negative in all CMV tests. Cases in Group 1 were judged as having the highest risk of overt CMV-IP. They were successfully treated with a combination of ganciclovir and immunoglobulin. Group 2 was diagnosed as having active CMV infection and ganciclovir monotherapy was effective for these patients. Groups 3 and 4 were not given anti-CMV therapy, but they were free from CMV-related manifestations throughout the study. The sensitivity and specificity of each survey method for the detection of Groups 1 and 2 were 1.0 and 0.89 in PCR, 1.0 and 1.0 in shell vial, 0.88 and 1.0 in culture, and 0.38 and 1.0 in cytology. Similarly, the positive and negative predictive values were 0.67 and 1.0 in PCR, 1.0 and 1.0 in shell vial, 1.0 and 0.97 in culture, and 1.0 and 0.88 in cytology. Thus, CMV survey on bronchoalveolar fluid was thought to be useful in detecting post BMT CMV-IP in its earliest stage.     

Leiomyosarcoma of the esophagus: results of surgical treatment

BACKGROUND: This study examined the results of surgical treatment of leiomyosarcoma of the esophagus. METHODS: Between January 1920 and December 1996, 17 patients (9 men and 8 women) with leiomyosarcoma of the esophagus were treated surgically at the Mayo Clinic. Median age was 58 years and ranged from 26 to 76 years. Symptoms included dysphagia in 11 patients (64.7%) and odynophagia in 6 (35.3%). The tumor was located in the middle third of the esophagus in 10 patients (58.8%) and in the cervical esophagus in 7 (41.2%). Procedures performed included esophagogastrectomy in 9 patients (Ivor Lewis in 5, left thoracoabdominal in 3, and transhiatal in 1), enucleation in 3, transgastric excision in 1, and exploration without resection in 4. RESULTS: The procedure was considered curative in 11 patients (64.7%). There was one operative death (mortality, 5.9%). Complications occurred in 3 patients (17.6%) and included anastomotic leak in 2 and bleeding requiring reoperation in 1. Growth pattern was infiltrating in 7, polypoid in 5, and intramural in 5. Histologically, the tumor was grade 1 in 6 patients, grade 2 in 2, grade 3 in 7, and grade 4 in 2. The tumor was postsurgically classified as stage I in 2 patients, stage IIA in 7, stage IIB in 1, stage IIIA in 5, stage IV in 1, and unknown in 1. Six patients (35.3%) received adjuvant treatment. Follow-up was complete in 16 patients (94.1%) and ranged from 1 to 182 months (median, 48 months). Five- and 10-year actuarial survivals were 47.0% and 31.0%, respectively. Seven patients (41.2%) are currently alive (median survival, 72 months); all underwent curative resection. Factors affecting survival included completeness of resection, growth pattern, postsurgical stage, tumor grade, and tumor location (p < 0.05). CONCLUSIONS: We conclude that leiomyosarcoma of the esophagus is rare. Complete resection provides long-term survival.     

Ethanol-induced gastrointestinal damage. Influence of endogenous antioxidant components and gender

This study compared the effects of undiluted and 8% ethanol administered orally on gastrointestinal antioxidant components of male and female rats. Eight percent ethanol increased the activities of duodenal glutathione peroxide (29% in males, 14% in females) and superoxide dismutase in female gastric (24%) and male duodenal (15%) mucosa. This dose of ethanol also increased the glutathione content of gastric mucosa (12% in males, 13% in females). Undiluted ethanol decreased glutathione levels in gastric mucosa (22% in males, 11% in females) and increased glutathione peroxide activity in gastric mucosa (14% in males, 9% in females). Undiluted alcohol also produced decreases in the activity of glutathione reductase in stomach (14% in males, 9% in females) and duodenum (16% in males, 12% in females). Undiluted ethanol caused mucosal damage in the body of the stomach in both genders, accompanied by an increase in luminal pH and fluid accumulation in the stomach; these changes were absent in rats given 8% ethanol. The increase in gastrointestinal antioxidant capacity associated with the administration of 8% ethanol may be a factor in the reported cytoprotective effect of lower doses of ethanol.     

Pathophysiology of infection with Ostertagia ostertagi in cattle

Infection with the abomasal nematode, Ostertagia ostertagi, is an important cause of impaired productivity in young cattle in temperate parts of the world. Such losses have been associated with marked changes in feed intake, gastrointestinal function, protein, energy and mineral metabolism, and in body composition. The reduction in feed intake is an important factor in the pathogenesis of infection and may account for a large part of the difference in weight gain between ad libitum fed control and infected calves. Despite the obvious importance of inappetance, only recently has an association been made between reduced intake, altered gut motility and elevated levels of certain gastrointestinal hormones, such as gastrin. It has been suggested that the elevated gastrin levels accompanying abomasal parasitism may impair reticulo-ruminal motility and slow down abomasal emptying, leading to a stasis of ingesta and a reduction in feed intake. The rise in blood gastrin levels may also be partly responsible for the marked hyperplasia of the fundic mucosa seen in abomasal infections. Pronounced changes in protein metabolism have also been associated with Ostertagia infection. Radioisotopic studies have demonstrated increased losses of albumin into the gastrointestinal tract which are accompanied by an increase in the rate of synthesis in the liver. Dietary protein breakdown in the abomasum is also likely to be impaired, although there is evidence of a compensatory increase in protein digestion in the lower gut of parasitised calves. Increased losses of albumin are not always accompanied by increases in faecal nitrogen, suggesting that albumin is broken down and recycled as ammonia. Radioisotopic studies in animals with intestinal nematode infections have demonstrated a marked reduction in muscle protein synthesis and an increase in protein synthesis in gastrointestinal tissue. Such changes in the balance of protein synthesis are likely to be brought about by alterations in the balance of certain metabolic hormones. Marked changes in energy metabolism also accompany Ostertagia infection. Parasitised calves exhibit a marked increase in non-esterified fatty acid levels, resulting from the mobilisation of adipose tissue, and a reduction in digestive efficiency of energy, probably associated with the increase in cycling of protein through the gastrointestinal tract and the compensatory increases in protein synthesis. Mineral metabolism may also be affected although relatively little work has been conducted in cattle. Changes in body composition reflect a reduction in deposition of muscle protein and fat, and an increase in bone content and water retention.     

The descriptive epidemiology and trends in incidence of nonocular malignant melanoma in Bombay and India

Nonocular malignant melanoma is a rare but lethal disease increasing in incidence and mortality in western countries with improved survival if diagnosed and treated early. This study reports its epidemiology from cancer registry data in six different parts of India; its anatomic distribution and trends in Bombay from 1964 to 1984. Age-adjusted incidence in Bombay patients shows no increase from 1964 to 1984 unlike in white caucasians. Males exceed females in patients 45 years or older unlike whites, but are equalled or exceeded by females in those less than 45 years. The sole of foot and internal mucous membranes are its major anatomic sites in Indians as in negroid blacks. This cancer in Indians resembles that in blacks and nonwhites in affecting less pigmented epithelia and skin. Susceptible melanosomes and ultraviolet light exposure may both be involved in its aetiopathogenesis.     

Diagnostic value of hysterosalpingography and laparoscopy in infertile women

Tubal pathology with tubal blockage due to the pelvic inflammatory diseases is one of the most frequent causes of infertility in a woman [1]. The two most important diagnostic procedures which are used for evaluation of tubal patency are hysterosalpingography and laparoscopic hydrotubation [4]. SUBJECT: The aim of the study was the comparison of hysterosalpingographic and laparoscopic findings and determination of accuracy of these two procedures in the diagnosis of tubal patency. MATERIAL AND METHODS: We studied and compared the results of hysterosalpingography and laparoscopy in 102 infertile women who were operated on at the Narodni Front Hospital of Gynaecology and Obstetrics in Belgrade during 1993 and 1994. Of 102 operated women 47 women were with primary infertility and 55 with secondary infertility. The patients were from 20 to 41 years of age, the average 28 +/- 2.4 years. RESULTS: Of one hundred and two operated women tubal blockage was found in 94 (92.1%) patients. Unilateral hydrosalpinx was found by hysterosalpingography in 16 (15.7%) subjects and bilateral hydrosalpinx in 30 (29.4%) women. Unilateral hydrosalpinx was found by laparoscopy in 17 (16.1%) patients and bilateral hydrosalpinx in 32 (31.4%) subjects. The concordant findings by hysterosalpingography and laparoscopy in the diagnostics of unilateral hydrosalpinx were found in 76.5% of cases, and in bilateral hydrosalpinx in 70.4%. This difference was not statistically significant. Unilateral tubal blockage was identified by laparoscopy in 26 (25.5%) patients and bilateral in 27 (26.5%) subjects. The concordant findings by hysterosalpingography and laparoscopy in unilateral tubal blockage were found in 61.5% of cases, and in bilateral tubal blockage in 70.4% of women. The total concordant findings by hysterosalpingography and laparoscopy in tubal blockage were found in 65.7 of cases, and concordant findings after hysterosalpingography and surgery were noted in 61.7% cases. The findings by laparoscopy and surgery were in harmony in 86.3% patients. Ovarian abnormalities were found by laparoscopy and surgery in 22 (21.6%) women. Pelvic adhesions were found by laparoscopy in 42 women of 49 patients in whom pelvic adhesions were found during the operation. Uterine congenital anomalies were found by laparoscopy in 3 (2.9%), women and by hysterosalpingography in 6 (5.9%) patients. DISCUSSION: Of 102 operated women tubal blockage was found in 94 (92.2%) women. Unilateral tubal blockage was found in 38 (40.4%) patients, and bilateral tubal blockage in 56 (59.6%) subjects. Hysterosalpingographic and laparoscopic hydrotubation findings in the diagnosis of tubal patency were concordant in 65% of cases, hysterosalpingographic and operative findings in 61.7% of patients, and laparoscopic and operative findings in 86.3% of subjects. Although concordant findings of 65.7% were noted in this study, which were similar to findings of other authors, the percentage of 62.5% [4], and 76% was observed [5]. During the operation pelvic adhesions were found in 49 patients, and laparoscopic in 42 women only. Ovarian abnormalities were found by laparoscopy in 22 (21.6%) patients, while uterine fibroid was found in 10 (9.8%) subjects. Uterine congenital anomalies were found by hysterosalpingography in 6 (5.9%) cases and by laparoscopy only in 3 (2.9%) patients. The advantage of visual hysterosalpingography seems to be in identification of some congenital uterine anomalies. However, the advantage of laparoscopy is identified by the possibility of visualisation of some other pelvic abnormalities which may be the cause of infertility. CONCLUSION: There are some hysterosalpingographic and laparoscopic advantages and disadvantages in the diagnosis of infertility in women. Only by using both procedures accurate results can be achieved in the tubes, the uterus and the ovary, that can be a cause of infertility in women.     

Elevated levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) activities in the sera and milk of cows with naturally occurring coliform mastitis

The presence of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) activities was determined in milk and serum of cows with naturally occurring coliform mastitis (CFM). TNF-alpha was detected in the sera from 26 of 32 cows with CFM. TNF-alpha levels were higher in the sera than in the milk. IL-6 was high in the sera of surviving CFM animals, but was low in animals that died and in healthy controls. Furthermore, the mean level of IL-6 was 20-fold higher in the milk than in the sera of mastitic cows. The level of IL-6 in the serum was correlated to that in the milk in individual animals. The presence of IL-6 and TNF-alpha in the sera appears to relate to severe clinical condition of CFM, in the milk whereas they may play a role in generating inflammation of the mammary gland.     

The effects of treatment with lipopolysaccharide on responsiveness of rat blood vessels

Effects of treatment with lipopolysaccharide (LPS) both in vivo (intraperitoneal administration of 20 mg.kg-1 LPS for 6 hours) and in vitro (incubation with 1 microgram.kg-1 LPS for 6 hours) on the responsiveness of the rat thoracic aorta, carotid, renal, femoral, mesenteric, pulmonary arteries, and the femoral and mesenteric veins were examined. Intraperitoneal administration of LPS did not change the blood pressure of rats, but increased the heart rate significantly. The same amplitude of relaxation was produced by L-arginine in the aortic strips treated by LPS in vivo and in vitro, and the responses were inhibited by NG-nitro-L-arginine (L-NOARG). The contractile responses to phenylephrine in the aortic strips were reduced by LPS-treatment in vivo or in vitro, but the extent of inhibition was greater in vivo than in vitro. Further, the attenuation of contractile responses to phenylephrine was completely reversed by L-NOARG in the strips treated with LPS in vitro, whereas the reversal by L-NOARG was incomplete in the strips treated with LPS in vivo. Different amplitudes of relaxations were also produced by L-arginine or SNP in the blood vessels treated by LPS in vivo or in vitro. However, the tail artery treated with LPS in vivo or in vitro did not relax in response to L-arginine but did produce a relaxation to SNP. These results suggest that the hyporesponsiveness of rat blood vessels after treatment with LPS in vivo or in vitro may be related to an enhanced NO production in the smooth muscle cells and that there is a possible heterogeneity of regional induction or activation of L-arginine/NO pathway by LPS in rat blood vessels.     

Trends in the prevalence of asthma in Scottish and English primary school children 1982-92

BACKGROUND: Some doubts exist as to whether the increase in the prevalence of asthma is real or an artefact. The 10 year trend of asthma up to 1993 in England and Scotland was therefore assessed. METHODS: Information on asthma and bronchitis attacks, occasional wheeze, and persistent wheeze in the last 12 months, was obtained using a self administered questionnaire completed by the parents. Exactly the same questions were asked in 14 study areas in Scotland and 22 study areas in England in 1982 or 1983 and in 1992 or 1993 in 5-11 year old children. RESULTS: The numbers of children with data for all respiratory illness were 5556 (85.2%) and 5801 (87.1%) in England and 3748 (90.4%) and 3738 (90.4%) in Scotland in 1982 and 1992, respectively. There was a significant increase in asthma attacks (approximately three times more in 1992 than in 1982) and occasional wheeze (30-60% more in 1992 than in 1982) in both sexes in England and Scotland. Persistent wheeze also increased in both countries, but the increase was significant only in England (30-40% more in 1992 than in 1982). CONCLUSIONS: The study coincides with others that suggest that the increased prevalence of asthma may be due, in part, to changes in diagnostic behaviour. However, the continuing increase of persistent wheeze in the total sample suggests that part of the increase is real. There was no difference in the increase of persistent wheeze between Scotland and England, but the trend was only significant in England.     

Blood flow and venous distensibility in the upper and lower extremities of newborn infants

The electrocapacitance plethysmograph was utilized to measure peripheral blood flow and venous distensibility in 17 newborn infants and 20 adults. Measurements were made in the upper and lower extremities in each subject under identical environmental conditions. Blood flow in the forearm and calf were found to be significantly higher in infants than adults. In infants there were no significant differences in the blood flow between the upper and lower extremities. In contrast, in the adults, the blood flow was significantly higher in the upper than in the lower extremities. Similarly, venous distensibility was observed to be higher in infants than in adults. While no significant differences were observed in the venous distensibility between the upper and lower extremities in infants, the venous distensibility was found to be higher in the forearm than in the leg in adults.     

Comparative study of astrocytes in human and rabbit retinae

Immunohistochemical location of Glial Fibrillary Acidic Protein (GFAP) was used to compare the morphology of astrocytes in vascularized and partially vascularized retinae (human and rabbit, respectively). Astrocytes in human and rabbit retinae were found in the same regions as the blood vessels. These cells in partially vascularized retinae differed from those in vascularized retina in several respects. Firstly, there were six morphological types in rabbit retina and only two in human retina. Secondly, in rabbit retinae there were astrocytes only related to blood vessels called "perivascular astrocytes" which were absent in human retinae. Thirdly, the astrocytes were located in the nerve fiber layer and ganglion cell layer in both types of retinae, but in human retinae these cells could also be seen in the internal nuclear layer. These observations demonstrate that there are many differences between astrocytes in human and rabbit retina, suggesting that rabbit retina could be used with caution as an experimental model in comparative studies with human retina.     

Treatment of psoriasis with fumaric acid esters: results of a prospective multicentre study. German Multicentre Study

Nasopharyngeal carcinomas (NPC) are common in Hong Kong and southern China but rare in Western countries. Telomerase activation is common in human cancers but has not been reported previously in NPC. Telomerase activation in NPC was determined using the sensitive TRAP (telomerase rapid amplification protocol) assay in 45 nasopharyngeal biopsies (36 NPC, nine normal nasopharyngeal mucosae) in four xenografted NPC tumours established in nude mice and in five in vitro NPC cell lines. Telomerase activation is common in NPC and can be detected at high frequencies (85% in primary tumours and 100% in recurrent tumours). The frequency of telomerase activation was lowest in NPC biopsies without lymph node involvement (60%) compared with those with positive lymph node involvement (100%), and the difference is statistically significant (P < 0.05; Fisher exact test). All the xenografted NPC tumours and in vitro NPC cell lines were strongly positive for telomerase activity. Our results suggest that telomerase activation is common in NPC and it may be useful as a diagnostic marker in the detection of tumour cells in nasopharyngeal biopsies. The high frequency of telomerase activation in stage I NPC (80% positive) suggests that it is an early event in tumour progression.     

Forty years of evolution of mortality in Belgium and The Netherlands

Age adjusted mortality in Belgium (B) and The Netherlands (NL) was calculated from 5 yearly age-specific death rates between the ages 45-74 and 75-85+ years. Mortality was available in Belgium from 1954 to 1991 or 1994 (depending on the cause of death) and from 1950 to 1993 in The Netherlands. In the 45-74 years age class all-cause mortality decreased in B between 1955 and 1992 with 33% in men and 48% in women. In NL this was 11% and 40%, respectively. In the age class 75-85+ it was 21% and 37% in B, and 4% and 36% in NL, respectively. Since 1980 to the last available year there was a marked decrease in mortality in the age class 75-85+ years in men and women from B and no change in NL. Wallonia always had the highest mortality, followed by B, Flanders and NL. However, recently the observed mortality in Flanders was the lowest. Mortality trends, in both age classes and sexes, were obtained between 1980 to the last available year for 11 causes of death in men and 13 in women. Among 48 possible comparisons, 38 (79%) were in favor of B, 9 in favor of NL and 1 ex aequo. Life expectancy in 1992 was compared in the 15 EU countries. For both sexes together B ranked 8th, NL 3rd. The difference in life expectancy between the two countries was 3 year in 1967 and 1 year in 1992. Flanders ranked 5th (0.3 year lower than NL) and Wallonia 14th (2.2 years lower) when substituted for B in the EU. Portugal had the best and Denmark had the worst results between 1967 and 1992). Changes in life style-fat, salt, fruit and vegetable intake and smoking habits -which occurred since 1960 in B, its regions and in NI are consistent with the changes in mortality and life expectancy. Curative medicine and medical technology cannot explain the observed differences and trends.     

Distribution of CD4+ T-lymphocytes levels in patients with clinical symptoms of AIDS in three west African countries

The characteristics of airway responsiveness to acetylcholine (ACh) in congenitally bronchial-hypersensitive (BHS) and bronchial-hyposensitive (BHR) guinea pigs were clarified in vivo and in vitro. We measured the change in ventilatory mechanics in response to ACh inhalation by means of the bodyplethysmograph and the contractile responses of isolated trachea to ACh and carbachol (CCh). Further, muscarinic receptor subtypes involved these responses were identified. The basal values for ventilatory mechanics in BHS were not significantly different from those in BHR. Respiratory resistance to ACh was progressively increased in a time- and dose-dependent manner in BHS. The contractile responses of tracheal smooth muscle to ACh in BHS were significantly greater than those in BHR, but CCh-induced responses in BHS and BHR were similar. ACh- and CCh-induced contractions were mediated via M3 receptors. These results suggested that the falling-down of BHS in response to ACh inhalation was caused by the strong constriction of the airway and the reduction in ventilation. Moreover, the airway hyperresponsiveness to ACh in BHS might be partly dependent on the change in acetylcholinesterase activity.     

Effects of a long-term hypertension control program on stroke incidence and prevalence in a rural community in northeastern Japan

BACKGROUND AND PURPOSE: Although randomized clinical trials have demonstrated the benefit of antihypertensive treatment in preventing stroke, the effectiveness of community-based programs is largely unknown. We investigated long-term community-based prevention activities. METHODS: In rural northeastern Japan, people aged > or = 30 years numbered 3219 in the full intervention community and 1468 in the minimal intervention community in 1965. Systematic blood pressure screening and health education began in 1963. Stroke was registered through 1987. RESULTS: More than 80% of people aged 40 to 69 years were screened in both communities in the 1960s. One community charged for screening services after 1968, whereas the other community intensified intervention; subsequently, screening rates and the follow-up of hypertensive individuals declined in the minimal intervention community, especially in men. In men, stroke incidence declined more (P < 0.001) in the full intervention (42% in the period 1970 to 1975, 53% in the period 1976 to 1981, and 75% in the period 1982 to 1987) than in the minimal intervention community (5% increase, 20% decrease, and 29% decrease, respectively); in women, the stroke incidence declined about 45% to 65% in both communities. Changes in stroke prevalence paralleled those in stroke incidence. Trends in systolic blood pressure levels tend to explain the differential stroke rates in men. CONCLUSIONS: Delivery of hypertension control services through intensive, free, community-wide screening and health education was effective in prevention of stroke for men in a community.