Frequency and significance of anti-gliadin and anti-endomysial antibodies in autoimmune hepatitis

Celiac disease has been associated with autoimmune disorders, but its frequency in autoimmune hepatitis is unknown. Sera from 157 patients with type 1 autoimmune hepatitis, 24 patients with type 2 autoimmune hepatitis, 62 patients with primary biliary cirrhosis, 30 patients with chronic hepatitis B, and 80 patients with chronic hepatitis C were tested for immunoglobulin A anti-endomysial antibodies by indirect immunofluorescence and immunoglobulin A and G antibodies to gliadin by enzyme immunoassay. Duodenal biopsy evaluation was recommended in patients seropositive for immunoglobulin A anti-endomysial antibodies. Immunoglobulin A anti-endomysial antibodies were present in eight of the 181 patients with autoimmune hepatitis (4%), including six with type 1 disease (4%) and two with type 2 disease (8%). Immunoglobulin A antibodies to gliadin were found in six of these eight patients, but they were also present in two others, including one patient with chronic hepatitis C. Five of the eight patients with immunoglobulin A antiendomysial antibodies, including three patients with no gastrointestinal symptoms, had duodenal biopsies and subtotal villous atrophy was present in all of them. No patient with primary biliary cirrhosis or chronic viral hepatitis had antiendomysial antibodies. The presence of celiac disease in autoimmune hepatitis is high (at least one in 36 patients) and it is predominantly asymptomatic. Screening with anti-endomysial and anti-gliadin antibodies should be performed and results confirmed with intestinal biopsy.     

Morbidity and mortality with outpatient anesthesia: the experience of a residency training program

PURPOSE: Previous studies regarding anesthetic-related morbidity and mortality rates in the oral surgery office have usually taken the form of a survey. This retrospective investigation of outpatient anesthetic morbidity and mortality was undertaken to compare the safety record of an oral and maxillofacial surgery training program with that of private practitioners. MATERIALS AND METHODS: Records from all outpatient general anesthesia cases performed in the Department of Oral and Maxillofacial Surgery at the Boston University Goldman School of Graduate Dentistry between August 13, 1990, and September 30, 1994, were reviewed for the incidence of nineteen separate categories of morbidity. RESULTS: There were 1,126 general anesthetics performed. There were 26 recorded incidents of morbidity (2.3%), none of which resulted in any postoperative sequelae. There were no deaths. The most common complication encountered was laryngospasm, with nine recorded incidents (0.8%). The second most common complication was cardiac dysrhythmia with eight recorded incidents (0.8%). CONCLUSIONS: The low incidence of anesthetic-related morbidity seen in this study can most likely be attributed to proper patient selection. A carefully reviewed medical history and physical examination are the two most useful methods to prevent anesthetic emergencies. Another factor considered when selecting the proper anesthetic method includes the length and difficulty of the surgical procedure, with outpatient general anesthesia being reserved for those procedures that are predicted to be relatively short (30 to 45 minutes), and with little potential for airway difficulties.     

Prevalence of thyroid autoantibodies in children and adolescents from Belarus exposed to the Chernobyl radioactive fallout

BACKGROUND: The long-term effects of ionising radiation, including radioiodine, on thyroid function are not well known. We compared thyroid immunity and function in two groups of children from Belarus, one of whom was exposed to the radioactive fallout of Chernobyl. METHODS: We measured serum free thyroxine 4 (free T4), free T3, and thyrotropin hormone (TSH) and the prevalence of thyroid autoantibodies (antithyroglobulin and antithyroperoxidase), in 287 children or adolescents living in Hoiniki (average caesium contamination of 5.4 Ci/km2). We also studied 208 children and adolescents living in Braslav (average contamination <0.1 Ci/km2), who were age 12 years or less at the time of the Chernobyl accident. FINDINGS: The prevalence of antithyroglobulin or antithyroperoxidase, or both, was significantly higher (p=0.0001) in individuals living in Hoiniki (56 [19.5%] of 287) than in those living in Braslav (eight [3.8%] of 208). In both villages, no sex differences were found in the antibody prevalence before age 13 years. Thereafter, a significantly higher prevalence of thyroid autoantibodies was found in girls from Hoiniki. The increase in the prevalence of circulating antibodies in the contaminated group was already apparent in individuals who, at the time of the accident, were in utero or newborn (15.7%), and was even more pronounced in children of 9 years or more (35.1%). No major alterations of serum FT-4, FT-3, or TSH were found. INTERPRETATION: 6-8 years after the Chernobyl accident, a significant increase in thyroid autoimmunity was found in children exposed to radioactive fallout. Pubertal age in girls is a risk factor for increased prevalence of thyroid autoimmunity. The autoimmune phenomena are limited to an increased prevalence of circulating thyroid autoantibodies without evidence of significant thyroid dysfunction. The future development of clinically relevant thyroid autoimmune diseases, especially hypothyroidism, is a possibility.     

Cholesterol mobilization and regression of atheroma in cholesterol-fed rabbits induced by large unilamellar vesicles

The antiatherogenic properties of repeated injections of egg phosphatidylcholine large unilamellar vesicles (LUVs) of 100 nm diameter were tested in an experimental model for atherosclerosis. Forty eight rabbits were divided into two diet groups fed standard rabbit chow or fed a cholesterol-enriched diet (0.5% by weight) to induce the formation of atherosclerotic lesions. Prior to the initiation of LUV therapy, the cholesterol diet was ceased and all animals were returned to standard rabbit chow. The treatment protocol consisted of a total of 10 bolus injections of vesicles, at a phospholipid dose of 300 mg/kg body weight or the equivalent volume of saline, with one injection given to each animal every 10 days. LUV injections brought about a large movement of cholesterol into the blood pool and resulted in a significant reduction in the cholesterol content as well as the degree of surface plaque involvement of aortic tissue in atherosclerotic animals. Most notably, the thoracic aorta of LUV-treated animals exhibited a 48% reduction in tissue cholesterol content per gram of protein compared to saline-treated controls. Histochemical analyses revealed that aortas from animals receiving the repeated injections of LUVs displayed less cholesterol deposits in lesions, and a moderate reduction in intimal-to-medial thickness. This regression of atheroma, induced by LUV therapy, was observed even though animals possessed persistent elevated plasma cholesterol levels after the cholesterol-enriched diet was ceased. These results suggest that repeated injections of LUVs, working with endogenous HDL, may be a useful therapy in the management of atherosclerosis.     

Decentralized suboptimal load-frequency control of a hydro-thermal power system using the state variable model

State space modelling and synthesis of decentralized suboptimal load-frequency control for hydro-thermal power systems are described in this paper. The state space models are derived by the partial fraction technique for reheat steam turbines, hydro turbines and hydro governors having numerator dynamics. Decentralized suboptimal load-frequency controls are synthesized by using the method of minimum error excitation and their performance is analysed as a function of tie-line power level. It is shown that the suboptimal control with feedback of some, but not all, of the remote area state variables is a feasible alternative to the optimal control, whereas local control without feedback of any remote state variable is inadequate for stabilizing the system.     

Adaptive control of speed and equivalence ratio dynamics of adiesel driven power-plant

A method of modeling, involving approximation of dead-times, is presented for diesel driven power prime-movers. The resulting predictive adaptive control scheme is compared to a conventional PI scheme on the basis of common disturbances encountered by a practical prime-mover. It is found that the adaptive scheme achieves significant improvement despite the nonlinearities introduced by turbocharger operation. It is observed in general that adaptive schemes, such as the one described, affect the prime-mover dynamics in essentially two ways. First, the engine fuel-flow response is improved by better control of the actuator. Secondly, by indirectly controlling the exhaust energy of the plant, the turbocharger air-dynamics is made faster, leading to better dynamic fuel/air ratio. The overall effect is good response of the prime-mover speed notwithstanding the fact that the diesel prime-mover is a low inertia structure and that the system parameters suffer from various nonlinear variations     

Avoidant personality disorder and the generalized subtype of social phobia.

Social phobia and avoidant personality disorder (APD) may be given as comorbid diagnoses. However, it is not known if the labels provide independent, useful diagnostic information. The authors classified social phobics by social phobia subtype and presence of APD. Generalized social phobics with and without APD (ns?=?10 and 10) and nongeneralized social phobics without APD (n?=?10) were distinguished on measures of phobic severity. The generalized groups also showed earlier age at onset and higher scores on measures of depression, fear of negative evaluation, and social anxiety and avoidance than did the nongeneralized group. APD criteria of general timidity and risk aversion were more frequently endorsed by social phobics with AD. The data suggest that both the generalized subtype of social phobia and the presence of APD do provide useful diagnostic information, but the additional diagnosis of APD may simply identify a severe subgroup of social phobics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lipopolysaccharides from three phytopathogenic pseudomonads

The use of acetylated phenyl 1-seleno-beta-D-galactofuranoside as a glycosyl donor for the synthesis of protected D-Galf-beta-(1-->3)-alpha-D-Manp as its methyl or ethylthio glycoside has been demonstrated. Activation of the selenoglycoside over a thioglycoside acceptor by NIS/TfOH is extremely selective and gives the ethylthio disaccharide in 91% yield. The parent disaccharide is found as a terminal and branched unit in the lipopeptidophosphoglycan oligosaccharides of the protozoan Trypanosoma cruzi, the causative agent of Chagas' disease.     

Sorption and diffusion of solvents in highly oriented polyethylene

Measurements have been made of the sorption and diffusion coefficients of various solvents in oriented linear polyethylene pipe produced by hydrostatic extrusion. In all cases the equilibrium sorption is a factor of about ten less than that for isotropic linear polyethylene, and the diffusion coefficients are a factor of about a hundred less.