Genetic regulation of enterocyte function: a quantitative in situ hybridisation study of lactase-phlorizin hydrolase and Na(+)-glucose cotransporter mRNAs in rabbit small intestine

The enterocyte undergoes sequential changes in its structure and function as it migrates rapidly from the small intestinal crypts to the villus tip. The mechanisms by which these changes are regulated "in tune" with ontogenic and dietary changes in the luminal environment are currently under investigation. This study has employed oligonucleotide probes to follow the expression of the lactase-phlorizin hydrolase (LPH) and Na(+)-glucose cotransporter (SGLT1) genes in rabbit small intestine using quantitative in situ hybridisation histochemistry. The profiles of LPH mRNA and SGLT1 mRNA accumulation along the crypt-villus axis were found to be very similar. Although mRNA was undetectable in the crypt. LPH and SGLT1 mRNA levels rose rapidly at the crypt-villus junction, reaching a maximum between 210 microns and 330 microns above this point. Further up the villus the level of mRNAs declined. SGLT1 mRNA was present in all small intestinal segments (duodenum, jejunum and ileum), whereas LPH mRNA was absent from the ileum. LPH activity rose and fell in conjunction with mRNA, but SGLT1 activity was greatest at the villus tip where mRNA levels were considerably reduced. These data have been used to discuss the genetic regulation of enterocyte differentiation and function.     

Recovery of reproductive function in rats treated with the aromatase inhibitor fadrozole

We report three cases of L-2-hydroxyglutaric acidemia and three cases of Canavan disease. The L-2-hydroxyglutaric acidemia cases are the first biochemically proven Turkish cases. Magnetic resonance imaging findings in the cases and similarities between the two diseases are emphasized. Both diseases are characterized by predominant subcortical white-matter involvement and dentate nuclei lesions with variable basal ganglia involvement. Canavan disease differs from L-2-hydroxyglutaric acidemia by the presence of typical brainstem involvement.     

Predictors of brief smoking intervention in a midwifery setting

The aims of this study were: to assess current practice in smoking cessation interventions by midwives and to examine the relationship between the use of smoking intervention, practitioner characteristics and organizational factors. A mail-out survey was sent to a random sample of 500 midwives. The response rate was 85% (n = 425). The results indicated that most midwives used minimal interventions (advice and education) for at least some of their clients. However, the more skilled and more time-intensive forms of intervention such as counselling about methods to quit, negotiating a quit date and follow-up were infrequently utilized. Moreover, participants estimated that half their smoking clients were not offered any advice about smoking. Organizational factors such as: hospital policy for smoking intervention, type of hospital, size of hospital, cohesion of staff and work pressure predicted the use of smoking interventions. Self-reported ability to intervene for smoking and the level of assessment undertaken were practitioner characteristics which predicted the use of smoking interventions. The barriers that inhibit the use of smoking intervention by midwives are discussed and methods for change canvassed.     

Discovering asymptomatic biochemical abnormalities on a Baltimore internal medicine service

To assess the frequency of abnormalities that could be discovered through biochemical profile screening on patients admitted to a city hospital internal medicine ward service, we conducted a prospective cross-sectional chart and laboratory review. All unassigned patients admitted to the general medicine service during 1- to 2-month period in late 1993 and the spring of 1994 were eligible. The main outcome measures were frequency of abnormal test results and identification of significance. Admitted patients (N = 222) were evaluated with a 24-panel biochemical profile. Of 5,328 tests, 29% were outside the standard reference range. Of 3,851 tests classified as screening, 1,049 (27%) were outside the reference range. Of overall screening tests, 741 (19%) were judged potentially important by the predetermined criteria. The prevalence did not differ significantly when analyzed by age, race, gender, or history of substance abuse. Our experience indicates that asymptomatic biochemical abnormalities are common in patients admitted to a city hospital medical service and that admission biochemical screening is an effective method of identifying potential comorbidity. Further studies are needed to assess the impact of this approach.     

Self- and other-directed aggression in child and adolescent psychiatric inpatients

OBJECTIVE: To examine self- and other-directed aggression in 89 children and adolescents on a psychiatric inpatient unit to determine ways in which aggressive and nonaggressive patients differ and to discover those factors associated with self-directed versus other-directed aggression. METHOD: Three types of data were collected: ongoing observations of aggressive behavior during hospitalization, Child Behavior Checklists completed by a parent or guardian at admission, and patient and family history data gathered from a retrospective chart review. RESULTS: Compared with nonaggressive patients, aggressive patients were more likely to have a history of antisocial behavior, to be victims of abuse or neglect, to have lived in a foster home, and to have had several primary caretakers. Both groups of aggressive patients engaged in three types of aggressive behavior with equal frequency and were strikingly similar on a host of other variables. Only the number of primary caretakers with whom a patient had lived discriminated self- from other-directed aggressive patients; patients who experienced frequent disruptions in caretaking were likely to engage in acts of self-injury during hospitalization. CONCLUSIONS: Whether a particular patient will engage in aggressive behavior during hospitalization can be accurately predicted from preadmission characteristics; however, the manner in which a patient is likely to aggress, i.e., toward others or self, is difficult to predict because of striking similarities between types of aggressive patients. Further investigations are needed to determine how self- and other-directed aggressive patients differ and to elucidate relationships between disrupted, unstable, or inadequate caretaking and aggression, particularly self-injury, in children and adolescents.     

Ultrasound guided percutaneous fine needle aspiration cytology of pancreas: a review of 61 cases

The study includes 61 cases which were subjected to ultrasound (US) guided fine needle aspiration cytology (FNAC) to find out the utility of this technique in the diagnosis of pancreatic lesions. Age of the patients ranged from 23 to 85 years with a median of 50 years. Male to female ratio was 36:25. One or more clinical diagnoses were offered in 16 and in 9 of these, the disease was related to pancreas. Subsequent to US, the lesions were localized to pancreas in 57 and the nature of pathology in the pancreatic lesion could be diagnosed in 31. By FNAC, 31 cases (50.8%) were diagnosed to have pancreatic malignancy which included adenocarcinoma (23 cases), papillary cystic tumour (1), muco-epidermoid carcinoma (1), acinic cell carcinoma (1), islet cell tumor (1), and non Hodgkin lymphoma (4). FNAC of liver in 2 cases and retroperitoneal lymph node in a case of pancreatic adenocarcinoma revealed metastasis. During follow up, 1 case of non Hodgkin's lymphoma showed CSF involvement. Three cases (4.9%) were suspected to have epithelial malignancy of which one was confirmed as an adenocarcinoma following surgery and histology. Four (6.6%) were benign lesions which included nonspecific inflammation (2 cases), tuberculous pancreatitis (1) and pseudopancreatic cyst (1). The remaining 23 cases (37.7%) had normal or inadequate cytology. Of these, FNAC of liver showed metastasis in 2 cases and one case each were diagnosed as adenocarcinoma and pseudopancreatic cyst respectively following surgery. None of the patients had any complication following FNAC. We recommend US guided FNAC to be routinely used for diagnosis of pancreatic lesion.     

Noradrenaline contractions of human prostate mediated by alpha 1A-(alpha 1c-) adrenoceptor subtype

1. The subtype of alpha 1-adrenoceptor mediating contractions of human prostate to noradrenaline was characterized by use of a range of competitive and non-competitive antagonists. 2. Contractions of the prostate to either noradrenaline (pD2 5.5), phenylephrine (pD2 5.1) or methoxamine (pD2 4.4) were unaltered by the presence of neuronal and extraneuronal uptake blockers. Noradrenaline was about 3 and 10 times more potent than phenylephrine and methoxamine respectively. Phenylephrine and methoxamine were partial agonists. 3. Pretreatment with the alkylating agent, chlorethylclonidine (10(-4M) shifted the noradrenaline concentration-contraction curve about 3 fold to the right and depressed the maximum response by 31%. This shift is 100 fold less than that previously shown to be produced by chlorethylclonidine under the same conditions on alpha 1B-adrenoceptor-mediated contractions. 4. Cumulative concentration-contraction curves for noradrenaline were competitively antagonized by WB 4101 (pA2 9.0), 5-methyl-urapidil (pA2 8.6), phentolamine (pA2 7.6), benoxathian (pA2 8.5), spiperone (pA2 7.3), indoramin (pA2 8.2) and BMY 7378 (pA2 6.6). These values correlated best with published pKi values for their displacement of [3H]-prazosin binding on membranes expressing cloned alpha 1c-adrenoceptors and poorly with values from cloned alpha 1b- and alpha 1d-adrenoceptors. 5. The good correlation between the functional data on the prostate and the binding data on the expressed alpha 1c-subtype clone for the affinities of the competitive antagonists suggests that they are the same subtype. As the expressed alpha 1c-adrenoceptor clone corresponds to the alpha 1A-adrenoceptor expressed in tissues, contraction of the human prostate to noradrenaline is therefore mediated by an alpha 1A-adrenoceptor.