Intestinal metaplasia with adherent Helicobacter pylori: a hybrid epithelium with both gastric and intestinal features

Helicobacter pylori seem to avoid areas of intestinal metaplasia in the gastric mucosa, but attachment of these bacteria to epithelium with the appearance of incomplete intestinal metaplasia has been documented. To characterize the nature of the epithelium to which H pylori was attached, we carried out an immunohistochemical study using monoclonal antibodies against gastric surface mucous cell mucins (M1), blood group-related carbohydrates antigens (Le(a), sialyl Le(a), Le(b), type 1H, and type 2H) and sialyl Tn antigen. The results of this study suggest that these areas of H pylori attachment represent a hybrid epithelium whose cells share characteristics of both gastric surface mucous cells and intestinal metaplastic cells. Whether all areas of incomplete intestinal metaplasia represent an intermediate stage between the normal gastric epithelium and the fully developed complete type of metaplasia remains to be determined.     

Superior vena cava syndrome after heart transplantation: percutaneous treatment of a complication of bicaval anastomoses

The aims of this study were to establish a working rabbit heart model of regional myocardial ischaemia in which electrophysiologic parameters and arrhythmogenesis could be correlated and to explore the mechanisms underlying the antiarrhythmic activity of lignocaine. Monophasic action-potential duration (MAPD90), effective refractory period (ERP), and conduction delay were measured at three ventricular sites in isolated hearts paced at 3.3 Hz. The hearts were treated before and throughout 30 min of ischaemia and 15 min of reperfusion with a vehicle or 20 microM lignocaine. In both groups, ischaemia produced a similar shortening in MAPD90. Lignocaine decreased ERP shortening during ischaemia from -56+/-4 to -32+/-6 ms. An ischaemia-induced increase in conduction delay was greater in the lignocaine than the control group (49+/-7 vs. 11+/-2 ms). Ischaemia-induced dispersion of repolarisation was reduced by lignocaine from 66+/-4 to 32+/-7 ms, and dispersion of refractoriness was decreased from 57+/-6 to 16+/-3 ms. Lignocaine decreased inducibility of ventricular fibrillation (VF) during ischaemia from 86 to 25%. We conclude that, in this model, the antiarrhythmic activity of lignocaine during regional ischaemia is associated with an increase in ischaemia-induced conduction delay and reduced dispersion of repolarisation and refractoriness.     

Isolation and characterization of a novel facultatively alkaliphilic Nitrobacter species, N. alkalicus sp. nov

BACKGROUND: The American College of Rheumatology (ACR) established criteria to discriminate among patients with seven types of vasculitis. Although designated as "classification criteria" for research, these criteria are often used for diagnosis. OBJECTIVE: To examine the operating characteristics of the 1990 ACR classification criteria in the diagnosis of Wegener granulomatosis, giant-cell arteritis, polyarteritis nodosa, and hypersensitivity vasculitis. DESIGN: Prospective cohort study. SETTING: University medical center and Veterans Affairs medical center. PATIENTS: 198 consecutive patients referred to rheumatologists for evaluation of possible vasculitis. Measurements: Blinded chart audits were done to classify patients according to the 1990 ACR classification criteria for Wegener granulomatosis, polyarteritis nodosa, giant-cell arteritis, and hypersensitivity vasculitis on the basis of the patients' initial presentation. Chart audits done 2 to 8 months after baseline provided the patients' final diagnoses, which were considered the gold standard, as in the development of the ACR criteria. Test operating characteristics of the ACR classification criteria were calculated according to 2 x 2 tables for the entire cohort and for only the patients with a final diagnosis of vasculitis. RESULTS: Vasculitis was diagnosed in 51 (26%) patients. Thirty-eight (75%) of 51 patients with vasculitis and 31 (21%) of 147 patients without vasculitis met ACR criteria for one or more types of vasculitis. The positive predictive values for the four vasculitides according to ACR criteria were 17% to 29% for the entire cohort and 29% to 75% for only the patients with a final diagnosis of vasculitis. CONCLUSION: The 1990 ACR classification criteria function poorly in the diagnosis of specific vasculitides.     

Helicobacter pylori does not migrate from the antrum to the corpus in response to omeprazole

BACKGROUND: Omeprazole is known to have an effect on Helicobacter pylori in vivo. One opinion is that H. pylori "migrates" from the antrum to the corpus in response to omeprazole therapy. METHODS: To determine whether H. pylori migrates in response to omeprazole, we assessed the presence of H. pylori in the antrum and corpus in duodenal ulcer patients receiving omeprazole for 4 wk. Culture and histological examination of antral biopsies (Genta stain) were performed before patients received omeprazole, at the end of therapy, and 4-6 wk later. The end points were presence or absence of H. pylori and the number of H. pylori colonies per biopsy. RESULTS: Seventy-two patients had H. pylori in both the antrum and corpus at entry and 4-6 wk after ending therapy. Three general patterns were prevalent at the end of omeprazole therapy: antrum- and corpus-positive (54%), antrum-negative and corpus-positive (24%), both antrum- and corpus-negative (21%), and one patient had antrum-positive with corpus-negative (1%). Evaluation of the number of colonies per biopsy in those who remained H. pylori-positive in both the antrum and corpus throughout showed that the number of H. pylori decreased in both the antrum and corpus during therapy (507 +/- 60 vs. 225 +/- 51, p < 0.01 and 415 +/- 58 vs. 290 +/- 46 0.1) for antrum and corpus, respectively, and tended to return to pre-therapy levels 4-6 wk later. The number of H. pylori in the corpus also decreased in the antrum-negative and corpus-positive group during therapy with omeprazole (433 +/- 87 vs. 185 +/- 61, p < 0.05). In most of the patients studied, the number of H. pylori in the corpus was less posttreatment than it was pretreatment. The decrease in H. pylori load was also reflected in the development of false-negative urea breath tests. CONCLUSIONS: Omeprazole is detrimental to H. pylori in both the antrum and the corpus; migration from the antrum to the corpus in response to omeprazole is a myth.     

Grain Boundary Responses to Heterogeneous Deformation in Tantalum Polycrystals

The evolution of heterogeneous deformation in a tantalum polycrystal was examined during a three-point bending experiment using electron backscatter pattern mapping. Slip bands formed at strains as low as 1%, and they became more intense with strain. Heterogeneous deformation was evident as intragranular orientation gradients as large as 30° were observed after a strain of about 8%. Nonmonotonic changes in the local average misorientation distribution were observed, implying that dislocation substructure developed in a complex manner. Slip bands were analyzed using plane traces computed from local orientation information. With the assumption of uniaxial stress, Schmid factors for favorable slip systems were identified for each grain and compared with observations, showing evidence for macroscopic activity on both {110} and {112} slip systems. Reconstructed boundary data were used to estimate the geometric potential for slip transfer at grain boundaries. The correlations indicated that when active slip systems were favorably oriented for slip transfer across the boundary, it was often observed in the form of continuous slip bands aligned across the boundary. In boundaries where geometrical alignment and Schmid factors were not favorable for slip transfer, there was a higher likelihood to form ledges (topographic discontinuities) along the grain boundaries. Dislocation pileups at grain boundaries were also correlated with a low potential for slip transfer.     

Development and validation of the Caregiver Empowerment Scale: A resource for working with family caregivers of persons with traumatic brain injury.

Objective: To use multitrait analysis to determine the measurement structure of the Caregiver Empowerment Scale (CES). Participants: An American sample of 87 adult primary family caregivers of persons with traumatic brain injury (TBI). Results: A four-factor structure was identified including factor 1 (Advocacy Self-Efficacy), factor 2 (Community Self-Efficacy), factor 3 (Caregiver Self-Efficacy), and factor 4 (Personal Self-Efficacy). Conclusions: The CES provides clinicians and researchers a means to assess self-perceived coping abilities of family caregivers of persons with TBI. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Diets deficient in rumen undegraded protein did not depress milk production

The objective of this study was to evaluate the National Research Council's recommendations for feeding levels of rumen undegraded protein (RUP) for cows fed a one-group total mixed ration. Sixty Holstein cows were paired by parity (1 to 6) and DIM (23 to 315) and were randomly assigned to one of two treatment sequences. Diets contained alfalfa silage (30% diet DM) and corn silage (26% diet DM), and were isonitrogenous (16% CP) and isocaloric (1.71 Mcal/kg). Soybean meal, protected soybean meal (Soy Best), and urea were used to make ration protein fractions that were predicted to be 35 or 29% RUP. The 35% RUP diet was formulated to provide 98 and 105% of the average requirement for RUP and rumen degraded protein (RDP), respectively. The ration containing 29% RUP provided 79 and 117% of average required RUP and RDP, respectively. All cows were group-fed the high RUP diet during a 2-wk pretreatment period, and then were fed one ration for 4 wk followed by the other for 4 wk according to their assigned treatment sequence. Data were collected in the last wk of each period. Mean milk production, milk fat, and milk protein were 32.6 kg/d, 4.35%, and 3.36%, respectively, with no treatment differences. Treatment response was not affected by degree of predicted RUP deficiency. National Research Council requirements for RUP may be too high for cows fed diets similar in energy to a one-group total mixed ration. Alternatively, estimates of RUP content of feedstuffs may be low.     

The immunologic effects of IVIG in Kawasaki disease

Kawasaki disease (KD) is an acute febrile illness of early childhood that is associated with the development of coronary artery aneurysms in 15-25% of the cases. The acute phase of KD is characterized by a deficiency of suppressor T cells, marked activation of the immune system and increased secretion of cytokines by immune effector cells. Evidence that this immune activation contributes to the vascular endothelial cell damage in KD is suggested by the observation that patients in the acute phase of KD have circulating antibodies lytic for vascular endothelial cells activated with gamma interferon, IL-1 or tumor necrosis factor. In contrast, sera from these patients do not lyse unstimulated endothelial cells. High dose intravenous gammaglobulin (IVGG) treatment is effective in preventing the occurrence of coronary artery abnormalities in KD. Patients treated with IVGG have a significant increase in T suppressor cells, a decrease in circulating activated T helper cells, and a decrease in spontaneous IgG and IgM synthesis. These observations suggest that IVGG reduces the vasculitis in KD by suppressing the marked immune activation associated with this disease.