Zinc concentrations in pure populations of peripheral blood neutrophils, lymphocytes and monocytes

It is doubtful if the measurement of plasma or serum zinc is of value in assessing zinc status. Leucocyte zinc has been suggested as an alternative since it may be representative of tissue zinc stores; but in many studies poorly defined cell populations make interpretation difficult. This paper describes detailed techniques for the isolation and analysis of pure populations of neutrophils, lymphocytes and monocytes. Zinc concentrations (+/- 1SD) in normal subjects were 1.26 +/- 0.27 nmol/mg protein, 1.85 +/- 0.32 nmol/mg protein and 2.58 +/- 0.65 nmol/mg protein in neutrophils, lymphocytes and monocytes respectively. Fasting caused a significant decrease in neutrophil and lymphocyte zinc, and an increase in monocyte zinc. Supplementation of zinc-replete subjects with 135 mg zinc/day for 3 weeks had no significant effect on cellular zinc concentrations.

Vaginal tumors in mice from methylcholanthrene and prenatal exposure to diethylstilbestrol

To test the hypothesis that mice exposed prenatally to diethylstilbestrol (DES) develop adenocarcinomas due to sensitivity of vaginal and cervical adenosis to carcinogens, sponges impregnated with methylcholanthrene (MCA) were lodged against the cervix and vaginal fornices of 6-month-old strain CD-1 mice exposed prenatally to DES. Only squamous cell carcinomas developed in these mice, but at a significantly higher rate than in MCA-treated mice not exposed prenatally to DES. An adenosquamous carcinoma and a precursor of adenocarcinoma developed in DES-exposed mice with control sponges.

Leucocyte zinc in non-Hodgkin's lymphoma and Hodgkin's disease

Zinc status and the effect of zinc supplementation were assessed in groups of patients with non-Hodgkin's lymphoma and Hodgkin's disease; patients were either untreated or in remission. In the patients in remission, plasma zinc was normal; and whereas 30% of untreated patients had low plasma zinc, the group as a whole did not differ from normal. For mononuclear cell zinc, the range of values in the disease group was far wider than in controls, but there was no significant difference between the means of the groups. Granulocyte zinc was significantly lower in both the groups of patients in remission from non-Hodgkin's lymphoma and Hodgkin's disease compared with the control group. Significant increases were found in the plasma copper, ceruloplasmin, and the copper-to-zinc ratio in several of the patient groups. Plasma zinc increased by 23% with zinc supplementation (50 mg elemental Zn/day), but there was no effect on mononuclear cell or granulocyte zinc. Apart from granulocyte zinc, there is little evidence of zinc deficiency in non-Hodgkin's lymphoma or Hodgkin's disease. However, the presence of depleted granulocyte zinc levels could modify the immune function of this cell population.

Ovariectomy of adult mice exposed prenatally to diethylstilbestrol

Mice exposed prenatally to diethylstilbestrol (DES) were ovariectomized at 5-10 weeks of age, or at 15 months of age. They were maintained to old age and studied for incidence of DES-related pathologic changes. Uterine metaplasia and adenomyosis were not seen after early ovariectomy, but adenomyosis persisted after late ovariectomy. No adenocarcinomas of the genital tract were found in 30 mice ovariectomized early, or in 18 mice ovariectomized at 15 months of age. This result is significantly different from the 14% frequency of genital tract adenocarcinomas reported previously in non-ovariectomized mice of this strain exposed prenatally to DES.

Nutrition and cellular immunity in hospital patients

1. The interrelations between nutritional and cellular immune function measurements were studied in seventy patients suffering from various degrees of malnutrition. They included patients with liver disease, inflammatory bowel disease, neoplastic disease, neurological patients, post-operative surgical patients and patients with respiratory problems. 2. Nutritional measurements included: anthropometry, serum proteins, various vitamins and trace elements, and a prognostic nutritional index (PNI) was calculated. 3. Immunological measurements included: (1) natural killer (NK) cell activity, (2) antibody-dependent cellular cytotoxicity (ADCC), (3) lymphocyte proliferation in response to the mitogens concanavalin A (Con A), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) in both AB and autologous serum. 4. There was no association between anthropometric measurements and tests of immune function. 5. The lymphocyte proliferation in response to mitogenic stimulation in the malnourished patients was depressed in autologous serum compared with the response of the same lymphocytes in pooled AB serum. The lymphocyte proliferation in response to Con A correlated with transferrin in autologous serum (r 0.46, n 49, P less than 0.01) and to a lesser extent in AB serum (r 0.33, n 51, P less than 0.05). There was a difference in the Con A-stimulated tritiated-thymidine uptake between patients with low and normal serum zinc levels (P less than 0.05) for cultures performed in autologous serum, but not AB serum. 6. There was a significant correlation between NK cell activity and vitamin C (r 0.43, n 60, P less than 0.01). There was no relation between nutritional measurements and ADCC or the lymphocyte response to stimulation with PHA or PWM. 7. The results suggest that the severity of overall malnutrition does not influence several different aspects of the cellular immune response. However, the results do suggest that certain individual nutrients, particularly vitamin C and Zn, do influence the immunoreactivity of different lymphocyte subpopulations.

Essential element nutritional status in cystic fibrosis

Serum calcium, magnesium, iron, copper and zinc were measured in 117 patients with cystic fibrosis. Apart from serum iron levels, all the other essential element levels were well maintained and there was no evidence of a need for supplementation. Serum iron was frequently low and the need for iron supplements must be considered after further investigation. The subjects studied covered a wide age range, had widely varying fat malabsorption and clinical grading, and also varying degrees of pulmonary involvement. We found no evidence that any of these parameters directly influenced essential element status as assessed by serum levels.

Tumors of female offspring of mice exposed prenatally to diethylstilbestrol

Strain CD-1 female mice exposed prenatally to diethylstilbestrol (DES) (CAS: 56-53-1; alpha,alpha'-diethyl-4,4'-stilbenediol) were mated to unexposed males. Female offspring of these matings were raised to the stage of terminal illness. They were never exposed to DES and so have been referred to as "DES-lineage mice." Ten uterine adenocarcinomas and 5 ovarian cystadenocarcinomas were found in 40 DES-lineage mice. These findings were significantly different from the absence of such tumors in 24 "vehicle-lineage" mice whose mothers had received injections only of oil and alcohol. The types of tumors that commonly occur spontaneously in the CD-1 strain appeared with comparable frequency in the 2 groups of mice. The DES-lineage mice did not show the increased frequency of adenomyosis and squamous metaplasia of the uterus, nor the reduced frequency of corpora lutea seen in mice exposed prenatally to DES.

Zinc, vitamin A and prostatic cancer

The serum zinc, vitamin A, albumin, copper and retinoid-binding protein content was measured in 27 patients with benign prostatic hyperplasia and 19 patients with carcinoma of the prostate. A significantly lower (P = less than 0.05) level of serum zinc was found in the cancer group as well as a significant zinc/vitamin A correlation (P = less than 0.05). The possible significance of this in relation to the pathogenesis of carcinoma of the prostate is discussed.

Nutritional and immunological assessment of patients with anorexia nervosa

The nutritional and immunological status of patients with anorexia nervosa was assessed. Anthropometric measurements were found to be lowered as were the serum levels of zinc (p<0.01), copper (p<0.01) and ceruloplasmin (p<0.05) in comparison with the control group. However the serum levels of albumin, pre-albumin, transferrin and retinol binding protein, vitamins A and D and leucocyte vitamin C were generally found to be within normal limits. Lymphocyte transformation was measured in response to stimulation with the mitogens Con A, PHA and PWM. Responses were normal in all patients with the exception of one who showed a depressed response to Con A. Natural killer cell activity was measured against the target cell line K562 and was not found to differ significantly from controls. It is suggested that the relatively normal protein and vitamin status is responsible for maintaining the apparently normal cellular immune function in patients with anorexia nervosa.

Uterine tumors in old female mice exposed prenatally to diethylstilbestrol

Pregnant strain CD-1 mice were treated with diethylstilbestrol (DES) or vehicle. Their female offspring were raised to old age and autopsied when terminally ill. Squamous metaplasia and adenomyosis were more common in uteri of these old mice exposed prenatally to DES than in control mice. Tumors of the uterine horns were seen in 17 of 143 DES-exposed mice and in 3 of 64 control mice. The controls had only leiomyomas, whereas 14 of the DES-exposed mice had adenocarcinomas. There were 5 cervical adenocarcinomas and 1 vaginal adenocarcinoma among treated mice but none in the control mice. Thus the effects of prenatal exposure to DES interacted with the effects of aging to produce a relatively high frequency of uterine adenocarcinoma.

Complications of pregnancy in mice exposed prenatally to DES

Women exposed prenatally to diethylstilbestrol (DES) develop a variety of reproductive tract anomalies. Most of these anomalies have been replicated in strain CD-1 mice after similar DES exposure. Recently, impaired reproductive performance in DES-exposed women has been reported. To see whether the mouse model also replicates this defect, a study of reproduction was performed. Pregnant CD-1 mice were injected with DES and their female offspring were raised to breeding age. The latter were then exposed continuously to untreated males for a maximum of 4 months. Among 74 mated mice, 34 became pregnant and 11 of these pregnancies ended in abortion or stillbirth. Other anomalies encountered were: two fetuses with compressed heads, one of which seemed blocked from delivery by a vaginal adenocarcinoma; two uterine tumors, one of which was a teratocarcinoma; two teratomas located in uterine lumina; and two uteri containing placentas without embryos. Since the frequency of successful pregnancies in the DES-exposed mice was reduced below control levels to a degree similar to that reported for DES-exposed women, the validity of the mouse model has been confirmed for this characteristic.

Palate morphology and fetal movements in mice after DPH

Effects of DPH on fetal development were studied using a dose which produced 65% cleft palate in the CD-1 strain. Generalized developmental retardation and diminution of fetal muscular movements occurred at the early fetal stage. Intermediate stages of palate closure persisted to term, indicating interference with palatine shelf rotation.

The effect of wheat bran and pectin on paracetamol absorption in the rat

1. The absorption of an oral dose of paracetamol was measured in rats given either a basal fibre-free diet, or the basal diet with either pectin or bran added. 2. Urinary excretion of the oral dose was significantly greater during the first 8 h in the pectin-fed rats compared with those on basal diet, though cumulative excretion after 72 h was the same. 3. Free paracetamol levels in the plasma were significantly higher in the pectin-fed rats compared with those on basal diet at 30, 60, 90 and 120 min after the oral dose. 4. The plasma half-life of intravenously-injected paracetamol was shorter in the pectin-fed rats than in those on basal diet alone, but the antipyrine half-lives were not significantly different. 5. Pectin feeding had no effect on either the apparent volume of distribution of paracetamol and antipyrine, or on the rate of gastric empyting. 6. Perfusion of the whole length of the small bowel showed a significantly greater capacity for paracetamol absorption in the pectin-fed rats. 7. Bran had no effect on paracetamol absorption. 8. It was concluded that dietary fibre intake affects drug absorption and that the effect varies with the type of fibre. Unexpectedly pectin accelerates rather than retards absorption of paracetamol, though the mechansim of this effect is unknown.

Adjusted calcium conflict resolved? Differing effects on plasma total calcium of changes in plasma albumin after venous stasis or myocardial infarction

Others have challenged the concept of adjusting total plasma calcium for albumin concentration on the grounds that after the application of a tourniquet the increase in calcium for a given increase in albumin differs significantly between normal individuals. We have confirmed this finding. In contrast, we have found that after myocardial infarction the fall in calcium for a given fall in albumin does not differ significantly between patients. Thus the adjustment of calcium for albumin using a single equation remains valid in patients with changes in albumin due to disease. We recommend that for consistent results blood should be taken with the minimum of venous stasis even though the patient's calcium is to be adjusted for albumin.

The gastrointestinal absorption of paracetamol in the rat

The absorption of [3H]paracetamol by rat small intestine, colon and stomach was studied in vivo and in vitro. Small intestinal in vivo studies, using a wide range of drug concentrations, showed that absorption was efficient and uniform throughout the small bowel, no site showing preferential absorption. Double reciprocal and direct plots indicated first order kinetics. The pattern was not observed when uptake was occurring from high concentrations of paracetamol in suspension. Gastric and colonic in vivo studies showed that there was appreciable absorption of [3H]paracetamol from these sites. In vitro studies using everted intestinal sacs showed no effect on paracetamol transfer when the incubation temperature was lowered to 10 degrees C or when iodoacetate (5 X 10(-2)M) and 2.4 dinitrophenol (5 X 10(-4)M) was added to the incubation medium. There was, however, a significant reduction in transfer of paracetamol against a concentration gradient of 10:1 applied across the mucosa. These data suggest that the uptake of paracetamol is by a passive transport process and confirm the efficiency of paracetamol absorption observed indirectly by others.

Cimetidine: an advance in gastric ulcer treatment?

Sixty patients with endoscopically confirmed gastric ulceration took part in a single-blind trial of cimetidine 1 g daily compared with conventional treatment--namely, carbenoxolone in patients aged under 60 and Caved-(S) in those over 60. Twenty-nine patients received cimetidine: in 12 (41%) ulcer healing was complete after one month, in 26 (90%) healing was complete after two months, and all ulcers were healed after three months of treatment. In the under-60s, ulcers were healed in a greater proportion of patients given cimetidine than in those given carbenoxolone. The difference, however, was significant only at the 5% level, which owing to small numbers was of doubtful clinical validity. In the over-60s cimetidine and Caved-(S) were of similar efficacy. The 54 patients with healed ulcers are being followed up for two years; so far there have been 16 recurrences (30%). Further trials are needed, which should include maintenance treatment aimed at lowering the unacceptably high recurrence rate.

Plasma whole blood and urine zinc in the assessment of zinc deficiency in the rat

Serial measurements of plasma, whole blood, and urine zinc have been made in young adult rats fed zinc deficient and zinc supplemented diets for a total period of 65 days. After commencing a zinc deficient diet plasma zinc fell within 48 hours to 25% of control values and remained at this level throughout the period of study. A substantial diurnal variation was observed in plasma zinc, and the level was significantly lower in the fasting state. Whole blood zinc was unaffected by fasting, showed no diurnal variation, and remained at control values even after 65 days of zinc deficient diet. Urine zinc fell to very low values, 10 days after commencing a zinc deficient diet, but after 30 days rose to control values. Under controlled conditions plasma zinc can be used as an indication of zinc deficiency. Whole blood zinc is of no value in the detection of zinc deficiency. Urine zinc concentration varies with time following a zinc deficient diet.

Plasma zinc after myocardial infarction

Plasma levels of zinc and albumin have been measured for eight consecutive days in patients suffering chest pain due to myocardial infarction or myocardial ischaemia. A substantial diurnal variation has been found in both controls and patients. Plasma zinc falls after myocardial infarction reaching the lowest level on day 2, thereafter returning to normal by day 8. The lowest plasma zinc levels occur within 48 h of a myocardial infarction and in some patients herald the development of a serious cardiac arrhythmia. Plasma albumin falls progressively after myocardial infarction, being lowest on day 8. The fall in plasma zinc is not totally explained by the fall in plasma albumin.

Palate development after fetal tongue removal in cortisone-treated mice

Morphological studies of cortisone-induced cleft palate have shown retardation in the rotation of palatine shelves from a sagittal to a transverse plane. Cortisone also reduces fetal muscular movements, which may explain why displacement of the tongue from between the palatine shelves is delayed. Previous work with extrauterine development of control fetuses demonstrated that fetal membranes and tongue were major obstacles to shelf rotation. Thus, removal of these obstacles might permit rotation and fusion of palatine shelves in cortisone-treated fetuses. In the present experiment, fetuses from cortisone-treated strain CD-1 mice were released from uterus and membranes and allowed to develop for eight hours in a fluid medium with the umbilical cord left intact. Compared to 4% fusion in utero, there was palatal fusion in 20% of fetuses released from membranes. When the fetal tongue was removed during extrauterine development, the frequency of fusions increased to 61%. Fusion appeared normal by the criteria applicable through light microscopy. Thus, cortisone induces cleft palate primarily through interference with shelf rotation. The palatine shelves of treated fetuses retain their ability to fuse when they can come in contact during the normal time for palate closure.

Nutrition in cryptogenic cirrhosis and chronic aggressive hepatitis

The nutritional status of 80 patients with non-alcoholic chronic liver disease was assessed by determination of various nutritional parameters in body fluids. With the exception of vitamin C there was a higher incidence (40%) of fat soluble vitamin deficiency (vitamins A, E, and carotene) than of the water soluble vitamins. Less than 10% of patients showed evidence of vitamin B12, nicotinic acid, thiamin, or riboflavin deficiency, and 17% had evidence of folic acid deficiency. The presence of deficiency was not related to age of the patient or fat absorption, and an inadequate dietary intake was not a major cause of deficiency. The incidence of nutritional deficiency is less frequent in non-alcoholic as compared with alcoholic liver disease.

Effects of anti-inflammatory steroids on mouse embryonic movements during palatal development

The frequency of spontaneous embryonic muscular movements was recorded for embryos from mice treated with cortisone or triamcinolone. Movement was significantly reduced in A/J strain mouse embryos exposed to these anti-inflammatory agents. Cleft palates induced by the drugs may originate from failure of the embryonic tongue to be withdrawn from between the palatine shelves.

Serum transaminase levels after experimental paracetamol-induced hepatic necrosis

The relationship between serum transaminase levels and the extent of paracetamol-induced liver necrosis has been investigated in the rat. Three methods of histological quantitation were used to assess of necrosis--arbitrary grading, point counting, and the image-analysis computer. Highly significant correlations were obtained between the three methods and all were found to be reproducible. A close correlation was found between the extent of hepatic necrosis and the serum ASAT and ALAT 24 hours after a large dose (4 g/kg) of paracetamol. Likewise, the mean grade of necrosis correlated reasonably well with the serum enzyme levels in the recovery phase at 36 and 72 hours, although the transaminase level for a given degree of necrosis was considerably lower at 72 hours than at 24 hours. These findings suggest that serum transaminase levels gives a reliable indication of the severity of hepatic necrosis if the time of ingestion of the paracetamol is known and taken into account.

Highly selective vagotomy for duodenal ulcer: do hypersecretors need antrectomy?

Two to five years after highly selective vagotomy (H.S.V.) for duodenal ulcer the results were similar in patients with high preoperative maximal acid outputs and those with lower acid outputs. Pain of ulcer type was experienced at some time by 6% of patients from each group, but it was mild and transient in some. No patients had recurrent ulceration at endoscopy or laparotomy, while incidence of individual symptoms was about equal in the two groups. Hence H.S.V. is adequate surgical treatment for patients with both duodenal ulceration and high levels of acid secretion. Antrectomy in such patients is not necessary provided that the incidence of incomplete vagotomy can be kept low.

Increase in urinary indican excretion in pancreatic steatorrhoea following replacement therapy

Urinary indican excretion was studied in 5 patients with steatorrhoea of pancreatic origin, 4 patients with steatorrhoea due to other causes, and 5 normal subjects. Treatment with pancreatic extract resulted in an immediate increase in indican excretion to above the normal range in patients with steatorrhoea due to pancreatic insufficiency. Administration of pancreatic extract did not result in a rise in the patients with steatorrhoea not due to pancreatic insufficiency, or in the normal subjects. In one patient with pancreatic insufficiency maintained on a low protein diet, the rise in indican excretion on replacement therapy was much slower and did not reach as high a level as in the patients on a normal protein diet. The possible mechanisms underlying these observations are discussed. It is suggested that the finding of a low indican excretion in the presence of steatorrhoea and its rise to above normal on pancreatic enzyme therapy is strongly suggestive of exocrine pancreatic insufficiency.

Vitamin E protection of the liver from paracetamol in the rat

1. Control, vitamin E-deficient, vitamin E-supplemented (deficient with added ‘normal’ intake) and vitamin E-treated rats were given paracetamol at a dose of 25.5 mmol (4 g)/kg body weight. Control rats were also given paracetamol with or without simultaneous vitamin E.

2. Plasma aspartate aminotransferase and alanine aminotransferase activities increased to very high values (mean 2842 and 1241 i.u./l respectively) in the control group, and even higher (mean 8220 and 2320 i.u./l respectively) in the vitamin E-deficient group.

3. In the vitamin E-supplemented group the rises in activity were similar but rather less than in the control group (mean 2417 and 815 i.u./l) and in the vitamin E-treated group only very small rises (mean 177 and 98 i.u./l) were seen.

4. Histological evidence of hepatic necrosis correlated closely with plasma enzyme activities.

5. It appears that paracetamol-induced hepatic necrosis is potentiated in vitamin E deficiency and reduced by prior treatment with α-tocopherol.

6. Vitamin E administered simultaneously with paracetamol at 12.8 or 19.2 mmol/kg also greatly reduced the expected rise in serum enzyme activities.

7. These observations may shed some light on the mechanism of paracetamol-induced hepatic necrosis, and may form a basis for preventing or reducing this lesion in man.

Clinical results of parietal cell vagotomy (highly selective vagotomy) two to four years after operation

In Leeds and Copenhagen 271 patients were treated electively for duodenal ulcer by parietal cell vagotomy without drainage between 1969 and 1972 inclusive, with no operative deaths. 108 patients have been followed up 2-4 years since operation. Gastric stasis necessitating re-operation occurred in only 2 cases. Gastric ulcer developed in 2 cases, and in 3 cases recurrence of the duodenal ulcer was suspected but was unconfirmed at re-operation. Uncontrolled comparison with the results of partial gastrectomy and of vagotomy with drainage, as performed at these two centers, has shown that after parietal cell vagotomy without drainage there is a much lower incidence of dumping, diarrhea and bile vomiting, and, on overall assessment, a greater proportion of perfect or very good results.

Plasma and urinary zinc in patients with malabsorption syndromes or hepatic cirrhosis

Plasma and urinary zinc have been measured in 19 patients with malabsorption and 21 patients with hepatic cirrhosis. The results have been compared with those of 20 control subjects and 23 patients with a variety of other diseases. The diurnal variation in plasma zinc levels has been confirmed and is of such magnitude that this must be taken into account in comparing results in groups of subjects. Plasma zinc levels, both fasting and after a meal, are significantly lower in patients with cirrhosis (71 and 60 mug/100 ml) and malabsorption (76 and 64 mug/100 ml) than in controls (97 and 81 mug/100 ml). In the patients with cirrhosis or malabsorption similar correlations exist between plasma zinc and plasma albumin, suggesting that the low plasma zinc levels may be, at least in part, dependent on the plasma albumin level. Urinary zinc excretion is increased in cirrhosis, but not in malabsorption, indicating that increased urinary loss is unlikely to explain the low plasma levels.

Incidence of dumping after truncal and selective vagotomy with pyloroplasty and highly selective vagotomy without drainage procedure

The incidence of dumping after truncal or selective vagotomy with pyloroplasty and highly selective vagotomy without a drainage procedure was assessed both clinically and experimentally. At a gastric follow-up clinic dumping was found to be significantly less frequent in patients who had undergone highly selective vagotomy without a drainage procedure than in patients who had undergone truncal or selective vagotomy with pyloroplasty (P < 0.05 or < 0.001, respectively). Hypertonic glucose given by mouth provoked the onset of dumping in 20% of patients with duodenal ulcer before operation, in 73% after truncal vagotomy and pyloroplasty, in 80% after selective vagotomy and pyloroplasty, and in 47% after highly selective vagotomy. The test meal also produced significantly greater decreases in blood pressure and increases in pulse rate in patients who had undergone vagotomy with pyloroplasty than in patients who had undergone highly selective vagotomy.

Vagotomy without diarrhoea

The incidence of diarrhoea after three types of vagotomy was assessed "blind" at a gastric follow-up clinic one year after operation. Diarrhoea was recorded in 24% of patients after truncal vagotomy and pyloroplasty, in 18% after selective vagotomy and pyloroplasty, but in only 2% of patients after highly selective vagotomy without a drainage procedure. The incidence of diarrhoea was significantly less (P < 0.01) after highly selective vagotomy than after either of the other procedures.Hypertonic glucose solution given by mouth to 15 representative patients from each group and to 15 patients before operation provoked the onset of diarrhoea in 67% of the patients who had undergone truncal vagotomy and pyloroplasty, in 60% of those who had undergone selective vagotomy and pyloroplasty, in 13% of those who had undergone highly selective vagotomy without a drainage procedure, and in none of the preoperative patients. Again the difference between the "highly selective" group and the other two groups of vagotomized patients was statistically significant.It is suggested that postvagotomy diarrhoea is attributable both to unregulated gastric emptying after truncal or selective vagotomy with a drainage procedure and to the extragastric denervation produced by truncal vagotomy. "Postvagotomy" diarrhoea can be virtually eliminated by using highly selective vagotomy without a drainage procedure.