Optimization of selectivity in high-performance liquid chromatography using desirability functions and mixture designs according to PRISMA

A computer program for the mobile phase optimization of high-performance liquid chromatography (HPLC) is described. The desirability function technique combined to the prisma mixture design was employed to enhance the quality of HPLC separations. The use of statistical models to predict the behaviour of retention times (tR) and band broadening at the different eluent compositions obtained by prisma was examined for dansyl amides and coumarins. The study showed that the dependence between the eluent composition and tR values of dansyl amides and coumarins can be expressed using quadratic regression models with a high degree of accuracy. Band broadening given by means of the band width at half-height (wh) was described by a linear regression model. Both models were used in calculating and predicting the resolution (Rs) in various solvent combinations. The desirability function converted the calculated (Rs) value into the desirability value (D), and the overall optimum was then defined by means of the overall desirability. The optimal eluent mixtures for the separation of compounds were easily read from the contour plot inside the horizontal plane of the prisma model. A good separation was achieved using the optimized solvent combination. Depending on the aims of the optimal separation, the program allows either optimization of critical pairs or achieving the overall optimum giving a reasonable separation for as many compounds as possible.

Survival of Lactobacillus plantarum DSM 9843 (299v), and effect on the short-chain fatty acid content of faeces after ingestion of a rose-hip drink with fermented oats

In a controlled and randomised double-blind study, 26 healthy adult volunteers consumed, for 21 d, 400 ml of a rose-hip drink containing oats (0.7 g/100ml) fermented with Lactobacillus plantarum DSM 9843 (RHL; containing 5 x 10(7) cfu ml(-1)), and 22 volunteers in a second group the same amount of a pure rose-hip drink (RH). Significant increases in the total faecal concentration of carboxylic acids (P < 0.05 after 1 week and P < 0.01 after 3 weeks of intake), acetic acid (P < 0.01 after 3 weeks of intake) and propionic acid (P < 0.01 after 3 weeks of intake and P < 0.05 eight days after intake ceased) were recorded in the RHL group, indicating increased fermentation in the colon. In both groups a significant increase was obtained in the concentration of faecal lactic acid (P < 0.001 after 1 and 3 weeks of intake). No changes were seen in the concentration of faecal butyrate. The numbers of faecal bifidobacteria and lactobacilli increased significantly in both groups after 3 weeks of intake. Sulphite-reducing clostridia rapidly decreased in the group receiving the product with Lb. plantarum DSM 9843 after 1 week of intake, and then also in the pure rose-hip group after 3 weeks of intake. No changes were seen in the numbers of total anaerobes, gram-negative anaerobes or total aerobes during administration. Lb. plantarum DSM 9843 was recovered in faeces from all volunteers in the RHL group. Median amounts were 7.0 (5.0-8.8) log10 cfu g(-1) after one week of intake, and 6.7 (5.0-8.9) log10 cfu g(-1) after 3 weeks, respectively. The strain was still recovered from faeces of five volunteers 8 d after administration ceased (> 4.8 log10 cfu g(-1)). During the period of intake the volunteers in the RHL group experienced a significant increase in stool volume, a significant decrease in flatulence and slightly softer stools. Volunteers in the RH group experienced a slight but significant decrease in stool volume.

Antibody response to Arcanobacterium haemolyticum infection in humans

Arcanobacterium haemolyticum causes pharyngitis, exanthema, and other infections. The evidence of the pathogenicity of A. haemolyticum depends on clinical descriptions of culture-positive patients and a comparison of carrier rates of patients with pharyngitis and healthy, matched controls. In this investigation, the antibody response of the host was studied for the first time, using SDS-PAGE and Western blot analyses. Paired acute and convalescent sera showed development of antibodies to A. haemolyticum in 7 of 8 patients. The antibodies reacted primarily with four distinct cell wall-associated proteins with estimated molecular masses of 80, 60, 50, and 30 kDa. Moreover, the reactivity of convalescent sera from 19 patients was compared with that of sera from 19 controls. Antibodies to A. haemolyticum were found in sera from 16 patients and 6 controls (P < .005); the antibody response of the patients was strong compared with that of the controls. These results indicate that A. haemolyticum infection induces an antibody response in the host.

Audible in utero sound caused by the ultrasonic radiation force from a real-time scanner

While investigating in utero sound levels during vibro-acoustic stimulation on the maternal abdomen it was noticed that noise level increased when the real-time ultrasonic scanner beam was directed at the sensing hydrophone. The noise was recorded and later analysed for frequency content and waveform. It appeared related to the scanning and frame rate frequencies of the scanner used. Sounds may originate from radiation pressure produced when the ultrasound beam is absorbed by tissue or reflected from bone or the metal hydrophone. This implies that although ultrasound cannot be heard per se, any modulation of its intensity will produce vibrations in the maternal tissues or reflecting structures such as skull bone, and especially stapes, malleus and incus, that would be heard as sound by the fetus. The intensity of the sound produced varied with orientation of the transducer beam and this may itself produce a stimulation. Based on our recordings (Fig. 1), it was calculated (please see Appendix) that the fetus would hear a sound corresponding to 84dB noise pressure level in air.

A prospective study of antibodies against parvovirus B19 in pregnancy

BACKGROUND

Parvovirus infection during pregnancy has been reported to be associated with spontaneous abortion and fetal loss.

OBJECTIVE

To show the incidence of antibodies against Parvovirus B19 early in pregnancy and sero-reactivities during and after pregnancy.

STUDY DESIGN

In a prospective study during a non-epidemic period, 457 women admitted to an antenatal care center were included. Serum samples were collected at 7-13, 21, and 33 weeks of gestation, and 7-9 weeks after delivery.

METHOD

Samples were evaluated for parvovirus specific IgG and IgM against two different parvovirus antigens.

RESULTS AND CONCLUSION

Parvovirus specific antibodies were present in 81% of the women in the first sample. Six women (six of 88 susceptible, 6.8%) seroconverted and 28 women (28/369, 7.6%) boosted their antibody response during or after pregnancy. All gave birth to healthy infants. One woman free of symptoms experienced an intrauterine fetal death at 37 weeks of gestation. She had no rise in B19 antibodies during pregnancy, but parvovirus DNA was found in maternal serum samples and in the placenta.

Satiety effects of spinach in mixed meals: comparison with other vegetables

The effects of vegetables in mixed meals on satiety were evaluated by varying the dose (portions 150 and 250 g containing 4.3 and 7.2 g of dietary fibre, respectively) and structure (cut and minced) of microwaved spinach. A control meal without spinach and the test meals with spinach were balanced regarding energy (2000 kJ) and digestible carbohydrates (59 g, 51 E%) and with protein and fat as far as possible similar. The meals were served in the morning, after an overnight fast, to ten healthy male volunteers. Satiety was registered and blood glucose as well as plasma insulin and C-peptide were analysed at regular intervals until 3.5 h postprandially. The largest spinach portions augmented satiety and reduced the postprandial glucose response. The total satiety scores seemed to be correlated positively to both the dietary fibre and the water content in the vegetable. Differences in structure had no influence on satiety scores.

Determination of digestible energy values and fermentabilities of dietary fibre supplements: a European interlaboratory study in vivo

The performance of methods to determine energy conversion factors for dietary fibre (DF) supplements and fermentability (D) values of their non-starch polysaccharides (NSP) was investigated. Heats of combustion, digestible energy (DE) and D values were determined on five DF supplements in five European laboratories on five separate occasions. In each instance the DF supplements were fed to juvenile male Wistar rats at two doses, 50 and 100 g/kg basal diet, for 3 weeks with food and faeces collected in the 3rd week. Among-laboratory variations in heats of combustion (delta Hc) were < 2%. DE values (kJ/g dry weight) at the upper and lower doses respectively were: 10.4 and 9.9 for a high-methoxyl apple pectin, 9.5 and 9.4 for a sugar-beet DF supplement, 12.2 and 12.7 for soyabean DF supplement, 3.8 and 4.0 for maize bran, and 0.3 and 0.3 for Solka-floc cellulose. Variations among laboratories, among occasions and among animals were < 1, < 2 and < 2.5 kJ/g respectively. The among-occasion: among-laboratory variance ratio for DE was 0.5, suggesting the method performed equally well in all laboratories. There was no evidence of learning of fatigue or fatigue in the performance of the method. D values were also independent of dose and at the high and lower doses were: pectin 0.92 and 0.95, sugar-beet NSP 0.68 and 0.68, soyabean NSP 0.86 and 0.88, maize bran 0.17 and 0.18, cellulose 0.07 and 0.06. Among-laboratory variance tended to increase with decreasing fermentability and ranged from 0.03 to 0.18. The DE and D data were not significantly different from a previously proposed relationship DE = 0.7 x delta Hc x D, where delta Hc is the heat of combustion of the supplement. We conclude that while the among-laboratory variation in the D of difficult-to-ferment NSP is too large for the reliable prediction of energy value the method for the direction determination of DE is both reproducible and repeatable, that DE is independent of dosage of DF supplement up to 100 g/kg diet, and that it is safe to discriminate between energy values with a precision of 3 kJ/g. The conversion of both DE and D to net metabolizable energy for the purpose of food labelling, tables and databases is described.

Influence of processing and cooking of carrots in mixed meals on satiety, glucose and hormonal response

The influence of processing and cooking on the metabolic response to carrots in mixed meals was explored in two consecutive harvest years. The contribution of dietary fibre (4.4 g 1989 and 6.6 g 1990) from carrots was chosen to be different in order to compare effects with varying doses. The meals, composed of carrots, creamed potatoes, meat balls, lingonberry jam, white bread and light beer, were served in the morning after an overnight fast to 10 healthy male volunteers. Carrots were investigated raw, processed (blanched and frozen) and variously cooked (thawed, boiled and microwaved). The amount of dietary fibre from the vegetable, and the content of energy, digestible carbohydrates, fat and protein were similar in the meals compared. Significantly lower glucose, insulin and C-peptide responses and higher satiety scores were elicited with raw carrots than with microwaved ones, harvest year 1989. The next year, with a higher dietary fibre intake from carrots, there were significant effects of processing only on the glucose response. Plasma beta-carotene levels tended to be higher postprandially with raw carrots than with microwaved ones. Hence, ordinary processing and cooking of vegetables can affect the metabolic response to a mixed meal. However, the influence seems to be varying and of minor importance in ordinary meals. Increasing vegetable portions entailing a higher soluble fibre content and a higher viscosity could further reduce the influence of processing.

Ulcerative colitis and indeterminate colitis in the city of Malmö, Sweden. A 25-year incidence study

BACKGROUND

This study was designed to assess time trends in the incidence of ulcerative colitis and indeterminate colitis in an urban population.

METHODS

Medical records of in- and out-patients with inflammatory bowel disease were reviewed by a panel to establish the diagnosis. All histopathologic specimens and almost all radiographs were re-examined.

RESULTS

During the time period 1958 to 1982 there were 354 new cases of definite ulcerative colitis, 117 of probable ulcerative colitis, and 100 of indeterminate colitis. This corresponds to an average annual incidence per 100,000 of 5.5, 1.8, and 1.6, respectively. The incidence was higher in men than in women. Peak incidence was between 20 and 29 years, but indeterminate colitis was most common in 10- to 19-year-old males. The incidence was stable from 1958 to 1972 but then increased in almost all age groups in both sexes. The increase in annual incidence of definite ulcerative colitis from 4.2 to 9.4/10(5) corresponds to an average annual increase of about 5% (p < 0.001). The increase in the incidence of definite ulcerative colitis was due to an increased proportion of patients with proctitis.

CONCLUSIONS

This study has shown an increased incidence of ulcerative colitis and indeterminate colitis, and we have found no reason to believe that this is a spurious finding.

Dose-response effects of boiled carrots and effects of carrots in lactic acid in mixed meals on glycaemic response and satiety

OBJECTIVE

To evaluate the effect of dosage on the metabolic response to vegetables added to a mixed lunch meal, and to relate the amounts to the tripartite plate model. Carrots were chosen as an example, and the carrots were blanched, frozen and boiled to include possible effects of processing and cooking. The effects of carrots steeped in lactic acid, as produced at fermentation, were also studied.

DESIGN

The test meals with carrots, and the control meal without vegetables, were balanced regarding energy (2000 kJ) and digestible carbohydrates (60 g) and similar in fat (17 g) and protein (16-19 g) content. The carrot portions of 100, 200 and 300 g contained 2.9, 5.8 and 8.7 g dietary fibre respectively. The meals were served in the morning after an overnight fast and in random order. Blood samples for the analysis of blood glucose, plasma insulin and C-peptide were collected and satiety was graded until 210 min postprandially.

SETTING

The study was performed at the research laboratory, Dalby Health Sciences Centre (primary care).

SUBJECTS

The 10 healthy, male volunteers, around 40 years of age, were recruited at random from the district's population list. None dropped out.

RESULTS

The larger the carrot portion the lower were the glucose and insulin/C-peptide responses and the higher the satiety scores. The minimum amount causing significant effects was 200 g. According to the plate model, 200 g of boiled carrots was the most that could be included on half the plate. Addition of lactic acid to 200 g carrots augmented the effects on satiety scores and hormonal response.

CONCLUSIONS

The addition of generous amounts of vegetables to a mixed meal improves the metabolic response.

The relations of emotionality and regulation to children's anger-related reactions

The purpose of this study was to examine the relations of emotionality (intensity and negative emotion) and regulation (attentional control, mode of coping) to preschoolers' naturally occurring anger reactions. School personnel's ratings of 4-6-year-olds' constructive coping and attentional control were associated with boys' constructive anger reactions whereas their ratings of acting out versus avoidant coping, emotional intensity, and anger intensity generally were correlated with low levels of constructive reactions to anger. Mothers' reports of children's constructive coping and low emotional intensity were associated with children's use of nonabusive language to deal with anger, whereas aggressive coping and negative emotionality were associated with escape behavior when angered. The findings are consistent with the conclusion that individual differences in emotionality and regulatory skills are associated with children's constructive versus nonconstructive anger reactions.

Effects of different vegetables in mixed meals on glucose homeostasis and satiety

Different vegetables--carrots, peas, Brussels sprouts and spinach--were added to a typical Swedish lunch test meal in portions of 96-164 g. The test and the control meals without vegetables were balanced with respect to digestible carbohydrates (59.7 g) and energy (2000 kJ, 475 kcal), and as far as possible also concerning protein and fat. The added vegetables contained 4.4 g dietary fibre. The meals were prepared by microwave heating and served in the morning after an overnight fast to 10 healthy, male volunteers. Postprandial blood glucose, plasma insulin and C-peptide levels were measured at regular intervals until 210 min. The satiety was graded on a simple scale of 1-10. The meal with spinach elicited significantly lower insulin and C-peptide responses than the control meal, but no significant differences in glucose response or satiety were observed. The other vegetables tested showed no significant effects either on glucose and hormonal responses or on satiety.

A four-year follow-up of hearing and development in children exposed in utero to vibro-acoustic stimulation

OBJECTIVE

To obtain information of hearing and neuro-development in children exposed to vibro-acoustic stimulation in utero.

DESIGN

Information collected from Swedish child care programmes.

SETTING

Department of Obstetrics and Gynaecology, Karolinska Institutet, Danderyd University Hospital, Sweden.

SUBJECTS

Children of 460 mothers exposed to vibro-acoustic stimulation for the assessment of fetal well-being during high- and low-risk pregnancies during 1985-1987.

MAIN OUTCOME MEASURES

Auditory test (20-25 dB at eight frequencies between 500 and 8000 Hz) and general neurological examination at four years of age.

RESULTS

No hearing damage or neuro-developmental abnormalities that could be connected to the vibro-acoustic stimulation were found.

CONCLUSIONS

Vibro-acoustic stimulation, as applied in clinical practice, did not endanger either neurological development or hearing in children exposed in utero.

Transient gene expression in strawberry (Fragaria x ananassa Duch.) protoplasts and the recovery of transgenic plants

A transient ß-glucuronidase (GUS)-assay was performed to evaluate electroporation parameters and optimize DNA delivery conditions into strawberry protoplasts. Optimal GUS-activity was obtained when protoplasts were subjected to 400 V/cm for 20 ms. GUS-activity could be further increased by the addition of carrier DNA to the electroporation mixture. Callus selected on 10 μg/ml hygromycin produced shoots which exhibited GUS-activity. The transformed nature of the shoots obtained after selection was confirmed by DNA-analysis.

Vibro-acoustic stimulation does not alter the duration of high and low fetal heart rate variability episodes

To study the effect of vibro-acoustic stimulation on high and low fetal heart rate (FHR) variability episodes. Prospective control study, in 21 high risk pregnancies between 32 to 39 weeks gestation. FHR pattern was recorded with cardiotocograph (CTG). After 5 min low FHR variability a vibro-acoustic stimulator was activated in contact with or above the maternal abdomen (sham) on a random basis on two consecutive days, and CTG was continued to obtain a complete high and low FHR variability cycle. Complete high and low FHR variability cycles were obtained in 12 patients with mean recording time of 129.5 minutes (range 69-185 min). The mean baseline FHR increased by 32.5 +/- 9.4 bpm after contact vibro-acoustic stimulation, but remained unchanged after sham stimulation. Mean duration of high FHR variability was 56.6 +/- 32.9 min and 47.3 +/- 23.7 min, respectively, and mean duration of the consecutive low FHR variability episode was similar after contact and sham stimulation. The complete cycles were 71.1 +/- 34.7 min and 66.2 +/- 21.2 min, respectively. Vibro-acoustic stimulation induced an abrupt change from low to high FHR variability, but the complete cycle of high and low FHR variability was not altered, when compared with the corresponding cycle following sham stimulation on the same fetus.

Vibro-acoustic stimulation in high-risk pregnancies; maternal perception of fetal movements, fetal heart rate and fetal outcome

Maternal perception of fetal movement in response to vibro-acoustic stimulation was compared with antenatal fetal heart rate monitoring as a test of fetal well-being in a population of gravidae with high-risk pregnancies (n = 517), admitted to the high-risk ward at Danderyd Hospital, Karolinska Institutet; a total of 2,015 tests were performed. The sensitivity and the specificity of the test compared to the fetal heart rate tracing was 81% and 89% respectively. If the test was performed within 24 hours of delivery, its predictive value for fetal asphyxia (i.e. a 5-minute Apgar score < 7) was 14% (7/49). Ten per cent of the patients felt no fetal movement in response to stimulation (irrespective of gestational age). In five cases where fetal heart rate tracings were pathological, stimulation nonetheless produced fetal movement and fetal outcome was good. Pathological heart rate tracings and no fetal movement in response to stimulation were present in 30 cases (out of 251 with no fetal movements at stimulation), in seven of which the infants had 5-minute Apgar scores < 7. Although many patients underwent repeated vibro-acoustic stimulation, there was no evidence of fetal habituation to the test. On 24 occasions (i.e. 1.2%), the patient denied vibro-acoustic stimulation, mostly because of previous discomfort due to vigorous fetal response. Where resources are limited, maternal perception of fetal movements in response to vibro-acoustic stimulation might be a useful alternative for preliminary screening of high-risk pregnancies.

Effect of dietary fiber on the disposition and excretion of a food carcinogen (2-14C-labeled MeIQx) in rats

We studied to what extent dietary fiber may affect uptake, retention, and excretion of a food carcinogen (2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline, MeIQx) occurring in fried meat. Four diets--one fiber-free control and three containing either insoluble dietary fiber isolated from sorghum (100 g/kg) and wheat bran (100 g/kg) or the highly soluble pectin (50 g/kg)--were investigated. The fiber diets were given in amounts of 10 g/day to rats. Thus, each rat received 1 or 0.5 g fiber and 100 micrograms 2-14C-labeled MeIQx uniformly mixed in its daily diet. A 4-day adaptation period with unlabeled MeIQx was followed by a 5-day experimental period with 14C-labeled MeIQx, during which urine and feces were collected separately for analysis of radioactivity and mutagenicity. Furthermore the composition and the fermentability of the dietary fiber were determined. The present study shows that a diet containing fiber, especially fiber isolated from sorghum and wheat bran, affects the excretion pattern of the food carcinogen MeIQx in a manner suggesting a lower uptake and a decreased transit time through the gastrointestinal tract in a more diluted form than a nonfiber diet. Furthermore, less radioactivity was retained in the kidneys with sorghum and wheat bran than with the other two diets. On the other hand, none of these types of dietary fiber affected the retention of the hepatocarcinogen MeIQx in the liver 24 hours after the last oral intake. DNA adducts were formed to a higher extent in the kidney than in the liver. The highest levels were found in animals given the wheat bran diet.

Vibroacoustic stimulation and intrauterine sound pressure levels

The sound pressure level in amniotic fluid generated by vibroacoustic stimulation, assessed with a hydrophone placed close to the fetal head, was studied in 16 subjects. The mean recorded sound pressure level was 115 dB and the highest level was 129 dB. The range of the background noise was 63.5-80.5 dB. There was no obvious relationship between the distance from the stimulator to the hydrophone and the intrauterine sound pressure level. Although sound pressure levels are high, they are probably reduced before reaching the cochlea of the fetus because of the surrounding amniotic fluid and the fluid in the middle ear.

Fermentation of vegetable fiber in the intestinal tract of rats and effects on fecal bulking and bile acid excretion

The fermentative breakdown and fecal bulking capacity of dietary fiber from various vegetables (carrots, rutabagas, peas, green beans and Brussels sprouts) were evaluated in balance experiments in rats. The excretion of bile acids, protein and fat was also studied. The addition of blanched vegetables providing 10 g of fiber/100 g of diet caused a two-(rutabagas) to threefold (carrots) increase in fecal dry weight compared to that with a basal fiber-free diet. With green beans and Brussels sprouts, only about 25% of the fecal dry weight could be accounted for as fiber, whereas with the other investigated vegetables, 40-47% was fiber. Of the remaining part, 11% on average was fat, and 18% was crude protein. Fiber in carrots and peas was the least degraded, with approximately 47% of the polysaccharide intake being excreted in feces. By contrast, the breakdown of the fiber in green beans and Brussels sprouts was more extensive, with a mean of 23% of the polysaccharides being recovered. Among individual fiber constituents, glucose, mannose and uronic acids were least fermented, with considerable differences between vegetables. Total excretion of bile acids was reduced only when Brussels sprouts were added, whereas the concentration of fecal bile acids was lowered with all vegetables except rutabagas. However, no uniform change in fecal bile acid pattern could be detected.

Fetal responses to different intensity levels of vibroacoustic stimulation

The fetal responses to three different intensity levels of vibroacoustic stimulation (mean 92, 103, and 109 dB) were investigated in 275 pregnant women between 32-42 weeks of gestation. A 103-dB and a 109-dB stimulation aroused fetal movements, perceived by the mother, significantly more often than did a 92-dB stimulation (P less than .05 and P less than .01, respectively). Fetal heart rate (FHR) accelerations occurred slightly more often at a 109-dB stimulation than at a 92-dB level, but the difference was not significant. In the second part of the study, the three modes of stimulation were compared under standardized conditions in ten normal patients. The immediate reaction concerning fetal body movements as measured by the mother or the observer and FHR accelerations were the same as described earlier. There was a significant delayed increase of fetal gross body movements after 8 minutes at the 103- and 109-dB stimulation levels. Thus, the fetal response to vibroacoustic stimulation changes with different intensity levels.

Penicillin tolerance in Arcanobacterium haemolyticum

It was previously found that Arcanobacterium haemolyticum, which can cause tonsillitis with exanthema, is not eradicated from the pharynx by administration of phenoxymethylpenicillin, despite minimum inhibitory concentration values of 0.015-1.0 micrograms/ml. Therefore, recent clinical isolates were studied for penicillin tolerance by using a disk diffusion screening test and a pour plate assay. Macrobroth dilution minimum inhibitory and bactericidal concentrations and antibiotic kill kinetics were determined for 4 isolates. Tolerance was present in 38 of 40 clinical isolates with the disk diffusion assay. With the pour plate assay all 40 isolates were tolerant, 34 of them highly tolerant. The presence of the tolerant phenotype was confirmed by macrobroth dilution assays. It is concluded that A. haemolyticum is often penicillin-tolerant, suggesting that phenoxymethylpenicillin administration would be ineffective in eradicating A. haemolyticum from the pharynx.

Maternal perception of sound-provoked fetal movements in low-risk pregnancies during the third trimester

Maternal perception of fetal movements after vibroacoustic stimulation (Servox) was studied longitudinally on 456 occasions in 90 low-risk pregnancies after 28 weeks gestation until delivery. A positive response to sound stimulation, recorded as a fetal movement by the mother, occurred on 444 (97%) occasions. Of the 12 negative responses eight occurred before 33 weeks showing a positive correlation with decreasing maturity. All the pregnancies had good outcomes. The low rate of false-positive tests (3%) adds support to the suggestion that this rapid test could play a role in the assessment of fetal well-being.

Maternal perception of sound-provoked fetal movements as a measure of fetal well-being

Maternal perception of sound-provoked fetal movements was studied on 613 occasions in 259 risk pregnancies. The response was compared with a non-stress (N-S) test performed immediately after the sound stimulation. A positive response to sound stimulation, recorded as a fetal movement by the mother, occurred on 534 occasions (87%) and was always accompanied by a normal N-S test; sensitivity 100%. An inconclusive (3%) or negative response to sound (10%) had a specificity of 89% and a predictive value for a pathological N-S test of 19%. There was a positive correlation between inconclusive or negative test results and fetal growth retardation (P less than 0.01), fetal hypoxia (P less than 0.05) and neonatal mortality (P less than 0.05). This rapid test may have a place as a simple first-line screening test.

Correlation of breast cancer metastases in chest X-rays to symptoms and survival

The sizes and locations of pulmonary and pleural metastases in chest X-rays of 50 symptomatic and 65 asymptomatic breast cancer patients were compared and correlated to survival. The diameters of the metastases were about the same in both groups as also their distribution. The incidence of pleural fluid was higher in symptomatic patients. The survival curve of symptomatic patients did not deviate from that of the asymptomatic ones. Symptoms in pulmonary metastatic disease do not mean rapid progress of the disease but may be beneficial in that they cause the patient to visit the oncologist early. The cost-effectiveness of chest X-rays in the follow-up is questionable.

Enzyme resistant starch fractions and dietary fibre

Starch fractions that are more or less enzyme resistant may behave like dietary fibre, both physiologically and analytically. Ungelatinized granules from potatoes, high amylose maize and green bananas are poorly digested. Starch made resistant to amylase due to new covalent bindings, formed at heat treatment or present in starch derivatives used as food additives, may also be more or less undigestible. "Resistant starch" present in bread and corn flakes is probably retrograded amylose. It is undigestible in the small intestine, but readily degraded by the large bowel microflora. Amylose-lipid complexes seem to be completely absorbed in spite of their resistance to amylase degradation in vitro. Since undigestible starch fractions behave physiologically like non-starch polysaccharides, they should be included in the dietary fibre concept. "Resistant starch" is analysed as glucose based fibre with all current methods except one, which includes an initial DMSO solubilization step.

Fermentation of dietary fibre in the intestinal tract: comparison between man and rat

1. The breakdown and faecal bulking capacity of dietary fibre preparations from wheat bran, apple, cabbage, carrot, and guar gum were compared in man and rat. 2. The degradation of the fibre showed good correlation between man and rat (r 0.99, regression coefficient 0.86). Wheat bran was the least well-digested, 66 and 59% of the neutral sugars being excreted in faeces of man and rat respectively. The breakdown of the fibre in apple, cabbage, carrot and guar gum was more complete and 4-29% of the neutral sugars were recovered in faeces. 3. The main dietary fibre constituents in each preparation were degraded to a similar extent in man and rat. The main dietary fibre constituents of apple, carrot, cabbage and guar gum were almost completely degraded. Of the xylose in wheat bran 45% (man) and 48% (rat) were recovered in faeces. However, the percentage excretion of glucose and arabinose from bran was higher in man. 4. A faecal glucan other than cellulose was identified in human faeces after guar gum, and has been provisionally identified as starch. No such glucan occurred in rat faeces. 5. A good correlation between the faecal bulking capacity in man and rat was seen (r 0.97, regression coefficient 0.56). Wheat bran had the best bulking capacity, while that of apple, cabbage, carrot and guar gum was less pronounced. Faecal bulking was inversely related to the amount of fibre which was water-soluble in each preparation. 6. It is concluded that this rat experimental model is useful for the prediction of fermentative breakdown and bulking capacity of dietary fibre in man. However, more comparative studies are needed to evaluate animal experiments regarding other physiological effects of dietary fibre.

Long-term immunosuppressive treatment in Crohn's disease

We studied the clinical effects of long-term immunosuppressive treatment in 42 patients with severe Crohn's disease and extensive colonic involvement. Mean observation period before and after start of therapy exceeded 5 years. All but one of the patients receiving azathioprine or 6-mercaptopurine improved, and 11 of 42 attained complete remission during therapy. Cyclophosphamide was substituted for azathioprine with inferior results in four patients with pancreatitis soon after initiation of azathioprine therapy. The frequency of both local and systemic complications decreased significantly during the period of therapy. Prednisolone could be withdrawn in 25 patients and reduced to less than 7.5 mg every other day in the others. The average remission period after withdrawal of all drugs in 10 patients was 40 months. The results were superior to those in a surgical series with comparable observation time drawn from the same background population. Aside from pancreatitis in four patients, no serious side effects were seen. Fertility was unaffected. The data demonstrate the feasibility of long-term azathioprine (6-mercaptopurine) treatment in extensive Crohn's disease.

Dietary fibre fermentation in the rat intestinal tract: effect of adaptation period, protein and fibre levels, and particle size

1. The fermentative breakdown of one resistant type of dietary fibre (wheat bran) and one easily-fermented fibre (low-methoxyl pectin) was studied with respect to the length of the adaptation period and fibre level in the diet. The breakdown of the resistant fibre was also studied regarding the protein level in the diet and particle size of the fibre. 2. Prolongation of the adaptation period from 4 to 18 d decreased the faecal dry weight considerably. The excretion of dietary fibre however, was similar, whereas a decrease in faecal nitrogen excretion could be seen. 3. A level of dietary protein of less than 50 g/kg impaired the fermentation of wheat-bran fibre, whereas a level higher than 100 g protein/kg did not further increase the degree of fermentation of the fibre. 4. The particle size did not change the fermentability of the fibre, equal amounts of the main components of coarse and milled bran being excreted in faeces. 5. Two different levels of wheat-bran fibre (48 and 96 g/kg) in the diet did not influence the fibre breakdown. Similar results were obtained with two levels of fibre from low-methoxyl pectin (42 and 84 g/kg), but a tendency towards a decreased percentage of faecal excretion of uronic acids was seen at the lower level of low-methoxyl pectin.

Bulk laxatives: their dietary fibre composition, degradation, and faecal bulking capacity in the rat

The intestinal dietary fibre degradation and faecal bulking capacity of various bulk laxatives were investigated by means of balance experiments on rats. Nitrogen, fat, and mineral excretion in faeces was also studied. The dietary fibre content of the various bulk laxatives was quite different (in g/kg dry matter): ACO fibre tablets (barley and citrus pulp), 451; Fiberform (wheat bran-based), 817; Inolaxol (sterkulia gum), 696; and Vi-Siblin (ispaghula husk), 533. The increase in faecal dry matter per 1 g dietary fibre was similar with ACO fibre tablets, Fiberform, and Vi-Siblin. Inolaxol gave a significantly (p less than 0.001) higher faecal dry-weight increment, mainly due to an increased mineral excretion. Of the dry-weight increment, 59-82% constituted undegraded dietary fibre. Thus, 68-97% of the fibre passed through the gastrointestinal tract without being degraded. All the bulk laxatives caused a similar increase in the faecal N content, whereas the increase in faecal lipids was most pronounced with Vi-Siblin. The water-holding capacity of faeces was more pronounced with Inolaxol and Vi-Siblin than with ACO fibre tablets and Fiberform.

Fermentation of dietary fibre components in the rat intestinal tract

1. The fermentative breakdown of dietary fibre from various sources in the intestinal tract was studied using rat balance experiments and gas-liquid chromatograhic analysis of dietary fibre monomers in feed and faces. 2. On a basal diet with 690 g maize starch/kg but no added fibre, small but detectable amounts of polymeric glucose, rhamnose, arabinose, xylose, galactose, mannose and uronic acids, i.e. sugars occurring in dietary fibre, were excreted in faeces. 3. Dietary fibre in wheat bran was rather resistant to fermentation; 63% was recovered in the faeces. Guar gum, on the other hand, was almost completely fermented, whereas 19 and 25% of the uronic acids in low and high methoxylated pectin respectively, were excreted in faeces. The various constituents of sugar-beet dietary fibre (approximately equal amounts of arabinose-based hemicellulose, pectin and non-starch glucan (cellulose)) showed quite variable availability for micro-organisms in that 6-12% of the arabinose, 17-25% of the uronic acids, and 52-58% of the cellulose were recovered in the faeces. 4. Faecal nitrogen excretion increased on addition of any one of the dietary fibre preparations studied, resulting in decreased true and apparent protein digestibility values. 5. The faecal dry weight increment was most pronounced when feeding bran and could then almost be accounted for by the remaining fibre and by protein. The less-prominent bulking effect of guar gum and pectins, that were much more extensively fermented, could be only partly explained by dietary fibre and protein.

Wheat bran increases high-density-lipoprotein cholesterol in the rat

1. Five groups of male Sprague Dawley rats were given for 6 months a diet with high protein and fat contents but a very low dietary fibre content (group B), and this diet mixed with (g/kg) 50 low-methoxyl pectin (group L), 50 high-methoxyl pectin (group H), 50 guar gum (group G) and 200 wheat bran (group WB, corresponding to 100 wheat fibre) respectively. 2. The weight increment was significantly lower in group G than in the other groups. Assuming no energy value of the dietary fibre, the weight increment (/kJ) was the same in groups B, L and H, lower in group G and higher in group WB, indicating that a proportion of the bran fibre might in fact be available as a source of energy. 3. Wheat bran increased total plasma cholesterol and high-density-lipoprotein cholesterol after 6, 12 and 26 weeks. Group G had significantly lowered plasma cholesterol after 12 weeks. Pectin on the other hand did not significantly influence total or HDL-cholesterol levels. It is therefore possible that the plasma cholesterol lowering effect of pectin previously demonstrated in the rat is dependent on the presence of significant amounts of dietary cholesterol as our diets did not contain added cholesterol. Plasma triglycerides decreased with age but were similar in all groups.

Effect of two kinds of pectin and guar gum on 1,2-dimethylhydrazine initiation of colon tumors and on fecal beta-glucuronidase activity in the rat

The effect of 5% low-methoxylated pectin, high-methoxylated pectin, and guar gum on 1,2-dimethylhydrazine initiation of colon cancer was investigated using groups of 30 rats. The growth of the rats in the different groups was very similar to that of control group fed a fiber-free diet. Both kinds of pectin increased the multiplicity of color tumors, whereas guar gum did not significantly influence carcinogenesis. Bacterial beta-glucuronidase activity in feces and colonic content was the same in pectin-fed rats and controls but significantly lower in the guar gum group. Thus, it was not related to the number of tumors in each group.