Familial congenital short small bowel with associated defects. A long-term survival

In 1974, Royer et al. described a familial syndrome consisting of a short and sluggish small bowel, malrotation of the gut, and pyloric stenosis. These authors stressed the uniformly fatal outcome of their four cases, as well as other possibly unrecognized cases previously described in the literature. The present report deals with two more familial cases, of which one represents a long-term survivor of the syndrome. The intensive work of maintaining nutrition, controlling infection, and managing the complications of associated defects are described.

Plasma and brain cholecystokinin levels in cancer anorexia

The syndrome of cancer anorexia includes early satiety in man and a reduction in the duration of feeding in experimental animals. These aberrations suggest dysfunction of peripheral and/or central nervous system satiety mechanisms in tumor-bearing individuals. Since the gut peptide, cholecystokinin (CCK), has been implicated as a potent satiety cue in man and animals, plasma and brain concentrations of CCK were measured by radioimmunoassay in anorectic tumor-bearing rats. Plasma concentrations of immunoreactive CCK were not significantly altered in either an acute Walker 256 carcinosarcoma or more chronic methylcholanthrene-induced sarcoma animal model of cancer anorexia. However, levels of immunoreactive CCK were significantly reduced in the hypothalamus and cerebral cortex of animals bearing the methylcholanthrene sarcoma during both mild and severe anorexia. These data demonstrate that elevations in immunoreactive CCK are not a major factor in the etiology of cancer anorexia. If brain CCK is involved in satiety, tumor-bearing rats may be attempting to compensate for their anorexia by down-regulating CCK production.

Propionate may mediate the hypocholesterolemic effects of certain soluble plant fibers in cholesterol-fed rats

The effects of propionate on serum and liver lipid concentrations were studied in cholesterol-fed rats. Both serum and liver cholesterol levels were significantly lower in rats fed the cholesterol-propionate diet than in rats fed the cholesterol diet without propionate. Liver triglyceride levels were also significantly lower in the propionate-treated group. Serum triglyceride concentrations were not influenced by the propionate feeding. Propionate intake was not associated with histologic changes in liver tissue. This study indicates that 0.5% sodium propionate-supplemented diets slightly but significantly reduced cholesterol accumulation in both serum and liver of cholesterol-fed rats. Thus propionate, a metabolic product of fiber fermentation, may mediate some of the hypocholesterolemic effects of certain soluble plant fibers.

Utilization of exogenous fat emulsion (Intralipid) in septic rats

Utilization of exogenous fat emulsion (Intralipid) in control, early septic, and late septic rats were studied. After intravenous infusion of 14C-Intralipid, cumulative amounts of 14CO2 in the expired breath in the 6-hr period were 42.8 +/- 1.8, 35.0 +/- 1.8, and 28.5 +/- 1.6% of the injected dose, respectively, for the three groups. The amount and the maximum rate of CO2 production correlated with the severity of sepsis. Significantly greater amounts of plasma triglyceride and free fatty acids were also observed in septic rats. The hyperlipemia associated with the observed decrease in plasma clearance of lipids may account for the decreased utilization of exogenous fat in septic rats.

Evaluation of a protocol for post-mortem examination of stillbirths

A variety of procedures have been recommended for post-mortem examination of stillbirths to determine the cause of the loss of the pregnancy and to provide an estimate of the risk of recurrence. We studied the relative usefulness of several such techniques, including gross and microscopical autopsy, photography, radiography, bacterial cultures, and chromosome studies. In 44 (35 per cent) of 124 cases of stillbirth or early neonatal death, structural physical abnormalities were evident at autopsy. In 35 of the 44 cases the abnormalities were due to chromosomal, single-gene, or polygenic disorders. The single most useful examination was the gross autopsy. Analysis of the various procedures suggests that when resources are limited, gross autopsy, photography, radiography, and bacterial cultures should be performed in all cases of stillbirth and early neonatal death, but that karyotyping and histopathology may be used selectively. This approach should minimize the use of expensive, low-yield procedures without compromising the ability to provide information for purposes of genetic counseling.

Biochemical and morphological studies of monkeys chronically exposed to methylmercury

This study was designed to correlated autopsy findings with the effects on cage behavior, laboratory values, and mercury clearance of long-term, low-dose exposure of primates to methylmercury. Six rhesus monkeys were given daily methylmercury hydroxide (MeHg) orally in apple juice on a preplanned dosage schedule. Three were sacrificed while receiving MeHg (group I) and the other 3 were sacrificed 2-5 mo after cessation of MeHg administration (group II). Whole-blood Hg levels (organic and inorganic) were assayed weekly, and major organ levels were assayed at autopsy. Whole-blood Hg levels were maintained between 1 and 2 micrograms/ml when the monkeys were given a MeHg dose of 80-125 micrograms/kg . d for up to 1 yr. The Hg burden of the major organs appeared to be dose- and duration-related. After periods of clearance (2.5-5 mo), intestinal wall Hg burden decreased to less than 1 microgram/g, and the hepatic Hg burden was still between 1.12 and 2.37 micrograms/g. However, the kidneys had a higher concentration of Hg, ranging from 10.34 to 29.54 micrograms/g. Whenever there was a high concentration of Hg, significant ultrastructural changes were observed. In the kidneys there were intracytoplasmic vacuoles and electron-dense inclusion bodies. In the small intestine of the animals cleared of mercury (group II), there were normal Paneth cells, as well as some degenerative cells characterized by dilation of endoplasmic reticulum and the presence of intracellular inclusion bodies. These findings suggest the long turnover time of Hg in these cell populations. During the period of study, weekly routine laboratory data including hematology, blood chemistry, and liver and kidney function tests did not reveal any significant changes.

Reactivation of Chlamydia trachomatis lung infection in mice by cortisone

To study the latency, chronicity, and recurrent nature of chlamydial infection, we attempted to reactivate Chlamydia trachomatis lung infection in mice by immunosuppressive therapy with cortisone. Mice were treated with subcutaneous injections of cortisone acetate (125 mg/kg) every other day, starting on day 14 after intranasal inoculation of C. trachomatis serotype B (TW-5). C. trachomatis was recovered from the lungs beginning day 6 after the start of cortisone treatment until the end of the observation period on day 12 of treatment. Overall, the reactivation was successful in 8 of 55 mice treated with cortisone, in contrast to 0 of 41 inoculated, untreated mice (P = 0.009) and 0 of 35 uninoculated, treated mice. Cortisone treatment affected the ability of peritoneal exudate cells to respond to migratory inhibition after exposure to purified whole organisms of C. trachomatis serotype B (TW-5) but had little effect on serum antibody titers, indicating a possible role for cellular immunity in resistance against C. trachomatis infection in the lung.

Effects of hypertonic glucose on the rates of plasma clearance and CO2 production of intravenously administered intralipid emulsion in dogs

Simultaneous infusion of glucose and Intralipid was carried out on dogs to evaluate the effect of glucose on utilization of the fat emulsion. For control experiments, normal saline was used in place of glucose. Results of these studies revealed that clearance of Intralipid and also of triglyceride and free fatty acid (FFA) from the plasma did not differ between the dogs receiving glucose and those receiving saline infusion. The rates of Intralipid clearance were 0.049 +/- 0.003 and 0.047 +/- 0.003 per minute (n = 16), respectively. Study with radioactive [14C]Intralipid also gave similar rates of 14C clearance from the plasma, 0.037 +/- 0.003 and 0.040 +/- 0.003 per minute (n = 4), respectively for the two groups. These suggested that clearance of Intralipid from the plasma was not affected by glucose. However, data on expired 14CO2 revealed that oxidation of the fat, which yielded CO2 as end product, was inhibited by glucose. The amount of 14CO2 expired in 2 hours was 10.4 +/- 1.4% for the saline group, which was significantly reduced to 3.0 +/- 0.4% (n = 4; p less than 0.01) for the glucose group. In each group, CO2 production was much delayed as compared to fat clearance from the plasma. Thus, the rate of clearance of Intralipid from plasma does not reflect the actual utilization of fat emulsion. In accordance with an experiment with insulin, it appears that suppression of CO2 production is directly related to plasma insulin levels.

Pathogenic mechanisms of heterotopic neural tissue associated with anencephaly

Central nervous tissue was found in both the lung and the abdominal surface of the diaphragm in an anencephalic baby with gastroschisis. These findings support the hypothesis that the heterotopic neural tissue in anencephalic babies is due to transamniotic implantation. It thus appears that the pathogenic mechanism of the heterotopic neural tissue in the lung is aspiration.

Effects of corticosteroids and cyclophosphamide on a mouse model of Chlamydia trachomatis pneumonitis

Suppression of the inflammatory reaction with daily doses of cortisone acetate or cyclophosphamide substantially prolonged the pulmonary infection in mice which had been intranasally inoculated with a trachoma biotype of Chlamydia trachomatis. Titration of organisms recovered from the lungs of treated mice revealed a drop in titer after day 2 (postinfection), followed by a prominent increase on day 6. In cyclophosphamide-treated mice the infection was resolved after day 12, whereas in cortisone acetate-treated mice a significant titer remained after day 17. In contrast, no organisms were recoverable after day 6 in control mice treated with saline or in mice treated with hydrocortisone succinate. Histologically, the ability of cortisone acetate and cyclophosphamide to inhibit the inflammatory reaction correlated with the respective course of chlamydial pneumonitis. This study demonstrated that mice were intrinsically capable of sustaining a lung infection induced by a human strain of S. trachomatis.

Plant fiber content of selected breakfast cereals

The protein, carbohydrate, fat, plant fiber, and kilocalorie values of 35 breakfast cereals and wheat bran are presented. The total plant fiber as well as the soluble plant fiber content of these cereals is included.

Glycosaminoglycans of pleural mesothelioma: a possible biochemical variant containing chondroitin sulfate

Glycosaminoglycans of a malignant pleural mesothelioma have been characterized histochemically and biochemically and compared with those of normal lung, pleural plaque, lung carcinoma, and other connective tissue neoplasms. Chondroitin sulfate constituted the major glycosaminoglycan (approximately 80% of total) present in the pleural mesothelioma while hyaluronic acid was present in only trace amounts (approximately 3% of total). In particular chondroitin 6-sulfate was the predominant isomer, constituting 80% of the total chondroitin sulfate. Control tissue exhibited different proportions of glycosaminoglycans and none of them contained as high an absolute concentration of chondroitin sulfate as the mesothelioma. These findings differ from previous reports demonstrating increased concentration of hyaluronic acid in mesothelioma and suggest the possible existence of a biochemically different form of this neoplasm.

Soluble and insoluble plant fiber in selected cereals and vegetables

Certain soluble plant fibers have hypocholesterolemic effects. However, information about soluble fibers of most foods is not available. A modification of Southgate's method was used to separate plant fiber into soluble and insoluble fractions. Both fractions were hydrolyzed with dilute sulfuric acid or trifluoracetic acid. Comparison of these two hydrolysis methods was discussed. The hydrolyzed sugars were measured by gas-liquid chromatography. Fiber content of selected cereals and vegetables were examined. Oat, corn, and cooked beans have greater proportions of soluble fiber than wheat and green vegetables. Soluble fractions of cereals and beans were mainly glucose whereas in green vegetables uronic acids were the major components. The differing fiber composition of various plant food sources probably is important in determining their physiological effects.

Oat-bran intake selectively lowers serum low-density lipoprotein cholesterol concentrations of hypercholesterolemic men

To evaluate selected metabolic effects of plant fibers, we fed control and oat-bran diets in an alternating sequence to eight men with previously documented hypercholesterolemia. The two solid diets differed only in the inclusion of 100 g of oat bran in the test diet. We randomized diet sequences and the measured intakes of carbohydrate, protein, fat, and cholesterol were virtually identical on the two diets. Serum total cholesterol concentrations were stable on control diets whereas a progressive reduction was observed in seven men on oat-bran diets. On oat-bran diets, average reductions in serum total cholesterol concentrations were 13% (p less than 0.01, N = 8); plasma low-density lipoprotein cholesterol concentrations were 14% lower (p less than 0.05) while high-density lipoprotein cholesterol concentrations were not changed. Fasting and postprandial serum glucose, insulin, and triglyceride concentrations were similar on the two diets. Fecal excretion of total bile acids was 54% higher (p less than 0.001) on oat-bran diets than on control diets but neutral steroid excretion was slightly lower while on oat bran. Palatable and inexpensive high-fiber foods such as oat bran may have a role in the treatment of certain patients with hypercholesterolemia.

A mouse model of Chlamydia trachomatis pneumonitis

A mouse model for studying infections due to Chlamydia trachomatis is described. Pneumonitis was produced by intranasal inoculation of four trachoma and one lymphogranuloma venereum strains. The infection was confirmed by cell culture isolation of the organisms from the lung, detection of serum antibody and delayed hypersensitivity, and the observation of inclusions in the interstitial cells of the lung by light and electron microscopy. This study indicates that mice may serve as a useful nonprimate animal model for the study of the pathogenesis and immunology of C. trachomatis infection.

Mineral and vitamin status on high-fiber diets: long-term studies of diabetic patients

High-fiber diets have a beneficial impact on glucose metabolism of selected persons with diabetes mellitus. A major concern is the long-term effects of fiber intake on mineral and vitamin status. We measured serum concentrations of selected minerals and vitamins and also assessed three fat-soluble vitamins in 15 patients fed high-fiber diets for an average of 21 mo. Average values for serum calcium, phosphorus, alkaline phosphatase, iron-binding capacity, magnesium, and hemoglobin values were normal. Vitamin B12 and folic acid concentrations in serum were also normal. Indirect assessment suggested that these patients had adequate intakes of the fat-soluble vitamins A, D, and K. These preliminary observations suggest that high-fiber diets containing a wide variety of natural foods are well tolerated for up to 51 mo; we failed to detect evidence suggesting mineral or vitamin deficiency in these patients.