[The kinetic observation of serum ketone body levels in surgical patients receiving MCT or LCT emulsions]

The changes of serum beta-hydroxybutyrate concentrations in patients after receiving medium chain triglycerides (MCT) or long chain triglycerides (LCT) were studied. The patients were divided into two groups: in Group 1, the dose of fat was 0.14 g/kg.h for fat emulsion clearance test: and in Group 2, the dose was 0.06 g/kg.h for total parenteral nutrition (TPN) support. The beta-hydroxybutyrate concentrations were estimated by an enzymatic method using Sigma's beta-hydroxybutyrate kit (Sigma Diagnostics, MO 63178, USA). The normal range of beta-hydroxybutyrate concentration in 30 healthy Chinese subjects was 1.04 +/- 1.42 mg/dl (range 0-3.88 mg/dl). In Group 1, we found that the concentrations of beta-hydroxybutyrate rose steadily after fat emulsion infusion. The concentrations in the medium chain triglyceride group were higher than those in long chain triglyceride group. The elevated concentrations of beta-hydroxybutyrate gradually returned to normal levels when the emulsion infusion was stopped. In Group 2, the concentrations of beta-hydroxybutyrate in the patients were within the normal range.

Transforming growth factor beta 1 and adrenocorticotropin differentially regulate the synthesis of adrenocortical cell heparan sulfate proteoglycans and their binding of basic fibroblast growth factor

Adrenocortical differentiated functions are under the control of both endocrine hormones such as ACTH and local factors such as transforming growth factor beta (TGF beta) or basic fibroblast growth factor (bFGF). Besides their regulatory actions on the synthesis of corticosteroids, these two classes of factors also exert some important effects on the cellular environment. We have examined here the regulation by ACTH and TGF beta of adrenocortical cell proteoglycan synthesis and secretion. Under basal conditions, adrenocortical cells synthesized and secreted several species of sulfated proteoglycans, 80% of them being recovered in solution in the culture medium. When analyzed by ion exchange chromatography, the cell extracts and the media from cells metabolically labeled with 35S-sulfate were found to contain two and three species of radioactive sulfated proteoglycans, respectively. All species were proteoheparan-sulfates. Treatment of adrenocortical cells with TGF beta 1 or ACTH resulted in a significant increase of the incorporation of 35S into both secreted and cell-associated proteoglycans. ACTH stimulated more than three times the amount of secreted proteoglycans eluting from DEAE-Trisacryl as peak B, whereas TGF beta preferentially increased the amount of peak C. No important modification of the size of the synthesized proteoglycans was observed. The subpopulation of heparan sulfate proteoglycans capable to bind bFGF was also largely increased after ACTH or TGF beta treatment and paralleled the variation in overall proteoheparan sulfate synthesis. Thus those effects of TGF beta and ACTH on proteoglycan synthesis may participate in an increased ability of adrenocortical cells to bind and respond to bFGF.

Monitoring of serum markers for fibrosis during CCl4-induced liver damage. Effects of anti-fibrotic agents

Liver fibrosis was induced in rats by repeated peritoneal injections of carbon tetrachloride (CCl4) over a period of 2-11 weeks. Serum procollagen III peptide (SPIIINP), prolidase (SP) and alanine aminotransferase (SALT) levels were monitored during the period of induction. The extent of fibrosis was semi-quantitatively estimated after collagen staining, and the anti-fibrotic effects of 16,16-dimethyl prostaglandin E2 (DMPGE2), colchicine, and zinc sulphate were studied. SPIIINP and SP were increased the first 2 weeks after CCl4 administration and peaked at 6 weeks. Alterations in SPIIINP and SP correlated well to the semi-quantitative histological score of liver sections during the first 6 weeks, and SP was positively related to SPIIINP throughout the whole induction period. DMPGE2 decreased SPIIINP, SP and SALT significantly in addition to a markedly decreased formation of liver collagens. Colchicine had a similar but less dramatic effect, whereas zinc sulphate only reduced SPIIINP without influencing liver damage. In conclusion SPIIINP seems to be a valuable indicator of liver fibrogenesis, and SP may play a limited role in indicating accelerated collagen metabolism in the liver. DMPGE2 obviously inhibited the production of collagens induced by CCl4. Colchicine also had an apparent effect on liver fibrosis, whereas zinc sulphate merely seemed to postpone it.

[Reduction mammaplasty]

Twenty-eight breasts of 15 patients with macromastia underwent reduction mammaplasty from 1982 to 1989. We followed up these patients postoperatively for 6 months to 7 years. The follow-up time for 8 patients was over 1 year, and 4 patients over 5 years. And 3 patients labored and lactated. These 15 patients were satisfied with this operative results. The operative technology was based on Pitange's method. This method improved the site of the nipple, transposition of nipple-areola complex, and design of dermal pedicle, so that it had better effects in the breast shape, breast fixation and incision scar concealed. We suggest that the purpose of macromastia treated in reducing volume, improving breast shape, preserving lactating function. This paper also discusses the methods for nipple site, nipple-areola complex transposition, breast resection and mastopexy.

Ion-exchange chromatography (IC) in the determination of serum transition metals and its clinical application

The reproducibility of ion-exchange chromatography (IC) (Dionex Bio-LC) in measuring the serum transition metals Cu and Zn was found to be fairly good (CV = +/- 2.1% and +/- 2.7% within runs, and +/- 2.5% and +/- 4.3% among runs for Cu and Zn, respectively). For clinical application, sera from 20 normal volunteers and 20 patients with cancers of the digestive tract (10 early and 10 late stage cases) were analyzed. The means of serum Cu (15.54 +/- 0.31 mumol/L) and serum Zn (14.84 +/- 0.31 mumol/L) in normal volunteers were very close to the values previously determined by atomic absorption spectrophotometry in our laboratory. In the group of late stage cancer patients, the means of serum Cu (24.18 +/- 0.63 mumol/L) and the Cu/Zn ratio (1.97 +/- 0.07) were significantly elevated (P < 0.01), while serum Zn (13.01 +/- 0.61 mumol/L) was remarkably decreased (P < 0.05). There were no significant changes of serum Cu, Zn and Cu/Zn ratio in early stage cancer patients. It is concluded that the IC method is rapid, accurate, sensitive, relatively simple and could be useful in diagnosing late stage cancers of the digestive tract.

[Iatrogenic addiction of pethidine: clinical feature and experience of detoxification]

Narcotic analgesic pethidine is widely applied in clinical practice to relieve pain caused by cancer or severe surgical conditions. Iatrogenic addiction following long term medication of narcotic analgesics have been noticed but rarely documented. In this presentation, the authors studied the clinical feature of pethidine dependency as well as experiences of residential detoxification in analysing 34 cases collected in the National Drug Dependence Treatment Center in previous two years. Manifestation of pethidine addiction are much alike to heroin and all abstinent syndromes can be relieved either by methadone or clonidine within 3 weeks except psychological craving throughout the detoxification period. In conclusion, the authors hold that iatrogenic narcotic addiction of this kind is curable as long as the addicts are highly and conscientiously motivated together with rehabilitation measures after detoxification.

Effects of dietary n-3 fatty acid-enriched chicken eggs on plasma and tissue cholesterol and fatty acid composition of rats

The purpose of this study was to examine the effects of feeding n-3 polyunsaturated fatty acid (PUFA)-enriched chicken eggs on plasma and liver cholesterol levels and fatty acid composition in rats. Eggs were collected from laying hens fed diets containing 10% flax seed (Hn-3), 12% sunflower seed (Hn-6), or wheat and soybean meal control (CON). Yolk powders were prepared and fed at the 15% level to weanling female Sprague-Dawley rats for 28 days. Consumption of n-3 PUFA-enriched yolks significantly reduced both plasma and liver total cholesterol. Liver total lipids and phospholipids of rats fed Hn-3 diet were enriched with linolenic, eicosapentaenoic, and docosahexaenoic acids with a concomitant reduction of arachidonic acid in liver phospholipids. The plasma cholesterol of rats fed yolk powders enriched with n-6 PUFA (mainly linoleic acid) was reduced to the same extent as in those fed the n-3 enriched, but the liver cholesterol was significantly increased, indicating differential effects of dietary n-3 and n-6 PUFA. The results demonstrated that the cholesterolemic and tissue lipid modulating properties of chicken eggs could be modified in a favorable way by altering the fatty acid composition of yolk lipids through manipulation of laying hen diets.

Estimating forage intake and energy requirements of free-ranging wapiti (Cervus elaphus)

A single dose marker method was calibrated to estimate intakes of pasture forage by wapiti. Each animal was offered 250 g of alfalfa–barley pellets labeled with chromic oxide (Cr2O3), and freshly voided fecal samples were collected before and for 6–7 days after administration. Dry fecal output was calculated by dividing the marker dosage by the average fecal marker concentration. Feed intake was then calculated from fecal output and feed digestibility as determined by total fecal collection or the ratio of acid-insoluble ash in feed and feces. The concordance of the marker estimate with measured feed intake was tested on penned wapiti fed alfalfa–barley pellets or herbage. On pasture, the marker method was compared with intakes estimated by the bite-count method. As an additional check, data from pen and field studies were pooled to establish the relationship between metabolizable energy intake and body-weight gain. The single dose marker method provided a practical way to assess feed intake of free-ranging animals. Metabolizable energy requirements for maintenance of live weight were 572 kJ/W0.75 for penned wapiti in winter and 936 kJ/W0.75 for wapiti on summer pasture. Tissues mobilized during winter provided 26 kJ/g, and metabolizable energy requirement per unit liveweight gain was 39 kJ/g on summer pasture.

[Drug abuse among 4139 medical professionals: field survey, assessment of psychosocial status and analysis of risk factors]

A cluster sampling survey among 4139 subjects was carried out to detect present trend of drug abuse of medical professionals. Higher prevalence rate (2.3%) was found compared with local residents in previous survey by the same authors. The drug of abuse of those positive cases are of the sedative-hypnotic type and benzodiazepine abused most predominantly. PSE, EPQ, reactive features of life events and SDSS were assessed to explore the clinical characteristics of the addicted cases. Adopting Logistic regression with interactive plus stepwise mode, risk factors were analysed. It was clearly revealed that all positive cases do coincide with the rule of iatrogenic drug dependency.

[An experimental study of shedan chuangbei oral liquid with low sucrose content]

The shedan chuangbei oral liquid in low sucrose content by adding stevioside not only reduces the cost of preparation but has better stability in quality and clarity. Qualitative analysis, TLC and determination of alkaloids all show correspondence in composition between the original drug and the new preparation.

Modulation of plasma and tissue cholesterol and fatty acid composition by feeding flax and canola seeds and oils to rats

Intact full-fat oil seeds might be more resistant to oxidation than extracted and refined oils and might therefore be used as sources of dietary fat. The present study was conducted to examine and compare the influence of feeding full-fat flax and canola seeds and oils on the plasma and tissue lipids of the rat. Male weanling Sprague Dawley rats (n = 4) were housed individually in metabolic cages and fed isoenergetic and isonitrogenous diets containing full-fat flax (FFF), flax meal + flax oil (FO), full-fat canola (FFC), canola meal + canola oil (CO), and soybean meal + animal tallow (AT). After 6 wk of feeding, plasma cholesterol levels were significantly (P < 0.05) reduced in rats fed flax diets (FF and FO) but not in those fed canola diets (FFC and CO). Liver cholesterol levels were not affected by dietary treatment. The highest levels of α-linolenic acid (LNA) and eicosapentaenoic acid (EPA) were recorded in the plasma, liver, heart and epididymal fat of rats fed the flax-containing diets. Intermediate levels of LNA and EPA in plasma and tissues were found in rats fed canola-containing diets. Rats fed flax diets had less arachidonic acid (AA) in plasma, liver, and heart tissues than those fed control and canola diets, indicating inhibition of AA synthesis by high dietary LNA provided by full-fat flax seed and flax oil. These results demonstrated that full-fat flax and canola seeds could be used as sources of dietary LNA to modify plasma and tissue lipids. Key words: Flax seed, canola seed, cholesterol, fatty acid, rat

Clinical and electrophysiological aspects of acute paralytic disease of children and young adults in northern China

Acute peripheral nervous system diseases leading to paralysis in children are rare in Europe and the USA, whereas epidemics of a Guillain-Barré-like syndrome occur annually among children in rural parts of northern China. To clarify the features of this disorder 36 patients, aged 15 months to 37 years (median 7) with this syndrome were investigated; 91% were from rural areas. In 47%, a prodromal illness was reported in the preceding 4 weeks. Leg weakness and resistance to neck flexion were the earliest symptoms. The weakness ascended rapidly and symmetrically to affect the arms and respiratory muscles, with maximum weakness occurring a mean of 6 days after onset of weakness. Bulbar weakness occurred in 61% of patients, but only 1 had extraocular paresis. Respiratory assistance was needed by 31% of patients. Tendon reflexes were lost as weakness developed. 42% of patients had raised concentrations of protein in the cerebrospinal fluid, and the mean cell count was 3 cells/microliters (range 0-12/microliters). Electrodiagnostic studies in 22 patients showed severe reductions in motor evoked amplitudes from distal stimulation. Sensory action potentials were normal. Electromyography revealed denervation potentials in limb muscles. The distinctive epidemiological, clinical, and neurophysiological characteristics of this illness suggest that the disorder is different from both Guillain-Barré syndrome and poliomyelitis. The neurophysiological findings support the hypothesis that the disorder is a reversible distal motor nerve terminal or anterior horn cell lesion.

Cytokine gene expression in the islets of the diabetic Biobreeding/Worcester rat

The Biobreeding Worcester rat provides one of the best models of autoimmune diabetes. Immunopathologic studies of acute diabetes show that the islets are infiltrated by T cells and macrophages. It has been hypothesized that the islets are damaged by the secretion of cytokines such as IL-1 and TNF-alpha and that their function may be altered by IL-6. In this study, we utilized in situ hybridization to determine the expression of the IL-1, TNF, and IL-6 genes within the pancreas of the acute diabetic Biobreeding Worcester rat. These studies showed that cells expressing IL-1, TNF, and IL-6 were present within the islets and in the exocrine pancreas surrounding islets, ducts, and vessels and in an interstitial location. Cells expressing TNF and IL-1 mRNA were present in about 20% of the islets, whereas cells expressing IL-6 were present in about 4% of the islets. Islets containing TNF- or IL-1-positive cells contained about three positive cells per islet whereas only about one IL-6-positive cell was present per islet. In 26% of the islets peri-insular TNF-positive cells were found. Peri-insular IL-1 positive cells were seen in 14% of the islets and 8% showed peri-insular IL-6 positive cells. In nondiabetic 30-day old DP or 90-day-old DR rats intra-islet cytokine gene expression was not seen. Our studies support the view that cytokines are important in beta cell destruction.

Cytokine gene expression in the islets of the diabetic Biobreeding/Worcester rat

The Biobreeding Worcester rat provides one of the best models of autoimmune diabetes. Immunopathologic studies of acute diabetes show that the islets are infiltrated by T cells and macrophages. It has been hypothesized that the islets are damaged by the secretion of cytokines such as IL-1 and TNF-alpha and that their function may be altered by IL-6. In this study, we utilized in situ hybridization to determine the expression of the IL-1, TNF, and IL-6 genes within the pancreas of the acute diabetic Biobreeding Worcester rat. These studies showed that cells expressing IL-1, TNF, and IL-6 were present within the islets and in the exocrine pancreas surrounding islets, ducts, and vessels and in an interstitial location. Cells expressing TNF and IL-1 mRNA were present in about 20% of the islets, whereas cells expressing IL-6 were present in about 4% of the islets. Islets containing TNF- or IL-1-positive cells contained about three positive cells per islet whereas only about one IL-6-positive cell was present per islet. In 26% of the islets peri-insular TNF-positive cells were found. Peri-insular IL-1 positive cells were seen in 14% of the islets and 8% showed peri-insular IL-6 positive cells. In nondiabetic 30-day old DP or 90-day-old DR rats intra-islet cytokine gene expression was not seen. Our studies support the view that cytokines are important in beta cell destruction.

Coronary vasomotion and coronary flow reserve during exercise

Coronary vasomotion and coronary blood flow are important determinants of myocardial perfusion in patients with coronary artery disease. New digital angiographic techniques allow to study, not only the dimensions of a stenotic lesion (quantitative coronary arteriography), but also coronary flow reserve (parametric imaging). In a preliminary study both techniques were combined and coronary dimensions, as well as coronary flow reserve were determined in 15 patients (seven normals and eight patients with coronary artery disease) at rest, 45 s after 10 mg i.c. papaverine, during two levels of supine bicycle exercise, as well as 5 min after 1.6 mg sublingual nitroglycerin. Our results show that with modern digital subtraction techniques, not only stenosis geometry, but also coronary flow reserve can be determined at rest and during exercise conditions.

Effect of feeding cholesterol to laying hens and chicks on cholesterol metabolism in pre- and posthatch chicks

Single Comb White Leghorn laying hens that were 60 wk of age were fed wheat and soybean meal diets containing either 0 or 1% cholesterol. Birds were artificially inseminated, and fertilized eggs were collected for incubation after a plateau of egg cholesterol content was reached. Posthatch chicks were raised with starter diets containing either 0 or .5% cholesterol. Samples of developing embryos and posthatch chicks at various stages were prepared for cholesterol analysis. As compared with controls, cholesterol content of eggs from hens fed 1.0% cholesterol diet was increased by approximately 70%. Embryos from the cholesterol-loaded eggs had significantly higher (P less than .05) cholesterol content. The plasma total cholesterol (TC) level in chicks from cholesterol-loaded eggs, when compared with TC in control eggs, was significantly higher at hatching but decreased to the same level by 2 wk after hatching. Cholesterol feeding to newly hatched chicks elevated plasma TC and high-density lipoprotein cholesterol levels. The TC contents of liver and heart, but not skeletal muscle, were significantly higher in chicks fed the .5% cholesterol starter diet than those fed the cholesterol-free diet. These results show that cholesterol metabolism in developing embryos and posthatch chicks is influenced by cholesterol in both maternal and chick diets.

Immunopathology of diabetes in the RT6-depleted diabetes-resistant BB/Wor rat

Insulin-dependent diabetes mellitus appears to be an autoimmune disease that is characterized morphologically by insulitis, an inflammation of the pancreatic islets of Langerhans that results in the destruction of the insulin-producing beta cells. The RT6-depleted DR rat provides a good model for the in situ study of insulitis. The authors used the anti-RT6.1 monoclonal antibody to selectively deplete RT6 T cells in DR rats and produce a synchronous and rapid development of insulitis that commences 10 days after treatment. The phenotype of cells that infiltrated the islets at different stages of insulitis in the RT6-depleted DR rat was determined by immunocytochemical techniques. A prodromal period of 10 days was present in which the authors could not detect morphologic alterations within the pancreas. This is followed by a second phase of early insulitis in which a few islets are infiltrated by macrophages and T cells. This rapidly progresses by 18 days to the final phase of generalized insulitis in which the islets are massively infiltrated by macrophages and T cells.