Solubility of calcium salts and carrageenan used in infant formulas did not influence calcium absorption in rats

Calcium absorption from tricalcium phosphate (TCP) was compared to that from calcium chloride, CaCl2, in the presence and absence of carrageenan in the rat model. There was no difference in percent calcium absorption as indicated by femur uptake of TCP or CaCl2 intrinsically labeled with 45Ca given by gavage (78.4 +/- 9.6 vs. 80.0 +/- 5.9, respectively). Thus, the difference in solubility of the two salts did not influence calcium absorption. When TCP was delivered by gavage in a solution containing 1% carrageenan, calcium absorption was not decreased compared to that of a control without carrageenan. In this model, calcium from TCP in the presence of up to 1% carrageenan is well absorbed.

Secretion of erythropoietin from microencapsulated rat kidney cells: preliminary results

Rat kidney epithelial cells were microencapsulated within alginate-poly(L)lysine-alginate membrane. The microencapsulated cells were incubated using a culture media containing cobalt and another without cobalt. The viability was measured by trypan blue exclusion test. Secretion of erythropoietin (EPO) was measured by radioimmunoassay (RIA). Viability of free cells was 53%. The viability of microencapsulated cells increased to 72% after 12 days of incubation and remained at this level. Samples of the culture media were collected every 2 days for RIA. Samples within the microcapsules were collected by breaking the microcapsules open. RIA of these samples showed the following for the media containing cobalt. Between day 16 and day 32 the concentrations of EPO were 5.3 mU/ml inside and 18.3 mU/ml outside the microcapsule. The medium from the same number of free cells contained 21.2 mU/ml of EPO. Culture media without cobalt collected during the same period contained 1.8 mU/ml inside and 9.9 mU/ml outside the microcapsules. The free cell culture with this media during the same period contained 8.3 mU/ml.

Ongoing ischemic pain as a workload indexed by P3 amplitude and latency in real-versus feigned-pain conditions

We tested four independent groups: real pain, real pain/tracking, feigned pain, and feigned pain/tracking. After baseline (auditory oddball task only, .8/.2), the real pain groups had an ischemia cuff applied, which generated intense pain after 14 min. The pain feigners were instructed to simulate pain. The oddball task was repeated during low pain (6 min following cuff application) and during high pain (7-15 min following application). Real pain ratings were affected by low versus high pain and by tracking (reporting pain regularly), which elevated ratings. Nontracking feigned- and real-pain subjects differed in oddball-evoked P3 amplitude and latency during high pain. Oddball P3 amplitude decreased and latency increased from real low pain to high pain. Tracked but not untracked real low pain affected oddball P3 amplitude. Real and feigned pain-tracking subjects did not differ in P3 amplitude. P3 latency differed between real-pain and feigning subjects during low-pain tracking. A 91% individual hit rate (real vs. feign) obtained.

Human pharmacokinetics of ibuprofen enantiomers following different doses and formulations: intestinal chiral inversion

The influences of absorption rate and dosage size on the pharmacokinetics of ibuprofen (IB) enantiomers were studied in six healthy subjects. Rapidly absorbed solutions (50, 100, 200, 400, 600, and 1200 mg) and regular 600-mg tablets of racemic IB were given orally, and plasma concentration-time courses of the enantiomers were followed. Solutions were absorbed faster (tmax less than 0.25 h) than the tablet (tmax = 2.17 +/- 1.17 h). While the S:R AUC ratios were unaffected by increasing the dose, they were significantly greater after the tablet (1.35 +/- 0.14) as compared with the solutions (1.15 +/- 0.16 to 1.24 +/- 0.26). This indicates a greater extent of chiral inversion for the tablet, perhaps due to a longer residence time in the gut, thereby allowing more presystemic inversion. To test this hypothesis, R-IB was incubated at 37 degrees C in the presence of excised segments of human ileum and colon obtained from three patients. Chiral inversion was evident in all segments. After 3 h, the extent of inversion ranged from 20.0 to 33.0%. In addition, incubation resulted in the formation of up to 23.3 and 13.0% of acylglucuronides of S- and R-IB, respectively. In all subjects, the AUC-dose relationships were nonlinear, indicating a gradual increase in the clearance of both enantiomers due, perhaps, to a parallel saturation of plasma protein binding sites. In humans, the chiral inversion of IB is not influenced by the dosage size but is enhanced by prolongation of the residence time in the intestine.

Gross and histologic effects of topical misoprostol on canine gastric mucosa

This study reports the histological effects of topical misoprostol, a synthetic PGE1 analog, administered in varying dosages on the resting canine gastric mucosa. Misoprostol did not macroscopically or microscopically damage the mucosa but its presumed permeability effects on the gastric vasculature induced marked edema of the mucosa and submucosa. Consistent features included increased thickness of both layers, dilated interglandular regions of the lamina propria, marked subepithelial edema, reduced depth and width of gastric foveolae, vasodilation of the vascular channels, reduced height of surface epithelial cells, swelling of their basolateral intercellular spaces, and increased amounts of surface adherent mucus. It is speculated that the mucosal edema, in addition to an increased mucus layer, may be important in the mechanism of gastric cytoprotection by increasing the distance of penetration or absorption for a mucosal-damaging agent, diluting its concentration, and disseminating any focal accumulations of red blood cells.

A controlled study of human resting gastric mucosal blood flow by endoscopic laser-Doppler flowmetry

We investigated regional variation in resting focal gastric mucosal blood flow obtained by endoscopic laser-Doppler flowmetry in patients with symptoms of dyspepsia or peptic ulcer (N = 12) and asymptomatic healthy volunteers (N = 6). Mucosal blood flow was measured for 1 min at the duodenum (first part), prepylorus, antrum and body (anterior and posterior walls), angularis, mid-greater curvature, fundus, and distal esophagus. At all sites, mean +/- SE blood flow in patients was 71.88% of the corresponding value in volunteers (1.15 +/- 0.10 and 1.60 +/- 0.13 volts, p less than 0.02, t test). In both groups, blood flow was highest in the fundus, followed by the body and lowest in the antrum; the angularis had a high blood flow, second only to the fundus. There was no correlation between age and blood flow. We conclude that regional variation in resting gastric mucosal blood flow exists in health and disease.

Cobalt as a gastric juice volume marker: comparison of two methods of estimation

We investigated the use of cobalt-EDTA, a novel, nonabsorbable liquid phase marker, in the estimation of secretory volumes during topical misoprostol (synthetic PGE, analog) administration in the canine chambered gastric segment. We compared atomic absorption spectrophotometry (AAS) and instrumental neutron activation analysis (INAA) in the estimation of [Co]. Mucosal bathing solutions containing cobalt-EDTA were instilled into and recovered from the chamber by gravity every 15-min period as follows: (i) basal--60 min; (ii) misoprostol periods--150 min (plus 0.1-, 1-, 10-, 100-, and 1000-micrograms doses of misoprostol for two periods per dose). The recovered solutions were analyzed for [Co] by AAS and INAA. Total cobalt recovery by AAS after chamber washout was 102.97 +/- 0.98%. Mean +/- SE volumes (12.14 +/- 0.33 and 13.24 +/- 0.60 ml/15 min) obtained respectively from AAS and INAA were significantly higher (P less than 0.001) than the recovered mean volumes (10.51 +/- 0.17 ml/15 min). The percentage error in volume collection increased (range: 9.3-52.7%) with the volume of secretion. Values of [Co] obtained by the two techniques were comparable and not significantly different from each other (P greater than 0.05). INAA-estimated mean +/- SE [Co] showed consistently higher coefficients of variation. Spectra obtained for all samples during INAA measurements showed significant Compton background activity from 24Na and 38Cl. Cobalt-EDTA did not grossly or histologically damage the gastric mucosa. We conclude that cobalt is not adsorbed, absorbed, or metabolized, and is a suitable and reliable volume marker in this model.(ABSTRACT TRUNCATED AT 250 WORDS)

The dose-response of canine focal gastric mucosal blood flow to misoprostol

We studied the dose-response of focal gastric mucosal blood flow measured simultaneously by laser-Doppler flowmetry and hydrogen gas clearance in the canine chambered gastric segment to topical misoprostol (0.1, 1.0, 10, 100, and 1000 micrograms in 10 ml of 150 mM NaCl for two 15-min periods per dose). Simultaneously obtained mucosal blood flow values showed a highly significant linear correlation (r = 0.63, n = 20, p less than 0.01) in the basal but not misoprostol periods between the two techniques. Laser-Doppler flowmetry measured a dose-dependent increase in blood flow (Emax = 6.4 +/- 2.8 V at the 100-micrograms dose; equivalent to 92.8% increase above the basal mean blood flow value; ED50 = 1.0 micrograms). Peak increase in blood flow by laser-Doppler flowmetry after dosing was attained in 6.1 +/- 0.7 min and maintained for 1.9 +/- 0.3 min. In contrast, hydrogen gas clearance showed a gradual decline in blood flow after misoprostol administration throughout all experiments. The duration of each hydrogen gas clearance measurement was 13.1 +/- 0.1 min. In conclusion, misoprostol dose-dependently and transiently increases focal gastric mucosal blood flow. However, only laser-Doppler flowmetry is sensitive enough to detect it. Although it can measure steady-state blood flow, owing to the duration of one measurement, hydrogen gas clearance is incapable of detecting rapid flow changes.

Ionic fluxes induced by topical misoprostol in canine gastric mucosa

We studied the dose response of ionic fluxes in canine chambered gastric segment mucosa to increasing doses of topical misoprostol (0.1, 1, 10, 100, and 1000 micrograms). The fluxes were also correlated with the simultaneous changes in focal gastric mucosal blood flow measured by laser-Doppler flowmetry. After misoprostol administration, there was a dose-dependent increase in focal gastric mucosal blood flow (Emax = 8.23 +/- 3.25 V at 10 micrograms; ED50 = 1.05 micrograms), pH, and the outputs of ions (Na+, K+, Cl-, and HCO3-) and fluid (Emax for pH and fluxes greater than or equal to 1000 micrograms). ED50 values for these outputs ranged from 215.40 to 340 micrograms (mean +/- SE = 279.08 +/- 24.27 micrograms). H+ output showed a dose-dependent decrease to zero at the 10-micrograms dose, the dose at and after which net HCO3- secretion became obvious. The slopes of the dose-response curves for the fluxes of fluid, Na+, K+, Cl-, and HCO3- were significantly different (p less than 0.01) from the slope of the curve for mucosal blood flow changes. There were no correlations between the changes in these fluxes and blood flow changes. Na+ and Cl- were the predominant cation (98.84%) and anion (98.19%), respectively, in the misoprostol-induced secretion. Misoprostol stimulates a composite alkaline gastric nonparietal secretion, predominantly Na+ and Cl-, but also containing K+ and HCO3-. Our results suggest different mechanisms for the effects on nonparietal secretion and focal gastric mucosal blood flow.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiostrongylus (Parastrongylus) eosinophilic meningitis

Angiostrongylus (Parastrongylus) cantonensis is the commonest cause of eosinophilic meningitis in the world. Infective third-stage larvae develop in slugs and snails. Humans are infected primarily in the central nervous system after ingesting an infected intermediate host. Damage by motile worms, inflammatory responses to foreign bodies, and possible toxicity of worm substances work in concert to produce the pathologic and clinical picture of neurologic angiostrongyliasis. This disease manifests itself by headache, paresthesias, generalized weakness, and occasionally visual disturbances and extraocular muscular paralysis. Eosinophilic pleocytosis is the major laboratory finding. Although the diagnosis of neurologic angiostrongyliasis is usually made clinically, serologic methods such as ELISA (enzyme-linked immunosorbent assay) can be helpful. Occasionally, living larvae can be identified histologically in the CSF, eye, or other tissue. There is no specific treatment for this disease. Corticosteroids may be useful to relieve increased intracranial pressure. The role of anthelmintic drugs, such as thiabendazole and ivermectin, is not yet known. The prognosis of neurologic angiostrongyliasis is usually good; however, fatal and chronic cases do occur. Appropriate preparation of food, control of mollusks and planarians, and elimination of rodents are important measures in limiting the further spread of eosinophilic meningitis caused by A. cantonensis.

Gastric mucosal blood flow in misoprostol pretreated aspirin-induced ulceration

To determine whether topical misoprostol (a synthetic PGE analog) pretreatment will increase or prevent a decrease in gastric mucosal blood flow (GMBF) during topical aspirin administration, we studied focal GMBF simultaneously by hydrogen gas clearance in a split canine gastric chamber model with one side as control. In the test chamber, immediately after topical misoprostol, there was a transient and significant increase (18%) in GMBF (55.71 +/- 7.80 to 65.84 +/- 6.12 mL/min/100 g; p less than 0.05). After 15 minutes, GMBF returned to premisoprostol levels and then showed a graded drop throughout the aspirin and postaspirin periods. No grossly visible mucosal lesions were observed. In the control chamber, mucosal lesions were observed 45 minutes after aspirin administration accompanied by a graded drop in GMBF throughout the experiments. Misoprostol neither produced a sustained increase in GMBF nor prevented the subsequent reduction in GMBF induced by aspirin. Therefore, maintenance of GMBF may not be important in cytoprotection by misoprostol. The sustained nonparietal secretion induced by this synthetic PGE1 analog may be important in gastric cytoprotection.

Focal gastric mucosal blood flow by laser-Doppler and hydrogen gas clearance: a comparative study

We compared focal gastric mucosal blood flow (GMBF) values simultaneously obtained by laser-Doppler flowmetry (LDF) and hydrogen gas clearance (HGC) from the same point in a chambered segment model of the gastric corpus in two sets of experiments (Experiments 1 and 2) involving nine anesthetized dogs (weighing 20-30 kg). We also investigated the feasibility of obtaining a conversion factor for LDF signal to absolute flow values. The GMBF values showed a highly significant linear correlation within individual experiments and for the combined data in experiments 1 (r = 0.7132, P less than 0.0001, n = 37) and 2 (r = 0.5660, P less than 0.0001, n = 61). The combined data did not corroborate a common regression line hypothesis in both experiments (Experiment 1: F = 6.59, P less than 0.0005; Experiment 2: F = 10.57, P less than 0.0005). There was a statistically significant difference between the slopes of the 5 and 4 linear regression lines obtained in Experiments 1 (F = 13.15, P less than 0.0005) and 2 (F = 21.14, P less than 0.0005), respectively. The LDF signal was stable and optical coupling is not a problem in this experimental model. HGC and GMBF values were reliable and highly reproducible within dog measurements. We conclude that LDF and HGC are comparable in the measurement of focal GMBF. Our data, however, did not suggest the existence of a conversion factor for LDF signal to absolute flow values from experiment to experiment. Conversion will have to be within individual experiments. Thus, LDF may only be useful in situations where qualitative changes in focal blood flow are investigated.

Skin potential reflex corresponding to transient motion discomfort

The qualitative and quantitative correspondence between the degree of motion discomfort and the skin potential reflex (SPR) was examined in four subjects. Head movement was provided three times during body rotation at three different angular velocities (Coriolis stimulus) to induce motion discomfort, and at rest as a control. SPRs were caused in the arousal sweat area by head movement. The wave form, latency, time-to-peak, and amplitude of SPR were analyzed. The amplitude of the depolarizing response (P response) of SPR increased proportionally to the angular velocity of body rotation and decreased in the course of repetitive Coriolis stimulation. It was revealed that the amplitude of P response of SPR in the arousal sweat area corresponds to the degree of transient motion discomfort.

Focal gastric mucosal blood flow in aspirin-induced ulceration

Focal gastric mucosal blood flow was studied during aspirin injury by hydrogen gas clearance in a chambered segment model of canine gastric corpus. Measurements were made simultaneously every 15 minutes at ulcerated and nonulcerated areas 1.5 hours before, during (20 mM of aspirin in 150 mM of HCl for 1 hour), and 2 hours after exposure of the mucosa to topical aspirin. There was a highly significant decrease (p less than 0.001) in flow at the ulcerated areas 30 minutes after exposure to aspirin, coinciding with the appearance of focal mucosal pallor followed by subsequent hemorrhagic foci and ulceration. This was not followed by recovery to basal flow values. Blood flow to the non-ulcerated areas was significantly but less severely reduced than in the ulcerated areas (p less than 0.05) 90 minutes after exposure to aspirin. This was followed by recovery to basal levels. It is proposed that aspirin induces reduction of focal mucosal blood flow of varying degrees and that mucosal areas with flow reduced to below a "critical value" develop gross damage.

Changes of skin potential level and of skin resistance level corresponding to lasting motion discomfort

The qualitative correspondence between degree of motion discomfort and electrodermal activity was investigated. Skin potential level (SPL) and skin resistance level (SRL) in the arousal sweat area and the thermal sweat area were recorded. In order to induce motion discomfort, Coriolis stimulation and/or horizontal body rotation were provided by using a rotatory chair. The degree of discomfort was evaluated according to reports by the subjects. It was observed that SPL depolarized in the arousal sweat area as well as in the thermal sweat area and SRL lowered in the thermal sweat area coincidentally with lasting motion discomfort. SPL showed better correspondence the recovery period from the motion discomfort.

Immunological aspects in patients with chronic active hepatitis--cellular immune responses

We studied host immune parameters which might be related to the activity and the pathogenetic mechanism of chronic active hepatitis. The subjects consisted of 45 cases with hepatitis B virus surface antigen (HBsAg)-positive chronic active hepatitis (CAH), 44 HBsAg-negative CAH, 22 with inactive chronic hepatitis, and 45 cases of normal persons, hepatitis B virus (HBV) carriers, or the patients with acute myocardial infarction. The in vitro assay for the in vivo activated lymphocytes was performed by measuring spontaneous thymidine uptake (SLT) of lymphocytes isolated from peripheral blood. SLT was significantly (p < 0.001) elevated in cases with HBsAg-positive (1227 +/- 806 cpm) and-negative CAH (1017 +/- 559 cpm) compared to the patients with inactive chronic hepatitis (347 +/- 79 cpm) and to the control group (320 +/- 106 cpm). SLT values observed in 7 cases with active disease (group I and II), in which remission and relapsing phase could be assessable, were elevated from 648 +/- 121 cpm in remission phase to 1548 +/- 606 cpm one to two weeks before the appearance of biochemical evidence (SGPT) of relapse. This pattern of SLT elevation, however, was not observed in patients with inactive hepatitis. Neither the abnormal distribution of T-cell subsets nor the presence of conventional HBV markers were related to the elevated SLT value. Our findings may therefore indicate that SLT might be useful in assessment of the disease activity in patients with CAH.(ABSTRACT TRUNCATED AT 250 WORDS)

Health care of the aged in Korea

Korea's population is now aging very rapidly, but the country has not yet shifted its priorities nor instituted programs to meet the needs of an aging population. While the death rate has already achieved low modern levels, there are still traces of malnutrition and other debilitative conditions among the elderly and ill health is generally believed to be an inevitable accompaniment of old age. This leads to resignation and stoicism rather than active steps to deal with the growing problems. Furthermore, care of the aged is still viewed as a private matter to be handled by the person's family and the state plays a very minor role. Medical practice is largely private with physicians drawing their financial support chiefly from fees of their patients. Only one-fourth of the elderly population is presently served to any significant degree by modern medical practitioners. The basic reason for the general lack of skilled care is economic, although folk medicine still plays a role. Only civil servants are covered by any type of health insurance and only 9% of the elderly receive any health care as social welfare recipients. Ninety-five percent of the elderly live in families, three-fourths of them with children and financially dependent upon the children. Bedfast patients are cared for by spouses or daughters-in-law. But fundamental changes are under way in the structure of families which make home care of incapacitated members impractical and burdensome.(ABSTRACT TRUNCATED AT 250 WORDS)

Pyloric function five to eleven years after Ramstedt's pyloromyotomy

Pyloric function after Ramstedt's pyloromyotomy was assessed in seven patients aged five to eleven years and compared to that in sixteen normal children. Gastric emptying (T 1/2) of liquid, as measured by the double sampling test, was faster in patients than in normal children. Duodenal reflux was calculated from the sodium content in gastric aspirates. At rest, it was greater in patients than in normal children. In the poststimulatory state, there was no difference. Gastric acid secretion was similar in both groups. Rapid gastric emptying might explain the high incidence of peptic ulcer reported in several series of long-term follow-up patients. Increased duodenal reflux at rest might account for a similar increased incidence in gastritis and dyspepsia.

Gastrin sensitivity in duodenal ulcer

The sensitivity to pentagastrin measured as D50C, the dose required for half maximal acid output (MAO) corrected for basal acid output, in 200 patients with active duodenal ulcer was significantly (p less than 0.001) higher than that in 36 age- and sex-matched controls, and was above the normal limit in 27% of the patients. The distribution of D50C was significantly different between early onset and late onset patients, defined as patients whose ulcer symptoms started at respectively age less than or equal to 30 years and age greater than 30 years. Among patients whose MAO/kg body weight was within 2 SD of the normal mean as established previously in 100 normal subjects, gastrin sensitivity was significantly greater in late onset than in early onset patients, and in those who were positive than in those who were negative for familial ulcer dyspepsia. Among patients with abnormally large MAO, the reverse was true, gastrin sensitivity being greater in early rather than in late onset patients, and in patients negative rather than in those positive for familial ulcer dyspepsia. These findings suggest that gastrin hypersensitivity is a distinct physiological abnormality in duodenal ulcer, the increased gastrin sensitivity in some patients with normal MAO has a genetic basis but the lateness in onset of their disease also suggests an environmental origin, and the increased gastrin sensitivity in some patients with abnormally large MAO is related to environmental factors encountered early in life.

Randomised crossover trial of tripotassium dicitrato bismuthate versus high dose cimetidine for duodenal ulcers resistant to standard dose of cimetidine

Of 212 patients with duodenal ulcer treated with four weeks of one gram daily cimetidine, 25 had ulcers which underwent no reduction in size despite treatment. The effects of tripotassium dicitrato bismuthate (TDB) tablet four times a day or cimetidine 1.6 g daily on the healing of these cimetidine resistant ulcers were compared in a randomised crossover trial. Ten of 12 patients on tripotassium dicitrato bismuthate and five of 13 patients on high dose cimetidine had complete healing (p less than 0.02). On crossing over, seven of the eight ulcers not healed by high dose cimetidine completely healed with TDB in another four weeks, and one of the two ulcers not healed by TDB healed with high dose cimetidine. Overall, TDB healed 85% of cimetidine resistant ulcers, whereas high dose cimetidine healed 40% (p less than 0.006). Tripotassium dicitrato bismuthate is recommended for cimetidine resistant duodenal ulcers.

Recovery of malignant tumor cells from the right atrium during hepatic resection for hepatocellular carcinoma

Tumor cells were recovered from the right atrium in three of five patients during hepatic resection for hepatocellular carcinoma. Mechanical factors during blunt mobilization and rotation of the hepatic tumor appeared to be responsible for tumor dislodgement into the venous circulation. Tumor embolization to the lungs may be one of the important reasons for the poor results of surgery in this disease. Two possible technical and therapeutic modifications are suggested to prevent or neutralize this phenomenon.