Meal skipping patterns and nutrient intakes of rural southern elderly

Dietary practices, a 24-hr food recall, self-reported health status, perceived well-being, and socioeconomic data were collected from 2890 rural elders selected from 11 southern states by a stratified randomization method based on income and population. Overall nutrient intakes were low, especially energy and calcium, and 16.3% of respondents consumed fewer than three meals daily. Though meal skippers snacked more frequently, their nutrient intakes were significantly lower than those of three-meal eaters. Meal skippers were more likely to be smokers, younger elders, females, those who ate alone and those with less education, higher BMI, and lower self-rated quality of well-being, especially economic and social well-being.

Simulation of oxygen saturation of hemoglobin solution, RBC suspension and hemosome by a neural network system

Hemoglobin-based artificial blood substitutes as oxygen carrier is advantageous over current plasma expander. In this study, oxygen saturation of hemoglobin solution, red blood cell suspension and artificial blood substitute under various conditions were measured by yeast-consuming-oxygen experiments instead of spectrophotometer. The empirical results were assigned into training feedforward back-propagation neural network system in order to simulate the oxygen saturation model modulated by those factors such as pH, [Cl-], [2,3-DPG], pO2 and pCO2. Consequently, this neural network is able to simulate accurately the oxygen saturation of Hb solution. The prediction of hemosome is not agreed well possible because of the resistance of transport of oxygen. However, the results showed neural net can offer a simple and convenient way in comparison with the conventional methods, especially in dealing with complex and ambiguous problem.

Fast and slow gating types of SR ryanodine receptor/channel purified from canine latissimus dorsi muscle

The ryanodine receptor/channel (RyR) mediates the release of calcium from the sarcoplasmic reticulum (SR) in both skeletal and cardiac muscle cells. There are three isoforms of the RyR: RyR1, RyR2, and RyR3. RyR1 is specifically expressed in skeletal muscles and RyR2 in cardiac muscles. RyR3 is yet another isoform found in non-muscle cells such as neuronal cells. Single channel recordings of RyR1 and RyR2 reconstituted in artificial lipid bilayer show that the characteristics of two isoforms are very distinct. RyR1 has a shorter mean open time and is activated at a higher concentration of Ca2+ than RyR2. In this study, we isolated the heavy SR membranes from canine latissimus dorsi muscles and investigated the single channel activities from the heavy SR membrane fraction using Cs+ as a charge carrier. Two different types of activities were observed. The fast-gating type (FG) with the mean open time of 0.9 ms was more frequently recorded (n = 12) than the slow-gating type (SG) with the mean open time of 269.2 ms. From the I-V relation, the slope conductance of the FG was calculated to be 514.7 pS and the SG, to 625.6 pS. The activity of the fast gating type increased by raising the concentration of Ca2+ in the cis-solution up to 100 microM. The appearance of the SG in the canine heavy SR membrane fraction suggests a possibility that two types of RyR isoform are co-expressed in mammalian skeletal muscle as well as in avian, amphibian and piscine fast twitch muscles.

Identification of malnutrition-related diabetes mellitus among hospitalized patients in Taiwan

A retrospective review of 1,089 diabetes mellitus admitted to the metabolic ward of Chang Gung Memorial Hospital was performed to screen for malnutrition-related diabetes mellitus (MRDM). None of the patients fulfilled the MRDM criteria, although 20 patients with a body mass index < or = 15 kg/m2 were further analyzed. These patients presented with poor glycemic control and most had associated chronic diseases. C-peptide levels were < 0.8 ng/mL in 17 patients and undetectable in six patients. Two patients experienced diabetic ketoacidosis (DKA). Insulin treatment was required by 18 patients with a mean (+/- SD) dosage of 30 +/- 9 U/day. During follow-up of 14 of the patients for 9.8 +/- 4.3 months, HbA1c decreased significantly. Their mean body weight and body mass index increased significantly from 36.6 +/- 4.6 kg to 47.2 +/- 6.2 kg and 13.9 +/- 0.9 to 18.0 +/- 1.9 kg/m2, respectively. Careful attention should be paid to diabetic control and associated chronic illness in patients with severe undernutrition.

Alteration of cerebral microcirculation by hemodilution with hemosome in awake rats

Our study showed that hemodilution with modified fluid gelatin resulted in an increase in local cerebral blood flow (LCBF), but no change at all in local cerebral oxygen delivery (LCOD) in rats. Hemosome, a lecithin encapsulated hemoglobin having the oxygen-carrying capacity, was developed to improve LCOD by hemodilution. Therefore, we have hypothesized that LCBF & LCOD would be increased by hemodilution with hemosome. To test this hypothesis, adult male Sprague-Dawley rats weighing approximately 350g were used and divided into the hemodilution and the control groups. Hemosome was made from pig red blood cells and lecithin. It's mean diameter was approximately 0.3 um and hemoglobin concentration was approximately 4g/dl. Isovolemic hemodilution, which lowered the systemic hematocrit from approximately 50% to approximately 30%, was achieved by rapidly replacing blood with the same volume of hemosome. Ten min later, LCBF in 14 brain structures were measured using the 14C-iodoantipyrine technique. Our results showed that LCBF of the control group ranged from 115 +/- 11 ml/100g/min in the medulla to 260 +/- 31 ml/100g/min in the occipital cortex. LCBFs were generally higher (p < 0.05, MANOVA) by 16% in the hemodilution group than in the control group. However LCODs were generally decreased (p < 0.05, MANOVA) by 18% in the hemodilution group than in the control. In conclusion, hemodilution with hemosome indeed improves LCBF but lowers LCOD in awake rats.

A reposition of Tennison's triangular flap in long lip deformity

The authors have used a new technique in 5 cases with severe long lip deformity and drooping of the Cupid's bow, who all have undergone Tennison's triangular flap method for unilateral cleft lip at primary repair. We corrected this deformity by repositioning Tennison's triangular flap back into its original site and then obtained (1) effective shortening of a vertical lip length, (2) restoration of a symmetric Cupid's bow, (3) prevention of tight upper lip, (4) refinement of the transverse scar, and (5) low recurrence.

Delayed presentation of cerebral arterial gas embolism following proven intraoperative venous air embolism

We describe the case of a 33-year-old woman who suffered a delayed-onset arterial gas embolism following a significant venous air embolism during surgery to remove an acoustic neuroma. We report the management of the problem and discuss the mechanisms by which this event might have occurred.

Long-term synaptic transformation of hippocampal CA1 gamma-aminobutyric acid synapses and the effect of anandamide

Evidence is presented for a distinctive type of hippocampal synaptic modification [previously described for a molluscan gamma-aminobutyric acid (GABA) synapse after paired pre- and postsynaptic excitation]: transformation of GABA-mediated synaptic inhibition into synaptic excitation. This transformation persists with no further paired stimulation for 60 min or longer and is termed long-term transformation. Long-term transformation is shown to contribute to pairing-induced long-term potentiation but not to long-term potentiation induced by presynaptic stimulation alone. Further support for such mechanistic divergence is provided by pharmacologic effects on long-term transformation as well as these two forms of long-term potentiation by Cl- channel blockers, glutamate and GABA antagonists, as well as the endogenous cannabinoid ligand anandamide.

Efficacy of intravenous delta-aminolaevulinic acid photodynamic therapy on rabbit papillomas

Endogenously induced protoporphyrin IX (PPIX), a metabolite of delta-aminolaevulinic acid (ALA), has been evaluated as a photosensitising agent for destruction of papillomas in cottontail rabbit papillomavirus-infected Dutch belted and New Zealand rabbits. Three factors were evaluated: (1) relative retention ratio of drug in normal tissue, papilloma and plasma over time; (2) tissue tolerance to treatment factors; and (3) efficacy of treatment protocol. Three drug doses of ALA were examined: 50, 100 and 200 mg kg-1. Actual PPIX concentrations in tissue and plasma were determined spectrophotofluorometrically. The optimal treatment time occurred 3-6 h post ALA injection. The highest PPIX concentration ratio between papilloma and normal skin was 6:1. Different light doses were investigated, using an injection to exposure interval of 3 h and an irradiance of 100 mW cm-2 at a wavelength of 630 nm. Efficacy without risk of significant damage to normal skin was obtained using 100-200 mg kg-1 ALA and 40-60 J cm-2. A long-term (3 months) cure rate of 82% was obtained with a single treatment, provided that papilloma depth did not exceed 8 mm, volume was not more than 1000 mm3 and the plasma concentration of PPIX immediately before exposure was above 500 micrograms ml-1. The short time between injection and treatment and high efficacy, together with PPIX disappearance from plasma and tissue within 24 h, make injected ALA a highly attractive drug for photodynamic therapy.

Functional expression of the tachykinin NK1 receptor by floor plate cells in the embryonic rat spinal cord and brainstem

1. The floor plate is a ventral mid-line structure that plays a pivotal role in the organization of the developing vertebrate central nervous system. Previous studies have demonstrated that the floor plate may provide signals that induce neuronal differentiation and guide axons; however, it is not known whether the floor plate can itself respond to signals that derive from surrounding tissue. 2. The peptide substance P is one of the first transmitters to be expressed in the developing spinal cord. To determine whether the floor plate may respond to substance P we have examined the expression of the principal substance P receptor (the tachykinin NK1 receptor) by floor plate cells of the rat embryonic spinal cord using immunocytochemistry, in situ hybridization and fura-2 calcium imaging. 3. Immunocytochemistry demonstrated selective expression of the NK1 receptor by cells at the ventral mid-line of the spinal cord. Double immunofluorescence labelling with the specific floor plate marker FP3 indicated that NK1 receptor expression is confined to cells in the lateral region of the floor plate. 4. In order to confirm the specificity of the NK1 receptor immunoreactivity we performed in situ hybridization histochemistry using antisense cRNA probes directed against the NK1 receptor. In situ hybridization demonstrated selective expression of NK1 receptor mRNA by floor plate cells. 5. The ontogeny of NK1 receptor protein and mRNA expression in the floor plate was defined. NK1 receptor expression occurred in a rostrocaudal progression that begins at embryonic day 10-11 (E10-E11) and is complete by E12-E14. The restriction of NK1 receptor expression to the lateral part of the floor plate was conserved throughout embryonic development. 6. NK1 receptor signalling was assessed by monitoring substance P-evoked changes in the intracellular concentration of calcium ions ([Ca2+]i) of acutely dissociated cells from the floor plate region. Application of substance P (5 nM) elevated [Ca2+]i in 10% of cells examined. 7. Selective neurokinin agonists were used to identify the receptor subtype involved in the substance P-evoked elevation of [Ca2+]i. Acetyl-[Arg6,Sar9,Met(O2)11]-substance P(6-11) (5 nM) and [Sar9,Met(O2)11]-substance P (5 nM), two highly selective NK1 receptor agonists, both elevated [Ca2+]i in floor plate cells that responded to substance P. [beta-Ala8]-neurokinin A(4-10) (50 nM) and senktide (50 nM), selective agonists respectively of NK2 and NK3 receptors, had no effect on [Ca2+]i.

Variable distributions of Ca(2+)-permeable and Ca(2+)-impermeable AMPA receptors on embryonic rat dorsal horn neurons

1. By measuring the apparent reversal potential (aErev) of kainate- and alpha-amino-3-hydroxyl-5-methyl-4-isoxazole propionic acid (AMPA)-evoked currents associated with changes in extracellular Ca2+ concentration ([Ca2+]e), we have been able to identify embryonic dorsal horn neurons grown in tissue culture that express Ca(2+)-permeable non-N-methyl-D-aspartic acid (NMDA) receptors. 2. The relative expression of Ca(2+)-permeable and Ca(2+)-impermeable non-NMDA receptors varies from cell to cell. This was evident from the range of a ErevS observed for kainate-evoked currents in a 0 mM [Na+]e, 10 mM [Ca2+]e bath. Under these conditions, aErev ranged from -96 to -21 mV, suggesting that the percentage of the non-NMDA receptors on each neuron that are Ca(2+)-permeable is variable. 3. To determine the extent to which the variability in aErev is due to variable receptor expression rather than experimental variability, we compared the effects of changes in [Ca2+]e on kainate-evoked currents and NMDA-evoked currents on the same cells. Assuming that all of the NMDA receptors on each neuron have a similar Ca2+ permeability, this approach provides an index of the sensitivity of our assay system. The reversal potential of NMDA-evoked currents in 10 mM [Ca2+]e ranged from -30 to -7 mV, whereas on the same population of neurons, the aErev of kainate-evoked currents ranged from -92 to -40 mV. 4. The rectification properties of the non-NMDA currents were generally linear or outwardly rectifying in normal bath solution. When the PCa/PCs ratio in 0 mM [Na+]e, 10 mM [Ca2+]e bath solution was assessed as a function of the rectification index in standard bath, a poor correlation was found between Ca2+ permeability and the rectification index. 5. The aErev of kainate-evoked currents was similar to that of cyclothiazide-enhanced AMPA-evoked currents observed on the same cells (-66.5 +/- 18.4 and -64.0 +/- 13.9 mV, mean +/- SD, respectively). This suggests that kainate is primarily activating the AMPA receptor and that the majority of non-NMDA receptors on embryonic dorsal horn neurons in culture are high-affinity AMPA receptors. 6. Immunocytochemical evidence suggests that the AMPA receptor subunits GluR1-4 are expressed to a variable degree from cell to cell in our cultures. We found evidence for low levels of expression of the kainate receptor subunits GluR5-7. The immunocytochemical observations support the physiological data indicating that much of the kainate-evoked current recorded in our experiments can be accounted for by kainate activation of AMPA receptors.(ABSTRACT TRUNCATED AT 400 WORDS)

Surgical treatment of second primary lung cancer: report of eight cases

Of 312 patients undergoing resection for lung cancer at National Taiwan University Hospital during 1980 to 1990, eight presented with second primary lung cancer. One patient had synchronous and seven patients had metachronous primaries. There were five males and three females with ages ranging from 41 to 77 years. In the metachronous group, two patients had a different histology between the first and the second tumor, and the intervals between the two tumors varied from 12 to 60 months. The initial resections included pneumonectomy in one and lobectomy in six patients. At the second operation, the surgical procedures included lobectomy in three, completed pneumonectomy in one, segmentectomy in another, and wedge resection in two patients. There was no operative mortality and all patients were regularly followed up from 6 months to 6 years after the second operation. Two patients died, one from repeated respiratory tract infection and the other from brain metastasis. Kaplan-Meier analysis showed 2-year and 3-year survivals of 80% and 60%, respectively. It can be concluded that surgical resection for second primary lung cancer is justified, as it can prolong the patient's survival. Lobectomy can be performed for patients with a second primary lung cancer and sufficient lung reserve, but limited resection should be chosen for patients with poor lung reserve.

Postnatal development of GABAA receptor function in somatosensory thalamus and cortex: whole-cell voltage-clamp recordings in acutely isolated rat neurons

GABAergic inhibition synchronizes oscillatory activity in the thalamocortical system. To understand better the role of this neurotransmitter in generation of thalamocortical rhythmicity, the postnatal development of GABAergic function mediated through activation of GABAA receptors was studied in thalamus and cortex. GABA-evoked chloride currents were recorded in dissociated rat cortical and thalamic neurons during postnatal development. Kinetic fits of GABA concentration/response relationships revealed developmental and regional alterations in the potency of GABA. Early in postnatal development (p5-p8), both thalamic and cortical neurons exhibited reduced potency of GABA (27-31 microM KD). Potency increased by p18-p25 in thalamic and cortical neurons (19-22 microM KD), to a level maintained in adult thalamic neurons. Adult cortical neurons exhibited reduced potency of GABA (40 microM KD). Benzodiazepine modulation of GABAA currents was also studied. Kinetic analyses of benzodiazepine augmentation of GABAA currents were best fitted assuming two effective sites with different affinities for clonazepam. The high-affinity site (KD of 0.05-0.27 nM) showed little variation with development in cortical neurons, contributing about 16-23% potentiation at all postnatal ages. Developing thalamic neurons (p5-p25) showed similar potency and efficacy of the high-affinity benzodiazepine site to cortical neurons. High-affinity benzodiazepine effects disappeared in adult thalamic neurons. A lower-affinity benzodiazepine site (25-50 nM KD) was greater in efficacy in cortical neurons compared to thalamic neurons at all ages, with efficacy ranging from 50% to 110% in cortex and from 20% to 60% in thalamus. Knowledge of developmental and regional alterations in GABAA receptor function may aid in understanding mechanisms involved in generation and control of normal and pathological thalamocortical rhythms.

Chondromyxoid fibroma of the femur: a case report with intra-cortical location

Chondromyxoid fibroma (CMF) is the least common benign cartilaginous tumor, comprising less than 0.5 to 1% of all skeletal neoplasms. This subject was a 16-year-old female with a three-year history of pain involving the distal femoral metaphysis. This case showed an unusual feature: it was intracortical in location. Radiologic differential diagnosis included metaphyseal fibrous defect, periosteal chondroma, simple or aneurysmal bone cyst, and cortical abscess. On operation, the lesion filled the intracortical defect with whitish myxoid soft tissue, bulging into the adjacent soft tissue. Microscopically, it showed typical features of chondromyxoid fibroma composed of mainly myxoid nodules and peripheral fibrous elements with focal chondroid differentiation.

A rheological equation to express the relations among hemoglobin contents, hematocrits, and viscosity of hemosome

The relations among hemoglobin contents, hematocrit and viscosity of hemosome at a fixed shear rate have been studied. These relations can be well fitted by a rheological equation with internal viscosity of hemosome, (Tk)h, as a parameter. Where, (Tk)h are correlated (r = 0.996) with logarithm of hemoglobin content of hemosome by an equation: (Tk)h = 0.315 ln (hemoglobin contents of hemosome) + 0.435. The correlation can serve as an alternative way to predict hemoglobin content of hemosome instead of Benesch's method. The results of this study serve as a reference to determine an optimal conditions for in vivo tests of hemosome.

Do immunosuppressants cause posttransplant diabetes mellitus?

BACKGROUND

Posttransplant diabetes mellitus (PTDM) was originally described by Starzl in 1964. The incidence is around 3-46%, according to several reports. Etiologies and risk factors of PTDM have been discussed after it was described and recognized as a complication of renal transplantation.

METHODS

Twenty-five consecutive renal transplants in 24 recipients were reviewed, and 3 cases of posttransplant diabetes mellitus were found. Cyclosporine A (CsA), Azathioprine (Aza) dose and maintenance dose of Prednisolone (Pred.), rejection episodes, total dosage of steroid used at the time of acute rejection were carefully recorded and analyzed.

RESULTS

The mean age of 3 living-related and 22 cadaveric transplant recipients was 32.7 +/- 7.5 and 33.5 +/- 6.8 years in PTDM and non-PTDM patients, and the onset of PTDM was, on the average, 11.3 +/- 10.6 months. Comparative studies between non-PTDM and PTDM groups showed that age, rejection episodes, total dose of methylprednisolone used in acute rejection, CsA level, and dosage of CsA, Aza and prednisolone at 1,6,12 and 24 months were not significantly different from one another.

CONCLUSIONS

No significant risk factors or definitive mechanism involved in the development of PTDM were identified in this study. It is suggested that immunosuppressants are involved in the occurrence of PTDM, and probably neither a single factor is responsible nor is dose dependency involved.

Photodynamic therapy using m-tetra(hydroxyphenyl) chlorin. An animal model

OBJECTIVE

To evaluate the potent photosensitizer m-tetra (hydroxyphenyl) chlorin (m-THPC) by using rabbits with cottontail rabbit papillomavirus-induced tumors and the canine larynx as model systems.

DESIGN

Nonrandomized control trial.

SETTING

Division of ear, nose, and throat research at a tertiary care teaching hospital.

MATERIALS

Rabbits were used for relative retention ratio studies and tissue tolerance tests. Studies on the swelling of normal tissues in the larynx after photoactivation were done with canines.

INTERVENTION

Animals were injected with 0.3 mg/kg of m-THPC. At varying intervals, tissues were exposed to 652 nm of light.

OUTCOME MEASURES

Outcome measures consisted of four elements: (1) decay of plasma concentration over time, (2) interval to and duration of maximal ratio between drug concentration in normal tissue and tumor, (3) maximal permissible light exposure to normal tissue (skin and laryngeal mucosa) at an optimal interval, and (4) efficacy--number of tumors with partial and complete response.

RESULTS

The largest papilloma to skin ratio (10:1) occurred 4 to 8 days after drug injection. The rabbit skin damage threshold was 40 to 60 J/cm2 at 6 days. The canine laryngeal edema and erythema thresholds were 50 to 70 J. A 75% cure rate of papillomas was achieved with tumors that were less than 100 mm2 in area at light doses that ranged from 25 to 75 J/cm2.

CONCLUSIONS

m-THPC shows efficacy in treating papilloma virus-induced tumors. We present a protocol for rapid optimization of the factors required for tumor destruction with minimal normal tissue damage, thus permitting determination of an optimal therapeutic protocol for any photosensitizer.

Treatment of renal artery stenosis after kidney transplantation by percutaneous transluminal angioplasty: report of two cases

Graft renal artery stenosis is one of the causes of hypertension after kidney transplantation. Surgical angioplasty was the treatment of choice before the development of percutaneous transluminal angioplasty (PTA) in the 1970s. Surgical repair was associated with some morbidity and graft loss while PTA was reported to have controversial results in the treatment of this disease. This is a report of two cases of graft renal artery stenosis occurring four and seven months after kidney transplantation that were treated with PTA. The immediate and short-term results of PTA were excellent, but the long-term effects require further follow-up.

Adjuvant immunotherapy with intrapleural Streptococcus pyogenes (OK-432) in lung cancer patients after resection

A prospective randomized study to evaluate the effect of adjuvant intrapleural OK-432 immunotherapy after resection of lung tumor was conducted in 93 patients with primary lung cancer. Among them, 46 patients had had intrapleural OK-432 injection, 47 had not. In the meantime, serial measurements of serum immunosuppressive acidic protein, of serum interleukin-2 receptor and of the subpopulation of the peripheral blood cells and lymphocytes were performed in all these patients. Patient characteristics in these two groups (sex, age, histological type, pathological stage, type of operation, and performance status) were compatible. The results showed that adjuvant intrapleural OK-432 injection after resection had no beneficial effect on a patient's survival time. Patients who received intrapleural OK-432, had an increase in blood leukocytes, granulocytes and monocytes and serum immunosuppressive acidic protein level. But the cell numbers of total T cells, suppressor/cytoxic cells, helper/inducer cells and natural killer cells of peripheral blood were decreased in the OK-432 positive group. Over half of the patients had transient 1- or 2-day febrile reactions after intrapleural OK-432 injection. It was concluded that neither clinical observation nor immunological monitoring of peripheral blood could demonstrate a beneficial effect from intrapleural OK-432 immunotherapy after complete resection of the tumor.