Mycophenolate mofetil treatment reduces cholesterol-induced atherosclerosis in the rabbit

Immunosuppressive therapy has been shown to either improve or, more frequently, enhance the development of atherosclerosis. We tested the effect of mycophenolate mofetil (MMF), an inhibitor of nucleotide synthesis widely used in transplant therapy, in diet-induced atherosclerosis in the rabbit. Two groups (n=10 each) of New Zealand White (NZW) rabbits were fed a 1% cholesterol diet for 12 weeks. One group received MMF (CHOL+MMF group) by gastric gavage (30 mg/kg daily) and the other group (CHOL) received the same volume of saline by the same route. There were no differences in the serum cholesterol (mean values > or =30 mmol/l in both groups after 2 weeks) or in the triglyceride, blood sugar, total protein, and albumin serum levels and weight gain in both groups of animals. The cholesterol-fed untreated rabbits had atherosclerotic plaques covering 43.9.1+/-SD 16.40% of their thoracic aorta and 41.9+/-22. 59% of their abdominal aorta, while the MMF treated group had 18. 5+/-7.17% and 17.7+/-9.71%, respectively (P<0.01). The cholesterol content of the aorta (mg/g) in the cholesterol-fed untreated group was 4.61+/-SD 1.21 in the thoracic aorta and 4.54+/-2.07 in the abdominal aorta, whereas the MMF treated group had and 2.83+/-0.84 and 2.77+/-1.44, respectively (P<0.01). Infiltrating macrophages (RAM 11 positive cells/100 nuclei) in the intimal layer of the aorta were 58.4+/-SD26.16 in the CHOL group and 8.5+/-5.51 in the CHOL+MMF group: (P<0.001). CD18 positive cells/100 nuclei were 27.4+/-17.6 in the CHOL group and 5.3+/-3.82 in the CHOL+MMF group (P<0.01), and the intima/media ratio was 0.66+/-0.11 in the CHOL group and 0. 30+/-0.09 in the MMF treated rabbits (P<0.001). MMF also reduced proliferating smooth muscle cells (HHF35 positive) infiltrating between the macrophages. These results indicate that MMF ameliorates importantly the atherogenic potential of a high cholesterol diet and this effect is associated with a reduction in macrophage and foam cell infiltration and smooth muscle cell proliferation and infiltration. Since chronic treatment with this drug is given routinely in various clinical conditions with relatively minor side effects, consideration may be given to its use as adjuvant therapy in atherosclerotic cardiovascular disease.

Helicobacter pylori eradication: proton pump inhibitor vs. ranitidine bismuth citrate plus two antibiotics for 1 week-a meta-analysis of efficacy

OBJECTIVE

To compare the efficacy of proton pump inhibitor vs. ranitidine bismuth citrate (RBC) with two antibiotics for 1 week in Helicobacter pylori eradication.

METHODS

Randomized trials comparing 1-week regimens with (i) proton pump inhibitor plus two antibiotics [clarithromycin (C) and amoxycillin (A) or a nitroimidazole (N)]; or (ii) RBC plus the same antibiotics. Eradication was confirmed by histology or 13C-urea breath test at least 4 weeks after therapy. Data sources included PubMed database and abstracts from congresses until October 1999. Statistical analysis was by meta-analysis combining the odds ratios (OR) of the individual studies in a global OR (Peto method).

RESULTS

Twelve studies met the selection criteria. Nine compared proton pump inhibitor vs. RBC plus C and A, and five compared proton pump inhibitor vs. RBC plus C and N. With RBC, C and A, mean H. pylori eradication efficacy by intention-to-treat analysis (pooled data) was 76.6% (95% CI: 72-81%) and 73.7% (95% CI: 69-78%) with proton pump inhibitor, C and A. The OR for the effect of RBC vs. proton pump inhibitor (plus C and A) on H. pylori eradication was 1.15 (95% CI: 0.8-1.64%). Mean H. pylori eradication with RBC, C and N was 87. 2% (95% CI: 83-91%), and 74.9% (95% CI: 74-84%) with proton pump inhibitor plus these two antibiotics. The OR for the effect of RBC vs. proton pump inhibitor (plus C and N) on H. pylori eradication was 1.76 (95% CI: 1.08-2.85%).

CONCLUSION

RBC and proton pump inhibitor have similar efficacy for H. pylori eradication when given with C and A for 1 week, but RBC seems to have a higher efficacy than proton pump inhibitor when C and N are the co-prescribed antibiotics.

[Low cholesterol egg powder. Nutritive and quality characteristics of the product]

The purpose of this study is to obtain a low cholesterol egg powder for the preparation of different foods for persons whose egg consumption is restricted. Egg white and yolk mixtures prepared in different proportions were dehydrated; the following dried mixtures were obtained: A (1:1), B (2:1) and C (3:1) of egg white:yolk respectively. These mixtures were evaluated using the following parameters: proximal analysis, microbiological assay and protein quality evaluation. Physical characteristics of the powder and the sensorial tests of foods prepared with these mixtures were carried out. The fat and the cholesterol content in the mixture C were decreased by 40% and 20% respectively. The microbiological tests showed that the three mixtures were safe for human consumption. The PER of sample A (whole egg) was 3.65 and for the mixture C 3:1 egg white:yolk was 3.05. The PER of the 50:50 protein mixtures eggs white and yolk: with corn lime treated flour (HMN) were higher than that of the casein standard. The sensorial tests of the foods prepared with all the mixtures were acceptable.

[Beliefs, attitudes and knowledge about sex education]

BACKGROUND

Previous reports show that Chilean teenagers have an inadequate knowledge about sexuality and reproduction.

AIM

To compare the knowledge about sexuality among adolescents coming from private and public schools, with and without sexual education programs.

MATERIAL AND METHODS

A structured anonymous inquiry, containing multiple choice and open questions, was applied to a sample of 229 adolescents attending seventh and eighth grade of junior school, in private and public schools of Temuco, Chile.

RESULTS

Eleven percent of adolescents had already their first sexual intercourse at a mean age of 12.2 +/- 2.4 years old. Of these, 96% came from public schools. An overall analysis of tests, disclosed a 53% of correct answers to the inquiry. Adolescents coming from private schools had a better performance than those coming from public schools. Sexual attitudes were not influenced by sexual education programs.

CONCLUSIONS

Adolescents coming from private schools have a better sexual knowledge level and more conservative attitudes towards sexuality. Overall knowledge is inadequate albeit overvalued. These teenagers are high risk group for unwanted pregnancies and sexually transmitted diseases and require efficient sexual education programs.

Expression and clinical significance of apolipoprotein D in epithelial ovarian carcinomas

OBJECTIVE

Apolipoprotein D is a protein component of the human plasma lipid transport system but is also associated with a more favorable prognosis in women with breast cancer. This retrospective study was undertaken to examine the tumoral expression of apolipoprotein D in epithelial ovarian cancer and to analyze the possible correlation with tumor and patient characteristics as well as androgen receptors and their prognostic significance.

METHODS

Immunohistochemical evaluation was used to examine apolipoprotein D expression in paraffin blocks from 68 epithelial ovarian carcinomas.

RESULTS

A total of 18 (26.4%) tumors stained positively. No significant correlation was found between apolipoprotein D expression and patient or tumor characteristics and androgen receptor status. However, apolipoprotein D expression was significantly associated with prognosis in patients with residual tumor greater than 1 cm. Thus, patients with apolipoprotein-D-negative tumors had a poorer overall survival than those with apolipoprotein-D-positive tumors (P = 0.039). In addition, multivariate analysis demonstrated that apolipoprotein D expression was an independent prognostic factor with initial tumor size in this group of patients (P = 0.005).

CONCLUSIONS

Our results led us to consider the existence of apolipoprotein D expression by a significative percentage of ovarian carcinomas, and this protein expression might be of clinical usefulness for identifying lesions with different evolution.

Nutrition-related problems of pediatric patients with neuromuscular disorders

Children with neuromuscular disorders have special health needs that place them at risk of nutritional problems. These needs may have detrimental effects on their development, immune and respiratory system. Identified nutrition-related problems are malnutrition, obesity, food intolerance, food allergies, drug-nutrient interactions, constipation and reflux. In order to improve the nutritional status of these patients, a nutritional assessment is recommended which should include anthropometric measurements and laboratory tests.

Sheep pulmonary adenomatosis: characterization of two pathological forms associated with jaagsiekte retrovirus

Pathological and immunohistochemical studies were performed on the lungs of 10 sheep with lesions of "classical" sheep pulmonary adenomatosis (SPA) and six sheep with "atypical" lung tumours. Lung tumour samples and other tissues from the same 16 animals were tested for the presence of jaagsiekte retrovirus (JSRV) by a polymerase chain reaction (PCR) that amplified a portion of the U3 long terminal repeat. The differences in the gross appearance of the classical and atypical forms paralleled the histopathological differences. The latter mainly concerned the stroma of the tumours which in the atypical cases was more heavily infiltrated by inflammatory cells and connective tissue fibres. JSRV major capsid protein was detected immunohistochemically in the epithelial transformed cells of both classical and atypical tumours, but the immune reactivity was slightly milder in atypical SPA. Proviral U3 sequences of JSRV were detected by specific PCR in all the tumour samples. Furthermore, the sequences of amplimers obtained from the two different pathological forms of the tumour were very similar. However, the dissemination of JSRV to other organs was greater in sheep with classical SPA than in those with atypical SPA. The pathological and virological features of these two forms of tumour are compared in an attempt to clarify whether classical and atypical SPA are two separate diseases or different expressions of a single disease spectrum.

Vitamin A deficiency and low prevalence of anemia in Yaqui Indian children in northwest Mexico

A study of 296 school-age Yaqui Indian children (6-10 y) was conducted in 26 rural communities. Vitamin A status was determined by retinol and carotenoid serum levels according to a method described previously (IVACG, 1982). Serum retinol and carotenoids in children were analyzed according to community size. Vitamin A intake was assessed in a sub-sample by means of a 24 h recall questionnaire. Serum retinol distribution showed that 6.3% of the children were below 10 microg/100 mL (0.35 micromol/L) and 40% were in the range of 10-20 microg/100 mL (0.35-0.70 micromol/L). Differences (p < 0.02) were found between small and large communities (Median, 95% CI): 19.2 (17.1, 20.9) microg/100 mL and 22.9 (20.3, 24.1) microg/100 mL. Serum carotenoid levels were significantly higher in large than in small and medium communities: 72 (68.2, 77.8) microg/100 mL versus 62.4 (53.3, 68.2) and 62.4 (55.7, 69.6) microg/100 mL, respectively. Food staples were wheat flour tortillas, pinto beans, corn tortillas, few animal products and scarce fresh vegetables. Mean vitamin A consumption was 244+/-29 microg RE (34.9% of the US RDA). Iron status showed that only 4 children were classified as anemic, with two of them having iron deficiency anemia. Iron deficient erythropoiesis was observed in 7.8% of the children and iron depletion only in 4.4%. The Yaqui diet seems to provide adequate amounts of iron but not of vitamin A or its precursors, which renders a vitamin A status of sub-clinical deficiency that could be considered a public health problem.

Up-regulation of GH-binding protein by mouse GH in transgenic mice overexpressing GH-releasing hormone

To study the effects of homologous mouse GH (mGH) on the presence and characteristics of serum GH-binding protein (GHBP) we have used transgenic mice expressing GH-releasing hormone (GHRH) as a model. Chromatographic techniques allowed the characterization of GHBP bioactivity, and immunological techniques were used to determine its concentration and molecular components. Chromatographic separation of labeled human GH or mGH cross-linked to serum GHBPs showed two GH-binding serum fractions in normal as well as in transgenic mice serum. SDS-PAGE of this material revealed a specific band of 66 kDa and another higher molecular weight broad band, which, in the presence of 2-mercapto-ethanol, is converted into the 66 kDa fraction. Since normal mice serum has an mGH concentration of 0. 40+/-0.06 nM and a GHBP concentration of 5.7+/-1.1 nM, while the high-affinity site for mGH has a K(d)</+/-27 nM, only a small percentage (2.9%) of total serum mGH is bound to GHBP in the sera of these mice. In transgenic mice serum, where the mGH concentration is 60 times higher (23+/-2.7 nM), 22.5% of total serum mGH is bound to serum GHBP. These values agree with the experimental data (4+/-2% and 17+/-4% for normal and transgenic mice serum respectively). The concentration of GHBP in GHRH transgenic mice was found to be increased four- to tenfold, depending on the technique used. This increment closely resembles the increased concentration of GHBP in the serum of transgenic bovine GH (bGH) mice, in which peripheral bGH levels are grossly elevated. Our results support the idea that the circulating levels of mGH in normal mouse serum are capable of influencing the levels of GHBP in peripheral circulation in a way similar to that of bGH, in spite of the different affinities of these two hormones. The fact that the up-regulation of GHBP occurs, even though a small percentage of mGH is bound in these animals, strongly suggests the existence of a physiological function for GHBP. These results also question some of the assigned or attributed physiological roles of GHBP, at least in the mouse, since only a negligible percentage of total mGH would be prevented from degradation and/or renal filtration by binding to GHBP. This small percentage of bound mGH also invalidates its role as a reservoir or a buffer of mGH concentration during pulses of GH release or rapid changes of mGH levels. Our results also demonstrate the presence of high molecular weight forms of GH-GHBP complexes that could be dissociated by dilution or in the presence of 2-mercapto-ethanol.

Synthesis and characterization of gamma-N-(2-furoylmethyl)aminobutyric acid

The product of acid hydrolysis of the Amadori compound gamma-N-(1-deoxy-D-fructosyl)aminobutyric acid was isolated and identified by (1)H NMR and (13)C NMR as gamma-N-(2-furoylmethyl)aminobutyric acid. This compound is an analogue to furosine, formed during acid hydrolysis of the corresponding Amadori compound. The retention time of the isolated compound was the same as that of the main peak observed in acid hydrolysates of stored orange juice powder. gamma-N-(2-Furoylmethyl)aminobutyric acid can be a useful indicator of the early stages of Maillard reaction in foods containing free gamma-aminobutyric acid.

Solution conformation and dynamics of the trisaccharide fragments of the O-antigen of Vibrio cholerae O1, serotypes Inaba and Ogawa

The conformational behavior of the trisaccharide fragments of the Ogawa and Inaba Vibrio cholera serotypes has been studied using NMR and molecular dynamics (MD). The obtained results indicate that there are no significant differences in the major conformation and in the extent of motion of the glycosidic torsions of these molecules. The differences in biological activity are probably not due to conformational effects but to van der Waals and/or hydrogen bonding interactions between the antigens and the biological receptor.

[Cytogenetic findings in ductal carcinoma of the breast]

Breast cancer in women is an important medical problem with public health and social implications. In spite of its great clinical importance, little is known about the cytogenetic features of breast carcinomas. Chromosomal abnormalities in some malignant tumors have been used for diagnosis and prognosis or for localizing genes involved in the pathology malignancies. In this report, we present the chromosomal abnormalities found in 32 primary breast ductal carcinomas. The tumor samples were studied using the technique for short-term culturing and cytogenetic analysis with G-banding. Only one tumor with normal karyotype was observed. Thirty one (99%) of the tumors had chromosomal abnormalities including 21 (65.6%) in which chromosome 1 was involved (trisomy, monosomy or structural abnormalities of the type t(1q;2p) and del(1q42). Other recurrent anomalies such as del(12p); del 4(p); +7; +8; -7; -3; were observed. The significance of these findings and their role in tumorogenesis will become more evident with close follow-up of women who have tumors with an abnormal karyotype.

Ecological approach of macrolide-lincosamides-streptogramin producing actinomyces from Cuban soils

We report in this study the frequency of Streptomyces strains to produce macrolide-lincosamide-streptogramin (MLS) antibiotics isolated from Cuban soils. The screening assay is based on the induction of MLS-resistance phenotype in a clinical isolated strain of Staphylococcus aureus S-18. Our results suggest that of 800 Streptomyces strains isolated from different soil samples, 6% were positives in the screening test used. The ferralitic red soil from Pinar del Río (north) provided the major percentage (3.6%) of MLS producing strains. The other soil samples tested belonging to Guira de Melena and Bauta in Havana, Matanzas City, Topes De Collantes (Villa Clara), and Soroa Mountains (Pinar del Rio) hill reached very low percentages.

Preliminary safety evaluation of a cyclotron facility for positron emission tomography imaging

This work describes the design characteristics of a medical imaging centre which uses positron emission tomography, with a cyclotron for fluorine-18 and nitrogen-13 production, and which has provided experimental information on operational data recorded by area dosimetry since 1995. Doses to radiopharmacy and medical staff have been measured both in normal work and in some handling incidents. Data on radiation levels in the installation have also been obtained and related to design details and shielding. Area dosimetry was carried out using a five-stationary detector network, with a sampling rate of 2 min(-1), and by thermoluminescent dosimetry (TLD). Staff were also monitored by TLD, using extra chips for finger dosimetry and to duplicate individual whole-body dosimetry in order to measure doses in certain single operations. For normal work, average whole-body doses to radiopharmacy staff were between 0.03 and 0.28 mSv/month, wrist doses were between 0.42 and 2.67 mSv/month, and finger doses were between 1.4 and 7.7 mSv/day for the left hand and 0.8 and 2.4 mSv/day for the right hand; such variation reflects the differing expertise of staff and the role played by optimisation. Finger doses between 16 and 131 mSv were measured in handling incidents, and finger doses of 20.2 and 20.7 mSv for the left hand and 22.0 and 22.3 mSv for the right hand were measured during handling of a syringe without shielding, containing 3 GBq. For medical staff, contributions to the whole-body dose of 2.0 and 1.9 microSv/procedure were measured for injection and placing the patient on the examination couch, respectively. Dose measurement on the middle finger of the right hand gives an average of 70 microSv during the injection. The provisions regarding the shielding design have proved to be adequate and effective during a 3-year operational period. Operational doses to medical staff are comparatively low, while radiopharmacy staff are the most exposed. The finger doses in these professionals may exceed the annual limit, unless operational restrictions in daily practice are adopted. On-line area dosimetry records based on dose rate probes have proved to be effective both for monitoring radiation levels during the operation and for detecting changes in the behaviour of the facility in the irradiation process.

Determination of cyanocobalamin, betamethasone, and diclofenac sodium in pharmaceutical formulations, by high performance liquid chromatography

The aim of this work was to develop an analytical method for a simultaneous determination of cyanocobalamin (Vitamin B12), betamethasone, and diclofenac, present in pharmaceutical formulations, by high performance liquid chromatography, assuring rapidity, accuracy, precision, and selectivity. The working conditions were as follows: RP18 column of 125 mm x 4 mm ID and a particle size of 5 microm; mobile phase acetonitrile-water (40:60; v/v) (pH* 3.45) adjusted with acetic acidl flow gradient from 0.8 to 1.9 ml/min.; injection volume of 20 microl; temperature 34 degrees C and detection at 240 nm. The method was adequately validated, and linearity, accuracy, as well as the system, method and interday precision, for each active principle, were determined.

Mycophenolate mofetil prevents the progressive renal failure induced by 5/6 renal ablation in rats

BACKGROUND

Extensive renal ablation is associated with progressive sclerosis of the remnant kidney. Because lymphocytes and monocytes accumulate in the remnant kidney, it is likely that they play a role in the renal scarring. Therefore, we treated rats with 5/6 nephrectomy (5/6Nx) with mycophenolate mofetil (MMF), a drug that has an antiproliferative effect and that suppresses the expression of intercellular adhesion molecules.

METHODS

Sprague-Dawley rats with 5/6Nx received MMF (30 mg. kg-1. day-1 by daily gastric gavage, N = 15) or vehicle (N = 16). Ten additional rats were sham operated. All rats were fed a 30% protein diet. Body weight, serum creatinine, and urinary protein excretion were determined weekly. Lipid peroxidation, as a measure of oxidative stress observed by urinary malondialdehyde determinations, was performed every two weeks. Histologic studies were done in the remnant kidney four weeks (9 rats from the vehicle-treated group, 7 rats from the MMF group, and 5 sham-operated rats) and eight weeks after surgery (the remaining rats). Glomerular volume, sclerosis in glomeruli (segmental and global) and interstitium (semiquantitative scale), infiltrating lymphocytes and macrophages (CD43- and ED1-positive cells), and expression of adhesion molecules (CD54, CD18, and CD11b) were analyzed.

RESULTS

MMF treatment prevented the progressive increment in serum creatinine and the proteinuria observed in the 5/6 nephrectomized rats during the eight weeks of observation (P < 0.01). Weight gain was comparable in the MMF-treated and sham-operated rats, whereas weight gain was decreased in untreated 5/6 nephrectomized rats. Excretion of malondialdehyde increased after surgery but returned sooner to control levels in the MMF-treated rats. Increments in glomerular size and mean arterial blood pressure induced by renal ablation were not modified by MMF treatment. Eight weeks after surgery, segmental sclerosis was present in 48.4 +/- 8.35% (+/- sd) glomeruli in the vehicle-treated group versus 25 +/- 10.5% in the MMF-treated group (P < 0.001). Interstitial fibrosis was reduced significantly with MMF treatment (P < 0.001). Infiltration with CD43- and ED1-positive cells in glomeruli and interstitium was two to five times lower in MMF-treated rats (P < 0.01). Expression of adhesion molecules CD18 and CD11b was similarly reduced.

CONCLUSION

MMF ameliorates the progressive renal damage in the remnant kidney after 5/6Nx. This effect is associated with a reduction in the infiltration of lymphocytes and monocytes, whereas glomerular hypertrophy and systemic hypertension are unchanged.

Bovine abortion associated with Neospora caninum in northern Spain

During 1996, aborted bovine fetuses from dairy herds in norther Spain were examined by histopathological, immunohistochemical and serological methods for evidence of infection by Neospora caninum. Microscopical brain changes consistent with those of neosporosis were detected in 36 of 81 fetuses and specific antibodies (IFAT titres > or = 1/16) in 32 of 63. Eight fetuses with neurological lesions were seronegative, and eight without lesions were seropositive. In 25 of 34 fetal brains with lesions consistent with published descriptions of neosporosis, immunohistochemical analysis revealed the presence of N caninum antigen. Depending on the diagnostic criteria, the prevalence of neosporosis related to bovine abortion was between 32 and 57 per cent of the fetuses submitted and between 33 and 58 per cent of the herds involved. Data on the geographical, seasonal and fetal age distribution of the infection are given for the fetuses examined and the value of the different diagnostic methods is discussed.

Report of an image quality and dose audit according to directive 97/43/Euratom at Spanish private radiodiagnostics facilities

An audit of Spanish private medicine radiodiagnostics facilities has been carried out, based partly on Spanish legislation relating to European Directives on health protection against ionizing radiation risks in medical exposure. The study included an appraisal of infrastructure and equipment, and aspects of quality assurance and radiation protection, by means of data collected through surveys. Of the 51 centres audited, a sample of 24 X-ray rooms was chosen, then an external evaluation with regard to image quality and patient dose was performed, by an advisory board of radiologists and medical physicists. The methodology used was similar to that of the group of European Union experts in European dose evaluation and image quality trials. Chest, abdomen, lumbar spine and breast examinations were monitored. Doses were measured with thermoluminescent dosimeters. A third of the X-ray rooms evaluated reached or exceeded dose reference values, and in a third of the cases the image quality left considerable room for improvement. Breast and chest examinations showed themselves to be the hardest to perform, not only as a result of exceeding the reference doses, but also due to failure to meet good image quality standards.