[Efficacy of high-dose dual therapy for Helicobacter pylori infection eradication in servicemen: a randomized controlled trial]

Objective: To assess the efficacy and cost-effectiveness of high-dose dual therapy compared with bismuth-containing quadruple therapy for treating Helicobacter pylori(H.pylori) infection in servicemen patients. Methods: A total of 160 H. pylori-infected, treatment-naive servicemen, including 74 men and 86 women, aged from 20 years to 74 years, with a mean (SD) age of 43 (13) years, tested in the First Center of Chinese PLA General Hospital from March 2022 to May 2022 were enrolled in this open-label, randomized controlled clinical trial. Patients were randomly allocated into 2 groups: the 14-day high-dose dual therapy group and the bismuth-containing quadruple therapy group. Eradication rates, adverse events, patient compliance, and drug costs were compared between the two groups. The t-test was used for continuous variables, and the Chi-square test for categorical variables. Results: No significant difference in H. pylori eradication rates were found between high-dose dual therapy and bismuth-containing quadruple therapy by ITT, mITT and PP analysis[ITT:90.0% (95%CI 81.2%-95.6%) vs. 87.5% (95%CI 78.2%-93.8%), χ²=0.25, P=0.617;mITT:93.5% (95%CI 85.5%-97.9%) vs. 93.3% (95%CI 85.1%-97.8%), χ²<0.01, P=1.000; PP: 93.5% (95%CI 85.5%-97.9%) vs. 94.5% (95%CI 86.6%-98.5%), χ²<0.01, P=1.000 ]. The dual therapy group exhibited significantly less overall side effects compared with the quadruple therapy group [21.8% (17/78) vs. 38.5% (30/78), χ²=5.15,P=0.023]. There were no significant differences in the compliance rates between the two groups [98.7%(77/78) vs. 94.9%(74/78), χ²=0.83,P=0.363]. The cost of medications in the dual therapy was 32.0% lower compared with that in the quadruple therapy (472.10 RMB vs. 693.94 RMB). Conclusions: The dual regimen has a favorable effect on the eradication of H. pylori infection in servicemen patients. Based on the ITT analysis, the eradication rate of the dual regimen is grade B (90%, good). Additionally, it exhibited a lower incidence of adverse events, better compliance and significantly reduced cost. The dual regimen is expected to be a new choice for the first-line treatment of H. pylori infection in servicemen but needs further evaluation.

Experimental study on stromal vascular fraction mediated inhibition of skin pigmentation in guinea pigs

Background

Pigment disorder dermatoses are common diseases with complex mechanisms. There are various methods for the clinical treatment of pigmentation diseases, but these have a poor curative effect and many adverse reactions. Currently, looking for safe and effective whitening agents is a popular research topic. Stromal vascular fractions (SVFs) are a compound cell component of adipose-derived stem cells (ADSCs) that can promote tissue regeneration, healing, and vascularization. The purpose of this experiment was to investigate the inhibitory effect of SVFs on pigmentation in guinea pigs.

Methods

After guinea pig subcutaneous fat was digested and centrifuged, SVFs were isolated and quantified. SVF was injected into the pigmentation area of the prepared guinea pig pigmentation model. The amount of inducible nitric oxide synthase (iNOS) was determined using immunohistochemical analysis, histopathological staining, and the Fontana-Masson (F-M) method for measuring melanin formation.

Results

The skin of the guinea pigs obtained stable and homogenous coloration following three treatments with narrow-band ultraviolet B (NB-UVB). Hematoxylin-eosin (HE) staining revealed that compared to the control group, the cuticle, granular layer, and spinous layer were thicker and the number of epidermal melanocytes and melanin granules increased. While the quantity of pigment granules in the treated group dramatically decreased, it did not significantly change in the blank control group. F-M staining revealed that melanin granules greatly expanded following ultraviolet irradiation and were continuously distributed in basal cells and spinous layers. The entire epidermis was evenly covered in melanin granules. The level of melanin dramatically decreased following therapy. According to immunohistochemical labeling, epidermal cells' cytoplasm and membranes are where iNOS is primarily found. In the epidermis of the irradiated group, iNOS expression was much higher than in the control group, and following treatment, it decreased in the experimental group.

Conclusions

SVFs have a reliable treatment effect on ultraviolet B (UVB)-induced pigmentation in guinea pig skin. SVFs can significantly inhibit pigmentation, effectively shorten the fading time of pigmentation, and play a role in skin whitening, providing a new breakthrough for the treatment of pigmentation diseases.

Critical Review of Synthesis, Toxicology and Detection of Acyclovir

Acyclovir (ACV) is an effective and selective antiviral drug, and the study of its toxicology and the use of appropriate detection techniques to control its toxicity at safe levels are extremely important for medicine efforts and human health. This review discusses the mechanism driving ACV’s ability to inhibit viral coding, starting from its development and pharmacology. A comprehensive summary of the existing preparation methods and synthetic materials, such as 5-aminoimidazole-4-carboxamide, guanine and its derivatives, and other purine derivatives, is presented to elucidate the preparation of ACV in detail. In addition, it presents valuable analytical procedures for the toxicological studies of ACV, which are essential for human use and dosing. Analytical methods, including spectrophotometry, high performance liquid chromatography (HPLC), liquid chromatography/tandem mass spectrometry (LC-MS/MS), electrochemical sensors, molecularly imprinted polymers (MIPs), and flow injection–chemiluminescence (FI-CL) are also highlighted. A brief description of the characteristics of each of these methods is also presented. Finally, insight is provided for the development of ACV to drive further innovation of ACV in pharmaceutical applications. This review provides a comprehensive summary of the past life and future challenges of ACV.

Molecular Mechanisms of Chondrocyte Proliferation and Differentiation

Cartilage is a kind of connective tissue that buffers pressure and is essential to protect joint movement. It is difficult to self-recover once cartilage is damaged due to the lack of blood vessels, lymph, and nerve tissues. Repair of cartilage injury is mainly achieved by stimulating chondrocyte proliferation and extracellular matrix (ECM) synthesis. Cartilage homeostasis involves the regulation of multiple growth factors and the transduction of cellular signals. It is a very complicated process that has not been elucidated in detail. In this review, we summarized a variety of signaling molecules related to chondrocytes function. Especially, we described the correlation between chondrocyte-specific regulatory factors and cell signaling molecules. It has potential significance for guiding the treatment of cartilage injury.

A Computational Study of Potential miRNA-Disease Association Inference Based on Ensemble Learning and Kernel Ridge Regression

As increasing experimental studies have shown that microRNAs (miRNAs) are closely related to multiple biological processes and the prevention, diagnosis and treatment of human diseases, a growing number of researchers are focusing on the identification of associations between miRNAs and diseases. Identifying such associations purely via experiments is costly and demanding, which prompts researchers to develop computational methods to complement the experiments. In this paper, a novel prediction model named Ensemble of Kernel Ridge Regression based MiRNA-Disease Association prediction (EKRRMDA) was developed. EKRRMDA obtained features of miRNAs and diseases by integrating the disease semantic similarity, the miRNA functional similarity and the Gaussian interaction profile kernel similarity for diseases and miRNAs. Under the computational framework that utilized ensemble learning and feature dimensionality reduction, multiple base classifiers that combined two Kernel Ridge Regression classifiers from the miRNA side and disease side, respectively, were obtained based on random selection of features. Then average strategy for these base classifiers was adopted to obtain final association scores of miRNA-disease pairs. In the global and local leave-one-out cross validation, EKRRMDA attained the AUCs of 0.9314 and 0.8618, respectively. Moreover, the model’s average AUC with standard deviation in 5-fold cross validation was 0.9275 ± 0.0008. In addition, we implemented three different types of case studies on predicting miRNAs associated with five important diseases. As a result, there were 90% (Esophageal Neoplasms), 86% (Kidney Neoplasms), 86% (Lymphoma), 98% (Lung Neoplasms), and 96% (Breast Neoplasms) of the top 50 predicted miRNAs verified to have associations with these diseases.

Effect of the Stromal Vascular Fraction on Changes in Melanin Formation in B16 Cells Treated by IBMX

OBJECTIVE

To investigate the effect of the stromal vascular fraction (SVF) on changes in melanin formation and tyrosinase activity in B16 cells treated by 3-isobutyl-1 methylxanthine (IBMX) and to explore the mechanism of SVF-mediated inhibition of pigmentation.

METHODS

We co-cultured extracted SVFs and B16 cells treated with IBMX in a certain proportion, and the marker molecule HMB-45 was detected by immunochemistry. Melanin content was determined by NaOH lysis. Activity of tyrosinase was measured by the DOPA oxidation method.

RESULTS

HMB-45 was commonly expressed in B16 cells induced by IBMX. After the addition of SVFs, the expression of HMB-45 decreased significantly and positively correlated with increases in SVFs. After the induction of B16 cells by IBMX, melanin content increased significantly. However, melanin decreased after SVF and B16 co-culturing; the effect was more substantial with the increase and decrease in SVFs, and the activity of tyrosinase decreased.

CONCLUSION

SVFs inhibit the production of melanin and reduce the activity of tyrosinase, possibly providing a new breakthrough for the treatment of pigment disorders.

NO LEVEL ASSIGNED

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Human Microbe-Disease Association Prediction With Graph Regularized Non-Negative Matrix Factorization

A microbe is a microscopic organism which may exists in its single-celled form or in a colony of cells. In recent years, accumulating researchers have been engaged in the field of uncovering microbe-disease associations since microbes are found to be closely related to the prevention, diagnosis, and treatment of many complex human diseases. As an effective supplement to the traditional experiment, more and more computational models based on various algorithms have been proposed for microbe-disease association prediction to improve efficiency and cost savings. In this work, we developed a novel predictive model of Graph Regularized Non-negative Matrix Factorization for Human Microbe-Disease Association prediction (GRNMFHMDA). Initially, microbe similarity and disease similarity were constructed on the basis of the symptom-based disease similarity and Gaussian interaction profile kernel similarity for microbes and diseases. Subsequently, it is worth noting that we utilized a preprocessing step in which unknown microbe-disease pairs were assigned associated likelihood scores to avoid the possible negative impact on the prediction performance. Finally, we implemented a graph regularized non-negative matrix factorization framework to identify potential associations for all diseases simultaneously. To assess the performance of our model, cross validations including global leave-one-out cross validation (LOOCV) and local LOOCV were implemented. The AUCs of 0.8715 (global LOOCV) and 0.7898 (local LOOCV) proved the reliable performance of our computational model. In addition, we carried out two types of case studies on three different human diseases to further analyze the prediction performance of GRNMFHMDA, in which most of the top 10 predicted disease-related microbes were verified by database HMDAD or experimental literatures.

Human Microbe-Disease Association Prediction Based on Adaptive Boosting

There are countless microbes in the human body, and they play various roles in the physiological process. There is growing evidence that microbes are closely associated with human diseases. Researching disease-related microbes helps us understand the mechanisms of diseases and provides new strategies for diseases diagnosis and treatment. Many computational models have been proposed to predict disease-related microbes, in this paper, we developed a model of Adaptive Boosting for Human Microbe-Disease Association prediction (ABHMDA) to reveal the associations between diseases and microbes by calculating the relation probability of disease-microbe pair using a strong classifier. Our model could be applied to new diseases without any known related microbes. In order to assess the prediction power of the model, global and local leave-one-out cross validation (LOOCV) were implemented. As shown in the results, the global and local LOOCV values reached 0.8869 and 0.7910, respectively. What's more, 10, 10, and 8 out of the top 10 microbes predicted to be most likely to be associated with Asthma, Colorectal carcinoma and Type 1 diabetes were all verified by relevant literatures or database HMDAD, respectively. The above results verify the superior predictive performance of ABHMDA.

[Effects of different carbohydrates on the simulation of human intestinal bacterial flora with in vitro culture]

OBJECTIVE

To investigate the optimal growth condition of human fecal bacterial flora in vitro by comparing the effect of different carbohydrates as cultural media.

METHODS

Three fecal samples (1, 2, 3) were collected and inoculated into a single-stage chemostat system, in which starch medium (VI) and starch polysaccharide medium(XP) were used. Samples were collected for bacterial genomic DNA extraction and polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) analysis. Bacterial composition and short chain fatty acid (SCFA) were then analyzed.

RESULTS

The single stage chemostat system reached steady after operating 8 days, when evaluated by the PCR-DGGE. Bacterial 16s rRNA high-throughput sequencing showed that the intestinal bacteria of these three volunteers was mainly composed of four bacterial phyla, namely, Bacteroidetes, Firmicutes, Proteobacteria and Actinobacteria. When the influence of bacterial abundance was considered, the similarity of bacterial composition between the original fecal samples to the harvested flora after culture was 0.847, 0.825, 0.968 in VI medium and 0.927, 0.926, 0.836 in XP medium, respectively. The similarity was decreased to 0.553, 0.580, 0.623 with VI medium and 0.617, 0.520, 0.574 with XP medium, when the number of bacterial species was considered. The variation of host individual also influenced the simulation. VI medium favored fecal sample 3, while XP medium more benefited sample 1 and 2. Bacteroides and Lachnospiraceae_incertae_sedis grew in both VI and XP medium. However, some species were only detected in VI medium and some were specifically found in the XP medium. The SCFA concentration in fermenters was 15-35 mmol/L, mainly propionate and butyrate.

CONCLUSIONS

The chemostat system works for stimulating human gut bacterial flora in vitro. The bacterial composition is affected by different carbohydrate in the culture medium yet with close simulation higher than 80%.

Review article: fungal microbiota and digestive diseases

BACKGROUND

The role of the fungal microbiota in digestive diseases is poorly defined, but is becoming better understood due to advances in metagenomics.

AIM

To review the gastrointestinal fungal microbiota and its relationship with digestive diseases.

METHODS

Search of the literature using PubMed and MEDLINE databases. Subject headings including 'fungal-bacterial interactions', 'mycotoxins', 'immunity to fungi', 'fungal infection', 'fungal microbiota', 'mycobiome' and 'digestive diseases' were used.

RESULTS

The fungal microbiota is an integral part of the gastrointestinal microecosystem with up to 10(6) microorganisms per gram of faeces. Next-generation sequencing of the fungal 18S rRNA gene has allowed better characterisation of the gastrointestinal mycobiome. Numerous interactions between fungi and bacteria and the complex immune response to gastrointestinal commensal or pathogenic fungi all impact on the pathophysiology of inflammatory bowel disease and other gastrointestinal inflammatory entities such as peptic ulcers. Mycotoxins generated as fungal metabolites contribute to disturbances of gastrointestinal barrier and immune functions and are associated with chronic intestinal inflammatory conditions as well as hepatocellular and oesophagogastric cancer. Systemic and gastrointestinal disease can also lead to secondary fungal infections. Fungal genomic databases and methodologies need to be further developed and will allow a much better understanding of the diversity and function of the mycobiome in gastrointestinal inflammation, tumourigenesis, liver cirrhosis and transplantation, and its alteration as a consequence of antibiotic therapy and chemotherapy.

CONCLUSIONS

The fungal microbiota and its metabolites impact gastrointestinal function and contribute to the pathogenesis of digestive diseases. Further metagenomic analyses of the gastrointestinal mycobiome in health and disease is needed.

Public health medicine training in Singapore

Public health as a discipline is difficult to characterize because it has to respond to changes in human societies. As such, public health training has two dimensions--(1) Orientation and (2) Competencies. Our orientation should be broad and multidisciplinary to keep "alive the idea of improving the public health as a primary value". On the other hand, competencies define our professional status and role, which are focused mainly on our work on status of health, surveillance and disease control, health services and their evaluation. The core competencies can be organized according to the following categories: (1) Epidemiologic, (2) Programme-based, (3) Laboratory-based and (4) Practice-based. The Singapore Programme is a 6-year post-intern medical training, with core components and electives clustered around 2 themes: (1) Health Policy and Management, (2) International Health.

[A multiple-channel system for synchronous acquisition and analysis of neural electrophysiological signals]

The technique for synchronous electrophysiological recording from multiple single cells has been widely applied, but there is still a shortage of suitable data acquisition and analysis systems to fit electrophysiological equipment made in China or Japan. Recently we have developed an acquisition and analysis system for multiple-channel electrophysiological recording. In this paper, we present the pivotal technique of the system and some examples of applications.

Ceftazidime-resistant Klebsiella pneumoniae bloodstream infection in children with febrile neutropenia

OBJECTIVES

To evaluate prevalence of ceftazidime-resistant Klebsiella pneumoniae (CRKP) in the pediatric oncology unit of University Hospital, Kuala, Lumpur, and to identify differences between febrile neutropenic pediatric patients with CRKP and ceftazidime-sensitive K. pneumoniae (CSKP) bacteremia.

MATERIALS AND METHODS

Febrile neutropenic patients treated between January 1996 and December 1997 at the pediatric oncology unit of University Hospital, Kuala Lumpur, were prospectively studied. Empirical antibiotic therapy consisted of ceftazidime and amikacin. Those who developed K. pneumoniae bacteremia were identified, and clinical features analyzed. Ceftazidime-resistance was documented via disk-diffusion testing. Production of extended-spectrum beta-lactamase (ESBL) was inferred on the basis of synergy between ceftazidime and amoxicillin-clavulanic acid. The different features between the two groups and variables associated with the development of CRKP bacteremia were analyzed using chi-square and t-tests and calculation of odds ratios. A multivariate analysis was used to identify independent factors for CRKP development.

RESULTS

Ceftazidime-resistance was seen in 51.6% of all K. pneumoniae isolates, and all these isolates were inferred to be ESBL producers. All isolates were sensitive to imipenem. Susceptibility to gentamicin was 90.5%. The mean continuous hospital stay prior to the detection of bacteremia was 13.7 days overall, but significantly longer in the CRKP group (21.9 d) compared to the CSKP group (4.3 d) (P = 0.003). Children with CRKP were more likely to have received antibiotics in the 2 weeks prior to detection of bacteremia (87.5% of cases) than the CSKP group (20.0% of cases) (P = 0.0008). Sepsis-related mortality was higher in those with CRKP (50.0%) than in the CSKP group (13.3%) (P = 0.02). Patients who did not receive CRKP-directed antibiotics within 48 hours of admission were more likely to have a fatal outcome than those who did (P = 0.009). Logistic regression analysis identified use of third-generation cephalosporins 2 weeks prior to presentation and a hospital stay of 2 weeks or more as independent risk factors for development of CRKP.

CONCLUSIONS

More than half of total K. pneumoniae isolated from blood cultures in the unit were ceftazidime-resistant. Children with febrile neutropenia with prolonged hospital stay and recent prior antibiotic exposure are at high risk of developing CRKP bacteremia. Mortality was significantly higher in this group. Early commencement of appropriate antibiotics (e.g., imipenem with or without gentamicin), according to susceptibility study results, may be beneficial in such circumstances.

Septicaemia in paediatric cancer patients: a 5-year surveillance study in university hospital, Kuala Lumpur, Malaysia

Infectious complications are the major cause of morbidity and mortality in children with malignancy. Empirical antimicrobial therapy in the management of fever of unknown origin should be tailored to local bacteriological data and antibiotic sensitivity patterns. Five-hundred-and-fifty-nine cases of culture-proven septicaemia occurring in pediatric cancer patients between 1990 and 1994 were retrospectively analysed and compared with a similar study done in our centre between 1976 and 1979. A wide spectrum of organisms was isolated. Staphylococcus epidermidis, Staphylococcus aureus, and Klebsiella pneumoniae were the most common and consistent bacteria isolated during the 5 year period. More than 70 per cent of the staphylococci were sensitive to methicillin and universally sensitive to vancomycin. However, a worrying trend of ceftazidime-resistance amongst gram-negative organisms was found. In these situations, the use of imipenem is recommended as resistance to this antimicrobial agent was exceedingly rare.

In vitro metabolism of adrenocortical hormones by mammary glands of lactating rats. A comparative study

A comparative study was made of the metabolism of tritium-labeled corticosterone, cortisol and aldosterone on incubation with minced mammary glands of lactating rats. The yield of total nonpolar (acylated) radiometabolites was highest for [3H]corticosterone, lowest for [3H]cortisol and intermediate for [3H]aldosterone. Unlike [3H]corticosterone, [3H]aldosterone yielded two 21-acyl derivatives (Metabolites I and II) in comparable amounts. Metabolite I (39%) was identified as [3H]aldosterone 21-oleate by isotope dilution analysis. Metabolite II (54%) could not be identified: it is intermediate in polarity between corticosterone 21-oleate and the less polar, corticosterone 21-stearate, and is distinctly less polar than the 21-palmityl, linoleoyl (and presumably also less polar than the arachidonyl) derivatives of aldosterone. The [3H]cortisol metabolites were not further investigated.

In vitro metabolism of [3H] corticosterone by mammary glands from lactating rats. Isolation and identification of 21-acyl[3H]corticosterone

[3H] Corticosterone undergoes extensive 21-acylation on incubation with minced mammary glands from lactating rats. A purified 21-acyl [3H] corticosterone fraction was obtained by subjecting extracts of the incubated tissues to Sephadex LH-20 column chromatography followed by partitioning between n-heptane/methanol. The methanol extracts were chromatographed consecutively on columns of silica gel and C18-silanized (reverse-phase) silica gel. The radioactive product was methoximated and re-chromatographed on the reverse-phase column. Mass spectral analysis of the 21-acyl [3H] corticosterone 3,20-dimethoxime and synthetic corticosterone 21-oleate 3,20-dimethoxime suggested identity. Confirmation of the precise nature of the 21-acyl moiety was obtained by isotope dilution analysis of the underivatized radiometabolite with corticosterone 21-oleate. The composition of the 21-acyl [3H] corticosterone fraction (i.e. before extensive purification) was ascertained by isotope dilution analysis with various corticosterone esters. It appears that [3H] corticosterone 21-oleate is a major component of this fraction, representing 80% of the radioactivity; [3H] corticosterone 21-linoleate is a minor component, i.e. 8.6%. [3H] Corticosterone 21-palmitate, [3H] corticosterone 21-arachidonate, and [3H] corticosterone 21-stearate, if indeed present, constitute considerably less than 14, 6, and 2%, respectively, of the radiometabolite fraction. It is suggested that bioacylation of corticosterone serves to modulate the biological action of the glucocorticoid hormone on the mammary glands during lactation.

Glucocorticoids and lactation. In vitro metabolism of glucocorticoids by rat mammary glands

In view of: 1. the extensive in vitro 21-acylation of [3H]corticosterone by rat mammary glands, especially during lactation; 2. the accumulation of 21-acyl [3H]corticosterone as the predominant form of the hormone in the alveolar nuclear fraction with which it is strongly associated; 3. the results of a systematic study of the influence of acylation per se of corticosterone and dexamethasone on their binding affinities for specific glucocorticoid-binding proteins; and 4. the extensive metabolic acylation, similarly, of adrenocortical hormones other than corticosterone, it is suggested that the acylation of glucocorticoid by the mammary gland may serve to modulate the biological action of the hormone on this target organ, and indirectly influence the flow of glucocorticoid from plasma to milk.

In-vitro uptake and metabolism of [3H] corticosterone by mammary glands from pregnant, lactating, and post-lactational rats and by parametrial adipose tissue from lactating rats

The study was designed to determine the influence of the physiological state on the in-vitro uptake and metabolism of glucocorticoid hormone by the mammary gland. [3H] Corticosterone was accordingly incubated with minced mammary glands from pregnant, lactating and post-lactational rats. The total uptake of [3H] corticosteroid was obtained from the concentration of radioactivity by the tissue and the specific activity of the steroid substrate. The extent of 21-acylation was determined as the percentage of the radioactivity in the chromatographed tissue extracts attributable to 21-acyl-[3H] corticosterone. The results indicated that the uptake of [3H] corticosteroid increased with advancing pregnancy, attained a high plateau level during lactation, and steadily declined during the post-lactational period. The extent of 21-acylation of [3H] corticosterone varied from 10 to 40%, fluctuating widely in all physiological states, particularly during the post-lactational period. It was inferred that the stromal elements, presumably the adipocytes, of the mammary gland can also acylate the corticosteroid hormone, a view which gained experimental support from similar studies with minced parametrial adipose tissue from lactating rats.

The levels of corticosterone-binding proteins in rat milk and coincidental serum, and the dissociation rates of the corticosterone.protein complexes

The corticosterone-binding protein present in rat whey was further characterized by determining, with the aid of a dextran-coated charcoal procedure, the apparent rate of dissociation of the corticosterone.protein complex. The half-time values for the dissociation of the corticosterone.protein complexes in rat whey and serum were compared and found to be identical, i.e. 23 min at 0 C, when the measurements were made over a period of 40 min. The possible presence in small amounts of a corticosterone.protein complex in whey with the much slower dissociation rate characteristic of mammary glucocorticoid receptor could not be detected even when the dissociation was followed over a much longer period. The charcoal adsorption method also provided independent estimates of the molar concentrations of the corticosterone-binding proteins in rat serum and whey. The mean concentration of corticosterone-binding protein in whey was found to be 15% of that in coincidental serum during early lactation. The serum levels of corticosterone-binding protein decline markedly at parturition and then rise from day 2 to day 6 of lactation in rats with small litters. The results of this and a previous study suggest that the corticosterone-binding protein in whey is probably derived from that in serum. The mode of transport of the corticosterone-binding protein from the bloodstream across the mammary epithelium into milk as well as the concentrations of the corticosterone-binding proteins in serum and whey may be factors influencing the uptake of the glucocorticoid by its target cells.

Fever in children with acute lymphoblastic leukemia

In this study among children with acute lymphoblastic leukemia, more febrile episodes occurred during induction of remission and relapse than during remission. Infection was mainly responsible for fever during remission, regardless of the neutrophil count. However, during induction and relapse, evidence suggests that the underlying malignancy is the more likely cause of fever if the neutrophil count exceeds 200 per mm3. For all cases, the risk of serious infection was high with severe neutropenia (neutrophil count less than 200 per mm3). Of the organisms identified, gram-positive and gram-negative bacteria were equally represented. Infection remains a serious problem in the management of children with leukemia.

Corticosteroid-binding proteins in human colostrum and milk and rat milk

A corticosteroid-binding protein was detected in the whey of human colostrum and milk which resembles serum corticosteroid-binding globulin in certain respects: the equilibrium association constants for cortisol and progesterone binding and the apparent molecular size, as determined by Sephadex G-200 chromatography, were similar, and cortisol andd progesterone competed strongly for binding to the same site in each instance. Dexamethasone-binding activity could not be detected. The concentration of corticosteroid-binding protein in the colostrum obtained before parturition is about 0.1 muM; the concentration declines rapidly after parturition to about 0.01 muM. A corticosteroid-binding protein was found, also, in the whey of mature rat milk at levels of about 0.3 muM. This protein resembles rat serum corticosteroid-binding globulin: the equilibrium association constants for cortisol, corticosterone, and progesterone binding, and the apparent molecular size, as determined by Sephadex G-200 chromatography, were similar; the elution behavior of the respective proteins on anion exchange chromatography with DEAE-Sephadex A-50 was similar, also. Identity of the corticosteroid-binding proteins in whey with corticosteroid-binding globulin in serum is not presumed, however. Rat and human whey exhibited very little testosterone- or 17 beta-estradiol-binding activity. It is suggested the corticosteroid-binding proteins may play a significant physiological role in regulating the concentration of the bound and unbound forms of progesterone and cortisol in the fluids bathing the epithelial cells lining the mammary ducts and acini.