An infantile late-onset case Group of B Streptococcus meningitis diagnosed with a rapid latex kit

Globally, vaccination has reduced the prevalence of meningitis caused by Streptococcus pneumoniae Neisseria meningitidis, and Haemophilus influenzae. However, neonatal Group B Streptococcus (GBS) meningitis continues to remain a problematic infection of the central nervous system. Here, we report a case of bacterial meningitis in a 34-day old male baby who presented with fever. A cerebrospinal fluid (CSF) test on the day of admission showed an increase in cell count with decreased glucose level. A rapid latex test of the CSF using a commercial kit diagnosed the causative pathogen as GBS. We administered the antibiotics ampicillin, cefotaxime, gentamicin and panipenem/betamipron to the patient for over 14 days. Partial seizures were frequently observed during the course and were well-controlled with midazolam and phenobarbital. Brain magnetic resonance imaging on day 17 showed subdural hygroma in the frontal region, and 99mTc ethyl-cysteinate dimer-single photon emission computed tomography confirmed a decreased cerebral blood flow predominantly in the left frontal region. After three years of follow-up, the condition of the patient improved without any neurological sequelae. Our report highlights that rapid identification of the causative organism is essential in infantile late-onset meningitis. In addition, we consider that the latex kit-based rapid testing of CSF is beneficial for identifying the causative agent of bacterial meningitis.

A peptide microarray fabricated on a non-fouling phosphatidylcholine-polymer-coated surface for a high-fidelity analysis of a cellular kinome

Phosphatidylcholine-polymer-coated plastic slides were utilized for the fabrication of peptide microarrays for cellular kinome analysis. According to the non-fouling features of the surface, the signal-to-noise ratio of the detection of phosphorylated peptides improved by about 100-fold from that of a peptide microarray fabricated on a glass slide blocked by a commercial BSA-based reagent. When the phosphatidylcholine-polymer-coated peptide microarray was applied to the analysis of the kinome of HCC827 cells, hyperactivation of c-Src and EGFR were successfully detected.

Proteome analysis of human placentae: pre-eclampsia versus normal pregnancy

Although placental proteins play multiple roles in fetal and placental development and in the maintenance of pregnancy, many remain inadequately characterized. In the present study, we comprehensively analyzed these proteins by using a proteomic approach. Samples were denatured with guanidine hydrochloride, which was found to be superior to the commonly used urea for the present purpose, and subjected to 2-dimensional (2D) electrophoresis (2-DE) to obtain placental proteome maps. The identified protein spots (ca. 60% of the total) on the proteome maps included several pregnancy-related proteins (PRPs). Furthermore, a novel 2D immunoblotting (2-DI) analysis of molecules related to pre-eclampsia revealed three immunopositive spots that appeared to correspond to dynactin p-50, a protein related to cell turn-over. The rate of positivity for dynactin p-50-reactive antibodies was significantly (P=0.0024) higher in 26 pre-eclamptic women than in 58 normally pregnant women. These results indicate that dynactin p-50 may be involved in the pathophysiology of pre-eclampsia.

Serum adenosine deaminase activity and its isoenzyme pattern in women with normal pregnancies

Adenosine deaminase (ADA) is a purine enzyme which is essential for the proliferation, maturation and function of lymphoid cells, and congenital deficiency of this enzyme is associated with severe combined immunodeficiency disease. The activity of ADA has changed in diseases characterized by the alteration of cell-mediated immunity such as rheumatoid arthritis, systemic lupus erythematosus and tuberculosis, so ADA has been considered as a nonspecific marker of cell-mediated immunity. In this study we examined changes in serum total ADA activity and the patterns of two ADA isoenzymes, ADA1 and ADA2 in normal pregnant women, and evaluated the possible role of the alteration of cell-mediated immunity during normal pregnancy as causes of changes in ADA activity. We measured serum activities of total ADA, ADA1 and ADA2 in normal pregnant women in the third trimester (n=24) and age-matched healthy nonpregnant women (n=24). Peripheral blood lymphocytes and monocytes were also measured. In normal pregnant women, serum total ADA activity averaged 10.5 +/- 0.5 U/L, which was significantly lower than in nonpregnant women (14.0 +/- 0.5 U/L ) (p<0.05), and mean serum ADA2 activity also significantly reduced that of nonpregnant women (p<0.05). There was no significant difference in ADA1 activity in normal pregnant and nonpregnant women. The decrease in total ADA activity was accompanied by the decrease in lymphocyte count. These results suggest that reduced serum total ADA activity reflects decrease in ADA2 activity, and which may be in part associated with depressed cell-mediated immunity during normal pregnancy.

Changes in the proportion of T helper 1 and T helper 2 cells in cord blood after premature rupture of membranes

This study investigated changes in the proportion of T helper (Th)1 and Th2 cells in cord blood after premature rupture of membranes (PROM), and evaluate the effects of PROM on the intrauterine fetal immune status. The proportion of CD3-positive T cells secreting interferon (IFN)-gamma as an index of Th1 cells, and interleukin (IL)-4 as an index of Th2 cells in cord blood of 12 newborns with and without PROM, were analyzed by flow cytometry. In cord blood of newborns with PROM, the proportion of IFN-gamma secreting cells significantly increased, and the proportion of IL-4 secreting cells was rather high but not significantly higher than that of newborns without PROM. These changes eventually caused a shift in the Th1/Th2 ratio to Th1 dominance in PROM. There was no significant correlation between the proportion of IFN-gamma secreting cells and the duration of PROM before the onset of labor. These results suggest that the increase in the proportion of IFN-gamma secreting cells after PROM, which eventually cause the Th1/Th2 ratios to show the Th1 predominance, may reflect in part intrauterine fetal immune responses to PROM.

Relation between serum uric acid and plasma adenosine levels in women with preeclampsia

The aim of this study was to examine the relationship between plasma adenosine and serum uric acid levels in women with preeclampsia. Maternal arterial blood sampling was performed to measure serum uric acid and plasma adenosine levels in 20 pregnant women complicated by preeclampsia and 22 normal pregnant women at 33-38 weeks of gestation. The average plasma adenosine levels were 0.31 +/- 0.12 micromol/l in the normal pregnant group and 0.45 +/- 0.11 micromol/l in the preeclampsia group. The mean serum uric acid level in women with preeclampsia was 5.9 +/- 0.60 mg/dl, significantly higher than in the normal pregnant women (4.4 +/- 0.69 mg/dl). Positive correlations were found between serum uric acid and plasma adenosine levels in both the group with (r(2) = 0.38, p < 0.05) and the group without (r(2) = 0.54, p < 0.05) preeclampsia. There was also a significant correlation between serum uric acid and plasma adenosine levels on the whole (r(2) = 0.59, p < 0.05). Our results suggest that increased adenosine is a contributing source of preeclamptic hyperuricemia.

Role of bursin in the development of B lymphocytes in chicken embryonic Bursa of Fabricius

Localization and role of bursin during Bursa of Fabricius (BF) ontogeny were examined by immunohistochemical staining and by in ovo injection with anti-bursin antibody. Mouse monoclonal anti-bursin antibody HU2 was generated by immunization with synthetic bursin. It recognized reticular cells (REC), follicular associated epithelium (FAE), FAE-supporting cells, and the basal layer of interfollicular epithelium (IFE) in the mature BF. Bu-1(+) cells were first detectable in the mesenchyme area at 13 days of embryogenesis (E13) before bud formation, then lined up along the bud, and homed into the bud at around E15. IgM(+) cells were detected in the bud after E13. Bursin was first observed at the under edge of the bud. Injection of HU2 into embryonal vein at E13 suppressed the appearance of IgM(+) cells in the Bursa at E17. These results indicate that bursin exists beneath the bud and may act on the appearance of IgM(+) cells during BF ontogeny.

Regulation of platelet aggregation in vitro by plasma adenosine in preeclampsia

The aim of this study was to evaluate the possible role of plasma adenosine in platelet aggregation in preeclampsia. We measured the plasma adenosine concentration [ADO] and in vitro platelet aggregation in the third trimester of normal pregnant (n = 15) and preeclamptic women (n = 15). The mean plasma [ADO] in preeclampsia was 0.68 +/- 0.08 microM (means +/- SEM), significantly higher than in normal pregnancy (0.42 +/- 0.09 microM) (p < 0.05). In preeclampsia, platelet aggregation in response to collagen was approximately 40% lower than that in normal pregnancy (p < 0.05). There was an inverse correlation between the plasma [ADO] and platelet aggregation in vitro (r = -0.27, p < 0.05). These results suggest reduced platelet aggregation in preeclampsia may be at least in part attributed to an elevation of the the plasma [ADO].

Changes in plasma adenosine concentrations during normal pregnancy

The aim of this study was to measure changes in plasma adenosine concentration [ADO] during a normal pregnancy and to evaluate the possible role of platelets and red blood cells (RBC) as causes of changes in plasma [ADO]. We measured the plasma [ADO] in normal pregnant women (n = 11) during the first, second and third trimesters. The mean plasma [ADO] in the third trimester was 0.41 +/- 0.08 microM (means +/- SEM), significantly higher than in the first and second trimesters (p < 0.05). In pregnant women, platelet and RBC counts, hematocrit and hemoglobin concentration decreased slightly throughout the pregnancy. The elevation in the plasma [ADO] correlated inversely with the platelet count (r = -0.43, p < 0.05). These results suggest that an increase in the plasma [ADO] in the third trimester may be attributed to the enhanced adenosine release from activated platelets.

[Diagnostic accuracy of carotid ultrasonography in screening for coronary artery disease]

OBJECTIVES

This study investigated the diagnostic accuracy of carotid ultrasonography in screening for significant coronary artery disease (% diameter stenosis > or = 75%).

METHODS

Five hundred sixty patients (342 males, 218 females, mean age 66.4 years) underwent both coronary angiography and carotid ultrasonography. Gensini's coronary score was calculated as a quantitative parameter of coronary atherosclerosis. The most hypertrophic intimal-medial complex thickness (IMT) of the bilateral common carotid arteries (distal and proximal to the echo probe in each artery) was measured within 2 or 3 cm from the carotid bifurcation. The mean IMT (mean of these 4 sites), the maximum IMT (maximum of these 4 sites), and number of plaques (localized hypertrophy of IMT > or = 1.1 mm) were calculated as a quantitative parameter of carotid atherosclerosis.

RESULTS

The screening parameters were determined as 0.85 mm mean IMT, 1.1 mm maximum IMT, and at least 2 sites of plaque. The sensitivity, specificity and accuracy rate for the detection of coronary artery disease were 57.3%, 61.6% and 59.6% for mean IMT, 43.5%, 71.1% and 58.6% for maximum IMT, and 60.8%, 70.5% and 66.1% for number of plaques. Furthermore, the overall results (except maximum IMT) were 73.3%, 49.2% and 60.2%.

CONCLUSIONS

These results suggest that carotid ultrasonography is useful as a non-invasive and easy screening method for coronary artery disease. Furthermore, carotid ultrasonography will allow routine observations to follow the progression of coronary atherosclerosis.

Small bowel obstruction in early pregnancy treated by jejunotomy and total parenteral nutrition

BACKGROUND

Small bowel obstruction in early pregnancy increases maternal and fetal morbidity and mortality and might be diagnosed mistakenly as hyperemesis gravidrum. Prompt diagnosis and therapy is essential.

CASE

A 29-year-old primigravida was admitted at 13 weeks' gestation with small bowel obstruction. After jejunotomy, total parenteral nutrition was given until oral intake was resumed completely 1 month after surgery. She was discharged with no complications and the rest of her pregnancy and delivery were uneventful.

CONCLUSION

Small bowel obstruction in early pregnancy should be diagnosed expeditiously and can be treated with jejunotomy and total parenteral nutrition.

Plasma adenosine levels increase in women with normal pregnancies

OBJECTIVE

The aim of this study was to investigate plasma adenosine levels during normal pregnancy and to evaluate the possible roles of platelet activation and 5'-nucleotidase as causes of changes in adenosine levels.

STUDY DESIGN

We measured plasma adenosine levels, the platelet activation markers beta-thromboglobulin and platelet factor 4, and 5'-nucleotidase activity, which catalyzes dephosphorylation from adenosine monophosphate to adenosine, in 34 nonpregnant women and 34 women with normal pregnancies in the third trimester.

RESULTS

The mean plasma adenosine level in pregnant women was 0.59 +/- 0.08 micromol/L (mean +/- SEM), which was significantly higher than that found in nonpregnant women (0.18 +/- 0.04 micromol/L; P <.01). In pregnant women plasma beta-thromboglobulin levels, platelet factor 4 levels, and 5'-nucleotidase activity were significantly higher than in nonpregnant women (P <.05).

CONCLUSION

The increase of plasma adenosine may be attributed at least in part to platelet activation and an increase of 5'-nucleotidase activity during normal pregnancy. This increase may be an endogenous compensatory mechanism that diminishes platelet activation and maintains vessel integrity during normal pregnancy.

B-cell-type malignant lymphoma with placental involvement

We present here a case of B-cell-type mediastinal malignant lymphoma during pregnancy complicated by placental involvement. In this case, some nodular high-echo patterns were recognized in the placenta by ultrasonography. A cesarean section and resection of the mediastinal tumor were performed at 33 weeks and 6 days of gestation due to the deterioration of the dyspnea. A female infant weighing 1,868 g was delivered and she is now a healthy 2-year-old. The mother, however, died of the disease 1 month after surgery, due to progression of the tumor. The placenta showed numerous white firm nodules varying from 3 mm to 3 cm in diameter. The pathologic findings of both the mediastinal tumor and the placenta indicated primary mediastinal (thymic) B-cell lymphoma.

Prenatal diagnosis of succenturiate lobe by ultrasonography and color Doppler imaging

At 16 weeks' gestation, ultrasonography demonstrated a band-like structure in the amniotic cavity of a 27-year-old woman. Color Doppler imaging revealed blood flow in this band-like structure and a diagnosis of a placenta with succenturiate lobe rather than an amniotic band was made.

Clinical trial of induction of labor versus expectant management in twin pregnancy

OBJECTIVE

The appropriate date of delivery in twin pregnancies is supposed to be earlier than that in singleton pregnancy. The aim of this study was to compare two strategies for managing twin pregnancies (i.e., immediate induction and expectant management).

METHODS

Seventeen patients underwent immediately induced labor by administration of oral prostaglandin E(2) at 37 weeks, while 19 patients underwent expectant management.

RESULTS

The average gestational age at delivery in the induction group was 37.5 +/- 0.4 weeks, significantly earlier than that in the expectant management group (39.0 +/- 1.1 weeks). However, there were no significant differences in the average birth weight between the two groups (2, 700 +/- 330 g in the induction group vs. 2,672 +/- 392 g in the expectant management group). The cesarean delivery rate in the induction group was 18%, not significantly different from that in the expectant management group (32%). The most common indication for cesarean section in the expectant management group was maternal infection, while there was no maternal infection in the induction group (p = 0.08).

CONCLUSION

It may be acceptable do intervene in twin pregnancies earlier than in singleton pregnancies during term.

Fetal middle cerebral artery Doppler waveforms in twin-twin transfusion syndrome

The aim of this study was to compare the fetal middle cerebral artery (MCA) Doppler waveforms in growth-retarded twin fetuses with (n = 11) and without (n = 24) twin-twin transfusion syndrome (TTTS). Umbilical artery (UA) and fetal MCA Doppler velocity waveforms were recorded on admission. The mean values of the UA pulsatility index (PI) of smaller twin fetuses with and without TTTS were significantly higher than those of normal singleton pregnancies. The mean values of the MCA PI of smaller twin fetuses in the TTTS group (+0.7 +/- 1 SD) were significantly higher than those of normal singleton pregnancies on admission, and these levels did not markedly change following amniocentesis. On the other hand, the values of the MCA of the growth-retarded fetuses without TTTS (-0.9 +/- 1 SD) were significantly lower than those of normal singleton pregnancies. Our findings suggest that measurement of fetal MCA PI is a useful method to assess growth-retarded fetuses in monochorionic twin pregnancies.

Conservative management of a case of placenta praevia percreta

Pregnancies complicated by placenta praevia and a history of caesarean section are associated with increased risk of placenta percreta (1). Placenta praevia percreta sometimes involves the bladder or other pelvic organ, invasion leading to genital bleeding or haematuria (2, 3). Bladder injury or uncontrollable profuse haemorrhage occasionally occurs in such patients during surgery. Examination of placental invasion is necessary as this clinical condition is severe. Treatment of placental myometrium invasion is required to prevent uncontrollable profuse haemorrhage during surgery. We present a multiparous patient who was diagnosed prenatally with placenta praevia percreta using magnetic resonance imaging (MRI) and who was treated conservatively with a good prognosis.

Prediction of oligohydramnios in prolonged pregnancy

A decrease in amniotic fluid in prolonged pregnancy is associated with increased fetal morbidity. However, few investigations have been reported on the prediction of this condition. Fetal renal arterial pulsatility index (PI), hourly fetal urine production rate (HFUPR) and amniotic fluid index (AFI) at 39 weeks were studied in 51 singleton pregnancies with (n = 14) and without oligohydramnios (AFI < 5, n = 37) in prolonged pregnancy. There was no difference in the average fetal renal arterial PI and HFUPR between the oligohydramnios group and the normal group. However, the average AFI in the oligohydramnios group was 7.5 +/- 0.9, which was lower than that in the normal group (p < 0.05). We speculated that AFI value at 39 weeks is useful for predicting the incidence of oligohydramnios in prolonged pregnancy.

Fetal brain death and Dandy-Walker malformation

The diagnosis of brain death by Doppler ultrasonography and magnetic resonance imaging is reported in a fetus at 23 weeks' gestation. This is believed to be the first instance in which brain death has been shown in a premature fetus with a brain-stem anomaly.

Sonographic evaluation of umbilical cord insertion with umbilical coiling index

PURPOSE

The aim of this study was to investigate the association between umbilical cord hypocoiling and abnormal placental insertion of the umbilical cord.

METHODS

Umbilical coiling was measured by sonography in 253 pregnant women in their second or third trimester. An umbilical coiling index, defined here as the reciprocal of the length of 1 umbilical vascular coil, of less than 0.1 was considered hypocoiled. The distance from the placental edge to the insertion of the umbilical cord was measured after delivery, and the results were used to classify cord insertion as normal, marginal, or velamentous.

RESULTS

Cord insertion was abnormal in 66.7% of the fetuses with umbilical hypocoiling but in only 1.3% of those whose coiling index was > or = 0.1 (p < 0.05).

CONCLUSIONS

Hypocoiling of the umbilical cord was highly associated with abnormal cord insertion. The presence of a hypocoiled umbilical cord may indicate the presence of abnormal cord insertion and thus may be useful for obstetric management.

Rheological Behavior of Suspensions Flocculated by Weak Bridging of Polymer Coils

A polymer coil with weak affinity for the solid surface makes a flexible bridge between particles by reversible adsorption. When the coil size is comparable to particle diameter in solution, the suspensions flocculated by reversible bridging show shear-thickening flow in a narrow range of shear rates. The force generated by the rapid extension of bridges within the lifetime is responsible for the shear thickening. Although it is expected that the bridges become more flexible with increasing coil size, the polymers with high molecular weights do not necessarily give rise to shear thickening. The striking shear thickening is induced by polymers with molecular weights, Mw, of 2.5 x 10(5) and 4.5 x 10(5). The viscosity enhancement in the shear-thickening region is considerably suppressed for polymers with Mw = 7.5 x 10(5). From the sedimentation experiments, a large portion of the segments of a coil with Mw = 7.5 x 10(5) is adsorbed in train on the particle surface. The addition of small amounts of surfactant leads to an increase in the fraction of loops at the expense of trains and the bridges become more flexible. As a result, the flow of suspensions in the presence of surfactant becomes shear thickening. The rheology of suspensions flocculated by reversible bridging can be modified by a balance between loop and train fractions in a bridge. Copyright 1999 Academic Press.

Cephaloceles and abnormal venous drainage

Seven cases of parietal cephalocele and three cases of occipital cephalocele associated with abnormal venous drainage were evaluated, and the mechanism of the development for venous system was discussed from the embryological viewpoint. In parietal cephaloceles the abnormally draining vein, which corresponds to the straight sinus, ascended along the interhemisphere apart from the tentorium and emptied into the superior sagittal sinus below the cephalocele. The superior sagittal sinus formed the confluence, which was positioned high up. Intraoperative findings revealed that cephalocele penetrated the superior sagittal sinus at the midline. In the case of occipital cephalocele, the straight sinus followed a postero-superior course, to drain into the confluence just above the neck of cephalocele. The results of our study suggest that the causation of abnormal venous drainage in the great vein of Galen, the straight sinus and the superior sagittal sinus may be secondary, through interaction with a developmentally pre-existing cephalocele.

Iatrogenic monoamniotic twin gestation with progressive twin-twin transfusion syndrome

OBJECTIVE

Intentional puncture of the membrane has been reported to be a promising new method for the management of twin-twin transfusion syndrome.

CASE REPORT

Treatment of twin-twin transfusion syndrome with serial amniocenteses resulted in unintentional puncture of the dividing membrane at 24 weeks of gestation. Fetal growth discordance increased, and twin-twin transfusion did not improve following the puncture. Intrauterine death of both fetuses at 27 weeks of gestation occurred.

CONCLUSION

Amniotic septostomy for the treatment of twin-twin transfusion syndrome should be performed with serious consideration.

Effects of soybean oil emulsion and eicosapentaenoic acid on stress response and immune function after a severely stressful operation

OBJECTIVE

To investigate the effects of soybean oil emulsion and oral or enteral administration of eicosapentaenoic acid (EPA) on stress response, cytokine production, protein metabolism, and immune function after surgery for esophageal cancer.

SUMMARY BACKGROUND DATA

It has been reported that safflower oil, rich in n-6 polyunsaturated fatty acid (n-6 PUFA), affects the survival rate of septic animals and decreases the immune function. It has also been reported that the administration of fish oil, in contrast, reduces these stress responses and stress-induced immunosuppression. In humans, the effects of soybean oil emulsion and the administration of EPA on stress response and immune function after surgery have not been established.

METHODS

Patients who underwent esophagectomy with thoracotomy were divided into three groups. Seven patients were fed by total parenteral nutrition (TPN) with soybean oil emulsion, which accounted for 20% of total calories. Seven patients were given oral or enteral administration of 1.8 g/day EPA, in addition to TPN with soybean oil emulsion. Nine patients served as the control group; these patients received fat-free TPN. Serum interleukin-6 (IL-6), C-reactive protein, concanavalin A (con A)- or phytohemagglutinin (PHA)-stimulated lymphocyte proliferation, natural killer cell activity, and stress hormones were measured.

RESULTS

The postoperative level of serum IL-6 was significantly higher in the group receiving soybean oil emulsion than in the fat-free group. Oral or enteral supplementation of EPA with soybean oil emulsion significantly reduced the level of serum IL-6 compared with the patients receiving soybean oil emulsion. Con A- or PHA-stimulated lymphocyte proliferation decreased significantly on postoperative day 7 in all groups of patients. The supplementation of EPA with soybean oil emulsion significantly improved the lymphocyte proliferation and natural killer cell activity on postoperative day 21 compared with the group receiving soybean oil emulsion.

CONCLUSIONS

Soybean oil emulsion amplifies, and the supplementation of EPA reduces, the stress response and stress-induced immunosuppression.

Effect of intravenous omega-6 and omega-3 fat emulsions on nitrogen retention and protein kinetics in burned rats

The effect of omega-3 fat emulsion on nitrogen retention and kinetics in relation to fatty acid profile were investigated in burned rats receiving total parenteral nutrition (TPN). A fat emulsion of a structured symmetrical triacylglycerol containing only eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (2:1) was prepared. Sprague-Dawley rats were fed by fat-free chow for 2 wk. Then rats were fed exclusively with one of three types of TPN for 7 d. Animals in group C received fat-free TPN (n = 11). Group omega 6 received safflower oil fat emulsion, which accounted for 20% of total caloric intake (n = 11). Group omega 3 received fat emulsion containing only EPA and DHA (1% of total calories, n = 11), in addition to safflower oil emulsion (19% of total calories). On day 5, each rat was subjected to 20% full-thickness scald burns. Rats were sacrificed under ether anesthesia 48 h after burning. The rats in group C became deficient in omega-6 essential fatty acids. Cumulative nitrogen balance was decreased significantly in group omega 6. The rates of whole-body protein synthesis were increased significantly in both groups omega 6 and omega 3. In omega 6, however, the rates of whole-body protein breakdown were increased significantly. In conclusion, the rates of whole-body protein breakdown increased and nitrogen retention was aggravated significantly in animals administered the safflower oil emulsion. Significant increases of urinary excretion of total catecholamine were also observed. Prostaglandin E2 and thromboxane B2 concentrations were not significantly different among three groups. Supplementation with the new omega-3 fat emulsion, however, improved protein metabolism in burned rats receiving TPN.

Effects of intravenous omega-3 and omega-6 fat emulsion on cytokine production and delayed type hypersensitivity in burned rats receiving total parenteral nutrition

BACKGROUND

The effects of fat emulsions containing omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) on fatty acid profile, cytokine production, and delayed type hypersensitivity (DTH) in burned rats receiving total parenteral nutrition (TPN) were investigated.

METHODS

A fat emulsion containing only eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) was prepared (omega-3 fat emulsion). Sprague-Dawley rats were fed fat-free chow for 2 weeks and were divided into three groups according to the contents of TPN. Groups C (n = 11) and C' (n = 14) received fat-free TPN. Group omega6 received safflower oil emulsion containing linoleic acid (omega-6 PUFA) (n = 11). Group omega3 (n = 11) received safflower oil emulsion (19% of total caloric intake) and fat emulsion containing only EPA and DHA (1% of total calories). On day 5, all rats except for those in group C' were subjected to a 20% full-thickness burn. Group C' did not receive burns. After 48 hours, the rats were killed.

RESULTS

The interleukin (IL)-8 concentration was significantly 45% lower in group omega3 than in group C (p < .05). The IL-10 concentration was significantly 15% lower in group omega3 than in group omega6 (p < .05). The IL-6 concentration was increased in group omega6 but not in group omega3 when compared with group C. The IL-6 and IL-8 were not detected in group C'. Prostaglandin E2 (PGE2) and thromboxane B2 (TXB2) concentrations were increased by burn injury, but there were no significant differences among the burned groups. Cell-mediated immunity was thus significantly decreased in burned groups (groups C, omega6, and omega3; p < .01). However, the decrease of DTH was smaller in group omega3 and significantly greater when compared with groups C and omega6 (p < .05).

CONCLUSIONS

omega-6 PUFAs increased serum inflammatory cytokine levels in a stressed state. omega-3 fat emulsion reduced IL-8 and IL-10 levels and prevented immunosuppression in burned rats that were receiving TPN.

Evidence for mechanisms of the acute-phase response to endotoxin in late-gestation fetal goats

OBJECTIVE

The aim of this study was to evaluate the relationship between febrile response to fetal endotoxin administration and fetal plasma endogenous pyrogen, tumor necrosis factor-alpha, the possible putative pyrogen mediator prostaglandin E2, and the endogenous antipyretic arginine vasopressin in late-gestation pregnant goats.

STUDY DESIGN

Changes in fetal core temperature, plasma tumor necrosis factor-alpha, prostaglandin E2, and arginine vasopressin levels were measured after administration of Escherichia coli endotoxin (70 microg/kg of fetal weight) to 10 fetal goats in late gestation.

RESULTS

Fetal body temperature did not rise after endotoxin administration. Fetal plasma tumor necrosis factor-alpha and arginine vasopressin increased to 87.5 +/- 15.2 pg/mL and 25.1 +/- 4.8 pg/mL, respectively, after 1 to 2 hours (P < .05). Fetal plasma prostaglandin E2 levels did not change significantly throughout the study.

CONCLUSION

The absence of a febrile response to endotoxin in late-gestation fetal goats is accompanied by a deficient responses in prostaglandin generation in the periphery and increased activity of the antipyrogen arginine vasopressin.

Effect of Adsorption Affinity of Polymers on the Viscosity Behavior of Suspensions

The viscosity behavior of suspensions flocculated by bridging was examined as a function of adsorption affinity of polymers for the particle surface. The polymer chains having strong affinity form fragile bridges between particles as a result of irreversible adsorption. Because the flocs are broken down on the application of shear fields, the flow is shear-thinning. The decrease in the adsorption affinity by the addition of small amounts of surfactant causes the reversible adsorption. The suspensions flocculated by reversible bridging are Newtonian at low shear rates because the polymer bridges are forming and breaking in a quiescent state. When the coil size is comparable to the particle diameter, the suspensions show shear-thickening flow in high shear fields. The shear thickening is induced by the elastic effects of extended bridges. The flow profiles of suspensions flocculated by polymer bridging are controlled by changing the adsorption affinity of polymers. Copyright 1998 Academic Press.

Fetal plasma hypoxanthine level in growth-retarded fetuses before labor

Hypoxanthine is one of the purine nucleotides and is presumed to accumulate during hypoxia and acidemia. It remains uncertain, however, whether plasma hypoxanthine concentration is a useful indicator of fetal asphyxia; and its relationship to other markers of fetal physiologic state is not clearly defined. The aim of this study was to evaluate whether the level of fetal plasma hypoxanthine is correlated with fetal hypoxia and acidosis in growth-retarded fetuses before the onset of labor. Cordocentesis was performed in 34 growth-retarded fetuses at 31-35 weeks' gestation for the measurement of umbilical venous plasma concentrations of hypoxanthine, hemoglobin and lactate concentrations, blood gases, and base deficit. Umbilical venous plasma hypoxanthine concentration was found to be increased significantly, in parallel with the degree of acidosis (r = -0.74, P < 0.05) and base deficit (r = -0.41, P < 0.05), but not to bear a significant relationship to the degree of hypoxemia or other measured variables. We conclude that increases in the plasma concentration of hypoxanthine may reflect an impaired physiological state in growth-retarded fetuses before labor.

Intracerebral monoamine concentration after ventriculoperitoneal shunting in the congenital hydrocephalus rat

This study investigated the relationship between neurotransmitters and improvement of symptoms after ventriculoperitoneal shunting in congenital hydrocephalus (LEW-HYR) rats. Twenty-four patent hydrocephalus rats, aged 12-14 days, were randomly assigned to the following four groups: ventriculoperitoneal shunt group, obstructed shunt group, burr hole group, and no treatment group. In addition, six normal rats served as control group. Head to body length ratio was measured before and 7 days after the procedures. Coordination movement was evaluated on the 7th postoperative day. High performance liquid chromatography (HPLC) was used to measure the concentrations of dopamine (DA), norepinephrine (NE), serotonin, homovanillic acid (HVA), 3-methoxyl-4-hydroxyphenylenglycol, 5-hydroxy-indolacetic acid (5-HIAA), and 3,4-dihydroxyphenylacetic acid in the whole cerebral cortex, the thalamus and hypothalamus, the midbrain, the lower brainstem, the cerebellum, and the striatum. Fluorohistochemical studies were also performed. Significant improvements were observed in body proportion and coordination movement in the ventriculoperitoneal shunt group compared to the burr hole group and the no treatment group. HPLC and fluorohistochemical studies revealed that concentrations of NE in the thalamus and hypothalamus and DA in the striatum were significantly lower in the burr hole group and the no treatment group. Concentrations of HVA and 5-HIAA in the cerebellum were significantly lower in the control group. The present study indicates that ventriculoperitoneal shunting may improve the changes in concentrations of neurotransmitter in specific neurons caused by hydrocephalus, and this may contribute to the improvement of the symptoms.

Effects of insulin-like growth factor-1 on endotoxin translocation in burned rats receiving total parenteral nutrition

The purpose of this study was to investigate the effect of insulin-like growth factor-1 (IGF-1) on the translocation of endotoxin from the gut of burned rats. Twenty-eight male Sprague-Dawley rats (7-wk-old) were subjected to 20% full-thickness scald burns and were divided into two groups. One group received 4 mg.kg-1.d-1 of IGF-1 (IGF-1 group, n = 14), and the other received saline (control group, n = 13). All rats were fed exclusively by total parenteral nutrition (TPN). On the second postburn day, rats were killed. The amount of endotoxin in the liver and spleen were measured. RNA from the terminal ileum was extracted, and Northern blot analyses of alpha-tubulin, beta-actin, cell division cycle-2 (cdc2), and immunoglobulin-A (IgA) were performed. Nitrogen balance was improved (p < 0.001), and the wet weight of intestine and its mucosa were increased significantly in the burned rats that received IGF-1. Gene expression of alpha-tubulin and beta-actin were not changed. Cdc2 was elevated (P < 0.05), but IgA was decreased (P < 0.05) in the IGF-1 group. Levels of endotoxin in the liver and spleen were significantly reduced (P<0.05) by the administration of IGF-1. A negative correlation between the levels of endotoxin in the liver and the weight of the intestinal mucosa was observed. In conclusion, IGF-1 improved nitrogen balance, promoted the proliferation of intestinal mucosa and reduced the translocation of endotoxin.

Effect of Electrode Pattern on the Column Structure and Yield Stress of Electrorheological Fluids

For electrorheological (ER) suspensions, the aggregate structures of particles were observed in electric fields by the use of transparent cells with different electrode patterns. Although the suspension is dispersed to noninteracting particles without electric fields, many aggregates are formed on the electrode surface in electric fields. Since the dipole-dipole interactions cause chain structures of particles and equilibrium conformations of chains are always aligned with electric field, the aggregates indicate the presence of columns spanning the electrode gap. The particle concentration in columns which are developed between parallel-plate electrodes is about 22 vol %. In striped electrodes, the particles construct striped aggregates along the electrodes and no particles remain in the insulating region. The particle concentration in striped aggregates is about 35 vol %. The nonuniformity of electric field is responsible for the high particle concentration. The increase in particle concentration of column lead to the high yield stress of electrified suspension. Therefore, the ER performance of suspension as an overall response can be improved by the electrode design.

Surgical management of cervicomedullary compression in achondroplasia

Achondroplasia is often associated with cervicomedullary dysfunction. MRI sagittal imaging was performed to determine whether surgical intervention was necessary to relieve cervicomedullary compression. Cervicomedullary compression was classified into severe and mild types based on the ratios of the brain stem diameter at the foramen magnum, the site of the most severe stenosis to the diameter at the pontomedullary junction and C3 level, where it is normal. This classification was found to be closely correlated with the severity of clinical symptoms and important in determining whether surgical intervention is necessary. Moreover, since the incidence of sudden death is high in patients aged 4 years or younger with achondroplasia, surgical intervention should be considered in all such patients if cervicomedullary compression is present.

Optical Properties of Nonaqueous Suspensions in Electric Fields

The optical properties of suspensions consisting of pigmented shell/polymer core composite particles dispersed in a silicone oil were studied in electric fields. In the absence of electric fields, the transmittance shows an exponential decay with sample thickness and particle concentration. The particles may be randomly dispersed in the medium. The application of electric field leads to an increase in the transmittance of suspensions. The clearing effect is very striking, especially for concentrated suspensions in a thick cell. In electric fields, the transmittance is almost independent of thickness in the range 0.15-1.1 mm and linearly decreases with increasing particle concentration. Microscopic observation shows that many discrete clusters are formed in electric fields. Based on the analysis of dipole-dipole interactions, the clusters may be composed of fully developed chains spanning the electrodes. Since the columns are aligned in the direction parallel to the optical path, the transmittance is not affected by the cell thickness. In addition, because of the increase in the cross section of the column, the transmittance shows a linear dependence on the particle concentration. The optical properties of suspensions can be explained by the column formation of particles in electric fields.

Possible inhibitory effect of lithium on peripheral conversion of thyroxine to triiodothyronine: a prospective study

The effect of lithium on thyroid function was studied in 18 neuroleptic-treated male chronic schizophrenic in-patients. Lithium carbonate was administered for 8 weeks at a dosage giving a mean serum level of 0.79 mmol/l. Blood was obtained just before and after 8 weeks of lithium administration to determine the serum free thyroxine (free T4) levels, free triiodothyronine (free T3) levels and thyrotropin (TSH) levels. Overall, free T4 and TSH levels significantly increased whereas free T3 levels did not change. Two (11%) patients had abnormally increased free T4 levels and abnormally decreased free T3 levels after 8 weeks of lithium administration. These findings suggest that lithium may inhibit the peripheral conversion of free T4 to free T3 in some susceptible patients.

A further prospective evaluation of an equation to predict daily lithium dose

BACKGROUND

Recently, one prospective study confirmed the safety and accuracy of a lithium-dose prediction equation created by Zetin et al., but no definitive conclusion on the reliability of the equation has been established as yet.

METHOD

The authors applied the Zetin et al. equation to 18 chronic male schizophrenic inpatients. Predicted doses to reach the serum lithium concentration of 0.4 mmol/L were calculated and prescribed in the form of lithium capsules. At Weeks 1 and 3 after treatment initiation, morning blood samples were collected about 12 hours after the last lithium dose for the measurement of serum lithium concentrations.

RESULTS

None of the 18 patients achieved the desired concentration (0.4 mmol/L) exactly. The mean +/- SD of serum lithium concentrations at Week 1 was 1.01 +/- 0.29 mmol/L (range, 0.2-1.5) and at Week 3 was 0.94 +/- 0.35 mmol/L (range, 0.2-1.8). Lithium concentrations were lower than 0.4 mmol/L in only 1 patient and were higher than 0.4 mmol/L in the other 17 patients. The deviations from the unexpected value were significantly correlated with the renal function (blood urea nitrogen and serum creatinine levels) but not with the neuroleptic doses administered to the patients. Moreover, our patients were relatively older and weighed relatively less than the patients described in the previous prospective study.

CONCLUSION

The Zetin et al. equation cannot always accurately predict a required lithium dose. Renal function data, even when they range within normal values, may be useful to improve the accuracy of the equation, particularly in patients who are older or weigh less than the norm.

Universal on-line detector for high-performance liquid chromatography via magneto-optical rotation

Detecting changes in magneto-optical rotation is useful as a universal on-line detector for high-performance liquid chromatography. Such apparatus is similar to a polarimeter except for the external magnetic field on a flow cell. Two modulation modes suitable for the magneto-optical rotation detector are discussed. Use of a semiconductor laser provides better sensitivity than a He-Ne laser. The detection limit is 0.006% (w/w) for polyethylene glycol 20000 in a 20-mul injection.

Ultrastructural changes of epithelium-connective tissue junction in experimental lingual tumors

In this study, plaque-like lesions, epithelial hyperplasias, and papillary invasive carcinomas were produced in the tongues of hamsters by the application of DMBA combined with trauma for 16 weeks. The junction between the neoplastic epithelial cells and the connective tissue was studied ultrastructurally. In plaque-like lesions, the basal lamina was partially decreased in both thickness and density or partially discontinuous. In epithelial hyperplasias, cytoplasmic projections were observed in the portion of the basal cell near the intercellular space, and the basal lamina was absent around these cytoplasmic projections. In papillary invasive carcinomas, however, numerous cytoplasmic projections extended from various portions of the basal surface of the basal cells into the underlying connective tissue. The basal lamina was also absent around these projections. In epithelial hyperplasias and papillary invasive carcinomas, some of the cytoplasmic projections appeared almost empty, some contained a small number of tonofilaments and ribosomes, and others were filled with a large number of ribosomes but did not contain the tonofilaments. The collagen fibrils were markedly reduced in number in the area around cytoplasmic projections. The cytoplasm of some fibroblasts in that area contained many intracellular collagen fibrils.