A Rare Primary Osteogenic Sarcoma of the Prostate and Bladder

Mesenchymal tumors of the genitourinary tract account for 5% percent of bladder malignancies and there are currently 35 documented cases of osteosarcoma type. Concomitant involvement of the prostate in mesenchymal genitourinary malignancies is even rarer. Herein we describe a case of a 72-year-old male with a history of radiation for prostate cancer who develops hematuria. A hematuria evaluation revealed osteosarcoma of the bladder and prostate. He underwent radical cystoprostatectomy with ileal conduit and adjuvant chemotherapy. His disease progressed despite treatment and he elected palliative care 10 months after initial resection. This case reviews a rare histological variant of genitourinary malignancy.

Primary Malignant Melanoma of the Urinary Bladder

There are only 30 reported cases of primary malignant melanoma of the bladder in the literature so far. Of those, 17 cases were reported as deceased within three years of presentation. Our case reported here is that of a 78-year-old female who presented with a new-onset incontinence and intermittent hematuria. She had no evidence of primary melanoma anywhere else in her body. The patient was treated with cystectomy and ileal conduit with plans for adjuvant chemotherapy. Unfortunately, the patient succumbed to her disease with diffuse metastatic involvement within 16 months of presentation.

Montney Fracturing-Fluid Considerations

The Montney gas reservoir has become a critically important component of current western Canadian gas supply and offers exciting future potential. However, this reservoir often presents variable and unique stimulation challenges. Unlike reservoirs that display little water sensitivity, such as the U.S. Barnett Shale and possibly the Muskwa in the Northeastern British Columbia Horn River Basin, recovery of water-based fluids in the Montney can be a key consideration in achieving economic production rates.

The use of water-based fracturing fluids in low-permeability reservoirs can result in loss of effective frac half-length caused by phase trapping associated with the retention of the introduced water-based fluid to the formation. This problem is increased by the water-wet nature of most tight-gas reservoirs (where no initial liquid-hydrocarbon saturation is or ever has been present) because of the strong spreading coefficient of water in such a situation.

The retention of increased water saturation (Sw) in the pore system after the injection of water-based completion fluids can restrict the flow of produced gaseous hydrocarbons, such as methane. Capillary pressures of 10 MPa-20 MPa, or much higher, can be present in low-permeability formations at low-water saturation levels. Inability to generate sufficient capillary-drawdown force using the natural reservoir-drawdown pressure can result in extended fluid-recovery times or permanent loss of effective fracture half-length. Furthermore, use of water in subnormally saturated reservoirs, where much of the connate water has been removed by long-term evaporation effects associated with gas migration, might also reduce permeability and associated gas flow through a permanent increase in Sw of the reservoir. Secondary costs, such as rig time for swabbing, can add to the negative economic impact.

The Montney is found to be a dry-gas reservoir in some areas, transitioning to an oil reservoir in other areas. Because of this, it would not be surprising to encounter retrograde condensate production through transition areas. In such a case, if sufficient drawdown pressure is applied to reduce reservoir pressure below the dewpoint, liquid hydrocarbons might condense from the produced gas phase, resulting in two-phase flow and potential trapping of the hydrocarbon liquid phase. Also, some areas of the upper Montney exhibit reservoir pressures in the 30 MPa range, whereas other areas exhibit lower pressures in the 17 MPa-21MPa range. The same drawdown on a lower-pressured reservoir could therefore result in condensate condensing from the gas phase, where it would not have in the higher-pressured reservoir. If a third aqueous fracturing fluid is introduced, three-phase flow might occur. The resulting reduced relative permeability to gas might drastically reduce production rates. Also, emulsion-formation potential exists, which could present an additional reduction in fluid flow and recovery.

Choice of fracturing fluid must be carefully determined for each area of the Montney, balancing economics with production. It is important to always keep in mind that key reservoir properties can vary dramatically in the Montney, as a function of both geographic location and depth.

This paper presents laboratory test results of regained methane permeability vs. drawdown pressure and contact time with Montney core under representative reservoir conditions. Water, foamed water and hydrocarbon-based fracturing fluid systems are evaluated.

The testing was funded by and arranged for by operators in preparation for actual fracturing treatments in two different fields. Core plugs, time and funding were limited; therefore, only tests deemed necessary for decision-making were run.  Limited repeat testing was therefore possible.

Alpha- and gamma-synuclein proteins are present in cerebrospinal fluid and are increased in aged subjects with neurodegenerative and vascular changes

BACKGROUND

Disease-specific biomarkers should reflect a fundamental feature of neuropathology and be validated in neuropathologically confirmed cases. Several synaptic proteins have been described in cerebrospinal fluid (CSF) of patients with dementia. In Lewy body disease alpha-synuclein is incorporated within Lewy bodies and alpha-, beta- and gamma-synucleins in dystrophic neuritis. These pathological changes are expected to be seen in CSF.

METHODS

A total of 25 CSF post-mortem samples (8 control and 17 subjects with dementia) were used to quantify alpha- and gamma-synucleins and IgG.

RESULTS

We describe for the first time the presence of gamma-synuclein in CSF. There is an elevation of both alpha- and gamma-synucleins in CSF from elderly individuals with Alzheimer's disease, Lewy body disease (LBD) and vascular dementia (CVD), compared to normal controls. gamma-Synuclein showed a greater elevation in LBD, IgG in CVD. The elevation of alpha- and gamma-synucleins was seen from Braak stage III onwards and remained stable until Braak stage VI. These results were not influenced by age at death or post-mortem delay.

CONCLUSIONS

The reported increases in alpha- and gamma-synucleins and IgG in the ventricular CSF of individuals with dementia are novel findings. They now need to be explored further using a greater number of cases in each subgroup, using lumbar CSF samples to determine their applicability and relevance to a clinical diagnostic setting. It needs to be established whether using these markers may help to discriminate LBD from other types of neurodegenerative and vascular dementias.

Fatal injuries in adolescents

Injuries are a major cause of morbidity and mortality among adolescents. Adolescents routinely experiment with high-risk behaviors, increasing their risk of injury. Major modes of injury in adolescents include motor vehicle collisions, drowning, suicide and homicide. This article reviews the risk factors for fatal injuries in adolescents and discusses current prevention strategies. Previous research identifies many risk factors associated with adolescent injuries. Practitioners can help prevent teen injuries by screening all adolescent patients and identifying those at high risk of injury. Patients at high risk need preventive counseling and evaluation for possible referral to other services. Current strategies are useful in preventing many injuries; however, further research is needed to evaluate these strategies and to design new prevention programs.

Graduated driver licensing in Wisconsin: a new law for teens and parents

The final components of Wisconsin's graduated driver licensing (GDL) statute [Biennial state budget act 1999 Wisconsin Act 9] went into effect on September 1, 2000. The GDL system seeks to reduce the number of teen motor vehicle collisions and fatalities by gradually introducing young drivers to all driving situations, beginning with the easiest and progressing to the more difficult. The stages of licensing are defined by the degree of risk involved. When teen drivers demonstrate the ability to drive safely in a restricted setting with high levels of supervision, they "graduate" to the next licensing level with fewer restrictions. Numerous factors are associated with the high rate of teen motor vehicle crashes and fatalities. Such factors include driver inexperience and easy distractibility, alcohol use and lack of seat belt use. The GDL addresses all of these risk factors. This article reviews the injury prevention strategies incorporated in the GDL and outlines the basic components of Wisconsin's law.

Prognostic factors for time receiving workers' compensation benefits in a cohort of patients with low back pain

STUDY DESIGN

Prospective inception cohort study.

OBJECTIVE

To develop a prognostic model that predicts time receiving workers' compensation benefits for low back pain claimants.

SUMMARY OF BACKGROUND DATA

As the cost and difficulty of managing low back pain escalate, any predictor of outcome is advantageous.

METHODS

To obtain the outcome and predictor variables, patient data from two separate databases were linked: a clinical database and an administrative (Ontario workers' compensation) database. Claimants injured between January 1 and December 31, 1994, were included and observed for 1 year from the date of accident. The outcome variable was cumulative number of calendar days receiving benefits.

RESULTS

Multivariable Cox proportional hazards regression (forward stepwise) showed eight significant predictors; five were associated with increased time receiving benefits compared with their reference groups: 1) working in the construction industry, 2) older age, 3) lag time from injury to treatment, 4) pain referred into the leg, and 5) three or more positive Waddell nonorganic signs. Three predictors were associated with reduced time receiving benefits: 1) higher values of questionnaire score, 2) intermittent pain, and 3) a previous episode of back pain. A predictive score was calculated to categorize claimants as at high or low risk for chronicity. When an arbitrary cutoff point was set at the 75th percentile of predictive score, negative predictive value was 94%.

CONCLUSION

This research identified eight factors for time receiving workers' compensation benefits among claimants with low back pain. This model discriminates between high- and low-risk claimants. Few low-risk claimants continued to receive benefits for more than 3 months.

Intertester reliability of a low back pain classification system

STUDY DESIGN

This prospective study of intertester reliability examined pairs of therapists' ability to agree independently on a patient's low back pain diagnosis.

OBJECTIVE

To determine the intertester reliability of a low back pain classification system among experienced and novice clinicians.

BACKGROUND

Many of the disparate categorization schemes for patients with low back pain are purely nominal, assigning designations based on the presumptive source of the problem without providing any practical guide for rehabilitation. A useful classification scheme reliably groups patients into treatment-directing categories.

METHODS

The study included 204 patients with low back pain referred to 10 clinics across Canada. Paired physiotherapists performed separate physical examinations on each patient. Both examiners then completed a simple ballot choosing one of five pain patterns.

RESULTS

Agreement on patient classification by independent examiners was 78.9% (kappa = 0.61).

CONCLUSION

This clinically relevant and clearly defined pain pattern system uses key elements of the history and examination to classify patients with low back pain. The pattern provides a framework for initiating active rehabilitation strategy. Using this approach, clinicians agreed on the categorization of 78.9% of mechanical low back pain cases.

Spontaneous onset of back pain

OBJECTIVES

To assess the frequency with which patients attribute low back pain to spontaneous onset.

DESIGN

A consecutive sample of two distinct groups of patients seeking treatment for back pain: those without need to identify cause (study group, n = 4,689) and those required to report a specific event to qualify for benefits paid for by a third party (compensated group, n = 6,687).

SETTING

Active exercise-based back pain rehabilitation clinics.

SUMMARY OF BACKGROUND DATA

Research on the natural history of back pain has revealed frequent reports of spontaneous recovery, usually within 8-12 weeks after onset. There is little comparable literature pertaining to the report of spontaneous onset.

METHODS

Data were collected for two groups of consecutive patients who attended for initial assessments of their back pain at 16 Canadian Back Institute locations, between May 1, 1994 and February 28, 1995. Patient responses were collected using a standardized, professionally administered questionnaire.

RESULTS

In the group without need to identify cause, 66.7% of patients could not identify an event producing their symptoms. For those required to report a specific event, only 9.8% of patients failed to attribute cause. Multivariate logistic regression revealed that the required-to-report group was approximately 15 times more likely to report an event (odds ratio = 14.95; 95% confidence interval = 13.44, 16.65) than the study group; those pursuing litigation were more than 2.5 times more likely to report a causative event (odds ratio = 2.68; 95% confidence interval = 2.09, 3.49).

CONCLUSIONS

Back pain occurred spontaneously in approximately 67% of patients seeking treatment in the study group. The authors consider spontaneous onset to be part of the natural history of back pain for this group.

Continuous quality improvement techniques enhance HMO members' immunization rates

To have a positive impact on the immunization rate of the 4,000 newborn infants it covers each year, Blue Care Network of Southeast Michigan (BCNSEM), a 240,000-member health maintenance organization that is based on an independent provider association model, convened a continuous quality improvement team. One of the results of this initiative was the development and implementation of an immunization registry, which is used as an internal tracking and reminder system for its members and providers. In recognition of its efforts, BCNSEM recently earned a Celebrating Innovation award from the American Association of Health Plans.

The incidence of spinal surgery in Canada

OBJECTIVE

To estimate the incidence of spinal surgery in 5 Canadian provinces over a 12-month period.

DESIGN

Cumulative incidence study.

SETTING

Five provinces (63% of Canada's population).

PARTICIPANTS

All patients who underwent spinal surgery between July 1, 1992, and June 30, 1993, in British Columbia, Alberta, Ontario, New Brunswick and Newfoundland.

MAIN OUTCOME MEASURE

Overall spinal surgery rates per province and by age and sex.

RESULTS

In the 5 provinces over the allotted 12-month period, 12,329 spinal surgical procedures were performed. The overall rate of spinal surgery for the 5 provinces was 80 per 100,000 population. Ontario had the lowest rate of 61 per 100,000; British Columbia had the highest at 89 per 100,000. Men aged 40 to 49 years in Newfoundland had the highest overall rate at 210 per 100,000. Calculation of relative risks determined that Newfoundland's under-20 age groups for both sexes were almost 3 times as likely to undergo spinal surgery as the same age groups in Ontario (male relative risk = 2.73, female relative risk = 2.84). Males in British Columbia and Alberta had a statistically significant increased risk of surgery across all age groups except for those under 20 years old, and females in British Columbia showed a statistically significant increased risk of surgery across all age groups compared with those in Ontario. Males underwent 57.7% of all spine operations.

CONCLUSIONS

The incidence of spinal surgery is not uniform across Canada. Overall, the per capita rate is lower than in the United States. The explanation for this divergence remains unclear.

Outcomes of surgeons who have undergone spine surgery

The objective of this study was to examine the prevalence, characteristics, and outcomes of spine surgery among a membership of American orthopaedic surgeons with a particular interest in spine care [North American Spine Society (NASS)] and a general membership of Canadian orthopaedic surgeons [Canadian Orthopaedic Association (COA)]. A 25-item multiple choice questionnaire was developed and mailed to both memberships. The COA response rate was 45.9%; the NASS response rate was 45.8%. Of those who replied, 17.2% had undergone spinal surgery, and the results differed significantly between the COA at 12.9% and NASS at 21.9%. As a percentage of the total mailing, 7.7% had undergone spinal surgery. These results differed significantly between the COA at 5.9% and NASS at 9.7%. Although the surgery rate for NASS respondents was more than 1.5 times that of COA respondents, they had strikingly similar outcomes. They are a highly motivated, self-employed group who missed little work before and after having surgery.

The relationship between nonorganic signs and centralization of symptoms in the prediction of return to work for patients with low back pain

BACKGROUND AND PURPOSE

The purpose of this study was to assess the relationship between the nonorganic signs (Waddell scores) of patients with low back pain, their response to repetitive end-range lumbar spine test movements (centralization of symptoms), and the rate of return to work at a 6-month follow-up.

SUBJECTS

Patients were assessed at five locations of the Canadian Back Institute. A consecutive sample of 126 patients with low back pain, with or without referred leg pain, was selected and reviewed.

METHODS

Physical therapists assessed patients' responses to repetitive test movements (centralization), as described by McKenzie, and tested the patients for nonorganic signs (Waddell scores). Therapists completed a data sheet that classified patients as either those who centralize their symptoms or those who do not centralize their symptoms and recorded their Waddell scores. Although the patients were classified at assessment, they remained in treatment. All patients followed a structured Canadian Back Institute protocol of active exercise, regardless of centralization status or Waddell score.

RESULTS

The inability to centralize symptoms indicated a decreased likelihood of returning to work, regardless of the Waddell score. A high Waddell score predicted a poor chance of returning to work, regardless of the patients' ability to centralize symptoms.

CONCLUSION AND DISCUSSION

A high Waddell score appears to be the best predictor of outcome, as indicated by return to work.

Effect of high-amylose starch and oat bran on metabolic variables and bowel function in subjects with hypertriglyceridemia

We compared the effects of a diet in which approximately 25% of the carbohydrate was replaced by high-amylose starch with those of a similar diet high in oat bran or low-amylose starch in 23 hypertriglyceridemic subjects who were overweight mostly because of abdominal adiposity. Each diet was consumed for 4 wk in random order and in a crossover fashion. Overall, the diets were high in carbohydrate (> 55% of energy) and low in fat (< 30% of energy); the amount of resistant starch in the foods containing high-amylose starch was 17 g in women and 25 g in men. The metabolic effects of specific starches on plasma lipids, fasting and postprandial glucose and insulin profiles, and bowel function were assessed at the end of each intervention. Plasma triacylglycerols (triglycerides) were significantly lower after the oat bran diet than after the other two diets (P < 0.02). No other effects on fasting plasma lipids, glucose, or insulin were noted. However, when the high-amylose starch comprised 33% of the carbohydrate content in a test meal, there was a significant but biologically small reduction in the overall postprandial plasma insulin concentration by 17% relative to the low-amylose diet (P < 0.01). Both the oat bran and the high-amylose diet resulted in an increased frequency of bowel actions and lower fecal pH (P < 0.02) relative to the low-amylose diet. However, unlike the oat bran diet, the high-amylose diet increased short-chain fatty acid concentrations in fecal water by 32% (P < 0.001).

A test to measure lift capacity of physically impaired adults. Part 1--Development and reliability testing

STUDY DESIGN

Two laboratory studies and one field study evaluated the safety and test-retest reliability of a new test of lift capacity. The first two studies were conducted in a carefully controlled laboratory setting. The first study investigated the safety and intra-rater reliability of the EPIC Lift Capacity test protocol with healthy adult subjects. The second study assessed the safety and inter-rater reliability of the test with disabled subjects. The third study was conducted in the field with 65 evaluators and investigated the safety and intra-rater reliability of the test with healthy adult subjects.

OBJECTIVE

To assess the safety and reliability of a new test of lift capacity.

SUMMARY OF BACKGROUND DATA

A new test of lift capacity has been developed. Test development occurred within the context of ergonomic standards and guide-lines of the major professional associations and public agencies that govern test development in the United States.

METHODS

In study no. 1, 26 healthy subjects participated. In study no. 2, 14 disabled subjects participated. In study no. 3, 318 healthy subjects participated. After subjects underwent basic screening and warm-up, the EPIC Lift Capacity test was administered. One to 2 weeks later, the test was administered again. Correlations between the times of testing were calculated.

RESULTS

No subjects were injured. Hamstring soreness the next day that resolved without complication was reported by some healthy subjects. None of the disabled subjects reported new symptoms.

CONCLUSION

The safety and reliability of the EPIC Lift Capacity test was adequately demonstrated in a laboratory setting and across multiple field sites with evaluators who have varying types and degrees of professional preparation.

Guidelines for the identification of barriers to rehabilitation of back injuries

Not all patients with back pain recover within the expected natural recovery period. Addressing only the physical component and ignoring the psychosocial may lead to treatment failure. Recognition of typical circumstances that may become barriers to rehabilitation enhances the recovery process. Barriers to rehabilitation and questions to help determine their existence are discussed. Asking pertinent questions enables clinicians to identify those who may need redirection. This re-direction may reduce treatment time, resulting in cost savings for the third party payer and a reduction in health care dollars spent on rehabilitation. Most importantly, resolution of possible barriers and rapid recovery allows the patient to return to a normal lifestyle.

Provider, payor, and patient outcome expectations in back pain rehabilitation

Return to work is used routinely to define successful back pain treatment. This study examined how the patient and three professional groups defined success for each of five categories of patients: not sponsored and working, sponsored and working, sponsored on modified duty, sponsored and off work for less than 10 weeks, and sponsored and off work for more than 10 weeks. The groups sampled were treating staff (n = 98), referring physicians (n = 98), third-party sponsors (n = 133), and patients (n = 648) representing all five patient categories. Each group provided a priority ranking for six objectives of treatment: Return to Work, Pain Control, Functional Improvement, Increased Strength and Range of Movement, Positive Attitude Shift, and Acquired Knowledge. The results indicated that the work status of the patient had a significant effect on the ranking of objectives by the treating staff and third-party sponsors. Physicians and patients considered pain control most important regardless of the patient category. Success in back pain rehabilitation is defined by different criteria. The determination of successful outcome must consider the patient's circumstances and acknowledge the perspective of the individual who is defining success.

Implementing CQI: measuring levels of service quality at physiotherapy clinics

The purpose of this study was to provide a profile of patient perceptions of the service quality delivered by a back pain rehabilitation clinic. Data were gathered and analyzed at the clinic level in twelve different locations across Canada. Measurement techniques were based on validated survey methods and developed from a growing stream of social science research. Results provided clinic managers with a profile of perceived service quality in terms of three key aspects: administrative support, quality of therapy received, and satisfaction with the results. The results also provided each clinic with benchmarks so that on-going service quality measurements can be incorporated into a system of continuous quality improvement. This process can assist rehabilitation clinics (and other health care providers) in improving service as well as ultimately reducing the costs of providing treatments involving physiotherapy.

Effect of dietary lipids and endocrine changes on polyunsaturated fatty acids in phospholipids of pancreas and brown adipose tissue of obese and lean rats

Obese (fa/fa) rats fed on control diet have lower proportions of linoleic acid (18:2n-6) and/or arachidonic acid (20:4n6) in IBAT and pancreas phospholipids compared with lean (Fa/-) rats. Lower stearic acid (18:0) to oleic acid (18:1n-9) mean ratios in fa/fa compared with Fa/- suggest enhanced delta 9-desaturase activity in the former. 18:2/20:4 mean ratios in pancreas, but not IBAT, are indicative of a reduced delta 6-desaturase activity in fa/fa rats. Absolute amounts of phospholipids (mg/unit tissue wt) were 2-fold greater in IBAT of fa/fa compared with Fa/- rats, irrespective of their diet. This was reflected in greater absolute amounts of 18:2n-6 and 20:4n-6 only in HSO and HTO fa/fa groups, but not in the control group. Adrenalectomy (Adx) or T3 treatment also modified phospholipid fatty acid composition of IBAT and pancreas phospholipids in animals fed on the control diet with fa/fa rats more sensitive to endocrine induced changes. In fa/fa rats T3 treatment increased docosahexaenoic acid (22:6n-3) in IBAT of both phenotypes compared with the control, but this effect was evident only in fa/fa and not Fa/- pancreas. T3 treatment also increased docosapentaenoic acid (22:5n-3) in IBAT from, both phenotypes, but no 22:5n-3 was evident in the pancreatic tissue of these animals. ADX also increased 22:6n-3 in the IBAT of fa/fa (Fa/- values were less than 1%) but not in the pancreas of fa/fa or Fa/-. ADX modified the relative proportions of 18:0 to 18:1 and 18:2 to 20:4 in IBAT and pancreas of fa/fa in a way that indicated decreased delta 9-desaturase and increased delta 6-desaturase activities; these effects tended toward normal again in pancreas of fa/fa rats on corticosterone replacement (CST).

Effect of discharge recommendations on outcome

STUDY DESIGN

The incidence of two common discharge recommendations, return to work unrestricted (RTWU) and restricted (RTWR) suggested that most restrictions were applied on the basis of patients' subjective reports of pain or therapists' unfounded fears that return to full duty would result in physical harm.

OBJECTIVES

This prospective study compares the therapist's return to work recommendation to the patient's actual work status and analyzes the effect of that recommendation on outcome.

METHODS

There were 1438 consecutive patients reviewed by structured telephone interviews during the two halves of the study: the control group when pain was accepted as a reason for restriction and the study group when it was not.

SUMMARY OF BACKGROUND DATA

In the control group, 44% of the patients were recommended to RTWU; for the study group, 81% received this recommendation. Compliance was 84% for the control subjects and 78% for the study group.

RESULTS

The absolute number of patients who returned to unrestricted work doubled in the study group.

CONCLUSIONS

The probability of a successful return to normal duty increased with a recommendation of RTWU (P = 0.0001), whereas the probability of failure increased when restrictions were imposed (P = 0.0001).

The effect of the Persian Gulf Crisis on the psychiatric hospitalization of Navy children and adolescents

The effect of the Persian Gulf Crisis on Navy families was studied through admission rates of children to a private psychiatric hospital, marital status and diagnostic categories. During that time there was a statistical increase in admission of young boys under age twelve and all children from remarried families. Almost one-half of these patients were diagnosed with Dysthymia whereas this diagnosis was given only once during the time period before or after the crisis.

The role of inositol lipids in the activation of monocytes by interleukin-1 and bacterial endotoxin

The effect of interleukin-1 (IL-1) and bacterial endotoxin (lipopolysaccharide, LPS) on the activation of phosphoinositidase C (PIC) and on prostaglandin E2 release was studied in monocytes (M phi). Both IL-1 alpha and IL-1 beta increased the release of PGE2 in a concentration-dependent manner, with EC50s of 0.48 nM and 0.12 nM, respectively. Intact M phi were prelabelled with [3H]inositol and the formation of inositol phosphates (IPs) was estimated by ion exchange chromatography. PIC activity was estimated directly by measuring the conversion of [3H]phosphatidylinositol-4,5-bisphosphate to aqueous soluble radioactivity by M phi homogenates. IL-1 alpha (5.8 nM) increased the accumulation of IPs within 1-4 minutes and increases in IP3 and IP4 occurred before the increase in IP1+2 whereas LPS only increased the IPs level after at least 30 min. IL-1 alpha increased PIC activity in M phi homogenates within 15 min with an EC50 of 0.58 nM and IL-1 beta (0.1 nM) also increased activity. Neither IL-1 alpha nor IL-1 beta affected the PIC activity of membrane or cytosolic fractions. LPS decreased activity in all fractions. These data indicate that IL-1, but not LPS, can directly lead to an increased activity of PIC which may be involved in eicosanoid formation in M phi.

Concentrations of linoleic acid in adipose tissue differ with age in women but not men

Samples of adipose tissue, taken post-mortem from the anterior abdominal wall near the umbilicus, were obtained from road-accident victims in the Aberdeen area; subjects were of either sex with a wide age distribution (7-88 years). Similar samples were obtained from elderly females (mean age 77) who had died in Aberdeen Royal Infirmary from a variety of causes. Fatty acid compositions of samples were determined by capillary gas chromatography of methyl esters, which were obtained by direct esterification of the adipose tissue. The mean linoleic acid content for all samples was low compared with published values for similar samples from Europe and North America. Cumulative frequency distribution curves for linoleic acid did not differ with age in males but significant differences (P less than 0.001) occurred in females, with decreased concentrations in those aged over 60 compared to younger groups. Concentrations of trans-unsaturated fatty acids ranged between 2 and 7 per cent but did not differ significantly between groups. Low adipose concentrations of linoleic acid are regarded as a reflection of its reduced long-term dietary intake and as a risk factor for the development of coronary heart disease.

Regulation of polyunsaturated fatty acid metabolism in tissue phospholipids of obese (fa/fa) and lean (Fa/-) Zucker rats. 1. Effect of dietary lipids on cardiac tissue

The present investigation addressed three questions: (i) Does the obese syndrome alter the fatty acid composition of cardiac tissue and membrane phospholipids in obese (fa/fa) rats? (ii) Are changes, if they occur, similar to those reported for tissues of the genetically obese (ob/ob) mouse? (iii) Can cardiac tissue phospholipids and their component fatty acids be modified by dietary lipids and if so does this occur to the same extent in both fa/fa and lean (Fa/-) rats? Proportions of polyunsaturated fatty acids (PUFA) in cardiac total phospholipids of fa/fa rats differed significantly from those of Fa/- rats and from those reported for ob/ob mice. Increased 18:2n-6 and decreased 20:4n-6 and 22:6n-3 in fa/fa rats indicated impaired PUFA metabolism, possibly reduced delta 6 and/or delta 5 desaturase activity, compared with Fa/- rats. No differences in hepatic delta 6 and delta 5 desaturase activity between fa/fa and Fa/- were found but enhanced activity of delta 9 desaturase activity in fa/fa as compared to Fa/- was evident. Inclusion of sunflower oil (SO) or triolein (TO) at 5% and 20% by weight in the diet elicited marked changes in the fatty acyl composition of cardiac phospholipids in both fa/fa and Fa/- rats when compared with animals fed the control Oxoid diet alone. Supplementation with triolein was most effective, reducing 18:2n-6 and increasing 20:4n-6 proportions in fa/fa rats so that they resembled those in Fa/- rats fed the control Oxoid diet. The type of fat rather than the amount of its dietary intake appears to be the main determinant of the observed changes in phospholipid composition.(ABSTRACT TRUNCATED AT 250 WORDS)