Comparative clinical prognosis of massive and non-massive pulmonary embolism: A registry-based cohort study

AIMS

Little is known about the prognosis of patients with massive pulmonary embolism (PE) and its risk of recurrent venous thromboembolism (VTE) compared with non-massive PE, which may inform clinical decisions. Our aim was to compare the risk of recurrent VTE, bleeding, and mortality after massive and non-massive PE during anticoagulation and after its discontinuation.

METHODS AND RESULTS

We included all participants in the RIETE registry who suffered a symptomatic, objectively confirmed segmental or more central PE. Massive PE was defined by a systolic hypotension at clinical presentation (<90 mm Hg). We compared the risks of recurrent VTE, major bleeding, and mortality using time-to-event multivariable competing risk modeling. There were 3.5% of massive PE among 38 996 patients with PE. During the anticoagulation period, massive PE was associated with a greater risk of major bleeding (subhazard ratio [sHR] 1.72, 95% confidence interval [CI] 1.28-2.32), but not of recurrent VTE (sHR 1.15, 95% CI 0.75-1.74) than non-massive PE. An increased risk of mortality was only observed in the first month after PE. After discontinuation of anticoagulation, among 11 579 patients, massive PE and non-massive PE had similar risks of mortality, bleeding, and recurrent VTE (sHR 0.85, 95% CI 0.51-1.40), but with different case fatality of recurrent PE (11.1% versus 2.4%, P = .03) and possibly different risk of recurrent fatal PE (sHR 3.65, 95% CI 0.82-16.24).

CONCLUSION

In this large prospective registry, the baseline hemodynamic status of the incident PE did not influence the risk of recurrent VTE, during and after the anticoagulation periods, but was possibly associated with recurrent PE of greater severity.

D-dimer levels and risk of recurrence following provoked venous thromboembolism: findings from the RIETE registry

BACKGROUND

Patients with venous thromboembolism (VTE) secondary to transient risk factors may develop VTE recurrences after discontinuing anticoagulation. Identifying at-risk patients could help to guide the duration of therapy.

METHODS

We used the RIETE database to assess the prognostic value of d-dimer testing after discontinuing anticoagulation to identify patients at increased risk for recurrences. Transient risk factors were classified as major (postoperative) or minor (pregnancy, oestrogen use, immobilization or recent travel).

RESULTS

In December 2018, 1655 VTE patients with transient risk factors (major 460, minor 1195) underwent d-dimer measurements after discontinuing anticoagulation. Amongst patients with major risk factors, the recurrence rate was 5.74 (95% CI: 3.19-9.57) events per 100 patient-years in those with raised d-dimer levels and 2.68 (95% CI: 1.45-4.56) in those with normal levels. Amongst patients with minor risk factors, the rates were 7.79 (95% CI: 5.71-10.4) and 3.34 (95% CI: 2.39-4.53), respectively. Patients with major risk factors and raised d-dimer levels (n = 171) had a nonsignificantly higher rate of recurrences (hazard ratio [HR]: 2.14; 95% CI: 0.96-4.79) than those with normal levels. Patients with minor risk factors and raised d-dimer levels (n = 382) had a higher rate of recurrences (HR: 2.34; 95% CI: 1.51-3.63) than those with normal levels. On multivariate analysis, raised d-dimers (HR: 1.74; 95% CI: 1.09-2.77) were associated with an increased risk for recurrences in patients with minor risk factors, not in those with major risk factors.

CONCLUSIONS

Patients with raised d-dimer levels after discontinuing anticoagulant therapy for VTE provoked by a minor transient risk factor were at an increased risk for recurrences.

Debunking the myth: low knowledge levels of HBV infection among Asian American college students

Objective:

To examine the hepatitis B virus (HBV)-related knowledge among Asian American college students and to determine whether there are significant differences in the level of HBV knowledge among Asian American subgroups.

Methods:

A cross-sectional survey was self-administered to assess a sample of 258 Asian American students’ knowledge about HBV at the campus of the research site.

Results:

Knowledge regarding transmission and consequences of HBV infection was poor. Of a possible knowledge score of 14, the median number of correct answers was eight. There were no significant differences between the subgroups of Asian American college students in total knowledge of HBV infection.

Conclusion:

The findings of this study point to the fact that the lack of knowledge and awareness is not limited to community settings only but also includes higher education environment. This finding brings to the forefront the importance of HBV education for Asian American college students.

Recommendations for radiological diagnosis and assessment of treatment response in lung cancer: a national consensus statement by the Spanish Society of Medical Radiology and the Spanish Society of Medical Oncology

The last decade has seen substantial progress in the diagnostic and therapeutic approach to lung cancer, thus meaning that its prognosis has improved. The Spanish Society of Medical Radiology and the Spanish Society of Medical Oncology have therefore produced a national consensus statement to make recommendations for radiological diagnosis and assessment of treatment response in patients with lung cancer. This expert group recommends multi-detector computed tomography as the technique of choice for investigating this disease. The radiology report should include a full assessment by the TNM staging system. Lastly, when the patient is on immunotherapy, response evaluation should employ not only response evaluation criteria in solid tumours, but also immune-related response criteria.

Evaluation of HLA-G5 plasmatic levels during pregnancy and relationship with the 14-bp polymorphism

PROBLEM

Plasmatic HLA-G levels increase during pregnancy, but the contribution of each different isoform has not been elucidated yet.

METHOD OF STUDY

HLA-G5 was analyzed by ELISA in 19 controls, 79 women in the first 8 weeks of pregnancy and in nine women monthly until delivery. Genotyping for the 14-bp polymorphism was performed by PCR amplification of exon 8.

RESULTS

HLA-G5 was detected in plasma from 80% of pregnant women. The levels did not change during pregnancy, and there were no differences compared to control non-pregnant women. There was a high interindividual variation that was maintained throughout the pregnancy. The presence of +14-bp allele was associated with HLA-G5 positivity. Pregnant women who were heterozygotic to 14-bp polymorphism had significantly higher levels of HLA-G5 compared to -14 bp/-14-bp homozygotic.

CONCLUSION

Plasmatic HLA-G5 levels do not change during pregnancy and its concentration depends on 14-bp polymorphism.

An influenza outbreak among pilgrims sleeping at a school without purpose built overnight accommodation facilities

This report describes a respiratory illness outbreak amongst a group of over 700 World Youth Day 2008 pilgrims staying at a basic accommodation venue for 1 week in July 2008. At this venue, 1 group of pilgrims was accommodated as a large group in a gymnasium and another group was sub-divided into smaller groups and accommodated in classrooms. Following confirmation of an influenza B outbreak by influenza point of care testing, control measures were promptly implemented. Isolation of cases, improved hand, respiratory and general hygiene, establishment of a mobile tent health facility at the accommodation venue, and the use of oseltamivir for the treatment of cases and prophylaxis of high risk contacts were implemented and the outbreak was brought under control within the week. Overall, 20% of pilgrims met the case definition for an influenza-like illness and 36% had an onset prior to arrival at the venue. The attack rate for those with onset while at the venue was significantly higher amongst pilgrims accommodated in the gymnasium than those staying in the classrooms. Findings from this study highlight the importance of early detection, the rapid implementation of control measures and appropriate prescribing of antivirals to manage influenza outbreaks. The findings also highlight the benefits of accommodating individuals in smaller groups within basic accommodation venues in the context of mass gatherings.

14-Base pair polymorphism of human leukocyte antigen-G as genetic determinant in heart transplantation and cyclosporine therapy monitoring

The 14-base pair (bp) polymorphism within the HLA-G gene has been investigated in heart transplant patients for the first time. The 14-bp polymorphism is associated with HLA-G mRNA stability and the patterns of alternative isoforms splicing, and therefore may influence the functionality of the HLA-G molecule. In heart transplantation, the highest production of soluble HLA-G was related to the -14/-14-bp genotype in the pre- and post-transplantation periods. Our study findings showed that the 14-bp polymorphism of the HLA-G gene influenced the expression of soluble HLA-G in heart transplantation and accordingly resulted in low rejection rates, being a possible marker of genetic variability associated with heart transplantation. In addition, the 14-bp polymorphism of the HLA-G gene is related to the absorber status of cyclosporine of each individual patient, and is useful for determining the oral dose of cyclosporine to manage patients (to adjust immunosuppressive protocols) so as to minimize the risk of a low or high immunosuppression and the side effects in the early stages of heart transplantation.

Current view of the immunopathogenesis in inflammatory bowel disease and its implications for therapy

Although the aetiology of inflammatory bowel disease (IBD) remains unknown, the pathogenesis is gradually being unravelled, seeming to be the result of a combination of environmental, genetic, and immunological factors in which an uncontrolled immune response within the intestinal lumen leads to inflammation in genetically predisposed individuals. Multifactorial evidence suggests that a defect of innate immune response to microbial agents is involved in IBD. This editorial outlines the immunopathogenesis of IBD and their current and future therapy. We present IBD as a result of dysregulated mucosal response in the intestinal wall facilitated by defects in epithelial barrier function and the mucosal immune system with excessive production of cytokines growth factors, adhesion molecules, and reactive oxygen metabolites, resulting in tissue injury. Established and evolving therapies are discussed in the second part of this editorial and at the end of this section we review new therapies to modulate the immune system in patients with IBD.

A new approach using tissue alkaline phosphatase histochemistry to identify Crohn's disease

In the present study, we investigate intestinal alkaline phosphatase activity in mucosal biopsies in patients with inflammatory bowel disease. Crohn's disease influences the alkaline phosphatase activity in the intestine, increasing its activity. We present a histochemistry-based method for alkaline phosphatase that is useful for the identification of Crohn's disease and the differentiation of ulcerative colitis.

Tryptophan metabolism and indoleamine 2,3-dioxygenase expression in coeliac disease

We have investigated the possible role of the metabolism of tryptophan and activity of the enzyme indoleamine 2,3-dioxygenase (IDO) in the immune regulation of coeliac disease (CD). Serum concentrations of tryptophan and its metabolites kinurenines were determined by high performance liquid chromatography in 24 patients with CD, seven patients with Crohn's disease and five healthy patients. We detected an increase of kynurenine (4.2 micromol/l +/- 0.27 versus 2.6 micromol/l +/- 0.54, P < 0002) and of the kynurenine/tryptophan ratio in supernatants of coeliac patients (11.5 micromol/l +/- 1.01 versus 6.5 micromol/l +/- 1.57, P < 0005) in comparison with healthy patients, respectively, and we found no differences with Crohn's disease patients. Immunohistochemistry analysis of intestinal biopsies from CD patients showed an increased expression of IDO, interferon-gamma, interleukin-10 and transforming growth factor-beta. Our data suggest that a mechanism(s) dependent on tryptophan catabolism might regulate the immune responses in CD.

New aspects in celiac disease

Celiac disease (CD) is a common autoimmune disorder characterized by an immune response to ingested gluten and has a strong HLA association with HLA-DQ2 and HLA-DQ8 molecules, but human HLA-DQ risk factors do not explain the entire genetic susceptibility to gluten intolerance. CD is caused by the lack of immune tolerance (oral tolerance) to wheat gluten. In this sense, the expression of soluble HLA-G in CD is of special interest because the molecule plays an important role in the induction of immune tolerance. The enhanced expression of soluble HLA-G found in CD may be part of a mechanism to restore the gluten intolerance. In this editorial, we review recent progress in understanding CD in relation to its prevalence, diagnosis and possible mechanisms of pathogenesis.

Tumor inflamatorio miofibroblástico pulmonar

Myofibroblastic inflammatory tumor is a controversial entity that shows great variability in clinical presentation, histological findings, evolution, and prognosis. It is a rare cause of primary lung tumor in adults; however, it is the most common cause of lung tumors in children. The diagnosis is fundamentally histological, although histological diagnosis is not easy because myofibroblastic inflammatory tumor is characterized by a polymorphic cellular infiltration of variable cellular composition that could be similar to other diseases such as lymphoma or low-grade sarcoma. We report the case of a 23-year-old woman in whom a solitary pulmonary nodule was discovered incidentally at plain-film chest x-ray.

sHLA-G levels in the monitoring of immunosuppressive therapy and rejection following heart transplantation

The aim of this study was to further determine the immediate influence, over a 12-h period, after the initiation of daily immunosuppressive treatment on the serum levels of sHLA-G in heart transplant patients during the post-transplant period (1 month). It was found that there are two patterns of patients in term of the changes observed in their levels of sHLA-G in response to the immunosuppressive treatment. One group (group A) showed no changes on sHLA-G while the other group (group B) a significant rise in sHLA-G levels was observed at 2 to 4 h post dose. Interestingly, it was observed that the patients in group B have better prognosis of acceptance of the heart graft than those of group A. On the other hand it was found that the patients with high levels of sHLA-G (77.3+/-34.8 ng/ml) in pre-transplant sera have a better prognosis of acceptance of the heart graft than those with low sHLA-G levels (9.7+/-7.1 ng/ml). In conclusion, both the intensity of changes of sHLA-G levels induced by immunosuppression and basal levels in pre-transplant could be used in the monitoring of the immunosuppression as well as the heart transplant evolution.

Soluble HLA-G in heart transplantation: their relationship to rejection episodes and immunosuppressive therapy

The aims of this study were to quantify the level of soluble HLA-G in heart transplant patients, to determine the relationship between the sHLA-G levels and the appearance of acute rejection episodes, and to identify the influence of immunosuppressive therapy on sHLA-G levels. Analysis of sHLA-G, measured by enzyme-linked immunosorbent assay in the transplant patients, revealed the existence of two similarly sized groups of patients. One group displayed a significant increase (p < 0.001) in sHLA-G during the first month after transplantation while the other group maintained low levels of the molecule (0-30 ng/ml) throughout the study. The latter group displayed a high incidence of recurrent severe rejection. A significant increase (p < 0.01) in sHLA-G 2 hours after administration of immunosuppressive treatment (mycophenolate mofetil, cyclosporine A/FK506, corticoids) was found. These results suggest that sHLA-G participates in the induction of certain levels of immunological tolerance in these recipients.

New advances in coeliac disease: serum and intestinal expression of HLA-G

Coeliac disease (CD) is a common autoimmune disorder characterized by an immune response to ingested gluten and has a strong HLA association with HLA-DQ2 and HLA-DQ8, but as human HLA-DQ risk factors do not explain the entire genetic susceptibility to gluten intolerance. Our aim was to investigate whether HLA-G, a gene located in the MHC class I region, and with important role in the induction of immunotolerance, may contribute to CD susceptibility. We demonstrated the expression of soluble HLA-G (sHLA-G) forms in intestinal biopsy and in serum of patients with CD. Indeed, all patients tested showed a positive expression of HLA-G in intestinal mucosa with different grade of immunoreaction. The serum levels of sHLA-G found in coeliac patients depend on the association with other diseases of autoimmune nature or genetics, and also depend on the transgressions in the diet with gluten ingested. The enhancer expression of sHLA-G in CD could be due as part of a mechanism to try restore the tolerance process towards oral antigens in a disease caused by loss of tolerance to dietary antigens and counteract the inflammation. In summary, in this paper, we demonstrate the association of CD with sHLA-G expression.

Protective effects of Rosmarinus tomentosus ethanol extract on thioacetamide-induced liver cirrhosis in rats

The capability of an ethanol extract of Rosmarinus tomentosus to protect rat liver in an experimental model of cirrhosis induced by thioacetamide (TAA) has been evaluated. Four groups of rats were used: Two of them received 300 mg TAA/l in the drinking water for 3 months while the other two, which served as controls, were given water ad libitum. During the same period and for each one of the treatments, one group received a semi-purified (SP) diet and the other one was fed the same diet supplemented with 1% of the dry residue obtained from R. tomentosus ethanol extract (SP+E). There was a significant reduction of TAA toxicity in rats fed the SP+E diet, as assessed by plasma and liver biochemical markers, and by liver histopathology. Plasma total protein concentration was restored, urea concentration and plasma alkaline phosphatase and gamma-glutamyl-transferase activities were reduced. A significant correction of plasma fatty acids concentrations was also evident. Hepatic alkaline phosphatase and gamma-glutamyl-transferase activities were significantly reduced in animals fed SP+E diet and glucose-6-phosphatase activity was significantly enhanced. The results suggest that R. tomentosus ethanol extract administered in the diet affords protection against TAA-induced cirrhosis, preventing most of the histological changes and functionality alterations own to this experimental pathology.

Dietary supplementation with monounsaturated and long-chain polyunsaturated fatty acids influences the liver structural recovery and hepatocyte binuclearity in female Wistar rats in experimental cirrhosis induced by thioacetamide

Oral administration of 300 mg/l thioacetamide (TAA) for 4 months causes hepatic lesions comparable to those described in alcoholic liver cirrhosis in humans and associated protein-energy malnutrition. In this sense, direct supplementation with monounsaturated fatty acids (MUFAs) and/or polyunsaturated fatty acids (PUFAs) might provide an advantage in the correction of the fatty acid deficiency in these patients. PUFAs are essential components of cell membranes maintaining its fluidity and function, important energy sources, and precursors of eicosanoids. Moreover, these fatty acids also modulate gene transcription, mRNA stability, and cellular differentiation.

METHODS

Fifty-four female Wistar rats (Interfauna Ibérica, Barcelona, Spain) weighing 110-120 g were used in this study. The animals were divided into two groups: one group was treated with 300 mg/l TAA dissolved in drinking water during 4 months, and the other group, which served as a control, was given water without TAA. To evaluate the changes induced by the administration of TAA for 4 months, TAA-treated (n = 7) and control animals (n = 5) were killed. Then, the TAA treatment was stopped and the rest of the animals in both TAA and control groups were divided into three experimental groups and three control groups which received for 2 weeks different type of diets. Using the TAA-induced liver cirrhosis model in rats, we analysed the effects of dietary supplementation with MUFAs and PUFAs on binuclearity and ultrastructure of hepatocytes. After TAA-induced cirrhosis, we analysed whether dietary supplementation with fatty acids may restore the normal percentage of binucleated cells, as well as the ultrastructure, nuclear area, and nuclear/cytoplasm index of hepatocytes.

RESULTS

Treatment with TAA causes cirrhosis characterized by the appearance of parenchyma nodules and fibrous septae, as well as qualitative and quantitative alterations in liver and plasma lipids. Our results indicate that dietary MUFAs support hepatocyte recovery regarding its ultrastructural and morphometric values. However, PUFAs-enriched diets (n-3 and n-3 + n-6) do not correct hepatomegaly, fibrosis or lipid accumulation. Thus, dietary PUFAs do not enhance hepatocyte recovery from morphological and ultrastructural alterations.

CONCLUSIONS

In our experimental model of cirrhosis, dietary supplementation with a high proportion of long-chain PUFAs (n-3 or n-6) negatively influences liver recovery. This negative effect was likely due to the increased susceptibility of cell membranes to lipid peroxidation, together with an alteration in lipid metabolism.

Optical mapping of electrical activation in the developing heart

Specialized conduction tissues mediate coordinated propagation of electrical activity through the adult vertebrate heart. Following activation of the atria, the activation wave is slowed down in the atrioventricular canal or node, after which it spreads rapidly into the left and right ventricles via the His-Purkinje system (HPS). This results in the ventricles being activated from the apex toward the base, which is a hallmark of HPS function. The development of mature HPS function follows significant phases of cardiac morphogenesis. Initially, the cardiac impulse propagates in a slow, linear, and isotropic fashion from the sinus venosus at the most caudal portion of the tubular heart. Although the speed of impulse propagation gradually increases as it travels toward the anterior regions of the heart tube, the actual sequence of ventricular activation in the looped heart proceeds in the same direction as blood flow. Eventually, the immature base-to-apex sequence of ventricular activation undergoes an apparent reversal, changing to the mature apex-to-base pattern. Using an optical mapping approach, we demonstrate that the timing of this last transition shows striking dependence on hemodynamic loading of the ventricle, being accelerated by pressure overload and delayed in left ventricular hypoplasia. Comparison of chick and mammalian hearts revealed some striking similarities as well as key differences in the timing of such events during cardiac organogenesis.

Expression of HLA-G in inflammatory bowel disease provides a potential way to distinguish between ulcerative colitis and Crohn's disease

In addition to being involved in nutrient uptake, the epithelial mucosa constitute the first line of defense against microbial pathogens. A direct consequence of this physiological function is a very complex network of immunological interactions that lead to a strong control of the mucosal immune balance. The dysfunction of immunological tolerance is likely to be a cause of inflammatory bowel disease (IBD), ulcerative colitis (UC) and Crohn's disease (CD). HLA-G is a non-classical major histocompatibility complex (HLA) class I molecule, which is highly expressed by human cytotrophoblast cells. These cells play a role in immune tolerance by protecting trophoblasts from being killed by uterine NK cells. Because of the deregulation of immune system activity in IBD, as well as the immunoregulatory role of HLA-G, we have analyzed the expression of HLA-G in intestinal biopsies of patients with UC and CD. Our study shows that the differential expression of HLA-G provides a potential way to distinguish between UC and CD. Although the reason for this differential expression is unclear, it might involve a different mechanism of immune regulation. In addition, we demonstrate that in the lamina propria of the colon of patients with UC, IL-10 is strongly expressed. In conclusion, the presence of HLA-G on the surface of intestinal epithelial cell in patients with UC lends support to the notion that this molecule may serve as a regulator of mucosal immune responses to antigens of undefined origin. Thus, this different pattern of HLA-G expression may help to differentiate between the immunopathogenesis of CD and UC.

Supporting the implementation of breast pathology recommendations: feasibility of a feedback mechanism to pathologists

AIMS

The aims of the study were to explore the feasibility, acceptability, impact and cost of a feedback program to pathologists reporting on breast specimens through a BreastScreen Service.

METHODS

The study was conducted at a single BreastScreen NSW Screening and Assessment Service. Pathology reports were audited against the ACN recommendations about pathology reporting [Australian Cancer Network Pathology Working Party. The Pathology Reporting of Breast Cancer: a guide for pathologists, surgeons and radiologists. Sydney: Australian Cancer Network, 1997] during two consecutive periods. Feedback was provided to pathologists at the completion of each audit. A comparison of completeness of pathology reports between audits was undertaken. The Screening and Assessment Service staff and participating pathologists were interviewed to assess acceptability and information about resource allocation.

RESULTS

The study demonstrated that the feedback mechanism was acceptable to pathologists and staff at the BreastScreen Screening and Assessment Service, and that participation in the study resulted in some improvements in pathology reporting.

CONCLUSIONS

The study demonstrated the feasibility of providing feedback to pathologists about their reporting of breast specimens. However, there were costs to the Service of participating. A way of managing these costs would need to be explored if the feedback mechanism was made a routine BreastScreen procedure.

Body mass index and some psychopathological symptoms in open community nuns

This article examines the connections between body weight and psychopathological symptoms in a religious community. The Symptom Checklist 90-Revised was administered to 34 nuns, whose body mass index (BMI) values significantly correlated with hostility (r=0.46, p<0.01). These findings support the idea that people living in open religious communities share social values regarding weight and body size, and reveal high levels of psychological discomfort when body weight increases.

Chronic diarrhea impairs intestinal antioxidant defense system in rats at weaning

The aim of the present study was to evaluate the influence of severe protein-energy malnutrition on the antioxidant defense system in the small and large intestine in rats at weaning. Chronic diarrhea and the subsequent malnutrition were induced by oral intake of a lactose-enriched diet. Twenty rats were weaned at 21 days of age, and the control group was fed a semipurified synthetic diet for two weeks. The malnourished group was fed the same diet but carbohydrates were replaced by lactose, and they developed diarrhea one day after. Rats were killed, and macroscopic and histological features were analyzed, DNA content was measured, and alkaline phosphatase, myeloperoxidase, and gamma-glutamyltranspeptidase activities were determined to assess the degree of intestinal injury. Glutathione levels as well as the activities of intestinal glutathione transferase, glutathione reductase, total glutathione peroxidase, selenium-dependent glutathione peroxidase, superoxide dismutase, and catalase were measured to study the antioxidant defense system. Malnourished rats showed loss of body weight and an increase in length and weight in jejunum and ileum, while no significant changes were observed in colon. Epithelial cells showed fewer and shorter microvilli, larger mitochondria with low inner density and loss of cristae, dilated endoplasmic reticulum, and Golgi apparatus. The protein-to-DNA ratio was higher in the jejunum, ileum, and colon of malnourished rats. Glutathione levels decreased 40% in jejunum and 50% in colon of malnourished rats. A 40-50% decrease in the activity of all the enzymes of the antioxidant defense system was observed in the jejunum and ileum of malnourished rats, while only catalase and glutathione transferase activities decreased 50% in colon. These results suggest that early chronic diarrhea and severe protein-energy malnutrition impair the antioxidant defense system in both the small and large intestine, which may have a role in the pathogenesis and maintenance of the vicious circle of malabsorption-diarrhea-malnutrition in infancy.

Experimental ulcerative colitis impairs antioxidant defense system in rat intestine

Increasing attention has been given recently to the role of free radicals in the pathogenesis of ulcerative colitis, since the inflamed intestine is exposed to oxidative stress generated by infiltrating macrophages and neutrophils within the lamina propia. The overall goal of this study was to evaluate whether experimental ulcerative colitis induces significant changes in the antioxidant defense system in an experimental model induced by the intrarectal administration of 2,4,6-trinitrobenzenesulfonic acid. Twenty rats were treated with 80 mg/kg body weight of trinitrobenzenesulfonic acid and 20 with the same volume of 0.9% NaCl. Rats were killed at one and two weeks after treatment to evaluate colon damage by light and electron transmission microscopy. The degree of tissue injury and inflammation was determined by measuring alkaline phosphatase, gamma-glutamyltranspeptidase, and myeloperoxidase activities and prostaglandin E2 and leukotriene B4. Glutathione levels and the activity of the enzymes of the antioxidant defense system were determined. Enzymatic markers of colon injury showed higher activities in rats with ulcerative colitis. Concentrations of prostaglandin E2 and leukotriene B4 were higher in the groups treated for one week with trinitrobenzenesulfonic acid and markers decreased after two weeks of treatment. All antioxidant enzyme activities were higher at one and two weeks after treatment; however, a significant decrease in total glutathione content was also observed. In conclusion, ulcerative colitis induced by trinitrobenzenesulfonic acid damages the intestinal mucosa and is accompanied by a shift in the antioxidant enzyme activities, and low levels of glutathione. This deficiency in glutathione could be a target for new therapies to treat ulcerative colitis.

Intestinal anti-inflammatory activity of UR-12746, a novel 5-ASA conjugate, on acute and chronic experimental colitis in the rat

The present study was undertaken to investigate the intestinal anti-inflammatory effects of UR-12746 on the acute and chronic stages of a trinitrobenzene sulphonic acid (TNBS) experimental model of inflammatory bowel disease (IBD) in the rat. UR-12746 is a novel, locally-acting compound which combines, through an azo bond, 5-aminosalicylic (5-ASA) and UR-12715, a potent platelet activating factor (PAF)-antagonist. UR-12746 oral pretreatment of colitic rats (50 and 100 mg kg(-1)) reduced acute colonic damage when evaluated 2 days after colonic insult. Postreatment for 4 weeks with UR-12746 (50 and 100 mg kg(-1)) resulted in a faster recovery of the damaged colonic mucosa, which was macroscopically significant from the third week. The intestinal anti-inflammatory effect of UR-12746 was associated with a decrease in leukocyte infiltration in the colonic mucosa, which was evidenced both biochemically, by a reduction in myeloperoxidase activity, and histologically, by a lower leukocyte count after morphometric analysis. This effect was higher than that seen with sulphasalazine, when assayed at the same doses and in the same experimental conditions. Several mechanisms can be involved in the beneficial effects showed by UR-12746: inhibition of leukotriene B(4) synthesis in the inflamed colon, improvement of the altered colonic oxidative status, and reduction of colonic interleukin-1beta production. The results suggest that the intestinal anti-inflammatory activity of UR-12746 can be attributed to the additive effects exerted by 5-ASA and UR-12715, the PAF antagonist compound, that are released in the colonic lumen after reduction of the azo bond by the intestinal bacteria.

Immunolocalization of the HNK-1 epitope in the autonomic innervation to the liver and upper digestive tract of the developing rat embryo

The immunohistochemical analysis of the HNK-1 epitope presence in the liver and upper digestive tract nerves was carried out in 12- to 18-day-old rat embryos embedded in acrylamide-agarose and observed with laser scanning confocal microscopy. The vagus and sympathetic trunk were intensely immunostained at all ages; branches of both structures were also HNK-1 positive, and ramified ventrocaudally following the course of the thoracic and abdominal aorta, caval vein, portal vein and ductus venosus. As early as day 12, some immunostained cells were seen in the mesentery that formed the enteric nervous system. Clearly immunostained HNK-1-immunoreactive fibres were detected innervating the digestive wall after day 14, forming both myenteric and submucosal plexuses. After day 16, the Glisson sheath showed streams of HNK-1-positive fibres coming from dorsal areas, lining the peritoneal surface of the diaphragm, invading the capsule, and ramifying superficially around the lobes of the liver. We saw no immunoreactive structures pervading the hepatic lobes at all ages studied, with the exception of occasional HNK-l-positive cells in the superficial parenchyma, which were visualized after 16 days of gestation. Our findings can help to understand the development of the gastrointestinal and liver innervation in the rat.

In vivo lipolysis in adipose tissue from two anatomical locations measured by microdialysis

In this study, the difference in lipolytic response in inguinal subcutaneous and epididymal adipose tissues of male Sprague-Dawley rats was assessed in vivo by microdialysis. Probes were perfused with Ringer solution in which increasing concentrations of isoproterenol (10(-7) - 10(-4) mol/L) were added. Glycerol release, expressed as extracellular glycerol concentration, was used as lipolytic index. The effect of isoproterenol on local blood flow was investigated using the ethanol technique. No differences were found in the interstitial glycerol concentration between both adipose tissues under basal conditions. When isoproterenol was perfused, a dose-response increase in glycerol production was induced in both tissues. Interstitial glycerol concentration from epididymal adipose tissue was higher than that of inguinal subcutaneous depot at all isoproterenol concentrations. No vasodilatory effect of isoproterenol was found. These results suggest that epididymal adipose tissue is more responsive in vivo to beta-adrenergic lipolysis stimulation than is subcutaneous fat pad from the inguinal region.

Experimental colitis induced by trinitrobenzenesulfonic acid: an ultrastructural and histochemical study

Inflammatory bowel disease (IBD) of humans is a chronic and devastating disease of unknown etiology. Models of acute colitis in animals have been achieved by intrarectal administration of agents such as 2,4,6-trinitrobenzenesulfonic acid (TNBS) into rat colon. This agent induces focal inflammation and alterations in the colon with features similar to those found in chronic inflammatory diseases in humans. The aim of this study was to assess the effect of TNBS administration on histological and ultrastructural features of the rat colon, especially in areas not affected by transmural inflammation. Also in areas without transmural inflammation, we observed a significant increase in crypt diameter and in the number and area of the goblet cells, as well as alterations in the contents of mucin in goblet cells. We conclude that TNBS treatment in rats led to severe changes in normal architecture of the colon and also in damaged areas where no direct inflammation was produced.

Dietary phospholipids rich in long-chain polyunsaturated fatty acids improve the repair of small intestine in previously malnourished piglets

Malnourished piglets were studied to establish how a diet containing long-chain polyunsaturated fatty acids (LC-PUFA) of the (n-6) and (n-3) series, esterified in the form of phospholipids, affects intestinal recovery after severe malnutrition. Piglets (7-d-old) were randomly assigned to two groups. One group was fed a piglet milk formula and the other was malnourished by protein-energy restriction for 30 d. Healthy and malnourished piglets were then divided into two subgroups fed for 10 d either an adapted milk formula (C and M) or the same diet supplemented with LC-PUFA phospholipids (C-P and M-P). The M-P group had greater protein, DNA, cholesterol and phospholipid levels and a lower triglyceride level in the jejunal segment than did the M group. The fatty acid composition of the jejunal mucosa and microsomes of the M-P piglets did not differ from that of healthy piglets (C). However, in jejunal mucosa, microsomes and phospholipids from malnourished piglets that did not receive LC-PUFA (group M) had significantly lower percentages of (n-6) LC-PUFA than those in healthy piglets (C). The (n-3) LC-PUFA percentages of jejunal mucosa were also lower in the M group than in the C group. The small intestine of piglets fed the LC-PUFA-supplemented formula recovered more completely from histologic lesions and biochemical alterations caused by the malnutrition process than the small intestine of piglets fed the control formula without LC-PUFA.

Effects of dietary polyunsaturated fatty acids and nucleotides on tissue fatty acid profiles of rats with carbon tetrachloride-induced liver damage

The deficiency of polyunsaturated fatty acids (PUFA) that occurs in plasma of patients with liver cirrhosis has been assessed in rats with severe steatosis and mild liver necrosis induced by repeated administration of low doses of carbon tetrachloride (CCl(4)). The contribution of both dietary (n-3) long-chain PUFA and nucleotides to the recovery of the altered fatty acid profiles of tissue lipids of these rats has also been studied. Two groups of rats were used. The first was intraperitoneally injected 0.15 ml of a 10% (v/v) CCl(4)solution in paraffin per 100 g of body weight, three times a week for 9 weeks; the second received paraffin alone. After the treatment, six rats of each group were killed. Afterwards, the remaining controls were fed a semipurified diet (SPD) for 3 weeks, and the remaining rats in the CCl(4)group were divided into three new groups: the first was fed the SP diet; the second was fed the SP diet supplemented with 1% (n-3) polyunsaturated fatty acids (PUFA diet); and the third was fed the SP diet supplemented with 250 mg nucleotides per 100 g diet (NT diet). Fatty acids of plasma, erythrocyte membranes and liver microsomes were analyzed. Decreases in linoleic and arachidonic acids in both total plasma lipids and liver microsomal phospholipids were the main findings due to CCl(4)treatment. The rats that received CCl(4)and the PUFA diet showed the lowest levels of (n-6) PUFA and the highest levels of (n-3) PUFA in liver microsomal phospholipids, as well as a significant increase of (n-3) PUFAs in total plasma lipids. The animals that received the NT diet showed no signs of fatty infiltration and exhibited the highest levels of (n-6) PUFAs in liver microsomal phospholipids. These results show that CCl(4)affects fatty acid metabolism which is accordingly reflected in altered tissue fatty acid profiles, and that balanced diets containing PUFA and nucleotides are important for the recovery of the damaged liver in rats.

Dietary monounsaturated n-3 and n-6 long-chain polyunsaturated fatty acids affect cellular antioxidant defense system in rats with experimental ulcerative colitis induced by trinitrobenzene sulfonic acid

The intrarectal administration of trinitrobenzene sulfonic acid in rats induces ulcerative colitis, which results in histological alterations of colonic mucosa, severe modification of the cellular antioxidant defense system, and enhanced production of inflammatory eicosanoids. This study evaluated the influence of different dietary fatty acids, i.e., monounsaturated, n-3, and n-3 + n-6 polyunsaturated fatty acids, on the recovery of the colonic mucosa histological pattern, the cellular antioxidant defense system of colon, and PGE2 and LTB4 colonic mucosa contents in a model of ulcerative colitis induced by intrarectal administration of trinitrobenzene sulfonic acid. Administration of dietary n-3 polyunsaturated fatty acids led to a minimum stenosis score, a higher histological recovery, lower colon alkaline phosphatase and gamma-glutamyltranspeptidase activities, and lower mucosal levels of PGE2 and LTB4 compared with the other two experimental groups. However, glutathione transferase, glutathione reductase, glutathione peroxidase, and catalase activities were lower in the group treated with n-3 polyunsaturated fatty acids than in the groups fed with either the monounsaturated or the n-6 + n-3 polyunsaturated enriched diet. We conclude that n-3 polyunsaturated fatty acids can be administered to prevent inflammation in ulcerative colitis, but they cause a decrease in the colonic antioxidant defense system, promoting oxidative injury at the site of inflammation.

Effects of morin on an experimental model of acute colitis in rats

The flavonoid morin was tested for anti-inflammatory activity in trinitrobenzenesulfonic acid (TNBS)-induced rat colitis. Rats were pretreated orally with several doses of the flavonoid (5, 10, 25, 100 and 200 mg/kg) 48, 24 and 1 h before and 24 h after colitis induction and examined for colonic damage 48 h after colitis induction. Colonic inflammation was characterized by diffuse hemorrhagic necrosis of the mucosa, bowel wall thickening, impairment of fluid absorption, increase in myeloperoxidase (MPO) activity, enhanced leukotriene B4 (LTB4) synthesis, glutathione depletion and increased levels of malonyldialdehyde (MDA). Morin treatment, at doses ranging from 10 to 200 mg/kg, significantly reduced colonic macroscopic damage. This beneficial effect was also confirmed by inhibition of colonic MPO activity. Several mechanisms may contribute to the protective effect exerted by morin. First, inhibition of colonic LTB4 synthesis is a common feature for all the active doses of the flavonoid. Second, the antioxidant properties of morin, which partially prevented colonic glutathione depletion (at doses of 10 and 25 mg/kg) or inhibited colonic MDA production (at doses of 100 and 200 mg/kg), can collaborate in preventing TNBS-induced inflammation.

Quantitative and ultrastructural changes in glia and pericytes in the parietal cortex of the aging rat

The frequency of astrocytes, microglia plus oligodendrocytes, and pericytes displaying nuclei was analyzed and quantified in 160-microm-wide strips of the parietal cortex (Par1 region) from young and aged Wistar rats. The study was performed on two groups of rats aged 3-4 and 32-36 months. Quantifications of the glial cell types and pericytes were made in 1-microm-thick sections stained with toluidine blue. Ultrathin sections were also made to analyze the ultrastructural features of these cells during aging. Astrocytes and pericytes increased in number by about 20% and 22%, respectively, with age. These increases were most significant in layers II-IV and V for both cellular types. Clusters of astrocytes were common in these layers of aging rats. The ultrastructural analysis also indicated changes in all cell types that stored inclusions and vacuoles with age, which were particularly abundant in microglial cells. End-feet astrocytes and pericytes surrounding the vascular wall also contained vacuoles and inclusions, and consequently the vascular wall increased in thickness. In conclusion, the aging process increased astrocyte and pericyte populations, but not microglia plus oligodendrocyte populations, in the rat parietal cortex. Although no significant change in nuclear size could be observed in any cell type, all glial cells as well as pericytes underwent morphological ultrastructural changes. These modifications may result from the need to correct possible homeostatic imbalances during aging.

Thymectomy for myasthenia gravis: outcome of treatment in a tertiary hospital

The clinical records of 24 of the 31 patients who underwent thymectomy for myasthenia gravis from January 1991 to December 1995 were reviewed. The mean age of patients was 36.5 years, with a male : female ratio of 1 : 5. The average duration of symptoms prior to consultation was 16.6 months. Most of the patients presented diplopia with clinical stage IIA prior to surgery. The most common procedure utilized was thymectomy via a median sternotomy under general anesthesia-epidural anesthesia. Five of the 24 patients (21%) were immediately extubated postoperatively while 19 remained intubated, with 12 patients attached to a ventilator. Extubation ranged from the first postoperative day up to more than two weeks postoperatively. The average length of ICU stay was 8.1 days and the average length of hospital stay was 31.1 days. The most common morbidity was pneumonia (38%). One patient had a brief reactive psychosis and another patient had phrenic nerve injury which manifested 2 weeks postoperatively. The average length of follow-up was 14.8 months and the mean follow-up period was 24.5 months. There was a general trend of decrease in the dose of medication. However, there was an increase in the medication in 3 patients with 2 showing clinical improvement.

Dietary nucleotides correct plasma and liver microsomal fatty acid alterations in rats with liver cirrhosis induced by oral intake of thioacetamide

BACKGROUND/AIMS

Dietary nucleotides modulate a number of metabolic processes, including long-chain polyunsaturated fatty acid metabolism. In this study, we evaluated the effect of dietary nucleotides on plasma and liver microsomal fatty acid profiles in a rat model of liver cirrhosis induced by oral intake of thioacetamide.

METHODS

Fifty-four female Wistar rats were assigned to one of the following groups: rats in the thioacetamide group (n=45) were given 300 mg thioacetamide/l in their drinking water for 4 months, and rats in the control group (n=9) received water during the same period. After 4 months of treatment, 9 rats in each group were killed. The remaining rats in the thioacetamide group were divided into two new groups, and the animals in each were allowed to recover for 1 or 2 weeks on either a nucleotide-free diet or the same diet supplemented with 50 mg of each of the following: AMP, GMP, CMP, IMP and UMP per 100 g diet.

RESULTS

Saturated (mainly stearic acid), monounsaturated, and n-6 long-chain polyunsaturated fatty acids (mainly arachidonic acid), and also the unsaturation index decreased in plasma of rats with experimental cirrhosis. Administration of the diet supplemented with nucleotides to thioacetamide-treated rats corrected plasma levels of saturated, n-6 long-chain polyunsaturated fatty acids and the unsaturation index. In liver microsomes, the cirrhotic rats showed lower levels of protein and higher levels of palmitic, oleic, linoleic and arachidonic acids. Protein concentrations and levels of all the above-mentioned fatty acids were corrected with the nucleotide-enriched diet.

CONCLUSIONS

Dietary nucleotides contribute to correcting plasma and liver microsomal fatty acid alterations in rats with liver cirrhosis induced by chronic oral administration of thioacetamide.

Severe malnutrition alters lipid composition and fatty acid profile of small intestine in newborn piglets

The goal of this study was to evaluate the influence of severe protein-energy malnutrition (PEM) on lipid composition and fatty acid profile in the small intestinal mucosa of lactating pigs. Malnutrition was achieved by 80% protein-energy restriction for 30 d (20% of the food intake in the control group) in 7-d-old newborn piglets. Malnourished piglets had significantly lower concentrations of cholesterol, phospholipid and triglycerides in the jejunum and ileum compared with freely fed controls. Fatty acid composition of the intestinal mucosa was severely affected by malnutrition. A sharp decline in the relative percentages of (n-3) and (n-6) long-chain polyunsaturated fatty acids (LC-PUFA) in malnourished piglets paralleled higher (n-9) fatty acid proportions in the total mucosa, microsomes and phospholipids of the jejunum. The structure of the small intestine was severely affected as assessed by light and electron microscopy, and alkaline phosphatase and disaccharidase activities in the intestinal mucosa were also significantly impaired. Plasma from malnourished piglets had significantly lower concentrations of (n-3) and (n-6) LC-PUFA than that of control piglets; however, the fatty acid composition of red blood cell membrane was unaffected. Our results suggest that early severe PEM dramatically modifies intestinal membrane lipid composition. Changes in the lipid composition of the small intestinal mucosa and in phospholipid distribution as well as in the fatty acid profile may alter membrane fluidity and organization. These alterations appear to affect the activity of membrane-bound hydrolytic enzymes.

Dietary nucleotides have cytoprotective properties in rat liver damaged by thioacetamide

Liver cirrhosis has been induced with thioacetamide administered via different routes in rats and other species. The oral intake of thioacetamide causes nodular liver cirrhosis in rats characterized by extensive fibrosis occupying most of the hepatic parenchyma. To characterize the cytological features of cirrhosis induced by thioacetamide, and the degree of recovery obtained with dietary nucleotides, we made a morphometric study of the hepatocytes in rats administered 300 mg/l of thioacetamide for 4 months, and in rats receiving the same hepatotoxic treatment but allowed a 2-weeks recovery period on a nucleotide-free diet or a 250 mg/100 g nucleotide-supplemented diet. Thioacetamide caused to cell damage and affected the ultrastructure of hepatocytes leading to a decrease in cytoplasmic area together with increased nuclear and nucleolar size. Dietary supplementation with nucleotides favoured recovery, restoring the cytoplasmic (TN=491.7+/-9.6 vs TAA=305.1+/-3.7), nuclear (73.6+/-2.8 vs 97.4+/-2.9), and nucleolar area of damaged hepatocytes (5.6+/-0.3 vs 14.0+/-0.9). The injury from thioacetamide intake increased liver collagen, but dietary nucleotides prevented hepatic deposition of this protein. This study supports the hypothesis that dietary supplementation with nucleotides is decisive in ensuring hepatocyte recovery after thioacetamide-induced liver damage, and that dietary nucleotides have antifibrotic properties.

Fatty acid profiles in subcutaneous and mesenteric adipose tissues from Zucker rats after energy restriction. Influence of dietary fat

Several disturbances concerning lipid metabolism are found in obese Zucker rats. The present study was designed to determine the effect of energy restriction on fatty acid profile of adipose tissue triglycerides from two different anatomic locations, in genetically obese rats. The impact of the addition of a high amount of olive oil to a restricted diet was also considered. Lean and obese male Zucker rats, 11 weeks old, were used. The former (n = 7) were fed a control diet ad libitum during 4 weeks, and the latter (n = 21) were randomized into 3 groups and fed either a control diet ad libitum or diets restricted to 75% of lean rat intake which provided different amounts of olive oil as fat source. Obesity induced strong modifications in fatty acid profiles from subcutaneous and mesenteric adipose tissues that were not corrected when a standard-fat 25% energy-restricted diet was used for feeding. In contrast, when a high amount of olive oil was included into the restricted diet, a new fatty acid profile in adipose tissue from obese rats, that mirrors the one of lean rats, was observed. Significant differences between two anatomic locations were found in the pattern of modifications produced by obesity, but not by dietary treatments.

Hepatotoxic agent thioacetamide induces biochemical and histological alterations in rat small intestine

We have assessed the effect of the oral ingestion of thioacetamide on small intestine structure and function. Thioacetamide-treated rats showed diminished mucosa weight; protein, DNA, and RNA content; and leucine aminopeptidase activity as compared to controls in both jejunum and ileum. In the jejunum, there was a reduction in the activities of alkaline phosphatase, ATPase, glucose-6-phosphatase, and myeloperoxidase, whereas in the ileum, maltase, lactase, and gamma-glutamyltranspeptidase were reduced. In both jejunum and ileum we found enlarged intercellular spaces, dark epithelial enterocytes, and lymphocyte infiltration. Enterocytes showed lobulated nuclei, deranged mitochondria with loss of their cristae, dilated rough endoplasmic reticulum containing dense material, and vesiculation of the smooth endoplasmic reticulum and the Golgi apparatus. Smooth muscle cells of the intestine exhibited ultrastructural alterations. These findings indicate that chronic oral intake of thioacetamide mimics not only hepatic alterations but also small intestine alterations normally associated with human cirrhosis.

Supplementation of coconut oil from different sources to the diet induces cellular damage and rapid changes in fatty acid composition of chick liver and hepatic mitochondria

Supplementation of 20% coconut oil from two commercial sources pharmaceutical ("Pharmacy") and cooking ("Pastry") use, to the chick diet for 14 days produced a clear damage to the hepatic mitochondria, accompanied by an accumulation of glycogen and lipid droplets in the hepatocyte cytoplasm. These effects may be accounted for the high proportion of fat supplemented to the diets (20%). Pharmacy coconut oil induced a high percentage of cellular death when administered for 14 days. Fatty acid profiles in liver and hepatic mitochondria rapidly changed (24 hr) after both coconut oils supplementation to the diet. The accumulation of shorter chain fatty acids (12:0 and 14:0) was always higher after Pharmacy than after Pastry diet feeding. This fact may contribute, at least in part, to the cellular damage mentioned above especially after Pharmacy diet feeding. Mitochondrial ratios of saturated/unsaturated and saturated/polyunsaturated fatty acids rapidly changed in parallel to these ratios in both diets. Most of the mitochondrial parameters measured tend to recuperate the control values when diets were supplied for 5-14 days. Nevertheless, the maintenance of the mentioned ratios after 14-days Pharmacy diet feeding at significantly higher levels than those observed in control, seems to suggest the lack of the homeostatic mechanism in these membranes and could be also related with the high percentage of cellular death observed after this dietary manipulation.

Effect of dietary nucleotides on degree of fibrosis and steatosis induced by oral intake of thioacetamide

The administration of thioacetamide in rats induces nodular cirrhosis of the liver, characterized by fibrous septae, parenchymal nodules, proliferation of the bile ducts, and excessive deposition of connective tissue elements. Nodular cirrhosis is also associated with changes in lipid metabolism, as shown by the accumulation of lipid droplets in the hepatocyte cytoplasm. Adequate nutritional support during cirrhosis is important to sustain liver function and promote recovery after the lesions have been induced. Supplementation with nucleotides may increase cellular proliferation and thus optimize hepatic recovery. The aim of this study was to investigate the effects of dietary nucleotide supplementation on the degree of fibrosis and steatosis in rats with liver cirrhosis induced by four months of oral intake of thioacetamide. The use of dietary nucleotides after thioacetamide administration was found to decrease the percentage area of fibrous septae. In animals with liver cirrhosis fed the nucleotide-supplemented diet for two weeks, the total area of fibrosis was reduced. Withdrawal of the hepatotoxic agent led to a decrease in the degree of steatosis in cirrhotic animals, which was significant in rats given the nucleotide-supplemented diet during a two-week recovery period. In conclusion, dietary nucleotides may be an important factor in the histological recovery of damaged liver in experimental cirrhosis.

Steatosis and collagen content in experimental liver cirrhosis are affected by dietary monounsaturated and polyunsaturated fatty acids

BACKGROUND AND METHODS

We used thioacetamide administered orally to induce cirrhosis in rats, and after these had recovered for 1 and 2 weeks we examined the effects of dietary supplementation with monounsaturated and n-3 polyunsaturated fatty acids, or with a combination of n-3 and n-6 polyunsaturated fatty acids, on the extent of steatosis and collagen content in the liver.

RESULTS

Nodular cirrhosis, increased collagen content, and lipid accumulation were established after 4 months of treatment with thioacetamide. When the animals were fed a diet rich in oleic acid for 2 weeks, the steatosis and fibrosis decreased. Supplementation with n-3 polyunsaturated fatty acids favored reductions in collagen content but did not reduce the fat accumulation. With a diet supplemented with a mixture of n-3 and n-6 fatty acids we found no reduction in either lipid accumulation or collagen content.

CONCLUSIONS

Fibrosis and steatosis may be influenced by dietary fat, and monounsaturated fat appears to influence favorably the histologic recovery of the damaged liver.

High-fat sunflower and olive oil diets affect serum lipid levels in steatotic rat liver differently

This work describes the long-term effects of two different diets, one rich in olive oil and the other in sunflower oil, on serum lipid and lipoprotein levels after the establishment of fatty liver in rats 8 and 15 months old. The serum lipid and lipoprotein levels as well as the steatotic process have been evaluated by biochemical and histological methods, respectively. The results showed that fatty liver was well developed with both long-term high-fat diets, and hepatocytes were filled with many lipid droplets. This process was more evident in the portal zones, where fat hepatocytes were more numerous. Serum total cholesterol (TC) and HDL-C levels were highest in the sunflower oil fed rats, whereas the TG and LDL-C levels were highest in the olive oil group. Finally, the atherogenic indexes (HDL/TC, HDL/LDL, HDL/(TC-HDL)) were higher in the sunflower oil diet group than in the olive oil group.

Role burdens: the impact of employment and family responsibilities on the health status of Latino women

This paper explores the relative effects of employment and family responsibility on the perceived health status of Latino women. The data source analyzed for this study was the 1990 Panel Study of Income Dynamics/Latino National Political Survey (PSID/LNPS) Early-Release File (n = 1,502). Regression analyses were used to investigate the contributions of variables associated with perceived health status, including sociodemographics, Latino ethnicity, language, employment, and family responsibility. The results suggest that annual employment hours, occupation, and family responsibilities, such as child care and weekly housework, significantly affect self-reported health status of employed Latinas. Both social causation and social selection may be underlying the associations found. The results suggest that there is need for the development of public policies that seek to increase Latinas' labor force participation rate since any expansion has the potential to have a positive impact on their health status.

Effects of luteolin 5-O-beta-rutinoside in streptozotocin-induced diabetic rats

We have investigated the antidiabetic activity of luteolin 5-rutinoside in streptozotocin(STZ)-induced diabetic rats. Treatment for 20 days with 2 mg/kg increased both pancreatic insulin and DNA content. When both luteolin 5-rutinoside (2 mg/kg) and glibenclamide (1 mg/kg) were administered concurrently to STZ-diabetic rats, a marked antidiabetic activity was achieved. This effect was evidenced by a significant decrease in glycemia levels (> 50%), a 2.5-fold increase in insulin blood levels and an increase in body and pancreas weight, compared to the diabetic control group.

Serum amino acid changes in rats with thioacetamide-induced liver cirrhosis

To date, no attempt has been made to study alterations occurring in the amino acid profile in chronic models of thioacetamide-induced liver cirrhosis. In this work, changes in serum amino acids and proteins in rats with thioacetamide-induced liver cirrhosis are reported, together with changes in enzyme activities in the liver and serum. Seventeen female Wistar rats were used. Eight rats were given 300 mg thioacetamide/l in drinking water for 4 months and nine rats were given water ad libitum during the same time-period. Significant increases in glycine, alanine, serine, methionine, glutamate, ornithine, phenylalanine, tyrosine, histidine and proline were observed in rats with the resulting experimental liver cirrhosis. Threonine, taurine, glutamine, lysine and citrulline tended to increase while isoleucine, leucine, aspartate, arginine and tryptophan tended to decrease. Total and nonessential amino acids increased significantly in cirrhotic animals. Total essential and aromatic amino acids tended to increase in the thioacetamide-treated group, whereas branched chain amino acids tended to decrease in the same group. Regarding serum proteins, a decrease in albumin concentration in the thioacetamide-treated animals was the only change detected. The liver enzyme activities under observation (aspartate and alanine aminotransferases, glutamate dehydrogenase and threonine deaminase) were lower in the thioacetamide group. Decreases were significant for both transaminases and threonine deaminase. Results for serum activities showed that transaminases did not change in thioacetamide-treated rats in comparison with controls. In contrast, alkaline phosphatase rose dramatically in cirrhotic rats. We conclude that the serum amino acid pattern in this chronic model of liver cirrhosis resembles in part that of the corresponding human disease.

Dietary long-chain polyunsaturated fatty acids influence the recovery of thioacetamide-induced liver cirrhosis in rats

BACKGROUND

The aim of this study was to evaluate the dietary supplementation with omega-3 and omega-6 long-chain polyunsaturated fatty acids on the fatty acid composition of plasma and red blood cell membranes in rats with thioacetamide-induced liver cirrhosis.

METHODS

Thirty-eight female Wistar rats were given 300 mg thioacetamide/L in drinking water for 4 months to induce the experimental liver cirrhosis. Sixteen rats were used as controls. After treatment with thioacetamide, nine rats of each group were killed. Then, thioacetamide-treated rats were divided into three new groups, each receiving a different diet for 2 weeks: a semipurified diet (n = 9), the same diet supplemented with omega-3 long-chain polyunsaturated fatty acids (n = 10), or the same semipurified diet supplemented with omega-3 and omega-6 long-chain polyunsaturated fatty acids simultaneously (n = 10). The remaining control rats were fed the semipurified diet. Liver histology and plasma and erythrocyte fatty acid composition were assessed.

RESULTS

An apparent improvement of the histological damage took place in the rats fed the omega-3+ omega-6-supplemented diet. The diet supplemented with polyunsaturated fatty acids of the omega-3 series induced increases in the omega-3 long-chain polyunsaturated fatty acid levels in total plasma lipids, plasma lipid fractions and in erythrocyte phospholipids, and decreases in omega-6 long-chain polyunsaturated fatty acids in erythrocyte phospholipids during the recovery of rats with thioacetamide-induced liver cirrhosis. The administration of the diet supplemented with both omega-3 and omega-6 long-chain polyunsaturated fatty acids contributed to increase the levels of total plasma saturated, monounsaturated, and omega-6 long-chain polyunsaturated fatty acids from cirrhotic rats.

CONCLUSION

We conclude that the simultaneous supply of long-chain fatty acids of the omega-3 and the omega-6 series can be beneficial to improve the fatty acid status of this experimental model of liver cirrhosis.

Effect of quercitrin on lactose-induced chronic diarrhoea in rats

Quercitrin (3-rhamnosylquercetin) is a bioflavonoid contained in several crude drugs traditionally used for its antidiarrhoeal activity. The antidiarrhoeic effect of quercitrin on experimental chronic diarrhoea in rats was studied. Adult rats were fed for 14 days with a synthetic diet in which all soluble carbohydrates were substituted by lactose, resulting in chronic diarrhoea with body weight loss, colonic hyperplasia, reduced average cell size, increased alkaline phosphatase activity, increased mucus production and cytopathological alterations of the enterocyte. The rest of the animals were allowed to recover from chronic diarrhoea for 3 or 7 days, by feeding them with a standard diet, and half of them were also given quercitrin orally (50 mg/kg day). Diarrhoea ceased 48 h after lactose withdrawal, and body weight recovery was apparent after 3 days. Nevertheless, most of the alterations of the colonic mucosa persisted at that time. Quercitrin-treated rats had less diarrhoeal output and did not show mucosal hyperplasia after three days of treatment. All animals had greatly recovered by the seventh day, but histological alterations were still present, although to a lesser extent in quercitrin-treated rats. Quercitrin and related flavonoids may play a role in intestinal repair following chronic mucosal injury.

Frequency of gallbladder cancer in Chile, a high-risk area

We report an autopsy study of gallbladder cancer prevalence in Chile, where the risk of this disease is among the highest reported world-wide. In 14,768 autopsy protocols obtained from 3 university hospitals, 45% of women and 20% of men older than 20 years had gallstone disease (the major known risk factor for gallbladder cancer). The prevalence of gallbladder cancer in Chileans was compared to that found in a Swedish-Czechoslovakian autopsy study previously published. These countries were chosen because of their high frequency of gallstone disease. The comparison was performed by using logistic regression models adjusting for possible differences in the age-sex structure or the true incidence of gallstones in both populations. We found that the most important single risk factor for gallbladder cancer in Chile was gallstone disease, with an estimated effect on the logistic scale meaning that the cancer risk for subjects with gallstones is seven times higher than for those without the disease. Second in importance was the risk for sex, women being 2.8 times higher than for men. The estimated difference in the sex composition and the incidence of gallstones resulted in 17.9% higher odds of cancer in Chile than in Sweden and Czechoslovakia. However, this difference was not significant. This study suggests that the major etiologic factors of gallbladder cancer in Chileans, Swedes and Czechoslovakians are primarily related to gallstone disease.