Mechanoreceptor afferent activity compared with receptor field dimensions and pressure changes in feline urinary bladder.

The relationship between vesical mechanoreceptor field dimensions and afferent nerve activity recorded in pelvic plexus nerve filaments was examined in chloralose-anesthetized cats. Orthogonal receptor field dimensions were monitored with piezoelectric ultrasonic crystals. Reflexly generated bladder contractile activity made measurements difficult, therefore data were collected from cats subjected to actual sacral rhizotomy. Afferent activity was episodic and was initiated at different pressure and receptor field dimension thresholds. Maximum afferent activity did not correlate with maximum volume or pressure. Furthermore, activity was not linearly related to intravesical pressure, receptor field dimensions, or calculated wall tension. Pressure-length hysteresis of the receptor fields occurred. The responses of identified afferent units and their associated receptor field dimensions to brief contractions elicited by the ganglion stimulant 1,1-dimethyl-4-phenylpiperazinium iodide (2.5-20 micrograms i.a.), studied under constant volume or constant pressure conditions, are compatible with bladder mechanoreceptors behaving as tension receptors. Because activity generated by bladder mechanoreceptors did not correlate in a simple fashion with intravesical pressure or receptor field dimensions, it is concluded that such receptors are influenced by the viscoelastic properties of the bladder wall. Furthermore, as a result of the heterogeneity of the bladder wall, receptor field tension appears to offer a more precise relationship with the activity of bladder wall mechanoreceptors than does intravesical pressure.


Effects of deoxycorticosterone acetate on glucose metabolism in nondiabetic and streptozotocin-diabetic rats.

A previous study in our laboratory showed that streptozotocin (STZ) induced diabetic, deoxycorticosterone acetate (DOCA) induced hypertensive rats exhibited significantly lower levels of plasma glucose than did normotensive diabetic animals. The present experiments further investigate the effects of DOCA treatment on fasting levels of plasma glucose and insulin and on their changes after oral glucose challenge in nondiabetic and STZ-diabetic rats. It was found that, in nondiabetic rats, DOCA-induced hypertension was associated with normal glucose levels and glucose tolerance but with significantly lower levels of plasma insulin. DOCA-treated diabetic animals showed significantly lower levels of plasma glucose, but their plasma insulin concentrations were not significantly different from those of the DOCA vehicle treated diabetic rats. DOCA-treated diabetic rats also had significantly higher plasma levels of cholesterol and triglycerides. It is suggested that DOCA may have a direct or indirect action on the assimilation, production, or utilization of glucose, perhaps leading to an improvement in insulin sensitivity and subsequently a decrease in insulin secretion.


Glucose uptake by adipocytes of obese rats: effect of one bout of acute exercise.

The effect of one bout of acute exercise on impaired glucose metabolism was studied in obese (480 +/- 20 g), untrained rats, at rest (n = 10) and after 60 min of swimming (n = 5). Using the euglycemic, hyperinsulinemic (10 mU.kg-1 x min-1) clamp, glucose clearance rate increased from 7.6 +/- 0.9 at rest to 9.7 +/- 0.5 mL.kg-1 x min-1 after exercise (p < 0.05). Glucose (3-O-[14C]methylglucose) transport (GT) into epididymal adipocytes were incubated with or without insulin. In the absence of insulin, GT was 0.13 +/- 0.02 and 0.26 +/- 0.07 fmol.cell-1 x min-1 at rest and after exercise, respectively. In the presence of insulin (25-1000 microU.mL-1) GT increased at rest from 0.97 +/- 0.08 to 1.13 +/- 0.07 fmol.cell-1 x min-1, and after exercise from 1.35 +/- 0.05 to 1.87 +/- 0.11 fmol.cell-1 x min-1. GT was significantly higher after exercise compared with rest (p < 0.004). At rest, maximal insulin effect was achieved at 100 microU.mL-1, whereas with exercise, GT increased gradually with the insulin dosage. The following may be concluded: (i) the biological effect of insulin is amplified in obese rats by one bout of exercise and (ii) exercise affects GT into enlarged adipocytes by enhancing tissue responsiveness to insulin and by a cellular mechanism unrelated to the insulin action.


Is accelerated oxidation of lactate required for dichloroacetate to lower the level of lactate in blood?

We examined mechanisms by which dichloroacetate (DCA), an activator of pyruvate dehydrogenase (PDH), led to a decrease in the concentration of lactate in blood in a unique "metabolic setting," where the concentration of lactate in blood was 5.4 +/- 0.5 mmol/L. Elevated levels of lactate were induced in anaesthetized rabbits by the administration of a large dose of insulin. The rate of consumption of oxygen was 1.2 +/- 0.1 mmol/min, the respiratory quotient was close to unity, and close to half of the PDH was in its active form; therefore, virtually all ATP synthesis should require flux through PDH. Hence, we predicted that DCA should not cause a significant decrease in the concentration of lactate in blood in this model. In contrast, if DCA was effective, new insights could be obtained into its mechanisms of action, at least in this setting. During steady-state hyperlactatemia, DCA was given as its sodium salt, 2 mmol/kg (n = 10); a control group (n = 5) received equimolar NaCl. Forty minutes later, the level of lactate in blood in the DCA group was 1.3 +/- 0.2 mmol/L, significantly lower than in the NaCl group (4.2 +/- 0.6 mmol/L). To determine the organ(s) responsible for removing lactate, arteriovenous differences were measured in organs drained by the jugular, femoral, and hepatic veins. There was no net uptake of lactate in these drainage beds after DCA was administered. From a quantitative analysis of the rate of removal of lactate and the rate of consumption of oxygen, it seems unlikely that the majority of the decrease in lactate could be directly attributed to an increase in its oxidation.


Motilin and the postprandial motility of the antrum.

This study was designed to establish whether the rise in plasma motilin observed after a meal in humans can influence the postprandial motor activity of the antrum. Antroduodenal postprandial motility profiles and indices obtained from 5 controls and 5 subjects infused with exogenous synthetic motilin (0.1 microgram.kg-1) or with the motilin receptor agonist erythromycin lactobionate (200 mg) were compared. Motilin infusion increased plasma motilin concentrations about 5 times above the physiological range but failed to modify the normal postprandial contractile response. On the other hand, in 4 of the 5 subjects, erythromycin induced an intense motor response that mimicked phase III of the migrating motor complex. Our study demonstrates that, during the postprandial period, motilin antral receptors can be stimulated only with doses of motilin exceeding the physiological plasma concentrations, and that the motor effect obtained did not mimic the usual postprandial motility pattern. Our results, therefore, do not support the proposal that the postprandial motility of the antrum is regulated by the plasma levels of motilin.


Incidence of multinucleated and polyploid aortic smooth muscle cells cultured from different age groups of spontaneously hypertensive rats.

Cell size and incidence of multinucleated, polyploid cells in cultured aortic smooth muscle cells from different age groups of spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY) were compared. Smooth muscle cells from SHR were generally larger than those from WKY, and the percentage of multinucleated smooth muscle cells was always higher in SHR than WKY in the three age groups of rats studied (3-4, 10-12, and 28-30 weeks). In smooth muscle cells from the 3- to 4-week group, there was a positive correlation between cell diameter and the percentage of multinucleated smooth muscle cells. Microdensitometric measurements also showed that the incidence of polyploid smooth muscle cells was always higher in SHR than WKY in the three age groups. There was a positive correlation between DNA density and nuclear area measurements in all the age groups of SHR and WKY. We conclude that cultured aortic smooth muscle cells from different age groups of SHR and WKY contained heterogeneous populations of cells and that, under our culture conditions, the polyploidy of the smooth muscle cells found in vivo was maintained in the SHR and WKY.


Absence of hepatic p-nitrophenol UDP-glucuronosyltransferase induction by spironolactone in male rats: possible involvement of testosterone.

This study was performed to determine whether the lack of spironolactone induction of hepatic p-nitrophenol UDP-glucuronosyltransferase in male rats could be attributed to a presumed interaction between spironolactone and testosterone. The effect of spironolactone was evaluated in four experimental groups: normal females, normal males, castrated males, and castrated males that received testosterone. Enzyme activity was measured in native microsomes and in microsomes activated with UDP-N-acetylglucosamine or Triton X-100. When the nucleotide was included in the incubations, it was observed that enzyme activity in castrated male rats decreased to values approaching those obtained in normal females. Treatment of castrated animals with testosterone enhanced enzyme activity so that no significant difference existed between this group and normal males. This suggests that testosterone may act as an endogenous inducer of hepatic p-nitrophenol glucuronidation. It was also found that only females and castrated males showed an increase in enzyme activity in response to spironolactone treatment. Thus, the absence of an additive effect of endogenous or exogenous testosterone and spironolactone on UDP-glucuronosyltransferase activity suggests that these compounds could share a common induction mechanism, which appears to reach its maximal capacity in male rats. Possible explanations of this observation are discussed. From the analysis of enzyme activity in native and Triton X-100 activated microsomes, it can be postulated that spironolactone enzyme induction in female and castrated male rats could be attributed to an enhancement in the transferase synthesis rather than to an alteration of the membrane environment.


Low concentrations of hydrogen sulphide alter monoamine levels in the developing rat central nervous system.

The central nervous system is one of the primary target organs for hydrogen sulphide (H2S) toxicity; however, there are limited data on the neurotoxic effects of low-dose chronic exposure on the developing nervous system. Levels of serotonin and norepinephrine in the developing rat cerebellum and frontal cortex were determined following chronic exposure to 20 and 75 ppm H2S during perinatal development. Both monoamines were altered in rats exposed to 75 ppm H2S compared with controls; serotonin levels were significantly increased at days 14 and 21 postnatal in both brain regions, and norepinephrine levels were significantly increased at days 7, 14, and 21 postnatal in cerebellum and at day 21 in the frontal cortex. Exposure to 20 ppm H2S significantly increased the levels of serotonin in the frontal cortex at day 21, whereas levels of norepinephrine were significantly reduced in the frontal cortex at days 14 and 21, and at day 14 in the cerebellum.


Reduced sensitivity to dexamethasone of pancreatic islets from obese (fa/fa) rats.

The direct effects of dexamethasone exposure on insulin secretion from islets of fa/fa rats and their lean littermates (Fa/?) were compared. After 72 h culture in 1 nM dexamethasone, glucose (27.5 mM)-stimulated insulin secretion over 90 min from islets of lean rats was significantly decreased compared with islets cultured without dexamethasone (12.9 +/- 1.4 vs. 5.7 +/- 1.0% of total islet content, p < 0.05). Higher doses of dexamethasone for 24-48 h culture produced similar effects. For islets of fa/fa rats, the minimum inhibitory concentration of dexamethasone was 10-fold higher, and islets required at least 48 h exposure for inhibitory effects to be observed. Dexamethasone also decreased the insulin response by islets to glybenclamide, indicating that dexamethasone effects were not specific to glucose transport or metabolism. The results suggest that islets of fa/fa rats may be less sensitive to direct inhibitory effects of glucocorticoids on glucose-stimulated insulin release than islets of lean animals.


Effects of chronic hypoxia on the whole-body insulin action in rats.

The effect of chronic hypoxia on the whole-body insulin action in rats was investigated. Rats were kept in a hypobaric hypoxia chamber maintained at a simulated altitude of 4000 m for 10 weeks. At the end of the experimental period, the mean body weight of the hypoxic rats was significantly lower than that of the control rats. The muscle weight to body ratio of the quadriceps muscle in hypoxic rats was larger than that in control rats, but those of the gastrocnemius, soleus, and extensor digitorum longus muscles did not differ between the control and hypoxic rats. On the other hand, the epididymal fat pads of hypoxic rats were markedly smaller than those of the control rats. The results of a euglycemic clamp experiment with infusions of 14 and 3.6 mU insulin.kg-1.min-1 indicated that the steady-state glucose infusion rate was not statistically different between hypoxic and control rats. It is suggested that chronic hypoxia did not influence the whole-body insulin action on glucose transport activity.


[The process of adaptation to illness in persons with acquired immunodeficiency syndrome].

This study was conducted to describe the adaptation process to illness. The study subjects were 50 AIDS patients. The study variables and tools of measurement were chosen according to the Psychosocial Adaptation Model of Craig and Edwards (1983). It was found that throughout the disease process an appraisal-reappraisal of the situation is continuous. The sick person constantly evaluated the severity of his losses and the availability of the coping strategies at his disposal. The study results demonstrated that persons afflicted with AIDS suffer considerable amount of physical and psychosocial prejudice. It was apparent that the patients who suffered severe physical, psychological and social losses used avoidance strategies. Those preoccupied with the physical losses had a tendency to use the strategy of emotional discharge. Otherwise the study subjects sought information rather than emotional discharge to come to terms with their losses. In addition, the use of logical analysis strategies was associated with an increase in psychological well-being. In contrast, the strategy of avoidance was associated with a decrease in well-being. Finally, the subjects with the advanced disease experienced more severe losses of a social nature and made less use of logical analysis strategies than did subjects in the early phases of the disease.


[Heart failure in the population: prevalence data].

We report on the prevalence of chronic heart failure (CHF) in a random sample of a population (aged 20-64 years) from the Veneto region in northern Italy. The relationship between CHF and hypertension and obesity was also investigated. These data were collected during an international research project coordinated by the World Health Organization. The overall prevalence of CHF was 2.0% both in the male and female population. The prevalence of CHF increased significantly with age and was positively correlated with body mass index in both sexes. Patients with borderline hypertension showed a 3.5-fold increased prevalence of CHF. The prevalence of CHF was 4.9-fold higher in hypertensive than in the normotensive subjects. Patients treated with hypotensive drugs had a significantly higher prevalence of CHF than untreated patients.


[The circadian rhythm of plasma vasoactive intestinal peptide, atrial natriuretic peptide, renin activity, aldosterone and cortisol in heart transplantation. The effects of immunosuppressive therapy].

Vasoactive intestinal peptide (VIP) is released both by neural endings and lymphocytes. Aim of our investigation was to study the effects of immunosuppressive therapy on VIP plasma concentrations. The research has been performed on 10 heart transplanted patients assuming cyclosporine (CYCL) and prednisone (PRED). The circulating T lymphocyte subsets, atrial natriuretic peptide (ANP), plasma renin activity (PRA), plasma aldosterone (PA) and plasma cortisol (PC) have been also assayed. Blood pressure (BP) and heart rate (HR) have been monitored over a 24-hour period to detect whether circulating VIP in heart transplanted patients is influenced by pharmacologically-induced interactions. Seriate samplings along the 24-hour span have been performed. Mean values of ANP, PRA and PA were increased, while VIP, PC and T lymphocyte subsets were decreased in heart transplanted patients as compared to clinically healthy subjects. ANOVA and Cosinor analysis showed, respectively, a statistically significant 24-hour variability and circadian rhythm for all the investigated variables only in normal subjects. BP and HR circadian rhythm in heart transplanted patients suggest that the adrenergic activity regulating the cardiovascular system is restored. This finding argues that the reduction in VIP plasma concentrations is likely due to the decreased lymphocyte production secondary to immunosuppressive therapy, or can also be ascribed to the inhibiting action of high circulating levels of ANP.


Prolonged asymptomatic catheter-induced left and right coronary artery spasm resistant to high dose of intracoronary nitroglycerin.

A 58-year-old woman, referred to our hospital to undergo invasive assessment of mitral valve stenosis, demonstrated prolonged asymptomatic catheter-induced left anterior descending and right coronary artery spasm during coronary arteriography. Coronary spasms were not associated with ECG and arterial blood pressure changes. Intracoronary injection of nitroglycerin (300 and 600 micrograms bolus) did not resolve coronary spasm. Coronary angiography, repeated 24 hours later using the same procedure and materials, did not show any evidence of coronary artery spasm. The present clinical case is interesting for 3 reasons. First, the presence of prolonged proximal double-vessel coronary spasm not associated with symptoms or signs of acute myocardial ischemia; second, the incapacity of high dose of intracoronary nitroglycerin to resolve the coronary spasm; third, the dramatic changes in the sensitivity of coronary artery to mechanical stimulation in different days.


[The effect of superoxide dismutase and catalase on the delayed toxicity of doxorubicin].

The production of oxygen-free radicals has been proposed as a determinant of the delayed toxicity of doxorubicin. The aim of the present investigation was to evaluate the potential cardioprotective effect of superoxide dismutase (SOD) and catalase (CAT) against the delayed cardiomyopathy induced by doxorubicin (DXR) in a rat model. Female Sprague Dawley rats received 3 mg/kg of DXR intravenously weekly for 4 weeks. SOD or CAT were administered intravenously at the dose of 10000 U/kg 2 min before and 30 min after each DXR administration. Cardiac toxicity was monitored by means of electrocardiography (QaT interval) and by light and electron microscopy evaluation of left ventricle fragments. DXR treated rats showed, in comparison with control animals, a decrease of body weight gain, a progressive and irreversible prolongation of QaT and significant morphologic lesions consisting in myocyte vacuolization and myofibrillar loss. SOD significantly prevented the impairment of body weight gain and QaT prolongation. Moreover, morphologic lesions were significantly reduced in rats receiving DXR + SOD. On the contrary, CAT seems to be completely devoid of protective effect.


[Variations in the purine metabolism of the reperfused heart].

Isolated hearts were subjected to 30 min of aerobic perfusion followed by 10 min of global normothermic ischemia and 40 min of reperfusion. We determined the release of purine catabolites (adenosine, inosine, hypoxanthine, xanthine, uric acid) and the incorporation of exogenous 3H-adenosine and 14C-hypoxanthine into cellular nucleotides. Ischemia-reperfusion produced remarkable reduction in the release of purine catabolites, with no significant variation in the incorporation of adenosine and hypoxanthine.


[L-propionylcarnitine taurine amide induces the metabolic recovery of the isolated postischemic rat heart].

The effect of reperfusion with L-propionyl-carnitine-taurinammide 1 mM was evaluated on the metabolic recovery of the isolated postischemic rat heart. Data referring to the tissue concentration of the high-energy phosphates, oxypurines, nucleosides, nicotinic coenzymes, lactate and pyruvate indicate that L-propionyl-carnitine-taurinammide significantly improves the metabolism of the reperfused myocardium. In particular, ATP, creatinphosphate, GTP, sum of adenine nucleotides and the energy charge resulted 1.80, 1.83, 3.47, 1.47 and 1.20 times higher respectively than the corresponding values recorded in control reperfused heart (p < 0.01 all). These data, out of supplying the necessary biochemical support to the beneficial effects of L-propionyl-carnitine-taurinammide on hemodynamics obtained in previous studies, suggest that L-propionyl-carnitine-taurinammide might represent a useful tool for the pharmacological treatment of myocardial infarction.


[Coenzyme Q9 biosynthesis in the aging myocardium after ischemia and reperfusion].

The purpose of the present study was to evaluate the biosynthesis of coenzyme Q9 (CoQ9) in isolated and perfused young (6 months) and aged (24 months) rat hearts, either under aerobic perfusion condition or during postischemic reperfusion. The young and aged hearts have been divided into 2 groups: Group A, aerobic perfusion for 60 min with recirculating Krebs-Henseleit solution, containing 0.8 microM p-OH-[U-14C]benzoate plus 2.5 mM mevalonlactone; Group B, severe ischemic perfusion for 30 min, followed by 60 min of reperfusion under the same experimental condition of Group A. At the end of the reperfusion the mitochondrial content of CoQ9 was lower in young than aged rat hearts (p < 0.01). In Group A the incorporation of the labeled precursor into mitochondrial CoQ9 was greater in the hearts of aged than young rats (p < 0.01); on the contrary, in Group B this incorporation was significantly reduced in aged than in young rats (p < 0.05). Thus, it is possible that, in the aged rat heart, the higher activity of CoQ9 biosynthesis is related to an elevated turnover of the coenzyme due to the aging process; moreover, this activity is partially reduced by an ischemic-reperfusion stress.


[Heterotopic heart transplantation in the rat: an experimental method for evaluating myocardial protection].

This research represents the first part of a project finalized to prolong the ischemic time of the explanted heart. Our experimental model utilizes rat hearts heterotopically transplanted into the abdomen of a recipient: a denervated heart but perfused by blood as to permit a good evaluation of the reperfusion damage. We used 3 different types of cardioplegic solutions to achieve cardiac arrest: the first of the intracellular fluid type, the second of the extracellular type and the third one as a standard cardioplegic solution supplemented by Ca++ antagonist. Cold saline 4 degrees C was used as control. Histological patterns, birefringence index and intracellular content of high energy phosphates were evaluated. Specimens were taken after 1 hour of ischemic time and after 1 hour of reperfusion. Early results show that administration of cardioplegic solution maintains birefringence index and preserve high energy phosphates: among the 3 different types of solution the intracellular type seems to achieve better results although the number of experiments is too small to show any statistical significance. These data show that this model is appropriate to test cardioplegic solutions and their effectiveness.


[The effect of peripheral reflections on the left ventricle].

In order to evaluate the effect of modifications in reflections timing on the ventricular performance, 10 isolated rabbit hearts were connected to rubber tubes of different lengths (0.5, 0.8, 1.0, 2.5 m) with terminal stopper and 2 cylindric small tubes as constant hydraulic resistance. The terminal connection produced wide reflections which returned to the ventricle in early, mid, late systole and in the diastolic phase (2.5 m). Ventricular and aortic pressure, and aortic flow were continuously recorded, sampled and stored on a personal computer. Instantaneous and total systolic ventricular work and stroke volume were calculated using an automatic procedure. Mean coronary perfusion pressure was calculated as difference between aortic and ventricular pressure in diastolic phase. The results demonstrate an important modification of the ventricular performance related to the anticipation of the reflected pulse. The anticipation produces a decrease in the stroke volume (-14.5%), a decrease in the external work of the ventricle (-21%) and a decrease in mean coronary perfusion pressure (-28%). The first two parameters describe the performance of the pump with respect to the load, and the third evaluates the perfusion of the pump itself. Reported to the clinical situation, these results demonstrate that an increased stiffness of the aorta has a double negative effect, a decrease in cardiac output and in external ventricular work, and moreover a decrease in coronary pressure, which produces a reduction of coronary flow.


[A noninvasive assessment of the gain in baroceptor control of the heart rate in man].

In this study we addressed the problem of the noninvasive evaluation of the overall gain of baroreceptor control of heart period. We studied a population of healthy controls (n = 49, age 30 +/- 2 years, systolic arterial pressure [by Finapres] 114 +/- 1 mmHg) and a group of mild hypertensive subjects (n = 14, age 51 +/- 2 years, systolic arterial pressure 151 +/- 5 mmHg). Subjects were studied at rest both in absence and in presence of chronic beta-adrenergic receptor blockade (atenolol: controls 50 mg po oid x 4 days; hypertensives 100 mg po oid x 2 weeks). Spectral analysis of RR interval and of systolic arterial pressure variabilities provided noninvasive markers of autonomic control of the SA node and of the vasculature. The index alpha, obtained from bivariate cross spectral and spectral analysis provided a quantitative assessment of the closed loop gain of baroreceptor control of the heart period. The index alpha resulted more elevated in the normotensive than in the hypertensive group. Additionally it appeared significantly increased at the end of the treatment with the beta-adrenergic blocking drug atenolol. Furthermore, alpha appeared significantly and negatively correlated with age, systolic arterial pressure and, although weakly, with low frequency; it was positively correlated with the average RR interval. In conclusion, this study suggested an important link between the average level of sympathetic activity and baroreceptor control of heart rate in normotensive and mild hypertensive subjects. The clinical importance of this sympathetic modulation of the gain of the heart period/arterial pressure relationship can now be assessed with this noninvasive approach.


[The relationship between anomalies in the autonomous nervous system and left ventricular dysfunction in patients with hypertrophic cardiomyopathy].

This study was undertaken to assess autonomic nervous system (ANS) activity and its relation to left ventricular function in 40 patients (mean age: 41 +/- 17 years) with hypertrophic cardiomyopathy (HC), in sinus rhythm, off-drugs. Patients were grouped according to the results of radionuclide angiography: 26 had an ejection fraction > 50% (Group A), whereas 14 had an ejection fraction < or = 50% (Group B). Evaluation of parasympathetic activity showed abnormalities in: heart rate (HR) response during Valsalva (< or = 1.1) in 2 Group A (8%) and 12 Group B (86%) patients (p < 0.001); HR variability during deep breathing (< or = 10 b/min) in 2 Group A (8%) and 14 Group B (100%) patients (p < 0.001); immediate HR response to standing (30:15 < or = 1.0) in 2 Group A (8%) and 6 Group B (43%) patients (p < 0.025). Assessment of sympathetic activity showed abnormalities in: systolic blood pressure fall to standing (> 20 mmHg) in 2 Group B (14%) patients only (NS); diastolic blood pressure response to handgrip (< 10 mmHg) in 4 Group B (29%) patients only (p < 0.025). Thus, in HC: impaired parasympathetic control is common in those patients showing left ventricular dysfunction; concurrent sympathetic abnormality may also occur in this subgroup of patients; ANS dysfunction seems to be merely an epiphenomenon which marks the severity of left ventricular derangement.


A review of recent events in the history of diabetes nutritional care.

This paper provides an historical documentation and discussion of events that have influenced diabetes nutritional management in recent years. Many factors have shaped the nutrition care that persons with diabetes receive today. Nutrition science research is part of the history, as are myriad discoveries, research, advanced technologies, and evolving health care systems. This review of the past four decades will contribute a perspective of how we have gotten to where we are today.


Perceived and actual knowledge of diet by individuals with non-insulin-dependent diabetes.

A study was conducted to investigate both the perceived and actual knowledge of diet by 101 individuals with non-insulin-dependent diabetes mellitus (NIDDM). A survey instrument was developed containing three sections: perceptions of diet knowledge, demonstrated knowledge of diet, and demographic information. Perceived and actual knowledge of diet in the study group were compared with the following variables: years of education, types of diabetes regimen, participation in care, recency of dietary instruction, understanding of diet, and levels of self blood glucose monitoring (SBGM). Analysis indicated significant differences for knowledge and levels of education, perceptions and knowledge and recency of instruction, perceptions and knowledge and understanding of diet, and perceptions and self blood glucose monitoring. A positive linear relationship was noted between perceptions and actual knowledge of the diabetic diet.


Management of obesity in diabetes mellitus.

A primary goal of treatment in obese individuals with NIDDM is weight loss and maintenance. Obesity is a precipitating factor for the development of NIDDM in individuals who are genetically at risk. A variety of weight-loss regimens are available to match the specific needs and lifestyles of individuals. Hypocaloric high-fiber diets have been found to be effective in achieving weight loss, as well as aiding in glycemic and lipid control. Very low calorie diets, administered under medical supervision, are useful for obese NIDDM patients with 18-55 kilograms of weight to lose. Lifestyle education appears to be an important element of any successful weight loss program.


Diabetes quality assurance checklist: assessment of inter-rater and intra-rater reliability.

The Diabetes Quality Assurance (DQA) Checklist was developed to measure adherence to standards of diabetes care. Two raters simultaneously scored a convenience sample of 23 charts of patients with diabetes. These raters scored each chart again 5-7 weeks later. Data obtained were used to assess inter-rater and intra-rater reliability. Inter-rater reliability was estimated for basic assessment at Time 1 (r = 0.94, 95% CI 0.86-0.97) and at Time 2 (r = 0.91, 95% CI 0.81-0.96); and for high-risk assessment at Time 1 (r = 0.88, 95% CI 0.73-0.95). Intra-rater reliability for the basic assessment was estimated for Reviewer 1 (r = 0.84, 95% CI 0.65-0.93) and for Reviewer 2 (r = 0.75, 95% CI 0.49-0.89); the high-risk estimate for Review 1 was 0.60 (95% CI 0.25-0.81) and for Reviewer 2 0.97 (95% CI 0.94-0.99). The DQA Checklist is useful for monitoring and assessing diabetes care.


A regional diabetes nutrition education program: its effect on knowledge and eating behavior.

The effect of a nutrition education program on knowledge and self-care behavior in a group of individuals with diabetes was evaluated. The nutrition education program was developed using outlines and knowledge tests produced by the University of Michigan Diabetes Research and Training Center. The program, sponsored by the American Diabetes Association, Akron Chapter, was presented free of charge to Northeast Ohio area residents. Forty-four individuals participated in the study. Results indicated a statistically significant (p < 0.01) gain in knowledge but no statistically significant change in eating behavior for the sample. However, post-food records indicated that the mean for the percentage of total kcalories (kcals) from protein and fat (ie, 20% and 28%, respectively) were within the American Diabetes Association's recommendations of no more than 20% of kcals from protein and 30% of kcals from fat. In addition, the percentage of kcals from carbohydrate and the recommended total number of kcals improved toward the recommended levels.


Vitamin and mineral supplementation in patients with diabetes mellitus.

Most patients with diabetes generally do not require routine vitamin and mineral supplementation, just like the rest of the population. However, based on the published medical literature, it would appear that some degree of supplementation with certain vitamins (eg, vitamins C and E) and minerals (eg, magnesium) may be worthwhile and become more commonly recommended in the future. The role of vitamins and minerals in controlling blood glucose levels in the patients with diabetes also is discussed.


A simplified approach to documentation of inpatient diabetes education.

The DTP/DR is an effective form for planning, implementing, and documenting patient response to diabetes teaching in the inpatient setting. The form improves the consistency of diabetes teaching, the quality of patient care, and the clarity of documentation. Use of the form decreases time required for documentation and facilitates the recording of patient/family responses to teaching.


Foot care: knowledge retention and self-care practices.

This study investigated the effectiveness of a "hands-on" foot care teaching/learning approach for adults with diabetes. By random assignment, the control group received a lecture presentation on foot care, while the experimental group participated in a hands-on session on foot care in addition to the lecture presentation. Data concerning the subjects' foot care knowledge and skills, the condition of their feet, and their level of HbA1c were gathered prior to and six months after the foot care educational sessions. No significant increases in knowledge about foot care were observed in the experimental group. The experimental group reported improvements in inspecting and washing their feet on a daily basis, and in care of the toenails. No significant differences were observed in the status of the subjects' feet. The HbA1c readings were significantly improved for both the experimental (t = 4.10, df = 10, p = 0.002) and control (t = 2.25, df = 9, p = 0.051) groups. A hands-on educational session may improve foot care practices temporarily. However, long term effects need to be studied to discern overall improvement of foot care practices and physical status of the feet.


Outcomes of hypoglycemia treated by standardized protocol in a community hospital.

Hypoglycemia in patients with diabetes was treated by a standardized protocol in a 300-bed community hospital. Patient outcomes were studied retrospectively using data from medical records. Hypoglycemia was defined as a blood glucose level below 80 mg/dL when symptoms were present, or 60 mg/dL regardless of symptoms. Treatment consisted of 20 grams of fast-acting carbohydrate repeated every 15 minutes until the blood glucose level was above 80 mg/dL. The blood glucose level was then rechecked one hour after treatment. Data from 179 episodes were evaluated. In 153 (85%) cases, the blood glucose levels were within the target range (80-200 mg/dL) at the conclusion of treatment. In 135 (76%) cases, the blood glucose level at one hour following treatment was within the same target range.


The relationship between health beliefs, adherence, and metabolic control of diabetes.

There is evidence that an individual's health beliefs influence performance of health behaviors. The purpose of this study was to determine whether health beliefs in persons with diabetes could be modified during a clinical education program and whether the health beliefs were related to adherence to self-care instructions and metabolic control of diabetes. Health beliefs and HbA1c were measured at baseline in 189 adult outpatients with diabetes. Diabetes educators then attempted to modify health beliefs that were not conducive to positive health behaviors. Following education, some health beliefs were modified in a positive direction. Modest, but statistically significant increases in perceived severity of diabetes, perceived ability to carry out recommended behaviors, and perceived benefits of treatment were observed. Although HbA1c improved significantly in a subgroup of patients, this improvement could not be directly associated with any health belief or with self-reported adherence by the measures used in this study.


Establishing and sustaining state-of-the-art diabetes patient education programs: research and recommendations.

Frequently, diabetes educators in hospitals report meeting severe organizational barriers when attempting to implement advances in diabetes patient education (DPE). This paper reports on how eight successful diabetes patient education programs coped with potential barriers. The results are based on interviews of professionals who played central roles in introducing and sustaining the programs. Many of the identified problems centered around two issues--acquiring needed resources and communicating about the program to a variety of key groups.


Nutritional considerations for other complications of diabetes.

The long-term complications of diabetes can have a devastating effect on an individual's self-esteem and outlook on life. Some preliminary studies have suggested that normalization of blood glucose levels may prevent or reverse the complications of diabetes in some individuals. Nutrition and diabetes meal planning play a critical role toward achieving this normalization. It is our job as diabetes educators to fully assess a patient's eating and life-style habits, as well as to recognize any complications from diabetes that the patient may be coping with at this time. Depending on the type of complication, diet alterations may need to be made to meet the patient's current needs, ie, reducing fiber content of the diet temporarily in patients with mild gastroparesis, or increasing the protein content of the diet in patients with nephropathy and a foot ulcer. By setting positive, attainable goals, the individual with diabetes may lead a healthier, more productive life in which the complications from diabetes can be prevented, reduced, or better tolerated.


[The occupational morbidity of workers in the foundry shops of Russia].

Epidemiologic studies concerning the occupational morbidity of the foundry workers were carried out for the first time within the Russian Federation. Studies revealed the causes of diseases during 13 years, helped to create the structure and prevalence of entities and analysed the parameters of development and course of diseases, which helped to define the risk groups in silicosis and vibration disease formation and establish the prophylactic measures.


[The characteristics of the development and course of pneumoconiosis under the conditions of a mountain climate].

Analysis of pneumoconiosis course in workers exposed to dust in the mines of different altitudes showed, that the increased altitude augmented mountainous hypobaric hypoxia hasten the development of pneumoconiotic process and increase the number of nodular pneumoconiosis growing progressively worse. Pneumoconiosis develops considerably earlier and nodular forms predominate in the newcomers than in native workers. The frequency of such complications, as chronic bronchitis, asthmatic syndrome decreases in accordance with increasing of altitude which can be explained by the features of inhabitants' immunologic status and peculiarity of the mountainous climate.


[Immunological studies in byssinosis from exposure to a mixed plant dust (jute, flax and kenaf].

Complex immunologic studies using 1 and 2 level tests in 221 individuals (171 workers of raw material processing shops and 50 volunteers) revealed the similar changes in immunologic status of people suffering from byssinosis and workers of long length of service: decreased T-lymphocyte level (owing to T-helpers), phagocyte count and increased serum IgA, IgM in comparison with healthy people. Depressed phagocytosis in 79.6% of people facing byssinosis and 71% of workers with the long length of service can be caused by Gram negative bacteria, contaminating the air of industrial premises. Workers with the short length of service showed increased T-cells level (owing to T-suppressors) and lowered serum IgA, which can be considered as a primary immune response to the dust.


[The results and outlook of a clinico-epidemiological study of the problem of the carcinogenic hazard in industry].

Much attention is paid to clinical and epidemiological aspects of carcinogenic hazards in the production of asbestos textile, asbestos cement, friction, graphite and furniture goods. "Dose-response" relationship in exposure to occupational carcinogens was studied, criteria of occupational malignant neoplasma appurtenance were worked out, role of carcinogenic factors in malignant tumors of rare localisations was shown, signs of carcinogenic aerosols effects described and prophylactic measures suggested.


[The immunostimulating properties of erythrocytes subjected to the action of ultraviolet irradiation and electromagnetic radiation during vibration exposure].

Erythrocytes exposed to the ultraviolet (EUV) and electromagnetic (EEM) irradiation in healthy rats and rats exposed to vibration can stimulate humoral immune response to the ram erythrocytes. EEM had immune-stimulating activity higher. Heavy subpopulation of EEM and EUV had immune-stimulating activity, light subpopulation of EUV and EEM weakened the immune-stimulating effect caused by heavy EEM and EUV during vibration.


[Local barotherapy in the combined treatment of occupational eczema].

Drug-free techniques in the treatment of occupational dermatoses present a major clinical research problem area. The active hyperemia local barotherapy technique was tested as a possible solution to this problem. 52 occupational eczema cases were studied, part of which, in addition to routine drug therapy, were exposed to local barotherapy. The technique was found highly effective with markedly decreased temporary disability of the patients, improved immediate and long-term therapeutic effects, and limited administration of drugs. The technique can be recommended for wide use in clinical practice.


[The gas chromatographic determination of dichlorobutenes and trichlorobutenes in washings from the skin].

A sensitive selective method of unsaturated chlorated hydrocarbons detection by means of gas chromatography in skin was worked out. The limits are: for 3,4-dichlorobutene (DCB)-1-0.0024 mu g, for 1,3 DCB-2-0.0027 mu g, for 1,4-DCB-2 (cys)-0.0024 mu g, for 1,4-DCB-2 (trans)-0.0032 mu g, for 2,3,4 trichlorobutene (TCB)-1-0.0093 mu g in analysed volume. The method can be used for the sanitary control of the skin contamination in subjects exposed to DCB and TCB.


[The gas chromatographic determination of sulfur- and oxygen-containing organic compounds released into the air of cellulose sulfate works].

The article presents data on the design of sensitive, selective, useful in group analysis method to detect dimethylsulphide, dimethyldisulphide, acetic, propionic, butyric and valeric acids, methyl alcohol and phenol by means of gas chromatography in the air of cellulose sulphate production working zone. The methods were tested in examining the work conditions in Bratsk found-lavage shops.


[Scientific and technical progress and railroad hygiene].

Article deals with the experience in using of real way hygiene for improvement of the work conditions for railway workers. Positive influence of hygiene on the scientific and technologic progress in the studied branch of industry was approved. New scientific and industrial structures in hygiene and health care of the railway workers may be created during the construction of the new economic relationship.


[Diseases of the upper respiratory tract in workers in "dusty" jobs].

Diseases of the upper respiratory tract are wide spread in the workers exposed to dust and closely correlate with the length of service. Pathologic process grows severe and disseminates the upper respiratory tract according to prolongation of the exposure to dust. The main pathologic mechanisms of process in the upper respiratory tract mucosa are: disorder of mucociliary clearance, disturbance of the regional immunity and the acid-base balance of tissues. Criteria of occupational connection of the nose, throat and larynx dystrophic diseases in workers exposed to dust are given.


Construction of shuttle vectors for cloning in Escherichia coli and Acetobacter pasteurianus.

New cloning vectors were prepared with the aid of a large plasmid isolated from Acetobacter pasteurianus and from plasmids pBR322 and pUC4-KAPA. Of the prepared cloning vectors, pACK5 contains a gene coding for kanamycin resistance, pACT7 and pACT71 contain a gene coding for tetracycline resistance and vector pACG3 with a gene coding for both kanamycin and tetracycline resistance. The vectors prepared only contained the beginning of replication from the pAC1 plasmid and possessed the ability to replicate within E. coli and A. pasteurianus. The vectors are highly stable in both strains and during the 5-d cultivation under nonselective conditions are not eliminated.


Interaction of 2-deoxy-D-glucose and adenine with phosphate anion uptake in yeast.

The transport of inorganic phosphate anions into yeast cells (after preincubation with glucose, fructose or another metabolizable sugar, and in the presence of glucose) shows two kinetic components with half-saturation constants of 40 mumol/L and 2.4 mmol/L. The uptake was strikingly stimulated by 2-deoxy-D-glucose (2-dGlc) at lower concentrations but inhibited above 100 mmol/L. A similar stimulation was caused by adenine (0.01-1 mmol/L) and a very small one by uracil and inorganic sulfate. It is suggested that either a phosphorylation reaction accompanies the transport (2-dGlc) or that some compounds stimulate the H(+)-ATPase more than inorganic phosphate itself and thus increase its rate of transport.


Protective efficacy of different cell-wall fractions of Mycobacterium tuberculosis.

Immunization with various cell-wall fractions of M. tuberculosis H37Ra, progressively depleted of lipids (cell-wall-insoluble fraction; CWIF), soluble proteins (cell-wall core; CWC), mycolic acids and arabinogalactans (cell-wall-protein-peptidoglycan complex; CW-PPC) elicited significant levels of both humoral and cell-mediated immune response. Mice immunized with these fractions, when challenged with an LD50 dose of M. tuberculosis H37Rv, exhibited significant protection as revealed by high survival rates and decreased bacterial load in lungs, liver and spleen, as compared to nonimmunized animals.


Effect of increasing methanol concentrations on physiology and cytology of Candida boidinii.

Concentration of methanol in the medium strongly affected not only the physiology but also the cytology of Candida boidinii strain 2 cells in a methanol-limited chemostat at a constant dilution rate D 0.1/h and at low pH 3.0. The formation of large cubic peroxisomes with high alcohol oxidase (AO) activity observed at low methanol concentration (S0 3 g/L) disappeared on increasing the methanol concentration in the inflow medium. The AO activity in the cells sharply decreased, followed by accumulation of riboflavin phosphate and residual methanol in the medium. The activity of catalase was relatively stable. At methanol concentration S0 > KI (KI equal to 12 g methanol per L), which included a substantial increase in methanol dissimilation, documented by higher formaldehyde and formate dehydrogenase activities and by lower yield coefficient on methanol, the yeast cells contained large lobe-shaped peroxisomes and a smaller number of larger mitochondria. The cells formed pseudomycelium with a thick septum between the mother and daughter cells.


Citric acid production by Aspergillus niger using media containing low concentrations of glucose or corn starch.

By using an appropriate ratio of carbon source to mineral components, we obtained comparable citrate yields in media containing different concentrations of glucose. The enzyme system of inoculum passed on gradually from "growth" state to "production" state during the mould growth. In the starch medium, the critical factors of citric acid production are the aeration efficiency of the medium and the amylase formation of the strain. The air interruption exhibited a prolonged inhibition of the production rate but not of the citrate yield in glucose medium while those parameters in starch medium containing excessive urea were briefly but severely inhibited. After being affected by these unfavorable conditions, the production activity of Aspergillus niger could be restored by applying an appropriate fermentation process.


Effect of nitrogen limitation and sporulation on sterol and lipid formation in Saccharomyces cerevisiae.

The content of sterols and lipids was compared in the cells of Saccharomyces cerevisiae cultivated in sporulation and the sterol-induction nitrogen-limited media. After 24 h the measured values in the two cultivations did not significantly differ. However, after subsequent 24 h, further formation of lipid globules and a corresponding increase of lipid and sterol content was detected only in the sterol-induction medium. To demonstrate the similarity of physiological state during the first day of the two cultivations, the combined cultivations were performed. Maximum sporulation, suggesting maximum similarity, of the two processes was achieved when the cells were grown in the sterol-induction medium for 15 h and then transferred to a sporulation medium.


Bacterial endotoxins as potential antitumor agents. Tumor mass loss in mice treated with bacterial lipopolysaccharides of Shigella dysenteriae serovar 1.

Natural and modified preparations of lipopolysaccharides and lipopolysaccharide-protein complexes isolated from the S- and R-form of Shigella dysenteriae serovar 1 were found to markedly inhibit the initial growth of mouse solid tumors derived from Németh-Kellner lymphoma, Gardner 6C3HED lymphoma, an ill-defined syngeneic lymphoma of DBA mice (Skalsky lymphoma) and LP-2 plasmacytoma. The biopreparations were given intraperitoneally, most frequently at a dose range from 50 to 200 micrograms per mouse; significant inhibitory effects on tumor growth were evidenced even in mice bearing tumors weighing 113 to 507 mg.


Effect of crude bacterial lipids on the course of Listeria infection in mice.

Crude lipids from 37 strains belonging to 32 bacterial species were isolated. By injecting mice with lipids 5 d prior to challenge with a virulent strain of Listeria monocytogenes, immunostimulatory activity in 19 preparations was found. In general, lipids of Gram-negative bacteria appeared to be more effective. As to bacilli, an extraordinary activity was found in the lipids of Bacillus firmus. Lipids of various species of the genus Listeria were found to be active in approximately one-half of cases. Among other Gram-positive bacteria, significant activity of lipids was found in Corynebacterium xerosis, Propionibacterium acnes and BCG. The composition of fatty acids in the lipids did not differ significantly from that reported in the literature and their mutual differences could not explain the different biological activity. In selected strains of Gram-negative bacteria lipids were repeatedly purified with anhydrous chloroform; these preparations were found to be inactive as compared with original chloroform-methanol lipids.


Protein kinase C isozyme expression in human leukemia-lymphoma cell lines--an immunocytochemical study.

There have been an increasing number of reports describing a pivotal role for phosphorylation in cellular responses for cell differentiation and proliferation. We examined an immunocytochemical expression of protein kinase C(PKC) isozymes (type I, II, and III) in 22 leukemia-lymphoma cell lines. Of these cell lines, 21 expressed type II PKC and 17 showed the co-expression of both types II and III PKC in varying degree. The cell line without PKC activity showed far less [3H]-TdR uptake and no heterotransplantation in nude mice. Types II and III PKC appear to relate to cell proliferation in certain leukemia-lymphoma cell lines.


Mitoxantrone and intermediate-dose cytosine arabinoside for poor-risk acute leukemias: response to treatment and factors influencing outcome.

Mitoxantrone (MIT, 12 mg/m2, i.v. 5 days) and intermediate-dose cytosine arabinoside (IDAC 1 g/m2/12 h, i.v. 3 days) was given to 43 patients with poor-risk acute leukemias (AL). Moderate or severe toxicity was infrequent. The proportion of complete remissions (CR) in the main patient categories was as follows: 15/18 (85 per cent) in acute myeloid leukemia (AML) in the first relapse, 2/6 in ALL in the first relapse, 0/2 in AML in relapse after bone marrow transplantation (BMT), 2/7 in AML refractory to first-line treatment (REF-AL), and 1/6 in postmyelodysplastic (PMD-AL) plus secondary AL (S-AL). The mortality rate during induction was 23 per cent. Median duration of CR was 24 weeks. The multivariate prognostic factor analysis on CR obtention showed that data concerning treatment for the first relapse and platelet count higher than the median of the series were favourable. On the contrary, PMD-AL, S-AL and REF-AL were unfavourable situations. A percentage of marrow erythroblasts superior to the median was a favourable prognostic factor for survival. Finally, the duration of CR after MIT-IDAC was directly related to the duration of previous CR. In conclusion, MIT-IDAC was highly effective to attain CR in AML in the first relapse. However, due to the poor long-term results in these patients, additional measures are recommended after CR.


Production of multiple cytokines by Hodgkin's disease derived cell lines.

The production of cytokines was analysed in Hodgkin's disease (HD) derived cell lines by enzyme linked immunosorbent tests (ELISA) and Northern blot experiments. Our results demonstrate that HD derived cell lines produce a variety of cytokines, such as IL1 alpha, IL4, IL5, IL6, IL8, TNF alpha, TNF beta and GM-CSF but not IL1 beta, IL2, IL3 and G-CSF. In cell lines with a high expression of CD25 (the light chain of the IL2 receptor), we found soluble IL2 receptors in the supernatants. In addition, receptors for IL6 could be detected in most of the HD derived cell lines. However the growth of HD derived cell lines, which produce IL6 and IL6 receptors could not be inhibited by anti-IL6 antibodies. From our data we conclude, that IL6 and additional cytokines may be involved in the biology of HD.


Trends in the management of childhood diarrhoea in Egypt: 1979-1990.

Until 1979, diarrhoeal disease accounted for roughly half of all infant and childhood deaths in Egypt, partly because curative care was largely inappropriate. The National Control of Diarrhoeal Diseases Project (NCDDP) addressed this problem from 1982 to 1991. Since 1979 many aspects of diarrhoeal disease in Egypt have been addressed in many studies. This paper reviews that literature, finding considerable improvements in case management, particularly in the use of oral rehydration solution and in feeding during diarrhoeal episodes. This is due primarily to the NCDDP. At the same time diarrhoeal mortality declined rapidly, both absolutely and as a percentage of total mortality. Persistent diarrhoeas, which have become an increasing proportion of the remaining mortality, have not been satisfactorily addressed, and irrational treatment with drugs remains a major problem.


Cytophagic histiocytic panniculitis: a diagnostic dilemma.

Cytophagic histiocytic panniculitis (CHP) is a recently recognized entity that frequently poses a perplexing diagnostic problem. Although the classical case presents with a relapsing fever, subcutaneous nodules, pancytopenia and liver dysfunction, most patients have in addition a multitude of other manifestations which confuse the clinical picture. Notwithstanding the variable clinical course, the disease frequently terminates in fatal hemorrhage. Diagnosis is based on histological features. A lobular panniculitis with an infiltrate of cytologically benign cytophagocytic histiocytes in skin nodules is the sine qua non of CHP. Hence, a deep skin biopsy which includes subcutaneous fat is mandatory to establish the diagnosis. Published information regarding this newly described entity remains scarce and we report two cases of CHP, one occurring in a 30-year-old Kadazan man and another in a 17-year-old Chinese woman seen at the University Hospital, Kuala Lumpur. The latter case presented with exudative ascites, an unusual feature, possibly due to intra-abdominal panniculitis. In addition, we record the development of cirrhosis in the same patient.


Effect of berberine on enterotoxin-induced intestinal fluid accumulation in rats.

We have determined the effects of berberine (Berberis aristita) on intestinal fluid accumulation due to enterotoxigenic E. coli (ETEC) heat-stable (ST) toxin in suckling (24-days old) Wistar rats. Intestinal fluid accumulation occurred in suckling Wistar rats by administration of culture filtrate containing ST-producing ETEC in serial dilutions up to 1/8 dilution by oral or intragastric route. When berberine (0.1 mg) and 1/8 dilution of ST-toxin were given together by oral or intragastric injection, a significant (p < 0.01) reduction in fluid accumulation was observed. Neither treatment with berberine orally before intragastric injection of ST-toxin nor intragastric administration of berberine after ST-toxin reduced the fluid accumulation due to ST-toxin.


Prognostic significance of karyotype analysis in children with acute lymphoblastic leukemia.

Chromosome studies, using bone marrow samples of 26 pretreated children (below 15 years of age) with Acute Lymphoblastic Leukemia were carried out to explore the potentialities of applying chromosomal findings as a prognostic indicator in these patients. Abnormal karyotype was identified in 15 patients (57.6 per cent). The chromosomes frequently involved in non-random numerical abnormalities were Nos. 8, 18 and 21. Structural chromosome changes observed consisted of deletion 6q- and translocation t (4;11). After karyotype analysis, patients were grouped into subsets on the basis of the karyotype pattern observed. They were followed up to evaluate their prognosis and survival period. Patients showing hyperdiploid clone with greater than 51 chromosomes had the best prognosis. Patients with normal karyotype and patients with deletion of the long arm of chromosome 6 showed intermediate prognosis whereas patients showing t (4;11), trisomy 8, trisomy 18, trisomy 21, and hypodiploid karyotype were associated with worst prognosis. Thus, karyotype analysis before treatment helps to classify ALL patients as poor, intermediate and good prognosis groups and on this basis therapy can be designed accordingly.


Evaluation of preventive health services for hospitalised children under a child health programme.

In the hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh, the Child Health Programme (CHP) has been offering preventive health care services to about 60,000 patients per year. The patient populations are mostly children who stay with their mothers or other relatives. In this programme, health education, immunisation and nutrition rehabilitation services are offered. Health education is offered as group discussion and face-to-face interaction between the educator and the mother. Immunisation is offered daily from 0700h to 1900h to all children and women attending the hospital. Nutrition rehabilitation services, both inpatient and outpatient, are offered to severely undernourished children. These preventive services are implemented by health workers and health assistants. All attendants and adult patients participate in health education sessions. More than 80% of unimmunized children and 50% of unimmunized women receive immunisation. The experience of the CHP shows that it is possible to offer different preventive health care services to all attendants and patients attending a busy hospital.


Production of chitinase by enterotoxigenic Aeromonas species isolated from clinical and environmental sources.

Thirty-six isolates of Aeromonas, 13 from children and 23 from the environment were tested for production of chitinase in culture supernatants. Thirty-four isolates of the three species (91% clinical and 96% environmental) produced constitutive chitinase. The environmental isolates elaborated significantly more (p < 0.005) of the enzyme than those from the children. Four of the environmental isolates also produced inducible chitinase. All isolates of Aeromonas were enterotoxic, however, the isolates producing inducible chitinase showed significantly higher enterotoxic activity. This study indicates that there is correlation between production of enterotoxin and chitinase in Aeromonas species.


Diarrhoea and feeding practices of young children attending two selected urban clinics in Dhaka.

Data were collected from 150 mothers attending the outpatient departments (OPD) of one maternal-child health (MCH) clinic and one paediatric hospital in Dhaka for treatment of diarrhoea of their children during the period from March '90 to May '90. Feeding practices before and after occurrence of diarrhoea were evaluated to determine the knowledge and practice of changes in dietary patterns. The majority (58.67%) of children, who were all less than 5 years old, were in the younger age group (0-1 year) with slightly more occurrence in male children. The incidence rate was higher among children of low-income families and uneducated mothers. Among the children, 60.67% had 6-8 loose stools per day and 66% suffered from watery diarrhoea, which was mostly in the younger (0-1 year) age group (p < 0.001). The majority (60%) of mothers had incorrect knowledge about changing their children's diets; only 40% knew how to do it correctly, which was significantly (p < 0.001) related to the educational level. During diarrhoeal episodes among the 0-1 year age group, the number of mothers exclusively breastfeeding increased considerably (14.77% to 35.23%), and the number of mothers only partially breastfeeding decreased (62.5% to 43.18%), withholding (48.38%) or adding (9.68%) some items, or both (13.98%), showing significant change (p < 0.005) in diet with the education of mothers. "Some food items cause diarrhoea, others increase the frequency of loose motion, and withholding or adding some food cures it," they believed. The results of the study show that, through proper nutrition education, mothers can be helped to provide better home management of diarrhoea.


Maternal practices and risk factors for dehydration from diarrhoea in young children: a case-control study in central Thailand slums.

To determine factors related to dehydration from diarrhoea, we conducted a hospital-based, case-control study in children aged 24 months or younger who had acute watery diarrhoea and attended Chonburi Regional Hospital in central Thailand during November 1988 through May 1989. The study compared 48 cases who had moderate or severe dehydration with 48 controls who had no dehydration. Both cases and controls belonged to low socioeconomic families and were living in urban slum areas. They had adequate health care facilities and access to ORS packets. Overall, 56% of the mothers used ORS solution at home. None of the mothers knew how to administer ORS, i.e. the fluid was not given at the onset of diarrhoea to prevent dehydration, and they gave no more than 60 ml over a 24-hour period to their dehydrated children. They also did not use home fluids. Multivariate analysis of data showed two factors significantly associated with dehydration: children's dirty fingernails that indicated inadequate maternal hygiene-related behaviour (Odds Ratio 6.4; 95% Confidence Intervals 1.5-27.6, p < 0.01), and frequency of vomiting in the 24 hours before rehydration (Odds Ratio 1.3; 95% Confidence Intervals 1.1-1.6, p < 0.001). Cases and controls had similar aetiologic agents and nutritional status. Providing proper education to mothers about oral rehydration therapy with special emphasis on the volume of ORS to be given, along with guidance to improve their personal hygiene should be considered important interventions in reducing the risk of dehydration and deaths from diarrhoea in these children.


Isolation of enterotoxigenic Vibrio cholerae non-01 from the Buriganga river and two ponds of Dhaka, Bangladesh.

Vibrio cholerae 01 is usually considered the most toxigenic member of the Vibrionaceae and V. cholerae non-01 isolated from the environment is non-toxigenic. In our survey of the pollution of some aquatic environments in and around Dhaka, Bangladesh, we wanted to investigate the toxigenicity of V. cholerae non-01 isolated from water and sediment samples of the Buriganga river and two ponds in Dhaka, in the rabbit ileal loop (RIL) model. Fluid accumulation was induced by 18 of 28 live cultures and five of 18 cell-free culture filtrates in RIL. Seven of ten V. cholerae non-01 which failed to induce fluid in RIL were subjected to repeated passage in rabbit gut. Within two consecutive passages, all the strains could induce fluid in rabbit gut. Both toxigenic and non-toxigenic strains were uniformly sensitive to chloramphenicol and gentamicin but resistant to neomycin, novobiocin, polymyxin-B, streptomycin and vancomycin. Tetracycline sensitivity was found among eight of 17 toxigenic and six of 12 non-toxigenic strains. Sensitivity to trimethoprime-sulfa-methoxazole was noted among seven of 17 toxigenic and six of 12 non-toxigenic strains. Occurrence of enterotoxigenic and drug-resistant V. cholerae non-01 in the surface water is a public health hazard.


Biochemical characteristics and enterotoxicity of Aeromonas species isolated from man and environment.

A total of 147 isolates of Aeromonas spp., of which 54 were isolated from children and adults with diarrhoea, 44 from variety of water sources and 49 from environmental sources, were tested for enterotoxin production and its correlation with biochemical characters. Lysine was decarboxylated by 38% of A. hydrophila, 35% of A. sobria and 20% of A. caviae. Majority strains were unable to utilise citrate as the sole source of carbon except one of A. hydrophila, 8 of A. sobria and 6 of A. caviae. Beta-haemolysis was shown by 108 isolates that included 79% of A. hydrophila, 76% of A. sobria and 70% A. caviae. About 56% of Aeromonas strains including A. caviae caused fluid accumulation in the rabbit ileal loop in the initial tests and the remaining did so after 1-3 consecutive passages. Enterotoxin production did not correlate with the positive biochemical characters such as Voges-Prauskauer reaction, lysin decarboxylation, haemolysin production, citrate utilisation and failure to ferment arabinose either singly or in combination. This study indicates that enterotoxicity of Aeromonas may not be correlated with any of the biochemical characters either singly or in combination.


Studies on the infectivity of gametocytes of Plasmodium berghei (NK 65) in Anopheles stephensi.

The infectivity of gametocytes of Plasmodium berghei (NK 65) has been studied in laboratory bred Anopheles stephensi. Mosquitoes were fed daily on infected male and female Mastomys natalensis and subsequent development of the oocysts was monitored in the midguts. Maximum number of oocysts were found in mosquitoes which were fed on infected female mastomys on D8 and in male mastomys on D7 post-inoculation. During the next peak of gametocytaemia, very few oocysts developed. These findings suggest that gametocytes are maximally infective only during the first peak, later on their infectivity declines although having sufficient number of gametocytes in the circulation.


Multi-drug resistance in salmonellae isolated from enteric fever cases at Porur--a semi urban area near Madras City.

A total of 249 isolations of Salmonella were made during 1991, of which 67.46 per cent were resistant to chloramphenicol. Resistance to ampicillin, co-trimoxazole and amoxycillin was higher (82.91, 77.69, 81.42 per cent respectively). Salmonella typhi was predominant agent forming 94.78 per cent and Salmonella paratyphi A caused the remaining infections. 44.98 per cent of the isolations were in children. This outbreak has been discussed in the light of other reports from India.


Efficacy of diethylcarbamazine medicated salt in interrupting Brugia malayi transmission in hill tribe settlements in Kerala State.

A filariasis survey carried out about eight years after achieving zero microfilaria (mf) rates following administration of diethylcarbamazine (DEC) medicated salt in the Kani hill tribe settlements in Quilon and Thiruvananthapuram districts of Kerala State revealed that there was no reappearance of Brugia malayi infection in the experimental areas. Mf rates were maintained at zero level in the experimental villages, while in the control villages, 2.9 per cent mf positives were observed. Mansonia (Mansonioides) uniformis dissected did not reveal filarial infection. It is concluded that DEC medicated salt regime in the experimental areas of Kani hill tribe settlements has been successful in effectively interrupting B. malayi transmission. Pilot studies in other B. malayi endemic areas of India using DEC medicated salt regime with the objective of eliminating B. malayi transmission are advocated, since the parasite has a restricted distribution in India and is already showing a declining trend.


Indoor resting density, survival rate and host preference of Culex quinquefasciatus say (Diptera: Culicidae) in Mysore City.

Monthly indoor resting density, age distribution, survival rate and host-preference of Culex quinquefasciatus, a filariasis vector were studied from June 1988 to May 1989 in Mysore city. During this period, a total of 7522 adults were collected in 72 man-hour of search spreading to twelve spots covering the entire city. The annual per man-hour density observed was 104.5, being 76.8 for female and 24.3 for male. Nulliparous and parous (1-parous and 2-parous) mosquitoes were collected throughout the year while 3-parous and 4-parous mosquitoes were recorded during cold and rainy seasons only showing an increase in the number of gonotrophic cycles. Precipitin test of blood smears from the gut content of C. quinquefasciatus was done by taking 2536 mosquito blood smears. Of these, 94.1 per cent preferred human blood, 1.4 per cent bovine and 3 per cent avain. As the species evaluated is a major vector of filariasis, the present study on its resting density and the host preference will be helpful in vector monitoring in Mysore city. Various results on this species at Mysore have been discussed in the light of earlier studies conducted elsewhere.


Inhibition of Salmonella ferlac by enterobacteria under in-vitro conditions.

Interactions of Proteus morganii, Proteus mirabilis, Proteus sp. Klebsiella oxaenae and Serratia marcescens isolated from vegetable salads of mass feeding systems with Salmonella ferlac (a new subgenus VI of Salmonella) isolated from a hostel cook's hands and lizard droppings were recorded following in-vitro nephelometric analysis. Nephelometric analysis revealed inhibition of S. ferlac by all the tested isolates from fifth hour of mixed culture interaction. K. oxaenae was the strong inhibitor.


An indirect fluorescent antibody (IFA) test for the serodiagnosis of Kala-Azar.

The IFA test developed using Leishmania donovani promastigote and amastigote antigens showed very high antibody titre in clinically and parasitologically established cases (30) of kala-azar, the geometrical mean reciprocal titre (GMRT) being 870 +/- 5.4 and 5370 +/- 1.80 respectively with the two antigens. In contrast, the GMRT of normal subjects of endemic area was only 12.44 +/- 6.19 and 80.35 +/- 1.66 respectively with these antigens. None of the subjects from non-endemic area suffering with other parasitic diseases, such as malaria, filaria, amoebiasis, leprosy or tuberculosis (20 cases each) gave a positive response to any of the antigen. The test holds promise in the diagnosis of Kala-azar.


Changes in the level of biogenic amines in experimentally infected and DEC treated proxy host mice.

The levels of biogenic amines, viz., epinephrine, histamine and dopamine were significantly altered in the blood and brain of the proxy host mice which were infected with the mf of Setaria digitata, a filarial parasite. When DEC, the drug of choice was administered to the infected mice, serotonine level was enhanced while the histamine level was decreased. The results were similar in normal mice which were given DEC.


Partial purification of acid phosphomonoesterase in axenically grown Entamoeba histolytica NIH-200.

Entamoeba histolytica possesses significant acid phosphatase activity as compared to alkaline phosphatase activity. The acid phosphatase activity in the amoebic cells eluted at higher saline concentration as three distinct peaks at 200, 300 and 400 mM sodium chloride.


Nasal carriage of Staphylococcus aureus in hospital staff and its antibiotic sensitivity in Enugu, Nigeria.

The nasal carriage of Staphylococcus aureus was investigated in 475 hospital staff of different categories. The overall carriage was 34.42 per cent with a significantly higher rate in females (67.53 per cent) than in males (23.81 per cent). Nurses, orderlies and attending physicians had a higher carriage rate than other categories of staff investigated. The rate was higher in personnel working in accident, neonatal and postnatal wards than in other wards. As many as 51.94 per cent of the strains of S. aureus were resistant to penicillin while 22.72 per cent of them were resistant to ampicillin.


Colonic immunity in patients and amoebic liver abscess.

Secretory immunoglobulin A (S-IgA), coproantibody titre (antiamoebic) and IgA, IgG, IgM immunocytes in rectal mucosa were studied in 13 patients with amoebic liver abscess (ALA) prior to and 4-6 weeks after completion of antiamoebic therapy. Ten asymptomatic Entamoeba histolytica cyst passers and 17 healthy age and sex matched volunteers served as controls. Fecal S-IgA levels and counts of IgA bearing immunocytes in mucosa were significantly higher in patients with ALA and cyst passers as compared to healthy controls and showed a significant fall after treatment. Fecal antiamoebic antibodies were high in cyst passers and in cases of ALA after treatment. Raised levels of S-IgA and IgA class immunocyte counts probably indicate a local mucosal immune response directed at containing the infection.


Occurrence of entomophilic nematode infestation among phlebotomid sandfly, Phlebotomus papatasi--a preliminary report.

Infestation of a nematode parasite was observed in the natural population of Phlebotomus papatasi in Pondicherry, India. Of the 877 males and 959 females sandflies examined for the natural infection, 11 females were found infested with nematodes (0.59%). The number of juveniles and/or eggs of nematodes per infected fly ranged from 1 to 192 (mean 51.36 +/- S.D 55.95). The presence of a stylet at the opening of the dorsal oesophageal duct suggests that the parasite belongs to the super family Tylenchoidea.


Hepatitis C virus infection in blood donors in Egypt.

A study was carried out on 90 serum samples from non-professional blood donors to find out the relative prevalence of HBV and HCV among those blood donors. Results demonstrated overall positivity rate of 14.4% for anti-HCV by RIBA test. The percentage of reactive sera was 6% for the age group of 20 to below 30 years, and 37.5% in those aged above 30 years, and this difference was statistically significant. Considering the combined reactivity of the tested 90 sera for anti-HBs and anti-HCV, the results showed that 41.1% of the sera were positive for anti-HBs; 10% reacted positively with both anti-HBs and anti-HCV, and 4.4% of the sera were positive for anti-HCV only. The high prevalence of anti-HCV in this study (14.4%) exceeds that reported in other countries, and is comparable with that of Saeed and associates (1991). These results may indicate endemicity of HCV in Egypt and/or a possible role of the endemic schistosomiasis. On the basis of data, suggesting that anti-HCV reflects persistent infection rather than immunity, screening for anti-HCV should be included in all blood transfusion services to exclude HCV which is responsible for 90% of PTH (Van der Poel et al., 1990; Weiner et al., 1990; and Esteban et al., 1991). The remarkably high seroprevalence of anti-HCV among Egyptian volunteer blood donors, which has not so far been reported from other countries, should be thoroughly studied. This should cover many aspects including large epidemiological studies, factors pertinent to Egypt as schistosomiasis, and other possible factors that might enhance HCV transmission in Egyptian population. High risk groups as the polytransfused and renal dialysis patients should be studied. Needless to say that, an accurate measure of HCV prevalence depends on specificity and sensitivity of the employed laboratory diagnostic tests; development of new tests for the detection of antibodies to HCV, together with development of tests for other markers such as HCV antigen and the polymerase chain reaction to detect HCV DNA in blood, will be of great help.


Beta-glucuronidase and hyperbilirubinemia in breast-fed versus formula-fed babies.

Breast milk and formula milk and the corresponding serum samples from 20 breast-fed babies, 20 formula-fed babies, and their mothers were examined at 3 days of age for beta-glucuronidase enzyme. Serum indirect bilirubin levels were also examined for all the infants. Serum indirect bilirubin concentrations were significantly higher (p < 0.001) in breast-fed (4.87 +/- 2.4 mg/dl) than in formula-fed infants (1.04 +/- 0.5 mg/dl). beta-glucuronidase activity in formula milk was negligible, while that in human milk was considerable (468.26 +/- 220.8 Sigma units/ml) and was correlated (p < 0.05) with that in the serum of the breast-fed (66.13 +/- 18.1 Sigma units/ml) than in formula fed infants (52.08 +/- 11.9 Sigma units/ml) and a significant (p < 0.05) correlation was found between its serum level and serum indirect bilirubin in both breast and formula fed infants. Also in breast-fed infants serum bilirubin concentrations were related to beta-glucuronidase activity in breast milk (p < 0.05): Breast milk beta-glucuronidase--by facilitating intestinal reabsorption of bilirubin--seems to be an important factor in the neonatal hyperbilirubinemia of breast-fed babies.


Breastfeeding and fertility. Part II: Breastfeeding practices.

A cross-sectional survey described the current breastfeeding status and antenatal care of 1134 urban mothers, attending MCH centers in Alexandria governorate and gave birth within the last two years, was carried out. The results indicated that the median duration of breastfeeding was 14 months. At six month postpartum the proportion of breastfeeding mothers was 0.8. The mean age of weaning was 20.7 (+/- 4.1) months. Less than 80% of mothers attended the antenatal visits. Information about breastfeeding was provided to 80% of mothers who attended the antenatal visits.


When and why Ain Shams University students started smoking?

The present study was carried out to determine the prevalence, age of first starting smoking and the risk factors associated with taking up regular smoking. The study included 1291 University students (861 males and 430 females), their ages ranged from 17 to 28 years. The over all percentage of smokers was 37.9% (52% males and 9% females), and 21% of males and 12% of females started smoking before the age of 14 and 80% of males and 57% of females before reaching 18 years of age. Smoker peer colleagues, high income, owning of a car, and family troubles, using drugs, smoking hashish and drinking alcohol are significant associated risk factors to taking up smoking.


Breast-feeding and fertility. Part I: Lactational amenorrhoea.

A cross-sectional survey describing the current fertility performance and breast-feeding of 1134 urban mothers, who gave birth within the last 2 years was carried out. Mothers were recruited from MCH centers in Alexandria governorate. The results indicated that the mean time elapsed since birth before return of menstruation was (5.1 +/- 4.3) months for breast-feeding mothers and (2.5 +/- 2.3) months for non-breast feeding mothers. At four-month of postpartum period, 50% of the mothers were still amenorrhoeic and at six-month, 31% of the mothers were still amenorrhoeic. A total confirmed pregnancies was 8.5% and 3% of new pregnancies occurred during amenorrhoea and while women were breast-feeding. Use of contraceptives was practiced by 57% of mothers, with 65% of all users starting as early as the second month.


Socio-cultural and nutritional risk factors of adolescents and young pregnant women in an endemic area of schistosomiasis.

The present study was undertaken in order to investigate the social, cultural, behavioral and environmental factors and their impact on the health and nutrition of young pregnant women and adolescent girls aged between 11 and 22 years, living in a rural area known to be endemic of schistosomiasis. A total sample of 34 pregnant women, 30 adolescent girls and 5 married never-pregnant women were recruited initially. The results revealed that early marriage before legal age still occur in rural areas in Egypt (15%). The mean age of marriage was 17.5 years (+/- 1.8) while the mean age at the first conception was 17.9 years (+/- 1.6). A high rate of illiteracy (72%) which was statistically significant was found among married women than adolescent girls. The daily intake of most nutrients were below the RDA except for protein and vitamin C among pregnant respondents. Iron, calcium and riboflavin were the nutrients most poorly supplied by the diets of pregnant women and adolescent girls. A significant statistical difference was found between the two groups in the intake of iron (z = 3.20, p < 0.05). About 60% of pregnant women and 80% of adolescent girls reported contact with canal water during household activities and field work. There was a lack of knowledge as regards schistosomiasis among respondents especially pregnant ones. Home deliveries with the assistance of traditional birth attendants is still the first choice by most of the pregnant respondents.


A study of the epidemiology of preterm labor.

A case-control study was designed in order to identify risk factors associated with preterm labor. All cases fulfilling the criteria of eligibility as preterm labor and attending the Ain Shams University Maternity Hospital during the period from January 1991 to June 1991 were included in the study. In the meanwhile, all women delivering after the 37th week of gestation during that period and in the same hospital and matched according to age (+/- 5 years) were included as the control group. Two hundred and thirty four cases and 216 controls were included in the study. An interview was performed to fill an epidemiologic and clinical questionnaire. Results showed that the lower the socioeconomic standard, the more the risk for preterm labor (p < 0.05), smoking whether active or passive is associated with preterm labor (p < 0.001), threatened or induced abortion, unwanted pregnancy, psychological trauma and surgical intervention during current pregnancy are associated with preterm labor (p < 0.001). History of preterm labor is associated with the present condition (p < 0.001). Anemia, hypertension, body weight less than 70 kgm are associated with preterm labor (p < 0.001).


Salmonella-induced enteritis. Clinical, serotypes and treatment.

Salmonella-induced enteritis is a widespread cause of morbidity and mortality especially in developing countries. The frequency of different Salmonella serotypes in different areas varies according to time and locality. The prevalence of different Salmonella serotypes in Yanbu area was studied in 136 stool cultures from patients admitted with gastroenteritis, to the medical ward of Royal Commission Hospital in the period 1/6/1991 to 30/10/1991. Fifteen different Salmonella serotypes were determined among 31 positive Salmonella isolates and all were of the gastroenteric group, diarrhoeagenic but noninvasive. The most common serotype was S. typhimurium (45.16%) followed by S. enteritidis (9.62%) then S. virchow (6.46%). Other forms of Salmonella were isolated from one patient each 3.23%, S. paratyphi B java, S. heidelberg, S. livingstone, S. infantis, S. bovis morbificans, S. corvallis, S. eastbourne, S. give, S. senftenberg, S. poona, S. adelaide, and S. johannesburg. Saudi patients comprised about 71% and 29% were patients of four different nationalities. Antibiograms of these cultures proved to be all sensitive to norfloxacin with different forms of resistance to chloramphenicol, ampicillin and trimethoprim. Norfloxacin proved to be effective in the treatment of resistant forms of Salmonella with negligible side effects and wide safety range.


Antibody level after measles vaccination.

The present study was designed to estimate the level of measles IgG antibody in infants early after vaccination and in preschool children to determine their immune status. Three groups were studied: Group I, unvaccinated infants, Group II, recently vaccinated infants and Group III vaccinated preschool children. Measles IgG antibody was measured using the ELISA technique. The study showed that 90% (18/20) of the unvaccinated Group I infants were seronegative and only 10% were seropositive for measles IgG antibody representing most probably persisting maternal antibodies. Fifty percent (15/30) of recently vaccinated Group II infants were seropositive. A statistically significant higher antibody level was observed in Group II infants in comparison to those of Group I. The majority of seropositive infants of Group II (10/15 = 66.7%) showed high antibody level representing successful vaccination. Seropositives represented 77.4% (24/31) of Group III preschool children and the majority of them 75% (18/24) showed high antibody level which was significantly higher than the comparable in Group II infants, most probably due to subclinical infection in addition to successful vaccination. Fifty percent (15/30) of Group II infants and 22.6% (7/31) of Group III children were seronegative, more likely due to failure of initial vaccination.


Familial and sociological correlates of behavioral deviance among juvenile boy delinquents in Alexandria.

Sixty five institutionalized juvenile boy delinquents aged 11 to 21 years were screened for behavioral deviance in relation to familial and social variables. Data of behavioral deviant children was compared with similar data available for the group of children not identified by the screen. Results of this study revealed statistical associations between behavioral deviance among juvenile boy delinquents and most of the studied familial/social backgrounds and morbid parent-child relationships. Knowledge about these issues should be applied in understanding and planning the treatment of the delinquent.


Influence of job characteristics on job satisfaction of pediatric nurses.

This study was conducted to determine the possible influence of job characteristics on job satisfaction of pediatric nurses. Eighty-nine pediatric nurses working in the pediatric units of the Maternity and Children Hospital in Jeddah, Saudi Arabia comprised the subject of the present study. A questionnaire of three parts was synthesized for this study. Part I is a multifaceted measure of job satisfaction (Smith et al., 1969) and known as job Descriptive Index. Part II is a job Characteristics Inventory (J.C.I) of 30 items developed by (Sims et al., 1976) to determine nurses perception of six characteristics, namely, variety, autonomy, task identity, feed back, dealing with others, and friendship opportunities. Part III comprised five demographic items. The study revealed that the overall degree of satisfaction of pediatric nurses was found to be relatively low with a mean percentage score of only 58.52%. Regarding the five job satisfaction subscales, nature of work (nursing of children) showed the highest mean percentage score. The study illustrates a positive strong correlation between job characteristics and job satisfaction with variety, task identity, and feedback being the statistically significant individual characteristics.


Some health aspects in instituted primary school children.

This study was conducted on 193 children aged 6-12 years. They were 93 children (65 boys and 28 girls) living in two residential institutions in Cairo and 100 non-instituted children (65 boys and 35 girls) who are their matched school peers. Anthropometric measurements, complete physical examination and laboratory investigations including haemoglobin concentration, complete urine and stool analysis were performed to all children. Results showed that 25.81% of instituted children have body weights below the 10th percentile and 60.22% have heights below the 10th percentile compared to 14% and 37% of non-instituted children respectively. The differences were statistically significant. The prevalence of vitamin deficiency manifestations, and skin diseases was significantly higher in the instituted group. The mean haemoglobin concentration was lower in the instituted children, with a significant difference in all males and in females aged 9-12 years. Intestinal parasitic infections were more prevalent in the instituted children. It was found that among instituted children weight and height were most affected by cause of institution and number of children cared for by a substitute mother while hemoglobin concentration was most affected by age at institution and the level of education of the substitute mother.


Genetic study of phenylketonuria.

Among four hundred and eighty mentally retarded patients referred to the Human Genetics clinic, Medical Research Institute, Alexandria University, Egypt; twelve cases were found to have pku, ten cases had classical pku and 2 cases atypical pku. Genetic studies of those patients and their families revealed segregation of autosomal gene(s) that are responsible for the development of the disorder with a recurrence risk of 0.283 +/- (1.96)(0.066). The high average inbreeding Coefficient indicated the important role played by consanguinity. Heterozygote detection is very important to normal sibs of affected patients to provide proper genetic counseling. Dietary management of the young infants in the first three months showed normal growth and development. Behavioral improvement was observed in cases who were treated late despite the fact that they were mentally retarded. Dietary control should be continued for a long life time to obtain good outcome in both sexes and to prevent the risk of fetal damage during child-bearing age in females.


An epidemiologic study of ovarian cancer. Part 1: Reproductive and social factors.

This study was undertaken to investigate the risk factors of ovarian cancer. A retrospective analysis was used in this study where 52 ovarian cancer cases and an equal number of a control group were obtained from the Western region of Saudi Arabia. Analysis of data showed that cases and controls did not significantly differ in any of the studied social factors, marital status, social class, and family history of cancer ovary. However, when reproductive factors were considered, the mean values of parity and number of abortions, but not age at first birth. Were found to differ significantly between cases and controls.


A study of some trace elements in fingernail and hair of Egyptian bilharzial patients using short neutron activation.

The concentration of 10 elements has been determined in fingernail and hair of four groups representing normal and hepatosplenic (bilharzial) subjects. Samples were collected from rural inhabitants to the east of Alexandria City and irradiated with thermal neutrons from a Triga Mark III Reactor, for 10 minutes. Measurements were made using HPGe detector, ADC and PDP 11/34. The analysis were performed using the RAYGUNprogram. The results showed an increase in the concentration of Al, Cl and I in both fingernail and hair of bilharzial patients than normal while Mg, Ca, K, Mn, Cu, and Sr decreased. Most of the elements showed a higher concentration in fingernail than in hair.


Serodiagnosis of visceral leishmaniasis among primary school children in Alexandria.

The present study was carried out on a primary school children of El-Max area, west of Alexandria to assess their serological status to VL using IFAT. The sample composed of 96 pupils (53 males and 43 females) aged 6-11 years. Blood drops were collected on whatman No. 3 filter paper for the serological test (IFAT). Positive reaction was obtained in 6.2% of the examined pupils. The positivity rate was insignificantly higher among the age group (8-10) years. Sex proved to have no effect on the percentage of positive reactors.


Cryptosporidium infection among primary school children in a rural area in Alexandria.

The present study was carried out on primary school children of both sexes to determine Cryptosporidium infection among them. A sample of 222 was randomly chosen. Their ages varied between 6 and 11 years. The required information as age, sex, socio-economic and environmental data, were collected through a designed questionnaire sheet. Stool samples were collected and examined, using Sheather's sugar solution and subjected to modified Ziell Neelsen stain. The results obtained revealed that, the prevalence rate of the infection was 13.51% among the examined pupils, with highest peak among the age group (6-8) years. No significant relation was found between sex and infection. There was a significant relation between infection and low socio-economic level. Also a significant relation was obtained between the infection and the presence of pets, livestock and animal's shed inside the house. A significant percentage of the infected pupils, were having a close contact with the soil through playing around the houses and in the field. The results revealed that a significant percentage of the infected children had diarrhoea.


Effect of processing on availability of essential amino acids in rice flour and cooked rice.

The availability of nitrogen, lysine and nine essential amino acids was determined in rice flour and cooked rice. Lysine availability was determined by the growth response method using regression analysis of body weight gain or moisture gain against lysine consumed from rice flour and cooked rice. The results show a good correlation between lysine consumed and weight gain or moisture gain (r = 0.86 + 0.8) for rats fed cooked rice and fair correlation for those fed rice flour. The results of lysine availability show that cooking increases availability by both ways of calculation. The availability of nitrogen and of essential amino acids was also determined by the balance trial method with rats. Results of balance trial show that cooking has no significant effect on essential amino acids availability. Data for weight gain, food efficiency and PER were significantly decreased by cooking.


Characteristics of 1,3-bis-(2-ethoxycarbonylchromon-5-yloxy)-2-((S)- lysyloxy)propane dihydrochloride (N-556), a prodrug for the oral delivery of disodium cromoglycate, in absorption and excretion in rats and rabbits.

The absorption and excretion of 1,3-bis-(2-ethoxycarbonylchromon-5-yloxy)-2- ((S)-lysyloxy)propane dihydrochloride (N-556), which is a prodrug for the oral delivery of disodium cromoglycate (DSCG), were studied in rats and rabbits. In both animal species, the plasma concentration of DSCG after oral administration of N-556 peaked within 1.0 h, and thereafter declined with a half-life of about 1.2 h in rats and rabbits. The area under the plasma DSCG level versus time curve (AUC) increased in proportion to the dose of N-556 in both animals. The bioavailability of N-556 as calculated from AUC was about 6% in rats and 40% in rabbits, whereas that of DSCG was only 0.1% in rats and 2.5% in rabbits. About 2% and 15% of the dose were respectively excreted as DSCG in the urine and bile after the oral administration of N-556 in rats. The ratio of biliary excretion to urinary excretion (B/U) after the oral administration of N-556 was about twice that after the intravenous injection of DSCG. In rabbits, the urinary and biliary excretions of DSCG after oral administration of N-556 were about 25% and 5%, respectively. The B/U ratio after the oral administration of N-556 in rabbits was similar to that after intravenous administration of DSCG. The difference in the systemic bioavailability of N-556 between rats and rabbits thus appears to be due to a first-pass effect, in addition to a difference in the absorption rate.