Morphometric analysis of small intestinal mucosa

Summary Morphometric techniques were employed to measure (i) lamina propria volumes and (ii) the absolute numbers of neutrophils and plasma cells, of A, M and G isotype, within the lamina propria of jejunal mucosa. Mucosal specimens were obtained with a Watson capsule (a) from 5 patients with untreated coeliac disease, and again at least 3 months after starting on a gluten-free diet, and (b) from 9 control individuals.Lamina propria volume of untreated coeliac mucosa (2.5 ± 0.17 × 10⁶ µm³) was increased 2.3-fold (p < 0.01) above that of control mucosae (1.35 ± 0.08 · 10⁶ µ m³). Compared with control mucosae, there was a 20-fold increase of neutrophils in untreated coeliac mucosae (p < 0.005). The total complement of all plasma cells in untreated coeliac mucosae (309) was twice that (149) of control mucosae. The populations of each isotype were also significantly increased over controls by factors of 1.6 (IgA;p < 0.05), 3.0 (IgM;p < 0.01) and 3.5 (IgG;p < 0.01). Their percentage distributions in untreated coeliac mucosae (A:M:G - 52:43:5) differed from those in control mucosae (A:M:G - 69:28:3) but were restored after treatment with a gluten-free diet.However, when each isotype was expressed per unit volume of lamina propria, there was an apparent fall (· 1.4) in IgA cells, while the increase in IgM and IgG cells was less marked i.e. · 1.4 and · 1.5 respectively. These precise measurements explain why many previous investigators found a paradoxical fall in IgA cells because the (increased) volume of distribution of these cells was not taken into account. The importance of morphometric techniques in achieving valid cell counts within the intestinal mucosa is thus illustrated by this study.Supported by Medical Research Council Great BritainPart of thesis submitted to Victoria University of Manchester by I. Dhesi.University of Manchester School of Medicine     

Preliminary study of an exercise programme for reducing fatigue and improving sleep among long-term haemodialysis patients

INTRODUCTION

Fatigue and quality of sleep are the main factors that contribute to a poor quality of life among patients on long-term haemodialysis. Studies have also emphasised the importance of exercise for improving the wellbeing of dialysis patients. This study aimed to determine the effectiveness of a predialysis low-to-moderate-intensity exercise programme for reducing fatigue and improving sleep disorders among long-term haemodialysis patients.

METHODS

In this quasi-experimental study, an exercise programme was conducted three times a week for 12 weeks before long-term haemodialysis patients underwent dialysis at two centres. The patients were categorised into either the exercise group (n = 28) or control group (n = 27). The latter was asked to maintain their current lifestyles. Assessments of fatigue and sleep disorder levels were performed for both groups using self-reported questionnaires at baseline and after intervention. The patients’ perception of the exercise programme was also determined using self-reported questionnaires.

RESULTS

Paired sample t-test indicated improvements in fatigue level in the exercise group (mean fatigue score: post-treatment 40.5 ± 7.9 vs. pre-treatment 30.0 ± 10.9). Improvements in sleep disorders were also observed in the exercise group (mean score: post-treatment 7.6 ± 3.3 vs. pre-treatment 10.1 ± 3.8). However, sleep quality deteriorated in the control group (mean score: post-treatment 10.7 ± 2.9 vs. pre-treatment 9.3 ± 2.9).

CONCLUSION

Simple low-to-moderate-intensity exercise is effective for improving fatigue, sleep disorders and the overall quality of life among haemodialysis patients.     

Degenerative and regenerative mechanisms governing spinal cord injury

Spinal cord injury (SCI) is a major cause of disability, and at present, there is no universally accepted treatment. The functional decline following SCI is contributed to both direct mechanical injury and secondary pathophysiological mechanisms that are induced by the initial trauma. These mechanisms initially involve widespread haemorrhage at the site of injury and necrosis of central nervous system (CNS) cellular components. At later stages of injury, the cord is observed to display reactive gliosis. The actions of astrocytes as well as numerous other cells in this response create an environment that is highly nonpermissive to axonal regrowth. Also manifesting important effects is the immune system. The early recruitment of neutrophils and at later stages, macrophages to the site of insult cause exacerbation of injury. However, at more chronic stages, macrophages and recruited T helper cells may potentially be helpful by providing trophic support for neuronal and non-neuronal components of the injured CNS. Within this sea of injurious mechanisms, the oligodendrocytes appear to be highly vulnerable. At chronic stages of SCI, a large number of oligodendrocytes undergo apoptosis at sites that are distant to the vicinity of primary injury. This leads to denudement of axons and deterioration of their conductive abilities, which adds significantly to functional decline. By indulging into the molecular mechanisms that cause oligodendrocyte apoptosis and identifying potential targets for therapeutic intervention, the prevention of this apoptotic wave will be of tremendous value to individuals living with SCI.     

Public health in the Calais refugee camp: environment,health and exclusion

The ongoing emergency for refugees is having profound and hidden health consequences for thousands of displaced persons who live in informal ‘makeshift’ camps across Europe. This interdisciplinary paper reports the results of the first environmental health assessment in such a location, in what was Europe’s largest informal refugee camp in 2016, in Calais, northern France. We detail the lack of facilities for sanitation, safe provision of food, water and shelter, demonstrating how conditions fall short of agreed international standards for formal refugee camps. Rather than the notion of migrants being the cause of health problems, this paper critically reveals the hidden materiality of bodily injury caused by poor health conditions, where the camp itself produces harm. Drawing upon theories of biopolitical exclusion, the paper concludes by (i) emphasising the empirical and conceptual themes that tie refugee politics and biologies together and (ii) makes a call for increased attention to makeshift camps as key sites of health exclusion in Europe and beyond.     

The development of olfactory and hippocampal pathways in the brain of the rat

Summary The temporal order of development of olfactory, hippocampal and thalamocortical connections has been determined by light microscopy. Scalpel lesions were made to interrupt these connections and the resulting terminal degeneration was stained by Eager's method (1970). A post-operative survival time of one to four days was used. Evidence of the development of these connections was first obtained at the following ages:Olfactory mucosa to olfactory bulb: axon fascicles by 16 days of gestation and terminals in glomeruli at birth;Olfactory bulb to prepyriform cortex at birth;Prepyriform to entorhinal cortex at 13 days after birth;Entorhinal cortex to hippocampus (the perforant path) at 9 days;Hippocampal dentate-Ammonic mossy fibres at 9 days;Hippocampal efferent projection to the septum at birth;Subicular projections to the anterior thalamus at birth and to the mammillary body at 6 days;Hippocampal commissural connections at birth;Corticothalamic and thalamocortical connections by 2 days.These results are discussed in relation to the question of how the development of brain connections is programmed.     

Age-standardized incidence rates of ameloblastoma and dentigerous cyst on the Witwatersrand, South Africa

Although a great deal is known about the incidence of cancer, including oral cancer, no such study has been done on odontogenic tumors and jaw cysts. There are therefore no standardized data which would allow for comparative incidences in different countries and between different groups. In the present study, cases of ameloblastomas and dentigerous cysts derived from the records of all the hospital pathology departments and private pathology practices on the Witwatersrand, were recorded for the 10-year period 1965--1974. The population at risk (1970 census) was 974,390 Whites and 1,567,280 Blacks. The annual incidence rates, standardized against the standard world population, for ameloblastomas per million population are 1.96, 1.20, 0.18 and 0.44 for Black males, females and White males, females, respectively. The equivalent four figures for dentigerous cysts are 1.18, 1.22, 9.92 and 7.26. These figures show that ameloblastoma is very much more common in Blacks than Whites in the population at risk. Conversely, dentigerous cysts are much more common in Whites. This makes it unlikely that dentigerous cysts predispose to ameloblastoma formation. These epidemiologic observations give rise to speculation as to whether some component of the South African Black diet or other environmental substance might possibly be an etiologic factor in ameloblastoma.