Auto-allergic reactions following internal irradiation of the liver

Complement fixation tests using crude liver antigen were carried out on rats following the injection of colloidal ¹⁹⁸Au calculated to deliver β radiation doses from 5000 to 10,000 rad. Marked increases in titre were recorded at doses in excess of 5000 rad. Further, tests for total haemolytic complement in ¹⁹⁸Au-injected rats at a dose of 8500 rad. showed a marked fall in serum complement. Attempts to demonstrate liver fixed γ-globulin and β_1C-complement were unsuccessful.

Separate groups were then subjected to prior splenectomy or treatment with methotrexate, an immuno-suppressive drug. The development of liver damage was observed in measurements of the serum concentration of transaminase, and complement fixing tissue antibodies, and in the histological appearance of liver biopsies.

Animals subjected to splenectomy developed more severe liver damage, whereas in those treated with methotrexate, there was evidence of amelioration of the radiation effect. The significance of these findings is discussed, and it is argued that the results provide some evidence that autoimmune processes contribute to radiation hepatitis.

     

Lasting improvement of hyperglycaemia and bodyweight: low-carbohydrate diet in type 2 diabetes. A brief report

In two groups of obese patients with type 2 diabetes the effects of 2 different diet compositions were tested with regard to glycaemic control and bodyweight. A group of 16 obese patients with type 2 diabetes was advised on a low-carbohydrate diet, 1800 kcal for men and 1600 kcal for women, distributed as 20% carbohydrates, 30% protein and 50% fat. Fifteen obese diabetes patients on a high-carbohydrate diet were control group. Their diet, 1600-1800 kcal for men and 1400-1600 kcal for women, consisted of approximately 60% carbohydrates, 15% protein and 25% fat. Positive effects on the glucose levels were seen very soon. After 6 months a marked reduction in bodyweight of patients in the low-carbohydrate diet group was observed, and this remained one year later. After 6 months the mean changes in the low-carbohydrate group and the control group respectively were (+/-SD): fasting blood glucose (f-BG): -3.4 +/- 2.9 and -0.6 +/- 2.9 mmol/l; HBA1c: -1.4 +/- 1.1% and -0.6 +/- 1.4%; Body Weight: -11.4 +/- 4 kg and -1.8 +/- 3.8 kg; BMI: -4.1 +/- 1.3 kg/m_ and -0.7 +/- 1.3 kg/m_. Large changes in blood glucose levels were seen immediately. A low-carbohydrate diet is an effective tool in the treatment of obese patients with type 2 diabetes.     

Recovery of function in free muscle transplants using microneurovascular anastomoses

Using the rectus femoris muscle of the rabbit, the functional capabilities of the normal and replanted muscle were studied after tenotomy, simple neurovascular repair, and orthotopic and heterotopic transplantation. Tenotomy alone altered the function more than did neurovascular repair, and although a muscle survived after replantation, it never achieved the functional capability of the normal muscle, maximum working capacity being only one fourth of the normal.     

Myotonic dystrophy: muscle involvement in relation to disease type and size of expanded CTG-repeat sequence

This study aimed to: classify a cohort of children and adolescents with myotonic dystrophy (dystrophia myotonica: DM) into congenital and childhood onset forms; estimate CTG expansion size; and quantify muscle strength, contractures, and motor function in children with DM and compare results with those of controls. Participants were clinically examined, medical records were reviewed, and isometric muscle strength, contractures, and motor function were measured. Participants were: 42 children with DM (18 females, 24 males; mean age 8y 9mo [SD 4y 7mo], range 10mo to 17y) and 42 age- and sex-matched, healthy controls. Children with DM were divided into three groups: severe congenital (n=13), mild congenital (n=15), and childhood (n=14). Children with childhood DM were significantly weaker than controls (wrist and ankle dorsiflexors [p=0.0044, p=0.0044 respectively]; hip abductors and flexors [p=0.0464, p=0.0217]; and knee flexors and extensors: [p=0.0382, p=0.0033]). Children with mild congenital DM were significantly weaker than controls in all assessed muscle groups. Contractures and skeletal deformities were more frequent at time of investigation than at birth, suggesting that foot and spine deformities in particular increase over time. Motor function score was significantly lower for children with DM than for controls. Children with severe congenital DM had the lowest motor function, with correlation between motor function and size of CTG repeat (p=-0.743). Children found jumping, heel standing, and head lifting the most difficult items to perform but few had difficulty walking, running, or stair climbing. DM in children is a heterogeneous disorder with a wide spectrum of muscle involvement, and owing to increased risk of contractures and skeletal deformities, regular follow-ups are recommended.     

Alzheimer's disease and depression: preclinical comorbidity effects on cognitive functioning

Both Alzheimer's disease (AD) and depression (D) are prevalent disorders in old age and may co-occur in the same individual. The present study examined whether a diagnosis of D in AD has negative effects on cognitive functioning in the preclinical stage of the diseases, as well as at the time when the diagnoses were rendered. Population-based samples of 13 individuals with incident AD and D, 109 incident AD cases without D, and 179 normal older adults were followed over a three-year period. The groups were compared preclinically and at the time of diagnosis on global cognitive functioning using the MMSE total and the specific item scores, as well as the occurrence of depressive symptoms. As expected, there were clear AD-related deficits preclinically, which were exacerbated at follow-up. In addition, there were D-related deficits on three MMSE items (i.e., following commands, reading, and writing). The poorer performance on the three MMSE items was linked to an elevation of depressive symptoms. However, D was not associated with greater decline in cognitive functioning over the three-year follow-up period. Thus, although depressive symptoms may result in slight cognitive deficits in preclinical AD, at the time of the dementia diagnosis these effects may be absorbed by the neurodegenerative process.     

A qualitative study of mothers' and fathers' experiences of routine ultrasound examination in Sweden

OBJECTIVE: to conceptualise mothers' and fathers' thoughts and feelings before, during and after the routine ultrasound examination during the second trimester of pregnancy. DESIGN, SETTING AND PARTICIPANTS: a grounded theory study. Two to four weeks after their ultrasound examination, 22 Swedish mothers and 22 fathers were interviewed in their homes. FINDINGS: the basic social process was confirmation of a new life. The four categories, visualising-the evident option, overwhelming to see life; becoming a family and reassuring, all represent a time span in the parents' process towards confirmation of a new life. The caregivers' way of assisting and supporting the process by information and treatment was very important to parents. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: as the ultrasound examination is perceived as a confirmation of a new life it is an extremely important milestone for both parents so the father should be encouraged to participate. It is an important and unique event for both women and men in their process towards becoming parents. This process was largely dependent on the treatment the parents had received during the examination and the information given. The findings of this study are of interest to midwives and others who perform ultrasound examinations as it explains why adequate time must be allowed for the examination and the importance of the information given before hand. When introducing new forms of fetal diagnosis in the future it should be kept in mind that this might irrevocably be accepted by parents who long for confirmation of a new life.     

eHealth technology and Internet resources: barriers for vulnerable populations

Disparities in accessing health information exist for various vulnerable populations. Reviewing access issues for those seeking and/or needing health information suggests that there are many factors that may inhibit access. These include a wide diversity in the education, background, and needs of those seeking information, and the distribution of information among many disciplines and information sources. The most needy among this group may require extensive, multispecialty healthcare and may have particular problems with access, treatment adherence, and working within the healthcare system.     

A fragment of histidine-rich glycoprotein is a potent inhibitor of tumor vascularization

In this study, we show that recombinant human histidine-rich glycoprotein (HRGP) has potent antiangiogenic properties as judged from effects on a syngeneic tumor model in C57/bl6 mice. Growth of fibrosarcoma, a very aggressive tumor, was reduced by >60% by HRGP treatment, and tumor angiogenesis was dramatically decreased. Treatment with HRGP led to increased apoptosis and reduced proliferation in the tumors. In contrast, HRGP did not affect apoptosis or DNA synthesis in endothelial cells or tumor cells in vitro. The mechanism of action of HRGP involves rearrangement of focal adhesions and decreased attachment of endothelial cells to vitronectin and, as a consequence, reduced endothelial cell migration. By using truncated versions of HRGP, we demonstrate that the isolated 150 amino acid-residue His/Pro-rich domain, which is also released by spontaneous proteolysis from purified HRGP, mediates the inhibitory effect on chemotaxis. Moreover, the His/Pro-rich domain must be released from HRGP to exert its effect. This study shows for the first time inhibitory effects of HRGP on tumor vascularization in vivo, thus providing proof of concept that HRGP is an angiogenesis inhibitor.