Comprehensive assessment of gastric emptying with a stable isotope breath test

Background The [¹³C]‐Spirulina platensis gastric emptying breath test (GEBT) with five samples is accurate relative to scintigraphy. This study was primarily designed to further validate this GEBT using a slightly different process for incorporating [¹³C] in Spirulina and to evaluate the utility of additional samples for assessing early gastric emptying. Methods After a 223 kcal, test meal labeled with ^99mTc and [¹³C]‐S. platensis, scintigraphic images, and five breath samples (45, 90, 120, 180, and 240 min, GEBT5) were collected in 14 controls (Part A). In Part B, nine breath samples were collected at 15, 30, 45, 60, 90, 120, 150, 180, and 240 min (GEBT9) in 30 subjects (15 controls, 15 dyspepsia). Using correlation between [¹³C] breath excretion and scintigraphic emptying, lag time (t₁₀, time for 10% emptying), emptying at 30 min (GE₃₀), and half time (t₅₀) were estimated for GEBT5 (Parts A and B) and GEBT9 (Part B). Key Results Half time values for scintigraphy, GEBT5, and GEBT9 were highly concordant. t₁₀ by GEBT9 (90%CI, 6–15 min) was more strongly correlated [CCC 0.80 (95% CI, 0.63–0.90)] with scintigraphy (90% CI, 5–12 min), than GEBT5 [10–19 min, CCC 0.73 (95% CI, 0.54–0.85)]. The correlation between estimated values (GEBT9) and linearly interpolated values (GEBT5) was closer at 60 [CCC 0.95 (95% CI, 0.91–0.97)] than 30 min [CCC 0.81 (95% CI, 0.71–0.89)]. Conclusions & Inferences The [¹³C]‐S. platensis GEBT can accurately measure GE. While 5‐ and 9‐samples are equally accurate for measuring t₅₀, GEBT9 provides a more comprehensive assessment of early GE (t₁₀ and GE₃₀).     

MINI-MENTAL STATE AND COGNISTAT PERFORMANCE IN AN OLDER AFRICAN AMERICAN SAMPLE

Ninety-three normal, healthy, community-dwelling African American men and women aged 60 and older completed the Folstein Mini-Mental State Examination (MMSE) and the Cognistat (formerly known as Neurobehavioral Cognitive Status Examination). Results indicated significant age and education effects on MMSE and Cognistat performance. The strength of the effects was less than had been noted in earlier work. Cognistat scores were lower than those reported in the original manual for the test as well as in comparison to an older sample in another study. Explanations were offered in terms of differences in cultural and educational exposure to testing as well as inappropriateness of the norms in the original manual. Age- and education-stratified normative data are presented that should be helpful to clinicians who work with and perform cognitive assessment in this population.     

Glycoprotein E (gE) specified by bovine herpesvirus type 5 (BHV-5) enables trans-neuronal virus spread and neurovirulence without being a structural component of enveloped virions

Bovine herpesvirus 5 (BHV-5) is a neurovirulent alpha-herpesvirus that causes fatal encephalitis in calves. We previously demonstrated that deletion of a glycine-rich epitope in the gE ectodomain dramatically reduced BHV-5 neurovirulence. To investigate the role of gE cytoplasmic tail sequences in the neuropathogenesis of BHV-5 in rabbits, we constructed a BHV-5gE recombinant virus with a short residual cytoplasmic domain lacking the YXXL motifs and the acidic (BHV-5gEAm480). In vitro, BHV-5gEAm480 produced on the average smaller plaques, compared with wild-type BHV-5, but it produced on the average substantially larger plaques than the gE ORF-deleted BHV-5. The truncated gE was not phosphorylated, and was not endocytosed from the cell surface. Importantly, the truncated gE was not incorporated into enveloped infectious virions, but its glycosylation and interaction with gI were not affected. In a rabbit model of infection, the BHV-5gEAm480 remained highly virulent, while the gE-null virus was avirulent. The gEAm480 mutant virus invaded most of the central nervous system (CNS) structures that are invaded by the wild-type BHV-5. The number of neurons infected by BHV-5gEAm480 was very similar to the number infected by BHV-5 wild-type and gEAm480-rescued viruses. Collectively, the results suggest that gE functions in transsynaptic transmission of BHV-5 and neurovirulence without being a structural component of the virion particle.     

Delayed Gastric Emptying After Sleeve Gastrectomy Is Associated with Poor Weight Loss

Obesity Surgery - Intermediate to long-term weight regain is a major challenge following sleeve gastrectomy (SG). Physiological changes that mediate the extent of weight loss remain unclear. We...     

Demonstration by immunoperoxidase histochemistry of calcitonin in the anterior lobe of the rat pituitary.

We have demonstrated by a specific immunoperoxidase procedure the presence of calcitonin-containing cells in the rat pituitary gland. These cells are widely distributed throughout the anterior lobe and seem to constitute the entire population of cells of the intermediate lobe. No such cells were seen in the posterior lobe. The presence of calcitonin-containing cells in the pituitary provides novel implications about the physiological significance of this hormone.