Whipple's disease in a man with weight loss and diarrhea

In a 45-year-old man with diarrhoea, upper abdominal pain and malabsorption Whipple's disease was diagnosed by gastroduodenoscopy with small bowel biopsies. The disease is rare and can present with gastrointestinal problems but also with cardiac or neurological complaints. Tropheryma whippelii, the aetiological organism, can be demonstrated by pathological investigation of biopsies and with the polymerase chain reaction (PCR). Treatment with trimethoprim-sulfamethoxazole 160-800 mg twice daily is the therapy of choice: it must be continued for a year, otherwise there is a high possibility of relapse. Correct diagnosis, based mostly on gastroduodenoscopy, can lead to the right therapy and recovery of the patient.     

Transient lowering of plasma vitamin B12 concentrations in Ouessant sheep fed on a potassium-rich ration.

The hypothesis tested was that a high intake of potassium (K) interferes with cobalt (Co)-vitamin B12 metabolism in ruminants. Ouessant sheep were fed either a low- (8 g K/kg dry matter) or high-K diet (43 g K/kg dry matter) with an adequate amount of Co (124 micrograms Co/kg dry matter). Plasma vitamin B12 concentrations were measured. Sheep fed a low-K diet, but containing only 70 micrograms Co/kg dry matter, served as positive controls. Feeding the low-Co ration produced a significant decrease in plasma vitamin B12 concentrations. The high- versus low-K ration induced a significant decrease in plasma vitamin B12 during the first 6 weeks, but thereafter the values in the high-K group rose to those seen in the low-K group. The mechanism by which dietary K may interact with Co-vitamin B12 metabolism in sheep is unknown.     

Plasma concentrations of the antioxidants beta-carotene and alpha-tocopherol in relation to lung function

OBJECTIVE: To study the association between plasma antioxidants (beta-carotene and alpha-tocopherol) and lung function in Dutch adults aged 20-59 y. DESIGN: Cross-sectional. SETTING: Population-based study. Subjects: A random sample (n=367) was drawn from all participants (men and women) aged 20-59 y with reproducible lung function measurements in 1995. INTERVENTION: Completion of general questionnaire and physical examination. MAIN OUTCOME MEASUREMENTS: Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and plasma levels of beta-carotene and alpha-tocopherol. RESULTS: Subjects with a high plasma beta-carotene level (90th percentile, that is 0.57 micromol/L) tended to have a higher FEV1 (73 ml, s.e.m. 60 ml; P=0.22) and a higher FVC (147 ml, s.e.m. 76 ml; P=0.05) than subjects with a low plasma beta-carotene level (10th percentile, that is 0.11 micromol/L) after adjustment for age, height, gender, smoking status, pack-years of smoking and alcohol consumption. There was no difference in lung function between subjects with high and low plasma alpha-tocopherol concentrations. CONCLUSIONS: The results suggest that subjects with a high plasma beta-carotene tended to have a higher FVC than subjects with a low plasma beta-carotene concentration which was borderline statistically significant. The difference for FEV1 between high and low levels of plasma beta-carotene tended to be in the same positive direction as that of FVC but did not reach the pre-set statistical significance level. There is no relation between plasma alpha-tocopherol and lung function. SPONSORSHIP: Ministry of Public Health, Welfare and Sports of the Netherlands and the National Institute of Public Health and the Environment.     

Active enhancement in the primate by bone marrow I. Ia-like determinants on nucleated bone marrow cells.

This study investigates the possibility that the active enhancing properties of bone marrow (BM) cells may be related to Ia-like determinants on their surface membranes. Less chromium was released on a cell per cell basis from nucleated baboon BM cells used as targets in complement-dependent cytotoxicity than from labelled lymph node lymphocytes. On the other hand, BM cells stimulated allogeneic lymphocytes in culture more vigorously than lymph node lymphocytes. BM cells with lymphocyte-activating properties could be enriched by fractionation on a discontinous bovine serum albumin gradietnt. BM cells responded poorly to allogeneic cell stimulation in mixed culture. Platelet absorption studies of an alloantiserum supported the conclusion that nucleated BM cells, and particularly BM fractions collected from the less dense interfaces of a bovine serum albumin gradient, express relatively more lymphocyte-activating or Ia-like determinants than "serologically defined" determinants.     

Detection of migrated allogeneic oligodendrocytes throughout the central nervous system of the galactocerebrosidase-deficient twitcher mouse

Summary Galactocerebrosidase-deficient oligodendrocytes of twitcher (twi/twi) mice degenerate prematurely. Transplantation of normal bone marrow cells has been shown to alleviate symptoms and to prolong survival time. However, characteristic ataxia (twitching) is not cured. In an attempt to improve further the condition of twitcher mice, allogeneic foetal liver cells were transplanted as a source of normal haemopoietic stem cells and supplemented with intracerebral transplantation of foetal brain cells. A reliable method was developed to detect donor-type cells in brain tissue. Bacteriophage . transgenic foetal mice were used as donors of both foetal liver and brain cells. Integrated copies of . DNA in donor cells were detected byin situ hybridization with biotinylated probes, which were then stained using streptavidin alkaline phosphatase. This technique was combined with immunohistochemistry to distinguish donor-type oligodendrocytes from macrophages. Immunoperoxidase staining with an antiserum to carbonic anhydrase-II produced dark perikarya of oligodendrocytes. The results demonstrated that local foetal brain cell grafts resulted in a wide dissemination of donor-type oligodendrocytes throughout the twitcher brain. The addition of a foetal brain cell graft to haemopoietic cell transplantation resulted in significantly prolonged survival of twitcher mice.     

Acyanotic and Cyanotic Congenital Heart Diseases

There has been tremendous progress in treatment of heart disease in children. Device therapy is increasingly being used in acyanotic congenital heart disease, while surgical results have improved significantly to give smile to many cyanotic heart disease children and their parents. This article makes an attempt to increase awareness of general pediatricians about common congenital heart diseases.     

Toward a highly‐detailed 3D pelvic model: Approaching an ultra‐specific level for surgical simulation and anatomical education

The surgical anatomy of the pelvis is highly complex. Anorectal and urogenital dysfunctions occur frequently after pelvic oncological surgery and are mainly caused by surgical damage of the autonomic nerves. A highly‐detailed 3D pelvic model could increase the anatomical knowledge and form a solid basis for a surgical simulation system. Currently, pelvic surgeons still rely on the preoperative interpretation of 2D diagnostic images. With a 3D simulation system, pelvic surgeons could simulate and train different scenes to enhance their preoperative knowledge and improve surgical outcome. To substantially enrich pelvic surgery and anatomical education, such a system must provide insight into the relation between the autonomic network, the lymphatic system, and endopelvic fasciae. Besides CT and MR images, Visible Human Datasets (VHDs) are widely used for 3D modeling, due to the high degree of anatomical detail represented in the cryosectional images. However, key surgical structures cannot be fully identified using VHDs and radiologic imaging techniques alone. Several unsolved anatomical problems must be elucidated as well. Therefore, adequate analysis on a microscopic level is inevitable. The development of a comprehensive anatomical atlas of the pelvis is no straightforward task. Such an endeavor involves several anatomical and technical challenges. This article surveys all existing 3D pelvic models, focusing on the level of anatomical detail. The use of VHDs in the 3D reconstruction of a highly‐detailed pelvic model and the accompanying anatomical challenges will be discussed Clin. Anat., 2013. © 2012 Wiley Periodicals, Inc.