Epithelial transport of drugs in cell culture. VII: Effects of pharmaceutical surfactant excipients and bile acids on transepithelial permeability in monolayers of human intestinal epithelial (Caco-2) cells.

The effects of anionic (sodium dodecyl sulfate and sodium dioctyl sufosuccinate) and nonionic (polysorbate 80 and polyoxyl 40 hydrogenated castor oil) synthetic surfactants and bile acids (sodium taurocholate, sodium taurodeoxycholate, and sodium taurodihydrofusidate) on epithelial integrity were studied in monolayers of human intestinal epithelial (Caco-2) cells grown on microporous polycarbonate filters. The effects of the surfactants on intracellular enzyme activity, cell monolayer permeability, and morphology were studied. The effects on permeability were studied by two methods: measurements of transport of marker molecules (mannitol and polyethylene glycol) and measurements of transepithelial electrical resistance. All surfactants demonstrated concentration-dependent effects on intracellular enzyme activities, permeability, and morphology. The effects of the anionic surfactants were more pronounced than those of the nonionic surfactants. The effects on transepithelial electrical resistance correlated with intracellular dehydrogenase activity. Fluxes of marker molecules were the most sensitive measure of epithelial integrity. The results indicate that the hydrophilic marker molecules permeate the epithelial monolayers through different pathways at different concentrations of the surfactants. The effects of the surfactants were reversible at intermediate concentrations, even though the morphology of the monolayers had changed. The results agree with published data obtained with experimental animals and indicate that Caco-2 cells can be used to study the concentration-dependent effects of surfactants and other pharmaceutical additives on intestinal epithelial permeability.     

MITOGENIC EFFECT BY LIPOPOLYSACCHARIDE AND POKEWEED LECTIN ON DENSITY-INHIBITED CHICK EMBRYO FIBROBLASTS

The B lymphocyte mitogens, bacterial lipopolysaccharide (LPS), pokeweed lectin, and tuberculin, induced proliferation in density-inhibited monolayer cultures of chick embryo fibroblasts. The stimulation was seen both as an early increase in sugar uptake and cell volume and later as an increase in thymidine incorporation and cell number. The concentration of LPS maximally stimulating fibroblasts was remarkably low, about 0.1–1 ng/ml. LPS preparation with very different sugar chains gave quite similar results indicating that the architecture of the hydrophilic carbohydrate part is not critical for the mitogenic effect.     

The Swedish childhood diabetes study

Summary In a nationwide incident case referent study we have evaluated vaccinations, early and recent infections and the use of medicines as possible risk determinants for Type 1 (insulin-dependent) diabetes mellitus in childhood. A total of 339 recently onset diabetic and 528 referent children, age 0–14 years, were included. Information about infections was collected from a mailed questionnaire and about vaccinations from childhood health care centres and schools. When vaccinations were considered as possible risk factors for diabetes, a significant decrease in relative risk estimated as odds ratio (OR) was noted for measles vaccination (OR=0.69; 95% confidence limits 0.48–0.98). For vaccination against tuberculosis, smallpox, tetanus, whooping cough, rubella and mumps no significant effect on OR for diabetes was found. The odds ratios for Type 1 diabetes for children exposed to 0, 1–2 or over 2 infections during the last year before diagnosis of diabetes revealed a linear increase (OR = 1.0,1.96 and 2.55 for 0, 1–2 and over 2 infections, respectively). The trend was still significant when standardized for possible confounders such as age and sex of the children, maternal age and education and intake of antibiotics and analgetics. In conclusion, a protective effect of measles vaccination for Type 1 diabetes in childhood is indicated as well as a possible causal relationship between the onset of the disease and the total load of recent infections.     

Das akute,subakute und chronische subdurale Hämatom

Zusammenfassung Es wurden 100 Fälle von subduralen Hämatomen behandelt, die sich aus 17 akuten, 20 subakuten und 63 chronischen Fällen zusammensetzten. Als Zeitgrenze für die einzelnen Gruppen wurde 24 Stunden und 14 Tage angenommen.Bezüglich der Symptome zeigte sich, daß die Pupillengröße bei der Beurteilung der Lokaldiagnose des Hämatoms von Bedeutung ist.In den Fällen der subakuten und chronischen Hämatome unterscheiden sich die Angiographiebilder, wenn das Hämatom entweder aus festen Gerinnseln besteht oder flüssig ist, was eine Bedeutung bei der Stellung der präoperativen Diagnose hat. Wenn das subdurale Hämatom fest ist, unterscheidet sich das entsprechende Angiographiebild auch von dem des epiduralen Hämatoms. In 70 Fällen wurde eine Trepanation und in 30 Fällen eine osteoplastische Lappenmethode durchgeführt.Die Mortalität in unserem gesamten Material war 15%. In den einzelnen Gruppe von Hämatomen war die Mortalität wie folgt: akute Fälle 59%, subakute 15% und chronische 3%.

---

Summary A series of 100 cases of subdural hematoma was analysed, consisting of 17 acute. 20 subacute and 63 chronic cases. The time limit chosen for the different groups was 24 hours and 14 days.As regards the symptoms, it was oberserved that an enlarged pupil was an important one for diagnosing the localization of the hematoma.The angiograms in the subacute and chronic groups differed according to whether the hematoma was entirely coagulated or entirely fluid. This observation may be of some importance in making the preoperative diagnosis concerning the type of hematoma, since in cases with subdural hematoma of firm consistency the angiogram differs also from that of an epidural hematoma.Trepanation was performed in 70 cases, and an osteoplastic technique was used in 30 cases.The mortality in the whole case material was 15 per cent. Within the groups the mortality was as follows: acute cases, 59 per cent; subacute, 15 per cent; and chronic, 3 per cent.

---

Resumen Los autores refieren los resultados del analisis de 100 casos de hematomas subdurales, de los cuales 17 casos eran agudos, 20 casos sub-agudos y 63 crónicos. El intervalo transcurrido desde la hemorragia a la operatión variaba entre 24 horas y 14 dias.En lo referente al aspecto clínico es evidente que el tamaño de la pupila tiene importancia para establecer el diagnóstico de hematoma.En el grupo de los hematomas subagudos y crónicos, ya sea en el caso de que el hematoma sea organizado por entero, o en el caso de que se trate de una colección liquida, las imagenes obtenidas por la angiografia no eran iguales, también la imagen obtenida en los casos de hematoma subdural es diferente de la que dan los hematomas epidurales.Se realizaron trépanos en 70 casos y craniectomías en 30.La mortalidad en nuestro material ha sido del 15 por ciento. Según los grupos la mortalidad se agrupa así: agudos 59%, subagudos 15% y crónicos 3%.

---

Résumé Les auteurs rapportent les résultats d'analyse de 100 cas d'hématomes sousduraux, dont 17 cas aigus, 20 cas sous-aigus et 63 chroniques. L'intervalle depuis l'hémorragie à l'opération a été limité à 24 heures et 14 jours, réciproquement.En ce qui concerne l'aspect clinique, il est évident que la grandeur de la pupille a une importance en posant le diagnostic du côté de l'hématome.Dans les groupes des hématomes sous-aigus et chroniques, dans les cas où l'hématome était soit coagulé en entier, soit liquide en entier, les images obtenues à l'angiographie différaient l'une de l'autre. Ce fait peut avoir de l'importance en posant le diagnostic préopératoire, car l'image obtenue dans les cas d'hématome sous-dural coagulé diffère aussi de celle obtenue dans les cas d'hématomes épiduraux.Une trépanation a été réalisée dans 70 cas et une technique à lambeau dans 30 cas.La mortalité dans notre matériel était 15 pour cent. Dans les groupes différents la mortalité était comme suit: aigus 59 pour cent, sous-aigus 15 pour cent et chroniques 3 pour cent.

---

Riassunto Vengono discussi 100 casi di ematoma subdurale, comprendenti 17 ematomi acuti, 20 subacuti e 63 cronici. Come limiti di tempo per i singoli gruppi sono stati scelti 24 ore e 14 giorni.Tra i sintomi è di particolare significato la midriasi dal lato dell'ematoma.Tra gli ematomi subdurali subacuti e cronici ha importanza il quadro angiografico per differenziare se l'ematoma è formato da sangue stabilmente coagulato o se è fluido, per stabilire un'esatta diagnosi preoperatoria. Quando l'ematoma subdurale è fluido esso si differenzia nel suo quadro angiografico da quello epidurale. In 70 casi è stata effettuata una trapanazione ed in 30 casi un lembo osteoplastico.La mortalità nel nostro materiale è stata del 15%. Nei singoli gruppi la mortalità è così distribuita: nei casi acuti 59%, nei subacuti 15%, e nei cronici 3%.

     

Comparison of somatosensory evoked responses from root and cord recorded by skin and epidural electrodes using stimulation of the median nerve in cervical radiculopathy and radiculomyelopathy

Somatosensory evoked potentials (SEPs) were recorded by stimulating the median nerve at the wrist from the skin and epidural space of the 7th cervical spine in patients suffering from cervical radiculopathy or radiculomyelopathy. The patients were divided into four subgroups according to the severity of the disease. Skin and epidural SEPs were calculated and compared with each other and with control values. Usually only one negative potential N13 was identified in the skin recording, but two potentials N11 and N13 occurred in the epidural recording. Lower amplitudes were obtained from the skin than from the epidural space. In the skin SEPs the mean of the central latency of N13 was significantly prolonged in the severe radiculomyelopathy groups, while the mean of the amplitude N13 showed only a tendency to decrease. In contrast, in the epidural SEPs a significant decrease in the mean of the N11 and N13 amplitudes together with a significant prolongation in the mean of the central latency of N13 could be found. In the epidural recording the amplitude changes in particular increased with the severity of the disease, but the highest number of abnormalities (61%) could be seen in the central latency of N13.     

Incidence of post-traumatic arthrosis after primary healing of scaphoid fractures: a clinical and radiological study

In a retrospective study of 229 patients with healed fractures of the waist of the scaphoid, the incidence and development of post-traumatic radiocarpal arthrosis was studied. With a minimum follow-up period of seven years, 5.2% of patients showed radiological evidence of radiocarpal arthrosis. It is concluded that an alteration of the carpal dynamics, due to deformation and shortening of the scaphoid, is the most likely cause of post-traumatic arthrosis after primary healing of scaphoid fractures.     

Clinical characteristics of multiple sclerosis in Västerbotten County in northern Sweden

Background: Most clinical data for multiple sclerosis are hospital based—that is, derived from patients referred to clinics specialising in the disease. Objectives: To present data derived from two population based multiple sclerosis populations, an incidence cohort and a prevalence population, from Västerbotten County, northern Sweden. Methods: The two populations were identified from multiple sources, and case ascertainment was assured through a personal clinical review, including interviews and examination of the patients. Results: Characteristics at onset for the different clinical subtypes of multiple sclerosis are presented, including the clinical spectrum of the first attack, the anatomical correlation between the first and second attacks, sex distribution, and disability distribution. Conclusions: Based on the comparison of present and earlier natural history data, multiple sclerosis appears to be a slightly more benign disease than previously recognised.     

Smoking habits and their confounding effects among occupational groups in Sweden

Smoking habits among different occupational groups in Sweden were estimated from nation wide surveys of living conditions in 1977 and 1980/81. These surveys were conducted by Statistics Sweden and consist of interviews covering the Swedish population aged 16-74 years. The sample includes about 12,000 persons for each of the two investigations. The results show that those who may be exposed to excess risks in their work environment, smoke more than those in other occupational groups. Transport and manufacturing workers, miners, wood and paper workers and painters, for example, have higher rates of daily smokers than the national average. The highest rates, however, were found among the category of early retired or unemployed. These findings confirm that an appropriate evaluation of occupationally-related diseases affected by smoking must take smoking data into consideration. If smoking data are available from other sources, adjusted work-related risks could be calculated. This presumes the absence of interaction effects. Procedures are given and illustrated. The paper also discusses the declining trends in smoking habits between 1977 and 1980/81 and possible reasons for differences in smoking habits between occupations.