Circulating tuberculostearic acid in tuberculosis patients

Tuberculostearic acid (TBSA), a mycobacterial cell wall constituent, was measured in plasma samples using a highly sensitive high-performance liquid chromatography method. Plasma TBSA concentrations in patients with active tuberculosis (20 [0.5-347] nmol/l; n = 125) were higher than in patients with a variety of non-tuberculous pulmonary and extrapulmonary inflammatory conditions (0.1 [0-29] nmol/l; n = 116) and in healthy controls (0 [0-2] nmol/l; n = 102) (p = < 0.001). The calculated sensitivity, specificity, positive and negative predictive values for tuberculosis were 95.2%, 87.9%, 89.5% and 94.4%, respectively, indicating that assay of plasma TBSA might be a valuable complementary diagnostic tool.     

Relevance of some of the theories of Ibn Khaldoun in his "Al Muqaddimah" to contemporary medicine. A personal interpretation

The subjects in this paper include Ibn Khaldoun's thoughts on writing, and their implications on today's medical writing. This paper discusses why people write, plagiarism, "Original" and "Copied' writings and where history writing goes wrong and how this can be applied to Medical writing today. The paper also discusses the nature of Science and Knowledge as viewed by Ibn Khaldoun, the anatomy of intelligence, types of thought processes, and effects of environment and craftsmanship on intellect. Ibn Khaldoun's definition of the "Medical" profession and its social standing is discussed as well as his emphasis of the importance of exercise, diet and climate on healthy living. Ibn Khaldoun has clear and advanced concepts on education and methodology of education. He emphasizes 3 stages of coaching, and the importance of travel in consolidating and clarifying knowledge attainment. He abhors coercion as a method of educating the young. Developing the interest of the pupil in the art he is studying, is thought by Ibn Khaldoun to be the central theme of good education. Relevance of all this to contemporary medical education is discussed. Ibn Khaldoun has fascinating ahead-of-time views on the influence of peer pressure and what is now known as "Emotional Intelligence" and he rejects the idea that intelligence is ethnically determined. Instead, he emphasizes the environmental, social and craftsmanship influence on human behavior. He stresses that the method of education has a lot to do with the "apparent" intelligence or "stupidity" of pupils.     

Use of pamidronate for acute pain relief following osteoporotic vertebral fractures

SIR, Osteoporotic vertebral fractures are common with increasingage. Although often asymptomatic, they are a cause of disablingback pain that may continue for several weeks. Current treatmentavailable in the acute phase is limited to analgesia and immobilization.Preliminary experience with the use of intravenous pamidronatefor pain relief in vertebral fractures secondary to osteoporosisin five patients is reported here. Five consecutive patients admitted with radiologically confirmedvertebral fractures were treated with     

Involvement of the Mitochondrial Pathway in Cold Storage and Rewarming-Associated Apoptosis of Human Renal Proximal Tubular Cells

The cellular and molecular mechanisms of cold storage-ATN are not well characterized. In our earlier studies, cold storage caused necrosis of human proximal tubular epithelial (RPTE) cells, whereas apoptosis was prominent during rewarming. An intriguing finding was the pronounced swelling of the mitochondria in the cold, which promoted us to further characterize its role in rewarming-associated apoptosis. Human proximal tubular epithelial cells were cold stored in University of Wisconsin (UW) solution for 48 h followed by 24 h of rewarming in regular cell culture medium. During the cold storage, there was no significant change in the Bcl-2 to Bax protein ratio, mitochondrial location of cytochrome C or caspse-3 activity. However, during rewarming, the Bcl-2 to Bax ratio increased, cytochrome C was translocated to cytosol, and caspase-3 was activated: events and timing were consistent with the occurrence of apoptosis during rewarming. In a time-course experiment, mitochondrial swelling was discernable by electron microscopy as early as at 2 h. Cold storage of isolated-mitochondria for 2 h was attended by an increase in the opening of the permeability transition pores (PTP), suggesting PTP opening as an early mechanism for mitochondrial swelling. Addition of antioxidants (deferoxamine or 2-methyaminochroman) to the storage solution suppressed mitochondrial pore opening and swelling, Bcl-2 to Bax ratio increase, cytochrome C translocation, caspase-3 activation as well as rewarming-induced apoptosis. Our data demonstrate for the first time that apoptosis following cold storage and rewarming of human renal tubular cells is accompanied by specific mitochondrial events, and that these events and apoptosis can be suppressed by adding antioxidants to the cold storage solution.     

Thioacetamide- and carbon tetrachloride-induced liver cirrhosis

Two methods of inducing liver cirrhosis in the rat were studied. Intragastric administration of CCl4 for 16 weeks according to Proctor and Chatamra was compared to the administration of thioacetamide in the drinking water (0.3 g/l) for the same period. CCl4 administration induced micronodular cirrhosis in 6/8 animals with a 27% mortality. Thioacetamide induced cirrhosis in 6/8 animals without mortality. The histologic pictures differed somewhat in that the CCl4 group exhibited more necrosis and cellular swelling while the thioacetamide group had more nuclear atypias and proliferation. Biochemically both groups had elevated plasma levels of aspartate aminotransferase. The lysosomal enzyme beta-hexosaminidase (beta-NAG) showed a transient increase in the thioacetamide animals, while beta-glucuronidase decreased. CCl4-induced cirrhosis led to an increase in beta-NAG. Plasma zinc decreased in both groups as well as liver zinc content in the CCl4 group, while there was a continuous elevation of liver zinc in the thioacetamide group. We conclude that oral administration of thioacetamide is a simple and reliable method of inducing experimental liver cirrhosis. The differences in histological appearances and some biochemical parameters may be caused by the different mechanisms of action of thioacetamide and CCl4.     

The action of human high density lipoprotein on cholesterol crystals. Part 1. Light-microscopic observations.

High density lipoprotein (HDL) was found in vitro to form myelin buds (liposomes) from washed crystals of free cholesterol (commercial or atheroma sources). This activity led to the progressive destruction and solubilization of the crystals. Low density and very low density lipoproteins did not have any effect. Liposome formation and solubilization were accelerated by calcium ions, phospholipase A and polyunsaturated lecithin (Lipostabil). Cholesterol crystals were nearly completely destroyed after 18 h incubation with HDL-Lipostabil.     

Antagonistic effects of zinc and aluminum on lead inhibition of delta-aminolevulinic acid dehydratase

In vitro and in vivo studies regarding the influence of metals on delta-aminolevulinic acid dehydratase activity in erythrocytes indicate that a lead concentration of 4 micrometer/l completely inhibits the enzyme. Zinc activates the enzyme both in vitro and in vivo at concentrations greater than 76 micrometer/l. Aluminum has an inhibitory effect at all concentrations in vitro whereas it activates the enzyme in vivo. Zinc and aluminum together activate the enzyme in vivo. The in vitro activation of zinc is inhibited by increasing concentrations of aluminum. Aluminum and lead together depress the enzyme activity in an additive way that can be reactivated by the addition of zinc.