Aspirin-induced Gastritis,Like Helicobacter pylori-induced Gastritis,Disinhibits Acid Secretion in Humans: Relation to Cytokine Expression

Background: Helicobacter pylori infection contributes to hypergastrinemia and hypersecretion of acid by blocking inhibitory reflex pathways to gastrin and parietal cells normally activated by antral distention. Our aim was to investigate whether a similar blockade of inhibitory responses could be provoked by inducing gastritis with aspirin, thus implicating a common inflammatory component, possibly a proinflammatory cytokine(s). Methods: We studied the effects of antral distention on stimulated acid secretion and gastrin release in H. pylori     

Constipation Assessed on the Basis of Colorectal Physiology

Background: Constipation is a collective term for symptoms of different aetiologies and pathophysiologies. Our aim was to determine the prevalence of colorectal pathophysiology findings in a prospective series of patients with chronic constipation. Methods: A total of 155 consecutive patients with chronic constipation underwent anorectal manometry, electromyography (EMG), the balloon expulsion test, colonic transit-time study, and defecography. Results: All investigations were completed by 134 patients (112 females) with a median age 52 (range, 17-79) years. Patients were categorized on the basis of transit time and pelvic-floor function as belonging to 1 of 4 groups: slow-transit constipation (STC) (delayed transit time but normal pelvic-floor function, n = 28), pelvic-floor dysfunction (PFD) (pelvic-floor dysfunction and normal transit time, n = 32), combined slow transit and pelvic-floor dysfunction (STC + PFD) (n = 27), and normal-transit constipation (NTC) (normal transit time and normal pelvic-floor function, n = 47). There was no difference between diagnostic groups in anal sphincter pressures. However, rectal sensitivity to balloon distension was lower (P < 0.05) in patients with delayed transit. Paradoxical puborectalis contraction (PPC) was found on EMG in 42 patients (31%). The prevalence of PPC was higher (P < 0.001) in patients with pelvic-floor dysfunction. Inability to evacuate the rectal balloon was reported by 37% of patients with pelvic-floor dysfunction and 12% of patients with normal pelvic-floor function (P < 0.001). Rectocele was the only anatomic abnormality at defecography which was associated with poor rectal emptying. Conclusions: About two-thirds of our patients with constipation had objective evidence of delayed transit or pelvic-floor dysfunction. No single test could reliably identify any of the pathophysiologic subgroups of constipation.     

Novel Donor Splice Site Mutation in the KVLQT1 Gene is Associated with Long QT Syndrome

KVLQT1 Gene Mutation and LQTS. Introduction : Inherited long QT syndrome (LQTS) recently has been associated with mutations in genes coding for potassium ( KVLQTI, KCNEI , and HERG ) or sodium ( SCN5A ) ion channels involved in regulating either sodium inward or potassium outward currents of heart cells, resulting in prolongation of the repolarization period. We describe a new mutation, a-1 donor splice site mutation in a kindred with two affected members (QTc = 0.61 and 0.54 sec).
Methods and Results : Single stranded conformation polymorphism (SSCP) analyses were performed on DNA fragments amplified by polymerase chain reaction from DNA extracted from whole blood. Aberrant conformers were analyzed by DNA sequencing. SSCP analysis of the KVLQTI gene revealed an aberrant conformer in the affected family members. DNA sequencing confirmed the presence of a G→A change in the last nucleotide of codon 344. This mutation does not cause an amino acid change, but a change of the splice site characteristics at the 3'end of exon 6. The mutation may affect, through deficient splicing, the putative sixth transmembrane segment of the K⁺ channel, and this type of mutation has not previously been described in KVLQTI.
Conclusion : The clinical course of LQTS in the affected family members, in whom no deaths occurred despite 20 to 30 syncopes, can he explained by the ability of the cellular machinery to perform partial correct splicing in the mutant allele. This type of mutation may be misinterpreted as a normal variant, since it is a point mutation causing neither an amino acid change nor the introduction of a stop codon.     

The competence of certified nurse assistants caring for persons with dementia diseases in residential facilities

In Sweden, a majority of elderly persons living in residential facilities have some form of dementia, and caring for them is a demanding and complex task. The formal education level of personnel in residential facilities is low. The aim of this paper is to describe certified nurse assistants' (CNAs) content of competence caring for persons with dementia diseases in residential facilities. Information from 22 diary notes was obtained and 12 CNAs in four residential facilities were interviewed. The diary notes and interviews were transcribed and analysed using conventional content analysis. Three main categories were generated from the diaries: Social and Health Care, Health Care Targeted towards Medicine and, finally, Organization. The same categories were generated from the interviews but with the addition of Knowledge – its use, growth and deficiencies. The results show that competence is mainly based on personal, experienced-based knowledge and 'standard routines'. In general, the nurse assistants' interest in developing knowledge is weak. Furthermore, CNAs lack competence in essential theoretical knowledge about dementia diseases. It is notable that CNAs, caring for people with serious dementia, know little about the reasons for the residents' divergent behaviour. Consequently, knowledge related to dementia and mental diseases must be highlighted. Therefore, formal education focused on these diseases is crucial.     

Protective immunity induced by vaccination with two Haemonchus contortus excretory secretory proteins in sheep

Two excretory secretory (ES) antigens of adult Haemonchus contortus with molecular weights of 15 and 24 kDa, respectively, were evaluated as protective immunogen against haemonchosis. Sheep were vaccinated three times and subsequently challenged with 20 000 infective larvae. Vaccination induced significant reduction (>70%) in mean faecal egg counts and abomasal worm burden compared to the non-vaccinated control group or adjuvant control group. Vaccination induced ES-specific antibodies and stimulated infiltration of mast cells in the abomasal tissue.     

Rhythmic contractions of isolated,pressurized small arteries from rat

The present study was undertaken to examine the influence of transmural pressure on vasomotion and to determine if any such influence was endothelium–dependent. Responses to changes in intravascular pressure of cannulated mesenteric small arteries were investigated under no–flow conditions. Both intact and endothelium–denuded arteries dilated passively when intravascular pressure was increased stepwise from 20 to 140 mmHg. When tone was induced by noradrenaline, pressure increase resulted only in dilatation, independent of endothelium. The sensitivity to noradrenaline was significantly increased in vessels without endothelium, indicating a relaxing influence of the endothelium. Rhythmic contractions in response to noradrenaline occurred in all intact arteries, but were absent when the endothelium was removed. The amplitude of the rhythmic contractions decreased significantly when transmural pressure was elevated. The frequency increased when pressure was elevated from 20 to 80 mmHg and then remained rather constant during further pressure increases. As shown previously in non–pressurized arteries, exogenous cyclic GMP induced oscillations in endothelium–denuded arteries. Pressure–related effects on vasomotion were not dependent on an intact endothelium. Ryanodine, ouabain or verapamil inhibited the rhythmic activity, confirming previous results in non–pressurized arteries. Thus, changes in transmural pressure can modulate vasomotion, but this effect does not appear to be mediated by the endothelium. Generation of vasomotion may depend on release of Ca²⁺ from intracellular stores, the activity of the Na⁺, K⁺–pump and transmembrane Ca²⁺ inflow in a pressurized artery as shown previously in these arteries under isometric conditions.     

Insulin stimulates the uptake of chylomicron remnants in cultured rat hepatocytes

The effects of insulin (10-1000 microU ml-1) on chylomicron remnant uptake and degradation were studied in hepatocyte monolayer cultures. Both uptake and degradation were stimulated by insulin. The degree of stimulation was influenced by cell density, being most pronounced in sparse cultures. The uptake was stimulated in a dose-dependent fashion and was noticed already at a physiological insulin level (100 microU ml-1). At this insulin concentration uptake was stimulated by approximately 50% (range 26-84%). As suggested by the increase in Vmax for the remnant uptake, the number of lipoprotein receptors on the hepatocytes was increased by 100 microU ml-1 of insulin. Apolipoprotein-E-free low density lipoproteins (LDL) competed much less efficiently for the uptake of radioactive remnants than did unlabelled remnant particles. About half of the stimulatory effect of insulin on the remnant uptake could, however, be abolished by adding an excess of LDL, indicating that at least part of the stimulation by insulin was due to increased activity of the LDL receptor. This study thus shows that physiological insulin levels increase chylomicron remnant uptake in hepatocyte monolayer cultures. It is assumed that the effect of insulin is to increase the number of lipoprotein receptors at the cell surface, and at least part of the stimulation is due to an increase in LDL receptor activity.