Sexually dimorphic and radiation dose dependent effect of cranial irradiation on body mass index

OBJECTIVES—To investigate the relation between cranial irradiation received during treatment for childhood leukaemia and obesity at final height.DESIGN—Retrospective cross sectional study.SETTING—Paediatric oncology centres at Great Ormond Street Hospital for Children and the Royal Marsden Hospital.SUBJECTS—Survivors of childhood leukaemia who received cranial irradiation, were in continuous first remission, and had reached final height. An unirradiated group of patients from the United Kingdom acute lymphoblastic leukaemia XI trial was also included; these patients were in continuous first remission and had been followed for at least four years from diagnosis.MAIN OUTCOME MEASURES—Body mass index standard deviation score (BMI z score) at final height for irradiated patients and at most recent follow up for unirradiated patients. Regression analysis was used to examine the effect on BMI z score of sex, age at diagnosis, and the dose of radiation received.RESULTS—For cranially irradiated patients, an increase in the BMI z score at final height was associated with female sex and lower radiation dose, but not with age at diagnosis. Severe obesity, defined as a BMI z score of > 3 at final height, was only present in girls who received 18-20 Gy irradiation and had a prevalence of 8%. Both male and female unirradiated patients had raised BMI z scores at latest follow up and there was no association with age at diagnosis.CONCLUSIONS—These data are further evidence for a sexually dimorphic and dose dependent effect of radiation on the human brain.     

Persistent value of air-augmented radiograph in neonatal high gastrointestinal obstruction, despite more modern techniques

Air is a safe and effective natural contrast agent in neonatal high gastrointestinal (GIT) obstruction. Successful early decompression often results in plain abdominal radiographs of low diagnostic yield. We present a series of neonates with high GIT obstruction in whom air-augmented abdominal radiographs (AAAR) were performed instead. Fourteen neonates presented with suspected high GIT obstruction. In 12 sick babies, obstruction was confirmed and the level of obstruction was determined. The other two neonates required additional positive contrast upper GIT studies. These confirmed small bowel malrotation. For neonatal high GIT obstruction an AAAR can provide a rapid and accurate diagnosis. Positive contrast agent studies should be performed when the AAAR is non-diagnostic.     

B1 and B2 antagonists and bradykinin-induced blood flow in rat skin inflammation

OBJECTIVE AND DESIGN: The aim of the present study was to examine the contribution of the two kinin receptors B1 and B2 to the increased blood flow observed in response to bradykinin (BK) in a blister model under different injury conditions. MATERIAL: Young male Sprague-Dawley rats weighing 250-350 g were used. METHODS: A vacuum-induced blister was raised in the rat hind paw and blood flow measured in the superfused blister base under four different conditions including, early phase acute injury; late phase acute injury; recurrent injury and early phase acute injury in the setting of chronic nerve damage. BK (10 microM) was superfused alone, or in the presence of the B1 antagonist DesArg9Leu8BK (DALBK), (10 nM) and/or the B2 antagonist [D-Arg,Hyp3,Thi5 D-Tic7,Oic8] Bradykinin (HOE 140) (10 nM). RESULTS: HOE 140 significantly inhibited the BK response in all models. Significant inhibition of BK-induced vasodilatation by DALBK was only observed in the late phase acute and recurrent injury models. CONCLUSIONS: The results suggest that the involvement of the inducible B1 receptor in skin inflammation site is related to the site, duration and recurrence of the injury condition.     

Ruthenium red selectively inhibits oedema formation and increased blood flow induced by capsaicin in rabbit skin.

It has been suggested that ruthenium red has a selective inhibitory effect on capsaicin-induced nociceptor stimulation. We have investigated the effect of ruthenium red on oedema formation and vasodilatation induced by intradermal (i.d.) injection of capsaicin in the rabbit in vivo. Responses induced by capsaicin were inhibited by ruthenium red, but responses induced by bradykinin, N-formyl-methionyl-leucyl-phenylalanine (FMLP), platelet activating factor (PAF), histamine and calcitonin gene-related peptide (CGRP) were not affected. These results suggest that ruthenium red selectively inhibits capsaicin-induced local plasma protein leakage and vasodilatation in the rabbit skin microvasculature.     

Human myeloid alpha 3-fucosyltransferase is involved in the expression of the sialyl-Lewis(x) determinant, a ligand for E- and P-selectin

The sialyl-Lex determinant (NeuAc alpha 2-->3Gal beta 1-->4[Fuc alpha- 1-->3]GlcNAc) has been identified as a major ligand in the selectin- mediated adhesion of neutrophils and monocytes to activated endothelium or platelets. This carbohydrate epitope is formed by the sequential action of alpha 3-sialyltransferase and alpha 3-fucosyltransferase on N- acetyllactosamine (Gal beta 1-->4GlcNAc) disaccharide termini of glycoconjugates. We have addressed the role of the human myeloid alpha 3-fucosyltransferase in the expression of this epitope at the leucocyte surface by determining its activity in human-mouse leukemic cell hybrids (WEGLI), normal human granulocytes and chronic myeloid leukemia (CML) cells using sialylated and desialylated glycoproteins and oligosaccharides as acceptor substrates. In contrast to what has been reported for the myeloid-type enzyme, we found that the alpha 3- fucosyltransferase of the cells studied can use sialylated acceptors be it that the activity is several times lower than with asialo- substrates. Characterization of the product obtained with a sialylated oligosaccharide indicated that the enzyme can catalyze the formation of the sialyl-Le(x) structure. Flow cytometry of the WEGLI cells using a sialyl-Le(x)-specific monoclonal antibody (MoAb) showed that these cells indeed express sialyl-Lex at their surface, provided that they contain human chromosome 11. Earlier the presence of this chromosome had been correlated with the expression of alpha 3-fucosyltransferase activity. In addition to sialyl-Le(x), WEGLI cells containing chromosome 11 showed high-expression levels of related structures recognized by antibodies VIM-2 and VIM-8, suggesting that fucose addition can occur at both distal and proximal GlcNAc residues in poly- N-acetyl-lactosaminoglycan sequences. Based on the human chromosome contents it could be ruled out that the alpha 3-fucosyltransferase of WEGLI cells is a Lewis-type alpha 3/4- or plasma-type alpha 3- fucosyltransferase, the genes of which have been mapped to chromosome 19. It is concluded that the enzyme studied is of the myeloid-type and indeed is involved in the synthesis of sialyl-Le(x) (and also VIM-2 and VIM-8 structures) in leukocytes provided that its expression is at a sufficiently high level.     

An outbreak of infection with a gentamicin and methicillin-resistant Staphylococcus aureus in a neonatal unit

A strain of Staphylococcus aureus resistant to gentamicin and methicillin and many other antibiotics caused an outbreak of infection in a neonatal unit. Eleven infants and three staff members became colonized with the organism. One of the staff suffered from psoriasis. Two infants developed septicaemia following infections of intravenous drip sites and one of these subsequently died. The strain was eliminated by closure and thorough cleaning of the unit and the transfer of infected or colonised patients to an isolation ward specially opened for this purpose.