Long-term effects of a change from a mixed diet to a lactovegetarian diet on human urinary and faecal mutagenic activity

This is an investigation of the long–term effects of ashift from a mixed diet to a lacto-vegetarian diet and of areturn to a mixed diet on the mutagenic activity in urine andfaeces. The participants were 20 normal weight, nonsmoking subjects.Dietary surveys and urinary and faecal samples were collectedbefore and 3, 6 and 12 months after the dietary shift as wellas 3 years after termination of the lacto-vegetarian diet period.The faecal samples were assayed for direct acting mutagens withthe fluctuation test for weak mutagens and the urinary sampleswere assayed with the same assay but with a metabolic activationsystem, the so-called S9 fraction. The dietary data showed anincrease in consumption of fruits, vegetables and dairy productsand a decrease in meat, fish, eggs, sweets and biscuits duringthe vegetarian diet period. These changes led to an increasein total carbohydrates, fibre, vitamin C and calcium and a decreasein fat and protein intake. Mutagenic activity in both urineand faeces decreased after shift to the vegetarian diet andmutagenic activity in faeces increased when the volunteers returnedto a mixed diet (P = 0.025 and 0.035 respectively when comparingthe diets). These data indicate that dietary factors may affectmutagenic activity in urine and faeces. However, it is stillnot clear whether a decrease in animal products, a change inother nutritional factors or a decrease in frying are the maincontributors to this change. ⁴To whom correspondence should be addressed at: Department of Food and Nutrition, University of Umea, S-901 87 UmeS, Sweden. Tel: +46 90 786 55 99; Fax: +46 90 786 64 87; Email: gunnar.johansson{at}kost.umu.se     

Recurrence of clinically significant hepatitis A following liver transplantation for fulminant hepatitis A.

BACKGROUND: We report hepatitis A virus (HAV) infection of a liver allograft following transplantation for fulminant liver failure due to HAV infection. This rare condition has been described in only three patients to date. After liver transplantation allograft function was good, but starting 80 days after transplantation, episodes of acute graft dysfunction were observed. OBJECTIVES: To elucidate the reason for acute hepatic dysfunction a large number of differential diagnoses were tested. RESULTS: HAV RNA was undetectable for more than 80 days after transplantation. Detection of genomic HAV RNA by RT-PCR in serum and stool at the time of graft dysfunction led to the diagnosis of recurrent HAV infection. CONCLUSIONS: We suggest that the risk of HAV reinfection after liver transplantation may be far higher than expected as results may be misinterpreted as rejection episodes.     

The natural interferon-alpha producing cells in systemic lupus erythematosus

Prolonged exposure of the immune system to type I interferons (IFN-alpha/beta/omega) in patients receiving IFN-alpha therapy frequently results in development of autoantibodies and autoimmune disease. This is attributed to the many immunostimulatory effects of these cytokines. Patients with the autoimmune disease systemic lupus erythematosus (SLE) have an ongoing IFN-alpha production. Recent studies of SLE demonstrated the presence of endogenous IFN-alpha inducers, acting specifically on natural IFN-alpha producing cells (NIPC), often termed plasmacytoid dendritic cells (PDC). These IFN-alpha inducers were potent, present at the blood level, and characterized as immune complexes that contained DNA and IgG as essential components. They were considered a likely reason for the activated IFN-alpha production in SLE, which, in turn, might be an important etiopathogenic factor. Here, we briefly review the biology of the type I IFN system, with emphasis on inducers, producing cells (especially NIPC/PDC), IFN-alpha actions, and target immune cells, which might be relevant in SLE. Based on such information and results from studies in SLE patients, we propose a hypothesis that explains how NIPC/PDC become activated and play a pivotal etiopathogenic role in SLE and perhaps also other autoimmune diseases. This hypothesis furthermore indicates new therapeutic targets.     

Über den Schmerzsinn des Skelettsystems

Ohne Zusammenfassung (Mit 4 Abbildungen.)     

Similar migration in computer-assisted and conventional total knee arthroplasty

Background and purpose — Computer-assisted surgery (CAS) in total knee arthroplasty (TKA) has been used in recent years in the hope of improving the alignment and positioning of the implant, thereby achieving a better functional outcome and durability. However, the role of computer navigation in TKA is still under debate. We used radiostereometric analysis (RSA) in a randomized controlled trial (RCT) to determine whether there are any differences in migration of the tibial component between CAS- and conventionally (CONV-) operated TKA.

Patients and methods — 54 patients (CAS, n = 26; CONV, n = 28) with a mean age of 67 (56–78) years and with osteoarthritis or arthritic disease of the knee were recruited from 4 hospitals during the period 2009–2011. To estimate the mechanical stability of the tibial component, the patients were examined with RSA up to 24 months after operation. The following parameters representing tibial component micromotion were measured: 3-D vector of the prosthetic marker that moved the most, representing the magnitude of migration (maximum total point motion, MTPM); the largest negative value for y-translation (subsidence); the largest positive y-translation (lift-off); and prosthetic rotations. The precision of the RSA measurements was evaluated and migration in the 2 groups was compared.

Results — Both groups had most migration within the first 3 months, but there was no statistically significant difference in the magnitude of the migration between the CAS group and the CONV group. From 3 to 24 months, the MTPM (in mm) was 0.058 and 0.103 (p = 0.1) for the CAS and CON groups, respectively, and the subsidence (in mm) was 0.005 and 0.011 (p = 0.3).

Interpretation — Mean MTPM, subsidence, lift-off, and rotational movement of tibial trays were similar in CAS- and CONV-operated knees.