Weaning anorexia may contribute to local inflammation in the piglet small intestine

Compromising alterations in villus-crypt structure are common in pigs postweaning. Possible contributions of local inflammatory reactions to villus-crypt alterations during the weaning transition have not been described. This study evaluated local inflammatory responses and their relationship with morphological changes in the intestine in 21-d-old pigs (n = 112) killed either at weaning (Day 0) or 0.5, 1, 2, 4 or 7 d after weaning to either milk- or soy-based pelleted diets. Cumulative intake averaged <100 g during the first 2 d postweaning, regardless of diet. During this period of weaning anorexia, inflammatory T-cell numbers and local expression of the matrix metalloproteinase stromelysin increased while jejunal villus height, crypt depth and major histocompatibility complex (MHC) class I RNA expression decreased. Upon resumption of feed intake by the fourth d postweaning, villus height and crypt depth, CD8(+) T cell numbers, MHC class I RNA expression and local expression of stromelysin returned to Day 0 values. Together the results indicate that inadequate feed intake during the immediate postweaning period may contribute to intestinal inflammation and thereby compromise villus-crypt structure and function.     

Drug therapy in Parkinson's disease

Levodopa is still the mainstay of the treatment of Parkinson's disease. Limitations of levodopa therapy have led to development of numerous therapeutic approaches at the level of levodopa/dopamine metabolism, dopamine receptors, dopamine transporter, and other neurotransmitter systems. New insights into the pathophysiology of Parkinson's disease have led to the promising concepts of neuroprotection and neurorestoration. In daily practice therapeutic management of Parkinson's disease is still symptomatic.     

Memory and learning are not impaired in presymptomatic individuals with an increased risk of Huntington's disease

Retrieval from long-term memory in patients with brain injuries was investigated with a memory scanning paradigm (Conway & Engle, 1994), that allows dissociation of scanning processes within short-term memory and memory retrieval processes from long-term memory. The study focused on the influence of brain injury on memory retrieval processes that are assumed to be automatic. Thirteen patients with memory impairment and 13 healthy matched control subjects were tested. In general, patients showed increased reaction times, but they showed set size independent retrieval from long-term memory indicating preserved automatic retrieval processes. In a subgroup of patients with more severe memory deficits, however, automatic retrieval processes appeared not to be intact. Learning profiles of the patients were characterized by smaller item chunks, indicating differences in the process of information acquisition.     

Factors leading to local recurrence or death after surgical resection of phyllodes tumours of the breast

BACKGROUND: Local recurrence and death from metastases are occasional, but consistent, themes in reports of patients with phyllodes tumours. Factors that might contribute to these outcomes were sought. METHODS: Data from 38 patients with a phyllodes breast tumour were reviewed retrospectively, reclassifying the pathological material using the Pietruszka and Barnes criteria. RESULTS: At a median of 12 months, nine patients had developed a local recurrence and four had died from metastases. Following local excision in 24 patients (for diagnosis in 13, for 'fibroadenoma' in nine and for phyllodes tumour in two patients), 13 had no further surgery and five had local recurrence (three of eight benign tumours, two of two malignant tumours). Wide local excision or mastectomy in 18 patients was followed by four recurrences (one of eight borderline tumours, three of ten malignant tumours). All patients with recurrence had margin involvement on histological examination, but not all patients with margin involvement developed recurrence. Lack of statistical correlation between local recurrence and age, delay, size, grade or type of surgery was confounded by selection bias for more extensive surgery for malignant tumours. Death correlated with size (P = 0.05) and grade (P = 0.03) of tumour. CONCLUSION: Inadequate preoperative diagnosis ('fibroadenoma' or failure of triple assessment) frequently led to local excision with positive margins. Without revision this often resulted in local recurrence. Local recurrence of any grade was usually followed by further recurrence. Death was related to tumour size and histological grade, confirming these as prognostic factors.     

Surgically created fourth-third cranial nerve communication: temporary success in a child with bilateral third nerve hamartomas. Case report

Shortly after birth, an otherwise healthy infant developed eye deviation and ptosis due to a hamartomatous lesion of the interpeduncular segment of the right oculomotor nerve. The left nerve became similarly involved when the child was 1.5 years of age. Direct nerve repair was not possible. Instead, the trochlear nerve was divided and its proximal end was attached to the distal end of the third nerve. Elevation of the upper eyelid and partial adduction of the eye developed gradually over the ensuing 3 to 5 months. Both functions were lost after an additional 2 months, presumably as a result of tumor recurrence or neuroma formation. This case report shows that surgically created fourth-third cranial nerve communication is feasible and may merit consideration under similar circumstances.     

WOMAC Osteoarthritis Index--additional dimensions for use in subjects with post-traumatic osteoarthritis of the knee. Western Ontario and MacMaster Universities

OBJECTIVE: To compare the sensitivity of WOMAC and the two added dimensions Sport and Recreation Function and Knee Related Quality of Life in subjects with radiographic knee OA to that in controls. To study the influence of age on the reported outcomes. DESIGN: Outcomes were compared between subjects having had meniscectomy 21 years ago and which at time of follow-up had definite radiographic OA (N=41, mean age 57), and age- and sex-matched controls without radiographic OA (N=50, mean age 53). For the purpose of studying the impact of age, the groups were divided in two age groups, younger and older than 50 years, respectively. Close to 50% of both groups reported current physical activity levels of at least recreational golf, dancing, hiking, etc. Symptoms and function were assessed by WOMAC Osteoarthritis Index and the added dimensions Sport and Recreational Function (Sport/Rec) and Knee Related Quality of Life (QOL). A percentage score was calculated, 0 indicating extreme knee problems and 100 indicating no knee problems. RESULTS: The control group had mean scores of 88-98 for the different dimensions. The OA group scored significantly lower in all dimensions (P< 0.0001). The most discriminative dimensions in both age groups were Sport/Rec and QOL with mean scores of 52 and 59 (ranges 0-100). CONCLUSION: The dimensions Sport and Recreation Function, and Knee Related QOL were highly sensitive and discriminant outcomes in both age groups and should be assessed in addition to WOMAC in subjects with post-traumatic osteoarthritis of the knee.     

Yoghurt enriched with Lactobacillus acidophilus does not lower blood lipids in healthy men and women with normal to borderline high serum cholesterol levels.

OBJECTIVE: To investigate whether intake of Lactobacillus acidophilus strain L-1 lowers serum cholesterol in healthy men and women. DESIGN: Randomised, placebo-controlled parallel trial. SETTING: Subjects were free-living. Blood sampling and distribution of yoghurts were administered at a local hospital. SUBJECTS: Seventy-eight adult men and women with cholesterol levels of 3.9-7.8 mmol/L (mean +/- s.d., 5.4+/-0.7). INTERVENTIONS: Subjects consumed 500 mL of control yoghurt daily for two weeks. They were then randomly allocated to receive 500 mL per day of control yoghurt or of yoghurt enriched with Lactobacillus acidophilus L-1 for another six weeks. The yoghurts were spiked with a trace of lithium; compliance as assessed by plasma lithium was excellent. RESULTS: Energy and nutrient intake was constant, and identical for the two groups. Mean body weight was stable. Baseline blood lipid concentrations in the control and treatment groups were highly similar. The effect of consumption of Lactobacillus acidophilus L-1 vs. control on total cholesterol was -0.02 mmol/L (95% CI, -0.18-0.15) after three weeks and 0.04 mmol/L (95% CI, -0.12-0.20) after six weeks. Serum LDL and HDL-cholesterol and triacylglycerol levels were also unaffected. CONCLUSIONS: Yoghurt enriched with Lactobacillus acidophilus L-1 does not lower serum cholesterol in men and women with normal to borderline high cholesterol levels.     

Adhesion molecules in lymphoma metastasis

Summary Recently, many surface proteins of lymphoid cells that mediate adhesion to other cells and extracellular matrix have been identified. Several of these cellular adhesion molecules (CAM) are also expressed by metastatic lymphoma cells and may mediate adhesion to tissue components during the metastatic process. Correlations observed between expression of certain CAM, like MEL-14 and CD44, and particular patterns of spread, support this notion, but conclusive evidence is scarce.We have used T-cell hybridomas to study the mechanisms of wide-spread lymphoid metastasis. The results obtained with this model are reviewed here. The advantages are that a large number of genetically similar cell lines can be generated, which can be grouped in large panels of highly invasive and non-invasive cells. Invasiveness of these cells in hepatocyte and fibroblast monolayers correlates with exprimental metastasis.Lymphoid CAM that are potentially involved in metastasis are reviewed. Several of these CAM are not, or not consistently, expressed by the invasive T-cell hybridomas, indicating that they are not indispensable. Notably, some of the CAM involved in the onset of an immune response or in migration into inflamed tissues, like ICAM-1 and VLA-4, and the homing receptors MEL-14 and LPAM-1 do not seem to be involved. CAM that are consistently expressed by the T-cell hybrids include LFA-1, the beta-1 integrin subunit CD29, CD31 (PECAM-1) and CD44 (Hermes homing receptor).We have generated considerable evidence that LFA-1 is required for efficient metastasis of T-cell hybrids, based on the behavior of LFA-1-deficient mutants and revertants. High levels of LFA-1 are required. The relevant counterstructure is probably ICAM-2 rather than ICAM-1. Preliminary results suggest that also a beta-1 integrin, possibly VLA-5, plays a role. Finally, we summarize evidence indicating that CD31 and CD44 are primary candidates for involvement in metastatic spread of T-cell hybridomas.     

Amyloid beta protein (Abeta) starts to deposit as plasma membrane-bound form in diffuse plaques of brains from hereditary cerebral hemorrhage with amyloidosis-Dutch type, Alzheimer disease and nondemented aged subjects

To clarify where and how beta-amyloid begins to deposit in senile plaques, we examined the ultrastructural localization of amyloid beta protein (Abeta) in diffuse plaques of brains with hereditary cerebral hemorrhage with amyloidosis-Dutch type. Alzheimer disease (AD), and from nondemented aged subjects. Serial ultrathin sections of osmium-plastic blocks were immunogold-labeled for Abetax-42 (Abeta42), and sections on grids were observed under the electron microscope (EM) after observing the exact localization of the diffuse plaques in sections on glass slides by the reflection contrast microscope. Abeta42 deposition, which was decollated with gold particles, appeared in 3 forms in all subjects under the EM: 1) Scattered small bundles of amyloid fibrils between cell processes, frequently seen in the densely stained area of diffuse plaques. 2) Scattered small foci of nonfibrillar materials between cell processes as a relatively minor form. 3) Abeta42 on a part of the cell surface plasma membrane of normal appearing cell processes, a major form in weakly immunostained areas. The last form was not associated with degenerative neurites or reactive glia. Abeta42 deposition on the cell surface plasma membrane appears to be an initial event in diffuse plaques, and then it develops into amorphous/fibrillar amyloid between cell processes.     

Pure primary choriocarcinoma of the urinary bladder with long-term survival

Choriocarcinoma was diagnosed in a 77-year-old woman with an acute massive, painless hematuria. One year after anterior pelvic exenteration and ileal conduit, the beta-human chorionic gonadotropin level increased to 934 mIU/mL without any sign of tumor progression. After six courses of chemotherapy (vincristine, actinomycin, and cyclophosphamide), the beta-human chorionic gonadotropin levels returned to normal. To our knowledge, this is the fourth case of pure choriocarcinoma in the bladder, with the longest survival time of 33 months so far.