Intestinal permeability in kwashiorkor

Intestinal permeability can be assessed non-invasively using the lactulose-rhamnose (L-R) test, which is a reliable measure of small intestinal integrity. AIMS: To determine risk factors for abnormal intestinal permeability in kwashiorkor, and to measure changes in L-R ratios with inpatient rehabilitation. DESIGN: A case-control study of 149 kwashiorkor cases and 45 hospital controls. The L-R test was adapted to study kwashiorkor in Malawi, with testing at weekly intervals during nutritional rehabilitation. Urine sugars were measured by thin layer chromatography in London. RESULTS: The initial geometric mean L-R ratios (x100) (with 95% confidence interval) in kwashiorkor were 17.3 (15.0 to 19.8) compared with 7.0 (5.6 to 8.7) for controls. Normal ratios are < 5, so the high ratios in controls indicate tropical enteropathy syndrome. Abnormal permeability in kwashiorkor was associated with death, oliguria, sepsis, diarrhoea, wasting and young age. Diarrhoea and death were associated with both decreased L-rhamnose absorption (diminished absorptive surface area) and increased lactulose permeation (impaired barrier function) whereas nutritional wasting affected only L-rhamnose absorption. Despite, clinical recovery, mean L-R ratios improved little on treatment, with mean weekly ratios of 16.3 (14.0 to 19.0), 13.3 (11.1 to 15.9) and 14.4 (11.0 to 18.8). CONCLUSION: Abnormal intestinal permeability in kwashiorkor correlates with disease severity, and improves only slowly with nutritional rehabilitation.     

DNA restriction fragment length polymorphism of HLA-DR2: Correlation with HLA-DR2-associated functions

HLA-DR2 can be divided into at least 3 distinct HLA-D clusters which correlate with structural differences within the HLA-D region. Further, a functional counterpart of this subdivision has been previously identified. The presence of a particular DR beta 2 polypeptide chain correlated precisely with the susceptibility of measles virus-infected HLA-DR2 homozygous typing cell lines to lysis by measles virus-specific, HLA class II-restricted CTL clones. To determine if a genetic basis for these functional differences could be detected, the degree of polymorphism at the DNA level within the serologically defined HLA-DR2 haplotype has been examined. By using DNA probes for DR beta and DQ beta 4 of the 5 HLA-D clusters of HLA-DR2 could be distinguished and a RFLP pattern was identified which correlates with known immunological functions associated with these various D types. In addition, this technique of 'molecular genotyping' was used to investigate a limited panel of patients with multiple sclerosis (MS) who were HLA typed as either HLA-DR2,2 or HLA-DR2,blank. The RFLP profile of the HLA-DR2 Dw2 D type was found in all of these MS patients.     

Evaluation of the structural proteins of the hamster neurotropic strain of measles virus with monoclonal antibodies

The virus-specified proteins produced by cells persistently infected with hamster neurotropic strain (HNT) of measles virus were assessed by a panel of monoclonal antibodies. In comparison to the Edmonston strain a number of differences were detected. The HA protein lacks epitopes identified by certain monoclonal antibodies. Some of the absent epitopes may relate to agglutination, because this biological phenomenon is not produced by HNT virus. Phosphoprotein (P) of the usual size (70 kDa) was not detected. Instead a protein with an approximate MW of 36 kDa which reacted with one monoclonal anti-P was identified. Although matrix protein (M) was not detected, mRNAs for P and M proteins were present. However, these in contrast to the mRNAs from Edmonston strain, did not translate in vitro. These abnormalities may relate to neurotropism and the capacity of HNT to produce persistent CNS infection.     

Cerebral blood flow relationships associated with a difficult tone recognition task in trained normal volunteers

Tone recognition is partially subserved by neural activity in the right frontal and primary auditory cortices. First we determined the brain areas associated with tone perception and recognition. This study then examined how regional cerebral blood flow (rCBF) in these and other brain regions correlates with the behavioral characteristics of a difficult tone recognition task. rCBF changes were assessed using H2(15)O positron emission tomography. Subtraction procedures were used to localize significant change regions and correlational analyses were applied to determine how response times (RT) predicted rCBF patterns. Twelve trained normal volunteers were studied in three conditions: REST, sensory motor control (SMC) and decision (DEC). The SMC-REST contrast revealed bilateral activation of primary auditory cortices, cerebellum and bilateral inferior frontal gyri. DEC-SMC produced significant clusters in the right middle and inferior frontal gyri, insula and claustrum; the anterior cingulate gyrus and supplementary motor area; the left insula/claustrum; and the left cerebellum. Correlational analyses, RT versus rCBF from DEC scans, showed a positive correlation in right inferior and middle frontal cortex; rCBF in bilateral auditory cortices and cerebellum exhibited significant negative correlations with RT These changes suggest that neural activity in the right frontal, superior temporal and cerebellar regions shifts back and forth in magnitude depending on whether tone recognition RT is relatively fast or slow, during a difficult, accurate assessment.      

糖尿病与重症牙周病相关的证据

数据来源：检索MEDLINE数据库从1970年1月至2003年10月出版的所有文献．并手工检索参考文献中的相关文献。纳入标准：以人为对象的临床试验或观察性研究，且以英语发表的文献。数据提取和合成：由3位作者分别提取数据，意见不同则由讨论解决。记录一系列指标：菌斑指数（PI）、牙石指数、牙龈指数（GI）、探诊出血指数（BOP）、牙周探诊深度（PPD）、临床附着丧失（CAL）、牙龈退缩、牙周指数和骨丧失指数。用血液中糖化血红蛋白百分浓度显示糖尿病控制与否。评估各牙周参数的整体差异，并应用固定效应模型或随机效应模型计算相应的95％CI。用Q检验进行同质性检验。用漏斗图检测发表偏倚。结果：18个横断面对照研究、3个前瞻性队列研究和2个临床试验的基线资料入选。