The detection of Escherichia coli heat-labile enterotoxin by enzyme-linked immunosorbent assay

An enzyme linked immunosorbent assay (ELISA) technique was modified and used to detect heat-labile (LT) enterotoxigenic Escherichia coli (ETEC) from specimens of faeces sent to a routine diagnostic laboratory. Strains of LT ETEC were detected in eight of 250 (3.2%) diarrhoeal stools but were not found in 110 non-diarrhoeal stools. All eight patients found to have LT ETEC were travellers returning with diarrhoea. LT ETEC was the most common bacterial pathogen found (15.4%) in this group of patients, exceeding Campylobacter sp. (5.8%) and Salmonella sp. (7.7%). The ELISA technique was simple to perform and visual readings were found to be reliable.     

Surgical complications of the Garren-Edwards Gastric Bubble

A retrospective review of our initial experience with the Garren-Edwards Gastric Bubble (American Edwards Laboratories) was undertaken to study its surgical complications. Between 22 February and 30 August 1986, 250 patients had 275 gastric bubbles endoscopically inserted as an adjuvant treatment for morbid obesity. Profiles of the first 104 patients revealed a mean weight of 113.0 kilograms (74 per cent above ideal body weight) and a mean weight loss of 10.1 kilograms (0.76 kilogram per week) followed by a gain of 0.48 kilogram from the period of peak weight loss at 13.7 weeks to removal at 19.4 weeks. Thirty-three per cent had endoscopic removal and the remainder passed per rectum. Ninety-two had undergone previous abdominal operation. Five instances of obstruction of the upper part of the gastrointestinal tract (mean 18.3 weeks after insertion) required three operative removals, one endoscopic retrieval from the second portion of the duodenum and one hypaque small intestinal series with oral mineral oil to induce spontaneous passage. Four of the five patients had prior abdominal operations--cholecystectomy in one instance, appendectomy in one, cholecystectomy and appendectomy in one and exploratory laparotomy for multiple stab wounds in one. One (multiple stab wounds) had adhesions at the point of the obstruction. The patient who underwent endoscopic retrieval had premature deflation at 6.7 weeks presumably due to a defective bubble. The weight gain after peak weight loss at 13.7 weeks likely represents spontaneous bubble deflation. Prior abdominal surgical treatment appears to be a significant risk factor for the development of obstruction after bubble deflation. In addition, two of five patients have been lost to follow-up study after insertion. Proper patient selection and careful monitoring may be crucial in reducing the morbidity associated with the Garren-Edwards Gastric Bubble.     

High branched-chain alpha-keto acid intake, branched-chain alpha-keto acid dehydrogenase activity, and plasma and brain amino acid and plasma keto acid concentrations in rats

Diets containing high quantities of individual branched-chain alpha-keto acids (BCKAs) or a combination of BCKAs as used for treatment of renal disease were fed to rats. When the diet contained a single BCKA, its concentration was high in plasma and the concentration of its corresponding amino acid was high in plasma and brain. Liver BCKA dehydrogenase (BCKD) was 42% active in control rats. Consumption of diets containing 0.38 mol/kg diet of alpha-ketoisocaproate (KIC), alpha-keto-beta-methylvalerate (KMV), or alpha-ketoisovalerate (KIV) resulted in complete activation of liver BCKD. Consumption of the diet containing the combination of BCKAs increased basal BCKD activity of liver twofold. Muscle BCKD was activated after feeding the KIV diet (2-fold), the KIC diet (3-fold), and the KMV diet (15-fold). Total BCKD activity of liver and muscle was unaffected by dietary treatments. Activation of liver and muscle BCKD by dietary BCKA is consistent with their ability to inhibit BCKD kinase in vitro.     

Lymphocyte transformation in patients with staged mycosis fungoides and Sézary syndrome.

Lymphocyte transformation was studied in patients with mycosis fungoides and the Sézary syndrome with particular reference to the stage of disease. Phytohemagglutinin-induced lymphocyte blastogenesis was normal in stage II, became depressed in stage III and was greatly reduced in stage IV disease. Similar abnormalities were found in patients with the Sézary syndrome once the proportion of abnormal cells in the peripheral blood exceeded 10%. It is concluded that stag III mycosis fungoides is probably a critical period in determining dissemination of the disease.