Zinc in breast milk during prolonged lactation: comparison between the UK and the Gambia

A total of 580 breast milk samples were collected from 56 lactating women living in a rural village community in The Gambia, West Africa, and 92 samples were obtained from 57 lactating women living in Cambridge, England. Total zinc content of each sample was measured by atomic absorption spectrometry, and pooled samples of the Gambian breast milks, representing successive periods of lactation, were fractionated into fat, whey and insoluble casein fractions, to examine zinc distribution. The two sets of milks both exhibited a dramatic decline in total zinc concentrations with increasing duration of lactation, in common with previous studies. However, the UK milks unexpectedly had lower zinc contents at all stages than the Gambian milks. Milk zinc levels were not significantly related to either maternal age or parity in the Gambian women. The proportion of zinc found in the sedimentable fraction remained nearly constant with increasing duration of lactation, but the proportion found in the fat fraction increased and the proportion in the whey fraction declined. These observations are potentially relevant for estimations of milk zinc availability and the fulfillment of zinc requirements by infants, and hence for infant feeding practices.     

Liquid crystal thermography; a reliable method for detecting soda lime exhaustion

The dynamic and functional state of soda lime can be more precisely assessed by measuring changes in wall temperatures of the absorption chambers rather than observing color change of the soda lime granules. We demonstrated in this report that the liquid crystal thermometer is an inexpensive and reliable measuring device for this purpose.     

Coexistence of amyotrophic lateral sclerosis and argyrophilic grain disease: A non‐demented autopsy case showing circumscribed temporal atrophy and involvement of the amygdala

We report a case of a 68‐year‐old right‐handed man with sporadic amyotrophic lateral sclerosis (ALS) and argyrophilic grain disease (AGD) having a 22‐month duration. His initial symptoms were dysarthria and swallowing difficulty at the age of 67. Subsequently bulbar palsy and pyramidal signs developed. His cognitive functions including face recognition, personality, and behavior were not changed compared with that of before the disease onset. However, magnetic resonance imaging disclosed severe right side‐predominant temporal atrophy. The neurological diagnosis was bulbar type ALS. Pathological examination disclosed histological evidence of ALS, including loss of Betz cells and lower motor neurons, corticospinal tract degeneration, and Bunina bodies. In addition, severe neuronal loss in the bilateral temporal cortex with an anterior gradient was found. Ubiquitin‐positive inclusions were encountered in the spinal anterior horn cells and hippocampal dentate gyrus, while few ubiquitin‐positive inclusions were noted in the affected temporal cortex. The amygdala, especially the basolateral nuclear group, was severely affected by neuronal loss with tissue rarefaction. Moderate neuronal loss was encountered in the parahippocampal gyrus, and to a lesser degree, in the ambient gyrus. Unexpectedly, many argyrophilic grains, coiled bodies, tau‐positive bush‐like astrocytes, pretangles, and ballooned neurons were found in the limbic system and temporal cortex. In the hippocampus, selective tau accumulation with minor neurofibrillary changes was observed in CA2 neurons. The present case suggests that (i) ALS and AGD do rarely coexist, and (ii) when ALS patients have severe temporal atrophy, not only ALS with dementia but also concurrent AGD should be considered in the differential diagnosis.     

Metabolic syndrome, C-reactive protein and increased arterial stiffness in Japanese subjects.

The aim of this study was to investigate whether the metabolic syndrome (MS) was associated with an elevated level of C-reactive protein (CRP) and increased arterial stiffness, and to clarify whether combined MS and CRP data had a stronger relation to arterial stiffness than did MS data alone. Brachial-ankle pulse wave velocity (baPWV), CRP, and conventional risk factors were evaluated in 3,412 men and 854 women. Adjusted mean values of baPWV in men with 0, 1, 2, and > or = 3 components were 1,309, 1,372, 1,422, and 1,462 cm/s, respectively (p for trend <0.001). Adjusted mean values of baPWV in women with 0, 1, 2, and > or =3 components were 1,212, 1,292, 1,357, and 1,391 cm/s, respectively (p for trend <0.001). Adjusted geometric mean concentrations of CRP in men with 0, 1, 2, and > or = 3 components were 0.036, 0.049, 0.059, and 0.076 mg/dI, respectively (p for trend <0.001). Adjusted geometric mean concentrations of CRP in women with 0, 1, 2, and > or = 3 components were 0.023, 0.030, 0.057, and 0.077 mg/dI, respectively (p for trend <0.001). In analyses of adjusted mean values of baPWV according to the number of MS components and according to CRP levels within or without top quartile levels, the p value for the trend was significant (<0.001) in both men and women but, in post hoc analyses, comparing high and low CRP levels in each MS component-number group, no significant difference was found. These results suggest that, for prediction of increased arterial stiffness, combining MS and CRP data has little additive effect compared to the use of MS data alone.     

Pathological and biochemical studies on a case of Pick disease with severe white matter atrophy

We report on a male patient with Pick disease who had shown severe white matter atrophy and dilatation of the lateral ventricle in the frontal lobe from an early stage. Upon admission to our hospital 2 years after disease onset, the patient showed apathy, and MRI revealed severe atrophy of the cortex and white matter of the frontal lobe. He died at age 74, 11 years after disease onset. Autopsy revealed severe atrophy of the frontal and temporal lobes, severe loss of white matter in the frontal lobe, dilatation of the lateral ventricles, and cortical thinning. Histopathological examination showed severe loss of myelinated fibers in the frontal white matter and severe neuronal loss with gliosis in the frontal and temporal cortices. Many Pick bodies were seen. Our patient had a rare case of Pick disease predominantly affecting the frontal lobe with severe involvement of the white matter from an early stage. This case suggests that myelinated fibers in the white matter as well as cerebral neurons are primarily affected in Pick disease.     

Squamous cell carcinoma of the thyroid--a report of three cases

Three cases of squamous cell carcinoma of the thyroid are reported herein. In all cases, the carcinoma occurred in old age and was characterized by a rapidly growing tumor, usually associated with dyspnea and dysphagia. The prognosis of all 3 cases was poor, with a mean survival of only 6.3 months. Although squamous metaplasia is an accepted etiology of this disease, clinical investigation of the cases presented here does not favor it in consideration of the clinical features of papillary carcinoma of the thyroid with squamous metaplasia. The histological findings of our cases revealed areas of cystic formation, suggesting that some of these carcinomas may be derived from remnants of embryonic origin.     

A new method for the quantification of beta-glucan in plasma and its application in the diagnosis of postoperative infection

In order to correctly diagnose and treat severe postoperative infections, it may be critical to detect and differentiate between endotoxin derived from Gram-negative bacteria and/or beta-glucan derived from fungi. In addition to the chromogenic assay, the turbidimetric kinetic assay has been performed for the quantification of endotoxin in plasma using Limulus amebocyte lysate as previously reported. However, it is also known that beta-glucan triggers the coagulation of Limulus amebocyte lysate. In the present study, the differentiation of beta-glucan from endotoxin and its clinical application were studied. Endotoxin was able to be inactivated in plasma using one-tenth dilution by 10 per cent ethanol or distilled water, followed by heating at 100 degrees C for 120 min, without affecting the activity of coexisting beta-glucan. The treated sample was then subjected to the turbidimetric kinetic assay using Toxinometer ET-201. Using this method, as little as 30 pg/ml of beta-glucan in the plasma may be assayed separately, with the amount of circulating beta-glucan in the plasma of normal subjects being less than 50 pg/ml. On the other hand, in patients with a fungal infection, the amount of beta-glucan in their plasma was elevated significantly. Clinically, beta-glucanemia may often occur in severe postoperative infection even if fungi are not detected.     

Clinical studies on the occurrence and the pathogenesis of optociliary veins

We reviewed retrospectively 20 cases of optociliary vein over the past 5 years. Fifteen of the 20 cases (75%) were over 40 years of age. There was no sex differences (9 males and 11 females). Causative ocular diseases were: central retinal vein occlusion (14 cases, 70%); optic disc drusen (2 cases, 10%); and optic nerve sheath meningioma, high myopia, glaucoma, congenital anomaly (1 case each, total 20%). The number of patients with an optociliary vein was high in central retinal vein occlusion (14/190 cases, 7.4%). We concluded that occurrence of optociliary vein is not restricted to cases with optic nerve sheath meningioma and this shunt vessel may occur under other conditions in which central retinal venous return is seriously disturbed. The most common cause of optociliary vein is central retinal vein occlusion.     

Response of Müller cells following experimental lensectomy-vitrectomy

We used morphological, biochemical and immunohistochemical methods to assess the response of Müller cells after experimental lensectomy-vitrectomy in rabbits. We observed widened intercellular spaces between the Müller cells and nerve fibers of ganglion cells, and increased electron opacity in the Müller cells of eyes injected with silicone oil. No apparent morphological changes were detected in the Müller cells of air-injected eyes. The specific and total activities of Müller cell-marker enzymes (glucose 6-phosphatase and glutamine synthetase) showed an initial increase, followed by a decrease. Glial fibrillary acidic protein immunoreactivity was not found in the Müller cells of the normal rabbit retina but was exhibited after surgery. Our results showed that markers of Müller cells associated with glycogenolysis and/or gluconeogenesis, glutamate-glutamine cycle and cytoskeletal protein metabolism were affected by the experimental lensectomy-vitrectomy.     

Predictive factors of etiologic agents of community-acquired pneumonia presenting at a district general hospital]

Community-acquired pneumonia is one of the major respiratory diseases causing hospital admission in previously healthy patients. Prompt and appropriate antibiotic selection is essential for recovery. The authors tried to determine the distribution of the etiologic agents of community-acquired pneumonias and to analyze predictive factors. Out of 188 cases of community-acquired pneumonia presenting to our hospital, etiologic agents were determined in 106 cases (56%). Twenty-nine cases were due to Streptococcus pneumoniae, 27 cases due to Mycoplasma, 17 cases due to Haemophilus influenzae and 21 cases due to Mycobacterium tuberculosis. M. tuberculosis was the cause in 11% of all cases and the importance of pulmonary tuberculosis must be emphasized as a community-acquired pneumonia. Out of 58 cases under 50 years old, Mycoplasma pneumoniae was the etiologic agent in 23 cases (40%) and S. pneumoniae in 7 cases (12%). Out of 62 cases not less than 70 years old. M. tuberculosis was the most common etiologic agent (15 cases, 24%). S. pneumoniae followed, being causative in 13 cases (21%). M. tuberculosis was the cause in 10 cases out of 31 cases who did not complain of fever at presentation. In 86 cases who did not show leukocytosis on admission, 21 cases were due to Mycoplasma (24%) and 15 cases were due to M. tuberculosis (17%). In particular 17 cases were due to Mycoplasma among 28 cases under 50 years old without leukocytosis (61%), and 11 cases were due to M. tuberculosis in the 27 cases no less than 70 years old without leukocytosis (41%).(ABSTRACT TRUNCATED AT 250 WORDS)