Visual function in breast-fed term infants weaned to formula with or without long-chain polyunsaturates at 4 to 6 months: a randomized clinical trial

OBJECTIVE: Breast-fed infants receive docosahexaenoic acid (DHA) and arachidonic acid (ARA) in their diet. Upon weaning, infants lose this dietary source of long-chain polyunsaturates because many commercial formulas do not contain these important constituents for neural membrane biogenesis. We evaluated the benefits of postweaning dietary supplementation of DHA + ARA on visual maturation. STUDY DESIGN: Healthy term infants (n = 61) were breast-fed to 4 to 6 months, then were randomly assigned to commercial formula or formula supplemented with DHA (0.36%) + ARA (0.72%). Measurements of red blood cell (RBC) fatty acids, visually evoked potential (VEP) acuity, and stereoacuity were done before and after weaning. RESULTS: At 1 year of age, RBC-DHA in the commercial formula-fed group was reduced by 50% from the weaning level, whereas there was a 24% increase in the DHA + ARA-supplemented group. The primary outcome measure, VEP acuity, was significantly more mature in supplemented infants at 1 year of age. Elevated RBC-DHA levels were associated with more mature VEP acuity. There were no significant diet-related differences in stereoacuity. CONCLUSIONS: These data extend through the first year of life the critical period in which a dietary supply of DHA and ARA can contribute in optimizing visual development in term infants.     

Responding to the information needs of patients with cancer

Cancer care has progressed from the days when doctors alone chose treatments for cancer patients and decided what information to give them. Patients are now more involved in their own care and information-giving has become a priority for nurses. However, achieving the right balance in information provision for individual patients is a challenge.     

Metabolism of SFZ—47 in chicken embryo by liquid chroma—tography—electrospray ion trap mass spectrometry

AIM:To develop an alternative method for investigation of drug metabolism by fertilized chicken eggs using 3H-1,2-dihydro-2-(4-methyl-phenylamino) methyl-1-pyrrolizinone (SFZ-47) as a probe drug. METHODS:SFZ-47(15 mg) was injected into the albumen of eggs from standardized breed chickens previously incubated for 10d. After 72 h of further incubation, the allantoic liquid was subjected to solid phase extraction on XAD-2 columns and analyzed by liquid chromatography-electrospray ion trap mass spectrometry method. RESULTS: Three major metabolites were identified, namely 4-(3H-1,2-dihydro-1-pyrrolizinone-2-methyl-amino) benzyl alcohol (SFZ-47-OH), 4-(3H-1,2-dihydro-1-pyrrolizinone-2-methyl-amino)-benzoic acid (SFZ-47-COOH), and its glucuronide conjugates. The metabolic profile was little different from that previously found in rabbits and dogs. CONCLUSION: The result demonstrates the usefulness of the fertilized chicken egg as a convenient source of both phase I and phase Ⅱ metabolites for further metabolism studies of SFZ-47.     

The Influence of Viral Genotypes and Rejection Episodes on the Recurrence of Hepatitis C After Liver Transplantation

Purpose. The aim of this study was to report the influence of hepatitis C virus (HCV) genotype and rejection episodes on the outcome of orthotopic liver transplantation (OLT), hepatitis recurrence, and progression to graft cirrhosis after OLT. Methods. Fifty-three patients who all had undergone OLT for end-stage liver cirrhosis were selected for this study. Hepatitis C genotype was determined. Recurrent hepatitis and rejection were diagnosed based on elevated liver function tests and a liver biopsy. Results. The patients were followed up for a mean of 51.9 ± 34.3 months. The cumulative survival rate was no different in OLT for hepatitis C and OLT for all other liver diseases. After OLT, serum HCV RNA was detected in 93%. Histological recurrence occurred in 85% of all patients. The 1-, 3-, and 5-year recurrence rates were 48%, 77%, and 85%, respectively. Of the 41 patients with recurrent hepatitis C, 4 (10%) had cirrhosis, 18 (44%) had hepatitis with fibrosis, and 91 (46%) had hepatitis without fibrosis at the end of follow-up. A total of 32% of the patients were infected by HCV genotype 1b and 68% by other HCV genotypes. The recurrence rates were significantly higher in patients infected with genotype 1b than in those with other genotypes (p = 0.04). Twenty of 48 patients (42%) experienced acute rejection. There was a strong association between the number of rejection episodes and the incidence of HCV-related cirrhosis (p < 0.01). Conclusion. Our findings showed the genotype 1b to result in a higher recurrence rate after OLT. On the other hand, rejection episodes were associated with a more rapid progression to graft cirrhosis. Received: May 7, 2002 / Accepted: November 19, 2002 RID="*" ID="*" Reprint requests to: H. Sugo     

Atracurium is associated with postoperative residual curarization

Editor—The paper by McCaul and colleagues¹ is misleading.The terms residual curarization and postoperative residual curarization(PORC) were described in 1979,² and this and the vast majorityof subsequent studies carried out focus on residual curarizationin the recovery room. To state that     

The astrocyte/meningeal cell interface is a barrier to neurite outgrowth which can be overcome by manipulation of inhibitory molecules or axonal signalling pathways

Invading meningeal cells form a barrier to axon regeneration after damage to the spinal cord and other parts of the CNS, axons stopping at the interface between meningeal cells and astrocytes. Axon behavior was examined using an in vitro model of astrocyte/meningeal cell interfaces, created by plating aggregates of astrocytes and meningeal cells onto coverslips. At these interfaces growth of dorsal root ganglion axons attempting to grow from astrocytes to meningeal cells was blocked, but axons grew rapidly from meningeal cells onto astrocytes. Meningeal cells were examined for expression of axon growth inhibitory molecules, and found to express NG2, versican, and semaphorins 3A and 3C. Astrocytes express growth promoting molecules, including N-Cadherin, laminin, fibronectin, and tenascin-C. We treated cultures in various ways to attempt to promote axon growth across the inhibitory boundaries. Blockade of NG2 with antibody and blockade of neuropilin 2 but not neuropilin 1 both promoted axon growth from astrocytes to meningeal cells. Blockade of permissive molecules on astrocytes with N-Cadherin blocking peptide or anti beta-1 integrin had no effect. Manipulation of axonal signalling pathways also increased axon growth from astrocytes to meningeal cells. Increasing cAMP levels and inactivation of rho were both effective when the cultures were fixed in paraformaldehyde, demonstrating that their effect is on axons and not via effects on the glial cells.     

Conceptual models of nursing: international in scope and substance? The case of the Roy adaptation model

This column focuses on exploration of the international applicability of conceptual models of nursing developed by nurse theorists from the United States. Viewpoints put forward by Marilyn E. Parker and William K. Cody are presented. Then, nurse scholars from Colombia and Japan discuss their experiences with use of the Roy adaptation model in their countries.