Low-density lipoprotein subfraction profiles in dialysis patients

Summary: Uraemic dyslipidaemia is a major risk factor for cardiovascular disease in end-stage renal failure patients. In patients without renal failure, high levels and qualitative abnormalities of low-density lipoprotein (LDL) are known to be atherogenic. Recently, LDL subfraction analysis has associated premature coronary artery disease with a high prevalence of small, dense LDL particles characterizing the LDL subclass phenotype B. We therefore examined the lipid profiles, LDL subfraction distribution and phenotypes in our population of haemodialysis (HD; n = 30) and peritoneal dialysis patients (PD; n = 17), and compared them to 40 asymptomatic, non-uraemic volunteers. Dialysis patients had significantly higher triglyceride and VLDL cholesterol concentrations and lower HDL cholesterol and smaller LDL peak particle diameters. PD patients had significantly higher total cholesterol, glycated haemoglobin and fasting blood glucose levels with smaller LDL peak particle diameters (24.4 [0.1] vs 24.8 [0.1 nm] than HD. Both groups showed significant negative correlations between plasma triglyceride and LDL peak particle diameter, and positive correlations between HDL cholesterol and LDL peak particle diameter. All the PD patients expressed the B phenotype (LDL peak diameter ± 25.5 nm) compared to 73% of HD patients. This study demonstrates that HD and especially PD patients have atherogenic lipid profiles which are associated with a predominance of small dense LDL particles and the highly atherogenic LDL subclass phenotype B.     

Lung dose rate and interstitial pneumonitis in total body irradiation for bone marrow transplantation

The effect of dose rate to the lungs and development of interstitial pneumonitis (IP) was evaluated in 114 bone marrow transplant patients receiving fractionated total body irradiation (TBI) (1200 rads TD in 6 fractions twice daily over 3 days) as part of their pre-conditioning regimen. The tumour dose (TD) was calculated as the mean lung dose as previously described (1). A 6MV linear accelerator at a mid-line dose rate of 7.5 rads/minute was used between March 1981 and June 1985 and a Co-60 source at 5 rads/minute thereafter. This resulted in a range of dose rates to the lung of between 6.9 and 8.9 rads/minute and 2.9 and 6.5 rads/minute respectively. In the majority of patients the aetiology of IP was investigated by lung biopsy with histology and culture. There was no statistically significant difference in the incidence of IP over the two sets of dose rates. Our study suggests tat the incidence of IP using fractionated TBI is not influenced by dose rates below 8.9 rads per minute.     

STUDY OF AN OUTBREAK OF SCURVY I. CLINICAL FEATURES

During the fall of 1935, CheeIoo University Medical SchooL accepted responsibility for the medical care of 19,000 refugees from the flooded farming districts of south-western Shantung, They were cared for in Tsinan at govemment expense, in 30 groups or "camps", of from 200 t0 1,400 persons each, and were provided with two meals a day, consisting of steamed bread, made of 4th grade wheat flour and millet flour, a thin millet congee and pieces of salt turnip. Many individuals supplemented this diet from time to time with small quantities of vegetables, such as raw onion, red pepper sauce and boiled caloloage bought from vendors. This was more common in the early fall than later in the winter, when their small private funds had, in many cases, been exhausted. Later in the winter, the ingredients of the bread were changed to include corn meal, 4th class wheat flour and millet flour.