Sleeping more as a way to lose weight

Caloric consumption in a society with readily available food is likely to be approximately proportional to the number of hours of being awake. Thus, replacing 1 h of inactive wakefulness (e.g. watching TV), with sleeping is likely to result in a substantial reduction in caloric intake. Calculations are presented to illustrate the possible benefits of such a switch on weight reduction.     

Experimental axonopathy induced by immunization with campylobacter jejuni lipopolysaccharide from a patient with guillain‐barré syndrome

Campylobacter jejuni (C. jejunj) infection is the most common antecedent in the axonal variant of Guillain‐Barré syndrome (GBS). Antibodies against nerve gangliosides found in GBS patients recognize cross‐reactive epitopes in the lipopolysaccharide (LPS) of C. jejuni. This led to the molecular mimicry hypothesis of GBS. We immunized eleven rabbits with a LPS extracted from HS:19 C. jejuni strain isolated from a patient with GBS and complete Freund's adjuvant (CFA)(group I). In a second experiment we immunized seven rabbits with LPS, CFA and keyhole limpet hemocyanin (KLH)(group II). All group I rabbits developed high titers of anti‐LPS, anti‐GM1, anti‐GD1b antibodies and lower titers of anti‐GD1a. One rabbit, 50 days after initial inoculation, showed tremor and weakness. All rabbits of group II developed high titres of antiganglioside antibodies and six animals showed weakness 59–113 days after initial inoculation. Two rabbits died. Pathology showed mild to moderate, tendentially grouped, axonal degeneration in sciatic nerves of four out of five animals. Control rabbits of group I (immunized with CFA only) did not develop antibodies, controls of group II (immunized with CFA + KLH) developed low titers of IgG anti‐GM1. None developed neurological signs or showed axonal degeneration. C. jejuni LPS is a potent B‐cell stimulator capable to induce a strong antiganglioside response in rabbits. However, to induce the neuropathy is crucial to employ KLH, a glycoprotein known to stimulate both humoral and cellular responses. This animal model reproduces the pathogenetic process hypothesized in axonal GBS with antiganglioside antibodies post C. jejuni infection.     

Gastric and duodenal polyps in familial adenomatous polyposis: a prospective study of the nature and prevalence of upper gastrointestinal polyps.

One hundred patients with familial adenomatous polyposis have prospectively undergone gastroduodenoscopy to identify and characterise polyps found. Forty six patients had polyps in the stomach or duodenum. Thirty five patients had adenomas (33 in duodenum, two in stomach) and 26 patients had fundic gland polyps. Some of these patients had polyps in the stomach and the duodenum. Adenomas in the duodenum were present in 33% of patients studied with Gardner's syndrome variant (p = 0.04). Adenomas were also more common in older patients. As adenomas may be a precursor of adenocarcinoma, routine surveillance of the stomach and duodenum with gastroduodenoscopy is recommended in patients affected with familial adenomatous polyposis.     

Disorders of perfusion of the anterior segment of the eye

Background: We have investigated the vascular perfusion of a wide variety of conditions of the anterior segment using fluorescein angiography.
Methods: The conditions were classified and findings reported according to the system set out below. Patients underwent full ocular examination. Fluorescein angiography of the anterior segment was carried out when indicated to investigate iris atrophy and neovascularisation. Specular microscopy of the corneal endothelium was used to detect changes in this tissue.
Results: The hypoperfusion was variable in degree and accompanied by varying degrees of iris hypoplasia and atrophy with neovascularisation. The degree of neovascularisation depended upon its rapidity of development, the pre-existing state of vascular perfusion and the underlying pathological condition.
Conclusions: Hypoperfusion with resultant ischaemia and neovascularisation is common in conditions of the anterior segment. An understanding of the changes is valuable in treating many conditions affecting the anterior segment. The changes observed may also occur elsewhere in the physical system and may be a significant part of the ageing process, either as scattered, disparate processes or as part of a general disease process.     

Postoperative radiation therapy in the management of lung cancer

Postoperative radiation therapy for lung cancer is still controversial. In a 9-year period, 69 patients with non-oat-cell carcinoma of the lung (16% stage I, 26% stage II, and 58% stage III) received such therapy. The radiation dose was less than 5,000 cGy in 42 patients, 5,000-5,900 cGy in 16, and 6,000 cGy or more in 11; follow-up ranged from 24 to 64 months. Actuarial survival at 2 and 4 years was 50% and 16%, respectively, for squamous cell carcinoma, and 40% and 26% for adenocarcinoma. The 5-year survival for stages I, II, and III cancer was 29%, 17%, and 19%, respectively. Histologic findings and type of surgery did not affect survival, but the radiation dose apparently did. The 3-year survival for patients who received less than 6,000 cGy was 35%, compared with 73% for patients who received higher doses. In eight patients, treatment failed within the irradiated volume: all had received doses of less than 6,000 cGy, and the volume in three was judged to be inadequate.     

Bile duct carcinoma in patients with ulcerative colitis

Six cases of bile duct carcinoma were encountered among 1207 patients with ulcerative colitis, a prevalence rate of 0.5%. The relative risk of bile duct carcinoma in patients with ulcerative colitis was 31.3. Colitis was extensive in all six patients with a mean duration of 23.2 years before the diagnosis of carcinoma. The mean age at the diagnosis of carcinoma was 38.5 years. Three patients had undergone colectomy 5–16 years earlier, and in four patients pericholangitis and sclerosing cholangitis preexisted. The tumors, histologically adenocarcinomas, were located in the common bile duct in five patients and in the hepatic duct in one. The mean survival was 11.8 months (one patients is still alive with recurrent carcinoma). Pericholangitis and sclerosing cholangitis is a frequent preexisting lesion in patients with bile duct carcinoma complicating ulcerative colitis and may be considered a premalignant lesion in these patients. Both sclerosing cholangitis and bile duct carcinoma are rare in Crohn's disease.     

Management of ventilator dependency following heart surgery

The foregoing discussion has reviewed the concept that postoperative ventilator dependency following heart surgery is due to a combination of risk factors, partly due to the nature of the patient population and partly to the process of patient care. Weaning from mechanical ventilation has been a controversial topic for decades, but the issue of rehabilitation before successful weaning has only recently achieved recognition. The fact that this process is often prolonged suggests that a certain logic must be used during the rehabilitation process. Appropriate minimization of risks with continued mechanical ventilation and concise protocols for gradually withdrawing support of mechanical ventilation may insure the quality of the patient care process. It should be understood by both the physician and patient that the ventilator for the patient population discussed previously acts merely as a "crutch" that will facilitate the process of rehabilitation.     

Optical response of the cultured bovine lens; testing opaque or partially transparent semi-solid/solid common consumer hygiene products

This study determines the relative ocular lens irritancy of 16 common partially transparent or non-transparent consumer hygiene products. The irritancy was found by measuring the changes in the sharpness of focus [referred to as the back vertex distance (BVD) variability] of the cultured bovine lens using a scanning laser In Vitro Assay System. This method consists of a laser beam that scans across the lens, and a computer, which then analyses the average focal length (mm), the BVD variability (mm), and the intensity of the beam transmitted. Lenses were exposed to the 16 hygiene products and the lens’ focusing ability was monitored over 192 h. The products are semi-solids or solids (e.g. gels, lotions, shampoos). They are categorized into six groups: shampoos, body washes, lotions, toothpastes, deodorant, and anti-perspirant. Damage (measured by > 1 mm BVD variability) occurred slower for the shampoos, especially in the case of baby shampoo. The results indicate that shampoos exhibit the lowest level of ocular lens toxicity (irritability) while the deodorant is the most damaging.     

Ocular accommodation in chickens: corneal vs lenticular accommodation and effect of age

The avian accommodative response has long been suspected of having a corneal component resulting from contraction of a limbal extension of the ciliary muscle. Efforts to confirm the existence of such a mechanism have been sporadic and the results contradictory. In addition, while the accommodative mechanism of the bird eye is commonly considered to be very effective, the effect of lenticular aging is not known. The accommodative responses of excised chicken eyes of various age, were measured by photographing changes in focal effects on incident fine parallel laser beams in response to electrical stimulation of the intraocular muscles. An opening at the posterior pole of the eye enabled the beams to exit in order to facilitate measurement of refractive change. The question of a possible corneal contribution was examined by taking advantage of the fact that corneal refractive power is neutralized when the surface of the cornea is in water. Accommodation was measured with the cornea in air and in water. The results indicate that there is little or no corneal accommodation and accommodative ability drops off substantially with age. The results may also indicate the existence of serious inter-breed differences in chicken accommodation.