The Presence of Insulin-degrading Enzyme in Human Ileal and Colonic Mucosal Cells

The aim of this research is to characterize the presence of insulin-degrading enzyme in human colon and ileal mucosal cells. Biochemical studies, including the activity-pH profiles, the effects of enzyme inhibitors, immunoprecipitation and western blots, were conducted. The majority of insulin-degrading activity in colon mucosal cells was localized in the cytosol. In both colon and ileum, cytosolic insulin-degrading activities had a pH optimum at pH 7.5, and were extensively inhibited by each of N-ethylmaleimide, p-chloromercuribenzoate, and 1,10-phenanthroline, but were very weakly affected by each of leupeptin, chymostatin, diisopropyl phosphofluoridate and soybean trypsin inhibitor. In the colon and ileum, more than 93% and 96%, respectively, of cytosolic insulin-degrading activities were removed by the mouse monoclonal antibody to human RBC insulin-degrading enzyme, as compared with less than 20% by the normal mouse IgG for both tissues. Further, a western blot analysis revealed that a cytosolic protein of 110 kD, in both human colon and ileum, reacted with the monoclonal antibody to insulin-degrading enzyme. It is concluded that insulin-degrading enzyme is present in the cytosol of human colon and ileal mucosal cells.     

The Involvement of Cytosolic Chymotrypsin-like,Trypsin-like,and Cucumsin-like Activities in Degradation of Insulin and Insulin-like Growth Factor I by Epithelial Tissues

Using specific substrates, benzyloxycarbonyl-Gly-Gly-Leu-p-nitroanilide, benzyloxycarbonyl-Gly-Gly-Arg-2-naphthylamide and benzyloxycarbonyl-Leu-Leu-Glu-2-naphthylamide, cytosolic chymotrypsinlike, trypsin-like and cucumsin-like activities were determined, respectively, in rat epithelial tissues and differentiated human Caco-2 cells. The cytosolic fractions of rat colonic, rectal, nasal, and alveolar epithelial cells and differentiated human Caco-2 cells contained these three distinct enzyme activities. However, effects of enzyme inhibitors revealed that these three distinctive activities were not extensively involved in cytosolic or homogenate degradation of insulin and insulin-like growth factor I (IGF-I). It is concluded that proteasome-like activities may not significantly limit nonparenteral absorption of peptide and protein drugs such as insulin and IGF-I.     

Auditory and visual semantic priming using different stimulus onset asynchronies: An event-related brain potential study

Semantic priming effects (behavioral and electrophysiological) were compared in the visual and auditory modalities across three stimulus onset asynchronies (SOAs; 0, 200, and 800 ms). When both prime and target were presented in the visual modality (the prime just to the left of a fixation point and the target to the right) there were N400 priming effects present across the three SOAs. However, the N400 in the 0-ms SOA condition extended longer in time (800 vs. 500 ms) than in the other SOAs. When both the prime and target were presented in the auditory modality (the prime to the right ear and the target to the left), the largest priming effects were found for the 800-ms SOA. Moreover, there was a relatively early priming effect present in the 0- and 800-ms SOA conditions but not in the 200-ms condition. The results are discussed in terms of modality differences in the time course of word comprehension processes.     

Development of a Measure of the Motives Underlying the Selection of Food: the Food Choice Questionnaire

A number of factors are thought to influence people's dietary choices, including health, cost, convenience and taste, but there are no measures that address health-related and non-health-related factors in a systematic fashion. This paper describes the development of a multidimensional measure of motives related to food choice. The Food Choice Questionnaire (FCQ) was developed through factor analysis of responses from a sample of 358 adults ranging in age from 18 to 87 years. Nine factors emerged, and were labelledhealth,mood,convenience,sensory appeal,natural content,price,weight control,familiarityandethical concern. The questionnaire structure was verified using confirmatory factor analysis in a second sample (n=358), and test–retest reliability over a 2- to 3-week period was satisfactory. Convergent validity was investigated by testing associations between FCQ scales and measures of dietary restraint, eating style, the value of health, health locus of control and personality factors. Differences in motives for food choice associated with sex, age and income were found. The potential uses of this measure in health psychology and other areas are discussed.     

CASE REPORT: Antibiotic-associated haemorrhagic colitis

Antibiotic-associated haemorrhagic colitis is an uncommon cause of bloody diarrhoea in patients taking penicillin or penicillin-related antibiotics. Symptoms of abdominal pain and bloody diarrhoea occur within 1 week of antibiotic use and resolve without specific therapy within days of discontinuing the offending antibiotic. There is an apparent increased incidence of the disease in patients of Oriental ethnicity. The pathogenesis is unknown. We present two cases of haemorrhagic colitis in patients taking penicillin-related antibiotics who presented within 4 months of each other. One of the patients was being treated for Helicobacter pylori infection. The published literature is reviewed with particular emphasis on the histology and pathogenesis of the condition.     

Change in process: bringing about change in health care through action research

• ? A 2-year action-research project aiming to facilitate the management of change was carried out in a district general hospital.
• ? Hospital managers and senior ward nurses had very different views concerning the source of challenges and problems within the hospital organization.
• ? A case-study of nurses' experience of change at ward level was produced as part of the diagnostic phase of the action research.
• ? The results of the case-study indicated that general managers and professionals had different agendas for change hut that there is common ground between them.

     

Determination of Pacing Capture in Implantable Defibrillators: Benefit of Evoked Response Detection Using RV Coil to Can Vector

SPLETT, V., et al. : Determination of Pacing Capture in Implantable Defibrillators: Benefit of Evoked Response Detection Using RV Coil to Can Vector. Automatic detection of capture in ICDs would be useful for ensuring normal pacing function and lead integrity and may increase device longevity. Evoked response detection can be difficult due to postpace polarization. Polarization on the RV coil to can vector, however, should be absent when pacing with a true bipolar lead (pace tip to ring). Polarization on the RV coil to can vector should be low in an integrated bipolar lead due to the large surface area of the coil. Ventricular-paced responses were prospectively recorded in 20 patients during ICD implantation or replacement. Capture and loss of capture responses were noted during threshold searches with electrograms recorded between the RV coil and can. A detector was designed to discriminate between capture and noncapture-paced responses using data from the first 11 patients and validated on the remaining 9. The detector had a sensitivity of 99.9% (detected capture on capture beats), and had a specificity of 100% (detected no capture on noncapture beats) for all lead configurations. There was no measurable polarization with true bipolar leads. In integrated bipolar leads, maximum polarization ranged from 0.0 to 16.7mV. In conclusion, paced evoked responses can be detected in ICDs using the RV coil to can vector using standard pacing waveforms. Special polarization reducing pacing waveforms are not required. These observations could be used to design ICDs with automatic pacing threshold detection.     

National Occupational Standards for medical illustrators

We live in a changing and complex world, which is about to become even more so as we become more standards-focused and driven by attaining documented quality levels throughout our working lives. Many of the different initiatives affecting our profession at the moment are standards-orientated. Some are being led by the Institute of Medical Illustrators, while others have a wider, national focus and are linked with the Government's Making the Change proposals. This paper attempts to clarify a rather confusing situation and demonstrate how the various initiatives will eventually link together to underpin the structure of medical illustration and healthcare science in the future.