An evaluation of the effect of eicosapentaenoic acid in the diet on macrophage PGE production and lymphocyte proliferation in a burned guinea pig model

This study was undertaken to determine if dietary eicosapentaenoic acid (EPA) could affect the production of PGE (PGE₂ and/or PGE₃) by splenic macrophages and the mitogen-induced proliferation of splenic lymphocytes.Guinea pigs received a 30% total body surface area burn following installation of gastrostomy feeding tubes. All animals received identical diets except for the lipid component which equalled 10% of total energy. The control diet contained only linoleic acid (LA) as the lipid component. The experimental diets contained increasing amounts of EPA. Fourteen days postburn, the animals were sacrificed and splenic lymphocytes and macrophages were obtained and cultured for lymphocyte proliferation with and without mitogen stimulation and for PGE₂ synthesis in response to bacterial lipopolysaccharide (LPS), respectively.Increasing amounts of EPA in the diets had no statistically significant effect on the total production of PGE (PGE₂ and/or PGE₃) by macrophages stimulated with LPS, however, when 100% EPA was used as the lipid component, the production of PGE₂ was increased. Also, increasing amounts of EPA in the diet did not affect lymphocyte proliferation following stimulation of the cells with various mitogens, although at an EPA:LA ratio of 75:25%, a significant increase in proliferation of unstimulated but not stimulated lymphocytes was observed. However, at a 100:0 ratio of EPA:LA, lymphocyte proliferation was back down to the control level. This study shows that dietary EPA in high concentrations may have some complex interaction with the immune system at least in the animal under the stress of a burn.     

Fusion of approaches to the treatment of organ failure

Because organ transplantation is the preferred treatment for organ failure, the demand for human organs for transplantation is large and growing. From this demand, several fields based on new technologies for the replacement or repair of damaged tissues and organs have emerged. These fields include stem cell biology, cloning, tissue engineering and xenotransplantation. Here we evaluate the potential contribution of these to the devising of alternative approaches to organ replacement. We present our vision for the development of two structurally complex organs – the lung and the kidney – based on a 'fusion' of new and established technologies.     

Impact of clinical history on fracture detection with radiography

The effect of knowledge of localizing symptoms and signs in the detection of fractures was studied. Forty radiographs of the extremities were examined twice by seven radiologists; the sessions were separated by 4 months. In 26 cases, a subtle fracture was present; 14 cases were normal. In half of the cases at each session, the precise location of pain, tenderness, or swelling was provided. The observer was asked to determine if the case was normal or abnormal (provide the exact location of the fracture) and to indicate the degree of confidence in the diagnosis. Responses were converted to a numeric scale for analysis. Analysis of receiver operator characteristic parameters indicates that clues regarding location of trauma facilitate detection of fractures. The improvement is based largely on an increased true-positive rate without an increased false-positive rate, regardless of the decision criteria of the radiologist (overall willingness to "overread" or "underread"). This has direct clinical applicability and reinforces the plea of radiologists for precise clinical information.     

Acute coronary syndromes

The first 150 words of the full text of this article appear below. Key points Coronary artery disease accounts for >30% ofdeaths in Western society. The diagnosis of myocardial infarctionshould be qualified by size, causation and time from occurrence. Mortalityis reduced by immediate or ‘primary’ percutaneouscoronary intervention or thrombolysis within the first 24 hof onset of ST-segment elevation myocardial infarction. Strategiesto reduce platelet activation (glycoprotein IIb/IIIa receptorantagonists, or clopidogrel) are now recommended in the treatmentof high-risk non-ST-segment myocardial infarction/unstable angina. Elevatedserum troponins may be the result of non-ischaemic myocardialdamage, especially in critical illness.