Effects of intrahepatic transplantation of pancreatic islets on hepatic metabolism in the rat.

The influence on hepatic metabolism of transplanting isologous pancreatic islets in the livers of streptozotocin-induced diabetic rats was investigated. Hyperglycemia and impaired weight gain were corrected in 7 of 10 islet recipients (transplant improved), and only a small benefit was obtained in the other three rats (transplant failed.) After 12 mo basal and glucagon-stimulated glucose output, urea output, and gluconeogenesis (production of ¹⁴C-glucose from ¹⁴C-lactate) were measured in perfused livers from these transplant-improved and transplant-failed rats and from 5 normal control and 5 nontransplanted diabetic rats. Basal glucose and urea output were similar in livers of transplant-improved and control rats, whereas gluconeogenesis was significantly increased in the transplant-improved group. Basal glucose and urea output and gluconeogenesis were significantly increased in the transplant-failed and nontransplanted diabetic rats; however, the values for all three parameters were significantly lower in the transplant-failed than in the diabetic rats. Glucagon (10^?10M) significantly increased glucose output in livers of transplant-improved and control rats but not in transplant-failed or nontransplanted diabetic rats, and glucagon significantly increased ¹⁴C-glucose production only in livers of control rats. The progressive increases (above normal) in basal glucose and urea output and in gluconeogenesis, together with increasing refractoriness of glucose output and gluconeogenesis to glucagon in transplant-improved, transplant-failed, and diabetic rats agreed fairly well with the progressive decrease in the plasma insulin/glucagon molar ratio in these respective groups. These findings suggest that pancreatic islets implanted in the livers of diabetic rats may influence hepatic metabolism in proportion to the degree of normalization of plasma insulin and glucagon levels.     

Health and welfare in St Helena: the contribution of W.J.J. Arnold, Colonial Surgeon, 1903–1925

St Helena is a remote south Atlantic island subject to insular problems of isolation and economic weakness which impact on health and welfare. It has long been British and in 1900 was used as a prison camp for Boers. One of the medical team looking after them was W.J.J. Arnold who remained on the island, as Colonial Surgeon and Acting Governor until his death in 1925. This paper considers the then health and welfare problems of this underdeveloped, isolated population and investigates their amelioration with reference to the work of Dr Arnold.     

Comparison of mouse and human retinal morphology and function in albinism: potential implications for therapeutic development

Background

Albinism is a disorder of melanin biosynthesis characterised by abnormal retinal development (foveal hypoplasia) and visual impairment, for which there are no effective treatments. Residual neural plasticity in the infant albino retina has previously been demonstrated. Therapeutic intervention during this developmental period has the potential to rescue visual function. Preclinical studies in murine albinism models are essential to develop novel therapeutics. We aimed to characterise retinal development, morphology, and function in the C57BL/6J-c2J null mouse model of oculocutaneous albinism (OCA), in preparation for future proof-of-concept treatment studies.

Surgical Complications in Early Post-transplant Kidney Recipients

Background

The purpose of this study was to determine the incidence of early surgical complications of kidney transplantation in our institution and its association with donor and recipient factors, as well as patient and transplant outcome.

Effect of sodium hypochlorite and Ricinus communis solutions on control of denture biofilm: A randomized crossover clinical trial

Statement of problem

The prevalence of complete edentulism remains high in the elderly, and previous data have shown that poor denture hygiene is common among patients with edentulism.

Association Between Clinical Tests Related to Motor Control Dysfunction and Changes in Pain and Disability After Lumbar Stabilization Exercises in Individuals With Chronic Low Back Pain

ObjectiveTo investigate whether clinical tests used to detect motor control dysfunction can predict improvements in pain and disability in patients with chronic nonspecific low back pain (LBP) who have undergone an 8-week lumbar stabilization exercise program.Study DesignA prospective cohort study.SettingOutpatient physical therapy university clinic.ParticipantsSeventy people with chronic nonspecific LBP were recruited, and 64 completed the exercise program (N=64).InterventionsThe lumbar stabilization program was provided twice a week for 8 weeks.Main Outcome MeasuresPain intensity (11-point numerical rating scale) and disability (Roland Morris Disability Questionnaire) and clinical tests, such as the Deep Muscle Contraction (DMC) scale, Clinical Test of Thoracolumbar Dissociation (CTTD), and Passive Lumbar Extension (PLE) test. Univariate and multivariate linear regression models were used in the prediction analysis.ResultsMean changes in pain intensity and disability following the 8-week stabilization program were ?3.8 (95% confidence interval [CI], ?3.2 to ?4.4) and ?7.4 (95% CI, ?6.3 to ?8.5), respectively. Clinical test scores taken at baseline did not predict changes in pain and disability at 8-week follow-up.ConclusionOur findings revealed that the DMC scale, CTTD, PLE test, clinical tests used to assess motor control dysfunction, do not predict improvements in pain and disability in patients with chronic nonspecific LBP following an 8-week lumbar stabilization exercise program.     

St. Helena familial genu valgum

A kindred on the mid-Atlantic island of St. Helena has severe "knock knees" and variable lesser malalignment at the elbows and wrists. The disorder is the consequence of hypoplasia of the corresponding bony condyles, with subsequent progressive degenerative osteoarthrophy. Inheritance is autosomal dominant and the condition seems to be a private syndrome which has arisen on the island by recent mutation. In view of the geographical localisation of the disorder and the anatomical distribution of the abnormalities, we propose the title "St. Helena Familial Genu Valgum".     

Prevalence and causes of visual impairment according to World Health Organization and United States criteria in an aged, urban Scandinavian population: The Copenhagen City Eye Study

PURPOSE: To evaluate the prevalence and causes of visual impairment in an epidemiologic study of aged, urban individuals in Denmark. DESIGN: Cross-sectional study. PARTICIPANTS: The study population consisted of 1000 randomly selected residents aged 60 to 80 years in Copenhagen, Denmark. Of 976 eligible persons, 946 (96.9%) could be examined. Information about best-corrected visual acuity (VA) was obtained from 944 cooperative persons (96.7%). METHODS: Data from the Copenhagen City Eye Study were used to assess the cause-specific prevalence of visual impairment as defined by the World Health Organization (WHO) (VA worse than 20/60-20/400 in the better eye) and the criteria used most commonly in the United States (VA worse than 20/40 but better than 20/200 in the better eye). Eligible subjects underwent an extensive ophthalmologic examination at The National University Hospital of Denmark. MAIN OUTCOME MEASURES: Best-corrected VA and primary causes of visual impairment. RESULTS: The prevalence of low vision according to the WHO definition ranged from 2.6% in subjects aged 70 to 74 years to 4.8% in subjects 75 to 80 years of age, with an age-adjusted relative prevalence of 1.58%. Using the U.S. definition, the overall age-adjusted prevalence of visual impairment was 2.9%. The causes of visual impairment according to the WHO criteria were age-related macular degeneration (AMD) (44.4%), cataract (33.3%), glaucoma in combination with cataract (11.1%), myopic macular degeneration (5.6%), and diabetic retinopathy (5.6%). However, according to the U.S. criteria, cataract was the most frequent primary cause (50.0%) and AMD was the second most frequent primary cause (34.4%) of visual impairment. Furthermore, using the U.S. criteria diabetic retinopathy was revealed as equally important as AMD and cataract as a cause of visual impairment among persons aged 65 to 69 years (33.3%). CONCLUSIONS: Increasing age was an independent predictor of visual impairment. Cataract and AMD were the leading causes. Adequate implementation of surgery to treat cataract could reduce visual impairment by 33.3% according to the WHO criteria and by 50% according to the U.S. criteria.     

Time to think outside the box? Prothrombin time,international normalised ratio,international sensitivity index,mean normal prothrombin time and measurement of uncertainty a novel approach to standardisation

BACKGROUND: The prothrombin time (PT) assay is the most clinically ordered coagulation test, and most often used for monitoring of vitamin K antagonist therapy (e.g., warfarin), where results are expressed as an international normalised ratio (INR). The INR is in essence the patient's PT 'mathematically adjusted' to a standardised value taking into account the peculiarities of the test system as defined by an ISI (international sensitivity index) and MNPT (mean normal prothrombin time). Although some manufacturers provide assigned ISI values for specific PT reagents and instrumentation, it is still recommended practice that laboratories check or validate these ISIs, as well as estimate the MNPT. Where an ISI is not provided by a manufacturer, the laboratory needs to estimate its own value. Current recommendations suggest the use of commercial reference-plasma calibration sets, but there is limited information on the performance of these in the field. RESULTS: We report a comparative study that assessed the utility of three such commercial calibration plasma sets, used as recommended, as well as alternate or supplementary procedures for estimation of ISI and MNPT. The latter included one novel approach using comparative data of 'existing' versus 'replacement' reagent, as well as assessment of external quality assurance data. Although MNPT value estimates were not grossly disparate, a wide variety of ISI values (e.g., 1.12-1.30 for our primary instrument) was obtained with the different plasma sets. CONCLUSION: Because of the above, further verification checks are required prior to acceptance of ISI and MNPT estimates generated from commercial plasma calibration sets. We also provide some recommendations regarding the process of standardisation of INR testing.