Efficacy of short‐term oral cobalamin therapy for the treatment of cobalamin deficiencies related to food‐cobalamin malabsorption: A study of 30 patients

Background: It has been suggested that oral cobalamin (vitamin B₁₂) therapy may be an effective therapy for treating cobalamin deficiencies related to food‐cobalamin malabsorption. However, the duration of this treatment was not determined. Patients and method: In an open‐label, nonplacebo study, we studied 30 patients with established cobalamin deficiency related to food‐cobalamin malabsorption, who received between 250 and 1000 μg of oral crystalline cyanocobalamin per day for at least 1 month. Endpoints: Blood counts, serum cobalamin and homocysteine levels were determined at baseline and during the first month of treatment. Results: During the first month of treatment, 87% of the patients normalized their serum cobalamin levels; 100% increased their serum cobalamin levels (mean increase, +167 pg/dl; P < 0.001 compared with baseline); 100% had evidence of medullary regeneration; 100% corrected their initial macrocytosis; and 54% corrected their anemia. All patients had increased hemoglobin levels (mean increase, +0.6 g/dl) and reticulocyte counts (mean increase, +35 × 10⁶/l) and decreased erythrocyte cell volume (mean decrease, 3 fl; all P < 0.05). Conclusion: Our findings suggest that crystalline cyanocobalamin, 250–1000 μg /day, given orally for 1 month, may be an effective treatment for cobalamin deficiencies not related to pernicious anemia.     

Prediction of lactose malabsorption in referral patients

Two hundred forty-two patients referred for various gastrointestinal complaints were evaluated for clinical parameters that would predict findings of lactose malabsorption. Breath hydrogen and blood glucose lactose tests were performed after ingestion of 50 g lactose. Presenting complaints, duration of symptoms, and patient demographics such as age, sex, and ethnic heritage were not different between lactose malabsorbers and absorbers as defined by the breath hydrogen lactose test. Foodrelated symptoms in general and after specific foods such as milk, ice cream, cheese, and yogurt were also similar between groups. Prior to testing, 30% of malabsorbers (N=161) and 36% of absorbers (N=81) reported lactoserelated symptoms (P=NS). The blood glucose response to lactose was abnormal in 60% of malabsorbers and 15% of absorbers. This study confirmed our impression that it is difficult to predict lactose absorption status by clinical parameters. The majority of our lactose malabsorber patients were unaware of lactose-associated symptoms. Furthermore, symptom assessment, demographics, food history, and blood glucose testing did not predict abnormal hydrogen responses to lactose.The opinions and assertations expressed herein are those of the authors and are not to be construed as reflecting opinions of the United States Air Force or the Department of Defense.This work has been presented in part at the Annual Scientific Session of the American Gastroenterological Association, San Francisco, California, May 19, 1986, and published as an abstract (Gastroenterology 90:1562, 1986).     

A survey and critical evaluation of a dual isotope (Dicopac) vitamin B12 absorption test

The results of all dual isotope tests (2142) carried out on 1989 patients, 807 males (40.6%) and 1182 females (59.4%), during a 10 year period (1976–1985 inclusive) in the Grampian Health Board Area (population 497,272) have been reviewed. Patient age ranged from 5–95 years with 45.5% over 60 years. The referring specialities were Gastroenterology (47.6%), Haematology (11.3%), Paediatries (2.1%) and all others (39.9%). According to the manufacturer's recommended criteria, results were classified as normal in 1054 (49.2%), abnormal in 659 (30.8%), equivocal in 337 (15.7%) and unsatisfactory in 92 (4.3%) tests. Vitamin B₁₂ malabsorption of ileal type was indicated in 544 tests (25.4%) and of gastric type in 115 (5.4%). Of the latter, 76 were related to pernicious anaemia, 10 to previous gastric surgery and 2 to gastric carcinoma. Of the 337 patients with equivocal results, 138 patients were reviewed and 115 (83.3%) found to have a documented cause for gastric malabsorption (96 pernicious anaemia and 19 previous gastric surgery). In 172 patients with proven pernicious anaemia the manufacturer's recommended criteria for gastric malabsorption were completely satisfied in only 76 (44.3%) but 167 (96.5%) had an excretion ratio 1.3 and 127 (73.8%) a ratio 1.7. Unsatisfactory tests were mainly due to incomplete urine collection (91.3%) or contamination with another isotope (5.4%).     

呼出气氢测定试验对飞行人员乳糖酶缺乏症的研究

对66名汉族飞行人员进行乳糖呼出气氢测定试验,乳糖吸收不良的发生率为83.3％,其中乳糖不耐受者占34.6％;与一般汉族人群无明显差别。对10名确定为中度以上乳糖吸收不良的飞行人员进行250ml鲜牛奶的试验结果,有50％呼出气氢含量在正常范围,并无一例出现胃肠道症状。提示较长期食用牛奶未能使乳糖酶缺乏状态发生改变,但每日食用适量牛奶属合理营养。     

Investigation of function of the lactose operon of escherichia coli K-12 under the influence of nonspecific regulators

The possible role of cyclic AMP in the stimulating action of ACTH and hydrocortisone on the lactose operon ofEscherichia coli K-12 was investigated. It was shown that ACTH had no effect on strainsE. coli WZ-78/F'lac (cya₈₅₅) andE. coli CA 8001 (L₁), in which the system of regulation of the function of the lactose operon by cyclic AMP is disturbed. Meanwhile this hormone stimulates the lactose operon in wild-type strains:E. coli 200 PS/F'lac andE. coli 3000. Hydrocortisone stimulates the function of the lactose operon both in the wild-type strainE. coli 3000 and in the mutantE. coli CA 8001 (L₁). It is considered that the stimulating action of ACTH on the lactose operon is mediated through cyclic AMP and that hydrocortisone stimulates the function of the lactose operon independently of cyclic AMP.Research Laboratory of Experimental Immunobiology, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR N. N. Zhukov-Verezhnikov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 33, No. 6, pp. 744–746, June, 1977.     

Milk and Dairy Products: Good or Bad for Human Bone? Practical Dietary Recommendations for the Prevention and Management of Osteoporosis

Osteoporosis affects women twice as often as men. Additionally, it is estimated that 0.3 million and 1.7 million people have hip fractures in the USA and Europe, respectively. Having a proper peak bone mass and keeping it as long as possible is especially important for osteoporosis prevention. One of the most important calcium sources is milk and dairy products. Breast milk is the best infant food, but milk should not be avoided later in life to prevent losing bone mass. On the other hand, more and more people limit their milk consumption and consume other dairy or non-dairy products. For example, they are usually replaced with plant beverages, which should be consumed carefully in several age groups. Additionally, an important element of milk and dairy products, as well as plant beverages, are probiotics and prebiotics, which may modulate bone turnover. Dietary recommendations focused on milk, and dairy products are an important element for the prevention of osteoporosis.     

中药配方颗粒辅料麦芽糊精的HPLC定量检测与中红外光谱半定量检测

目的 建立中药配方颗粒辅料麦芽糊精的检测方法,为中药配方颗粒质量评价提供分析技术支持。方法 建立配方颗粒中果糖、葡萄糖、蔗糖、麦芽糖、乳糖的HPLC定量检测方法,根据样品经糖化酶水解后的葡萄糖增加量换算出麦芽糊精含量。基于中药浸膏与麦芽糊精不同比例混合物的中红外光谱（mid-infrared spectroscopy,MIRS）特征峰差异,建立配方颗粒中麦芽糊精的半定量检测方法。结果 所建立的HPLC方法可以准确定量检测配方颗粒中果糖、葡萄糖、蔗糖、麦芽糖、乳糖。如果中药浸膏自身含有较多可经糖化酶水解产生葡萄糖的成分（淀粉、蔗糖等）,HPLC检测配方颗粒中麦芽糊精时存在系统性正误差,可通过中药浸膏酶解后葡萄糖增加量、待测样品酶解后蔗糖减小量等部分修正正误差。如果中药浸膏自身少含或不含淀粉、蔗糖等可经糖化酶水解产生葡萄糖的成分,HPLC检测配方颗粒中麦芽糊精时存在系统性负误差,换算公式偏差、麦芽糊精纯度、样品处理损失等导致根据样品酶解后葡萄糖增加量计算的麦芽糊精“检测含量”预期低于根据生产投料计算的麦芽糊精“名义含量”。麦芽糊精含量越高,配方颗粒MIRS中1200～900 cm-1区域的...     

The prevalence of lactase deficiency and lactose intolerance in Chinese children of different ages

Objective To determine lactose metabolism and lactase activity in Chinese children of diff erent ages, prevalence of lactase deficiency (LD), and lactose intoleran ce (LI).
Methods All 1168 healthy subjects between 3 and 13 years were recruited from schools in four large cities in China. They were screened by a 25 g lactose tolerance tes t. Some subjects were challenged with 50 g milk powder on different days. Bot h indicators, the expiratory H₂ concentration and intolerance symptoms, were a nalyzed.
Results LD occurred in 38.5% of children in the 3-5 year age group, and 87% of the 7-8 year and 11-13 year old groups. The age of occurrence for LD may be at 7-8 years among Chinese children. The prevalence of LI among Chinese children w as 12.2% at age 3-5 years, 33.1% at age 7-8 years, and 30.5% at age 11-13 yea rs, respectively.
Conclusion The results demonstrate that LD is very common in Chinese children from these fo ur cities. LD and LI have a dose dependent response: lactose absorption and sym ptoms are based on lactase activity. The relationship between breast feeding hi story (or the history of cow milk intake) and lactase activity among Chinese chi ldren has not been established.      

有关乳糖不耐受的研究进展

乳糖不耐受与人类尤其是婴儿期的营养和健康密切相关,影响人类对乳及其制品的摄入。了解乳糖不耐受的分型、临床症状及诊断,对维持人体健康、降低老年人群骨质疏松的危险性有着重要意义。对乳糖酶基因多态性的研究为人类了解、预防和控制该症提供了广阔的前景。乳糖酶分型的检测有可能成为对骨质疏松症患者进行早期基因筛查的一种行之有效的手段,而如何对乳糖不耐受进行改善和控制,尚需从多方面加以深入研究。     

Celiac disease: from gluten to skin

Celiac disease (CD) is an autoimmune gluten-dependent enteropathy characterized by atrophy of the intestinal villi that improves after a gluten-free diet. CD is often associated with extraintestinal manifestations. In the past few years, growing evidence has documented the involvement of skin diseases among the extraintestinal manifestations of CD. This association could be related to the impairment of intestinal absorption and motility, other than to immunological and hormonal changes. The aim of this review is to report all CD-associated skin manifestations described in the literature and to analyze the possible mechanisms involved in this association. The opportunity to evaluate the possible presence of CD in patients affected by skin disorders is discussed.