Locally invasive auricular aspergillosis after ear piercing in a neutropenic patient with leukemia.
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Adolescent↗
Biomedical subjects
I Ramirez
Publications and source records attributed to I Ramirez.
Perceptual analysis in different voice samples: agreement and reliability.
The objective of this study was to estimate the agreement and reliability of voice evaluation by a group of expert listeners using the central portion of a sustained vowel and a fragment of connected speech as voice samples. Ratings were made using Wilson's Buffalo III Voice Screening Profile. Analysis showed that intraindividual listeners' agreement presented variability in the evaluation of both voice samples. In the evaluation of the central portion of the sustained vowel, interindividual listener agreement was moderate for breathiness, hyponasal resonance, and overall voice rating; in connected speech, agreement was moderate for most voice qualities (breathy, rough, high/low pitch, and hyponasal resonance). Finally, Wilson's Buffalo III Voice Screening Profile presented good reliability values for both voice samples, with overall voice rating achieving higher values (.90) than any other voice-quality variable.
Adult↗
Amino acid intake during lactation and amino acids of plasma and human milk.
The aim of this study was to determine the free amino acid pool in plasma and milk in marginally nourished lactating women. Twenty-eight rural women (age, 23.9+/-5y; weight 50.2+/-4.9 kg; height, 148.2+/-4.8 cm) were studied under metabolic balance conditions. Subjects were divided into 6 groups (5-6 women in each), representing rural mothers postweaning and in the 15, 3rd, and 6th months of lactation; nonpregnant, nonlactating controls were from rural and urban areas. Amino acid analyses of diet and of plasma and milk samples were performed using a Beckman 6300 amino acid analyzer. Lysine intakes were lower than the recommended intake for lactating women (RDA). Plasma amino acid profiles differed between the lactating and weaned groups: aspartate and isoleucine increased at the 6th month (P < 0.05), while valine declined over weaning time (P < 0.05). In milk, valine and proline decreased at the 6th month (P < 0.05), while serine rose at the 3rd month. Free amino acid pools were 1- to 15-fold higher in plasma than in milk for branched-chain amino acids and basic, aromatic, and neutral amino acids. In mammary tissue these amino acids can be channeled to tissue and milk protein synthesis or to catabolic pathways. Glutamate was 40-fold higher in milk with respect to plasma content. This was the predominant amino acid in the free amino acid pool in milk. These results suggest selective amino acid transport in mammary tissue during lactation.
Adult↗
Pilot studies of species-specific chemotherapy of childhood acute lymphoblastic leukemia using genotype and immunophenotype.
Genotype and immunophenotype can be used to define biological species of acute lymphoblastic leukemia (ALL). The purpose of these two pilot studies, conducted between 1986 and 1994, was to explore the feasibility and acceptability of classifying ALL in this manner for selection of treatment rather than using conventional risk for failure factors such as age and initial white blood cell count. The possibility that conventional risk factors would be overcome and survival improved by this approach was also considered. Flow cytometry and chromosome analysis were used to classify the ALL of 150 children into one of five biologic categories as defined by cell surface antigens, DNA index and chromosome number and arrangement. Chemotherapy regimens depended on the assigned category. There was no provision for cranial irradiation and use of alkylating agents, anthracyclines and epipodophyllotoxins was restricted in order to reduce risk of late adverse sequelae. All patients are included in the analysis regardless of presenting condition or adherence to protocol. The majority of patients were Mexican-American or African-American. Eight-year event-free survival (EFS) is 60.7% (+/-4%) and 8-year overall survival (OAS) 72.6% (+/-3.7%). EFS and OAS varied significantly among the biologic categories despite differences in chemotherapy regimens. When the patients with B-precursor ALL were retrospectively classified by current Pediatric Oncology Group (POG) criteria, 8-year EFS was 82% (+/-7.3%) for the good risk group, 68.9% (+/-5.9%) for the standard risk and 48.8% (+/-7.6%) for the poor risk, all significant differences. However, when retrospectively classified according to the Rome/NCI prognostic criteria the 8-year EFS for standard risk patients was 69.1% (+/-5.1%) and for high risk 58.8% (+/-6.9%), not a statistically significant difference. Numbers of T cell and B cell patients are too few for comparison. Gender and ethnicity influenced survival as in treatment based on prognostic factors. Initial central nervous system (CNS) relapse occurred in five patients (3%) and combined CNS and hematological relapse in six (3%). Factors significantly associated with CNS and combined relapse were leukemic pleocytosis in the initial CSF sample, pro-B immunophenotype and DNA index <1.16, but not initial white blood cell count. Only three survivors appear to have serious late adverse sequelae, the only neurologic the result of asparaginase-induced cortical vein thrombosis. The results suggest that use of biologic species as defined by immunophenotype and genotype to select therapy of ALL is feasible and acceptable but under the conditions of these studies offered no apparent therapeutic advantage over conventional risk grouping. However, the introduction of molecular genotyping and novel gene targeted therapeutic agents justify further exploration of this approach.
Adolescent↗
Fatty acid oxidation affects food intake by altering hepatic energy status.
Inhibition of fatty acid oxidation stimulates feeding behavior in rats. To determine whether a decrease in hepatic fatty acid oxidation triggers this behavioral response, we compared the effects of different doses of methyl palmoxirate (MP), an inhibitor of fatty acid oxidation, on food intake with those on in vivo and in vitro liver and muscle metabolism. Administration of 1 mg/kg MP selectively decreased hepatic fatty acid oxidation but did not stimulate food intake. In contrast, feeding behavior increased in rats given 5 or 10 mg/kg MP, which inhibited hepatic fatty acid oxidation to the same extent as did the low dose but in addition suppressed fatty acid oxidation in muscle and produced a marked depletion of liver glycogen. Dose-related increases in food intake tracked dose-related reductions in liver ATP content, ATP-to-ADP ratio, and phosphorylation potential. The findings suggest that a decrease in hepatic fatty acid oxidation can stimulate feeding behavior by reducing hepatic energy production.
Adenosine Diphosphate↗
Inhibition of wound-induced accumulation of allene oxide synthase transcripts in flax leaves by aspirin and salicylic acid
Allene oxide synthase (AOS) mediates the conversion of lipoxygenase-derived fatty acid hydroperoxides to unstable allene epoxides, which supply the precursors for the synthesis of the phytohormone jasmonic acid (JA). In this study the characterization of AOS gene expression in flax (Linum usitatissimum) is reported. AOS was constitutively expressed in different organs of flax plants. Additionally, AOS gene expression was enhanced after mechanical wounding in both the directly damaged leaves and in the systemic tissue located distal to the treated leaves. This wound-induced accumulation of AOS required the de novo biosynthesis of other unknown proteins involved in the signaling pathway modulating wound-induced AOS gene expression. Furthermore, the wound-induced AOS mRNA accumulation was correlated with the increase in the levels of JA. Both JA and its precursor, 12-oxo-phytodienoic acid, activated AOS gene expression in a dose-dependent manner. Thus, JA could activate its own biosynthetic pathway in flax leaves. Moreover, neither salicylic acid (SA) nor aspirin influenced AOS enzymatic activity. It is interesting that pretreatment with SA or aspirin inhibited wound-induced accumulation of AOS transcripts. These results suggest that a potent inhibition of JA biosynthetic capacity in leaves can be affected by SA or aspirin at the level of AOS gene expression.
Journal Article↗
Stimulation of fluid intake by nutrients: oil is less effective than carbohydrate.
It has been thought that the ability of nutrients to reinforce ingestion is related to their ability to provide metabolizable energy. This implies that the reinforcing effect of carbohydrate should be similar to that of fat. To test this concept, rats were trained in an apparatus that infused water or nutritive solutions/suspensions into their stomachs every time they drank a sapid solution. Each training trial lasted for 1 day. Successive training trials were interspersed by 1-day periods in which the rats were infused with plain water and offered plain water or a tastant different from the training taste (i.e., taste paired with vehicle infusion). Three different sapid solutions were used: a sweet solution (saccharin), a nonsweet solution (NaCl), and a mixture of sweet and nonsweet. Starch or maltodextrin infusions strongly and consistently stimulated intake of these solutions. Oil infusions also significantly stimulated intake, but feebly and less consistently. Indeed, in the one experiment in which the only sapid fluid offered was saccharin, oil infusions had no significant effect. Two different oil suspensions (one fine and one coarse) were equally ineffective in stimulating saccharin intake. To determine whether some unsuspected flaw in the infusion experiments somehow produced invalid results, an additional experiment was conducted in which rats ingested starch or oil suspensions by mouth. Consistent with the infusion experiments, starch stimulated ingestion to a much greater degree than did oil. It is concluded that intragastric infusion of triglyceride oil is a less potent reinforcer of ingestion than is equicaloric infusion of carbohydrate.
Animal Nutritional Physiological Phenomena↗
Satiety from fat? Adverse effects of intestinal infusion of sodium oleate.
To determine whether damage to the intestinal mucosa by oleic acid causes the suppression of food intake observed in response to intraintestinal infusion of the fatty acid, we measured lactate dehydrogenase (LDH) activity, a marker for cell damage, in the intestinal lumen after intestinal infusion of fatty acid under conditions similar to those employed in studies of eating behavior. Infusions of 25 or 51 mM sodium oleate (neutralized oleic acid) markedly and rapidly increased LDH activity, whereas infusions of saline had little or no effect. Infusion of octanoate, which has been reported to be ineffective in reducing eating behavior, did not increase intestinal LDH activity relative to saline infusion. Similarly, infusion of ethyl oleate or free (nonneutralized) oleic acid neither increased luminal LDH activity nor suppressed food intake. Infusion of sodium oleate also produced a strong conditioned aversion to sucrose. The results strongly suggest that the suppression of food intake induced by intraintestinal infusion of sodium oleate is due to the injurious effects of this unphysiological form of the fatty acid.
Animals↗
High-dose mercaptopurine and intermediate-dose cytarabine during first remission of acute myeloid leukemia.
High-dose, continuous infusion of intravenous mercaptopurine (HD 6MP) followed by intermediate-dose continuous cytarabine (ID Ara-C) has been shown to produce remissions in children with relapsed acute myeloid leukemia (AML). The purpose of this pilot study was to explore the feasibility of using this drug regimen as a component of treatment during the first remission of AML. Of 17 children with newly diagnosed AML registered in the study, 14 developed complete remission on conventional induction therapy and subsequently received the HD 6MP and ID Ara-C combination. The dosages of HD 6MP were escalated from 500 mg/m2 to 1250 mg/m2 in 24-hr infusions. The initial dosages of ID Ara-C were escalated from 250 mg/m2 to 650 mg/m2/24 hr and from 1 day to 4 days. Conventional treatment for AML was administered simultaneously. Seven of the 14 children remain in initial complete remission for 15 to 46 months and have completed treatment. Severe pancytopenia was observed in all patients, but there were no toxic deaths and no deaths during remission. The inclusion of HD 6MP and ID Ara-C in the treatment of AML in first remission appears to be feasible. Evaluation of its efficacy will require a comparative clinical trial.
Acute Disease↗
Intragastric carbohydrate exerts both intake-stimulating and intake-suppressing effects.
Ingestion-contingent infusions of 6% carbohydrate did not affect saccharin intake during the first ingestive bout, but later they greatly stimulated ingestion, slowed the rate of decline of ingestion during bouts, and increased the average bout size. This suggests that the intake-stimulating effect of carbohydrate infusions is partly attributable to conditioned desatiation. Satiation can also be conditioned because more concentrated infusions (24% carbohydrate) did not increase daily intake or average bout size, even though both concentrations stimulated ingestion during the first 0.5-6.0 min of a test session, as well as during extinction tests when only water was infused. Increased intake may be partly mediated by a hedonic mechanism because naloxone, an opioid antagonist, decreased intake in rats infused with carbohydrate to a greater degree than it decreased intake in rats infused with water.
Animals↗
Is fructose sweeter than glucose for rats?
Because it is generally thought that the intensity of the taste of fructose is greater than that of glucose for rats, it seemed surprising when sham-fed rats drank substantially less of a mixture of 6% fructose plus saccharin than of a mixture of 6% glucose plus saccharin. At least 3 different factors contribute to this effect. First, the taste of fructose is less attractive to rats than is the taste of glucose; sham-fed rats strongly preferred glucose over fructose (no saccharin was used in this experiment). The second factor is experience. Rats having substantial previous experience with glucose, but not with fructose, consistently preferred glucose over fructose. Conversely, rats having substantial previous experience with fructose, but not with glucose, initially showed no consistent preference but subsequently tended to prefer glucose. The third factor is an interaction between saccharin and the type of sugar. Rats given only one solution at a time drink approximately as much fructose as glucose when the solutions contain no saccharin. The addition of 0.25% saccharin to 6% glucose stimulated intake, whereas the addition of the same amount of saccharin to 6% fructose did not stimulate intake. As a result, rats ingested substantially more of a mixture of 0.25% saccharin plus 6% glucose than they did of a comparable mixture of saccharin and fructose, even though rats ingest similar amounts of fructose and glucose without saccharin in single-bottle tests. Because the differential effect of saccharin on intake appeared within 2 h in naive rats, and did not greatly change over a 3-day period, it is probably not attributable to conditioning. These results suggest that these sugars have qualitatively different tastes.
Animals↗
Stimulus specificity in flavor acceptance learning.
Infusing rats with 6% carbohydrate whenever they drank a test fluid stimulated their intake of 0.03-0.3% saccharin, 0.9% sodium chloride, and 0.5% oligosaccharide solutions within 1 to 3 days, but did not greatly increase intake of cherry-flavored water, 2% saccharin, 0.45% sodium chloride, monosodium glutamate, 0.025% sucrose octaacetate, or 0.4% maltodextrin, when food was available adlib. In general, it was more difficult to detect an effect with aversive stimuli, but it was possible to detect a significant effect with one such aversive flavor by either increasing the number of animals to permit detection of a small effect, or by using a preference test. For most stimuli, however, rats that had been trained with food available and then tested when food deprived showed significant increases in fluid intake, compared to rats that had been given the same flavor without carbohydrate infusions, even when plain water was infused in all rats during the food deprivation test. The following forms of evidence indicate that the increased intake is due to a form of Pavlovian conditioning. It tends to increase over repeated trials and to persist for a day after the carbohydrate infusions have been discontinued. Indeed, in one experiment, increased intake even persisted for a day when the infusion conditions were reversed, such that control rats were infused with carbohydrate and experimental rats were infused with water. Increased ingestion is attenuated by preexposure to the infusion in the absence of an appropriate taste solution. Increased ingestion is attenuated by preexposure to the taste solution in the absence of infusions (i.e., latent inhibition). Although increased intake is a form of associative conditioning, it is unlike malaise-conditioned taste aversions because taste aversions were conditioned to monosodium glutamate, cherry flavor, and saccharin with equal ease. The ease with which infusion increased intake is influenced by at least three different factors, degree of aversiveness, stimulus intensity, and rats' innate predisposition to acquire certain stimulus-response relationships more readily than others.
Animals↗
Gastric emptying of ingested fat emulsion in rats: implications for studies of fat-induced satiety.
Evidence that ingested fat acts in the intestine to produce satiety stems from studies showing that intraintestinal infusion of fat emulsion inhibits eating behavior of rats. In this study, we determined the appropriateness of infusion parameters used in these behavioral studies by measuring gastric emptying rates of both the aqueous and lipid components of Intralipid ingested normally by rats. Stomach contents were collected at different times 0-40 min after rats ingested Intralipid containing [14C]polyethylene glycol (PEG) and phenol red (PR) and were assayed for PEG, PR, and fat. The proportion of ingested fat remaining in the stomach was significantly greater than the proportion of ingested PEG or PR at all time points examined. Despite initial gastric emptying of fat during ingestion, consumption of Intralipid (0.5 or 1.1 kcal/ml) did not suppress subsequent solid food intake. The results indicate that 1) ingested fat emulsion rapidly partitions in the rat stomach into an aqueous phase, which empties rapidly, and a lipid phase, which empties slowly, and 2) normal ingestion of Intralipid is not immediately satiating. These observations raise questions about the physiological significance of the rapid and marked suppression of feeding behavior produced by intraintestinal infusion of Intralipid.
Animals↗
The 20 mm Medtronic Hall prosthesis in the small aortic root.
BACKGROUND AND AIMS OF THE STUDY: The choice of prosthesis becomes crucial in the narrow aortic annulus. The 20 mm Medtronic Hall valve has a reduced sewing ring that fits in an annulus where only a 19 mm valve would fit. This study assesses the hemodynamic performance of this prosthesis at rest and at exercise, and compares it with two 19 mm mechanical prostheses. MATERIALS AND METHODS: Forty-two patients were studied by Doppler echocardiography, a mean of 34 months following surgery. Twenty-six had a 19 mm prosthesis implanted (12 standard St. Jude Medical and 14 Monostrut valves) and 16 had a 20 mm Medtronic Hall. Parameters studied were peak velocity and transvalvular gradient, both at rest and at exercise, effective orifice area and valve index. RESULTS: No differences were found between the two 19 mm valves, but when compared with the Medtronic Hall valve at rest, this valve showed significantly lower peak velocity and gradient (2.9 vs. 3.3 m/sec, p < 0.01, and 17 vs. 23 mmHg, p < 0.003, respectively) and higher effective orifice area and valve index (1.3 vs. 1.0 cm2, p < 0.01 and 0.81 vs. 0.62 cm2, p < 0.006, respectively). There were also significant differences under exercise. CONCLUSIONS: The 20 mm Medtronic Hall prosthesis shows a significantly better hemodynamic performance, both at rest and under exercise, than other, 19 mm mechanical prostheses and represents a superior choice in valve replacement with a small aortic root.
Aged↗
Stimulation of fluid intake by maltodextrins and starch.
Maltodextrin solutions are more potent stimulators of fluid intake than are starch suspensions, even though these two substances are both glucose polymers. When rats were offered a choice of two fluids, one containing maltodextrin and the other containing the same concentration of starch, rats preferred maltodextrin; this preference increased over successive days for rats given 7.4% or 10% carbohydrate but not for rats given 1% carbohydrate. Rats offered fluids containing artificial flavors mixed with maltodextrin and starch acquired preferences for flavors paired with 10% or 7.4% maltodextrin but not for flavors paired with 1% maltodextrin. In an attempt to determine whether this greater preference for maltodextrin is due to an innate flavor preference, rats were given a choice of maltodextrin containing sucrose octaacetate vs. plain starch; these rats initially preferred starch but subsequently ingested more maltodextrin flavored with sucrose octaacetate than plain starch. Direct evidence for a postingestive factor was obtained by giving rats intragastric infusions of either maltodextrin, starch, or vehicle whenever they drank a dilute saccharin solution. Both carbohydrates stimulated fluid intake, but maltodextrin did so more rapidly (within 1 day rather than the 2 days of training required with starch infusions). These results indicate that some difference in the postingestive effects of maltodextrin and starch contributes to the greater intake-stimulating effect of maltodextrin. The postingestive factor responsible for the difference between maltodextrin and starch has not been identified, but it is not the amount of utilizable energy because rats prefer maltodextrin over starch even when the starch suspension contains more calories than does the maltodextrin solution. It is proposed that the postingestive factor differentiating these substances is rate of digestion.
Animals↗
Glucose polymer taste is not unitary for rats.
The present studies examined rats' responses to two maltodextrin preparations. One maltodextrin, a maltooligosaccharide, had an average chain length of 4.4 glucose units. The other maltodextrin was a maltopolysaccharide, having an average chain length of 22. In 24-h preference tests, rats strongly preferred 1% and 5% maltodextrin over water, regardless of the type of maltodextrin offered. When given a choice of two maltodextrins, rats preferred the maltooligosaccharide, but the degree of preference was influenced by the rats' previous experience with maltodextrins. Conditioned flavor aversion experiments were conducted to determine whether rats detect qualitative flavor differences between the these two maltodextrins. Rats trained to avoid one maltodextrin also avoided the other maltodextrin. Nevertheless, rats could be trained to drink maltooligosaccharide but avoid maltopolysaccharide; these rats showed no reliable tendency to respond to the intensity of maltooligosaccharide flavor. Therefore, maltodextrins of varying chain length differ more in flavor quality than in flavor intensity. This difference in flavor quality is not attributable to known sweet and starch flavors because neither maltodextrin contained much glucose and because rats trained to avoid the polysaccharide did not avoid starch. Because rats can discriminate between solutions containing only 0.5-1% maltodextrin, their ability to discriminate among carbohydrates must be far more acute than that of humans.
Animals↗
Food intake in diabetic rats: relationship to metabolic effects of insulin treatment.
Hyperphagic streptozotocin-diabetic rats were given week-long treatment with 0 (vehicle), 3, or 6 U/rat/day of regular insulin via a SC osmotic pump. Insulin reduced urinary glucose excretion and plasma glucose and increased body weight in a dose-related manner starting on the first day of treatment. Insulin treatment also increased carcass weight, carcass fat, and liver glycogen within 3 days. Food intake did not decrease until the fifth day of insulin treatment, and this change was unrelated to the amount of insulin administered. These results show that the effects of insulin on food intake and metabolism of diabetic rats can be dissociated with respect to both time course and dose of insulin. The findings indicate that hypoinsulinemia, glycosuria, body weight loss, and depletion of body fat and liver glycogen are symptoms of diabetes, not causes of diabetic hyperphagia.
Animals↗
Sucrose and fructose have qualitatively different flavors to rats.
Previous studies suggest that rats might be able to discriminate between sucrose and fructose, but no previous study has examined this possibility in much detail. Rats were conditioned to avoid either sucrose or fructose by injecting them with lithium chloride when they drank these substances. Control rats were given the same injections but were not exposed to either sugar during training. After training, the rats were given a choice of fructose vs. sucrose. Data from control rats provided information about the relative taste intensity of the sugars. If the sugars possess only a single gustatory quality, control rats should prefer the sweeter sugar; under this assumption, sucrose appears to be two-four times sweeter than fructose. The two sugars share a common taste because rats trained to avoid sucrose avoided fructose when the fructose concentration was much greater than the sucrose concentration. Nevertheless, the two sugars are discriminable because, when the apparent sweetness of the sugars was matched, rats showed a greater aversion to the sugar they were trained to avoid. Aversions to sucrose and fructose also generalized to maltodextrins, but sucrose may have a somewhat greater maltodextrin flavor than does fructose. It is proposed that the biological function of maltodextrin taste is to allow animals to sense the ratio of glucose to fructose in foods.
Animals↗