Ferrography is a technique for magnetically harvesting and separating metallic particles from aqueous and non-aqueous suspensions. We have adapted this method of analysis to the study of cartilaginous and osseous wear particles, as well as fragments of soft tissue, found in the synovial fluid of human joints. As ferrography employes magnetism to harvest particles and arrange them in an orderly fashion, it is first necessary to impart a positive magnetic susceptibility to the biological materials. The trivalent paramagnetic cation of the rare earth element erbium is used for this purpose. Based on this principle, a method for the ferrographic analysis of synovial fluid has been devised, which is presently being employed in the study of human joint disease. Using this technique, improved diagnosis of arthritis may be possible. In addition, it may lead to a deeper understanding of the aetiology and pathogenesis of degenerative arthritis and other destructive joint diseases.

Arthritis↗

PubMedDate not supplied

Substrate oxidation in patients with cirrhosis: comparison with other nutritional markers.

BACKGROUND: Malnutrition in patients with hepatic cirrhosis is associated with abnormal fuel metabolism marked by reduced glucose oxidation and increased lipid oxidation. A low respiratory quotient (R/Q) indicates reduced glucose and increased lipid oxidation. The aim of this study was to determine if there is an association between substrate oxidation, using indirect calorimetry, and other markers of malnutrition in patients with cirrhosis awaiting liver transplantation. METHODS: Indirect calorimetry (MedGraphics) was used to determine resting energy expenditure and R/Q after an overnight fast. Anthropometric measurements including tricep skinfold thickness (TSF) and midarm muscle circumference (MAMC) were performed and expressed as a percentage of standard values. A 24-hour urinary creatinine excretion was collected to calculate creatinine height index (CHI) and serum albumin. A subjective global assessment (SGA) score was completed on each patient by a dietitian and physician. Spearman rank correlation was used for statistical comparison of R/Q to other nutritional markers. RESULTS: Fifteen patients (7 men, 8 women; mean age, 52 years) were studied. Mean values include: body mass index (BMI) 27.7 kg/m2 +/- 7.3, R/Q 0.78 +/- 0.04, serum albumin 2.97 g/dL +/- 0.56, TSF 71% +/- 27%, MAMC 85% +/- 13%, CHI 75% +/- 18%, and SGA median score A. There was a significant correlation (p < .05) between R/Q and serum albumin, CHI, and SGA score. There was a greater than 90% correlation of SGA estimation by a physician and dietitian. CONCLUSIONS: There is good correlation between R/Q values and serum albumin, CHI, and SGA score. BMI and anthropometric measurements may suggest normal nutrition when, in fact, indirect calorimetry (R/Q) suggests changes consistent with abnormal fuel metabolism and poor nutrition. R/Q can be a useful adjunct in the nutrition assessment of patients with hepatic cirrhosis.

Adult↗

PubMedDate not supplied

Influence of tacrolimus and prednisone on serum lipids after liver transplantation.

BACKGROUND: Hyperlipidemia after orthotopic liver transplant is thought to be the result of the immunosuppression therapy given postoperatively. The purpose of this study was to evaluate serum lipid levels pretransplant, 4 months, and 12 months posttransplant. METHODS: A retrospective chart review of 50 patients after liver transplantation was completed. Pretransplant serum lipid levels (triglyceride, cholesterol, and high-density lipoprotein [HDL]) were compared with values at 4 months and 12 months posttransplantation. Pretransplant serum lipid levels were compared using one factor analysis of variance (ANOVA) model. Values between the viral, alcohol, and cholestatic groups were compared using two-factor ANOVA model. RESULTS: Of the 50 patients (22 females, 28 males) with a mean age of 52 years (range, 16 to 69 years), all 50 had completed their 12-month follow-up at the time of this study. The etiology of liver disease included: viral hepatitis (21), alcohol (8), primary biliary cirrhosis and sclerosing cholangitis (7), and others (14). The protocol for immunosuppression included tacrolimus and prednisone. Mean serum triglyceride levels included: 134 mg/dL pretransplant, 155 mg/dL at 4 months, and 169 mg/dL at 12 months posttransplant (p = .117). Mean total serum cholesterol levels included: 174 mg/dL pretransplant, 165 mg/dL at 4 months, and 163 mg/dL at 12 months posttransplant (p = .654). Mean HDL levels included: 39 mg/dL pretransplant, 45 mg/dL at 4 months and 44 mg/dL at 12 months posttransplant (p = .032). There was not a significant difference in serum lipids between the different categories of liver diseases. CONCLUSIONS: Although a significant positive effect was observed with HDL, the present data show that total serum cholesterol and triglyceride did not change significantly over time after orthotopic transplantation. This is most likely related to the type of immunosuppressive therapy given posthepatic transplantation.

Adolescent↗