Feeding rats on diets containing the synthetic antioxidants ethoxyquin, butylated hydroxyanisole, and oltipraz results in 15-, 9-, and 6-fold increases, respectively, in the hepatic levels of aflatoxin B1-dialdehyde reductase (AFAR) protein. By contrast, treatment of rats with either of the inducing agents phenobarbital or 3-methylcholanthrene results in an approximate increase of only 1.4-fold in the amount of AFAR in rat liver. Northern blotting has shown that these increases in levels of hepatic AFAR protein are accompanied by corresponding increases in AFAR mRNA. Immunodepletion of AFAR from rat liver extracts has revealed that AFAR makes a considerable contribution to carbonyl metabolism in livers from animals treated with synthetic antioxidants and that it is the major reductase that can utilize aflatoxin B1-dialdehyde as a substrate. The immunodepletion experiments also revealed the presence of at least one other inducible carbonyl-reducing enzyme that, like AFAR, can metabolize 9,10-phenanthraquinone. Carbonyl-reducing activity from rat liver has been resolved into six enzyme-containing peaks by anion-exchange chromatography on Q-Sepharose. This method has been used to show that, in addition to AFAR, two other rat liver carbonyl-reducing enzymes are induced by ethoxyquin, and that these are distinct from NAD(P)H: quinone oxidoreductase. Collectively, these data show that synthetic antioxidants can influence substantially the capacity of rat liver to metabolize reactive carbonyl-containing compounds.

Aldehyde Reductase↗

PubMed1996

Development of a prognosis-based clinical staging system for infants infected with human immunodeficiency virus.

PURPOSE: To develop a prognosis-based clinical staging system for infants infected with human immunodeficiency virus. METHODS: Abstraction of data from medical records of 75 infected children. For each clinical finding present in infancy, the magnitude of the relative risk (RR) for early death was used to assign subjects to different clinical stages. RESULTS: Stage IV (RR > 3) included subjects with Pneumocystis carinii pneumonia, other opportunistic infections, or encephalopathy. Stage III (RR, 2 to 3) included those with anemia, thrombocytopenia, hepatitis, fever, oral candidiasis, or one or more serious bacterial infections. Stage II included those with hepatomegaly, splenomegaly, failure to thrive, or persistent diarrhea, and stage I included those who had lymphadenopathy or were free of symptoms. When clinical staging was applied to the study population at ages as early as 6 months, survival curves were significantly different (IV vs III: p < 0.0005; III vs II + I: p < 0.005). CONCLUSIONS: Clinical staging should be beneficial in advising parents about an infant's prognosis, therapeutic decision making, and stratification for clinical trials.

Child, Preschool↗

PubMed1996

Maternal body mass, proportional weight gain, and fetal growth in parous women.

This study is designed to examine the impact of maternal body mass index (BMI), proportional weight gain, and other variables on fetal growth. From a 10% random sample of 5722 Norwegian and Swedish para one and two women (n = 561), three hundred and sixty-nine women for whom prepregnant weight and height were recorded and for whom four fetal ultrasound measurements were taken at 17, 25, 33, and 37 weeks of gestation, were divided into low, average, and high body mass index groups (weight/height2). Fetal growth rate (mm/day) was determined by taking the mean of three measurements of the sagital and transverse diameters of the fetal abdomen (MAD) in each of three study time periods: weeks 17 to 25, first period; weeks 25 to 33, second period; weeks 33 to 37, third period. Proportional weight gain (kilograms gained within a specific time period/prepregnant weight) was measured in those same intervals. Fetal growth rate was significantly slower in the first and second periods, and significantly faster in the third time period for women with a low BMI, compared with those of average BMI. Fetal growth also significantly increased with increases in proportional weight gain in the second and third periods, but not in the first. Fetal growth appears to be independently associated with maternal BMI and proportional maternal weight gain.

Adult↗

PubMed1996

Suture haemorrhoidectomy: a day-only alternative.

BACKGROUND: Haemorrhoidectomy is a common treatment for third degree symptomatic haemorrhoids, and day surgery has increased because of increasing pressure for hospital beds. The aim of the present study is to describe a technique of suture haemorrhoidectomy (SH), conducted as a day-only procedure, and compare the effectiveness and outcomes of this method with the conventional Milligan-Morgan haemorrhoidectomy (MMH). METHODS: The results of 18 consecutive patients, mean age 52 years (31-73) undergoing SH between April 1994 and June 1995 were compared with a historical control group of 17 consecutive patients, mean age 45 years (29-72), who had MMH in the preceding year. Seven patients were excluded because of intercurrent anal pathology (1), thrombosed haemorrhoids (1) or loss to follow-up (5). An interviewer followed up patients using a telephone questionnaire. RESULTS: Mean follow-up was 6 months in the SH group and 18 months in the MMH group. There was no significant difference in total operative time. The SH group had a significantly shorter mean time to first void of 3 h versus 11 h (P < 0.005), mean time to first bowel action of 11 h versus 48 h (P < 0.005) and mean in-hospital stay of 10 h versus 77 h (P < 0.005). The SH group had a significantly decreased linear analogue pain scale, a mean of 1 versus 3 (P < 0.05). The complications were: two readmissions for pain relief in the SH group and urinary retention in one MMH patient. None of the study group have had recurrence of haemorrhoids. CONCLUSION: Suture haemorrhoidectomy as a day-only procedure is safe, less painful and reduces in-hospital admission time. The long-term effectiveness and complications of the technique are as yet undetermined.

Adult↗

PubMed1996