摘要:

Non‐insulin‐dependent diabetes mellitus is frequently associated with premature atherosclerosis. Abnormalities in lipid and lipoprotein metabolism contribute to the increased risk of coronary heart disease. One of the most common lipid abnormalities in non‐insulin‐dependent diabetes mellitus is hypertriglyceridaemia. In the present paper, the authors review the metabolism of triglyceride‐rich lipoproteins, with special emphasis on the post‐prandial state. Several studies have demonstrated that levels of atherogenic post‐prandial lipoproteins are increased in patients with non‐insulin‐dependent diabetes mellitus. An increased supply of glucose and free fatty acids contributes to overproduction of very low‐density lipoproteins, increasing the burden of triglyceride‐rich lipoproteins on the common lipolytic pathway at the level of lipoprotein lipase. Low lipoprotein lipase activity and increased amounts of lipolysis‐inhibiting free fatty acids further impair lipolysis of post‐prandial lipoproteins. The clearance of atherogenic remnants is also delayed in non‐insulin‐dependent diabetes mellitus. There is evidence that a relative hepatic removal defect exists, secondary to impaired remnant‐receptor interaction and increased competition with very low density lipoprotein remnants. Correction of the increased post‐prandial lipaemia in non‐insulin‐dependent diabetes mellitus is advisable, as it may contribute to attenuation of the risk on premature atherosclerosis. When dietary measures and hypoglycaemic agents have failed to achieve acceptable lipid levels, lipid‐lowering drugs should be advised. Fibric acids and hydroxymethylglutaryl coenzyme A (HMG CoA) reduc

ISSN:0014-2972    

DOI:10.1046/j.1365-2362.1996.114256.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

ISSN:0014-2972    

DOI:10.1046/j.1365-2362.1996.112255.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

The aim of this study was to investigate the involvement of the monocyte‐derived cytokines interleukin 1β (IL‐1β), interleukin 6 (IL‐6) and tumour necrosis factor‐α (TNF‐α) in idiopathic inflammatory bowel disease. Endoscopic biopsies of normal and inflamed intestinal mucosa were obtained from patients with ulcerative colitis (n = 11) and with Crohn’s disease (n = 10). Intestinal mucosal cells were isolated by collagenase digestion. Cell viability, morphology and CD14 expression were determined. To measure cell‐associated cytokine levels, cells were lysed and analysed for IL‐1β and TNF‐α in specific radioimmunoassays and for IL‐6 using a biological assay. Compared with mucosal cells from control patients without inflammatory bowel disease the inflamed intestine in ulcerative colitis and Crohn’s disease displayed markedly enhanced levels of IL‐1β (median 245 pg 10−6cells, range 30–1275) and IL‐6 (median 22 U 10−6cells, range 1–298). Non‐inflamed mucosa in patients with ulcerative colitis and Crohn’s disease did not shown elevated levels of IL‐1β (median 50 pg 10−6cells, range 33–90) or IL‐6 (mean below detection limit of assay, i.e. 1 U 10−6cells). In contrast, no clear cut difference between inflamed and non‐inflamed mucosa could be detected for TNF‐α. High tissue levels of IL‐6 were associated with a high endoscopic grade of local inflammation. These results suggest that the monocyte‐deri

ISSN:0014-2972    

DOI:10.1046/j.1365-2362.1996.123262.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

The authors compared the effect of recombinant human erythropoietin (rhEPO) in combination with iron with that of iron therapy only in the treatment of postpartum anaemia. Ninety patients (30 patients/group) received either rhEPO (300 U kg−1, i.v. or s.c., once) and iron (parenteral and oral), or iron therapy only. Erythropoiesis was assessed by haemoglobin and haematocrit increase, absolute reticulocyte counting and reticulocyte flow cytometry. Ferrokinetics was assessed by serum ferritin, transferrin and transferrin saturation measurements. There was no difference before therapy for baseline haematological values or iron status. Patients with endogenous EPO levels below 145 mU mL−1had a significant benefit from intravenous rhEPO administration with highest haematocrit and haemoglobin levels 4 and 14 days after therapy. rhEPO‐treated groups showed a higher absolute reticulocyte count 1 and 4 days after therapy and an elevated percentage of high fluorescent reticulocytes (HFRs). Parenteral iron therapy caused a significant increase of ferritin and transferrin saturation, while transferrin concentration decreased. Ferritin and transferrin levels were lowest after i.v. administration of rhEPO, 1 and 4 days after therapy. C‐reactive protein concentration was highest in patients who underwent caesarean section until the end of the observation period. A single dose of rhEPO in combination with iron was more effective in treating postpartum anaemia than iron therapy only, in patients who had low EPO levels despite peripartal blood loss. Postpartum low endogenous EPO levels might be a consequence of inhibiting inflammatory cytokines that are released after spontaneous or operati

ISSN:0014-2972    

DOI:10.1046/j.1365-2362.1996.109261.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

The activity of the human erythrocyte sodium–lithium countertransport (SLC) is stable over long periods in individuals. However, it is becoming increasingly evident that the transport system is susceptible to modulation, both acutely and chronically, by various factors. In this study, the authors observed temporal variation in SLC over a period of 10 h (08.00–18.00 hours) in healthy volunteers. SLCVmaxwas maximum (0.354 ± 0.051 mmol L−1cell−1 h−1; mean ± SE) at ‘mid‐day’ and significantly higher than in the morning (0.291 ± 0.035 mmol L−1 cell, h;P < 0.010). Its value in the evening (0.316 ± 0.042 mmol L−1cell−1 h−1) was lower than at ‘mid‐day’ (P < 0.045) but higher than in the morning (P < 0.037). These changes were not accompanied by any significant change in the affinity of the transporter for external sodium,Km. Changes in SLCVmaxdid not correlate with the corresponding ones in either plasma cortisol or aldosterone. However, they correlated well with those in plasma renin activity, the correlation between mid‐day and a.m. sets of values (r = 0.718;P = 0.019) being better than that between mid‐day and p.m. (r = 0.688;P = 0.028). The authors conclude that changes in SLC occur during the day, and this need be taken into account in the p

ISSN:0014-2972    

DOI:10.1046/j.1365-2362.1996.111251.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

The authors investigated the production of interleukin‐2 (IL‐2) and interferon‐gamma (IFN‐γ) by phytohaemagglutinin (PHA)‐stimulated T‐lymphocytes from 21 untreated patients with acute brucellosis. PHA‐stimulated T‐lymphocytes from acute brucellosis patients showed normal IL‐2 production but defective IFN‐γ production (brucellosis patients 531 ± 103 pg mL−1vs. healthy controls 1024 ± 212 pg mL−1) after 72 h of culture. This altered pattern of IL‐2 and IFN‐γ production by T‐lymphocytes was observed in seven brucellosis patients whose T‐lymphocytes exhibited a normal proliferative response to PHA (61 612 ± 18 422 cpm) as well as in the 14 patients with a defective T‐lymphocyte proliferative response to the PHA after 5 days of culture (19 479 ± 4409 cpm). After antibiotic therapy, production of the two lymphokines by the PHA‐stimulated T‐lymphocytes from acute brucellosis patients was similar to that of T‐lymphocytes from healthy control subjects. The authors conclude that PHA‐stimulated T‐lymphocytes from untreated pati

ISSN:0014-2972    

DOI:10.1046/j.1365-2362.1996.108250.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

The authors investigated the effect of the position of fatty acids within dietary triglycerides on the composition of plasma lipids. Sixty volunteers consumed two diets of equal fatty acid compositions for 3 weeks each. In the palm oil diet 82% of palmitic acid was attached to thesn‐1 andsn‐3, and 18% to thesn‐2 position of glycerol. In the diet rich in a palm oil analogue, Betapol, these figures were 35% and 65% respectively. Oleic and linoleic acid in palm oil were mainly in thesn‐2 position, and in Betapol mainly in thesn‐1 andsn‐3 position. The proportion of palmitic acid in the 2 position of fasting plasma triglycerides was 10.2 g 100 g−1on palm oil and 12.3 on Betapol; that of oleic acid was 46.9 vs. 43.6 (P < 0.0001). Overall oleic acid content of triglycerides was 1.4 g 100 g−1lower on Betapol than on palm oil (P = 0.002). Betapol increased palmitic and palmitoleic acid in cholesteryl esters by 1 g 100 g−1(P < 0.0001) at the expense of oleic and linoleic acid. The positional configuration of dietary fatty acids has small but consistent effects on lipid metabolism that persist beyond

ISSN:0014-2972    

DOI:10.1046/j.1365-2362.1996.t01-1-105263.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

In 24 h oesophageal pH monitoring, pH 4 is widely but arbitrarily used as the threshold between reflux and non‐reflux pH values. The aim of the study was to define pH thresholds objectively, based on Gaussian curve fitting of pH frequency distributions. Single‐channel 24 h oesophageal pH monitoring was performed in 26 healthy volunteers and 26 patients with pathological gastro‐oesophageal reflux, and five‐channel pH‐metry was performed in 14 healthy volunteers and 14 patients. The calculated pH thresholds varied between healthy volunteers from 5.0 to 6.4 in the upright position and from 4.5 to 5.7 in the supine position, but were constant between different oesophageal recording sites. In 15 and nine patients (single‐channel and five‐channel pH‐metry respectively), pH thresholds could not be determined at the distal oesophageal sites. However, the calculated pH thresholds in the proximal oesophagus were in the same range as in the control subjects. The authors conclude that the use of the conventional threshold of pH 4 leads to underestimation of the extent of gastro‐oesophageal reflux, but are reluctant to advocate the use of higher thresholds

ISSN:0014-2972    

DOI:10.1046/j.1365-2362.1996.104249.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

Concentrations andex vivoproduction of interleukin‐1β (IL‐1β), tumour necrosis factor‐α (TNF), interleukin‐6 (IL‐6), interleukin‐1 receptor antagonist (IL‐1RA) and TNF soluble receptors were followed in bronchoalveolar lavage (BAL) fluid and blood from 10 HIV‐seronegative patients withPneumocystis cariniipneumonia (PCP) and compared with values found in healthy volunteers. During the acute phase of PCP, TNF but not IL‐6 or IL‐1β was detectable in BAL fluid. At that time, plasma concentrations of the proinflammatory cytokines were low, whereas plasma concentrations of the anti‐inflammatory cytokines were high. Theex vivoproduction capacity of proinflammatory cytokines was suppressed in the acute phase, in the blood as well as at the site of infection. During convalescence the production capacity of the blood cells normalized. The IL‐1RA production capacity of the alveolar cells was also suppressed in the acute phase, b

ISSN:0014-2972    

DOI:10.1046/j.1365-2362.1996.118253.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

The research described here provides one mechanism of uniting current effects of nitric oxide (NO) with the elevated levels of homocysteine detected in patients with cardiovascular and other disease. Time‐ and dose‐dependent studies of the inhibition of purified mammalian methionine synthase by NO were performed. Thein vitrostudy gave an effective IC50value of 3 μmol L‐1. Methionine synthase converts cellular homocysteine to methionine and is a major enzyme in the biosynthetic pathways for folates,S‐adenosylmethionine and biological methylations, sulphur amino acids and polyamines. Nitric oxide‐induced inactivation of methionine synthase alters the levels of these metabolites and could therefore provide a connection between the cardiovascular effects of NO, the plasma homo‐cysteine levels and cardiovascular diseases that is complementary to the more traditional NO‐induced stimulation of guanylate cyclase and the convertion of homocysteine to oxidized s

ISSN:0014-2972    

DOI:10.1046/j.1365-2362.1996.122254.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY