Control of diarrhoeal disease in Tonga 1978-83.

Tonga, like many developing countries, suffers from a shortage of medical staff and a high morbidity and mortality from paediatric diarrhoeal disease. In 1980 a programme was started to train medical assistants and village administrators in the correct use of oral rehydration salt solution for rehydration. The effect on morbidity, mortality, and admission to hospital over the six years 1978-83 was assessed. After the introduction of the scheme the number of deaths due to diarrhoea fell considerably and the state of hydration in children admitted to hospital with diarrhoea greatly improved. It is recommended that similar programmes be adopted where clinical problems of diarrhoea with dehydration persist. Instruction in the use of oral rehydration fluid was most effectively given by non-medical staff to groups of mothers, rather than by paediatricians in their inevitably brief, although important, explanation given in hospital.

Effects of diet composition and fasting on glucose turnover in lean and polygenic obese mice.

Effects of high beef tallow (BT), high corn oil (CO) or low-fat (LF) diets upon the outcome of genetic obesity were investigated. Diets were instituted ad libitum at the time of weaning. When mice were six months of age, blood samples were taken 1, 5, 15, 30, and 60 minutes after intravenous injection of glucose-U-14C. Within dietary treatments, obese and lean mice showed similar plasma glucose-U-14C disappearance patterns. Plasma glucose disappearance always tended to be faster in ad libitum-fed mice relative to 24-hour fasted mice. Body glucose pool sizes tended to be larger in fed obese BT and LF mice compared to their lean counterparts. This pattern was not seen in non-fasted CO mice. Fasting caused a decrease in body glucose pool sizes in all mice. In contrast to CO and LF mice, lean BT mice appeared to conserve glucose during fasting the same as the obese line. Since the glucose disappearance curves can be described by a two-exponential decay function, at least a two-component or two-pool system must be involved in plasma glucose turnover. Calculated rate constants were used to express interchanges of carbon molecules between the glucose and glycogen pool and the net movement of glucose carbon to a carbon pool representing "irreversible end products". The data indicate that differences in glucose metabolism, in part, explain the possibility that dietary energy source can overcome the genetic tendency to leanness.

The effect of ethanol and/or acetaldehyde on the incorporation of U14C-glucose into human umbilical artery lipids.

The effect of ethanol, acetaldehyde and a combination of ethanol and acetaldehyde added in vitro was determined on their abilities to alter conversion of glucose to lipid. When human umbilical arteries were perfused with acetaldehyde at a 0.5% concentration, a significant reduction (p less than 0.05) of 14C incorporation into lipid was observed. This reduction was found to be the result of depressed incorporation of glucose into phospholipid (PL) and triacylglycerides (TG). Acetaldehyde at a concentration of 0.25% appeared to depress incorporation; however, this was not significant. Acetaldehyde plus ethanol at final equal concentrations of 0.25%, 0.5% and 1.0% had no effect on incorporation of U14 C-glucose into lipid. Ethanol at concentrations of 0.5%, 0.25% and 0.125% had no effect on the incorporation of U14 C-glucose into lipid. The study suggests that acetaldehyde can depress the conversion of glucose into umbilical artery lipids. However, acetaldehyde in the presence of equal concentrations of ethanol does not exhibit this ability to depress conversion of glucose to lipids suggesting some cellular counter effect of these two agents.

Electrophoretic evaluation of sera from dogs with cancer.

A quantitative electrophoretic method was developed for evaluating sera from dogs with naturally occurring malignant tumors. Electrophoretic migration ratios (EMR) were devised to standardize characteristic protein components and to analyze alterations in mobility of these protein components, using a computerized densitometric technique. Sera values from dogs with lymphosarcomas, osteosarcomas, and mammary tumors were compared, using conventional methods of statistical analysis. Results indicate a statistical difference existed between mean values of EMR and alpha2-globulins of sera from dogs with tumors and those values from normal dogs. In addition, unique EMR and concentration of protein components were identified for dogs with lymphosarcomas, osteosarcomas, and mammary tumors.

Kinetic analysis of cholesterol turnover in rat tissues.

A number of studies have been conducted on serum cholesterol disappearance following a single injection of tracer. They have shown 2 or 3 component curves depending on the length of time of observation. They have been interpreted to indicate pools of cholesterol in fast or slow equilibrium with serum and generally depicted as representing groups of tissues. A cholesterol kinetic study was conducted using rats so that each tissue could be analyzed for appearance-disappearance of cholesterol from 30 minutes to 75 days. Serum and liver appeared to die-away for 30 days in a 2 component configuration, then exhibited a repetition of the same curve in the next 30 days. Skeletal muscle and kidney had a slow buildup for 2 weeks, then a plateau for 2 weeks then a 2 component die-away. Adipose showed a high plateau from 30 minutes to 30 days then a 2 component die-away, with specific activity higher than serum at all times. The data are interpreted to indicate that adipose tissue sequestered part of the tracer dose and all tissues reached equilibrium at about 30 days. After that time all tissues had a statistically significant 2 component die-away curve. The mathematical models tested suggest that in the steady state, cholesterol enters and exits the slow pool of serum, kidney, muscle and adipose and in liver enters both pools. Interpretation of the complete die-away is that the tracer dose first equilibrates with membrane free cholesterol, then with the intracellular cholesterol, and finally dies-away at the rate of release by the slow intercellular pool.

Failure of phenobarbitone to prevent febrile convulsions.

One-hundred-sixty-five children without known neurological disorder who presented with their first febrile convulsion between the ages of six months and three years were assigned to daily phenobarbitone treatment or to a control group and followed up at a special clinic for six months. One-hundred-and-sixty-one-one children completed the trial, and of the 88 children assigned to phenobarbitone treatment 10 had further convulsions during this period compared with 14 of the 73 control children. Only 49 of those assigned to phenobarbitone took the drug regularly throughout the trial, and four of these had further febrile convulsions, a proportion not significantly different from that in the controls. All four had mean plasma phenobarbitone concentrations over 69 mumol/l (16 mug/ml) during the trial and in three the plasma concentration was at or over this figure within eight hours over 69 mumol/l (16 mug/ml) during the trial and in three the plasma concentration was at or over this figure within eight hours of the repeat convulsion. Regular phenobarbitone does not seem to prevent febrile convulsions. Attention should instead be directed to organising emergency services to allow early termination of fevrile convulsions, whether first or subsequent, to prevent irreversible brain damage.