Children-in-law in caregiving families.

Data were collected from 252 coresident caregiving daughters and daughters-in-law and their husbands. We hypothesized that biological children would give more care than children-in-law and that children-in-law would have very different caregiving experiences and resultant appraisals than biological children. Contrary to our hypotheses, we found that the experiences are very similar for biological children and children-in-law in caregiving families. We suggested that the important factor is not the relationship to the elder that has the impact--it is the quality of the relationship with the elder that is consistently significant.

Accuracy of biplane long-axis left ventricular volume determined by cine magnetic resonance imaging in patients with regional and global dysfunction.

Left ventricular (LV) volumes and ejection fraction can be obtained by applying Simpson's rule to multiple short-axis tomographic planes. A simpler method for determining LV volumes using the area-length equation is widely accepted and requires less time to acquire and analyze. Its accuracy, however, is questionable in deformed or asymmetrically contracting ventricles. This study compares biplane long-axis to serial short-axis computed LV volumes obtained by cine gradient-echo magnetic resonance imaging (MRI) in 2 distinct patient populations: (1) patients with global LV dysfunction, and (2) patients with regional LV dysfunction. A total of 114 patients were studied using both methods. Among 37 patients with global LV dysfunction, there was no statistically significant difference between methods (long axis vs short axis) for determining LV end-diastolic volume (203 +/- 91 vs 201 +/- 90 ml), end-systolic volume (142 +/- 81 vs 141 +/- 82 ml), and ejection fraction (33 +/- 12 vs 33 +/- 13%). However, in the 77 patients with regional dysfunction, LV end-diastolic volume was statistically slightly higher when obtained using the long-axis approach (157 +/- 53 vs 152 +/- 51 ml; p=0.004). Otherwise, end-systolic volume (97 +/- 49 vs 95 +/- 49 ml) and ejection fraction (40 +/- 13 vs 40 +/- 13%) were similar (p=NS). The correlation between LV volumes and ejection fractions for both groups was excellent (r >0.91). Thus, in this study group, biplane long-axis and serial short-axis computed LV volumes and ejection fractions were similar in patients with global or regional LV dysfunction. In critically ill patients unable to complete a comprehensive MRI examination, the biplane long-axis-derived volumes provide adequate data.

Placebo-controlled trial of ulcerative colitis with oral 4-aminosalicylic acid.

Forty patients with active ulcerative colitis were randomly assigned to receive either 4 g of oral enterically coated 4-aminosalicylic acid (para-aminosalicylic acid) or placebo. The duration of treatment was 12 weeks. Disease activity was assessed by grading clinical symptoms of blood, mucus, urgency, sigmoidoscopic findings, and degree of histological inflammation in rectal biopsy specimens. At 12 weeks, 11 of 20 patients (55%) who received 4-aminosalicylic acid showed improvement in clinical and sigmoidoscopic variables. In contrast, only 1 of 20 patients (5%) who had received placebo showed improvement (P less than 0.005). Eighteen of the 19 patients in the placebo group who showed no improvement were treated subsequently with open-label 4-aminosalicylic acid. Of the 18, 11 showed clinical and sigmoidoscopic improvement. Patients allergic or intolerant to sulfasalazine with extensive disease were more likely to respond to 4-aminosalicylic acid.

Direct visual detection of aflatoxin synthesis by minicolonies of Aspergillus species.

Single-spore colonies of Aspergillus flavus and Aspergillus parasiticus, grown for 4 to 5 days at 25 degrees C on a coconut extract agar containing sodium desoxycholate as a growth inhibitor, produced aflatoxin, readily detectable as blue fluorescent zones under long-wave (365 nm) UV light. Over 100 colonies per standard petri dish were scored for aflatoxin production by this procedure. Progeny from some strains remained consistently stable for toxin production after repeated subculture, whereas instability for toxin synthesis was revealed among progeny from other strains. Spore color markers were used to rule out cross-contamination in monitoring strains. A yellow-spored and nontoxigenic strain of A. flavus, reported previously to produce aflatoxin in response to cycloheximide treatment, proved to be toxin negative even after repeated exposure to cycloheximide. Extended series of progeny from another strain of A. flavus and from a strain of A. parasiticus were each compared by this plating procedure and by fluorometric analysis for aflatoxin when grown in a coconut extract broth. Both of these strains showed variation for toxin synthesis among their respective progeny, and specific progeny showed a good correlation for aflatoxin synthesis when examined by the two procedures.

Improved method of screening for aflatoxin with a coconut agar medium.

Nine isolates of Aspergillus flavus and Aspergillus parasiticus were screened for aflatoxin production on a coconut extract agar medium. Aflatoxin-producing colonies were detected under long-wave UV light (365 nm) by blue fluorescence on the reverse side after 2 to 5 days of growth. Aflatoxin production was verified by chemical analysis. Several types of shredded coconut available in the United States were tested and found to be satisfactory. No additives were required. Various parameters affecting the test were investigated.

In Vitro Growth of Acremonium coenophialum, an Endophyte of Toxic Tall Fescue Grass.

Acremonium coenophialum, an endophytic fungus present in toxic tall fescue grass and seed, grew very slowly or not at all with conventional media and cultural practices. However, a considerable increase in growth was achieved in a relatively dilute medium consisting solely of glucose and yeast extract. The optimal levels of glucose and yeast extract were 3 to 6% and 0.35% (wt/vol), respectively. The addition of salts which lowered the pH suppressed growth. Even when the pH was controlled, the addition of KH(2)PO(4) at a level of 3.2% or more greatly inhibited growth. A. coenophialum grew better in shake culture than in stationary culture. The optimal temperature was 23 degrees C, and the optimal pH was 6.5.

A toxic metabolite of Nigrospora oryzae (Berk and Br.) petch.

Nigrospora oryzae was isolated from dallisgrass (Paspalum dilatatum Poir.) collected in Auburn and from hay shipped under refrigeration to Florida. Some of these samples were eaten by cattle and horses that subsequently developed lameness. Metabolites of N. oryzae were separated by thin layer chromatography and tested for toxicity. Only one metabolite was toxic. Metabolite A showed toxicity to brine shrimp with an LD50 = 500 micrograms/ml in 8 h. It also had an antibiotic effect on Bacillus megaterium ATCC 14581 with a minimum inhibitory level of 10.1 micrograms/disc. As little as 435 micrograms of a crude methanolic extract of N. oryzae showed mild toxicity to chick embryos. The metabolite was not toxic to mice nor rats at the levels tested. Quantitative procedures developed for the determination of metabolite A showed that the maximum production occurred in yeast extract-sucrose liquid medium with an initial pH of 5-6, when incubated as a stationary culture for 28 days at 25 degrees C. It was concluded that metabolite A is a weak antibiotic rather than a mycotoxin, and was probably not associated with the symptoms of lameness observed in cattle and horses. The antibiotic is not one previously reported for N. oryzae.

Effects of aflatoxin on the growth performance and immune responses of weanling swine.

Aflatoxin (AF)-contaminated ground corn was mixed with a commercial swine ration to yield 2 concentrations (500 mg of AFB1/kg of feed [A] and 300 mg of AFB1/kg [B]) and was fed to 2 groups of pigs. Groups A and B were fed the AF-containing ration, whereas control group C was fed the same commercial ration mixed with ground corn devoid of AF. A comparative analysis of the average weight gain per pig in each of the treatment groups, compared with that in the control group, indicated a significantly (P less than 0.01) greater weight gain in the control group. The average feed conversion rate was also significantly (P less than 0.01) lower in group A pigs, compared with that in the control group. The humoral immune response to Erysipelothrix rhusiopathiae, measured by enzyme-linked immunosorbent assay, did not reveal a significant difference among groups; there were no consistent differences observed in the proliferative responses of lymphocytes to mitogens. In contrast, a significant (P less than 0.05) reduction in complement titers was observed, whereas an increase in serum immunoglobulin G and M values occurred in the AF-treated group A, compared with that in group C. Gross enlargement of the liver, substantiated by histologic evidence of toxic damage to the hepatic parenchyma, revealed that AF at concentrations of 500 mg/kg of feed was toxigenic and produced an adverse effect on the growth rate, feed efficiency, and general well-being of young pigs.

Effects of aflatoxin on young turkeys and broiler chickens.

The effect of crude aflatoxin (AF) on the growth, performance, and immune response of turkeys and broilers was studied. Crude AF, produced from a natural outbreak of Aspergillus flavus on corn, was ground and mixed in rations to contain either 0, 100, 200, 400, or 800 ppb of aflatoxin B1 (AFB1). Turkeys (Experiment 1) and broilers (Experiment 2) were used in identical experimental designs. In each, 200, 14-day-old birds were divided equally by sex into five groups of 40 and were fed one of five AF diets for 35 days. In Experiment 1, crude AF greater than or equal to 400 ppb was highly toxic to turkeys. These levels produced signs and lesions of aflatoxicosis as well as a significant decrease in weight gain and feed conversion during 5 weeks. In addition, microscopic lesions, indicative of aflatoxicosis, were evident as low as 100 ppb, and significant decreases in cell-mediated immunity were noted in the 200 ppb group birds. Experiment 2 indicated that chickens were less susceptible to crude AF than turkeys. Neither morbidity nor mortality occurred in broilers. Gross lesions consistent with AF toxicity were evident in birds given 800 ppb and microscopic lesions were observed in birds given 100 ppb. Feed conversion was significantly increased in the 800 ppb broilers only. Cell-mediated immunity, measured by a delayed hypersensitive skin test, was significantly decreased in broilers receiving AF at 200 ppb or greater. Neither humoral immunity nor the development of the acquired immunity to Newcastle disease or fowl cholera vaccination were decreased in turkeys or broilers given AF.

Predictive value of a low serum trypsinogen.

Previous studies, in selected populations, have determined that a low serum trypsinogen can be seen in chronic exocrine pancreatic disorders (CP) and primary diabetes mellitus (DM). In this study, we investigated the predictive value of a low serum trypsinogen. The study population consisted of 488 consecutive emergency room patients admitted to our hospital on whom a serum amylase was drawn by the emergency room staff. Of the sera drawn, 418 were saved and tested for immunoassayable trypsinogen. Ten of 418 (2.4%), had a low level of this marker (less than 10 ng/ml). Of these 10, four had obvious historical or clinical evidence of CP during their initial hospitalization. Six patients, however, had no initial evidence of CP. Follow-up was obtained in three of the six, and all three had evidence of CP despite absence of symptoms. Of the 418 patients, 37 had DM. A low trypsinogen was found in three of these 37, and all three had concomitant CP. We conclude that this new assay has excellent predictive value in diagnosing chronic exocrine pancreatic disorders.

Diagnostic assays in acute pancreatitis. A study of sensitivity and specificity.

The sensitivity and specificity of five assays used to diagnose acute pancreatitis were studied: two amylase assays; one lipase; one trypsinogen; and one pancreatic isoamylase. Thirty-nine patients with acute pancreatitis were compared to 127 controls with abdominal pain. Using the upper limit of normal both amylase assays appeared sensitive but somewhat nonspecific (specificities of 88.9% and 86%, respectively). The trypsinogen and pancreatic isoamylase assays were also relatively nonspecific (specificity of 82.8% and 85.1%). Most nonspecific elevations occurred between a one- and twofold elevation of each assay. Lipase, however, maintained excellent specificity (99%) at its upper limit of normal. If the level of best cutoff is used instead (the level that best enhances sensitivity and specificity), the specificities of both amylase assays, as well as the trypsinogen and pancreatic isoamylase assays, exceed 95%. At the best cutoff level, trypsinogen maintains a qualitative advantage in sensitivity over lipase or pancreatic isoamylase (97.4% as compared to 86.5% and 84.6%).

Effects of purified aflatoxin on broiler chickens.

Purified aflatoxin B1 (AFB1) or AFB1 plus aflatoxin B2 (AFB2) was given daily for 5 weeks in gelatin capsules to 2-week-old feather-sexed broilers. In Experiment 1, pure AFB1 was given in doses equivalent to the quantity of toxin received, if diets containing either 0, 200, 500 or 1000 ppb of AFB1 were consumed. In Experiment 2, pure AFB1 or AFB1 plus B2 was administered in capsules in doses equivalent to the quantity of toxin received, if diets containing either 0, 100, 200, or 400 ppb of AFB1 were consumed. In Experiment 1, pure AFB1 greater than or equal to 500 ppb was only mildly toxic. These levels produced a significant decrease in the 5-week weight gain and microscopic lesions indicative of alfatoxicosis. No morbidity, mortality, or effects on feed conversion or immune responses, however, were noted in birds given pure AFB1 at these levels. Gross liver lesions indicative of aflatoxin toxicity occurred at the 1000 ppb only. Results of Experiment 2 were similar to the first. Weight gain and feed conversion were not affected for broilers receiving pure AFB1 as low as 200 ppb. No morbidity, mortality, or gross lesions were evident in birds given either pure AFB1 or AFB1 plus AFB2 as high as 400 ppb. However, cell-mediated immunity as measured by a delayed hypersensitive skin test was significantly affected in birds receiving 400 ppb AFB1 plus AFB2. No effects on humoral immunity or the development of acquired immunity to Newcastle disease or fowl cholera vaccination were noted.

Effect of purified aflatoxin on turkeys.

Purified aflatoxin B1 (AFB1) or AFB1 plus aflatoxin B2 (AFB2) was given daily for 5 weeks in gelatin capsules to 2-week-old Nicholas X Nicholas turkeys. In Experiment 1, pure AFB1 was given in dosages equivalent to the quantity of toxin received if diets containing either 0, 200, 500, or 1000 ppb of AFB1 were consumed. In Experiment 2, either pure AFB1 or AFB1 plus AFB2 was given in capsules equal to the quantity of toxin received if a diet containing either 0, 100, 150, or 200 ppb of AFB1 was consumed. In Experiment 1, pure AFB1 administered by capsule equal to 500 and 1000 ppb was highly toxic and by the second week, it resulted in 100% morbidity, mortality, and gross and microscopic lesions. Aflatoxin B1 at 200 ppb caused none of these changes. However, it did cause a significant depression in feed conversion, but not weight gain, during all weeks and also a reduction in cell-mediated immunity (CMI) as measured by a delayed hypersensitive skin test to mycobacterium. Results in Experiment 2 were similar to the first. Aflatoxin B1 and AFB1 plus AFB2 as high as 200 ppb resulted in no morbidity, mortality, or gross or microscopic lesions. Also, no significant reductions in either weight gain or feed conversion were evident in any level of either AFB1 or AFB1 plus AFB2. However, numerical, but not statistically significant, dose-related reductions in all CMI tests were noted in birds receiving either AFB1 or AFB1 plus B2 at as low as 100 ppb.

Association of an endophytic fungus with fescue toxicity in steers fed Kentucky 31 tall fescue seed or hay.

Previous research has implicated an endophytic fungus as being associated with fescue toxicity (summer syndrome) in cattle grazing Kentucky 31 tall fescue (Festuca arundinacea Schreb.) pastures. Hay and seed were harvested from Kentucky 31 pastures known to be either fungus-free or heavily infested with an endophytic fungus identified as Acremonium coenophialum Morgan-Jones and Gams. Four diets containing either 60% fungus-free seed, 60% fungus-infested seed, 85% fungus-free hay or 85% fungus-infested hay were group-fed to three steers each (avg wt 239 kg) in a 53-d feeding trial. Presence of the fungus reduced (P less than .05) daily gains (kg/d) in steers fed either the seed diets (.96 vs .20) or the hay diets (.66 vs .28). Feed intake was depressed 36% for the seed diets and 8% for the hay diets when the fungus was present. Rectal temperatures were elevated .6 C (P less than .05) for both groups receiving diets containing the fungus, but respiration rate was elevated only in the fungus-infested seed group. In vitro dry matter disappearance was not decreased by presence of the fungus. Steers receiving fungus from either seed or hay were nervous and highly excitable, which resulted in large variations in plasma epinephrine and norepinephrine concentrations. The results of this experiment further implicate an endophytic fungus as being associated with fescue toxicity.

Improved fluorometric-iodine method for determination of aflatoxin in corn.

Several innovations in the fluorometric-iodine (FL-I) method for determining aflatoxin in corn made the procedure faster and more convenient than the original method. Ground corn was packed into a chromatographic column and the aflatoxins were extracted with methylene chloride. Sep-Pak C18 cartridges were used for sample cleanup. A 5 min thin layer chromatographic slide analysis confirmed the presence of aflatoxin, which was quantitated by fluorometric determinations of the iodine derivative of aflatoxin B1.

Toxigenicity of fungi from grain sorghum.

The mycoflora of nine varieties of grain sorghum was determined by plating serial dilutions of ground samples on rose bengal-streptomycin agar. Seventeen species of fungi representing 10 genera were identified. Curvularia, Penicillium, Mucor, and Aspergillus were dominant genera. Extracts of P. herquei were highly toxic to brine shrimp, while those of C. clavata, C. lunata, and Mucor mucedo showed low to moderate toxicity. Extracts of C. clavata, C. lunata, and M. mucedo were highly toxic to chicken embryos; those of six other species showed low to moderate toxicity. Extracts of C. clavata, C. lunata, M. mucedo, Fusarium moniliforme, Alternaria tenuissima. P. herquei, and P. steckii showed varying degrees of toxicity to day-old cockerels.

Penitrem A and Roquefortine Production by Penicillium commune.

Extracts of Penicillium commune, a fungus isolated from cottonseed, showed biological activity in day-old cockerels. Two neurotoxic metabolites were isolated and identified as penitrem A and roquefortine. This is the first report of roquefortine being produced by a fungus other than Penicillium roqueforti as well as the first report of penitrem A and roquefortine being produced in the same culture. Production of these toxins on liquid media and cottonseed was determined.

Protocols for surveys, sampling, post-collection handling, and analysis of grain samples involved in mycotoxin problems.

This report examines and summarizes current knowledge regarding mycotoxin surveys, sampling techniques, conditions conducive to post-collection production of mycotoxins in grain samples, and analytical methods for mycotoxin analysis. Priority attention is given to samples of corn suspected of containing aflatoxin. The report includes recommendations where deems appropriate by the Ad Hoc Work Group.