Metallothionein induction in islets of Langerhans and insulinoma cells.

Isolated pancreatic islets from rat and mouse and the insulinoma cell lines, betaHC9 and RINm5F, were investigated to determine the regulation of metallothionein (MT). Dexamethasone (DEX) increased rat and mouse islet and insulinoma cell MT levels in a time- and concentration-dependent manner. Rat islet MT expression was increased with interleukin-1beta (IL-1beta), but not tumor necrosis factor-alpha (TNF). However, MT induction by IL-1beta and TNF was synergistic with DEX in rat islets and insulinoma cells. Mouse islet MT failed to respond to IL-1beta alone, although IL-1beta and TNF were synergistic. IL-1beta and TNF did not synergize with DEX for mouse islet MT induction. Zinc sulfate induced MT in rat islets but not mouse islets. MT messenger RNA levels were significantly increased in rat islets in response to DEX and IL-1beta plus DEX. The inducible nitric oxide synthase inhibitors N(G)-monomethyl-L-arginine and aminoguanidine failed to inhibit IL-1beta induced MT levels in insulinoma cells, and the nitric oxide generating agent sodium nitroprusside failed to significantly affect MT levels. Phorbol dibutyrate increased MT levels in rat islets and betaHC9 cells, but phorbol dibutyrate and IL-1beta effects were not additive. Transgenic MT-null and wild-type mouse islets had similar insulin contents, but basal and glucose-stimulated insulin release from MT-null islets were significantly lower than in wild-type islets. Blood glucose levels in MT-null mice were, however, slightly lower than those in wild-type mice. Thus, MT induction in pancreatic islets and beta-cells is regulated by cytokines and DEX, and protein kinase C activation may play a role. However, regulation of MT induction in mouse and rat islets differs. MT also appears to modulate insulin release from pancreatic islets.

Nineteen cases of plague in Arizona. A spectrum including ecthyma gangrenosum due to plague and plague in pregnancy.

We review the cases of 19 successfully treated plague patients, with emphasis on the clinical and epidemiologic features of the disease. Proper staining and culturing of bubo aspirates; prompt institution of streptomycin, chloramphenicol or tetracycline therapy in presumptive cases, and supportive care are the crucial factors in the treatment of plague. This disease should be considered in patients in a toxic condition who have lymphadenitis, pneumonia or septic shock and who have been in endemic areas within the past ten days.

Nutritional assessment of pregnant and lactating Navajo women.

Nutritional parameters of 87 Navajo women were assessed at term and in 23 of these women after 1 month of lactation. Serum levels of zinc, retinol-binding protein, folacin, protein, Hb, and ferritin and hair zinc content were determined. Twenty-four-hour dietary recalls were recorded for the subsample of 23 women. Median nutrient intakes were less than 60% of the Recommended Dietary Allowance of calcium, magnesium, zinc, copper, vitamins A (lactation only), D, E, and B6, biotin, and folacin. Serum zinc fell below 50 microgram/dl in 68% of the subsample at term and remained below 65 microgram/dl 43% during lactation. Serum retinol was below normal ( less than 33 microgram/dl) in 24% of these women at term and 23% at 1 month. Low serum folacin (less than 6 ng/ml) was detected in 9% at term and 24% at 1 month. Anemia was present in 15 to 20% of the women. Serum protein, retinol-binding protein, ferritin, and hair zinc were essentially normal. Biochemical findings confirmed dietary inadequacies among Navajo women and indicate needed nutritional improvement.

Protein and calorie malnutrition among preschool Navajo Indian children, a follow-up.

A follow-up study was conducted on the infant and child-feeding programs to determine the prevalence of protein and calorie malnutrition among preschool Navajo Indian children. These programs were introduced on the reservation in 1968. The numbers of patients admitted to the Public Health Service Indian Hospital, in Tuba City, Arizona, with deficits in weight for their chronological ages, marasmus, and kwashiorkor were compared during two 5-year-periods, 1963 to 1967 and 1969 to 1973. The results show an 18% reduction in the total number of patients under 5 years of age admitted to the hospital and a 39% reduction in the number of patients admitted with deficits in weight for their chronological ages. Marasmus has practically disappeared, with only two cases described since the end of fiscal 1969. The number of cases of kwashiorkor has also decreased by 50%, mainly in the last 4 years. The height and weight data on 1,462 Head Start children from all over the reservation were measured in September 1973, and these measurements were compared with data obtained in September 1967. While they still show a significant deviation from the Boston growth curves, there is a definite improvement from 1967 to 1973. This improvement was especially noticeable in height. Thirty percent of the girls and 30% of the boys fell below the 3rd percentile for Boston in 1967. In 1973, these figures were 11% and 16%, respectively. In the case of the girls in 1973, the numbers below the 3rd percentile are significantly smaller for younger girls than for the older girls, suggesting that the growth retardation occurred in the first 2 years of life, and that the older children had not received the full benefit of the free infant formula feeding programs. This trend, however, was not present in boys. It is concluded that the infant and child feeding programs have contributed to improved growth among Navajo preschool children. At the same time, concern is expressed that these feeding programs will be replaced by a Food Stamp Program and that the gains made will be reversed. Concern is also expressed for the regressive effects of inflation and rising food prices and the effects they will have on the nutritional status of the Navajo people.