Autoclave and beta-amylolysis lead to reduced in vitro digestibility of starch.

In this study, a combination of autoclave and beta-amylolysis was used to modulate the digestibility of normal corn starch (NCS) and wheat starch (WS). The modification procedure comprised three cycles of autoclave at 35% moisture content and 121 degrees C, beta-amylolysis, and one additional cycle of autoclave. Starch materials were sampled at each stage and characterized. The fine structure of starch was determined using high-performance size-exclusion chromatography, the micromorphology of starch dispersion was imaged using cryo-SEM, the crystalline pattern was evaluated using wide-angle X-ray powder diffraction, and the digestibility was measured using Englyst assay. After beta-amylolysis, amylose was enriched (from 25.4 to 33.2% for NCS and from 27.5 to 32.8% for WS) and the branch density was increased (from 5.2 to 7.7% for NCS and from 5.3 to 7.9% for WS). Cryo-SEM images showed that the autoclave treatment led to the formation of a low-swelling, high-density gel network, whereas beta-amylolysis nearly demolished the network structure. The loss of A-type crystalline structure and the formation of B- and V-type structures resulted from autoclave, which suggests the formation of amylose-based ordered structure. Englyst assay indicated that, due to beta-amylolysis, the resistant starch (RS) content was increased to 30 from 11% of native NCS and to 23 from 9% of native WS. In contrast, autoclave showed only minor impact on RS levels. The increase of RS observed in this study is associated with enhanced branch density, which is different from the four types of RS commonly defined.

Properties of starch subjected to partial gelatinization and beta-amylolysis.

The overall objective of this research is to understand the impact of partial gelatinization and beta-amylase hydrolysis (beta-amylolysis) on the physicochemical properties of starch. Three starches (normal corn, waxy corn, and wheat) were chosen as test examples and thermally treated at 40% moisture content to up to 95 degrees C and then subjected to beta-amylolysis. The enzyme treatment resulted in over 10% maltose yield. Subsequent debranching analysis showed the production of chain stubs as short as having the degree of polymerization of 2 and 3, suggesting a thorough beta-amylolysis at certain branch locations. For starch samples subjected to partial gelatinization, polarized light microscopy shows reduced intensity of birefringence and differential scanning calorimetry shows reduced enthalpy change associated with gelatinization. Both indicate the reduced chain organization due to the treatment. Further, a substantial transformation of initial A-type crystalline structure to B- and V-types upon treatments is noticed from X-ray powder diffraction measurements. In addition, the rapid viscosity analysis (RVA) indicated a drastic viscosity reduction, increased peak temperature, and improved stability of pasting behavior due to hydrothermal treatments and beta-amylolysis. Overall, our results point out the possibility of obtaining modified starches having desirable stable pasting behavior by using a combined partial gelatinization and beta-amylolysis approach.

Brain metastases from unknown primary site.

We report our experience with 32 patients presenting with brain metastasis from unknown origin. This constitutes 11.5 percent of 276 consecutive patients with brain metastasis seen over a period of eight years at the University of Mississippi Medical Center. Patients with solitary resectable lesion underwent surgery followed by irradiation. All patients with multiple metastasis were treated with whole brain radiation and dexarnethasone. The mean survival was 31.50 weeks for patients with single lesion and 19.11 weeks for multiple lesions. The investigations and treatment management of brain metastasis from unknown primary site are discussed.

Survival of carcinoma of the prostate patients less than 55 years old compared to older patient groups.

Both incidence and death rate from cancer of prostate are rising. Prostate cancer is the most common malignancy in man and second most common cause of death in men. Lung cancer is the leading cause of death in men. Carcinoma of prostate is generally a disease of older men. Carcinoma of prostate can also occur in the middle-aged men. This study was performed to find whether the middle-aged men survived longer than older men when both groups of patients were compared according to equivalent stage of the disease. In this series, survival is slightly better in younger age groups when patients of all stages are pooled together. Due to small number of patients in younger age groups, survival difference cannot be calculated for each stage of the disease.

Report of a prospective trial--split course versus conventional radiotherapy in the treatment of non small cell lung cancer.

A prospective randomized trial was started in January 1982, to compare morbidity and survival of two different radiation regimens for the treatment of non-small cell lung cancer (NSCLC). The trial was closed in December 1988. One group of patients was treated by conventional daily radiation therapy, and the other group by split course therapy. To maintain uniformity, a single physician staged and treated all patients and noted morbidity during treatment. Two hundred seventy-three consecutive lung cancer patients were treated. Only patients who completed the full radiation therapy course were included in this study. One hundred fourteen patients were treated with split course therapy, and 159 patients were treated by conventional daily radiation therapy. A few patients did not return for the second course of treatment, which accounts for the different number of patients in the two arms of the study. There was no statistically significant difference in survival between the two arms. Median survival for the split course and the continuous fraction therapy regimens was 11.6 months and 10.9 months, respectively. Split course radiation was associated with less morbidity.

Management of brain metastases: past, present, and future.

Brain metastasis is an important cause of morbidity and mortality in cancer patients. Because most of these patients die of systemic disease, the primary therapeutic goal is to improve the quality of life. Conventional therapy for brain metastases is usually whole-brain irradiation. Chemotherapy often results in regression of brain metastases in chemosensitive tumors. We review our institutional experience in the treatment of brain metastasis with both radiation and chemotherapy. In the future, improvement in the management of brain metastases will depend on improved chemotherapy, radiosensitizers, and radiotherapy techniques such as stereotactic radiosurgery.

Heterogeneity of a major allergen from olive (Olea europea) pollen.

Studies were carried out in order to confirm and extend knowledge of the physico-chemical properties of an allergenic material found in the pollen of the olive tree (Olea europea). The sera from 88% of patients who were sensitive to olive pollen contained IgE that reacted with a 19,000 Mr component and many also reacted to a 17,000 Mr band as shown by SDS-PAGE immunoblotting. A monoclonal antibody (OL-1) produced to the 19,000 Mr component also reacted with the 17,000 Mr band, and with bands at 21,000 and 41,000 under non-reduced conditions. HPLC separation followed by SDS-PAGE and immunoblotting of the fractions indicated that the allergen fraction from which the 19,000 and 17,000 components were derived had a mol. wt between 50 and 60 kD. Isoelectricfocusing followed by immunoblotting and development with (OL-1) indicated heterogeneity of the allergen with respect to pI values. Two of the strongest components of the six identified which reacted with (OL-1) had pIs of about 5.0 and 6.0 confirming the published data. The study therefore showed that olive pollen contains a number of allergenic components, with various mol. wts and pI values, with some epitopes in common, which may in the native state be bound together or aggregated.

Management of malignant thymoma.

Six cases of malignant thymoma were treated by various methods, i.e., surgery, radiotherapy and chemotherapy. The combination of surgery and radiotherapy seems to be the most effective method of treatment. Histology does not seem to influence survival.

Reactivity of mast-cell-bound IgE idiotypes with anti-idiotypic antibody: mediator release or inhibition of antigen-induced mediator release?

When anti-idiotypic antibodies specific for idiotopes on IgE antibodies react with mast-cell-bound IgE antibody, the reaction may be expected to lead either to mediator release or to inhibition of allergen-induced release. This study was carried out to determine which would occur. Anti-idiotype antiserum (anti-Ids) was raised in syngeneic mice by immunisation with affinity-purified DNP-specific mouse monoclonal IgE. Sera from these immunised mice and from a similarly immunised rabbit inhibited the binding of the monoclonal IgE to radio-iodinated dinitrophenylated (DNP) ovalbumin, whereas a high concentration of affinity-purified rabbit antimouse epsilon-chain-specific antibody was unable to inhibit even though it was shown to bind to the monoclonal IgE. The mouse anti-Ids did not give a positive passive cutaneous anaphylactic reaction in rats sensitised with high-titre grass-pollen-specific IgE-containing antiserum, whereas it gave a positive result in rats sensitised with the DNP-specific monoclonal IgE. Rabbit antimonoclonal antiserum and rabbit anti-epsilon-chain antibody both gave positive results in these two assays. The results indicated that anti-idiotypic antibodies specific for idiotopes on IgE antibody can react and release mediators from IgE-sensitised mast cells. The significance of this in view of the increased levels of anti-idiotypes that can occur during immunotherapy is discussed.

To dispose or re-use?--an evaluation of sluice room equipment.

From my own experience at this hospital, I would recommend disposable bedpans and macerators as the system of choice for hospital sluice rooms for the following reasons: (1) It saves engineering time. The machines are much simpler to maintain than bedpan washers, and the time spent is purely on mechanical maintenance or repair rather than on monitoring of performance. I estimate that our fitters spend less than half the time on maintenance or repair of macerators than they did on bedpan washers. (2) It is safer. With a macerator, when a machine failure does occur it is complete and results in an emergency call to the engineering department. With a bedpan washer, the danger is that the machine failure, ie problems with the washer arm or failure of the machine to reach disinfection temperature, will not be complete and will go unnoticed. This presents an infection control hazard, and it is inevitably considered to be the responsibility of the hospital engineers if things do go wrong. There are of course other factors to be considered when choosing sluice room equipment, such as saving of nurses time, saving of energy, cost of disposables etc. But these are part of a wider debate and not the sole concern of the unit engineer. I choose only to offer the benefit of my own experience in the installation repair and maintenance of both systems, and hope that it will be of value to other engineers.

Induction of polyclonal and monoclonal antibodies with a single allergen separated from birch pollen extract by SDS-PAGE and nitrocellulose blots.

A Gold staining allergenic band, Bet v 1, was excised from a nitrocellulose blot following SDS-PAGE of birch pollen extract. This was used to raise a polyclonal rabbit antiserum and monoclonal mouse antibodies specific only for the Bet v 1. The method offers practical advantages for the production of antibodies to individual allergens in complex extract mixtures, without laborious purification methods.

Comparison of survival of black and white patients in each stage of Hodgkin's disease during 1970-1980.

A survival and mortality study of all the patients referred to the radiotherapy department between 1970 and 1980 with a diagnosis of Hodgkin's disease was performed. Generally, black patients with cancer have a poorer survival rate compared with that of white patients with cancer, as reported by the U.S. Department of Health and Human Services. In this series, no difference in survival and mortality was found between patients of the two races when they were compared in each stage of Hodgkin's disease.

Combined therapy as an alternative to exenteration for locally advanced vulvovaginal cancer. II. Results, complications, and dosimetric and surgical considerations.

We have introduced a therapeutic alternative to exenteration for locally advanced vulvovaginal cancer using surgery for the vulvar (external genital) phase of this disease presentation, combined with radiotherapy for the internal genital phase (with adequate overlap of fields to protect surgical margins). The rationale is that this approach treats the cancer and its dual regional spread patterns, while at the same time preserving the bladder and/or rectum, and should be associated with less morbidity and mortality than exenterative surgery. This report updates our experience with a total of 48 treated cases (37 primary cases and 11 cases of recurrent disease). Of the 37 primary cases, 20 were FIGO stage III, 4 were FIGO stage IV, and 3 other cases represented "field" cancers involving vulva and/or cervix and/or vagina. Utilizing a Life Table analysis, the 5-year survival for the primary cases was 75.6%. Published FIGO survival for stage III is 32% and for stage IV 10.5%. Life Table analysis projects a 62.6% survival for recurrent cases and an overall 72% 5-year survival for all 48 cases treated. With 48 patients treated, 48 bladders and 48 rectums were at risk for surgical removal had exenteration been employed. One patient had a total pelvic exenteration for local failure, and one had a posterior exenteration for local failure. One bladder and one rectum were lost to permanent diversion because of radiation injury. Thus, 5 of these major viscera were lost of the 96 total, and 91 (94.8%) were retained. Radiation therapy and surgical details have been reviewed relevant to local control and local failure and complications. The continuing evolution of treatment modifications of all modalities will be discussed. The apparent advantages of this combined therapeutic approach over exenterative surgery include high probability of bladder and/or rectal preservation, low primary mortality, low treatment morbidity, and very good results in cancer control.

Carcinoma of the piriform sinus.

Carcinoma of the piriform sinus is one of the most aggressive tumors of the head and neck region. Almost 80% to 90% of the patients will be first seen in the advanced stages. No method of treatment is satisfactory. We present results of various methods of treatment, of which the combination of surgery and radiotherapy may be the best.