Independent effects of food intake and insulin status on insulin-like growth factor-I in young pigs.

The independent effects of decreased food intake and diabetic hyperglycemia on serum GH, serum IGF-I and tissue IGF-I expression were examined in young streptozotocin-diabetic pigs. Each of three treatments (control, diabetic, and insulin-treated diabetic) were represented within three levels of regulated food intake (FI) provided as three meals per day equivalent to 100, 50, and 10% of the voluntary FI consumed by the untreated diabetics. Reduction of food intake was associated with decreased body weight gains, decreased serum IGF-I concentrations, and increased serum GH concentrations. Nutrient restriction also tended to decrease the relative abundance of IGF-I mRNA in liver and skeletal muscle. Diabetic pigs with hyperglycemia and hypoinsulinemia had higher serum concentrations of IGF-I than pair-fed controls, but exogenous insulin treatment of these diabetic pigs increased serum IGF-I even further and also tended to increase the relative abundance of IGF-I mRNA in liver and skeletal muscle. When the statistical effects of reduced FI were eliminated, neither the present form of diabetes nor exogenous insulin affected serum GH. In summary, diabetes-induced changes in IGF-I in these pigs depended primarily on the reduced level of food intake occurring in these hypoinsulinemic, hyperglycemic subjects.

Side effects of alternative iron supplementation: a pilot study.

Iron deficiency anemia is a significant health problem for women. An intervention utilizing home visits by a nurse and the intake of alternate iron supplements was examined. Outcome measures of hematocrit levels and side effects are reported in this manuscript. Ten African-American inner city homeless women in transitional housing agreed to participate in this longitudinal study. Each participant was encouraged to take the alternate iron supplements for a three month period. Hematocrit values increased from recruitment through the third month. A paired t-test was significant (t value -5.39; df, 9; p < .0001). In addition, the side effect of fatigue decreased from recruitment through the third month. A paired t-test was significant (t value 3.18: df, 7: p = .015). During the weekly and monthly visits, when the subjects were asked if the supplements had any effect on their feelings of well-being, two women stated they had "little effects." In terms of side effects there were no complaints of nausea, stomach ache, or black tarry stools. Of the approximately 12 visits to each subject, constipation was reported only two times by two subjects. While the women did not report black stools they did offer that the vitamins seemed to color their stools green (three reported it one time and two subjects reported it three times). The benefits and the lack of side effects may have far-reaching implications for client populations such as the elderly and pregnant women who typically have difficulty with anemia and constipation alike. The weekly visits by the nurse may have added to the compliance and success of this program.

Relation of scores on the Open Middle Test to self-control and academic achievement of inner-city fourth-grade children.

The construct validity of the Open Middle Test, a measure of children's social problem-solving ability, was investigated by assessing its relationship to self-control (Self-control Rating Scale) and academic achievement (Wide-Range Achievement Test). Subjects were 113 minority fourth graders from two urban parochial schools. A significant correlation was obtained between Open Middle Test effectiveness scores of first responses and WRAT Reading scores. No other correlations were significant. However, mean differences were significant for Open Middle Test effectiveness ratings of first responses and chosen responses, suggesting possible deficits in the evaluation of self-generated problem solutions. Implications of the results for training programs and for the use of the Open Middle Test as an outcome measure are discussed.

Verapamil does not alter succinylcholine-induced increases in serum potassium during halothane anesthesia in normal dogs.

Six dogs were studied to determine whether verapamil pretreatment exacerbates the increase in serum potassium levels associated with succinylcholine. Dogs were anesthetized with halothane, 1.26 +/- 0% (mean +/- SEM; end tidal). Arterial blood-gas tensions, blood pressure, heart rate, temperature, and serum potassium levels were measured. Each dog underwent control and experimental studies separated by seven days. In the experimental study, a 0.15 mg/kg bolus of verapamil was followed by a 4.0 micrograms X kg-1 X min-1 continuous infusion of verapamil. Normal saline was used in the control study. Succinylcholine, 1 mg/kg bolus, was given 10 min after the initial saline or verapamil bolus. Vital signs again were measured 1, 3, 5, 10, and 15 min after succinylcholine, and plasma verapamil levels were measured 8 and 15 min after verapamil administration. Serum potassium concentrations increased from 3.9 +/- 0.2 to 5.0 +/- 0.2 mEq/L in control studies and from 3.7 +/- 0.2 to 4.8 +/- 0.3 mEq/L in animals pretreated with verapamil. Verapamil pretreatment does not alter the increase in serum potassium induced by succinylcholine in normal dogs.

Pneumothorax: a complication of nerve conduction studies using needle stimulation.

Two patients developed left pneumothorax after nerve conduction studies were done as part of their evaluation for left thoracic outlet syndrome (TOS). Chest x-rays indicated a 20% and 10% left pneumothorax, respectively. Stimulation was accomplished at Erb point with a 1 1/2-inch needle electrode after unsuccessful attempts at percutaneous stimulation. Because of this complication, this procedure has been discontinued and only percutaneous stimulation at Erb's point is being used. The diagnosis of TOS is determined by other criteria.

Crohn's disease of the mouth and ovary.

A patient is presented who has granulomatous involvement of the gingiva, ileum, cecum, appendix, and ovary consistent with Crohn's disease. A discussion of the uncommon oral and ovarian lesions is presented.

Nerve conduction studies in patients treated with cis-diamminedichloroplatinum(II): a preliminary report.

We performed serial histories, physical examinations, and nerve conduction studies on seven cancer patients who were treated with cis-diamminedichloroplatinum(II). Total cumulative doses ranged from 200 to 350 mg/m2. In nerve conduction studies, three of seven patients showed subclinical, predominantly sensory, changes compatible with a peripheral neuropathy.

Oxypurinol nephrolithiasis in regional enteritis secondary to allopurinol therapy.

A patient with regional enteritis and recurrent uric acid nephrolithiasis was treated with allopurinol. While on 600 mg of allopurinol daily, she began to pass many small, soft, yellow stones. Analysis of the stones by liquid chromatographic and gas chromatograph/mass spectrometric techniques revealed that their major constituent was oxypurinol, a metabolite of allopurinol. Metabolic studies of the patient indicated that increasing doses of allopurinol were associated with increases in xanthine and oxypurinol excretion, while uric acid excretion was not reduced. This case illustrates a complication of high-dose allopurinol therapy in the treatment of uric acid nephrolithiasis.

Complications of colonic diverticulitis.

About half of the patients in whom diverticulitis develops have subsequent attacks. Recurrence increases the likelihood both of complications, such as perforation, abscess, fistula, obstruction, and hemorrhage, and of the necessity for surgical intervention. For these reasons, patients who have had two or more attacks of acute diverticulitis should be considered candidates for prophylactic resection.

Diagnosis and differential diagnosis of colonic diverticulitis.

A patient over 40 years of age who complains of lower abdominal pain, constipation or diarrhea or both, and increased flatulence should be suspected of having diverticulosis. When pain becomes more severe and persistent, diverticulitis must be considered. Diagnosis depends on roentgen demonstration of the presence of diverticula. Sigmoidoscopy and barium enema study are essential to exclude coexisting disease but in diverticulitis may need to be postponed until severe local and systemic signs of inflammation have subsided. A number of diseases can simulate diverticulitis, and differential diagnosis may present considerable difficulty. Irritable colon syndrome and acute appendicitis may be indistinguishable clinically from diverticulitis. Differentiation from carcinoma is usually not difficult, but exclusion of coexistent carcinoma may be impossible except by resection. Ulcerative colitis is also easily distinguished except when, rarely, it coexists. Crohn's disease of the colon is less easily differentiated, especially in patients over 40, in whom the two diseases often coexist. Other colonic diseases, such as ischemic colitis, and pelvic inflammatory diseases usually show characteristic features which make them readily distinguishable from diverticulitis.

Adenocarcinoma of the small bowel in association with regional enteritis. Four new cases.

Four cases of carcinoma of the small bowel following chronic regional enteritis are presented. Search of the medical literature revealed 31 other cases reported up to the present. We must entertain the possibility that chronic regional enteritis may predispose to the development of cancer of the small bowel.