Iron Metabolism in Patients Undergoing Regular Dialysis Therapy

Thirteen patients with chronic renal failure maintained on regular renal dialysis were studied. Seven proved to have iron deficiency on the basis of marrow iron studies, reticulocyte iron uptake, and saturation of the serum iron-binding capacity. They absorbed iron when given it by mouth and were able to utilize it for haemoglobin formation. Iron-deficient patients given 600 mg of ferrous sulphate daily for three months showed an increase in haemoglobin, but the failure to replace stores of iron is probably related to their relatively limited ability to absorb iron and the variable but sometimes considerable blood loss occurring with each dialysis.The loss may be occult, and prolonged iron therapy may be required. This is most safely achieved by giving iron by mouth.     

Diagnosing breast carcinoma in young women.

OBJECTIVE--To assess the individual and combined diagnostic accuracy of clinical examination, mammography, and fine needle aspiration biopsy in young women with breast cancer. DESIGN--Analysis based on case notes of patients presenting with breast cancer during 1971-89. SETTING--A combined breast clinic. PATIENTS--Consecutive series of 81 women aged less than 36 with histologically proved breast cancer presenting with a discrete mass over 19 years. MAIN OUTCOME MEASURES--Results of clinical examination, xeromammography or conventional mammography, fine needle aspiration biopsy, and examination of tissue removed by surgery. RESULTS--The clinical diagnosis was correct in 47 women and radiography in 35. Fine needle aspiration biopsy was correct in 47 of the 63 women in whom it was successfully performed. Fine needle aspiration was significantly more accurate than mammography (78% v 45%, p less than 0.01). Ten (16%) patients had negative results on clinical examination, mammography, and fine needle aspiration. CONCLUSION--Mammography alone seems inadequately sensitive to detect breast cancer in young patients. When all investigations give negative results excision biopsy is the only way of obtaining a definitive diagnosis.     

Phenotypic characteristics of Serpulina pilosicoli the agent of intestinal spirochaetosis

Abstract This study showed that the antigenicity of a malarial epitope increased with the length of the epitope when inserted at positions aa²⁶ (amino acid position 26) and aa¹⁹⁶, but not at aa²¹³, of the Pseudomonas aeruginosa major outer membrane protein OprF (326 amino acids). Immunization studies showed that a 19-aa epitope was significantly more immunogenic than a 7-aa epitope when inserted at aa²⁶ of OprF, while neither an 11 - nor a 19-aa epitope fused to the C-terminus of glutathione 5-transferase was immunogenic.     

The Collembolan,oudemansia Esakii,an Intertidal Marine Insect in Hong Kong,with Emphasis on the Floatation Method of Collection

Summary Oudemansia esakii is shown to be a truly marine insect as all stages of the life cycle are found in intertidal sand in Hong Kong. The motile stages migrate vertically and forage during low tide, but burrow into the sand with incoming tidal conditions. An air bubble often forms around them while in the soil. Total forced immersion for 75 hours showed no harmful effects. The greatest burrowing depth is 36 cm and the optimal littoral position is three feet above low water. A floatation method using graded sieves is superior to MacFadyen's high gradient technique. Pertinent hydrographic data are included, as are biological relationships.Marine Science Laboratory, the Chinese University of Hong Kong     

Needling renal cysts and tumours: cytology and radiology.

Renal masses found by intravenous urography, ultra-sound scanning, and arteriography were needled in 102 patients. Simple renal cysts containing clear fluid and no cytological abnormalities were found in 85 patients. Two unsuspected renal cell carcinomas were found on puncture; cytological examination showed malignant cells in the aspirate. Another five renal tumours were needled deliberately before nephrectomy, and a firm preoperative diagnosis of renal cell carcinoma was made on aspiration cytology in three. Benign cysts which had bled were particularly hard to diagnose. With care, radiology and cytology in combination can provide the firm diagnostic base needed for sound clinical management. The radiology-cytology team must be alert to the unusual finding that indicates a complex lesion, such as an unsuspected renal tumour.     

Experimental results and clinical implications of the four R's in fractionated radiotherapy

Summary Experimental and clinical data on the four R's in fractionated radiotherapy are reviewed. The clinical importance of redistribution has not been proven in the experiment yet. On reoxygenation no unequivocal data in human cancer exists and a lot of variability in rodent tumours. Repair and regeneration are the most important of the four R's in fractionated radiotherapy. The presented experimental and clinical evidence suggests a differential response between tumour and late responding normal tissues with regard to these two R's. Tumours appear to have, in general, a smaller capacity for repairing sublethal radiation damage but a higher capacity for repopulation than late responding normal tissues.     

Genetic Structure and Antimicrobial Resistance of Escherichia coli and Cryptic Clades in Birds with Diverse Human Associations

The manner and extent to which birds associate with humans may influence the genetic attributes and antimicrobial resistance of their commensal Escherichia communities through strain transmission and altered selection pressures. In this study, we determined whether the distribution of the different Escherichia coli phylogenetic groups and cryptic clades, the occurrence of 49 virulence associated genes, and/or the prevalence of resistance to 12 antimicrobials differed between four groups of birds from Australia with contrasting types of human association. We found that birds sampled in suburban and wilderness areas had similar Escherichia communities. The Escherichia communities of backyard domestic poultry were phylogenetically distinct from the Escherichia communities sourced from all other birds, with a large proportion (46%) of poultry strains belonging to phylogenetic group A and a significant minority (17%) belonging to the cryptic clades. Wild birds sampled from veterinary and wildlife rehabilitation centers (in-care birds) carried Escherichia isolates that possessed particular virulence-associated genes more often than Escherichia isolates from birds sampled in suburban and wilderness areas. The Escherichia isolates from both the backyard poultry and in-care birds were more likely to be multidrug resistant than the Escherichia isolates from wild birds. We also detected a multidrug-resistant E. coli strain circulating in a wildlife rehabilitation center, reinforcing the importance of adequate hygiene practices when handling and caring for wildlife. We suggest that the relatively high frequency of antimicrobial resistance in the in-care birds and backyard poultry is due primarily to the use of antimicrobials in these animals, and we recommend that the treatment protocols used for these birds be reviewed.