Bullying in Pattani primary schools in southern Thailand.

BACKGROUND: The purpose of this research was to examine risk factors that affect the likelihood of students in Pattani primary schools bullying other children. Risk factors investigated include school rural/urban location, age, gender, religion, family physical abuse and preference of cartoon type. Identifying students who are at high risk of bullying could assist educational authorities to introduce better strategies for reducing the problem. METHODS: A total of 1440 students at public and private primary schools in Pattani province were interviewed to collect relevant data. Pearson's chi-square test was used to assess the associations between the likelihood of bullying and possible risk factors. Logistic regression was used to investigate independent associations between the predictor variables and the outcome. RESULTS: We found that 32.9% reported that they had (ever) bullied other children. Bullying was significant associated with age (odds ratio 1.56 for 11+ years, 95% confidence intervals 1.23, 2.18) and family physical abuse (odds ratio 4.50, 95% confidence intervals 3.40, 5.89). In addition, Those students who preferred action cartoons tended to bully others 1.87 times more than those who preferred watching comedy cartoons. CONCLUSIONS: There are significant differences in our population in rates of bullying others that vary according to age, preferred cartoon type and whether or not family (parental) physical abuse has been witnessed. The factor 'preference for cartoon type', not examined in previous research, remained significant after multivariable adjustment. Although there is an association, the cause of this is not clear but merits further examination.

Cytogenetic analysis of the bipotential murine pre-B cell lymphoma, P388, and its derivative macrophage-like tumor, P388D1, using SKY and CGH.

Spectral karyotyping (SKY) and comparative genomic hybridization (CGH) were used to elucidate the divergent cytogenetic make-up of the prototypical bilineage lymphoblastic pre-B lymphoma, P388, and its progenitor macrophage-like tumor, P388D1. P388 was found to be diploid and genomically stable. P388D1 was triploid, highly unstable and characterized by numerous marker chromosomes (Chrs) and composite rearrangements. The karyotype of P388D1 was so complex that its clonal relatedness to P388 would have remained questionable without confirmation by molecular analysis of the clonotypic immunoglobulin heavy-chain and light-chain gene recombinations that coexisted in both tumors. The intrinsic instability of the P388D1 genome was indicated by the observation that only four out of 42 aberrations uncovered by SKY (in a total of 27 metaphases) occurred consistently (100% incidence), whereas 27 changes occurred non-randomly (27 to 96% incidence) and 11 alterations randomly (4 to 11% incidence). Persistent cytogenetic instability was also observed in P388 'macrophages' after phorbol ester- and ionomycin-induced conversion in vitro of P388 lymphoma cells. The 'cytogenetic noise' in these cells was manifested by a multiplicity of sporadic chromosomal aberrations; ie 25 distinct changes were identified by SKY in 40 metaphases. The results in P388D1 and P388 'macrophages' were interpreted to indicate that the myeloid differentiation program in the bipotential pre-B cell lymphoma P388 is invariably characterized by karyotypic instability. The study presented here demonstrates the power of the combined SKY and CGH approach to resolve complicated karyotypes of important and widely used mouse tumors.

The contribution of the large intestine to energy supplies in man.

Herbivores obtain a considerable proportion of energy requirements from carbohydrate by the chain of anaerobic carbohydrate fermentation producing short-chain fatty acids that are absorbed then metabolized. The evidence for this sequence occurring in the large intestine of man is reviewed and estimated to produce 5 to 10% of human energy requirements. Further small amounts of energy may come from large intestinal absorption of fat and the bacterial breakdown products of protein.

Intakes and sources of dietary fiber in the British population.

Intakes of dietary fiber and its different components have been measured in a random sample of the population in Cambridgeshire, England and compared with data from the British National Food Survey. Sixty-three men and women ages 20 to 80 were included in the sample. Total dietary fiber intake was 19.9 +/- 5.3 g/day compared with the calculated value of 19.7 g/day from the 1976 National Food Survey. There was a 4-fold range in fiber intake from 8 to 32 g/day; no significant trends with age or between men and women were detected. Vegetables supplied the majority of the fiber (41.3%); cereals 30.5%, and fruit and mixed sources 28.2%. Of the components of dietary fiber noncellulosic polysaccharide, cellulose, and lignin intakes were 13.8, 4.7, and 1.4 g/day, respectively. In the noncellulosic fraction, hexoses contributed 7.4 g, pentoses and uronic acids 3.3 and 3.0 g. Vegetables and unrefined cereals were the main sources of pentose. These intakes are low in comparison with limited international data from developing countries and of a similar order to those known in dietary experiments to produce low stool weights, slow transit time, and concentrated feces. They could readily be increased by simple dietary changes.

Novel molecular cytogenetic techniques for identifying complex chromosomal rearrangements: technology and applications in molecular medicine.

Molecular cytogenetic techniques that are based on fluorescence in situ hybridisation (FISH) have become invaluable tools for the diagnosis and identification of the numerous chromosomal aberrations that are associated with neoplastic disease, including both haematological malignancies and solid tumours. FISH can be used to identify chromosomal rearrangements, by detecting specific DNA sequences with fluorescently labelled DNA probes. The technique of comparative genomic hybridisation (CGH) involves two-colour FISH. It can be used to establish ratios of fluorescence intensity values between tumour DNA and control DNA along normal reference metaphase chromosomes, and thereby to detect DNA copy-number changes such as gains and losses of specific chromosomal regions and gene amplifications. Spectral karyotyping (SKY) is a novel molecular cytogenetic method for characterising numerical and structural chromosomal aberrations. SKY involves the simultaneous hybridisation of 24 differentially labelled chromosome-painting probes, followed by spectral imaging and chromosome classification, and produces a colour karyotype of the entire genome. The use of SKY has contributed significantly to the identification of chromosomal anomalies that are associated with constitutional and cancer cytogenetics, and has revealed many aberrations that go undetected by traditional banding techniques. In this article, we have reviewed these new molecular cytogenetic techniques and described their various applications in molecular medicine.

Nutrition after ileostomy.

The nutritional consequences of life with an ileostomy have been reviewed. Ileostomists tend to eat earlier in the day and to avoid fruit and vegetables when compared to people without an ileostomy. They are generally well nourished but may be prone to salt and water depletion because of the continual losses in the ileal effluent. The reservoir and absorptive capacities of the intact colon are demonstrated by these studies conducted on people with an ileostomy.

Genetic reporter system for oncogenic Igh-Myc translocations in mice.

The Myc-deregulating chromosomal T(12;15)(Igh-Myc) translocation, the hallmark mutation of inflammation- and interleukin 6-dependent mouse plasmacytoma (PCT), is the premier model of cancer-associated chromosomal translocations because it is the only translocation in mice that occurs spontaneously (B lymphocyte lineage) and with predictably high incidence (approximately 85% of PCT), and has a direct counterpart in humans: Burkitt lymphoma t(8;14)(q24;q32) translocation. Here, we report on the development of a genetic system for the detection of T(12;15)(Igh-Myc) translocations in plasma cells of a mouse strain in which an enhanced green fluorescent protein (GFP)-encoding reporter gene has been targeted to Myc. Four of the PCTs that developed in the newly generated translocation reporter mice, designated iGFP(5'Myc), expressed GFP consequent to naturally occurring T(12;15) translocation. GFP expression did not interfere with tumor development or the deregulation of Myc on derivative 12 of translocation, der (12), because the reporter gene was allocated to the reciprocal product of translocation, der (15). Although the described reporter gene approach requires refinement before T(12;15) translocations can be quantitatively detected in vivo, including in B lymphocyte lineage cells that have not yet completed malignant transformation, our findings provide proof of principle that reporter gene tagging of oncogenes in gene-targeted mice can be used to elucidate unresolved questions on the occurrence, distribution and trafficking of cells that have acquired cancer-causing chromosomal translocations of great relevance for humans.

Plasma cell tumour progression in iMycEmu gene-insertion mice.

The authors have recently reported that gene-targeted iMyc(Emu) mice that carry a His(6)-tagged mouse Myc cDNA, Myc(His), just 5' of the immunoglobulin heavy-chain enhancer, Emu, are prone to 'spontaneous' neoplasms of the B-lymphocyte lineage. The present study has used histological, immunohistochemical, and molecular genetic methods to investigate a subset of these neoplasms referred to as extraosseous plasmacytomas (PCTs). It is shown that 20.8% (20/96) of tumour-bearing iMyc(Emu) mice on a mixed genetic background of segregating C57BL/6 and 129/SvJ alleles develop PCT by 500 days. The Myc(His)-induced PCTs produced monoclonal immunoglobulin and developed in the gut-associated lymphoid tissue (GALT), particularly the mesenteric node and Peyer's patches. The PCTs overexpressed Myc(His), at the expense of normal Myc, and exhibited gene expression changes on cDNA macroarrays that were consistent with Myc(His)-driven neoplasia. Surprisingly, in one of three PCT-derived cell lines, Myc(His) was 'replaced' by a naturally occurring T(12;15) translocation, which changed the mode of Myc deregulation from gene insertion (Myc(His) transgene) to chromosomal translocation (juxtaposition of normal Myc to the immunoglobulin heavy-chain locus Igh). These findings provide evidence that recreation of the mouse PCT-associated T(12;15)(Igh(Emu)-Myc) translocation by gene insertion in mice results in the predictable development of PCTs in approximately one-fifth of the tumour-bearing mice. Myc(His)-driven PCTs recapitulate aspects of human plasma cell neoplasms, for which relatively few models exist in mice. For example, PCT development in the iMyc(Emu) mice may provide a good system to study the mechanism by which human MYC facilitates the progression of plasma cell myeloma (multiple myeloma) in humans.

The effect of luminal pH on large intestinal absorption in ulcerative proctocolitis.

The sensitivity of large intestinal absorption to pH and the absorption of short-chain fatty acids were measured in ulcerative proctocolitis by a dialysis bag method. Lowering luminal pH from 7 to 5.5 significantly reduced absorption of salt and water in proctocolitis, but not in normal controls. Short-chain fatty acid absorption was not affected by inflammation or change in pH when patients with ulcerative proctocolitis were compared with controls.

Meningitis caused by Streptococcus suis type II.

A 49 year old head porter developed meningitis shown to be caused by Streptococcus suis type II. The rare human infections with the organism, a pathogen of pigs, usually occur in those employed handling pig meat and are associated with auditory or vestibular dysfunction.

Is the rectum usually empty?--A quantitative study in subjects with and without diarrhea.

The authors have investigated the frequency with which the rectum contains feces by recording the presence or absence of fecal contamination of the membrane or of discoloration by feces of the contents of dialysis bags placed in the unprepared rectum for one hour. Feces were present in the rectum in 31 per cent of 32 studies in normal control subjects, in 49 per cent of 80 studies in obese subjects (P less than 0.05 from controls), in 36 per cent of 28 studies in patients with the irritable bowel syndrome, and in 31 per cent of 103 studies in patients with ulcerative proctocolitis, whether or not they had diarrhea. Fecal staining of the bag and its contents occurred much more frequently in 27 studies in subjects with various other diarrheal diseases (67 per cent, P less than 0.02 from controls), including eight with steatorrhea (87 per cent, P less than 0.02 from controls). The frequency with which feces were present was unaffected by age, sex, or time of day of the study. These results provide quantitative support for the assertion that in subjects without diarrhea the rectum is usually empty. In patients with diarrhea or steatorrhea and no distal large intestinal inflammation, however, the rectum usually does contain fecal material.

The interpretation of retrograde pancreatography in the elderly.

Endoscopic retrograde pancreatography is regarded as the most specific technique in the diagnosis of chronic pancreatitis. In the elderly the relevance of endoscopic retrograde pancreatography changes in establishing the diagnosis is disputed. The pancreatograms of 101 patients aged seventy-five years or more, who had endoscopic retrograde pancreatography for suspected biliary or pancreatic pathology, were reviewed. Only four patients subsequently proved to have unequivocal chronic pancreatitis. There was no significant difference in the size or contour of the main pancreatic duct, or in side branch changes between those patients presenting with common bile duct stones, incidental biliary pathology and pain of probable pancreatic origin. Three definite diagnostic criteria for the diagnosis of chronic pancreatitis emerged--duct obstruction with a stricture, gross irregularity of the main pancreatic duct and the presence of large cavities.

Analgesic ingestion and other factors preceding relapse in ulcerative colitis.

To investigate factors which predispose to relapse in patients with ulcerative colitis, we conducted a survey to compare the events occurring in the four weeks preceding the clinic attendance of 62 outpatients in remission with those taking place in the same period before the onset of relapse in 21 patients attending with active disease. The only event which occurred significantly more often in patients who subsequently relapsed was ingestion of paracetamol and other inhibitors of prostaglandin synthesis (76% (16/21) relapse vs 39% (24/62) remission, p less than 0 . 01). Recent upper respiratory tract infection (38% vs 26%) was not significantly more common in patients in relapse than in remission, and emotional stress, atopic events, antibiotic treatment, dietary indiscretions, foreign travel, and gastroenteritis were relatively rare in both groups. The surprisingly high prevalence of analgesic ingestion before relapse itself requires confirmation but does lend indirect support to the theory that colonic mucosal prostaglandin deficiency induces relapse in some patients with ulcerative colitis.

Mucosal surface pH of the large intestine of the rat and of normal and inflamed large intestine in man.

The surface pH of rat distal colonic mucosa and human rectal mucosa was measured in vitro using first a small pH electrode with a flattened tip. In buffer with pH 7.56 the mean rat colonic surface pH was 6.72. Lowering the buffer pH in steps resulted in a small fall in surface pH, the values being buffer pH 7.06 surface pH 6.64, buffer pH 6.58 surface pH 6.61 and finally buffer pH 6.09 surface pH 6.39. Similar results were obtained with a buffer where butyrate, 30 mmol/l replaced chloride and when a CO2/bicarbonate buffer was used. During the time taken for the study transmural potential difference only changed by 1-2 mV. Serosal surface pH changed with buffer pH, suggesting that the maintained surface pH is a property of the mucosal surface only. The surface pH of human rectal mucosa was similar to that of rat distal colonic mucosa. As buffer pH fell from pH 7.51 to 5.96 mucosal surface pH only fell from pH 6.80 to 6.26. The values obtained in ulcerative proctitis did not differ from normal mucosa. Secondly pH microelectrodes were used to measure the juxta mucosal pH and the pH-microclimate thickness when luminal pH was controlled. The microclimate had a pH 6.63 adjacent to the mucosa with a thickness of 840 micron. The importance of mucus in maintaining the microclimate was shown by n-acetyl cysteine thinning and prostaglandin E2 thickening the layer. These results describe a surface microclimate in the large intestine of appreciable thickness and a constant juxta mucosal pH. Luminal pH changes produce only a small change in microclimate pH.

Spontaneous bacterial peritonitis due to Campylobacter jejuni.

A patient with alcoholic cirrhosis complicated by ascites developed spontaneous bacterial peritonitis. Campylobacter jejuni--(a microaerophilic bacillus)--was isolated from ascitic fluid and blood.

Short chain fatty acid absorption by the human large intestine.

Short chain fatty acid absorption from the human rectum has been studied in 46 subjects attending an obesity clinic, using a dialysis bag technique. From a mixed electrolyte solution, acetate concentrations fell from 97.0 to 64.2 mmol/l, and sodium from 97.8 to 85.1 mmol/l with respective net absorption rates of 8.1 and 5.2 mumol/cm2/h. From a solution with mixed short chain fatty acids acetate concentration fell from 62.3 to 37.6 mmol/l, propionate from 20.2 to 11.5 mmol/l, and butyrate from 25.7 to 17.3 mmol/l with absorption rates of 5.2, 1.8, and 1.9 mumol/cm2/h. Lowering pH from 7.2 to 5.5, to test the possibility that absorption occurred by passive non-ionic diffusion, had no effect on absorption rates, although pH rose rapidly in the dialysis fluid. These results are comparable with rates of acetate absorption from the animal large intestine. The hypothesis that short chain fatty acids are not absorbed from the large gut and therefore contribute to faecal bulk by retaining water in the bowel lumen may need revision.

The diet of individuals: a study of a randomly-chosen cross section of British adults in a Cambridgeshire village.

1. The dietary intakes of sixty-three adults, randomly-selected from the electoral role of a large village near Cambridge, have been measured using the weighed-intake technique for 7 d. 2. Mean (+/- SD) daily intakes (g) for men and women respectively were: energy (MJ) 10.0 +/0 2.4, 8.2 +/- 2.1; fat 104 +/- 27, 90 +/- 27; protein 77 +/- 20, 67 +/- 16; carbohydrate 285 +/- 81, 229 +/- 74; sucrose 91 +/- 47, 57 +/- 33. 3. When interviewed at the end of the study 40% of subjects said they were watching their weight. 4. Women ate less food over all than men, and proportionately less potato and bread, and used only one-third as much sugar in drinks, probably in an attempt to control their weight. Men took considerably more alcohol than the women. In the age-group 20-39 years alcohol provided 9% (1.0 MJ/d) of the total energy intake in the men. 5. Wide variation in the intake of nutrients was observed amongst the individuals. For vitamin C and fibre intake this was partly partly explained by seasonal variation but for most nutrients total energy intake and food choice were the main determinants. The range of intakes of nutrients such as fat was similar in these individuals to that seen amongst countries internationally. It is suggested that if differences in nutrient intake amongst the various populations of the world can be associated with disease risk, then the same interpretation should be possible in individuals.

Rectal absorption of short chain fatty acids in the absence of chloride.

The absorption of short chain fatty acids by the human rectum in the absence of chloride has been studied using a dialysis bag technique. Absorption rates of sodium, water, and short chain fatty acids were unchanged on replacing chloride with sulphate. Final concentrations of bicarbonate were 35.4 +/- 3.4 mmol/l in the presence of chloride and 37.1 +/- 5.2 mmol/l in the absence of chloride. The rates of movement of bicarbonate into the dialysates were similar. If bicarbonate is secreted in exchange for chloride then it also appears to be secreted in exchange for absorbed short chain fatty acids.

Diet and health of people with an ileostomy. 1. Dietary assessment.

1. People with an ileostomy experience digestive problems with some foods. Why those foods are avoided is not known nor is it certain whether this interferes with the nutritional adequacy of their diet. 2. A detailed dietary assessment has therefore been made of thirty-seven subjects with ileostomies and a similar number of age- and sex-matched healthy controls. All food and drink eaten over 1 week was weighed and recorded. In addition. A larger group of seventy-nine ileostomy subjects and seventy matched controls answered a questionnaire designed to identify foods which upset them and which they avoided. 3. Total nutrient and energy intakes were similar in the two groups but the subjects with an ileostomy ate less dietary fibre (g/d; mean + SD: ileostomy subjects 18.0 +/- 5.9, controls 20.9 +/- 5.5; P less than 0.05) mainly due to lower fruit and vegetable intakes. Iron and vitamins A and C intakes were also less. 4. A majority of ileostomy subjects had a pattern of food intake different from the controls, taking more of their energy in the morning and less at night. A variety of food items upset more than half of them including nuts, pips, seeds, skins, onions, beetroot, lettuce, raw cabbage and carrot, peas, sweetcorn, mushrooms and dried fruit. 5. On the basis of the results it is possible to formulate general dietary advice for people with an ileostomy.