Adriamycin-induced modulation of host defenses in tumor-bearing mice.

Using the C57BL/6/EL4 tumor model, studies were carried out to demonstrate the feasibility of administering Adriamycin (ADM) in therapeutic doses and schedules such that the host antitumor defenses would not be suppressed and in some cases might be stimulated by treatment. ADM treatment caused prolongation of survival and, in general, either stimulated host cytolytic activities above untreated control levels or had no effect. These effects by ADM were observed with the ADM-sensitive parent EL4 line as well as with an ADM-resistant subline, indicating that the effects did not result entirely from direct antitumor activity. The cytolytic activities examined were those of cytolytic T-lymphocytes, lymphokine-activated killer cells, and splenic and peritoneal macrophages. All activities were assessed against the syngeneic EL4 target line. The information obtained in this investigation provides a rational basis for the future development of curative protocols with ADM plus biological response modifiers, which would depend on a functional immune system for optimum efficacy and would also exploit synergistic immunomodulating effects of the agents used in combination.

The Supreme Court's spring term: abortion, the right to die, and the decline of privacy rights.

KIE: Wing analyzes the constitutional significance and the important long-term implications for health policy of three 1990 U.S. Supreme Court decisions: Hodgson v. Minnesota, Ohio v. Akron Center for Reproductive Health, and Cruzan v. Director, Missouri Department of Health. Hodgson and Ohio upheld state statutes requiring parental notification of a minor's impending abortion. Cruzan upheld a state court decision refusing to allow the family of a patient in a persistent vegetative state to discontinue life-sustaining treatment. Wing argues that these decisions reach far beyond "the abortion issue" or "the right to die." Not only have they narrowed the constitutional protection of individual privacy, but they allow states to regulate activities like abortion in a manner that indicates that the Court is prepared to repeal the notion that individual privacy is entitled to enhanced judicial protection.^ieng

PIP: In the spring of 1990 several Supreme Court decisions were handed down that will drastically affect health policy in the US for decades. Hodgson v. Minnesota affirmed a Minnesota statute that required unemancipated minors seeking abortion to give 48-hour notice to both parents. The only exceptions are in cases of medical emergency or through a judicial bypass. Ohio v. Akron Center for Reproductive Health upheld the constitutionality of an OHio law that requires physicians to personally give a 24-hour notice or a 48-hour constructive notice by mail before performing an abortion for an unemancipated minor. A judicial bypass is also allowed in the Ohio law. Cruzan v. Missouri Department of Health affirmed the constitutionality of a state court decision to deny the family of a woman in a persistent vegetative state to discontinue her life-sustaining treatment. This decision severely changes the right to die that has previously been upheld by lower courts. The 2 abortion cases have clearly shown the court to has taken a stance that will significantly weaken the right to abortion in Roe. The Cruzan case raises many questions about the vested state interest in protecting its citizens compared to an individual's right to refuse treatment.^ieng

The emerging relevance of antitrust laws to the delivery of health care.

Until relatively recently, antitrust enforcement in the delivery of health care was virtually non-existent. Not even 15 years ago, many legal observers might have concluded that the professional services of medical care providers were exempted from the federal antitrust laws altogether; or that many providers were engaged in local activities beyond the reach of federal interstate commerce jurisdiction. Even 10 years ago, many providers were arguing that collective agreements among potential competitors were not only sound public policy, but also that such concerted activities were actively encouraged by various federal laws. Today, however, the enforcement of the federal antitrust is an integral part of the complicated legal environment of American health care delivery.

Turnover of 65Zn and 82Sr in growing rats. A comparative investigation.

Analysis of bone retention data using 2- or 3-compartment models gives nearly equal relative accretion rates for zinc and calcium (85Sr) in endochondral bone and calcifying cartilage. The rate for zinc in cortical bone is 70% of that for calcium. As the existence in cortical bone of large, slowly exchanging compartments limitating accretion is consistent with the data, the relative accretion rate for zinc may more closely reflect the relative accretion rate of cortical bone.

Speech, privacy, and the power of the purse: lessons from the abortion "gag rule" case.

PIP: In Rust v. Sullivan, 59 U.S.L.W. 4451 (1991), the US Supreme Court ruled that neither the privacy interests of family planning clients nor the 1st Amendment interests of their counselors prevented the government from banning all discussion of abortions in federally funded family planning clinics. In doing so, the Court also reaffirmed its view that the state and federal legislatures have virtually unlimited discretion in limiting or conditioning social welfare programs, a view having even greater long-term implications for American health policy than the implications of Rust for the constitutional protection of abortion. Rust upheld the Department of Health and Human Services' 1988 directive prohibiting the use of any funds from Title X of the Public Health Service Act (authorizing family planning programs) in programs where abortion is a method of family planning. This means that a clinician may lawfully respond to a client's inquiry about abortion only with a denial that abortion is an option. Thus, while allowing women the constitutional protection to chose an abortion, the Court has allowed the legislature to freely use the power of the purse to discourage or prevent the choice of abortion. Rust's greatest impact may well be in its acceptance of the enormous power wielded by the government over funded activities, especially in health policy. Justice Rehnquist believes there is not constitutional right to health, welfare, or any other government benefit; the legislative branches of the government cannot be required by judicial interpretation of the Constitution to provide any particular benefit or service to anyone. Even when the government chooses to fund a particular benefit, it is free to condition that benefit with virtually no judicially enforceable limits on that discretion.^ieng

Effects of early wound healing and wound treatment with zinc tape on intestinal absorption and distribution of zinc in rats.

In rats operated with large excisional skin wounds which were not treated with zinc tape, the serum zinc concentration was decreased at every observation time during the first post-operative day and the absorption of zinc from the intestine was increased. Slight decreases in the zinc concentration were seen in some tissues while liver zinc was very high. In rats with wounds treated with zinc tape, serum zinc was markedly increased at 6 hours, lower but above control levels at 7 and 12 hours and markedly increased again at 24 hours. The absorption of zinc from the intestine was low. Zinc concentration were elevated in most tissues sampled; they were high in testis and kidney and very high in liver. The results strongly indicate that the operative trauma and/or acute inflammatory conditions in the wounds in animals not treated with zinc tape initiate a movement of zinc from serum, some tissues and the content of the intestine to the liver. In the zinc tape treated group the increase in liver zinc was supplied mostly by the zinc tape. It is assumed that these large increases in zinc concentration in the liver are the result of the incorporation of zinc into certain zinc containing proteins which are produced in response to the inflammatory process in the wound. An increase was also found in the copper concentration in the liver of zinc tape treated animals and a decrease in the iron concentration in the liver of both groups of operated animals compared to controls.

The availability of zinc in endosperm, whole grain and bran-enriched wheat crispbreads fed to rats on a Zn-deficient diet.

The hypothesis that factors such as dietary fibre and phytate in wheat bran limit the availability of Zn was tested in growing rats fed on low-Zn diets with different wheat crispbreads as the major source of Zn. Six groups of six weanling male rats each were fed on 5 parts semi-synthetic Zn-deficient diet and 1 part wheat-endosperm crispbread for 1 week. At the beginning of the second week, the crispbread in the diet of five groups was exchanged for crispbread made using one of the following wheat flours: (1) whole grain, (2) bran-enriched whole grain, (3) endosperm with Zn added to the whole-grain level, (4) endosperm with Zn added to the bran-enriched level, (5) whole grain with Zn added to the bran-enriched level. These diets were given ad lib. together with deionized water for 2.5 weeks. The relative absorption of Zn was lowest from the three non-supplemented diets (75-82%). All the added Zn was absorbed. As appetite, body-weight increase, Zn absorption, Zn retention and the Zn concentrations in serum and bone differed only slightly among groups fed on diets with similar Zn concentrations, it is concluded that factors such as dietary fibre or phytate in wheat bran limit the availability of Zn in wheat crispbreads very little when all the Zn is needed for growth and development in rats.

The effect of wheat bran on the absorption and accumulation of cadmium in rats.

1. The major purpose of the present study was to determine whether the addition of wheat bran to endosperm crisp bread in a composite diet given to rats for 6 weeks causes an increase in the accumulation of cadmium in the rats due to the Cd content in the bran, or whether binding factors in the bran, such as dietary fibre and phytic acid, reduce or prevent the accumulation of this Cd. A second purpose was to determine whether the accumulation of Cd can be estimated by measuring the absorption of 109Cd given in a single meal of the diet. 2. Three groups of eight rats were fed on one of three diets. Half of each diet consisted of a basal mixture of starch, protein, oil, minerals and vitamins. The remainder consisted of crisp breads based on refined wheat flour (endosperm group), wheat flour + bran in equal amounts (bran group) and wheat flour + Cd to give a Cd content similar to that of the bran group (endosperm + Cd group). After 41 d on the diets, the rats were deprived of food but not water for 12 h and then given a 5 g test meal of their respective diets with 109Cd added. After 3 h the remaining 109Cd-labelled diets were replaced with the unlabelled diets for 3 h before the rats were killed. 3. The total Cd contents in the wall of the proximal small intestine, including mucus, and in the liver and kidneys were highest in the endosperm + Cd group and lowest in the endosperm group.(ABSTRACT TRUNCATED AT 250 WORDS)

An evaluation of the radiopacity of composite restorative materials used in Class I and Class II cavities.

The radiopacity of 28 shades of 18 composite brands, recommended for use in Class I and Class II cavities, and one amalgam were tested in accordance with the instructions in the latest draft standards of ISO for resin-based filling materials. The composition of the inorganic fillers in the materials was analyzed by optical emission spectroscopy. Twelve composites showed radiopacity greater than enamel, for five the radiopacity was lower than that of dentin, and for two materials the radiopacity was between that of enamel and dentin. The optical emission spectroscopy analyses showed a large variety in the composition of the fillers. The elements added to increase radiopacity in the composite materials are barium, strontium, zinc, zirconium, and ytterbium.