Milk's effect on the bioavailability of iron from cereal-based diets in young women by use of in vitro and in vivo methods.

A study was conducted in healthy young women to measure and compare the availability of iron from cereal-based diets with and without milk by use of in vivo and in vitro methods. In vitro iron-bioavailability tests demonstrated that the amounts of soluble and ionizable iron in cereal-based diets were increased two- and three-fold, respectively, when milk was added. 54Fe, a stable isotope of iron, and fecal monitoring were used to determine iron absorption in eight young women. Iron absorption was higher with milk than without milk in seven of the eight subjects but did not differ significantly between the two treatments. The results suggest that in vivo and in vitro effects differ and that the absorption of iron from cereal-based diets is neither enhanced nor inhibited by the addition of milk.

Zinc protoporphyrin. Past, present, and future.

The course of zinc protoporphyrin research has progressed at an increasingly rapid pace on several fronts. A variety of biochemical and clinical evidence viewed in toto now suggests that ferrochelatase catalyzes zinc protoporphyrin formation in states of relative iron-deficient erythropoiesis and in lead-inhibited iron metabolism. Furthermore, a redefinition of the relationship of zinc protoporphyrin to certain other parameters of iron status has been made based upon changes during the earliest states of iron depletion. These clinical studies show that the zinc protoporphyrin level and the ferritin level vary in concert but that changes in the percent transferrin saturation and in the hematocrit results are less consistent. Thus zinc protoporphyrin and ferritin are closely linked metabolically such that iron-deficient erythropoiesis becomes an initial manifestation of iron depletion. The measurement and expression of results as mumoles zinc protoporphyrin/mole heme have improved the quality of results, partly by the elimination of the assumed hematocrit designed into existing instruments. Other refinements in hematofluorometry technology have permitted exploration of the potentially extensive applications of zinc protoporphyrin measurements for lead surveillance and diagnosis, blood banking, pediatrics, obstetrics, sports medicine, and other clinical situations where a very sensitive, cost-effective indication of iron status is required.

Evaluation of endoscopic variceal sclerotherapy in various grades of liver disease.

Forty four patients with portal hypertension of varying etiology, including 25 patients with an acute episode of variceal bleeding and 19 with past history of hematemesis, were followed up for eighteen months following endoscopic variceal sclerotherapy (EVS). Of 11 patients in Child's A group, two died of acute bleed, three were subjected to shunt surgery and the remaining six survived the follow-up period. Ten of 11 cases in Child's C did not survive more than six months in spite of sclerotherapy. We conclude that rebleed and death due to rebleed following EVS occur more commonly in patients with poor hepatic reserve (Child's C) as compared to patients in Child's A and B.

Vocal fold impact stress analysis.

Vocal fold impact stress (force/area) has been implicated as a factor possibly contributing to the formation of nodules and polyps. The force of impact of a moving body is related to its acceleration. Since the mass of the folds is relatively constant, one expects impact force to be directly proportional to acceleration. A measure that reflects the relative displacement of the vocal folds is photoglottography (PGG). The velocity and acceleration of the folds are easily obtained by calculating the first and second derivatives of the PGG displacement waveform. This study, therefore, compared the second derivative of the PGG signal with simultaneously measured impact stress in an excised canine larynx model. Glottal transillumination (PGG) was measured with a subglottic transducer. A miniature force transducer placed in the midline between the vocal folds measured impact stress at the midglottal position. For nine different larynges, there was a positive and linear relationship between the second derivative of PGG and impact stress. The statistically significant results support the hypothesis that the second derivative of PGG m ay provide a use fulnoninvasive way to estimate relative vocal fold impact stress.

Tuberculosis of rectum simulating malignancy and presenting as rectal prolapse - a case report and review.

Tuberculosis of the gastrointestinal tract (GIT) occurs as a primary lesion or secondary to a focus of tuberculosis elsewhere in the body, most commonly in the lungs. Tuberculosis can affect any part of the GIT from the oesophagus to the anal canal. Two main types are - the tuberculous ulcer and the rarer hypertrophic type which is generally found at the ileocecal junction, less commonly in the colon or rectum. Tuberculosis of bowel distal to ileocecal junction is rare and is seldom considered as a differential diagnosis of rectal stricture (2%). We report a case of rectal tuberculosis presenting with rectal prolapse and masquerading as malignancy, clinically, radiologically as well as on colonoscopy. The diagnosis was confirmed by repeated histopathological examination. The patient underwent definitive surgery along with anti-tuberculous therapy.