Kwashiorkor: A Prospective Ten-Year Follow-up Study

The physical status of 123 cases of kwashiorkor, followed up longitudinally for 10 years, was analysed. Their status was compared with that of 97 control siblings who had never suffered from kwashiorkor, but who had grown up under the same environmental conditions as the expatients. It was found that 10 years after the episode of kwashiorkor about half of the children had reached international growth standards in weight and height, thus demonstrating the capacity for complete physical recovery. No significant anthropometric or biochemical differences were found between ex-patients and control siblings at the 10-year follow-up examination. This is adequate proof that the episode of kwashiorkor per se cannot be held responsible for the growth retardation that occurred in some of the children. The children who were most severely retarded in weight and height on admission tended to remain the most severely retarded in growth after 10 years. The children who were the oldest on admission were more retarded in weight after 10 years than the children who were admitted at a younger age. Although these facts may imply that the severity and possibly the duration of the malnutrition episode adversely affected subsequent physical growth, a high current incidence of hypoalbuminaemia was found in both ex-patients and control siblings, indicating continuing malnutrition, the effects of which cannot be separated from possible deleterious effects of thil original malnutrition episode. Linear growth also correlated significantly with midparental height and a complex of adverse social circumstances.Failure to attain international growth standards in some of the children was therefore apparently due to a combination of factors and at present it is impossible to distinguish any single one of these as being more important than the others. Since about half of the children did reach adequate growth standards despite their poor living conditions, it is clearly worth while to treat every case of malnutrition. At the same time public health supervision and preventative social measures should be greatly increased to protect the child population throughout the growing period. S. Afr. Med. J., 45, 1427 (1971

On the interplay between sedimentation and phase separation phenomena in two-dimensional colloidal fluids

Colloidal particles that are confined to an interface effectively form a two-dimensional fluid. We examine the dynamics of such colloids when they are subject to a constant external force, which drives them in a particular direction over the surface. Such a situation occurs, for example, for colloidal particles that have settled to the bottom of their container, when the container is tilted at an angle, so that they `sediment' to the lower edge of the surface. We focus in particular on the case when there are attractive forces between the colloids which causes them to phase separate into regions of high density and low density and we study the influence of this phase separation on the sedimentation process. We model the colloids as Brownian particles and use both Brownian dynamics computer simulations and dynamical density functional theory (DDFT) to obtain the time evolution of the ensemble average one-body density profiles of the colloids. We consider situations where the external potential varies only in one direction so that the ensemble average density profiles vary only in this direction. We solve the DDFT in one-dimension, by assuming that the density profile only varies in one direction. However, we also solve the DDFT in two-dimensions, allowing the fluid density profile to vary in both the $x$- and $y$-directions. We find that in certain situations the two-dimensional DDFT is clearly superior to its one-dimensional counterpart when compared with the simulations and we discuss this issue.Comment: 17 pages, 10 figures, submitted to Molecular Physic

Lekner summations and Ewald summations for quasi-two dimensional systems

Using the specific model of a bilayer of classical charged particles (bilayer Wigner crystal), we compare the predictions for energies and pair distribution functions obtained by Monte Carlo simulations using three different methods available to treat the long range Coulomb interactions in systems periodic in two directions but bound in the third one. The three methods compared are: the Ewald method for quasi-two dimensional systems [D.E. Parry, Surf. Sci. $\bm{49}$, 433 (1975); \it{ibid.}, $\bm{54}$, 195 (1976)], the Hautman-Klein method [J. Hautman and M.L. Klein, Mol. Phys. $\bm{75}$, 379 (1992)] and the Lekner summations method [J. Lekner, Physica A$\bm{176}$, 485 (1991)]. All of the three method studied in this paper may be applied to any quasi-two dimensional systems, including those having not the specific symmetry of slab systems. For the particular system used in this work, the Ewald method for quasi-two dimensional systems is exact and may be implemented with efficiency; results obtained with the other two methods are systematically compared to results found with the Ewald method. General recommendations to implement with accuracy, but not always with efficiency, the Lekner summations technique in Monte Carlo algorithms are given.Comment: 50 pages, 9 figures, 4 table

The microaerophilic microbiota of de-novo paediatric inflammatory bowel disease: the BISCUIT study

<p>Introduction: Children presenting for the first time with inflammatory bowel disease (IBD) offer a unique opportunity to study aetiological agents before the confounders of treatment. Microaerophilic bacteria can exploit the ecological niche of the intestinal epithelium; Helicobacter and Campylobacter are previously implicated in IBD pathogenesis. We set out to study these and other microaerophilic bacteria in de-novo paediatric IBD.</p> <p>Patients and Methods: 100 children undergoing colonoscopy were recruited including 44 treatment naïve de-novo IBD patients and 42 with normal colons. Colonic biopsies were subjected to microaerophilic culture with Gram-negative isolates then identified by sequencing. Biopsies were also PCR screened for the specific microaerophilic bacterial groups: Helicobacteraceae, Campylobacteraceae and Sutterella wadsworthensis.</p> <p>Results: 129 Gram-negative microaerophilic bacterial isolates were identified from 10 genera. The most frequently cultured was S. wadsworthensis (32 distinct isolates). Unusual Campylobacter were isolated from 8 subjects (including 3 C. concisus, 1 C. curvus, 1 C. lari, 1 C. rectus, 3 C. showae). No Helicobacter were cultured. When comparing IBD vs. normal colon control by PCR the prevalence figures were not significantly different (Helicobacter 11% vs. 12%, p = 1.00; Campylobacter 75% vs. 76%, p = 1.00; S. wadsworthensis 82% vs. 71%, p = 0.312).</p> <p>Conclusions: This study offers a comprehensive overview of the microaerophilic microbiota of the paediatric colon including at IBD onset. Campylobacter appear to be surprisingly common, are not more strongly associated with IBD and can be isolated from around 8% of paediatric colonic biopsies. S. wadsworthensis appears to be a common commensal. Helicobacter species are relatively rare in the paediatric colon.</p&gt

Independent prognostic value of angiogenesis and the level of plasminogen activator inhibitor type 1 in breast cancer patients

Tumour angiogenesis and the levels of plasminogen activator inhibitor type I (PAI-I) are both informative prognostic markers in breast cancer. In cell cultures and in animal model systems, PAI-I has a proangiogenic effect. To evaluate the interrelationship of angiogenesis and the PAI-I level in breast cancer, we have evaluated the prognostic value of those factors in a total of 228 patients with primary, unilateral, invasive breast cancer, evaluated at a median follow-up time of 12 years. Microvessels were immunohistochemically stained by antibodies against CD34 and quantitated by the Chalkley counting technique. The levels of PAI-I and its target proteinase uPA in tumour extracts were analysed by ELISA. The Chalkley count was not correlated with the levels of uPA or PAI-I. High values of uPA, PAI-I, and Chalkley count were all significantly correlated with a shorter recurrence-free survival and overall survival. In the multivariate analysis, the uPA level did not show independent prognostic impact for any of the analysed end points. In contrast, the risk of recurrence was independently and significantly predicted by both the PAI-I level and the Chalkley count, with a hazard ratio (95% CI) of 1.6 (1.01-2.69) and 1.4 (1.02-1.81), respectively. For overall survival, the Chalkley count, but not PAI-I, was of significant independent prognostic value. The risk of death was 1.7 (1,30-2.15) for Chalkley counts in the upper tertile compared to the lower one. We conclude that the PAI-I level and the Chalkley count are independent prognostic markers for recurrence-free survival in patients with primary breast cancer, suggesting that the prognostic impact of PAI-I is not only based on its involvement in angiogenesis. (C) 2003 Cancer Research UK

Self-Organization, Layered Structure, and Aggregation Enhance Persistence of a Synthetic Biofilm Consortium

Microbial consortia constitute a majority of the earth’s biomass, but little is known about how these cooperating communities persist despite competition among community members. Theory suggests that non-random spatial structures contribute to the persistence of mixed communities; when particular structures form, they may provide associated community members with a growth advantage over unassociated members. If true, this has implications for the rise and persistence of multi-cellular organisms. However, this theory is difficult to study because we rarely observe initial instances of non-random physical structure in natural populations. Using two engineered strains of Escherichia coli that constitute a synthetic symbiotic microbial consortium, we fortuitously observed such spatial self-organization. This consortium forms a biofilm and, after several days, adopts a defined layered structure that is associated with two unexpected, measurable growth advantages. First, the consortium cannot successfully colonize a new, downstream environment until it selforganizes in the initial environment; in other words, the structure enhances the ability of the consortium to survive environmental disruptions. Second, when the layered structure forms in downstream environments the consortium accumulates significantly more biomass than it did in the initial environment; in other words, the structure enhances the global productivity of the consortium. We also observed that the layered structure only assembles in downstream environments that are colonized by aggregates from a previous, structured community. These results demonstrate roles for self-organization and aggregation in persistence of multi-cellular communities, and also illustrate a role for the techniques of synthetic biology in elucidating fundamental biological principles

The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic and macrophage infiltration, microvessel density and survival in patients with primary operable breast cancer

The significance of the inter-relationship between tumour and host local/systemic inflammatory responses in primary operable invasive breast cancer is limited. The inter-relationship between the systemic inflammatory response (pre-operative white cell count, C-reactive protein and albumin concentrations), standard clinicopathological factors, tumour T-lymphocytic (CD4+ and CD8+) and macrophage (CD68+) infiltration, proliferative (Ki-67) index and microvessel density (CD34+) was examined using immunohistochemistry and slide-counting techniques, and their prognostic values were examined in 168 patients with potentially curative resection of early-stage invasive breast cancer. Increased tumour grade and proliferative activity were associated with greater tumour T-lymphocyte (P<0.05) and macrophage (P<0.05) infiltration and microvessel density (P<0.01). The median follow-up of survivors was 72 months. During this period, 31 patients died; 18 died of their cancer. On univariate analysis, increased lymph-node involvement (P<0.01), negative hormonal receptor (P<0.10), lower albumin concentrations (P<0.01), increased tumour proliferation (P<0.05), increased tumour microvessel density (P<0.05), the extent of locoregional control (P<0.0001) and limited systemic treatment (Pless than or equal to0.01) were associated with cancer-specific survival. On multivariate analysis of these significant covariates, albumin (HR 4.77, 95% CI 1.35–16.85, P=0.015), locoregional treatment (HR 3.64, 95% CI 1.04–12.72, P=0.043) and systemic treatment (HR 2.29, 95% CI 1.23–4.27, P=0.009) were significant independent predictors of cancer-specific survival. Among tumour-based inflammatory factors, only tumour microvessel density (P<0.05) was independently associated with poorer cancer-specific survival. The host inflammatory responses are closely associated with poor tumour differentiation, proliferation and malignant disease progression in breast cancer