Vitamin A and E blood levels in erythrodermic and pustular psoriasis associated with chronic alcoholism

Vitamin A and E blood levels were determined, using a high-performance liquid chromatographic method, in 7 patients with erythrodermic psoriasis or psoriatic acral pustulosis associated or not associated with chronic alcoholism, during and after the acute episode. These vitamins were also studied in 5 patients with psoriasis vulgaris involving more than 80% of the surface body area and associated with chronic alcohol intake and in 17 patients with psoriasis vulgaris involving more than 50% of the skin but without chronic alcoholism. Vitamin A blood levels were reduced in all the patients in the group "erythrodermic psoriasis/psoriatic acral pustulosis", while vitamin E blood levels were below the normal range during the acute psoriatic episode only in the 5 patients having a history of chronic alcohol intake in this group. In the other groups--psoriasis vulgaris with chronic alcoholism and psoriasis vulgaris without heavy alcohol consumption--vitamin A and E blood levels were not reduced. The implication of vitamin E in psoriasis, probably by its antioxidant activity, and its relationship with selenium are discussed. We suggest that attention should be paid to the vitamin A deficiency in erythrodermic or pustular psoriasis and to the vitamin E deficiency when these inflammatory diseases are associated with chronic alcoholism.

Cell surface expression and functional significance of adhesion molecules on human myeloma-derived cell lines

Multiple myeloma is characterized by the presence of malignant plasma cells predominantly localized in bone marrow. Our prior studies have suggested that human myeloma derived-cell lines adhere specifically to fibronectin and to bone marrow stromal cells (BMSCs) via beta 1 and beta 2 integrins as well as RGD peptide, and that tumour cell to BMSC contact triggers interleukin-6 (IL-6) secretion from BMSCs. Since IL-6 is a growth factor for myeloma, adhesion may be important in paracrine IL-6 mediated tumour cell growth. We therefore examined phenotypic expression of adhesion molecules on the U266 and IM-9 human myeloma-derived cell lines using the panel of monoclonal antibodies (MoAbs) directed at adhesion molecules submitted to the Vth International Conference on Human Leukocyte Differentiation Antigens. U266 and IM-9 myeloma cell lines express mainly CD29, CD49d, VLA-1, CD18, CD54, ICAM-2 and ICAM-3. In contrast, CD49b, VLA-3, CD49f, CD11b, VCAM-1, selectins and selectin-ligands were not expressed on these cell lines. Specific adherence of IM-9 cells to BMSC line LP101 was demonstrated which could be partially blocked by pre-incubation and culture of tumour cells with anti-beta 1 integrin, anti-beta 2 integrin, anti-CD49d, anti-VLA-5, anti-CD11a, anti-CD44 and anti-CD54 MoAbs. The combination of these MoAbs (anti-CD29, CD18, CD11a, CD49d, VLA-5, CD44, CD54, ICAM-2, ICAM-3 MoAbs) decreased but did not completely abrogate binding of IM-9 to BMSCs. Moreover, increases in IL-6 secretion from BMSCs after adherence of IM-9 cells were also partially blocked by these MoAbs. These findings suggest that multiple adhesion pathways may mediate adherence of myeloma cell lines to BMSCs, localizing tumour cells in the marrow microenvironment and triggering IL-6 secretion by BMSCs which may augment tumour cell growth.

Histogenetic consideration of ovarian sex cord-stromal tumors analyzed by expression pattern of cytokeratins, vimentin, and laminin. Correlation studies with human gonads

A total of 30 sex cord-stromal tumors including 9 adult type and 5 juvenile type granulosa cell tumors (GCTs), 4 Sertoli-Leydig cell tumors (SLTs), 1 gynandroblastoma, 5 thecomas, 2 fibromas and 3 sclerosing stromal tumors were immunohistochemically evaluated by means of cytokeratins of different molecular weight, vimentin and laminin with regard to the histogenesis of these tumors and to the embryogenesis of the sex cord and stroma of developing gonads. For comparison, 7 embryonic gonads, 9 fetal and 9 adult ovaries, 14 fetal and 5 postnatal testes, and 1 gonadoblastoma were also examined. The coelomic epithelium of all gonads were positive for both cytokeratins (CAM 5.2 and AE1) and vimentin. In fetal ovaries, the granulosa cells of primordial follicles express low molecular weight cytokeratins only and those cells of more maturing follicles did not express any cytokeratin or vimentin. In adult ovaries, the granulosa cells of primordial follicles coexpressed low molecular weight cytokeratins and vimentin, but those cells of more maturing follicles expressed vimentin only. In fetal testes before 20 weeks gestational age, the Sertoli and Leydig cells did not express any cytokeratins and vimentin. After that time, both cells expressed vimentin only throughout life. The rete ovarii and rete testis from fetal to adult life coexpressed both low molecular weight cytokeratins and vimentin. The rete ovarii in all ages and rete testis in prenatal and childhood ages were surrounded by the laminin-positive basement membrane, however, the rete testis in adult were not. In neoplasia, the GCTs, thecomas, fibromas, and sclerosing stromal tumors expressed vimentin only.(ABSTRACT TRUNCATED AT 250 WORDS)

Induction of stable microtubules in 3T3 fibroblasts by TGF-beta and serum

Previous studies have shown that fibroblasts induced to migrate into an in vitro wound rapidly generate an array of stable, post-translationally detyrosinated microtubules (Glu MTs) oriented toward the direction of migration. To understand how cells generate a stable array of MTs at a specific location, we have analyzed the contribution of media components to the formation of oriented Glu MTs in wounded monolayers of 3T3 fibroblasts. When confluent monolayers were placed in serum-free medium (SFM) for 2 days before wounding, the cells contained virtually no Glu MTs or nocodazole-resistant MTs and were incapable of generating Glu MTs in response to wounding. Such SFM-treated monolayers were capable of generating oriented Glu MTs within 1 hour of wounding, if calf serum (CS) was added back to the medium. The Glu MTs in the CS refed cells were oriented toward the wound in cells at the wound edge, and were juxtanuclear in cells within the monolayer, demonstrating that CS restored the Glu MT array characteristic of each cell type. To determine the nature of the ‘Glu MT-inducing’ factor in CS, we subjected CS to different treatments and found that the CS factor was nondialyzable, resistant to heat, mild acid and trypsin, but inactivated by treatment with dithiothreitol. The factor was not absorbed by charcoal and was present in lipoprotein-deficient serum. These properties are consistent with the properties of a number of polypeptide growth factors, so we screened purified growth factors for their ability to induce Glu MTs in wounded SFM-treated monolayers. Of all the growth factors tested, only TGF-beta 1 and TGF-beta 2 induced a significant level (> or = 70% of the CS response) of oriented Glu MTs. The SFM-treated cells were exquisitely sensitive to TGF-beta 1, with significant induction of Glu MTs observed at 0.01 ng/ml TGF-beta 1. Induction of Glu MTs observed by immunofluorescence after CS or TGF-beta treatments were paralleled by increases in Glu tubulin detected on western blots. The Glu MTs formed after either CS or TGF-beta 1 treatment showed enhanced resistance to nocodazole, confirming that both treatments increased the level of stable MTs in cells. The TGF-beta 1 induction of stable MTs was slower than that of CS (2-4 hours onset versus 1 hour onset), but by 24 hours the level of MT stabilization in TGF-beta 1 was even greater than that in CS.(ABSTRACT TRUNCATED AT 400 WORDS)

Variations in iron-status measures during the menstrual cycle

To determine whether normal physiologic changes associated with hormone fluctuations over the menstrual cycle affect concentrations of iron-status indicators, we examined data from 1712 women aged 18-44 y from the Second National Health and Nutrition Examination Survey (NHANES II) after adjusting for potential confounders. Adjusted mean values of hemoglobin (Hb), transferrin saturation (TS), and serum ferritin (SF) were lowest for women whose blood was drawn during menses and highest for women examined in luteal or late luteal phase of the menstrual cycle (Hb = 130 vs 133 g/L; TS = 21.2% vs 24.8%, P < 0.01 for both; and SF = 17.2 vs 24.0 micrograms/L, P < 0.05). The prevalence estimate of impaired iron status was significantly higher for women whose blood was drawn during the menstrual phase than for women whose blood was drawn during the luteal and late luteal phases. Our findings suggest that the phases of the menstrual cycle affect the concentration or values of iron-status indicators. These cyclic variations in indicators of iron status are a potential source of error when iron status is assessed in large population surveys that include women of reproductive age.

Cloning and sequence analysis of the gene encoding the crystalline surface layer protein of Rickettsia typhi

The nucleotide sequence of the gene (slpT) encoding the crystalline surface layer protein (SLP) of Rickettsia typhi was determined. The slpT gene consists of 4935 bp coding for a 1645-amino-acid (aa) protein containing a predicted signal peptide at the N terminus. The size of the predicted SLP exceeds the observed size (135 kDa) on SDS-PAGE. The N-terminal aa sequence of the 32-kDa protein of R. typhi reported by Hackstadt et al. [Infect. Immun. 60 (1992) 159-165] was found in the C-terminal portion of the deduced aa sequence, suggesting that the product of slpT is processed into the mature SLP and the 32-kDa protein.

Analysis of antigenic characteristics of Rickettsia tsutsugamushi Boryong strain and antigenic heterogeneity of Rickettsia tsutsugamushi using monoclonal antibodies

Twenty-four monoclonal antibodies were produced by immunizing BALB/c mice with Rickettsia tsutsugamushi Boryong strain and used for the analysis of antigenic characteristics of R.tsutsugamushi Boryong strain and antigenic heterogeneity of R.tsutsugamushi by indirect immunofluorescent(IF) test. R. tsutsugamushi Kato, Karp, Gilliam, TA686, TA716, TA763, TC586, TH1817, and Boryong were used for the analysis of antigenic heterogeneity of R.tsutsugamushi. Five monoclonal antibodies were reactive with 27-kDa protein, four monoclonal antibodies were reactive with 47-kDa protein, and eight monoclonal antibodies were reactive with 56-kDa protein of R.tsutsugamushi Boryong strain. The reactive protein of seven monoclonal antibodies could not be identified by immunoblotting method. All monoclonal antibodies to 27-kDa protein and three monoclonal antibodies to 47-kDa protein, and five monoclonal antibodies to 56-kDa protein were reactive with three to eight strains among nine strains of R. tsutsugamushi tested. One monoclonal antibody reactive to 47-kDa protein(KI18) and two monoclonal antibodies reactive to 56-kDa protein(KI36, and KI37) reacted with all the strains of R. tsutsugamushi tested. Strain-specific monoclonal antibody(KI58) could be found among antibodies which were reactive with 56-kDa protein. There was no strain which showed same reactivity pattern to these 24 monoclonal antibodies among nine strains. From this results, it could be concluded that Boryong strain is antigenically different from other strains of R.tsutsugamushi and antigenic heterogeneity of R.tsutsugamushi is due to the antigenic diversity of several proteins of R. tsutsugamushi including 56-kDa protein.

Urinary epidermal growth factor in patients with gliomas: significance of the factor as a glial tumor marker

Epidermal growth factor (EGF) content in urine from patients with glial tumors was examined by radioimmunoassay techniques with labeled human EGF and its rabbit EGF polyclonal antibody. There was no cross-reaction with transforming growth factor-alpha, which has a common receptor with EGF. Forty glial tumors were divided into three groups according to the clinical stage: Samples from Group A patients were obtained before therapy and/or after biopsy; in these patients a large volume of tumor was apparent on computerized tomography (CT). Group B samples were obtained after gross total removal of the tumor and/or chemo- and radiation therapy; these patients showed a small volume of residual tumor on CT. Samples from Group C patients were obtained after gross tumor total removal and/or chemo- and radiation therapy; no tumor was detected on CT scans in these patients. Urinary EGF levels in Group A samples were statistically significantly higher than in samples from healthy individuals (p < 0.001), Group B patients (p < 0.10), and Group C patients (p < 0.02). In addition, high-grade glial tumors in Group A cases showed a significantly higher level of urinary EGF than low-grade tumors in Group A patients (p < 0.05), or patients with meningioma (p < 0.02), metastatic brain tumor (p < 0.05), and cerebral infarction (p < 0.001). Longitudinal changes of urinary EGF levels in glioma patients mostly synchronized with the clinical course and therapeutic interventions. Therefore, urinary EGF, as a glial tumor marker, may be of practical value for diagnosing a malignant glioma and evaluating for the efficacy of chemo- and radiation therapy.

Vitamin and mineral supplement use and mortality in a US cohort

OBJECTIVES

Vitamin and mineral supplementation is a common practice in the United States, yet little is known about the long-term health effects of regular supplement use.

METHODS

To examine the relationship between reported use of supplements and mortality, we analyzed data from US adults 25 to 74 years of age who were examined in the First National Health and Nutrition Examination Survey (1971 to 1975), with vital status determined through 1987.

RESULTS

At baseline, 22.5% of the cohort reported using supplements regularly and 10.0% reported irregular use. The risk of mortality for regular supplement users was similar to that for nonusers. No consistent mortality benefits or risks of supplement use were found across a number of population subgroups. The risk for those who reported supplement use at both the baseline and a follow-up interview approximately 10 years later was similar to the risk for those who reported not using supplements at either interview.

CONCLUSIONS

We found no evidence of increased longevity among vitamin and mineral supplement users in the United States. Considering the wide use of supplements in the general population, the cost-effectiveness and the safety of supplement use need to be better defined.

Radiological evaluation of pulmonary vein obstruction including two examinations by magnetic resonance imaging

Congenital obstruction of the pulmonary vein without anomalous drainage can cause long-standing pulmonary congestion and pulmonary arterial hypertension, and it may include stenosis of individual pulmonary veins and pulmonary vein atresia. We reviewed seven cases of pulmonary vein obstruction, five of which were accompanied by other cardiac anomalies. Right pulmonary veins were involved in all seven cases; one case was bilateral. Pulmonary veins were occluded totally in five and partially in three lungs. Diagnostic pulmonary catheterization and angiography were performed. Chest radiographs of total occlusion cases showed decreased lung volume, features of pulmonary edema, interstitial lesions, and pleural changes, which were quite specific, whereas pulmonary venous dilatation was the dominant finding in partial obstruction cases. Pulmonary perfusion scan (n = 3) showed total perfusion defects in the cases with total occlusion of pulmonary veins. Magnetic resonance (MR) imaging (n = 2) demonstrated totally occluded pulmonary veins at the venoatrial junction in two lungs and membranous focal obstruction in one lung. Two children underwent pneumonectomy and had the diagnosis histologically confirmed. Although catheterization and angiography are essential for the diagnosis of pulmonary vein obstruction, MR imaging is a useful adjunct.

Different stroke volumes for the left and right ventricles in the moving-actuator type total artificial heart

A new electromechanical moving-actuator type total artificial heart (TAH) has been developed to solve the imbalance problem without an extra compliance chamber. A different stroke volume was achieved by the large left sac size and the asymmetry of the actuator motion referred to the center position. The left ventricle consists of a double sac with the outer sac attached to the actuator providing active diastolic filling, while the double sac of the right ventricle being free from the actuator, and having sufficient suction produced due to the rigid pump housing. The stroke volume difference between the left and right sac is compensated through the air in the interventricular space of the variable volume (VV) space. Computer simulation based on the geometrical relationships between the blood sacs and the actuator was performed to simulate the physical mechanisms of the moving-actuator type TAH. Results were then compared with the measured pressure changes in various chambers of the pump and the stroke volume differences in mock circulation test. In two acute calf experiments, the balanced left and right atrial pressures were achieved in the moving-actuator type TAH without an extra compliance chamber.

Endodermal sinus tumour associated with benign teratoma of the common bile duct

We report a 5-year-old boy with endodermal sinus tumour associated with benign cystic teratoma of the common bile duct (CBD). To our knowledge, there has been one case of teratoma of the CBD in the English literature with no morphological or radiological description. Our case presented a lobulated polypoid mass obstructing the distal CBD on sonography and computed tomography, which resembled the botryoid masses of rhabdomyosarcoma.

Pregnancy nutrition surveillance system--United States, 1979-1990

Since 1979, the CDC Pregnancy Nutrition Surveillance System (PNSS) has monitored behavior and nutritional risk factors among low-income pregnant women participating in public health programs. Although the states contributing to the system have varied over the period, the PNSS is able to characterize the behavior and health outcomes of pregnant women from diverse low-income populations. In 1990, 66.2% of the women in the system initiated prenatal care during the first trimester of pregnancy; 26.4% smoked during pregnancy. Since 1979, the prevalence of smoking remained relatively stable for white women, but declined for blacks and Hispanics. Prepregnancy body mass index (BMI, defined as kg/m2) showed marked changes from 1979 through 1990; the prevalence of underweight (BMI < 19.8) declined steadily and the prevalence of overweight (BMI > 26) increased steadily. In 1990, 39.3% of the women had gestational weight gains below levels recommended by the National Academy of Sciences. Both prepregnancy underweight and inadequate gestational weight gain were associated with greater risk for low birth weight in the PNSS. The prevalence of anemia at each trimester has remained stable since 1979. In 1990, 9.8%, 13.8%, and 33% of the women reported by the PNSS were anemic in the first, second, and third trimesters, respectively. Anemia in the first trimester appeared to be strongly associated with a high risk of low birth weight; this association was attenuated in later trimesters. These findings indicate the need to improve iron nutrition among low-income women.

Chemotactic response of macrophages to Acanthamoeba castellanii antigen and antibody-dependent macrophage-mediated killing of the parasite

The chemotactic potential of antigens of Acanthamoeba castellanii for macrophages and the ability of naive and immune rat peritoneal macrophages to kill A. castellanii in vitro were assessed. The amoebolytic capacity of immune rat serum and complement was also examined. No parasite was killed in the presence of heat-inactivated naive rat serum. Low numbers of parasites were lysed in the presence of heat-inactivated immune rat serum, whereas significantly greater numbers of parasites were lysed in the presence of nonheat-inactivated naive and immune rat serum. Macrophages from naive rats were capable of lysing some parasites. However, the amoebolytic capability of these cells was significantly increased in the presence of serum from immune rats. Regardless of the source of serum used, macrophages from immune rats demonstrated about twice the amoebolytic proficiency of cells from naive rats. Macrophages from naive rats showed their highest capacity for lysing amoebae when incubated in the presence of gamma interferon and immune rat serum. The greatest overall proficiency in lysing parasites was displayed by cells from immune rats incubated with A. castellanii in the presence of gamma interferon and nonheat-inactivated serum from immune rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinicopathologic and immunophenotypic study of non-Hodgkin's lymphoma in Korea. Lymphoreticular Study Group of the Korean Society of Pathologists

This study sponsored by the Lymphoreticular Study Group of the Korean Society of Pathologists was carried out to provide nationwide data about the histopathologic-immunophenotypic features of malignant lymphomas in Korea. Two hundred and ninety Non-Hodgkin's lymphoma (NHL) among 312 malignant lymphomas collected from three representative areas in Korea were histologically reclassified. Two hundred and fifty three cases were immunohistochemically studied. T-cell lymphoma comprised 35.2% of NHL in this study and showed a quite comparable incidence to that of Japan and China, but it was much higher than in Western countries. A very low prevalence rate of the follicular variety (4.0%) and a higher propensity of primary extranodal involvement (60%) are additional characteristics of NHL in Korea. The most common histologic subtype of B cell lymphoma was diffuse large cell type, whereas the most common subtype of T cell lymphoma was diffuse mixed small and large cell type.

Inflammatory pseudotumor of the lung manifesting as a posterior mediastinal mass

A case of inflammatory pseudotumor of the lung in a 6-year-old boy is presented. The respiratory illness presented as a mycoplasma pneumonia and there had been a similar episode of mycoplasma pneumonia one and a half years previously. Computed tomography revealed a large, calcified right posterior mediastinal mass and exploratory thoracotomy revealed a large posterior mediastinal mass that had an endobronchial component and grew exophytically from the lung. The present case suggests that inflammatory pseudotumor of the lung can manifest as a mediastinal mass and could be associated with mycoplasma pneumonia infection.

Fatty liver. Chemical shift phase-difference and suppression magnetic resonance imaging techniques in animals, phantoms, and humans

In vitro animal and human models were used to evaluate the potential of chemical shift magnetic resonance imaging (MRI) for assessing fatty liver. Phantoms of varying fat content were created from mayonnaise-agar preparations. Fatty liver was induced in eight rats by feeding them ethanol for three to six weeks (36% of total calories), whereas eight control rats were fed a normal diet. T1-weighted in-phase and opposed-phase MR images were obtained of the phantoms animals, and 28 human subjects. Additional images obtained in animals included long TR images with in-phase and opposed-phase technique, and hybrid chemical shift water and fat suppression. The rats were killed and histologic status was graded blindly by a hepatopathologist as normal, mild, moderate, or severe fatty change, for correlation with MR grading. Quantitative analysis of MR images included fat signal fraction for animals, and relative signal decrease between in-phase and opposed-phase images for phantom and human data. Phantom in-phase signal increased linearly with respect to fat content, whereas opposed-phase signal decreased linearly. MRI and histologic grading of rat livers were highly correlated, especially when based on water suppression images (r = 0.91, P = .0001). Opposed-phase images were also highly correlated, while fat suppression images were less effective. There was no overlap between MR-derived fat fractions for control (2.6%-5.7%) versus ethanol-fed rats (7.7%-17.9%, P = .0002). Human liver considered to be fatty by visual inspection (n = 8) had higher relative signal decrease than nonfatty liver (n = 22) (P less than .001). Phantom, animal, and human data demonstrate that comparison of T1-weighted in-phase and opposed-phase images is both practical and sensitive in the detection and grading of fatty liver.

Characteristics of vitamin and mineral supplement products in the United States

A 1986 nationwide survey of 11,775 adults 18 y or older and 1877 children 2-6 y old identified approximately 3400 different (unique) vitamin and mineral supplement products being taken. The most commonly included nutrient listed on the product labels was vitamin C, which was present in 50% of the unique products examined. Calcium and iron were the most commonly included minerals and were present in 25% of the unique products examined. Prenatal and children's chewable products came in a relatively narrow potency range and generally contained nutrients in amounts approximating or less than the US recommended daily allowances. These products also contained significant minimum amounts of nutrients. Potencies of products not targeted for use by these special groups, particularly those products that were self-prescribed, varied widely and ranged from insignificant to extremely large amounts of nutrients. Units used to declare product potency or to prescribe the dosage varied.

Identification and regulation of insulin-like growth factor binding proteins produced by hormone-dependent and -independent human breast cancer cell lines

Using molecular hybridization, ligand blotting and immunoprecipitation, our studies were designed to identify the insulin-like growth factor binding proteins (IGFBPs) produced by human breast cancer cells in culture and evaluate their regulation by estradiol (E2) and polyamines (PA). We demonstrate that the hormone-dependent MCF-7 and -independent BT-20 cell lines express the mRNA for IGFBP-2 (1.7 kb) and secrete this BP (31 kDa) in the conditioned medium. In contrast, the hormone-independent MDA-MB-231 cell line does not express the IGFBP-2 gene, while synthesizing and secreting IGFBP-1. E2 administration (10(-9) M) did not significantly influence IGFBPs secretion in MCF-7 cells. Addition of alpha-difluoromethylornithine (DFMO, 4 mM), an inhibitor of PA biosynthesis, consistently lowered IGFBP-2 mRNA in the MCF-7 and BT-20 cell lines and IGFBP-1 mRNA in MDA-MB-231 cells. Surprisingly, however, this compound either did not influence IGFBPs secretion in MCF-7 cells or actually increased their secretion in the BT-20 and MDA-MB-231 cell lines. PA involvement in IGFBPs production by breast cancer cells is complex and may involve differential regulation of transcriptional and post-translational events.

Arteriovenous malformation of the uterus--a cause of massive operative bleeding

Arteriovenous malformations of the uterus are extremely rare and they occur either in congenital or acquired forms. The most common clinical presentation is abnormal uterine bleeding, which may be aggravated by therapeutic curettage. Because of their rare incidence and clinical importance in management of patients, we report a case of arteriovenous malformation causing serious bleeding during a hysterectomy for uterine leiomyoma. The patient was a 47-year-old multiparous woman who had a history of chronic vaginal bleeding for one year. Numerous anomalous blood vessels draining into the right and left uterine arteries were found on the anterior wall of the uterus and parametrium.

Polyamine involvement in the secretion and action of TGF-alpha in hormone sensitive human breast cancer cells in culture

These experiments were designed to test polyamine (PA) involvement in the secretion and action of transforming growth factor alpha (TGF-alpha) in hormone responsive MCF-7 breast cancer cells in liquid culture. At the same time, we evaluated the influence of culture conditions (with serum vs. serum depleted) and subclonality of MCF-7 cells on PA involvement in estrogen (E2) and TGF-alpha stimulated cell proliferation. Despite inducing a profound suppression of cellular PA levels and inhibiting basal and E2-stimulated growth, administration of the PA synthesis inhibitor alpha-difluoromethylornithine (DFMO) did not influence either basal or E2-induced TGF-alpha secretion. In the same experiments, on the other hand, addition of DFMO completely blocked the growth stimulatory effect of exogenous TGF-alpha. However, when the culture conditions were changed to serum-free medium, TGF-alpha and E2-induced cell proliferation was affected modestly or not at all by DFMO administration, despite similar suppression of cellular ornithine decarboxylase (ODC) activity and PA levels. In addition, different clones of MCF-7 cells differed in their sensitivity to the antiproliferative effect of DFMO as well as in basal levels of ODC activity and PA. We conclude that PAs are not involved in basal or E2-stimulated TGF-alpha secretion in MCF-7 breast cancer cells. On the other hand, PAs do seem to be important mediators of TGF-alpha and E2-induced breast cancer cell proliferation, though the degree of such involvement appears to be influenced by serum factors and clonal variability of MCF-7 cells.

[Emergency therapy with granulocyte-macrophage colony-stimulating factor (GM-CSF)]

Granulocyte-macrophage colony stimulating factor (GM-CSF) has been tested for tolerability and efficacy on a compassionate need case basis in 17 patients (5 females, 12 males aged 4-72 years, median 35 years). GM-CSF was given at the rate of 3.5-32 micrograms/kg for 2-64 days as a continuous infusion for the following indications: impending rejection following bone marrow transplantation (5 patients), severe neutropenia secondary to chemotherapy in tumor patients (5), severe aplastic anemia (3), immune granulocytopenia (2) and accidental overdose with cytostatic agents (2 patients). Tolerance of GM-CSF was good in regard to doses of up to 16 micrograms/kg. Fever, myalgia and eosinophilia were the most frequent side effects. The patient treated with 32 micrograms/kg developed thrombosis of the vena cava. Efficacy is more difficult to assess in this heterogenous population, but 11 of 17 patients showed increased granulocyte counts and 3 patients clearly recovered from severe neutropenia. The role of GM-CSF in this recovery, however, cannot be proven. The results further indicate that GM-CSF cannot reverse ongoing rejection following allogenic BMT and cannot correct immune neutropenia. The value of GM-CSF therapy in patients with severe aplastic anemia and in the context of chemotherapy still needs to be defined. It is certainly indicated in patients with an accidental overdose of chemotherapeutic agents.

Indications for surgical treatment of putaminal hemorrhage. Comparative study based on serial CT and time-course analysis

Serial computerized tomography (CT) scans were correlated with a precise time-course analysis of the neurological condition of 180 patients with hypertensive putaminal hemorrhage. All patients entered the study within 3 hours of the ictus. In this series, 111 patients were treated conservatively and 69 surgically. The neurological condition of each patient was measured by means of a newly proposed grading system for intracerebral hemorrhage-intracranial hemorrhage (ICH grade) which is a modification of the Glasgow Coma Scale. Serial CT scans revealed that most hemorrhages were completed within 6 hours after ictus. Based on the ICH grade at 6 hours postictus, a clinical classification of the severity of putaminal hemorrhage was defined: fulminant, rapidly progressive, slowly progressive, and nonprogressive. According to this classification, precise time courses of the ICH grade were compared between the conservative and surgical treatment groups in a 7-day postictal period. Activities of daily living at 6 months after ictus were also compared. Surgical treatment for a rapidly progressive hemorrhage appears to be beneficial if undertaken in patients under 65 years of age. Surgery in a slowly progressive hemorrhage should be considered only in a small number of patients who deteriorate neurologically with conservative treatment. In this series of patients, surgical treatment of fulminant and nonprogressive hemorrhage was not likely to improve the quality of life or functional recovery. Regardless of treatment modality, CT provided evidence that patients with anterior capsular hemorrhage (16% in this series) showed good recovery of motor and speech function.

Serum LDH and LDH isoenzymes in chronic renal failure: effect of hemodialysis

Serum levels of several commonly measured enzymes are abnormal in patients with end-stage renal disease (ESRD). In the present study we measured serum total LDH activity and LDH isoenzymes in a group of 25 ESRD patients shortly before, during, and immediately after hemodialysis. Baseline serum total LDH activity in the ESRD group was midly but significantly higher than that found in the normal control group. The observed elevation was associated with an isomorphic pattern. Single passage of blood through the extracorporeal apparatus led to a rise in total LDH, LDH-3, LDH-2 and LDH-4, a pattern consistent with release from the platelets. A steady increase was noted in total LDH, LDH-5 and LDH-1 of arterial blood during hemodialysis. This was thought to be due to ultrafiltration-induced hemoconcentration, enzyme release from the formed elements within the extracorporeal circuit and complement-mediated leukocyte activation and pulmonary leukostasis. These observations should be taken into consideration with regards to interpretation of LDH and LDH isoenzyme values and proper time of blood sampling in ESRD patients.

The response of nerve tissue to chymopapain

This study was undertaken to clarify the effects of topically injected chymopapain on the spinal cord and peripheral nerves in rabbits, and also the effect of ganglioside on sciatic nerves which had been damaged by chymopapain. There were no abnormal macroscopic or microscopic findings when chymopapain was injected around the sciatic nerve sheath or around the spinal dura mater, but when it was injected directly into the nerve sheath there was immediate paralysis and severe axonal necrosis; the Schwann sheath remained intact and there was haemorrhage. Injection into the dura resulted in massive haemorrhage, perivascular neutrophil infiltration and necrosis of grey matter. In those treated with ganglioside, regeneration of the damaged sciatic nerve was shorter than in those not so treated.

[Comparison of five modes of dialysis in neurosurgical patients with renal failure]

In neurosurgical patients with renal failure, dialysis entails specific problems, chief of which is increased intracranial pressure and progressive brain edema as a result of rapid lowering of the serum osmolality. Another major problem is a tendency to hemorrhage, in response to either systemic heparinization or insufficient dialysis. The authors describe the results obtained with hemodialysis (HD), continuous arteriovenous hemofiltration (CAVH), continuous ambulatory peritoneal dialysis (CAPD), continuous peritoneal dialysis (CPD), and intermittent peritoneal dialysis (IPD). Nine patients were treated with HD, one with CAVH, five with CAPD or CPD, and two with IPD. Three of the six patients treated with continuous dialysis (CAVH, CAPD, and CPD) died, whereas intermittent dialysis (HD and IPD) carried an 82% mortality rate (nine of 11 patients). The causes of death were progressive brain edema in three cases, intracranial hemorrhage in three, gastrointestinal bleeding in three, overhydration due to insufficient dialysis in one, septicemia in one, and rupture of a cerebral aneurysm in one. Continuous dialysis appeared to be superior to intermittent dialysis in these neurosurgical patients in that it produced less brain edema and was less often associated with hemorrhage due to insufficient dialysis. In HD and CAVH, systemic heparinization was also thought to account for the high incidence of hemorrhage. However, CAVH with short half-life anticoagulants may be useful in patients who have abdominal complications and are therefore not suitable candidates for peritoneal dialysis.

Pathophysiology of rhinitis. Lactoferrin and lysozyme in nasal secretions

The antimicrobial proteins lactoferrin (Lf) and lysozyme (Ly) are invariably found in nasal secretions. To investigate the cellular sources and the secretory control of these nasal proteins in vivo, 34 adult subjects underwent nasal provocation tests with methacholine (MC), histamine (H), and gustatory stimuli. Nasal lavages were collected and analyzed for total protein (TP), albumin (Alb), Lf, and Ly. MC (25 mg), H (1 mg), and gustatory stimuli (spicy foods) all increased the concentrations of TP, Alb, Lf, and Ly. However, when each protein was assessed as a percentage of TP (i.e., Alb% = Alb/TP; Lf% = Lf/TP; Ly% = Ly/TP), MC and gustatory stimuli, which both induce glandular secretion, selectively augmented Lf% and Ly% without changing Alb%, while H, which primarily increases vascular permeability, increased Alb% without significantly affecting Lf% or Ly%. Gel electrophoresis and immunoblotting analysis of nasal secretions demonstrated both Lf and Ly in cholinergically induced secretions. Furthermore, histochemical analyses of nasal turbinate tissue revealed Lf and Ly colocalization within the serous cells of submucosal glands, providing evidence that both proteins are strictly glandular products within the nasal mucosa. Therefore, both Lf and Ly are produced and secreted from the glands, and their secretion may be pharmacologically regulated in attempts to improve host defenses.

Effects of progesterone or luteinizing hormone on folliculogenesis in intact or hypophysectomized immature hamsters

Since exogenous progesterone (P4) causes superovulation in hypophysectomized (hypoxed) cyclic hamsters treated with gonadotropins, the current study was performed to evaluate the roles of P4 and luteinizing hormone (LH) as a folliculotropic complex in the immature hamster. Intact or hypoxed immature hamsters were injected daily, beginning on Day 23, with 1 mg P4 and/or 20 micrograms LH for 4 days. Treatment with P4 alone or combined with LH in intact immature hamsters increased the number of antral follicles (6.7 and 4.3, respectively, vs. 1.5 per ovary in controls), but neither treatment maintained large follicles in hypoxed animals. In contrast, in hypoxed hamsters, the number of small preantral follicles was enhanced by P4 or LH (406 and 409, respectively, compared to 302 per ovary in untreated controls), but with no additive effects by combined treatment. The stimulatory effect of P4 in intact hamsters was unrelated to serum levels of follicle-stimulating hormone, estradiol, or LH. Moreover, in the hypoxed hamster, P4 or LH acts directly to increase the numbers of small preantral follicles with 2 to 5 layers of granulosa cells, whereas equally large doses of stilbestrol or estradiol cyclopentylpropionate are ineffective. In the hypoxed or intact hamster, the effects of P4 or LH may involve either recruitment of smaller follicles into larger stages or prevention of atresia. The present experimental design can not distinguish between these possibilities.

Nuclear magnetic resonance microscopic ocular imaging for the detection of early-stage cataract

A nuclear magnetic resonance (NMR) microscopic ocular imaging was performed at 7.0 Tesla to investigate its usefulness in the detection of early-stage cataracts. For this study, galactose cataracts were generated in experimental rabbits through diet (35% galactose), and enucleated eyes were imaged at various times after initiation of the diet. In previous studies using a 0.6 Tesla conventional magnetic resonance imager (MRI), the contrast between normal and cataractous tissues in the lens was not well defined, mainly due to the partial volume effect coming from the limitation of resolution and signal-to-noise ratio (SNR). With resolution of 60 X 60 X 80 microns, early localized precataractous tissue changes were clearly observed after 5 days diet. Precataractous tissue changes were seen histologically but no visible evidence of lens change was detected by the conventional slit lamp biomicroscope at this time. Substantially elongated spin-spin relaxation times (T2) in localized cataractous tissues (72.4 +/- 8.8 msec) were consistently observed compared with those in normal lens region (16.1 +/- 3.2 msec); however, the changes of the spin-lattice relaxation time (T1) were not significant. Some ocular NMR microscopic images with corresponding histological photographs are demonstrated to show the potential of NMR microscopy.

The role of serial angiography in the management of bacterial and fungal intracranial aneurysms--report of two cases and review of the literature

The authors review 149 cases of bacterial and mycotic intracranial aneurysms reported since 1957 and describe two cases of bacterial aneurysms managed in their institution. The overall mortality rate was 39%. Bacterial aneurysms accounted for 0.49-4.3% of all intracranial aneurysms. Among the reported cases, the mortality rate for patients treated with antibiotics alone was high, whereas it was low among those who underwent elective surgery. The authors conclude the following: 1) Distal aneurysms should be treated with high-dose antibiotics and followed with serial cerebral angiography at 7 days, 14 days, 1 month, 3 months, and 1 year after the initiation of therapy; 2) proximal aneurysms should be treated with high-dose antibiotics, and surgery is rarely indicated; 3) any significant associated hematoma should be evacuated and the aneurysm resected, if possible; and 4) if serial angiography shows enlargement of an aneurysm, surgery should be considered. The clinical features and management of mycotic and bacterial aneurysms are discussed in detail.

Timolol side effects and inadvertent overdosing

The case reports demonstrate that significant and potentially dangerous side effects from timolol maleate occur as a result of inadvertent overdosing. Because many glaucoma patients are elderly and vision is frequently impaired, overdosing may be the mechanism of side effects in many patients especially the elderly. A simple dropper that would withdraw only one drop and deliver the same would resolve this problem.

Nucleolar organizer regions of lymphomas in Korea

Nucleolar organizer regions (NORs) are loops of DNA which occur in the nucleoli of cells and which possess ribosomal RNA (rRNA) genes. The numbers and/or configurations of NORs have been thought to be related to cellular activities. To assess the applicability of NORs associated protein (Ag-NORs) in the field of diagnostic histopathology, a silver staining was done in paraffin sections of malignant lymphomas, tonsils and reactive lymph nodes and the numbers of Ag-NORs in the nuclei of low-grade and those of high-grade lymphomas were compared. A significant difference was found between the numbers of Ag-NORs in the nuclei of low-grade lymphoma (a mean of 1.3 per nucleus) and those of high-grade lymphomas (a mean of 4.2 to 8.3 per nucleus). The Ag-NORs were often observed in nuclei in areas where nucleoli themselves were not visible in H&E stain. It is suggested that this method would be of great value in the field of tumor histopathology.

Conservative treatment of tuberculosis of the thoracic and lumbar spine in adults and children

We have treated 75 cases of spinal tuberculosis with chemotherapy as outpatients. The drugs used were INH, rifampicin and ethambutol for the 48 adults, and INH, rifampicin and PAS for the 27 children. No operations, apart from the evacuation of large abscesses, were carried out. Every patient was followed up for at least three years and the outcome was judged to be favourable in 95%. This is better than in some series in which radical surgery has been used. Although we recognize the advantages of operation in certain circumstances, we believe that our conservative regimen can be confidently recommended for use in less privileged countries, where adequate facilities for hospital treatment may not be available.

Effect of estrogens on follicular development and ovarian and uterine estrogen receptors in the immature rabbit, guinea pig and mouse

Immature rabbits, guinea pigs and mice were injected with estradiol cyclopentylpropionate (ECP) or diethylstilbestrol (DES) for 3 days to evaluate whether estrogen enhances follicular maturation. Also, estrogen receptors in the ovary and uterus from these animals were measured. Uterine weight increased in all animals treated with ECP or DES, whereas actual ovarian weight increased only in the guinea pig. This correlated with the ability of estrogens to significantly increase the number of antral follicles in the guinea pig ovary. In the rabbit and mouse, estrogen increased only the number of small or large preantral follicles. However, the number of estrogen binding sites in the ovarian cytosol and nucleus was greater in the rabbit and the mouse than in the guinea pig. The affinity of ovarian cytosol receptors was the lowest for the guinea pig among the 3 species. Thus it is seen that estrogen does not enhance follicular maturation in all animal species. The ovarian response to estrogen is not only dependent upon estrogen receptors but also unknown mechanism(s) that may be related to paracrine or autocrine functions.

Blood-flow measurement in muscle with Xe-133

An alternative method to the conventional miniature probe system for the measurement of blood flow in muscle has been developed. Xenon-133 was injected into the quadriceps muscles of ten subjects. A gamma camera and an online computer were then used to measure the half-clearance time of the Xe-133 while the subject was both at rest and exercising on an upright bicycle ergometer. The blood flow in the muscle was then calculated from the acquired data.

Differences in the pattern of weight growth of nutritionally at-risk and well-nourished infants

A mathematical model was used to examine the patterns of weight growth of two groups of infants exposed to various ecological and nutritional conditions and practices. Statistical comparison of the parameters of weight model estimated from longitudinal data demonstrated different level and profile contour of weight growth in these two populations. In addition to differences in the growth levels, the growth patterns of these two groups are significantly different. The Taiwanese infants experience more pronounced upward and downward changes in growth velocity than the United States (US) infants in the first 6 mo of life. In the second 6 mo, the US infants show a decline in growth velocity whereas the Taiwanese infants maintain a low and constant growth rate. Possible explanations for the different growth profile of the Taiwanese infants in the first 6 mo may be related to: catch-up growth after possible intrauterine undernutrition, genetic growth pattern of Taiwanese infants, and growth characteristics of breast-fed infants.

Primary well differentiated lymphocytic lymphoma of the lung--a clinical and immunohistochemical study of four cases

Four cases of well differentiated lymphocytic lymphoma with or without plasmacytoid differentiation of the lung are described. Two cases were single and the others were multiple. Histologic pictures of the lesion showed mass with perivascular, interstitial and alveolar extension in three cases and only interstitial and perivascular involvement in one. Histologically three cases were lymphoplasmacytic lymphoma and one was small lymphocytic lymphoma. Dutcher bodies, granulomas and germinal centers were also found in tumors. Immunohistochemical study revealed monoclonal lymphocytic proliferation in all cases in fresh frozen sections and in three in paraffin sections. Treatment is surgical resection. Chemotherapy is used for residual disease after surgery.

Stimulatory and inhibitory effects of progesterone on follicular development in the hypophysectomized follicle-stimulating hormone/luteinizing hormone-treated hamster

Cyclic hamsters hypophysectomized at estrus (Day 1 of the cycle) and injected with 5 micrograms follicle-stimulating hormone (FSH) on Day 1 and 20 micrograms luteinizing hormone (LH) in polyvinylpyrrolidone (PVP) from Days 1-4 ovulated 15.3 ova, in response to 30 IU human chorionic gonadotropin (hCG) administered at 1500 h on Day 4 (Kim and Greenwald, 1984). When 1 mg progesterone (P4) was administered daily from Days 1-4 concurrent with the above regimen, ovulation increased to 38 ova, a clearcut superovulatory response. However, daily injection of 1, 10, or 100 micrograms P4 plus FSH and LH reduced the number of antral follicles present on the afternoon of Day 4 to 3-4 per ovary, compared to 9 per ovary after FSH-LH alone, and the ovulation rate was drastically reduced with most animals being anovulatory. Substituting 1 mg 17 alpha-hydroxyprogesterone or estradiol cyclopentylpropionate for P4 on Days 1-4 did not alter the number of antral follicles on Day 4 from FSH-LH alone, whereas 1 mg androstenedione or 1 mg testosterone cyclopentylpropionate reduced the number of antral follicles to 3 or less. Hence, the stimulatory effects of 1 mg P4 are not attributable to its conversion to other P4 derivatives. After the concurrent injection of 1 mg P4 and FSH-LH, on the afternoon of Day 3, an average of only 1.8 large preantral follicles was present per ovary. By the morning of Day 4, however, the ovary contained 14 large preantral and early antral follicles in addition to 8 large antral follicles. Injection of hCG at this time resulted in the ovulation of 14.5 ova.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhibition of lactate dehydrogenase-X by imino-derivatives of gossypol:structure activity relationship

Six imino-derivatives (II, III, IV, V, VI, VII) of gossypol (I) have been synthesized, and their effects were evaluated on the purified mouse lactate dehydrogenase-X. Three of these derivatives (V, VI, VII) with aldehyde groups substituted with hydrophobic functionalities showed equivalent or more inhibitory effects on lactate dehydrogenase-X than gossypol, whereas three other derivatives (II, III, IV) with aldehyde groups substituted with hydrophilic functional groups lost the ability to inhibit lactate dehydrogenase-X. It is suggested that two aldehyde groups of gossypol are not essential to inhibit lactate dehydrogenase-X. Furthermore, the hydrophobic property of the gossypol molecule seems to play a more important role in inhibiting lactate dehydrogenase-X. Therefore, lactate dehydrogenase-X inhibition by gossypol may not be associated with its antifertility mechanism, because the aldehyde group of gossypol is known to be required for its antifertility effect.

Estrogen receptors in ovary and uterus of immature hamster and rat: effects of estrogens

Cytosolic and nuclear estrogen receptors in the ovary and uterus of immature rats and hamsters were determined to evaluate why exogenous estrogens were ineffective in stimulating follicular maturation in the hamster compared to the rat. Animals were injected sc with oil or single injection of 1 mg estradiol cyclopentylpropionate (ECP) on Day 23 or a daily injection of 2 mg diethylstilbestrol (DES) on Days 23-25 and killed on Day 26. Total binding sites for estrogen in ovarian cytosol of control hamsters were half the number in the rat ovary (28 fmole/mg protein) and about 50% of the receptors were occupied in the hamster. The apparent affinity of the estrogen-cytosol receptor complex was also lower in the hamster (Kd; 1.41 nM) than in the rat (Kd; 0.52 nM). After ECP treatment, there was a tendency for translocation in all 4 tissues examined even though some differences were not statistically significant. However, after DES treatment both cytosol and nuclear estrogen receptors decreased in both species. This discrepancy may be due to the difference in the time course of the nuclear translocation, the difference in metabolism and difference in the binding potencies of ECP and DES. The lack of ovarian responsiveness to estrogen in the hamster thus appears to be due to the reduced number of cytosol receptor sites which have a low affinity for estrogen and are already partially occupied.

Cavernous angioma of the cauda equina producing subarachnoid hemorrhage. Case report

A case of a cavernous angioma of the cauda equina is presented. The patient was a 28-year-old man who experienced sudden low-back pain and headache without neurological symptoms. Lumbar puncture revealed subarachnoid hemorrhage. He had suffered a similar episode 3 years previously. Selective spinal angiography did not demonstrate any abnormal vascularity. Metrizamide myelography and magnetic resonance imaging were useful in demonstrating the presence of a tumor. Laminectomy at L1-3 and total removal of the tumor were performed without neurological deficit.

Occupied and unoccupied FSH receptors in follicles of cyclic, hypophysectomized or hypophysectomized/gonadotropin-treated hamsters

Occupied and unoccupied FSH receptors were measured in follicles from intact cyclic hamsters or in animals hypophysectomized on day 1 (= estrus) which were untreated or given ovine FSH on day 1 plus LH on days 1-4 or FHS and LH plus 1 mg progesterone on days 1-4. Intact hamsters, from days 2-4, the number of occupied and unoccupied FSH receptors and receptor affinity was unchanged in antral follicles. For the untreated hypophysectomized hamsters, serum FSH was undetectable beyond day 3 but receptor affinity increased on day 2 and the number of occupied FSH receptors was still very high on day 4. Thus, in the hypophysectomized untreated hamster the ovary is not hormonally deprived - at least up until day 4. Treatment of the hypophysectomized hamsters with FSH-LH restored all follicular values of levels of intact hamsters on days 2 and 3. On day 4, although serum FSH was undetectable since day 3 the number of occupied FSH receptors was 70% of control values. The FSH-LH regimen developed by day 4 large antral follicles in the hypophysectomized hamsters. Collectively, the experiments demonstrate that in intact hamsters as a result of the prolonged peak of serum FSH on day 1 FSH binds avidly to receptors in granulosa cells and persists until day 4. Thus, the follicles in the hypophysectomized groups develop in response to exogenous LH but with hamster FSH still present, bound to granulosa cells.

Steroidogenic effects of lipoproteins and 25-hydroxycholesterol on luteal and ovarian cells: a comparison of two pseudopregnant rat models

Steroidogenesis was compared between luteal cells from immature pseudopregnant (PSP) rats induced by either 5 IU pregnant mare serum gonadotropin (PMSG) alone or 50 IU PMSG combined with 25 IU human chorionic gonadotropin (hCG). It was also determined whether differences in steroidogenesis existed when the entire ovary (ovarian cells) or just luteal cells from Day 4 PSP rats were exposed in vitro to lipoproteins or 25-hydroxycholesterol (25-OH chol). In the absence of luteinizing hormone (LH), basal steroid accumulation, especially progesterone (P4) was around fourfold greater in luteal cells from rats treated with PMSG alone than from rats receiving PMSG-hCG. However, serum P4 and LH were about fivefold greater in the latter group. It is therefore likely that net cellular cholesterol uptake per luteal cell is lower in the PMSG-hCG treated rats, but this is offset by a much greater mass and number of corpora lutea. Lipoproteins (HDL and LDL) and 25-OH chol stimulated in vitro luteal steroidogenesis from rats treated with PMSG alone or PMSG-hCG, and their responses were virtually identical. Therefore, luteal steroidogenesis in the rat always depends on exogenous cholesterol even though treatment in the preovulatory period with PMS or PMSG-hCG and serum LH and follicle-stimulating hormone (FSH) levels on Day 4 PSP are very different. When ovarian cells from PMSG-hCG treated rats were incubated with LH plus HDL or 25-OHP, the production of 20 alpha-DHP was considerably greater than luteal cell production which may be due to a contribution from nonluteal cells. Indeed, about 30% of the cells in the PMSG-hCG group represent nonluteal components as estimated by weight and deoxyribonucleic acid content.

Iron deficiency anemia and educational achievement

The present study investigates the effect of iron supplementation on measures of school performance among 78 iron-deficient anemic and 41 nonanemic children in an economically deprived rural area in Central Java, Indonesia. All the subjects were treated for ancylostomiasis before iron supplementation. They were randomly assigned to either an iron or placebo group. Hematological and behavioral measurements were obtained immediately before (T1) and after (T2) the iron and placebo treatments. Iron treatment for a 3-mo period resulted in substantive increases in mean Hgb, Hct, and transferrin saturation among the iron-deficient anemic children. Furthermore, changes in the iron status of iron-deficient anemic children were associated with significant changes in the school achievement test scores of iron-deficient anemic children. T2 evaluation of achievement test scores indicated that the difference between iron-treated anemic and nonanemic children was still statistically significant. However, when T1 scores were entered as a covariate, iron-deficient anemic subjects treated with iron obtained significantly higher delta achievement scores. Findings from the present study indicate that iron supplementation among iron-deficient anemic children benefits learning processes as measured by the school achievement test scores.