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Summary Chronic diarrhoea presents a diagnostic challenge for both human physicians and equine veterinarians. There is currently no consensus in the equine veterinary literature on the definition of chronic diarrhoea. The differential list is extensive and identifying diarrhoea by pathophysiologic mechanism can help remove less likely diagnoses. Achieving a definitive antemortem diagnosis is also challenging. Results from non‐invasive diagnostics may only lead to the conclusion that inflammation is present. Cellular infiltrate, if present, may not be representative of the underlying disease. Invasive diagnostics resulting in acquisition of full‐thickness biopsies may result in a diagnosis when other methods have failed. However, there is currently minimal data correlating these findings with those from full post‐mortem examination. This article discusses the various diagnostic options and reviews the available literature on their value in evaluating currently available patients with chronic diarrhoea. [ABSTRACT FROM AUTHOR]

Objective The serum squamous cell carcinoma antigen (SCCA) level is a well-known tumor marker for squamous cell carcinoma. In this study, we examined the impact of immunoglobulin (Ig)-bound macromolecular SCCA on serum SCCA levels measured by 2 different methods. Methods Seventy-five serum samples with an SCCA level >5.0 ng/mL as determined by a chemiluminescent immunoassay (CLIA) were also analyzed using a chemiluminescent enzyme immunoassay (CLEIA). The levels of IgG- and IgA-type anti-SCCA antibodies, which form immunoglobulins and macromolecules, respectively, were determined using an enzyme-linked immunosorbent assay. An absorption test was performed to confirm the presence of anti-SCCA antibodies. Results The correlation coefficient between the values measured by CLEIA and CLIA was 0.768. The ratio of SCCA levels measured by CLEIA to those measured by CLIA in 14 samples with IgG-type anti-SCCA antibodies was significantly lower than that in samples without these antibodies (P <.031). Absorption tests showed that SCCA levels measured by CLIA might be falsely high in samples with IgG-type anti-SCCA antibodies, probably due to reactions with SCCA1. Conclusion The level of SCCA as measured by CLIA and CLEIA methods correlate well, but the presence of SCCA antibodies can affect the results of the CLIA method. [ABSTRACT FROM AUTHOR]

Monoclonal immunoglobulin-G (IgG) antibodies are now emerging as therapeutic tools to tackle various disorders, including those affecting the brain. However, little is known about how these IgG molecules behave in the brain. To better understand the potential behavior of IgG molecules in the brain, here we established a specific protocol to immunolocalize rat IgG injected into mouse striatum with an anti-rat IgG antibody. Using double immunolabeling, IgG-like immunoreactivity (IR) was mainly found in neurons but scarcely observed in glia 1 h after intrastriatal injection of IgG, whereas some surrounding glia contained IgG-like IR 24 h after injection. However, preabsorption with a large excess of rat IgG to confirm the authenticity of this labeling failed to eliminate this neuronal IgG-like IR but rather exhibited nuclear staining in glial cells. Because this unexpected nuclear staining escalated with increasing amount of absorbing IgG, we postulated that this nuclear staining is due to formation of immune complex IgG–anti-IgG, which can be removed by centrifugal filtration. As expected, this nuclear staining in glial cells was eliminated after centrifugal filtration of the IgG/anti-IgG mixture, and authentic IgG-like IR was chiefly detected in the cytoplasm of neurons around the injection channel. This study is the first demonstration of neuronal redistribution of injected IgG in the mouse brain. Neuronal internalization of exogenous IgG may be advantageous especially when the therapeutic targets of monoclonal IgG are intraneuronal such as neurofibrillary tangles or Lewy bodies. [ABSTRACT FROM AUTHOR]

Abstract Background Levothyroxine (LT4) pseudomalabsorption due to medication non-adherence results in significant costs for Health Service. High dose LT4 or LT4/paracetamol absorption test is used in such cases. Hence, establishment of an optimal test protocol and timing of sample collection is of utmost importance. Case presentation A 34-year old woman was admitted to our Department because of severe hypothyroidism [on admission thyrotropin (TSH) > 100 μIU/ml, free thyroxine (FT4) 0.13 ng/dl (ref. range 0.93–1.7)] despite apparently taking 1000 μg of LT4 a day. Autoimmune hypothyroidism had been diagnosed 4 years before during post-partum thyroiditis. Subsequently, it was not possible to control her hypothyroidism despite several admissions to two University Hospitals and despite vehement denial of compliance problems. There was no evidence of coeliac disease or other malabsorption problems, though gluten-free and lactose-free diet was empirically instigated without success. A combined paracetamol (1000 mg)/LT4 (1000 μg) absorption test was performed in one of these Hospitals. This showed good paracetamol absorption (from 75 μIU/ml, and FT4 still below reference range). After admission to our Department we performed a 2500 μg LT4 absorption test with controlled ingestion of crushed tablets, strict patient monitoring and sampling at 30 min intervals. We observed a quick and striking increase in FT4 from 0.13 to 0.46, 1.78, 3.05 and 3.81 ng/dl, at 0, 30, 60, 90 and 120 min, respectively. Her TSH concentration decreased to 13.77 μIU/ml within 4 days. When informed, that we had managed to “overcome” her absorption problems, she discharged herself against medical advice and declined psychiatric consultation. Conclusions Adequate patient supervision and frequent sampling (e.g. every 30 min for 210 min) is the key for successful implementation of LT4 absorption test. Paracetamol coadministration appears superfluous in such cases.

Background: Levothyroxine (LT4) pseudomalabsorption due to medication non-adherence results in significant costs for Health Service. High dose LT4 or LT4/paracetamol absorption test is used in such cases. Hence, establishment of an optimal test protocol and timing of sample collection is of utmost importance. Case presentation: A 34-year old woman was admitted to our Department because of severe hypothyroidism [on admission thyrotropin (TSH) > 100 μIU/ml, free thyroxine (FT4) 0.13 ng/dl (ref. range 0.93–1.7)] despite apparently taking 1000 μg of LT4 a day. Autoimmune hypothyroidism had been diagnosed 4 years before during post-partum thyroiditis. Subsequently, it was not possible to control her hypothyroidism despite several admissions to two University Hospitals and despite vehement denial of compliance problems. There was no evidence of coeliac disease or other malabsorption problems, though gluten-free and lactose-free diet was empirically instigated without success. A combined paracetamol (1000 mg)/LT4 (1000 μg) absorption test was performed in one of these Hospitals. This showed good paracetamol absorption (from < 2 μg/ml to 14.11 μg/ml at 120 min), with inadequate LT4 absorption (FT4 increase from 5.95 pmol/l to 9.92 pmol/l at 0 and 120 min respectively). About 2 years prior to admission to our Department the patient was treated with escalating doses of levothyroxine [up to 3000 μg of T4 and 40 μg of triiodothyronine (T3) daily] without significant impact on TSH (still > 75 μIU/ml, and FT4 still below reference range). After admission to our Department we performed a 2500 μg LT4 absorption test with controlled ingestion of crushed tablets, strict patient monitoring and sampling at 30 min intervals. We observed a quick and striking increase in FT4 from 0.13 to 0.46, 1.78, 3.05 and 3.81 ng/dl, at 0, 30, 60, 90 and 120 min, respectively. Her TSH concentration decreased to 13.77 μIU/ml within 4 days. When informed, that we had managed to "overcome" her absorption problems, she discharged herself against medical advice and declined psychiatric consultation. Conclusions: Adequate patient supervision and frequent sampling (e.g. every 30 min for 210 min) is the key for successful implementation of LT4 absorption test. Paracetamol coadministration appears superfluous in such cases. [ABSTRACT FROM AUTHOR]

This study investigates the self-healing performance of cement-based materials using the water absorption test. The experimental method was performed in compliance with ASTM C 1585 on paste specimens mixed with research cement (RC), ground granulated blast-furnace slag (GGBS), anhydrite, and calcium sulfo-aluminate (CSA) expansion agents as inorganic binders. The water flow test was also performed for comparison and the self-healing products were analyzed. The results showed that the proposed method using the water absorption test could effectively evaluate the self-healing performance and that the mixture with GGBS and CSA expansion agents displayed the best performance. The temporal variation in water absorption rates was used to analyze the effects of primary self-healing (due to the further hydration of unreacted materials) and secondary self-healing (due to ion diffusion). The analysis provided results similar to those of the water absorption test. A comparison with an experiment on self-healing products confirmed that the amount of generated calcite had a larger effect on self-healing than the total amount of self-healing products. [ABSTRACT FROM AUTHOR]

A mathematical model for the transport process of migrating corrosion inhibitor (MCI) in cement-based material and a two-dimensional numerical solution method using commercially-available software are proposed. The numerical analysis results are in a good agreement with experimental data obtained from the two-dimensional absorption tests for nonreactive MCI but do not coincide with the data for reactive MCI. The reason behind may be that the latter reacted with calcium hydroxide (CH) in cement mortar and hindered the transport process. Therefore a modified transport model involving the pore-blocking effect of reactive MCI in cement-based materials is established according to the chemometrics method. The numerical and test results prove that the amendatory model is reasonable to understand the mass transfer of reactive MCI in cement mortar. Variance analyses of the factors in the model are also performed to find the key factor affecting the MCI transport process. A basic transport model and numerical analysis method of MCI in concrete is proposed. The model is corrected involving pore-blocking effect for reactive MCI based on chemical metrology. The numerical calculation results of the proposed model have a fine agreement with experimental results. [ABSTRACT FROM AUTHOR]

Abstract: Background: A recently developed non-radioactive vitamin B12 absorption test (CobaSorb) was further explored to identify the best marker for reflection of vitamin B12 absorption and to determine the duration of the test. Methods: Seventy-eight healthy individuals (age 21–81 years) were given three oral doses of 9 μg vitamin B12 per day for 5 successive days. Non-fasting blood samples were collected on days 1 to 5 before administration of vitamin B12 and on day 8. Cobalamins and holotranscobalamin were measured. Results: Performance of the vitamin B12 absorption test was evaluated in individuals with holotranscobalamin or cobalamins below the 75% percentiles. We used a change greater than 2×CVday-to-day in holotranscobalamin (22%) and cobalamins (12%) to indicate a change caused by absorption of vitamin B12. Among individuals with a baseline holotranscobalamin below the 75% percentile (<75 pmol/L, n =57), 98% had an increase in holotranscobalamin >22% from day 1 to day 3. In contrast, only 72% of the individuals with baseline cobalamins below the 75% percentile (<335 pmol/L, n =57) had an increase in cobalamins >12%. Conclusions: In healthy individuals with baseline holotranscobalamin <75 pmol/L, vitamin B12 absorption is well reflected by an increase in holotranscobalamin after 2 days administration of oral vitamin B12. [Copyright &y& Elsevier]

The purpose of this pilot study was to establish the dependence or independence of oxalate absorption on the quantity of the test dose of sodium oxalate over a range of test doses corresponding to physiological dietary oxalate intake values. Gastrointestinal oxalate absorption was measured with the [ 13 C 2 ]oxalate absorption test. Six healthy volunteers were always tested under standardized dietary conditions with 63 mg dietary oxalate and 800 mg dietary calcium per day. The volunteers were tested thrice each with sodium oxalate test doses of 25, 50, 200, and 600 mg. Additionally, 1000 mg sodium oxalate was applied once to three of these volunteers. The oxalate absorption of the six volunteers tested under the standardized conditions with 50 mg sodium [ 13 C 2 ]oxalate was 7.2 ± 2.62 % (mean ± SD), similar to the 120 volunteers tested previously: 8.0 ± 4.4 % (mean ± SD). The tests with sodium [ 13 C 2 ]oxalate doses in the range 25–1000 mg revealed similar percent oxalate absorption values. In conclusion, in healthy volunteers, the amount of oxalate absorbed in the gastrointestinal tract increased proportionally with the higher test doses of oxalate. However, percent oxalate absorption remained unchanged with test doses in the dose range of physiological dietary oxalate intakes. [ABSTRACT FROM AUTHOR]

Calcium oxalate (CaOx) urolithiasis is the most common urinary stone disease (70-75 % of all stones consist of CaOx in countries with western diet). Oxalate is the most lithogenic substance in CaOx crystallisation in urine. Oxalate is either synthesized within the body or absorbed from food. As oxalate is not metabolized in the human body, it appears unchanged in urine. Conventional analysis methods cannot distinguish between endogenous and exogenous oxalate. Our [ 13 C 2 ]oxalate absorption test enabled measurement of intestinal oxalate absorption and quantification of the influence of Ca- and Mg-supplementation on it. The effects of the oral administration of these supplements were compared in order to obtain valid data for recommendations for CaOx urolithiasis patients. A 10mmol supplement of both ions decreased the oxalate absorption significantly, calcium being more than twice as effective. * Revised version of a paper presented at the 26 th Annual Meeting of the German Association for Stable Isotope Research (GASIR) October, 6 to 8, 2003, Cologne, Germany. [ABSTRACT FROM AUTHOR]

R2 anti-reticulin antibody was detected in 15 of the 9,500 serum samples examined (0.16%) from a mixed hospital population. The antibody titre varied from 1∶40 to 1∶320, and the R2 was of the IgG clas sin 13 of the 15 positive samples. All the 15 serum samples with R2 were negative on human liver, confirming the lack of cross reaction of this antibody. The reactivity of R2 was not absorbed by soluble fractions of type I collagen, showing that this antibody is not directed against this antigen. R2 was confined to two groups of pathological conditions: connective tissue and digestive tract diseases. Four of 15 patients with R2 had rheumatoid arthritis and in two of these four cases the antibody was of the IgA class. [ABSTRACT FROM AUTHOR]

In this study, the electrical resistance of guinea pig small intestine was examined during postnatal development in vitro. The interrelationship between sugar, neutral amino acid or peptide-current calculated from potential difference and their influxes across the mucosal border of the small intestine was also investigated during postnatal development. At all stages from one week to adult animal, the electrical resistance remained at nearly the same value. Currents of glucose, maltose and lactose corresponded with influxes at any stage and these sugars were completely carried by an active transport system from the period of lactation. Glycine might be actively transported at any stage of development. Therefore the transmural potential differences induced by these substances are adequate indices of intestinal absorptive capacities. On the other hand, glycyl-glycine transport was independent of Na and glycyl-ghycine induced PD does not reflect the influx. [ABSTRACT FROM AUTHOR]