On the Diagnosis of Folic Acid Deficiency

Hansen, H. A.

doi:10.3109/00016346709157071

Cited by 37 publications

(36 citation statements)

References 26 publications

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“…Lowenstein, Brunton, Cooper, Milad, and Hsieh (1963) reported megaloblastic marrow changes in 16 out of 62 patients who did not receive any form of supplement; an incidence of 26%. Hansen (1964) found morphological changes in the marrow in one-third of pregnant women.…”

Section: Significance Of Hypersegmented Neutrophilsmentioning

confidence: 97%

“…Diagnostic criteria are uncertain and the apparent incidence varies in different hospi-tals, from being so low that the condition is regarded as a rarity (Clark, 1952) to being so common that it is diagnosed in 1 in 25 of all pregnant subjects (Hourihane, Coyle, and Drury, 1960). Divergent views have been expressed about the value of the newer tests for folic-acid deficiency (Chanarin, Rothman, and Watson-Williams, 1963 ;Hibbard and Hibbard, 1963 ; Ball and Giles, 1964 ;Hansen, 1964), and there is disagreement both about the wisdom of folic-acid supplements in pregnancy (Varadi, 1964;Forshaw, Moorhouse, and Harwood, 1964) andabout how large this supplement should be. The purpose of this paper is to report some of the results of a clinical trial in pregnancy wherein normal pregnant women…”

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confidence: 99%

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Iron Deficiency and its Relation to Folic-acid Status in Pregnancy: Results of a Clinical Trial

Chanarin¹,

Rothman²,

Berry³

1965

BMJ

149

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BRITISHIsotope~~~b MEDICAL JOURNAL impression that multiple metastases are more readily shown by scanning than by pneumography or angiography. Single metastases are often revealed by these latter methods, but second or third ones are not often shown.While it is possible to predict the pathology of a certain number of lesions by studying the topography, this is by no means always so. Planiol (1963) uses an entirely different technique by means of which she is able to make a specific diagnosis in a much higher percentage of cases. Her method depends upon the change in count rate at fixed points on the skull at intervals of 2, 24, and 48 hours after an intravenous injection of radioiodinated human serum albumin. She has shown that meningiomas take up the isotope early and metastases late, while the astrocytomas take it up at an intermediate SummaryThe results of 100 brain scans are described. All the scans were made with 203Hg chlormerodrin using a standard technique. There was no selection of cases referred by neurologists and neurosurgeons, except that patients under the age of 18 were excluded.There were 53 positive scans, and all these patients appeared to have lesions, though not all these were confirmed histologically. There were 42 negative scans. Of these, 22 were probably truly negative. The remaining 20 were proved to be false-that is, these patients harboured tumours not demonstrated by the method. The causes of the false negatives are discussed and their reduced number in the future is foreshadowed.There were five equivocal scans. These showed some departure from the normal, but the appearances were not sufficiently clear-cut for definite diagnosis.Since a positive scan always denotes a lesion and the scanning process is painless and free from risk, it seems that, ideally, this investigation should be made before angiography and/or pneumography. But a negative scan in the face of positive clinical evidence of a mass always requires further investigation.The method is particularly valuable in the investigation of out-patients and of patients whose clinical picture hardly justifies submission to the more traumatic procedures which also carry some morbidity.Scanning has been a great help in the diagnosis of metastases, because the older-established neuroradiological procedures tend to show only the larger ones. The results in these cases suggest that secondary deposits in the brain are more often multiple than was previously suggested by classical neuroradiological investigation, although well known by pathologists.Location of brain turnours by modern scanning techniques is accurate. In some cases the contour and topography allow a precise pathological diagnosis to be made. Unfortunately this is by no means always so, but it is hoped that still greater accuracy will be achieved by refining the technique.Isotope encephalography has clearly earned its place alongside other neuroradiological contrast methods of investigation. , 1965, 1, 480-485 The application of newer methods to the detection of vitamin...

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Section: Significance Of Hypersegmented Neutrophilsmentioning

confidence: 97%

mentioning

confidence: 99%

Iron Deficiency and its Relation to Folic-acid Status in Pregnancy: Results of a Clinical Trial

Chanarin¹,

Rothman²,

Berry³

1965

BMJ

149

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“…Vitamin B12 in plasma was determined by a microbiological method using Euglena gracilis (Hutner et al, 1956), reference range 135-735 pmol/l. Folate in plasma and blood was assayed with Lactobacillus casei, according to the technique described by Hansen (1964). Measured by this method, the reference range of folate is 4-35 nmol/l in plasma and 100-450 nmol/l in blood.…”

Section: Analysis Of Blood Samplesmentioning

confidence: 99%

Absorption studies in patients six to 10 years after construction of ileostomy reservoirs.

Nilsson¹,

Andersson²,

Hultén³

et al. 1979

Gut

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SUMMARY The absorption of fat, bile salts, and vitamin B12 was studied in 14 proctocolectomised patients six to 10 years after construction of a continent ileostomy. All patients were in excellent health and displayed no signs of malnutrition. Schilling test disclosed subnormal absorption of vitamin B12 in one patient and borderline values in five. Faecal loss of bile acid was increased in 12 patients and fat malabsorption occurred in two. Except for slightly pathological liver tests in two patients, routine laboratory tests, including plasma concentration of vitamin B12 and folic acid, were normal. There were no signs of sodium or potassium depletion.In 1969 the continent ileostomy was introduced as an alternative to the conventional ileostomy (Kock, 1969). Since then the method has been modified several times because of difficulties in maintaining perfect continence in some of the patients. An extensive review of the development of the method, experimental background and functional results, has recently been published (Kock et al., 1977). The functional results were good and the physical health of the patients excellent. There is, however, a general lack of knowledge concerning long-term metabolic effects of the ileal pouch.The construction of a reservoir of the terminal part of the ileum results in stagnation of the intestinal contents in the pouch for several hours. The bacterial flora of effluents from the reservoir has been found to be intermediate between those from a conventional ileostomy and those from normal stools (Brandberg et al., 1972). The mucosal morphology was altered, with an increased cell turnover and shortening of the villi . These findings might indicate that absorption disturbances would appear in the long run.Absorption studies of fat, d-xylose, phenylalanine, and vitamin B12 have been performed in patients with ileostomy reservoirs within two years after the construction of the reservoir. In these studies only marginal absorptive impairment was found and there was no significant difference between patients with ileostomy reservoirs and patients with conventional ileostomies (Jagenburg et al., 1971. Received for publication 4 January 1979Since the long-term metabolic consequences are known only to a limited extent, the present study was designed to evaluate intestinal absorption in patients with continent ileostomy six to 10 years after operation. Taking into account the altered bacterial flora and the altered mucosal morphology of the reservoir, and in view of the fact that the reservoir is constructed from the terminal ileum, we decided to focus our interest on the absorption of vitamin B12, bile salts, and fat. MethodsAt the time of the investigation 46 patients, who had been operated with proctocolectomy and continent ileostomy at our hospital because of ulcerative colitis or polyposis of the colon, had been observed for more than six years. Of these patients 16 lived in the neighbourhood of Gothenburg and were asked to take part in the study. Two patients refused to participate beca...

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“…7469). The assay was performed as described by Hansen (1964) with the following modifications: the incubation time at 37°C was shortened to 20 h, a larger initial inoculum was used and the medium was Dano Folic Acid Casein (Ferrosan Pharmaceuticals AB, Copenhagen). Growth was estimated turbidimetrically on a Beckman B spectrophotometer at 675 nm and compared with values obtained from a standard curve made up from known amounts of synthetic pteroylmonoglutamate.…”

Section: Assay Of Folic Acidmentioning

confidence: 99%

The Effect of Anticonvulsant Therapy upon the Absorption of Folates

et al. 1973

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1. The absorption of orally administered pteroylmonoglutamate and pteroyltetraglutamate, measured as peak rise in serum folate levels, was examined in normal volunteers and in epileptic patients on anticonvulsant drugs. 2. Although the fasting serum folate levels were low in the patients, they absorbed the two folate forms as well as the volunteers did and there was no difference between the absorption of pteroylmonoglutamate and pteroyltetraglutamate. 3. The findings indicate that the folate deficiency, caused by anticonvulsant drugs is not due to interference with the intestinal conjugase or the mechanism of absorption in itself.

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On the Diagnosis of Folic Acid Deficiency

Cited by 37 publications

References 26 publications

Iron Deficiency and its Relation to Folic-acid Status in Pregnancy: Results of a Clinical Trial

Iron Deficiency and its Relation to Folic-acid Status in Pregnancy: Results of a Clinical Trial

Absorption studies in patients six to 10 years after construction of ileostomy reservoirs.

The Effect of Anticonvulsant Therapy upon the Absorption of Folates

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