Effects of iron supplementation and discontinuation on serum copper, zinc, calcium, and magnesium levels in women

The purpose of this study was: 1) to establish the prevalence of depleted iron stores, iron deficiency, and low serum levels for copper, zinc, calcium, and magnesium in a healthy female population; and 2) to examine the effects of iron supplementation and discontinuation on the serum levels of the above minerals. One hundred eleven healthy women between the ages of 18 and 40 yr reported for fasted morning blood sampling for iron, copper, zinc, calcium, and magnesium status. Forty-five subjects were either iron-deficient as defined by a hemoglobin level below 120 g.l-1 (four subjects) or iron deplete as defined by a serum ferritin value below 20 micrograms.l-1 (43 subjects). Two subjects fit both criteria. This subgroup continued with the study and were prescribed a normal therapeutic iron dose (320 mg elemental iron per day, taken as two Slow-Fe tablets.d-1 for a period of 12 wk). The subjects then discontinued the iron supplementation for a further 12 wk. The response of the various blood minerals was monitored at 6-wk intervals. Twenty-five subjects completed the full 24-wk treatment. The main conclusions to be made from this study were that: 1) For this sample population of women, iron depletion was quite common (39%), although low hemoglobin values (< 120 g.l-1) were only seen in 3.6%. No subjects fell below the criteria for low serum copper levels (< 13.3 mumol.l-1) nor low serum magnesium levels (< 0.6 mmol.l-1). Seven subjects (6.5%) fell below the criteria for low serum zinc levels (< 11.5 mumol.l-1) while two subjects (1.8%) were below the criteria for low serum calcium levels (< 2.20 mmol.l-1). 2) Therapeutic oral iron supplementation was successful in raising mean serum ferritin values from 15.9 micrograms.l-1 to 36.5 micrograms.l-1 but was not associated with decrements in serum copper or calcium levels. 3) The treatment did not significantly effect serum zinc and magnesium levels during the supplementation period, but a downward trend continued through the discontinuation phase so that at 18 and 24 wk serum zinc and magnesium levels were significantly lower than baseline. 4) Oral contraceptive use was associated with elevated serum copper and ferritin values and lowered serum magnesium levels.

Haemodialysis as a model for studying endogenous plasma DNA: oligonucleosome-like structure and clearance

The rate of clearance of extracellular plasma DNA in man has important implications for pathogenetic mechanisms in systemic lupus erythematosus (SLE), as well as for certain other clinical states. Present knowledge of this parameter is derived exclusively from studies of injected, naked DNA in animals. Recent information indicates that the physiologic form of plasma DNA in SLE is that of oligonucleosome-like molecules rather than of naked DNA and consists of multimeric complexes of DNA bound to histone, probably arising from an apoptotic process. In order to study the rate at which these oligonucleosome-like complexes are removed from plasma and to do so in man rather than experimental animals, we exploited the observation that during haemodialysis large amounts of DNA are released, apparently within the dialysis coil, into the patient's plasma. Since this release appears to cease promptly with termination of the procedure, it offered the potential for estimating the rate of removal of such DNA from human plasma. Moreover, if that DNA, as postulated, were shown to possess an oligonucleosome-like structure resembling that found endogenously in human SLE, the relevance of such information to the human disease state would be further enhanced. The present results support the conclusion that DNA released into plasma during haemodialysis possesses such an oligonucleosome-like structure. The plasma half-life of that DNA in man was found not to exceed 4 min. The highly dynamic state thus implied for extracellular endogenous plasma DNA in man has important implications for pathogenetic mechanisms dependent on dsDNA in SLE. Moreover, individuals undergoing chronic haemodialysis, who are thereby exposed to a very large cumulative amount of such DNA, might serve as models for studying its long-term sequelae.

[The effect of nifedipine on arterial pressure and exercise tolerance in hypertensive patients]

The aim of this research was to assess whether the antihypertensive therapy with nifedipine, a dihydropyridine calcium-antagonist, is able to control hypertension not only at rest but also during exercise. So, 20 male hypertensive patients, mean age 48 years, were evaluated by symptom limited bicycle exercise (10 W/min) before and after 6 and 12 months of therapy with nifedipine in a slow releasing form (40-60 mg/day). Exercise tolerance significantly increased after 12 months of antihypertensive therapy with nifedipine (from 146 +/- 5 to 153 +/- 4 W, p < 0.05). Systolic and diastolic blood pressure decreased after 6 and 12 months both at rest (from 160 +/- 6/109 +/- 9 mmHg to 132 +/- 3/91 +/- 3 and 135 +/- 4/93 +/- 1 mmHg, respectively, both p < 0.001) and during exercise (at end exercise: from 238 +/- 7/121 +/- 5 mmHg to 216 +/- 6/106 +/- 3 and 213 +/- 6/107 +/- 3 mmHg, respectively, both p < 0.001). No significant changes in heart rate were observed during antihypertensive therapy both at rest and during exercise test. In conclusion, long-term antihypertensive therapy with nifedipine was effective in the control of hypertension both at rest and during physical stress. Moreover, an improvement in effort tolerance was observed in hypertensive patients.

The role of the pericardium in conditioning the effects of physical training

More work needs to be done on the extent to which the pericardium can modulate the cardiovascular response to exercise and the mechanisms whereby this modulation is brought about. Studies are needed to differentiate the effects of the pericardium on the cardiovascular exercise response, comparing trained with untrained subjects. Evidence is accumulating that exercise training in patients with heart failure improves not only the performance of exercising muscles, but also has some beneficial effects on central hemodynamics. The extent to which these beneficial effects can be attributed to conditioning the pericardium remains speculative.

[What have we learned from large trials?]

Clinical trials, during myocardial infarction, showed the importance of thrombolytic therapy on coronary patency, to improve left ventricular function, to reduce early and late mortality. Since the efficacy of thrombolytic therapy is now well established, most clinical trials were made to compare the efficacy of SK, rt-PA and APSAC and to evaluate concomitant drugs. Recanalization and coronary patency, reocclusion and incidence of side effects, left ventricle function's improvement and lowered mortality have been used to assess drugs' activity. At the moment the efficacy of three thrombolytic drugs seems to be the same. So the drug's choice is related not to drug's efficacy but to side effects of the drugs. Concomitant intravenous heparin therapy is now under study; utility of this therapy is shown by its theoretical assumptions and by clinical trials results. Large clinical trials are working to extend our knowledge, improving the patients' management in our every day clinical practice. Furthermore, large trials do not replace but go together with studies performed on few patients, whose results often give advance notice of those of large ones.

[A new anti-ischemic drug for the treatment of stable effort angina pectoris: nicorandil. Comparison with placebo and isosorbide-5-mononitrate]

The aim of this study was to investigate antianginal and antiischemic activity and tolerance of a new nitrate derivative, nicorandil (N). This research has been carried out in 18 patients, aged 47-70 years, suffering from stable effort angina with fixed ischemic threshold. The study started with 10 days of washout, during which the patients exercised twice on bicycle to verify the reproducibility of the test. Then, they took N or isosorbide-5-mononitrate (ISM) for 14 days according to a double blinded cross-over balanced study. Between the 2 periods patients took placebo (PL) for 14 days. In the first day and in the last day of each period, 2 hours after the last drug intake, patients performed a stress test on bicycle. Like ISM, N significantly increased, versus PL, 1 mm of ST depression time (ischemic threshold) in the first and in the last day, without differences between the 2 drugs and between the days. Moreover, ST depression was significantly lower at maximal common work (MCW) versus PL. The rate-pressure product was not different from PL after N and ISM at maximal common work, but is was increased at the ischemic threshold. In conclusion, like ISM, N has shown antiischemic activity in patients suffering from stable angina pectoris on effort with fixed ischemic threshold. After 14 days of treatment there was no evidence of tolerance. The activity of N seems essentially due to an increase of coronary blood flow to ischemic zones.

[Transdermal nitroglycerin in stable effort angina. I. Therapeutic effect and duration of the action of a single dose. Comparison with placebo and isosorbide dinitrate]

To assess the efficacy of 2 doses of a transdermal system for nitroglycerin, 10 and 20 mg (NTTS 10 and NTTS 20) and isosorbide dinitrate 40 mg (ISD 40) on exercise tolerance test, a double-blind within patients placebo (PL) controlled study was performed: 12 male patients, aged 47-71 years, with stable effort angina, with fixed ischemic threshold, received, according to a 4 x 4 latin square design, NTTS 10, NTTS 20, ISD 40 and PL, at 7.00 am on 4 consecutive days. Bicycle exercise tests were performed 4 and 12 hours post-dosing, after which the systems were removed. NTTS 10 and 20 and ISD 40 increased significantly ischemic threshold, anginal threshold and decreased maximal ST depression at the fourth hour. Only NTTS 10 and NTTS 20 showed antiischemic activity after 12 hours. During exercise, at the fourth and twelfth hour, there was no significant difference in rate-pressure product between placebo and NTTS 10 and 20 and ISD 40. Therefore the antiischemic activity of these drugs was not related to a decrease of myocardial oxygen consumption. In conclusion, in comparison with PL, NTTS 10, 20 and ISD 40 had antiischemic and antianginal activity at the fourth hour, while at the twelfth hour this activity was observed only after NTTS 10 and 20, without differences between the 2 doses.

[Transdermal nitroglycerin in stable effort angina. II. Administration of continuous high doses and alternate high-low doses. Absence of tolerance]

Aim of this study was to evaluate the efficacy of 2 different schedules of nitroglycerin (N), given by means of transdermal therapeutic system (TTS): continuous (20 mg patch at 8.00 am and at 8.00 pm NTTS/c) and high/low doses therapy (20 mg patch at 8.00 am and 10 mg at 8.00 pm NTTS/a), respectively. Eighteen volunteers, gave informed, written consent; male patients, aged 57 +/- 2 years, with stable effort angina pectoris, were randomly given, in double-blind condition, NTTS/c, NTTS/a or placebo (PL), each for 1 week period, according to a 3 x 3 latin square design. Bicycle exercise tests were performed on the first and on the last day of each period of the study, 12 hours after the last patch. NTTS/c and NTTS/a increased ischemic threshold and decreased the ischemic depression ST at maximal common work, compared to placebo, without differences between tests performed at 1 and 7 day. In conclusion, NTTS/a showed antiischemic activity after 7 days, so no tolerance was observed in those patients.

Assessment of Package Integrity Using a Spray Cabinet Technique

A novel spray cabinet technique was developed to determine the microbial integrity of aseptically filled juice packages as an alternative to immersion techniques. The spray cabinet was constructed to include two pumps and 32 nozzles to achieve complete coverage over all surfaces of the test packages. A cell culture of Lactobacillus cellobiosus was sprayed onto the packages during testing. Standard pinhole orifices were used to determine the efficiency of the spray cabinet technique, 10-μm holes and 5-μm holes were detectable after 15 and 30 min of spraying, respectively. Aseptically filled juice packages were subjected to an abusive handling procedure designed to create package defects in order to compare package integrity by the spray cabinet technique and an immersion method. The spray cabinet technique provided better detectability than the immersion method.

An extended family of protein-tyrosine kinase genes differentially expressed in the vertebrate nervous system

We have used PCR to identify 13 novel protein-tyrosine kinase genes (tyro-1 to -13), six of which (tyro-1 to -6) are preferentially expressed in the developing vertebrate nervous system. The tyro-2 and tyro-9 genes encode kinase domains that exhibit strong amino acid sequence similarity to the equivalent regions of the receptors for EGF and FGF, respectively, and may encode novel receptors for these or related polypeptide ligands. The tyro-1 to -6 genes are all expressed during central nervous system neurogenesis and exhibit distinct and highly regionalized patterns of expression in the adult brain. Together with recent studies in invertebrates, these data are consistent with the hypothesis that protein-tyrosine kinases play a central role in neural development.

Bone-inducing activity of mature BMP-2b produced from a hybrid BMP-2a/2b precursor

The human osteoinductive proteins BMP-2a and BMP-2b have been cloned and expressed in mammalian cells. In order to improve expression levels we examined the role of the proregion in assembly and export. Use of the BMP-2a proregion combined with the mature region of BMP-2b leads to dramatically improved expression of mature BMP-2b. Mature BMP-2b has been purified to near homogeneity from the BMP-2a/2b hybrid, and its structural properties and biological activity determined. Recombinant mature BMP-2b homodimer elicits bone formation in vivo.

[Effects of indenolol on left ventricular mass in patients with essential arterial hypertension]

This study evaluated the effect of long-term antihypertensive therapy with indenolol, a beta blocking agent with beta 2 stimulating activity, its antihypertensive hemodynamic mechanism and its effect on hypertensive left ventricular (LV) hypertrophy. Fourteen hypertensive patients, mean age of 48 years, were serially studied during 12- month therapy with indenolol (60-120 mg daily), by recording blood pressure, electrocardiogram and echocardiogram. Blood pressure, heart rate and cardiac output significantly decreased after 1 months of therapy, LV posterior wall thickness decreased after 6 months, interventricular septum thickness and LV mass decreased after 12 months. LV fractional shortening did not change throughout the study. Blood pressure normalized (less than or equal to 140/90 mmHg) in 50% of the patients; LV mass normalized in 40% of the patients. In conclusion, indenolol was an effective antihypertensive agent, also in the long-term treatment. Its antihypertensive hemodynamic effect seems to be due mainly to a reduction in cardiac output. Indenolol caused a regression of LV hypertensive hypertrophy without impairment of LV systolic function.

[A case of left internal capsular infarction with auditory hallucination and peculiar amnesia and dysgraphia]

A 46-year-old businessman suddenly became to behave curiously on the morning, September 1, 1988. He forgot how to go through an automatic ticket gate, which he used every day. In his company, he also forgot how to open the cash box, and he wrote a meaningless report for his business. From the night on that day, he had experienced auditory hallucination in which whispering words of some criticism to his performance for a few days. On the next day, he was admitted to a psychiatric hospital because he was suggested to have schizophrenia. By day 6 after the onset, his curious symptoms completely disappeared. However, slight verbal memory disturbance and cognitive dysfunction still remained. Because the brain CT on day 6 showed a small localized subcortical infarction in the left hemisphere he was transferred to our clinic on day 20 to elucidate the relation between the abnormal behavior and the infarction. His blood pressure was 116/64 mmHg and pulse was regular 63/min. He was clear and did not have any neurological deficit. He kept his episodic memory regarding the events at the onset and could almost recall them precisely. Results of standard blood tests, electrocardiogram, ultrasound cardiogram, electroencephalogram as well as cerebral angiography were normal. Computed tomography and magnetic resonance imaging showed an infarcted lesion in the genu of the left caudate nucleus, adjacent to the anterior part of the thalamus.(ABSTRACT TRUNCATED AT 250 WORDS)

Propionyl carnitine in stable effort angina

The aim of this study was to investigate the anti-ischemic activity of propionyl carnitine (PC) in 18 informed, volunteer male patients, aged 37-70, suffering from a typical stable effort angina. The study design was randomized, balanced, crossover, and double blinded. The study lasted 75 days. In the first 15 days of washout the patients performed two maximal symptom-limited bicycle tests to verify the repeatability of the parameters examined. Then one group received PC for 30 days 500 mg three times a day, and the other group received placebo (PL) three times a day. At the end of 30 days the groups exchanged treatments. At the end of each period, 2 hours after the last oral administration, the patients performed a maximal symptom-limited bicycle exercise test with increased loads of 10 watts/min. No significant differences were observed between the two tests performed during the wash-out period, for a 1 mm ST-segment depression time, for the time to the end of exercise, and for the rate x pressure product at the same experimental time. The oral administration of PC in coronary patients increased both the 1 mm ST-segment depression time and the time to the end of exercise. Furthermore, the drug reduced the ischemic depression of ST at maximal common work and at maximal work. After PC, the rate x pressure product was not significantly different in relation to placebo at submaximal and maximal exercise. Thus PC seems to have an antiischemiclike effect, probably related to its metabolic activity.

Ofloxacin treatment of nongonococcal urethritis. A multi-center study in Asia

Ofloxacin, a new quinolone antibacterial agent, is active in vitro against gonococcal and nongonococcal urogenital pathogens. Chlamydia trachomatis infection is the most common cause of nongonococcal urethritis. In a multicenter study in seven Asian countries, 105 mal patients with chlamydial urethritis and 46 male patients with nongonococcal and nonchlamydial urethritis were treated with oral ofloxacin at a dosage of 200 mg twice daily for 5 to 10 days. The evaluation performed at day 5 and/or day 10 after treatment revealed good results in 58.2% and 96.8% of the chlamydial urethritis group, and 73.1% and 79.4% of the nongonococcal, nonchlamydial urethritis group, respectively. No severe side effects were observed. Ten-day treatment with ofloxacin showed good clinical efficacy on nongonococcal urethritis.

Myelin-associated glycoprotein (MAG) and rat brain-specific 1B236 protein: mapping of epitopes and demonstration of immunological identity

The myelin-associated glycoprotein (MAG) and the brain 1B236 protein are 100-kDa glycoproteins containing 30% carbohydrate that exist in two developmentally regulated forms and are specific to the nervous system. Recent cDNA cloning experiments in several laboratories using primarily immunological means of identification have determined the complete primary sequence of a rat brain glycoprotein that seems to correspond to both MAG and 1B236, suggesting that these proteins are identical. However, MAG was previously considered to be an oligodendrocyte/myelin specific component in the CNS at all ages, whereas 1B236 was thought to be primarily a neuronal component in adult rats but synthesized by oligodendrocytes at the time of active myelination. The composite term 1B236/MAG was proposed to describe the molecule identified by the cDNAs. In order to explore further the relationship between MAG and 1B236, as well as their developmentally regulated forms, experiments were carried out on rat samples utilizing synthetic peptides corresponding to sequences throughout the 1B236 molecule, antisera raised to synthetic peptides in the C-terminus of 1B236 that distinguish between the two developmentally regulated forms, and well-characterized polyclonal and monoclonal antibodies raised to purified MAG. Epitope mapping demonstrated that reactive sites were distributed throughout the extracellular and intracellular domains of 1B236/MAG. Only antibodies reacting with the smaller of the two forms of 1B236/MAG detected the glycoprotein in the peripheral nervous system. Both anti-MAG and anti-1B236 antibodies revealed a drastic reduction of the level of 1B236/MAG in 25-day-old myelin-deficient rats and in adult quaking mice, and both types of antibodies revealed a slight shift of 1B236/MAG toward higher apparent Mr in quaking mice as had previously been reported for MAG. The results indicate that MAG and 1B236 are almost certainly identical since they cannot be distinguished immunologically by the reagents available and that quantitatively most of the glycoprotein is associated with oligodendrocytes and myelin rather than neurons at all ages.

A cluster analysis for threshold perimetry

Cluster analysis in perimetry is a technique used in the evaluation of localised visual field loss. It has previously been applied to suprathreshold data and, unlike the indices currently available to indicate localised loss, it is influenced by the relative positions of individual defects. This paper describes a cluster analysis for use with data from Program 31 of the Octopus perimeter. To demonstrate the technique, sensitivity values of normal 60-year-old subject were altered to simulate localised loss. Illustrative examples of clinical cases are given, showing differing degrees of localised loss that do not influence the corrected loss variance (CLV) but influence the computed cluster parameters. It is hoped that the value of this form of analysis will be demonstrated in clinical follow-up of glaucoma patients.

Tissue specificity, localization in brain, and cell-free translation of mRNA encoding the A3 isoform of Na+,K+-ATPase

The isolation of multiple Na+,K+-ATPase cDNAs from rat brain has led to the discovery of a family of alpha-isoform genes. Using A1 (alpha), A2 (alpha+), and A3 (alpha III) Na+,K+-ATPase gene probes, we have analyzed the distribution of Na+,K+-ATPase mRNAs in adult and fetal rat tissues by RNA blot and hybridization histochemistry. A1 Na+,K+-ATPase mRNA was found ubiquitously among various tissues, with highest levels in transport epithelial and neural tissues. A2 mRNA was found in adult neural and muscle tissues, and A3 mRNA was found only in neural tissues and fetal heart muscle. Both A1 and A2 mRNAs were less abundant in fetal brain than in adult brain; in contrast, A3 mRNA was abundant at both stages. In situ mapping of brain areas that contain A3 mRNA suggests that this Na+,K+-ATPase isoenzyme is expressed predominantly by neural cells. Analysis of Na+,K+-ATPase proteins generated by cell-free translation of synthetic mRNAs suggests that the A3 protein has properties similar to A2 (alpha+).