[Disorders of fluid and electrolyte metabolism in elderly diabetics]

Disorders of fluid and electrolyte metabolism in elderly diabetics were studied. High frequency of hyperkalemia (20.8%), hypomagnesemia (14.6%), hypocalcemia (13.7%), hyperphosphatemia (8.6%), hyponatremia (8.1%) and hyperchloremia (7.2%) was observed among 332 elderly diabetics. Furthermore, hyperkalemia, hyperphosphatemia, hyponatremia, hyperchloremia, hypercalcemia and hypermagnesemia were more frequent in diabetics with renal insufficiency (serum Cr greater than or equal to 1.5 mg/dl) than in diabetics with normal renal function (serum Cr less than or equal to 1.4 mg/dl). In addition, statistically significant negative correlation were observed between plasma glucose levels and serum levels of sodium and chloride in diabetics with normal renal function. These results clearly demonstrated that the most important causal factor of electrolyte disorders in elderly diabetics might be the renal dysfunction due to diabetic nephropathy and/or nephrosclerosis. Moreover, glucose intolerance is also one of the causal factors for hyponatremia and hypochloremia. Disorders of fluid and electrolyte metabolism were manifest in 31 diabetic patients with hyperosmolar non-ketotic coma. The frequency of patients with abnormally elevated serum levels of sodium, potassium and chloride, and patients with abnormally lowered serum levels of calcium was high in this morbid state. Water and sodium deficit, examined in 11 cases of hyperosmolar non-ketotic coma, was 4780 +/- 2100 ml (107 +/- 43 ml/kg body weight) and 290 +/- 170 mEq (6.8 +/- 4.2 mEq/kg body weight), respectively. However, no significant deficit of potassium was observed in the patients. Statistically significant positive correlations between water deficit and serum Cr levels and with serum effective osmolarity were observed. However, there were no significant correlations between water deficit and plasma glucose levels, serum sodium levels and serum osmolarity.(ABSTRACT TRUNCATED AT 250 WORDS)

[Serological and immunohistochemical studies in pregnant women with systemic lupus erythematosus]

The present report is a detailed, prospective analysis of 29 pregnancies in 19 patients with systemic lupus erythematosus (SLE). The clinical pregnant status was correlated with maternal serologic patterns. Poor obstetrical prognosis was associated with low or declining complement (C3 and C4) levels and rising antinuclear and anti-DNA antibody titers. Complement levels reflected clinical changes more accurately than either antinuclear factor. A smooth antepartum course and successful delivery occurred when complement values remained normal. Immunohistochemical studies showed granular or linear depositions of immunoglobulin and complement on syncytial trophoblast and stromal tissue in placenta with SLE. Slight deposits of IgG were observed on the stromal tissue in normal placenta. Immune complex deposition on the trophoblast correlated to both serologic evaluation and course of SLE pregnancy. Obstetrical prognosis can be evaluated by serial determinations of serologic status. These data suggest that declining levels of maternal complements in SLE may be partly due to immune complex deposition in the placenta, resulting in the increased placental dysfunction.

[Healing promoting effect of proamipide, a novel drug that increases gastric defense mechanisms, on acetic acid-induced gastric ulcers in the rat]

The healing process of acetic acid-induced gastric ulcers was studied for over 180 days after ulcerogen injection, and the effect of a new antiulcer agent, proamipide, was also assessed by histological measurements. In the control group, rapid reduction in the macroscopic ulcer index and increment in histological indices such as healing, regeneration of defective mucosa and proliferation of granulation tissue were observed from the 5th day to the 60th day after the ulcer induction followed by significant aggravation on the 120th and 140th day, suggesting the recurrence or relapse of gastric ulcers may occur at about 120 to 140 days after acetic acid administration. Proamipide (20 mg/kg/day, p.o.) decreased all of these indices significantly from those in the control group. This indicates that proamipide remarkably promotes the healing process in acetic acid-induced gastric ulcers, the regeneration of the injured mucosa and also the formation of granulation tissue. The glandular index in the surrounding areas of the regenerated mucosa was lower than that in the central part in the control animals and this difference was decreased by proamipide intake, suggesting an imbalance in the regenerated mucosa of the scar may have significant roles in the induction of the recurrence or relapse of gastric ulcers.

Evidence of hypovitaminosis D in patients with mitral ring calcification

In order to evaluate the role of calcium regulating hormones in the pathogenesis of mitral ring calcification, we have studied the serum levels of PTH and vitamin D metabolites in aged females both with and without mitral ring calcification (MRC). In the patients with MRC (n = 17), significantly lower levels of serum total protein (6.6 +/- 0.2 in the MRC group vs 7.1 +/- 0.1 g/dl in the control group, mean +/- SEM), BUN (15.7 +/- 0.9 vs 18.3 +/- 0.9 mg/dl), creatinine (0.7 +/- 0.02 vs 0.9 +/- 0.02 mg/dl) and calcium (8.4 +/- 0.1 vs 9.2 +/- 0.1 mg/ml) were observed as compared with those in the controls (n = 32). Significantly higher PTH levels (0.57 +/- 0.07 vs 0.38 +/- 0.04 ng/ml) were found in the MRC group. Levels of all three vitamin D metabolites in the MRC group were significantly lower than those in the control group (25-OHD; 11.2 +/- 1.4 vs 19.6 +/- 1.2 ng/ml, 24,25(OH)2D; 0.7 +/- 0.1 vs 1.3 +/- 0.1 ng/ml and 1,25(OH)2D; 12.5 +/- 2.4 vs 43.0 +/- 3.5 pg/ml). The correlation coefficient between PTH and 1,25(OH) 2D was -0.382(n = 49, p less than 0.01). Thus, the significantly higher PTH levels in the MRC group might result in hypovitaminosis D. In conclusion, evidence of hypovitaminosis D in the patients with mitral ring calcification was demonstrated.

Secretion of calcitonin from the thyroid gland increases in aged rats

Age-related changes in the secretion rate of immunoreactive calcitonin against antiserum for human calcitonin (iCT) from the thyroid gland were investigated in adult (4-5 months old) and aged (24-29 months old) male Wistar rats anesthetized with 1.0-1.2% halothane. The secretion rate of iCT was calculated by measuring the concentration of iCT using a radioimmunoassay method in both the thyroid venous blood plasma and the systemic arterial blood plasma, as well as measuring the thyroid blood plasma flow. The secretion rate of iCT was 0.271 +/- 0.063 ng.kg-1.min-1 in the adult and 1.248 +/- 0.147 ng.kg-1.min-1 in the aged rats, indicating a significant increase in secretion in the aged rats. The concentration of iCT in the systemic arterial blood plasma was 0.091 +/- 0.013 ng/ml in the adult and 0.480 +/- 0.026 ng/ml in the aged rats. The age-related increase in the secretion rate of iCT from the thyroid gland seems to result in an increase in iCT concentration in the systemic arterial blood plasma. Furthermore, the content of iCT in the thyroid gland was also increased in the aged rats. Therefore, it is suggested that both the synthesis and secretion of iCT in the thyroid gland are increased in aged rats.

Clinical evaluation of the plasma levels of immunoreactive atrial natriuretic peptide in elderly patients with heart diseases

Plasma levels of immunoreactive atrial natriuretic peptide (ANP) were estimated in 69 elderly patients over 60 years of age (mean 76.4 years) with or without heart diseases and in ten young, healthy volunteers (mean 33.0 years) to evaluate the clinical significance of ANP in the elderly. Plasma ANP levels in nine patients without heart diseases were significantly (P less than .01) higher than in the ten young, healthy subjects (mean +/- SD, 46.0 +/- 22.0 vs 22.1 +/- 6.3 pg/mL) and a significant positive correlation was observed between ANP level and age in these subjects (r = 0.60, P less than 0.01). Plasma ANP levels in 60 patients with heart diseases (158.4 +/- 158.5 pg/mL) were significantly (P less than 0.05) greater than in nine patients without heart diseases. Plasma ANP levels in patients with congestive heart failure or atrial fibrillation were 285.8 +/- 185.2 or 223.0 +/- 185.9 pg/mL, respectively; each of these values was significantly (P less than 0.01) higher than in patients without heart diseases. In three patients with paroxysmal atrial fibrillation, plasma ANP levels during atrial fibrillation were three times greater than when atrial fibrillation returned to normal sinus rhythm (377.3 +/- 78.5 vs 101.1 +/- 68.5 pg/mL). These results indicate that plasma ANP levels increase with advancing age, and that increased ANP levels are associated with various heart diseases in elderly subjects, possibly through stretch of the atrial wall.

Reduced occurrence of vertebral crush fractures in senile osteoporosis treated with 1 alpha (OH)-vitamin D3

To examine whether the administration of 1 alpha (OH)-vitamin D3 (1 alpha (OH)D3) could prevent the occurrence of vertebral crush fractures in senile osteoporosis, crush fractures of the thoracic or lumbar spine in senile osteoporosis treated with 1 alpha (OH)D3, 1.0 microgram/day (22 cases), 1 alpha (OH)D3 1.0 microgram/day + Ca 1.0 g/day (16 cases) or Ca 1.0 g/day (23 cases) were compared with those in non-treated controls (25 cases). The average treatment periods were 1.7 +/- 0.7 years in the 1 alpha (OH)D3 group, 2.1 +/- 1.0 years in the 1 alpha (OH)D3 + Ca group and 1.7 +/- 0.9 years in the Ca group. Occurrence of spinal crush fractures per 1000 patient years was significantly less in the 1 alpha (OH)D3 + Ca group (P less than 0.01) than in the non-treated control group. These findings suggest that administration of 1 alpha (OH)D3 is effective in preventing the occurrence of pathological fractures in senile osteoporosis.

Effects of aging on parathyroid hormone stimulated ionic fluxes in rat parotid cell aggregates

The effects of aging on parathyroid hormone stimulated calcium and phosphate efflux from isolated rat parotid cell aggregates differed from that of epinephrine stimulated calcium efflux in magnitude, chronology, and ionic dependence. Parathyroid stimulated ionic fluxes were maximal at 1-3 months of age, declined until 12 months and remained constant thereafter. Epinephrine stimulated calcium efflux remained maximal between 3 and 12 months and declined until at least 24 months. Absolute stimulation of calcium efflux over basal levels was maximal at 4-8% while phosphate efflux was 20-30%.

Eastern Cooperative Oncology Group: a comparison of adjuvant doxorubicin and observation for patients with localized soft tissue sarcoma

Forty-seven patients with stage I, II, or III soft tissue sarcoma were entered into a prospective randomized Eastern Cooperative Oncology Group (ECOG) adjuvant protocol. Eligibility included conservative or radical primary treatment for local cure. Patients were then randomized to control or Adriamycin (Adria Laboratories, Columbus, OH). Adriamycin was administered at 70 mg/m2 (slow push, every 3 weeks for seven courses for a maximum of 550 mg/m2). To date, 32 patients, 17 males and 15 females, with an age range of 17 to 75 years (median, 44 years) have been followed sufficiently long to be included in this analysis. Nine patients have died. The median follow-up of the remaining 23 patients is 30 months (range, 2 to 50 months). Survival was not significantly different between Adriamycin or control. However, the disease-free interval was slightly different in favor of observation. This preliminary report does not support the hypothesis that Adriamycin is an effective adjuvant therapy for soft tissue sarcoma. Due to the small numbers, these results must be interpreted in relation to our ability to detect a difference, if in fact one existed. These preliminary data suggest that adjuvant Adriamycin not be used outside the confines of a clinical trial such as the current intergroup adjuvant sarcoma study.

Bone fracture in elderly female with primary hyperparathyroidism: relationship among renal function, vitamin D status and fracture risk

Among 12 aged postmenopausal females with primary hyperparathyroidism, 5 had no bone fracture and 7 had fractures. Both serum 1,25 (OH)2D levels and creatinine clearance values in patients with fracture were significantly lower than those without fracture (p less than 0.025). In addition, significant positive correlation was observed between serum 1,25 (OH)2D levels and creatinine clearance values (p less than 0.05). These data suggest that decreased serum 1,25 (OH)2D level due to renal dysfunction may causally correlate to bone fracture in postmenopausal primary hyperparathyroidism.

Separation and quantitation of plasma free fatty acids as phenacyl esters by HPLC

We have developed a rapid method for the separation of plasma free fatty acids as their phenacyl esters by high-performance liquid chromatography (HPLC) using a reversed-phase (C18) column. The derivatives of series of both saturated and unsaturated fatty acids (C12:0-C22:6) are simultaneously separated within 45 min and detected with ultraviolet at 241 nm. The limit of detection of fatty acids was approximately 0.5 nmol in 20 microL injected volume of extracts, and the coefficient of variation of the present method did not exceed 3.0%. Comparison of the results of the present HPLC method with those of gas chromatography, gave very good correlations for all fatty acids in human plasma.

An enzyme immunoassay for osteocalcin

A sensitive and specific enzyme immunoassay for bovine osteocalcin was developed with the use of enzyme-labeled antigen. Bovine osteocalcin was conjugated with beta-D-galactosidase for use in the immunoassay. The minimum amount of osteocalcin detectable by this method was 5-10 pg/assay. The enzyme immunoassay could detect immunoreactive osteocalcin levels in normal human sera, giving a value of 6.58 +/- 0.72 ng/ml (mean +/- SE of 16 human subjects). The correlation coefficient between the levels measured by this method and radioimmunoassay was 0.94.

Parathyroid hormone stimulates phosphate efflux through an apparently adenosine 3',5'-monophosphate-independent process in rat parotid cell aggregates

The effects of PTH on phosphate fluxes and cAMP and protein secretion in rat parotid cell aggregates were studied. PTH-(1-34) as well as PTH-(1-84) stimulated phosphate efflux in a dose-dependent [5 X 10(-7) to 7 X 10(-6) M for human (h) PTH-(1-34), 2 X 10(-7) to 5 X 10(-6) M for bovine (b) PTH-(1-34), and 3.8-114 U/ml for bPTH-(1-84)] and time-dependent [detectable by 15-30 min after incubation with N-terminal PTH and 30-45 min after incubation with bPTH-(1-84)] manner. The effect of PTH on phosphate efflux was saturable, with maximal stimulation at 10(-6) M above for N-terminal PTH and at 57.8 U/ml and above for bPTH-(1-84). Half-maximal stimulation of phosphate efflux by hPTH-(1-34), bPTH-(1-34), and bPTH-(1-84) was achieved at 5.7 X 10(-7) M, 10(-7) M, and 40 U/ml, respectively. Neither bPTH-(1-34) nor bPTH-(1-84) had any effect on phosphate uptake by parotid cell aggregates at the concentrations examined. bPTH-(1-34) and bPTH-(1-84) also stimulated amylase secretion, with a significant increase in cAMP production (70-90% over basal). However, (BU)2cAMP did not stimulate phosphate efflux. Isoproterenol (10(-5) M) markedly stimulated cAMP production and amylase secretion without causing a significant increase in phosphate efflux. Oxidized bPTH-(1-84) and the C-terminal fragment of hPTH had no stimulating effect on phosphate efflux. The present results suggest, therefore, that PTH may play an important role in regulating rat parotid cell phosphate metabolism through an apparently cAMP-independent process.

Hypercalcemia due to spontaneous hemorrhage in a parathyroid adenoma during recovery from acute renal failure

A 89-year-old woman showed transient and mild hypercalcemia (11.0 mg/dl) at the phase of recovery from acute renal failure. Serum PTH level elevated to 2.1 ng/ml when hypercalcemia was observed, and decreased to 1.1 ng/ml. Autopsy study revealed the bleeding within parathyroid adenoma. The transient and mild hypercalcemia seen in the patient was considered as the result of the bleeding within parathyroid adenoma. This unusual manifestation of parathyroid adenoma, bleeding, usually causes hypercalcemic crisis. The mild hypercalcemia observed in this patient despite of bleeding into parathyroid adenoma might be due to old age of the patient and the existence of renal failure in the patient.

Long-term treatment of postmenopausal osteoporosis with active vitamin D3, 1-alpha-hydroxycholecalciferol (1 alpha-OHD3) and 1, 24 Dihydroxycholecalciferol (1, 24(OH)2D3)

The effects of active vitamin D3 analogues on radial mineral content (RMC) in postmenopausal osteoporosis were examined. Seventy eight subjects with postmenopausal osteoporosis were divided into 5 groups; Group 1 (n = 23) as the control group and Group 2 (n = 27), Group 3 (n = 8), Group 4 (n = 9) and Group 5 (n = 11) which were given 1 microgram of 1, 24(R) (OH)2D3 per day, 1 microgram of 1, 24(S)(OH)2D3 per day, 0.5 and 1 microgram of 1 alpha-OHD3 per day for 6 to 24 months, respectively. After 3-months administration of these drugs, RMC values were significantly increased in Groups 2 (102.8 +/- 1.8%), 4 (103.9 +/- 3.3%) and 5 (114.2 +/- 3.6%), when compared with the controls (97.9 +/- 2.4%). RMC in Group 3 (97.9 +/- 2.4%) was not significantly different from the control value. The administration of 1 alpha-OHD3 caused in increase in RMC in a dose-related manner. A rapid decrease in RMC was observed after withdrawal of the treatment in Groups 2, 4, and 5. A subsequent increase in RMC was observed after re-administration of 1 alpha-OHD3 and 1, 24(R)(OH)2D3. Serum Ca levels were increased in the group treated with 1, 24(R)(OH)2D3 and were decreased after the discontinuation of 1 alpha-OHD3 administration. Serum A1-P activity was decreased by treatment with 1 alpha-OHD3 (1 microgram per day) and a subsequent increase was observed in both groups treated with 1, 24(R)(OH)2D3 and 1 alpha-OHD3. Serum PTH levels were decreased by the administration of 1, 24(R)(OH)2D3 and 1 alpha-OHD3. In the group treated with 1 microgram of 1 alpha-OHD3 per day, hypercalcemia (2 out of 11 cases and these patients took calcium tablets) and an increase in BUN (1 out of 2 hypercalcemic patients) were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Platelet thromboxane synthesizing activity in non-insulin-dependent diabetes: correlation with diabetic retinopathy and diabetic treatment

Since elevated thromboxane A2 synthesis could be expected to lead to microvascular injury in diabetic patients, it is important to determine the relationship between thromboxane A2 synthesis and diabetic microvascular complications. In the present study, the activity of thromboxane A2 synthesis in platelets was assessed in 57 Type 2 (non-insulin-dependent) diabetic patients by measuring the conversion of exogenously added 14C-arachidonic acid into 14C-thromboxane B2. The activity of thromboxane synthesis was significantly higher in diabetic patients than in 16 age-matched control subjects (2.61 +/- 0.07 vs 1.95 +/- 0.12 microgram . 10(9) platelets-1 . 3 min-1, respectively, p less than 0.001). When the diabetic patients were divided into three groups (nil, background, and proliferative retinopathy) on the basis of severity of diabetic retinopathy, there was a trend to increased thromboxane synthesizing activity as diabetic retinopathy develops. However, no statistically significant changes were demonstrated among these three groups. In the diabetic patients, a positive correlation was found between thromboxane synthesizing activities and glycosylated hemoglobin values (biochemical indicator of long-term glycemic control), but not between the activities and plasma glucose levels. To ascertain the effect of desirable diabetic treatment on thromboxane synthesizing activity in platelets, 9 newly diagnosed patients and 6 poorly controlled patients were examined. During treatment, all patients had declining plasma glucose and glycosylated hemoglobin levels. Thromboxane synthesizing activities in 6 patients treated by insulin decreased significantly during treatment (3.16 +/- 0.17 to 2.49 +/- 0.22 microgram . 10(9) platelets-1 .3 min-1, p less than 0.01), but 9 diabetic patients treated by diet or sulphonylureas still maintained their elevated thromboxane synthesizing activity levels (2.76 +/- 0.24 to 2.66 +/- 0.25 microgram . 10(9) platelets-1 .3 min-1,NS). These results suggest that the increased thromboxane synthesizing enzyme system is involved in the abnormal platelet function in diabetes independently of diabetic retinopathy, and that appropriate metabolic control using insulin might be successful in lowering the increased thromboxane synthesizing activity.

Studies on the role of the lpr gene in the development of immunological abnormalities and lupus nephritis. Analyses in F2 mice

In order to clarify role of lpr gene of MRL/Mp-lpr/lpr (MRL/l) mice in the development of immunological abnormalities and lupus nephritis, F2 mice were obtained from crosses of (MRL/1 X AKR) F1 mice and examined with regard to lymph node enlargement, numbers of immunoglobulin (IgM and IgG) producing cells (PC) in the spleen, serum levels of anti-trinitrophenyl (TNP) and anti-DNA antibodies, amounts of circulating immune complexes (IC) and histopathological findings of the kidney. Out of total numbers of 234 F2 mice, 54 mice (F2[+]mice) (23.1%) were with lymphoproliferation and 180 mice (F2[-]mice) (76.9%) without it. As parental controls, 39 MRL/1, 27 AKR and 21 F1 mice were also checked. There were significant differences in the all of the parameters tested between F2 (+) and F2 (-) mice. Significant differences were also observed between F2 (+) and MRL/l mice in the weight of mesenteric lymph nodes, numbers of IgGPC, levels of IgG antibodies and amounts of IC, but not in the numbers of IgMPC and levels of IgM antibodies. All of F1 mice tested mimicked AKR mice in the values of various parameters described above. In MRL/l and F2 (+) mice, there were no significant correlations between the weight of mesenteric lymph nodes and other parameters. These data seem to show that the lpr gene behaves as a single recessive trait and there exists gene(s) which suppresses expression of the lpr gene.

Long term administration of cyclophosphamide into MRL/1 mice. II. The effects on the isotype of anti-DNA antibodies and immunoglobulin secreting cells in the spleen

Weekly injections of cyclophosphamide (Cy) at a dose of 20 mg/kg body weight prevented IgM to IgG class switch of serum anti-DNA antibodies and also immunoglobulin secreting cells in the spleen of MRL/Mp-lpr/lpr (MRL/1) mice. Culture experiments revealed that splenic B cells of Cy treated mice gave rise to more IgM and less IgG secreting cells than those of untreated mice in response to lipopolysaccharide. These results suggested that Cy suppressed enhanced differentiation of B cells into IgG secreting cells in MRL/1 mice, which would result in reduction of IgG anti-single stranded DNA antibodies and improvement of murine lupus like syndrome.

Growth hormone response to human pancreatic growth hormone releasing factor in cattle

The effects of a growth hormone releasing factor, human pancreatic growth hormone releasing factor-44 (hpGRF-44), on growth hormone (GH) secretion in calves, heifers and cows were studied. A single intravenous (iv) injection of 0.1, 0.25, 0.5 or 1.0 microgram of synthetic hpGRF-44 per kg of body weight (bw) in calves significantly elevated the circulating GH level within 2-5 min, while no increase in plasma GH was observed in saline injected control calves. The plasma GH level increased proportionally to the log dose of hpGRF-44, and reached a peak at 5-10 min (p less than 0.01). Subcutaneous injection of hpGRF-44 also elevated the plasma GH level, but the peak value at 15 min was 37% of that of iv injection (p less than 0.05). Intravenous injection of 0.25 microgram of hpGRF-44 per kg of bw to female calves, heifers, and cows significantly elevated mean the GH levels from 8.5, 2.3, and 1.6 ng/ml at 0 time to peak values of 97, 26, and 11.6 ng/ml, respectively (p less than 0.01). The plasma GH response and basal level in calves were significantly higher than those of heifers or cows (p less than 0.025). The plasma GH response to hpGRF-44 as well as the basal level decreased with advancing age. The plasma GH response to hpGRF-44 and basal GH in male calves were significantly greater than those in female calves (p less than 0.001). These results indicate that synthetic hpGRF-44 is a potent secretogogue for bovine GH, and suggest its usefulness in the assessment of GH secretion and reserve in cattle.

Long term administration of cyclophosphamide in MRL/1 mice. I. The effects on the development of immunological abnormalities and lupus nephritis

Weekly injection of cyclophosphamide (Cy) into MRL/Mp-lpr/lpr (MRL/l) mice, at a dose of 10-20 mg/kg, from 1 month of age prevented the development of generalized lymph node enlargement, decreased serum levels of anti-DNA antibodies and immune complexes, and markedly prolonged their life span. Cy effectively suppressed enhanced differentiation of B cells, as evidenced by decreased number of immunoglobulin secreting cells in the spleen. Cy was also shown to suppress abnormal expansion of Thy-1 positive cells in lymphoid organs of MRL/1 mice. These results suggested that Cy prevented the development of murine lupus like syndrome in MRL/1 mice through suppression of spontaneous polyclonal B cell activation and also by reducing the number of T cells to exert excessive helper activity on B cells.

Rectification of immunological abnormalities and lupus nephritis by the transfer of bone marrow cells

Two-month old MRL/1 mice, which spontaneously develop lymphoproliferative syndrome and severe lupus nephritis at 4-5 months of age, were irradiated and reconstituted with bone marrow cells from a congenic strain MRL/n mice. In the chimeric (n----1) mice, the early onset of the lupus nephritis was prevented as evidenced by decrease in the degree of proteinuria, diminished intensity of immune deposits in glomeruli, and milder histopathologic changes in kidneys. Lymph node swelling as well as generation of a large number of splenic IgSC was also prevented. Anti-ss DNA antibody response in the chimeric mice, however, varied tremendously from one animal to another.

Dietary arachidonic acid supplementation increases thromboxane synthesizing activity in platelets from diabetics

Thromboxane A2 has been implicated in thrombotic vascular diseases. The diabetic population has a high incidence of vascular complications. In the present study, activity of thromboxane synthetase in platelets of type 2 (non-insulin dependent) diabetic patients was studied. Thromboxane synthesizing activity in diabetic platelets was significantly higher than that in controls (p less than 0.05). An effect of dietary arachidonic acid on thromboxane synthesizing activity in platelets was also studied. Dietary arachidonic acid supplementation containing 1.7g of arachidonic acid per day for 1 week caused a significant increase of arachidonic acid content in plasma total lipids (p less than 0.05), but the increase of arachidonic acid in plasma total lipids did not correlate with the level of arachidonic acid in platelet phospholipids. Thromboxane synthesizing activity in platelets from the diabetics and the controls was augmented by a diet enriched in arachidonic acid from 2.20 +/- 0.15 to 2.56 +/- 0.20 and from 1.71 +/- 0.23 to 2.01 +/- 0.34, respectively. The increase in diabetic subjects was statistically significant (p less than 0.05). These results suggest that fatty acids of dietary origin are important factors in development of thrombotic vascular diseases.

Identification of immune-complex deposition and T-lymphocyte in fulminant B-viral hepatitis with immunohistochemical techniques

Cryostat sections of the liver representing fulminant B-viral hepatitis were investigated with antisera against human immunoglobulin G(IgG), immunoglobulin M(IgM), C3, C4, C1q, hepatitis B surface antigen (HBsAg), and T-lymphocytes using the immunofluorescence and immunoperoxidase techniques. The liver showed positive staining for IgG, IgM, C3, C4, C1q, and HBsAg in the viable and necrotic hepatocytes and Kupffer cells in a granular fashion. Furthermore, the cell membrane of lymphocytes present in the liver were positively stained with anti T-lymphocyte sera. The numbers of T-lymphocytes recognized were predominant both in portal tracts and within hepatic lobules over those of non-T-lymphocytes. It suggests that perhaps some of the end results of fulminant hepatitis inflammatory reactions may be mediated in part by T-lymphocytes.

An unusual form of vitamin D-dependent rickets in a child: alopecia and marked end-organ hyposensitivity to biologically active vitamin D

A 12-yr-old female patient with an unusual form of vitamin D dependency and alopecia is described. She was a product of consanguineous mating and developed signs and symptoms suggesting vitamin D dependency early in life. Neither 150 microgram/day (6 microgram/kg.day) 1 alpha-hydroxyvitamin D3 nor 5 microgram/day (0.2 microgram/kg.day) 1,25-dihydroxyvitamin D3 proved to have an effect on her abnormal serum chemistry. Seven million international units per day (about 2 x 10(5) IU/kg.day) of native vitamin D restored her serum chemistry to normal and brought about marked improvement on skeletal radiographs, when her serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and 24,25-di-hydroxyvitamin D were 4250, 4.8, and 35 ng/ml, respectively. Even with the high serum levels of vitamin D metabolites, her intestinal 47Ca absorption rate remained in the lower normal range and urinary calcium excretion was decidedly low. Association of hypoparathyroidism was ruled out. These results suggest that the patient has extreme and-organ (intestine) hyposensitivity, probably of congenital origin, to the biologically active metabolites of vitamin D.