Evaluation of the spindle-inhibiting effect of Ni++ by quantitation of chromosomal super-contraction

In vitro exposure of human lymphocytes to spindle inhibitors reduce the average chromosome length (Andersen and Rønne, 1981, 1983. Andersen et al 1983). In this report chromosome length measurements were used for indirect but quantitative evaluation of the effects of Ni++ on spindle function. In two donors 4 h or 20 h exposure of phytohemagglutinin stimulated peripheral lymphocyte cultures to 10(-3) M but not 10(-4) M Ni++ induced statistically significant reductions in average chromosome length, indicating that Ni++ is a powerful spindle inhibitor in a narrow concentration range just below the lethal concentration. Although systemic effects are unlikely to occur, local effects induced by Ni++ released after pulmonary deposition of Ni containing dusts cannot be ruled out. Spindle dysfunction may result in aneuploidy. The significance of the finding reported here in relation to nickel carcinogenicity is presently unknown.

Etiology and pathophysiology of gestational diabetes mellitus

In pregnancy, several physiologic changes take place, the sum of which tends to reset the glucose homeostasis in the direction of diabetes. About 1-2% of all pregnant women develop an abnormal glucose tolerance in pregnancy, but most often glucose tolerance returns to normal postpartum. This condition is called gestational diabetes mellitus (GDM). The possibility that glucose tolerance deteriorates in pregnancy because of diabetes-like changes in the secretory function of the endocrine pancreas has been investigated in healthy controls and in normal-weight gestational diabetic subjects. The insulin responses to oral glucose and mixed meals are equally large in these two groups, but the insulin response per unit of glycemic stimulus is significantly lower in the gestational diabetic subjects than in the controls. Diabetes-like changes in glucagon secretion are not observed in either group. Insulin degradation is unaffected by human pregnancy and the proinsulin share of the total plasma insulin immunoreactivity does not increase in pregnancy. Insulin receptor binding to monocytes from normal pregnant women is increased in midpregnancy but is significantly decreased in late pregnancy. No difference in insulin binding (at tracer insulin concentration) to monocytes from healthy pregnant controls and gestational diabetic subjects is found. The insulin concentration necessary to reduce tracer insulin binding by 50% (ID50) is lower in the gestational diabetic subjects diagnosed in late pregnancy than in the pregnant controls. Together, these findings indicate that the number of insulin receptors on monocytes is decreased in GDM at this stage of pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Release of gastrointestinal hormones in cardiodepressive shock

In previous studies increased plasma levels of vasoactive intestinal polypeptide (VIP), somatostatin and pancreatic polypeptide (PP) were demonstrated in a porcine endotoxin shock model. Unchanged levels of gastric inhibitory polypeptide (GIP) and secretin point to a specific shock reaction of peptide release and not to a diffuse mucosal leakage. A porcine model of cardiodepressive shock was developed to enable discrimination to be made between a general low-flow state and endotoxin reaction. Infusion of the tricyclic antidepressive agent nortriptyline 15 mg/kg bodyweight resulted in a grave shock state. Increased plasma levels of somatostatin, PP and insulin were found. No increase in VIP levels could be demonstrated. Endotoxin given after nortriptyline administration resulted in the increase of VIP levels regularly seen during endotoxinaemia. VIP release during endotoxin shock is related to endotoxin and not to a general low flow state.

Influence of the maternal plasma glucose concentration at delivery on the risk of hypoglycaemia in infants of insulin-dependent diabetic mothers

Plasma glucose concentrations at birth and at two hours of age were measured in 53 infants of insulin-dependent mothers (IDMs). The plasma glucose concentrations at delivery were measured in the mothers of 17 IDMs and in the remaining 36 mothers, glucose was estimated by interpolation from concentrations achieved just before and after delivery. Clinical and laboratory data from the two groups were otherwise similar, so the groups were combined for further analyses. The maternal plasma glucose at delivery correlated positively with the glucose concentration of the IDMs at birth (rho = 0.82, p less than 0.001) and negatively with the glucose concentration at two hours of age (rho = -0.46, p less than 0.001). Maternal plasma glucose concentration was higher in mothers delivered by caesarean section than in vaginally delivered mothers (p less than 0.05). Eleven IDMs became hypoglycaemic at two hours of life (plasma glucose less than or equal to 1.7 mmol/l). These infants had higher cord plasma glucose concentrations at birth than those who remained normoglycaemic; the maternal glucose concentration was also higher. None of the IDMs became hypoglycaemic if the maternal glucose concentration at delivery was less than 7.1 mmol/l. In 28 IDMs the simultaneous plasma concentrations of non-antibody bound immunoreactive insulin (IRI) were recorded. Cord plasma IRI correlated with glucose and IRI at two hours of age (rho = -0.73, p less than 0.001 and rho = 0.77, p less than 0.001, respectively). Cord plasma IRI was higher in IDMs who became hypoglycaemic than in the remaining infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Methotrexate-leucovorin synchronization of human lymphocyte cultures. Induction of high resolution R- and G-banding

This report describes simple techniques for induction of high resolution R- and G-banding. A methotrexate (MTX) induced S-phase block was released after 18 h by exposure to leucovorin (LV). G-bands were induced by adding ethidium bromide (EB) to the cultures followed by a modified trypsin treatment of the slides, including inhibition of trypsin activity by trypsin inhibitor. To obtain R-banded preparations 5-bromodeoxyuridine (BUdR) and Hoechst 33258 (H) were simultaneously added to the LV released cultures. The synchronization technique and the R- and G-banding procedures are simpler than most techniques, formerly published, and ensure high metaphase yield, reproducibility and slides with well defined high resolution R- or G-banding.

VIP in cerebrospinal fluid of patients with multiple sclerosis

The concentration of VIP was measured radioimmunochemically in cerebrospinal fluid (CSF) from 14 healthy volunteers and from 22 patients with multiple sclerosis. Significantly lower levels of VIP was obtained in the patients (18 +/- 3 pmol/l) than in controls (37 +/- 4 pmol/l). There was no correlation between the level of VIP in CSF and other CSF parameters such as albumin. IgG or cell content; nor between VIP concentration and the physical handicap or neuropsychiatric symptoms. There was a trend towards lower values of VIP in patients with steadily progressing rather than intermittent course of the disease but the difference between the groups was not significant.

Chelation of cadmium

The toxicity of cadmium is determined by chelation reactions: in vivo, Cd2+ exists exclusively in coordination complexes with biological ligands, or with administered chelating agents. The Cd2+ ion has some soft character, but it is not a typical soft ion. It has a high degree of polarizability, and its complexes with soft ligands have predominantly covalent bond characteristics. Cd2+ forms the most stable complexes with soft donor atoms (S much greater than N greater than 0). The coordination stereochemistry of Cd2+ is unusually varied, including coordination numbers from 2 to 8. Even though the Cd2+ ion is a d10 ion, disturbed coordination geometries are often seen. Generally, the stability of complexes increases with the number of coordination groups contributed by the ligand; consequently, complexes of Cd2+ with polydentate ligands containing SH groups are very stable. Cd2+ in metallothionein (MT) is coordinated with 4 thiolate groups, and the log stability constant is estimated to 25.5. Complexes between Cd2+ and low molecular weight monodentate or bidentate ligands, e.g., free amino acids (LMW-Cd), seem to exist very briefly, and Cd2+ is rapidly bound to high molecular weight proteins, mainly serum albumin. These complexes (HMW-Cd) are rapidly scavenged from blood, mainly by the liver, and Cd2+ is redistributed to MT. After about 1 day the Cd-MT complex (MT-Cd) almost exclusively accounts for the total retained dose of Cd2+, independent of the route of exposure. MT-Cd is slowly transferred to and accumulated in kidney cortex. The acute toxicity and interorgan distribution of parenterally administered Cd2+ are strongly influenced by preceding MT induction, or decreased capacity for MT synthesis; however, the gastrointestinal (GI) uptake of Cd2+ seems unaffected by preceding MT induction resulting in considerable capacity for Cd2+ chelation in intestinal mucosa, and this finding indicates that endogenous MT is not involved in Cd2+ absorption. The toxicity of parenterally administered Cd2+ is strongly enhanced when administered as complexes with NTA or STPP , but it is much decreased when administered as a complex with EDTA. In chronic oral exposure the toxicity and GI uptake of Cd2+ is not changed when Cd2+ is administered as a complex with the detergent formula chelating agents NTA, EDTA and STPP . The uptake of Cd2+ from ligated intestine in vivo was not affected by administration of Cd2+ as complexes with CYS or GSH, but significantly reduced by complexation with EDTA or BAL. The acute toxicity of orally administered Cd2+ is reduced when Cd2+ is administered as a complex with EDTA.(ABSTRACT TRUNCATED AT 400 WORDS)

Hereditary diffuse leucoencephalopathy with spheroids

The clinical, genetic, and morphological features of a previously unknown progressive neuropsychiatric disease are presented. By genealogical investigation of the background of an uncharacteristic case of presumed organic psychosis, we traced 71 relatives from four generations. The anamnestic data showed various combinations of psychiatric symptoms (depression, anxiety, aggressiveness, and severe dementia), neurological symptoms (impaired balance with retropulsion, hyperkinesia, and epilepsy), and somatic symptoms (gastrointestinal disorders, arthritis, and gynaecological problems) in 17 (11 dead and 6 living) members of the family. Age at onset varied between 8 and 60 years. Some patients rapidly developed severe dementia and died a few months after the onset of symptoms, while in others the course was prolonged with dementia over several decades. The genetic interpretation indicated an autosomal dominant inheritance with possible full penetrance but widely variable expressivity. Morphological studies were performed on the central nervous system of four decreased family members (three siblings and their maternal uncle). The same type of widespread leucoencephalopathy was seen in the four autopsy cases. It was characterised by degeneration and loss of myelin sheaths and axons, occurrence of numerous neuroaxonal spheroids in the affected white matter, accumulation of lipid-laden macrophages, and gliosis. The bilateral, frontal, fronto-parietal, and temporal locations of the most pronounced, diffusely demarcated lesions corresponded fairly well to the symptoms of an organic psychosyndrome with its main substrate in the forebrain. For this new clinico-pathological entity, the name "hereditary diffuse leucoencephalopathy with spheroids" (HDLS) is proposed. As a working hypothesis, it is suggested that not only genetic, but also immunological and possible endocrine factors may contribute to the development of the disease.

Autoimmune haemolytic anaemia treated with multiple transfusions, immunosuppressive therapy, plasma exchange, and desferrioxamine

Severe autoimmune haemolytic anaemia in a five year old boy was unaffected by treatment with prednisone and splenectomy, but subsided after combined immunosuppressive therapy and three plasma exchanges. Over five months, a total of 93 transfusions of concentrated erythrocytes was given (equal to 18.6 grams of iron or 1.1 g/kg BW). This resulted in severe iron overload with cardiac, hepatic, and pancreatic complications, together with growth-retardation. These complications disappeared after treatment with desferrioxamine and vitamin C, but despite a normal growth hormone response to glucagon the concentration of somatomedin in serum remained low. Treatment by plasma exchanges and immunosuppressive agents may therefore be of value in severe haemolytic anaemia refractory to corticosteroids and splenectomy. Iron chelating therapy should be considered if multiple transfusions result in iron overload.

The short-term effects of a low-dose oral contraceptive on glucose metabolism, plasma lipids and blood clotting factors

Twelve young women were prospectively evaluated for the short-term metabolic effects of a low-dose oral contraceptive containing 30 micrograms ethinyl estradiol and 150 micrograms levonorgestrel. To each volunteer a 50 g glucose challenge was administered monthly as a screening test for changes in the glucose metabolism. Fasting and 30 minutes glucose and insulin values were measured and blood specimens were collected for determination of fasting triglycerides, cholesterol and blood clotting factors II, VII, X. During treatment the fasting plasma glucose level decreased significantly in the first two cycles and then normalized. No change in incremental glucose values was observed. Fasting insulin concentrations, incremental insulin values and the insulinogenic index did not change during the study period. Total plasma cholesterol values decreased during treatment, whereas the plasma triglyceride levels were unaffected. Immediately after tablet intake, an increase was found in the blood clotting factors and the elevated levels continued constantly throughout the study period. Comparing the data from the present study with data from previous investigations on low-dose ethinyl estradiol/levonorgestrel compounds, there seems to be no difference in the influence on blood clotting factors, glucose and lipid metabolism between treatment for 3 and 6 months. From the study, it is concluded that the impact of oral contraceptives on metabolic functions may emerge during the initial treatment cycles.

The renin-aldosterone system in nephrogenic diabetes insipidus and the influence of hydrochlorothiazide and indomethacin

Three generations of a family with nephrogenic diabetes insipidus were studied. Treatment of a male infant patient with hydrochlorothiazide normalized the serum sodium concentration and improved the clinical condition, but did not influence the polyuria. Although indomethacin alone was without long-term effect, combined therapy with hydrochlorothiazide and indomethacin regulated serum sodium better than hydrochlorothiazide alone. The renin-aldosterone system was not activated in healthy carriers or patients with nephrogenic diabetes insipidus neither in infancy during severe hypernatremic dehydration nor in adult patients.

Interstitial deletion in the "critical region" of the long arm of the X chromosome in a mentally retarded boy and his normal mother

A family in which an intestitial deletion of the X chromosome, del(X)(q13q21.3), is segregating was ascertained through a boy with cleft lip and palate, agenesis of the corpus callosum, and severe mental retardation. The possible causal relationship to his chromosome abnormality is discussed. Although the deletion occurred within the critical region, the mother showed no signs of gonadal dysgenesis. A phenotypically normal daughter was, as her mother, monosomic for this region of the X, and both showed random inactivation of the X chromosome.

Thallium poisoning--toxin elimination and therapy in three cases

Three cases of thallium poisoning occurred within the same family after eating a meal of poisoned sour milk. The 58 year old mother died after four days cardiovascular insufficiency. Massive thallium concentrations were found in blood, urine, liver and kidney. The 59 year old father presented after four days with a neurology typical for classic thallotoxicosis with potentially lethal blood thallium levels. This patient recovered after therapy including Prussian Blue, forced diuresis and two six hour hemoperfusions with a charcoal column. Urinary elimination of thallium over two weeks was almost 300 mg, whereas a maximum total of 63 mg were removed with hemoperfusion. A retrospective estimate of the total dose ingested and the large distribution volume of thallium suggest that hemoperfusion did not affect the course of the intoxication. The 28 year old son, later convicted for homicide, was admitted on the tenth day after the meal with very discrete neurological symptoms. This patient had low blood and urine thallium levels. He recovered uneventfully after treatment with Prussian Blue and forced diuresis. However, both surviving patients developed alopecia after two weeks. All three patients had raised liver transaminases. Intensive therapy with gut decontamination, Prussian Blue and forced diuresis should be the mainstay of therapy.

Absorption kinetics and steady-state plasma concentrations of theophylline following therapeutic doses of two sustained-release preparations

Ten healthy volunteers received two sustained-release preparations as a single and multiple dose regimen in an open crossover study. Plasma theophylline concentrations were measured by an enzyme immunoassay. The limited fluctuation of the theophylline levels at steady state, with twice daily administration, clearly demonstrated the marked sustained release properties of both preparations. Results indicate similar properties for the two preparations. Significant correlations between the single dose period and steady state were found for Cmax and AUC (r = 0.76 and 0.87, respectively) with one formulation, whereas this was not the case for the other (r = 0.27 and 0.49). The daily dose necessary to keep the plasma concentration within the therapeutic range of 55-110 mumole/liter varied from 7.9 to 22.9 mg/kg. Only mild side effects were recorded, but they were not correlated to the plasma theophylline concentration.

Wild animal mycobacterial isolates. Characterization by cellular fatty acid composition and polar lipid patterns

Thirteen strains of mycobacteria isolated from deer and various species of wild birds were analysed by gas chromatography (GG) for cellular fatty acids and by thin-layer chromatography (TLG) for polar lipids. These strains were compared to reference strains of Mycobacterium avium, M. para tuberculosis and M. mal-moense. All the examined strains exhibited a generally similar fatty acid pattern characterized by relatively large amounts of hexadenca-noate (16:0), octadecenoate (18:1), octadecanoate (18:0) and 10-me-thyl-octadecanoate (tuberculostearic acid, 10-Me-18:0). Several additional acids were also generally present but in smaller amounts. By means of small but distinct differences in fatty acid composition, the wild animal isolates could be distinguished from both M. paratuber-culosis and M. malmoense but not from M. avium.

The TLG polar lipid patterns on the other hand separated the wild animal isolates into 2 distinct groups of complex and simple polar lipid composition which corresponded to the morphologically smooth and rough types, respectively. The complex patterns of the smooth strains were comparable to those of the M. avium serovars whereas both the rough wild animal isolates and all the M. paratuber-culosis strains showed a simple pattern of polar lipids.

Both fatty acid profiles and TLG polar lipid patterns support allocation of the wild animal isolates to the MAIS complex. Moreover, the 2 chemical techniques, particularly the GC procedure, are very useful for a more rapid and precise identification of the slow-growing wild animal mycobacterial isolates which have hitherto been characterized on basis of vague criteria.

Effects of coal combustion products and metal compounds on sister chromatid exchange (SCE) in a macrophagelike cell line

Investigations of genotoxic effects of particles have almost exclusively been performed by organic extraction, while direct investigations in cells capable of engulfing particles have only been performed in few cases. Thus, in most studies, the eventual effects of particle-associated metal compounds have remained undiscovered. The present study attempted direct measurement of genotoxic effects of particulate coal combustion products by using the P388D(1) macrophage cell line. The capability of these cells for phagocytosis was demonstrated with insoluble particles. The sister chromatid exchange (SCE) test was used for measuring genotoxic effects of test compounds. Dimethylnitrosamine and benzo(a)pyrene did not increase SCE, indicating that the P388D(1) cell line has lost the capacity for metabolism of latent organic carcinogens, reducing the value of these cells for evaluating genotoxic effects of complex particles. Indirect evidence has been obtained that the cell line may be infected with a virus. Thus, interactions between virus and test compound may lead to erroneous results. This should be kept in mind during evaluation of the results. The effects of metals with reported carcinogenic or mutagenic effects on SCE were compared in P388D(1) cells and human lymphocytes: NaAsO(2), CdCl(2), K(2)Cr(2)O(7), CoCl(2), CH(3)HgCl and MnSO(4) increased SCE in both cell systems. Pb(CH(3)COO)(2), BeSO(4) and NiSO(4) had a weak effect on SCE in P388D(1). Pb(CH(3)COO)(2) and NiSO(4), but not BeSO(4), increased SCE in human lymphocytes. Cr(CH(3)COO)(3) increased SCE in human lymphocytes at high concentration, but was a strong inducer of increased SCE in P388D(1) cells, which take up Cr(III) by phagocytosis. This suggests that the Cr(III) ion is an ultimate carcinogenic form of chromium. Generally P388D(1) cells and human lymphocytes respond to in vitro exposure to metals in agreement with reported mutagenic/carcinogenic effects of the metals. Of four precipitated coal fly ash samples tested, only one sample (from an electrostatic precipitator downstream of a cyclone at an electricity generating plant burning pulverized coal) had a clear increasing effect on SCE in P388D(1). Extraction of this sample with medium with 10% serum yielded an extract capable of increasing SCE. The extracted particles still increased SCE, but less than unextracted particles. Emission samples taken with impactor sampler after a dilution probe using controlled cooling of the flue gas were obtained from an oil-fired (one sample) and a coal-fired (one sample < 3 mum and one sample < 3 mum) steam boiler. The only sample increasing SCE was the sample < 3 mum from the coal-fired boiler. Extract from this sample also increased SCE. The results demonstrated that the use of phagocytizing cells for assessment of genotoxic effects of particles offers a useful system, since the particles can be investigated directly. Furthermore, particles, extracted particles and extract can be investigated in the same system.

Fatty acid and polar lipid analysis as tools in the identification of Mycobacterium leprae and some related slow-growing mycobacterial species

Some species of slow-growing Mycobacteria, including Mycobacterium leprae (1 strain), M. lepraemurium (2 strains), M. paratuberculosis (12 strains) and a group of 12 M. avium-like strains (isolates from wild animals) were examined by gas chromatography (GC) for cellular fatty acids and by thin-layer chromatography (TLC) for polar lipids. All the GC patterns, including that of M. leprae, contained high levels of tuberculostearic-, stearic-, octadecenoic- and palmitic acid. Tetradecanoic-, pentadecanoic-, hexadecenoic- and heptadecanoic acid were also generally present but in lower concentrations. In addition to these acids shared by all strains, each bacterial species or group was found to exhibit compounds which were not detected (or detected in considerably lower quantities) in the other taxa examined. Thus each bacterial species or group could be distinguished by their GC profiles. The corresponding TLC patterns were also rather complex. A total of 39 different spots were distinguished. A few of these were shared by all strains, some were characteristic of certain species or groups, whereas others were strain-specific. Both M. leprae and M. lepraemurium shared several features with the other strains but could be distinguished from each other and from the others by their patterns of slow-moving (polar) spots. The 12 M. avium-like strains were divided into two main groups, one with only a few slow-moving spots (rough stains), and one with several slow-moving spots (smooth strains) which included the M. avium reference strains.

Plasma concentrations of the cyclic nucleotides, adenosine 3',5'-monophosphate and guanosine 3'.5'-monophosphate, in healthy adults treated with theophylline

Plasma concentrations of cyclic adenosine monophosphate and cyclic guanosine monophosphate were measured in 10 health adults before, during and after periods of theophylline administration. Cyclic adenosine monophosphate concentrations did not change significantly, but cyclic guanosine monophosphate concentrations decreased by 29% on average when theophylline was administered. The change in cyclic guanosine monophosphate was not correlated to the plasma concentration of theophylline in the range studied.

Metal interactions in carcinogenesis: enhancement, inhibition

Metals constitute a fundamentally important part of the total human environment. Since human exposure often involves complex mixtures of metal compounds and, possibly, organic compounds which may be carcinogenic per se, interactions between these compounds may add significantly to human cancer risk. Our present knowledge about these kinds of interactions is very limited. The best investigated area is benzo(a)pyrene (BP)-metal oxide particle interactions in respiratory carcinogenesis in the hamster. Metal oxide particles were also shown to modify the carcinogenic effect of nitrosamines. Several reports describe experiments in which selenium compounds exerted a generally anticarcinogenic and antimutagenic activity. Inorganic arsenic compounds, which are accepted to be carcinogenic in man, have so far been negative in animal experiments except for one recent suggested report. Several authors have, however, suggested that these compounds may act as cocarcinogens due to their inhibition of DNA repair, although animal experiments to demonstrate a cocarcinogenic effect of arsenic compounds have been negative so far, except for one preliminary report. The concentration of zinc in the diet seemed to influence both transplanted tumor growth and the carcinogenicity of several organic compounds, and the possibility of a correlation between dietary zinc and certain cancer forms in man has been suggested. Protection against development of Leydigiomas usually induced by cadmium injection was afforded by simultaneous injection of zinc salts. Nickel carcinogenesis has been reported to be antagonized by manganese, and synergism between Ni and organic carcinogens, e.g. BP, has been demonstrated. There is no firm evidence that lead may be a cocarcinogen, although some limited experimental evidence is available. Oxidizing agents have been demonstrated to increase, and reducing agents to antagonize, the mutagenic effect of chromium compounds in vitro. The content of carcinogenic and other metals in asbestos has been suggested to modify the carcinogenic properties of asbestos. Since much of the information available at present is suggestive, further research on these interactions as well as other possible interactions in metal carcinogenesis is needed. Studies should be made both in well defined in vitro systems and in relevant animal models.

Monoamine metabolites in successive samples of spinal fluid. A comparison between healthy volunteers and patients with multiple sclerosis

Homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA) and 4-hydroxy-3-methoxyphenylglycol (HMPG) were measured in the cerebrospinal fluid from patients with multiple sclerosis and from healthy volunteers. The fluid was withdrawn with the persons in the lateral recumbent position. In the controls and in 4 of the patients 10 successive samples of 2 ml each were analyzed. In the remaining patients the first 2 ml and last 2 ml of a total 20 ml were analysed. The highest values were obtained in the last portion. Patients with multiple sclerosis had significantly lower levels of 5-HIAA than controls in both the first and last CSF samples. Patients with a progressive course of prominent residual symptoms had a lower concentration of 5-HIAA and HVA than those with a relapsing course and little residual symptoms. The difference was significant for 5-HIAA.

Clinical studies on multiple sclerosis. I. Presentation of an incidence material from Gothenburg

Probable and possible MS cases with a debut during the years 1950-1964 within the city of Gothenburg were identified (312 cases). This corresponds to an incidence of 5.3 per 100,000. The material was stratified according to diagnostic probability into three categories. For the final analysis cases with the lowest diagnostic probability were omitted (about 9%). The follow-up was completed during 1977, i.e. 13-27 years from onset. A longitudinal analysis of each case was based upon a mixed prospective/retrospective study in which the authors personally examined the majority of the cases during most of the years. The female/male ratio was 1.5-1.6. The mortality rate was higher for males due in part to an earlier progressive development of multiple sclerosis and in part to a higher trend for acquisition of other mortal diseases. Bouts, as the first manifestation of the disease, were more frequent in young ages than in old, and more frequent among females than in males. The averages bout frequency decreased significantly with the duration of the disease as well as with the age of onset. The opposite trend was characteristic for development of a progressive course. Among symptoms at onset, those indicating lesions of long sensory and/or motor tracts (particularly the sensory) dominated. Such initial symptoms were seen in 30-40% of the younger patients and 70% of the older patients. The rest was divided between cases with optic nerve lesions (20-30% among younger, 12-15% among older patients) and brain stem lesions (approx. 25% among younger, 10-19% among older patients). The occurrence of various symptoms during the first two decades of the disease was also analyzed and the pattern of symptoms presented graphically. These results will be treated further in subsequent studies.

A complex four-break rearrangement between chromosomes 4 and 13 resulting in a recombinant chromosome 4

A complex four-break rearrangement between chromosomes 4 and 13 was ascertained in a 10-year-old mentally retarded girl. The rearrangement was inherited from the phenotypically normal mother, who had an inverted insertion of part of the long arm of chromosome 4 into the long arm of 13 and, in addition, a pericentric inversion of the deleted 4. Meiotic crossing-over between the normal and the inverted 4 resulted in a recombinant chromosome 4, which was inherited by the proband, together with the 13/4 insertion. In this way the proband became monosomic for 4q35 leads to qter and trisomic for 4pter leads to 4p15, but she showed only minor physical malformations, as compared with other reports on the trisomy 4p syndrome. The cytogenetic findings are difficult to describe using the ISCN nomenclature.

Bromocriptine treatment for male infertility

Four oligozoospermic men with marginally raised serum prolacatin levels were treated with bromocriptine for a period of 90 days. Bromocriptine treatment did not result in an increase in sperm count.

Homogeneous enzyme immunoassay of serum digoxin with use of a bichromatic analyzer

We applied the Enzyme Multiplied Immunoassay Technique (EMIT; Syva Corp., Palo Alto, CA) for determination of serum digoxin to the ABA-100 bichromatic analyzer. Assay conditions were almost exactly as prescribed for the manual procedure, but the ABA-100 offers high automation, smaller reagent volumes, and shorter reaction time. Precision studies gave CV's of less than 10%. Sixty patients' samples, analyzed for digoxin by radioimmunoassay and this enzyme immunoassay, gave a correlation (r) of 0.941. Results obtained with the ABA-100 were apparently slightly higher. One kit provides reagents for 250 assays, as compared to 70 assays with the manual procedure. In an emergency situation a result will be available about 60 min after the patient's sample is received; one operator can analyze about 120 samples in 8 h.

Homogeneous enzyme immunoassay of serum digoxin with use of a bichromatic analyzer

We applied the Enzyme Multiplied Immunoassay Technique (EMIT; Syva Corp., Palo Alto, CA) for determination of serum digoxin to the ABA-100 bichromatic analyzer. Assay conditions were almost exactly as prescribed for the manual procedure, but the ABA-100 offers high automation, smaller reagent volumes, and shorter reaction time. Precision studies gave CV's of less than 10%. Sixty patients' samples, analyzed for digoxin by radioimmunoassay and this enzyme immunoassay, gave a correlation (r) of 0.941. Results obtained with the ABA-100 were apparently slightly higher. One kit provides reagents for 250 assays, as compared to 70 assays with the manual procedure. In an emergency situation a result will be available about 60 min after the patient's sample is received; one operator can analyze about 120 samples in 8 h.

Receptor binding and biological effect of insulin in human adipocytes

The binding of 125I-labelled insulin to human adipocytes was studied at 37 degrees C. The precipitability of the 125I-labelled insulin preparation (0.03 nmol/l) in trichloroacetic acid and the concentration of biologically active insulin (7.5 nmol/l) remained constant in buffer incubated with human adipocytes (100 microliter cells/ml suspension) for 30--60 minutes at 37 degrees C, whereas more than half of the insulin was inactivated by rat fat cells under the same conditions. A constant level of binding of 125I-labelled insulin (0.03 nmol/l) to human adipocytes was obtained after 45 minutes. The apparent dissociation constant of receptor binding was about 0.2 nmol/l as compared to about 2 nmol/l for rat adipocytes. Conversion of [UP14C]glucose to lipids was stimulated half-maximally by about 0.05 nmol/l of insulin (similar to rat adipocytes). Thus, half-maximal stimulation of human adipocytes was obtained with a recptor occupancy of about 20--30 per cent.

Effect of 2-aminonaphthalene on glutathione content and cytochrome P-450 p-nitroanisole O-demethylation activity in mouse liver

Four days after single i.p. administrations of 2-aminonaphthalene to C3H mice, the liver content of reduced glutathione and the liver microsomal cytochrome P-450 O-demethylation activity were decreased. No changes were observed in oxidized glutathione.

A prospective study of parapareses in western Sweden

As a consequence of a WHO inquiry about possible complications to poliomyelitis immunization, a prospective incidence study was performed during 1971 in the western region of Sweden, in order to obtain data relevant to the inactivated vaccine used here. After rejection of surgical and secondary cases, the study consisted of 10 Guillain-Barré cases, three incipient MS cases, two infectious and one probably vascular case. By using a procedure of retrospective controls it was demonstrated that the efficiency of prospective case ascertainment is dependent on diagnosis. The incidence of de novo parapareses as defined was approximately 1.7/100,000/year of which 1.0/100,000/year was due to MS. CSF and virological investigations were performed early in prospective cases, in MS cases within 5 to 11 days after onset, and it was shown that no changes occurred in later CF titrations. Routine virological tests did not contribute to diagnosis in patients having paraparesis. No vaccine-associated cases of paraparesis occurred during the 1-year period of the study.

Effect of ethanol on the glucose-mediated insulin release in triply catheterized anesthetized pigs

In order to further elucidate the potentiating effect of ethanol on the glucose-mediated insulin response, triply catheterized anesthetized pigs were submitted to an intravenous glucose infusion test after a four-hour preinfusion with ethanol (11 pigs) or saline (six pigs, control experiment). During the tests portal, hepatic, and peripheral venous blood was drawn simultaneously. Two series of ethanol-preinfusion experiments were carried out: in one series the serum ethanol concentration was maintained at approximately 10 mM and in the other at 19 mM. Compared with saline, 10 mM of serum ethanol induced a more than threefold increment in the insulin secretory response to glucose as estimated in the portal blood (p less than 0.01). Likewise, hepatic and peripheral venous blood insulin levels were enhanced (p less than 0.01). In contrast, 19 mM of serum ethanol did not elevate serum insulin levels above those found in the control experiments. When individual incremental portal insulin areas were plotted against the corresponding average value of serum ethanol in the preinfusion period, a significant inverse relationship was found (p less than 0.02), indicating a decrease in the potentiating effect of ethanol on the glucose-mediated insulin response with increasing levels of serum ethanol. Comparison of portal and hepatic incremental insulin areas revealed that ethanol did not, in the concentration range investigated, influence the hepatic insulin degradation rate. In conclusion, ethanol seems to potentiate, in an inverse concentration-dependent manner, the glucose-mediated insulin response through an action directly on the pancreas.

Microvascular techniques for polar artery reconstruction in kidney transplants

The complications of ureteral ischemia make revascularization of polar vessels attractive in cadaver and live-related transplants. Thirty-two patients underwent reconstruction of polar vessels of 1.2 to 2.5 mm, in diameter after revascularization of the major vessels as follows: (1) inferior epigastric artery to polar artery, ten patients - six cadaver transplants, four living-related transplants (The vessels are spatulated and sutured precisely by microvascular techniques with Nos. 7-0 or 8-0 Tevdek); (2) polar vessel with a patch of aorta to iliac artery, one patient - living relative donor; (3) polar artery to the main renal artery or branch, 17 patients - 14 cadaver transplants, three living-related transplants [A Waters "MOX"-100 machine is used with cryoprecipitated plasma (800 mg. of SoluMedrol and 80 U. of insulin added) for preservation.]; (4) autogenous saphenous vein graft, two patients - one child receiving on adult live-related kidney and one cadaver transplant with three arteries and a stenosis of the inferior polar vessel; (5) polar artery to vein patch in iliac artery, two patients - cadaver transplants. Follow-up was done by arteriography (18 patients), direct observation (two patients), and by use of ultrasound (one patient). The remaining 11 patients have exhibited no evidence of occlusion. Twenty of 21 patients exhibited patent vessels; one thrombosed at the time of the transplant operation. Long-term patency in those patients studied was 95%. We advocate small-vessel reconstruction in human renal transplantation, either during ex vivo preservation (workbench surgery) or at the time of transplantation.

Glucose- and tolbutamide-mediated insulin response after preinfusion with ethanol

Intravenous glucose tolerance tests (1VGTT) were carried out in five normal subjects after ethanol preinfusion for one, two or four hours. Constant serum level of ethanol was maintained throughout the experiments. Control experiments were performed with saline. Basal levels of serum glucose and insulin were unaffected by ethanol. As regards glucose tolerance a nonsignificant rise in the glucose assimilation constant was seen. During IVGTT peak insulin concentration was unaffected by preinfusion with ethanol for one or two hours, but significantly elevated after four hours. The declining part of the insulin concentration curve was significantly elevated after one or four hours of preinfusion. The insulin increment per glucose increment (the insulinogenic index) rose with the duration of the preinfusion period and, compared to the control experiment, a twofold increment was seen after four hours. When tolbutamide (1 gram) was given intravenously to two of the subjects after preinfusion with ethanol for four hours, the subsequent insulin response followed the same pattern as seen in the four-hour-IVGTT experiment. As the potentiation increases with the duration of the preinfusion period, it might be explained by cummula-tive changes in the beta cell. However, a diminished hepatic degradation rate of insulin cannot be ruled out.