Sensitive homologous radioimmunoassay for human parathyroid hormone to diagnose hypoparathyroid conditions

A sensitive radioimmunoassay for human parathyroid hormone (hPTH) to diagnose hypoparathyroid conditions is described. The antiserum was raised in goats against extracted hPTH. Synthetic human PTH fragment (53-84) is used as a standard and 125I-Tyr52hPTH (53-84) as a tracer. After a two-step incubation (24 h + 24 h) at 4 degrees C, the bound and free fractions are separated by a mixture of second antibody and polyethylene glycol solution. The detection limit for hPTH (53-84) is 2 pmol/L hPTH (53-84) (2 mol/tube). The PTH level in 36 healthy subjects was 5-12 pmol/L. Of 14 patients with hypoparathyroidism 11 patients had PTH concentrations below normal, two patients had levels on the lower limit of the normal range (5 pmol/L). The concentration of one patient with pseudohypoparathyroidism was markedly elevated. This assay is suitable for detecting low PTH levels and for studying changes of PTH concentration within the normal range.

Gastroparesis secondary to a medulloblastoma of the posterior fossa

A patient with a 4-month history of unexplained nausea and vomiting is reported. The only abnormality found initially was severe gastroparesis found by gastric emptying scan. Subsequently, a posterior fossa tumor was found. The pathogenesis of this unusual presentation and the role of the gastric emptying scan is discussed.

Rat brain microvessel extracellular matrix modulates the phenotype of cultured rat type 1 astroglia

Astroglia from immature rat cerebral white matter which were plated on the insoluble extracellular matrix (ECM) secreted by rat cerebral microvessel endothelial cells (RCMEC) and maintained in a defined medium were induced to become stellate and to express glutamine synthetase. These effects were not elicited by RCMEC-conditioned medium. ECM secreted by rat pleural mesothelium elicited a lesser proportion of stellate astroglia and did not induce glutamine synthetase.

Recurrent psoas abscess

Recurrence of a psoas abscess in exactly the same location is very unusual--in fact, we found no other reports in the literature. Laparotomy performed after the patient presented with the second abscess revealed an impacted calculus and diverticulitis of the appendix as the cause. Computed tomography was effective in establishing the diagnosis, but the question of the best method of treatment remains. Percutaneous drainage was insufficient in this case.

Two years of intrauterine contraception with levonorgestrel and with copper: a randomized comparison of the TCu 380Ag and levonorgestrel 20 mcg/day devices

IUDs releasing 20 mcg/day of levonorgestrel (LNg20) were in randomized trial together with the Copper T, model TCu 380Ag, in seven centers involving 2244 women. Two-year (25 months) gross cumulative pregnancy rates were 0.2 +/- 0.2 and 0.9 +/- 0.3 for the levonorgestrel and copper releasing devices, respectively (P greater than 0.05). There were no ectopic pregnancies in more than 1600 woman-years of use of each device. Removal rates for bleeding and/or pain or for medical reasons other than menstrual problems did not differ significantly between devices. Oligomenorrhea or amenorrhea prompted 10.7 per hundred (gross rate, 8.4 net rate) women using the LNg 20 IUD to request removal in the two-year period, significantly above the 0.2 per hundred rate among women with the Copper IUD (P less than 0.001). At the end of two years an estimated 59.4 per 100 women were continuing use of the LNg 20 IUD, and 67.5 per 100 (P less than 0.001) with the TCu 380Ag. This difference is almost wholly ascribable to a marked reduction in bleeding episodes and days among women using the LNg 20 device with concomitant removal of device. Hemoglobin rose an average of 0.5 g/dl (P less than 0.001) for this group whereas women using the TCu 380Ag experienced a decline of 0.2 g/dl compared with baseline values (P less than 0.001).

Development and experimental application of contact probe catheter for laser angioplasty

A sapphire contact probe laser catheter was developed to increase the dimensions of tunnels created by laser angioplasty. The device consisted of a round sapphire probe (2.2 mm diameter) attached to an 8F catheter into which a 0.2 mm optical fiber was inserted with a tip maintained at 3 mm from the sapphire. The fiber was connected to a continuous wave neodymium yttrium aluminum garnet (Nd-YAG) laser. A saline perfusate was circulated through the catheter during laser emissions to prevent excessive heating of the fiber tip. The system was used in vitro on 16 sections of atherosclerotic calcified human cadaver aortic walls, using diluted blood as a medium, at powers ranging from 10 to 40 W and exposure times from 1 to 4 seconds. Six craters were created at each energy level. The system was also used on six human cadaver, agar-embedded, obstructed iliac and femoral arteries, using 40 W and 2 second laser emissions. Dimensions of probe-created craters were compared with those obtained using bare fibers. The shape of the probe craters was that of a truncated cone with the entry hole wider than the exit, as opposed to the cylindrical shape created with unmodified bare fibers. At 120 J (seconds X watts), areas of entry and exit probe-formed holes were greater than those created with the bare fibers (6.7 +/- 0.5 and 3.4 +/- 0.6 versus 0.2 +/- 0.01 mm2, respectively, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Incorporation of tritiated galactose into galactocerebroside by cultured rat oligodendrocytes: effects of cyclic adenosine 3',5'-monophosphate analogues

Cells dissociated from the forebrains of 21-day-old rats were enriched in oligodendroglia by Percoll gradient centrifugation, seeded on polylysine-coated surfaces, and cultured in a serum-containing medium. Incorporation by the cultures of tritium from D-[3H]galactose into the galactosyl residue of galactocerebroside (galC) increased in an almost linear fashion for 48 h with 1-8 muCi of D-[3H]galactose (30 mCi/mumol) per milliliter medium. Treatment for 2 days (day 1-3 after seeding) with 10(-4) M or 10(-3) M dibutyryl cyclic adenosine 3',5'-monophosphate (db cyclic AMP) or 10(-4) M 8-bromo cyclic AMP stimulated galC radiolabelling. Incorporation of D-[3H]galactose into galC during a terminal 48-h radiolabelling period was not stimulated when the cells were continuously treated with these cyclic AMP analogues for 8 rather than 2 days.

Esophageal tear following forceful removal of an impacted oral-gastric lavage tube

We report an unusual complication of oral-gastric lavage in a drug overdose patient. During the lavage procedure, the oral-gastric tube became impacted in the esophagus. Forceful removal of the tube resulted in an esophageal tear. The patient did well with conservative management and was discharged with no long-term sequelae.

Spontaneous rupture of the spleen in primary plasma cell leukemia. Scintigraphic-pathologic correlation

A rare case of spontaneous rupture of the spleen occurring in a patient with primary plasma cell leukemia is presented. The scintigraphic-pathologic correlation is presented together with a review of the literature.

The effect of nucleotides on the rate of spontaneous quantum bumps in Limulus ventral photoreceptors

The effect of intracellular nucleotides on the rate of spontaneous quantum bumps in Limulus ventral photoreceptors has been examined. Internal dialysis of photoreceptors with solutions lacking nucleotide leads to an elevation of the quantum bump rate that can be reversed by introduction of nucleotide. Similarly, elevation occurs after treating intact cells with the metabolic inhibitor 2-deoxyglucose. This effect can be reversed by intracellular injection of ATP. The rate of spontaneous quantum bumps in unpoisoned cells can be reduced to below normal levels by injection of ATP. These results support the hypothesis that high-energy nucleotides suppress the rate of spontaneous quantum bumps.

[Nephrolithiasis--correlation of calculus type and pathogen spectrum. Calculus analysis and microbiologic diagnosis in 173 surgically treated patients]

The microbiological findings from intraoperative swabs were correlated with the consistency of the calculi in 173 patients, who had been operated on due to nephrolithiasis. The following parameters were taken into consideration: age and sex of the patients, consistency of calculi and germ spectrum of intraoperative swabs from the upper urinary tract. Three main groups were formed corresponding to the consistency of the calculi (carriers of infection calculi, of calciumoxalate calculi and of uric acid calculi) and these were compared to one another regarding the above mentioned parameters.

Inositol uptake by cultured isolated rat Schwann cells

The uptake of radiolabeled myo-inositol by Schwann cells isolated from the sciatic nerve of 2-4 day old rats was found to occur by a saturable, sodium-dependent phlorizin-inhibited mechanism with an estimated Km of 30 microM. The system was inhibited by galactose and glucose but not by galactitol. At high concentrations of myo-inositol, a diffusion-like process appeared to be functional. The characteristics of the saturable system are very similar to those of myo-inositol uptake by the endoneural fascicle preparation of sciatic nerve.

Long-term experience with Norplant implants in international clinical trials

Norplant subdermal implants containing levonorgestrel were used for contraception and compared with the Copper T, Model T Cu 200, during 42 months of use in an open study in Chile, the Dominican Republic, and Finland. Among 324 women enrolled for the implant regimen, there were no pregnancies in the 1st 2.5 years, and 2 by the end of 42 months. 1st segment net and gross cumulative pregnancy rates were 0.7 and 1.2/100 respectively, at 3.5 years. Cumulative pregnancy rates for the T Cu 200 group were 2.9, net and 3.5/100, gross at 42 months. More than 1/2 of the implant acceptors, 51.6/100 were continuing use at 3.5 years, somewhat above the continuation rate of the T Cu acceptors, 43.5/100, but not significantly so.

Interception of lymphatic drainage by Nd: YAG laser irradiation in rat urinary bladder

Lymphatic drainage can be demonstrated by colloidal indian ink injection. A small intramural indian ink spot in the bladder dome is separated from the rest of the rat urinary bladder by encircling transmural Neodymium-YAG (Nd:YAG) laser irradiation. In untreated animals there is an ink flow via the lymphatic vessels to the regional lymph nodes within several hours. In treated animals, after laser irradiation, the indian ink remains in the bladder dome and a penetration of the irradiated area cannot be found by macroscopic and histologic examination. Indian ink will be found in the regional lymph nodes after the ninth day of absorption of the coagulation necrosis and recanalisation of the intercepted lymphatics. Evidence for the interception of the lymphatic drainage is demonstrated by the distinctly delayed ink flow and the injected ink's remaining in the irradiated area. From this, we conclude that Nd:YAG laser irradiation is especially suitable for tumor coagulation, since simultaneous interception of lymphatic drainage will inhibit the spreading of tumor cells.

[Spinal hemangioblastoma in infants with dysraphic malformation of the CNS]

Spinal hemangioblastoma in early infancy is an extreme rarity. In the case presented here such a hamartomatous tumor is combined with dysraphic malformation of the CNS in a male infant aged seven months. The morphological, epidemiological and clinical aspects are discussed with special reference to the possibility of congenital occurrence.

Heterotopic ossification heralded by a knee effusion

A knee effusion suddenly appeared in a 44-year-old woman one month after she suffered a neurological catastrophe. Heterotopic ossification (HO) subsequently developed above her knee. Because treatment of HO with disodium etidronate may be successful if started early, awareness of the association between acute arthritis and new bone formation in certain clinical settings is important.

Plasma amino acid, glucagon, and insulin concentrations in dogs with nitrosamine-induced hepatic disease

Plasma amino acids, glucagon, and insulin concentrations were determined once a week in dogs that developed acute hepatic necrosis and chronic hepatic insufficiency after treatment with dimethylnitrosamine. During the acute phase, plasma concentrations of most amino acids increased, with the changes usually correlating with increased glucagon values. Insulin correlated with changes in 10 of 21 amino acids, but the latter were not the most abundant nor the branched-chain amino acids. During the chronic phase, plasma phenylalanine tyrosine, and methionine concentrations remained increased throughout the study. Plasma values of these amino acids did not correlate with plasma concentrations of either glucagon or insulin. The values of the most abundant amino acids were less than base-line levels during the chronic phase, and 9 of 10 of these correlated positively with glucagon concentrations, but not insulin. Only proline correlated positively with insulin. Isoleucine and valine showed a negative correlation with insulin. The low concentrations of the nonaromatic amino acids increased during the time from the early to late chronic phase, during which time plasma glucagon increased and insulin remained unchanged. This study shows that a significant positive correlation existed between glucagon and the most abundant plasma amino acids during the chronic phase of hepatic insufficiency, at which time most plasma amino acid concentrations were returning toward base line. Increased glucagon values did not correlate with any evidence for deterioration of hepatic function.