Detection of subclinical abortion by assay of pregnancy specific beta 1 glycoprotein

Ethnic variation in cholecystectomy rates and outcomes, Manitoba, Canada, 1972-84

We used population-based data from the Province of Manitoba's universal health insurance plan to compare the cholecystectomy experience of Native Americans and non-Natives from 1972 to 1984. The age-adjusted cholecystectomy rates for Native females were higher than for non-Native females with the peak rate occurring at age 30-39 for Native Americans and at age 60-69 for non-Natives. The rates for males were three times lower than for females and did not differ between Natives and non-Natives. Native Americans were more likely readmitted to hospital for surgical complications than non-Natives and this held true after controlling for age, sex, rural versus urban residence, teaching versus non-teaching hospital, multiple discharge diagnoses or complex versus simple cholecystectomy (relative odds 1.46, 95 per cent confidence interval 1.17, 1.18). The explanation for the relatively high rates of cholecystectomy among Native American females may be related to high rates of known risk factors for gallstone disease (such as obesity and high parity). However, the higher rates of surgical complications require further study.

Diagnosis of early pregnancy by enzyme immunoassay of Schwangerschafts-protein 1

Serum Schwangerschafts-protein 1 (SP1) and beta subunit of human chorionic gonadotropin (beta-hCG) were measured by enzyme immunoassay and radioimmunoassay, respectively, in the follicular phase and luteal phase of 50 human menopausal gonadotropin treatment cycles. SP1 could be detected in 63% of blood samples taken in the follicular phase up to the level of 1.56 micrograms/l. Using a cutoff level of 2 micrograms/l, SP1 could be used to diagnose pregnancy 16 to 25 days after the ovulating dose of hCG. The serum SP1 level is not affected by hCG injections and it can be used for diagnosis of pregnancy even when hCG has been given recently. SP1 also may be used as a prognostic indicator of the outcome of the pregnancy.

New placental proteins: chemistry, physiology and clinical use

In the past decade, several new placental proteins have been isolated and studied. The 'pregnancy-specific' beta 1-glycoprotein (SP1) is a major placental product with unusual physicochemical properties that has been extensively investigated, but its biological function remains uncertain. Pregnancy-associated plasma protein A (PAPP-A), a glycoprotein of mol. wt 400,000, has effects in vitro on the coagulation and complement cascades, probably by its properties of protease inhibition. Placental protein 5 (PP5) may be involved in the coagulation and fibrinolytic systems, and in follicle maturation and semen liquefaction. 'Placental protein 12' (PP12) is not a product of the placenta at all; it appears to be produced in the female genital tract under the influence of progesterone and may also be produced by proliferating liver cells. Further study may reveal new roles for these placental proteins beyond their traditional roles as tumour markers.

Early conceptual loss in subfertile patients

The incidence of early conceptual loss was studied in 27 subfertile women by measuring their serum and urine hCG levels in the luteal phase. Eleven patients eventually had clinically confirmed pregnancies, nine of whom had had significant hCG elevations in previous menstrual cycles. In the remaining 16 patients, who have so far failed to achieve a clinical pregnancy, only three had had elevated hCG results. Thus 'apparent' early conceptual loss in non-pregnancy cycles was found to be more often associated with the fertile group of patients.