The feasibility of a multidimensional intervention in lymphoma survivors with chronic fatigue

PURPOSE

Chronic fatigue (CF) affects 25-30% of lymphoma survivors, but interventions designed to reduce fatigue are lacking. The main aim of this study was to test the feasibility of a multidimensional intervention study in lymphoma survivors with CF. Secondary aims were to describe individual changes in fatigue, quality of life (QoL) and physical performance from pre (T0) to post (T1) intervention.

METHODS

This feasibility study was as a one-armed intervention study performed in 2021. Hodgkin or aggressive non-Hodgkin lymphoma survivors received mailed study information and Chalder Fatigue Questionnaire and were asked to respond if they suffered from fatigue. The 12-week intervention included patient education, physical exercise, a cognitive behavioural therapy (CBT)-based group program and nutritional counselling. Feasibility data included patient recruitment, completion of assessments, adherence to the intervention and patient-reported experience measures. Participants responded to questionnaires and underwent physical tests at T0 and T1.

RESULTS

Seven lymphoma survivors with CF were included. Of all assessments, 91% and 83% were completed at T0 and T1, respectively. Adherence to the interventional components varied from 69% to 91%. At T1, all participants rated exercise as useful, of whom five rated the CBT-based program and five rated individual nutritional counselling as useful. Five participants reported improved fatigue, QoL and physical performance.

CONCLUSION

Lymphoma survivors with CF participating in a multidimensional intervention designed to reduce the level of fatigue showed high assessment completion rate and intervention adherence rate. Most of the participants evaluated the program as useful and improved their level of fatigue, QoL and physical performance after the intervention.

TRIAL REGISTRATION

ClinicalTrials.gov, identifier: NCT04931407. Registered 16. April 2021-Retrospectively registered. https://www.

CLINICALTRIALS

gov/ct2/show/NCT04931407.

Cardiorespiratory fitness and left ventricular function in breast cancer survivors a decade after Epirubicin treatment

Background

Anthracyclines are effective chemotherapeutic agents commonly used in breast cancer (BC) treatment. Cardiotoxicity is a serious adverse effect of anthracyclines, but knowledge of long-term cardiac effects is limited. To our knowledge, no prior study has investigated both cardiorespiratory fitness assessed by peak oxygen consumption (V̇O2 peak) and left ventricular (LV) function in long-term follow up of BC survivors (BCS) treated with anthracyclines.

Purpose

To assess long-term adverse effects of Epirubicin on cardiorespiratory fitness and LV function in BCS.

Methods

The CAUSE-trial is an ongoing study comparing exercise effects in BCS of stage I-III BC recruited from the Cancer Registry of Norway and controls with no cancer diagnosis. We present preliminary results from the baseline assessments in this trial. BCS (n=93) treated with Epirubicin between 2008 and 2013 were compared to age-matched controls (n=11). V̇O2 peak was assessed by incremental treadmill cardiopulmonary exercise test and LV function by echocardiography.

Results

At baseline, BCS were 58±7 years old and had received a cumulative dose of 339±85 mg/m2 Epirubicin 11±1 years before examination. There was no difference in V̇O2 peak between BSC and controls. LV ejection fraction was lower in BCS compared to controls assessed by 2D (57±3% vs. 59±2%, p=0.01) and 3D echocardiography (57±3% vs. 61±4%, p=0.006). LV global longitudinal strain was also lower (in absolute value) in BCS compared to controls (−20.6±1.3% vs. −22.0±1.3%, p=0.002). There was no difference in global work index and efficiency between BCS and controls.

Conclusion

Our findings indicate no difference in cardiorespiratory fitness between BCS and controls a decade after Epirubicin treatment. Systolic LV function was slightly lower in BCS compared to controls. Importantly, systolic LV function in BCS was within normal range, and the difference is probably not of clinical importance. There was no difference in myocardial work between BCS and controls.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): The Cancer Registry of Norway

Associations between birth size and later height from infancy through adulthood: An individual based pooled analysis of 28 twin cohorts participating in the CODATwins project

BACKGROUND

There is evidence that birth size is positively associated with height in later life, but it remains unclear whether this is explained by genetic factors or the intrauterine environment.

AIM

To analyze the associations of birth weight, length and ponderal index with height from infancy through adulthood within mono- and dizygotic twin pairs, which provides insights into the role of genetic and environmental individual-specific factors.

METHODS

This study is based on the data from 28 twin cohorts in 17 countries. The pooled data included 41,852 complete twin pairs (55% monozygotic and 45% same-sex dizygotic) with information on birth weight and a total of 112,409 paired height measurements at ages ranging from 1 to 69 years. Birth length was available for 19,881 complete twin pairs, with a total of 72,692 paired height measurements. The association between birth size and later height was analyzed at both the individual and within-pair level by linear regression analyses.

RESULTS

Within twin pairs, regression coefficients showed that a 1-kg increase in birth weight and a 1-cm increase in birth length were associated with 1.14-4.25 cm and 0.18-0.90 cm taller height, respectively. The magnitude of the associations was generally greater within dizygotic than within monozygotic twin pairs, and this difference between zygosities was more pronounced for birth length.

CONCLUSION

Both genetic and individual-specific environmental factors play a role in the association between birth size and later height from infancy to adulthood, with a larger role for genetics in the association with birth length than with birth weight.

Genetic factors contribute more to hip than knee surgery due to osteoarthritis - a population-based twin registry study of joint arthroplasty

OBJECTIVE

To explore and quantify the relative strengths of the genetic contribution vs the contribution of modifiable environmental factors to severe osteoarthritis (OA) having progressed to total joint arthroplasty.

DESIGN

Incident data from the Norwegian Arthroplasty Registry were linked with the Norwegian Twin Registry on the National ID-number in 2014 in a population-based prospective cohort study of same-sex twins born 1915-60 (53.4% females). Education level and height/weight were self-reported and Body Mass Index (BMI) calculated. The total follow-up time was 27 years for hip arthroplasty (1987-2014, 424,914 person-years) and 20 years for knee arthroplasty (1994-2014, 306,207 person-years). We estimated concordances and the genetic contribution to arthroplasty due to OA in separate analyses for the hip and knee joint.

RESULTS

The population comprised N = 9058 twin pairs (N = 3803 monozygotic (MZ), N = 5226 dizygotic (DZ)). In total, 73% (95% confidence intervals (CI) = 66-78%) and 45% (95% CI = 30-58%) of the respective variation in hip and knee arthroplasty could be explained by genetic factors. Zygosity (as a proxy for genetic factors) was associated with hip arthroplasty concordance over time when adjusted for sex, age, education and BMI (HR = 2.98, 95% CI = 1.90-4.67 for MZ compared to DZ twins). Knee arthroplasty was to a greater extent dependent on BMI when adjusted for zygosity and the other covariates (HR = 1.15, 95% CI = 1.02-1.29).

CONCLUSION

Hip arthroplasty was strongly influenced by genetic factors whereas knee arthroplasty to a greater extent depended on a high BMI. The study may imply there is a greater potential for preventing progression of knee OA to arthroplasty in comparison with hip OA.

Frequent sampling allows detection of short and rapid surges of exhaled ethane during cardiac surgery

During cardiopulmonary bypass (CPB), hypoperfusion and reperfusion may cause oxidative stress and lipid peroxidation that generates ethane. The aim of this pilot study was to assess the feasibility of frequent sampling of exhaled ethane during cardiac surgery. After approval of the Research Ethics Committee, 10 patients undergoing combined aortic valve and coronary artery bypass surgery were enrolled. Breath samples were drawn in the perioperative period and analyzed by a rapid, sensitive and validated gas-chromatographic method. Increased exhaled ethane was regularly seen following sternotomy, after the start of CPB and after aortic clamp removal, whereas no change was seen after termination of bypass. In one patient, the maximum increase in exhaled ethane was 30-fold. Peak durations lasted only 2–4 min. This study demonstrates that frequent sampling of breath ethane is feasible in a clinical setting, allowing detection of rapid ethane surges of short duration.

The effect of strength training on muscle cellular stress in prostate cancer patients on ADT

BACKGROUND

Androgen deprivation therapy (ADT) for prostate cancer (PCa) is associated with several side effects, including loss of muscle mass. Muscle atrophy is associated with reduced mitochondrial function and increased muscle cellular stress that may be counteracted by strength training. Thus, the aim of this study was to investigate the effect of strength training on mitochondrial proteins and indicators of muscle cellular stress in PCa patients on ADT.

METHODS

Men diagnosed with locally advanced PCa receiving ADT were randomised to a strength training group (STG) (n=16) or a control group (CG) (n=15) for 16 weeks. Muscle biopsies were collected pre- and post-intervention from the vastus lateralis muscle, and analysed for mitochondrial proteins (citrate synthase, cytochrome c oxidase subunit IV (COXIV), HSP60) and indicators of muscle cellular stress (heat shock protein (HSP) 70, alpha B-crystallin, HSP27, free ubiquitin, and total ubiquitinated proteins) using Western blot and ELISA.

RESULTS

No significant intervention effects were observed in any of the mitochondrial proteins or indicators of muscle cellular stress. However, within-group analysis revealed that the level of HSP70 was reduced in the STG and a tendency towards a reduction in citrate synthase levels was observed in the CG. Levels of total ubiquitinated proteins were unchanged in both groups.

CONCLUSION

Although reduced HSP70 levels indicated reduced muscle cellular stress in the STG, the lack of an intervention effect precluded any clear conclusions.

Toxicity of plasma from hemodialysis patients treated with heparin or prostacyclin

Hemodialysis was performed in 6 uremic patients with either a bolus dose of 5 000 IU heparin or prostacyclin at a constant infusion rate of 5 ng/kg/min. Clinical data, plasma triglycerides (TG), free fatty acids (FFA), platelet aggregation, white blood cell count and plasma toxicity were measured prior to and during both procedures. No serious side-effects were recorded. Heparin induced a fall in plasma TG, a rise in FFA and increased plasma toxicity. Prostacyclin infusion had no effect on these parameters. During both tests a marked drop in white blood cell count was found 15 min after the start of hemodialysis. During heparin dialysis no clotting was observed in the extracorporeal circuit. During prostacyclin dialysis clotting was observed at the venous line in three cases.

The effect of systemic heparinization on plasma lipoproteins and toxicity in patients on hemodialysis and continuous ambulatory peritoneal dialysis

The lipid patterns of plasma from 6 patients on hemodialysis (HD) and 6 patients on continuous ambulatory peritoneal dialysis (CAPD) were compared and correlated to plasma toxicity as measured by the survival of human macrophages cultured in vitro. The median values for plasma triglycerides (TG), cholesterol, low density lipoprotein (LDL) cholesterol, apolipoprotein B and lipolytic activities (lipoprotein lipase and hepatic lipase) were insignificantly higher in CAPD plasma than in HD plasma. The median high density lipoprotein (HDL) cholesterol/LDL cholesterol ratio was significantly higher in HD plasma than in CAPD plasma. In both groups systemic heparinization was followed by a significant increase in free fatty acids and in plasma toxicity. The difference in plasma toxicity was insignificant. In the whole group of patients (n = 12) toxicity in post-heparin plasma was correlated to pre-heparin very low density lipoprotein (VLDL) TG, but not to LDL TG. Separately post-heparin toxicity in CAPD plasma was correlated to pre-heparin total TG, VLDL TG and post-heparin LDL TG.

Hemodialysis and cell toxicity in vitro related to plasma triglycerides, post-heparin lipolytic activity and free fatty acids

Plasma triglyceride (TG) concentrations, post-heparin lipolytic activities and the free fatty acid (FFA) pattern of uremic and normal plasma were compared and correlated to plasma toxicity as measured by the effect on human mononuclear phagocytes cultured in vitro. Plasma TG concentration and FFA: albumin molar ratios were significantly higher in uremic plasma, and a correlation was found between TG concentrations prior to heparinization and post-heparin FFA concentrations. Uremic plasma toxicity was significantly correlated to increased post-heparin FFA: albumin molar ratio. The post-heparin lipoprotein lipase activity in uremic plasma collected 120 min after heparinization was higher than in normal plasma. Qualitative and quantitative experiments in vitro showed increased plasma toxicity with increasing FFA: albumin molar ratios. The proportion of unsaturated FFA in uremic post-heparin plasma increased compared to saturated FFA during incubation for 96 hours. Altered lipid metabolism after systemic heparinization thus seems to be important for the cell toxicity of uremic plasma in vitro.

Serum and cerebrospinal fluid morphine pharmacokinetics after single doses of intravenous and intramuscular morphine after hip replacement surgery

AIM

To compare the time course of morphine and metabolite concentrations in serum and cerebrospinal fluid (CSF) after intravenous and intramuscular administration after surgery.

METHODS

This was a randomized double-blind, double-dummy study in patients who had undergone hip replacement surgery. Morphine (M, 10 mg) was administered intravenously (IV) or intramuscularly (IM). Arterial blood and CSF samples (from a spinal catheter) were drawn simultaneously at 10, 30, 60, and 120 min after administration. Morphine and metabolites [morphine-3-glucuronide (M-3-G), morphine-6-glucuronide (M-6-G), and normorphine (NM)] were determined by a validated liquid chromatography-tandem mass spectrometry method.

RESULTS

Thirty-eight patients were included: 13 men and 25 women, 20 in the IV, 18 in the IM group. Serum concentrations of M after 10 min were consistently higher after IM than IV, concentrations of M-3-G and M-6-G after IM surpassed those of IV after 45 min. NM was not found. None of the metabolites was found in CSF. CSF morphine concentrations and CSF/serum concentration ratios were consistently higher after IV compared to IM. The mean AUC(CSF)/AUC(serum) (0-120 min) concentration ratios were 0.18 and 0.09 after IV and IM, respectively.

CONCLUSIONS

The uptake of morphine to the CSF was consistently higher after IV administration than after IM already after 10 min. The higher CSF concentration may be caused by an initially higher morphine blood/CSF gradient following IV morphine injection. The pharmacokinetic findings are compatible with a more rapid and extensive initial effect of IV morphine compared with IM.

Comparative single- and multiple-dose pharmacokinetics of levodopa and 3-O-methyldopa following a new dual-release and a conventional slow-release formulation of levodopa and benserazide in healthy volunteers

The objective was to assess the single- and multiple-dose pharmacokinetics of levodopa and 3-O-methyldopa following administration of a new dual-release and conventional slow-release formulation of levodopa/benserazide in the dose ratio of 4:1. In an open-label, two-way cross-over study, 20 healthy volunteers were randomized to receive first either Madopar DR or Madopar HBS for 8 days. Then they crossed over to the other formulation. A first dose of 200 mg levodopa and 50 mg benserazide ('250' mg) was given on day 1, '125' mg t.i.d. on the subsequent 6 days (days 2-7), followed by '250' mg on day 8. The two treatment periods of 8 days were separated by a wash-out period of at least 7 days. Blood samples were taken at specific times over a 12-hour period (day 1) or a 36-hour period (day 8). Plasma concentrations of levodopa and 3-O-methyldopa were measured by high-performance liquid chromatography for pharmacokinetic evaluation. The pharmacokinetics of levodopa after a single-dose administration (day 1) of Madopar DR and Madopar HBS were significantly different as reflected by the respective mean values of maximum plasma concentration (C(max) 1.99 vs. 0.82 mg x l-1), time to reach maximum concentration (t(max) 0.7 vs. 2.6 h) and area under the plasma concentration-time curve (AUC(0- infinity ) 4.52 vs. 3.18 mg x h x l-1). The respective values after multiple doses (day 8) were: C(max) 1.98 vs. 0.93 mg x l-1, t(max) 0.7 vs. 2.3 h and AUC(0-infinity ) 4.84 vs. 3.96 mg x h x l-1. The relative bioavailability (Madopar DR vs. Madopar HBS) was 1.73 on day 1 and 1.32 on day 8. Bioequivalence could not be demonstrated for log-transformed data of AUC and C(max) within a predefined range of 80-125 and 70-143%, respectively. In conclusion, the observed differences in C(max), t(max) and AUC are consistent with a faster rate and higher extent of levodopa absorption after administration of Madopar DR. Statistical evaluation of these kinetic data showed that Madopar DR is not bioequivalent to Madopar HBS.

An exported inducer peptide regulates bacteriocin production in Enterococcus faecium CTC492

Production of the bacteriocins enterocin A and enterocin B in Enterococcus faecium CTC492 was dependent on the presence of an extracellular peptide produced by the strain itself. This induction factor (EntF) was purified, and amino acid sequencing combined with DNA sequencing of the corresponding gene identified it as a peptide of 25 amino acids. The gene encodes a prepeptide of 41 amino acids, including a 16-amino-acid leader peptide of the double-glycine type. Environmental factors influenced the level of bacteriocin production in E. faecium CTC492. The optimal pH for bacteriocin production was 6.2. At pH 5.5, growth was slow, and very little bacteriocin was formed. The presence of NaCl or ethanol (EtOH) was also inhibitory to bacteriocin production, and at high concentrations of these solutes, no bacteriocin production was observed. The induction factor induced its own synthesis, and by dilution of the culture 106 times or more, nonproducing cultures were obtained. Bacteriocin production was induced in these cultures by addition of EntF. The response was linear, and low bacteriocin production could be induced by about 10(-17) M EntF. This response was attenuated by low pH or the presence of high concentrations of NaCl or EtOH, and 300 times more EntF was needed to induce detectable bacteriocin production in the presence of 6.5% NaCl. High levels of bacteriocin production in cultures grown at low pH or in the presence of high concentrations of NaCl or EtOH were obtained by addition of sufficient amounts of EntF.

Accumulation of nicotine in human hair during long-term controlled exposure to a low concentration of nicotine vapour

Hair from 5 subjects were exposed in dynamic exposure chambers to air nicotine vapour for 72 hr or 12 months at concentrations of 200 or 5 micrograms/m3, respectively. Nicotine in the chamber air and human hair was determined by GC/ MS. A linear accumulation of nicotine in hair was found with time for all hairs during the long-term, low concentration exposure, with individual hair nicotine uptake rate constants ranging from 0.70 to 3.75 x 10(-3) m3/g x hr. The corresponding hair nicotine uptake rate constants during short-term, high concentration exposure, were significantly higher, ranging from 1.35 to 15.11 x 10(-3) m3/g x hr, showing, however, a highly significant linear correlation with the individual long-term exposure rate constants, r2 = 0.9961. It is indicated that long-term hair nicotine uptake rate constants calculated from controlled exposure experiments with pure nicotine vapour are adequate for estimation of individual long-term hair accumulation of nicotine from environmental tobacco smoke even at variable and intermittent exposure. Although higher than the long-term uptake rate constants, the short-term uptake rate constants seem well fitted for a differentiation between different types of hair in their ability to adsorb nicotine also during long-term exposures. The short-term uptake rate constants might also be useful parameters for establishing a reliable cut-off limit in the hair concentration of nicotine between smokers and non-smokers which otherwise seems to be overlapping.

A test chamber for experimental hydrogen fluoride exposure in humans

An inhalation chamber was built to perform experimental studies with hydrogen fluoride (HF), other gases, and particulate matter. The present study sought to describe a new gas delivery system and the distribution and concentration of HF gas in the chamber. The aluminum chamber has a volume of 19.2 m3 and a variable ventilation rate of about 1 to 10 air changes per hour. The negative pressure difference between the chamber and outside air can be regulated from 0 to 300 Pa. HF was fed at concentrations of up to 4000 mg/m3 directly into the ventilation duct feeding the chamber through openings with diameters as small as 50 microns, oriented opposite to the airflow. Gas flow was varied from about 0.1 dm3/min at a pressure of 4 atm. The dilution factor of HF concentration from cylinder to chamber was on the order of 10(3) to 10(4). The standard deviation (SD) of the HF concentrations at a fixed measurement point during a 1-hour test was typically 0.05 mg/m3 at a time-weighted average (TWA) concentration of 2.66 mg/m3. The SD of the TWA HF concentrations at six locations in the chamber was typically 0.05 mg/m3 and 0.29 mg/m3 at 0.61 and 3.46 mg/m3, respectively. Human exposure could be predicted from calculations based on ventilation data, gas flow, and observed ratio between calculated and measured concentrations. When the target exposure concentration was 1.5 mg/m3, the measured mean exposure concentration was typically 1.54 mg/m3 (range: 1.4-1.7 mg/m3, SD 0.09 mg/m3, n = 8). The chamber is well-suited for inhalation studies in humans. Chamber atmosphere was controlled and has proved to be stable and homogeneous, even in tests with HF, a highly reactive gas in the class of superacids.

Interindividual differences in hair uptake of air nicotine and significance of cigarette counting for estimation of environmental tobacco smoke exposure

Hair from 80 male subjects, smokers and non-smokers, was exposed continuously in a dynamic exposure chamber to constant nicotine vapour concentrations of 20, 200 or 2000 micrograms/m3 for 72 hr. Subgroups of high and low nicotine adsorbing hair were also exposed intermittantly to environmental tobacco smoke for 8 months. Air and hair concentrations of nicotine were determined by gas chromatography/mass spectrometry. The chamber experiments demonstrated a hair nicotine uptake which followed a second order relation to the applied concentrations of nicotine, y = -0.00018x2 + 0.715x + 1.13, r2 = 0.99999. The function and the experimental points showed linearity up to an air nicotine vapour concentration of about 200 micrograms/m+, covering the most relevant range of environmental exposure. An approximately 7- and 2-fold interindividual variation was observed in the hair uptake rate constant of nicotine vapour for the investigated material within the 10 to 90 and 25 to 75% percentiles, respectively. The factors causing this variation were not identified. It was shown that subject age, hair diameter and hair content of eumelanin were without correlation to the rate constants of hair nicotine uptake. The exposure of subgroups of hair to environmental tobacco smoke showed similar uptake profiles of nicotine as that experienced with exposure to pure nicotine vapour, supporting the relevance of controlled chamber nicotine vapour exposures as a relevant tool for the evaluation of hair nicotine uptake from a more complex environmental situation. Standardized measurements of air nicotine vapour and particulate concentrations in a modern office during 3 hr periodical smoking periods, showed that the number of cigarettes smoked was a poor indicator for the estimation of individual exposure to environmental tobacco smoke constituents. Hair nicotine measurements so far seem to be superior to other suggested methodologies for estimation of environmental tobacco smoke exposure, but further studies should be initiated to identify factors determining the rate constant of hair nicotine uptake.

Long-term effects of inhaled nicotine

Tobacco smoking has been reported to be associated with increased risk of cardiovascular disease and cancer, particularly of the lungs. In spite of extensive research on the health effects of tobacco smoking, the substances in tobacco smoke exerting these negative health effects are not completely known. Nicotine is the substance giving the subjective pleasure of smoking as well as inducing addiction. For the first time we report the effect on the rat of long-term (two years) inhalation of nicotine. The rats breathed in a chamber with nicotine at a concentration giving twice the plasma concentration found in heavy smokers. Nicotine was given for 20 h a day, five days a week during a two-year period. We could not find any increase in mortality, in atherosclerosis or frequency of tumors in these rats compared with controls. Particularly, there was no microscopic or macroscopic lung tumors nor any increase in pulmonary neuroendocrine cells. Throughout the study, however, the body weight of the nicotine exposed rats was reduced as compared with controls. In conclusion, our study does not indicate any harmful effect of nicotine when given in its pure form by inhalation.

Plasma concentrations of progesterone, oestradiol, LH and 15-ketodihydro-PGF2 alpha in Norwegian semi-domestic reindeer (Rangifer tarandus tarandus) during their first reproductive season

Blood samples were collected from eleven 1.5 year old female reindeer three times a week from September 1992 until February 1993 and daily in October and November 1992. Blood samples were collected every third hour for a period of three weeks from two females that showed regular oestrous cycles. Plasma progesterone, oestradiol, LH and 15-ketodihydro-PGF2 alpha were analysed to characterize variations in ovarian function. Reindeer are seasonally polyoestrous. Average duration of oestrous cycles was 19.4 days (range: 13-33 days). Short periods of high progesterone concentrations (4-8 days duration) occurred in five animals before the onset of regular oestrous cycles. The first regular cycle had a significantly longer luteal phase than did the following cycles. During luteolysis 15-ketodihydro-PGF2 alpha was released in a pulsatile pattern. Maximal oestradiol concentrations preceded preovulatory LH peaks by about 3 h in the two frequently sampled animals. The duration of LH surges was 12 and 15 h, respectively.

Uptake of nicotine in hair during controlled environmental air exposure to nicotine vapour: evidence for a major contribution of environmental nicotine to the overall nicotine found in hair from smokers and non-smokers

Hair from smokers and non-smokers has been exposed in a dynamic exposure chamber to air nicotine concentrations ranging from 1.5 to 45 and from 20 to 2000 micrograms/m3 for 8 weeks and 72 hr, respectively. Accumulated hair nicotine was quantified by GC/MS. Hair was also collected for direct measurements of nicotine in 0-2, 2-4 and 4-6 cm segments from the scalp. Human hair showed a high affinity for air nicotine and the chamber experiments revealed a linear relationship between the initial hair uptake rates of nicotine and the duration of exposure at all air nicotine concentrations applied. Hair nicotine uptake rate decreased with time after 4 to 6 weeks exposure to 15 and 45 micrograms/m3 air concentrations of nicotine, but not to the 1.5 micrograms/m2 nicotine concentration. Ratio between the hair uptake rate of nicotine and the applied air concentration of nicotine decreased with increasing air concentrations of nicotine. Segment analysis of hair revealed an outward increasing gradient of nicotine in hair. Hair uptake pattern of air nicotine suggests the uptake to be governed by an equilibrium between nicotine in air and nicotine on the hair surface, possibly combined with a slower diffusion process of nicotine from the hair surface into the hair core. The hair segment analysis of nicotine indicates that environmental nicotine is the dominating contributor to the overall nicotine found in hair both from smokers and non-smokers.

In vitro maturation of oocytes from Norwegian semi-domestic reindeer (Rangifer tarandus)

In vitro maturation of oocytes has been described for several species, but to our knowledge this is the first attempt to mature oocytes from reindeer in vitro. Reindeer are seasonal breeders with their main period of breeding activity starting in the beginning of October. Little knowledge exists about in vivo oocyte maturation, fertilization and development of the early embryonic stages after fertilization. The aim of the present study was to examine whether reindeer oocytes collected out of breeding season could be matured in vitro in conventional medias used for bovine oocytes.

Effect of nicotine on the enterochromaffin like cells of the oxyntic mucosa of the rat

Smoking has an unfavourable effect on peptic ulcer disease. The pathophysiological mechanisms underlying this effect are not known. The enterochromaffin like (ECL) cell is the cellular source of histamine participating in the regulation of acid secretion. The ECL cell is under functional and trophic control of gastrin and the vagus nerves. Nicotine may affect acid secretion through vagal pathways. Furthermore, nicotine may also stimulate neuroendocrine cells. The present study examined if chronic nicotine administration could stimulate the function and growth of the ECL cell. Rats inhaled nicotine vapour at a concentration of approximately 6.2 mumol/m3, 20 hours/day, 5 days/week for 11 weeks. Steady state plasma nicotine concentration was 461.8 (137.5 (SD)) nmol/l. The ECL cell density, histamine content and histidine decarboxylase activity of the oxynitic mucosa were similar to the controls. We also examined the effect of acute nicotine stimulation on the acid output and histamine release from the totally isolated vascularly perfused rat stomach. Nicotine did not stimulate acid secretion or histamine release. Thus no evidence could be provided to support the hypothesis that nicotine exerts its negative effects on peptic ulcer disease by stimulating the ECL cell.

Subcellular localization of transferrin and pyrophosphate in liver cells after perfusion in situ or incubation in vitro

Rat livers were perfused in situ with [125I]-transferrin, FITC-dextran and [32P]-inorganic pyrophosphate (PP). In a parallel set of experiments rat liver homogenates was incubated with [125I]-transferrin and [32P]-PPi. In both sets of experiments cellular organelles were prepared by density gradient centrifugation in metrizamide. In the perfusion experiments [125I]-transferrin and FITC-dextran accumulated in fractions rich in plasma membrane enzymes, whereas in the homogenate experiments [125I]-transferrin remained in soluble fractions. [32P]-PPi remained in soluble fractions in both sets of experiments, i.e. PPi did not co-localize with transferrin taken up by intact cells. In another set of experiments fractions rich in endosomes were tested for their ability to synthesize PPi from ATP. No PPi was found. The results argue against a role for PPi in transferrin-iron release within endosomes.

Effects of calcium on hepatocyte iron uptake from transferrin, iron-pyrophosphate and iron-ascorbate

Calcium stimulates hepatocyte iron uptake from transferrin, ferric-iron-pyrophosphate and ferrous-iron-ascorbate. Maximal stimulation of iron uptake is observed at 1-1.5 mM of extra-cellular calcium and the effect is reversible and immediate. Neither the receptor affinity for transferrin, nor the total amounts of transferrin associated with the cells or the rate of transferrin endocytosis are significantly affected by calcium. In the presence of calcium the rate of iron uptake of non-transferrin bound iron increases abruptly at approximate 17 degrees C and 27 degrees C and as assessed by Arrhenius plots, the activation energy is reduced in a calcium dependent manner at approx. 27 degrees C. At a similar temperature, i.e., between 25 degrees C and 28 degrees C, calcium increases the rates of cellular iron uptake from transferrin in a way that is not reflected in the rate of transferrin endocytosis. By the results of this study it is concluded that calcium increases iron transport across the plasma membrane by a mechanism dependent on membrane fluidity.

Raynaud's phenomenon after combination chemotherapy of testicular cancer, measured by laser Doppler flowmetry. A pilot study

The pathophysiology of Raynaud's phenomenon after Cisplatin-Bleomycin-Vinblastine combination chemotherapy, its relationship to polyneuropathy, and response to transcutaneous nerve stimulation (TNS), was studied in eight patients previously treated for testicular cancer. Peripheral circulation in the index finger was measured by laser Doppler flowmetry before and after cold provocation. In all patients there was an exaggerated and prolonged vasoconstrictor response to cold, with a mean flux reduction of 61%, and a mean restitution time of greater than 7 min, characteristic of Raynaud's phenomenon of the vasospastic type. The normal controls had a mean flux reduction of 24% and a restitution time of 1.5 min. Clinical examination and nerve conduction measurements revealed a mild polyneuropathy in five of the eight patients, but an etiological relationship with Raynaud's phenomenon could not be ascertained. There was no measurable effect of TNS.

[Occupational health care, coordination with primary health care]

Occupational health care is a privately financed health service offered to the healthiest part of the population. It is not governed in the same way as primary health care. In this paper we conclude that the present model of organization is inadequate. The entire responsibility for organization of occupational health care should be placed with the Ministry of Health and Social Affairs. This will ensure efficient use of resources.

Pyrophosphate-loaded hepatocytes show increased iron uptake from transferrin

Exogenously added pyrophosphate was found associated with hepatocytes in suspension, particularly in the presence of calcium ions. The cell-associated pyrophosphate was recovered with the stroma fraction. Pyrophosphate thus bound did not affect cellular ATP, leakage of lactate dehydrogenase or trypan blue exclusion. Compared to control cells, pyrophosphate-loaded hepatocytes showed an approximately 70% increase in iron accumulation from transferrin. The excess iron was handled by the pyrophosphate-loaded cells as control cells. The relevance of pyrophosphate to hepatocyte iron uptake is discussed.

Iron uptake and heme synthesis by isolated rat liver mitochondria. Diferric transferrin as iron donor and the effect of pyrophosphate

Isolated rat liver mitochondria accumulate iron from fully saturated transferrin at neutral pH. With 5 microM iron as diferric transferrin, accumulation at 30 degrees C amounts to approx. 40 pmol/mg protein per h. With access to a suitable porphyrin substrate, 70-80% of the amount of iron accumulated is recovered in heme. Mobilization of iron and synthesis of heme both depend on a functioning respiratory chain. Vacant iron-binding sites on mono- and apotransferrin compete with the mitochondria for iron mobilized from transferrin. Pyrophosphate at concentrations in the range 10-50 microM enhances mobilization of iron, counterbalances the inhibitory effect of mono- and apotransferrin and enhances metallochelatase activity. The results emphasize the putative suitability of pyrophosphate as an intracellular iron-transport ligand in situ.

Radioimmunoassay and enzyme-linked immunoassay of antibodies directed against lymphadenopathy-associated virus (LAV) proteins larger than the core protein (P24)

The acquired immunodeficiency syndrome (AIDS) may be transmitted by blood transfusions and by blood products from donors who have been infected with the lymphadenopathy-associated virus (LAV). Such donors may generally be identified on the basis of a positive test for antibodies-against LAV proteins. We have already described an anti-LAV assay based on the use of crude virus-infected tissue culture medium, which avoids elaborate, expensive and potentially hazardous virus purification steps. This test was operationally specific for antibodies to the approximately 24 kD core protein of the virus (P24; Neurath et al. J. Virol. Methods 11, 75, 1985). Molecular exclusion chromatography of crude LAV antigen preparations allows separation of most of P24 from larger proteins of LAV (PL). PL and 125I- or beta-lactamase-labeled anti-LAV were used as reagents for radioimmunoassay (RIA)--or enzyme-linked immunoassay (ELISA)--inhibition tests to detect antibodies directed predominantly against PL (anti-PL). Among 257 individuals belonging to groups at high risk of developing AIDS, 117 (45.5%) were positive for anti-PL and 108 (42%) for anti-P24, respectively. The 2 individuals among 600 random blood donors found to be anti-P24-positive in the preceding study also had anti-PL in their serum. Sera from 500 additional blood donors were screened for anti-PL and 1 of these was positive. The implication of these findings for screening of blood donors is discussed.

Radioimmunoassay and enzyme-linked immunoassay of antibodies to the core protein (P24) of human T-lymphotropic virus (HTLV III)

Human T-cell lymphotropic viruses designated HTLV III or LAV are considered to represent the causative agent(s) of the acquired immunodeficiency syndrome (AIDS). Individuals who have been infected with these viruses may generally be identified on the basis of a positive serological test for antibodies against the protein components of these viruses. Purified viruses or viral proteins have been utilized for developing such tests. Since AIDS may be transmitted by blood transfusion and by blood products, screening of donors for antibodies to HTLV III/LAV has become a necessity. Such screening may be facilitated by the application of assays based on the use of crude virus-infected tissue culture media avoiding elaborate, expensive and potentially hazardous virus purification steps. Serum specimens were mixed with an appropriate dilution of an HTLV III-infected tissue culture-derived fraction, obtained by precipitation with polyethylene glycol 6000 and treatment with Tween 80 and tri-n-butylphosphate (to disrupt virus particles), and incubated with polystyrene beads coated with antibodies to HTLV III/LAV (anti-HTLV III). Subsequently, washed beads were incubated with either 125I- or beta-lactamase-labeled anti-HTLV III. The radioactivity or enzymatic activity associated with the beads was proportionate to the quantity of HTLV III antigen originally added to the beads. The presence of anti-HTLV III in serum specimens resulted in decreased antigen binding and thus in decreased radioactivity or diminished beta-lactamase activity associated with the beads. The test was specific for antibodies to the approximately equal to 24 kDa core protein of HTLV III. The prevalence of these antibodies (given in parentheses) in distinct populations was as follows: random blood donors (0.33%); hemophiliacs (36.4%); random homosexual males (25.1%); homosexual males preselected on the basis of positive markers for infection with hepatitis B virus (50%); and those with persistent lymphadenopathy (70%).

Transferrin as a donor of iron to mitochondria. Effect of pyrophosphate and relationship to mitochondrial metabolism and heme synthesis

Rat liver mitochondria accumulate iron mobilized from transferrin by pyrophosphate. The uptake has a very low energy dependence, but it is highly dependent on a functioning respiratory chain. Reduction of the ferric-iron-pyrophosphate complex is not linked to any specific respiratory complex. Half of the amount of iron accumulated is passed into heme. Iron once accumulated is very little accessible to chelation by added ferric or ferrous iron chelators. Iron uptake and heme synthesis are maximal if a suitable porphyrin substrate is added simultaneously with iron. The results represent further evidence that pyrophosphate is a possible candidate for intracellular iron transport. Also, the results suggest that iron uptake is coupled to simultaneous porphyrin uptake and heme synthesis.

Pyrophosphate as a ligand for delivery of iron to isolated rat-liver mitochondria

Rat liver mitochondria accumulate iron mobilized from transferrin by pyrophosphate. The capacity of the mitochondria to accumulate iron is higher than the capacity of pyrophosphate to mobilize iron from transferrin: with ferric-iron-pyrophosphate as iron donor, iron uptake and heme synthesis are about 10-times that at corresponding concentrations of iron-transferrin plus pyrophosphate. Uptake of iron from ferric-iron-pyrophosphate depends on a functionary respiratory chain and involves reductive cleavage of the ferric-iron-pyrophosphate complex. Apotransferrin inhibits uptake of iron from ferric-iron-pyrophosphate by competing with the mitochondria for iron. The results focus on pyrophosphate as a possible candidate for intracellular iron transport.

Liver attenuation values at computed tomography related to liver copper content

Forty-three patients were examined with computed tomography of the liver and liver biopsies with measurement of hepatic copper content. All recorded liver attenuation values were within normal range, even in patients with markedly elevated hepatic copper content. No statistically significant correlation between the liver attenuation values and the copper concentrations in liver tissue was demonstrated. At present, therefore, computed tomography has no place in monitoring the development of copper accumulation.