THE DISAPPEARANCE OF HCG AND RETURN OF PITUITARY FUNCTION AFTER ABORTION

Plasma concentrations of HCG/LH and FSH were monitored after a first trimester abortion in eighteen healthy female volunteers three times weekly until the onset of first menstruation. Plasma concentrations of the HCG were measured with a specific RIA for the beta subunit (beta-sub-HCG) from the samples of six of these subjects. The elimination of HCG during the first 12 days was studied from plasma concentrations measured by the radioimmunoassay of LH. The experimental data were well explained by a mathematical model consisting of three exponentially decreasing components. The half-lives of the two more slowly decreasing components were 27 and 168 h. The estimate of the complete disappearance of HCG was 37.7 days, when the specific (beta-sub-HCG) assay was used. Recovery of pituitary function occurred within 4--9 days after abortion, as judged by increased plasma FSH concentrations. In fourteen of eighteen subjects a midcycle LH peak was observed which occurred between 16 and 29 days after abortion. Plasma oestradiol concentrations increased 2--16 days after the rise in plasma FSH. Considerable amounts of HCG still circulated in the blood but the preovulatory peak of oestradiol never began before HCG/LH concentrations had decreased to below the range of the mid-cycle LH peak.     

A case repot of Merkel cell carcinoma on chronic lymphocytic leukemia: differential diagnosis of coexisting lymphadenopathy and indications for early aggressive treatment

Background  

Chronic lymphocytic leukemia (CLL) is a monoclonal disorder, characterized by a progressive proliferation of functionally incompetent B lymphocytes. There is increased evidence of association between CLL and skin cancers, including the uncommon Merkel cell carcinoma (MCC).     

EC-coupling in normal and failing hearts

Systolic heart failure may be due to too few cardiomyocytes, or to reduced contractile function of the heart cells. In the latter situation the myocardial function is impaired and this condition is called myocardial failure. The pathophysiological mechanism behind this cellular defect is not known, but Ca2+ handling is altered. Although the most important trigger of sarcoplasmatic reticulum (SR) Ca2+ release, the L-type Ca2+ current, seems to be unaltered, SR Ca2+ load is reduced in human heart failure. This could explain the reduced contractility observed in failing hearts. Three possible mechanisms have been suggested to explain the reduction in SR Ca2+ load. They are leak through the SR Ca2+ release channel (RyR), impaired SR Ca2+ ATPase (SERCA) function and increased Na+/Ca2+-exchanger (NCX) function. Leak through RyR is not consistently found. Increased NCX function is probably secondary to a change in Ca2+ handling, and thus not a primary mechanism, but blockade of the NCX might have therapeutic potential. Reduced SERCA function is probably a primary mechanism for the observed systolic dysfunction, and further insight is to be gained through studies in genetically modified models.     

Long-term follow-up of kidney transplant patients with posttransplant lymphoproliferative disorder: duration of posttransplant lymphoproliferative disorder-induced operational graft tolerance,interleukin-18 course,and results of retransplantation

BACKGROUND: Posttransplant lymphoproliferative disorder (PTLD) can be resolved in many transplant patients by the reduction or cessation of immunosuppression, after which many grafts continue to function as the result of a form of operational tolerance. When graft function deteriorates, retransplantation may be an option. Cytokines such as interleukin (IL)-10 and IL-18 may play a role in PTLD tolerance induction and tumor regression. We report long-term follow-up on the duration of graft tolerance and the course of retransplantation in a series of patients who underwent kidney transplantation and demonstrated PTLD, and in whom we were able to perform IL-18 analyses. RESULTS: Patients were followed for up to 7 years after PTLD diagnosis. Treatment consisted of immunosuppression cessation with radiation therapy in cases with overt monomorphic lymphomas. All patients' PTLDs were resolved, and all patients but one (whose graft was removed) demonstrated a period of operational graft tolerance of up to 5 years. Five patients underwent retransplantation without sign of recurrence of the PTLD up to 3 years after transplantation. In the eight patients analyzed, IL-18 increased significantly during PTLD regression and follow-up in those with long-term operational tolerance. CONCLUSION: We report on a series of patients with resolved PTLDs demonstrating long-term recurrence-free survival, of whom most experienced a long period of operational graft tolerance. IL-18 seems to play a role in the resolution of the PTLDs. Five patients underwent retransplantation with standard immunosuppression without recurrence. A previous diagnosis of PTLD should not be regarded as a contraindication for later retransplantation.     

Effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured individuals

STUDY DESIGN: Pre-post training intervention. OBJECTIVES: To evaluate the effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured (SCI) patients, and to assess the correlation between peak aerobic capacity (VO(2Peak)) and insulin sensitivity. SETTING: Spinal Cord Rehabilitation Unit, Sunnaas Hospital, Nesoddtangen, Norway. METHOD: Six recently injured SCI individuals participated in the arm training intervention and were randomly admitted to a high-intensity (HI; 70-80% heart rate reserve (HRR)) and low-intensity (LI; 40-50% HRR) group. The 1 h interval training consisted of 3 min exercise bouts interspersed with 2 min of rest, three times a week for 8 weeks. In addition, a correlation coefficient was obtained between VO(2Peak) and insulin sensitivity in 11 SCI patients. RESULTS: The 8-week training program resulted in a significant increase in VO(2Peak) and maximal power output (PO(Max)) for the group as a whole (P<0.05). VO(2Peak) increased significantly more and total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio and triglycerids decreased significantly more in the HI group than in the LI group (P=0.05). Training-induced changes in insulin sensitivity were significantly different between the groups (P=0.05), which was due to a nonsignificant decline in insulin sensitivity in the HI group and a nonsignificant improvement in the LI group. A significant positive correlation was found between VO(2peak) and insulin sensitivity (r=0.68, P=0.02). CONCLUSION: The interval arm training protocol as used in the present study enables recently injured SCI patients to do substantial work at a relatively high intensity. Results indicate that improvements in physical capacity and lipid profile were more pronounced in response to high-intensity training. The significant correlation between maximal oxygen consumption and insulin sensitivity indicates that, as in the able-bodied population, peak aerobic capacity is a predictive value with regard to insulin sensitivity in SCI. Future studies with larger groups assessing the role of exercise intensity on insulin sensitivity in SCI are suggested.     

Assessment of the validity and consequences of different methods of expressing the severity of dental fluorosis in a subject

The aim was to assess the validity and consequences of different methods of expressing severity of dental fluorosis in a subject. The analyses were based on Ugandan children (n = 481), aged 10-14 years, with life-long consumption of drinking water with either 0.5 or 2.5 mg fluoride per liter. Fluorosis was assessed using the Thylstrup and Fejerskov (TF) index. All children (n = 219) with 28 teeth and fluorosis on at least 1 tooth pair were selected to test methods of expressing fluorosis, e.g. the TF score on the most severely affected tooth, a maxillary central incisor, the median and the mean scores. A test group (n = 40), the 10 most and the 10 least severely affected children in each district, was used to evaluate the methods and a reference group (n = 179) to confirm or refute the findings in the test group. To evaluate consequences of the different methods of expressing severity of fluorosis in a subject, children from the low (n = 130) and the high fluoride (n = 132) districts not included in the test or reference group formed the community comparison groups. Comparison between the median (gold standard) and mean scores showed a significant deviation in the reference group only. Most of the partial recording methods, such as the score for the most severely affected tooth, were significantly and systematically higher than the median. While for all recording methods the median score was zero in both communities, the distribution of the subjects according to severity differed significantly between the communities.     

PERINATAL CAMPYLOBACTER FETUS SS JEJUNI ENTERITIS

ABSTRACT. Vesikari, T., Huttunen, L. and Mäki, R. (Department of Clinical Sciences, University of Tampere; Department of Paediatrics, Central Hospital of Päijät-Häme, and Department of Microbiology, Tampere Central Hospital, Finland). Perinatal Campylobacter fetus ss jejuni enteritis. Acta Paediatr Scand, 70:261, 1980. –A 2-day-old breast-fed male infant developed mucoid and bloody diarrhoea, and Campylobacter fetus ss jejuni was isolated from the stools but not from the blood. The probable source of transmission was his mother in whom symptoms of Campylobacter jejuni - associated illness began one day earlier. Both showed IgM, IgG and IgA antibody responses to autologous and reciprocal strains of Campylobacter jejuni as studied by ELISA.