Axial and appendicular bone mineral density in patients with long-term deficiency or excess of calcitonin

Whether calcitonin deficiency causes and calcitonin excess prevents bone loss is controversial. We therefore measured plasma calcitonin levels and bone mineral density at the radius (by single photon absorptiometry) and lumbar spine (dual photon absorptiometry) in patients with an excess or deficiency of calcitonin. We studied 21 patients who had undergone subtotal thyroidectomy 6.8 to 29 years previously and had no calcitonin secretory reserve, and 11 patients who had received a diagnosis of medullary thyroid carcinoma 6.8 to 23 years previously and had chronic hypercalcitoninemia. Bone-density values, expressed as Z-scores (i.e., as the number of standard deviations above or below the normal means adjusted for age and sex), were indistinguishable from normal in the patients who had undergone thyroidectomy (means +/- SE: radius, 0.36 +/- 0.15; spine, 0.27 +/- 0.17). In the patients with medullary thyroid cancer, radial bone-density values were normal (-0.26 +/- 0.39), but spinal density was significantly reduced (-0.75 +/- 0.17, P less than 0.01). There were no significant correlations between the duration of calcitonin excess or deficiency and the bone density at either site. Bone mineral density was not affected by whether or not thyroxine replacement therapy was given. We conclude that skeletal mass is not affected by endogenous plasma calcitonin in adults.     

中国汉族雄激素过多症女性21-羟化酶缺陷症携带者基因检测

目的　初步了解中国汉族女性雄激素过多症患者中2 1-羟化酶缺陷症(2 1- hydroxylasedeficiency,2 1- OHD)携带者发生率,探讨促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)兴奋试验结果与基因突变检测结果的相关性。方法　82例汉族女性雄激素过多症患者及14名健康女性进行ACTH兴奋试验,并应用PCR扩增产生限制性酶切位点方法检测已知的9个2 1- OHD常见突变位点。结果　雄激素过多组(n=82 ) F0 显著高于正常对照组(P<0 .0 1) ;17- OHP0 及17- OHP6 0 也显著高于对照组(P<0 .0 1) ,而F6 0 差异没有统计学意义(P>0 .0 5 )。比较17- OHP净增值及17- OHP净增值/ F净增值,雄激素过多组也均显著高于正常对照组(P<0 .0 1)。正常对照组未检测出细胞色素P4 5 0 (cytochrome P4 5 02 1,CYP2 1)基因突变。发现雄激素过多组4例CYP2 1基因突变携带者(4/ 82 ,4 .9% ) ,分别携带V2 81L(2例) ,i2 g及Q318X(各1例) ,携带者的ACTH兴奋试验结果与正常对照及未检出突变的雄激素过多症患者的结果存在一定的交叉。结论　82例汉族雄激素过多症女性中2 1- OHD携带者为4例,占4 .9%。ACTH兴奋试验不能用以发现携带者,应进行基因检测确定。     

Hepatitis B surface antigen with an excess or deficiency in subtypic determinants in sera from asymptomatic carriers in Japan

Using the solid-phase enzyme immunoassay with monoclonal antibodies, hepatitis B surface antigen (HBsAg) was subtyped in sera from 5082 asymptomatic carriers who donated blood units at regional blood centers in Japan. Among them, 5004 sera contained HBsAg of a regular subtype, i.e., adw, adr, ayw or ayr, while 74 contained HBsAg with excessive subtypic determinants, such as adyw, adyr, adwr, aywr, or adywr. The presence of subtypic determinants on the selfsame particle was ascertained by sandwiching HBsAg between two monoclonal antibodies of distinct subtypic specificities. The remaining 4 sera contained HBsAg that possessed only one subtypic determinant, such as ad, ar or aw. HBsAg particles of atypical subtypes would have been given rise to by a point mutation in the S gene involving the codons regulating subtypic specificities.     

Vitamin D deficiency in children with recurrent respiratory infections,with or without immunoglobulin deficiency

Purpose

The objective of this study was to evaluate thevitamin D concentration in patients with recurrent respiratory infections with or without immunoglobulin G, A or M (IgG, IgA, IgM) deficiency, and to find a correlation between the vitamin D concentration and the response to hepatitis B vaccination.

The influence of bicycle exercise, with or without hand immersion in cold water, on forearm sweating in young and middle-aged women

Forearm sweat production rate (SPR) and external auditory meatal temperature (TEAM) were examined in five young and five middle-aged women in response to intermittent exercise, on three separate occasions. The first experiment was a control study, while in the second study the left hand was immersed in cold water at the onset of sweating during each exercise bout, and in the third study this immersion was accompanied by venous occlusion of the upper left arm. TEAM increased by 0.5 degrees C during exercise with no significant differences between the groups on any occasion. The young women displayed a greater peak SPR during exercise in the control than the middle-aged women (52.5 +/- 23.9 vs. 16.7 +/- 6.5 mg cm2 h-1, P less than 0.001). With hand immersion, peak SPR was depressed to 14.0 +/- 4.6 mg cm2 h-1 (P less than 0.001) in the young women and to 13.1 +/- 4.5 mg cm2 h-1 in the middle-aged (P less than 0.05). With hand immersion and venous occlusion the peak SPR in young women increased (43.0 +/- 9.2 mg cm2 h-1). In the older women SPR was 14.9 +/- 6.1 mg cm2 h-1, which was not different from either control or cold-immersed values. Thus, forearm SPR during low-intensity intermittent exercise is greater in young compared with middle-aged women, despite similar changes in TEAM. The response to hand immersion in cold water was more marked in the young subjects.     

Detection of functional ovarian hyperandrogenism in women with androgen excess.

BACKGROUND. Distinguishing between ovarian and adrenal causes of androgen excess may be difficult. We have found that women with the polycystic ovary syndrome have supranormal plasma 17-hydroxyprogesterone responses to the gonadotropin-releasing hormone agonist nafarelin. We determined the usefulness of testing with nafarelin to distinguish ovarian causes of hyperandrogenism in women. METHODS. We studied 40 consecutive women with hyperandrogenism who had oligomenorrhea, hirsutism, or acne. All 40 underwent testing with nafarelin, dexamethasone, and corticotropin with measurement of circulating concentrations of gonadotropins and steroid hormones, and 19 underwent ovarian ultrasonography. RESULTS. The plasma 17-hydroxyprogesterone response to nafarelin was supranormal in 23 of the 40 women (58 percent), and the plasma androgen response to corticotropin was elevated in 23; 13 women had both abnormalities. Only one woman had conclusive evidence of a steroidogenic block; she had nonclassic adrenal 21-hydroxylase deficiency. Of the 23 women with abnormal responses to nafarelin, only 11 (48 percent) had elevated base-line serum luteinizing hormone concentrations. Of the 13 women with abnormal responses to nafarelin who underwent ultrasonography, 7 (54 percent) had polycystic ovaries. Peak plasma 17-hydroxyprogesterone concentrations after nafarelin administration correlated closely with plasma free testosterone concentrations after dexamethasone administration (r = 0.75, P less than 0.001). CONCLUSIONS. Approximately half of women with oligomenorrhea, hirsutism, or acne have an abnormal response to the gonadotropin-releasing hormone agonist nafarelin, suggesting an ovarian cause of their androgen excess.     

Aftereffects of short-term exposures to heat or cold on monoamine oxidase activity

Bulletin of Experimental Biology and Medicine -     

Platelet parameters in women with iron deficiency anemia

BACKGROUND: In iron deficiency anemia (IDA), several changes in platelets have been reported. Therefore, a relationship between iron metabolism and thrombopoiesis should be considered. The aim of this study was to evaluate the platelet parameters in women with IDA. MATERIALS AND METHODS: Eighty-six women of mean age 37 +/- 13 (16-70) years with IDA were enrolled this study. The relationship between serum iron parameters (such as iron, iron-binding capacity, iron saturation and ferritin) and platelet parameters (such as platelet counts, platelet crit, mean platelet volume and platelet distribution width) were evaluated by using Pearson correlation and stepwise logistic regression tests. RESULTS: Thrombocytosis and thrombocytopenia were noted in 24 (27.9%) and two (2.3%) patients, respectively. Platelet counts were increased when serum iron, iron saturation, ferritin and mean platelet volume were decreased in this study. There was a linear relationship between platelet counts and platelet crit (p<0.001) but inverse relationships between platelet counts and both mean platelet volume and iron saturation (p<0.001, for both). Also there were a linear relationship between platelet distribution width and mean platelet volume (p<0.001) and an inverse correlation between platelet distribution width and mean corpuscular volume (p<0.001). We did not find any correlation between platelet crit and studied iron parameters (p>0.05). CONCLUSIONS: In IDA, the most important factor affecting platelet counts was iron saturation. These changes in the platelet parameters may be related to low levels of tissue iron. This study suggested that decreased iron saturation might stimulate megakaryopoiesis. Moreover, iron may have an inhibitor effect on platelet counts.     

Exploratory factor analysis of the Wechsler Adult Intelligence Scale-Revised in a sample of brain-damaged women.

The first exploratory factor analysis of the WAIS-R using an exclusively female sample (N = 152) of brain-damaged patients was conducted. Means for age, education, and Full Scale IQ were 43.51 years(SD = 18.22), 12.60 years(SD = 2.47), and 86.34(SD = 13.32). Results indicated that either a two- or three-factor model was plausible for this sample. The two-factor solution supported Wechsler's (1981) Verbal and Performance IQ designations, while the three-factor model revealed Verbal-Comprehension (i.e., Information, Comprehension, Vocabulary, and Similarities), Perceptual-Organization (i.e., all Performance subtests), and Freedom From Distractibility (i.e., Digit Span) factors. Comparison of the factor structures for the present sample with those of normal women and brain-damaged men suggested factorial equivalency across groups.     

Genetic and immunologic analysis of a family containing five patients with common-variable immune deficiency or selective IgA deficiency

A family with 13 members included 2 subjects with selective IgA deficiency (IgA-D) and 3 subjects with common-variable immune deficiency (CVID), diseases which usually occur sporadically. Reciprocal combinations of B and T cellsin vitro between one normal and two immune-deficient family members and normal subjects revealed that defective Ig synthesis was determined by the B cells, while the patient T cells functioned normally. Normal T helper and suppressor function was demonstrated even in one patient with CVID who developed a T-cell lymphoproliferative disorder associated with elevated IgM; this patient's B cells made only IgMin vitro. Immune deficiencies were inherited in this family in a pattern consistent with an autosomal dominant trait with incomplete penetrance. All the immune-deficient patients in this family possessed at least one copy of an MHC haplotype previously shown to be abnormally frequent in IgA-D and CVID: HLA-DQB1*0201, HLA-DR3, C4B-Sf, C4A-deleted, G11-15, Bf-0.4, C2-a, HSP70-7.5, TNF-5, HLA-B8, and HLA-A1. The patient who developed the lymphoproliferative disorder was homozygous for this haplotype. Four immunologically normal members, one of whom was 80 years old, also possessed this MHC haplotype, indicating that its presence is not sufficient for disease expression. A small segment of another MHC haplotype associated with Ig deficiency in the population also occurred in this family, but it was not associated with immune deficiency. The presence of neutral amino acids at position 57 of DQ, previously correlated with IgA-D, was associated with disease in this family approximately to the same degree reported previously in unrelated patients. Thus the expression of immunodeficiency in individuals bearing a disease-associated MHC haplotype appears to require either additional genes or an environmental trigger.     

Vitamin D deficiency in women with femoral neck fracture

Calcium (Ca) metabolism, with particular reference to serum vitamin D metabolites, was investigated in 40 women with femoral neck fracture (mean age 77.1 ± 8.6 yr). All the patients were ambulant before the fracture; eight were long-term geriatric in-patients.

Serum total and ionised calcium and serum albumin levels were significantly lower, and serum parathormone (PTH) levels significantly higher in fracture patients than in controls.

Both serum 25-OH-D and 1,25-(OH)₂D were significantly lower in fracture patients than in controls. We concluded that vitamin D, serum PTH and calcium levels should be checked with greater frequency in patients at high risk for osteoporosis and osteomalacia before they reach the age of 70.