Development of a Model System for Analysing Graft-versus-Host-Mediated Immune Suppression

F1 hybrid mice injected with parental T lymphocytes undergo a graft-versus-host (GvH) reaction, one of the consequences being a highly depressed cytotoxic T-lymphocyte (CTL) potential against alloantigens and modified self antigens. In the present study we demonstrate that concanavalin A (Con A) can be used for analysing such GvH-mediated immune suppression. Thus, both alloantigen- and Con A-induced responses were reduced by approximately 80% in F1 suppressed (F1s) animals as compared to F1 control (F1c) mice. Although interleukin 2 (IL-2) production was found to be reduced by approximately 50% it did not account for the reduced CTL response in F1s mice. The addition of IL-2 to Con A-stimulated F1s spleen cell cultures did not reconstitute the response. The results suggest that the suppressive mechanism operates by preventing a large fraction of Lyt-2+ CTL precursors from acquiring IL-2 reactivity. However, a small fraction of CTL precursors, escaped the suppression and differentiated into effector CTL.     

Dyspnoea in a cross-sectional and a longitudinal study of middle-aged men: The Study of Men Born in 1913 and 1923

In a longitudinal population study, 855 men, born in 1913 andinitially examined when 50 years old, were followed for 17 yearswith measurements of dyspnoea and other variables performedat ages 50, 54, and 67 years. In addition a sample of 226 menborn in 1923 was followed from 50 to 57 years of age. At thelatest examination, four different methods for measuring dyspnoeawere used, one based on questionnaire, one on interview, andtwo on visual analogue scales. The estimates from these methodswere highly intercorrelated, and correlated with measures ofcardiopulmonary function as well. The prevalence of dyspnoeagrade 2 (shortness of breath when walking with someone of thesame age on the level) or more, not counting the mildest formof dyspnoea in these populations, was 2.8%, 3.0%, 5.2% and 10.3%at 50, 54, 57 and 67 years of age, respectively. Dyspnoea gradel (shortness of breath when walking quickly on the level oruphill) was less well related to age. A scoring system to differentiatevarious possible causes of dyspnoea was applied. About one thirdof the dyspnoeic men had signs and symptoms of cardiac disease,one quarter had pulmonary disease, and a quarter had a combinationof both causes. The remaining 20% had no signs or symptoms indicatingcardiopulmonary disease but in the majority of the cases otherplausible causes were found.     

Left ventricular function before and after kidney transplantation. A prospective study in patients with juvenile-onset diabetes mellitus

The aim of the present investigation was to discover whetherdisturbed left ventricular (LV) function limits renal replacementtherapy in patients with juvenile onset diabetes mellitus. Seventeenpatients given functioning kidney grafts were studied non-invasively(M-mode echocardiography, apexcardiography, phonocardiography)before renal transplant and an average of six, 13 and 44 monthsafter transplant. The main pretransplant findings were pronouncedLV hypertrophy with impaired diastolic LV function (prolongedrelaxation time + signs of decreased LV distensibility) anda hyperdynamic circulation. Most of these abnormalities were significantly less severe aftersuccessful kidney transplantation. LV mass decreased by 37%44 months after transplant (p<0.01) and LV diastolic andsystolic volumes decreased with a subsequent increase in ejectionfraction from 0.65 to 0.78 (p<0.01). The LV distensibilityand filling pattern improved significantly while the prolongedrelaxation time was unchanged. These findings imply that pretransplant disturbances in LV functionare related more to factors such as hypertension, volume overloadand uraemia than to diabetes per se because no pronounced improvementin the metabolic disorder resulting from diabetes can be expected,even after the most successful transplant. Disturbed LV functionshould not, therefore, exclude uraemic diabetics from renalreplacement.     

INFLUENCE OF FLUID REGIMENS ON PERIOPERATIVE BLOOD-GLUCOSE CONCENTRATIONS IN NEONATES

Blood concentrations of glucose were measured during surgeryand during the first 8 h after operation in 30 neonates undergoingmajor surgery during the first week of life. Fifteen of theneonates were given Ringer-acetate as the only crystalloid peroperativefluid; to the other 15, 10% glucose i.v. was administered duringsurgery, In the Ringer-acetate group, mean (SD) blood concentrationof glucose increased from 3.1 (2.0) to 4.3 (2.4) mmol litre^–1duringsurgery. The corresponding increase in the glucose-supplementedgroup was 3.4 (1.5) to 6.3 (2.2) mmol litre^–1. In theRinger-acetate group, peroperative blood concentrations of glucosewere found to be low if a preoperative glucose infusion wasinterrupted at the start of anaesthesia. Hypoglycaemia occurredin both groups, but more often in the group given Ringer-acetateonly (3/15 vs 1/15). Hypogly-caemia was found only in neonatesless than 48 h of age and during the first 1 h of anaesthesiaonly. Monitoring of blood concentrations of glucose and adjustmentof the glucose infusion appears to be desirable during and aftersurgery in neonates.     

A technique for studies of the contractile apparatus in single human muscle fibre segments obtained by percutaneous biopsy

Human muscle samples were obtained with the percutaneous biopsy technique. The samples were membrane-hyperpermeabilized (skinned) using a chemical or freeze-drying technique. Short single fibre segments were dissected from the sample, transferred to an experimental chamber, connected to a force transducer and manipulator, and exposed to temperature-controlled solutions. The force generating-capacity, the sensitivity of the contractile apparatus to calcium and the caffeine threshold for calcium release from the sarcoplasmic reticulum could be studied in the short muscle fibre segments obtained from man with the percutaneous muscle biopsy technique. The average length of the fibre segments between the connectors was 0.44±0.21 mm. Thus, detailed studies of the contractile machinery can be made on human skinned muscle fibres with only minimal discomfort to the patient or subject during biopsy, which should be useful in studies of neuromuscular disease, muscle plasticity or in applied physiology.     

Psychological Development at 7 Years of Age in Children with Congenital Hypothyroidism: Timing and Dosage of Initial Treatment

ABSTRACT. Sixty of 68 consecutive patients detected during the first two years of the Swedish screening programme for congenital hypothyroidism were Griffiths tested at the age 6.5–7.5 years. The test quotients of the patients could not be distinguished from those of reference population. Replacement therapy with 8.7 ± 2.8 μg of l -thyroxine (mean±SD)/kg/d had been started at 15.0 ± 7.1 days of life. Furthermore, normal results on Griffiths tests were also found in 13 patients with delayed normalization of serum TSH, i.e. ≥ 19 mU/l at the age of six weeks, as well as in patients with retarded skeletal maturity and/or very low neonatal serum levels of thyroxine, i.e. < 18 nmol/l and tri-iodothyronine, i.e. <0.92 nmol/l. Our findings indicate that replacement dose of 6–11 μg l -thyroxine/kg/d is adequate and allows normal psychological development if treatment is started early.     

Blood Lipids and Diet in Swedish Adolescents Living in Norsjö, an Area with High Incidence of Cardiovascular Diseases and Diabetes

ABSTRACT. In Norsjö in Northern Sweden a cardiovascular intervention programme, for adults is presently tested. The aim of the present study was to investigate the presence of factors related to cardiovascular disease in all 15-year-old adolescents living in Norsjö in 1987 and 1988. The total cholesterol concentration in serum, as an average for the test period, was 4.2 mmol/l and 4.7 mmol/l for boys and girls, respectively. Fourteen per cent of the boys and 32% of the girls had a total cholesterol concentration exceeding 5 mmol/l. Twenty-seven per cent of the adolescents had high values for two or more variables related to risk of developing cardiovascular disease. The evaluation of the dietary registrations showed unsatisfactory values for fibre, P/S ratio and total fat. The dietary habits were better in the 15-year-olds in 1988 than in 1987 as judged by significantly higher average daily intake of fibre as well as a higher content of fibre per megajoule in the food.