Effect of maternal and infant covariates on sibship correlation in birth weight

Birth weight on 12,644 singleton infants from 6,196 sibships born in Maryland between 1980 and 1984 were used to estimate the effects of nine maternal and infant covariates on the sibship correlation in birth weight. Assuming a homogeneous correlation across all families, the estimated intraclass correlation was 0.4664 (+/- 0.0099). This high sibship correlation makes it possible to predict, with reasonable accuracy, the birth weight of a child given information on previous sibs, as well as covariates on the mother and/or infant pertinent to a given pregnancy. The reduction in variance associated with incorporating information on the nine covariates used here was approximately equal to that obtained by conditioning on a single previous sib. Testing for heterogeneity in correlation among different groups of families showed that a crude measure of parity (first live birth vs. other), time between births, mother's marital status, and maternal age at the birth of the last child significantly influenced the sibship correlation in birth weight.     

FEASIBILITY OF CONDUCTING CARDIOVASCULAR OUTCOME RESEARCH IN AUSTRALIAN GENERAL PRACTICE: RESULTS FROM THE ANBP2 PILOT STUDY

1. The present study aimed to determine the feasibility of conducting a 5 year cardiovascular outcome trial of the treatment of 6000 elderly hypertensive patients in Australian general practices. 2. General practitioners (GPs) were invited to participate by mail and personal follow-up. Patient records were reviewed to identify subjects for a blood pressure (BP) screening programme. Blood pressure was measured on three occasions and eligible subjects were included if the average BP was 160 mmHg systolic or 90 mmHg diastolic if systolic BP was 140 mmHg. 3. Seven hundred and forty-one GPs were approached and 89 were enrolled in the study (12% of mail invites and 75% of those receiving a personal contact). In 16 practices where screening was completed, 82 000 records were reviewed to identify 4% patients eligible for screening. Twenty-two per cent of eligible subjects attended screening. Of 1938 subjects screened, 180 (9%) had BP 5=160/90 mmHg. Forty-seven percent of subjects (n = 916) were receiving antihypertensive therapy and 184 (20%) were withdrawn from therapy. One hundred and sixteen (63%) of these subjects had BP return to study entry levels within 6 weeks. Fifty-seven newly diagnosed and 81 previously treated subjects were randomized (7% of the screened population). 4. Based on the high participation rate of GPs, the response rate of patients to attend a BP screening programme and the 7% randomization to screening ratio for entry into the study, the ANBP2 pilot study has demonstrated that it is feasible to recruit subjects from Australian general practices to a cardiovascular outcome trial.     

A diagnostic algorithm for male genital oedema

Male genital oedema can be defined as swelling or the appearance of swelling of the scrotum and/or the penile shaft and prepuce. Despite the various causes of genital oedema reported in the published work, a concise approach to the evaluation and management has not been sufficiently addressed.     

Lipodermatosclerosis: review of cases evaluated at Mayo Clinic.

BACKGROUND: Lipodermatosclerosis describes bound-down, sclerotic skin involving the lower extremities. OBJECTIVE: Our purpose was to describe the demographic and clinical features of patients with lipodermatosclerosis. METHODS: This was a retrospective study of patients presenting to Mayo Clinic between 1976 and 1998 with a diagnosis of lipodermatosclerosis. RESULTS: Of 97 patients, 84 (87%) were women. Mean age was 62 years (range, 25-88 years). Mean body mass index was 34.3 (range, 17.8-71.5). Clinical signs were bilateral involvement in 44 patients (45%), induration localized to a discrete plaque in 49 (51%), erythema in 69 (71%), hyperpigmentation in 57 (59%), ulceration in 13 (13%), concomitant edema in 69 (71%), and varicosities in 55 (57%). Vascular studies performed on 72 patients showed abnormalities in 49: deep venous incompetence in 33 (67%), calf muscle pump abnormality in 19 (39%), abnormal pulsatility in 10 (20%), and obstruction in 1 (2%). CONCLUSION: Lipodermatosclerosis was associated with female sex, middle age, high body mass index, and venous abnormalities.     

Induction of the anti-ergotypic response

The injection of syngeneic activated T cells into rodents caninduce a T cell response against activation markers of the Tcells, ergotopes. The responding antl-ergotypic T cells havebeen shown to suppress experimental autoimmune encephalomyelitis(EAE). This paper reports the characteristics of the antl-ergotypicresponse. It was found that irradiated activated T cells wereas good as untreated living activated T cells in inducing anti-ergotypiccells in vivo. Glutardialdehyde-fixed (0.3%) cells were poorstimulators in vivo and non-stimulatory in vitro. Dilution ofglutardialdehyde to 0.003% before fixation preserved the stimulatorycapacity in vitro. Fixation or irradiation of T cells at differenttimes after activation showed that the stimulatory ergotopeappears only after more than 12 h of activation. This ergotopeis not secreted by activated T cells, but is a structural componentof the activated T cell. Injection of solubilized proteins fromactivated T cells, but not of supernatants from activated Tcells, was able to induce an anti-ergotypic response in vivo.In vitro supernatants from activated T cells also were not stimulatoryto anti-ergotypic T cells. The anti-ergotypic response couldbe measured in draining lymph nodes 3 days after injection,reached a maximum after 7–10 days and subsided thereafter.It was earlier and stronger than the anti-ldiotypic response.Induction of the response was dose dependent. As few as 100cells were able to induce a marked anti-ergotypic response.The ease of the induction and the strength of the anti-ergotypicresponse suggest a physiological role in immunoregulatlon.     

Die normale Nierensch Welle für Glucose bei langdauernder Zuckerbelastung

Zusammenfassung An 21 Patienten wurde die Harnschwelle für Zucker, die tubuläre Rückresorptionskapazität und die Zuckerausscheidung bestimmt. Hierbei ergab sich bei langdauernder Zuckerbelastung eine absolute Vergrößerung der ausgeschiedenen Zukkermengen mit Abfall der Harnzuckerschwelle. Diese Verminderung wurde durch einen absoluten Abfall der tubulären Rückresorptionskapazität und relativen Abfall im Verhältnis zur filtrierten Zuckermenge hervorgerufen. Diese Einschränkungen traten mit zunehmender Versuchsdauer in Erscheinung und werden auf eine Erschöpfung der tubulären fermentativen Vorgänge bezogen. Vielleicht finden hierin auch die anderweitig beobachteten tubulären Degenerationen bei langdauernder Zuckerbelastung ihre Erklärung. Eine länger dauernde Glykosurie scheint für die Tubulusepithelien eine echte Belastung darzustellen.Diese Arbeit ist meinem Chef, Herrn Prof.Wollheim, zu seinem 60. Geburtstag am 24. 3. 60 gewidmet.     

Demonstration of Ri-type adenosine receptors in bovine myocardium by radioligand binding

Summary Adenosine has been shown to have negative inotropic, chronotropic and dromotropic effects on the heart. The pharmacological profiles of these effects suggest that they are mediated via R_i (A₁) adenosine receptors, but a direct demonstration of these receptors is still missing. In the present study we report direct labelling of these receptors with (-)N⁶-[¹²⁵I]-p-hydroxyphenylisopropyladenosine ([¹²⁵I]HPIA). The radioligand bound in a saturable and reversible manner to a crude membrane preparation, the B _max-value was 30.5 fmol/mg protein and the K _D-value 1.1 nmol/l. A similar affinity of the ligand was obtained in kinetic and competition experiments. Competition experiments with a variety of adenosine analogues gave a pharmacological profile characteristic of R_i adenosine receptors with high affinities of N⁶-substituted derivatives and a marked stereospecificity for N⁶-phenylisopropyladenosine (PIA). Purification of the membrane preparation by density gradient centrifugation resulted in a 30-fold increase in the number of binding sites which was paralleled by a similar increase in the number of binding sites for [³H]ouabain. Guanine nucleotides decreased binding of [¹²⁵I]HPIA in a dose-dependent manner, but the IC₅₀-values were considerably higher than those reported in other tissues. Finally, binding of [¹²⁵I]HPIA appeared to be entropy-driven which has been shown to be characteristic of agonist binding to R_i adenosine receptors. These results suggest the presence of R_i adenosine receptors in ventricular myocardium which may be responsible for the mediation of the effects of adenosine and its analogues.Abbreviations [¹²⁵I]HPIA (-)N⁶-[¹²⁵I]-p-hydroxyphenylisopropyladenosine - (-)IHPIA (-)N⁶-iodo-p-hydroxyphenylisopropyladenosine - (+)/(-)PIA (+)/(-)N⁶-phenylisopropyladenosine - CHA N⁶-cyclohexyladenosine - NECA 5-N-ethylcarboxamidoadenosine - App(NH)p 5-adenylylimidodiphosphate - Gpp(NH)p 5-guanylylimidodiphosphate