Screening of an Elderly Female Population for Hypo- and Hyperthyroidism by Use of a Thyroid Hormone Panel

ABSTRACT. The elderly female population living in a rural primary health care district in the south of Sweden was screened for hypo- and hyperthyroidism. A total of 1 442 (97.3 %) of the 1 482 women 60 years of age or older attended the study. By use of a computer-evaluated thyroid hormone panel, 178 women (12.3%) were identified as probably abnormal. Among them, 8 women (0.55% of total) with previously unknown thyroid disease were detected as overtly hypothyroid. If also 13 women with spontaneous subclinical hypothyroidism were included, the prevalence of earlier unknown hypothyroidism was 21/1 442 (1.5%). The number of subjects with hyperthyroidism discovered by screening was 28/1 442 (1.9%). Although much remains to be elucidated regarding medical, social and economic factors, the high figures obtained for newly discovered abnormal thyroid function suggest that screening for hyper- and hypothyroidism may be worthwhile in such an elderly female population.     

Epidemiologic study of excessive oral melanin pigmentation with special reference to the influence of tobacco habits

Abstract – The prevalence of oral melanin pigmentation was studied in a population of 30 118 adult individuals in Sweden. Among these, 9.9% showed melanin pigmentation in the oral mucosa. The anterior labial gingiva in the mandible was the most frequently pigmented location. The presence of melanin pigmentation was positively correlated to tobacco smoking. Among tobacco smokers 21.5% were pigmented as compared to 3.0% among individuals not using tobacco. The smoking-rdated oral pigmentation, smokers' melanosis, could thus be calculated at a prevalence of 18.5% among smokers and the total frequency of smokers' melanosis was calculated at 6.8%. The prevalence of pigmentation was found to increase promninendy during the first year of smoking but aiso to decrease to the level found among non-tobacco users about 3 years after cessation of smoking. Snuff dipping did not significandy elevate the prevalence of oral melanin pigmentation.     

IMMUNOREACTIVE TRYPSIN SCREENING FOR CYSTIC FIBROSIS

ABSTRACT. Immunoreactive cationic trypsin (irCT) was measured in 22 cystic fibrosis (CF) and 132 control infants. IrCT was analysed with radioimmunoassay of dried blood samples collected for PKU screening around the 5th day of life and stored on filter paper. The mean ± 1 SD level of irCT for the control infants was 42±19 μg/l. Sixteen of the 22 CF children had an irCT level above 100 μg/l (mean + 3 SD) while 6 had a level at or below this cut-off limit. A specificity of 99%, which gives a sensitivity of 73%, and an approximative noise: signal ratio of 30: 1, suggests that the irCT test may be unsatisfactory as a neonatal screening method for CF.     

Immunogenicity in rabbits and monkeys of influenza ISCOMs conjugated with repeated sequences of the Plasmodium falciparum antigen Pf155/RESA

Rabbits and monkeys were immunized with two fusion proteins, ZZ-M3 and ZZ-M5, coupled to pre-formed influenza virus membrane glycoprotein ISCOMs. The fusion proteins comprise two IgG-binding domains from staphylococcal protein A (ZZ) and repeated amino acid sequences from the C-terminal (M3) or central (M5) repeat regions of the Plasmodium falciparum antigen Pf155/RESA. The induced antibody responses were of long duration, could be efficiently boosted and were comparable to those obtained with Freund's Adjuvant. The produced antibodies reacted with M3, M5, protein A and the influenza glycoprotein, recognized Pf155/RESA and inhibited merozoite invasion in vitro. These results suggest that coupling of immunogens to pre-formed ISCOMs may be a basis for construction of multivalent subunit vaccines.     

Multiple cross-reactivities amongst antigens of Plasmodium falciparum impair the development of protective immunity against malaria

The majority of protein antigens of the malaria parasite Plasmodium falciparum contain short sequences that are extensively repeated in tandem arrays. Some antigens contain a single block of repeats whereas in other antigens there may be two or more blocks of related repeats. The repetitive sequences in an individual antigen may be highly conserved but more usually there is some degeneracy which occasionally is extensive. The repetitive sequences encode immunodominant epitopes to which much of the antibody response in malaria is directed. Recently, we have found that there are extensive cross-reactions amongst the epitopes encoded by related repetitive sequences. These cross-reactions may involve different blocks of repeats in the one antigen or repetitive sequences in different antigens. It is proposed that these cross-reactions interfere with the normal maturation of a high affinity antibody response in malaria by causing an abnormally high proportion of somatically-mutated B cells to be preserved during clonal expansion.     

Clinical and Biochemical Outcome of Marrow Transplantation for Gaucher Disease of the Norrbottnian Type

ABSTRACT. Three children, two girls and one boy, with Gaucher disease of the Norrbottnian type were treated by allogeneic bone marrow transplantation (BMT). Two of the donors were heterozygotes for Gaucher disease, and the third did not carry the gene. Engraftment was achieved in all three children but the boy became a chimera. The children have been followed from 1.5 to 6 years after transplantation. In each case the outcome was favourable, and in two children (patients 1 and 3) the BMT has been life saving. In all three cases a positive biochemical effect was apparent. Almost all biochemical parameters normalized within one year. The authors conclude that BMT is the treatment of choice in severe cases of Gaucher disease. BMT should be considered early in the course of disease and vigorous efforts made to find a suitable donor.