The effect of a period of intensive exercise on the isoform test to detect growth hormone doping in sports

ObjectiveThe major objective of this study was to investigate the effects of several days of intense exercise on growth hormone (hGH) testing using the World Anti-Doping Agencies hGH isoform differential immunoassays. Additionally the effects of circadian variation and exercise type on the isoform ratios were also investigated.Study design15 male athletes performed a simulated nine day cycling stage race. Blood samples were collected twice daily over a period of 15 days (stage race + three days before and after). hGH isoforms were analysed by the official WADA immunoassays (CMZ Assay GmbH).ResultsAll measured isoform ratios were far below the WADA decision limits for an adverse analytical finding. Changes in the isoform ratios could not be clearly connected to circadian variation, exercise duration or intensity.ConclusionsThe present study demonstrates that the hGH isoform ratios are not significantly affected by exercise or circadian variation. We demonstrated that heavy, long term exercise does not interfere with the decision limits for an adverse analytical finding.     

Action of sublingual nifedipine on left ventricular filling in hypertensive crisis

We studied the left ventricular filling before and 15 minutes after sublingual absorption of one Nifedipine capsule in 33 untreated hypertensive patients (mean age: 68.6) without other cardiac disease and presenting an hypertensive access. This study was carried out with Doppler-echocardiography. Sample volume was set at the tips of mitral leaflets. The protocol included: early peak filling velocity (VE), atrial peak velocity (VA), mitral pressure half-time (T1/2), isovolumic relaxation time (TRIV), velocity time integral of total mitral curve (VTIT) and velocity time integral of atrial curve (VTIA). We also studied VE/VTIT ratio which has been correlated to peak filling rate/mitral stroke volume ratio in radionuclide angiography. RESULTS: [table: see text] The variations of VA/VE, VTIA/VTIT, VE/VTIT and T1/2 are statistically significant but decrease of TRIV is not significant. The arterial blood pressure decreases from 184/103 to 153/83 and cardiac rate increases from 81.8 to 87.9 beats/minute. CONCLUSION: On hypertensive emergencies sublingual nifedipine significantly improves rapid left ventricular filling without change of TRIV. Acceleration of cardiac rate is moderate.     

Involvement of 5-hydroxytryptamine and bradykinin in the hyperalgesia induced in rats by collagenase from clostridium histolyticum

The involvement of bradykinin, 5-hydroxytryptamine, substance P and prostanoids in the hyperalgesia elicited by collagenase in rat paw was investigated. Collagenase (100μg) induced a slight hyperalgesia in kininogen deficient rats in comparison with the behavioural response obtained in normal rats. Lisinopril (10^–5M), and angiotensin-converting enzyme inhibitor, increased the duration of the hyperalgesia elicited in normal rats. Ondansetron (0.5 to 5μmol/kg), a 5-HT₃ antagonist, suppressed the hyperalgesia as did methysergide (1.1 to 11μmol/kg), a mixed 5-HT₁ and 5-HT₂ receptor antagonist. However, the hyperalgesia was not modified by RP67580 (1.8 to 18μmol/kg), a NK₁ receptor antagonist, and was only slightly delayed by indomethacin (2mg/kg), a cyclo-oxygenase inhibitor. The oedema-promoting effect of 5-HT (6nmol) was inhibited by methysergide but not by ondansetron. The swelling induced by collagenase in rat paw was reduced by methysergide but not by ondansetron. We conclude that the behavioural reponse induced by collagenase depends on an interactions between bradykinin and 5-HT. Prostanoids play a minor role in the beginning of the reaction whereas substance P is not significantly involved in this hyperalgesia. Received: 23 September 1996 / Accepted: 20 January 1997     

MR imaging of cervical carcinoma: a practical staging approach.

Cervical carcinoma is the third most common gynecologic malignancy and is typically seen in younger women, often with serious consequences. The International Federation of Gynecology and Obstetrics (FIGO) staging system provides worldwide epidemiologic and treatment response statistics. However, there are significant inaccuracies in the FIGO staging system, and magnetic resonance (MR) imaging, although not included in that system, is now widely accepted as optimal for evaluation of important prognostic factors such as lesion volume and metastatic lymph node involvement that will help determine the treatment strategy. MR imaging examination obviates the use of invasive procedures such as cystoscopy and proctoscopy, especially when there is no evidence of local extension. Brachytherapy and external beam therapy are optimized with MR imaging evaluation of the shape and direction of lesion growth. In general, T2-weighted MR imaging more clearly delineates cervical carcinoma and is preferred for evaluation of the lymph nodes. Dynamic gadolinium-enhanced T1-weighted imaging may help identify smaller tumors, detect or confirm invasion of adjacent organs, and identify fistulous tracts. MR imaging staging, when available, is invaluable for identifying important prognostic factors and optimizing treatment strategies.     

Evaluation of various methods of studying fecal occult blood

Occult blood testing for detection of asymptomatic colorectal cancer is an old concept. The authors review the literature about the screening value of current tests. Among the chemical tests, Hemoccult is the most popular and the best studied. Sensitivity and specificity are moderate. False negative reactions are due either to the test itself (high level of sensitivity, loss of reactivity) or to the tumour (intermittent or insufficient bleeding, localization etc...). False positive reactions are due to the interference of a high peroxidase diet. The Hemoccult test is nevertheless interesting because it is simple, cheap and well accepted. Detected cancers tend to be at a relatively early stage: 60 to 80% of Dukes A or B. New methods--Hemoquant and immunochemical methods--are being developed. Their high degree of sensitivity and specificity for human hemoglobin makes them too complex and too costly. Whatever the efficacity of a test to detect occult blood may be, we must know whether the screening of an asymptomatic population could decrease the mortality rate of colorectal cancer, before using it on a large scale. Only long-term controlled trials can give us an answer in the future.     

Human fetal brain antigen expression common to tumors of neuroectodermal tissue origin

The antigenic relationship between human tumors of neuroectodermal origin and fetal brain were further investigated by characterization of two hybridoma antibodies derived from a fusion of P3-NS1/1-Ag 4-1 (NSI) myeloma cells and splenocytes hyperimmunized to second trimester human fetal brain homogenate. Monoclonal antibodies (MAs) 1H8cl 2 and 1H8cl 3 were analyzed by cell surface radioimmunoassay (CS-RIA), quantitative absorption, indirect immunofluorescence, and peroxidase-antiperoxidase (PAP) immunohistology. MA 1H8cl 3 is the more broadly reactive, binding to 9/14 glioblastoma (GBM), 2/3 neuroblastoma, 1/2 melanoma, and 1 medulloblastoma cell line(s) by CS-RIA analysis, and to 12/15 GBM, fetal brain, spleen, and liver, and adult spleen by PAP analysis. MA 1H8cl 2 is more restricted, binding to 7/14 GBM, 2/3 neuroblastoma, 1 medulloblastoma, and 2/3 fetal skin fibroblast cell line(s) by CS-RIA, and to 9/15 GBM and fetal brain and spleen by PAP analysis. Control non-central nervous system tumors and normal adult tissue including brain, thymus, lymph node, liver, kidney, lung, skin, and pancreas, were unreactive with both 1H8cl 2 and 1H8cl 3 by CS-RIA, PAP, and absorption analysis. The data presented here establish the unique nature of the detected antigenic specificities as compared to previously described oncofetal and onconeural antigens, and define two immune reagents which are operationally specific for tumors of neuroectodermal origin within the adult central nervous system.     

Residential Drug Abuse Treatment for Probationers: Use of Node-Link Mapping to Enhance Participation and Progress

Node-link mapping, a graphic representation tool, was used to enhance substance-abuse treatment in a 4-month residential criminal justice program. Twelve communities of 30 to 35 probationers (“residents”) were randomly assigned to either mapping-enhanced or standard counseling. During group sessions, counselors and residents in the mapping communities collaborated to develop node-link maps representing critical issues. Counselors in standard communities used their own methods. Treatment motivation (i.e., desire for help) was assessed at intake and was used to categorize residents into three levels. Treatment involvement was measured at the middle and at the end of the program. Residents, as well as their counselors, rated those in mapping communities as participating more in group sessions than those in standard communities. Mapping residents also reported better personal progress toward treatment goals, more positive affective responses to treatment, and greater treatment engagement. Residents with higher motivation at intake had higher treatment involvement scores regardless of type of counseling received.     

Role and Operative Risk of Bilateral Adrenalectomy in Hypercortisolism

n = 78), ectopic ACTH syndrome ( n = 3), and primary adrenocortical nodular dysplasia (Carney-Meador syndrome) ( n = 1). Before operation 37% of the patients had severe symptoms of hypercortisolism. A bilateral posterior approach was undertaken in 58 patients, whereas 18 patients had an anterior transabdominal approach and 6 patients a laparoscopic approach. There were two operative deaths (2.4%). Postoperative complications occurred mostly in cases of advanced disease and were observed in 14 patients (17%), among whom 4 had severe complications. At long-term follow-up, one recurrence of hypercortisolism and 12 Nelson syndromes (15%) were observed. In conclusion, bilateral adrenalectomy carries an acceptable operative risk, and we recommend bilateral adrenalectomy rather than long-term suppressive therapy in patients requiring prompt and definitive control of their hypercortisolism or after pituitary surgery failure.     

The cervical aortic arch: A case with diffuse arterial dysplasia and neurocutaneous angiomatosis

The authors present a case of cervical aortic arch which was discovered in a child of 5 years. The association with a diffuse and major vascular dysplasia, mainly neuroectodermic, is worth reporting. Only 40 cases of this abnormality have been published up to now. The anatomic classification of the different types of cervical aortic arch is presented.