HL-A Genotypes and MLR in Familial Sarcoidosis

Investigations of HL-A genotypes and MLR reactivity were performed in two families with an increased frequency of sarcoidosis. No significant correlation between either HL-A or MLR alleles and disease was demonstrated. Individuals possibly homozygous for MLR alleles were found in this material. A possibly impaired stimulatory capacity of cells from sarcoidosis patients is discussed.     

High frequency of asymptomatic visual field defects in subjects with transient ischaemic attacks or minor strokes

The hypothesis that asymptomatic visual field defects can be found in patients with carotid transient ischaemic attacks (TIA) or minor strokes was tested. Twenty-two consecutive male patients with TIA and 18 patients with minor strokes from the carotid artery territory were examined by perimetry, cerebral computerised tomography and regional cerebral blood flow. Asymptomatic visual field defects were found in many TIA and minor stroke patients, 29% (5/17) and 57% (8/14), respectively (NS). Eighty-five per cent (11/13) of the scotomas were solely or predominantly located in the upper part of the visual field (P = 0.008 for absolute defects and P = 0.03 for relative defects). We conclude that both carotid territory TIA and minor stroke patients have a high frequency of asymptomatic visual field defects, predominantly located in the upper part of the visual field.     

Maternal Acceptability of a Dietary Intervention Designed to Lower Children''s Intake of Saturated Fat and Cholesterol: The Dietary Intervention Study in Children (DISC)

Objective This report examined the acceptability to mothers of a dietary educational and behavioral intervention for preadolescent children with elevated levels of serum low-density lipoprotein cholesterol (LDL-C) who were enrolled in the Dietary Intervention Study in Children (DISC).Design DISC is a randomized, controlled clinical trial. Subjects were randomly assigned to either an intervention or usual-care (control) group.Subjects/setting To be eligible for the study, participants were required to have the average of 2 fasting LDL-C values fall between the 80th and 98th sex-specific percentiles. Three hundred thirty-four 8- to 10-year-old children and their families were randomly assigned to an intervention group, and 329 were assigned to a usual-care (control) group. This study examined data from 232 subjects in the intervention group. Data were collected at 6 intervention sites around the United States.Intervention Those assigned to the intervention group participated in a multidisciplinary dietary intervention that included a series of group and individual sessions over a 3-year period. Children and their caretakers were taught to follow a nutritionally adequate diet that was low in total fat, saturated fat, and cholesterol and high in polyunsaturated fat.Main outcome measures Three nonconsecutive 24-hour diet recalls were collected at baseline and at 1 year by trained and certified dietitians. A questionnaire designed to assess diet acceptability was administered at months 4, 8, 11, and 15. Demographic measures were collected at the onset of the study.Statistical analysis performed Statistical procedures included factor analysis and regression analysis.Results Regression analysis suggested that perceived effectiveness of the dietary intervention and mothers’ having few concerns about disadvantages of the diet were significantly related to higher overall fat intake in children in one-parent families. Maternal willingness to implement the diet was significantly related to lower saturated fat intake.Applications/conclusions In attempts to change eating behavior of children, interest and cooperation of the parents are essential to achieving successful results. These analyses further suggest that maternal acceptability translates into willingness to implement the diet and may facilitate changes that are associated with reduced saturated fat intake in children. J Am Diet Assoc. 1998;98:31-34.     

The use of obstetric analgesia in Sweden 1983–1986

Summary. The use of obstetric analgesia was investigated in a Swedish population-based prospective study of 335 207 births, which represents almost all women who had vaginal deliveries in Sweden between 1983 and 1986. Lumbar epidural analgesia (EDA) was used in 16%, paracervical block (PCB) in 12%, pethidinc or morphine in 49% and pudendal block in 62%. All four types of analgesia were much more commonly used by nulliparae than multiparae. Variables such as maternal age, smoking, nationality, relationship with the infant's father and gestational age had only moderate influence on the rates of different types of analgesia. EDA and PCB were more frequently used in larger than in smaller hospitals and in the daytime than at night. No such differences were found for pethidine or morphine, or pudendal block, which were administered routinely by midwives.     

Flow rate, sodium and potassium concentration in mixed saliva of complete denture-wearers

Flow rate, sodium and potassium concentrations in stimulated mixed saliva obtained from eleven elderly (mean age 63) inexperienced denture-wearers, were determined. Salivary samples were collected at four different dental stages: 1. Before tooth extraction. 2. After tooth extraction. 3. Three weeks after wearing newly constructed complete dentures. 4. Following one year of denture wearing. Plasma electrolytes were included for comparison. The salivary sodium and potassium concentrations varied from stage to stage without showing corresponding variations in sodium and potassium in the blood. This points to selective action and an active transport system in the salivary cells. The mean flow rate and salivary electrolyte concentration showed a definite significant rise following the wearing of new complete dentures as compared with the previous dentulous and edentulous stages (Period A, non-denture-wearers). The mean flow rate was 2 ml/min after denture-wearing compared to 0-75 ml/min at the dentulous and edentulous stage (Period A). The stimulant effect represented by the dentures was found to be even more pronounced after one year. Mean sodium and potassium concentration at Period A were at levels of 5.50 and 13.67 mequiv /I respectively, as compared to levels of 23.72 and 19.40 mquiv./l respectively, after insertion of dentures. The difference was significant at a level of P<0.005. Although sodium concentration correlated well with flow rate, potassium concentration did not show any correlation with variations during secretion, following the wearing of dentures.     

FAMILIAL HYPOCALCIURIC HYPERCALCAEMIA: ASSOCIATION WITH NEONATAL PRIMARY HYPERPARATHYROIDISM, AND POSSIBLE LINKAGE WITH HLA HAPLOTYPE

A kindred is described, six members of which fulfilled criteria for the syndrome of familial hypocalciuric hypercalcaemia (FHH). The majority of these individuals were asymptomatic: their hypercalcaemia was revealed by biochemical screening after parathyroid surgery had failed to diminish the elevated serum calcium concentration of the index case. In contrast to those members of the family diagnosed as adults, the daughter subsequently born to the index case included in her expression of FHH clinical features of severe neonatal primary hyperparathyroidism. Four hyperplastic parathyroid glands were excised, and following surgical intervention the baby improved clinically and accelerated the healing of her skeletal lesions. Her case suggests that an association does exist between FHH and neonatal primary hyperparathyroidism. Of the ten individuals at risk, inheritance of hypocalciuric hypercalcaemia was paralleled in eight cases by inheritance of the HLA haplotype All BW55 CW3 DR4. Such possible linkage has not previously been reported.     

Autonomic and Peripheral Nerve Function in Early Diabetic Neuropathy

ABSTRACT. Sundkvist G, Lilja B, Rosén I, Agardh C-D (Departments of Internal Medicine and Clinical Physiology, Malmö General Hospital, and Departments of Clinical Neurophysiology and Internal Medicine, University Hospital, University of Lund, Lund, Sweden). Autonomic and peripheral nerve function in early diabetic neuropathy. Possible influence of a novel aldose reductase inhibitor on autonomic function. Acta Med Scand 1987; 221:445–53. Autonomic and peripheral nerve functions as well as the possible short-term effect of a novel aldose reductase inhibitor (ARI) on neuropathy were evaluated in 30 male type I diabetics (age 25–44 years, mean 34; duration of diabetes 10–20 years, mean 34) with neurographic signs of peripheral neuropathy (PN). Autonomic neuropathy (AN) was established by the heart rate reactions to deep breathing (E/I ratio = vagal function) and to tilt (acceleration index = sympathetic and vagal functions; the brake index = vagal function). Twenty-nine patients, 13 with AN, completed the study. Among neurographic variables, only sural nerve function tests correlated with autonomic functions. Patients with AN showed significantly lower mean sensory action potential amplitudes (SAPA) sural, indicating axonal losses, than patients without AN (3.58±0.79 μV vs. 7.34±1.12 μV; p<0.01). PN as measured by neurography did not improve during ARI treatment. On the other hand, vagal function (brake indices) improved (p<0.05) during ARI in AN patients.     

Light and electron microscopic studies of physical injury to the skin II. Friction

Frictional injury to the skin causes inter- and intra-cellular oedema of the epidermis, and if severe produces membranous rupture and formation of an intra-epidermal blister. The appearances arc consistent with direct physical damage to the cells.     

Fibrinogen and IgG in the hyaline zone in man after orthodontic movement

Abstract – Fibrinogen and IgG were demonstrated in the hyaline zone with direct immunofluorescent staining after orthodontic tooth movement in man. It was suggested that presence of plasma proteins in the hyaline zone contributed to its hyaline appearance. Fibrin and IgG may, furthermore, attract phagocytes and form a network for the reorganization of the necrotic tissue in the hyaline zone.