Langzeitverlauf der endothelin-plasma- und der interleukin-2-rezeptor-serumspiegel nach lebertransplantation

In a prospective study levels of interleukin-2 receptors (II-2-R) in serum and of endothelin (ET) in plasma were sequentially determined in 97 patients (39 women, 58 men) before and after liver transplantation (Ltx). The aim of the study was no evaluate the correlation and the time course of these two parameters after Ltx. The postoperative levels of Il-2-R and ET were higher in transplant recipients with no postoperative complications than in patients who had undergone operations to the liver. Patients suffering from acute rejection episodes after transplantation had more markedly increased Il-2-R and ET levels than those with an uneventful course, and this persisted for 3 months. A significant rise of Il-2-R concentrations 3–6 days before a biopsy confirmed rejection proved to have a sensitivity of 68% and a specificity of 68% respectively. A corresponding ET increase preceded rejection episodes confirmed by biopsy with a sensitivity of 62% and a specificity of 67%, respectively. These laboratory data can be obtained daily: they cannot undermine the “gold standard” of liver biopsy, but they are extremely beneficial in determining the timing and indication for the liver biopsy.     

Accuracy at radiography and probing for the diagnosis of proximal caries

In 63 teenagers the proximal surfaces of premolars to be extracted for orthodontic reasons and the adjacent surfaces of neighboring teeth, 598 surfaces in all, were examined radiographically and by probing. Direct inspection after extraction revealed that 51% of the surfaces had incipient carious lesions and 5% lesions with cavities. Of the surfaces with cavities 82.1% were correctly diagnosed radiographically if any radiolucency, regardless of its extent, was used as a diagnostic criterion. However, this yielded a false positive rate of 19.6%. If only radioluccncies extending at least into the inner third of the enamel were called positive the true positive rate was 36.7% and the associated false positive rate 1.6%. At a 5% cavity frequency the predictive positive values were 17% and 53%, respectively. Probing yielded a true positive rate of about 29% and a false positive rate of 1.1% with a predictive positive value of 50-57%. All radiolucencies extending into the dentin were associated with cavities. When the most liberal radiographic criterion was used 37.5% of all carious lesions, whether associated with a cavity or not, were detected and 3.8% of sound surfaces were falsely called carious. The corresponding predictive positive value at the actual rate of incipient lesions and lesions with cavities was 92.6%.     

Potential adrenal gland imaging agents. II: Radioiodination of p-hydroxyphenyl derivatives of digitoxigenin, dihydrodigitoxigenin and scillarenin

Potential Adrenal Gland Imaging Agents. II: Radioiodination of p-Hydroxyphenyl Derivatives of Digitoxigenin, Dihydrodigitoxigenin and Scillarenin As potential adrenal gland imaging agents the p-hydroxyphenyl derivatives of the aglycones digitoxigenin (1) , dihydrodigitoxigenin (2) and scillarenin (3) are synthetized and radioiodinated. The aglycones are dehydrogenated to the corresponding ketones and reacted regioselectively with 2-(4-lithiophenoxy)tetrahydropyran (18) to yield 7-9 . The protecting group is removed under mild conditions and 3-(p-hydroxyphenyl)-3-hydroxydigitoxigenin (10), 3-(p-hydroxyphenyl)-3-hydroxydihydrodigitoxigenin (11) and 3-(p-hydroxyphenyl)-3-hydroxyscillarenin (12) are obtained. The insertion of the p-hydroxyphenyl group allows the aglycone derivatives to be radioiodinated rapidly. An activity of 10 to 41 mCi per mg starting material is obtained with carrier-free ¹³¹I.