Clinico-hemodynamic characteristics of patients with initial signs of hypertension

Multifactor analysis was used to make clinical and hemodynamic comparisons in 42 patients with borderline arterial hypertension, 27 with Stage I hypertension, 40 with Stage II hypertension, and 40 healthy persons. Central hemodynamic parameters at rest and during graded bicycle ergometer exercise were measured by the Defares carbon dioxide return respiration method modified by V. L. Karpman. As compared with patients with hyperkinetic circulation, those with hypokinetic one were older, had a longer history of arterial hypertension, obesity, more common left ventricular hypertrophy, higher baseline diastolic pressures and total peripheral vascular resistance, less increase in cardiac index and greater enhancement of total peripheral vascular resistance during submaximal exercise. There was a clear-cut correlation between the progression of arterial hypertension and increase in values of factors I (clinical and hemodynamic) and III (cardiotonic).     

Abnormal T-cell subpopulation function in CLL: excessive suppressor (T gamma) and deficient helper (T mu) activity with respect to B-cell proliferation

T-cell function directly influences several B-cell functions. The effect of T-cell subgroups on B-cell function (DNA synthesis) was evaluated for controls and patients with B-cell type of CLL. Control and CLL intact T cells, T cells with receptors for IgG (T gamma), and T cells without Fc receptors at isolation (T non-gamma) were admixed with control B cells. Two predominant differences between control and CLL T cells were observed. First, CLL T gamma cells were excessively effective at suppressing B-cell DNA synthesis, and secondly, control T non-gamma cells were more efficient than CLL T non-gamma at promoting control B-cell DNA synthesis. While it is unclear whether the qualitative and quantitative T-cell abnormalities are part of the CLL disease process, it is possible that excessive T gamma cell numbers and function may reflect an appropriate immune response to a malignant B- cell clone.     

Allogeneic marrow grafting with partially mismatched, unrelated marrow donors

Forty patients with advanced hematologic malignancies or severe aplastic anemia received marrow grafts from partially mismatched, unrelated marrow donors. All patients were administered conventional prophylaxis for acute graft-v-host disease (GVHD) consisting of methotrexate and low-dose glucocorticoids. All but two patients who survived at least 30 days showed durable engraftment. Six patients survive 17+ to 36+ months following transplantation. Severe acute GVHD was seen in 47% of the patients; however, no direct correlation between GVHD and the degree of mismatching could be determined. Fatal infections were seen in 29 patients, and in the majority the infection occurred after the granulocyte count had risen to greater than 500 cells/microL. We conclude that the problems encountered in this pilot study can potentially be solved, and that further studies with this type of marrow grafting are warranted.     

Changes in serum concentrations of growth hormone, insulin, insulin- like growth factor and insulin-like growth factor-binding proteins 1 and 3 and urinary growth hormone excretion during the menstrual cycle

Few studies exist on the physiological changes in the concentrations of growth hormone (GH), insulin-like growth factors (IGF) and IGF-binding proteins (IGFBP) within the menstrual cycle, and some controversy remains. We therefore decided to study the impact of endogenous sex steroids on the GH-IGF-IGFBP axis during the ovulatory menstrual cycle in 10 healthy women (aged 18-40 years). Blood sampling and urinary collection was performed every morning at 0800 h for 32 consecutive days. Every second day the subjects were fasted overnight before blood sampling. Follicle stimulating hormone, luteinizing hormone (LH), oestradiol, progesterone, IGF-I, IGFBP-3, sex hormone-binding globulin, dihydroepiandrosterone sulphate and GH were determined in all samples, whereas insulin and IGFBP-1 were determined in fasted samples only. Serum IGF-I concentrations showed some fluctuation during the menstrual cycle, with significantly higher values in the luteal phase compared to the proliferative phase (P < 0.001). Mean individual variation in IGF-I concentrations throughout the menstrual cycle was 13.2% (SD 4.3; range 0.1-18.3%). There were no cyclic changes in IGFBP-3 serum concentrations and no differences in IGFBP-3 concentrations between the luteal and the proliferative phases. Mean individual variation in IGFBP- 3 concentrations throughout the menstrual cycle was 8.8% (SD 2.7; range 3.2-14.1). IGFBP-1 concentrations were inversely associated with insulin concentrations, and showed a significant pre-ovulatory increase that returned to baseline at the day of the LH surge. Fasting insulin concentrations showed large fluctuations throughout the menstrual cycle without any distinct cyclic pattern. No cyclic changes in urinary GH excretion during menstrual cycle were detected. We conclude that, although IGF-I concentrations are dependent on the phase of the menstrual cycle, the variation in IGF-I concentrations throughout the menstrual cycle is relatively small. Therefore, the menstrual cycle does not need to be considered when evaluating IGF-I or IGFBP-3 serum values in women suspected to have GH deficiency.