Clinical applicability of an amino-terminal radioimmunoassay for determination of parathyroid hormone

With a radioimmunoassay using hPTH 1-34 for antibody production, for radioiodination and as a standard, hPTH 1-34 was detectable (detection limit 40 pg/ml) preoperatively in peripheral blood in 14 of 29 patients with hyperparathyroidism, but in no controls. In all patients with parathyroid adenoma and detectable hPTH 1-34 preoperatively, the values fell after parathyroid surgery. Contrastingly, three of four patients with diffuse parathyroid hyperplasia and two of three with normal parathyroid glands showed a rise in hPTH 1-34 postoperatively, which was concomitant with very low serum calcium levels. In studies of hPTH 1-34 in central venous blood (3 patients), levels were detectable in all samples, but not in simultaneously drawn peripheral blood. Values for hPTh 1-34 in central blood correlated to PTH determined from a bovine assay, but the peripheral samples showed no correlation. The low levels of circulating N-terminal immunoreactivity in peripheral blood make this assay inapplicable for routine diagnostic purposes. These low levels are due not only to low secretion rates, but also to rapid peripheral metabolization.     

The early introduction of HIV infection among Norwegians at highest risk

Patients with acute hepatitis B and hepatitis non-A non-B-like illness seen between 1981 and 1984 were chosen for the study of the introduction of HIV among persons at highest risk for HIV infection in Norway. HIV was introduced into these risk groups in 1982, but the prevalence of HIV seropositivity increased only slightly during the following 2 years.     

哮喘患儿血清嗜酸细胞阳离子蛋白的临床观察

目的：探讨嗜酸细胞阳离子蛋白（ＥＣＰ）在小儿哮喘病的临床意义。方法：用荧光酶联免疫法测定哮喘发作期、缓解期及肺炎患儿与正常儿童血清ＥＣＰ浓度。同时检测最高呼气峰流速（ＰＥＦ）及外周血嗜酸粒细胞（Ｅｏｓ）计数。结果：哮喘发作组血清ＥＣＰ明显高于哮喘缓解组、肺炎组及正常对照组；ＥＣＰ与Ｅｏｓ之比值与ＰＥＦ呈负相关。结论：血清ＥＣＰ测定可反映小儿哮喘支气管粘膜炎症情况，对指导临床诊断、治疗有重要参考价值。     

Antibiotic sensitivity of isolates from nosocomial and community-acquired urinary tract infections

This report presents the results of antibiotic sensitivity testing of 1,534 urinary tract isolates obtained from hospitalized patients during a twelve-month period. In vitro sensitivities demonstrated that gentamicin was the most effective antibiotic, followed by chloramphenicol and nalidixic acid. Fifty-nine to 61 per cent of the isolates were sensitive to colistin, kanamycin, cephalosporin, and nitrofurantoin. Fewer than half were sensitive to ampicillin, streptomycin, and tetracycline. Bacterial isolates from women with urinary tract infection were significantly more sensitive than those from men. In addition, isolates from community-acquired infections were more sensitive than those of nosocomial origin. This difference in sensitivity suggests the presence of a more antibiotic-resistant hospital flora for the major types of organism.     

Infections in patients treated with high-dose chemotherapy for germ cell tumours

25 patients with disseminated germ cell tumours were treated with high-dose cisplatin and etoposide (40 mg/m² and 200 mg/m² daily × five, respectively) leading to severe myelosuppression. A comprehensive study was undertaken in order to identify and describe the bacterial, viral and fungal infections in this group of patients. Fever (> 38.5°C) and leucopenia (white blood cell count < 1.0 × 10⁹/l) were observed in 61 of 90 treatment cycles (68%). A microbiological aetiology compatible with the clinical manifestations of infection could be identified in 33 of the 61 febrile episodes (54%). Bacteraemia occurred in 14 episodes in 12 patients. Eight episodes (57%) involved gram-positive aerobic bacteria.     

Rapid elimination by glomerular filtration of free prostate specific antigen and human kallikrein 2 after renal transplantation

PURPOSE: The low molecular mass and short half-life of free (f) prostate specific antigen (PSA) implies elimination from blood by glomerular filtration. In addition, patients with terminal renal failure have increased fPSA in serum but there have been sparse data reported on the rates and pathways of elimination of PSA complexes and human kallikrein 2 (hK2). We studied glomerular filtration dependent elimination of fPSA and hK2 in patients with renal insufficiency undergoing successful renal transplantation. MATERIALS AND METHODS: We studied 14 patients with immediate onset of renal function after renal transplantation. Blood samples were obtained before and at regular intervals up to 160 hours after transplanted kidney reperfusion. Measurements of fPSA, total PSA and hK2 were performed with immunofluorometric assays and complexed PSA was determined by a chemiluminiscence assay. Glomerular filtration rates were monitored by analyzing serum creatinine and cystatin C. NONMEM, a multivariate pharmacokinetic approach, was used to determine the elimination rates of fPSA and hK2 after renal transplantation. RESULTS: Serum fPSA and hK2 but not PSA complexes, decreased rapidly after renal transplantation. Significant reductions in fPSA and hK2 were observed after only 16 and 8 hours, respectively. fPSA and hK2 showed similar elimination patterns, decreasing to 42% and 44% of their original levels compared to cystatin C, which was at 44% after 160 hours. The median half-lives of fPSA and hK2 were 17.4 and 11.5 hours, respectively. CONCLUSIONS: These results verify the hypothesis that fPSA and hK2 are eliminated from the blood circulation by glomerular filtration and severe renal failure influences the levels of the 2 proteins in serum.