Complement Components in Normal Serum and Plasma Quantitated by Electroimmunoassay

The concentrations of Clq, Cls, C3, C4, C5, C3 proactivator, and Cl? inactivator in serum and EDTA plasma from 100 normal adults were determined by electroimmunoassay. The normal range of each of the proteins is given. The Clq values varied more closely with the Cls values than with the levels of the other complement components. C3, C5, and C3 proactivator seemed to form a fairly interdependent group. The reproducibility of double determinations (interplate variation) was 4.9% to 7.9%. The variation of the complement component levels on repeated sampling from normal individuals was investigated. Also, repeated freezing and thawing and storage at room temperature of serum and plasma were studied for their effect on the quantitation of the complement components. C3 and C4 values obtained by electroimmunoassay were in agreement with the values obtained by single radial immunodiffusion.     

Gamma 2-MSH in congestive heart failure: relation to atrial natriuretic peptide, arginine vasopressin and catecholamines

A possible role of the proopiomelanocortin derived peptide gamma 2-melanocyte stimulating hormone (gamma 2-MSH) has been studied in patients with various degrees of congestive heart failure (CHF). The profile of changes in circulating levels of gamma 2-MSH-like immunoreactivity (-LI) has been compared with those of atrial natriuretic peptide (ANP)-LI, arginine vasopressin (AVP)-LI and catecholamines in CHF. Patients with moderate CHF (New York Heart Association stages I-II) showed significantly higher levels of h-alpha ANP-LI and NA (P less than 0.05) compared to controls. Patients with severe CHF (stages III-IV) had significantly higher levels of all hormones measured compared to controls: noradrenaline, P less than 0.001; adrenaline, P less than 0.001; gamma 2-MSH-LI, P less than 0.001; h-alpha ANP-LI, P less than 0.05; AVP-LI, P less than 0.01. For the catecholamines and gamma 2-MSH-LI there was a significant increase from moderate to severe forms of CHF. A significant correlation was observed between gamma 2-MSH-LI and noradrenaline, and between h-alpha ANP-LI and noradrenaline in patients with CHF. The present results show that gamma 2-MSH-LI is increased only in severe forms of cardiac failure, and that this change is more closely related to the increase in circulating levels of noradrenaline than to increased levels of ANP-LI or AVP-LI.     

Expression and Signal Transduction of T-Cell Antigen Receptor (TCR)/CD3 Complexes on Fresh or In Vitro Expanded T Lymphocytes from Patients with Hodgkin's and Non-Hodgkin's Lymphomas

T-cell responses against soluble antigens, alloantigens and mitogens are frequently diminished in patients with certain types of cancer. In the present study, the authors investigated possible mechanisms for the partial T-cell immunodeficiency in patients with Hodgkin's or non-Hodgkin's lymphomas. It was found that T-cells from lymphoma patients had significantly reduced proliferative responses to EBV-transformed B-cell lines and to anti-TCR/CD3 MoAb; a 30–50% reduction of cells expressing membrane T-cell receptor (TCR) complexes; and a significantly reduced signal transduction function. Long-term in vitro culture conditions were developed to expand T cells in TCR/CD3-dependent or TCR/CD3-independent manners. With such methods, it was found that the decreased T-cell responses in patients with Hodgkin's and non-Hodgkin's lymphomas appeared to be an intrinsic T-cell defect (not at the antigen presenting cell level), and the T-cell responses could be recovered after only a few days in culture. Thus, it is suggested that the T-cell response–defect in Hodgkin or non-Hodgkin lymphoma patients is a reversible phenomenon, dependent on the patient's tumour-bearing environment.     

Increased insulin resistance and fat cell lipolysis in obese but not lean women with a high waist/hip ratio

Increased lipolysis in abdominal adipocytes has been suggested to be of importance for the insulin resistance typical for abdominal obesity. In order to differentiate between fat distribution, measured as waist/hip ratio (WHR), and amount of body fat, glucose disposal during a euglycaemic clamp as well as lipolysis in isolated cells from abdominal and gluteo-femoral regions were studied in 20 obese and 20 lean postmenopausal women with a high (n = 10) and low (n = 10) WHR, respectively. The lipolytic response was increased in cells from obese women irrespective of region. Furthermore, lipolysis was enhanced in abdominal compared with the gluteo-femoral cells in obese women with a high WHR. Fasting blood glucose and insulin were increased in both groups of obese women while the degree of insulin resistance was most pronounced in the obese women with a high WHR. It is concluded that increased body fat is associated with both insulin resistance and increased lipolysis, and that this relationship is stronger in the presence of a high WHR. A high WHR may increase the expression of obesity as a risk for insulin resistance and this may be mediated through an increased lipolytic rate.     

Low-dose warfarin decreases coagulability without affecting prothrombin complex activity

Abstract. Objectives. To asses the efficacy of a fixed, low dose of warfarin in lowering factor VII coagulant activity (FVII: C) and to investigate the effects on the plasma coagulation cascade. Design. An open pilot study with two dose levels of warfarin: 1.25 and 2.5 mg day^?1 during two consecutive 4-week periods. All subjects received aspirin 75 mg day^?1. Prothrombin fragment 1 + 2 (F_{(1 + 2)}), protein C, protein S, FVII:C, factor X and P-prothrombin complex activity (P-PT) were measured at baseline, at 2-week intervals and 4 weeks after end of treatment. Coagulation activation peptide F_{(1 + 2)} was used as a marker of thrombin formation [13]. Subjects. Twelve male patients with a history of myocardial infarction. Inclusion was made through a written questionnaire. Results. Warfarin 1.25 mg day^?1 lowered FVII:C from 113 U dl^?1 to 107 U dl^?1 (P = 0.025) and F_{(1 + 2)} from 1.60 nmol l^?1 to 1.27 nmol l^?1 (P = 0.013) but had no effect on protein C or P-PT. A dose of 2.5 mg day^?1 induced further lowering of FVII:C (91 U dl^?1, P = 0.0042), and also of protein C from 116% to 99% (P = 0.034) and P-PT from 107% to 81% (P = 0.0096) mean values. Conclusion. Warfarin 1.25 mg day^?1 seems to exert an anticoagulant effect without reduction in PT or the natural anticoagulant protein C and is suggested, in combination with aspirin, to be a safe and simple therapy against arterial thrombotic disease, making regular PT controls unnecessary.     

The medical hierarchy and perceived influence on technical and ethical decisions

Abstract. Objective. To investigate the influence of hierarchial position and perceived influence on ethical and technical decisions. Design. The study was conducted as a postal questionnaire survey. Subjects. A random sample of 329 Danish physicians working at departments of internal medicine and related subspecialties. Of these, 270 (82%) returned a completed questionnaire. Main outcome measure. Self-reported perceived influence in discussions about technical and ethical issues in connection with decisions to terminate treatment for patients with terminal malignant illness. Results. The odds ratio for perceived influence between consultants and house officers is 14.9 for ethical issues, 44.9 for technical issues, and 652.3 for questions concerning departmental policy. Gender plays no role, when one controls for hierarchial position. Conclusions. Hierarchial position is the major determinant of perceived influence on technical and ethical decisions. Position seem to play a larger role in technical than in ethical decisions.