Elderly Patients with Suppressed Serum TSH but Normal Free Thyroid Hormone Levels Usually Have Mild Thyroid Overactivity and are at Increased Risk of Developing Overt Hyperthyroidism

The clinical and biochemical characteristics of 15 elderly patientswith low levels of thyrotrophin (TSH) (<0.1 mU/L) but normalfree tri-iodothyronine, (T3) and free thyroxine (T4) (groupS) were compared with 10 euthyroid subjects (group E) and 10hyperthyroid patients (group T). Free T3 and free T4 were significantlyhigher (p<0.05) in group S(6.3±0.5 and 18.6±1.0pmol/l, respectively) than in group E(4.6±0.3, 12.6+0.6).In common with elderly hyperthyroid patients (group T)patientsin group S had few signs or symptoms of thyrotoxocosis, butthe Wayne score (clinical index of hyperthyroidism) was higherin group S than in euthyroid subjects (p<0.05). Thyroid microsomal,thyrogolobulin or thyrotrophin receptor antibodies were commonin group T (n=9)but not in groups S(n=2) or E(n=1). This suggestsa low prevalence of Graves' disease in group S compared to groupT. Combined thyrotrophin releasing hormone (TRH; 200 µgi.v.) and gonadotrophin releasing hormone GnRH; 100 µgi.v.) tests were performed; no cases of low TSH due to hypopituitarismwere identified in group S. During a mean of 7.9 (4–12)months of observation TSH reverted to the normal range (>0.2mU/L)in 7 of 15 patients in group S; thyroid hormone concentrationsrose above the normal range in four, however, only two patientsrequired treatment for hyperthyroidism. It is unlikely thatthe suppressed TSH of patients in group S was due to mild thyroidhormone excess; although this is often a transitory phenomenon,these patients are at increased risk of developing overt hyperthyroidism.     

马兜铃酸的倍半萜的酯类化合物VI.绵毛马兜铃中马兜铃酸萜酯I的结构鉴定

从绵毛马兜铃(Aristolocha mannisima Hance)中分得一个马兜铃酸倍半萜的酯类化合物,经红外、紫外、高分辩质谱和多种一维和二维核磁共振谱鉴定,确定了其骨架结构及顺反构型,命名为马兜铃酸萜酯I。     

Composition of human plaque fluid

The composition of pooled resting plaque fluid was determined in four groups of college-age students (18-22 years), each composed of 50 individuals, who abstained from oral hygiene for 36 hours and did not eat or drink for at least one hour prior to plaque collection. Plaque samples from each group were pooled under mineral oil in small centrifuge tubes and centrifuged at 37,000 g for one hour at 4 degrees C. Supernatants were then combined under mineral oil and centrifuged at 5000 g (4 degrees C) for 15 minutes. In general, the inorganic composition of plaque fluid in the four groups was quite similar and in agreement with values reported by other investigators, but quite different from those of saliva or serum. The mean composition was: Ca, 7.07 +/- 0.51 mmol/L; P, 23.2 +/- 5.3 mmol/L; Na, 18.6 +/- 2 mmol/L; K, 85.1 +/- 5.3 mmol/L; Mg, 3.9 mmol/L; Cl, 42.8 +/- 9 mmol/L; F, approximately 0.004 mmol/L; pH, 5.69 (5.63-6.01). Acetate, propionate, succinate, butyrate, lactate, and formate were determined in two samples analyzed, with acetate and propionate being the predominant acids found. It was also demonstrated, through the titration of one of the plaque fluid samples, that the observed buffer capacity in plaque fluid was mostly related to its organic acid composition. It was noted, however, that when the initial pH in plaque fluid exceeded 6.5, phosphate contributed significantly to the buffer capacity. The contribution of other soluble species (proteins, peptides, amino acids) to the observed buffering in plaque fluid appeared to be small.(ABSTRACT TRUNCATED AT 250 WORDS)     

Palindromic rheumatism: an allergic manifestation?

A case of palindromic rheumatism is presented in which the arthritic attacks usually were accompanied by an allergic vasculitis and dermatitis. Although this is not proof of the etiology, the constant association is suggestive of an allergic cause. A brief review of palindromic rheumatism in included.