Cardiac manifestations in mid-gut carcinoid disease

The extent of heart disease and its relationship to the serotoninmetabolite 5-hydroxyindoleacetic acid (5-HIAA), was studiedwith M-mode, 2D and Doppler echocardiography in 42 consecutivepatients, 30 females and 12 males, median age 63 (range 23–75)years with histologically verified mid-gut tumour, liver metastasesand 24-h urinary 5-HIAA excretion above 47 µmol. 24h^–1. All patients had normal left ventricular ejection fractions,median 65% (interquartile range (IQR) 54–74%). Moderateto severe tricuspid regurgitation (TR) was diagnosed in 22 patients(59%); mitral or aortic regurgitation was found in nine (24%)and six (16%) patients, respectively. The mitral flow peak early(E) on late (A) velocity ratio was significantly decreased comparedto age-matched normal subjects. The group of patients with 5-HIAAexcretion exceeding 1000µmol. 24h^–1 contained significantlymore patients with severe TR than those with a lower excretion. The decrease in the El A ratio may indicate reduced left ventricularcompliance, possibly secondary to fibrous changes similar tothose seen intra-abdominally and in the right side of the heart.As serotonin is degraded in the lung circulation, other mediatorssuch as tachykinins and cytokines (PDGF) may be involved.     

Toxicokinetics of Formate during Hemodialysis

ABSTRACT. During hemodialysis in a methanol poisoned patient, formate elimination followed first order kinetics with a plasma half-life of formate of 165 min. The mean dialysator (1.6 m²) clearance of formate was 148 ml/min (n=8, SD ± 11, range 128–161) at a blood flow of 215 ml/min. By applying first order kinetics, a volume of distribution of 0.5 l/kg was found, assuming that the dialysator clearance equals the total body clearance of formate. Formate, the main toxic agent in methanol poisoning, is thus probably more effectively removed by hemodialysis than methanol. This fact, and the very slow endogenous methanol elimination during appropriate ethanol treatment, should be considered when deciding on the treatment of a methanol poisoned patient presenting with metabolic acidosis.     

Effect of repetitive exposures to gamma rays on the hematopoietic system of the rat

Rats were subjected to a series of one or more doses of 75 r gamma irradiation, at seven day intervals between exposures. Hematologic examinations weremade following the last exposure in each series of irradiations. The maximumchanges observed were, to a great extent, independent of the number of previous exposures, and appeared to reflect principally the effects of the lastirradiation. These results were ascribed to the regenerative capacity of the hematopoietic system to recover during the seven day interval between radiationexposures.

Submitted on February 10, 1955 Accepted on March 5, 1955     

COMBINED TEST OF HYPOTHALAMIC-PITUITARY FUNCTION IN GROWTH-RETARDED CHILDREN TREATED WITH GROWTH HORMONE: II. Secretion of LH, FSH, TSH, Prolactin and ACTH

Abstract. P. C. Eskildsen, B. B. Jacobsen, K. W. Kastrup, S. Krabbe, P. E. Lebech and K. E. Petersen (The Children's Hospital Fuglebakken, Herlev Hospital and Frederiksberg Hospital, Copenhagen, Denmark). Combined test of hypothalamic-pituitary function in growth-retarded children treated with growth hormone. Acta Paediatr Scand, Suppl. 277: 14, 1979.—A total number of 23 patients treated with human growth hormone were retested by use of a combined pituitary stimulation test. Plasma concentrations of GH, FSH, LH, TSH, T₄, T₃, prolactin (PRL), ACTH and cortisol were measured before and after stimulation with hypoglycemia, TRH and LHRH. The test was performed in patients with persistent GH deficiency (group A) and patients with transitory GH deficiency (group B). In group A a normal pubertal development was found in three patients, whereas in prepubertal subjects the FSH/LH responses were smaller than those of prepubertal patients in group B. Also plasma ACTH increase was less pronounced in group A patients than in group B. In contrast, the plasma TSH and PRL responses were more sustained in group A than in group B. The secretory pattern of TSH and PRL was comparable in the two groups of patients. Thus, in patients with persistent GH deficiency additional multiple disturbances of the hypothalamic-pituitary function often appeared whereas in most patients with transitory GH deficiency the combined pituitary test was normal at the reinvestigation.     

SERUM CONCENTRATIONS OF THYROXINE-BINDING GLOBULIN, PREALBUMIN AND ALBUMIN IN HEALTHY FULLTERM, SMALL-FOR-GESTATIONAL AGE AND PRETERM NEWBORN INFANTS

Abstract. Jacobsen, B. B., Peitersen, B., Andersen, H. J. and Hummer, L. (The University Clinic of Paediatrics, Children's Hospital Fuglebakken and the Departments of Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark). Serum concentrations of thyroxine-binding globulin, prealbumin and albumin in healthy fullterm, small-for-gestational age and preterm newborn infants. Acta Paediatr Scand, 68: 49, 1979.—Simultaneous serum concentrations of thyroxine-binding globulin (TBG), prealbumin (TBPA) and albumin (Alb) were measured in 130 fullterm, 32 small-for-gestational age and 25 preterm infants during their first six days of life. In all infants serum concentrations of TBG were higher and serum TBPA and Alb were lower than in male adults. Even higher serum TBG levels wer found in the mothers. There was no correlation between serum concentrations in paired maternal and cord sera. In infants with birth weights appropriate for gestation serum TBG, TBPA, and Alb concentrations increased progressively with gestational age. In small-for-gestational age infants born at term serum concentrations of TBG and Alb were lower than those in full-term, but higher than those in premature newborns. Serum TBPA in small-for-gestational age babies was evne lower than seen in prematures. A positive correlation was found between thyroid hormones and TBG concentrations, not between serum TBPA and thyroid hormones. The ratios between serum concentration of thyroid hormones and proteins might indicate that more thyroid hormonebinding sites are occupied in fullterm than in low birth-weight newborns. However, the main reason for the different serum levels of thyroid hormones in fullterm, small-for-gestational age and preterm babies is probably the various serum TBG concentrations demonstrated in these infants.