Metabolic effects of tumour necrosis factor alpha in NMRI mice

Following a single injection of 7.5 x 10(7) U kg-1 of human recombinant tumour necrosis factor-alpha (TNF-alpha) to female NMRI mice, marked hypoglycaemia was observed within a 2 h period, accompanied by a severe depletion of liver glycogen and a drop in rectal body temperature when compared with pair-fed controls. There was no alteration in plasma alanine, lactate or pyruvate values, but an elevation of acetoacetate and 3-hydroxybutyrate when compared with pair-fed controls. Production of 14CO2 from U-14C-glucose was reduced in TNF-alpha treated animals, while production of 14CO2 from U-14C-palmitate was not significantly different from controls, suggesting that the glucose was not being used to provide an increased metabolic rate. Glucose utilisation by different tissues was investigated by the 2-deoxyglucose tracer method. This showed that 2 h following TNF-alpha infusion glucose utilisation was increased in colon, liver, kidney and spleen by 500, 350, 36 and 25% respectively. However, when calculated on a whole-animal basis the major contributor to the increased glucose consumption was the liver. Plasma levels of both FFA and triglycerides were also elevated in TNF-alpha treated animals, suggesting that increased consumption of glucose by the liver may be utilised for lipogenesis. The rate of conversion of glucose into lipids in the liver was more than doubled 2 h after TNF-alpha administration with a concomitant rise in plasma and adipose tissue. These results suggest that administration of TNF-alpha produces a severe hypoglycaemia in order to serve an increased lipogenesis in liver and adipose tissue, which appears to be independent of the anorectic effect.     

Red cell aggregation and the echogenicity of whole blood.

To study the relationship between red cell aggregation and whole blood echogenicity, red cell aggregation was quantitated by a photometric method, whole blood echogenicity was quantitated by videodensitometry and sedimentation rate was quantitated by a modified Westergren method. Changes in red cell aggregation were produced by alterations in the hematocrit. The results showed that red cell aggregation increased in a linear fashion with increases in hematocrit. The sedimentation rate decreased in a linear manner with increases in hematocrit. Whole blood echogenicity showed a biphasic response, with an initial increase in echogenicity, peaking at hematocrits varying from 14-24% and decreasing thereafter. Over the physiologic range of hematocrits, an increase in the formation of red cell aggregates is associated with a decrease in the echogenicity of whole blood. Thus, red cell aggregates were not visible using our ultrasound equipment at physiologic hematocrits, and the echo contrast in blood under our experimental conditions at these hematocrits must represent either plasma spaces, platelet aggregates or possibly white cell aggregates. The association between spontaneous contrast and a propensity for thromboembolism imply that platelet aggregates are the most likely origin of in vivo echo contrast in flowing blood.     

Some personality characteristics of imprisoned heroin addicts

A group of 20 imprisoned heroin addicts was compared on 4 personality dimensions with a group of non-addict fellow prisoners and a group of normal controls. The 4 personality measures examined were level of self-esteem, perceived locus of control, tendency to self-deception and tendency to project a flattering self-image. The addict group was significantly lower in self-esteem and significantly less inclined to project a flattering self-image than the normal controls. However the addicts were similar to their fellow prisoners on all the psychological measures. The addict and non-addict prisoners were also similar in respect of various socioeconomic indices and criminal history. The belief that one could give up use of heroin without outside help was found to distinguish a subgroup of addicts who were at an earlier stage in the addiction process. However this subgroup did not differ from the more experienced addicts on the 4 psychological measures.     

Amnionicity and chorionicity in twin pregnancies: prediction using ultrasound

A total of 66 twin pregnancies was studied antenatally with ultrasound, followed up clinically, and the placentae examined pathologically to determine if, solely on the basis of antenatal sonography, an accurate assessment of amnionicity and chorionicity could be made. Sonographic features noted included number of placental sites, whether a membrane separating the fetuses could be visualized, fetal position and amount of amniotic fluid, and in some cases fetal positioning vis-a-vis each other and the uterine wall. Documentation of two placental sites confirms the presence of a dichorionic and, therefore, a diamniotic pregnancy. Documentation of a membrane separating the fetuses confirms the presence of a diamniotic pregnancy; lack of visualization of a separating membrane does not reliably predict, but does suggest, a monoamniotic pregnancy. Other features frequently assist in prediction of amnionicity, chorionicity, and zygosity; the most helpful of these was the "stuck twin" sign, in which one twin moved freely but the other remained in a fixed position adjacent to the sidewall of the uterus despite changes in maternal positioning, indicating the presence of a nonvisualized membrane. Presence of absence of entanglement or intermingling of fetal parts or umbilical cords may also be helpful. In the absence of such sonographic features, antenatal sonographic diagnosis of a monoamniotic pregnancy cannot be made reliably.     

Management and response to treatment of Helicobacter pylori gastritis.

Gastritis associated with Helicobacter pylori was present in gastric biopsies from 24/95 (25%) children and adolescents undergoing endoscopy for recurrent abdominal pain and upper gastrointestinal symptoms. H pylori associated gastritis occurred mainly in older children (8-16 years) and was significantly associated with low socioeconomic class and a family history of peptic ulcer disease. Antral nodularity was a common endoscopic finding in H pylori positive children. Eighteen children, all over 5 years of age, were treated with tripotassium dicitratobismuthate (De-Nol) for two months and ampicillin for two weeks. In 12 children follow up gastric biopsies were obtained six weeks after completion of treatment. In 9/12 (75%) children H pylori was eradicated, and gastritis improved.     

Low birth weight and preterm delivery in relation to early-gestation vaginal bleeding and elevated maternal serum alpha-fetoprotein.

OBJECTIVE: To determine whether early-gestation vaginal bleeding and elevated maternal serum alpha-fetoprotein (MSAFP) are independent risk factors for adverse infant outcomes. METHODS: We conducted a cohort study of 201 women with an elevated MSAFP (at least 2.0 multiples of the median [MOM]) and a second-trimester ultrasound evaluation at Swedish Hospital Medical Center between January 1989 and March 1991, and 211 women with MSAFP levels below 2.0 MOM who had also undergone ultrasound evaluations during the same period. RESULTS: Stratified analyses demonstrated that early-gestation bleeding and elevated MSAFP were independent risk factors for the delivery of both preterm and low birth weight infants. Compared with women with no history of early-gestation bleeding or elevated MSAFP, women with early-gestation bleeding alone had a relative risk (RR) of preterm delivery of 4.3 (95% confidence interval [CI] 1.5-12.1); non-bleeders with elevated MSAFP had an RR of 4.6 (95% CI 1.9-10.9). A combined history of early-gestation bleeding and elevated MSAFP was associated with an almost sixfold increased risk of preterm delivery (RR 5.8; 95% CI 2.2-15.6). Analyses restricted to women with normal-appearing appearing placentas by second-trimester ultrasound evaluations yielded similar results. CONCLUSIONS: These findings support an earlier report documenting the independence of early-gestation bleeding and elevated MSAFP as predictors of adverse infant outcomes.