Fructosamine and glycated haemoglobin in the assessment of long term glycaemic control in diabetes

Fructosamine and glycated haemoglobin were measured simultaneously in 147 children with diabetes. If glycated haemoglobin is considered as the 'gold standard' for long term glycaemic control, then fructosamine is a poor indicator of actual glycated haemoglobin values, with wide 95% confidence (fiducial) limits. This shows that it is impossible to accurately predict glycated haemoglobin concentrations and therefore, by implication, longer term glycaemic control, from measurements of fructosamine. As the major studies on the prevention of microvascular complications in diabetes have used glycated haemoglobin levels to assess glycaemic control, it is suggested that this measurement should be used in all children with diabetes in preference to the measurement of fructosamine.     

Interactive MR-guided biopsies of the thyroid gland: validation of a new method

The aim of this study was to demonstrate the clinical feasibility and utility of an interactive MR-guidance system to target and biopsy thyroid lesions, and to compare resolution between ultrasound and interventional MR imaging in the evaluation of thyroid lesions. Twenty thyroid lesions of 18 patients were interactively biopsied using a 0.5-T superconducting open magnet system. Stereotactic localization of the needle and imaging was accomplished using T1-weighted gradient-recalled-echo (GRE) images. Representative cytological material was retrieved in 16 of 20 lesions (benign cystic or colloid goiter: n = 14; one de Quervain's thyroiditis and one follicular neoplasia). Lesions smaller than 1.5 cm detected by ultrasound could not be visualized adequately on GRE images. Lesions smaller than 1.5 cm were successfully biopsied by ultrasound (three colloid and haemorrhagic goiters and one adenoma). Magnetic-resonance-guided interactive biopsies and positioning of non-ferromagnetic needles in the thyroid gland are technically feasible and safe. Compared with high-resolution ultrasound, lesions larger than 1.5 cm can be adequately visualized and biopsied. Magnetic-resonance-guided placement of non-ferromagnetic needles is no substitute for high-resolution ultrasound in clinical work-up of thyroid lesions. Received 1 December 1997; Revised 3 February 1998; Accepted 4 February 1998     

Monoclonal Antibody Prophylaxis Against the in Vivo Toxicity of Ricin in Mice

A BALB/c murine IgG₁ monoclonal antibody, designated BG11-G2, specific for ricin was generated. BG11-G2 antibody did not bind to either purified ricin chain A or chain B, but recognized an antigenic determinant whose conformation requires the combination of the two chains in the formation of the native ricin molecule. It did not react with the protein synthesis inhibitor, T-2 mycotoxin, or with the sodium channel blockers, saxitoxin and tetrodotoxin. As little as 0.78 μg/ml of BG11-G2 IgG₁ anti-ricin monoclonal antibody completely protected against the in vitro toxicity of ricin as determined by [³H]leucine uptake in EL-4 cell assays. Passive intraperitoneal infusion of purified BG11-G2 antibody into BALB/c mice one day prior to a lethal challenge with ricin considerably delayed the onset of toxicity and death. Better protection was obtained with BG11-G2 infused before and after ricin challenge.     

Comparative studies on the properdine level in the blood of two groups of students of moderate and increased muscular activity

Summary A comparison of the properdine level in two groups of students with moderate and increased muscular activity showed a rise of the properdine level by 27 to 30% in the blood of the students with increased muscular activity.

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Zusammenfassung Ein Vergleich des Properdinspiegels von zwei Gruppen Jugendlicher mit geringer und größerer körperlicher Aktivität ergab, daß in dem Blut der Studenten mit stärkerer körperlicher Aktivität um 27 bis 30% mehr Properdin enthalten war.

     

Infectious disease: changing antibiotic susceptibility

The field of ophthalmology is fortunate to have an array of antibiotics to treat bacterial infections. Because many of the older antibiotics are no longer useful for treating systemic infections, their use and associated acquired resistance have been reduced. These antibiotics, therefore, likely will continue to be effective for treating ophthalmic infections. The bacteria that cause recurrent infections (e.g., blepharitis) may acquire antibiotic resistance because of the repeated use of one particular agent for therapy (e.g., erythromycin). Recurrent pathologies and those that are treated with antibiotics that have varied broadspectrum activities should be cultured routinely to confirm infection and to institute appropriate therapy. Resistant trends of Staphylococcus aureus to the second-generation fluoroquinolones have been confirmed, and new trends of resistance for Pseudomonas aeruginosa have emerged. These antibiotics are effective but should be used judiciously to avoid bacterial resistance to them and to ensure their future potency.     

The experimental reconstruction of articular cartilage using autogenous periosteal and perichondreal implants

Injured cartilage has a limited capacity to heal itself. Untreated damage leads to secondary osteoarthritis. There is a need to find a way to reconstruct cartilage in order to prevent secondary osteoarthritis. The aim this study was to evaluate and compare the chondrogenic potential of three different cell materials: perichonrdrial grafts, periosteal grafts and bone marrow in situ. The mesenchemal cells contained in these materials can differentiate in the joint environment into chondrocytes and rebuild articular cartilage.
Forty nine (49) White New Zealand rabbits were used in our experiment. An osteochondrial (full-thickness) defect was created in the joint surface of both ends of the femoral bone. The animals were divided according to the procedure used:
I - cartilage reconstruction by periosteal grat,
II - cartilage reconstruction by perichondrial graft,
III - no graft.
The joint was not immobilized after surgery. Follow-up exams were performed at 4, 8, and 12 weeks. The results were evaluated macroscopically and microscopically.
The results pointed to the chondrogenic potential of periosteum and perichondrium after grafting to cartilage defects. On gross examination the articular surface was found to be reconstructed. Microscopic examination revealed regeneration, with the formation of hyaline-like cartilage. Regenerating tissue was also found in the group without grafts. The structure resembled normal articular cartilage; however, neither the joint surface nor the subchondrial bone were fully reconstructed. No qualitative or quantitative differences were found between the groups treated with periosteal and perichondral grafts.
Our study confirmed that grafts of periosteum or perichondrium have chondrogenic potential, i.e. the ability to generate cartilage tissue whose features are similar to those of the hyaline chondrial tissue in the joint. Both materials have similar chondrogenic potential. The chondrogenic properties of perichondrium and perisostem produce better results in the various categories in comparison to those of bone marrow.