Doctors'' characteristics do not predict long-term glycaemic control in type 2 diabetic patients.

Glycaemic control in type 2 diabetic patients varies widely between general practitioners (GPs). To increase our understanding of this variation, linear random effects models were used to examine the predictive value of GP characteristics on the course of annual HbA1c measurements, in 688 newly diagnosed type 2 diabetic patients between one and five years after diabetes diagnosis. We found that characteristics of centrally supported GPs, such as interest in diabetes, experience, practice type, list size, and weekly working hours, did not predict their patients' glycaemic control.     

A comparison between LCM virus-specific secondary cytotoxic T lymphocytes generated by Con A and by the homologous antigen.

An investigation was made of the properties of cytotoxic T cells induced by Con A and exposure to LCM virus-infected cells. As a basis for such studies, the optimal conditions for in vitro Con A stimulation of in vivo LCM virus-primed C3H mouse splenocytes were determined. The most potent cytotoxicity was obtained when responder cells were cultured in the presence of Con A in a concentration of 2 micrograms/ml for 3 days, but strong cytotoxicity was also measured on days 2 and 4. When stimulation was performed by the homologous antigen maximal response was seen on day 4 although marked cytotoxicity was also noted on day 3. Effector cells produced by the two different procedures showed equally high degrees of cytotoxicity against LCM virus-infected target cells, whereas they did not appear cytotoxic against non-infected targets. If LCM virus-immune mice were treated intravenously with 280 micrograms of Con A per animal, moderate cytotoxicity was demonstrable in splenocytes from these mice 1, 2 and 3 days after treatment. The in vitro generation of secondary cytotoxicity by Con A as well as by the homologous antigen was found to be totally dependent on DNA synthesis. The reactivated cells were investigated for in vivo anti-viral effect by measuring their ability to protect intracerebrally LCM virus-infected mice from a fatal outcome of this infection. LCM virus-primed splenocytes stimulated by the homologous antigen caused complete protection, while Con A-reactivated cells did not protect at all. Secondary cytotoxic cells stimulated by Con A and by LCM virus showed fairly similar in vitro characteristics, but fundamentally different in vivo qualities.     

Soluble urokinase plasminogen activator receptor during allogeneic stem cell transplantation

Previous studies have found that soluble urokinase plasminogen activation receptor (suPAR) increases during inflammatory and malignant illness and elevated suPAR levels may be associated with poor clinical outcome. The purpose of this study was to investigate plasma levels of suPAR during the course of allogeneic stem cell transplantation (SCT). Twenty SCT patients were included in the study. suPAR was measured by ELISA in daily taken plasma samples during the pretransplant conditioning with chemotherapy and weekly for 1 month after infusion of the graft. suPAR levels before the start of the conditioning were significantly elevated when compared to those of healthy controls. During the conditioning in particular treatment with antithymocyte globulin was associated with significantly increased suPAR levels (P = 0.012). At day +7 after infusion of the graft, suPAR levels had decreased to pretreatment levels. High suPAR levels at day 0 were associated with increased mortality (P = 0.011). The present study found increased suPAR levels during the conditioning in SCT patients. Further, the data indicated that increased suPAR levels may be associated with increased mortality, suggesting suPAR as a candidate for further studies as an outcome predictor in SCT.     

Distribution of whaleworm (Anisakis simplex,Nematoda, Ascaridoidea) L3 larvae in three species of marine fish; saithe (Pollachius virens (L.)), cod (Gadus morhua L.) and redfish (Sebastes marinus (L.)) from Norwegian waters

The frequency distribution of Anisakis simplex L3 larvae between host tissues was investigated in three host species: saithe, cod and redfish. Fish were sampled from Norwegian coastal waters and examined for the presence of A. simplex in muscle and viscera. In all three of the host species, A. simplex larvae were most frequently detected in the viscera; the percentages of total infection for saithe, cod and redfish were 99.6%, 97.8% and 88.0%, respectively. In general, the distribution patterns of A. simplex L3 between muscle and viscera were not significantly affected by host size. The observations that distributions vary between species and are not affected by host size do not support an earlier hypothesis which states that A. simplex L3 distributions are determined by an optimal pre-encapsulation migratory distance within host tissues. In contrast, it is suggested that A. simplex L3 distributions are governed by the conditions encountered within host tissues, and are possibly related to the availability of nutrients. Received: 9 July 1997 / Accepted: 15 September 1997     

Seven week culture of functional human mast cells from buffy coat preparations

Functional, mature human mast cells have been generated by in vitro differentiation of CD133(+)/CD34(+) progenitor cells isolated from e.g. cord blood, peripheral blood, bone marrow or fetal liver. However, the protocols published so far require long term cultivation, i.e. up to 15 weeks for mast cell differentiation, which makes such approaches not only laborious but also costly. Here, we have developed a protocol for generating functional human mast cells from peripheral blood already within 7 weeks. Human CD133(+) progenitors were isolated from buffy coat preparations of peripheral blood and cultured in the presence of stem cell factor (SCF) and IL-6 for 7 weeks. IL-3 was added to the culture medium during the first 3 weeks, and fetal calf serum (FCS) added during the last week. In vitro differentiated CD133(+) cells exhibited multiple characteristics of mature mast cells. Thus, cells contained tryptase and expressed functional levels of FcepsilonRI. Anti-IgE stimulation induced significant release of histamine and PGD(2) and also of chemokines including MCP-1, IL-8, MIP-1alpha, and MIP-1beta. The fact that our in vitro differentiated mast cells are derived from a generally available source of progenitor cells makes this novel protocol widely applicable to any patient group, irrespective of age. Moreover, this progenitor source is more readily available than e.g. bone marrow or cord blood-derived progenitors. Consequently, our protocol has great potential in studies on mast cell biology and mast cell pathology, and e.g. on evaluation of drug effects.     

Paediatric outcomes following intrauterine exposure to serotonin reuptake inhibitors: a systematic review

The use of serotonine reuptake inhibitors (SRIs) is increasing among Danish pregnant women. This systematic review addresses the potential adverse effects on the foetus and child of maternal SRI medication. The literature indicates a slightly increased risk of cardiovascular malformations and persistent pulmonary hypertension of the new-born, while evidence regarding the risk of preterm labour, low birth weight, low Apgar score, prolonged QT interval and miscarriage is less clear. An estimated 20-30% of infants will have neonatal symptoms following intrauterine SRI exposure. The symptoms may be caused by SRI withdrawal, toxicity or their overlap, but symptom aetiology basically remains controversial. The infants may exhibit neurological, gastrointestinal, autonomic, endocrine or respiratory symptoms. Although the symptoms are self-limited, the families may be seriously affected. In general, studies do not address this important aspect. Evidence concerning long-term effects is surprisingly sparse and many studies have important methodological limitations. However, present evidence does not convincingly indicate detrimental long-term effects. Until sufficient safety studies have been carried out, SRI must be used with caution in pregnancy and every treatment of the pregnant woman should be thoroughly considered.