A 17-year-old with rash, fever, myalgias, and nephritis

Patients on hemodialysis are at increased risk for developing active tuberculosis (TB) after primary infection. Although this increased risk is well documented, the prevalence of TB infection, as indicated by a positive tuberculin skin test (TST), is not well described. End-stage renal disease is also known to be a risk factor for skin test anergy, but the rate of anergy in hemodialysis patients is unclear. We sought to identify rates of anergy and TST positivity in patients at four hemodialysis units in St Louis, Missouri, from June 1996 through August 1996. Data obtained from patients and medical records included age, years on hemodialysis, medical history, and basic laboratory data. Patients without a history of TB or a positive TST had a TST with Tubersol, as well as candida and tetanus controls, placed by the Mantoux method. Tests were read 48 hours later. Of the patients enrolled at these units, 307 of 331 (93%) were evaluated. Patients had a mean age of 58 years (range, 19 to 91 years) and had been on hemodialysis for a mean of 3.7 years (range, 1 week to 18.7 years). Blacks made up 81% of the population. A history of a positive TST was obtained from 24 patients (8%), and an additional seven (2%) had a history of active TB. Of the 276 patients tested, 93 did not respond to either control antigen, but five of these patients had a positive TST, leaving 88 (32%) anergic. Anergy was related to age, immunosuppressive drug use, and the reagents used, but not to urea reduction ratio. Positive TSTs were found in 17 of 188 of nonanergic patients (9%) (6% of all tested patients). Overall, 48 of 307 patients (16%) had a positive TST or history of TB. TB or a positive TST was associated with liver disease and peptic ulcer disease, but not socioeconomic status. All 17 newly identified TST-positive patients received chest radiographs. No new cases of active TB were found. Only two of 17 of these patients (12%) were started on isoniazid (INH) prophylaxis. We identified high rates of TST positivity and anergy in the hemodialysis patients tested. Hemodialysis patients should receive regular TST screening, and INH prophylaxis needs to be more strongly encouraged. Studies are ongoing to define the rate of TST conversion over time.     

Action of KI and several iodocompounds on [3H]uridine incorporation into thyroid RNA.

The present studies were performed in order to further clarify the action of iodine and iodocompounds on the incorporation of labelled uridine into thyroid RNA. KI decreased RNA labelling but did not alter total [3H]uridine uptake or [3H]inulin distribution space. KI also inhibited the increase in RNA labelling produced by 8 mM glucose. T4 was more potent on a molar basis than KI in impairing uridine incorporation. TETRAC, TRIAC and isopropyl-T3 also decreased RNA labelling, while T2 and isopropyl-T2 were ineffective. KI did not alter the distribution of the uridine derivatives, UMP, UDP and UTP, as determined by the distribution of [3H]uridine in these compounds by paper chromatography, suggesting that the action of KI does not take place at the step of uridine phosphorylation. Like its effect on TSH, KI also impairs the stimulatory effect of exogenous cAMP and cGMP on RNA labelling, suggesting that its action is exerted beyond the step of cyclic nucleotide formation. Iodine and iodocompounds may exert their inhibitory action on RNA labelling at the step of nucleotide polymerization.     

The role of reduced glutathione in thyroglobulin proteolysis iv vitro.

During the process of secretion of the thyroid hormones, stored thyroglobulin (Tg) is digested within the lysosomes. An acid protease has been found, but this enzyme hydrolyses Tg at a relatively slow rate and has a low pH optimum (3.6). Since previous work has shown a stimulatory effect of reduced glutathione (GSH) on Tg digestion the following studies have been performed. Homogenates were obtained from dog thyroid and total homogenate or different subcellular fractions were used as enzyme source. Labelled thyroglobulin (125-I) was purufied from prelabelled dog thyroid and its hydrolysis, judged from the increase in butanol soluble radioactivity, was studied. The greatest stimulatory effect of GSH on Tg hydrolysis was found around pH 5.6. When butanol soluble radioactivity was considered as a function of incubation time and tissue concentration a linear relationship was found. GSH effect was evident at 2 mM. Subcellular distribution studies showed that the GSH-stimulated proteolytic activity was mainly found in the 15 000 times g pellet. Labelled Tg hydrolysis was progressively decreased with increasing amounts of non-labelled purified Tg. GSH also stimulated labelled insulin hydrolysis, but failed to alter haemoglobin or casein degradation. GSH could also be replaced by other reducing agents, like cysteine or dithiothreitol. The significance of these findings is discussed in relation to the process of thyroid hormone secretion.     

Biosynthesis and regulation of iodolipids in calf thyroid

The incorporation of 125I into iodolipids was investigated in calf thyroid slices. Time course studies showed that the iodination of lipid reaches a plateau after 30 min of incubation. A highly significant correlation was found between iodination of lipid and of protein (r = 0.906), suggesting that both reactions may be related. Addition of PTU or MMI caused a significant inhibition of lipid iodination, indicating that a peroxidase could be involved in this reaction. The iodinated lipids are not attached to protein, since they migrated in BEA chromatography and pancreatin digestion of the samples did not modify the percentage radioactivity. The iodolipid fraction observed in BEA chromatography was eluted and analysed by TLC. Iodinated free fatty acids and neutral lipids comprised most of the radioactivity. Although iodolipids are present in every subcellular fraction, the 20 000 X g pellet had the greatest proportion of iodinated fatty acids and neutral lipids.     

The role of various hierarchic structures of the brain in psychoemotional stress

The hypothalamus is the brain structure the most involved in the formation of the stress reaction. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 121, No. 5, pp. 578–582, May, 1996