Tumor Markers in Colorectal Carcinoma An Evaluation of Carcinoembryonic Antigen, Tissue Polypeptide Antigen, Placental Alkaline Phosphatase and Pseudouridine

The biologic markers carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), placental alkaline phosphatase (PLAP) and pseudouridine were analysed in 37 patients with colorectal carcinoma. CEA, TPA and PLAP were derived from the serum and pseudouridine from the urine. The incidence of all four markers increased with advancing stages of the disease. Patients with distant metastases had elevated levels of CEA, TPA, PLAP and pseudouridine in 85, 27, 18 and 33 per cent of the total cases, respectively. When survival was compared, patients with 2 to 4 elevated markers had shorter survival than those with none or only one elevated marker.     

Methionine sulfoximine prevents the accumulation of large neutral amino acids in brain of hyperammonemic rats

Accumulation of neutral amino acids in the brain due to altered transport across the blood-brain barrier appears to be a consequence of portal-systemic shunting and hyperammonemia. It has been suggested that high brain concentrations of glutamine, a product of cerebral ammonia detoxification, accelerates the transport of other neutral amino acids from blood to brain. To test this hypothesis, normal rats were infused with ammonium salts with or without pretreatment with L-methionine-dl-sulfoximine (MSO), an inhibitor of glutamine synthesis. Pretreatment with MSO prevented most ammonium salt-induced changes in the concentrations of the neutral amino acids in brain, suggesting that hyperammonemia alters the transport of neutral amino acids across the blood-brain barrier by causing the brain glutamine level to rise.     

Nutritional status and measles: a community study in Guinea-Bissau

In an urban settlement area with 6217 inhabitants, 1188 children of 0-71 months of age were weighed and measured in December 1978. Fourteen per cent of those more than nine months old were underweight for age. In February 1979 a measles epidemic started in the area and reached its peak in April. At least 236 of the children initially weighed caught the disease and 59 died of measles. Forty-nine of these had not been underweight in December 1978. In the age interval 9-35 months there was a tendency for measles death to be associated with a relatively low nutritional status. In a geographically-defined sub-population of the studied children, mean weight velocity from December to May was lower in those who had measles in the period than in those who did not contract it. The observations confirm the negative impact of measles on nutritional status. On the other hand, they question the supreme importance given to pre-existing malnutrition in explaining the high measles mortality in West African communities.     

Tracheotomy — A satisfactory method in the treatment of acute epiglottitis. A clinical and functional follow-up study

A follow-up study, including clinical examination, X-ray and function tests, of 27 children with acute epiglottitis treated with tracheotomy at the ENT-Department, Mölndal Hospital during 1971–1975 has been performed. The function tests were an important part of the investigation and included measurement with the He-dilution technique, flow—volume curves and the forced oscillation technique. No child had any detectable tracheal stenosis or any other serious per- or postoperative complication. The only complication at all was one ugly scar on the neck. The tracheotomized patient needs very little sedation and the time spent at the intensive care unit can be shorter than for those patients treated with nasotracheal intubation.     

Organization of diagnosis, treatment, and further measures for patients with gastrointestinal cancer (author's transl)

One third of the total surgical care at the Department of Surgery, University of Lund, Sweden, is for cancer patients. Gastrointestinal cancer occupies 9,000 of a total of 12,000 bed-days and this disease is usually handled by the team who cares for the specific organ in which the cancer is localized. A particularly important part of gastrointestinal care is endoscopy (gastroscopy and colo-sigmoideo-rectoscopy). These diagnostic procedures can sometimes be curative. The value of preoperative liver tests for diagnosing liver metastases in colorectal cancer is very low because of the low prevalence of liver metastases in this population. Palliative therapeutical procedures, such as Celestin-tubes for esophageal or cardia carcinoma and transhepatic endoprostheses for bile duct occlusive cancer, have been tested. Palliative cytostatic therapy is partly established, i.e., intraarterial infusion of 5-FU for recurrent rectal carcinoma in the lower pelvis. This type of treatment has a very good pain relief effect. Cytostatic therapy for tumour control in patients without symptoms e.g. primary or secondary liver carcinomas, has not yet been established. Most of the patients with cytostatic therapy are treated on an outpatient basis. The cytostatic therapist must always be properly protected when working with cytostatic drugs. It is very important that the patient who gets cytostatic therapy is followed in order to see if the drug has any growth-controlling effect. A cost-benefit analysis of the therapy should also be made.     

Pre-HbA1c in children with insulin dependent diabetes mellitus

Day-to-day fluctuations in blood concentration of the glycosylated hemoglobin, HbA1c or HbA1, are mainly due to variations in content of the intermediate aldimide form, preHbA1c. Using electrofocusing we have studied this component adjacent to the HbA1c band, which represents the stable ketoamine form. The fraction of preHbA1c present rapidly increases upon incubation of erythrocytes in 20 mM glucose at +37 degrees C, and the reaction is fully reversible if glucose is removed. In children with insulin-dependent diabetes mellitus with different degrees of metabolic control, levels of preHbA1c varied between 0.2 and 3.7% of total hemoglobin (median value 1.3%, N = 25). A clear correlation was found between preHbA1c and urinary glucose concentrations during the 12 hours preceding blood sampling (r = 0.75, p less than 0.001, df = 18). As expected, pre-HbA1c did not correlate to HbA1c or glycosylated albumin, which reflect long- and medium-term diabetic control.     

Secretory otitis media. Aspects on treatment and control.

In a double-blind study, 228 secretory otitis media patients were evaluated according to mucolytic and decongestive treatment. No definite difference comparing with the placebo group was registered. About 50% of all patients were cured within 4 weeks after the diagnosis was established. Those patients who earlier had been treated with antibiotics because of a preceding acute otitis media had a better cure rate than the untreated group. Suggestions on treatment and control of secretory otitis media are given.     

SELECTIVE DEVELOPMENT OF TOLERANCE TO β-ADRENOCEPTOR AGONISTS IN SKELETAL MUSCLE AS COMPARED WITH AIRWAY SMOOTH MUSCLE FROM THE GUINEA-PIG

1. Guinea-pig were fed with a diet containing terbutaline or placebo for 4--5 days. The trachea, soleus muscle and the extensor digitorum longus (EDL) from these animals were prepared for recording of isometric contractions in vitro. 2. After treatment with terbutaline in vivo, the response of the pilocarpine-contracted trachea to terbutaline and isoprenaline was slightly suppressed with no change in maximum relaxation. 3. After treatment with terbutaline in vivo the maximum depression of the incomplete tetanic contractions of the soleus muscle brought about by terbutaline or isoprenaline was diminished by about 70%. The response of the EDL was also attenuated after previous treatment with terbutaline in vivo. 4. These data indicate a selective development of tolerance to the effects of beta-adrenoceptor agonists in skeletal muscle as compared with tracheal smooth muscle. 5. The present results provide an experimental analogue to the clinical observation that patients being treated with beta-adrenoceptor agonists become tolerant to the tremorogenic rather than to the bronchodilating effect.