HYPERLIPOPROTEINEMIA IN NEWBORN INFANTS

ABSTRACT. Andersen, G. E., Lous, P. and Friis-Hansen, B. (Neonatal Department, Rigshospitalet, and the Department of Clinical Chemistry, Bispebjerg Hospital, Copenhagen, Denmark). Hyperlipoproteinemia in newborn infants. A study of 1025 families. Acta Paediatr Scand, 68: 683, 1979.—As part of a screening study for the detection of hyperlipoproteinemia in 10000 newborns, cord serum lipids and lipoproteins were measured in detail in 1025 infants. Elevated cord serum VLDL-LDL-cholesterol could easily be identified by a rapid turbidimetric estimation of cord serum VLDL-LDL. Cord serum VLDL-LDL-cholesterol was found to be significantly higher than normal in premature, asphyxiated and betamethasone-phenobarbital-ritodrine treated infants. Other obstetric complications, however, were not associated with hyperlipoproteinemia. Furthermore all 2050 parents had their serum cholesterol determined. 3 parents had familial hypercholesterolemia (FH). One child also had FH, though her cord serum total cholesterol and VLDL-LDL-cholesterol were normal. The 2 other children of the 3 FH parents, had normal lipids and lipoproteins both at birth and follow-up.     

IMMUNOLOGICAL STUDIES IN TWO CHILDREN WITH RECURRENT PAROTITIS

ABSTRACT. In two children with recurrent parotitis, labial salivary gland biopsies showed chronic sialoadenitis. Immunofluorescence studies disclosed deposits of immunoglobulins and complement in juxta-acinar small vessels. Case 1 had gluten enteropathy, IgA deficiency and high titres of antinuclear antibodies (ANA), and in vivo fixation of ANA to nuclei of different cells in lip, skin and jejunum was present. Case 2 showed deposition of IgM in the dermo-epidermal junction of the skin. These findings suggest that autoimmune reactivity and immune complexes may play a role in the pathogenesis of this disorder.     

HORMONAL TREATMENT BEFORE RADICAL PROSTATECTOMY: A 3-YEAR FOLLOWUP

Purpose

Hormonal treatment administered before radical prostatectomy has been shown to decrease the rate of positive surgical margins. We determine whether preoperative hormonal treatment has any impact on the subsequent failure rate.

Materials and Methods

We prospectively evaluated 122 patients with stages T1bNxM0 to T3aNxM0, grades 1 to 3 prostate cancer, including 64 randomly assigned to immediate radical retropubic prostatectomy and 58 randomly assigned to radical retropubic prostatectomy preceded by 3 months of pretreatment with a gonadotropin-releasing hormone agonist. We performed intention to treat analysis on the data with failure defined as lymph node involvement, serum prostate specific antigen greater than 0.5 ng./ml., or the need for postoperative hormonal or radiation adjuvant treatment.

Results

The positive margin rate was 23.6 versus 45.5% in the pretreatment plus prostatectomy versus prostatectomy only groups (p = 0.016). There were 20 failures (34.5%) in the pretreatment plus prostatectomy subgroup and 26 (40.6%) in the prostatectomy only group (p = 0.48). A negative surgical margin was associated with a significantly lower risk of progression than a positive surgical margin (20.8 versus 50.0%, p = 0.0016), and progression was delayed by approximately 1 year after hormonal pretreatment. However, at a median followup of 38 months there was no difference in progression-free survival (p = 0.57).

Conclusions

Although hormonal pretreatment significantly decreased the positive margin rate, it did not result in any difference in progression-free survival when followup exceeded 3 years. Thus, our current results do not support the routine administration of hormonal treatment before radical prostatectomy.     

Skeletal muscle sympathetic activity at rest in trained and untrained subjects

The effect of physical training on muscle sympathetic activity (MSA) was studied by comparing resting levels of MSA in 8 well-trained racing cyclists and in 8 age-matched untrained subjects (mean age 22 yrs). In addition, MSA was determined for 5 untrained subjects before and after an 8-week training program on cycle erogmeters (training group). Recordings were made from the peroneal nerve at the knee with the subject in recumbent position. The well-trained cyclists were characterized by a clearly higher maximal oxygen uptake (VO₂ max) and lower heart rate at submaximal exercise (180 W) than their untrained counterparts. These variables were also significantly changed with training in the training group. In contrast, there were no training-related effects on MSA. Thus, MSA expressed as either the number of sympathetic bursts/100 heart beats (+2%, NS) or bursts/min (-10%, NS) did not differ between the well-trained cyclists and the untrained controls. Furthermore, no changes in MSA occurred with training in the training group (bursts/100 heart beats: +8%, NS; bursts/min -2%, NS). Individual variations in MSA were large and independent of training state. It is concluded that differences in physical conditioning do not account for the large inter-individual differences in MSA in resting man.     

REGIONAL DISTRIBUTION OF 11C-LABELED LIDOCAINE,BUPIVACAINE, AND ROPIVACAINE IN THE HEART,LUNGS, AND SKELETAL MUSCLE OF PIGS STUDIED WITH POSITRON EMISSION TOMOGRAPHY

The regional myocardial uptake and kinetics of ¹¹C-lidocaine, ¹¹C-bupivacaine, and ¹¹C-ropivacaine were examined in the pig, utilizing positron emission tomography to determine whether disproportionate distribution exists among these agents. The three drugs were rapidly distributed to the myocardium and lung with mean peak radioactivities occurring between 0·35 and 0·48 min post-injection in myocardium and 0·35 and 0·65 min in lung. Radioactivities peaked later in skeletal muscle than in the myocardium and lung, occurring between 1·1 and 2·7 min post-end injection. Blood radioactivities for bupivacaine and ropivacaine were significantly higher than those of lidocaine, whereas myocardial, lung, and muscle uptakes for the three agents were not significantly different. Myocardium–blood partition coefficients were similar for bupivacaine and ropivacaine (0·55 and 0·49 respectively), while it was three times higher for lidocaine (1·4). A similar relationship existed for skeletal muscle– and lung–blood partition coefficients. Bupivacaine and ropivacaine t_1/2z in skeletal muscle were significantly longer than those of lidocaine. The results of this study indicate that the increased cardiotoxicity associated with bupivacaine does not appear to be related to disproportionate distribution in the myocardium when compared to lidocaine and ropivacaine. © 1997 by John Wiley & Sons, Ltd.     

Antihistaminergic pretreatment prevents tissue extravasation of albumin from intra–abdominal trauma in rats

Intra–abdominal surgery causes a loss of plasma into tissues within and around the abdomen, endangering tissue viability. Mast cells, containing histamine, are abundant in the abdominal cavity. In a model of mechanical intra–abdominal trauma, we investigated whether pretreatment with histaminergic H, and H₂ receptor blockers counteracts this extravasation. In Wistar rats under chloralose anaesthesia, tissue clearances of labelled albumin were determined by a double isotope technique. Four groups were studied: Traumatized rats, pretreated (n=10) and non–pretreated (n = 9): non–traumatized rats; pretreated (n=10) and nonpretreated (n = 9). In the traumatized rats, given pyrilamine 10 mg kg^-1 (H₁) plus cimetidine 25 mg kg^-1 (H₂) just before the trauma, the blockers prevented the haemoconcentration from loss of plasma and the drop in arterial pressure during the very trauma procedure, observed among non–pretreated rats. Furthermore, they significantly decreased the clearance of albumin in the abdominal wall and the pancreas. In the non–traumatized animals, the blockers lowered arterial pressure and heart rate. In conclusion, the anti–hista–minergic pretreatment decreased the trauma induced leakage of albumin, by mechanisms which may involve readjustments of pressures and flows in capillaries as well as a prevention of histamine effects on capillary permeability.