Further studies of concordant fluctuation in sensitivity of peripheral leucocytes to unrelated allergens and the meaning of nonspecific 'desensitization'

These studies pertain to the significance and mechanism of concordant fluctuation in sensitivity of peripheral leucocytes to release of histamine by unrelated allergens. One type of concordant fluctuation occurs during injection of allergen. In this type, reduction of leucocyte sensitivity is only partial and recovery is rapid when injection of allergen ceases, and the reduction is related to degranulation of basophils and decrease in the histamine content. The nonspecific nature of the concordant, proportionate reduction in sensitivity to unrelated allergens suggests degranulation of a population of basophils in the circulation that apparently carries the reaginic antibodies for all allergens to which the subject is hypersensitive. Another type of concordant loss of peripheral leucocyte sensitivity to unrelated allergens occurs uncommonly, without clear relation to allergen injection. In this type, reduction of leucocyte sensitivity proceeds gradually to the point of unresponsiveness to allergen and persists for prolonged periods. The nonspecific nature of this type is not associated with decrease in histamine content of the peripheral leucocytes (basophils). In both types, simultaneous determination of other indices of hypersensitivity (sensitivity of skin and bronchi, and reaginic antibody content of serum) showed no significant changes concomitant with fluctuation in peripheral leucocyte sensitivity. This suggests basophils in the peripheral blood behave differently from mast cells in tissues. The findings point to important limitations in the use of in-vitro measurement of sensitivity of peripheral leucocytes (basophils) as an index of hypersensitivity of a person and as a means of monitoring the efficacy of injection therapy. The term ‘desensitization’ should be used precisely to distinguish loss of hypersensitivity of tissues throughout the body from reduced sensitivity of only certain cells.     

Active Involvement of Expectant Fathers in Pregnancy: Some Further Considerations

In this followup to her previous JOGN article, the author presents a review of the recent literature on the man's experience of pregnancy and an expanded concept of active involvement of expectant fathers in pregnancy. Active involvement of the expectant father in pregnancy, namely, the acceptance of the emotional impact of pregnancy and the construction of a mental picture of himself as a participant in the caretaking and nurturing of the infant, may enhance the father's later role in parenting. Recent research suggests that for a man to have the opportunity to participate in the early parenting experience, he must negotiate that future role with his partner during pregnancy and prepare consciously for that style of fatherhood. Much additional research is needed concerning a man's experience of pregnancy and childbearing; the concept of "active involvement" may be a springboard for such research. Better understanding of the process of paternal role development is important in the face of expanding women's roles and the increased interest among men in assuming greater childrearing responsibilities.     

HEPATIC MICROSOMAL ENZYME INDUCTION AND ADRENAL CRISIS DUE TO o,p''DDD THERAPY FOR METASTATIC ADRENOCORTICAL CARCINOMA

Two cases are described in which metastatic adrenocortical carcinoma associated with Cushing's syndrome was treated with mitotane (o,p'DDD). The first patient had initially been treated by bilateral adrenalectomy and, whilst responding to mitotane biochemically and by remission of metastases, experienced repeated episodes of adrenal crisis requiring a substantial increase in steroid therapy. The second patient failed to respond to the drug, but evidence of hepatic enzyme induction was noted during its administration. It is suggested that hepatic microsomal enzyme induction can occur in association with treatment with mitotane and that this can lead to an increased destruction of exogenous steroid with clinical consequences.     

Changes in body size and fatness of Australian schoolchildren 1911–1976

ABSTRACT. Data have been analysed from surveys of Queensland schoolchildren done in 1911, 1950 and 1976. Over this period there has been a marked increase in both height-for-age and weight-for-age in boys and girls. However, in boys, this increases growth has been associated with minimal increase in fatness. In girls there has probably been a real increase in body fatness, particularly since 1950. Raw data from past growth studies would make the analysis for secular changes in stature more meaningful and accurate. We suggest that a central data bank for Australian growth studies be set up.     

Common Hematologic Problems of the Immediate Newborn Period

Hematologic problems in the early periods of postnatal life are common. Many complications of the common hematologic problems in the newborn, including death, might be prevented with astute nursing care. Frequently encountered blood disorders of the immediate newborn period, clinical manifestations, common treatments, and nursing management are presented.     

LONG-TERM BACKACHE AFTER EXTRADURAL OR GENERAL ANAESTHESIA FOR MANUAL REMOVAL OF PLACENTA: PRELIMINARY REPORT

A questionnaire designed to investigate the incidence of newlyacquired, long-term backache was sent to women who had previouslyundergone manual removal of the placenta during a 12-month periodin one maternity hospital. There was a significantly greaterincidence of long-term backache in patients who had extraduralanaesthesia specifically for manual removal of the placentacompared with patients receiving a general anaesthetic for thesame procedure. The results of this retrospective study in asmall population warrant examination in a large, prospective,controlled investigation. (Br. J. Anaesth. 1993; 70: 214-215) Before delivery of baby/after delivery of baby Since delivery,have you had any of the following problems:     

Stereospecific effects of tryptophan on gastric emptying and hunger in humans

The amino acid tryptophan (tryp) is a potent inhibitor of gastric emptying in both animals and humans. Animal studies suggest that this effect may be specific for the L-enantiomer. The effects of _D- and _L-tryptophan on gastric emptying, intragastric distribution and appetite in humans were evaluated. Ten volunteers ingested 300 mL of either _L-tryp (50 mmol/L), _D-tryp (50 mmol/L) or normal saline labelled with ^99mTc sulfur colloid on three occasions, separated by between 3 and 7 days. Hunger and fullness were measured with a visual analogue scale at -2, 15, 30 and 60 min after ingestion of each drink. Saline emptied faster from the stomach than both _L-tryp and _D-tryp (P <0.05) and _D-tryp emptied faster than _L-tryp (P <0.005). Emptying from the proximal stomach was fastest for saline (P <0.05) and faster for _D-tryp than _L-tryp (P <0.005). Emptying from the distal stomach was faster for saline than both _D- and _L-tryp (P <0.05). A reduction in hunger (P <0.05) and a non-significant trend for an increase in fullness were observed after all three drinks. At 60 min, fullness was greater after _L-tryp than after ingestion of _D-tryp (P <0.01). These observations indicate that the effect of tryptophan on gastric emptying in humans is stereospecific, consistent with the concept that stereospecific receptors for tryptophan exist in the human small intestine.