Circadian variations of plasma atrial natriuretic peptide in four types of hypertensive disorder during pregnancy

Summary. Circadian variations in plasma atrial natriuretic peptide were studied, to clarify the characteristic pathophysiology of pregnancy-induced hypertension (PIH). The mean 24-h values (range) of atrial natriuretic peptide in mild and severe PIH, pregnancy-aggravated hypertension, chronic hypertension and normal pregnancy were 130·1 (97·3−207·0), 225·4 (202·8−281·8), 213·1 (183·2−249·5), 81·3 (61·8−116·1) and 77·1 (56·0−123·5) pg/ml, respectively. The values in PIH and pregnancy-aggravated hypertension were significantly higher, although those in chronic hypertension were no different from normal pregnancy. Plasma atrial natriuretic peptide showed a clear circadian rhythm with acrophase in the middle of the night, in mild and severe PIH. In the other hypertensive disorders, a circadian rhythm could not be confirmed. The results indicate that the elevated values of plasma atrial natriuretic peptide in hypertensive disorders during pregnancy relate to generalized vasoconstriction, and that the diurnal rhythm is a specific characteristic of PIH.     

Effect of clonidine on the height of a child with glycogen storage disease type VI: A 13 year follow-up study

A 9-month-old male was found to have hepatomegaly when he was treated by his doctor for bronchitis. At the age of 2 years and 3 months, glycogen storage disease (GSD) of type VI (GSD VI) was diagnosed in this patient. Despite the recommended diet therapy, his growth was not good, changing under or along the line of ?2.0 SD. At the age of 6 years, oral clonidine therapy (0.15 mg/day, 0.2 mg/m² body surface per day) was started. Six to 10 months after the initiation of clonidine therapy, his height began to increase more than the values for ?2.0 SD and once reached the value for ?1.0 SD at the age of 10 years. His growth rate and bone age increased. Clonidine therapy was continued regularly for 7 years until the age of 13 years, 11 months. At that time his development was normal and his height reached 150.8 cm (–1.34 SD). However, cessation of the treatment at the patient's free will resulted in a reduction of the growth rate at age 15 years 6 months. These observations suggest the effect of clonidine therapy on height. Side effects were not noted during the clonidine therapy. Other clinical and laboratory findings of GSD VI also completely improved during treatment. In conclusion, administration of clonidine could be another treatment modality in children with GSD, not only of type VI but also I and III.     

Toxicity and Metabolism of Trimethylarsine in Mice and Hamsters

Toxicity and Metabolism of Trimethylaisinc in Mice and Hamsters.YAMAUCHI, H., KAISE, T., TAKAHASHI, K., AND YAMAMURA, Y. (1990).Fundam. Appl. Toxicol. 14, 399–407. Trimethylarsine (TM-As)proved to be an arsenic compound of low toxicity, with a poLD50 of 7870 mg/kg in mice. A single po dose of 10 mg/kg ofTM-As caused no hemolysis, but a single po dose of 750 mg/kginduced mild, transient hemolysis in hamsters. TM-As was veryrapidly eliminated into the urine, with a biological half-lifeof 3.7 hr. TM-As was oxidized In vivo to form trimethylarsineoxide (TMAO) and excreted as such into the urine. TM-As wasnever demethylated In vivo. A mechanism was demonstrated bywhich a part of TM-As was eliminated directly into the expiredair. We drew a conclusion that TM-As is far less toxic thanarsine, most probably due to its In vivo conversion to TMAO.c 1990 Society of Toxicology.     

The Characteristics and Distribution of the Scar Tissue Predict Ventricular Tachycardia in Patients with Advanced Heart Failure

Background: Contrast‐enhanced magnetic resonance imaging (CMR) identifies scar tissue as hyperenhanced areas. We sought to clarify the relationship between the scar characteristics and occurrence of sustained ventricular tachycardia (VT) in patients with advanced heart failure. Methods: CMR was performed in 29 patients with dilated cardiomyopathy (DCM group) and 18 patients with ischemic cardiomyopathy (ICM group). The characteristics, volume, and distribution of the hyperenhanced areas were analyzed by CMR. The CMR parameters and clinical arrhythmic events were compared between the two groups. Results: In the DCM group, almost all hyperenhanced areas were nontransmural, and presented frequently in the midwall layer. The volume of the hyperenhanced areas and total number of hyperenhanced segments were greater in patients with sustained VT than in those without. On the other hand, in the ICM group, transmural or subendocardial hyperenhanced areas were detected in the territory of the coronary arteries. The volume of the hyperenhanced areas and total number of transmural hyperenhanced segments in patients with sustained VT were unexpectedly smaller than in those without. However, the percentage of nontransmural hyperenhanced segments was greater in patients with sustained VT than in those without. Conclusions: The presence and magnitude of the nontransmural scar tissue may predict sustained VT in patients with advanced heart failure. There was the possibility that a recruitment bias was responsible for the finding of the smaller scars in the ICM patients with sustained VT.     

Increased Natural Killer-Cell Activity is Associated with Infertile Women

PROBLEM: An increase in natural killer (NK)-cell activity has been observed in women with unexplained recurrent miscarriages. Because of the many similarities between infertility and early pregnancy loss patients, we investigated whether infertile women had raised NK-cell activity. METHOD OF STUDY: We tested 94 infertile women who, in spite of treatment, were unable to conceive for 6 or more months. NK-cell activity was measured by using a chromium-51 release cytotoxicity assay. with K562 human myeloid leukemia cells as targets. RESULTS: NK-cell activity of the infertile group (mean +/- SD; 40.2%+/-14.7) was significantly higher than the control group (31.5%+/-11.9, P < 0.0001). The increased NK-cell activity was not associated with age, infertile duration, depression scores, treated hyperprolactinemia, or treated endometriosis. CONCLUSIONS: In certain patients, elevated NK-cell activity may be considered an independent risk factor for infertility.     

Severe aplastic anemia in a patient with primary immunodeficiency

This paper reports the case of a 6 year old boy with primary immunodeficiency disease, whose marrow cells showed dyshematopoietic features, that was subsequently transformed to severe aplastic anemia. He was first diagnosed as having congenital immunodeficiency comprising deficiency of immunoglobulin A (IgA), IgG2 and IgG4, depressed mitogen responses, lymphopenia with inverted CD4/CD8 ratio and an increased proportion of T-cell receptor γ/δ-bearing cells. Cytogenetic study of the peripheral blood showed a normal karyotype of 46, XY, but that of the marked hypoplastic marrow demonstrated one cell with monosomy 7 and another with trisomy 8 in the 20 cells examined.     

The outbreak of mumps in a small island in Japan

A major mumps outbreak occurred on a small island, Ikeshima, in Nagasaki Prefecture from August 1994 to February 1995. There were 236 patients with the mumps at Ikeshima Miners' Hospital during that period. The Measles-Mumps-Rubella (MMR, Toitsukabu) vaccination coverage in the 43 children at the nursery school was 65.1% and it was 61.9% in the 21 children aged 4–5 years not attending the nursery school. Coverage was 66.6% in the 63 kindergarten students and 53.7% in 56 first-graders. The overall MMR vaccination coverage among these children was 61.7% (113/183) from 1989 to 1992. Children from the second grade to junior high school received monovalent mumps vaccine, Torii strain. None received Zishakabu MMR. The age of the patients ranged from 1 to 43 years, with a mean of 9.1 years. The majority (77.5%) were primary school children. The attack rates for vaccinated and unvaccinated children in grades one to six were: 6.7% (2/30) and 88.5% (23/26), 25% (3/12) and 44.1% (30/68), 11.1% (1/9) and 64.4% (29/45), 25% (2/8) and 60% (45/79), 22.2% (2/9) and 35.9% (28/78), 0% (0/5) and 24.7% (18/73), respectively. The overall frequency in the primary school was 41.4% (183/442 children). The frequency in the nursery school for children aged 4–5 years was 14.0% (6/43). It was 17.5% (11/63) in children aged 5–6 years in the kindergarten, 5.2% (11/213) in children not attending school with an age range of 1–5 years, and 4.2% (10/237) in junior high school students. Although the frequencies of MMR coverage for the nursery school children and kindergarteners were not high enough to eradicate mumps outbreaks, the MMR vaccination program was thought to have influenced the low frequency of mumps among the children. Close physical interactions among the first-graders would have contributed to their high frequency of mumps. Some patients presented with suspected mumps parotitis several times, but no such serological confirmation of reinfection was obtained.