EFFECTS OF LIFELONG ETHANOL CONSUMPTION ON RAT LOCUS COERULEUS

The effects of lifelong ethanol consumption and ageing on themorphology of locus coeruleus (LC) were studied in alcohol-preferringAA (Alko Alcohol) rats of both sexes. Ethanol (12% v/v) wasthe only available liquid for the ethanol-consuming rats from3 months up to 24 months of age. Young (3-month-old) and old(24-month-old) control groups were included in the measurements.The LC morphometry was performed by an unbiased disector method.In the old control rats, the total neuron number, neuronal densityand the volume of the LC proper did not differ from the youngcontrols. In the ethanol-exposed rats, the total neuron numberof the LC was decreased by 30% and the LC neuronal density by22%, compared to the age-matched controls. No gender differencewas found in the vulnerability of LC neurons to ethanol-induceddegeneration. The results suggest a remarkable sensitivity ofthe LC neurons to the ethanol-induced degeneration in both maleand female rats. The possible mechanisms and functional implicationsof this neuronal loss are discussed.     

Microvolt T-Wave Alternans During Exercise and Pacing in Patients with Acute Myocardial Infarction

Cardiac Arrhythmias and Risk Stratification after Myocardial infarction (CARISMA) is a prospective multicenter trial designed to document the incidence of cardiac arrhythmias after acute myocardial infarction (AMI), and to assess the predictive accuracy of various arrhythmic risk markers. In this substudy of the CARISMA trial, microvolt T-wave alternans (TWA) was assessed with specific equipment 6 weeks after AMI during bicycle exercise, atrial (A) pacing, and simultaneous ventricular and atrial (V + A) pacing in 80 patients with left ventricular ejection fraction (LVEF) <40%. The agreement between the acute test results was determined by overall proportion of concordance and the kappa statistic. Sustained TWA was observed in 24, 45, and 50% of the patients during the exercise test, A pacing, and V + A pacing, respectively. The number of indeterminate TWA was significantly lower during V + A pacing (n = 7) than exercise test (n = 34). The TWA concordance rate was 71% between exercise and V + A pacing (κ= 0.53, P = 0.001), 79% between exercise and A pacing (κ= 0.54, P < 0.001), and 95% between the two pacing modes (κ= 0.89, P < 0.001). Patients with positive TWA in all tests had lower LVEF (28 ± 7% vs 35 ± 9%, P < 0.01) and wider QT dispersion (99 ± 44 ms vs 67 ± 38 ms, P < 0.01) than those with inconsistent test result. The low number of indeterminate tests and high concordance between the test results indicate that V + A pacing may provide a valuable means to assess TWA in patients who cannot complete the exercise test.     

Fibronectin in synovial fluid and tissue in rheumatoid arthritis

Fibronectin is a glycoprotein found in body fluids, loose connective tissue matrix and in basement membranes. Fibronectin in rheumatoid arthritis synovial fluid was immunologically indistinguishable from the plasma form, as shown by double-diffusion analysis. Fibronectin isolated from rheumatoid synovial fluid by affinity chromatography on gelatin--Sepharose had a polypeptide pattern similar to that of plasma fibronectin in SDS--polyacrylamide gel electrophoresis. In fifty-one patients with rheumatoid arthritis and related diseases fibronectin concentrations is synovial fluid were 445 +/- 103 micrograms/ml (mean +/- SD) and within normal range, 335 +/- 52 micrograms/ml, in plasma. Immunofluorescence staining showed a prominent increase of fibronectin in the proliferating synovial connective tissue in rheumatoid arthritis as compared to normal synovial membrane. The results suggest an increased local production of fibronectin in rheumatoid synovial tissue.     

Collagen metabolism in normal and complicated pregnancy: changes in the aminoterminal propeptide of type III procollagen in serum

The turnover of type III collagen, a major constituent of the myometrium and the uterine cervix, during pregnancy was evaluated by monitoring serum antigens related to the aminoterminal propeptide of type III procollagen. Their concentration increased markedly towards term in most uncomplicated pregnancies, while their size distribution throughout the pregnancy resembled that seen in the sera of normal healthy persons. In some patients, however, the level remained low, indicating interindividual variation in the release into serum and metabolism of the propeptide. There were no distinct changes during or immediately after vaginal delivery. Values exceeding the reference range for uncomplicated pregnancies were found during weeks 28-37 in patients with pre-eclampsia, essential hypertension, intrahepatic cholestasis of pregnancy or twin pregnancy. Thus, pregnancy should be taken into account when evaluating results of the serum assay for the aminopropeptide and the use of this assay as an indicator of pregnancy complications warrants further study.     

PREVALENCE AND TEN-YEAR (1970-1979) INCIDENCE OF INSULIN-DEPENDENT DIABETES MELLITUS IN CHILDREN AND ADOLESCENTS IN FINLAND

ABSTRACT. The prevalence and incidence of insulin-dependent diabetes mellitus in Finnish children and adolescents were studied by means of a national register of drug-treated diabetics and hospital records. At the end of 1979 the prevalence of diabetes in children aged 0-14 was 191/100000, and in those aged 0-19, 262/100000 respectively. During the 10-year period from 1970 to 1979, 3916 new diabetics aged 0-19 years were registered. The annual incidence of diabetes was 27.3/100000 in the age group 0-19 years and 28.6/100000 in those 0-14 years. The peak incidence of diabetes in girls occurred at 12 years of age and in boys at 14 years. There was a seasonal variation in the symptom debut, with peaks in April and in September and low rates in the summer. A regional variation in the prevalence and incidence rates was evident the rates being highest in eastern and lowest in northern Finland. The prevalence of diabetes mellitus increased clearly during the observation period, and the incidence tended to increase especially during the last years. Both prevalence and incidence rates of diabetes mellitus in Finnish children are high by international standards, possibly the highest in the world.     

Quinidine reduces biliary clearance of digoxin in man

Quinidine is known to reduce the renal clearance of digoxin, but this effect does not completely explain the influence of quinidine on the total clearance of digoxin. We therefore studied the effect of quinidine administration on biliary clearance of digoxin in five patients with atrial fibrillation. Biliary clearance of digoxin under steady state conditions before and during treatment with quinidine was investigated using a duodenal-marker-perfusion technique. Quinidine caused an average 42% (range 21-65%, P less than 0.02) reduction of the measured biliary clearance of digoxin. We conclude that the biliary effect adds to the previously demonstrated inhibitory effect of quinidine on the renal clearance of digoxin and helps to explain the decrease in total clearance of the drug. This is the first demonstration in man of a pharmacokinetic drug interaction at the level of biliary excretion.     

Disease-related distress among insulin-treated diabetic patients: Associations with health status, psychosocial factors and self-care practices

Background: Diabetes is a chronic illness that affects manydomains of life. This cross-sectional study examined disease-relateddistress and its associations with health and psychosocial factorsamong insulin-treated diabetic persons. Method: The sample (n=423)was drawn from the Social Insurance Institution's drug registry.Health indicators were duration of diabetes, complications,and glycaemlc control. Psychosocial measures included generaland diabetes-specific social support, diabetes locus of control(DLC), self-efficacy, diabetes health beliefs and self-carepractices and subjective health. Results: Most respondents reportedmoderate diabetes-related distress. In multi-variate analysis,severe diabetes distress was related to lower net benefits ofregimen (ß = –0.29, and p<0.001), poorerperceived health (ß = –0.25, and p<0.001),higher perceived threat of complications (ß = 0.19,and p<0.001), less adequate social support (ß =–0.16, and p<0.01), stronger beliefs in chance (ß= 0.15, and p<0.01) and internal DLC (ß = 0.11,and p<0.05) and more frequent exercising (ß = 0.10,and p<0.05). Conclusions: The results suggest that emotionaladjustment to diabetes is predominantly determined by diabetes-relatedcognitions and subjective health and to a lesser degree by objectivediabetes indlcators, which underlines the Importance of assistingthe patient with adjustment with the disease in health carecentres.     

ACUTE LIVER FAILURE AND ENCEPHALOPATHY (REYE'S SYNDROME?) DURING SALICYLATE THERAPY

ABSTRACT: Sillanpää, M., Mäkelä, A.-L. and Koivikko, A. (Department of Paediatrics, University of Turku, Turku, Finland). Acute liver failure and encephalopathy (Reye's syndrome?) during salicylate therapy. Acta Paediatr Scand, 64: 877, 1975.–A case of hepatotox-icity and encephalopathy (Reye's syndrome?) associated with salicylate therapy is presented and the aetiology of this syndrome is discussed. Hepatotoxicity developed with salicylate serum concentrations not exceeding therapeutic serum levels. The importance of controlling serum salicylate concentration and transaminase activity particularly during the first fourteen days of therapy is emphasized.