A prognostic role for ceruloplasmin in the diagnosis of indolent and recurrent inflammation.

Ceruloplasmin is increased in infections, inflammatory diseases, and neoplastic diseases and may be scarcely visible to the naked eye because it imparts a faint green color to the serum. This poses an interesting question as to a possible prognostic role for ceruloplasmin in the diagnosis of persistent or recurrent infection. The clinical course of 50 patients with tainted serum was reviewed retrospectively and ceruloplasmin levels correlated with diagnosis and outcome. Group I consisted of 20 healthy controls with normal ceruloplasmin levels: 35.1 +/- 2.0 mg/dL (range 25 to 45 mg/dL). Group II was made up of 23 surgical patients; 10 of these patients had elevated levels of ceruloplasmin, nine of whom had significant infections (64.2 +/- 3.2 mg/dL), and one patient was on estrogen (73.7 mg/dL). Group III consisted of 27 medical patients; 25 of these patients had elevated levels of ceruloplasmin, 20 of whom had infections (54.1 +/- 2.6 mg/dL), and five had malignancies (61.0 +/- 3.0 mg/dL). Ceruloplasmin levels were consistently elevated in all patients with infections relative to controls (P less than .001) with a variable response in other disease states. Therefore, ceruloplasmin may be useful as a serum marker for indolent or recurrent infections.     

End systolic pressure-length relations in halothane anaesthetised dogs: effects of regional ischaemia and inotropic agents.

STUDY OBJECTIVE--The aim was to investigate the effects of regional myocardial ischaemia, calcium, and verapamil on (a) the hysteresis and (b) slope and length axis intercept of the left ventricular end systolic pressure-length relationship. DESIGN--Segment length in myocardium supplied by the left anterior descending coronary artery was measured in anaesthetised dogs using sonomicrometry. Three levels of regional myocardial ischaemia were produced by stenosis and occlusion of the left anterior descending artery (ischaemia 1, ischaemia 2, and occlusion). A snare placed around the descending thoracic aorta was used to obtain temporary aortic occlusions. SUBJECTS--Seven open chested mongrel dogs were used, weight 17 kg (range 16-20). MEASUREMENTS AND MAIN RESULTS--After abrupt release of temporary aortic occlusions, end systolic lengths were greater than before the occlusion in the normal myocardium. This hysteresis was abolished by regional myocardial ischaemia. However, hysteresis was insensitive to calcium and verapamil. The length axis intercept of the end systolic pressure-length relationship was increased during ischaemia 2, during coronary occlusion, and after administration of verapamil; its slope was increased after coronary occlusion. CONCLUSIONS--(1) Viscoelastic properties of the myocardium make a major contribution to hysteresis of the end systolic pressure-length relationship; and (2) the length axis intercept of this relationship is not constant and its slope does not appear to be a sensitive indicator of regional myocardial contractility during regional ischaemia.     

Dose-Ranging Study of Ceftriaxone for Uncomplicated Gonorrhea in Men

Uncomplicated gonorrhea in men was successfully treated with ceftriaxone in single intramuscular doses of 125 mg (15 patients), 250 mg (16 patients), or 500 mg (15 patients). All 45 pretreatment gonococcal isolates tested were inhibited by ≤0.016 μg of ceftriaxone per ml. Treatment was well tolerated and caused no toxicity.