COMPARISON OF TWO COMMERCIAL TEST KITS FOR QUANTIFICATION OF SERUM CARBOHYDRATE-DEFICIENT TRANSFERRIN

Serum levels of carbohydrate-deficient transferrin (CDT) weremeasured in subjects of two independent studies using two differentcommercial kits. The kits measure CDT either as a percentageof total transferrin (AXIS %CDT^TM, AXIS Biochemicals AS, Norway),or as the absolute amount (CDTect^TM, Pharmacia, Sweden). Ina population of males (mean age 41 years) consisting of alcoholics,heavy, moderate and non-drinkers, a strong correlation was foundbetween AXIS %CDT and CDTect results (r=0.92, n=58, P<0.001).Sensitivity and specificity in detecting chronic alcoholic drinkingof over 60 g/day were 78 and 94% for the AXIS assay, and 83and 88% for the CDTect assay, respectively. In a populationfrom a birth cohort study, consisting of 21-year-old males andfemales with less excessive alcohol consumption, the correlationbetween AXIS %CDT and CDTect CDT was weaker but still statisticallysignificant (r=0.46. n=212, =<0.001). In this population,with specificities >83% in detecting alcohol consumptionlevels of     

Seminal peroxidase positive cells are not an adequate indicator of asymptomatic urethral genital infection

The relationship between asymptomatic urethral infection and seminal white blood cells, as detected using the peroxidase enzyme system, was examined. Eighty-four semen donors were tested. Twenty-four (29%) were diagnosed as having an active urethral genital infection. There was no statistical relationship between the total number of concentrations of peroxidase-positive cells and a urethral genital infection. Further studies should concentrate on the subtypes of seminal leucocytes and their surface receptors using monoclonal antibodies.     

Antisperm antibodies and lymphocyte subsets in semen—not a simple relationship

The significance of white blood cells in the ejaculate remains a matter of controversy. Several authors have suggested that such cells are important in the modulation of an antisperm antibody response, i.e. a predominance of suppressor/cytotoxic to helper/inducer T cells may prevent the development of antisperm antibodies. In order to examine this relationship further we have documented the white blood cell types, with emphasis on the T-lymphocyte populations, in the ejaculates of men from infertile couples with and without antisperm antibodies; the latter group was divided further into two groups--vasovasostomized men and idiopathic men. All seven of the men without antisperm antibodies had a predominance of suppressor/cytotoxic T cells to helper/inducer T cells in the ejaculate. However, only in some of the men with antibodies was there a predominance of T-helper/inducer cells. It is clear that the relationship between antisperm antibodies and seminal leucocytes is therefore not as straightforward as has been proposed.     

Cardiovascular responses to insertion of the laryngeal mask

We have compared, in 40 healthy patients, the cardiovascular responses induced by laryngoscopy and intubation with those produced by insertion of a laryngeal mask. Anaesthesia was induced with thiopentone and maintained with enflurane and nitrous oxide in oxygen; vecuronium was used for muscle relaxation. Arterial pressure was measured with a Finapres monitor. The mean maximum increase in systolic arterial pressure after laryngoscopy and tracheal intubation was 51.3% compared with 22.9% for laryngeal mask insertion (p less than 0.01). Increases in maximum heart rate were similar, (26.6% v 25.7%) although heart rate remained elevated for longer after tracheal intubation. We conclude that insertion of the laryngeal mask airway is accompanied by smaller cardiovascular responses than those after laryngoscopy and intubation and that its use may be indicated in those patients in whom a marked pressor response would be deleterious.     

Diclofenac and post-tonsillectomy haemorrhage

The authors noticed a marked increase in the incidence of reactionary post-operative haemorrhage after tonsillectomy during the course of 1992. This increase appeared to be related to the introduction of diclofenac as a post-operative analgesic. A retrospective review of casenotes of patients having tonsillectomy under the care of the senior author (P. M. R.) in 1992 revealed that four of the 73 patients (5.5%) receiving diclofenac at induction of anaesthesia suffered reactionary haemorrhage requiring operative control, as compared with two of 293 (0.7%) receiving other analgesics.