摘要:

Abstract.Both the transient hypoxic ventilatory drive test and the single‐breath carbon dioxide (CO2) response test have been used to assess peripheral chemoreflex sensitivity. We tested their comparability in 14 healthy adults (10 men, aged 31–73 years, mean 55.4 years). The within‐subject reproducibility of both tests was also assessed (n= 7 for each). The mean transient hyoxic ventilatory response was 0.287 ± 0.0591min‐1(%Sao2)‐1(mean ± SEM, range 0.018–0.718) and single‐breath CO2response was 0.276 ± 0.0411 min‐1T‐1(range 0.081–0.501). Both tests were reproducible with a mean coefficient of variation of 20.1% and 17.7%, respectively. There was, however, no significant correlation between the results of the transient hypoxic and single‐breath CO2tests when data were compared by linear regression analysis (r= 0.23,P= 0.43), suggesting that separate pathways of the peripheral chemoreflex existed for hypoxia and hypercapnia, respectively, and that these tests were specific for each. The authors conclude that these tests are reproducible but need to be used in combination for an adequate assessment of th

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1995.tb01962.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract.The aim of the present study was to investigate the relationship between ET plasma concentrations and other hormonal systems in acute volume regulation of patients with cirrhosis. Ten healthy controls and 10 cirrhotic patients, five without and five with ascites were studied after 1 h in a sitting posture and subsequently subjected to 1 h head‐out water immersion. Blood was collected for determinations of ET‐1, ET‐3, ANF, aldosterone, renin activity and noradrenaline. In addition, in 10 patients with compensated cirrhosis the effect of loop diuretics on ET‐3, aldosterone and renin was studied. ETs in cirrhosis were significantly (P<0.01) higher than in controls both before (ET‐1, 19.6 ± 1.3pgmL‐1vs. 11.8 ± 0.4pgmL‐1; ET‐3, 18.5±1.4pgmL‐1vs. 9.5 ± 0.5 pgmL‐1) and after water immersion (ET‐1, 18.6± 1.2 pgmL‐1vs. 12.4±0.3 pgmL‐1; ET‐3,18.7 ± 1.7pgmL‐1vs. 10.0±0.5pg mL‐1). In cirrhotic patients, basal and immersion concentrations of ET‐1 were significantly correlated to noradrenaline plasma concentrations (r= 0.79,P<0.05). ET‐3 plasma concentrations in cirrhosis were correlated to renin activity (r= 0.65,P<0.05). Furthermore, ET‐3 in cirrhosis was inversely correlated to systolic and mean arterial blood pressure (r= ‐0.55,P<0.01 andr= ‐0.50,P<0.05, respectively). To investigate the effect of hypovolaemia in compensated cirrhosis, 10 patients without ascites were studied before and after treatment with loop diuretics. In compensated cirrhosis ET‐3 was significantly increased 6h after oral diuretic treatment (17.9 ± 1.0 pgmL‐1vs. 15.5±0.4pg mL‐1,P<0.001). The presented data demonstrate relations of endothelins, particularly of ET‐3 to n

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1995.tb01963.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract.Guanylin is a recently discovered peptide hormone that activates intestinal guanylate cyclase (GC‐C) and thereby stimulates intestinal chloride secretion. Immunohistochemistry showed its presence in enterochromaffin (EC) cells of the gut.In vitrostudies suggested that guanylin plays an important role in the endogenous modulation of intestinal salt and water secretion. In the present study the concentration of circulating immunoreactive (1R)— guanylin in plasma of patients with intestinal diarrhoea due to chronic bowel inflammation and patients with carcinoid tumours were measured with a specific radioimmunoassay. In 22 patients with Crohn's disease and eight patients with ulcerative colitis, plasma concentrations of IR‐guanylin were 44 ± 3 and 42± 4 fmol mL‐1, respectively. Levels were not different from that in 44 healthy volunteers suggesting that the circulating hormone is not involved in diarrhoea of these patients. In 17 patients with symptomatic carcinoid tumors the median concentration of circulating IR‐guanylin was significantly enhanced (94±16 fmol mL‐1, range 37–312 fmol mL‐1). Immunohistochemistry revealed the presence of immunoreactive guanylin in carcinoid tissues, suggesting that these tumours co‐release guanylin along with their usual resident hormone, serotonin. Enhanced local secretion of guanylin may play a causal role in diarrhoea of these patients and its elevation in plasma may be of diagnostic value in this type

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1995.tb01964.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract.In 30 male patients suffering from recurrent condylomata acuminata, immediate hypersensitivity parameters (total IgE, PTT and prick tests) and delayed hypersensitivity against seven recall antigens (multi test) were studied. Thirty healthy male volunteers, matched in age, were the controls. Significantly higher immediate hypersensitivity activity was shown in the patient group. Qualitative evaluation of delayed type hypersensitivity showed that controls had a positive test 16 times more often than patients. A rather homogeneous suppression of delayed type hypersensitivity was found in the patient group mainly as regards the presumably most common antigens vs. the control group. This suppression was proved to be related to disease duration. The hypothesis of a CD4+ Th‐2 lymphocyte predominance in recurrent condylomata, owed to longstanding or repetitive antigenic stimulation seems to adequately explain the findings of the present stud

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1995.tb01965.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract.Oral lichen planus (OLP) is a common oral disorder that manifests a mucosal reaction to a variety of aetiological factors, including liver disorder. This study investigated the relationship between OLP and hepatitis C virus (HCV) infection by studying the prevalence of hepatitis B and C virus infection or liver disease in 45 patients with OLP in the Northern Kyushu region of Japan where the prevalence of HCV infection is the highest in the country. Serum hepatitis B virus surface antigen (HBsAg) was positive in only four patients. Serum anti‐HCV or serum HCV RNA was positive in 28 (62%) and 27 (60%) of 45 OLP patients, respectively. The majority (35 of 45, 78%) of OLP patients suffered from liver disease, including chronic hepatitis C (22/45, 49%), HCV‐related liver cirrhosis (two), and HCV‐related hepatocellular carcinoma (two). These results suggest that HCV is a major cause o

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1995.tb01966.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract.Pulmonary damage in cystic br osis (CF) is associated with chronic inflammation mediated in part by proinflammatory 5‐lipoxygenase products (5‐LOP, leukotrienes and 5‐hydroxyeicosatetraenoic acid) from polymorph neutrophil granulocytes (PMN). The authors studied 5‐LOP formation of PMN from CF patients andin vitroeffects of added eicosapentae‐noic acid (EPA) and fish oil. Circulating PMN were isolated from 10 CF patients without acute infections and 10 control persons of the same age (4–20 years). Total 5‐LOP liberation from PMN of CF patients was significantly increased over controls after incubation with the calcium ionophore A23 (1 μmol L‐1) without arachidonic acid (AA) (380 ±24 vs. 294±28pmol mL‐1) and with 10μmolL‐1AA (1303±104 vs. 1015 ± 104 pmolmL‐1), and there were nonsignificant trends to high values after incubation with 5μmolL‐1platelet activating factor (PAF, 134% of controls) and 1 μmol L‐1formyl‐methionyl‐leucyl‐phenylalanine (FMLP, 125%). The addition of 100 mu;g mL‐1fish oil to PMN of CF patients challenged with A23 completely suppressed synthesis of proinflammatory 5‐LOP of the 4‐series, while inactive 5‐LOP metabolites of the 5‐series were produced. Added EPA (10 μ molL‐1) also suppressed 4‐series 5‐LOP and significantly reduced leukotriene B4concentration by 48% from 39.9 ±3.2 to 20.6 ± 11.4 pmol L‐1again with a concomittant increase of inactive 5‐series metabolites. The authors conclude that the turnover of endogenous and exogenous AA is enhanced in CF, possibly due to stimulated phospho‐lipase A2activity. The relatively small effect of the receptor dependent stimuli PAF and FMLP may be caused by a down‐regulation of PMN receptors in CF. Supplementation of long‐chain ω‐3‐fatty acids may be beneficial for reduc

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1995.tb01967.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract.The effect of infusions of recombinant insulin‐like growth factor‐I (IGF‐I) (34, 103 or 688pmol kg‐1min‐1), insulin (3.4, 10.3 or 68.8pmol kg‐1min‐1) or combined infusions (34pmol IGF‐I+ 3–4pmol kg‐1min‐1insulin or 103pmol IGF‐I + 3–4pmolkg‐1min‐1insulin) on glucose metabolism was investigated in dogs using a [3‐3H]‐glucose infusion and euglycaemic clamp. All insulin doses decreased glucose production rate (Ra) in a dose‐dependent manner (P<0.05). All IGF‐I doses decreased glucose Ra (P<0.05) but this decrease was not dose dependent. The decrease in glucose Ra with the combined infusion of 34pmolkg‐1min‐1IGF‐I + 3–4pmolkg‐1min‐1insulin was greater than 34 pmol kg‐1min‐1IGF‐I (P<0.05) but not different from 3.4 pmol kg‐1min‐1insulin. All insulin and IGF‐I doses increased glucose utilization rate (Rd) in a dose‐dependent manner (P<0.01). The increase in glucose utilization was greater following both combined infusions than with either component infused alone (P<0.05). Although at the doses selected, insulin and IGF‐I had similar effects on glucose utilization with additive effects when the two peptides were combined, IGF‐

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1995.tb01968.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract.Essential thrombocythaemia (ET) is frequently associated with neutrophil and platelet dysfunction, and with increased incidence of vascular complications (thrombosis, haemorrhage). Several interactions between platelets and neutrophils have been reported, and the reciprocal actions between these cells may have an important role both in thromboregulation and in diseases such as those caused by uncontrolled neutrophil activation. In the current paper the authors studied 15 patients affected by ET and 10 normal subjects as controls. Circulating neutrophils and platelets were purified and were re‐combined in constant ratios (50:1, 100:1 and 200:1) and the individual platelet to neutrophil ratio. Super‐oxide anion (O‐2) generation and luminol‐enhanced chemiluminescence (CL) were studied after neutrophil stimulation with fMLP. In normal subjects both O‐2generation and CL were inhibited by autologous platelets in a dose‐dependent manner. In ET patients, on the contrary, platelet‐dependent inhibition of O‐2generation did not occur, while a dose‐dependent inhibition of CL was observed. Two groups of ET patients were found: patients with neutrophil O‐2generation and CL within the normal range, and patients with significantly reduced neutrophil respiratory burst. However, no differences were found between these two groups of patients in terms of platelet effects towards fMLP‐stimulated neutrophils. Therefore, platelets from ET patients were not able to exert the homeostatic control towards neutrophil O‐2generation shown by platelets from normal subjects, and this phenomenon may have a role in the clinical setting. In fact, O‐2has been shown to be a very strong direct platelet activator, is able to inactivate nitric oxide (which is a powerful inhibitor of platelet aggregation and adhesion to endothelium), and is directly involved in neutroph

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1995.tb01969.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract.There is scant information on the progression of coronary artery disease in non‐dilated sites in the months following percutaneous trans‐luminal coronary angioplasty (PTCA) or on its relationship with restenosis. To assess the incidence of this progression and its relationship with restenosis at various times after PTCA, the authors selected 371 consecutive patients who had undergone a first successful PTCA for angina on native coronaries followed by a repeat angiographic study. The angio‐grams were analysed by a computer‐assisted method; progression was defined as a 20% decrease in diameter and restenosis as a 30% decrease in diameter or a return to>50% stenosis. The relationship between progression and restenosis was analysed in the whole population and then, using the Mantel‐Haenszel chi‐square test, in two subgroups: patients with a stable clinical state, who were restudied routinely and those whose worsened state had prompted repeat angiogra‐phy. The relationship was assessed at different times between angioplasty and the repeat angiography. Progression was observed in 80 patients (22%) and restenosis in 155 patients (42%). There was a highly significant relationship between progression and restenosis in the total population (χ2= 26.4, odds ratio = 3.9 andP<0.0003) and in the group of patients that were routinely restudied (χ2= 31.6, odds ratio = 5.3 andP<0.0001), but not in the group of patients in whom restudy was performed because of clinical worsening (χ2= 0.13, odds ratio = 1.5 andP= NS). With respect to the length of follow‐up, in the total population the relationship was significant only at 6 and 7 months (P<0.0001), and in the group receiving a routine restudy only at 4–5 and 6–7 months (P<0.0001). Progression in non‐dilated sites appeared to be strongly and transiently linked with restenosis, suggesting that PTCA may enhance both restenosis and progres

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1995.tb01970.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract.It has been shown that danazol (14‐ethinyl‐testosterone) induces hyperglucagonaemia. To investigate the effect of chronic glucagon excess on carbohydrate metabolism, we studied six patients before and after treatment with danazol for immuno‐thrombopenia. Glucose tolerance and insulin, C‐pep‐tide and glucagon secretion during an oral glucose tolerance test (oGTT) as well as peripheral and hepatic insulin sensitivity were determined by means of euglycaemic clamp technique (40mUm‐2min‐1) before and after 3 months of danazol therapy. Overall glucose turnover (R2) was assessed radioisotopically. (1) Plasma glucagon levels rose significantly from 88 ±16 pgmL‐1before to 683 ± 148pgmL‐1after therapy (P<0.01). (2) Glucose levels during an oGTT were not significantly different before and after therapy. Glucose‐stimulated insulin secretion at 60 and 120min and the area under the curve (AUC) for insulin during the oGTT. were significantly increased after danazol treatment compared with pre‐treatment values (P<0.05), whereas glucagon secretion showed a similar decrease at both time points of investigation (NS). (3) Rdduring steady state showed a significant decrease during the entire period of euglycaemic clamp following therapy (after 240min, 3.8 ±0.6 vs. 5.3 ±0.7 mg kg‐1min‐1,P<0.05). The decline in glucagon during the clamp was similar during steady state before and after therapy. (4) Basal hepatic glucose output did not differ significantly before and after therapy (1.74 ±0.41 vs. 1.45 ±0.22 mg kg‐1, NS), whereas hepatic glucose output during the clamp was significantly less suppressed after danazol therapy. The authors conclude that chronic glucagon excess leads to a decrease in peripheral and hepatic insulin action which is accompanied by

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1995.tb01971.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY