ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1977.tb01561.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Abstract.Eighteen patients with atrial fibrillation were given digoxin 0.13 mg twice daily for 3 weeks and β‐methyldigoxin 0.10 mg twice daily for another 3 weeks. At the end of each 3 week period an exercise test was performed and the effects on the heart rate of the two drugs were compared. No difference in heart rate was obtained at rest, whereas the heart rate after 6 min of exercise was higher during treatment with digoxin (131 beats/min) than when the patients were taking β‐methyldigoxin (124 beats/min). There were no significant differences between digoxin and β‐methyldigoxin in their effects on the ECG (R‐R intervals, T‐wave, Q‐T duration). The plasma concentrations of the two glycosides were determined by radioimmunoassay and by86Rb‐uptake inhibition assay. Comparable plasma concentration values (1.0 ng/ml for digoxin, 1.1 ng/ml for β‐methyldigoxin, mean values) were obtained by radioimmunoassay, but the86Rb‐technique gave significantly higher values (mean 1.5 ng/ml) for β‐methyldigoxin.It is concluded that β‐methyldigoxin is equal to digoxin for producing slowing of the heart rate in patien

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1977.tb01562.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Abstract.In search of new practical diagnostic methods for the early diagnosis of hereditary medullary carcinoma of the thyroid (MCT) calcitonin release has been studied following induction by pentagastrin, cholecystokinin‐pancreozymin (the C‐terminal octapeptide, C8‐CCK, and the native swine extract), and ethanol in eighteen cases of MCT (all but one clinically occult), three ‘borderline cases’, seven first degree relatives of patients with hereditary MCT and thirty‐five healthy controls.Pentagastrin, subcutaneous (s.c.) or intravenous (i.v.), induced a pronounced and rapid increase of serum calcitonin within 2–5 min. The elevation was roughly proportional to the tumour mass as estimated at operation. Seventeen out of eighteen MCT patients responded to s.c. pentagastrin with a significant increase in serum calcitonin and the response correlated well with that induced by calcium infusion test. Only two blood samples, at times 0 and 5 min, were necessary for diagnosis. In the MCT patients, i.v. pentagastrin produced more pronounced elevations of serum calcitonin than did s.c. pentagastrin, whereas no increase was seen in the control group. The subjective discomfort caused by i.v. pentagastrin was somewhat more intense but lasted shorter than that induced by s.c. administration. No serious complications were seen.All of nine MCT patients responded to C8‐CCK with increments in serum calcitonin exceeding those of the control group and both of two responded similarly to the native cholecystokinin‐pancreozymin extract. Generally the serum calcitonin response was lower and more variable after C8‐CCK than after s.c. or i.v. pentagastrin, and the subjective discomfort was also more pronounced with abdominal cramps during the injection. Ethanol in the dose used was the least effective stimulator for serum calcitonin release.Clinically suspected MCT carriers with palpable tumours can be diagnosed by determination of the basal, i.e. non‐stimulated serum calcitonin levels. Other possible Sipple genome carriers, who are at the time clinically healthy with normal basal serum calcitonin, should be subjected to a s.c. or i.v. pentagastrin stimulation test at each examination. These tests are much simpler to perform than a calcium infusion test, but seem to have about

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1977.tb01563.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Abstract.Human arylesterase is localized in liver microsomes where the presence of different electrophoretic bands corresponding to the serum bands can be recognized.Serum arylesterase is mainly a result of liver activity and its high level might be explained by a low rate of elimination in urine. The behaviour of arylesterase towards inhibitors shows certain similarities to that of some of the proteases, such as trypsin.The clinical value of serum arylesterase determination in assessing liver function is confirmed by its isoenzyme behaviour in cirrhossis and porto‐caval shun

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1977.tb01564.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Abstract.An antiserum was raised in rabbits against human plasmin‐antiplasmin complex and rendered specific for neoantigens of this complex by absorption with purified plasminogen and plasma. Polystyrene particles were coated with the specific antibodies and used in an agglutination test for the determination of plasmin‐antiplasmin complex in the plasma from various patients. Purified plasmin‐antiplasmin complex at a concentration of 0.1–0.2 mg/l was found to cause a clear agglutination of the particles.Activation of fresh human plasma with urokinase caused progressive generation of agglutinating activity up to a plasma dilution of 1/480. Intravenous infusion of streptokinase into patients resulted in an increase of the plasmin‐antiplasmin titre of at least 1/240. Sera from patients with rheumatoid factor also agglutinated the particles but this activity could be removed by absorbing rheumatoid factor on insolubilized human IgG.Out of 101 male and twenty‐three female control subjects, only three men had a plasmin‐antiplasmin titre above 1/16. Of 230 hospitalized patients, plasmin‐antiplasmin titres of 1/40 or more were detected in twenty‐five patients. Most of these patients had diseases which are frequently associated within vivocoagulation or fibrinolysis, but among them there was only one who showed diffuse intravascular coagulation detectable by classical methods. In the absence of an increased plasmin‐antiplasmin titre none of the haemostasis analyses were indicative ofin vivocoagulation or fibrinolysis. Seven out of eight patients with diffuse intravascular coagulation of various origin had plasmin‐antiplasmin titres of 1/80 or 1/160.Thus, the present latex agglutination test, owing to its simplicity and sensitivity, appears to be a practical routine screening test for detecting fibrinolytic

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1977.tb01565.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Abstract.The metabolism of human antithrombin III (heparin cofactor) was studied in four control subjects, in four subjects with peripheral obliterative arterial disease, in six patients with recent venous thrombosis and in one patient with clinically severe haemophilia A. The labelled antithrombin III had a high specific activity (5.75 units/mg) and displayed a single band on SDS‐polyacrylamide gel electrophoresis. On Sephadex G‐100 gel filtration the labelled material eluted in the same position as the antithrombin III activity in plasma. Crossed immunoelectrophoresis of a mixture of fresh plasma and labelled antithrombin III against a specific antiserum, revealed a single precipitin line in which radioactivity was concentrated. The changes in electrophoretic mobility of both the plasma antithrombin III and the labelled material following the addition of heparin to the mixture or following coagulation were identical. The purified antithrombin III behaved as a homogeneous protein in the turnover experiments. The plasma radioactivity data were approximated by a sum of two exponential terms and the metabolism of antithrombin III represented by a two compartment mammillary model.Results in the control subjects were as follows: plasma antithrombin III concentration 19.6±2.3 mg/100 ml; intravascular fraction 0.45±0.05; fractional catabolic rate 0.55±0.02 of the plasma pool per day; half‐life of the plasma radioactivity 2.83±0.26 days. Circulating large molecular weight degradation products of labelled antithrombin III could not be detected by Sephadex G‐100 gel filtration. No significant differences in these parameters were found in the patients with peripheral arterial insufficiency. The turnover rate of antithrombin III was normal in the patient with haemophilia A.In three patients with venous thrombosis not treated with heparin, the turnover of labelled antithrombin III was in the normal range. In three patients with venous thrombosis, treated with heparin, the plasma radioactivity half‐life was significantly shortened (2.13±0.08 days) and the fractional catabolic rate increased (0.75±0.05 of the plasma pool per day). In one of these patients, the labelled antithrombin III had been incubated with an equimolar amount of heparin prior to injection. In this patient the plasma radioactivity half‐life was in the same range as in the other two pat

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1977.tb01566.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Abstract.In a group of eighty‐three patients with untreated Paget's disease of bone, plasma alkaline phosphatase activity (AP), plasma non‐protein‐bound hydroxyproline concentration (PHP) and urinary excretion rate of total hydroxyproline (THP) were closely correlated with each other but not with fasting plasma concentrations of calcium or inorganic phosphate. Probit plots of AP and THP showed log‐normal distributions overlapping the normal

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1977.tb01567.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Abstract.A rapid intravenous glucose load (20 g) was given with a phentolamine infusion during and after elective abdominal surgery. Plasma levels of glucose, free fatty acids, and insulin were measured to investigate the influence of surgical stress on insulin secretion.When Ringer's lactate solution was infused into a control group of subjects during surgery, plasma levels of insulin did not change during and after the surgery while plasma levels of glucose and free fatty acids increased gradually during this period. Similar results were also noted in another control group in whom only Ringer's lactate solution and phentolamine had been infused. This evidence suggests that insulin secretion responding to endogenous hyperglycaemia is suppressed during surgery.In the group which was given the glucose load during infusion of only Ringer's lactate solution, plasma levels of insulin significantly increased soon after the glucose load and then gradually decreased. In another group which was given the glucose load during infusion of Ringer's lactate and phentolamine, plasma levels of insulin also increased significantly after the glucose load and remained elevated during surgery. The maximum increment of plasma insulin after the glucose load in the latter group was significantly higher than that in the former group.From these results it is suggested that suppression of insulin secretion by surgical stress is inhibited by the alpha blocking agent phentolamine.

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1977.tb01568.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Abstract.The half‐life of injected monocomponent insulin, as judged by radioimmunoassay, has been found to be 3–31/2 min in a group of healthy women. This value is unaffected by pregnancy. Tests were repeated in non‐pregnant women during an infusion of GHRIH to ensure that endogenous insulin secretion was suppressed by the dose of insulin given. Similar values were obt

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1977.tb01569.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Abstract.Cholesterol metabolism has been studied in a group of healthy males drawn from a New Guinea highland population whose plasma cholesterol concentration is low by Western standards and does not rise with age.Mean values from compartmental studies in six subjects were: pool A mass 289 mg/kg; production rate 1069 mg/day or 17.4 mg kg‐1day‐1. The average rate of endogenous synthesis measured by sterol balance in twelve men was 751 mg/day or 12.4 mg kg‐1day‐1. There was evidence of probable suppression of synthesis by about 500 mg/day when I g/day of egg yolk cholesterol was added to the diet of six subjects for 5 weeks. In the latter group, mean cholesterol absorption was 39% (390 mg/day) but the plasma cholesterol concentration did not rise, possibly reflecting compensatory reduction in synthesis.It is suggested that these results were unexceptional, except possibly for the failure of the plasma cholesterol concentration to rise when cholesterol was ingested, despite gross differences in diet and many other

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1977.tb01570.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY