摘要:

Abstract.Following induction of the microsomal liver enzymes, lower total prednisolone concentrations in plasma and an altered pattern of the prednisolone metabolites generated were observed. The purpose of the present study was to establish whether—as a consequence of an enhanced clearance—lower unbound concentrations of prednisolone in plasma are detectable after enzyme induction and to determine if the altered prednisolone metabolism modulates the biological effect.Before and during phenytoin dosage in ten volunteers, the mean (±SD) total body clearance (ml min‐1kg‐1) of both total and unbound prednisolone increased from 2·74±0·47 to 3·94±0·66 (P<0·001) and from 10·76±2·68 to 16·00±3·17 (P<0·001), respectively. These increments were due to increased non‐renal clearances. The immunosuppressive activity as a function of time in plasma determined as the percent inhibition of the mixed lymphocyte reaction decreased by one third after phenytoin dosing, while theEC50values of unbound prednisolone were unaffected. Thus enzyme induction decreases both the unbound prednisolone concentration

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1984.tb00695.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.Type III hyperlipoproteinaemia (HLP) is, amongst others, characterized by the E2/2phenotype as determined by isoelectric focusing of apolipoprotein E. However, one of our clinically symptomatic type III HLP patients showed a E3/3phenotype.After complexation with phospholipid vesicles, apo E from this patient was, in contrast with apo E from a type IV HLP patient (E3/4phenotype), unable to compete with low density lipoprotein (LDL) for binding to the specific LDL receptors on cultured human fibroblasts. This defect in binding to the LDL receptor was not due to an impaired lipid binding capability. The clinical symptomatic type III hyperlipoproteinaemia of our patient is probably due to a functionally inactive apo E3.

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1984.tb00696.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.Serum lipids and apolipoproteins (apo) A‐I, A‐II, and B were measured in twenty‐four patients with severe primary hypothyroidism (Thyrotropin above 40 mU/l), before and during l‐thyroxine treatment. Apo A‐I, A‐II, and B were assayed by immunonephelometry, using monospecific antisera.The serum levels of total cholesterol (TC), of low‐density lipoprotein cholesterol (LDLc), and of the major LDL apoprotein, apo B, were markedly increased in the untreated hypothyroid patients compared to the values during therapy (TC: mean±SD, 8·87±2·9v.5·48±1·6 mmol/l; LDLc: 6·66±2·6v.3·78±1·4 mmol/l; apo B: 1·66±0·48v.1·14±0·37 g/l;P<0·00001 for all variables). High‐density lipoprotein cholesterol (HDLc) was slightly higher before than during therapy (1·58±0·7v.1·31±0·4 mmol/l;P<0·05), while the main HDL apoprotein, apo A‐I, was significantly elevated (1·49±0·42v.1·13±0·27 g/l;P<0·0002). The increase of the second major HDL apoprotein, apo A‐II, was less pronounced (0·33±0·1v.0·30±0·08 g/l;P<0·022). The apo A‐I to apo A‐II ratio, which reflects the relative concentrations of the HDL subfractions HDL2and HDL3, was significantly higher before than during treatment (P<0·0006). Serum triglyceride levels were moderately elevated in the untreated hypothyroid patients (1·34±0·6v.0·95±0·4 mmol/l;P<0·002). The small decrease in body weight during therapy did not correlate with the changes of the various lipid and apoprotein parameters.These data indicate that severe hypothyroidism has a differential influence on the serum concentrations of the major HDL apoproteins, A‐I and A‐II, and sugges

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1984.tb00697.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.This paper reports the results of the second collaborative study of radioimmunological parathyroid hormone (PTH) determination in twenty‐two serum samples, performed by twenty‐four laboratories in the European PTH Study Group (EPSG). It demonstrates that radioimmunoassay systems can yield results that are clinically relevant in the differential diagnosis of hypercalcaemia. However, it also emphasizes, that numerical values, generated by a spectrum of different immunoassay systems cannot be compared directly. Numerical values can be compared, if the same reagents and method, provided as a kit, are used.Using their ‘in house’ reagents, fourteen out of twenty laboratories discriminated between low and normal iPTH serum, eleven of them between normal and marginal hyperparathyroid sera, seventeen of them between normal and grossly hyperparathyroid sera. Four laboratories agreed to a ranking order of serum samples, which was expected to cover all ranges on an average standard calibration curve, six were mistaking once, and ten two or more times.Using the kit, all participants but one discriminated between sera with low, normal, marginal and grossly elevated PTH and all agreed to the above ranking order of these sera.As far as these criteria are concerned, there was no relation between the quality of results, obtained with ‘in house’ reagents, and differences in antisera (but one, which was an anti human 1–34 PTH antiserum), methods of tracer preparation, and peptides used for tracer preparation. But only few laboratories, using bovine PTH standards were able to satisfy the above described conditions, whereas all of the laboratories, using human PTH standard preparations, did so with min

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1984.tb00698.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.Rabbit alveolar saturated phosphatidylcholine (SPC) can be separated by differential and density gradient centrifugation of lung lavage into three fractions. One fraction (‘B’), which is analogous to conventionally prepared alveolar surfactant, contains 46·0±5·9% (SD) of lavage SPC, and is made of large multilamellar vesicles or sheet‐like structures. A second fraction (‘C’) does not sediment after centrifugation at 80000gfor 90 min, contains 29·8±14·0% of lavage SPC, and a uniform population of small vesicles. This fraction incorporates3H‐palmitate administered intravenously with a small delay with respect to fraction ‘B’. A third fraction (‘D’) contains almost all the cells of lavage and less than 5% of lavage SPC.We conclude that alveolar SPC consists of more than one compartment. The possible significance of isolat

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1984.tb00699.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.The effect of captopril on blood pressure (BP) and various components of the renin‐angiotensin system was assessed in ten severely hypertensive patients. Captopril acutely reduced the BP with a maximum decrease of 23% at 90–120 min.Maintenance treatment with captopril alone could not control the BP in any of the patients. Addition of hydrochlorothiazide markedly reduced the BP, while supplementation with propranolol caused no consistent changes.Three patients attained a supine diastolic blood pressure (SDBP) ≤90 mmHg. Only two patients had a fall in SDBP less than 10 mmHg. One patient stopped because of taste disturbances.Monitoring the renin‐angiotensin system showed suppressed plasma concentrations of angiotensin II and increased levels of angiotensin I and renin, indicating the inhibition of converting enzyme activity. Plasma concentration of renin substrate decreased significantly. This observation has important implications for the methodology of renin assays.Captropril is an effective alternative in the treatment of hypertensive patients not readily controlled with conventional

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1984.tb00700.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.To establish the sensitivity of the gallbladder in relation to plasma concentrations of cholecystokinin, a dose‐response study was performed in five normal volunteers. Cholecystokinin octapeptide was infused in ascending incremental dose sequence, interval blood samples taken for estimation of plasma hormone concentrations and gallbladder emptying rates monitored continuously using99mTc‐HIDA. In five other volunteers, gallbladder emptying rates following a liquid fat meal were measured. Infusion rates of 0·0, 0·75 ± 0·2, 6·8 ± 0·5, 23·8 ± 1·6 and 66·1 ± 2·5 pmol cholecystokinin kg‐1h‐1produced plasma concentrations of<3·0 (undetectable),<3·0, 6·6 ± 1·8, 13·3 ± 1·5 and 26·9 ± 2·9 pmol l‐1respectively and gallbladder emptying rates (% min‐1) of 0·0, 0·0, 0·14 ± 0·15, 1·57 ± 0·38 and 4·29 ± 1·12. Following the fat meal, peak plasma cholecystokinin concentrations reach 30 pmol l‐1and gallbladder emptying rates (% min‐1) are 3·86 ± 1·01.We conclude that the threshold of the gallbladder to circulating cholecystokinin octapeptide is around 6 pmol l‐1, but that infusions which result in plasma levels of around 25 pmol l‐1produce gallbladder emptying rates comparable with those seen after oral fat. This suggests that the gallbladder is equally sensitive to endogenous and exogenous cholecystokinin and that plasma concentrations observed after o

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1984.tb00701.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.The action of catecholamines and somatostatin on cyclic adenosine 3′,5′ monophosphate (cyclic AMP) formation in human isolated gastric glands is reported.We show that: (1) there is a beta 2 receptor‐mediated stimulation of cyclic AMP production in fundus. Catecholamines act with the order of potencies isoproterenol (ED50= 50 nmol l‐1)>epinephrine (ED50= 0·1 μmol l‐1)>norepinephrine (ED50= 5 μmol l‐1). Their action is completely reversed by propranolol at doses 103times lower than practolol, while unaffected by phentolamine; (2) isoproterenol and Vasoactive Intestinal Peptide (VIP) have additive effects on cyclic AMP in fundic glands whereas no additivity is observed between histamine and isoproterenol; this, together with the absence of catecholamine effect in antral glands, suggests that the beta 2 receptor is located on parietal cells; (3) somatostatin (1 μmol l‐1) non‐competitively inhibits the stimulation by catecholamines but does not affect VIP and histamine stimulations.These results suggest a physiological stimulatory effect of catecholamines on gastric acid secretion in man, through a beta 2 receptor coupled to the cyclic AMP system, regula

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1984.tb00702.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.A 62‐year‐old man with clinical and biochemical findings consistent with homozygous Tangier disease is presented. Widespread atherosclerosis was present. Bile lipid analysis showed a low molar percentage of cholesterol with a low saturation index. The data suggest that high density lipoprotein cholesterol may act as a preferential precursor of bilary cholesterol. Coagulation and platelet studies indicated that the patient's platelets were hyper‐responsive to aggregating agents and produced an increased amount of thromboxane B2. A platelet storage pool deficiency was also

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1984.tb00703.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract.Clinical significance of immune complex‐like material in the serum was investigated in tumour patients undergoing plasma exchange with albuminsaline solution and subsequent chemotherapy. Immune complexes were detected by the C1q binding assay or the Raji cell radioimmunoassay in nine out of forty‐five patients before this therapy.Levels of immune complexes were decreased to 10–30% of the initial value by plasma exchange depending on exchanged plasma volume. In contrast to other serumproteins likeα1‐antitrypsin andα2‐macroglobulin, which showed protein specific increase during follow up after plasma exchange in all patients, recovery rates of immune complexes and IgG were highly individual but parallel in each patient.Clinical response to this protocol did not correlate with immune complex status, suggesting that removal of the measured immune complex like material had little clinical significance or was not longlasting enough to provide therapeu

ISSN:0014-2972    

DOI:10.1111/j.1365-2362.1984.tb00704.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY