Infradian, notably circannual, cardiovascular variation gauging effect of intrauterine exposure to beta-adrenergic agonists.
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Biomedical subjects
Publications and source records attributed to M Cagnoni.
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Decreased levels of angiotensin converting enzyme plasma activity were found in systemic sclerosis. No relationship with clinical characteristics of the disease and increased von Willebrand factor antigen concentration (a widely accepted marker of endothelial injury) were statistically demonstrated. An inverse relationship between the reduced activity of the enzyme and erythrocyte sedimentation rate was detected (r = 0.410, p less than 0.05). We hypothesize that in systemic sclerosis, angiotensin converting enzyme activity might be affected by a decrease in endothelial production or by interference of circulating factors. Further studies are needed to determine if angiotensin converting enzyme activity could be used as a marker of endothelial injury in scleroderma.
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A case of pachydermoperiostosis characterised by the presence of finger clubbing, periostosis, sweating of hands and feet is described. Modifications of capillaroscopic pattern and of arteriovenous anastomoses are reported. The periungual border and finger tip tissue showed diffuse endothelial hyperplasia, hyalinosis, and sclerosis with packing of collagen fibres. Electron microscopy showed hypertrophic and activated endothelia (numerous and hypertrophic Golgi complexes, several Weibel-Palade bodies, vesicles of micropinocytosis, and glycogen particles), the basal membrane thickened and reduplicated, perivasal infiltrate in superficial derma, reticulation and segmentary reduplication of basal membrane in arteriovenous shunt. In the perineural connective tissue numerous Luse bodies (long spacing collagen) were evident. The data indicate that in the early phase of pachydermoperiostosis morphological endothelial and collagen fibre abnormalities are present, though there is a normal peripheral blood flow.
Blood pressure and heart rate were oscillometrically monitored with an automatic Nippon Colin instrument (Komaki, Japan) and were also self-measured by a 20-year-old man treated with an inhalant-decongestant containing an adrenergic and a corticosteroid analog. The subject also collected 24-hr urines for aldosterone determination. An elevation of urinary aldosterone excretion was observed compared to the usual value range of a peer group. After removal of the drug, urinary aldosterone dropped as did urinary potassium, whereas plasma potassium rose. Chronobiologic serial sections, carried out to follow the time course of blood pressure and heart rate, showed decreasing trends in MESOR after discontinuance of treatment. A decrease in the hyperbaric index, a measure of blood pressure excess over 24 hr, was also observed. Another subject treated with the same and a third treated with a similar inhalant-decongestant, who also monitored their blood pressures automatically and/or with self-measurements, showed similar effects: a decrease in blood pressure after removal of treatment and an increase in blood pressure when (for testing only) treatment was briefly resumed.
At present, neonates are being given screening tests for relatively rare diseases, such as phenylketonuria. The time has come to give emphasis to assessing the risk for major handicapping diseases, such as coronary heart disease, stroke, and certain diseases of the kidney. Modern technology for blood pressure and heart rate monitoring and data analysis provides noninvasive means to determine when preventive measures are indicated.
The 4-hr sampling schedule for a single day demonstrated a prominent circadian rhythm of prolactin (PRL) in clinically healthy women and in mastopathy (FM) patients (with mesor hyperprolactinemia). This chapter reports on differences in time series of serum PRL observed between FM patients and healthy women in the follicular and luteal phases. Thirteen FM patients and six healthy women (controls) were sampled at intervals of 60 min for 24 hr in the two phases of the menstrual cycle. Serum PRL was determined by RIA. The results from spectral analysis of these data showed prominent circadian rhythms and an ultradian (12-hr) significant component in the PRL of controls and FM patients in both phases of the menstrual cycle. The acrophases of the 12-hr rhythms, however, clearly differed in controls and FM patients.
The lymphocyte surface phenotype of lymph nodes from patients with larynx or urinary bladder carcinoma was investigated by using a panel of monoclonal antibodies. The phenotype pattern of lymphocytes from lymph nodes invaded by malignant cells (as assessed by histopathology) was different from that of the cells from noninvaded or normal control nodes. Although the proportion of natural killer cells or macrophages was similar in the 3 groups of lymph nodes, invaded lymph nodes contained a higher proportion of T-cells and a lower B-cell percentage. Furthermore, cells from invaded nodes comprised 15-20% of T3+ T8+ cells that coexpressed the M1 marker and, to some extent, also the Leu 7 marker. A large proportion of cells with multiple markers were activated, as shown by the expression of Tac and HLA-DR antigens. In 2 patients activated T8+ cells expressing also M1 and Leu 7 markers infiltrated the tumor site. The presence of these activated cells both in involved nodes and tumor mass may indicate that they originate in response to cancer.
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Bromocriptine mesylate lowers the serum concentration of prolactin and TSH in patients with prostatic hypertrophy as a function of drug administration time. The effect of a 2.5-mg dose in lowering these two hormones in presumably similar patients is statistically highly significant and relatively large at unusual test times (in the evening); at other, conventional test or administration times (early morning or midday), it is smaller, questionable, or not demonstrable with the dose and conditions used. Dosing without timing may lead to reduced effect or lack of effect, ambiguity and controversy, and lack of timing may account for the circumstance that an effect of bromocriptine upon TSH in human serum was not previously established. Rigorous assessment of the effect of bromocriptine mesylate upon circulating TSH and prolactin requires consideration of the entire spectrum of rhythms, ultradian and infradian as well as circannual. The circadian approach here analyzed represents a step toward that goal and indicates that the circadian frequency is a critical determinant of this response. Manipulation of TSH concentration in serum, in turn, is of interest in view of the demonstrated alteration of the circannual TSH rhythm in patients with prostatic cancer.
Classical epidemiology associates human breast cancer with several risk factors including, among others, so-called preclinical hypothyroidism, fibrocystic disease of the breast (FM), and hyperprolactinemia. Relationships among FM, hyperprolactinemia, and thyroid function are of interest because of the possibility of multiple risk combinations. Prolactin and TSH (the latter as a presumed index of preclinical hypothyroidism) undergo rhythmic changes and hence should be chronobiologically investigated. Serum samples obtained at 4-hour intervals throughout a 24-hour span from 23 healthy women and from 25 women with FM (histologically verified) here summarized suggest that circadian mesor-hyperprolactinemia is a feature associated with FM. In a broader context, however, such impressions and an often considered modest impairment of thyroid function in some patients must be viewed in the light of new chronobiologic rules. These include a reciprocity of the circannual amplitudes of TSH and prolactin in relation to breast cancer risk, revealed by cooperative studies. A yet broader chronoepidemiologic view reveals that the reciprocal relation of the circannual amplitudes of circulating TSH and prolactin is (sex) inverted in patients with cancer of the prostate.
Prolactin and TSH were determined in serum samples obtained at 4-hourly intervals throughout a 24-hour span from healthy women and from women with fibrocystic mastopathy, fibroadenoma or carcinoma of the breast. Data were subjected to analysis by the population mean-cosinor method. Differences in circadian mesor of prolactin among the 4 groups were statistically significant (P < .01), with healthy women having the lowest value. Prolactin amplitude differences among the groups were of borderline statistical significance (P = .05), while no differences in circadian acrophase were apparent. No statistically significance differences in TSH circadian mesor, amplitude or acrophase could be demonstrated. Individual values from subjects with breast disease were compared with time-qualified tolerance intervals based on data from healthy subjects. If these results can be corroborated on larger populations, sampling about 3 hours after arising may best detect an abnormal serum prolactin elevation. Results from this and other studies indicate the need for multi-variable and multifrequency investigations of breast disease.
Urinary melatonin excretion is lower in East-Asian (Japanese) than in North-American (whites of mixed ethnic origin) women. Moreover, a statistically significant circadian rhythm is demonstrated by population-mean cosinor in the data pool from both groups of women. Furthermore, statistical significance characterizes interactions of effects from geographic differences (between ethnic groups) with temporal factors. Such spatio-temporal interactions await further scrutiny with a view inter alia of carcinogenesis as it is influenced by a spectrum of intermodulating rhythms.
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