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The force required to induce hemivein pulsation is associated with the site of maximum field loss in glaucoma.

PURPOSE: To determine the factors associated with central retinal vein pulsation changes in glaucoma and identify any hemiretinal vein pulsation changes and their association with sectoral visual field loss. METHODS: One hundred twenty-six patients with glaucoma and 40 normal subjects had automated perimetry, blood pressure, and intraocular pressure measured. A hemifield sensitivity loss was calculated from the upper and lower halves of each field. Those without spontaneous venous pulsation on the optic disc had an ophthalmodynamometer applied, to measure the minimum ophthalmodynamometric force (ODF) necessary to induce venous pulsation. When ODF was restricted to the hemiveins, the force needed to induce pulsation in each hemivein was measured. RESULTS: Eighty-three patients with glaucoma had no spontaneous venous pulsation. The minimum ODF was strongly correlated with mean deviation (Spearman rank r = -0.475, P < 0.0001). Mixed linear regression analysis showed that mean deviation (P < 0.0001) and pulse blood pressure (P < 0.0001) were significantly associated with minimum ODF. There was a strong association between differences in hemifield sensitivity loss and in hemivein ODF (rank r = 0.369, P < 0.0001, n = 80). Multiple linear regression modeling demonstrated that lower hemivein ODF was independently associated with upper field loss (P = 0.003) and upper hemivein ODF with lower field loss (P < 0.0001). CONCLUSIONS: These venous pulsation findings in glaucoma are independent of blood pressure. The hemifield and hemivein association suggests that the major hemivein change is adjacent to the site of major disc damage.

Aged↗

Epidemiology of syphilis in Hungary between 1952 and 1996.

Trends in morbidity from syphilis in Hungary between 1952 and 1996 were analysed. The incidence of syphilis/100,000 inhabitants declined rapidly owing to the public health and therapeutic measures of the early 1950s (1952: total=73.6, early infections=60.2; 1962: total=13.7, early infections=8.7). After a temporary, slight increase until 1973 the number of reported syphilis cases declined continuously between 1978 and 1989 (1989: total=0.9, early infections=0.84). In 1994 a marked increase occurred when compared with 1993 (1993: total=early: 1.4. 1994: total=2.3, early infections=2.2). Incidence trends were statistically analysed using Chi-square test and linear regression. Chi-square analysis showed that the changes in the incidence of total and early syphilis are significant (P<0.00001) comparing the time intervals 1952-1962 with 1962-1966 and 1975-1979 with 1988-1992. The same trends were found using the linear regression test, except for the time interval of 1960-1973.

Adolescent↗

What are production diseases, and how do we manage them?

The term "Production Diseases" referred traditionally to those diseases induced by management practices, metabolic diseases are typical examples. Recently, the term "Production related diseases" has been enhanced to include other traits, such as infertility, and diseases such as mastitis and lameness that might involve infectious agents but exacerbated by nutritional or managemental factors. The presentation deals with Production Diseases in the context of integrated herd health programs, using periparturient diseases and traits as an example. Studies, based on 9377 lactations of cows calving in the period 1995 through 1998 from the author's practice in 7 Israeli Holstein herds, show that most periparturient diseases and traits are followed by increased culling, lower production associated with late peaks and lower persistency, and impaired fertility. The effects are independent of other diseases, and at times are long lasting. Production Diseases are often multifactorial and appear at the same stage of lactation. Independent relationships among them must be established, so that common cause effects, direct and indirect causal associations, and incidental relationships can be differentiated. Control of Production Diseases often involves various disciplines and therefore calls for a "multivariate approach". Such an approach, centered on the herd, has led to the adaptation of integrated programs for herd health. The programs are characterized by the adaptation of multidisciplinary, multifactorial, and a population approach to clinical entities. Preventive measures and routine examinations are the hard core of programs, but deeper involvement in nutrition, production and economics is called for. A routine monitoring and causal analysis of periparturient traits and diseases, production, fertility and abortions are carried out, relevant data are processed, and monitoring reports are issued routinely. Five different linear regression models evaluate factors responsible for losses of a) peak milk yield; b) economy corrected (ECM) peak milk yield; c) extended 305-d milk yield; d) daily 3.5% FCM in the first 90 days in milk; and e) persistencies. Three different logistic and linear regression models evaluate factors that contribute to a) "non pregnancy to first service"; b) unobserved heat; and c) open days. Narrowing down the field of investigation is essential for an intervention to be efficient. Conclusions are drawn from the epidemiological study and the proposed recommendations are weighed with cost/benefit considerations. Possible losses are quantified and used with expected return value in decision analysis. Production Diseases are at times the outcome of managemental mistakes brought about by the drive for higher yields. Integrated herd health programs help to control the negative effects of management by enhancing production under optimal feeding and management regimens. The estimated contribution of improved management to the Israeli national herd phenotypic increase in yield, and the improved fertility that followed the increase in milk yield presented, show that the goal is within reach.

Animal Husbandry↗

Aerobic capacity, obesity, and atherosclerotic risk factors in male adolescents.

Correlations between aerobic capacity, obesity, and atherosclerotic risk factors were evaluated in adolescents with low-to-moderate levels of physical fitness. Subjects with higher levels of fitness had a more favorable risk profile with decreased body mass index, lower systolic and diastolic blood pressure and plasma triglyceride levels, and higher plasma high-density lipoprotein-cholesterol levels. Simple linear regression analysis revealed an association between body mass index and blood pressure, plasma triglyceride and plasma high-density lipoprotein-cholesterol. The level of aerobic fitness as determined by exercise duration was also associated with the same atherosclerotic risk factors. However, multiple linear regression analysis demonstrated that body mass index provided the largest explanation, by those variables examined, of the interindividual variance in blood pressure, plasma triglyceride, and high-density lipoprotein-cholesterol. Aerobic fitness contributed only minimally to the variation in these risk factors. These findings suggest that if aerobic conditioning is used to modify atherosclerotic risk factors, it should be accompanied by a reduction in weight in adolescents with low-to-moderate levels of physical fitness.

Adolescent↗

Vitamin E status of infants at birth.

Preterm infants may be susceptible to chronic lung disease and retinopathy of prematurity because of deficient antioxidant mechanisms including deficiency of vitamin E. The aim of this study was to evaluate the status of the antioxidant vitamin E among preterm and term livebirths. Umbilical cord blood samples collected from 40 preterm and 180 term babies were analyzed for vitamin E levels using high performance liquid chromatography. Linear regression analysis was used to examine the relationship of vitamin E with gestational age, birth weight and appropriateness of weight for gestational age. The median vitamin E level of preterm babies (2.61 mg/L) was not significantly different from that of term babies (2.77 mg/L), p = 0.2. Linear regression analysis demonstrated a weak but statistically significant correlation between cord blood vitamin E levels and gestational age (r = 0.14, p = 0.046). Vitamin E levels did not correlate with birth weight or weight for gestational age. Preterm babies had a higher incidence of vitamin E deficiency compared to term babies (38% v 19%, p = 0.02). Our findings lead us to conclude that vitamin E accumulates in the fetus throughout the third trimester so that preterm infants are likely to have vitamin E deficiency.

Birth Weight↗

Prediction of the volume of distribution of a drug: which tissue-plasma partition coefficients are needed?

The aim of this study was to identify the tissue-plasma partition coefficients (Kp) needed for an initial prediction of the volume of distribution at steady state (Vd(ss)) of a drug in humans. Values of Kp were collected from the literature. Only Kp values plausibly representing true steady state distribution were accepted, and data had to be available for muscle, fat, skin and at least five other organs. The apparent volume of distribution of a drug in an organ/tissue (Vapp) was calculated as Kp multiplied by the volume of the organ/tissue, and the Vd(ss) as the sum of all available Vapp values. The percentage contribution of each Vapp to the Vd(ss) was estimated. In addition, linear regressions were calculated between Kp values of all drugs in a specific organ/tissue and Kp in muscle or fat. Finally, the Vd(ss) was re-calculated using (for basic drugs) the Kp in fat to calculate Vapp in fat and lungs and the Kp in muscle for the Vapp of all other organs/tissues. The two sets of estimates of Vd(ss) were compared by linear regression. The same calculations were performed for acidic drugs, except that muscle Kp was used also forthe lungs. Distribution to fat and muscle accounted for 84% (61-91%) (median and range) of the total estimated Vd(ss) of the basic drugs (n = 17). The regressions between Kp in organs/tissues and muscle Kp were statistically significant except in the case of liver. For acidic drugs (n = 18), distribution to fat and muscle accounted for 65% (42-92%) of Vd(ss), and the regressions of Kp were significant for all organs/tissues except kidney and bone. For both types of drugs, correlations between organ/tissue Kp values and Kp in fat were generally worse. There were excellent linear correlations between Vd(ss) calculated by means of only two Kp values and the originally calculated Vd(ss) (r2> or = 0.99 for both basic and acidic drugs; slopes were notsignificantly different from unity). Thus, initial estimation of the Vd(ss) of a new drug can normally be based on only two Kp values, those of muscle and fat. The muscle Kp can be used to represent all lean tissues, including the residual "carcass", with the exception that fat Kp can be used for distribution of basic drugs to lungs.

Adipose Tissue↗

The mechanism of the vagal bradycardia evoked by diencephalic stimulation in the rabbit.

Blood pressure, in the rostral arterial system, was varied in the range 38-122 mm Hg by impeding the flow through the descending thoracic aorta in rabbits, anaesthetized with urethane and chloralose, in whom the spinal cord had been transected at mid-cervical level. Resting heart rate (H.R.) varied inversely with mean rostral arterial blood pressure (B.P.). The linear regression of H.R. on B.P. had a slope that averaged -0.38 beats X min-1 X mm Hg-1. Electrical stimulation in the lateral hypothalamic area, using 10 s trains of 300 microA X 1 ms constant current cathodal pulses at 60 Hz, caused H.R. to slow, provided that B.P. was above a threshold value and that the baroreceptor afferent pathway was intact. The mean threshold pressure was 49.5 mm Hg. Above threshold, the linear regression of the fall in H.R. during stimulation (delta H.R.) on B.P. had a slope that averaged -1.33 beats X min-1 X mm Hg-1. Linearity was good (r = 0.96). The results suggest that an inflow of baroreceptor impulses is essential for electrical stimulation of the cardioinhibitory region in the lateral hypothalamic area of the rabbit to cause bradycardia. This action is brought about by an increase in the gain of the vagal cardiodecelerator limb of the baroreceptor reflex.

Animals↗

Relationship of gated SPECT ventricular function parameters to angiographic measurements.

OBJECTIVES: Left ventricular volumes and ejection fractions constitute important information in the diagnosis of cardiac disease. This investigation examined the relations of functional parameters computed with a recently published scintigraphic gated tomographic method with those from angiography, analyzing discrepancies arising from differences involved in modeling the left ventricle. BACKGROUND: While left ventricular ejection fractions obtained from myocardial perfusion gated single-photon emission computed tomography (SPECT) have demonstrated accurate comparisons with other imaging modalities, validations of volumes have not been examined as extensively, and some recent studies have reported a wide range of angiographic correlation. It is important to know how volumes obtained by a new class of methods compare with those from older, well-established techniques in order to interpret individual patients' results, particularly when scintigraphic images are severely hypoperfused. METHODS AND RESULTS: Tc-99m sestamibi myocardial perfusion gated SPECT data were processed retrospectively for 58 patients studied by single-plane angiography. Endocardial borders were generated automatically on paired vertical and horizontal long-axis Tc-99m sestamibi gated tomograms for computing ventricular volume using a Simpson's rule summation of elliptical slices. Linear regression and paired t tests were used to compare SPECT with angiographic parameters for all patients and for groups identified on the basis of tomogram visual examination as hypoperfused, ischemic or nonischemic, with the latter category further subgrouped as to fixed defects or normal perfusion. Linear regression analysis demonstrated Pearson correlation coefficients of 0.87 for end-diastolic volumes, 0.91 for end-systolic volumes, and 0.86 for ejection fraction; paired t test analysis showed end-systolic volumes to be nearly identical (p > 0.99) to angiographic values. However, paired t tests also revealed gated SPECT end-diastolic volumes and ejection fractions were significantly lower (p < 10(-4)) than angiography. Correlations and trends were essentially the same for all subgroups except for the small sample (n = 10) of patients with normal perfusion. CONCLUSIONS: Gated SPECT provides ventricular volumes and ejection fractions that correlate well with angiography, even in hypoperfused and ischemic populations. However, gated SPECT end-diastolic volumes and ejection fractions are significantly lower than angiographic measurements, partly because of inclusion of greater outflow tract amounts in standard angiographic models. Because myocyte concentration decreases rapidly at the ventricular base, it is likely that most gated SPECT methods will produce endocardial borders encompassing less of the outflow tract than do angiographic outlines.

Coronary Angiography↗

Multivariate predictors of intravascular ultrasound end points after directional coronary atherectomy.

OBJECTIVES: This study attempted to identify the clinical, angiographic, procedural and intravascular ultrasound predictors of directional atherectomy results assessed by intravascular ultrasound. BACKGROUND: Several angiographic and intravascular ultrasound variables have been associated with the outcome of directional coronary atherectomy. No study has incorporated both modalities into a predictive model. METHODS: One hundred seventy patients were analyzed using preintervention and postintervention intravascular ultrasound and quantitative angiography. Clinical and procedural variables were collected by independent chart review. Quantitative and qualitative angiographic analysis was performed by a core laboratory in blinded manner. Intravascular ultrasound was performed using a transducer-tipped catheter, rotating within a stationary imaging sheath, and withdrawn automatically at 0.5 mm/s. Clinical, procedural, angiographic and ultrasound variables were tested in a multivariate linear regression model. Dependent ultrasound variables included postatherectomy lumen cross-sectional area and percent cross-sectional narrowing (plaque plus media/external elastic membrane cross-sectional area) and, in a subgroup of 47 patients studied using volumetric analysis, percent plaque volume removal. RESULTS: By multivariate stepwise linear regression analysis, predictors of residual lumen cross-sectional area (correcting for reference lumen area) included arc of calcium and preatherectomy plaque plus media cross-sectional area; predictors of residual cross-sectional narrowing were arc of calcium, preatherectomy plaque plus media cross-sectional area and lesion length; and predictors of percent plaque volume removal were arc of calcium and atherectomy device size. CONCLUSIONS: The preintervention lesion arc of calcium measured by intravascular ultrasound is the most consistent predictor of the effectiveness and results of directional coronary atherectomy.

Atherectomy, Coronary↗

Relation between pulmonary clearance and particle burden: a Michaelis-Menten-like kinetic model.

OBJECTIVES: To test the validity of a Michaelis-Menten-like kinetic model of pulmonary clearance of insoluble dusts. METHODS: Data were investigated from studies of pulmonary clearance in F344 rats exposed to antimony trioxide (Sb2O3), photocopy test toner, polyvinyl chloride powder (PVC), and diesel exhaust particles. The Michaelis-Menten-like model was used to develop a relation in which the pulmonary clearance half time was a linear function of lung burden. After combining all data, linear regression techniques were applied to investigate the underlying relations. With the estimated intercepts and slopes, the Michaelis-Menten-like kinetic parameters kmax (maximal clearance rate) and m1/2 (a characteristic lung burden at which kmax is reduced by 50%) were derived for the four dusts. RESULTS: The experimental data fit the linear regression very well (R2 = 0.989), suggesting that pulmonary clearance for the four dusts followed Michaelis-Menten-like kinetics. Values of the intercept terms were not significantly different among the four dusts (P = 0.294), indicating that the intrinsic clearance rates of F344 rats were the same among the four experiments. The intrinsic clearance half time was estimated to be 77.8 days, leading to an estimated kmax of 0.0089 day-1. However, the slopes of the linear relations were significantly different among the four dusts (P < 0.001). Values of m1/2 were ranked in the order of: Sb2O3 (0.69 mg) < photocopy test toner (0.97 mg) < diesel exhaust (2.49 mg) congruent to PVC (2.90 mg). CONCLUSION: This study suggests that the Michaelis-Menten-like kinetic model reasonably describes the kinetic behavior of pulmonary clearance in F344 rats. The parameters m1/2 can be used to differentiate the potency of a particular dust for impairing pulmonary clearance.

Air Pollutants↗

Prediction of percutaneous absorption from physicochemical data: a model based on data of in vitro experiments.

Correlations between in vitro percutaneous absorption data and physicochemical properties of industrial chemicals are evaluated in order to develop predictive mathematical models based on said properties. Percutaneous diffusion of 16 pounds of occupational interest, eight of which were polycyclic aromatic hydrocarbons (acenaphthene, anthracene, benzo(a)anthracene, chrysene, phenanthrene, fluorene, naphthalene, pyrene), six organophosphorus insecticides (acephate, chlorpyrifos, dimethoate, fenitrothion, methamidophos, omethoate) and two phenoxycarboxylic herbicides (2,4-D, MCPA), were tested in vitro using monkey (Cercopithecus aetiops) skin. The test apparatus consisted of nine static diffusion cells with normal saline, gentamycin sulphate and 4% bovine serum albumin as receiving solution. Test compounds were applied at various concentrations in 30 microliters of acetone solution and determined, in the receiving phase, by chemical analysis. Values for ln Kow (octanol/water partition coefficient) were correlated with experimentally determined values of the permeability constant Kp (r = 0.90, P < 0.001) and lag time (r = 0.81, P < 0.01). Analysis of variance in a model of multiple linear regression between Kp, ln Kow and water solubility [water] of the compounds, showed that the data had a highly significant fit (P < 0.0001). A more general model which also included molecular weight (MW) and vapour pressure was evaluated as well, but the two variables made no substantial difference. Multiple regression analysis between lag time, ln Kow and [water] was significant (P < 0.0001), whereas introduction of vapour pressure and MW as independent variables did not significantly improve the predictive effect on lag time. Our experimental system, therefore, enables the values of Kp and lag time to be predicted with reasonable precision on the basis of ln Kow and [water] values, using the algorithm derived from the multiple linear regression equation.

Animals↗

Vein adaptation to the hemodynamic environment of infrainguinal grafts.

PURPOSE: Although arteries appear to remodel in response to changes in hemodynamic parameters such as shear stress, little is known about functioning human vein grafts. This study was designed to explore diameter changes in human saphenous vein grafts after infrainguinal bypass. METHODS: We used duplex ultrasonography to measure hemodynamic variables that might affect the diameter of 48 in situ saphenous vein grafts during the first year after infrainguinal arterial bypass. Volumetric flow rate, average velocity, peak systolic velocity, and vein diameter in the proximal and distal thirds of these grafts were each measured at 1 week and at 3, 6, and 12 months after operation. Veins were divided into three groups based on initial size (1 week after bypass) in the below-knee segment: small, < 3.5 mm diameter; medium, 3.5 to 4 mm diameter; and large, > 4 mm diameter. RESULTS: Distal vein diameters at 1 week for small, medium, and large grafts were 2.9 +/- 0.1, 3.7 +/- 0.1, and 4.3 +/- 0.1 mm, respectively (p < 0.001), but by 12 months these diameters were 3.6 +/- 0.2, 3.8 +/- 0.2, and 3.9 +/- 0.2 mm, respectively (p = 0.54). Large veins decreased in diameter, whereas small veins increased in diameter, as confirmed by linear regression of percent change in diameter versus initial vein graft diameter (r = -0.62, p < 0.001). Volumetric flow rate, peak systolic velocity, and shear stress also tended to approach uniform values over time. Of the hemodynamic variables studied, the best predictor of diameter change was shear stress (linear regression of percent change in diameter vs shear stress, r = 0.67, p < 0.001). Veins with a diameter increase greater than 10% over time had significantly higher initial shear stress than veins with a diameter decrease greater than 10% over time (28.6 +/- 3.8 vs 13.1 +/- 1.8 dynes/cm2, p < 0.01), whereas initial volumetric flow rates in these two groups were similar (135 +/- 23 vs 130 +/- 15 ml/min). CONCLUSIONS: Infrainguinal in situ vein graft diameter, volume flow rate, peak systolic velocity, and shear stress all tend to stabilize at uniform values regardless of the initial vein graft diameter. Of the hemodynamic variables studied, shear stress is most strongly associated with the change in diameter over time. Thus human saphenous vein appears to be capable of adapting to its hemodynamic environment after arterial grafting by modulating diameter to normalize shear stress.

Adaptation, Physiological↗

Comparison of the utility of CT scans and intravascular ultrasound in endovascular aortic grafting.

Using CT scans and intravascular ultrasound (IVUS), aortic, aneurysm neck, and endoluminal graft cross-sectional dimensions were compared in a canine model before and after placement of endoluminal grafts in normal aortas (n = 10) and in artificially constructed abdominal aortic aneurysms (n = 15). Measurement of diameters (n = 83) revealed an average difference or bias between imaging modalities of 0.17 +/- 0.92 mm. Measurements obtained using IVUS were slightly larger than CT values (8.84 +/- 1.0 vs. 8.65 +/- 1.1, p < 0.03) but correlated very well by linear regression analysis (r = 0.948, p < 0.02). Analysis of cross-sectional area (n = 44) revealed an average difference or bias of 7.21 +/- 7.76 mm2 between the two modalities. Again IVUS measurements were larger than CT measurements (65.0 +/- 16.5 vs. 57.9 +/- 11.9, p < 0.001) and linear regression analysis showed less correlation (r = 0.897, p < 0.001). Qualitative assessment of the graft and stent characteristics was more precise using IVUS. Graft folding, stent-aorta interfaces, and thrombus formation were easily identified by IVUS, whereas these more subtle characteristics were missed by CT scanning and arteriography. These studies demonstrate that IVUS measurements were slightly larger than CT values; however, both modalities demonstrate small bias and good correlation. Qualitative analysis of the aneurysmal aorta and endoluminal graft using IVUS is comparable to and in some respects more detailed than measurements from CT scanning and arteriography.

Animals↗

Kinetic catalytic determination of trace Cu(II) in water samples with the thioglycolic/thiolactic acid-chromate reaction.

The use of two novel similar indicator reactions as applied to the kinetic determination of Cu(II) in water is investigated. The methods rely on the catalytic effect of the analyte on the oxidation of thioglycolic (TGA) and thiolactic (TLA) acids by chromate in acidic media. The extent of the reactions was followed spectrophotometrically at 345 nm. Pseudo-first-order rate coefficients, k(obsd), were determined as a function of catalyst concentration. Interference of Fe(III) and Pb(II) was suppressed by complexation with pyrophosphate. For the reaction of TGA, a linear regression for k(obsd) versus [Cu(II)] was obtained for the entire concentration range considered. Although the plot corresponding to TLA oxidation exhibits a sharp change of slope at approximately 1.8x10(-5) M Cu(II), it can still be described effectively by two linear regressions with different slopes. The reaction of TGA is more sensitive than that of TLA at low Cu(II) concentration. The opposite is true for higher catalyst contents. The detection limits were 65 microg L(-1) for TGA and of 80 microg L(-1) for TLA oxidation, respectively. The relative standard deviations, of 0.4% for TGA and 1.1% for TLA oxidation, respectively, were obtained for five replicate runs at 1000 microg L(-1). Samples of river and wastewater from the mining region of Baia-Mare, Northern Romania were analyzed using the more sensitive reaction of thioglycolic acid. Results were compared to those obtained by the officially standardized methods. Good agreement was obtained, even for an untreated sample. Measurements did not require prior separation of interfering species.

Journal Article↗

Decreased serum adiponectin in adolescents and young adults with familial primary hypercholesterolemia.

Decreased serum adiponectin is associated with dyslipidemia. However, serum adiponectin status has never before been studied in patients with familial-related severe primary hypercholesterolemia (FRSPH). The aim of this study is to measure serum adiponectin level in a group of young patients with FRSPH and determine its correlation with insulin-resistant status. Twenty-three patients with FRSPH [average LDL-cholesterol (LDL-C) = 250.8 (190-610) mg/dL] without clinical manifestations of metabolic syndrome as well as 46 healthy (control) adolescents and young adults (<30 yr old) were included. The serum adiponectin, fasting sugar, insulin, lipids, systolic and diastolic blood pressure (SBP and DBP), and anthropometrical indices such as body mass index and waist circumference were obtained. The homeostasis model assessment (HOMA) was calculated to estimate the insulin resistant status. Compared with healthy controls, patients with FRSPH had a significantly lower mean serum adiponectin level (7.7+/-1.8 microg/mL vs. 10.1+/-4.3 microg/mL, P= 0.013). After adjustment for HOMA and associated covariates, multiple linear regression analysis showed that patients with FRSPH are significantly associated with hypoadiponectinemia. Compared with healthy controls, patients with FRSPH had a significantly lower mean serum adiponectin level (7.7 +/-1.8 microg/mL vs. 10.1+/-4.3 microg/mL, P = 0.013). After adjustment for HOMA and associated covariates, multiple linear regression analysis showed that patients with FRSPH are significantly associated with hypoadiponectinemia. The serum adiponectin levels are lower in young patients with FRSPH without clinical manifestations of metabolic syndrome. The mechanism of hypoadiponectinemia in patients with FRSPH is probably independent of insulin resistance.

Adiponectin↗

Levels of immunoglobulin E (IgE) in paired examinations of serum and synovial fluid in rheumatoid arthritis and reactive synovitis of local origin.

Levels of IgE were examined in pairs of serum and synovial fluid of the knee joint in a series of 78 patients with rheumatoid arthritis (RA), reactive synovitis during osteoarthrosis, and after injury. The IgE levels in synovial fluid were significantly lower (p less than 0.05) in all groups; in RA, they were in significant correlation (r=0.6208, p less than 0.0001) and in direct linear regression to the levels in serum. In 5 patients of the whole series, however, the IgE levels in serum were lower by one order of magnitude as compared with synovial fluid. Serum levels of IgE in RA were in significant correlation and in direct linear regression to the titres of rheumatoid factors according to the latex-fixation test (r=0.3688, p=0.0249) and the haemagglutination test with sheep red cells (r=0.3721, p=0.0235).

Adult↗

A rapid, sensitive, and easy-to-perform solid phase insulin radioimmunoassay.

Accurate measurement of basal insulin release in perifusion, perfusion and low-density beta-cell preparations has been difficult with present assays. A simple, competitive, equilibrium, 15-hour insulin assay using 125I-insulin with microtiter plate immobilized antibody, has been developed. This method, a Solid-phase-RadioImmunoAssay (SPRIA), is very sensitive and has a broad useful range (1 - 64 microU/ml). For a test series of 4 standard curves, interassay variation between controls of 1, 4, 16, and 64 microU/ml was +/- 5.2% (SEM) and intra-assay variation over the range of standards between 0.5 to 64 microU/ml was 5.1% (SEM). Nonspecific binding was not significantly different from empty borosilicate culture tubes; 4.0 +/- 0.4 and 3.5 +/- 0.5 counts/minute (mean +/- SEM; n = 54), respectively. This SPRIA can be used with existing gamma-counters, while reducing the radioactive and glass waste presently produced by RIA (test-tubes can be reused). The radioactivity of unused test-tubes was compared against test-tubes used for greater than 10 assays, values were 3.5 +/- 0.5 and 4.4 +/- 0.6 counts/minute mean +/- SEM; n = 54), respectively. Results of an oral glucose tolerance test (oGTT) performed on four male Wistar Furth rats showed a close correlation between SPRIA and RIA insulin values (linear regression, r2 = 0.990). This SPRIA measured plasma insulin levels from a human oGTT with a variation of less than or equal to 3.7% (SEM) between sample triplicates. Standard curves from three commonly measured insulin isoforms (human, rat and porcine) showed a high correlation (multiple linear regression, r2 = 0.998, n = 5 standard curves). In order to determine SPRIA's ability to measure acid extracts, insulin recovery from 2N acetic acid was compared against insulin recovery from Dulbecco's Modified Eagles medium (DME). The insulin recovery from 2N acetic acid was greater than 90% of that achieved with DME. In conclusion, an easy-to-perform assay which is ideal for the rapid quantification of insulin from isolated islets of Langerhans, isolated beta-cells, acetic acid extracts or plasma with greater sensitivity, and less waste than the conventional RIA has been developed.

Adult↗

Single beat determination of regional myocardial strain measurements in patients with atrial fibrillation.

Atrial fibrillation (AF) and congestive heart failure share several features and often coexist in the same patients; therefore, serial assessment of regional myocardial function is important for patients with AF. However, the clinical assessment of regional myocardial function in AF is unreliable and difficult because of beat-to-beat variation. Recent reports have shown that the ratio of the preceding to the prepreceding R-R interval (RR1/RR2) can be used to assess global left ventricular systolic function. Accordingly, we tested the hypothesis that regional wall motion can be estimated from a single beat based on RR1/RR2 in patients with AF. Peak systolic strain at basal, mid, and apical segments of the septal wall was measured by Doppler tissue imaging from an apical 4-chamber view for 30 seconds in 50 patients with AF (mean ejection fraction 52.1 +/- 15.3%; mean heart rate 76.4 +/- 16.0/min). There was a positive linear relationship between peak strain and RR1/RR2 and RR1, and a negative relationship with RR2, with the correlation of peak strain to RR1/RR2 was better than that in RR1 or RR2. Furthermore, peak strain at RR1/RR2 = 1 was calculated from the linear regression and compared with the average measured value of all recorded cardiac cycles in each patient. In all cases, average peak strain showed a significant positive correlation with RR1/RR2 at each segment (r = 0.99). In conclusion, regional myocardial strain at RR1/RR2 = 1 on the linear regression represents the average value of all recorded cardiac cycles in patients with AF.

Aged↗