Marginal Elevation Research Articles

Absence of circulating IgG immune complexes in minor recurrent aphthous ulceration.

A monoclonal rheumatoid factor binding assay has been employed to detect IgG type immune complexes in sera from 21 patients with minor recurrent aphthous ulceration and 31 control subjects. In only one of the ulcer group patients was there a marginal elevation of immune complexes above the normal range, with no statistically significant difference between the patient and control groups. Assays of intrinsic serum rheumatoid factor and serum IgG, IgM and IgA levels also showed no significant differences between patient and control groups, with all mean values falling within the normal ranges.

Age-related differences in the induction of 2–5A synthetase and 2–5A dependent binding protein activities by interferon in guinea pig peritoneal macrophages

2-5A synthetase and binding protein activities in peritoneal macrophages have been compared between young (6 month) and old (22-24 month) guinea pigs. Enzyme activities are lower in aged animals with a 17% and a 31% reduction in synthetase and binding protein activities, respectively. In addition, the response to the addition of mouse fibroblast interferon by macrophages from these two age groups is also substantially different. Whereas addition of interferon to young guinea pig macrophages elicits a 3.8- and a 1.7-fold increase in the synthetase and binding protein activities, only a marginal elevation in these two enzyme activities is found with interferon-treated old guinea pig macrophages. Analysis by thin layer chromatography demonstrates a marked difference in the relative distribution of the various oligomeric forms of 2-5A synthesized by young or old guinea pig macrophages. The binding protein in old animals appears to be significantly more thermolabile than the corresponding activity from young animals. The altered response to interferon and the difference in enzymatic properties in aged animals may represent part of the mechanisms involved in the progressive loss of the adaptative ability of an organism to environmental changes during senescence.

Radiologic manifestations of early gastric lymphoma

The radiologic features of 12 early gastric lymphomas in six patients were analyzed and correlated with the clinicopathologic findings. One 0.7-cm lesion on the anterior wall of the corpus could not be detected radiologically either prospectively or retrospectively. All tumors were smaller than 7.0 cm (mean, 3.5) and located within the stomach. A frequent finding was localized, slight enlargement of folds with a smooth contour, suggesting submucosal tumor infiltration. These folds were more apparent in the radiograph than in the surgical specimen, and were easily deformed by the compression method or became less prominent in the more distended stomach. Ulcer was demonstrated in all lesions, usually appearing as an unicentral, indefinite shallow depression. Deep, well demarcated ulcer was found in three lesions, and a smooth marginal elevation indicated a submucosal tumor growth. These findings were proven to be helpful in differential diagnosis from carcinoma and peptic diseases. All patients are alive and free of recurrence 15-112 months (mean, 53) after surgical resection.

Overview: toward a dysregulation hypothesis of depression.

The authors suggest that the activity of neurotransmitter systems in the affective disorders and related psychiatric syndromes may be better understood as a reflection of a relative failure in their regulation, rather than as simple increases or decreases in their activity. A model organized around the concept of "dysregulation" posits that persistent impairment in one or more neurotransmitter homeostatic regulatory mechanisms confers a trait vulnerability to unstable or erratic neurotransmitter output. Evidence from clinical and animal model studies for dysregulation of the noradrenergic system in depression is examined with respect to criteria generated by such a general model, and a specific configuration of noradrenergic dysregulation in some forms of depression is proposed.

Fibrinopeptide-A in diabetes mellitus. Relation to levels of blood glucose, fibrinogen disappearance, and hemodynamic changes.

Plasma and urine fibrinopeptide-A (FPA) levels were investigated in type I and II diabetic patients. Plasma FPA and 24-h urinary excretion of FPA were significantly elevated in diabetic patients compared with normal volunteers, indicating augmented thrombin activity in diabetes. Plasma and urine FPA did not differ between type I and type II diabetic subjects. Comparison of plasma FPA with blood glucose and hemoglobin A1 (HbA1) indicated that elevation of FPA is rapidly reversible and intermittent during hypo- and hyperglycemia. Although elevated plasma FPA was seen in patients of short as well as long duration of diabetes, plasma and urine FPA correlated with duration of diabetes in type I patients. In type I diabetic patients with vascular complications, hyperglycemia induced by an oral glucose challenge was accompanied by elevation of plasma FPA and acceleration of fibrinogen disappearance. These responses were not seen when the patients were treated with intravenous (i.v.) heparin before the glucose challenge. In patients without vascular complications, there was also an acceleration of fibrinogen disappearance and a marginal (not statistically significant) elevation of plasma FPA seen after the FPA response observed in vascular disease patients. In all patients, induced hyperglycemia resulted in a decrease in hematocrit and hemoglobin (blood volume expansion) and an increase in pulse pressure indicating hemodynamic changes. The association of hyperglycemia and hemodynamic changes with augmented thrombin activity is consistent with a mechanism for fibrin formation and deposition based on endothelial injury and/or increased vascular permeability. Fibrin deposition due to such a mechanism may participate in the development of the vascular complications of diabetes.

Biochemical responsiveness of a bovine kidney cell line to inorganic mercury.

Mercury compounds are known environmental pollutants. A bovine kidney cell line (MDBK) was used to assess the importance of a variety of biochemical cell functions to mercuric chloride (Hg) cytotoxicity. Mercury concentrations utilized ranged between 1–10 μM and elicited 0–45% cytotoxicity at 24-hr post-exposure. Leucine incorporation into cellular protein decreased in a concentration-dependent manner which paralleled the cytotoxicity. Thymidine incorporation into deoxyribonucleic acid was less sensitive to Hg inhibition. K+-dependent phosphatase (KP), succinate dehydrogenase (SDH) and acid phosphatase (AP) were monitored in surviving cells 24 hr post-exposure and in a cell-free system. The activity of KP was reduced to 50% of control activity following 24 hr exposure of MDBK cells to Hg. The activities of SDH and AP of treated cultures remained at control levels. Measurement of reduced glutathione after 24-hr treatment indicated a marginal elevation (120–176%). In a cell-free system, KP, SDH and AP were sensitive to Hg to varying degrees; KP and SDH were most sensitive with IC50s of 1 and 10 μM Hg, respectively. The importance of the biochemical changes in relation to the developing cytotoxicity are discussed.

Genesis and evolution of proteinuria in diabetes mellitus.

Approximately 40-45% of insulin-dependent diabetic (IDD) patients will develop, with time, clinical proteinuria, a forerunner of certain renal failure. Before this, however, up to 45% of IDD patients excrete supranormal amounts of protein in the urine, though still undetectable by dipstix test. This microproteinuria appears to be glomerular in origin, consists mainly of albumin and IgG, and is associated with poor glycemic control and marginal elevation of arterial pressure. Glomerular hemodynamic disturbances, and loss of charge selectivity of the glomerular membrane, are probably responsible for this microproteinuria, which appears reversible by correction of hyperglycemia and raised blood pressure. Once the dipstix test becomes positive (i.e. total urinary protein excretion exceeds 0.5 g/24h) and blood pressure rises into the hypertensive range, glomerular filtration rate (GFR) falls relentlessly. By the time GFR is as low as 20 ml/min/1.73 m2, more IgG relative to albumin is being filtered, giving rise to a low selectivity proteinuria, a condition consistent with changes in the size selectivity properties of the glomerular filtre. Glycemic control does not affect the decline in GFR, although blood pressure control and low protein diet can slow it, presumably by altering the self-perpetuating hemodynamic disturbances that occur in surviving glomeruli. The recent demonstration that IDD patients with microalbuminuria in excess of 30 micrograms/min have approximately a 20-fold increase in risk of developing persistent detectable proteinuria has provided a link between these two phases of diabetic nephropathy. The reversibility of the early microalbuminuria heralds a real chance of preventing the later irreversible phase of end-stage renal failure.

Urinary mutagens in humans after fried pork and bacon meals

Urinary mutagenic activity on Salmonella typhimurium strain TA1538 with S9 was determined after morning meals of fried pork and bacon. Both in fasting and non-fasting subjects a very marginal elevation of urinary mutagenic activity was observed, accounting for a small fraction only of the total amount of mutagens ingested.

Purine nucleotide reutilization by human lymphoblast lines with aberrations of the inosinate cycle.

A purine nucleotide (inosinate) cycle is demonstrated with human lymphoblasts. The lymphoblast requires approximately 50 nmol of purine/10(6) cell increment. When the inosinate cycle is interrupted by the genetic, severe deficiency of either or both purine nucleoside phosphorylase (PNP) or hypoxanthine phosphoribosyltransferase (HPRT), purine accumulates in the culture medium as inosine, guanosine, deoxyinosine, and deoxyguanosine (PNP deficiency or PNP, HPRT deficiency) or hypoxanthine and guanine (HPRT deficiency). This accumulation represents an additional 25 to 32 nmol of purine which must be synthesized per 10(6) cell increment. PNP-deficient lymphoblasts have PPRibP contents characteristic of normal lymphoblasts, about 20 to 25 pmol/10(6) cells. HPRT-deficient lymphoblasts have four times higher PPRibP contents. The lymphoblast deficient for both PNP and HPRT has only a marginal elevation of PPRibP content, 1.5 times normal values. The elevated PPRibP content of HPRT-deficient cells reflects the efficient, unilateral reutilization of the ribose moiety of purine ribonucleotides and is not a cause of purine overproduction. Purine overproduction characterizing PNP-deficient lymphoblasts appears similar to overproduction from deficiency of HPRT, i.e. a break in the inosinate cycle rather than overactive de novo purine synthesis.

MMPI-168 Factor Score Profiles for Major Diagnostic Groups

The purpose of the present study was to examine the MMPI-168 factor score profiles for groups of psychiatric patients whose clinical scale score profiles matched prototype patterns for schizophrenia ( N = 199), depression ( N = 215), and personality disorder ( N = 126). The MMPI-168 factor score profiles for a sample of 27 psychiatric outpatients meeting DSM III criteria for borderline personality were also examined. Suggestion of significant psychopathology was attributed to mean factor scores at or above the 90th percentile in a college student normative sample. According to this criterion, the personality disorder group had mean factor score: profile that evidenced significant elevation only on the Somatization factor. The depression group evidenced significant elevation on the Somatization and Depression factors. The borderline personality group evidenced significant elevation on Somatization and Depression, plus marginal elevation on Low Morale and Psychotic Distortion. The schizophrenia group evidenced significant elevation on Somatization, Depression, and Psychotic Distortion. All four diagnostic groups have elevated scores on a new general psychopathology screening scale (PSY). The results suggest that factor score profiles may contribute toward diagnostic interpretation of MMPI-168 records through simple representation of primary dimensions of psychopathology.

Treatment of maternal hyperthyroidism with antithyroid agents and changes in thyrotrophin and thyroxine in the newborn

Eleven pregnant women with concomitant hyperthyroidism were treated with antithyroid drugs. At monthly intervals serum thyroxine (T4) and triiodothyronine (T3) were measured with radioimmunoassay, the Sephadex uptake of radioactive triiodothyronine (T3U) determined the free T4 and T3 indices calculated (FT4I, FT3I). TSH-binding inhibiting immunoglobulins (TBII) were determined by the radiomembrane assay. Serum TSH and T4 were measured at delivery from cord blood and/or from the newborn infants some days after birth. Serum TSH was significantly elevated in one infant. There was an inadequate post-partal rise in serum T4 concentration in this child and in another who showed only a marginal elevation of TSH. The mothers of these infants were given carbimazole in doses of 30 and 25 mg/day, respectively, at the time of delivery. No significant changes were seen in other infants, the daily doses being 20 mg of carbimazole or less. There was no clinical indication of hypo- or hyperthyroidism in any of the newborn. The TBII were positive in most patients and there was a trend of normalization during treatment. No relationship between the dose of antithyroid drug and the level of TBII could be seen. During treatment the dose was adjusted according to the FT3I values. This seems to be an adequate laboratory test for this purpose.

A CASE OF THE SIMPLE NONSPECIFIC GIANT ULCER AT THE MIDDLE PART OF THE ESOPHAGUS

A case of the simple nonspecific giant ulcer at the middle part of the esophagus was reported. A 66 year-old woman was hospitalized with complaint of dysphagia and retrosternal pain. X-ray pictures showed slight irregularity like filling defect in the right-posterior wall of the middle part of the esophagus. Endoscopically, giant ulcer with marginal elevation measuring about 15cm in dianeter was observed. Biopsied specimen of the esophageal mucosa showed no malignancy histologically. Morphologic findings were different from those of the ulcer disease combined with reflux esophagitis near the esophago-gastric junction.

Clinical and Physiological Significance of Borderline Hypertension at Youth

Marginal blood pressure elevation at youth is widely prevalent. Clinically such patients represent a dilemma, since they are at highest risk to develop hypertension and its sequelae, but the risk is not sufficiently strong to mandate antihypertensive medication. The decision as to whether to treat will depend on the presence of other risk factors for hypertension. Multiple and complex pathophysiologic abnormalities have been described in borderline hypertension. A better understanding of the relationship of some of these abnormalities to the development of hypertension is needed.

Effects of a polychlorinated biphenyl mixture (aroclor 1254) and DDT on biliary thyroxine excretion in rats.

Treatment of rats with a polychlorinated biphenyl mixture (Aroclor 1254; PCB) causeda 4- to 5-fold increase in the 3-hr biliary excretion of 125I-thyroxine (T4). In treated rats bile flow was increased and the 125I-T4 bile:plasma ratios (B/Pratios) and biliary clearance rate of plasma 125I-T4 were greatly elevated. The proportion of biliary 125I present as T4-glucuronide was larger in PCB-treated rats. PCB also elevated thyroid 13II uptake andreduced serum PBI concentrations. DDT did not affect the biliary excretion of 125I-T4, but did increase bile flow and the biliary clearance rate of plasma 125I-T4. It also caused a marginal elevation of B/P ratios and increased the proportion of biliary 125I present as T4-glucuronide slightly but significantly. DDT did not affect thyroid 13II uptake or serum PBI concentrations. The effects of PCB were similar to those of the polycyclic hydrocarbon-type of enzyme inducers. The results of DDT-treatment were similar to those produced by the phenobarbital type of inducer...

Ionised calcium levels in "normocalcaemic" hyperparathyroidism.

Five subjects presenting with renal stone, hypercalciuria and normal total serum calcium showed persistent elevation of ionised plasma calcium and marginal elevation of plasma parathyroid hormone concentration. Neck exploration revealed a parathyroid adenoma in each, and parathyroidectomy has been followed by reduction in both plasma ionised calcium and urine calcium. Ionised calcium measurement is an important aid in the differential diagnosis of idiopathic hypercalciuria from ‘normo-calcaemic’ hyperparathyroidism.

Principal Features of Cuban Geology

The Cuban orthogeosyncline consists, from north to south, of a platform region (Bahamas parageosyncline), a foredeep or miogeosyncline (Old Bahamas Channel, Cayo Coco, and Remedios facies-structural zones), a marginal elevation or welt (Las Villas facies-structural zone), and a eugeosyncline. The latter includes several intrageosynclinal depressions, of which the Zaza facies-structural belt is the most extensive, and some intrageosynclinal positive areas. The history of the orthogeosyncline lasted from Early Jurassic to relatively recent time. The tectonic history may be divided into three gross cycles: Lower-Middle Jurassic; Upper Jurassic-Paleogene; and Paleogene-Neogene. Each gross cycle is divisible into structural levels or subcycles. In general, deformation is most intense in the oldest structural level and least intense in the youngest. Continental drift of Cuba from South America, as postulated by Corral, does not seem likely Instead, an origin more like that which is explained by the tectogene hypothesis seems probable. However, the belt of negative gravity anomalies that underlies north Cuba coincides with the position of the marginal elevation, and not with the positions of the eugeosyncline or miogeosyncline. Basically, the island of Cuba is part of a more extensive, but inactive, orthogeosyncline or island arc that extends the length of the Greater Antilles. The shape of this island arc probably was determined by the presence of a large island that occupied the present position of the Caribbean Sea. This island subsequently may have been subjected to the processes of basification, or conversion to oceanic crust. If this is true, Cuba now appears to be an intrageanticlinal structure within a new, modern Antillean geosyncline that includes the Greater Antillean arc and the newly formed oceanic areas nearby.