RESUMEN
Although it is known that concentrations of immunoreactive ACTH increase during late gestation in fetal sheep plasma, the nature of the ACTH has not been well characterized. We used two-site immunoradiometric assays to separately measure high mol wt ACTH precursors (POMC and pro-ACTH) and ACTH-(1-39) in plasma of fetal sheep with chronic arterial and venous catheters. We compared the ratio of these peptides as a function of gestational age under basal conditions and in response to exogenous vasopressin and/or corticotropin-releasing hormone. Under basal conditions, the concentration of precursors was not changed throughout the last third of gestation; however, ACTH-(1-39) increased significantly approaching term. The molar ratio of precursors to ACTH-(1-39), therefore, decreased from 15.8 +/- 1.0 at 110 days to 7.9 +/- 0.6 at 140 days gestation. At all gestational ages, vasopressin and corticotropin-releasing hormone increased ACTH-(1-39) and precursors, albeit with different time courses. At 120 days gestation, arginine vasopressin plus CRH produced synergistic increases in ACTH-(1-39) and precursors, whereas the response was only additive at other ages. The present results indicate that the elevation in the resting plasma immunoreactive ACTH concentration that occurs near term is constituted by an increase in the concentration of ACTH-(1-39) relative to those of POMC and pro-ACTH, which may have further physiological significance. Also, CRH and AVP are potent stimulators of both ACTH-(1-39) and ACTH precursors.
Asunto(s)
Hormona Adrenocorticotrópica/metabolismo , Feto/fisiología , Edad Gestacional , Precursores de Proteínas/metabolismo , Hormona Adrenocorticotrópica/sangre , Animales , Hormona Liberadora de Corticotropina/farmacología , Sinergismo Farmacológico , Femenino , Sangre Fetal/química , Ensayo Inmunorradiométrico , Embarazo , Ovinos , Vasopresinas/farmacologíaRESUMEN
A forty-nine-year-old patient was found to have Schistosoma eggs inside his prostatic cancer. At the time of diagnosis, the patient already had spread of metastatic disease in lumbar spine. Review of the literature revealed this to be the first such case published in English literature. Despite advanced stage of disease (Stage D2), the patient responded well to immediate orchiectomy and regional irradiation. Two years after diagnosis was established, the patient was without clinical evidence of disease, when he suddenly died. The cause of death was not established because the family declined an autopsy.
Asunto(s)
Adenocarcinoma/complicaciones , Enfermedades de la Próstata/complicaciones , Neoplasias de la Próstata/complicaciones , Esquistosomiasis/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Próstata/parasitologíaRESUMEN
The autologous mixed lymphocyte reaction (AMLR) measures the proliferative response of peripheral blood T cells to surface antigens of non T cells. The AMLR of SLE patients with active or inactive disease either with (13) or without (6) immunosuppressive treatment was low compared with age and sex-matched controls, confirming previous reports. Only one patient with inactive, untreated SLE and one with drug induced lupus (procainamide) showed normal AMLR. Autologous reactivity was also reduced in 2 patients without treatment who presented with clinically complex disease syndromes, including primary biliary cirrhosis, or polyarteritis nodosa, together with Sjögren's syndrome and serological evidence of lupus. The AMLR could not be increased by changing the ratio of responder to stimulator cells. Patients with decreased AMLR also showed a decreased response to phytohemagglutinin which suggested a general depression of T cells. There was no correlation between the decreased AMLR and age, clinical features or anti-DNA antibody levels of the patients. In allogeneic mixed lymphocyte reactions (MLR) it was shown that non-T cells from SLE patients were poorer stimulators of allogeneic T cells than normal cells, and T lymphocytes from SLE patients were poorer responders to allogeneic non-T cells than were normal T cells. Both effects were much more marked in patients with active disease than in those with inactive SLE. This suggests a defect in both responder and stimulating cell populations in SLE.
Asunto(s)
Lupus Eritematoso Sistémico/inmunología , Prueba de Cultivo Mixto de Linfocitos , Linfocitos T/inmunología , Adulto , Anciano , Anticuerpos/análisis , ADN/inmunología , Femenino , Humanos , Inmunosupresores/farmacología , Cirrosis Hepática Biliar/complicaciones , Lupus Eritematoso Sistémico/inducido químicamente , Lupus Eritematoso Sistémico/complicaciones , Masculino , Persona de Mediana Edad , Fitohemaglutininas/farmacología , Poliarteritis Nudosa/complicaciones , Prednisona/farmacología , Procainamida/efectos adversos , Síndrome de Sjögren/complicaciones , Linfocitos T/efectos de los fármacosRESUMEN
Two patients who developed massive pulmonary oedema, profound vasoconstriction and hypertension followed by hypotension after Atrax Robustus envenomation are described. The pulmonary oedema is due to increased pulmonary capillary membrane permeability which may be due to neurogenic or toxic causes. Use of artificial ventilation with high level PEEP, isoprenaline and high dose steroids allowed support of the patients during volume replacement with albumin. When the circulation was stable and airway frothing ceased, conventional dehydration therapy further improved lung function. Both patients were discharged well.