Treatment of prostate cancer with gonadotropin-releasing hormone analogue: effect on lipoprotein[a].

Because of its association with cardiovascular disease, lipoprotein[a] (Lp[a]) has attracted the interest of the medical community. Even though serum concentrations of Lp[a] are mainly controlled by the apolipoprotein[a] gene locus, hormonal and metabolic factors, including manipulations of sex hormone levels, have been associated with changes in Lp[a] levels. We report here that the GnRH analog buserelin reduced concentrations of Lp[a] by 48% in elderly males suffering from cancer of the prostate. In contrast, apolipoprotein B levels increased during treatment, whereas other lipid factors, including serum cholesterol, triglyceride, high and low density lipoprotein cholesterol, and apolipoprotein A-I, were not affected. Although the study does not exclude a specific Lp(a)-lowering effect of buserelin, our results suggest that GnRH analogs may reduce Lp[a] levels in the circulation.

Evaluation of two commercial procedures for quantification of human immunodeficiency virus type 1 RNA with respect to HIV-1 viral subtype and antiviral treatment.

To determine the reliability of two commercial assays for quantifying the human immunodeficiency type 1 (HIV-1) RNA levels in patients infected with different HIV-1 subtypes and managed with various drug regimens, blind testing of 127 plasma samples from 57 patients infected with HIV-1 subtypes A, B, C and E was performed using the Amplicor HIV-1 Monitor Test (Roche) and Quantiplex HIV-1 RNA 3.0 Assay (Chiron). Included were time course studies in 7 patients in whom the virus load was correlated with CD4+ cell counts and therapy. Both assays were accurate and precise to measure standardized amounts of viral load and displayed high correlation coefficients that were independent of gender and treatment modality, even though some assay-specific differences may exist in the quantification of viral subtype RNA. Time course studies showed comparable inverse associations between the CD4+ count and viral load measured by the two assays. Hence, both the Amplicor HIV-1 Monitor Test and the Quantiplex HIV-1 RNA 3.0 Assay promise to be useful for the management of HIV-1 infected patients.

Protein distribution in the human perilymph. A comparative study between perilymph (post mortem), CSF and blood serum.

The large differences in the protein content of perilymph and serum as well as the perilymph volume limit of 10-15 microliter cause serious problems when collecting samples of uncontaminated perilymph in order to analyse its protein composition. In 8 out of 24 extremely carefully taken samples of perilymph removed during autopsy, we were able, by keeping to certain selection criteria, to carry out electrophoretic analyses which were suitable for reproduction and comparison. Comparison of human perilymph, CSF and serum, using SDS-Page and Western blotting, gave the expected agreement which had been suggested by tests on guinea pigs. However, a closer examination of individual proteins pointed to some relatively large differences in quantity and quality.

[Genetic study in 8 families with a child with cystic fibrosis]. / Genetische Untersuchung bei 8 Familien mit einem Kind mit zystischer Fibrose.

Cystic Fibrosis (CF) is the most common genetically determined disease in Caucasians. Major advances in our understanding of the genetics of cystic fibrosis have occurred during the past couple of years. The CF gene has been localized at 7 q31 by the use of linkage analysis with protein and DNA polymorphisms. DNA probes showing close linkage to the CF gene have been discovered and are being used to identify the gene itself and also for purposes of genetic diagnosis. We investigated 35 blood samples from members of 8 CF families with the probes J3.11/MspI, metH/TaqI, metH/MspI, metD/TaqI and 7 c22/EcoRI. In 8 out of 11 siblings of our CF patients we got full information about the carrier status. Since we investigated the siblings as well as the parents of our patients, these results may be of benefit for a later prenatal diagnosis.

[Comparison of the classical Gibson-Cooke methods and the chloride-sensitive electrode in sweat testing for diagnosis of cystic fibrosis]. / Vergleich zwischen klassischer Gibson-Cooke-Methode und Chlorid-sensitiver Elektrode zur Schweisstestung bei der Diagnose der zystischen Fibrose.

In 43 children and adolescents (30 healthy and 13 CF patients) the Quantitative Pilocarpine Iontophoresis Test (QPIT) was compared with the ion-specific electrode. We found an excellent correlation between these two methods (r = 0.93) and no false positive or false negative results. With both procedures the total chloride-ion-concentration in sweat of healthy subjects and patients with CF differed significantly (p less than 0.001). Both, the original Gibson and Cooke-sweat-test (QPIT) and the assessment of chloride with the sensitive electrode are highly reliable procedures for confirming the diagnosis of CF.

[Initial clinical experiences with beta 2-transferrin in oto- and rhinorrhea]. / Erste klinische Erfahrungen mit beta 2-Transferrin bei Oto- und Rhinoliquorrhoe.

We developed tests to measure beta 2-transferrin, and then used this method to investigate the efficiency of beta 2-transferrin in the diagnosis of cerebrospinal fluid rhinorrhea and otorrhea. We also assessed whether the immunochemical method satisfied the five requirements, which are important in the modern investigation of the cerebrospinal fluid (CSF): High rate of accuracy; Wide area of application; Rapid availability; High sensitivity; No risks to the patient. 14 patients known to be suffering from a CSF leakage were investigated with special attention to the above five points. Eight patients had a CSF otorrhea, five a rhinorrhea, and one patient had a post operative CSF leakage from a retroauricular wound. In temporal bone fractures with CSF leakage regular insertion of sterilized foam rubber sponges into the ear allows adequate samples to be collected. In CSF rhinorrhea with profuse leakage there is no difficulty in collecting enough fluid for analysis. If there is too little fluid or if the question of localization arises we insert sterile sponges, as for CSF otorrhea, into the right and the left of the nose as far as the nasopharynx. They are left in place for 6 hours to provide an adequate sample. The analysis of the samples of CSF otorrhea showed a protein content of 3-6 g/l whereas the samples of CSF rhinorrhea, especially from sponges, showed a content of up to 39 g/l.(ABSTRACT TRUNCATED AT 250 WORDS)

A new method for using fluorescein to demonstrate oto- and rhinoliquorrhea. I. Sample preparation by electrophoresis and photometric identification of fluorescein.

We have described a new method for the identification of sodium fluorescein in cases of cerebrospinal fluid (CSF) leakage. To take samples, small sponges of Merocel are placed into the nostrils or external auditory canal, as indicated. They are left in situ for 12h after intrathecal injection of 5% sodium fluorescein. Fluorescein is identified by electrophoretic separation on 1% agarose gel and demonstration with the fluorescence photometer. This method of testing has various advantages: the use of small sponges enables collections of minimal amounts of CSF; potential sources of disturbance (e.g. hemoglobin, etc.) are eliminated; false-positive results are avoided; the time needed for sample analysis lasts only 10 min. All necessary materials and equipment, as well as the taking and analysis of samples, are described in detail. The method used was tested both clinically on patients and in the laboratory and its sensitivity is clearly illustrated.

[Immunologic cerebrospinal fluid diagnosis using beta-2-transferrin principles and method]. / Immunologische Liquordiagnostik mittels beta 2-Transferrin-Grundlagen und Methodik.

By using this method beta 2-transferrin, a protein variant can be identified. This variant is produced by neuraminidase activity of the brain and up to now could only be found in cerebrospinal fluid (CSF). In the analysis of CSF, by applying immunofixation with an antiserum and silver staining two bands, the beta 1-transferrin and the beta 2-transferrinband can be demonstrated. When examining serum, nasal secretion, tears, saliva and or other body fluids, only one band, the beta 1-transferrinband can be seen. It is therefore possible to identify CSF accurately. First of all methods of taking samples are explained and required analysis briefly described. Two points were of particular interest to us: The sensitivity of the method and Tracing of possible disturbing effects. Following several, different series of tests we got these results: 1 microliter pure CSF (that corresponds to approx. 1/50 of a drop) and 100 microliter CSF (two drops) per 1 ml nasal secretion can be identified by this method. It is possible that disturbing effects may be caused by blood contamination or a high protein content. For this reason haemoglobin must eliminated by using chromatography. Furthermore it is necessary to reduce a protein content of more than 5 g/l with ammonsulfat precipitation. If care is taken in respect of these two points disturbing effects can be avoided. In clinical application the immunological CSF identification seems to have a very high level of sensitivity and, in comparison with other methods many advantages.

Efficiency of various methods of identifying cerebrospinal fluid in oto- and rhinorrhea.

This paper describes methods of cerebrospinal fluid (CSF) leakage diagnosis which have been used in the post-war period. We have listed advantages and disadvantages and given our opinion as to the value of each method. In the form of comparison we have provided a detailed breakdown of the exact procedure of beta 2-transferrin identification used for the immunological diagnosis of CSF leakage. This method, which was developed further by us, is discussed with regard to the results of all sample analysis which have been carried out so far. The result of the discussion is to emphasize the many advantages of this method. In addition, there is a direct comparison made between the fluorescein method and the use of beta 2-transferrin.

[Detection of beta 2-transferrin with agarose gel electrophoresis, immunofixation and silver staining in cerebrospinal fluid, secretions and other body fluids]. / Nachweis von beta 2-Transferrin mittels Agarosegel-Elektrophorese, Immunfixation und Silberfärbung in Liquor cerebrospinalis, Sekreten und anderen Körperflüssigkeiten.

A method is described for the detection of beta 2-transferrin (asialotransferrin) in 1 microliter cerebrospinal fluid. Owing to its low content of sialic acid, beta 2-transferrin migrates more slowly than the main transferrin component (beta 1-transferrin) in electrophoresis. The high sensitivity and specificity of the test depend on immunofixation of the electrophoretically separated transferrin in the agarose gel, and on the visualization of the immune complex by staining with alkaline silver nitrate solution. Since beta 2-transferrin occurs practically only in cerebrospinal fluid and not in other body fluids, its detection in secretions from the nose or ear can be used for the diagnosis of rhinoor otoliquorrhoea. Even under unfavourable conditions, 10% cerebrospinal fluid can be detected in a secretion. Operator time for investigation of a secretion sample is 110 minutes and the analysis time is 5 hours. The direct costs are 95 German marks. Forty two secretions have been investigated so far. Eighteen were shown to contain cerebrospinal fluid, and this was confirmed by subsequent operative findings on the patients.

Early detection of anastomotic leaks after low anterior resection of the rectum.

PURPOSE: Lysozyme destroys the mucopolysaccharide chains of the cell wall of gram-negative bacteria. It is a component of local defense and is formed in macrophages. Determination of lysozyme content in the wound seems to be the most reliable method for early recognition of wound infection. METHODS: In a prospective randomized study on the efficacy of single vs. double staple technique in anterior rectum resection, the effluent from the pelvic drain was examined with regard to its lysozyme activity. RESULTS: Lysozyme activity in drained secretion remained stable for more than 24 hours at room temperature. When the single staple technique was used, enzyme activity was sharply increased (mean, 9.6 mg/dl on the first postoperative day) compared with the double staple technique (mean, 5.5 mg/dl on the first postoperative day). The difference was statistically significant (P < 0.0001). Mean lysozyme activity was increased in those patients with clinically (18 mg/dl on the first postoperative day) and radiologically (15.3 mg/dl on the first postoperative day) detected dehiscence (P < 0.0001). CONCLUSION: Lysozyme determination may be reproduced by detection of enzyme stability in drained secretion. Determination of lysozyme content seems to be a new possibility for early recognition of anastomotic dehiscence.

[Diagnosis of fetal thrombocyte count in relation to obstetric management of maternal idiopathic thrombocytic purpura (Werlhof disease)]. / Probleme bei der fetalen Thrombozytenzahldiagnostik in Hinblick auf das geburtshilfliche Management bei maternaler idiopathischer thrombozytischer Purpura (ITP--M. Werlhof).

Beside maternal, fetal platelet count is the essential parameter for the decision about the obstetrical management in ITP-patients in pregnancy. Evaluation of fetal platelet count contains different problems. Using heparinised capillary tubes in fetal blood sampling procedure, platelet aggregation occurs and therefore false low platelet counts are found, by the commonly used method of conductivity measurement. A recently observed case is reported.

A map of cochlear perilymph protein based on high-resolution two-dimensional electrophoresis.

For systematic characterization of cochlear perilymphatic (PL) fluid proteins and to compare the complex protein mixtures of PL fluid, cerebrospinal fluid (CSF) and blood plasma, we subjected eight postmortem PL fluid samples to two-dimensional (2D) electrophoresis. To avoid contamination of perilymph by blood and blood plasma, the samples were taken immediately after death and analyzed by keeping to certain selection criteria. When compared with CSF, PL fluid in the scala vestibule was found to have an albumin content of approximately 1-2g/l, or 10 times the level of CSF albumin. Due to the small volume of the sample obtained, it was not possible to concentrate the PL fluid. As a result, protein spots in the 2D-gel could only be detected with a highly sensitive silver stain. Visual inspection of the resulting 2D-electrophoretograms showed that most of the "CSF-specific" protein clusters were present in the PL fluid pattern.