Inflammatory and bone turnover markers in a cross-sectional and prospective study of acute Charcot osteoarthropathy.

AIMS: To assess markers of inflammation and bone turnover at presentation and at resolution of Charcot osteoarthropathy. METHODS: We measured serum inflammatory and bone turnover markers in a cross-sectional study of 35 people with Charcot osteoarthropathy, together with 34 people with diabetes and 12 people without diabetes. In addition, a prospective study of the subjects with Charcot osteoarthropathy was conducted until clinical resolution. RESULTS: At presentation, C-reactive protein (P = 0.007), tumour necrosis factor-α (P = 0.010) and interleukin-6 (P = 0.002), but not interleukin-1ß, (P = 0.254) were significantly higher in people with Charcot osteoarthropathy than in people with and without diabetes. Serum C-terminal telopeptide (P = 0.004), bone alkaline phosphatase (P = 0.006) and osteoprotegerin (P < 0.001), but not tartrate-resistant acid phosphatase (P = 0.126) and soluble receptor activator of nuclear factor-κß ligand (P = 0.915), were significantly higher in people with Charcot osteoarthropathy than in people with and without diabetes. At follow-up it was found that tumour necrosis factor-α (P = 0.012) and interleukin-6 (P = 0.003), but not C-reactive protein (P = 0.101), interleukin-1ß (P = 0.457), C-terminal telopeptide (P = 0.743), bone alkaline phosphatase (P = 0.193), tartrate-resistant acid phosphatase (P = 0.856), osteoprotegerin (P = 0.372) or soluble receptor activator of nuclear factor-kß ligand (P = 0.889), had significantly decreased between presentation and the 3 months of casting therapy time point, and all analytes remained unchanged from 3 months of casting therapy until resolution. In people with Charcot osteoarthropathy, there was a positive correlation between interleukin-6 and C-terminal telopeptide (P = 0.028) and tumour necrosis factor-α and C-terminal telopeptide (P = 0.013) only at presentation. CONCLUSIONS: At the onset of acute Charcot foot, serum concentrations of tumour necrosis factor-α and interleukin-6 were elevated; however, there was a significant reduction in these markers at resolution and these markers may be useful in the assessment of disease activity.

Importance of cannulated prolactin test in the definition of hyperprolactinaemia.

PURPOSE: Recent guidelines suggest that a single prolactin measurement is adequate to confirm hyperprolactinaemia. This may lead to unnecessary investigation of artefactual hyperprolactinaemia. Prolactin measurement drawn from an indwelling cannula after rest removes stress as a confounding variable. The objective was to determine the frequency of true hyperprolactinaemia amongst patients referred following a single prolactin measurement. METHODS: A cannulated study was considered if prolactin on referral ('Referral Prolactin') was <5,500 mU/L (260 ng/mL) but >410 mU/L (19 ng/mL) in males or >510 mU/L (24 ng/mL) in females, irrespective of clinical context. Case-notes of 267 patients undergoing cannulated prolactin measurement over a 10-year period (2000-2010) were reviewed. Pre-existing pituitary disease, dopamine antagonist use, and macroprolactinaemia were excluded. Morning ante-cubital vein cannulation was followed immediately by withdrawal of 'Repeat Prolactin' sample. After 120-min bed-rest, 'Resting Prolactin' was withdrawn through the cannula. RESULTS: 235 patients were included for analysis. 64 (27%) were within normal range; following Repeat Prolactin in 41 (17%) and Resting Prolactin in 23 (9%) cases. Referral Prolactin was higher in patients with true hyperprolactinaemia, 1,637 ± 100 mU/L (77.2 ± 4.7 ng/mL) than with artefactual hyperprolactinaemia, 1,122 ± 68 mU/L (52.9 ± 3.2 ng/mL; P < 0.001) but there was substantial overlap. 21 out of 171 cases (12%) with true hyperprolactinaemia had a macroadenoma. Presenting symptoms did not predict true hyperprolactinaemia. Referral Prolactin of 2,000 mU/L (94 ng/mL) had 97% specificity to identify true hyperprolactinaemia. CONCLUSIONS: Reliance on a single, non-rested prolactin value may lead to over-diagnosis of hyperprolactinaemia. A resting sample should be considered with random values <2,000 mU/L (94 ng/mL).

The relationship between postprandial bile acid concentration, GLP-1, PYY and ghrelin.

BACKGROUND: Gut hormones peptide YY (PYY) and glucagon-like peptide-1 (GLP-1) play an integral role in appetite control and energy homeostasis. Entero-endocrine L-cells can be stimulated by nutrients and or bile acids to co-secrete PYY and GLP-1. The aim of this study was to determine the response of bile acids, PYY, GLP-1 and ghrelin after a test meal. DESIGN: Twelve subjects with a BMI of 22·8 (0·52) kg/m² [mean (SEM)] received a 400 kcal test meal after which blood samples were taken every 30 min from 0 to 180 min. PYY, GLP-1 and ghrelin were measured by radioimmunoassays. Fractionated bile acids were measured by HPLC-MSMS. RESULTS: PYY positively correlated with glycochenodeoxycholic acid (GCDCA) (rs = 0·23, P = 0·03) and taurochenodeoxycholic acid (TCDCA) (rs = 0·26, P = 0·02). GLP-1 positively correlated with GCDCA (rs = 0·22, P = 0·047) and glycodeoxycholic acid (GDCA) (rs = 0·3, P = 0·005). Ghrelin negatively correlated with GDCA (rs = -0·45, P≤ 0·0001), TCDCA (rs = -0·23, P = 0·034) and taurodeoxycholic acid (TDCA) (rs = -0·44, P≤ 0·0001). CONCLUSION: PYY and GLP-1 responses correlated with chenodeoxycholic acid (CDCA) counterparts, whereas ghrelin negatively correlated with deoxycholic acid (DCA) counterparts. Specific bile acids may thus differentially affect entero-endocrine cells.

The neurological morbidity of carotid revascularisation: using markers of cellular brain injury to compare CEA and CAS.

AIM: This comparative study attempts to evaluate the profile of S-100beta and Neuron-Specific Enolase (NSE), biomarkers of brain injury, in patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS) and to correlate this with haemodynamic and embolic events detected using trans-cranial Doppler (TCD). METHODS: 52 patients with internal carotid artery stenosis requiring intervention were recruited. 24 patients underwent CAS, and 28 underwent CEA. TCD was performed peri-operatively to record mean Middle Cerebral Artery (MCA) velocity and number of High Intensity Transient Signals (HITS) in the MCA of the operated side. Serum was drawn pre-operatively and at six time points in a 48 hour post-operative period, and then assayed using automated commercial equipment. Within and between group variability in markers were assessed by Generalized Estimation Equations modelling. RESULTS: CAS caused more HITS (p=0.028) but less haemodynamic disturbance (p=0.0001) than CEA. Treatment modality (CAS versus CEA) had no direct effect on S-100 changes (p=0.467). NSE levels declined after revascularisation in the CAS group but not after CEA (p=0.002). S-100beta levels rose in patients who had higher numbers of HITS (p=0.002). S-100beta and NSE were not associated with changes in MCA velocity (p>0.5). S-100beta alone increased significantly at 24 hours in those patients with a post-operative neurological deficit (p=0.015). CONCLUSIONS: Trans-cranial Doppler findings suggest that the mechanisms of rise in S-100beta and NSE levels may differ and may be due to increased peri-operative micro-embolisation and cerebral hypoperfusion respectively. Further studies are required to assess the clinical significance of these observed changes.

M2-PK as a novel marker in ovarian cancer. A prospective cohort study.

BACKGROUND: Pyruvate kinase isoenzyme M2-PK is instrumental to tumour metabolism and hence over-expressed in tumour cells leading to detectable plasma concentrations. OBJECTIVES: To assess the degree of association between M2-PK plasma concentrations and ovarian cancer and to determine the cut-off values for its sensitivity and specificity for differentiating between benign and malignant ovarian disease. SETTINGS: The Gynaecological Cancer Centre at both King's College and St. Thomas' Hospitals, London, UK. METHODS: Patients with suspected ovarian cancer referred to the above centre were recruited prospectively during the years 2004-2005. Blood samples were collected before surgery for plasma M2-PK assays. Results were assessed with respect to cancer diagnosis, patient and tumour characteristics. Statistical analysis including the receiver operator characteristic (ROC) curve was performed using Analyse-It and SPSS V 13. RESULTS: 100 patients with age range 14-88 years and a median of 57 years were recruited in the study. Of whom 52 were diagnosed with invasive ovarian cancer. Of these 35 (67%) were Stage III and above with two secondary tumours. M2-PK was not related to patient age (p = 0.43). There was a significant correlation between CA125 and M2-PK (p < 0.001). The mean M2-PK concentration in cancer patients was 52 U/ml versus 27 U/ml in patients with benign conditions (p < 0.001). At a cut-off value of 22 U/ml the sensitivity of M2-PK for detecting cancer was 70% with a specificity of 65%. CONCLUSION: M2-PK was significantly raised in ovarian cancer patients, however its role in clinical practice needs further evaluation.

Tumour M2-PK as a predictor of surgical outcome in ovarian cancer, a prospective cohort study.

BACKGROUND: Optimal cytoreduction is a major prognostic factor in ovarian cancer; several clinical, radiological and biochemical predictors have been studied. Tumour M2-PK (TU M2-PK) is over-expressed in tumour cells and can be detected in plasma samples but its role in ovarian cancer has not yet been evaluated. OBJECTIVES: To assess the potential clinical applications of TU M2-PK in ovarian cancer particularly in relation to surgical cytoreduction. SETTINGS: The Gynaecological Cancer Centre at both King's College and St Thomas' Hospitals; London; UK. METHODS: Patients with suspected ovarian cancer were recruited prospectively during the years 2004-2005. Blood samples were collected before surgery for plasma TU M2-PK assays. Data were analysed in relation to cancer diagnosis and outcome. Statistical analysis was performed using Analyse-It' and SPSS' V13. RESULTS: 100 patients were recruited; 52 diagnosed with invasive ovarian cancer, 13 with borderline tumours and 35 patients had benign conditions. The mean M2-PK concentration in cancer patients was 52 U/ml vs 31 U/ml in patients with borderline tumours and 22 U/ml in those with benign conditions (p < 0.001); it was significantly raised in association with late stage disease and higher grade (p < 0.05). Taking 35 U/ml as a reference point, TU M2-PK predicted sub-optimal cytoreduction in advanced stage disease with a sensitivity of 69%, specificity of 60% and overall efficacy of 61% (95% CI: 44-75%). CONCLUSION: TU M2-PK was significantly raised in ovarian cancer patients, particularly those with higher stage disease. The potential clinical application as a predictor of surgical outcome in ovarian cancer needs further evaluation.

Measurement of serum 7α-hydroxy-4-cholesten-3-one as a marker of bile acid malabsorption in dogs with chronic diarrhoea: a pilot study.

Bile acid malabsorption is a common cause of chronic diarrhoea in people, however it has never previously been investigated in dogs, despite clinical suspicion of its existence. The goal of this study was to assess the feasibility of measuring serum 7α-hydroxy-4-cholesten-3-one (C4) in dogs, as a potential marker of bile acid malabsorption, and to see whether this is related to clinical disease severity or the presence of hypocobalaminaemia. Serum C4 concentration was measured in 20 clinically healthy control dogs and 17 dogs with chronic diarrhoea. Three of the 17 affected dogs (17.6 per cent) had a C4 concentration significantly above the range of clinically healthy dogs; these dogs were all poorly responsive to conventional therapy. These results suggest that bile acid malabsorption may be a clinically relevant disorder in dogs with chronic diarrhoea and serum C4 may be a useful tool to investigate this further.

Protein synthesis in pulmonary, cardiac, and skeletal muscle in acute hypertension induced by aortic constriction in the rat.

OBJECTIVE: The aim was to investigate nucleic acid composition and rates of protein synthesis in cardiopulmonary tissues and skeletal muscle in response to hypertension induced by aortic constriction. METHODS: After five days of abdominal aortic constriction, protein, RNA, and DNA contents were measured in the lung, the left and right atria, the left and right ventricles, and gastrocnemius muscle from young male Wistar rats weighing 120-140 g. Rates of protein synthesis were also measured in these tissues with L[4-3H]phenylalanine. RESULTS: Aortic constriction significantly increased the right atrial weight and in contrast reduced the lung weight, compared to pair fed and sham operated controls. The wet weights of all other tissues were unaffected. The concentrations of right atrial proteins, RNA, and DNA were also significantly reduced though total protein, RNA, and DNA contents were unaltered. The left ventricular RNA concentration increased and there were variable alterations in protein and DNA composition. The protein, RNA, and DNA compositions of the other tissues showed patterned responses, which included reductions in lung and skeletal muscle DNA concentrations, reductions in the skeletal muscle RNA/DNA ratio, and a decrease in the lung protein/DNA ratio. In response to aortic constriction there were increases in the left ventricular fractional rate of protein synthesis in mixed, high salt (myofibrillar), and low salt (sarcoplasmic) fractions. Rates of protein synthesis in all other regions of the heart, lung and skeletal muscle were not significantly changed. CONCLUSIONS: We conclude that in abdominal aortic constriction, the left ventricles display early adaptive responses without any concomitant change in mass. Those regions of the rat cardiopulmonary system which are not directly exposed to the acute pressure overloading, ie, right atrium, lungs, and skeletal muscle, also show disturbances.

Plasma homovanillic acid profile at different phases of the ovulatory cycle in healthy women.

Variation in some central monoamine levels has been shown to be influenced by cyclical changes in gonadal hormones in women; however, there is less consensus about how the human menstrual cycle affects turnover of dopamine. Fluctuations in plasma homovanillic acid (HVA) are thought to represent changes in central dopamine turnover and activity and, some suggest, may be used to monitor the response to neuroleptic medication or to predict those more likely to respond to antipsychotic treatment. We have measured the effect of fluctuations in gonadal hormones on the level of plasma HVA at four consecutive points across the menstrual cycles of 30 healthy volunteers. We found no significant change in plasma HVA over the cycle and there was no correlation with either estradiol or progesterone levels. This study suggests that peripheral markers of central dopamine function do not change significantly with physiological changes in gonadal hormones levels.

Relationship between early liver graft viability and enzyme activities in effluent preservation solution.

Determination of cellular enzyme activities in washout preservation solution used in hypothermic liver graft storage may allow development of an index that could be clinically valuable in prediction of early post-transplant graft function. In the present study, we collected washed out preservation fluid at the time of graft rinsing from 53 liver recipients. Aspartate aminotransferase and, to a lesser extent, lactate dehydrogenase levels correlated with early postoperative graft viability as assessed by 1-month graft survival and standard biochemical indices of liver function. Those patients with the highest aspartate aminotransferase activity in the washout preservation solution experienced the highest levels of this enzyme postoperatively (area-under-the-curve day 1-3; 1340 vs. 788 IU/L), total bilirubin (area-under-the-curve day 1-5; 901 vs. 538 mumol/L), and rejection frequency (67% vs. 31%) (all P < 0.05), with a significantly lower 1-month graft survival rate compared with patients with low effluent levels (62% vs. 92%, P < 0.05). Two markers of endothelial cell damage, purine nucleoside phosphorylase and a creatine kinase isoenzyme, measured in the fluid did not correlate with early graft viability. It is suggested that assay of aspartate aminotransferase activities in preservation fluid washout samples is a clinically useful indicator of graft viability.

On the feasibility of inducing tolerance in man: a study in the cynomolgus monkey.

Our previous work on the in vitro generation of cytotoxic T lymphocytes from the blood of 15-22-week-old fetuses, and on the induction of immunological tolerane in both radiation chimeras and neonatal mice, using T lymphocyte-depleted allogeneic bone marrow cells, has led us to believe that it should be possible to establish red cell chimerism in human fetuses by the infusion of allogeneic adult bone marrow cells. The essential prerequisite appears to be the removal of immunocompetent T lymphocytes from the bone marrow transplant, for new T cells generated from donor stem cells become tolerant to the histocompatibility antigens of the host's thymus and cannot, therefore, cause graft-versus-host disease (GVHD). Such an approach could be used in the treatment of fetuses diagnosed at an early stage as suffering from life-threatening inherited blood disorders. The experiments described here were designed to test this hypothesis in a sub-human primate species, Macaca fascicularis. Twenty-two cynomolgus monkeys received infusions of haploidentical (paternal) bone marrow between days 51 and 95 of gestation. There was no evidence of chimerism in animals inoculated after day 75 from mating. Eight out of 14 fetuses inoculated before day 70 were late intra-uterine deaths, four were hydropic and in one, histological confirmation of GVHD was obtained, indicating that tolerance can be induced at this time, as GVHD can occur only if donor cells survive. The T cell-depletion technique used here did not appear to prevent GVHD.

Antenatal diagnosis of steroid sulphatase deficiency: case report and literature survey.

Steroid sulphatase deficiency is a recently recognised genetically determined inborn error of metabolism. Originally identified as an enzyme disorder of the placenta (commonly termed placental sulphatase deficiency), it is now known that the progeny of affected pregnancies have a generalised steroid sulphatase deficiency and that the enzyme defect persists throughout life. The disorder is characterised clinically by markedly low maternal oestrogen excretion in the presence of normal fetal growth and development. The importance of antenatal diagnosis lies in the differentiation of this disorder from the more ominous fetal defects that result in low oestrogen concentrations. This paper summarises the relevant literature and describes a case in which biochemical tests were used for the antenatal diagnosis of steroid sulphatase deficiency. The pregnancy resulted in a healthy baby boy delivered vaginally after a spontaneous labour.

Amino acid measurement by high-performance liquid chromatography using electrochemical detection.

The measurement of amino acids by high-performance liquid chromatography has become more common in recent years. Separation can be by gradient elution of the native amino acids followed by reaction with ninhydrin or by pre-column derivatisation with ultraviolet or fluorescent detection. The use of electrochemical detection for the measurement of amino acid derivatives formed with either o-phthalaldehyde or phenylisothiocyanate is discussed. A method for the assay of amino acids in human blood serum and urine samples using phenylisothiocyanate as the derivatizing agent and electrochemical detection is described and compared to previously reported methods based on o-phthalaldehyde derivatisation.

Assay of plasma glycine by HPLC with electrochemical detection in patients undergoing glycine irrigation during gynaecological surgery.

A method for the measurement of plasma glycine by HPLC with electrochemical detection after derivatization with phenylisothiocyanate (PITC) is described. The absorption of glycine in eighteen women undergoing intrauterine glycine irrigation during transcervical resection of endometrium was assessed by measurement of plasma glycine before, immediately after and 24 h after surgery. The plasma glycine concentration was normal in all women before surgery (range 120-386 mumol/l) but had risen dramatically in some patients after surgery (range 180-24,800 mumol/l) before returning to normal levels over the following 24 h (range 173-553 mumol/l). No clinical consequences were observed despite the large increases in plasma glycine; mild hyponatraemia occurred in only one patient. These findings, albeit in a limited number of patients, support the hypothesis that the symptoms sometimes associated with the use of glycine buffers are most likely due to water overload with hyponatraemia rather than a toxic affect of glycine itself.

Carbohydrate deficient transferrin in the assessment of alcohol misuse: absolute or relative measurements? A comparison of two methods with regard to total transferrin concentration.

Carbohydrate deficient transferrin (CDT) is now accepted as a potentially useful marker for the detection of alcohol misuse. It is not clear whether absolute values or values expressed relative to the total transferrin concentration provide the same diagnostic efficiency. CDT was measured in 35 patients with alcohol related liver disease, 35 subjects abusing alcohol without evidence of liver disease and 35 patients with chronic viral hepatitis using two commercial methods (CDTect and %CDT). To compare the methods, results were normalised by dividing the actual result by the upper limit of the reference range. Subtracting normalised %CDT results from the normalised CDTect results demonstrated a linear relationship between CDTect and total transferrin. This linear relationship could be abolished by calculating the CDTect/total transferrin ratio. The sensitivity of the methods was similar with CDTect (43 and 57%) being slightly superior to %CDT (40 and 46%). Specificity was similar (78%) for both methods. Calculation of the CDTect/total transferrin ratio improved the sensitivity and specificity slightly. The linear relationship between CDTect and total transferrin may produce misleading results in populations with a high prevalence of abnormal total transferrin concentrations and could cause difficulties in method comparisons unless taken into account.

Total pancreatic and salivary serum iso-amylase activities in alcohol misusers in relapse and remission and in alcoholic liver disease.

By means of immunoinhibition by specific salivary monoclonal antibodies in combination with a chromogenic substrate, assays of serum amylase were performed in control subjects, in chronic alcohol misusers in relapse or remission and in patients with alcoholic liver disease (ALD). There was a selective increase in the salivary isoenzyme in the ALD group. There were no significant changes in either of the alcohol misusing groups, compared with control subjects. It is suggested that the increase in salivary iso-amylase observed in patients with ALD is related to the previously reported functional and histological abnormalities in the parotid glands of this group of patients. It is also suggested that assay of pancreatic iso-amylase may be more discriminatory than total amylase levels in detecting pancreatic disease in patients with alcoholic cirrhosis.

Changes in brain natriuretic peptide concentrations following open cardiac surgery with cardioplegic cardiac arrest.

Elevated brain natriuretic peptide (BNP) concentration in peripheral blood reflects impaired cardiac ventricular function. We investigated the release pattern of BNP following cardioplegic cardiac arrest during heart surgery. In particular, we sought to discover whether there is an increase in peripheral BNP concentrations following reperfusion of the ischaemic heart. A secondary aim of the study was to investigate whether allopurinol, an anti-oxidant, has any effect on BNP release. A total of 29 patients scheduled for elective coronary artery bypass grafting were recruited, of whom 12 were randomly allocated to receive allopurinol with their pre-medication. Blood specimens were taken at six time points from the indwelling arterial catheter, the first before surgery and the last 2 h following the termination of cardiopulmonary bypass (CPB). BNP was found to decrease markedly when the aortic cross clamp was applied and the heart was isolated from circulation (P=0.0001). There was a slight increase in BNP following cross clamp release and myocardial reperfusion (P=0.04). A more substantial increase occurred with weaning from CPB when ventricular filling occurred (P=0.0015). Only the final BNP value, 2 h after CPB, was elevated compared with baseline (P=0.0013). Allopurinol had no demonstrable effect on changes in BNP.

Serum carnosinase activities in central nervous system disorders.

Serum carnosinase activity was assayed in five groups of patients with neurological disorders. Enzyme activities in patients with idiopathic epilepsy (mean +/- S.E.M., 148 +/- 11 nmol/ml per min) and motor neurone disease (155 +/- 15 nmol/ml per min) were similar to the control group (161 +/- 7 nmol/ml per min). Reduced serum carnosinase activity was observed in patients with Parkinson's disease (109 +/- 11 nmol/ml per min, P < 0.005), multiple sclerosis (82.5 +/- 10.0 nmol/ml per min, P < 0.005) and patients following a cerebrovascular accident (74.6 +/- 5.4 nmol/ml per min, P < 0.001) compared with the control group. Carnosinase activity, 5-10% of that found in serum, was detected in CSF samples. The cause of reduced serum carnosinase activities in central nervous system disorders is unclear, although anoxic damage to carnosinase-producing cells or disruption of the blood-brain barrier may be responsible.

Primary cultures of prostate cells and their ability to activate carcinogens.

Differences in the incidence of prostate cancer (CaP) amongst different migrant populations point to causative agents of dietary and/or environmental origin. Prostate tissues were obtained following transurethral resection of the prostate (TURP) or radical retropubic prostatectomy. After surgery, TURP-derived or tumour-adjacent tissue fragments were minced in warm PFMR-4A medium (37 degrees C) and suspensions pipetted into collagen-coated petri dishes. Non-adherent material was removed by washing with fresh medium after 12 h. Adhered cells subsequently reacted positively with monoclonal antibodies to prostate specific antigen (PSA). PSA was also detected in the medium. The genotoxicities of the chemical carcinogens 2-amino-1-methyl-6-phenylimidazo[4,5-b] pyridine (PhIP), its N-hydroxy metabolite (N-OH-PhIP) and benzo[a]pyrene (B[a]P) in adherent cell populations from different donors (n=8) were examined. Cells were treated in suspension for 30 min at 37 degrees C in the presence of the DNA repair inhibitors hydroxyurea (HU) and cytosine arabinoside (ara-C). DNA single-strand breaks were detected in cells by the alkaline single cell-gel electrophoresis ('Comet') assay and quantified by measuring comet tail length (CTL) in microm. All three carcinogens induced dose-related increases in CTLs (P<0.0001) in cells from four donors 24 h post-seeding. However, in cells from a further two donors the genotoxic effects of PhIP, N-OH-PhIP and B[a]P were much less apparent after 48 h than after 24 h in culture. After 96 h in culture, cells from these donors appeared to be resistant to the comet-forming activity of the compounds. However, B[a]P-DNA adducts were still measurable by (32)P-postlabelling for up to 14 days following a 24-h exposure to 50 microM B[a]P in adhered cells from another two donors. This study shows that primary cultures of cells derived from the prostate can activate members of two classes of chemical carcinogens. Further development may provide a robust model system in which to investigate the aetiology of CaP.

Role of plasma phosphate measurements in detecting rickets of prematurity and in monitoring treatment.

Twice weekly plasma and urine measurements were made in 24 very low birth weight infants. Intravenous feeding was given whilst infants required respiratory support. Subsequently they received breast milk or formula milk with a vitamin D supplement of 400 U/day. Fourteen babies required intravenous feeding for more than 10 days. Six developed radiological rickets or severe osteoporosis, and these infants had plasma phosphate levels < 1.2 mmol/L on breast milk or < 1.8 mmol/L on formula milk. Babies without radiological rickets had plasma phosphate levels > 1.2 mmol/L on breast milk and > 1.8 mmol/L in all but one on formula milk. Successful treatment of rickets was associated with a rise in plasma phosphate to the above levels. Untimed urine calcium and phosphate concentrations expressed as creatinine ratios were not helpful in detecting babies with rickets, but may be useful in monitoring therapy.