Bromocriptine reduces growth hormone in acromegaly.

We assessed serum growth hormone (GH) levels in ten patients with acromegaly during a 24-hour profile and a 75-g oral glucose tolerance test (GTT). Serum GH levels were measured after five weeks of bromocriptine mesylate therapy, 20 mg daily (P1), after five weeks without bromocriptine mesylate therapy (P2), and again five weeks following restarting treatment with bromocriptine, 20 mg daily (P3). During the 24-hour profile, the following occurred: (1) mean serum GH level of the group was lower during P1 (20.5 mU/L) and P3 (20.8 mU/L) than P2 (49.6 mU/L); (2) in six individual patients during P1 and P3, there was a significant reduction in the mean serum GH value; and (3) a marked circadian variation in the serum GH value was present both with and without the drug therapy in five patients. During the GTT, the mean serum GH value was lower during P1 (18.4 mU/L) and P3 (16.7 mU/L) than P2 (43.3 mU/L), and in seven individual patients during P1 and P3, there was a significant reduction in the mean serum GH value. Overall, a clear reduction in serum GH values due to bromocriptine was demonstrated. In individual patients, serum GH values during a 24-hour profile and GTT gave similar indications of response.

Viral antibody titers. Comparison in patients with multiple sclerosis and rheumatoid arthritis.

Higher titers of antibodies to measles virus envelope antigens, hemolysin and hemagglutinin, Epstein-Barr virus (EBV) capsid antigen and nuclear antigen, and rubella virus hemagglutinin were demonstrated in serum samples of patients with multiple sclerosis and rheumatoid arthritis than in age- and sex-matched control subjects. A significant correlation was observed between antibodies to measles and rubella viruses both in patients with multiple sclerosis and rheumatoid arthritis, but such a correlation was not observed between antibodies to EBV and measles or rubella viruses. Whether elevated levels of antibodies to EBV are due to reactivation of the virus, or elevated levels of antibodies to all the enveloped viruses result from cross-reactions between viruses and host tissue, or perhaps reflect defects in immunoregulation, needs further investigation.

Intralaboratory quality control of hematology. Comparison of two systems.

Two systems for quality control have been compared, viz., the whole-blood control preparation method and the algorithm method using the geometric moving average XB and a new estimator Y. The system involving whole-blood controls has the advantage of simplicity of operation, but the economic cost of commercial preparations is often high. The algorith system has the advantage that results of all the test samples are used in the calculation; to some extent, this provides a buffer against random variation. The number of count-outs in a given channel is related to the precision of the channel, which in turn is a function of the number of determinations and calculations required for that result. An error of around 1% is introduced into the result each time a calculation is performed. A successful quality control scheme should contain elements of both control preparation and algorithm methods.

Factors influencing the survival of patients with testicular teratoma.

The histology of 51 cases of testicular teratoma, with or without seminoma, was reviewed and classified according to the World Health Organization criteria. Full pathological and clinical details were obtained, and patients were followed up for periods varying from one to 10 years from orchidectomy. Multiple factors were studied in order to discover which affected prognosis. The pathological stage of the tumour proved to be the most important indicator. The previously described poor prognosis associated with yolk sac tumour was not confirmed.

Antibodies specific for measles virus envelope antigens and autoantibodies in patients with chronic active hepatitis.

Distinctly increased levels of antibodies to measles virus envelope antigens haemolysin and haemagglutinin were found in the sera of patients with chronic active hepatitis compared with a normal control group, using immunofluorescence and functional tests. Similarly, a higher incidence of smooth muscle antibody of both IgG and IgM classes was observed in the patients and an important correlation was found between haemolysin antibodies specific for measles virus and smooth muscle antibody of IgG and IgM classes. In contrast, there was no such correlation between the virus specific haemolysin antibodies and antinuclear antibodies. The increased levels of antibodies to measles virus envelope antigens and of autoantibodies may reflect defects in immunoregulation rather than persistent infection with measles virus.

Pre-transplantation immunological monitoring and graft survival in recipients of renal allografts.

Various immunological parameters were measured pre-transplantation in 82 renal transplant recipients. The results were compared with the clinical course of the recipient post-transplantation and with the results of 40 controls. Only one test C3 inactivation products (C3i) was associated with transplant outcome in that 0/30 patients with no rejection episodes had C3i whereas 9/38 patients with rejection episodes, including 3/12 patients whose graft failed, had C3i.

Warts in general practice.

Eight hundred and ninety seven patients referred by their general practitioner to Health Centre Wart Clinics were interviewed. Seventy one patients (7.9%) were found to have lesions other than cutaneous warts. Females were significantly more likely to have plantar warts on their toes (p less than 0.002) and non-plantar warts on their fingers (p less than 0.03) and less likely to have non-plantar warts on the palms of their hands (p less than 0.03) than males. Patients living in large households (5+ persons) were more likely than patients living in smaller households (2-4 persons) to report an infected co-habitant (p less than 0.001). Patients with periungual warts were significantly more likely to be nailbiters. (p less than 0.001). Patients presenting with warts greater than two years in duration were more likely to have multiple warts than those with warts less than one month in duration (p less than 0.001). Patients who frequently immersed their hands in water were more likely to present with multiple warts on the hands (p less than 0.001). Multiple plantar warts were associated with moist or macerated feet (p less than 0.001). The role of the family doctor in diagnosing and preventing the spread of this infection is discussed.

Availability and acceptance of health education among socially 'at risk' pregnant women attending health centres in Belfast.

This study highlights the large number of pregnant women in Belfast who fall into the 'at risk' category based on socioeconomic factors and suggests a need for greater emphasis on health education by professionals in both the fields of health and education in order to improve the knowledge and change the attitudes and behaviour of pregnant women; this could play an important part in reducing infant mortality and handicap in our society. The study showed that neither patients nor health care teams see health education as an integral part of antenatal and postnatal care and that little impact has been made in encouraging patients to plan their pregnancies, stop smoking and eat a more balanced diet.

Smoking in pregnancy--a health education problem.

The smoking habits and knowledge and demographic characteristics of 380 pregnant patients in Belfast were investigated. Over half of the women smoked but only 11.5% stopped smoking after becoming pregnant in spite of the fact that almost 65% of them knew that smoking could have an effect on the baby. The study showed that some smokers changed their attitude to smoking before and after delivery and that little effort is being made by general practitioners to dissuade their antenatal patients from smoking. More emphasis on health education for school children is required and also more individual effort on the part of health professionals to dissuade women from smoking, especially when they are pregnant.

Arterial pressures in a general practice.

Systolic and diastolic readings of blood pressure were recorded for 5386 (2585 males and 2801 females) members of a general practice situated in and around Ballycastle, County Antrim. Polynomials to predict blood pressure from age were derived for systolic and diastolic pressures of males and females. Polynomials to predict blood pressure variance from age were derived for both systolic and diastolic pressure of each sex. Age-sex adjusted diastolic and systolic scores were calculated for each of the 5386 members of the practice using a technique similar to that reported by Hamilton et al. (1954 a, b).Parent-child correlations ranging from -0.21 to 0.17 were observed; however, when all sibships were considered together irrespective of size coefficients which were significantly greater than zero generally involved the mother of the child. No sib-sib correlation (all sibship sizes combined), except those involving twins exceeded the value 0.13. Husband-wife correlations were similar to the corresponding parent-offspring correlations when both husband and wife were aged 45 years or more. Generally speaking, the coefficients found in this study were lower than those of other workers and reasons are discussed why the estimates of the present paper may not be unbiased.

Potato avoidance during pregnancy in women with a previous infant with either anencephaly and/or spina bifida.

This investigation is a direct attempt to test Renwick's (1972) hypothesis that 95% of anencephaly and spina bifida (ASB) is preventable by the avoidance of potatoes during pregnancy. Although the numbers involved in the study are small, the investigation fails to support the concept that short-term avoidance of potatoes before conception and throughout pregnancy in women who have had a previous ASB infant reduces the recurrence risk. In the potato-free group, of 23 pregnancies which went to term two infants had ASB (8-7%); whereas in the non-potato-free group, of 56 which went to term two infants had ASB (3-6%). The recurrence risk in both groups was about 5%. The incidence of ASB in the groups shows no significant difference (P = 0-58) and in the potato-free group was not reduced by 95% as postulated by Renwick.

British and West African facial form in ideal occlusion.

True lateral cephalometric radiographs of 20 adult male British subjects and 20 Nigerian adult males were collected. All subjects showed an ideal occlusion of the teeth. These radiographs were analysed using a facial polygon joining the points Nasion, Sella, Articulare, Gonion and Menton. Additionally, measurements were made of the axial inclination of the incisor teeth and the distances from the incisal edges and apices of the teeth to the facial plane. Statistical examination of the results using "t" tests revealed that the average British mandible had a longer ramus but shorter body joined at a wider angle than the Negro, that the nasal part of the face was longer on average in the British group and that the incisor teeth, on average, projected further and were inclined further forward in the Nigerian group. A linear discriminant function in only three variables predicted with 100 per cent accuracy membership of the two groups. The three variables were the mandibular body length, the height of the nasal part of the face, and the amount by which the incisal edges of the lower incisor teeth projected beyond the facial plane.

Respiratory symptoms and lung function in a group of solderers.

A total of 1611 women working in a large electronics company were interviewed using a modified version of the Medical Research Council's questionnaire on respiratory symptoms, and their lung function was tested using a Vitalograph dry wedge spirometer. When the prevalence of symptoms was compared using the chi 2 test among four occupational groups--namely, solderers, ex-solderers, non-solderers, and office workers--few significant differences were found. The group of ex-solderers tended to have a greater prevalence of symptoms than the other three groups. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were measured, and when these were compared for smokers, the office workers were found to have a greater mean age adjusted FVC and FEV1 than the three other groups. The pattern was less distinct for non-smokers. When duration of exposure to solder fumes was allowed for, differences in lung function were more suggestive of being related to smoking habit than occupational exposure to solder fumes.

A comparison of the accuracy of the Siemens injection vaporizer and the Enfluratec 3 vaporizer.

The accuracy of two Siemens injection vaporizers was examined under operating theatre conditions. For comparison, two Enfluratec 3 vaporizers were tested. The concentrations of enflurane produced by the vaporizers were measured both by an anaesthetic agent monitor and by chromatography. Five experimental modes were used with enflurane delivered either in air/oxygen or in nitrous oxide/oxygen mixtures and the experiments were repeated five times. In every case, the mean concentration values produced by the anaesthetic agent monitor were higher than those obtained by chromatography. The difference may have been due to leakage of the gas sample from the "gas-tight" syringes and/or improper calibration of either analyzer. The Siemens devices were less reliable than the Enfluratecs when enflurane was given in nitrous oxide/oxygen. The former vaporizers seem to be less robust than the Enfluratecs and should be used according to the manufacturer's recommendations. The pressures in the central system were higher than those called for. In addition, improper coupling of the Siemens apparatus to the ventilator may well have influenced the results.