PLANET TOPERS: Planets, Tracing the Transfer, Origin, Preservation, and Evolution of their ReservoirS.

The Interuniversity Attraction Pole (IAP) 'PLANET TOPERS' (Planets: Tracing the Transfer, Origin, Preservation, and Evolution of their Reservoirs) addresses the fundamental understanding of the thermal and compositional evolution of the different reservoirs of planetary bodies (core, mantle, crust, atmosphere, hydrosphere, cryosphere, and space) considering interactions and feedback mechanisms. Here we present the first results after 2 years of project work.

Insulin allergy treated with human insulin (recombinant DNA).

Two insulin-dependent diabetic subjects treated with pork and beef insulin during a period of 6 mo developed severe local reactions. Both patients had an important allergic history (asthma, urticaria, drug reactions, rhinitis). Skin-testing revealed type I allergy to beef and pork insulin. Specific IgE-insulin binding was demonstrated with both insulins. After negative skin testing with NPH Lilly human insulin (recombinant DNA), treatment was started with this compound and remained successful during a period of 6-9 mo. In one patient a local reaction occurred when regular human insulin (recombinant DNA) was added to NPH in order to obtain better control. Skin testing with regular human insulin was positive, but not with NPH human insulin alone. The mechanism of this phenomenon remains unsolved.

Ascending contamination of a jejunostomy feeding reservoir.

In general bacterial contamination of enteral feeding solutions is considered to be exogenous in origin. However, during feeding through catheter jejunostomy another source of contamination seems possible. We describe a patient in whom bacterial contamination of the feeding solution given through a catheter jejunostomy occurred frequently. Microbiological evaluation of several feeding samples showed that with this particular type of catheter enterostomy contamination was dual in origin. A not aseptic manipulation of the feed prior to administration led only to slight contamination. Most of the contamination however was endogenous--ie. ascending from the gut of the patient. In contrast to some previous studies, no clinical or laboratory deterioration could be observed in relation to the contamination. The food value of the feed expressed as the glucose concentration was significantly reduced after contamination with the causative organisms.

Measure of blood ionized calcium versus total calcium in normal man, in renal insufficiency and in hypercalcemia of various origins.

Ca++ and Ca tot were measured and compared at 2 years interval (S1 and S2) in 45 normal volunteers: 26 females and 19 males age 20/65 years. For Ca++ the mean difference between S1 and S2 was small (0.009 mmol/l) but significant (p less than 0.01). For Ca tot the mean difference between S1 and S2 (0.06 mmol/l) was very significant (p less than 0.001) due to the combination of various factors: technical, sex difference and proteins. In both series (S1 + S2) Ca++ did not differ significantly between females and males, whereas Ca tot was significantly (p less than 0.05) higher in males (mean difference 0.06 mmol/l) for S1 and non significant for S2. In 63 normal volunteers we cross correlated the factors of calcium homeostasis and showed significant relationship between Ca++/Ca tot r = 0.428 (p less than 0.001), Ca++/PTH r = -0.297 (p less than 0.05), Ca tot/Proteins r = 0.518 (p less than 0.001). The relationship between Ca tot and PTH does not reach the level of significance. We compared Ca++ and Ca tot in renal insufficiency (RI) (n = 16), hyperparathyroidism surgically confirmed (Hyper P) (n = 10), cancer with hypercalcemia (C) (n = 9) and in normal volunteers (N) (n = 63). The relationship between Ca++ and Ca tot in the pathologic groups has significantly steeper slopes than the control group (N), p less than 0.05 for RI and C and p less than 0.01 for Hyper P. The increase of the Ca++/Ca tot ration in RI and Hyper P is positively correlated to PTH levels, nor albumin variations neither pH and P04 variations could completely account for the increase of the ratio. The increase of Ca++/Ca tot in cancer is independent of PTH and cannot entirely be explained by the albumin drop.

Factors affecting the determination of ionized calcium in blood.

Reproducibility with the same electrode on the same day is expressed by the CV. For standard solutions CV = 0.68%, for blood CV = 1.36%, for serum CV = 0.92%. The measure with 2 different Orion electrodes performed on blood samples on the same day gives no more variation between electrodes than within electrode. Results of Ca++ measured with SS-20 Orion and ICA1 Radiometer electrodes on the samples of normal blood or serum are significantly higher with the ICA1 electrode than with the SS-20 Orion. The use of decreasing concentration of NaCl (170 to 110 mmol/l) in calibration solutions shows an apparent increase of Ca++ concentration in normal blood. Sampling conditions may affect Ca++ results. The pH of peripheric venous blood drawn without torniquet in 57 normal people was 7.34 +/- 0.03 and differs from the normal arterial pH values (740 +/- 0.02). By applying the following equation: Ca++ (pH 7.40) = Ca++ [1-0.53 (7.40 - pH)], Ca++ can be adjusted to pH 7.40. The correction in pathologic condition should, however, take in account the real arterial pH of the subject. We tested if sitting versus recumbent position could modify Ca++ results. The difference was non significant. Heparin, necessary for blood and plasma sampling, may affect the electrode membrane and binds calcium ions. We compared in the same blood sampling the same dilutions of 2 kinds of heparin. Heparin Radiometer: 10 microliters in 1 ml blood (8 UI) and heparin Roche: 10 microliters in 1 ml blood (50 UI) and observed significantly higher Ca++ results with the lower concentration of heparin. Storage of serum 24 hours at -20 degrees C does not alter the Ca++ results. After 7 days at -20 degrees C the Ca++ decreases by 3.6% in average, mainly due to pH increase.

[Anaphylaxis induced by exertion]. / Door inspanning geïnduceerde anafylaxie.

A 44-year-old man with a two-year history of episodes of exercise-related urticaria and facial angioedema was admitted to our department because of vascular collapse during an athletic activity. The diagnosis of exercise-induced anaphylaxis was established after excluding other causes of shock. This clinical syndrome was described recently; it consists of urticaria, local angioedema and/or cardiorespiratory failure following exercise. Factors possibly associated with or predisposing to attacks include personal and family histories of atopy, food ingestion and weather conditions. Not every effort evokes these reactions, indicating the presence of other, still unknown variables and therefore complicating the diagnosis because provocation tests often have false-negative results. With reference to this case, the clinical syndrome, its pathophysiology and its treatment are discussed.

Pneumococcal osteomyelitis and cellulitis in an adult patient with diabetes mellitus.

A 48-year-old diabetic patient was admitted to hospital with fever and extensive infection of the tissues around the right elbow. Diagnosis was made of cellulitis and underlying osteomyelitis caused by Streptococcus pneumoniae. Although seen in patients with seriously impaired host defence mechanisms pneumococcal osteomyelitis and cellulitis has not been reported in a diabetic patient.

Evaluation of magnesium before and after jejuno-ileal versus gastric bypass surgery for morbid obesity.

Jejuno-ileal bypass surgery for morbid obesity can cause metabolic and electrolyte imbalances. Another case of severe, symptomatic magnesium deficiency after jejuno-ileal bypass surgery is described. This complication was not encountered in a prospective evaluation of the magnesium status after gastric restrictive bypass surgery. Significant (p less than 0.005) body weight decrease was not accompanied by any (serum, erythrocyte or urinary) evidence of magnesium loss for 12 months after surgery.