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The interrelationships between serum 25-hydroxycholecalciferol, serum parathyroid hormone and bone changes in anticonvulsant osteomalacia.

Serum 25-hydroxycholecalciferol (25-HCC) and serum parathyroid hormone (iPTH) were measured in 59 randomly selected adult epileptic outpatients receiving chronic anticonvulsant therapy. Quantitative morphometric analysis of iliac crest biopsies was performed. A mild degree of osteomalacia was found which was inversely correlated to dietary vitamin D intake. Serum 25-HCC was reduced in the epileptic patients compared to a control group, although dietary intake of vitamin D was higher than the mean daily intake in the Danish population. Serum 25-HCC was positively correlated to dietary vitamin D intake, but not correlated to the severity of bone changes, indicating that other factors than circulating 25-HCC are responsible for the development of anticonvulsant osteomalacia. Serum 25-HCG was inversely correlated to serum iPTH in patients with a low dietary calcium intake. The mean value of serum iPTH was not increased, and there was no correlation between serum iPTH and bone morphometry.

Adolescent

Simultaneously obtained skin-puncture serum, skin-puncture plasma, and venous serum compared, and effects of warming the skin before puncture.

Specimens of skin-puncture serum and plasma and venous serum were simultaneously obtained from healthy adults and in each specimen the concentrations of 12 chemical constituents were measured. No clinically important difference was found in the concentrations of the constituents measured in skin-puncture serum and plasma with or without warming the skin before puncture. When the concentration of each of the measured constituents was compared in skin-puncture specimens and venous serum there were important differences in the concentrations of glucose, potassium, total protein, and calcium. Except for glucose, the concentrations of these were higher in venous serum. The degree of hemolysis was the same in skin-puncture serum and plasma, but less in venous serum. The greater hemolysis in skin-puncture specimens was not reflected in a clinically important increase in the values of lactate dehydrogenase and potassium. We conclude that there is a difference in the concentration of some chemical constituents in skin-puncture specimens and venous serum and that these differences should be considered when results for these types of specimens are compared.

Adult

Raised total thyroxine and free thyroxine index but normal free thyroxine. A serum abnormality due to inherited increased affinity of iodothyronines for serum binding protein.

2 people from different families had high levels of serum-thyroxine (T4) and a high free T4 (FT4) index but a normal serum triiodothyronine (T3) and serum-reverse-T3 (rT3). The abnormal serum thyroid hormone profile appeared to be inherited in an autosomal dominant manner. Serum-FT4 in affected relatives was normal. The increases in serum-T4 and FT4 index are explained on the basis of an observed increase in affinity of T4 for thyroxine-binding globulin, thyroxine-binding prealbumin, and albumin. The FT4 index did not reflect the true concentration of circulating free T4 in these cases. Thyroid function in the propositi was normal and the results of T4, T3, and rT3 kinetic studies accorded with increased binding of T4 by serum proteins and normal binding of the other iodo-thyronines. This "euthyroid high total T4, normal T3 syndrome" should be kept in mind during diagnostic evaluation of thyroid function.

Female

The effect of serum oncotic pressure on serum cholesterol levels: a study in "normal" and nephrotic subjects.

Clinical data in neprtotic and nonnephrotic subjects were examined to help delineate the mechanism of hypercholesterolemia in nephrotic syndrome. Analyses of the relationship between total serum cholesterol and serum albumin levels and between total serum cholesterol and calculated serum oncotic pressure in 500 nonnephrotic individuals revealed strong positive correlations (r = 0.9714, p less than 0.001 and r = 0.9720, p less than 0.001, respectively). Serum beta-lipoprotein concentration was found to bear an inverse relationship to measured serum oncotic pressure in 13 nephrotic patients (r = -0.8192, p less than 0.01). Our results lend support to the thesis that serum oncotic pressure is the major governing factor in hypercholesterolemia in nephrotic syndrome.

Adolescent

[Experimental foreign serum pancreatitis. Histologic and histochemical findings in the exocrine pancreas of the mouse after repeated intraperitoneal injections of serum of other species (author's transl)].

Adult white mice were continually treated by intraperitoneal injections of normal serum of various species (neat, horse, man, rabbit, mouse) for 3 hours up to 16 days. Control animals received injections of physiological saline under the same conditions. In the mouse pancreas, the repeated intraperitoneal injections of foreign serum conformably resulted in an interstitial edema, a first granulocytic and histiocytic, later on markedly lymphoplasmactyic interstitial inflammation with single dystrophic acinar cells as well as in a mild intersitial fibrosis after 8 or 16, resp., days of serum application. Histochemically, the exocrine pancreas cells showed a moderate increase in activity of adenosintriphosphatase, nonspecif esterase as well as acid and acaline phosphatase. All the changes described were most considerably pronounced after treatment with bovine serum. The interstitial pancreatitis after continual foreign serum applications regarded as the morphologie expression of a pathogenic immune phenomenon of the serum sickness type in case of a serum sickness reaction taking place preferably in the peritoneal cavity.

Acid Phosphatase

Serum lysozyme, serum proteins, and immunoglobulin determinations in nonspecific inflammatory bowel disease.

The serum levels of lysozyme, serum electrophoresis, and serum immunoglobulins were determined prospectively in 101 patients with ulcerative colitis, ulcerative proctitis, Crohn's disease, or nonclassifiable nonspecific inflammatory bowel disease. Although the mean serum lysozyme concentration of patients with Crohn's disease (10.5 +/- 6.8 microgram/ml) and ulcerative colitis (9.6 +/- 4.1 microgram/ml) performed by a standardized lysoplate method was significantly greater than normal controls (6.0 +/- 1.5 microgram/ml), the results did not correlate with the diagnosis nor with the degree of disease activity. Individually separated protein fractions and serum immunoglobulins also did not correlate with the serum lysozyme levels. This study indicates that measurement of the level of serum lysozyme in individual patients is not helpful in determining the cause or degree of activity of nonspecific inflammatory bowel disease.

Adult

Enzymes of collagen biosynthesis in skin and serum and dermatological diseases. II. Serum enzymes.

Serum immunoreactive prolyl hydroxylase protein and galactosylhydroxylysyl glucosyltransferase activity were measured in 54 patients wtih various dermatological diseases and compared with corresponding values in 32 control subjects. These serum enzymes were at the control level in the great majority of the patients, and no correlation was found between serum and skin enzymes, except for one weak correlation in lichen ruber planus. Some patients with psoriasis, lichen ruber planus, keloids, erythema nodosum or chronic discoid lupus erythematosus, however, did have at least one of these enzymes elevated in the serum, and a significant correlation (P less than 0.01) between the two enzymes was found in the total disease material. Thus it does seem that diseases limited only to the skin can sometimes raise these serum enzyme levels. The mean levels of serum immunoreactive prolyl hydroxylase and galactosylhydroxylysyl glucosyltransferase activity were significantly elevated (P less than 0.001) in active systemic connective tissue diseases such as systemic lupus erythematosus, scleroderma or dermatomyositis compared with the controls, and 4 out of 7 values for immunoreactive prolyl hydroxylase and 3 out of 7 for galactosylhydroxylysyl glucosyltransferase activity were above the 95% confidence limit of the controls. Since the levels of the skin enzymes were not elevated in most of these patients, however, the main sources for the elevated serum enzymes were probably tissues other than the skin.

Adolescent

Prediction of the concentration of penicillins in ascitic fluid from serum kinetics and protein binding of the antibiotics in serum and ascitic fluid of dogs.

Ascites was induced in dogs by partial ligation of the inferior vena cava. Concentrations of ampicillin, penicillin G, oxacillin, cloxacillin, dicloxacillin, nafcillin, and methicillin in ascitic fluid and serum were each determined in three animals. All antibiotics were administered intramuscularly in a dose of 15 mg/kg (dry weight) for both single-dose and multiple-dose (eight doses at 4-hr intervals) studies. Binding of antibiotics to serum and ascitic fluid proteins was measured by ultracentrifugation. After single doses the highly protein-bound drugs (oxacillin, cloxacillin, dicloxacillin, and nafcillin) had lower percentages of penetration (ratio of peak in ascitic fluid to that in serum, multipled by 100) than did methicillin, ampicillin, and penicillin G, which have a lower degree of protein binding. The effect was partially overcome by repetitive doses, but five to six doses were usually required to reach equilibrium. In addition to protein binding, serum kinetics (particularly the log mean total concentration of drug in serum after multiple doses) were important determinants of antibiotic concentrations in ascitic fluid. The total antibiotic concentration in ascitic fluid at equilibrium can be accurately calculated from the log mean serum concnetration and the percentages of protein binding in serum and ascitic fluid.

Ampicillin

Pharmacological studies on experimental nephritic rats. (4) Improvement of hyperlipemic models in rats utilizing anti-rat kidney rabbit serum and effects of anti-hyperlipemic agents on serum lipid levels.

Three hyperlipemic models in rats were compared regarding serum lipid levels and known anti-hyperlipemic agents were tested for their effects on the hyperlipemia. In rats fed a cholesterol diet (group A), only serum cholesterol level resulted in a marked increase as compared with normal level. In animals given a large dose (0.7 ml/100 g body weight, i.v.) of anti-kidney serum (group B), extremely high elevations of serum total lipid, phospholipid, triglyceride and cholesterol levels were observed. In animals given a small dose (0.3 ml/100 g body weight, i.v.) of anti-kidney serum and fed the cholesterol diet (group C), elevations of these serum lipids except for triglyceride were not only greater than in group B, but also synergistic. On the contrary, serum triglyceride level and proteinuria were less in group C than in group B. Furazabol, clofibrate the beta-sitosterol given orally for 7 days at doses of 1,100 and 500 mg/kg/day, respectively were clearly effective on the hyperlipemia of group C, without affecting the proteinuria. Furthermore, this model was more sensitive to these anti-hyperlipemic agents than groups A and B. From the above results, group C would seem to be an adequate and effective experimental hyperlipemic model.

Animals

Simultaneous radioimmunoassay for corticosterone and deoxycortisol in human serum: sex differences in the mean serum concentrations.

A specific radioimmunoassay is described which allows the simultaneous determination of serum corticosterone and deoxycortisol. The method involves extraction with dichloromethane, purification by paper chromatography in a modified Bush-system and quantitation by radioimmunoassay. The normal serum concentration of both steroids were found to be dependent on sex and menstrual cycle. Mean concentrations (+/- S.D.) in males, females (follicular phase) and females (luteal phase) were 4210 +/- 2170 ng/1,2410 + 1480 ng/1 and 4390 +/- 2320 ng/1 for corticosterone and 499 +/- 273 ng/1, 207 +/- 152 ng/1 and 335 +/- 182 ng/1 for deoxycortisol. After adrenal stimulation by corticotropin itself or by insulin induced hypoglycemia, the serum concentrations of corticosterone became significantly higher than those of deoxycortisol. After oral administration of dexamethasone serum concentrations of both steroids were suppressed to levels below the limit of the normal range. One hour after oral metyrapone administration at midnight, serum corticosterone decreased, while serum deoxycortisol increased by a factor of about five. After eight hours serum concentrations of both steroids were increased considerably. Corticosterone attained levels slightly higher than the normal range and deoxycortisol rose to levels which were higher than the normal mean concentrations by a factor of about 500.

17-Hydroxycorticosteroids

Mammalian serum susceptibility of Serratia marcescens: detection of three human serum susceptibility categories.

A total of 65 strains of S. marcescens, including 36 currently employed O- and H-antigen reference strains, were examined for their susceptibility to the bactericidal activity of 80 vol % of fresh human serum. The majority of strains (57 = 87.6%) proved 'delayed serum-sensitive' (DSS); 4 strains (6.2%) were 'promptly serum-sensitive' (PSS), whereas 4 strains (6.2%) resisted (NSS) complement-mediated killing by human serum. Fresh sera obtained from 7 adult human volunteers yielded essentially identical kinetic killing data against representative NSS, DSS and PSS strains of S. marcescens. These observations were interpreted as further justification for the assignment of clinical isolates of S. marcescens to 3 categories of human serum susceptibility: DSS, PSS and NSS. Species differences among fresh sera from sheep, rabbits and guinea pigs, as contrasted with fresh human serum, were noted. In general, PSS strains of S. marcescens were killed in a slightly delayed fashion; DSS strains of S. marcescens were killed in an unpredictable kinetic pattern by sheep and rabbit sera, whereas fresh guinea pig serum entirely failed to kill selected DSS isolates of S. marcescens.

Adult

A syndrome of osteoporosis, increased serum immunoreactive parathyroid hormone, and inappropriately low serum 1,25-dihydroxyvitamin D.

Although most patients with postmenopausal osteoporosis have normal or low values for serum immunoreactive parathyroid hormone (iPTH), we have reported previously that a small subset (about 10% of the total group) have increased values. We studied three patients representative of this latter group. Serum iPTH was two to three times higher than the age-adjusted normal mean, serum ionized calcium and total calcium were in the lower half of the normal range, and serum 1,25-dihydroxyvitamin D [1,25(OH)2D] was in the low-normal range. Six months of treatment of one patient with 0.5 microgram/day of synthetic 1,25(OH)2D improved calcium absorption and balance; however, serum iPTH remained high. After surgical removal of 1,010 mg of hyperplastic parathyroid tissue, serum iPTH decreased to normal. These and other data suggest that increased serum iPTH in these patients was caused by secondary hyperparathyroidism, possibly because of inadequate conversion of 25-OH-D to 1,25(OH)2D.

Aged

Effect of serum and serum components on the mitogen-induced proliferation of murine lymphocytes.

By increasing the concentration of human serum, the dose-response profile of the Concanavalin A-induced proliferation of murine spleen lymphocytes becomes broader and the optimal cell proliferation takes place at higher concentrations of mitogen. It is shown that this behavior is due to the globulin fraction of serum which greatly decreases the binding of Concanavalin A to lymphocytes. Cohn fractions III and IV have a similar effect. On the other hand, cell proliferation takes place also in the absence of Pooled Human Serum at appropriate concentrations of Concanavalin A and within a very narrow range of cell concentrations. In the presence of the albumin fraction of serum, proliferation takes place over a wider range of mitogen and cell concentrations. As a result of these phenomena, the mitogenic effect of Concanavalin A varies greatly in function of the concentration of serum. Analogous results were obtained with fetal calf serum.

Animals

Brdicka currents observed with bovine serum albumin and completely reduced bovine serum albumin in the presence of urea.

In ammonia buffers of varying composition and pH, native bovine serum albumin and completely reduced bovine serum albumin, denoted by p(SH)35, yield quite different Brdicka current-voltage (i-E) curves, but they are identical in the presence of 5 mM calcium chloride. This means that in the presence of calcium, bovine serum albumin becomes completely reduced to p(SH)35. In 8 M urea and ammonia buffers the Brdicka i-E patterns of serum albumin and p(SH)35 are identical even in the absence of calcium, the effect of calcium on the first wave being negligible while calcium slightly increases the second wave. The maximum polarographic effect is attained at urea concentrations of about 5-6 M. Quite generally, the appearance of a second Brdicka wave is attributed to complexation of Co(II) with S- and a group of ligands that is different on the second than on the first wave. The effect of calcium on Brdicka currents of bovine serum albumin in the absence of urea is attributed to an orientation of the protein on the surface of the electrode such that all disulfide groups are reduced and with other ligands can complex with Co(ii). Denaturation of bovine serum albumin in buffers with a pH less than 10.5, and which are 8 M in area, is (polarographically) completely reversible if dilution is made within 15 minutes after preparation. Changes in Brdlcka I-E patterns upon longer aging at varying pH are attributed-in part at least-to dimerization of the denatured protein by interaction of pS- in one molecule with -S-S-in another.

Ammonia

Serum immunoglobulin levels and electrophoretic patterns of serum proteins in trypanosome-infected bushbuck (Tragelaphus scriptus).

Serum immunoglobulin levels and relative proportions of serum proteins were determined in bushbuck and zebu cattle inhabiting tsetse-infested areas of Uganda and animals living in tsetse-free areas. Serum IgM pand IgG levels were significantly increased in infected bushbuck and zebu cattle. Serum from captive bushbuck showed low levels of immunoglobulins. Serum protein concentrations in infected and non-infected cattle were similar but infected bushbuck had higher serum protein levels than uninfected animals.

Agglutination Tests

Inhibition of lymphocyte cytotoxicity by serum from patients with alcoholic liver disease: partial characterization of serum inhibitors.

Studies were performed to explore the effect on normal lymphocyte function of serum derived from patients with alcohol-induced liver injury and healthy controls. We examined the effect of such serum on the generation of both spontaneous and Concanavalin A (Con A)-induced lymphocyte cytotoxicity for Chang target cells. Normal lymphocytes, when incubated in the presence of 5% serum from patients with alcoholic liver disease, showed a marked (20.75 ± 5.1% mean ± SEM) reduction in the capacity to generate spontaneously cytotoxic cells compared to 5% control serum (3.2 ± 1.9%) (p < 0.001). Similar results were found in studies of Con A-stimulated cytotoxicity (36 ± 7.2% vs. 5 ± 2.3%; p < 0.001). Fractionation of serum by gel chromatography demonstrated the presence of inhibitory activity of various molecular weights, although a major peak of inhibitory activity (approximately 270,000 daltons) was identified in severe alcoholic hepatitis. Thus, this study demonstrates the presence of serum inhibitors in alcoholic liver disease which influence normal lymphocyte function.

Antilymphocyte Serum

Effect of fasting on free and esterified carnitine levels in human serum and urine: correlation with serum levels of free fatty acids and beta-hydroxybutyrate.

Serum levels of free L-carnitine, acylcarnitines, creatinine, beta-hydroxybutyrate, free fatty acids, cholesterol, triglycerides, and glucose were determined in healthy volunteers during a 24-36-hr fast. The effect of oral administration of free L-carnitine (1 g/person) on these parameters was studied. Urinary excretion of carnitine and creatinine was monitored throughout. Serum and urine levels of free carnitine and its renal clearance decreased during the fast. However, the serum concentration and urinary excretion of acylcarnitines increased during the same interval. Following the ingestion of free L-carnitine, both serum and urinary levels of free L-carnitine rose. Within 6 hr of ingestion, 10% of the administered dose could be accounted for by urinary excretion. No significant effect on the other serum constituents under study was seen following the oral L-carnitine dose. A significant negative correlation was found between serum levels of free L-carnitine and beta-hydroxybutyrate and free fatty acids (r equal -0.567, p less than 0.001 and r equal -0.607, p less than 0.001, respectively) during the fast.

Acetylcarnitine