MMPI-2 subgroups in a sample of chronic pain patients

MMPI-2 scores of 307 female and 161 male chronic pain patients were analyzed by gender using a multivariate clustering method. Two subgroups were found for both sexes replicating previous results. The major subgroup corresponded to the classical "Conversion V" and the minor corresponded to the "Generally elevated" profile. The results also indicated a satisfactory internal consistency and a high discriminant validity of the Swedish version of the MMPI-2.

Test ordering pattern at the chemical pathology laboratory, hospital universiti sains malaysia

The utilization of the chemical laboratory resources at the Hospital Sains Malaysia was evaluated. More than 100,000 test requests received and performed over a 12-month period, were analyzed retrospectively. The analysis conducted included the abnormal results obtained, the degree of duplication of tests, and the extent of test-panel ordering. It was found that a relatively moderate degree of over-ordering was evident. The findings suggested that the main reasons for over-ordering were the use of panel tests of ordering, in addition to a small, yet significant degree of duplication. Strategies for cutting down the test ordering have been reviewed and discussed.

Pyridoxal 5'-phosphate inhibits DNA binding of HNF1

An efficient Escherichia coli expression system was constructed for the production of a variant form of HNF1 protein having the additional five amino acid residues (Asp-Arg-Trp-Gly-Ser) at the NH(2)-terminal. The cDNA encoding HNF1 was ligated to 6 x His tag and inserted into an inducible bacterial expression vector pRSET A. After expression in E. coli, the recombinant product was purified by Ni-NTA affinity column chromatography. The purified product showed expected NH(2)-terminal sequence and specific binding to the HNF1 site. The effect of pyridoxal 5'-phosphate and its analogues on the binding activity of recombinant HNF1 was examined and found that only pyridoxal 5'-phosphate effectively inhibited the DNA binding. The concentration of pyridoxal 5'-phosphate that inhibited 50% of DNA binding was around 100 microM. Furthermore, we identified Lys197 of HNF1 molecule as the essential residue of DNA binding. These observations suggest that pyridoxal 5'-phosphate directly interacts with tissue-specific transcription factor HNF1 and modulates the binding to DNA.

Purification, characterization and developmental expression of chick (Gallus domesticus) liver PSP protein

We have isolated a perchloric acid-soluble protein designated as C-PSP from the post-mitochondria supernatant fraction of chick liver. It is soluble in 5% perchloric acid and purified by ammonium sulfate, fractionation and CM-Sephadex chromatography. The C-PSP showed approximately 70% homology with PSP isolated from rat liver (L-PSP1) with its partial amino acid sequences. The protein has a molecular mass of approximately 14 kDa which was slightly higher than that of L-PSP1. It inhibited protein synthesis in a rabbit reticulocyte lysate system. C-PSP was mainly expressed in liver and kidney and was also expressed in intestine, gizzard, glandular stomach, heart, brain and spleen though its expression was low. The expression of C-PSP in liver increased gradually from the 1st day to the 2nd week and it remained almost the same until the 13th week. C-PSP was also found in day 8 chick embryonic tissues. Interestingly, we found that C-PSP was expressed as a differentiation-dependent manner in the nervous cells of chick embryos. Thus, our findings are the first report on the presence of a PSP in avian tissues which may be involved in the regulation of cellular growth and differentiation.

[Microalbuminuria in rheumatoid arthritis]

To assess the prevalence of microalbuminuria in patients with rheumatoid arthritis and its correlation with disease activity and drug treatment, we studied 65 patients with rheumatoid arthritis and 51 sex and age matched control persons. Microalbuminuria was significantly increased in patients with rheumatoid arthritis (27.7%) as compared to 7.8% in the control group. Patients with microalbuminuria had a significantly greater median duration of disease (11.2 v 7.8 years; p < 0.001). We found a significant correlation to C-reactive protein as a marker for disease activity. Also, a significant association to treatment with gold and penicillamine was found. The measurement of microalbuminuria by immunochemical methods represents a simple and sensitive test to detect subclinical renal damage and may be a sensitive indicator of disease activity in patients with rheumatoid arthritis. We suggest its use in the monitoring of patients with rheumatoid arthritis to detect early subclinical renal dysfunction and drug induced renal damage.

[Kidney function problems in rheumatoid arthritis]

Rheumatoid arthritis is a systemic, disabling disease with significant excess mortality which is partly caused by renal disease, infection and renal insufficiency being the main contributors. The bulk of renal problems in reumatoid arthritis are related to complications such as vasculitis and amyloidosis, and complications to the medical treatment of the disease, the main offenders being gold salts, penicillamine and cyclosporine. Also, there is increasing evidence that reumatoid arthritis per se can cause subclinical renal dysfunction with microalbuminuria as well as clinical disease, caused by immune-complex mediated glomerulonephritis and interstitial tubular fibrosis. In reumatoid arthritis serum creatinine can overestimate renal function by as much as 30% and it is suggested that more sensitive methods such as measuring urinary albumin excretion and glomerular filtration rate should be used for monitoring renal function.

Microalbuminuria in patients with rheumatoid arthritis

OBJECTIVES

To assess (a) the prevalence of microalbuminuria in patients with rheumatoid arthritis, (b) the association between urinary albumin excretion and disease activity as estimated by the erythrocyte sedimentation rate and C reactive protein (CRP), and (c) the association between urinary albumin excretion and treatment with antirheumatic drugs.

METHODS

Sixty five patients with rheumatoid arthritis attending two rheumatology clinics were compared with 51 control subjects matched by age and sex. The controls consisted of 20 healthy subjects, 16 patients with osteoarthritis and 15 with non-articular rheumatism. Patients with hypertension, diabetes mellitus, or evidence of previous renal disease were not included. Urinary albumin was assayed by immunoturbidimetry in random urine samples on two occasions within seven months. The results were expressed as the ratio of urinary albumin to urinary creatinine ratio. Disease activity was assessed by the erythrocyte sedimentation rate and CRP. A drug history for the year before entry to the study was obtained for each patient.

RESULTS

Urinary albumin to creatinine ratio in patients with rheumatoid arthritis was significantly greater than in controls (p < 0.01). Microalbuminuria (urinary albumin to creatinine ratio 3-30 mg/mmol in either or both urine samples) was present in 27.7% of patients with rheumatoid arthritis and 7.8% of the control subjects. A significant relation was noted between urinary albumin to creatinine ratio and CRP, and the duration of disease. The number of patients treated with either gold or penicillamine was significantly greater in patients with microalbuminuria than in patients with normoalbuminuria.

CONCLUSIONS

Microalbuminuria is frequently present in patients with rheumatoid arthritis. Treatment with gold and penicillamine seems to increase the risk of developing microalbuminuria. Urinary albumin measured by immunochemical methods is a simple and sensitive test to detect early subclinical renal dysfunction and drug induced renal damage in rheumatoid arthritis. Urinary albumin excretion was found to be significantly correlated with CRP and may be a sensitive indicator of disease activity in patients with rheumatoid arthritis.

[Needles for bone marrow examination]

Over the past decades, numerous new bone biopsy needles have been introduced. Pathological investigation requires sufficiently large and well-preserved specimens. This article reviews the literature concerning the quality of the instruments. Comparison of the various types of needles in controlled studies is not available. Bone-marrow biopsy is discussed in the context of obtaining optimal specimens and choice of biopsy needle.

Cardiac performance and thyroid function. The correlation between systolic time intervals, heart rate and thyroid hormone levels

In the search for a clinical correlate to thyroid function, correlations were sought between the plasma level of thyroid hormones and the cardiac function, assessed by heart rate and the systolic time intervals. The present study is the first to 1) use a curvilinear correlation and 2) do so in the entire hormone range. A third degree Chebychew's regression equation was used to enable curvilinear correlation. In a population of 10 hypothyroid, 14 euthyroid, and 25 hyperthyroid patients a statistically significant curvilinear correlation was found between the thyroid hormone levels and the systolic time intervals. The correlation coefficients showed the heart rate equally correlated to the thyroid hormone levels as the best correlated of the systolic time intervals. The correlation between the heart rate and T3 was almost linear, with a heart rate increase of 4 beats/minute with each increase in plasma T3 of 1 nmol/l.

CONCLUSION

The thyroid function reflects in the cardiac function in a curvilinear regression between T3 and systolic time intervals and in an almost linear regression between T3 and heart rate. The variation, however, is too great and the slope too low, to suggest the use of the heart rate as a clinical correlate to thyroid function.

The effects of propranolol and verapamil on hyperthyroid heart symptoms and function, assessed by systolic time intervals

The effects of acute and chronic administration of propranolol and verapamil on heart rate and systolic time intervals were studied in 10 hyperthyroid patients and 10 normal subjects, both groups without signs of cardiovascular or pulmonary disease. In normal subjects iv propranolol reduced heart rate significantly, and both drugs increased the total electromechanical systole significantly without difference between the drugs. This effect was insignificant when the drugs were given orally. In hyperthyroid patients both drugs reduced heart rate significantly in acute and chronic administration, and no difference between the two drugs was found. Neither drug altered cardiac contractility as assessed by systolic time intervals. These results indicate that the metabolic effects of thyroid hormone on contractility were unaltered and unblocked by the drugs. None of the participants developed signs of heart failure. Verapamil can thus be used as an alternative to propranolol in the treatment of tachycardia in hyperthyroidism.

Non-Hodgkin malignant lymphoma in the nails in the course of a chronic lymphocytic leukaemia

We describe a 70-year-old woman with B-cell chronic lymphocytic leukaemia without nodal involvement, who developed non-Hodgkin malignant lymphoma in the toe-nails. Clinically, the affected nails looked like a typical mycotic infection, but later small tumours developed which affected the nails, and biopsy established the diagnosis. Treatment with chlorambucil (Leukeran) and prednisolone had a striking effect. Malignant infiltration of B lymphocytes in the nails is very rare, but should be considered in patients with malignant haematologic disease.

[Polycythemia vera in a Danish family]

The occurrence of polycythaemia vera in a Danish woman and her two sons is described. No environmental agent could be identified and it is suggested that the cases represent a genetic susceptibility to this myeloproliferative disease.

Variations in blood viscosity in patients with acute cardiogenic pulmonary oedema treated with frusemide

In 10 patients with acute cardiogenic pulmonary oedema, treatment with large doses of intravenous frusemide (mean dose 156 mg) induced no signs of haemoconcentration. On the contrary, during an observation period of 2 h after start of treatment we registered a significant reduction of mean blood viscosity and mean haematocrit, indicating haemodilution. All the patients also received a basic treatment of intravenous pethidine and nasal oxygen and the conclusion is therefore that large doses of intravenous frusemide in treatment of acute cardiogenic pulmonary oedema can be given without risk of haemoconcentration when combined with intravenous pethidine and nasal oxygen.