The pathophysiological influence of leptin and the tumor necrosis factor system on maternal insulin resistance: negative correlation with anthropometric parameters of neonates in gestational diabetes.

The contribution of the tumor necrosis factor (TNF) system and leptin was studied in insulin resistance and neonatal development during the course of normal pregnancy and gestational diabetes mellitus (GDM). Thirty patients with GDM and their neonates (n = 30), 35 healthy pregnant women (15 in the first, nine in the second and 11 in the third trimester) and their neonates (n = 20), and 25 healthy matched non-pregnant women participated in the study. Significantly elevated levels of maternal TNF-alpha, sTNF receptor (R)-1 and R-2, leptin (detected by enzyme-linked immunosorbent assay) and fasting C-peptide (measured by radioimmunossay and raised body mass index (BMI) were found in GDM patients and in the third trimester of normal pregnancies. TNF-alpha, sTNFR-2, C-peptide, leptin concentrations and BMI positively correlated with each other in GDM. An inverse relationship between the body length, head circumference and body weight of the newborns, and maternal TNF-alpha, leptin and C-peptide concentrations was shown in GDM. In healthy pregnancies the maternal serum leptin level was in a negative linear correlation with the head circumference of the newborns. In conclusion, increased TNF-alpha and leptin levels may contribute to insulin resistance in GDM and in the third trimester of normal pregnancy and may negatively influence the anthropometric parameters of the newborns.

Presymptomatic diagnosis of familial colon polyposis.

The gene responsible for familial adenomatous polyposis (FAP) has recently been mapped, identified and this makes the presymptomatic molecular diagnosis of the disease possible. It can be performed by direct mutation analysis or indirect haplotype analysis. In families where several affected individuals are available the indirect haplotype analysis is the easiest way for performing presymptomatic diagnosis of persons at risk. Among Hungarian families we have performed haplotype analysis using D5S346, a highly polymorphic dinucleotide CA repeat marker located 30-70 kb downstream from APC gene with the combination of restriction endonuclease Rsal site polymorphism. Marker regions were amplified by polymerase chain reaction (PCR) and basen on the above-mentioned polymorphic systems, the haplotype at the APC locus was determined. We believe that haplotype analysis of individuals at risk in large FAP families containing several affected members is a rapid, efficient, and highly valuable method for presymptomatic diagnosis of familial colon polyposis.

[The morphological characteristics of the chondriome of human lymphoblastoid cells producing the human immunodeficiency virus]. / Morfologicheskaia kharakteristika khondrioma limfoblastoidnykh kletok cheloveka, produtsiruiushchikh virus immunodefitsita cheloveka.

The mitochondrial complex condition of continuous CEMT4 cell line infected by the human immunodeficiency virus has been investigated. The mitochondrial morphology of these and of intact cells was similar in great extent, though several changes were observed. For example, mitochondrial profiles with multiple dichotomous branches and anastomosis cristae were noted in the former. These changes resulted in the augmentation of the inner membrane square of mitochondrion. The formation of mitochondrial clusters connected with special junctions was a very characteristic part of the infected cell. Contacts were seen to be formed between the outer membranes neighboring profiles. These contacts look as X-like little bridges, or net-like or plate-like structures. The mutual transition of all these structures was observed using goniometer adapter. As has been shown by the three-dimensional reconstruction of mitochondrial junction zones, this area is presented by a single mitochondrion being structurally very complicated and very large in size compared to the neighbouring ones.

The role of Brunner's glands in the mucosal protection of the proximal part of duodenum.

In the course of a prospective study authors examined the role of the hyperplasia of Brunner's glands in the mucosal protection of proximal part of duodenum in patients with peptic ulcer, chronic pancreatitis and chronic renal insufficiency. Their method for this study was the histological examination of the endoscopic biopsy specimens. The hyperplasia of Brunner's glands occurs with significant frequency in all the three examined groups of patients, while we found it less frequently in the controls. Hyperplasia of Brunner's glands is one of the protective mechanisms of the organism, which serves the protection of the duodenal mucosa between the pyloric ring and the papilla of Vater, against the damaging effect of the hydrochloric acid.

Release of prostacyclin (PGI2) from trophoblast in tissue culture: the effect of glucose concentration.

It is known that short term cell culture system offers a reliable and reproducible means for measuring placental PGI2 production in vitro, in which factors controlling its production and metabolism can be studied. The aim of the present investigation was to study the effect of glucose on generation of PGI2 by trophoblast obtained from early pregnancy in short term cell culture. Trophoblast was cultured using the method of Jogee et al and the concentration of 6-oxo-PGF1 alpha in culture supernatans was measured by a specific direct radioimmunoassay (New England Nuclear, USA). There was a significant decrease in 6-oxo-PGF1 alpha production by trophoblast cells when incubating with increased glucose concentrations (300 and 600 mg/dl) compared to controls (without glucose). These data show for the first time that high concentrations of glucose inhibit PGI2 production by cultured trophoblast cells obtained from early pregnancy. The implication of these findings for the mechanism of development of congenital anomalies in diabetic pregnant women is discussed.

Platelet sensitivity to adenosine diphosphate and to prostacyclin in diabetic pregnancies.

Platelet sensitivity to adenosine diphosphate (ADP) and to prostacyclin (PGI2) was studied in normal and diabetic pregnant women. The threshold concentrations of ADP inducing the second phase of aggregation were used to determine the platelet sensitivity to PGI2. The sensitivity of platelets to ADP increased in both groups in the second trimester, thereafter it decreased both in normal and diabetic pregnancies. In contrast, sensitivity to PGI2 increased in the last trimester of pregnancy. No difference could be observed between diabetic and normal groups. The similarity of the results between the two groups could be explained by the normoglycaemic state of well-controlled diabetic pregnant women.

Comparative metabolic effects of oral contraceptive preparations containing different progestagens. Effects of desogestrel + ethinylestradiol on the haemostatic balance.

In two open randomized studies carried out in female volunteers the effects of a new low dose oral contraceptive (O.C.) combination desogestrel + ethinylestradiol (150 micrograms/30 micrograms; Marvelon) on blood coagulation were compared with those of either the combination levonorgestrel + ethinylestradiol (150 micrograms/30 micrograms) or a triphasic preparation containing levonorgestrel + ethinylestradiol. A total of 78 women were involved in the studies which covered a period of 4 cycles; a pretreatment cycle followed by 3 treatment cycles, each consisting of 21 days of drug administration, followed by a 7-day tablet-free period. A blood sample was taken before treatment, after 2 weeks, 2 cycles and 3 cycles of treatment. The following parameters were measured: prothrombin; activated partial thromboplastin time; factors VII, VIII, X; fibrinogen; antithrombin III; euglobulin lysis time; platelet count and aggregation ratio; triglycerides and cholesterol and a glucose tolerance test was made. The effects of the different preparations on these parameters were compared statistically using either an analysis of covariance or the Wilcoxon test. No clinically significant differences were observed between the desogestrel containing preparation and the two other preparations. Any changes in treatment versus pretreatment values were slight and in agreement with the literature on other O.C.'s.

Effect of pyelonephritis during pregnancy on mother and fetus.

Pyelonephritis during pregnancy was found to have a higher incidence when the patient's history contained some indication of an earlier renal disease. Pregnancy associated with chronic nephritis has to be interrupted in the first trimester as the particular conditions of pregnancy predispose to pyelonephritis. Provided pregnancy pyelonephritis is diagnosed and treated early enough the incidence of intrauterine fetal death, premature, birth and perinatal fetal loss will not be higher than the average, but developmental retardation has a slightly higher incidence. The degree of renal disturbance not only increase the probability of pyelonephritis but also the damage suffered by the mother and fetus. The prevention of inflammatory renal and appropriate treatment of inflammatory renal diseases and the constant control of the patient is the task of prenatal and nephrological care, so as to avoid early and late complications.