High-resolution CT features of severe asthma and bronchiolitis obliterans.

AIM: To evaluate the high-resolution CT findings of severe asthma (SA) and bronchiolitis obliterans (BO) and determine whether any reliable discriminating HRCT features exist. MATERIALS AND METHODS: HRCT examinations of the chest of 30 patients with SA and 14 patients with BO were analysed. Images were scored for the presence and extent of 21 CT findings. RESULTS: The most consistent HRCT features in SA were bronchial wall thickening in 30 (100%), expiratory air trapping in 19 of 22 examinations with expiratory images (87%), inspiratory decreased attenuation in 18 (60%), and bronchial luminal narrowing in 12 (40%). The most consistent HRCT features in BO were expiratory air trapping in 10 of 10 examinations with expiratory images (100%), bronchial wall thickening in 13 (93%), inspiratory decreased attenuation in 11 (79%), ground glass opacity in seven (50%), and mosaic pattern of attenuation in seven (50%). Decreased attenuation was more extensive in BO than in SA on both inspiratory and expiratory images. The mosaic pattern of attenuation was present in seven (50%) BO patients but in only one (3%) SA patients (P=0.0006). CONCLUSIONS: Mosaic pattern of attenuation, when present, is highly suggestive of BO, but SA and BO may be indistinguishable.

Monoclonal antibodies against a C-terminal peptide of human brain acetylcholinesterase distinguish between erythrocyte and brain acetylcholinesterases.

Monoclonal antibodies (mAbs) were raised against a peptide of the 10 C-terminal amino acids of human brain acetylcholinesterase (AChE): H-Tyr-Ser-Lys-Gln-Asp-Arg-Cys-Ser-Asp-Leu-OH. Two positive clones (mAbs 190-1 and 190-2) were selected and tested for their ability to distinguish between mammalian brain and erythrocyte AChEs. In a solid-phase enzyme antigen immunoassay as well as by Western- and dot-blot analysis, both antibodies showed clear binding to AChE from human and bovine brain but not to AChE from erythrocytes. MAbs 190-1 and 190-2 reacted with neither AChE from electric eel nor butyrylcholinesterase from human serum. Both antibodies were used in a quantitative assay for AChE in amniotic fluids, where AChE activity could be found only in samples from open neural tube-defect pregnancies, but not in fluids from normal pregnancies or in artificially blood-contaminated samples.

Characterization of salt-soluble forms of acetylcholinesterase from bovine brain.

The hydrophilic, salt-soluble (SS) form of acetylcholinesterase (AChE) from bovine brain caudate nucleus exists mainly as a tetramer sedimenting at 10.3S (approximately 40%), and a monomer sedimenting at 3.4S (approximately 60%). The enzyme is N-glycosylated and contains similar HNK-1 carbohydrates as detergent-soluble (DS) AChE. No O-linked carbohydrates could be detected. Amino acid sequencing showed that the N terminus of SS-AChE is identical to that of DS-AChE. In tetrameric SS-AChE, two pairs of disulfide-linked dimers are associated by hydrophobic forces located in the C terminus. Antibodies were raised against a peptide identical to the last 10 amino acid residues of bovine brain DS-AChE. The peptide included the sequence of residues 574-583 (H-Tyr-Ser-Lys-Gln-Asp-Arg-Cys-Ser- Asp-Leu-OH) of the enzyme. The antibodies cross-reacted with tetrameric, but not with monomeric, SS-AChE, showing that in the latter form, the C terminus is truncated. Limited proteolysis of tetrameric SS-AChE at the C terminus led to the formation of an enzymatically active monomer, which did not react with anti-C-terminal antibody. Although the DS form of AChE contains a structural subunit that serves as membrane anchor, no anchor was detected in SS-AChE. Enzyme antigen immunoassays showed that SS-AChE reacted with all monoclonal antibodies directed against the catalytic subunit of DS-AChE, but not with monoclonal antibodies targeting the membrane-anchored subunits. From our results, we conclude that SS-AChE utilizes the same alternative splicing pattern as DS-AChE, leading to tetrameric SS-AChE devoid of the membrane anchor.(ABSTRACT TRUNCATED AT 250 WORDS)

Serum alpha-fetoprotein and alcohol consumption.

Fifty-nine persons, 23 chronic alcoholics and 36 normal healthy persons with a well described alcohol consumption, had the serum concentration of alpha-fetoprotein determined by a sensitive monoclonal immunofluorescent assay. A significant elevation in S-AFP was found in alcoholics, median 4.1 kIU/l as compared to 3.0 kIU/l in near-abstainers (< 12 g ethanol per day) (p < 0.02). This difference was not explained by differences in age. S-AFP correlated positively with age (p = 0.01). In non-alcoholics a borderline significant correlation with S-AFP was found with average daily alcohol consumption (self-reported) (p = 0.09) and a significant correlation with the serum concentration of carbohydrate-deficient transferrin (S-CDT) (p = 0.004). In 11 alcoholics 2 months of abstention from alcohol was accompanied by a median reduction of 21% in S-AFP (p < 10(-5)). In alcoholics, but not in social drinkers, S-AFP correlated with S-ASAT (p = 0.004). The increase of S-AFP with alcohol consumption may reflect reversible alcohol-induced liver affection.

[Skiing injuries. Review over the winter of 1990-1991 in a clinic in the French Alps]. / Skiskader. Opgørelse over vinteren 1990-1991 i en klinik i de franske Alper.

The popularity of skiing has increased in recent years, producing an increase in the absolute number of ski injuries despite a decrease in the overall injury rate. A review of 620 injuries in a surgery in Val d'Isére, in the French Alps, during the winter season 1990-1991 confirmed the evolution in the epidemiology of ski injuries. In our study, fractures only constituted 11% of the ski lesions. The upper extremity was involved in 28% and the lower extremity in 49% of the injuries. 33% of the absolute number of injuries and 72% of the admissions to hospital were on account of knee injuries. More attention should be paid to the individual preparation of the skier.

Heterogeneity in copper and glycan content of ceruloplasmin in human serum differs in health and disease.

Crossed immunoelectrophoresis of human serum revealed two heterogeneity types of ceruloplasmin with different electrophoretic migration. The two types both consisted of peptides with Mr 150,000, 100,000 and 45,000, which were interpreted as native ceruloplasmin and two hydrolytic fragments. The two types were different in copper content, and one type could reversibly be changed into the other. The glycan microheterogeneity of ceruloplasmin was analyzed by crossed affinoimmunoelectrophoresis with free Lens culinaris agglutinin (LCA) and wheat germ agglutinin (WGA). A third of the ceruloplasmin molecules, both high and low copper type, bound to LCA and two thirds to WGA. The heterogeneity and the microheterogeneity of ceruloplasmin in two groups of patient sera were compared to sera from healthy individuals. The ceruloplasmin type with respect to copper content was a much better factor than either glycan microheterogeneity or total serum concentration in discriminating between the three groups.

Occupational formaldehyde exposure and increased nasal cancer risk in man.

A comprehensive data linkage system for the detailed investigation of occupational cancer has newly been established in the Danish Cancer Registry, providing employment histories back until 1964. Based on this system a study of 839 cases of cancer of the nasal cavities, sinuses and rhinopharnyx and 2,465 cancer controls diagnosed in Denmark during the period 1970-1982 was conducted. Histories of exposure to formaldehyde, wood-dust and 10 other specified compounds or procedures, were assessed by industrial hygienists unaware of the case-control status of the cancer patients under study. Some 4.2% of the male and 0.1% of the female controls had been exposed to formaldehyde. A statistically significant excess risk (p less than 0.05) for carcinoma of the nasal cavity and sinuses among males with a history of exposure to formaldehyde (RR = 2.8), wood-dust (RR = 2.5) and paint lacquer and glue (RR = 2.1) was found. When adjustment was made for wood-dust exposure the relative risk associated with formaldehyde was reduced to 1.6, which is not significantly in excess of 1.0, although still compatible with a 3- to 4-fold increase in risk using conventional 95% confidence limits. The joint action of exposure to wood-dust and formaldehyde was in accordance with an additive effect. The excess risk of sino-nasal cancer with exposure to paint, lacquer and glue remained statistically elevated after adjustment for contemporary exposure to wood-dust and formaldehyde.