Diurnal and weekly rhythms of health-related variables in home recordings for two months.

Several telecare systems for long-term monitoring of the well-being of patients at home have been developed as an aid in healthcare and to reduce hospitalization costs. Most of the systems have been designed to measure only one or two variables. Because well-being is a combination of both psychological and physiological wellness, there is a need to monitor several psychophysiological variables simultaneously in out-of-hospital conditions for a long period. To understand better the variability of patients' wellness-related variables in long-term recordings, the knowledge of the normal variation in health-related variables in healthy people is necessary. In our study, 14 healthy working middle-aged men were studied daily for 24 h and periods of 50 to 79 days. The variables measured were beat-to-beat heart rate, motor activity, blood pressure, body weight, and temperature. At night respiratory frequency, time of movements, amount of quiet sleep, and ballistocardiographic respiratory variation were also measured. Heart rate variability in the waking period was calculated later (standard deviation of the 5 min average of the successive normal to normal beat to beat intervals). Daily self-reported well-being, activities, and consumption of alcohol were monitored by keeping a behavioral diary. After normalizing the physiological data, the diurnal and weekly variability was calculated for each variable. In several variables the most notable diurnal and weekly variability was found between working time and free time. In conclusion, diurnal and weekly rhythms in several wellness-related physiological and psychological variables were identified, depending on working and free-time in healthy middle-aged men.

Concomitant monitoring of serum neuron-specific enolase and creatine kinase BB in small cell lung cancer.

Serum neuron-specific enolase (NSE) and serum creatine kinase isoenzyme BB (CK-BB) were measured in 43 small cell lung cancer (SCLC) patients. The overall sensitivity of NSE (greater than 12.5 ng/ml) was 65%; in limited disease (LD) 48% and in extensive disease (ED) 100%. CK-BB was detected in 14 patients (32%); the sensitivity was 17% in LD and 64% in ED. During treatment NSE declined or stabilized to normal level in LD together with objective response in 75% (21/28), and rose again with progression in 28% (6/21). CK-BB fell to normal in all 5 patients with LD, in 3 of them with objective response. In ED elevated NSE and CK-BB declined to normal with objective response in 73% (8/11) and in 25% (2/8) of the evaluable patients respectively. We conclude that serum NSE is a potential marker for staging and response monitoring in SCLC, but that CK-BB gives additional information of limited value.

Synovial fluid lipids in rheumatoid arthritis.

Synovial fluid from the inflamed knee joints of 30 patients with rheumatoid arthritis (RA) contained 2.75 +/- 0.81 mmol/l cholesterol (51% of the corresponding mean serum level) and 0.32 +/- 0.13 mmol/l triglycerides (35% of the corresponding mean serum level). The ratio of synovial fluid triglycerides to cholesterol indicates that in RA the concentration of very low density lipoproteins (VLDL) is lower in synovial fluid than in serum. In a few patients, however, the "relative triglyceride concentration" in synovial fluid (i.e. synovial fluid tg/chol:serum tg/chol) was greater than 1. This concentration did not correlate, moreover, with the clinical activity of the disease.

Hexosamine-containing macromolecules in human colon carcinomas.

Normal, transitional, and carcinoma areas of five colons resected for carcinoma were examined morphologically, histochemically, and biochemically. The transitional area contained a larger amount of non-sulphated acid mucin than the normal mucosa as verified histochemically. Normal mucosa contained mainly sulphated mucin. The hexosamine-containing macromolecules present in different areas were isolated and characterized. They were divided into the following groups: 1) acid glycosaminoglycans, 2) high-molecular-weight glycopeptides, and 3) low-molecular weight glycopeptides. The concentration of the total hexosamine-containing material was in the carcinoma area twice as high as in normal areas. Acid glycosaminoglycans were identified as hyaluronate, heparan sulphate, dermatan sulphate, and chondroitin 4-(6)-sulphate. Their concentraitons were found to increase from normal to transitional and from transitional to carcinoma areas. The high-molecular-weight glycopeptide was composed of fucose, galactose, glucosamine, galactosamine, sialic acid, and variable amounts of sulphate. The sulphation degree of the glycopeptide was higher in normal mucosa than in transitional or carcinoma areas: The low-molecular-weight glycopeptides consisted of about a half of the total hexosamine-containing substances. The concentration of saline-insoluble fraction of the low-molecular-weight glycopeptides was in transitional areas about two times, and in carcinoma areas about four times, higher than in normal mucosa.

Polysaccharides of metaplastic mucosa and carcinoma of the gallbladder.

The polysaccharide composition of the human gallbladder well was studied in carcinomas and metaplastic changes of various degrees, and the results obtained were compared with those for the normal material previously presented (Terho, T., and Laitio, M. Biochim. Biophys. Acta 338: 135, 1974). Elevated amounts of acid connective tissue polysaccharides (heparitin and dermatan sulfates as well as chondroitin 4- or 6-sulfate, or both, could be observed in carinomas. In histochemical stainings it was found that in carcinomas and in the two specimens classified as group III (containing the most extensive metaplastic changes at disposal), the intracellular mucin was mainly neutral or nonsulfated acidic. The amounts of sulfated mucin were relatively insignificant. This mucin polysaccharide material was isolated and its composition was determined. It was observed to be large polysaccharide material was isolated and its composition was determined. It was observed to be large molecular (approximate molecular sizes 1 to 2 times 10-6), and to be composed of fucose, galactose, glucosamine, and galactosamine as well as small amounts of sialic acid. The basic structure of these polysaccharides is thus similar to that of normal sulfated mucin. The almost total absence of acid groups, however, causes the polysaccharide material in question to stain in a manner identical with neutral mucin when investigated with histochemical methods. The carcinomas also contained some sulfomucin; its proportion, however, was small as compared with the amounts of nonsulfated acid and neutral mucin in biochemical characterization. A small molecular polysaccharide fraction, assumed to originate in membrane-bound glycoproteins, was isolated from the insoluble gallbladder tissue residue. The proportion of this fraction was larger in carcinomas than in normal material. This rise as well as the rise in the quantity of acid connective tissue polysaccharides is presumably due to the large number of cells in the carcinoma tissue as well as to fibrosis.