Sex differences in illness beliefs and illness behavior in patients with suspected coronary artery disease.

The aim of this study was to explore sex differences in illness beliefs and behavior in patients with suspected coronary artery disease (CAD). Twenty-eight patients, 16 women and 12 men, were interviewed. The results show that both men and women think of CAD as a 'men's disease' and have equal knowledge of CAD risk factors. However, especially the men considered their own risk of developing CAD lower than their estimated probability of their own sex and as low as their estimated risk for women. Both men and women did not attribute their symptoms indicative of CAD to their heart. Women, especially those who did not attribute their symptoms to their heart, had a longer patient delay than men, although their symptoms were indicative of CAD. To conclude, men as well as women should be made more aware of their own risk of developing CAD and of the manifestation of CAD symptoms. Physicians could be encouraged to ask patients more explicitly and thoroughly about their illness beliefs, to check their knowledge and inform them about CAD.

Effect of acute phase proteins, especially alpha 2-macroglobulin, on granuloma formation around Schistosoma mansoni eggs in the rat.

A new model for the study of granuloma formation in the liver is described. Rats received an injection of 20,000 Schistosoma mansoni eggs in the portal vein and granuloma formation was evaluated at 3, 5 and 7 weeks post-injection. Liver collagen was estimated at the same time and serum procollagen III peptide, a marker of collagenesis, weekly. With this model, wherein the number of S. mansoni eggs and the time of injury are standardized, the effect of high levels of acute phase proteins especially alpha 2-macroglobulin on granuloma formation was studied. It appeared that in rats with high levels of alpha 2-macroglobulin the mean size of granulomas was significantly greater at 3 and 5 weeks compared with controls. In both groups an increase in liver collagen was observed during this period, reaching a peak at 5 weeks in the acute phase group. This model facilitates the study of the effects of S. mansoni eggs on granuloma formation.

Glycosylation of four acute-phase glycoproteins secreted by rat liver cells in vivo and in vitro. Effects of inflammation and dexamethasone.

We have studied the role of the liver in the relative increase of Concanavalin A (Con A)-reactive molecular forms of various positive rat acute-phase glycoproteins (APGPs) occurring in serum during inflammation. Secretion media of hepatocytes isolated from inflamed rats showed a 2 to 5-fold increase of the total amounts of four APGPs studied in comparison to secretion media of control hepatocytes. These changes were in analogy with those observed for corresponding sera, except for alpha 1-antitrypsin. All the different Con A-reactive molecular forms were present in the media, with exception of the most reactive form of ceruloplasmin. In vitro and in vivo, dexamethasone augmented the secretion of three APGPs, and especially of the Con A-most reactive forms. The in vitro effect of dexamethasone--augmented secretion of Con A-reactive molecular forms of alpha 1-acid glycoprotein and haptoglobin--was comparable with the results obtained for hepatocytes isolated from inflamed rats. In vivo, dexamethasone treatment resulted in an even higher increase of the serum concentration of the Con A-most reactive forms of both APGPs than experimental inflammation did. Although an extrahepatic contribution cannot be excluded, these results suggest that alterations in the Con A reactivity of APGPs as observed during the acute-phase of inflammation have their origin in the liver. A change in the Con A reactivity of glycoprotein indicates a modulation of its glycosylation. Since dexamethasone can affect these changes in vivo and in vitro, glucocorticoids most probably are involved in the regulation of the glycosylation of the APGPs during biosynthesis in the liver.