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Soluble Fc gamma receptors are produced by cleavage of the membrane receptors or by alternative splicing. They are found in biologic fluids. After a brief description of the structure and mode of production of soluble Fc gamma R, we address the question of ligands and function of the soluble Fc gamma R by using recombinant molecules and transgenic animals. We show that soluble Fc gamma R are not only IgG-binding factors which interfere with, and block, Fc-dependent immune reactions but also molecules that interact, in vitro, with non-Ig-ligands such as CR3 and CR4 and are trigger or regulate immune functions via these receptors.

In order to gain further insight into the mechanism of platelet dysfunction frequently reported in diabetes we investigated circulating fatty acids, lipid composition of platelet membrane and platelet function in Type 2 diabetic patients. In these subjects, percentages of C16 : 1n-7 and C18 : 1n-9 in serum phospholipid fraction and of C16 : 1n-7 in serum cholesterol ester fraction were decreased. Moreover, the content of C20 : 4n-6 in serum cholesterol esters was altered in Type 2 diabetic subjects: C18 : 0 and C20 : 3n-6 were increased but C20 : 4n-6 content was similar to controls. Aggregation in vitro did not differ from controls but aggregation in vivo was increased in Type 2 diabetic subjects. No correlation was observed between metabolic parameters -i.e., HbA1, blood glucose, serum triglycerides and total cholesterol, circulating fatty acids and fatty acid content of platelet membrane. A negative linear correlation was found between aggregation in vivo and C20 : 4n-6 content of platelet membrane. Moreover, a U shaped relationship was observed between platelet aggregation in vitro and C20 : 4n-6 content of platelet membrane suggesting that C20 : 4n-6 level should be tightly controlled otherwise platelet hyperreactivity may occur. These results indicate that despite a normal mean C20 : 4n-6 content in the platelet membrane, regulation of C20 : 4n-6 metabolism is less strictly controlled in Type 2 diabetes mellitus and confirm the importance of arachidonic acid platelet content in the regulation of platelet aggregability.

After a mathematical evaluation of 20 mixtures containing different proportions of potato (P), lupin (L) and whole egg (E) on dry basis and kept the latter component in a constant amount of 6 per cent, a mixture of 60:34:6 (P:L:E) was chosen for a further experimental work at a lab level because of his better nutritional value for the pre-school children feeding. When an eighteen percent suspension of the mixture mentioned above was dehydrated in a drum drier an adecuate yield of flakes was obtained with an appropriate water absorption. The sensory evaluation test of the dehydrated product as a sauce indicated a higher acceptance than purées. On the other hand, during a 90 days period storage test of the product as flakes, it did not show microbiological problems, although after 45 days rancidity appeared in the dehydrated product.

Platelet function, estimated from plasma beta-thromboglobulin (beta-TG, ng/ml), is frequently altered in insulin-dependent diabetics (IDDs). As several factors may affect beta-TG, we studied respectively in 15 IDDs, the roles played by: (i) diabetic control evaluated from glycosylated haemoglobin (HbA1); (ii) plasma C-peptide and pancreatic glucagon; (iii) plasma lipids and the relative percentages of fatty acids in total plasma lipids. Plasma beta-TG did not correlate significantly with the first 3 parameters. However, beta-TG was correlated: (i) positively with plasma triglycerides (P less than 0.01), cholesterol (P less than 0.02), phospholipids (P less than 0.05) and total plasma lipids (P less than 0.01) and the percentage of oleic acid (C18 : 1 omega 9) in plasma lipids (P less than 0.01); (ii) negatively with the percentage of linoleic acid (C18 : 2 omega 6) in plasma lipids (P less than 0.02). No correlation was found between beta-TG and the percentages of the other saturated (C16 : 0, C18 : 0), monounsaturated (C16 : 1 omega 7) and polyunsaturated fatty acids (C18 : 3 omega 6, C20 : 3 omega 6 and C20 : 4 omega 6). The present results indicate that beta-TG in IDDs can be markedly improved by all dietary and therapeutic measures which lower plasma lipids and increase the percentage of the linoleic acid in the body.

Ten patients aged between 18 and 73 years admitted to our intensive care unit were placed on exclusive artificial nutrition with Enteronutril receiving on average 2.855 +/- 496 kcal/day (715 +/- 125 g). This solution is poor in lipids (1.5%) and contains no linoleic acid (C18:2). Its effects on serum lipids were analysed after 5, 10 and 15 days of treatment. Total cholesterol (TC) and phospholipids (PL) showed no significant change. However, triglycerides (TG) rose on d15 and pre-beta-lipoproteins were significantly higher on d5. The latter rose further from d10 to d15. The C18:2 fraction of total lipids (TL) fell precipitously on d5 (-50%). Although C18:2 remained stable from d5 to d10, a new, slower decrease occurred from d10 to d15. This decrease was accompanied by a specific rise in oleic (C18:1) and palmitoleic (C16:1) acids. Palmitic (C16:0) and stearic (C18:0) acids were unaffected. Arachidonic acid (C20:4) remained within normal limits up to d15. Eicosatrienoic acid which was measurable on d0 presented no significant rise during the course of the study. The changes in C18:2 were inversely proportional to those of C18:1 or C16:1. This translated a lack of C18:2 relative to delta 9 desaturase (freed of the inhibition usually exerted by C18:2). These results showed that the body could maintain a sufficient level of linoleic acid to synthesize arachidonic acid by drawing on its C18:2 reserves from fatty tissue. Nevertheless, these reserves were progressively exhausted beyond d10, thereby causing a shortage of arachidonic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

The authors studied disturbances of lipid clearance in cases of aseptic osteonecrosis of the femoral head by means of an induced intravenous hyperlipemia test. With reference to investigations in 19 patients, the authors first draw attention to the frequency of ethylism and of fatty degeneration of the liver (13 patients). A significant decrease was noted in the coefficient of lipid clearance in the 19 patients. This was particularly marked when fatty degeneration of the liver was present. The etiological role of these anomalies should be considered, as fatty degeneration and hyperlipaemia may also be found in other pathological conditions responsible for primary osteonecrosis of the femoral head (corticotherapy).

The relationship between breast cancer, liposoluble vitamins, cholesterol and triglycerides was investigated by means of a hospital-based case-control study conducted at Milan (Italy) and Montpellier (France). These parameters were measured in blood samples taken from 319 cases and 344 controls. The interview included an evaluation of dietary intake of liposoluble vitamins. No difference emerged in liposoluble vitamin consumption, whereas a statistically significantly higher serum level of cholesterol and plasma level of vitamin E existed in cases compared to controls. The difference in plasma vitamin E was confirmed after adjustment for total cholesterol and triglycerides. In contrast, vitamin A variations appear to follow triglyceride trends. A multivariate analysis of the vitamin E plasma level was performed after classification of cases and controls according to quintile distribution of controls. All known risk factors plus age, serum total cholesterol and triglycerides were used as covariates. The odds ratio value for the highest quintile of plasma vitamin E is: 4.2 (1.9-9.0).

The hepatorenal syndrome is considered to be a functional renal failure due to active renal vasoconstriction. The purpose of this work was to study the urinary elimination of prostaglandins and the plasmatic polyunsaturated fatty acid precursors of prostaglandins. The urinary elimination of PGE2 was not significantly different in the groups of patients studied: controls, group I (193 +/- 42 ng/24 h), cirrhotic patients without ascites, group II (274 +/- 43 ng/24 h), cirrhotic patients with ascites, group III (269 +/- 41 ng/24 h). The urinary elimination of PGE1 and PGF2 alpha varied in the same way as PGE2. In cirrhotics with hepatorenal syndrome (group IV) the urinary elimination of vasodilating prostaglandins was greatly decreased (p less than 0.001); PGE2 (53 +/- 16 ng/24 h), PGE1 (65 +/- 11 ng/24 h). The urinary elimination of PGF2 alpha was also decreased (293 +/- 75 ng/24 h). On the other hand, the urinary elimination of thromboxane, a vasoconstrictor, increased progressively from group I (287 +/- 75 ng/24 h) to group IV (980 +/- 266 ng/24 h) (p less than 0.05). Plasmatic arachidonic acid was significantly decreased in group IV (5.0 +/- 0.6 p. 100) compared to group I (10.0 +/- 0.6 p. 100) (p less than 0.001), to group II (10.3 +/- 0.5 p. 100) (p less than 0.001), and to group III (8.5 +/- 0.7 p. 100) (p less than 0.05). In conclusion, in hepatorenal patients, urinary excretion of a vasoconstricting prostaglandin (thromboxane) is increased while urinary excretion of vasodilating prostaglandins is decreased. This decrease could be secondary to a lack of plasmatic arachidonic acid, precursor of prostaglandins.

The authors report a case of general and local poisoning after erroneous intravaginal administration of podophyllin for warts. The clinical course mainly showed a 10 day paralytic ileus, vaginal and urethral lesions and a severe peripheral neurological illness: paresthesia, dysesthesia and ataxia. The authors stress the potential toxicity of podophyllin and recommend great caution in using this product.

Eleven insulin-dependent diabetics exhibiting a fair but less than ideal diabetic control (HbA1 = 10.0 +/- 0.6%) were submitted in a random order to two 6 week-study periods of: continuous subcutaneous insulin infusion (CSII) and optimized conventional insulin therapy. Plasma lipids, fatty acids in plasma lipids and platelet function were estimated at baseline and at the end of each study period. Declines in HbA1 were observed at the end of either CSII or conventional period compared with baseline, but the differences were only significant under CSII (P less than 0.02). Plasma lipids and apoproteins remained unchanged at the end of the two study periods compared with baseline. Both CSII and optimized conventional treatment were followed by a significant increase of arachidonate in plasma lipids. A deterioration of the platelet function estimated from ADP or epinephrine-induced platelet aggregation and TxB2 generation by platelets was found under optimized conventional treatment while the platelet function appears to be normal at baseline and under CSII. These data indicate that slight but not sufficient improvements of diabetic control can result in deterioration of the platelet function. It seems that these deleterious effects are mediated through an increased production of arachidonate and in turn of TxB2.

In order to gain insight into the mechanism of platelet dysfunction in insulin-dependent diabetics we studied in 17 patients the influence of a 6-week period with a dietary supplement of gamma-linolenate: 2 g/d (group I, n = 8) or 500 mg/d (group II, n = 9). Serum lipids, plasma beta-thromboglobulin (beta TG), platelet aggregation in vitro, and TxB2 and PGE1 released from platelets during the aggregation process were measured. In group I, serum triglycerides fell from 1.57 +/- 0.28 mmol/l to 0.99 +/- 0.17 mmol/l (P less than 0.01) and cholesterol fell from 5.85 +/- 0.55 mmol/l to 5.08 +/- 0.52 mmol/l (P less than 0.01). In group I plasma beta TG fell from 100.0 +/- 15.7 ng/ml to 73.7 +/- 12.1 ng/ml (P less than 0.025), while the sum of the percentages of the C18:3 omega 6 and its chain elongated (C20:3 omega 6) and desaturated (C20:4 omega 6) metabolites increased in serum triglycerides (P less than 0.05), cholesterol esters (P less than 0.02) and phospholipids (P less than 0.02). No changes were observed on the other parameters in either group. The results show that the lowering effects of gamma-linolenate on serum triglycerides, cholesterol and plasma beta TG occur only with daily intakes of 2 g. The changes in fatty acid composition of serum lipids suggest that the gamma-linolenate intake of 2 g may exert its beneficial effect through an increased incorporation of long-chain polyunsaturated fatty acids, but no firm conclusion can be drawn as membrane platelet fatty acid composition was not evaluated.

EB 51 (Trivemil) is an original fat emulsion containing L. aminoacids and glucids in its liquid phase in the following proportions: amino acids: 60 gl/l corresponding to 8,77 g of nitrogen or 250 calories, sorbitol: 100 g/l or 400 calories wheatgerm oil: 38 g/l or 350 calories. This preparation supplies 1000 per liter. Its objective is to furnish simultaneously the amino acids as well as the energy necessary for their anabolism. EB 51 was administered in 43 patients during several days at a dosage of 1000 or 1500 ml. The tolerance of the product was excellent. Its usefulness was appreciated by nitrogen balance studies as well lipid blood tests. The clearing of the plasma in practically all the cases was very good and the nitrogen saved was almost equivalent to the amount furnished. The indications, dosage and contreindications of EB 51 are detailed.

The best route of insulin administration by infusion pumps remains a subject of controversy. For that reason plasma lipids and apolipoproteins were compared in three groups of nine patients who had been treated for several months or years with conventional treatment (group I), continuous subcutaneous insulin infusion (CSII, group II) or continuous intraperitoneal insulin infusion (CPII, group III). Plasma cholesterol and apolipoprotein B remained increased on CPII compared with CSII even when similar satisfactory or even tight diabetic control was achieved with both techniques. This study suggests that cholesterol and perhaps apolipoprotein B biosynthesis by the liver is increased in patients treated with CPII compared to those treated with CSII.

Several anorectal diseases are described. Most are sexually transmitted (gay bowel syndrome or heterosexual transmission). The clinical aspect of nearly all of them is similar. Thus, the diagnosis usually cannot be done on clinical grounds alone: one has to request the help of the laboratory. Amebiasis, giardiasis, chancroid and donovanosis are frequent in Africa but rare in our countries, except in male homosexuals. Shigellosis, salmonellosis, pediculosis, scabies and campylobacter infections are seen in male homosexuals because of orofecal contacts. Condylomata acuminata are frequent in our country. The typical clinical aspect leads to an easy diagnosis. Electrocoagulation is the treatment of choice. Anorectal gonococcal are also frequent in our country, both homosexually and heterosexually transmitted. The clinical aspect suggests the diagnosis, but this must be confirmed by the laboratory.