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Objectives: To evaluate the performance of a strategy in which, after immunoreactive trypsinogen (IRT) determination, genetic analysis is replaced by a biological test, the pancreatitis-associated protein (PAP) enzyme-linked immunosorbent assay (ELISA)., Study Design: The French newborn screening program includes cystic fibrosis (CF) screening by the IRT/CFTR mutation strategy. PAP was assayed on screening cards, in parallel with IRT, in all newborns from 5 French regions (n = 204,749). Analysis of PAP values in CF and non-CF newborns with elevated IRT allowed direct comparison between the current strategy and the proposed IRT/PAP strategy., Results: A protocol in which newborns with IRT >50 ng/mL and PAP >1.8 ng/mL and those with IRT >100 ng/mL and PAP >1.0 ng/mL are directly recalled for sweat testing would have the same performance as the IRT/CFTR mutation strategy., Conclusions: The IRT/PAP strategy is an alternative for CF newborn screening, which avoids the drawbacks of genetic analysis and is cheaper and easier to implement than the current IRT/CFTR mutation strategy.

The influence of gender on the glucose response to exercise remains contradictory. Moreover, to our knowledge, the glucoregulatory responses to anaerobic sprint exercise have only been studied in male subjects. Hence, the aim of the present study was to compare glucoregulatory metabolic (glucose and lactate) and hormonal (insulin, catecholamines and estradiol only in women) responses to a 30-s Wingate test, in physically active students. Eight women [19.8 (0.7) years] and eight men [22.0 (0.6) years] participated in a 30-s Wingate test on a bicycle ergometer. Plasma glucose, insulin, and catecholamine concentrations were determined at rest, at the end of both the warm-up and the exercise period and during the recovery (5, 10, 20, and 30 min). Results showed that the plasma glucose increase in response to a 30-s Wingate test was significantly higher in women than in men [0.99 (0.15) versus 0.33 (0.20) mmol l(-1) respectively, P<0.05]. Plasma insulin concentrations peaked at 10 min post-exercise and the increase between this time of recovery and the end of the warm-up was also significantly higher in women than in men [14.7 (2.9) versus 2.3 (1.9) pmol l(-1) respectively, P<0.05]. However, there was no gender difference concerning the catecholamine response. The study indicates a gender-related difference in post-exercise plasma glucose and insulin responses after a supramaximal exercise.

Objective: To determine whether the osteoarticular changes associated with genetic hemochromatosis could be explained by metabolic parathyroid hormone (PTH) disorders., Methods: The study involved 210 patients with liver iron overload syndromes. Osteoarticular changes were numerically scored as the number of damaged joints. PTH 1-84 and 44-68 were assayed., Results: An increase in serum PTH 44-68 levels was found in one-third of untreated patients who had no calcium or PTH 1-84 abnormalities. Serum PTH 44-68 levels correlated positively with serum ferritin levels. In multivariate analyses, the number of affected joints correlated positively with age, serum PTH 44-68 levels, and serum ferritin levels., Conclusion: Liver iron overload syndromes, especially genetic hemochromatosis, are associated with elevated circulating levels of PTH fragments containing the 44-68 region, which appears to play a role in osteoarticular changes. This increase seems to be a consequence of iron overload.

Endothelial cells were isolated from bovine thoracic aorta and cultured. Bovine aortic endothelial cells (BAEC) were incubated with radiolabeled arachidonic acid (3H-AA) or eicosapentaenoic acid (14C-EPA) (1 microM) for 3 hr. Both fatty acids were predominantly incorporated into phosphatidylcholine (57 +/- 2% and 62 +/- 2% respectively) and slightly into phosphatidylethanolamine (11 +/- 0.5% and 12 +/- 0.6% respectively). phosphatidylinositol (26 +/- 1.5% and 10 +/- 0.5% respectively) and neutral lipids (6 +/- 0.5% and 15 +/- 1% respectively). After BAEC incubation with 3H-AA for 24 hr with or without EPA (1 microM), the release of radioactive metabolites of AA induced by thrombin (5.5 U/ml) was strongly reduced by the preliminary treatment with EPA (72 +/- 5%). After BAEC incubation with AA, EPA or vehicle (control), endothelin-1 levels were measured by RIA in the culture medium and we observed that: 1) the basal production of endothelin-1 was not modified after either AA or EPA treatment, 2) the thrombin-evoked release of endothelin-1 was significantly reduced by EPA (5.8 +/- 0.82 and 3.8 +/- 0.50 pg/microg proteins in control and EPA-treated cells, respectively); 3) by contrast, AA had no significant effect on the thrombin-evoked release of endothelin-1. In conclusion, EPA reduces strongly the endothelin-1 release but AA is ineffective. This reduction of endothelin-1 release may account partly for some of the vascular effects of EPA.

The level of parathyroid hormone was measured by heterologue C terminal radio-immunological assay in 69 patients with clinical or radiological manifestations of the type seen in primary articular chondrocalcinosis. They were divided into three groups: P1 with undetermined clinical arthropathies; P2 with sub-chondral and arthosic arthropathies; P3 with radiologically definite chondrocalcinosis. They were compared with 57 control subjects broken up into four groups: T1 with chronic rheumatic arthritis, T2 with low back pain, T3 with primary hyperparathyroidism due to adenoma, and T4 with secondary hyperparathyroidism with renal insufficiency. A form of normocalcemic hyperparathormonaemia was demonstrated in more than one out of two patients in group P1 (15/29). It was seen in three-quarters of the cases in group P2 (12/16). And it was seen in more than a quarter of the cases in group P3 (7/24). This hyperparathormonaemia was statistically significant only in groups P1 and P2 compared to the normals in groups T1 and T2. The results we obtained in this study seem to be in complete concordance with those we obtained earlier in idiopathic hemochromatosis. This hyperparathormonaemia seems to regress with age and is often only discovered when the characteristic articular lesions have appeared. The discovery of normocalcemic hyperparathormonaemia several years before the appearance of the radiological signs of the disease would appear to be an important argument in favour of the diagnosis of early articular chondrocalcinosis. The existence of raised parathyroid hormone in primary articular chondrocalcinosis as well as in idiopathic hemachromatosis is special etiopathogenic interest even if there remain numerous questions concerning its origin and mode of action.

The rise in serum myoglobin (MGB), total CPK (CKT) and its MB isoenzyme (CK - MB) was studied and compared over the first three days of acute myocardial infarction (AMI) and correlations were sought between the peak values of these three parameters and haemodynamic and biological indices of left ventricular function. Blood was taken from MGB (radio immunological technique), CKT and CK - MB (spectrophotometry) estimation every 2 hours for 24 hours and then every 6 hours up to the 72nd hour in 36 patients with AMI less than 12 hours old. On admission, this protocol was completed by a haemodynamic study (right heart pressures, systemic blood pressure, cardiac output measurement by thermodilution), arterial gases and ECG recordings. The average delays before the pathological rise, the maximal peak value and the return to normal were significantly shorter (p less than 0.001) for MGB (2, 6 and 25 hours) than for CK - MB (5,16 and 34 hours) or CKT (5,21 and 57 hours). The sensitivity of the diagnosis of myocardial infarction was not significantly higher with MGB than CKT or CK - MB either in the whole group (sensitivity of 91.6 p. 100 for MGB and 86.1 p. 100 for CKT and CK - MB) or in a subgroup of ten patients without transmural infarction (70 p. 100 for MGB compared with 60 p. 100 for CKT and CK - MB). A significant correlation was found between the peak values of MGB (p less than 0.02) and CK- MB (p less than 0.02) and the indices of left ventricular function (PCP, PAO2 and LVSWI). This was not observed with CKT. In conclusion, apart form technical problems which remain unresolved time-consuming investigation), serum MGB gives a much earlier and as sensitive a biochemical diagnosis of AMI as CKT and CK - MB. MGB and CK - MB are much better prognostic indicators than CKT as judged by the indices of left ventricular function. Finally, MGB estimation should be of particular value in the diagnosis of secondary extension of infarction.

A rapidly migrating variant of albumin has been discovered in a 28-year-old breton woman. At least eight relatives also bear the trait. This new variant is described in terms of its electrophoretic mobilities, immunological properties and heat- and storage stability. Two other reports of the slow type are presented, but no family study was performed in these cases. It is suggested that bisalbuminaemia could be a relatively common inherited condition in Brittany.

Seventy six patients with chronic inflammatory rheumatism were treated with various non-steroid anti-inflammatory drugs for 5 to 7 days. The average variations of several serum proteins were studied. The variation of haptoglobin remained nil. Those of other serum proteins remained negative and significantly different from zero, distributed from the greatest to the smallest value of the degree of statistical significance as follow : ceruloplasmin (p < 0.0001), orosomucoide (p < 0.02), fibrinogen (p < 0.02) alpha-2-macroglobulin (p < 0.04) and alpha-1-antitrypsin (p < 0.05). The study of the partial results showed the variability of the degree of significance of the serum proteins in relation to the non-steroid anti-inflammatory drugs. The practical interest of these serum protein seemed low to measure in the short term, the efficacy of non-steroid anti-inflammatory drugs. Their interest in long term studies remains to be demonstrated compared with that of the measurement of the sedimentation rate by the technic of the sigma E.S.R.

Hemodialysis (HD) amyloidosis is due to beta 2-microglobulin (beta 2M) storage, the importance of which could vary with the permeability of dialysis membranes. We studied long-term variations of beta 2M in 52 patients who had been dialyzed over 1.5-20 years (mean +/- SD = 7.5 +/- 5.2), 3 X 4 h weekly. Serum samples had been stored at 30 degrees C and RIAs were done in one run with the same kits (Immunotech). At least 2 assays were done for each patient in samples collected 1-9.5 years apart. Mean beta 2M concentration in 26 ESRF patients was 31 +/- 18 mg/l. According to duration of HD and membranes used, Cuprophan (CUP) versus polyacrylonitrile (AN69), mean concentrations of beta 2M were (mg/l +/- SD): at 6 months, 55 +/- 36 vs. 54 +/- 20 (n.s.); 2 years, 55 +/- 24 vs. 61 +/- 23 (n.s.); 4 years, 79 +/- 18 vs. 64 +/- 19 (n.s.); 6 years, 69 +/- 17 vs. 55 +/- 17 (n.s.); 8 years, 76 +/- 18 vs. 54 +/- 12 (less than 0.01); 10 years, 77 +/- 17 vs. 54 +/- 14 (less than 0.02). The effect of changing membranes was also studied: CUP-AN69 (69 +/- 28 months), 79 +/- 21 vs. 54 +/- 14 (less than 0.01). Serum beta 2M (1) increased rapidly after the beginning of HD; (2) reached a plateau after 2 years in patients treated with AN69 and 4 years with CUP; (3) were significantly lower after 8 years with AN69 than with CUP, and (4) decreased significantly after changing CUP for AN69.(ABSTRACT TRUNCATED AT 250 WORDS)

Thirty six patients suffering from myocardial infarction were investigated by assay of their serum myoglobin, total creatine kinase and creatine kinase isoenzyme MB activities. Determination of serum myoblobin presents, with regard to creatine kinase MG, two major advantages: a very early increase after the onset of the pain (about three hours later) and a very quick clearance, allowing the diagnosis of a second episode of necrosis after about one day.

The present study is a survey of the different types of bisalbuminemia. In the inherited and familial form, the anomaly is fortuitously discovered and not associated with disease. The abnormal albumin fraction only differs from the normal one in a slight alteration in the aminoacid sequence, responsible for increased ("fast type") or decreased ("slow type") electrophoretic mobility. The anomaly is genetically determined and is transmitted as an autosomal codominant character. The condition is relatively rare, but has been observed in most parts of the world, with some higher incidence in many American Indian tribes. In the acquired transient biaslbuminemia, the abnormal component of the albumin is always of the fast type and occurs in patients either receiving large amounts of beta-lactamine type antibiotics, or suffering from pancreas diseases.

Two groups, A and B, were selected at random amongst a total of 31 patients suffering from chronic inflammatory rheumatic disorders. The patients in group A (n = 16) received succesively: Placebo (2d), Indomethacin (5d). Indomethacin + aspirin (5d). The order of the 5 day treatment periods was reversed for the patients in group b (n = 15). The daily dose of indomethacin was 150 mg. That of aspirin was 1500 mg. Four parameters were measured at the end of each period of treatment: total serum indomethacin, articular index (Ritchie), ESR (Westergren) and the sigma ESR - a new technique for the measurement of sedimentation rate. No conclusions could be drawn from the analysis of variations in ESR. Concordant and statistically significnat variations in articular index and the sigma ESR showed a reduction in the activity of indomethacin under the influence of aspirin. The inhibitory effect of aspirin. The inhibitory effect of aspirin continues after the drug stopped. This reduction in indomethacin activity is not related to a decrease in serum concentrations of the medication which are not significantly altered when aspirin is taken.

The authors present their view of screening for central nervous system malformations in Brittany, having studied 192 case histories of subjects seen in the three years of genetic counselling in Rennes. Ultrasound usually manages to demonstrate anencephaly but all too often it fails to demonstrate spina bifida. Furthermore serum or amniotic fluid alphafetoprotein levels are often poorly interpreted. Microcephaly and encephaloceles occur rarely. The ultrasound diagnosis of the latter is easy whereas it is more difficult to diagnose microcephaly. The authors point out that there are familial forms of hydrocephaly and of holoprosencephaly which are not all that rare and fairly easy to diagnose so long as one remembers this very serious abnormality.

Twenty-eight male subjects underwent a maximal exercise test on an ergometric bicycle, 13 untrained and 15 trained subjects. At rest and after this maximal exercise, indicated by the increase of the serum lactate and pyruvate acids, venous blood samples were taken to study the release of muscular enzymes (SGOT, SGPT, LDH, alpha HBDH, CPK, CPK MB) and myoglobin in the next 24 h (3 min, 30 min, 8 h and 24 h after the end of this test). The statistic analysis of the results shows significant increases in comparison with the values at rest, according to the enzymes and the groups of subjects, especially for CPK, SGOT, SGPT for which the results are homogeneous with a peak at the 3rd min and the 8th h in the three groups and for HBD and LDH in the groups of trained subjects. However these values remain most often within the normal limits. These results are compared with those of previous works on the same subjects.

The amniotic alpha 1-foetoprotein of the 17th week of pregnancies with amenorrhea was tested by electroimmunodiffusion and radioimmunology. The results show a very good correlation between both methods. We can see from this study the possibility for any laboratory to test alpha 1-foetoprotein in amniotic fluid of patients with high risk pregnancies, as the beginning of pregnancy when amniotic punction is necessary without using radioimmunology.