A B S T R A C T The immunoreactive forms of parathyroid hormone (iPTH) in the plasma of six patients wilth primary, adenomatous hyperparathyroidism and six patients with ectopic hyperparathyroidism due to nonparathyroid cancer were compared by using gel filtration on columns of Bio-Gel P-150 and radioimmunoassay of iPTH in eluted fractions after concentration. We found much less (p <0.001) small (mol wt < 9,500) COOHterminal fragments of iPTH in plasma samples from ectopic hyperparathyroid patients (0.52+0.13 ng eq/ml) than in samples from primary hyperparathyroid patients (3.70±1.15 ng eq/ml). The quantity of iPTH eluting with or before native bovine PTH was the same in both syndromes (ectopic hyperparathyroidism, 0.82± 0.22 ng eq/ml; primary hyperparathyroidism, 0.73±0.09 ng eq/ml), and these values correlated positively with plasma calcium concentration (ectopic hyperparathyroidism, r = 0.908; primary hyperparathyroidism, r = 0.919). In both syndromes, plasma samples had an iPTH component that eluted well before PTH (mol wt 9,500), but this component was present in much larger quantities in three patients with ectopic hyperparathyroidism. We conclude that (a) the decreased quantity of biologically inactive COOH-terminal fragments of iPTH circulating in ectopic hyperparathyroidism accounts for the previously reported relatively lower total serum iPTH values in this syndrome as compared with primary hyperparathyroidism (Riggs et al. 1971. J. Clin. Invest. 50: 2079; (b) there appears to be sufficient iPTH with presumed biologic activity to account for the hypercalcemia in both syndromes; (c) a large PTH component, not previously recognized in plasma, is present in both ectopic and primary hyperparathyroidism and may exist as the predominant immunoreactive form of the hormone in some patients with ectopic hyperparathyroidism.

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The health and well-being of every child is affected by both the quality and quantity of food, but when does nutrition first begin to be important? Is it after the birth or from the moment of conception, or perhaps even before this? This paper will focus on the nutritional status of the mother, before as well as during pregnancy, and its relationship to the birth weight and subsequent health of the child. Pre-pregnant weight is a major factor affecting birth weight; underweight women may be at increased risk of delivering a low birthweight infant and of complications of pregnancy, whilst those who are excessively obese are at greater risk of gestational diabetes and hypertension. Animal studies have demonstrated that severe vitamin and mineral deficiencies have dramatic effects on reproductive outcome, and there is now growing evidence that even marginal deficiencies in women may have deleterious effects on pregnancy outcome. Nutrition interventions which involve low-risk women appear to have little effect but beneficial effects have been demonstrated in interventions directed at high-risk women. Information about nutrition should be the mainstay of any advice given to prospective parents.

A vitamin B6 deficiency develops during pregnancy and contributing factors include: a disturbance in vitamin B6 metabolism caused by increasing levels of oestrogens; increasing fetal demand for vitamin B6; a disturbance in vitamin B6 status caused by oral contraceptive usage prior to conception; a deficient intake of vitamin B6. Hormonal changes and increasing fetal requirements impose considerable stress on maternal vitamin B6 status but are the inevitable consequences of pregnancy. In contrast, longterm use of oral contraceptives before pregnancy and an inadequate vitamin B6 intake, both prior to and during pregnancy, are potentially avoidable. Dietary intakes of vitamin B6 in many women fall well below the recommended 1.5–2.0mg/day before pregnancy and 2.5mg/day during pregnancy. Although supplementation with synthetic vitamin B6 is advocated by many, much greater emphasis should also be placed on a wholesome, healthy diet. Examples are given of foods high and low in vitamin B6 and of a daily diet providing 2.5mg of vitamin B6.