Calcitonin (CT) is a known potent inhibitor of bone resorption but its effect on cartilage enzymatic degradation has been incompletely studied. Salmon CT, at a concentration of 0, 0.1, 0.25, 0.5, 2.5 and 50 ng/ml, was added at 24 or 72 h to the culture medium of chondrocytes from human osteoarthritic hips and knees. The spontaneous collagenolytic activity, measured using a radiolabeled type II collagen, was inhibited by CT in a dose-dependent manner. However, CT had no effect on the total collagenolytic activity assayed after APMA activation. Stromelysin and plasmin activity, measured by degradation of casein and a synthetic substrate, were also unaffected by CT. Chondrocyte phospholipase A2 activity, assayed using a labeled specific substrate, was decreased by CT. Chondrocyte pre-incubation with CT significantly decreased the cell binding of labeled TNF alpha, but did not affect IL-1 beta cell binding. Attachment of chondrocytes on fibronectin was markedly stimulated by CT, while attachment to type II collagen was not. Significant effects were obtained using at least 2 or 5 ng/ml of CT. CT appears to decrease collagenolytic activity by decreasing its activation and/or increasing its inhibition by tissue inhibitors of metalloproteinases (TIMP). CT might act on osteoarthritic chondrocyte activation via mechanisms such as phospholipase A2 activity, human necrosis factor-alpha or fibronectin receptor expression.
Following the pioneer work of Dr Marjory Warren in 1935, the speciality of geriatric medicine has evolved during the last 25 years. Research has recently gained momentum and, now that there are more than T O million people aged 60 years and over in the UX (Central Statistics Office, 1970) and 2.5 million over the age of 75 years, we need to know more about the ageing process and the problems of living in later life.There have been few surveys of health and nutrition in the elderly and a proportion of these have examined only particular nutrients. There is limited information about the effect of social and economic factors on the health and nutrition of elderly people and the current trend of economic inflation makes it impossible to provide accurate up-to-date details. The 19th centuryBarker, Oddy & Yudkin (1970) refer to the analysis by modern techniques of a small survey by William Yield, Mayor of Manchester, in 1841, and they note that: (a) families whose incomes were reduced by unemployment did not switch from meat to bread, but reduced consumption all round; and (b) there was little difference between meat consumption by the poorest classes in 1841 and the 1930s.They also analysed the 1862-3 dietary surveys of Dr Edward Smith and, comparing the data with current information, they comment that: (a) people will not eat enough to satisfy their true energy needs if the diet does not contain adequate amounts of palatable and more expensive foods; and (b) during the last IOO years, the average intake of fat and calcium has increased, whereas the intake of iron has fallen. The 20th centuryBoyd-Orr (1936) startled the country when he showed that 50% of the population had intakes below the required standard of one or more nutrients and that the average diet of 1076 of the population was inadequate, in all constituents which he assessed, to maintain health.Food policies during and since the Second World War appear to have eliminated frank sub-nutrition in the UK, and the social and food survey of the elderly in Sheffield by Bransby & Osborne (1953) tended to confirm this achievement. Six subjects ( 2 % ) out of 303 people who were studied took less than 4200 kJ/d (1000 kcal/d), married couples fared better than their single counterparts, and size of https://www.cambridge.org/core/terms. https://doi
Bunnell test negative. Blood culture revealed Haemophilus influenzae type B sensitive to all the usual antibiotics except sulphonamide. This child was treated with ampicillin and made a good recovery. My point in recording this case history is to emphasize that septicaemia due to Haemophilus influenzae may not be as rare as we had thought and one can easily envisage such a child as I have mentioned developing osteomyelitis due to this organism.-I am, etc.,
Cardiac intracavitary metastasis is very uncommon. In a 55-year-old man presenting with a massive pulmonary embolism pattern, transthoracic echocardiography (TTE) allowed us to visualize an isolated right ventricular metastasis extended into the pulmonary trunk. It led to the discovery of a primary testis embryonal carcinoma. No intracaval and right atrial localization was observed. Despite an urgent complete cardiac metastasis resection and concomitant orchidectomy, TTE showed on postoperative day 6 an uncommon total intracardiac regrowth spreading again to the pulmonary trunk. Combination chemotherapy (etoposide, cisplatin, and bleomycin) was immediately undertaken. This is the first well-documented case of an isolated right ventricular germ-cell cancer metastasis extended into the pulmonary trunk, without intracaval and right atrial involvement, where the outcome was marked with immediate regrowth despite cardiac surgery and orchidectomy. In conclusion, TTE should be considered alongside germ-cell cancer standard staging procedures.
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