Early growth delay in diabetic pregnancy: relation to psychomotor development at age 4

Ninety nine consecutive insulin dependent and 101 non-diabetic pregnant women were examined by ultrasonograph to assess early fetal growth. In 42 of the diabetic mothers and three of the non-diabetic mothers the scan showed early intrauterine growth delay. At 4-5 years of age all children available for study were evaluated by the Denver developmental screening test. Only 23 of the 34 children of diabetic mothers with early intrauterine growth delay had normal test scores compared with 46 of the 50 children of diabetic mothers with normal intrauterine growth. The children failed in personal-social development, gross motor development, and particularly in language and speech development. Children of diabetic mothers with normal early fetal growth had scores very similar to those of the children of non-diabetic mothers, of whom 76 of the 86 tested had normal scores.This study suggests that children with a history of growth delay in early diabetic pregnancy should be screened for possible developmental impairment.     

Fibrin Degradation Products and Ovarian Tumours

Fibrin degradation products (F.D.P.) were determined in the serum of 163 women in whom ovarian tumours had been suspected on palpation at gynaecological examination and who were afterwards examined by laparoscopy or subjected to laparotomy. F.D.P. were found in the serum (0·5-30 mg/100 ml) of 23 (72%) out of 32 patients with malignant tumours. Of 131 patients with benign findings F.D.P. (traces to 2 mg/100 ml) were found in six (4·5%), and in most of these the occurrence of F.D.P. could be explained on other clinical grounds. The findings suggest that the examination of F.D.P. in suspected malignant ovarian tumour may be of diagnostic value.Determination of F.D.P. in malignant ascitic fluid showed very high values, ranging between 40 and 350 mg/ 100 ml. This argues for the occurrence of F.D.P. in the blood being due to an extravascular breakdown of fibrin caused by tumour cells, but they may also be due to thromboplastic and fibrinolytic agents from the tumour entering the blood stream.     

Two different mechanisms in patients with venous thrombosis and defective fibrinolysis: low concentration of plasminogen activator or increased concentration of plasminogen activator inhibitor.

Fibrinolytic components after venous occlusion and concentrations of tissue plasminogen activator inhibitor were studied in 100 consecutive patients with confirmed recurrent deep vein thrombosis or pulmonary embolism. After 20 minutes of venous occlusion the fibrinolytic response was decreased in 33 patients, as measured both amidolytically with S-2251 and on fibrin plates. Two different mechanisms responsible for the poor fibrinolytic response could be distinguished. Twenty two of the patients in whom the response was poor released normal amounts of tissue plasminogen activator antigen, as assayed by immunoradiometric assay, but had appreciably increased concentrations of tissue plasminogen activator inhibitor. The 11 other patients in whom the response was poor had both low tissue plasminogen activator activities and low tissue plasminogen activator antigen concentrations but normal concentrations of tissue plasminogen activator inhibitor. The results show not only that defective synthesis or release of tissue plasminogen activator may be important in the pathogenesis of venous thrombosis but also that a large group of patients with thrombosis have an increased concentration of the inhibitor to tissue plasminogen activator.     

Prostaglandin production by human epidermal cells in vitro: A model for studying pharmacologic inhibition of prostaglandin synthesis

An inv itro model for studying the biosynthesis of prostaglandins by isolated human epidermal cells is described. Production of prostaglandin E₂-equivalent activity over an 18-hour incubation period was measured using a radioimmunoassay. Prostaglandin production was significantly inhibited by indomethacin and aspirin in a concentration-dependent manner.