Both the fresh weight and dry weigh increase of peach fruit [Prunus persica (L.) Batsch. cv. Golden Queen] have a double-sigmoid pattern. However, the lag period of slow fresh weight increase (fresh- weight-stage II) began and finished 1 month earlier than the start and finish respectively of the lag period of dry weight increase (dry-weight-stage II). Similarly, after the fruit had matured the rate of fresh weight increase declined 1 week before the rate of dry weight increase declined. The stone increased in dry weight rapidly in fresh-weight-stage II and this was accompanied by a compensating decline in the rate of dry weight increase of the flesh. There was no rapid increase in the dry weight of the seed until the rate of dry weight increase of the stone declined at the beginning of dry-weight-stage II. Although the decrease in the growth rate of the stone was accompanied by a marked increase in soluble sugar in the flesh, there was no compensating increase in growth rate of the flesh. While the second rapid stage of fresh weight increase (fresh-weight-stage III) was not accompanied by other apparent physiological changes, the second rapid stage of dry weight increase began at the same time as ripening commenced. The rate of natural abscission and the rate at which chlorophyll was degraded, both of which are known to indicate the level of ethylene present in the tissue, were high in dry-weight-stage I and dry-weight-stage III and low in dry-weight-stage II. The rate of growth of the fruit and its parts during different stages, the growth of the seed, the rate of abscission and chlorophyll degradation and the level of the major metabolites present in the fruit were all intricately interrelated. We have discussed the physiological significance of these observations and the way in which they may relate to earlier studies of peach fruit growth.

SummaryTo avoid angiography in patients with clinically suspected pulmonary embolism and non-diagnostic lung scan results, the use of D-dimer has been advocated. We assessed plasma samples of 151 consecutive patients with clinically suspected pulmonary embolism. Lung scan results were: normal (43), high probability (48) and non-diagnostic (60; angiography performed in 43; 12 pulmonary emboli). Reproducibility, cut-off values, specificity, and percentage of patients in whom angiography could be avoided (with sensitivity 100%) were determined for two latex and four ELISA assays.The latex methods (cut-off 500 μg/1) agreed with corresponding ELISA tests in 83% (15% normal latex, abnormal ELISA) and 81% (7% normal latex, abnormal ELISA). ELISA methods showed considerable within- (2–17%) and between-assay Variation (12–26%). Cut-off values were 25 μg/l (Behring), 50 μg/l (Agen), 300 μg/l (Stago) and 550 μg/l (Organon). Specificity was 14–38%; in 4–15% of patients angiography could be avoided.We conclude that latex D-dimer assays appear not useful, whereas ELISA methods may be of limited value in the exclusion of pulmonary embolism.

Summary.Objective. To determine the role of four ELISA D-dimer assays in the exclusion of pulmonary embolism.Design. Blinded comparison using pulmonary angiography and/or lung scintigraphy as a reference method.Setting. A secondary and tertiary referral centre. Patients and methods. Consecutive patients with suspected pulmonary embolism underwent lung scintigraphy, followed by angiography if a non-diagnostic result was obtained. Comorbid conditions resulting in elevated plasma D-dimer levels were defined a priori. Cut-off levels for 100% sensitivity were determined. A decision-analytic model was used to determine effectiveness and costs in the management pulmonary embolism.Main outcome measures. The exclusion efficacy of the various assays at a sensitivity of 100%, and cost-effectiveness.Results. A total of 179 patients were included (78 inpatients and 101 outpatients; 74 patients had comorbid conditions). Pulmonary embolismcould be adequately excluded in between 8% and18%of allpatients,andinbetween 3% and7% and11% and 27% of inpatients and outpatients,respectively, depending on the assay used. D-dimer assays could exclude pulmonary embolism in <5% of patients with comorbid conditions, whereas this increased to 14-32% in outpatients without comorbid conditions. A cost-effectiveness analysis showed a cost reduction of 10% at a specificity of 30%, largely due to a 28% decrease in angiography requirements. Furthermore, for every 2% decrease in sensitivity, one per 1000 evaluated patientswoulddieasaresultofinadequatelytreatedpulmonary embolism.Conclusion. D-dimer ELISA assays may have a role in the exclusion of pulmonary embolism in symptomaticoutpatients, where the application may reduce angiography by 30% and costs by 10%.

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A recombinant endotoxin-neutralizing protein, rBPI23, was shown to partially prevent endotoxin-induced activation of the fibrinolytic and coagulation systems in experimental endotoxemia in humans. In a placebo-controlled, blinded crossover study, eight volunteers were challenged twice with an intravenous bolus injection of endotoxin (40 EU/kg of body weight) and concurrently received either rBPI23 (1 mg/kg) or placebo (human serum albumin, 0.2 mg/kg). rBPI23 treatment significantly lowered the endotoxin-induced fibrinolytic response, ie, reduced the release of tissue-type plasminogen activator, urokinase-type plasminogen activator, plasminogen activator inhibitor antigen, and complex formation of plasmin alpha 2-antiplasmin (P = .0078 for each). Plasminogen activator inhibitor activity was also reduced, but not significantly according to the Hochberg method (P = .0304). The endotoxin-induced activation of the procoagulant state as reflected by increase in F1 + 2 fragments and TAT complexes was blunted by rBPI23 infusion (P = .0391 [not significant according to the Hochberg method] and .0078, respectively). These results indicate that rBPI23 is capable of reducing both the activation of the fibrinolytic and the coagulation systems after low-dose endotoxin infusion in humans.