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Biomedical subjects

B Haneberg

Publications and source records attributed to B Haneberg.

At least 19 recordsLinked to original sources

[AIDS in the Third World. Africa suffers most].

AIDS is now world-wide, and the HIV infection is spreading rapidly via the heterosexual route. Among the Third World countries those in sub-Saharan Africa are the hardest hit, it is estimated that one in 40 of the adult population is already infected. Half of the victims are women, who will give birth to a large number of infected children. The clinical picture of full-blown AIDS in an African patient is not very different from elsewhere. However, other AIDS-related conditions seem to be influenced by a variety of endogenic pathogens which might explain the development of the typical wasting syndrome, i.e. "Slim" disease. Tuberculosis is the most typical opportunistic infection in Africa, and adds another dimension to the misfortune. The outlook is gloomy in the light of the potential for widespread disruption of normal social and economic activities.

Acquired Immunodeficiency Syndrome

Immunoglobulin E in the feces of children and adolescents from some tropical and subtropical countries.

Eighteen of 27 individuals, aged from 6 months to 19 years (mean 5 years, 7 months), from countries in the tropics or the subtropics had either intestinal parasitic infestations or intestinal enteropathogenic bacterial infections or both. Fourteen of those with intestinal pathogens had detectable concentrations of IgE in their fecal extracts, ranging from less than 0.5 to 420 IU/ml extract (mean 33 IU/ml). This rate of occurrence was significantly higher than the number of IgE-positive fecal extracts in a group of 54 healthy nonallergic Norwegian children (p less than 0.001), but did not differ from that of a group of 40 allergic children (p greater than 0.20). The individuals with intestinal helminthic infection had the highest fecal IgE concentrations. Of the 9 individuals who did not have any demonstrable intestinal pathogen, low concentrations of IgE could be detected in feces from only 2, which did not differ from the rate in the healthy Norwegian controls. The concentrations of IgE in the feces of the subjects from tropical/subtropical regions correlated linearly with the corresponding serum concentrations of IgE (r = 0.69; p less than 0.001). The results indicate that the combined load of intestinal pathogens, including helminths, protozoa, and enteropathogenic bacteria, may stimulate IgE production in the gut.

Adolescent

Automated differential leukocyte counts in newborn infants. Comparison of Coulter VCS and Technicon H1 with manual counts.

There was good agreement between results obtained with Coulter VCS/Technicon H1 and manual counting with respect to neutrophils and eosinophils. Coulter VCS overestimates the lymphocyte percentage compared to manual counting and to H1. If, however, the percentage of so called "naked" cells are added to the percentage of manually counted lymphocytes, the agreement between VCS and the manual method is improved. The alarms given by the two instruments are of little value in detecting left shift or nucleated red blood cells.

Automation

Improved automated differential counts of leukocytes from newborn infants using pre-dilution of blood samples.

A method for automated differential leukocyte counting using peroxidase staining and light scatter (H1) failed to present results in more than 25% of blood samples from newborn infants. These failures were mostly seen at or below 2 weeks of age, and with high concentrations of haemoglobin F (HbF). Dilution of the blood with equal amounts of isotonic saline made the problem disappear almost completely. The results of differential counts on such diluted blood samples also compared more favourably with traditional manual counts of blood smears than did the results obtained with undiluted blood. The present method with blood diluted 1/2 is therefore recommended for routine use in newborn infants.

Automation

A familial syndrome of diaphyseal cortical thickening of the long bones, bowed legs, tendency to fracture and icthyosis.

The clinical and radiological features of a dominant bone disorder found in six members of the same family are described. The bone disorder was mainly characterized by endosteal cortical thickening of long tubular bones and bowing of the weight-bearing ones. The clinical symptoms were waddling gait, muscle weakness and leg pains, and there was a tendency to fractures. All affected individuals had icthyosis of slight or moderate degree.

Adult

Serial determination of serum ferritin in children with acute lymphoblastic leukemia. Evaluation of its usefulness as a prognostic index.

Thirty children with acute lymphoblastic leukemia were monitored with serial serum ferritin determinations for up to 17 months. In children with acute lymphoblastic leukemia before initiation of therapy, or in relapse, the mean serum ferritin concentration was 636 microgram/l. In children who went into primary remission. the mean serum ferritin concentration fell from 265 microgram/l prior to start of treatment, to 161 microgram/l after 3 months of treatment. Five patients relapsed. Their serum ferritin levels prior to the relapses ranged from 7 to 135 microgram/l. At the time of relapse a further increase in serum ferritin was found in only 2 of the children. Thus, whereas high serum ferritin levels may signal disease activity in acute lymphoblastic leukemia, a normal serum ferritin level does not exlude disease activity or impending relapse.

Adolescent

Acute response of parathyroid hormone in congenital osteopetrosis.

Indices of calcium and phosphorus metabolism were studied in 3 children with osteopetrosis before and after infusion of bovine parathyroid hormone extract. Basal plasma concentrations of calcium, alkaline phosphatase and 25-hydroxy vitamin D tended to be low. Plasma immunoreactive PTH levels were at the upper normal range in two patients. A marked increase in urinary cyclic AMP in all patients was solely due to an increase in the nephrogenous cAMP. After vitamin D treatment urinary cAMP was essentially unchanged with the same preponderance of nephrogenous cAMP. Following PTH infusion plasma cAMP showed a brisk rise. There was also a prompt rise in urinary cAMP and a distinct decrease in the calcium to sodium clearance ratio indicating increased calcium reabsorption. Phosphaturic effect was only observed when PTH was given in the highest dose level. The findings are consistent with a state of low grade hyperparathyroidism which could not be related to the plasma levels of 25-hydroxy vitamin D or calcium.

Child

Natural and immune antibodies to rabbit erythrocyte antigens.

Natural agglutinins to rabbit erythrocytes were found in all human sera studied. In the newborn, the antibodies were of IgG class; in the 6-month-old infants they were mainly of IgM class. Older children and adults had both IgG and IgM antibodies. Agglutinins to rabbit erythrocytes were also found in serum from fourteen of fifteen other species studied. The trichloroacetic acid extract from rabbit erythrocyte stromata (TCA-preparation) contains at least three different antigenic determinants: one which we hitherto to have found only on rabbit erythrocytes, one which is closely related to human blood group B antigen, and one which is closely related to the I antigen. The TCA-preparation did not elicit delayed hypersensitivity skin reactions in humans in spite of high titred agglutinins in serum, but did so in immunized guinea-pigs.

Adolescent

Lymphocyte multiplication in vitro induced by mitogens and antigens.

A simple technique requiring only 0.2 ml whole blood for measuring the response of lymphocytes in cultures to each of various mitogens and antigens has been elaborated. The response is quantified by comparing the number of lymphocytes with and without a stimulating agent. The increment of cell numbers is given by a cell multiplication index. In healthy subjects PHA induced almost a doubling of the cell numbers in 3 days, i.e. an index of 1.90 +/- 0.38. After 7 days the indexes for PHA, PWM and Con A were 7.25 +/- 4.12, 2.72 +/- 0.65 and 1.81 +/- 0.31, respectively. PPD and Candida-extract induced cell multiplication in skin positive individuals, with indexes ranging from 1.12 to 3.05. In contrast, patients with various severe immune deficiencies showed decreased responses to at least one mitogen, depending on the type of the deficiency. Likewise, skin test negative individuals had no or faint in vitro response to the antigens. The method, which correlated well with the response by a conventional method for incorporation of tritiated thymidine, has a high degree of precision and sensitivity, and should be applicable for routine use.

Adult

Acute hemolytic anemia related to diphtheria-pertussis-tetanus vaccination.

Three infants developed severe hemolytic anemia following the second or third diphtheria-pertussistetanus vaccination. Direct antiglobulin tests were positive, and the infant most severely affected also had reduced serum complement levels, indicating an immunological mechanism for the hemolysis. The presence of IgM on the erythrocytes from 2 of the infants could be demonstrated by antiglobulin tests or immunization experiments. Heat eluates of the erythrocytes from one of the infants contained antibodies to tetanus and diphtheria toxoids, as well as to Bordetella pertussis, suggesting that these antibodies were antigenically bound to the erythrocytes. Virus antibodies or isoagglutinins, present in the serum, were not found in the eluate. No antibodies against the vaccine components could be demonstrated in eluates of erythrocytes from control subjects. In vivo experiments showed that tetanus and diphtheria toxoids were easily bound to human erythrocytes. This finding could help explain the pathogenesis of the autohemolysis.

Acute Disease

Fetal thymus transplantations in severe combined immunodeficiency.

Two brothers with severe combined immunodeficiency were treated with repeated transplantations of fetal thymus tissue. The first patient was not treated until he was critically ill, and the intramuscular transplants had no effect. He died at 11 months of age of overwhelming pneumonia. At postmortem examination a transplanted thymus seemed viable. In the second patient an intramuscular transplant had no effect, but three subsequent intraperitoneal transplants led to transient increase in circulating T lymphocytes with a concomitant fall in B lymphocytes. The results suggested an additive effect of each transplant. However, delayed hypersensitivity skin tests and in vitro mitogen responses were not influenced. Initially, transfer factor was given, and fetal liver was administered intraperitoneally together with the last thymic transplant. Neither of these measures had any observed effect, and this patient, similarly, died of pneumonia at nearly 12 months of age.

B-Lymphocytes

Fragments of immunoglobulins in human faeces.

Fab-fragments of IgG were easily demonstrated in extracts of faeces from healthy infants and children. Employing immunoelectrophoresis with antisera to whole human serum and to Fab-fragments of IgG, a marked precipitation line, likely to represent such fragments, was evident in the cathodal or gamma-region. Usually no precipitate was formed with antisera specific for gamma-heavy chains or Fc-fragments of IgG. Presumably IgG in the gut is partially destroyed before being excreted with faeces. Results of immunoelectrophoresis, gel filtration as well as polyacrylamide gel electrophoresis, using antisera to alpha-heavy chains, indicated the presence of fragments of IgA in some faecal extracts. Fragments of IgA could not be demonstrated in IgA-deficient patients, and no fragments of either class, or only traces of Fab-fragments of IgG, were found in agammaglobulinaemic patients. No antibody activity against rabbit erythrocytes was found in gel filtrations containing such fragments; any reaction was not observed either in the direct agglutination test or in a modified antiglobulin test.

Agammaglobulinemia

Case report: maldescent of the thymus in a hypoparathyroid infant with Pharyngeal Pouch Syndrome.

The clinical and pathological findings in a 6-month-old boy with III-IV pharyngeal puoch syndrome are reported. The infant had multiple congenital anomalies including absence of the parathyroid glands, maldescent of the thymus, aberrant right subclavian artery and dysfunction of the glossopharyngeal nerve. Because of persistence of the thymus in the cervical area, a thymic shadow was not found on roentgenographic examination of the anterior mediastinum. The weight and histology of the thymus were normal, as were studies of humoral and cellular immunity.

Abnormalities, Multiple