Biomedical subjects
Publications and source records attributed to E Cohen.
Classification criteria and pathogenetic mechanisms of vasculitis in childhood are discussed. The paper is focused on the role played by immunocomplexes, cell-mediated immunity and granulomatous reactions in vascular injury.
Sixty individuals were typed for D-related human leukocyte antigens (HLA-DR) using two methods: the standard eosin exclusion method and a recently described one-color ethidium bromide technique. As a result, 88 of the 90 DR antigens detected by the standard technique were also detected by one-color fluorescence (sensitivity = 97.8 percent). However, of the 99 DR antigens identified by ethidium bromide fluorescence, 11 were left undetected by eosin exclusion (sensitivity = 88.9 percent). The one-color ethidium bromide fluorescence technique, although originally intended to conserve technical time, demonstrated an additional advantage in our laboratory. The enhanced sensitivity of the procedure may help in the identification of previously undetected DR antigens.
The outcome of lupus nephritis was studied in 12 children. Their age at onset was 5-13 years (mean 9.8 +/- 2.1 years), less than that reported in recent years of children with lupus nephritis. All patients had clinical symptoms and signs and/or laboratory findings of renal involvement. Renal biopsy, performed in all patients, showed: minimal change in 3 patients, mesangial glomerulonephritis in 5, focal proliferative glomerulonephritis in 3 and membranous glomerulonephritis in one patient. There was no correlation between age at onset and histological categories, while clinical data were well correlated with the degree of histological involvement. 11 patients were followed for 5.16 +/- 3.2 years (range 1-13 years); 7 patients are in complete remission, 3 patients have only microscopic hematuria and/or mild proteinuria, one patient died because of infection complicating pulmonary involvement. Our report confirms a more favorable evolution of lupus nephritis in children than in adults. In particular none of our patients whose disease started before the age of 10 years had poor outcome, in contrast to previous report describing a higher mortality and morbidity in younger children. The more favorable prognosis of our patients could depend not only on the absence of the more severe form of lupus nephritis that is diffuse proliferative glomerulonephritis, but also on the earlier diagnosis and subsequent therapy.
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The feasibility of using an enzyme immunoassay (EIA) to detect simultaneously the antibodies bound to platelets and lymphocytes on glass slides was investigated. A peroxidase-antiperoxidase (PAP) immune complex method was used in which lymphocytes and platelets were attached to glass slides by poly-L-lysine and the preparations were stored at -20 degrees C for subsequent assays. Test sera were incubated with the cells. Reagents linking the platelet and/or leukocyte antibody to the PAP enzyme marker were added, followed by a staining step to localize the antigen-antibody complex. Any brown staining of the perimeter of the cells and in the cytoplasm was considered indicative of a positive reaction. A total of 146 sera were assayed; 36 were from Roswell Park Memorial Institute (RPMI) plasmapheresis donors, 75 were from RPMI oncology patients, and 35 were from other laboratories. The PAP method agreed with complement lysis inhibition assay (CLIA) by 97 percent in detecting antibodies capable of reacting with platelets while concordance with complement dependent lymphocytotoxicity (CDL) was 81 percent. With further investigation, this method could be adapted as a screening procedure in the clinical laboratory. It is easy, inexpensive, and could be performed in a few hours.
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Here is referred the case history of a boy - age 6 yrs - who was hospitalised for a persistent high temperature with generalised limphonodes hypertrophy. The limphonode biopsy together with decreased NK activity and increased antiEAD and antiVCA antibodies allowed the diagnosis of chronic mononucleosis.
Twenty-one children, age range 5 mo - 14 yrs, affected by candidosis, were treated with ketoconazole (tablets or suspension). Patients had alimentary tract involvement (12), oesophagitis (1), urinary tract candidosis (3), vaginitis (2), septicaemia (1), endophtalmitis (1) and chronic pulmonary illness with persistence of Candida albicans in sputum (3). Daily drug doses ranged from 3 to 13 mg/Kg and treatment period from 7 days to 14 months. Pharmacokinetic study in 15 children showed large individual variability of drug serum levels. Pharmacokinetic parametres, related to different schedules of the two ketoconazole formulations (tablets and suspension) are reported; drug levels after chronic administration are also evaluated. A daily dose of 3 mg/Kg of ketoconazole suspension, given in 3 administrations, did not result in sufficiently high levels, which indeed were obtained with a daily dose of 10 mg/Kg (3.3 X 3). The effect of treatment is proven by negativization of cultures in 90% of patients, by disappearance of clinical signs in 67% by improvement in 9%. The therapeutic effect on the remaining 24% (5 patients) is not evaluable. Adverse effects were only nausea and pyrosis in four cases; no laboratory abnormalities were found. A daily dosage from 7 to 10 mg/Kg, in two or three administrations, is suggested to obtain therapeutic levels in children.
A review of recently published work is presented on the nature of the agglutination of human peripheral lymphocytes and cultured lymphoblastoid cells by the hemolymph agglutinins of two arachnoids, the Horsefoot (Limulus polyphemus), alias Horseshoe Crab, and the Saharan Scorpion (Androctonus australis). Microagglutination techniques were utilized to study the specificity of the whole serum and purified agglutinin(s) of Limulus and the whole serum agglutinin(s) of Androctonus. Peripheral human lymphocytes of patients with chronic lymphocytic leukemia (CLL) gave higher agglutination titers and scores than did normal cells, with both species of invertebrate agglutinins. However, human B cells gave higher, although overlapping degrees of agglutination, than T cells. The major cell membrane receptor site for agglutinins of both species was the sialic acid moiety, N-acetyl neuraminic acid. Selected literature on plant and invertebrate agglutinins (lectins) was reviewed. These lectins are underscored as valuable cell membrane probes of surface receptors of human lymphocyte subpopulations.
OBJECTIVE: To examine the differences in predefined biomechanical parameters of spinal manipulation using a single method common to the training of both novice and expert manipulators. DESIGN: Analytic Cohort Study. PARTICIPANTS: Fifteen novice manipulators and fifteen experienced physicians provided 2 applications of spinal manipulation therapy (SMT) to 15 healthy, male student volunteers. Assignment of volunteers was randomized, and the order of the first interaction with the manipulators was determined by coin toss and then inverted for the second. INTERVENTION: The bilateral transverse-thenar thoracic maneuver was selected from the diversified system of treatment to be used as the test procedure. Selection was guided by mechanical simplicity. SMT was applied at the physician's discretion to the region of T3-T10. Standard informed consent procedures were followed. MAIN OUTCOME MEASURES: Preload force, rise rate of thrust and thrust force were selected as prospective primary outcome measures. Secondary descriptive measures included impulse, rise time, downward incisural point (DIP), fall time, total force, force components and direction cosines. RESULTS: Both novice and experienced manipulators were familiar with the transverse-thenar procedure, but only three of the experienced manipulators professed common use of it. Mean values for primary outcomes were all higher for the experienced participants; however, no statistically significant differences were found. DISCUSSION: Differences are presumed to exist between novice and experienced manipulators, as evidenced by measurement of arbitrarily selected thoracic and lumbar SMT. However, no systematic differences were found when the manipulators have a similar lack of practice experience specific to the test procedure. These results suggest the importance of regular use in developing skill of performance.
HTLV1 antibodies were tested in a group of 740 Ethiopian immigrants who arrived in Israel in Operation Solomon, 1991. HTLV1 antibodies were not found in a single individual. This survey and previous ones conducted on 314 immigrants of the 1984-85 Operation Moses suggest that HTLV1 infection is not present among Ethiopian immigrants residing in Israel.
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With a careful cost-restructuring plan based on benchmark information, The Foster G. McGaw Hospital of Loyola University reduced its operating budget by $33 million and put in place the structure for sustained progress in cost reduction.
The activity of the enzyme leucine aminopeptidase (LAmP) in serum was examined in 305 pregnant women (174 women with normal pregnancy, and 131 women with disturbed pregnancy). The activity of this enzyme increases during the normal development of pregnancy. In disturbed pregnancies, the LAmP activity is lower as compared to normal pregnancies. A peculiar case: toxemia of pregnancy, where the activity of the enzyme is considerably increased. This fact may be compared with the increase of LAmP activity in cases of liver damage. The LAmP activity test in pregnancy is reliable and can be performed practically in every laboratory, thus deserving its place among the many tests meant to assess the normal function of the foeto-placental unit. This test may also help in the diagnostic of some specific pregnancies such as twin pregnancy, hydatidiform mole and extra-uterine pregnancy.