Prostaglandin E1 for primary nonfunction following liver transplantation.
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Adult↗
Biomedical subjects
J Forster
Publications and source records attributed to J Forster.
Platelet-associated IgG, IgM, and C3 in paediatric infectious disease.
Elevated amounts of platelet-associated serum proteins (PASP) can be detected in idiopathic thrombocytopenic purpura (ITP) and are considered to be of patho-aetiological importance especially in the case of acute ITP, that commonly follows acute febrile illnesses. Using a micro-enzyme-linked immunoassay we examined PASP (IgG, IgM, and C3) in 120 paediatric patients with acute fever caused by viral (n = 45), bacterial (n = 48), or non-detectable agents (n = 27) and compared those values to the levels of PASP of an own paediatric control group (n = 21). Two of the patients presented mild temporary thrombocytopenia without clinical signs in the course of their infectious disease. While having normal platelet counts, the majority of our patients (69.2%) however, showed increased levels of PASP (IgG, IgM, C3; single or combined). Significant differences of PASP levels by discrimination of viral and bacterial diseases could not be demonstrated. Elevated platelet-associated complement was of special interest, because - in the absence of low platelet counts due to platelet-specific antibodies - it must be regarded as an indicator for immune complexes (IC) binding to thrombocyte surface IgG Fc-receptors. Thus we suggest that platelets play a considerable role in the elimination of circulating IC.
Adolescent↗
Rubella vaccination.
Rubella vaccination programmes aim to prevent congenital rubella infections. Previously differing programmes have now converged according to the following principle: First vaccination should be given at the age of 15 months (together with measles and mumps vaccine) to both boys and girls, in order to diminish the circulation of the wild virus. Teenage girls require (re-)vaccination to ensure their immunity. Also non-immune women have to be identified and vaccinated before they become pregnant. A low acceptance rate increases the risk of infection of pregnant women, independent of the vaccination omitted. As a rule natural and vaccine-induced immunity prevents congenital rubella infections. These infections are exceedingly rare in children born to immune mothers, and are always caused by the wild virus. This minimal risk will disappear only with the eradication of rubella virus, still a distant goal in countries offering vaccination only on a voluntary basis.
Adolescent↗
A comparative study of serum ultrafiltrable, ionized, and total calcium in the diagnosis of primary hyperparathyroidism in patients with intermittent or no elevation in total calcium.
Measurement of serum ionized calcium has been shown to be more sensitive a method of diagnosing primary hyperparathyroidism than total calcium in patients with subtle or intermittent elevations of total calcium. The measurement of ionized calcium, however, is technically difficult. The measurement of serum ultrafiltrable calcium would circumvent technical difficulties because atomic absorption spectroscopy would be used to measure the calcium of a filtrate produced by passing serum through a filter which excludes protein-complexed calcium (Worthington ultrafree filter). The normal range for ultrafiltrable calcium (4.7 to 6.8 mg/dl) was determined in 138 patients by nonlinear least-squares analysis and chart review. The serum concentration of ultrafiltrable calcium correlated well with ionized calcium (r = 0.91). Previous studies have demonstrated no benefit in measuring ionized calcium, as opposed to total calcium, in the diagnosis of primary hyperparathyroidism unless there was subtle, intermittent, or no elevation of the total calcium. This comparative study of ultrafiltrable, ionized, and total calcium was, therefore, done in six patients with primary hyperparathyroidism who exhibited intermittent, minimal, or no elevations in serum total calcium. All six patients had symptoms referrable to hyperparathyroidism. All six underwent parathyroid surgery, and a parathyroid adenoma was found in each case. These six patients had a total of 24 concurrent preoperative determinations of ionized, ultrafiltrable, and total calcium levels. The total calcium value was elevated in only 9 of these 24 determinations (38%), ultrafiltrable calcium was elevated in 15 (63%), and ionized calcium was elevated in 23 (96%). The values of ionized calcium were elevated more frequently than both total calcium (p less than 0.0005) and ultrafiltrable calcium (p less than 0.025). The values for ultrafiltrable calcium were more frequently elevated than those for total calcium; this difference, however, was not significant. This study confirms our previous reports showing that ionized calcium is a more sensitive indicator of primary hyperparathyroidism in patients with intermittent or borderline elevation of the total calcium and extends those observations to show that ionized calcium is also a more sensitive indicator of primary hyperparathyroidism than ultrafiltrable calcium in this group of patients.
Calcium↗
Ultranarrowband searches for extraterrestrial intelligence with dedicated signal-processing hardware.
Multichannel spectroscopy with millihertz resolution constitutes an attractive strategy for a microwave search for extraterrestrial intelligence (SETI), assuming the transmission of a narrow-band radiofrequency beacon. Such resolution matches the properties of the interstellar medium, and the necessary receiver Doppler corrections provide a high degree of interference rejection. We have constructed a frequency-agile swept receiver with an 8,388,608-channel spectrum analyzer, on-line signal recognition, and multithreshold archiving. A search of 250 Sun-like stars at 1.4 and 2.8 GHz has been carried out with the Arecibo 305-m antenna, and a meridian transit search of the northern sky is in progress at the Harvard-Smithsonian 26-m antenna. Successive spectra of 400 kHz at 0.05 Hz resolution are searched for features characteristic of an intentional narrowband beacon transmission. These spectra are centered on guessable ("magic") frequencies (such as the 21-cm hydrogen hyperfine line), referenced successively to the local standard of rest, the galactic barycenter, and the cosmic blackbody rest frame.
Astronomy↗
The relationship of purine metabolism to the macrophage-mediated increase of high energy phosphates in skeletal muscle.
Previous investigations have demonstrated that the high energy phosphate and adenine nucleotide content of wounded tissue are decreased. Purine metabolism was investigated in incubated lambda-carrageenan wounded skeletal muscle and in muscle exposed to peritoneal macrophages or macrophage-conditioned media. Wounded muscle released predominately uric acid into the incubation medium; whereas, nonwounded muscle released inosine, hypoxanthine, and xanthine as well as uric acid. Macrophages incubated with nonwounded muscle changed the purine release pattern toward one of wounded muscle. The conversion of inosine to allantoin and uric acid by macrophages increased linearly with the addition of up to 1 X 10(7) macrophages per incubation. Muscles incubated in macrophage-conditioned media had a decreased release of inosine and hypoxanthine and higher tissue levels of creatine phosphate, ATP, ADP, AMP, and adenosine compared to muscles incubated in standard media. These data suggest that the macrophage determines the pattern of purine release from wounded skeletal muscle in the incubated system and that in conditioned media a high energy phosphate promoting factor may exert its effect by mechanisms that augment the adenine purine pool.
Adenine Nucleotides↗
Discontinuation of bee venom immunotherapy in children and adolescents.
Sixty-six patients with a history of systemic allergy reactions to bee stings, positive skin prick test to less than or equal to 100 micrograms/ml bee venom, and positive radioallergosorbent test (RAST) results were given venom immunotherapy. IgE and IgG antibodies to bee venom were measured by RAST and enzyme-linked immunosorbent test (ELISA), respectively. IgE and IgG anti-bee venom levels rose initially, but subsequently fell during immunotherapy. In 31 patients in whom specific IgE fell to low (less than 6% counts bound) or unmeasurable levels, immunotherapy was discontinued, and sting challenge was carried out 1 to 3 years later. All patients tolerated sting challenge well. The specific IgE and IgG antibody levels did not change significantly after treatment was stopped. Our data suggest that hyposensitization treatment can be stopped when specific IgE serum concentrations have fallen to low or unmeasurable levels and specific IgG antibody values are maintained, and that in a considerable number of patients venom immunotherapy has a lasting therapeutic and immunologic effect.
Adolescent↗
Hypercalcemia in critically ill surgical patients.
Critical surgical illness, commonly accompanied by shock, sepsis, multiple transfusions, and renal failure, is usually associated with low total calcium and/or low or normal ionized calcium. A seminal case of hypercalcemia in a surgical intensive care unit (SICU) patient prompted the review of 100 patients with longer than average SICU days (greater than 12) to determine the incidence, associated factors, and possible etiologies of this condition. Ten patients had elevated measured, and five others had elevated calculated, ionized calcium (5.9 +/- 0.25 mg%), an incidence of 15%. Compared to the 85 patients who did not develop hypercalcemia, this population had a significantly higher frequency of the following: renal failure, dialysis, total parenteral nutrition (TPN) usage greater than 21 days, bacteremic days greater than 1, transfusions greater than 24 units, shock greater than 1 day, SICU days greater than 36, and antibiotics used greater than 7. In addition, this group had significantly more days of hypocalcemia early in their hospital course. There was no difference in sex, age, mortality, or incidence of respiratory failure. Two patients studied in depth had renal failure requiring dialysis and no malignancy, milk-alkali syndrome, hyperthyroidism, or hypoadrenalism. Parathormone (PTH) concentrations were high normal or elevated (N terminal 20 and 21 pg/ml; C terminal 130 microliters Eq/ml and 1009 pg/ml) at the time of elevated calcium (total 9.2 to 14.6 mg%; ionized 4.9 to 8.2 mg%). Immobilization does not increase PTH. In renal failure, PTH elevation is a consequence of hypocalcemia rather than hypercalcemia. Moreover, five patients did not have renal failure. Shock, sepsis, and multiple transfusions containing citrate may lower total and/or ionized calcium and thus stimulate PTH secretion. Whatever the mechanism, approximately 15% of critically ill surgical patients develop hypercalcemia, which may represent a new form of hyperparathyroidism.
Acute Kidney Injury↗
[Improved immunocompetence in two children with chronic Epstein-Barr virus infection under treatment with a standardized thymus hormone preparation (thymostimulin)].
Two children with chronic Epstein-Barr virus infection were treated with a standardized thymic hormone preparation (thymostimulin, TP-1 Serono). The treatment was well tolerated. No adverse reactions, no side effects were observed. Results of immunological investigations showed a trend towards normalisation. Additional clinical evidence showed up, which pointed to a response to the therapy.
Child↗
[Herpes simplex encephalitis in the newborn infant--a review].
Neonatal herpes simplex encephalitis is a rare, but very threatening disease which leads to death or to severe cerebral damage with only a few exceptions. In the past few years antiviral agents have become available which have proved to influence the course of the disease in a positive manner. Therefore the problem is a challenge for neonatologists and pediatric neurologists. The virologic and epidemiologic aspects of neonatal herpes encephalitis and its prophylactic, diagnostic and therapeutic possibilities are reviewed. The efficacy of virustatic therapy is related to the onset of therapy which should be started as soon as possible. The typical EEG- and CT-changes are due to an already advanced stage of the disease. Virologic examinations in the first days are of limited value. Brain biopsy should not be performed in this age group. Therefore the indication to start antiviral chemotherapy depends exclusively on the clinical picture.
Antibodies, Viral↗
[Need for the determination of chloramphenicol levels in the treatment of bacterial-purulent meningitis with chloramphenicol succinate in infants and small children].
17 cases of purulent meningitis in 15 children, aged 1 day to 5 years (median 8 months) were treated with continuous i.v. infusion of chloramphenicol succinate. Free chloramphenicol in serum and cerebrospinal fluid (C.F.) was assayed by high performance liquid chromatography (HPLC). CF chloramphenicol levels averaged 45 +/- 14% of the serum level. Out of 16 patients only five received the usually recommended dosage. In three others because of initially or progressively high serum levels the dose had to be diminished. In eight others because of subtherapeutic levels the dose had to be raised. The highest dose (390 mg/kg body weight/d) was required in a 2 month old boy. He was shown to have a clearance rate for free chloramphenicol considerably higher than has been reported so far. Maturation of the metabolism could be observed in a small-for-date newborn who acquired a grey baby syndrome during the treatment of his first meningitis. Several weeks later he required exactly the recommended dose to reach therapeutic chloramphenicol levels. As a consequence of these observations we strongly recommend meticulous drug monitoring of chloramphenicol in order to meet the large biological variations seen particularly in neonates and young infants in their capacity to reach and maintain therapeutic serum levels.
Bacterial Infections↗
Concentration of gonadotrophins in the plasma of sheep given gonadal steroid antisera to raise ovulation rate.
The concentration of FSH and LH in peripheral plasma was studied in sheep from 8 h before to 17.5 h after injection (i.v.) with antisera to the steroids androstenedione, oestradiol, oestrone and testosterone. The fitted mean concentration of LH increases after all treatments and the increase was associated with a higher frequency of LH pulses. The greater concentration was evident for all groups by the period 3.5-6.5 h after injection, but by the end of the sampling period the concentration had returned to or towards the values in the controls. For FSH, significant change was limited to those animals given anti-oestrogen sera but it was more rapid than for LH, both groups receiving anti-oestrogen sera showing an increase during the period 0.5-3.0 h after injection. The ovulation rate was increased by treatment and an effect close to 0.75 corpora lutea per ewe was maintained by treatment in subsequent oestrous cycles. This declined to 0.25 corpora lutea after two oestrous cycles without treatment.
Androstenedione↗
[Current views on enteritis].
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Adolescent↗
Micro-enzyme-linked immunoassay for the quantitation of platelet-associated IgG (PAIgG).
An enzyme linked immunoassay was developed using the microtiter system to measure platelet-associated IgG (PAIgG). One single determination needs 2 x 10(6) platelets usually obtained from 3 ml blood anticoagulated with EDTA. Platelets are incubated with peroxidase-conjugated anti-human IgG. Its unbound fraction is adsorbed to an IgG coated microtiter plate, quantitated by a colour reaction and found to be inversely related to the amount of PAIgG. Healthy donors (n = 40, aged 1 day to 35 years) possessed 3.6 +/- 2.0 (mean +/- S.D.) fg IgG/platelet. Increased levels of PAIgG were found in patients with acute (n = 16) and chronic (n = 5) idiopathic thrombocytopenic purpura. Postrecovery platelets had normal values of PAIgG. Widely varying levels of PAIgG were found in patients with freshly diagnosed acute lymphocytic leukemia.
Blood Platelets↗
Epidemiology of human rotaviruses as determined by electrophoresis of genome RNA.
An epidemiological survey was made of rotavirus infection in a children's hospital by determining changes in rotaviral genome patterns by means of polyacrylamide gel electrophoresis. In 180 fecal samples collected between December 1978 and June 1981, 53 distinct patterns were obtained belonging to 13 different types. Two of these patterns dominated in endemic nosocomial infections of neonates until 1981, when one of them was replaced by a third pattern. Two epidemics of diarrhea in the neonatal wards were associated with an endemic and an exogenic rotavirus strain respectively. The latter was not established as an endemic strain. Three patterns were found exclusively in isolates from infants with nosocomial infection and one pattern was found with a doubled fifth segment, suggesting a double infection. The latter findings support the conjecture that there is reassortment of rotavirus genomic segments in vivo.
Antigens, Viral↗
[Nosocomial dyspepsia in newborn and young infants. A 15-month prospective study with continuous Rotavirus surveillance].
A 15 months prospective study of gastroenteritis in hospitalized newborns and infants (N = 201) was combined with a Rotavirus infection surveillance. Stool specimens were investigated weekly (CFT). From patients with gastroenteritis (N = 320) an infectious agent could be detected on average in 41% of each patient group: Rotavirus N = 54, Staph. aureus N = 22, toxin producing E. coli N = 4, other bacteria N = 25, Candida albicans N = 17, Echovirus 11 N = 1. With certain exceptions, the pathogens were distributed equally within the patient groups. However, Candida albicans appeared most frequently in premature children and the highest incidence of Rotavirus infections was observed in premature small for date babies. Rotavirus caused the mildest illness. The severest forms had usually no detectable cause. Bacteria took up an intermediate position. 68% of patients with detectable Rotavirus in the faeces had symptoms. However, treatment was required in only 25% of premature and small for date babies and 40% of normal newborns. In newborns and infants an isolated tachypnoea was observed 3 days prior to onset of a Rotavirus induced gastroenteritis. Breast fed infants showed no evidence of increased protection. Rotavirus antibodies were detectable in 58% of children prior to infection. The study presents evidence for the value of separate of patient care and meticulous hand disinfection, especially in the case of Rotavirus induced gastroenteritis.
Antibodies, Viral↗
The benefits of drug monitoring in patients with bacterial meningitis, eg, chloramphenicol monitoring.
Regular drug monitoring during therapy with chloramphenicol sodium succinate is actually recommended by expert centers. In this report a case of meningitis due to Salmonella typhimurium is described, which underlines the necessity of examining both the chloramphenicol and the chloramphenicol succinate concentrations. It is suggested that medical microbiologists and clinicians should be encouraged to take advantage of new, quick, and sensitive methods for drug monitoring in order to achieve optimal therapy.
Chloramphenicol↗
Evidence for structuring of water in growing oocytes: an X-ray microanalysis and nuclear magnetic resonance study.
Energy dispersive X-ray microanalysis measured the Na, K, Cl, P, Mg, S and Ca contents (mM/kg dry weight) in the nucleus and yolk-free cytoplasm of growing Xenopus laevis oocytes quick frozen in the ovary. Nuclear magnetic resonance measurements of T2, the transverse relaxation time of water protons, were obtained on small immature oocytes and on large, fully grown oocytes. Changes in the nucleus and cytoplasmic content were observed for all elements except for Ca. Nuclear/cytoplasmic macroscopic gradients of K, Cl, Na, and Mg increase with growth. The T2 times of large oocytes were found to be shorter than those of small oocytes. The data in this report further support the hypothesis that intraoocytic water and elements do not exist in an ideal dilute solution and that changes in the states of water and elements occur during oocytic growth.
Animals↗