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J Nikoskelainen

Publications and source records attributed to J Nikoskelainen.

At least 73 records · Page 4Linked to original sources
PubMed1990

Immunochemical analysis of the extracellular slime substance of Staphylococcus epidermidis.

To analyze immunochemically the extracellular slime substance of Staphylococcus epidermidis, rabbits were repeatedly immunized with the crude slime extract isolated from an adherent, slime-producing clinical Staphylococcus epidermidis strain. Immunoelectron microscopy demonstrated that the target antigens of the resulting antibodies were located in the extracellular slime-like layer of bacterial cells. When these target antigens were characterized by immunoblotting, a variety of antigens were detected, including many with molecular masses higher than 80 kilodaltons and also a predominant one with a molecular mass of 30 kilodaltons. No characteristic differences were observed between the tube adherence test positive and negative Staphylococcus epidermidis isolates. Although there was variation in the number and intensity of high molecular mass antigens, such variations did not correlate with the tube adherence test. Of the 110 Staphylococcus epidermidis isolates studied, 106 (96%) expressed the 30-kilodalton antigen. This component was found in no other Staphylococcus spp. examined in the study. The bacterial component was not only easily detached from bacterial cells but also water-soluble, characteristics implicating a slime-like nature. Further studies are needed to definitively establish the origin and nature of the 30-kilodalton Staphylococcus epidermidis-specific component, and determine its potential benefit as a diagnostic tool.

Antibodies, Bacterial↗
PubMed1990

Emergence of ciprofloxacin-resistant coagulase-negative staphylococcal skin flora in immunocompromised patients receiving ciprofloxacin.

Seven septicemias in neutropenic leukemia patients (two with fatal outcome) caused by ciprofloxacin-resistant coagulase-negative staphylococci were diagnosed in the hematologic unit of Turku University Central Hospital in 1988 soon after the introduction of the drug. Coagulase-negative staphylococcal skin flora of 28 neutropenic patients receiving ciprofloxacin prophylaxis and therapy for gram-negative bacterial infections were compared with those of 31 untreated patients and 33 hospital personnel working in the same unit. In ciprofloxacin-treated patients the flora were almost completely ciprofloxacin-resistant, whereas in the control groups resistant flora were detected only occasionally. Similarities in the plasmid profile patterns were found in 91% of the ciprofloxacin-resistant coagulase-negative staphylococci, suggesting an epidemiologic relation between these strains. It seems evident that cross-infection is responsible for the spread of ciprofloxacin-resistant coagulase-negative staphylococci in these patients.

Aged↗
PubMed1990

Oral infections related to radiation and immunosuppressive therapy.

The frequency of oral infection complications after cytotoxic chemotherapy and radiochemotherapy is significant, often contributing to serious septic infectious complications. Generally, the more intense the cytotoxic therapy, the more common are the oral infection complications. In the present review, the spectrum of oral infections related to radiation and immunosuppressive therapy are evaluated and the different local and systemic treatment modalities are presented.

Bacterial Infections↗
PubMed1990

Surgical treatment of active native valve endocarditis.

A report is presented of 24 patients (23 male), mean age 38 years, who underwent surgery for active native valve endocarditis of the left heart in 1975-1988. The aortic valve was affected in all patients, and also the mitral valve in five. Pre-existing aortic valve disorder was present in 17 cases (13 congenitally bicuspid 4 rheumatic affection). There were five hospital deaths (20.8%). Staphylococci as causal organism and extensive infection predicted the highest mortality and morbidity. The mean follow-up time was 39.7 (range 2-114) months. Two reoperations because of prosthetic valve dehiscence revealed endocarditis of the implanted valve. Strong correlation was found between favourable postoperative course and rapid normalization of C-reactive protein levels, which did not fall in patients with persistent infection. Early surgery is recommended if the course of bacterial endocarditis is severely complicated.

Adult↗
PubMed1990

Neutrophils are responsible for the reappearance of chemiluminescence after allogeneic bone marrow transplantation.

The nature of the cells generating the early chemiluminescence (CL) response after allogeneic bone marrow transplantation (BMT) was studied in six patients; five transplanted for acute leukaemia and one for multiple myeloma. Peripheral blood was fractionated into 14 fractions with Percoll narrow range density gradient centrifugation on days +14, +17, +20, and +27 after BMT. The leucocytes were recovered in fractions 7-14 which were analysed for cell morphology and CL response. On days +14 to +20 after BMT the CL response was detected in the fractions containing morphologically mature neutrophils. In one of these fractions the CL response per phagocyte was significantly higher than in the neighbouring fractions although morphologically the cells were similar. The results suggest that the cells responsible for the early CL after BMT are neutrophils and possibly an active subpopulation of neutrophils produced by the marrow graft.

Bone Marrow Transplantation↗
PubMed1990

Graft-versus-leukaemia activity associated with CMV-seropositive donor, post-transplant CMV infection, young donor age and chronic graft-versus-host disease in bone marrow allograft recipients. The Nordic Bone Marrow Transplantation Group.

Risk factors for post-transplant relapse were analysed retrospectively in 163 patients treated with allogenic bone marrow transplantation for acute myeloid leukaemia (AML), acute lymphoblastic leukaemia (ALL) or lymphoblastic lymphoma in first to fourth remission or during relapse. Multifactorial analysis was performed according to Cox with fixed pretransplant covariates and post-transplant cytomegalovirus (CMV) infection and graft-versus-host (GVHD) as time-dependent covariates. Advanced stage of leukemia at the time of transplantation was an important risk factor for subsequent relapse. Furthermore, the study confirmed a graft-versus-leukaemia (GVL) activity associated with chronic GVHD, including de novo chronic GVHD (intensity factor 0.08, p = 0.004). In a model excluding chronic GVHD, female donor-to-male recipient (a risk factor for GVHD), was associated with decreased post-transplant relapse risk (intensity factor 0.3, p = 0.008), suggesting that an allo-reaction against a minor transplantation antigen (Hy) may mediate antileukaemic activity. A decrease of the relapse risk by a factor 0.18 was observed in recipients with AML as well as ALL when the donor was CMV seropositive (p = 0.0002). This effect was restricted to patients who had laboratory evidence of post-transplant CMV infection. When CMV infection occurred and donor was seropositive the relapse risk was reduced by a factor 0.035. The effect was not mediated through an increased occurrence of grade 2-4 acute or chronic GVHD and could not be explained by a statistical bias due to censoring of patients who died in remission. Rather, donor CMV immunity was associated with GVHD independent GVL activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Regulatory T-cell function in primary humoral immunodeficiency states.

The function of B cells and highly purified T-cell subpopulations was studied in patients with various primary humoral immunodeficiencies. In the presence of normal T4+ cells B cells of the patients with X-linked agammaglobulinemia (XLA) were not capable either for IgM or IgG synthesis, whereas B cells of the patient with hyper-IgM syndrome and three of eight patients with common variable immunodeficiency (CVI) could produce normal amounts of IgM, but not IgG. All patients with XLA and the patient with hyper-IgM syndrome exhibited normal helper function by T4+ cells for both IgG and IgM synthesis of normal B cells. The function of CVI T4+ cells was variable. When the function of the patients' T8+ cells was tested against normal B cells, one CVI patient had overactive suppression capacity; in other patients the suppressor cell activity was normal. The findings indicate considerable heterogenicity in the function of lymphocyte subpopulations of the CVI patients.

Adolescent↗
PubMed1988

Luminol-enhanced chemiluminescence of peripheral blood leukocytes as an early indicator of graft take after allogeneic bone marrow transplantation in patients with acute myelogenous leukaemia.

The luminol-enhanced chemiluminescence (CL) of peripheral blood leukocytes was studied daily in five patients with acute myelogenous leukaemia (AML) in first remission, who were undergoing allogeneic bone marrow transplantation (BMT). The CL was measured after stimulation of leukocytes with opsonized zymosan in highly diluted whole blood. All patients had an undetectable CL level on day +7, post BMT, simultaneously with severe pancytopenia caused by the pre-conditioning for BMT. Subsequently, CL started to rise, reaching the maximum level, twice that of healthy controls, on day +11. This preceded the rise of blood leukocytes above 1.0 x 10(9) l.-1 and that of neutrophils above 0.5 x 10(9) l.-1 by 3-14 days, but coincided with the appearance of large unstained cells (LUC; a parameter given by a Technicon H 6000 blood analyzer). One of the patients later had a transient decline of CL. This preceded the fall in white blood count and platelets by 7 days, suggesting marrow suppression. We conclude that in AML the measurement of leukocyte CL is a more sensitive test for prediction of graft take than the conventional blood counts.

Blood Cell Count↗
PubMed1988

Comparison of 123I monoclonal granulocyte antibody and 99Tcm-HMPAO-labelled leucocytes in the detection of inflammation.

Thirteen patients with a suspicion of bacterial infection or inflammatory disease were studied with 99Tcm-HMPAO-labelled leucocytes (99Tcm-WBC) and 123I-labelled monoclonal antibodies against granulocytes (123I-MoAb-gc) within 5 days of the first study. Images were obtained at 30-40 min, 3-5 and 20-24 h. The quality of 99Tcm-WBC images was superior to that of the 123I-MoAb-gc. Eight cases were negative with both agents. Six inflammatory or infectious sites in five patients were clearly positive with 99Tcm-WBC even at 30 min, becoming moderately or strongly positive at 3-5 h but only three of them were weakly positive with 123I-MoAb-gc. One cause of the poor result with 123I-MoAb-gc may be the quite low activity in granulocytes and high plasma activity. We cannot recommend 123I-MoAb-gc as a primary imaging agent for inflammatory or infectious diseases for which 99Tcm-WBC seems very useful.

Adult↗
PubMed1988

Allogeneic bone marrow transplantation in multiple myeloma: a report of four cases.

Allogeneic bone marrow transplantation offers a new and promising form for treatment of multiple myeloma incurable with chemotherapy. We present four cases of advanced multiple myeloma given bone marrow transplantation from HLA-identical and MLC-negative sibling donors. One patient had a recurrent plasmacytoma 8 months later and one died 12 days after the transplantation whereas the other two are in good clinical remission 15 and 19 months post-transplantation.

Adult↗
PubMed1987

Bacterial colonization of intravascular catheters and anergy to recall skin antigens.

The skin reactivity of 46 ICU patients was tested against recall antigens: mumps, candidin, streptokinase-streptodornase, and purified protein derivative of tuberculin. At the same time, the intravascular catheters used in these patients were cultured with a semiquantitative method. Twelve patients did not react to any of the antigens. There was a statistically significant association between anergy in skin testing and lethal outcome of the current illness. Catheter cultures from 11 patients yielded over 15 colony-forming units of bacteria. No association was found between positive catheter cultures and skin reactivity to any of the antigens. This indicates that catheter colonization is independent of host factors reflected by skin testing and supports the view that transmission of microorganisms into catheters is more important than poor host defense in the initiation of catheter-related infections.

Aged↗
PubMed1987

Graft-versus-leukaemia activity associated with cytomegalovirus seropositive bone marrow donors but separated from graft-versus-host disease in allograft recipients with AML.

To elucidate whether a relationship existed between bone marrow donor cytomegalovirus (CMV) immune status and the probability of staying in remission after transplantation, a retrospective multicentre analysis was performed in 69 patients who received allogeneic bone marrow transplantation during relapse or second remission of AML, or second remission of ALL. None of 12 AML patients with CMV seropositive donors had posttransplant relapse, in contrast to 7 of 10 AML patients with seronegative donors. Kaplan-Meier estimates of the 2-yr probability of staying in remission for the two groups were 100% and 0%, respectively (p less than 0.0005). This effect was independent of disease stage, donor and recipient age, recipient pretransplant CMV immune status and the occurrence of posttransplant CMV infection in recipients, and was not mediated through an increased occurrence of overt graft-versus-host disease (GvHD) in recipients with CMV seropositive donors. The increased probability of staying in remission was associated with an increased probability of 3-yr disease-free survival (p less than 0.01). No similar effect was observed in patients with ALL. This study may suggest an allograft-versus-leukaemia effect in AML, associated with CMV seropositive donors, which seems separate from GvHD and independent of the occurrence of posttransplant CMV infection.

Adolescent↗
PubMed1987

Haematogenous candida endophthalmitis after abdominal surgery.

Two cases of bilateral endogenous candida endophthalmitis occurring after abdominal surgery are presented. The first patient was treated with intravenous amphotericin B followed by oral ketoconazole. The active chorioretinal lesions resolved in 4 weeks. Subretinal neovascularization with fibrous scarring developed in the right macula, and a hole developed in the left macula of this patient leading to impaired visual acuity of both his eyes. The second patient was first examined by an ophthalmologist 5 months after onset of the infection with simultaneous decrease of visual acuity. Five months earlier she had received a 2-week course of miconazole. Oral corticosteroids were administered for treatment of active chorioretinal lesions observed in both her eyes. Both chorioretinal lesions and vitreous opacities disappeared within a year without fibrous scarring. The visual acuity of the left eye improved from 0.5 (observed on first examination) to 1.0. The visual acuity of the right eye remained at the level of finger counting only.

Adenoma, Islet Cell↗