[Report on two-year's veterinary activities in Turkey].
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Animals↗
Biomedical subjects
P Krause
Publications and source records attributed to P Krause.
Is the use of marginal liver grafts justified?
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Cyclosporine↗
Prevention of transfusion-associated cytomegalovirus infection in neonatal patients by the removal of white cells from blood.
The usual methods employed to reduce the risk of transfusion-associated cytomegalovirus (TA CMV) disease have been to transfuse blood or cellular blood components that are CMV antibody-negative or to administer deglycerolized frozen red cells. To determine if the reduction of white cells (WBCs) in blood by filtration will also eliminate TA CMV disease in a high-risk population, 48 surviving very low birth weight (less than 1250 g) neonatal infants born to CMV-seronegative mothers at three participating institutions in the Hartford, Connecticut area and receiving at least one CMV-seropositive blood transfusion were studied. The incidence of TA CMV disease in 26 neonatal patients who received blood prepared by a modified spin-cool-filter technique and in 22 neonatal patients who received blood filtered through a WBC-reduction filter was compared with the incidence of transfusion-associated disease in similar populations reported in other studies. The CMV antibody prevalence of the blood donor population was found to be 37 percent. At the time of discharge of the individual neonatal infants in the population studied, and/or 2 to 6 months later, 47 of the 48 who had undergone transfusion had CMV antibody-negative serologic tests and/or urine culture. The other infant transiently seroconverted because of passive transfer of the antibody. None of the 48 neonatal infants had clinical evidence of CMV infection. This study indicates that WBC reduction of donor blood can reduce and perhaps prevent TA CMV disease in high-risk neonatal patients.
Cytomegalovirus Infections↗
Allogeneic hepatocyte transplantation using FK 506.
Hepatocyte transplantation is an intriguing alternative to orthotopic liver transplantation. While engraftment of syngeneic hepatocytes can be achieved with relative ease, engraftment of allogeneic hepatocytes has been far more complicated. We used FK 506 (Tacrolimus), a novel and highly efficient immunosuppressant, which has been reported to augment liver regeneration in rats. Recipients of isolated syngeneic (LEW) and allogeneic (Wistar F.) rat hepatocytes (major histocompatibility barrier) recieved different immunosuppressive regiments with FK 506 or Cyclosporine A (CsA). Mature syngeneic hepatocytes could be retrieved up to post op day 300 with the lowest number of hepatocytes on post op day 20. Following allogeneic transplantation, no mature hepatocytes could be identified after post op day 10, though ductular like structures within the spleen were found in FK 506 but not CsA-treated animals. The epithelial cells of ductular like structures exhibit cytological features of CK-19 positive cells. Our results suggest that under CsA or FK 506 immunosuppression long-term survival of mature allogeneic hepatocytes within the spleen cannot be achieved across a major histocompatibility barrier though FK 506 allows engraftment of allogeneic donor type ductular cells.
Animals↗
Selective intraportal transplantation of DiI-marked isolated rat hepatocytes.
Transplantation of isolated hepatocytes is a promising alternative to orthotopic liver transplantation in experimental animal models with acute hepatic failure and hereditary enzyme defects. Conventional light microscopy identification of hepatocytes within recipient livers has been limited due to the inability to distinguish between donor and recipient liver cells. In this study, we labeled hepatocytes intracellularly with the fluorescent dye DiI-18 prior to selective intraportal or intrasplenic transplantation. Syngeneic LEW rat hepatocytes were isolated and 2 x 10(7) fluorescence-labeled cells were transplanted by intraportal infusion selectively into 2/3 of the recipient liver lobules to avoid lethal portal hypertension. Rats were sacrificed on postop days 1, 3, 5, 10, 20, and 40. Histological examination was performed using light and fluorescence microscopy counterstained by light green dye. The quantity of transplanted hepatocytes residing within the recipient liver was determined by FACS analysis after enzymatic digestion of the recipient liver lobules. Engrafted hepatocytes were identified in the periportal regions of transplanted liver lobules. The stained hepatocytes were retrieved up to 20 days postop using fluorescent microscopy. Using FACS analysis the number of labeled hepatocytes was found to diminish over time following transplantation from 2.1% on postop day 1 to 0.5% on day 10. Labeled hepatocytes transplanted into the spleen were retrieved in clusters up to 20 days postop (the last day of observation). Furthermore, the migration of labeled hepatocytes from spleen to liver parenchyma was observed following intrasplenic transplantation. However, after selective intraportal transplantation, only fluorescent debris was found in splenic and pulmonary tissue upon examination of various organs. This article describes the method of fluorescent labeling of rat hepatocytes and reports the feasibility and limitations of using DiI-18 as a marker.
Animals↗
Sputum bacteriology in nursing home pneumonia: a retrospective study.
INTRODUCTION: Pneumonia is the most lethal infection in nursing homes. The Infectious Disease Society of America recommends that attempts be made to obtain quality sputum to focus antibiotic therapy. This is especially important within the enclosed space of a nursing home, where constant pressure from broad spectrum, empiric antibiotics sets the stage for the emergence of resistant organisms. METHODS: We reviewed all cases of radiographic pneumonia diagnosed on-site at the Wisconsin Veterans Home, a 721-bed facility, for the recording of sputum bacteriology and 30-day mortality. RESULTS: Ninety-nine cases of radiographic pneumonia diagnosed on-site were identified over 1 year. Mortality was 10% within 30 days. Fourteen quality sputum specimens were obtained and processed microbiologically. None of the individuals who had a sputum specimen died within 30 days, probably because the ability to obtain a sputum specimen is a marker of higher functional status. DISCUSSION: Even if empiric therapy continues in the majority of cases, cultures in individual cases may alert clinicians to noncovered, resistant pathogens, and allow focused antibiotic therapy with agents like amoxicillin that might extend the usefulness of empiric, broad spectrum antibiotics. Institutions may also sum the results of sputum bacteriology to assist in the choice of empiric antibiotic therapy. Sputum bacteriology may benefit both the individual resident and the entire population of the institution.
Journal Article↗
Surveillance for respiratory illness in long-term care settings: detection of illness using a prospective research technique.
BACKGROUND: The overall frequency and severity of viral respiratory infections affecting residents of long-term care facilities (LTCFs) is not well described. This is due primarily to the cumbersome and expensive techniques required for adequate surveillance of respiratory illnesses and the associated costs and availability of a laboratory capable of the relevant and timely report of diagnostic tests. Here we describe our technique for surveillance of respiratory illness in the LTCF. Elements of it may serve as strategies for routine care. METHODS: Nurses were trained to record respiratory complaints and to track them using a histogram-based calendar charting system. For the research technique, all new illnesses during the winter months, no matter how minor, were sampled for viral culture. RESULTS: Influenza A and B, parainfluenza types 1 through 4, herpes simplex virus types 1 and 2, rhinovirus, and respiratory syncytial virus (RSV) were detected in the nursing homes studied. Outbreaks of influenza were documented annually by prospective surveillance. Outbreaks of parainfluenza type 1 and RSV indistinguishable clinically from influenza were detected. CONCLUSIONS: Intense surveillance for respiratory illness and viral pathogens using the described research technique identified viral activity reliably on an annual basis in several large LTCFs. Elements of the research protocol may be adapted for general use to create a cost-effective surveillance program for LTCFs that have limited resources. Such a technique is essential for implementing effective measures for outbreak prevention and control.
Journal Article↗