Differences in HLA types in children with insulin-dependent diabetes diagnosed in 1960s, 1970s, and 1980s.
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Child↗
Biomedical subjects
S Kontiainen
Publications and source records attributed to S Kontiainen.
Reactive arthritis associated with Shigella sonnei infection.
Several studies have failed to show an association between Shigella sonnei dysentery and reactive arthritis. We describe 3 patients who had reactive arthritis and a recent or concurrent S sonnei infection. To our knowledge, this is only the second study to suggest this association. We propose that S sonnei should be considered as a triggering agent for reactive arthritis.
Adult↗
Thyroid infiltrating cells in juvenile autoimmune thyroiditis: a follow-up of 1 year.
The composition of the cellular infiltrate in thyroid glands of 12 patients with juvenile autoimmune thyroiditis (JAIT) was followed for a period of 1 year. The diagnosis of JAIT was based on a firm goiter and on cytologic criteria of lymphocytic thyroiditis. Samples from the thyroid gland were obtained by fine-needle aspiration biopsy three times at 6-month intervals. Lymphocytes with a few lymphoid blasts and plasma cells dominated the cellular infiltrate. The relative number of the different cell types remained unchanged during the follow-up time of 1 year. Analysis of the lymphocytes revealed that about 60% of the infiltrating lymphoid cells were T cells and about 30% expressed B-cell markers. The T helper/suppressor ratio was significantly higher in the thyroid (2.2) than in the corresponding blood sample (1.2). Practically no changes were seen in the proportions of lymphocyte subclasses either in the gland or in the blood of the patients during the follow-up. At the time of diagnosis more than half of lymphocytes in the thyroid were HLA class II positive as were most of the glandular epithelial cells. The proportion of cells expressing class II was similar in samples taken at diagnosis and 6 and 12 months later, indicating a continuous state of immunoactivation in the thyroid gland.
Adolescent↗
HLA-antigens and immunity to insulin in insulin-dependent diabetics with or without diabetic neuropathy.
In order to define genetic, immunological and metabolic risk factors and markers associated with diabetic neuropathy (DN) 47 insulin-dependent diabetic patients with neuropathy were compared to 30 age-matched insulin-dependent diabetes mellitus (IDDM) patients without neuropathy. Patients with diabetic neuropathy more often had proliferative retinopathy and Albustix positive proteinuria than patients without neuropathy. Judged by haemoglobin A1 (HbA1) concentrations measured during the preceding two years glycaemic control was worse in patients with than without diabetic neuropathy. The frequency of HLA-antigens DR3, DR4, DR3/DR4, B8, and B15 were increased and those of DR2 and B7 decreased in the diabetic patients. The frequency of any of these HLA-antigens did not differ in patients with or without diabetic neuropathy. There were no significant differences in the frequencies of insulin antibodies or proliferative responses to insulin antigens between patients with or without diabetic neuropathy. However, patients who were HLA-DR3/DR4 heterozygotes and had diabetic neuropathy responded to insulin antigens more often by proliferation than DR3/DR4 positive patients without diabetic neuropathy. Thus poor glycaemic control is associated with an increased risk for diabetic neuropathy. Patients with DR3/DR4 heterozygocity and failing to respond to insulin antigens by proliferation seem to be less prone to develop diabetic neuropathy.
Adult↗
Bacteriology of odontogenic apical periodontitis and effect of penicillin treatment.
The microbiology and treatment of apical periodontitis was studied in 62 patients, followed-up for 1 year. The clinical treatment and the radiological technique were standardized. One third of the patients received no systemic antibiotics, one third received phenoxymethylpenicillin for 1 week, and one third for 3 months. On the average, 0-2 facultatively anaerobic and 4-6 anaerobic bacteria were isolated from periapical infections. The genera Bacteroides and Fusobacterium in addition to anaerobic gram-positive cocci were found most frequently. Minimum inhibitory concentrations of benzylpenicillin against 269 strains were tested. 12 strains were resistant at the concentration 2.4 micrograms/ml, including 4 strains of Fusobacterium sp. All patients were free of symptoms 1 month after the admission. Only 1 patient failed to show any progress in radiological healing. No differences between the groups in relation to penicillin therapy were found.
Adult↗
Bacteria in ulcera crurum.
Bacterial cultures derived from 432 chronic leg ulcers were analysed retrospectively to determine which bacteria are most commonly found in these ulcers. The study covered a 2-year period. Two-thirds of the patients were over 70 years of age. Staphylococcus aureus was found in nearly half of the ulcers studied, Pseudomonas sp. in one-third, pyogenic streptococci and enterococci in every fifth and Proteus sp. in every tenth. The frequency by which pyogenic streptococci were isolated was about 10 to 20 times as high as previously reported. Obligate anaerobic bacteria were also frequently isolated. The sensitivity of the isolates from the second year to antimicrobial agents likely to be chosen if systemic therapy were required is also reported. The results are discussed in relation to previous findings.
Aged↗
The majority of the activated T cells in the blood of insulin-dependent diabetes mellitus (IDDM) patients are CD4+.
Twenty-five recently diagnosed insulin-dependent diabetic patients were screened for the presence of activated T lymphocytes using the anti-IL-2 receptor monoclonal antibody; thirteen had elevated levels of activated T lymphocytes. The activated cells were mostly confined to the CD4 subset, with the CD4/CD8 ratio in IL-2 receptor expressing cells averaging 5 +/- 1 (s.d.) compared with 1.3 +/- 0.3 for all T cells. In recent onset insulin-dependent diabetes blood there was no lack of CD4 CD45R+ (suppressor/inducer) T cells. The activated IL-2 receptor, expressing cells belonged to both CD4 subsets, 'helper inducer' (CD44B4) and 'suppressor inducer', (CD42H4).
Adolescent↗
Insulin responses and lymphocyte subclasses in children with newly diagnosed insulin-dependent diabetes.
Children with newly diagnosed insulin-dependent diabetes mellitus (IDDM) had increased numbers of CD25 positive lymphocytes in peripheral blood and peripheral blood mononuclear cells responded to insulin antigens by proliferation. The CD25 positivity and insulin proliferation were associated to the duration of symptoms before the diagnosis of IDDM. Thus increased numbers of CD25 positive cells were found in 89% and insulin induced proliferation in 100% of patients with symptoms of diabetes of less than 1 week's duration before diagnosis, while CD25 positivity and insulin-induced proliferation were observed in 36% and 29% of children who had had symptoms for 4 weeks or more before diagnosis. Children with IDDM also had increased numbers of CD4 positive T cells in peripheral blood. The frequency of HLA-DR4 and HLA-DR3/4 in diabetic children was higher and that of HLA-DR2 lower than in the normal population. Insulin, islet cell, gastric-parietal cell, thyroid and antinuclear antibodies did not correlate to the duration of symptoms before diagnosis.
Adolescent↗
Bacteria isolated from skin and soft tissue lesions.
The pathogens most often isolated from lesions in skin and soft tissues were Staphylococcus aureus and Streptococcus pyogenes. Cultures from venous leg ulcers, decubitus ulcers and infectious gangrene often yielded also Pseudomonas spp., enterobacteria and enterococci. Obligate anaerobes were frequently isolated especially from abscesses and decubitus ulcers. One third of the abscesses and half of the decubitus ulcers yielded obligate anaerobes.
Abscess↗
Optochin resistance in Streptococcus pneumoniae strains isolated from blood and middle ear fluid.
Optochin resistant Streptococcus pneumoniae having typical pneumococcal morphology in culture and Gram stain and giving clear agglutination with anti-pneumococcal polysaccharide antisera were isolated from primary cultures of blood and middle ear fluid. The isolated pneumococci were either fully sensitive to penicillin and other antimicrobial agents commonly used or relatively resistant to penicillin and resistant to cloxacillin, tetracycline, erythromycin, sulphatrimethoprim and clindamycin.
Aged↗
Multiply resistant Streptococcus mitis isolated from conjunctival exudate of newborns.
Streptococcus mitis resistant to most of the commonly used antimicrobial agents but sensitive to cefotaxime, clindamycin, vancomycin and rifampicin was isolated from conjunctival exudate of newborns. The isolate had group C streptococcal antigen, was beta-haemolytic on horse but alpha-haemolytic on sheep blood agar plates and might therefore be misidentified as beta-haemolytic group C streptococci.
Conjunctiva↗
Rapid grouping of beta-haemolytic streptococci.
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Agglutination Tests↗
Suppression of in vivo antibody responses by suppressor factors induced by human myeloma proteins.
Suppressor factors induced in vitro, using purified human IgG and IgA myeloma proteins, were shown to efficiently suppress murine antibody production in vivo. The suppression was not isotype specific, viz. IgG and IgA suppressor factors suppressed the production of IgM and IgG antibody. Neither the suppressor factors (SF) nor the inducing proteins suppressed the proliferative responses to concanavalin A and purified protein derivative (PPD). The results are compared to the in vitro findings and discussed in the context of isotype regulation, hypogammaglobulinemia and immunotherapy.
Animals↗
Mononuclear cells in synovial fluid of rheumatoid arthritis patients undergoing joint surgery.
Analysis of synovial fluid from patients with rheumatoid arthritis (RA) and a long history of RA, who were undergoing synovectomy and joint surgery, revealed that 71 +/- 15% of the mononuclear cells in the synovial fluid were lymphocytes. 3 +/- 2% lymphoid blast cells, and 26 +/- 15% of monocytes/macrophages. The lymphocyte population consisted mainly of T cells, and 72 +/- 15% of lymphocytes were OKT11-positive. OKT8-positive cells (48 +/- 9%) dominated over OKT4-positive (32 +/- 8%) cells with a mean OKT4/OKT8 ratio of 0.69. On the basis of Ia- and Tac-markers, very few of the lymphocytes were activated. Few B cells (12 +/- 7%) and no plasma cells were seen. The results are discussed in relation to previous reports.
Antibodies, Monoclonal↗
Cells infiltrating the thyroid in juvenile autoimmune thyroiditis.
Cell samples derived from the thyroid glands of twelve children with juvenile autoimmune thyroiditis (JAIT) were analysed. The cytological findings were those of chronic lymphocytic thyroiditis in eight and suggestive of that disease in four patients. About 86% of the cells infiltrating the thyroid were lymphocytes, 4% were lymphoid blasts, 6% neutrophils and 3% monocytes. Analysis using monoclonal antibodies showed that about 60% of the lymphocytes were T cells and half of the lymphocytes expressed HLA Class II-antigens. T helper cells dominated with a T helper/suppressor ratio of 2.2 in thyroid while the ratio was 1.2 in peripheral blood. Of the thyroid epithelial cells, 80% also expressed HLA class II. The immune activation and immunoglobulin synthesis within the thyroid are discussed.
Antibodies, Monoclonal↗
[Clinical applications of autoantibody research].
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Antibodies, Antinuclear↗
Suppressor factors generated from human mononuclear cells by means of purified myeloma proteins.
Peripheral blood mononuclear cells (PBMC) from normal human donors were cultured in Marbrook flasks in the presence of purified IgG or IgA myeloma proteins. The culture supernatants were tested for their ability to suppress pokeweed mitogen (PWM)- or Epstein-Barr virus (EBV)-driven Ig synthesis by normal PBMC. Two supernatants from PBMC cultured with IgG and one from PBMC cultured with IgA were tested and suppressed PWM-driven Ig synthesis as measured by a reverse haemolytic plaque assay and by quantitation of the Ig secreted into the culture medium of the PWM-driven cells. This suppression was not restricted to the Ig isotype of the 'inducing' myeloma protein, but was extended to IgG, IgA, and IgM. The suppressive effect could be absorbed out with human IgG.
Antibody Formation↗