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PubMed1997

Nucleotide sequencing of a part of the 5'-noncoding region of echovirus type 9 and rapid virus detection during the acute phase of aseptic meningitis.

A part of the 5'-noncoding region of echovirus type 9 isolates was sequenced, and an attempt was made for rapid virus detection in clinical samples obtained from 22 subjects hospitalized with aseptic meningitis. The sequence identity of 440-bp products amplified from the region by RT-PCR was 87.7% between the standard echovirus type 9(Hill strain) and the isolates. Specific IgM antibodies to Hill strain were positive in 45.5% by immunofluorescent antibody staining of virus-infected cells. A high detection rate of PCR products was observed in cerebrospinal fluids (CSFs; 54.5%) at admission, and in peripheral mononuclear cells (PMCs; 72.7%) at the end of hospitalization. Viral genomes were detectable for 2 days in serum samples, and for 6 days in PMC samples after onset of disease. When specific IgM antibody titers were less than 1:40, the amplification rate of viral genome from serum samples was 50.0%. These results indicate that the combination of specific IgM determination and viral genome amplification from CSFs will be a rapid and reliable method for early diagnosis.

Acute Disease↗
PubMed1998

Detection by PCR of enteroviruses in cerebrospinal fluid during a summer outbreak of aseptic meningitis in Switzerland.

Enteroviruses (EV) are among the most common causes of aseptic meningitis. Standard diagnostic techniques are often too slow and lack sensitivity to be of clinical relevance. EV RNA can be detected within 5 h by a commercially available reverse transcription-PCR (RT-PCR) test kit. Cerebrospinal fluid (CSF) samples from 68 patients presenting with aseptic meningitis during a summer outbreak in Switzerland were examined in parallel with cell culture and commercial RT-PCR. RT-PCR was positive in all 16 CSF specimens positive by cell culture (100%). In addition, 42 of 52 (80%) CSF samples negative by cell culture were PCR positive. In 26 of these 42 (62%) patients, viral culture from other sites (throat swab or stool) was also positive. The CSF virus culture took 3 to 7 days to become positive. Echovirus 30 was the type most often isolated in this outbreak. The sensitivity of CSF RT-PCR based on clinical diagnosis during this aseptic meningitis outbreak in patients with negative bacterial culture results was 85%, i.e., considerably higher than the sensitivity of CSF virus culture (24%). We conclude that this commercial RT-PCR assay allows a positive diagnosis with minimal delay and may thus influence clinical decisions.

Adolescent↗
PubMed2000

Analysis of soluble interleukin 6 receptor in cerebrospinal fluid in inflammatory and non-inflammatory conditions.

The objective of this study was to investigate the pathophysiological roles of soluble interleukin 6 receptor (sIL-6R) in cerebrospinal fluid (CSF). CSF was obtained from patients suspected with meningitis. Eight patients without any meningeal signs or symptoms were enrolled as controls. An additional 34 CSF samples were collected to measure both biologically active and immunoreactive sIL-6R. All CSF samples were proven to be aseptic. IL-6 and sIL-6R were measured using specific ELISAs. Patients were divided into three groups on the basis of cell number in CSF; inflammatory group (cell number >5 microl, mean 241+/-363.1, n=61); non-inflammatory group (cell number < or =5 microl, mean=2.1+/-1.7, n=12) and controls (cell number < or =5 microl, mean=0.3+1.7, n=8). Among these three groups, the differences in protein (F (2,78)=8.274, P<0.0001) and IL-6 concentration (F (2,78)=6.475, P<0.001) were statistically significant but those of sIL-6R concentration were not. There were only weak correlations between log (sIL-6R) versus log (cell number) (r=0.23, P=0.0375), log (protein) (r=0.239, P=0.0358) and log (IL-6) (r=0.27, P=0.0167). Amounts of immunoreactive and biologically active sIL-6R were closely correlated (r=0.62, n=34, P<0.005). It was concluded that sIL-6R is present constitutively in CSF and its level may not increase significantly in inflammatory conditions; infiltrating cells in CSF are not the main source of sIL-6R; and sIL-6R in CSF can bind IL-6.

Case-Control Studies↗
PubMed1987

Cerebrospinal fluid and peripheral blood leukocyte subsets in acute inflammation of the CNS.

Leukocyte subsets in CSF and peripheral blood (PB) were determined in 21 patients with acute inflammation of the CNS using the monoclonal antibodies OKT3, OKT4, OKT8, Leu12, and OKM1 in an immunoperoxidase slide assay. There was a predominance of OKT3-positive cells in nearly all samples. Significant differences between acute aseptic and bacterial meningitis only were found in CSF and represented by a higher Leu12 and a lower OKT3 percentage in aseptic inflammation and a higher absolute amount of OKT4-, OKM1- and Leu12-positive cells in bacterial meningitis. Comparison between CSF and PB showed significant differences only in aseptic meningitis with a higher percentage of Leu12-positive cells and a lower percentage of OKT8-positive cells in CSF. The OKT4/OKT8 ratio seems to be generally lower in aseptic meningitis but significant differences only were found in comparison with healthy blood donors. In a case of herpes simplex encephalitis the ratio was strongly increased in CSF during the early phase of specific antibody production because of an absolute rise of OKT4-positive cells.

Acute Disease↗
PubMed2002

Urinary creatinine instability falsely increases the deoxypyridinoline/creatinine quotient.

BACKGROUND: The concentration of urinary deoxypyridinoline crosslinks (Dpd) (as in line 17)-normalized with respect to the urinary creatinine concentration is used as a biochemical marker of pathological bone resorption. METHODS: The effect of various storage conditions on the stability of Dpd/creatinine in urine specimens was examined in a sample of 14 individuals without aseptic endoprosthetic loosening (control) and 14 patients with aseptic endoprosthetic loosening (AEL). RESULTS: In the control group, values of Dpd/creatinine measured after 1 day of storage at -20 degrees C were significantly greater (p < 0.005) than values measured in fresh urine specimens. In the AEL group, increases in urinary Dpd/creatinine values were less pronounced (NS to p < 0.05). Increases in Dpd/creatinine were primarily the mathematical consequence of significant decreases in urinary creatinine concentration in the control group (p < 0.0001) and the AEL group (p < 0.05, after at least 7 days of storage). The decrease in urinary creatinine concentration appears to reach a plateau--between 75% and 80% of the original value--after approximately 10 days of storage. CONCLUSION: To prevent falsely increased Dpd/creatinine quotients, we suggest that urinary creatinine should be measured exclusively in fresh urine specimens or consistently in specimens stored for at least 14 days at -20 or -80 degrees C.

Adult↗
PubMed1998

Hymenobacter roseosalivarius gen. nov., sp. nov. from continental Antartica soils and sandstone: bacteria of the Cytophaga/Flavobacterium/Bacteroides line of phylogenetic descent.

Aseptically collected sandstone and soil samples from the antarctic Dry Valleys were inoculated into oligotrophic media and incubated under low light intensities. A total of 41 Gram-negative isolates were obtained with reddish colonies spreading on agar. A sandstone isolate and four soil strains were characterized further. They were nearly identical in morphological, physiological, biochemical and chemotaxonomic properties. They produced large amounts of extracellular polymer and utilized for growth: glucose, saccharose, mannitol, sorbitol, L-aspartate, malate and acetate, but not D-ribose, adonitol, DL-alanine, glutamate, glycolate, lactate or succinate. All strains hydrolyzed gelatin, starch, casein, xylan, Tweens 80 or 60 and dead or living yeast cells, but not cellulose or pectin. Nitrate was not reduced, ethanol was not oxidized and acid was not produced from maltose, mannitol or dulcitol. Ammonia was not produced from peptone. They were strictly aerobic. Major fatty acids were n 16:1 d 9, n 16:1 d 11, n 17:1 d 11, and i 15:0. The strains contained the quinone MK-7 and phosphatidylethanolamine as the main phospholipid. The base ratio ranged from 55 to 61 mol% G+C. A 16S rRNA sequence analysis of strains AA-688 and AA-718 showed these to be identical and to represent a special phylogenetic group within the Cytophaga/Flavobacterium/Bacteroides major line of descent. Three soil strains labeled "Taxeobacter" Txc1, Txg1, and Txo1 (Reichenbach, 1992) belonged to the same group but had lower sequence similarities (<95%). Some of their characteristics were different from those of the antarctic strains: the utilization of C-compounds, hydrolysis of polymers, temperature tolerances, major fatty acids and base ratios. Txc1 and Txg1 may later have to be considered as members of this group, possibly on the species level, while Txo1 could represent a different related genus. It is concluded that the five antarctic strains represent a new genus and species for which the name of Hymenobacter roseosalivarius is proposed. The type strain is AA-718T (DSM 11622T).

Antarctic Regions↗
PubMed2005

Glutamatergic dysfunction in OCD.

The role of glutamatergic dysfunction in the pathophysiology of OCD has hardly been explored despite recent reports implicating glutamatergic dysfunction in OCD. We decided to investigate CSF glutamate levels in adult OCD probands compared to psychiatrically normal controls. In total, 21 consenting psychotropic drug-naïve adult OCD patients, diagnosed using SCID-IV-CV, and 18 consenting psychiatrically normal controls with age within 10 years of age of the patients, who did not have any history of head injury or neurological illness, were included into the study. Aseptically collected and stored CSF samples obtained from the patients and control subjects were used for glutamate estimation, which was carried out by a modification of the procedure described by Lund (1986). CSF glutamate (micromol/l) level was found to be significantly higher [F(1,31)=6.846, p=0.014] in OCD patients (47.12+/-4.25) compared to control subjects (41.36+/-3.63) on analysis of covariance. There was no effect of gender, age, duration of illness, Y-BOCS score, or CGI-S score on CSF glutamate levels. Our study provides preliminary evidence implicating glutamatergic excess in the pathophysiology of OCD, which needs to be further explored by studies from other centers involving larger sample sets from different age groups.

Adolescent↗
PubMed1992

Effect of aseptic abscesses in protein-deficient rats on the relationship between interleukin-6 and the acute-phase protein, alpha 2-macroglobulin.

1. Rats established on a normal (20% protein) diet or a protein-deficient (3% protein) diet were given either a subcutaneous injection of turpentine (5 ml/kg), which induces formation of aseptic abscesses, or saline. Plasma samples were obtained at timed intervals (0-14 days) after the injection for determination of albumin, total protein, alpha 2-macroglobulin (a major acute-phase protein in the rat) and interleukin-6 concentrations. The magnitude and pattern of the acute-phase protein response was then compared with the local inflammatory reaction, assessed histologically, and with changes in the circulating concentration of interleukin-6, which is an important mediator of the acute-phase protein response. 2. After turpentine injection there was an early fall in the plasma albumin and total protein concentrations in both normal and protein-deficient rats. After 12 h the total protein concentration increased in both groups of animals reaching a peak at about 48 h, whereas the plasma albumin concentration continued to fall reaching a minimum at 48 h. The main alpha 2-macroglobulin response was delayed and attenuated in the protein-deficient rats (onset 9 versus 24 h, peak concentration 8.95 +/- 0.5 versus 5.33 +/- 0.75 g/l, P < 0.01, and area under the concentration-time curve 18.43 +/- 2.13 versus 7.96 +/- 1.48 g/l-1 days, P < 0.01, in the normal group and protein-deficient group, respectively). 3. The circulating interleukin-6 concentration showed a transient early rise at 1 h, and was followed by a larger more sustained peak at 6-48 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗
PubMed2005

Survey of bacteriological contamination of cosmetic creams in Iran (2000).

The bacteriological quality of a variety of unused and used cosmetic creams was investigated. A 1-g sample from each product was aseptically placed in 9 ml of sterile Tween-peptone diluent, and 10-fold serial dilutions were prepared. The pour plate technique was used for aerobic bacterial colony counts, and microorganisms that grew in the culture were identified. The incidence of contamination by Gram-positive Bacilli, Staphylococcus aureus and non Escherichia coli Gram-negative organisms was found to be higher for used cosmetic creams (54%, 38% and 8%, respectively) than for unused creams (38%, 25% and 0%, respectively). Viable microorganisms were not recovered from 17% of the unused items whilst only 10% of the used creams did not contain viable microorganisms. The significance of the results is discussed and the importance of adopting suitable quality control guidelines is highlighted.

Bacteria↗
PubMed1987

Idiopathic effusive pericarditis with tamponade in the horse.

Pericarditis and pericardial effusion are considered to occur rarely in the horse. The clinical and laboratory features of idiopathic pericarditis with effusion diagnosed in 10 horses over a seven-year period were reviewed. Consistent physical findings included tachycardia, ventral oedema, jugular venous distention and diminished heart sounds. Electrocardiographic features included diminished voltages and electrical alternans, and the effusion was identified by echocardiography in the six horses in which it was performed. Pericardiocentesis relieved clinical signs in nine horses. Laboratory analysis of pericardial fluid samples classified six cases as aseptic serofibrinous, three cases as eosinophilic, and one case as histiocytic. One horse died and three were destroyed. The remaining six horses recovered following pericardiocentesis (performed once or twice) with or without corticosteroid treatment, and were alive one month to seven years after diagnosis.

Animals↗
PubMed1996

Intrathecal production of neopterin and beta 2 microglobulin in tick-borne encephalitis (TBE) compared to meningoencephalitis of other etiology.

To study the pathophysiology of tick-borne encephalitis (TBE), the kinetics of neopterin and beta 2 microglobulin (beta 2M) production were measured in sequential, cerebrospinal fluid (CSF) and serum samples in 133 patients with aseptic meningoencephalitis (TBE, n = 72; non-TBE, n = 61). Intrathecal production of neopterin was demonstrable in all patients. Neopterin levels in CSF were elevated already at day 2: geometric mean value in TBE 36 nmol/l (range 1-253), in the non-TBE group 29 nmol/l (0.2-96). At day 9 and week 6 the neopterin level was significantly higher in TBE (86 (19-725) and 17 (4-122) nmol/l) than in non-TBE (28 (5-109) and 3 (0.2-58) nmol/l) (p < 0.001). After 1 year CSF levels were within the normal range. The beta 2M response in CSF followed the pattern of neopterin. The intensity and duration of neopterin and beta 2M was not correlated to the clinical course. Neopterin seems to be a more sensitive indicator of intrathecal T-cell response and inflammatory reaction than beta 2M. The results indicate that a long-lasting strong inflammatory reaction is of pathophysiological significance in TBE.

Adolescent↗
PubMed2004

Incidence and antifungal susceptibility of Candida species in neonatal septicemia.

Septicemia is the leading cause of morbidity and mortality in neonates. In this study, 828 consecutive neonates suspected of having septicemia from various neonatal intensive care unit hospitals in Gulbarga, Karnataka were investigated for isolation of microorganisms. Two samples of blood were collected aseptically for isolating the etiology. The cultures were positive in 346 (41.9%) cases for aerobic bacteria and 68 (8.3%) for Candida species. Among Candida species, C. tropicalis--27(39.7%) was the predominant organism followed by C. albicans 16(23.5%) and C. guillermondi 13(19.1%). The standard macrobroth dilution method was carried out to determine the minimum inhibitory concentration (MIC); C. krusei ATCC 6258 standard strain was included for quality control purpose. 4(25.0%) stains of C. albicans were resistant to amphotericin-beta and 2(12.5%) to fluconazole. High-level resistance to fluconazole was observed in C. krusei 4(40.0%).

Antifungal Agents↗
PubMed1990

Stability of cefotaxime in two peritoneal dialysis solutions.

The stability of cefotaxime sodium at room and body temperatures in peritoneal dialysis solutions containing 1.5% or 4.25% dextrose was determined. Cefotaxime sodium 2 g was added to three 2-L bags of dialysis solution containing 1.5% dextrose, and cefotaxime sodium 500 mg was added to three 500-mL bags of dialysis solution containing 4.25% dextrose. The bags were stored at 25 or 37 degrees C Samples from bags stored at 25 degrees C were drawn aseptically at 0, 12, 24, 48, and 72 hours, and samples from bags stored at 37 degrees C were drawn at 0, 6, 12, and 24 hours. The pH of each sample was determined, and the cefotaxime concentration was measured by a stability-indicating high-performance liquid chromatographic method. At 37 degrees C the initial mean cefotaxime concentration declined to 97.9% at six hours, 89.1% at 12 hours, and 68.8% at 24 hours in the 1.5% dextrose solution; the mean percentages remaining in the solution containing 4.25% dextrose were 96.4%, 86.1%, and 71.0% at 6, 12, and 24 hours, respectively. At 25 degrees C the initial cefotaxime concentration declined to 92.4%, 84.4%, and 74.2% at 24, 48, and 72 hours, respectively, in 1.5% dextrose solution and to 92.0%, 84.3%, and 80.3% at 24, 48, and 72 hours, respectively, in 4.25% dextrose solution. In both solutions, cefotaxime concentration decreased by more than 10% at and after 12 hours at 37 degrees C and between 24 and 48 hours at 25 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

Cefotaxime↗
PubMed1989

Bone marrow sampling.

Bone marrow sampling may be indicated in the evaluation of iron metabolism, fever of unknown origin, anemia, leukocytosis and other hematologic abnormalities. The commonly accepted means of marrow sampling are needle aspiration and needle biopsy. The preferred site for obtaining the sample is the iliac crest. Contraindications to the procedure include infection or previous radiation therapy at the sample site, poor patient cooperation and major coagulation defects. The assistance of a skilled technician, use of a prepackaged tray, thorough patient education, use of local anesthesia and attention to aseptic technique help simplify bone marrow sampling.

Biopsy, Needle↗
PubMed1995

Adenosine deaminase activity in the CSF of patients with aseptic meningitis: utility in the diagnosis of tuberculous meningitis or neurobrucellosis.

We assayed 229 CSF samples from 180 adults with meningitis of different etiologies for adenosine deaminase activity (ADA) and evaluated the usefulness of this assay in the differential diagnosis of aseptic meningitis. Cases of meningitis were classified as tuberculous meningitis (TBM), pyogenic meningitis, viral meningitis, self-resolving aseptic meningitis without a specific diagnosis, meningitis associated with other infections, and neoplastic meningitis. We also tested 117 CSF specimens for which parameters were normal. We chose a cutoff point of 10 IU/L on the basis of our results and found elevated ADA levels in 50% of the patients with TBM (no differences between patients with AIDS and those who did not have AIDS were observed). Among samples from patients with aseptic meningitis, we observed high ADA levels in only two of five of the patients with neurobrucellosis. Therefore, we concluded that in cases of aseptic meningitis, a CSF ADA level of > or = 10 IU/L has a sensitivity of 48%, a specificity of 100%, a positive predictive value of 1, and a negative predictive value of 0.91 as a diagnostic criterion for TBM or neurobrucellosis. ADA levels were also > 10 IU/L in 30% of the patients with pyogenic meningitis, but this diagnosis was easily excluded on other grounds.

Adenosine Deaminase↗
PubMedDate not supplied

Normative data for commercial pineapple juice from concentrate.

Normative data for pineapple juice from concentrate were determined for 19 samples, including 5 that had been aseptically processed and representing 4 of the major pineapple growing regions of the world. Values are reported for sugars, organic acids, including isocitric acid, metals (specifically potassium, sodium calcium, and magnesium), delta 13C, and oligosaccharides. Although geographical variation existed, the observed ranges and variances were small enough to be useful in describing authentic pineapple juice. Two concentrates (one aseptically and one nonaseptically processed) were intentionally adulterated (individually) with 3 commercially available inexpensive sweeteners (high fructose corn syrup, cane invert syrup, and beet medium invert syrup). Oligosaccharide analysis of these samples either by liquid chromatography or by capillary gas chromatography yielded oligosaccharide patterns that were useful for the detection of these sweeteners at 10% levels. Principal-component analysis (PCA) was used to represent graphically both the pure and adulterated samples based on their measured chemical parameters.

Beverages↗
PubMed1989

Synthesis of the active metabolite of vitamin D, 1,25(OH)2D3, by synovial fluid macrophages in arthritic diseases.

Synthesis of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) has been shown in cells from knee joint synovial fluid of 20 patients with inflammatory rheumatoid disease, reactive or psoriatic arthritis, or gout, all of which had high synovial fluid cell counts, and by cells from a patient with aseptic necrosis of a femoral condyle after short term (less than 24 hours) or long term (seven days) primary culture. Cells from 18 patients with inflammatory arthritis, five of which had low synovial fluid cell counts and cells from six patients with osteoarthritis were unable to synthesise this metabolite from 25-hydroxyvitamin D3 (25(OH)D3). Macrophages are believed to be the cells responsible for synthesising 1,25(OH)2D3 because these were significantly more numerous in samples that formed 1,25(OH)2D3; they were also the predominant cell type present in the aseptic necrosis sample and the only cell type present in preparations maintained for one week in monolayer culture.

Arthritis↗
PubMed2006

Molecular and epidemiologic analysis of enterovirus B neurological infection in Argentine children.

BACKGROUND: Human enteroviruses are one of the major causes of central nervous system (CNS) infections in pediatrics. STUDY DESIGN: We have studied 1242 children under 15 years old with suspicion of CNS infection from January 1998 to December 2003. CSF was obtained and molecular typing of human enterovirus B serotypes was performed by RT-PCR and sequencing of the N-terminal part of VP1 gene. RESULTS: According to the clinical syndromes, patients were grouped as aseptic meningitis (n=654, 52.6%), encephalitis (n=239, 19.2%), febrile seizures (n=153, 12.3%), febrile infant (n=84, 6.7%), neonatal disease (n=70, 5.6%),), acute flaccid paralysis (n=31, 2.4%) and acute disseminated encephalomyelitis (n=11, 0.9%). HEV was detected in 335/1242 CSF samples (26.97%) and was associated to aseptic meningitis (n=243, 72.5%); febrile infant (n=31, 9.2%); neonatal infection (n=26, 7.7%); encephalitis (n=25, 7.5%), febrile seizures (n=9, 2.68%); acute flaccid paralysis (n=1, 0.3%). Seasonal incidence of HEV-B species was analyzed showing that in Buenos Aires infections occur mainly during late spring and summer. Molecular serotyping was completed in 60/335 samples. Echovirus 30, Echovirus 9, Coxsackie B3 to B5 and Echovirus 33 were the most frequently identified. CONCLUSIONS: We showed that HEV are responsible for a considerable proportion of hospitalizations in children with central nervous system compromise reaching 27% of overall etiology.

Argentina↗