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Production and characterization of monoclonal antibodies to toxic shock syndrome toxin 1 and use of a monoclonal antibody in a rapid, one-step enzyme-linked immunosorbent assay for detection of picogram quantities of toxic shock syndrome toxin 1.

Twenty-six hybridoma cell lines that produced monoclonal antibodies to toxic shock syndrome toxin 1 (TSST-1) were generated by immunizing mice with a highly purified preparation of TSST-1 and fusing their splenic lymphocytes with SP2/0-Ag-14 cells. One monoclonal antibody of the immunoglobulin G1 isotype, designated as PEC-1 10-2SCH, was selected for extensive study. The specificity of this antibody was determined by testing spent culture fluid filtrates of TSST-1- and non-TSST-1-producing strains of Staphylococcus aureus by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and enzyme-linked immunoelectrotransfer blot techniques. Monoclonal antibody PEC-1-10-2SCH was specific for TSST-1-producing strains of S. aureus, reacting with TSST-1 and two other proteins which appear to be unique to S. aureus strains that produce TSST-1. Monoclonal antibody PEC-1-10-2SCH was used in conjunction with polyclonal rabbit antibodies to TSST-1 in a rapid, one-step, sensitive, specific, and quantitative enzyme-linked immunosorbent assay. This assay was shown to be more sensitive, faster, and simpler to perform than previously described isoelectric focusing, immunodiffusion, and solid-phase radioimmunoassays for TSST-1. Monoclonal antibody PEC-1-10-2SCH was not reactive with Staphylococcus protein A under the conditions of the test.

Antibodies, Monoclonal↗

Extracorporeal shock wave lithotripsy of middle ureteral calculi: ventral shock wave application.

A total of 150 patients presenting with stone in the middle iliac ureter were treated with extracorporeal shock wave lithotripsy using a Dornier HM-4 lithotriptor. For adequate radiological stone visualization and excellent fragmentation, the prone position was used in all patients. In 45 patients (30%) an ureteral stent was placed before treatment. The overall success rate was 82% (123 of 150 patients). All patients were treated on an outpatient basis without anesthesia.

Adult↗

Extracorporeal shock wave lithotripsy for large renal stones. To what size is extracorporeal shock wave lithotripsy alone feasible?

The complications after extracorporeal shock wave lithotripsy (ESWL) for large renal calculi could be reduced by insertion of ureteral stents. In a prospective study, the critical stone size for ESWL combined with ureteral stenting was looked for. Sixty consecutive patients entered the study, 17 patients suffered from renal calculi with a length of greater than 4 cm and a width of greater than 3 cm (group 1), and in 43 patients the calculi measured between 4 x 3 and 2.5 x 1.5 cm2 (group 2). ESWL was performed with the Dornier apparatus HM-3. A ureteral stent was placed immediately before ESWL. In group 1 with very large stones, significantly more obstructive problems were encountered. Three months after ESWL, only 6 of 14 (43%) were free of stones or with stone material likely to discharge spontaneously. In group 2, a success rate of 25 of 29 (86%) was noticed, which was considered satisfactory. For most stones greater than 4 x 3 cm2 the combination of percutaneous nephrolithotomy and ESWL seems to be the preferred treatment.

Adult↗

Epitope mapping of Porphyromonas gingivalis heat-shock protein and human heat-shock protein in human atherosclerosis.

To identify T- and/or cross-reactive B-cell epitopes of P. gingivalis and human heat-shock protein (HSP)60 in atherosclerosis patients, we synthesized 104 overlapping synthetic peptides spanning whole molecules of P. gingivalis HSP60 and human HSP60, respectively. T-cell epitopes of P. gingivalis HSP were identified with the use of previously established P. gingivalis HSP-reactive T-cell lines. B-cell epitopes of P. gingivalis HSP60 and human HSP60 were identified by the use of patients' sera. Anti-P. gingivalis, anti-P. gingivalis HSP60, or anti-human HSP60 IgG antibody titers were higher in the atherosclerosis patients compared with the healthy subjects. Five immunodominant peptides of P. gingivalis HSP60, identified as T-cell epitopes, were also found to be B-cell epitopes. Moreover, 6 cross-reactive B-cell epitopes of human HSP60 were identified. It was concluded that P. gingivalis HSP60 might be involved in the immunoregulatory process of atherosclerosis, with common T- and/or B-cell epitope specificities and with cross-reactivity with human HSP60.

Aged↗

[Shock wave therapy of the rabbit VX2 bladder cancer--THP-ADM concentration in the tissue after combination therapy of THP-ADM and shock wave].

Tissue concentration of THP-ADM was analysed after the administration of THP-ADM with or without exposure of high energy underwater shock waves (SW) to rabbit bladder VX2 cancer. THP-ADM was administered intravenously (2 mg/kg) or into the urinary bladder (10 mg/body). After the administration of THP-ADM, SW was exposed (6,000-10,000 shots) to VX2 bladder cancer or normal bladder tissue. One hour later, THP-ADM tissue concentration was measured by high performance liquid chromatography method. In intra-venous group, THP-ADM concentration of cancer tissue was significantly lower (p < 0.02) in SW group than that of non-SW group. In bladder instillation group, THP-ADM concentration of normal bladder tissue was significantly higher (p < 0.02) in SW group than that of non-SW group and the average concentration of cancer tissue was higher about three times in SW group than that of non-SW group.

Administration, Intravesical↗

Shock waves do more than just crush stones: extracorporeal shock wave therapy in plantar fasciitis.

Heel pain is a common orthopaedic problem, The cause of this clinical entity remains an enigma. The overall prognosis is good, however, and the symptoms generally settle well with time. There appears to be little evidence of the effectiveness of local steroid injections and dorsiflexion night splints. Extracorporeal shock wave therapy (ECSW) has been used in orthopaedics since the 1980s. With this, a new tool has become available for the treatment of plantar fasciitis, achillis tendinitis, shoulder pain and tendinosis of the elbow. In our pilot study we found good results with the use of ECSW therapy in resistant plantar fasciitis. Additional controlled studies are required to define the precise role of this new modality in the treatment of chronic plantar fasciitis.

Chronic Disease↗

[Do shock waves damage the kidney? Morphologic and functional changes of the kidney following exposure to shock waves].

The introduction of extracorporeal shockwave lithotripsy (ESWL) as a routine procedure has brought about a dramatic change in the therapy of urolithiasis. More than 500,000 patients have been treated successfully. Although a tissue damaging effect of the shock wave on the kidney was regarded as non-existent, phenomena such as hematuria during ESWL treatment and subsequent subcapsular hematomas suggest the possibility of damage in the region of the renal parenchyma by the shockwave itself. To investigate this possibility canine kidneys were examined histologically at different intervals after shockwave exposure. Extensive histological changes such as hemorrhage and sometimes direct tubular damage were found, with scar formation after three months. These changes are limited to the areas exposed to ESWL treatment.

Animals↗

Symptoms of post-extracorporeal shock wave lithotripsy: long-term analysis of gallstone patients before and after successful shock wave lithotripsy.

OBJECTIVE: Considerable information is presently available about stone-free rates after extracorporeal shock wave lithotripsy (ESWL) of gallbladder stones. Another important item and one that has been poorly investigated is symptom relief after successful ESWL. The aim of the present trial was to determine the course of biliary and gastrointestinal symptoms after successful ESWL of gallstones. METHODS: Ninety patients were followed for an average of 18 months after stone disappearance and discontinuation of oral bile acids. A standardized questionnaire was combined with a clinical and ultrasound examination. Relief of symptoms was correlated to patient characteristics, stone volume, and gallbladder functions. RESULTS: Twelve patients (13%) developed recurrent stones. The probability of stone recurrence was 5.5% (+/- 2.5%) after 1 yr, 12% (+/- 4.5%) after 2 yr, and 30.5% (+/- 9.5%) after 3 yr. Sixty-two of 78 stone-free patients were asymptomatic (80%). Most patients lost their typical biliary symptoms, but statistics also revealed significant differences of nonspecific symptoms and food intolerances pre- and postlithotripsy. CONCLUSIONS: This trial has confirmed that patients with symptomatic gallstone disease exhibit a wide spectrum of symptoms, many of which are relieved by ESWL. The fact that at least every fifth patient is not free of symptoms after the gallstone has been removed is in keeping with the findings after cholecystectomy. According to our data, recurrence rate after successful ESWL is higher than previously reported and similar to results after oral litholysis, with no differences between single and multiple stones.

Adult↗

Marked conservation of complementarity-determining region 3 of the beta-chain of TCRs recognizing a mycobacterial heat shock protein 60-derived peptide with strong sequence similarity to human heat shock protein 60.

The variable gene usage and sequence of human TCRs specific for a particular MHC/peptide combination have been investigated. The peptide comprises amino acids 456-466 of the 65-kDa Mycobacterium tuberculosis heat shock protein (hsp60), and is recognized in the context of HLA-DP. TCRs from both synovial fluid and peripheral blood (PB)-derived T cell clones used only five different V beta genes, three of which are closely related (V beta 6.7a, V beta 6.7b, and V beta 21.3). Among TCRs using these three genes there was marked conservation of the beta-chain sequence, whereby complementarity-determining region 3 (CDR3) contained an amino acid motif (*R*G*, amino acids 96-100) in association with either J beta 1.4 or J beta 2.5. These conclusions were strengthened by analysis of peptide-stimulated T cell lines that revealed not only TCR beta-chain sequences identical with those seen in T cell clones, but also additional beta-chains with similar CDR3 region sequences and J gene usage. In contrast, T cell lines derived by using IL-2 or a control peptide revealed variable usage of V beta and J beta genes; V beta 6.7a/b sequences from these lines and from freshly isolated PB did not contain the CDR3 motif noted in TCRs from Ag-specific T cells. We suggest that the remarkably limited diversity of TCRs noted in this study is a consequence of the similarity between the mycobacterial hsp60 peptide and the equivalent peptide from human hsp60, and reflects the trimming of the TCR repertoire required to maintain self-tolerance.

Amino Acid Sequence↗

Isolation of complementary DNAs for heat shock protein (HSP) 70 and heat shock cognate protein (HSC) 70 genes and the expressions in post-ischaemic gerbil brain.

A complementary DNA (cDNA) library was constructed with a plasmid vector from cerebral cortices of gerbils at 8 h of reperfusion after 10 min of bilateral common carotid ligation. After the 3rd screening of this cDNA library with a human genomic DNA probe for HSP70 (pH2.3), 4 cDNA clones were isolated (named pGA3' pGB1' pGD3 and pGE4' respectively). Southern and Northern blot analysis, and partial nucleotide sequence analysis indicated that pGA3 and pGE4 were the HSP70 cDNA clones, and that pGB1 and pGD3 were the HSC70 cDNA clones, which selectively recognized HSP70 or HSC70 mRNA, respectively. HSP70 mRNA is present in a very small amount in normal controls, and is greatly induced after the transient ischaemia. HSC70 mRNA is constitutively expressed in a normal gerbil brain, but is still inducible. In situ hybridization study demonstrated that the HSP70 mRNA was present in a very small amount in the hippocampal pyramidal and dentate granule cells in the sham control, and that the mRNA was greatly induced in the cells of hippocampus, dentate gyrus, medial habenula, ventral thalamic nuclei, caudate putamen, ventromedial and arcuate hypothalamic nuclei, amygdaloid nuclei and cerebral cortex after 8 h of reperfusion. HSC70 mRNA was present in almost the same areas of sham control, and was slightly induced after 8 h of reperfusion. Our results indicate that HSP70 and HSC70 cDNA clones were first isolated from post-ischaemic gerbil brain, and selectively recognize HSP70 or HSC70 mRNA, respectively. A regional difference in the induction of the HSP70 and HSC70 mRNA in post-ischaemic gerbil brain was observed by in situ hybridization.

Animals↗