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PubMed1992

[Therapeutic catheterization: the percutaneous closure of a persistent ductus arteriosus and of interatrial communication].

Between february and december 1990, we attempted percutaneous closure of patent ductus arteriosus (PDA) in 26 patients and in one ostium secundum atrial septal defect (ASD). One of the PDA was right sided with right aortic arch and two were post surgical leaks. We used the "USCI-Rashkind PDA double disc occluder" and the newly designed "Lock Clamshell" occluder for the ASD. Twenty seven patients (20 females and 7 males), aged 1.3 to 16 years (M = 5.6) and weighing 9.5 to 56 kg (M = 21.3), were studied. Diagnosis was made clinically with the aid of Doppler colour flow echocardiography, with follow-up studies at 24 hours, 6 months and 1 year after the procedure. Diameter of the ductus varied from 1.6 to 8.2 mm (M = 2.6). Successful implant of the device was achieved in 25 cases (95%), of which 18 (72%) were totally occluded at 24 hours and 21 (84%) after 6 months, remaining small residual leaks in four (16%). In only one patient total occlusion was demonstrated 1 year after device implantation. We achieved 22 (88%) total occlusions. One case was not possible to occlude, due to its large size. Angiocardiography demonstrated adequate anatomy in 18, and difficult in 8 patients. Twelve and 17 mm devices were used in 16 and 9 patients, respectively. Successful second implant with subsequent total occlusion was achieved in one patient with a previous moderate residual leak. The ASD was central and single, with a diameter of 20 mm. Immediate total occlusion was achieved. We conclude that percutaneous PDA closure is a safe and effective procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

The intraexaminer and interexaminer repeatability of the alternate cover test using different prism neutralization endpoints.

PURPOSE: The alternate cover test (ACT) measures the magnitude of a deviation, but different prism endpoints may be used. This study investigated the intraexaminer and interexaminer repeatability of the ACT using two different prism neutralization endpoints. METHODS: To determine repeatability of two prism neutralization endpoints (first neutral and midpoint of reversal), two experienced examiners measured near point phoria on 72 subjects. Measurements were repeated with examiners masked to each other and the first results. Paired t-tests were used to assess interexaminer and intraexaminer repeatability and the agreement between different prism endpoints for each examiner within each session. Signed and absolute differences in phoria magnitude were calculated. RESULTS: For two different test sessions with the same examiner using the same prism neutralization endpoint (intraexaminer repeatability), none were significant except examiner 1 using first neutral (p = 0.038). Average signed differences (ASD's) between two test sessions for each comparison were <0.5 prism diopter (pd) with SD's of </=2.56 pd. Absolute differences ranged from 1.30 to 1.89 pd. When two different examiners used the same prism endpoint within the same session (interexaminer repeatability), there were no significant differences between examiners. ASD's between the two examiners for each comparison were </=0.53 pd with SD's </=2.03 pd. The absolute differences ranged from 1.19 to 1.67 pd. Comparisons of the two different prism endpoints by the same examiner at a single test session were all significantly different (p < 0.005), but the differences (<1 pd between the two endpoints) were not clinically significant. ASD's were <1 pd with SD <2 pd. Absolute differences ranged from 1 to 1.58 pd. CONCLUSIONS: With experienced examiners, either prism endpoint provides high interexaminer and intraexaminer repeatability (</=0.5 pd). Although the two prism endpoints differ statistically, the differences are not clinically significant.

Adult↗
PubMed2005

[Large-scale genotyping in research into autism spectrum disorders and attention deficit hyperactivity disorder].

INTRODUCTION AND DEVELOPMENT: Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are two neuropsychiatric disorders beginning in childhood that present a high degree of familial aggregation. ASD is characterised by social interaction and communication disorders, whereas patients with ADHD display persistent inattention and/or hyperactive-impulsive behaviour. With the exception of a few cases of autism in which cytogenetic anomalies or mutations have been reported in specific genes, the aetiology of these diseases remains unknown. This is a group of multifactorial diseases with several genes having a lesser effect and there is also an environmental component. Genetic linkage studies have pointed to about 20 chromosomal regions that could well contain genes that grant susceptibility to autism, to ADHD or to both disorders. The challenge to researchers lies in the clinical characterisation, recruitment of patients with ASD and ADHD, gene dosage quantification studies, comparative genomic methylation and hybridisation in order to identify chromosomal rearrangements in patients with autism and severe mental retardation. CONCLUSIONS: Genotyping large SNP-type collections that are potentially functional in genes that are candidates for these disorders, based on pharmacological, biochemical and neuropathological data together with that coming from animal models and linkage studies in a wide collection of samples from patients and controls, will enable us to identify the genetic components of these pathologies and to define their biological foundations.

Attention Deficit Disorder with Hyperactivity↗
PubMed2005

[Epidemiological research in autism: an integrative view].

INTRODUCTION: Sixty years after the first descriptions of Autism, the same diagnostic criteria based on clinical observation used then are still valid today. Two years ago, the Instituto de Salud Carlos III set up the Grupo de Estudio en los Trastornos del Espectro Autista (Autism Spectrum Disorders Study Group) with the aim of evaluating the current state of research in autism spectrum disorders (ASD) in Spain. This group established collaborative links with different associations and set up a way of working that was more coordinated and closer to the real day-to-day situation experienced by the families involved. AIMS AND DEVELOPMENT: The aim of this review is to update certain areas of knowledge concerning the distribution of the factors that determine ASD, that is to say, about the epidemiology of these disorders. At the same time, it intends to arouse a greater degree of interest among professionals who are more directly involved in the study of pervasive developmental disorders. The latest diagnostic tools offer a higher degree of certainty in the complicated process of evaluating a case with symptoms of autism. Nevertheless, given the effectiveness of early attention and how it affects the prognosis, population-based ASD screening programmes must be implemented. These would have to include the use of Modified Check List for Autism in Toddlers (M-CHAT)-type questionnaires, followed by several levels of diagnosis, in order to reduce the number of false positives while at the same time increasing the true positives.

Autistic Disorder↗
PubMed2004

Autism with ophthalmologic malformations: the plot thickens.

PURPOSE: To review the association of autism spectrum disorder (ASD) in individuals manifesting thalidomide embryopathy and Möbius sequence and compare them with three new studies in which ASD was also associated with ocular and systemic malformations: (1) a Swedish study of individuals with CHARGE association (Coloboma, Heart, choanal Atresia, developmental or growth Retardation, Genital anomaly, and Ear involvement); (2) a Swedish study of Goldenhar syndrome; and (3) Brazilian Möbius syndrome (sequence) study. METHODS: In the Swedish CHARGE study, 31 patients met the inclusion criteria (3+ or 4 of the common characteristics of the CHARGE syndrome). The same team of investigators also evaluated 20 Swedish patients with Goldenhar syndrome. In the Brazilian Möbius study, 28 children with a diagnosis of Möbius sequence were studied; some children had a history of exposure during their mother's pregnancy to the abortifacient drug misoprostol in an unsuccessful abortion attempt. RESULTS: In the CHARGE study, five patients had the more severe autism disorder and five had autistic-like condition. In the Goldenhar study, two had autism disorder and one had autistic-like condition. In the Brazilian Möbius study, the systemic findings of the misoprostol-exposed and misoprostol-unexposed patients were almost undistinguishable, and ASD was present in both groups (autism disorder in five and autistic-like condition in three). CONCLUSION: Autism spectrum disorder has been reported in two conditions with known early pregnancy exposure to the teratogenic agents thalidomide and misoprostol. In the Brazilian Möbius study, autism also occurred in both the misoprostol-exposed and misoprostol-unexposed groups. Autism also was present in patients with both CHARGE association and Goldenhar syndrome.

Abnormalities, Drug-Induced↗
PubMed2005

Catheter closure of perforated secundum atrial septal defect under intracardiac echocardiographic guidance using a single amplatzer device: feasibility of a new method.

OBJECTIVES: Little is known about the feasibility and effectiveness of perforated secundum atrial septal defects (ASDs) transcatheter closure. This study tested whether this type of fenestration can be percutaneously closed using a single Amplatzer PFO or Cribriform Occluder device in a patch-like fashion under intracardiac echocardiographic (ICE) guidance and monitoring. METHODS: Twenty-four adult patients with perforated ASDs underwent transcatheter single Amplatzer PFO or Cribriform Occluder device closure by using ICE as the primary imaging tool, both for crossing the flap valve and monitoring each stage of the procedure. The entire atrial septum and fossa ovalis end diastolic dimensions on 2 orthogonal ICE planes, as well as the distance between the eccentric guidewire passage and the more adjacent rim of the fossa ovalis on the longitudinal ICE plane, have been measured. RESULTS: On the basis of the ICE fossa ovalis size and its geometric evaluation, in order to completely cover the fossa ovalis with a single device, 2 Amplatzer PFO Occluders 25 mm, 9 Amplatzer PFO Occluders 35 mm, and 13 Amplatzer Cribriform Occluders (four 25 mm and nine 35 mm) have been implanted successfully. During follow-up (31.4, 7.2 months), complete closure by contrast echo color Doppler occurred in 16/24 (67%) patients after 24 hours, 19/24 (79%) after 1 mouth, 20/24 (83%) after 3 months, 22/24 (92%) after 1 year, and 23/24 (96%) after 2 years. CONCLUSIONS: Transcatheter closure of perforated ASDs using a single Amplatzer Occluder device under ICE guidance appears to be a suitable procedure, providing a low rate of residual shunting.

Adult↗
PubMed1992

[Clinical classification and surgical treatment of cor triatriatum].

Twenty-one patients (age 35 days to 39 years) with cor triatriatum were treated surgically over a 17 year period at our institute. We define cor triatriatum as a congenital heart anomaly with the presence of an abnormal diaphragm that subdivides the left atrium into an accessory and a true left atrial chambers and that has "direct" hemodynamic communication between an accessory and a true left atrial chambers through one or more fenestration irrespective of accompaniment of an atrial septal defect or a partial anomalous pulmonary venous connection. By contrast with our findings of the hearts with cor triatriatum, every representative classification, such as Lucas-Schmidt's one, had some lack or duplication of the addressed types respectively. So we presented a clinical classification of cor triatriatum as follows: type I is the classical form with intact atrial septum, type IIa has an ASD between an accessory and a right atrial chambers, type IIb has an ASD between a right and a true left atrial chambers, and type IIc is a complexed form that has both communications of IIa's and IIb's. Of 14 typical cor triatriatum without isomerism nor other major complexed anomalies, 7 cases belonged to type I, and IIa 4, IIb 2, IIc 1 respectively. Of 7 so-called atypical cases, 5 cases belonged to type IIc and the rest two were unclassified complexed forms. Characteristically all of atypical cases had persistent left superior vena cava in common. 17 patients underwent total corrections and the rest 4 cases with single right ventricles underwent palliative operations for Fontan procedure in the near future. Transaccessory chamber approach for type I and IIb as the first choice provided ample exposure for complete excision of the obstructing membrane. Trans-right atrial approach were employed for closure of ASDs or for the other intraatrial partitions. Incision of the atrial septum should be avoided to prevent postoperative supraventricular arrhythmias if possible. There were no surgical death nor late death over 6 years follow-up period on the average. There existed some atypical cases that seemed very difficult to make differential diagnoses preoperatively, so careful surgical investigations into intraatrial anatomy should be made to perform proper corrections especially in the atypical cases.

Adult↗
PubMedDate not supplied

[Best practice guidelines for research in autistic spectrum disorders].

INTRODUCTION: Achieving a better knowledge of autism and other pervasive developmental disorders known as autistic spectrum disorders (ASD), poses a major scientific challenge. These disorders are some of the earliest and most severe psychopathological disorders in infancy; they include an heterogeneous group of conditions; its prevalence rate seems to be continually increasing and they generate a significant social impact. AIMS AND DEVELOPMENT: Nowadays, there is a current international agreement on the general requirements to be fulfilled by research projects and the priority areas to be considered when developing ASD high quality research. In Spain, although there are some established research groups with broad experience and expertise in these disorders, public funding opportunities and research development are still scarce. For this reason, the Study Group of the Instituto de Salud Carlos III has generated by consensus some Good Practice Guidelines for Research in ASD. CONCLUSIONS: After comparing priorities and recommendations from international reference documents with the results obtained after having carried out an exhaustive bibliographic revision of articles published in autism in the last 30 years by Spanish authors, methodological and ethical recommendations are established. Finally, structural deficiencies to be corrected and emerging research initiatives to be supported are identified.

Child Development Disorders, Pervasive↗
PubMed2005

[A cross-sectional study on prevalance and risk factors of disabilities in aged 0-6 years children in Beijing, China].

OBJECTIVE: To explore the epidemiological status of disabilities on vision impairment (VI), hearing loss (HL), mental retardation (MR), autism spectrum disorder (ASD) and motor disorder (MD) in aged 0-6 years old children in Beijing. METHODS: A total of 28 738 children under 7 years old were recruited from permanent residents of Beijing City by 2-phase cluster sampling. The screening procedure was 2-phase, and the diagnosis criteria were developed by the experts group. RESULTS: The overall disability rate was 11.45 per thousand (95 % CI:10.22-12.68). The false negative rates in HL and ASD were 0.14 per thousand, 0.80 per thousand, respectively, with a adjusted overall rate of 12.19per thousand. The prevalence rates of different kind disabilities from high to low were MR 9.31per thousand, MD 2.12per thousand, ASD 1.53per thousand (0.73per thousand before adjusted), HL 1.04per thousand (0.91per thousand before adjusted) VI 0.73per thousand. The results of logistic regression analysis showed that the possible non-biological risk factors for those disabilities were being male, living in city area, advancing age, mother with low education, mother engaged in labor work, and family with low income. It was primarily (49.62%) those prenatal factors other them the known suspected factors that causing disabilities. CONCLUSIONS: Compared with data from a countrywide study in 1987, the overall disability rate had a mild decrease (16.36%) with the most (56.85%) appeared in HL. It is indispensable to establish a disabilities surveillance program for the early recognition and intervention of children with disabilities. It is also crucial to clarify a disability definition for children combined with their characteristics of growth and development. We strongly recommended in developing a new definition on children' disabilities and establishing new criteria according to the contents of developmental disabilities of Center for Disease Control, USA.

Age Distribution↗
PubMed2006

Cardioversion corrects cardiac arrhythmia and reverts the resultant reversed shunt flow direction during transcatheter closure of atrial septal defect--a case report.

Closure of atrial septal defect (ASD) is critically dependent on the shunt flow direction. However, shunt flow direction through ASD may change under variable clinical conditions. We present here a 53-year-old woman with a confirmed left-to-right shunt ASD prior to Amplatzer Septal Occluder placement. The development of atrial flutter during the procedure had been found to change the shunt from unidirectional to bidirectional and the procedure was then forced to a temporary halt. The cardiac arrhythmia and altered shunt direction simultaneously reverted to the old state after cardioversion. A successful placement of Amplatzer septal occluder was successfully performed afterward and she recovered uneventfully.

Atrial Flutter↗
PubMed2006

Mental health in the United States: parental report of diagnosed autism in children aged 4-17 years--United States, 2003-2004.

Autism is a lifelong neurodevelopmental disorder characterized by early onset of impairments in social interaction and communication and unusual, stereotyped behaviors. Autism (i.e., autistic disorder) often is classified with two related, although less severe, developmental disorders: Asperger disorder and pervasive developmental disorder--not otherwise specified. These three constitute the autism spectrum disorders (ASDs). Diagnosis of ASDs is based exclusively on developmental pattern and behavioral observation. Two population-based studies conducted by CDC in selected U.S. locations reported ASD prevalence of 3.4 and 6.7 per 1,000 children, respectively. CDC also conducts two nationally representative surveys, the National Health Interview Survey (NHIS) and the National Survey of Children's Health (NSCH), in which parents are asked whether their child ever received a diagnosis of autism. Because of similarities in methodology used by the two surveys, CDC analyzed 2003-2004 data from NHIS and data from the first-ever NSCH (collected during January 2003-July 2004) to 1) estimate the population-based prevalence of parental report of diagnosed autism in the United States and 2) assess parental reporting of child social, emotional, and behavioral strengths and difficulties and special-health care needs among children with and without reported autism. This report describes the results of that analysis, which indicated that the prevalence of parent-reported diagnosis of autism was 5.7 per 1,000 children in NHIS and 5.5 per 1,000 children in NSCH. Prevalence estimates in the two studies were similar across age, sex, and racial/ethnic populations. The consistency in estimates between the two surveys suggests high reliability for parental report of autism. These estimates suggest that, as of 2003-2004, autism had been diagnosed in at least 300,000 U.S. children aged 4-17 years. In addition, parental reports of autism were associated with reported social, emotional, and behavioral symptoms and specialized needs. Thus, these surveys might be useful to assess health, education, and social service needs of children with autism.

Adolescent↗
PubMed2006

Lower adrenocortical and adrenomedullary responses to hypoglycemia in premenopausal women with systemic sclerosis.

OBJECTIVES: To evaluate function of the hypothalamic-pituitary-adrenal (HPA) axis, adrenomedullary hormonal system (AMHS), and sympathetic noradrenergic system (SNS) in premenopausal women with systemic sclerosis (SSc). METHODS: Insulin-induced hypoglycemia (0.1 IU/kg) was performed in 17 longterm, glucocorticoid-naive SSc patients with low disease activity and in 18 healthy women matched for age and body mass index (BMI). Concentrations of glucose, adrenocorticotrophic hormone (ACTH), cortisol, androstenedione (ASD), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), 17a-hydroxyprogesterone (17OHP), epinephrine (EPI), norepinephrine (NE), interleukin 1ss (IL-1ss), IL-6, and tumor necrosis factor-a (TNF-a) were analyzed in plasma. RESULTS: Basal plasma levels of cortisol, ASD, 17OHP, DHEAS, IL-1ss, IL-6, and TNF-a were not significantly different in SSc compared to controls. Patients had higher basal ACTH (6.76 +/- 1.0 pmol/l in SSc vs 4.14 +/- 0.45 pmol/l in controls; p < 0.05), lower basal DHEA (9.02 +/- 1.64 nmol/l in SSc vs 17.0 +/- 2.8 nmol/l in controls; p < 0.05), and lower basal NE (1.61 +/- 0.26 nmol/l in SSc vs 2.57 +/- 0.38 nmol/l in controls; p < 0.05). Patients had comparable responses of glucose and ACTH to hypoglycemia. General linear model for repeated measurements, with BMI and age as covariates, revealed that the responses of 17OHP (p < 0.05), ASD (p < 0.05), DHEA (p < 0.01), EPI (p < 0.001), and NE (p < 0.001) to hypoglycemia were lower in SSc compared to controls. Cortisol response to hypoglycemia tended to be lower in SSc patients (p = 0.06) compared to controls. CONCLUSION: Our data indicate decreased adrenocortical and adrenomedullary functions in premenopausal women with SSc. Whether the observed changes in the neuroendocrine system are secondary to chronic disease deserves further investigation.

Adrenal Cortex↗
PubMed1991

[Congenital cardiopathies at an internal medicine service].

STUDY OBJECTIVE: Description of 32 cases of congenital heart disease in the adulthood, admitted in the First Department of Medicine of Hospital Santa Maria, Lisboa between 1980 and 1989. DESIGN: Retrospective study. SETTING: Admission from the Emergency Room and Outpatients Clinic to an Internal Medicine Department of a General Hospital. PATIENTS: Adult patients with congenital heart disease. MATERIAL AND METHODS: All the 32 cases of congenital heart disease admitted between the 1st January 1980 and the 31st December 1989 were studied retrospectively. The clinical findings diagnosis and special examinations were analysed. MAIN RESULTS: The admission age varied between 15 and 83 years old being 21 female (65.6%) and 11 males (34.4%). The 32 cases of congenital heart disease, were distributed as follows: 19 were atrial septal defects (ASD); 4 were bicuspid aortic valves; 3 were coarctations of the aorta; 3 were tetralogy of Fallot; 2 were patent ductus arteriosus; 1 was an Ebstein anomaly with cianosis. From the 19 cases of atrial septal defect (ASD), 15 were female and 4 were male. The mean age of admission was 57.1 +/- 14.9. Congestive heart failure (CHF) was the reason for admission in 11 cases. The EKG findings were atrial fibrillation (AF) in 11 cases and atrial flutter in 1. Pulmonary hypertension was observed in the 17 echocardiographically documented cases. Infeccious endocarditis was diagnosed in 2 of the 4 bicuspid aortic valves. CONCLUSIONS: Congenital heart disease is not a very rare disease. In our 32 cases, 19 (59%) were ASD. CHD and AF were very common in this patology, in relation to the advanced age of this population. The echocardiography was a very useful diagnostic procedure. The 2 infective endocarditis cases between the 4 bicuspid aortic valves, is a way to remember the importance of prophylaxis.

Adolescent↗
PubMed1991

[Angiocardiographic evaluation of the left ventricular function in adult and pediatric subjects with interatrial defect of the ostium secundum type].

In order to assess left ventricular function in adults and children with ostium secundum atrial septal defect (ASD), 42 patients were examined by hemodynamic and angiocardiographic techniques. Patients were divided into three groups: Group I, 18 patients (mean age 42 years) with ASD; Group II, 14 patients (mean age 9 years) with ASD; Group III, 10 patients without cardiopathies who represented the control group. The following parameters of ventricular function were assessed: left ventricular end diastolic volume, global and regional left ventricular ejection fraction, left ventricular telediastolic pressure, mean pulmonary artery pressure, the ratio between pulmonary flow and systemic flow (QP/QS). Group I patients showed higher values of left ventricular end diastolic pressure and mean pulmonary artery pressure (16 +/- 0.6 mmHg; 33 +/- 1.5 mmHg) in relation to those of Group II (5.1 +/- 0.4 mmHg; 14 +/- 1.4 mmHg) and Group III (8.1 +/- 0.5 mmHg; 18 +/- 1.6 mmHg). In both cases the difference was statistically significant (p less than 0.001). A significant difference (p less than 0.05) was also noted in the incidence of mitral valve prolapse between patients in Group I and II. There was no significant difference (p = NS) however, between overall ejection fraction values in the three groups of patients; a lower regional ejection fraction (postero-basal segment) was recorded in Group I patients with mitral valve prolapse in comparison to patients in the other two groups (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Autosomal dominant atrial septal defect of ostium secundum type. Report of three families.

The authors report on three Sicilian families with 17 individuals (10 females and 7 males) in successive generations affected by atrial septal defect of ostium secundum type (S-ASD) without conduction defect. The anomaly was inherited as an autosomal dominant trait. Cytoplasmic inheritance could be excluded, the anomaly being transmitted also by fathers. Familial S-ASD is probably more frequent than commonly reported since cardiological examination of the relatives is not routinely performed in every case of apparently sporadic ASD.

Adult↗
PubMed1990

[Transesophageal Doppler echocardiography in the diagnosis of atrial septal defect].

To assess the usefulness of transesophageal Doppler echocardiography (TEE) in diagnosing atrial septal defect (ASD), we studied eight cases with secundum type ASD, in which the diagnosis was confirmed by cardiac catheterization and surgery. In all cases, TEE provided clear images of the interatrial septum with its defect. Shunt flow through the defect was observed by color Doppler technique, and its velocity was measured using the FFT mode. In two cases, right-to-left shunt blood flow was detected. Two types of probes were used in this study, a lateral scanning probe and a longitudinal scanning probe. The scanning plane of the former was perpendicular to the axis of the probe, and that of the latter was parallel to it. The two probes facilitated the measurement of the two right-angled dimensions, with which we could calculate the defect area, assuming the defect to be an ellipse. The volume of a left-to-right shunt was obtained by multiplying the defect area by the integration of flow velocity against time. Shunt volume per cardiac cycle obtained by this method correlated well with that obtained by the Fick's method during cardiac catheterization. In six cases without a right-to-left shunt, the coefficient of correlation was 0.98, and in all eight cases it was reduced to 0.72. Thus, we concluded that TEE is useful for diagnosing and evaluating ASD.

Adolescent↗
PubMed1990

Identification of lipopolysaccharide-binding proteins in 70Z/3 cells by photoaffinity cross-linking.

A radioiodinated, photoactivatable derivative of Salmonella minnesota Re595 lipopolysaccharide (LPS) was used to label LPS-binding proteins in 70Z/3 cells. The labeled proteins were resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and visualized by autoradiography. 125I-Labeled-2-(p-azidosalycylamido)1,3'-dithiopropionamide S. minnesota Re595 LPS (125I-ASD-Re595) labeled a limited number of proteins. The most prominent of these had a apparent molecular mass of 18 kDa. Less prominent labeling of 25- and 28-kDa proteins was also seen. Labeling was saturated by 5 micrograms/ml 125I-ASD-Re595 and was inhibited by a 10-100-fold excess of unlabeled LPS or lipid A. Labeling was maximal within 30 min at 37 degrees C; much less labeling occurred at lower temperatures. The proteins labeled with 125I-ASD-Re595 appear to be on the surface of the cell, since they can be digested by trypsin and were found in the membrane fraction of the cell but not in the cytosol. Studies with competitive inhibitors suggested that the proteins bind to the lipid A region of the LPS molecule. Biologically inactive lipid A analogs were poor inhibitors of labeling, suggesting that the LPS-binding proteins could discriminate between active lipid A and inactive analogs. These studies suggest that the 18- and 25-kDa proteins bind specifically to the lipid A region of the LPS molecule and should be considered as candidates for a functional LPS receptor.

Affinity Labels↗
PubMed1989

[Cost-effectiveness analysis of two-dimensional/Doppler echocardiography, cardiac catheterization and angiography in the diagnosis of congenital heart disease].

To compare the costs and effectivenesses of 2-dimensional/Doppler echocardiography (2D/DE), cardiac catheterization (CC) and angiography (CA) in the evaluation of cardiac anatomy in patients with congenital heart disease, these three kinds of examinations were performed in 100 patients before operation. The 100 patients had 120 separate cardiovascular abnormalities, of which 100 (83.3%) were prospectively identified by 2D/DE. The sensitivity and specificity of 2D/DE were: ASD, 87.9% and 100%; VSD, 97.9% and 96.1%; PDA, 86.7% and 98.2%, Tetralogy of Fallot, 6 of 6 patients; the overall sensitivity and specificity of the less common defects, 31.6% and 95.8%. Ninety-seven (80.8%) were prospectively identified by catheterization. The sensitivity and specificity of catheterization were: ASD, 87.9% and 100.0%; VSD, 80.9% and 94.6%; PDA 93.3% and 96.6%; Tetralogy of Fallot, 6 of 6 patients, the less common defects, 52.6% and 95.5%. Forty-five (81.8%) were prospectively identified by angiography in 55 patients. The sensitivity and specificity of angiography: ASD, 5 of 7 patients, VSD, 88.0% and 94.3%; PDA, 2 of 2 patients; Tetralogy of Fallot, 5 of 5 patients; the less common defects, 68.8% and 100.0%. The economic evaluations were performed. The costs of the depreciation (including equipments and houses), hospital bed, water and electricity, management and staffs' wage were: 2D/DE, RMB 46.09 per patient; catheterization, RMB 314.17 per patient; angiography, RMB 314.17. The ratios of cost to outcome (cost per correct diagnosis) of 2D/DE, CC and CA were: 55.33, 388.82 and 384.07 respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗