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PubMed1981

Complex ventricular arrhythmias after myocardial infarction during convalescence and follow-up: a harbinger of multi-vessel coronary disease, left ventricular dysfunction and sudden death.

Sixty-one medically treated patients had coronary and left ventricular angiography and 24-hour electrocardiographic monitoring 10-24 days after myocardial infarction, and then had serial 24-hour electrocardiographic monitoring during the 13 +/- 11 months after myocardial infarction. Complex ventricular arrhythmias (2 or more sequential ventricular premature depolarizations (VPDs), multiform VPDs, bigeminy) during follow-up were associated with a high mortality rate and occurred most commonly in the setting of three-vessel coronary disease, proximal left anterior descending coronary disease and low left ventricular ejection fraction. By contrast, patients without complex VPDs in either the late hospital or posthospital phase of myocardial infarction had no mortality during the year following myocardial infarction; furthermore, these patients had a higher incidence of single-vessel coronary disease and less left ventricular dysfunction. These results emphasize the adverse prognostic significance of complex ventricular arrhythmias in the year after myocardial infarction and their association with extensive coronary artery disease and left ventricular damage.

Arrhythmias, Cardiac↗
PubMed1975

Bactericidal activity of meningococcal antisera. Blocking by IgA of lytic antibody in human convalescent sera.

Humoral IgA, separated and purified from human sera drawn 12, 27, and 33 days after infection with serogroups B, Y, and C meningococci, respectively, has been shown to inhibit complement-mediated bacteriolysis by IgG and IgM purified from the same sera. Inhibition was dependent on the ratio of lytic to blocking antibody, was strain specific, and was greater for IgG than IgM. IgM was found to be more active than IgG in a bactericidal test. Activity of IgA appeared unrelated to the presence of a prozone in the whole serum. Similar inhibition was noted for IgA separated from rabbit sera.

Animals↗
PubMed2003

[The characteristic of vernier acuity on retrobulbar neuritis patients].

PURPOSE: To investigate the clinical characteristic of vernier acuity in retrobulbar neuritis patients. METHODS: The vernier acuity test soft wear system was developed to detect the 15 cases (25 eyes) with retrobulbar neuritis patients. There were 8 eyes of 6 cases with acute retrobulbar neuritis and 17 eyes of 9 cases with chronic retrobulbar neuritis. Subjects' age ranged from 11 to 58 (mean = 25.87). There were 14 eyes of 7 cases male and 11 eyes of 8 cases female. The best visual acuity ranged from 0.05 to 0.7. Two fixed targets and a movable target are shown on the computer screen. The examine was asked to adjust the position of the central target and the relationship between it and align them by using a track-ball. The computer automatically records the deviations of distances between the movable target and the specific one, and computes the average threshold and its variance. RESULTS: There was significant statistical difference in the vernier threshold and its variance between the normal subjects and patients with retrobulbar neuritis in acute stage or convalescence. The correlation coefficient between visual acuity and vernier acuity threshold was -0.88 in the patients with retrobulbar neuritis in acute stage of neuritis (P < 0.01). The correlation coefficient between visual acuity and threshold variance was -0.46(P < 0.05). In convalescence, with an improvement of the disease and the increase of visual acuity, the vernier acuity threshold decreased and the threshold variance reduced. The difference of threshold and its variance between acute stage and convalescence had statistical signification (P < 0.01). The correlation coefficients between visual acuity and vernier acuity threshold was -0.93 in convalescence (P < 0.01). The correlation coefficients between visual acuity and vernier threshold variance was -0.84(P < 0.01) in convalescence. No significant statistical difference was found in the correlation between the vernier threshold in acute stage and in convalescence (P = 0.261). No significant statistical difference was found in the correlation between visual acuity in acute stage and in convalescence (P = 0.11). The correlation coefficients between vernier threshold variance in acute stage and in convalescence was -0.67 (P < 0.01). There was statistical difference among the difference of threshold, visual acuity and standard deviation between acute stage and convalescence respectively (t-test, P < 0.01). CONCLUSIONS: It is suggested that vernier acuity, which changed with the state of the disease, was one of the indexes to evaluate the visual function of patients with retrobulbar neuritis. It could be use as an observation index of supervising the change of patients' visual function and the reaction to medication and guiding medication.

Adolescent↗
PubMed1991

Disposition of oral quinine in acute falciparum malaria.

Plasma quinine concentrations following oral quinine sulphate 10 mg salt/kg have been measured by HPLC in 15 adult Thai patients with uncomplicated falciparum malaria. In 10 of the same patients the study was repeated in convalescence. In acute malaria plasma concentrations were approximately 50% higher than in convalescence; the mean acute peak plasma quinine concentration was 8.4 mg.l-1 compared to 5.7 mg.l-1 in convalescence. There was considerable variation in the rate of drug absorption, particularly in acute malaria. The mean time to peak plasma concentration was 5.9 h in acute malaria and 3.2 h in convalescence. The apparent clearance of oral quinine (CL/f) during the illness was 1.51 ml.kg-1.min-1, which was significantly lower than in convalescence--2.67 ml.kg-1.min-1. Estimated free quinine clearance was also lower in the acute phase: 30.6 compared to 49.0 ml.kg-1.min-1 in convalescence. Mean (SD) plasma protein binding of quinine was 94.7% in acute malaria and 92.8% in convalescence. Binding was significantly correlated with the plasma concentration of alpha 1 acid glycoprotein (r = 0.5), which was significantly higher in the acute phase; 1.48 g.l-1 compared to 1.05 g.l-1 during convalescence. Oral quinine sulphate was well absorbed in uncomplicated falciparum malaria. High blood concentrations following the administration of oral quinine in acute malaria are probably related to increased plasma protein binding, lower apparent volume of distribution, and a reduction in its systemic clearance.

Administration, Oral↗
PubMed2002

Pathogenesis of transient high myopia after blunt eye trauma.

OBJECTIVE: To determine the pathogenesis of transient high myopia after blunt eye trauma. DESIGN: Two observational case reports and literature review. METHODS: Refraction was measured in two patients with an autorefractometer in the acute and convalescent stages after a blunt eye injury. The anterior chamber angle, the ciliary body, and the choroid were examined by ultrasound biomicroscopy (UBM) in the acute and convalescent stages. In one patient, the anterior chamber depth, lens thickness, and axial length were measured by A-scan ultrasonography in the acute and convalescent stages. MAIN OUTCOME MEASURES: Comparison of the refraction, anterior chamber depth, lens thickness, axial length, and the UBM-determined appearance of the choroid and ciliary body during the acute stage with the values during the convalescent stages. RESULTS: The first patient showed a myopic shift of -9.75 diopters (D) and an anterior chamber shallowing of 0.94 mm measured 3 days after trauma by an air bag inflation compared with the measurements at the convalescent phase. UBM showed an annular ciliochoroidal effusion with ciliary body edema, anterior rotation of the ciliary processes, and disappearance of the ciliary sulcus. Eleven days after the injury, these UBM findings normalized, and the myopia decreased to -0.75 D, 27 days after trauma. The second patient had a myopic shift of -8.9 D compared with the convalescent phase, immediately after blunt trauma by a firework. Seven days after the injury, UBM revealed a partial cyclodialysis in addition to findings similar to those in the first patient. Ten days after injury, a myopic shift (-4.75 D), anterior chamber shallowing (by 1.1 mm), and thickening of the crystalline lens (by 0.27 mm) were observed compared with the convalescent phase. Associated UBM findings confirmed the anterior shift of the lens-iris diaphragm. Seventeen days after trauma, the UBM findings, including the cyclodialysis, were normalized, and the myopia had decreased to -1.0 D. CONCLUSIONS: Transient high myopia after blunt trauma is caused by anatomic changes in the ciliary body and crystalline lens. The anterior shift of the lens-iris diaphragm caused by ciliochoroidal effusion with ciliary body edema and thickening of the crystalline lens from blunt eye trauma are involved in traumatic high myopia.

Adult↗
PubMed2002

Antioxidant protection against iron in children with meningococcal sepsis.

OBJECTIVE: To assess antioxidant protection against iron-catalyzed reactive oxygen species in meningococcal sepsis and to establish whether severity of illness is related to deficiencies in these antioxidant systems. DESIGN: Prospective, controlled study. SETTING: Pediatric intensive care unit of a postgraduate teaching hospital. PATIENTS: Twenty children aged 6 months to 15 yrs (median, 5 yrs) with meningococcal septic shock were studied. Paired convalescent samples taken 8-10 wks after discharge were available in nine children. INTERVENTIONS: Routine management for meningococcal sepsis. MEASUREMENTS AND MAIN RESULTS: Patients were classified for disease severity using the Glasgow Meningococcal Septicaemia Prognostic Score. Paired acute and convalescent samples were compared. Transferrin level (1.77 +/- 0.08 g/L) and total iron-binding capacity (46.2 +/- 2.0 microM) were significantly decreased in acute patients compared with paired convalescent samples (2.85 +/- 0.10 g/L and 74.4 +/- 2.5 microM, respectively; p <.0001). The iron saturation of transferrin was significantly increased in acute disease (36.9% +/- 2.5%) compared with convalescence (18.8% +/- 1.5%; p =.0003). Iron-binding antioxidant protection was not significantly different in acute (81.4% +/- 1.7%) and paired convalescent samples (85.6% +/- 2.5%; p =.54). However, patients with more severe meningococcal septicemia (GMSPS, >10; n = 12) had significantly diminished protection (77.5% +/- 2.4%) compared with less severe disease (87.1% +/- 1.6%; p =.0028), and there was a significant correlation between disease severity and iron-binding antioxidant protection (R =.48; p =.00067) in acute disease. Paired ceruloplasmin levels were available in six patients and were decreased in acute disease (0.29 +/- 0.02 g/L) compared with convalescence (0.40 +/- 0.04 g/L), although not statistically significant (p =.076). However, there was a significant correlation between plasma ceruloplasmin and disease severity (Pearson product moment correlation, p =.038) in the acute patients. Iron-oxidizing antioxidant assays were performed in four paired samples and were diminished in acute patients (53.3 +/- 4.4%) compared with convalescence (67.8 +/- 3.2%; p =.015). Acute samples demonstrated a significant relationship between iron-oxidizing antioxidant protection and both disease severity (r =.30; p =.012) and plasma ceruloplasmin levels (r =.48; p =.00067). CONCLUSIONS: Children with meningococcal septicemia exhibit abnormal plasma iron chemistry and decreased protection against iron-catalyzed oxidative damage. Such deficiencies correlate with disease severity.

Acute Disease↗
PubMed1978

Experimental Haemophilus influenzae type b meningitis: immunological investigation of the infant rat model.

Infant rats inoculated intraperitoneally with Haemophilus influenzae type b develop bacteremia and meningitis. Rats were infected at 10 to 12 days of age and studied for the development of serum anticapsular antibody and bactericidal and opsonizing activity. Seven and 11 weeks after inoculation, convalescent animals showed a higher frequency of anticapsular antibody responses than uninfected controls, but 35 to 40% of the infected group had undetectable levels of anticapsular antibody (<0.10 mug/ml). In contrast, all of the convalescent animals, but none of the controls, showed moderate titers of serum bactericidal activity; and bactericidal activity persisted after absorption of the convalescent sera with type b capsule. Bactericidal activity was detected primarily in the eluted fraction corresponding to a molecular weight of 150,000 and was present in the offspring of convalescent females. Offspring of convalescent females were protected against challenge with H. influenzae type b, and control offspring could also be protected by passive immunization with convalescent serum which lacked detectable anticapsular antibody. Convalescent serum samples efficiently opsonized H. influenzae type b, and this activity persisted after absorption of the serum with capsular antigen. These data are consistent with the hypothesis that antibody to the noncapsular surface antigens of H. influenzae type b play an important role in host defenses.

Animals↗
PubMed1987

The principal protein antigens of isolates of Mycoplasma pneumoniae as measured by levels of immunoglobulin G in human serum are stable in strains collected over a 10-year period.

To determine whether antigenic variation in protein antigens of Mycoplasma pneumoniae occurred over time, 12 isolates obtained from pneumonia patients over a 10-year period (1964 to 1974) were compared by immunoblotting (Western blotting) against acute and convalescent human serum samples obtained from the same patients. The strains selected were isolated from patients who had low anti-lipid complement-fixing antibody titers in their acute-phase serum samples and high titers in their convalescent-phase serum samples. The polypeptide composition of the strains was closely similar by protein staining even when compared with prototype FH-Liu. On immunoblotting, all strains showed five bands (170, 130, 90, 45, and 35 kilodaltons [kDa]) which were stained more intensely by convalescent-phase than by acute-phase specimens. A sixth band (62 kDa) was detected by the conjugate alone. In FH-Liu, one band (110 kDa) was prominently stained by convalescent-phase specimens; this band was much less apparent in all of the clinical isolates. Two isolates possessed an additional band (92 kDa) which was stained more prominently by some but not all convalescent-phase specimens. Because of its known antigenic relationships and culture similarities, Mycoplasma genitalium was used for comparison. More polypeptides of M. genitalium than of M. pneumoniae were recognized by acute-phase serum samples, and 4 of 12 convalescent-phase serum samples showed increases in antibodies to certain M. genitalium polypeptides. However, these reactive polypeptides did not correspond in molecular mass to polypeptides recognized in M. pneumoniae; thus the signature profile of human convalescent-phase specimens with M. pneumoniae was distinct. These five polypeptides, individually or in combination, are especially promising for use in detection of human serum antibodies by enzyme-linked immunosorbent assay because they were found in all M. pneumoniae isolates tested.

Antibodies, Bacterial↗
PubMed1998

Immune responses against major outer membrane antigens of Neisseria meningitidis in vaccinees and controls who contracted meningococcal disease during the Norwegian serogroup B protection trial.

Sera from vaccinees and controls who contracted serogroup B meningococcal disease during the blinded and open parts of a two-dose protection trial in Norway were compared for antigen-specific and bactericidal antibodies against vaccine strain 44/76 (B:15:P1.7,16). From 16 of 20 (80%) vaccinees and 26 of 35 (74%) controls, one or more serum samples (n = 104) were collected during the acute phase (1 to 4 days), early convalescent phase (5 to 79 days), and late convalescent phase (8 to 31 months) after onset of disease. Binding of immunoglobulin G (IgG) to the major outer membrane antigens (80- and 70-kDa proteins, class 1, 3, and 5 proteins, and lipopolysaccharide [LPS]) on immunoblots was measured by digital image analysis. Specific IgG levels in vaccinees increased from acute to early convalescent phases, followed by a decline, while controls showed a small increase over time. Vaccinees had significantly higher levels than controls against class 1 and 3 porins and LPS in acute sera, against all antigens during early convalescence, and against class 1 and 3 porins in the later sera. Vaccinees who were infected with strains expressing subtype P1.7,16 proteins demonstrated a level of IgG binding to protein P1.7,16 with early-convalescent-phase sera that was fourfold higher than that of those infected with other strains. Bactericidal titers in serum against the vaccine strain were 192-fold higher for vaccinees than those for controls during early convalescence, but similarly low levels were found during late convalescence. A vaccine-induced anamnestic response of specific and functional antibody activities was thus shown, but the decrease in protection over time after vaccination indicated that two vaccine doses did not induce sufficient levels of long-term protective antibodies.

Antibodies, Bacterial↗
PubMed1988

Natural killer cells in Behçet's disease.

We studied natural killer (NK) cell activity and numbers in the peripheral blood obtained from patients with Behçet's disease (BD) in inactive and convalescent stage, and from healthy controls. Ratios of helper/suppressor cells (OKT4/OKT8) were below 1.0 in patients with active stage and were normal in the convalescent stage of BD. A relative increase of OKT8+ cells and at the same time of Leu 7+ cells was obtained in the active and convalescent BD stages. Double marker analysis revealed that the sub-population of cells expressing both the T8+ and the Leu 7+ antigen (T8+/Leu 7+) was increased in patients with active stage, and normal in the convalescent stage. The frequency of cells reactive with Leu 11 monoclonal antibody (active NK cells) was evaluated in patients with BD. Data from peripheral blood showed an increased sub-population of T8+/Leu 7+ double marker cells, and a decreased Leu 11+ cell sub-population in patients with active BD, but the majority of Leu 7+ cells in patients with convalescent stage lacked OKT8 antigen when investigated in a double marker system. A parallel increase of Leu 11+ cells was observed in the convalescent stage. This phenotypic analysis was carried out with the NK in vitro functional evaluation of cell populations from peripheral blood. NK cell activity in the clinically active stage of BD was significantly lower than that of healthy controls and patients in the convalescent stage. The decrease of peripheral blood NK function in patients with active BD may be related to the presence of immature forms of NK cells and/or to the increased percentage of T8+/Leu 7+ cells.

Adult↗