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PubMed1993

Titration streptomycin therapy in Menière's disease: current concepts.

Soon after its discovery, streptomycin sulfate was found to be beneficial in the treatment of tuberculosis. However it also was found to have toxic effects, primarily vestibular and typically sparing the auditory nerve until higher doses were administered. The first reported use of streptomycin in the treatment of vertigo was in 1948. This was soon followed by its use for treating Menière's disease. Although excellent control of vertigo was achieved significant post-treatment oscillopsia was experienced by these completely ablated patients. A protocol of titration streptomycin therapy was established that effectively controls vertigo while decreasing the incidence of oscillopsia. This report presents three patients with Menière's disease treated with this protocol.

Adult↗
PubMed2005

Monitoring of pulmonary mechanics in acute respiratory distress syndrome to titrate therapy.

PURPOSE OF REVIEW: This paper reviews recent findings regarding the respiratory mechanics during acute respiratory distress syndrome as a tool for tailoring its ventilatory management. RECENT FINDINGS: The pressure-volume curve has been used for many years as a descriptor of the respiratory mechanics in patients affected by acute respiratory distress syndrome. The use of the sigmoidal equation introduced by Venegas for the analysis of the pressure-volume curve seems to be the most rigorous mathematical approach to assessing lung mechanics. Increasing attention has been focused on the deflation limb for titration of positive end-expiratory pressure. Based on physiologic reasoning, a novel parameter, the stress index, has been proposed for tailoring a safe mechanical ventilation, although its clinical impact has still to be proved. Evidence has confirmed that a variety of underlying pathologies may lead to acute respiratory distress syndrome, making unrealistic any attempt to unify the ventilatory approach. Although extensively proposed to tailor mechanical ventilation during acute respiratory distress syndrome, there is no evidence that the pressure-volume curve may be useful in setting a lung-protective strategy in the presence of different potentials for recruitment. SUMMARY: The Venegas approach should be the standard analysis of pressure-volume curves. In any patient, the potential for recruitment should be assessed, as a basis for tailoring the most effective mechanical ventilation. Further studies are needed to clarify the potential use of the pressure-volume curve to guide a lung-protective ventilatory strategy.

Humans↗
PubMed1977

End-point dilution and plaque assay methods for titration of cricket paralysis virus in cultured Drosophila cells.

Cricket paralysis virus, an insect picorna-like virus, caused a distinct c.p.e. in cultured Drosophila melanogaster cells, allowing the development of titration methods based on end-point dilution or plaque assay methods. The end-point dilution (TCD50) method is more sensitive and economical than plaque assays and is easily scored. The data indicate a minimum infectivity/particle ratio of about 1/2000.

Culture Techniques↗
PubMed1984

Plaque titration and inhibition tests for bovine parvovirus.

Bovine parvovirus readily produced plaques when inoculated into 60% confluent, actively growing bovine embryonic lung cells. Incorporation of DEAE-dextran, MgCl2 and DMSO in the agarose overlay medium was found to improve plaque production, especially with the latter chemical. In contrast, protamine sulphate inhibited plaque development. It was found that plaque titration and plaque inhibition tests could be conveniently carried out in 24-well cell culture plates, using an agarose overlay containing DMSO, DEAE-dextran and foetal calf serum. The procedures were highly sensitive, when compared with other established techniques.

Animals↗
PubMed2002

PCR-based cloning and immunocytological titration of infectious porcine endogenous retrovirus subgroup A and B.

Two pig endogenous retroviruses (PERV), PERV-A and -B, productively infect human cells and are therefore considered to constitute a potential risk in pig-to-human xenotransplantation. A PCR-based cloning technique to isolate infectious PERV proviruses was established. Overlapping 3' half and 5' halves of PERV proviral genomes were amplified using DNA extracted from human 293 cells infected with PERV-A or -B. These clones were fused at a unique restriction site in the overlapping region and tested for their infectivity. Representative constructs possessed the same infectious properties as their parent isolates. We also developed a polyclonal anti-PERV serum by using recombinant PERV capsid protein derived from one of the infectious constructs as immunogen and established an immunocytological method for detection and titration of PERV infection. This detection method proved to be more sensitive than the current method of choice (transfer of MLV-lacZ vectors) for infectivity assessment of PERV. These findings should be considered for future characterization of PERV isolates.

Animals↗
PubMed2005

Water molecules in the antibody-antigen interface of the structure of the Fab HyHEL-5-lysozyme complex at 1.7 A resolution: comparison with results from isothermal titration calorimetry.

The structure of the complex between hen egg-white lysozyme and the Fab HyHEL-5 at 2.7 A resolution has previously been reported [Cohen et al. (1996), Acta Cryst. D52, 315-326]. With the availability of recombinant Fab, the X-ray structure of the complex has been re-evaluated at 1.7 A resolution. The refined structure has yielded a detailed picture of the Fab-lysozyme interface, showing the high complementarity of the protein surfaces as well as several water molecules within the interface that complete the good fit. The model of the full complex has improved significantly, yielding an R(work) of 19.5%. With this model, the structural results can be compared with the results of isothermal titration calorimetry. An attempt has been made to estimate the changes in bound waters that accompany complex formation and the difficulties inherent in using the crystal structures to provide the information necessary to make this calculation are discussed.

Antigen-Antibody Complex↗
PubMed1977

A simple and efficient microassay method for titration of interferon.

A simple and efficient microassay method for the titration of interferon was developed by the use of microtest plates for handling a large number of samples. L929 cells pretreated with interferon were infected with vesicular stomatitis virus (VSV) and cultured in the presence of 3H-uridine. The activity was expressed by the reduction of extracellular radioactive RNA released after destruction of the infected cells, which was measured in terms of the radioactivity incorporated into cold TCA-insoluble materials in the culture fluid. The interferon titer determined by this method was in the same order as that by the plaque reduction method. The activity by this method was parallel to, but lower than that expressed by the yield reduction of infectious viruses. This method requires only 0.025 ml of each test sample with higher than 1 NIH ref. unit/ml to detect its interferon activity and takes 2 to 3 days for assaying hundreds of samples.

Animals↗
PubMed1981

Anticomplement immunofluorescence for the titration of antibody to varicella-zoster virus.

Anticomplement immunofluorescence (ACIF) was tested for its use for the titration of antibody against varicella-zoster virus (VZV). ACIF antibody responses of patients with VZV infection were specific for VZV antigen and heterotypic responses to herpes simplex virus type-1 and cytomegalovirus antigens were not observed. Comparative studies of ACIF, membrane immunofluorescence (MIF) and indirect immunofluorescence (IF), using acetone-fixed antigen, were carried out with nonimmune sera and convalescent sera of patients who had recovered from varicella, herpes zoster and Rumsey Hunt disease. Nonspecific staining occurred with some nonimmune sera at a 1:4 dilution in the MIF and IF tests, after freezing and thawing of the serum, but not in the ACIF test. The antibody titers in convalescent sera agreed well in these three methods and the highest titer was obtained by MIF. The titers in ACIF and IF were similar but the ACIF antibody decreased earlier than the IF antibody during convalescence. On the other hand there was a discrepancy between the titers of ACIF and those of MIF and IF antibody in the sera of healthy adults, all sera with titers higher than 10 in the MIF and IF tests had titers below 10 in the ACIF test. The average titer of ACIF antibody declined to less than 10 with increasing age (13 to more than 20 years), whereas the MIF antibody increased during the same period of life.

Adolescent↗
PubMed1981

Titration of bactericidal activity against smooth and rough strains of Salmonella which are resistant in isotonic medium.

Bactericidal factors in antisera against various chemotype strains of Salmonella were assayed by means of the spot method. Certain smooth and rough strains were resistant to the killing effect of immune mouse sera when the activity was assayed in an isotonic salt medium and guinea pig complement was used. However, the sensitivity was found to be increased in various degrees by assaying it in a medium containing hypotonic concentrations of NaCl or tris(hydroxymethyl)-aminomethane-HCl (Tris-HCl). Keeping the resistant bacteria in hypotonic solutions before or after treatment with complement increased the titer of antiserum, indicating that the hypotonic solution increases the sensitivity of bacterial cells to the antiserum and/or complement. The optimal salt concentration for the assay of serum-sensitive and -resistant smooth strains was 0.02 M NaCl. With Ra through Rd chemotype strains, 0.1 M NaCl before complement treatment and 0.05 M NaCl after the treatment was the best. Isotonic medium was necessary for the titration of the Re chemotype strain. Specificity of the killing effect which was assayed by the hypotonic spot method was shown by adsorption studies on the immune sera. Use of C4-deficient guinea pig complement resulted in low titers against certain strains of bacteria and high titers were restored by the addition of the C4 component of complement. These results indicate that serologically specific bactericidal factors including antibody can be assayed by the spot method using hypotonic NaCl or Tris-HCl.

Antibodies, Bacterial↗
PubMed1981

A simplified micro-method for cytotoxicity testing using a flat-type titration plate for the detection of H-2 antigens.

A new micro-method for cytotoxicity testing using a flat-type titration plate has been developed. This micro-method is so simple that it involves no washing and staining procedures. In this method, cell viability is judged on the basis of the refractility change in the lymphocytes seen under the phase-contrast microscope. This micro-method has higher sensitivity and reproducibility than the dye exclusion method and 51Cr-release assay. Fixation of cells with glutaraldehyde and tight covering of the plate allow us to read the result even after 3 weeks. These advantage of the new method enable us to deal with a large number of samples at one time. We also introduce a rapid technique for the preparation of a cell suspension from the lymph node without killing the animal.

Animals↗
PubMed1993

Self-titration of nicotine: evidence from the Scottish Heart Health Study.

Data from 2754 cigarette smokers who smoke no other forms of tobacco are extracted from the baseline cross-sectional survey of the Scottish Heart Health Study. Carbon monoxide in expired-air (CO-E), serum thiocynate and serum cotinine measurements from these smokers are compared with the carbon monoxide (CO), nicotine and tar yields of the cigarettes which they smoke, controlling for daily cigarette consumption, the sex of the smoker and the other cigarette yields. CO-E is found to increase positively with CO and tar yield, but inversely with nicotine yield. Thiocyanate increases positively with CO, is not significantly affected by tar, but increases inversely with nicotine. Cotinine is affected only by tar, in a positive direction for women. We conclude that smokers appear to self-titrate their consumption of nicotine by more aggressive smoking of lower-strength cigarettes.

Adult↗
PubMed1983

Protamine titration after cardiopulmonary bypass.

A method of protamine titration, with the use of the 'Haemochron 400' system for reversal of heparinisation after cardiopulmonary bypass is described. Twenty-three patients, average age 47 years, undergoing this procedure for either valve replacement or coronary artery bypass grafting were studied. Accurate reversal of heparinisation was achieved using comparatively small doses of protamine. A linear relationship between the dose ratio of protamine and heparin and the time interval between their respective administrations was defined where only a single dose of heparin had been administered.

Adult↗
PubMed1993

Intranasal fentanyl titration for postoperative pain management in an unselected population.

A randomized, double-blind study was undertaken to investigate the suitability of intranasally administered fentanyl for postoperative pain management under routine conditions in an unselected population. For postoperative pain relief, patients received either 0.027 mg fentanyl intranasally and sodium chloride 0.9% intravenously (intranasal group, n = 53) or sodium chloride 0.9% intranasally and 0.027 mg fentanyl intravenously (intravenous group, n = 59). These doses were repeated every 5 min until the patients were free of pain or refused further analgesia. Pain severity was evaluated before beginning opioid titration and 5, 10, 15, 20, 30, 40, 50, 60, 70 and 80 min thereafter. Adequate pain relief was achieved in 52 of 53 patients in the intranasal and in all patients in the intravenous group. Pain intensities evaluated on a 101-point numerical rating scale as well as on a verbal rating scale decreased significantly in both study groups within 5 min. At the 15 min measurement point, numerical rating scale pain intensity and at the 10 and 20 min point, verbal rating scale pain intensity was significantly lower in the intravenous group. The incidence of side effects was low in both groups and no patient complained of intranasal pain. Intranasally administered fentanyl would appear to be suitable for the management of postoperative pain.

Administration, Intranasal↗
PubMed1990

Titration of antibodies against neutrophil cytoplasmic antigens is useful in monitoring disease activity in systemic vasculitides.

Titration of antibodies against neutrophil cytoplasmic antigens (cANCA), as detected by indirect immunofluorescence, is shown to be clinically useful for monitoring disease activity in Wegener's granulomatosis and microscopic polyarteritis. Ten patients were followed (eight from presentation) prospectively for up to 2 years; during this time there were six episodes of vasculitic relapse in four patients and five infective episodes and one pulmonary embolus in four patients. Titres of cANCA were markedly raised, both at presentation (1/32-1/2048) and at vasculitic relapse (1/125-1/1048) but not in infection or embolism (negative, 1/16). Thus the titre of these antibodies can distinguish nonvasculitic illness from vasculitic relapse, in contrast to C-reactive protein levels which were raised in both. Titres of cANCA fell gradually after vasculitic relapse, in keeping with the half-life of IgG (3 weeks). C-reactive protein is a better measure of recovery.

Adult↗
PubMed2006

Efficacy study of galantamine in possible Alzheimer's disease with or without cerebrovascular disease and vascular dementia in Thai patients: a slow-titration regimen.

The objective is to evaluate the efficacy of galantamine when a slow titration regimen is employed in Thai Alzheimer's disease (AD) patients with or without cerebrovascular disease and vascular dementia (VaD). A 6-month, multicentre, open-label, uncontrolled trial was undertaken in 75 AD patients. Eligible patients received an initial galantamine dose of 8 mg/day and escalated over 5-8 weeks to maintenance doses of 16 or 24 mg/day. Primary efficacy measures were AD Assessment Scale-cognitive subscale (ADAS-cog) and the Clinician's Interview-Based Impression of Change-Plus version (CIBIC-plus). The Behavioural Pathology in AD Rating Scale (BEHAVE AD), the AD Cooperative Study Activities of Daily Living Inventory and Pittsburgh Sleep Quality Index were the secondary efficacy variables. Analyses were based on the intent-to-treat population. Treatment with galantamine showed significant improvement in cognition on the ADAS-cog and CIBIC-plus at month 6. Galantamine showed favourable effects on activities of daily living. Behavioural symptoms and sleep quality were also significantly improved (p < 0.05). Galantamine was well tolerated. The adverse events were mild-to-moderate intensity. The most frequent adverse events commonly reported were nausea (16.4%), dizziness (9.6%) and vomiting (6.8%). The results of this study may be consistent with galantamine being an effective and safe treatment for mild-to-moderate AD patients with or without cerebrovascular disease and VaD. Flexible dose escalation of galantamine was well tolerated. The daily maintenance dose of galantamine was 16 mg/day, followed by a back up dose of 24 mg/day.

Aged↗
PubMed1979

The specificity of secondary MLC assayed by titration of primed lymphocyte populations.

The specificity of responses in secondary MLC was studied by titration (100 x 10(3) to 5 x 10(3)) of responder primed lymphocytes. In all instances, significant proliferative responses of responder primed lymphocytes to the specific stimulator occurred using lower responding cell numbers. When tested against allogeneic stimulating donors, three patterns of responses were observed: no significant responses, responses only at higher (100 x 10(3)) responding cell densities, and responses at lower responding cell densities, similar to those with the priming donor. In instances where primed lymphocytes responded significantly to allogeneic stimulating cells at lower cell densities, the responses were considered positive and the stimulating cells positive for the PL determinant. In several instances, primed lymphocytes responded significantly to allogeneic stimulators negative for the specific HLA-D and/or HLA-DR specificities. On the other hand, in experiments where allogeneic stimulating donors shared either HLA-D or DR specificity with the priming donor, a significant response was always observed. Thus, the PL determinant was present on stimulating allogeneic cells negative for specific HLA-D and DR specificities. The present data suggest that an analysis of the specificity of primed populations could be profoundly affected by the responder cell density at which the assay is performed. Also, the data suggest that other MHC determinants, including non-HLA loci may be important in secondary MLC.

Chromosome Mapping↗
PubMed1978

The use of low ionic strength solution (LISS) in elution experiments and in combination with papain-treated cells for the titration of various antibodies, including eluted antibody.

The investigation presents evidence for the value of suspending red cells in a low ionic strength medium for elution experiments since this has the effect of increasing the uptake of antibodies by the red cells. In addition it has been shown that for the titration of low affinity antibodies, and also of eluted antibodies, the combining capacity of which may be impaired through the elution process, it is an advantage to use a LISS-enzyme (papain) technique.

Antigen-Antibody Reactions↗