Diagnosis of renovascular disease by extra- and intrarenal Doppler parameters

It is still a matter of debate as to which parameters should be used for noninvasive diagnosis of renovascular disease by renal Doppler sonography (RDS). The accuracy of RDS in the detection of renal artery stenosis (RAS) was tested in 95 consecutive, moderate to severe hypertensive patients (I-II World Health Organization [WHO] stages). Reno-aortic ratio (RAR) for peak systolic velocity (PSV) was also calculated to assist in the diagnosis of significant (>50%) RAS. Paired receiver-operating characteristic (ROC) analysis was plotted for evaluating the relationship between sensitivity and specificity for each parameter. In a subset of 57 kidneys, the influence of blood pressure and age on intraparenchymal parameters was evaluated. Measurements of maximal peak systolic velocity (PSV) at the site of stenosis, RAR for PSV, and minimum acceleration index in the main renal artery showed high accuracy (areas under the ROC curve 0.97, 0.88, and 0.80, respectively). Among intraparenchymal parameters, early systolic acceleration showed the best area under the ROC curve (0.90), but provided a low positive predictive value (29%) and was significantly influenced by blood pressure (multiple r=0.56; p=0.001). Pulsatility and resistive indices were found to be less powerful as absolute values, and both significantly influenced by blood pressure and age (multiple r=0.60 and 0.50; p=0.001, p=0.02, respectively). However, interindividual variance of intrarenal indices should be minimized by calculation of side difference, although this procedure would become misleading or impossible in patients with bilateral RAS or a single kidney, respectively. These results support the use of extraparenchymal parameters for noninvasive detection of RAS, and emphasize that intrarenal parameters cannot be considered as absolute values.     

Prognostic risk assessment in primary breast cancer by behavioral and immunological parameters.

Investigated the predictive power of an immunologic effector cell, the natural killer (NK) cell, as well as selected psychological and demographic factors, to breast cancer prognostic risk status. 75 women (aged 28–74 yrs) with Stage I or II breast cancer were interviewed about their perceptions, attitudes, and interpersonal support. Ss also completed the SCL-90 and the Profile of Mood States. Blood was then drawn to assay NK functional activity. All assessments took place after surgery. It was found that NK activity predicted the status of cancer spread to the axillary lymph nodes. Ss who had low levels of NK activity were rated as well-adjusted to their illness; Ss who had higher NK activity appeared to be distressed or maladjusted. Findings are discussed in the light of recent animal findings linking environmental stress and behavioral responsiveness to biological vulnerability via endocrine and immune pathways. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between parasitical inoculum and immunological parameters in experimental toxocariasis

Swiss female mice were inoculated with different infective doses of Toxocara canis eggs to evaluate the percentage of recuperated larvae in different organs and immunological parameters such as spleen index (SI), liver index (LI) and lung index (LuI) and blood eosinophilia during 3 weeks post infectionem (p.i.) with only one challenge. It was found that T. canis larvae arrived at the liver between 10 and 15 hours p.i. by the food-fishhook technique. When the inoculum was more than 200 eggs, there was a reinvasion of liver and lungs at 504 hours p.i. The larval arrival at the brain was delayed in an inverse relationship to the inoculum but the percentage of recovery was about 7 and 8%. The organic indexes were in a direct relationship with the inoculum size and the increase in eosinophilic levels in massive infections (2000 eggs) was in agreement with a strong immune response.     

Atypical mycobacterial pulmonary disease and bronchial obstruction in HIV-negative children

Atypical mycobacterial infection in HIV-negative children usually presents with cervical lymphadenopathy. We report on 10 children who are HIV-negative and who presented with pulmonary disease, in whom either culture-proven atypical mycobacterium infection (four), positive avian Mantoux test (five), or lack of response to human tuberculosis treatment (one) had been observed. One case was subsequently diagnosed as chronic granulomatous disease and illustrates that children with atypical mycobacterial pulmonary infection should have their immune status fully investigated. Bronchial obstruction was observed in eight cases, and of these, endobronchial disease was found in six children. The diagnosis of atypical mycobacterial disease is difficult, and a negative avian Mantoux test does not exclude the diagnosis. The availability of clarithromycin and rifabutin has offered new therapeutic options in treating atypical mycobacterial pulmonary infection, but management of these cases can be prolonged and difficult.     

Nontuberculous mycobacterial cutaneous infection confirmed by biochemical tests, polymerase chain reaction-restriction fragment length polymorphism analysis and sequencing of hsp65 gene

We report a woman in whom a slow-growing scotochromogenic strain of Mycobacterium was cultured from skin lesions. According to its phenotypic and biochemical characteristics we could predict only that it might be M. szulgai, M. scrofulaceum or M. gordonae. Polymerase chain reaction amplification of the hsp65 gene and subsequent restriction fragment length polymorphism analysis on the isolated strain showed that its restriction pattern differed from both M. scrofulaceum and other scotochromogenic species. Ninety-nine per cent similarity was detected between the isolated strain and M. gordonae by sequencing of the hsp65 gene. This result suggests that the isolated strain may be either a slow-growing scotochromogenic Mycobacterium most resembling M. gordonae or a novel mycobacterial species.     

Variability of Alternaria alternata: biochemical and immunological characteristics of culture filtrates from seven isolates

Biochemical variability of culture filtrates from the common allergenic mold Alternaria alternata was studied. Differences between culture filtrates from 7 different isolates and between 4 batches of culture filtrate from the same isolate were observed, suggesting the unreliability of presently employed biochemical methods in the routine standardization of mold allergens and the possibility of difficulties in developing standard techniques for their purification. Dextranases, cellulases, and agarases, found in one culture filtrate, may be a further source of problems in laboratory techniques employing A. alternata. The proportions of nitrogen:carbohydrate:dialyzed dry weight were different in culture filtrates from each isolate. Polysaccharides in culture filtrates from 3 of the 7 isolated contained glucose, mannose, xylose, galactose, and a fifth, unidentified sugar. Polysaccharides from one isolate lacked xylose, and the fifth sugar was not demonstrable in 4 of the isolates. Despite the biochemical differences, extensive antigenic cross-reactivity between different isolates was found in precipitin studies and inhibition of antibody binding.     

Ulcerative colitis: an immunological disease?

Ulcerative colitis is an inflammatory disease of the large intestine of unknown aetiology. The nature of the inflammatory infiltrate together with the response to corticosteroids suggests that an abnormal immune response is at work. The key question of whether the immune system is responding to an abnormal breach in the mucosa due to another primary abnormality or whether the primary defect lies within the immune response itself has not been answered. Thus far, it is clear that both T and B cell compartments are involved in the persistence of inflammation but the initial interactions that take place in the mucosa in terms of antigen processing and presentation have not been adequately investigated. Those critical steps and potential defects that push T cells and B cells into a heightened state of activation need to be identified.     

Diagnosis of sickle-cell disease by DNA analysis in Nigeria

OBJECTIVE: To compare genotyping of leucocyte DNA by PCR and Dde I with the conventional genotyping of haemoglobin of the same subject. DESIGN: Comparative study. SUBJECTS: 25 adults, 16 males and nine females. MAIN OUTCOME MEASURES: Predictability. RESULTS: In all cases the results were comparable. CONCLUSIONS: The technology can be applied locally to prenatal diagnosis of sickle-cell disease by chorionic sampling and, therefore, improve the management of sickle-cell disease in Nigeria.     

Individual housing influences certain biochemical parameters in the rat

OBJECTIVE: A modified Abbe flap of the lambda figure type, designed by the author and used before or after secondary cleft lip repair in 146 consecutive cases since 1990 is described. DESIGN: This series consisted of 71 cases with unilateral deformity and 75 cases with bilateral deformity at adolescent or adult ages. The technical details of this method and representative cases with the results are shown. The philtrum is created by incising the two branches of the lambda flap obliquely at 45 degrees to the skin surface in the lower lip, then matching them in the central recipient bed of the deficient upper lip. RESULTS AND CONCLUSIONS: The resultant upper lip is not only full and slack, but also attractive with an acute cubic contour of the philtrum. Furthermore, the residual scar at the donor site is concealed in the mentolabial fold.     

Effects of lovastatin on natural killer cell function and other immunological parameters in man

Suppression of cholesterol synthesis by 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, such as lovastatin, has been shown to inhibit mitogen stimulated proliferation of natural killer (NK) cells and other lymphocytes in vitro. This effect is only partially overcome by provision of exogenous free or lipoprotein cholesterol but is reversed by mevalonate, suggesting that proliferating lymphocytes have a specific requirement for a nonsterol isoprenoid product of mevalonate. The effect of lovastatin (20 mg bid) on a range of immune function parameters was determined in a randomized, placebo-controlled, double-blind ex vivo study in 52 patients with primary hypercholesterolemia. No significant differences (P < 0.05) were found between lovastatin and placebo groups for basal NK or interleukin-2 (IL-2)-induced cell-mediated cytotoxicity, PHA-stimulated lymphocyte proliferation, or relative numbers of T lymphocytes (CD3+), B lymphocytes (CD19+), total NK cells (CD3-, CD16+, CD56+) and CD57+ NK cells or in immunoglobulin levels after 4 or 8 weeks of treatment. In contrast to previous in vitro data, no statistically or clinically significant changes were observed in any parameter of lymphocyte function in patients treated with lovastatin.     

Some normal biochemical parameters of pigs in Pupua New Guinea

The normal values of serum glutamic oxaloacetic transminase, serum glutamic pyruvic transaminase, serum lactic dehydrogenase and serum alkaline phosphatase, total protein, urea, creatine, cholesterol, glucose, magnesium, calcium and inorganic phosphorus were measured monthly over a 12-month period from 10 "pure" Native and 10 Native X British Crossbred pigs. Except for cholesterol, no significant difference was found between the two groups. Similar estimations were made for 5-month and 11-month Village pigs in which the serum alkaline phosphatase, inorganic phosphorus, total protein, urea, creatinine and calcium were significantly lower when compared with the corresponding age group of the pure Native pigs and Crossbred pigs. These lower values are thought to be due to the effects of the malnutrition-parasite complex of Village pigs.     

Diagnosis of Fabry's disease

On the basis of a study of 9 new cases of Fabry's disease (7 hemizygotes and 2 heterozygotes), the authors recall that the disease often presents as a painful syndrome of the extremities but its exact nature usually remains obscure for long periods. The association of such pain with angiokeratomas and the notion of a family history is highly suggestive of the disease. The biochemical possibilities in the diagnosis of the latter are described. All patients underwent transcutaneous renal biopsy. In the 7 hemizygotes and one of the heterozygotes, light microscopy revealed diffuse characteristic vacuolisation of the glomerular cells. In the other heterozygote, the glomerular lesions were very limited, seen only by electron microscopy.     

Immune response to recombinant mycobacterial proteins in patients with tuberculosis infection and disease

The capacity of four Mycobacterium tuberculosis recombinant antigens to elicit proliferation and cytokine production by human T cells was evaluated. Proliferative responses of peripheral blood mononuclear cells (PBMC) to all antigens were greater in healthy tuberculin reactors than in pulmonary tuberculosis patients, and proliferative responses of pleural fluid cells were greater than those of PBMC from patients with tuberculous pleuritis. The proliferative responses to the four recombinant antigens were similar in all patient groups, and there was no selective unresponsiveness to any antigen in pulmonary tuberculosis patients. The 38-kDa antigen induced less interferon-gamma than did the 10-, 30-, and 65-kDa antigens, and all four antigens induced similar amounts of interleukin-10. These results suggest that none of the four recombinant antigens are immunodominant, and that the 10-, 30-, and 65-kDa antigens are similar in their capacity to induce a potentially protective Th1-like response.