Diagnosis of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis

BACKGROUND: The diagnosis of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF) patients may be difficult to establish because ABPA shares many characteristics with coexisting atopy or other lung infections in these patients. This study aimed to evaluate the sensitivity and specificity of various paraclinical parameters in the diagnosis of ABPA in patients with CF. METHODS: Accumulated data from a 5-year period in 238 CF patients were used to divide patients into two groups designated the ABPA group (n=26) and the non-ABPA group (n = 35). Patients in both groups were colonized with Aspergillus fumigatus (Af.), but only the ABPA group consistently demonstrated specific IgE antibodies and specific precipitins. Patients without A. fumigatus colonization were not assigned to either of these groups (n = 177). By this selection as the true diagnosis, 10 patients were selected from the ABPA group and 10 patients from the non-ABPA group. RESULTS: The groups were comparable as to age, sex, lung function (P=0.6), and presence of chronic Pseudomonas aeruginosa infection (P>0.1). No significant difference between the groups in unspecific atopic parameters such as eosinophil count (P=0.9) or eosinophil cationic protein (ECP) in sputum, plasma, or serum (P=0.9, P=0.59, and P = 0.9, respectively) was demonstrated. Total IgE was significantly higher in the ABPA group (P<0.01). The groups were comparable in skin prick test (SPT) positivity to a standard panel of aeroallergens (pollen, dander, molds, and mites) (P>0.2). Statistically significantly higher levels in the ABPA group were demonstrated in specific IgE to Af. (P < 0.05), SPT positivity to Af. (P < 0.02), and Af. precipitins (P < 0.05). Histamine release (HR) to Af. tended to be higher (P=0.075) in the ABPA group. Specific IgE to Af. was determined by Magic Lite (ML), CAP, and Maxisorp (in-house RAST). The CAP level was one to two classes higher than the ML level; however, the results were comparable (r=0.66, P<0.005). IgE to Af. measured by CAP was the test which offered the highest positive predictive value (PPV) and negative predictive value (NPV). Optimal diagnostic cutoff levels for the diagnosis of ABPA were determined: class 2 for HR to Af., 200 kIU/l for total IgE, and 3.5 (titer) for precipitating antibodies to Af., and class 2 for IgE to Af. (by CAP System). CONCLUSIONS: Unspecific atopy markers were of limited value for the diagnosis of ABPA. Patients with ABPA do not seem to be more atopic to other aeroallergens than non-ABPA patients. The most valid parameters for the diagnosis of ABPA in CF are SPT to Af., IgE to Af. in combination with precipitating antibodies to Af., and/or total IgE.     

肾综合征出血热病毒特异性双价纯化免疫血清F（ab）2的制备和临床治疗应用

１９８８年至１９９１年对收治的发病５日以内的肾综合征出血热（ＨＦＲＳ）病人应用姬鼠型ＨＦＲＳＶ陈株及家鼠型ＨＦＲＳＶＲ２２株，免疫猪所制备的特异性双价纯化免疫血清Ｆ（ａｂ）２（称Ｆ（ａｂ）２血清），治疗ＨＦＲＳ病人６５例作为研究组，以４４例作为对照组。治疗结果表明：①球结膜水肿渗出减轻，２４小时出血减轻；②白细胞病毒抗原消失迅速；③研究组出院平均早９．１天；④在洽疗后２、４日，对照组的特异性免疫荧光ＩｇＭ抗体明显高于研究组的。⑤其他实验室检测指标都以研究组为优。提纯后的免疫血清Ｆ（ａｂ）２无抗体－介导反应，无副作用及过敏反应。它含有特异性中和抗体及其他免疫因子，可中和清除体内的病毒抗原，减轻病毒血症及毛细血管壁的损伤，阻断病情发展，促进病情恢复。     

动脉粥状硬化与血清中磷脂酰胆碱特异性磷脂酶C活性的相关性研究

炎症在动脉粥状硬化(AS)形成过程中起关键作用,PC-PLC在炎症反应中扮演重要角色。为探讨PC-PLC活性与动脉粥样硬化的关系,本研究建立了动脉粥状硬化家兔模型,并用解毒活血颗粒灌胃,分别获得正常家兔血清、造模家兔血清和药物家兔血清,检测其中PC-PLC的活性。结果表明,造模组中钙离子依赖性和非钙离子依赖性两种PC-PLC活性均明显高于正常组,而加药组中这两种PC-PLC活性受到显著抑制。说明伴随动脉粥样硬化的发生,PC-PLC活性明显升高,而活血解毒颗粒能减轻动脉粥样硬化的程度,同时能显著抑制PC-PLC活性。     

Metastatic prostatic carcinoma presenting as left-sided cervical lymphadenopathy: a series of 11 cases

Eleven cases of metastatic prostatic carcinoma in cervical lymph nodes as a primary presenting sign were identified in a survey of 250 cervical lymph node biopsies from men. The diagnosis was clinically unsuspected in all cases. All occurred on the left side of the neck. These 11 cases represented 11% of all metastatic carcinomas in the neck and 20% of those with left-sided involvement. The diagnosis was readily confirmed by immunostaining for prostate specific antigen and prostate specific acid phosphatase. Six patients are alive and well at an average of 25.8 months and five others survived for an average of 34.4 months, the combined survival being 29.7 months. This contrasts with the dismal fate of patients with metastatic adenocarcinoma from other sites who all died at an average of 2 months from diagnosis. Prostatic carcinoma should always be considered in the differential diagnosis of metastatic carcinoma in cervical lymph nodes in elderly men, as appropriate treatment results in worthwhile prolongation of life.     

Immunohistochemical study of neuron specific enolase and S-100 protein in Hirschsprung's disease

Summary The distribution of whole differentiated neurons in the intestines from 15 children with Hirschsprung's disease was investigated using neuron specific enolase (NSE) and the perineuronal elements were studied using S-100 protein immunostaining.In aganglionic segments, NSE immunoreactive ganglion cells and S-100 positive satellite cells were absent, but the hypertrophic nerve trunks did show a markedly positive NSE and S-100 immunoreactivity.Two different forms of aganglionic segment were present. One was the middle aganglionic segment of long segment aganglionosis which was almost completely dennervated. In the other type, there were several NSE positive nerve fibers in the muscularis propria of both the aganglionic segment of short segment aganglionosis and the distal aganglionic segment of long segment aganglionosis. These latter two aganglionic segments seemed to be innervated by extrinsic nerves.     

Effects of Killed and Live Attenuated Influenza Vaccine on Symptoms and Specific Airway Conductance in Asthmatics and Healthy Subjects

Killed and live influenza virus vaccines were given to asthmatics and healthy subjects to investigate symptoms and alterations in their respiratory performance after vaccination. Polyvalent killed influenza virus vaccine was given to 16 asthmatics and live attenuated influenza virus vaccine to 23 asthmatics and 21 healthy subjects. Fourteen of the 16 asthmatics vaccinated with the killed vaccine displayed a significant rise in serum antibody level as measured by a single radial haemolysis in gel (SRH test). 11 of the 23 asthmatics and 14 of the 21 healthy subjects vaccinated with the live attenuated vaccine displayed a significant rise in the SRH test. Among the subjects with no measurable initial antibodies and with a significant rise in the SRH test, one asthmatic vaccinated with the killed vaccine experienced symptoms of common cold with fever and dyspnoea 1 week after vaccination. Three asthmatics and four healthy subjects vaccinated with live attenuated vaccine experienced mild symptoms, mainly rhinorrhoea, cough and sore throat 2 to 3 days after vaccination. No alterations in specific airway conductance in asthmatics or in healthy subjects were observed. We conclude that both killed and live attenuated influenza virus vaccines are tolerated well by asthmatics and appear to be safe for asthma patients.     

胃肠道癌患者血清中抗癌胚抗原(CEA)抗体的检测及意义

目的：探讨循环中抗癌胚抗原（ＣＥＡ）特异性抗体的情况，评价ＣＥＡ及抗体的联合检测在胃肠道癌诊断中的作用。方法：用放免法检测血清中 ＣＥＡ含量，用酶联免疫吸附法（ＥＬＩＳＡ）检测抗 ＣＥＡ ＩｇＧ抗体，用竞争抑制法检测抗体的特异性。结果：胃肠道癌患者血清 ＣＥＡ含量升高者（≥１５ ｎｇ／ｍｌ）为 ３０．９％（２１／６８），抗 ＣＥＡ ＩｇＧ抗体阳性者为３５．３％（２４／６８），ＣＦＡ及抗 ＣＥＡ抗体的联合检测可使阳性率提高到５４．３％（３７／６８）；胃肠道良性疾病患者（多发性息肉、溃疡、胰腺炎等）血清ＣＥＡ升高者为３．３％（１／３０），抗 ＣＥＡ　ＩｇＧ抗体阳性者为 ３．３％（１／３０）；健康对照组血清 ＣＥＡ升高者为 ０，抗 ＣＥＡ ＩｇＧ抗体阳性者为 ２．５％（１／４０）。结论：胃肠道癌患者血清中抗癌胚抗原（ＣＥＡ）抗体的检出率较高，这些抗体可作为胃肠道癌的一种肿瘤标志物。     

Miscibility and Intermolecular Specific Interactions in Blends of Poly(hydroxyether sulfone) and Poly(N‐vinylpyrrolidone)

Summary: The blends of poly(hydroxyether sulfone) (PHES) with poly(N‐vinylpyrrolidone) (PVPy) were investigated by means of differential scanning calorimetry (DSC) and FTIR spectroscopy. The miscibility of the blend system was established on the basis of the thermal analysis results. DSC showed that the PHES/PVPy blends prepared by casting from N,N‐dimethylformamide (DMF) possessed single, composition‐dependent glass transition temperatures, indicating that the blends are miscible in the entire composition. The experimental glass transition temperatures have higher values than those calculated on the basis of additive behavior; the variation of the glass transition temperatures of the blends was accounted for by the Kwei equation. FTIR studies indicate that competitive hydrogen bonding interactions exist upon addition of PVPy to the system, which were involved in the self‐ and cross‐association, i.e., ? OH···O?S, ? OH···OH of PHES and ? OH···O?C< of PVPy. The FTIR spectra in the range of the sulfonyl stretching vibrations showed that the hydroxyl‐associated sulfonyl groups are partially “set free” upon addition of PVPy to the system. The IR spectroscopic investigation of both the model compounds and the PHES/PVPy blends suggests that the strength of the hydrogen bonding interactions in the blend system increases in the following order: ? OH···O?S, ? OH···OH and ? OH···O?C<.

Plot of glass transition temperature for PHES/PVPy blends as a function of weight fraction of PVPy. The prediction of the Kwei equation yields the values of k = 1 and q = 122.     

Experimental rat model for therapeutic retinal pigment epithelium transplantation—unequivocal microscopic identification of human donor cells by in situ hybridisation of human-specific Alu sequences

Transplantation of retinal pigment epithelial (RPE) cells is discussed as a possible therapeutic approach for retinal degeneration. Xenogeneic transplantation of human RPE cells in animal models has been studied extensively. Various methods have been used to identify the graft cells, but these methods interfere with cell behaviour so that the monitored physiological post-transplantation course may be influenced. In the present study, we applied a method for an unequivocal identification of the graft cells without interfering cell metabolism or behaviour using in situ hybridisation (ISH) of human specific Alu sequences. Visualisation of the strong extended nuclear signal of Alu sequences was much easier than that of the small nuclear signals of donor-specific sex chromosome probes. With Alu probe, even single graft cells can be identified and their development can be observed in short-term and long-term studies. With this procedure, we could prove that donor cells were injected correctly into the subretinal space by a special injection technique that we developed previously. In combination with immunohistochemistry, donor cells could be clearly discriminated from macrophages, which contained phagocytosed donor cell fragments. Application of these ISH methods for species-specific identification was valuable for follow-up-studies of RPE transplantation.