Composition of the Inflammatory Infiltrate in Pediatric Penile Lichen Sclerosus Et Atrophicus (Balanitis Xerotica Obliterans): A Prospective, Comparative Immunophenotyping Study

Dermatopathological evaluation of pediatric preputial inflammatory disease rarely allows for specific diagnosis other than pediatric penile lichen sclerosus et atrophicus (balanitis xerotica obliterans, LSA/BXO). A prospective immunopathological study was performed on 20 consecutive, unselected, clinically and histopathologically confirmed LSA/BXO cases to determine the relative presence of T and B lymphocytes. There were seven cases with early stages of disease, eight with florid disease, and five with later stages of disease. Two ritual circumcision specimens and 12 specimens with non-LSA/BXO balanitis, collected during the same period, were used as controls. The infiltrate in LSA/BXO patients was wholly composed of T cells (positive with UCLH-1 antibody) in all cases. B cells (positive with L-26 antibody) were found only focally in small, discreet, easily recognizable (follicular or early follicle-like) aggregates, positioned slightly deeper than the band-like infiltrate of T cells. T cells were inconspicuous in 9 of the 12 control specimens. In the three other controls, T cells were much more obvious and these patients showed clinical features possibly suggestive of LSA/BXO in early, fiediagnosable phases of development. We conclude that limited immunophenotyping may be a useful adjunct to diagnosis in pediatric cases in which onb limited tissue is available 07 the disease may be m e difficult to classify with confidence.     

IgG and IgM Antibody Responses to Pneumococcal Vaccination in Splenectomized Children and in Children Who Had Non-Operative Management of Splenic Rupture

ABSTRACT. The IgG and IgM type specific anticapsular pneumococcal antibody titres were studied with ELISA during one year following vaccination with a 14-valent pneumococcal polysaccharide vaccine in four different patient groups: 41 children splenectomized after a traumatic rupture, 16 splenectomized because of disease, 15 non-surgically managed after splenic rupture, and 19 healthy controls. Serum samples were obtained before vaccination and after 14, 60, 180, and 360 days. The IgG antibody responses were equally good in all of the patient groups, while the IgM antibody responses were less pronounced in the splenectomized. In the non-surgically managed patients, the IgM antibody titres after vaccination, as well as antibody responses per se, were significantly higher for all 12 pneumococcal types studied than in the patients who were splenectomized. Both the IgG and the IgM antibody titres were highest at 14 days after vaccination. However, while the IgG titres for most pneumococcal types remained elevated at 360 days, the IgM titres soon fell to prevaccination levels. The antibody response was less good for the types 3 and 6 A. The results indicate that the IgG antibody response to pneumococcal polysaccharide vaccination is unaffected in splenectomized individuals, but the IgM antibody response is decreased. In patients with a healed traumatically damaged spleen, both the IgG and IgM responses seem to be normal.     

肾病综合征婴幼儿发生院内感染的因素分析

目的分析肾病综合征(NS)婴幼儿发生院内感染的因素。方法对2005年1月-2007年10月在本院住院的NS婴幼儿的性别、住院时间、血清清蛋白(抽血2 mL,3 000 r.min-1离心10 min后吸取血清,采用溴甲酚绿法测定其血清清蛋白水平)、尿蛋白排出量(留取24 h尿液,采用邻苯三酚红钼法测定尿蛋白水平)、IgG(抽血2 mL,3 000 r.min-1离心10 min后吸取血清,采用免疫散色比浊法测定其血清IgG水平)、肾脏病理类型及免疫抑制剂的使用等因素进行分析,探讨其与院内感染发生的相关性。结果1.住院时间≥30 d者,院内感染发生率(86.6%)显著增高(P<0.05);2.血清清蛋白水平<20 g.L-1者更易发生院内感染;3.24 h尿蛋白排出量≥100 mg.kg-1.d-1者的院内感染发生率(63.6%)显著高于<100 mg.kg-1.d-1者(24.6%)(P<0.05);4.联用免疫抑制剂者院内感染率(60.0%)显著高于单用泼尼松者(31.7%)(P<0.05);5.血清IgG在患儿该年龄段IgG正常值下限75%以下者,其院内感染发生率显著增高(P<0.05)。结论NS婴幼儿院...