Oligoclonal immunoglobulins in HIV infection

We tested 150 patients infected with human immunodeficiency virus (HIV) for the presence of oligoclonal bands in serum, prompted by reports that these abnormal proteins may have prognostic significance. Sixty HIV-negative individuals from "at-risk" groups were tested along with 80 HIV-negative, healthy blood donors for the presence of these bands. All sera were tested by isoelectric focusing, because it is more sensitive for this purpose than more-conventional electrophoretic techniques. In the HIV-positive group, 61% of the sera had oligoclonal bands; in the HIV-negative "at-risk" group, 36% had bands. No bands were detectable in sera from the healthy blood-donor group. Some patients were also followed for differing periods throughout their infection, and changes in their oligoclonal banding patterns could not be correlated with disease progression. The fact that oligoclonal bands were found to be present without HIV infection in a substantial number of individuals from within the "at-risk" groups leads us to conclude that the presence of oligoclonal bands in HIV infection is of limited prognostic significance.     

Oligoclonal immunoglobulins in serum of patients with chronic viral hepatitis

Zone electrophoresis on agarose gel was performed in serum samples from patients with chronic viral hepatitis. On the basis of the clinical, serological, and biochemical evaluation, the patients were divided into three categories: chronic type B hepatitis; chronic type delta hepatitis; and chronic non-A-non-B (NANB) hepatitis. The results of the electrophoretic analysis showed a high incidence of oligoclonal immunoglobulin bands (OIBs) in patients with chronic B hepatitis and chronic delta hepatitis and a low incidence of OIBs in patients with NANB. Since other biochemical and serological characteristics are variable and do not correlate with clinical symptoms of disease, we suggest that oligoclonal immunoglobulins could be used as a marker to aid in studies of the natural history and pathologic course of the various types of chronic hepatitis.     

Daily variation of lipids and hormones in sera of healthy subjects.

The physiological day-to-day variation of selected hormone and lipid concentration values in sera of healthy subjects was studied. We drew blood specimens from 14 healthy volunteers, aged 22 to 40 years, (8 male and 6 female) at 0800 h on six separate days over a ten day interval. On one occasion all the twelve specimens from each subject (6 days X 2 replicates) were assayed for the hormones: thyroxine and cortisol; and the lipips: cholesterol and triglyceride which were analyzed by enzymatic methods. The assays were performed on one occasion in order to eliminate the batch-to-batch analytical variation which would tend to blur the physiological day-to-day variation. Using an analysis of variance technique, the total variation was separated into the physiological intraindividual day-to-day variation, the biological inter-individual variation, and the within-batch analytical variation. The mean physiological day-to-day variations in terms of percent coefficient of variation were 7.5% for thyroxine, 26.6% for cortisol, 4.8% for cholesterol, , and 25.0% for triglycerides.     

Testing of maternal sera in pregnancies at risk for neonatal alloimmune thrombocytopenia

The utility of prenatal testing of maternal serum for platelet-reactive antibody was assessed in 25 women at risk of delivering infants with neonatal alloimmune thrombocytopenia (NAT). Seventeen women were incompatible with their husbands for the PlA1 antigen and three for Baka; in five families, no demonstrable platelet-specific antigen incompatibility was found. Analysis of the clinical outcome demonstrated that women with platelet-specific antibody detectable in any of the assays at any time during gestation were at risk of delivering thrombocytopenic infants (neonatal platelet count 31,250/microliters if mother did have antibody, as compared with 138,750/microliters if she did not; p less than 0.005). When only PlA1-incompatible pregnancies were examined, this association remained significant (mean neonatal platelet count in infants exposed to anti-PlA1, 34,285/microliters; that in infants not so exposed, 243,000/microliters; p less than 0.001). Changes in antibody strength throughout pregnancy did not correlate with the severity of NAT. The combination of the antigen-capture enzyme-linked immunosorbent assay and the indirect immunofluorescence test appeared to be most sensitive in detecting relevant platelet-specific alloantibodies. It is concluded that the detection of platelet-specific alloantibody in maternal serum in pregnancies at risk for NAT predicts moderate to severe NAT. However, the failure to detect such antibody does not always predict a normal neonatal platelet count.     

Cellular activity in healthy subjects with cardiovascular integral risk factors

The study was made of permeability of erythrocytic membrane (PEM), electrokinetic properties of cellular nucleus (ECN) and phagocytic activity of neutrophils (PAN) in whole blood of 130 healthy subjects with integral risk factors of cardiovascular disease. First-level test immunogram was analysed. Hypercholesterolemia and hyperbetalipidemia were associated with high PAN. Obese patients with cardiovascular hereditary load had elevated PAN and PEM. In smokers PEM was elevated but ECN was subnormal, PAN rose in parallel with number of cigarettes smoked for a day. Combination of the risk factors led to low activity of the nucleus and high PAN. It is concluded that healthy subjects with integral risk factors develop changes in functional cell activity.     

Activities of aspartate and alanine aminotransferases and alkaline phosphatase in sera of healthy subjects.

The activities of serum aspartate aminotransferase (EC 2.6.1.1, L-aspartate: 2-oxoglutartate aminotransferase, ASAT) and alanine aminotransferase (EC 2.6.1.2, L-alanine: 2-oxoglutarate aminotransferase, ALAT) were determined in the sera of 1484 apparently healthy subjects using kinetic methods according to the Scandinavian recommendation (33). In the adult sera the mean activity of ASAT was 21.4     

Analysis of purine nucleotides in lymphocytes from healthy subjects and AIDS patients.

The most important purine nucleotides (NAD, AMP, IMP, GMP, XMP, ADP, ATP, GDP, GTP) were analyzed by HPLC in the lymphocytes of healthy subjects and HIV-1 seropositive patients at different stages of the disease (ARC-AIDS). Several differences, which focus attention on the behaviour of purine nucleotide metabolism in the lymphocytes of these patients, were observed.     

Arrhythmic risk evaluation during exercise at high altitude in healthy subjects: role of microvolt T-wave alternans

Background: Altitude‐induced sympathetic hyperactivity can elicit rhythm disturbances in healthy subjects, in particular during exercise. Aim: To asses the real susceptibility of healthy myocardium to malignant ventricular arrhythmias during exercise at high altitude using microvolt T‐wave alternans (MTWA). Methods: We evaluated eight healthy trained participants (one female, 42 ± 9 years) during a mountain climbing expedition on Gashembrum II (Pakistan, 8,150 m). MTWA and heart rate variability (HRV) were measured in each subject at sea level and at high altitude, both under rest conditions and during exercise. MTWA was determined with the modified moving average method. HRV was expressed as root mean square of successive differences. Results: Rest HRV at high altitude was significantly lower compared to rest HRV at sea level (36 ± 5 vs 56 ± 9 ms, P = 0.003). HRV during exercise was significantly lower with respect to rest condition both in normoxia (46 ± 7 vs 56 ± 9 ms, P = 0.0001) and hypoxia (27 ± 4 vs 36 ± 5 ms, P = 0.005). Moreover, HRV was significantly lower during exercise at high altitude compared to exercise at sea level (27 ± 4 vs 46 ± 7 ms, P = 0.0002) and arrhythmias were more frequent during exercise in hypoxia. Nevertheless, MTWA was absent under rest conditions both at sea level and at high altitude and minimally evoked during exercise in both conditions (22 ± 3 μV and 23 ± 3 μV, respectively, P = 0.2). Conclusions: In spite of an enhanced sympathetic activity, MTWA testing during exercise at high altitude was negative in all participants. Healthy trained subjects during exercise under hypoxia seem to be at low risk for dangerous arrhythmias.     

健康体检人群脉搏波传导速度及其相关因素分析

目的 健康体检人群脉搏波传导速度(pulse wave velocity,PWV)及其相关因素分析.方法 入选健康体检323人,根据PWV水平分为两组:对照组(PWV＜9 m/s)37人,观察组(PWV≥9m/s) 286人.PWV由Complior仪器测定.结果 观察组人群高血压发病率显著高于对照组.观察组收缩压、舒张压、脉压、甘油三酯水平均显著高于对照组[(141.2±19.9) mmHg比(129.0±18.8)mmHg,P＜0.001; (88.4± 11.1) mmHg比(82.1±10.8) mmHg,P=0.001; (52.8±12.9) mmHg比(46.8±10.6) mmHg,P=0.007;(2.13±1.64) mmol/L比(1.19±0.73) mmol/L,P＜0.001)].观察组高密度脂蛋白胆固醇(HDL-C)水平显著低于对照组[(1.26±0.37) mmol/L比(1.51±0.40)mmol/L,P=0.002)].相关性分析提示总体人群中PWV与年龄、收缩压、舒张压、脉压、血糖、糖化血红蛋白、尿酸、甘油三酯呈显著正相关性(γ=0.124,0.307,0.259,0.255,0.187,0.340,0.169,0.278,均P＜0.05),而与HDL-C呈显著负相关性(γ=-0.283,P＜0.001).多元线性回归分析提示PWV与收缩压、糖化血红蛋白有关(β=0.314,P=0.003;β=0.307,P=0.003).结论 PWV是动脉僵硬度的评价指标,高密度脂蛋白胆固醇可能参与了其中的保护作用,具体机制有待于进一步探讨.     

AIDS and AIDS-related conditions: screening for populations at risk

Since its onset, the acquired immunodeficiency syndrome (AIDS) epidemic has been associated with certain subgroups in the U.S. population. These include gay and bisexual men, intravenous drug users, hemophiliacs and blood product transfusion recipients. Members of these groups feeling either well or unwell may present themselves at clinics with a high level of anxiety regarding AIDS. Their needs for clinical evaluation of symptoms, education and reassurance, or further referral may be acute. The experience of the AIDS screening clinic at the AIDS/oncology clinic at San Francisco General Hospital has led to the development of protocols for nurse practitioners to use in screening members of AIDS risk groups, both the "worried well" and those who are symptomatic. This is a presentation of the clinic's screening history and physical examination criteria, including the markers of suspicion and algorithms of diagnostic studies that have been useful tools in the clinic.     

Contingent negative variation in subjects at risk for migraine without aura.

Migraine is a complex disease with a significant genetic background. One possible strategy to investigate the genetics of migraine is the evaluation of functional vulnerability markers or biological elementary endophenotypes in individuals with the greatest probability of developing the disorder (high-risk design). In this study the contingent negative variation (CNV) was recorded in 35 high-risk subjects with a positive family history of migraine without aura (FHP), 35 low-risk individuals without a positive family history (FHN), and 35 migraineurs (migraine without aura). FHP subjects and migraine patients differed significantly from FHN individuals with regard to amplitude and habituation slope of the early CNV component (initial CNV or iCNV). FHP participants demonstrated the same iCNV abnormalities and distribution among iCNV characteristics as migraineurs. The amplitude of the iCNV correlated significantly with the relative number of subjects suffering from migraine among first- and second-degree relatives. The higher the density of affected individuals in the family, the more pronounced were the CNV abnormalities in relatives. This study provides evidence that the familial factor contributes to the abnormal amplitude, and to a lesser degree, habituation of the iCNV, and that the iCNV may be used as a functional-genetic vulnerability marker in further research of migraine genetics.     

Anti-adrenal medullary antibodies in IDDM subjects and subjects at high risk of developing IDDM

Previous reports have noted the presence of anti-adrenomedullary antibodies in subjects with insulin-dependent diabetes mellitus (IDDM). We initiated a study to evaluate the presence of complement-fixing anti-adrenomedullary antibodies (CF-ADM) in the following subjects: group 1 (age 4-60 yr), anti-islet cell antibody-positive (ICA+) subjects at high risk of developing diabetes, in which 9 (32%) of 28 were positive for CF-ADM; group 2 (age 6-41 yr), anti-ICA negative (ICA-) subjects at high risk of developing diabetes, in which 0 (0%) of 15 were positive for CF-ADM; group 3 (age 1-58 yr), ICA+ diabetic subjects, in which 7 (30%) of 23 were positive for CF-ADM; group 4 (age 5-68 yr), ICA- diabetic subjects, in which 1 (4%) of 24 was positive for CF-ADM; group 5 (age 20-56 yr), volunteer blood bank donor controls, in which 2 (6%) of 32 were positive for CF-ADM; and group 6, known healthy controls, in which 0 (0%) of 14 were positive for CF-ADM. CF-ADM were increased in group 1 compared with group 2 (P less than .02) and both control groups (P less than .02). CF-ADM were increased in group 3 compared with group 4 (P less than .03) and both control groups (P less than .03 vs. group 5, P less than .05 vs. group 6). Presence of CF-ADM was associated with presence of ICA in group 1 (P less than .02) and group 3 (P less than .03).(ABSTRACT TRUNCATED AT 250 WORDS)     

泊沙康唑在健康志愿者肺组织中的药动学与药效学研究

泊沙康唑是一种具有广谱抗菌作用的三唑类抗真菌药,对曲霉、隐球菌、念珠菌、组织胞浆菌及酵母等有效。美国已批准泊沙康唑的适应证包括：在应用免疫抑制剂患者中的侵袭性曲霉病和念珠菌病的预防性用药,及难治性口咽部念珠菌病的治疗,而将泊沙康唑用于肺部及其他弥漫性真菌病的治疗尚处于临床研究阶段。作者以一项前瞻性、开放的临床试验进行了泊沙康唑在健康志愿者肺组织中的药动学／药效学（PK／PD）研究。     

厦门市艾滋病高危人群规模估计及疫情评估

目的估计厦门市艾滋病各类高危人群的规模和艾滋病感染者人数,为艾滋病防治工作提供依据。方法依据厦门市10余年来积累的艾滋病监测及调查的基线数据,运用Work-book法,估计厦门市艾滋病高危人群基数,评估艾滋病疫情。结果估计厦门市现有艾滋病高危人群73239～189522人,估计艾滋病感染者约914人。结论厦门市艾滋病仍处于低流行的状态,但高危人群规模较大,应有针对性地开展干预和防控。     

Variability of FeNO in healthy subjects at 2240 meters above sea level

Fraction of exhaled nitric oxide (FeNO) is a marker of eosinophilic airway inflammation. Altitude above sea level can affect measurements of this index, but there is only limited information regarding the diurnal variation (ante meridiem vs. post meridiem) and reproducibility of FeNO on consecutive days at moderate altitudes. To evaluate the diurnal variability of FeNO and assess its reproducibility over five consecutive days in healthy individuals living at 2240 m, and to compare the FeNO readings taken with two different analyzers. Healthy non-smoking adults were measured using NIOX MINO^® or NOA 280i^® devices. One group (n = 10) had readings taken morning and afternoon for five consecutive days with the NIOX MINO^® equipment; while the second group (n = 17) was measured on only one morning but by both the electrochemical analyzer (NIOX MINO^®) and the chemiluminescence method (NOA 280i^®). The study group consisted of 27 subjects aged 28.7 ± 6 years. Morning and afternoon FeNO measurements were 15.2 ± 7.5 ppb and 15.2 ± 7.9 ppb (p = 0.9), respectively. The coefficient of variation (CV) of these measurements (a.m. vs. p.m.) was 10.7 %, and the coefficient of repeatability (CR), 4.2 ppb. The concordance correlation coefficient (CCC) between the two measures (morning vs. afternoon) was 0.91. The CV and CR of the five morning readings were 15.4 % and 4.3 ppb, respectively; while those of the five afternoon measures were 13.6 % and 3.5 ppb, respectively. The CCC between the NIOX MINO^® equipment and the NOA-280i^® device was 0.8, with 95 % limits of agreement of ?8.35 to 0.29 ppb. In adults living at 2240 m above sea level, FeNO measurements show minimal diurnal variation, and readings are reproducible (<15 %) over a period of at least five consecutive days; however, the FeNO measurements obtained with the NIOX MINO^® and NOA 280i^® devices are not interchangeable due to the wide limits of agreement recorded.