Serum p55 and p75 tumour necrosis factor receptors as markers of disease activity in juvenile chronic arthritis.

OBJECTIVE: To determine the expression of tumour necrosis factor alpha (TNF alpha) and its soluble receptors (p55 and p75) in the sera and synovial fluid of patients with juvenile chronic arthritis (JCA), and their correlation with disease activity parameters. METHODS: Ninety eight sera from 45 patients with JCA (14 systemic, 12 polyarticular, 19 pauciarticular), 20 sera from age matched healthy controls, and five synovial fluids from five antinuclear antibody (ANA) positive pauciarticular JCA patients were tested for the presence of TNF alpha, soluble TNF receptors p55 and p75 (sTNFRp55, sTNFRp75), and interleukin-6 (IL-6) by an enzyme amplified sensitivity immunoassay. Physician global estimate of disease activity, weekly fever score and joint score, C reactive protein (CRP), erythrocyte sedimentation rate (ESR), and haemoglobin concentration were evaluated as parameters of disease activity. The expression of p55 and p75 on peripheral mononuclear cells (MNCs) from five patients with systemic JCA and synovial MNCs from five ANA positive patients with pauciarticular JCA was evaluated by flow cytometry. RESULTS: TNF alpha serum concentrations did not differ significantly between the patients with active JCA and the control group. No correlation was found between TNF alpha and parameters of disease activity, but both p55 and p75 showed a significant positive correlation with the physician global estimate of disease activity (p < 0.001), ESR (p < 0.001), CRP (p < 0.001), and serum concentrations of IL-6 (p < 0.001). Serum concentrations of haemoglobin correlated inversely with the concentrations of p55 and p75 (p < 0.001). Synovial lymphocytes selectively expressed the p75 surface receptor. CONCLUSIONS: sTNFRp55 and sTNFRp75 each represent a sensitive marker of disease activity in JCA. Their increased expression in biological fluids may support the hypothesis that TNF alpha has a role in the pathogenesis of JCA.     

Modulation of ryanodine-induced contractures in human skeletal muscle pretreated with dantrolene

Dantrolene seems to be the causal therapy in malignant hyperthermia (MH) crisis but the complex mechanisms of MH and dantrolene therapy are still not fully understood. The influence of dantrolene on ryanodine-induced contractures has been reported in animal studies only. In the present study 20 patients from] 7 families were tested for MH using the protocol of the European Malignant Hyperthermia Group. In addition ryanodine-induced contractures were evaluated following bolus application of 10.0 μmol · 1^-1 ryanodine. After pretreatment with 1 μimol · 1^-1 dantrolene ryanodine-provoked contractures developed significantly later in MHS (15.8±1.8 min) and MHN (46.0±4.2 min) muscle specimens than after ryanodine alone (MHS 4.8±0.7 min), (MHN 13.7±0.9 min). They were no longer observed in either group after pretreatment with 5 μimol · 1^-1 dantrolene. We conclude that dantrolene is able to attenuate ryanodine-induced contractures dose-dependendy, and therefore it is speculated that dantrolene could specifically act at the ryanodine receptor binding site.     

The Presence of Insulin-degrading Enzyme in Human Ileal and Colonic Mucosal Cells

The aim of this research is to characterize the presence of insulin-degrading enzyme in human colon and ileal mucosal cells. Biochemical studies, including the activity-pH profiles, the effects of enzyme inhibitors, immunoprecipitation and western blots, were conducted. The majority of insulin-degrading activity in colon mucosal cells was localized in the cytosol. In both colon and ileum, cytosolic insulin-degrading activities had a pH optimum at pH 7.5, and were extensively inhibited by each of N-ethylmaleimide, p-chloromercuribenzoate, and 1,10-phenanthroline, but were very weakly affected by each of leupeptin, chymostatin, diisopropyl phosphofluoridate and soybean trypsin inhibitor. In the colon and ileum, more than 93% and 96%, respectively, of cytosolic insulin-degrading activities were removed by the mouse monoclonal antibody to human RBC insulin-degrading enzyme, as compared with less than 20% by the normal mouse IgG for both tissues. Further, a western blot analysis revealed that a cytosolic protein of 110 kD, in both human colon and ileum, reacted with the monoclonal antibody to insulin-degrading enzyme. It is concluded that insulin-degrading enzyme is present in the cytosol of human colon and ileal mucosal cells.     

Replication of Marburg virus in human endothelial cells. A possible mechanism for the development of viral hemorrhagic disease.

Marburg and Ebola virus, members of the family Filoviridae, cause a severe hemorrhagic disease in humans and primates. The disease is characterized as a pantropic virus infection often resulting in a fulminating shock associated with hemorrhage, and death. All known histological and pathophysiological parameters of the disease are not sufficient to explain the devastating symptoms. Previous studies suggested a nonspecific destruction of the endothelium as a possible mechanism. Concerning the important regulatory functions of the endothelium (blood pressure, anti-thrombogenicity, homeostasis), we examined Marburg virus replication in primary cultures of human endothelial cells and organ cultures of human umbilical cord veins. We show here that Marburg virus replicates in endothelial cells almost as well as in monkey kidney cells commonly used for virus propagation. Our data support the concept that the destruction of endothelial cells resulting from Marburg virus replication is a possible mechanism responsible for the hemorrhagic disease and the shock syndrome typical of this infection.     

Rational diagnosis and treatment in unclassified arthritis: how clinical data may guide requests for Lyme serology and antibiotic treatment.

To improve the appropriateness and efficiency of diagnostic serological tests and subsequent antibiotic treatment, clinical data from 102 patients with unclassified arthritis were analysed to investigate whether the presence of positive IgG antibodies to Borrelia burgdorferi could be predicted. The clinical data were blindly ranked from 1 to 4 (1, Lyme arthritis unlikely; 4, Lyme arthritis very likely). Antibodies to B burgdorferi were positive in nine of 102 patients (9%). Six of 15 (40%) patients with rank numbers 3 and 4 were positive for antibodies to B burgdorferi, in contrast with only three of 87 (3%) patients with rank numbers 1 and 2. The likelihood ratio of positive Lyme serology for patients ranked 3 and 4 was 12.0, for patients ranked 2 to 4, 4.5, and for patients with arthritis of the knee, 3.0. These likelihood ratios were associated with a post-test probability of 55, 30, and 20% respectively. The clinical history in patients with unclassified arthritis can largely predict the presence of antibodies to B burgdorferi. The absolute value of a likelihood ratio can be a contributing factor in deciding to request tests for antibodies to B burgdorferi in patients with unclassified arthritis.     

Bicycle helmet use by adults: the impact of companionship.

Most of the nearly 1,000 fatal bicycle-related injuries annually could be prevented if riders used safety helmets. Helmet use by adult bicyclists has received relatively little attention because educational campaigns to promote helmet use generally focus on children. Helmet use by adult and child bicyclists at 120 suburban and rural sites in three Maryland counties was observed on two Saturdays in 1990-91 during an evaluation of the impact of a mandatory helmet law. Concordance or discordance of helmet use within various groups of bicyclists--adults only, adults with children, and children only--was recorded. Helmet use among 2,068 adult bicyclists was 49 percent, 51 percent, and 74 percent in the three counties. In two counties combined, 52 percent (365 of 706) of solo adult bicyclists wore helmets compared with only 5 percent (5 of 94) of solo child bicyclists (P < .001). Helmet use or nonuse was concordant among 87 percent of 277 adult-adult pairs, 94 percent of 50 child-child pairs, and 91 percent of 32 adult-child pairs of bicyclists observed. Concordance rates of helmet use or nonuse were similarly high among pairs of adult bicyclists of the same or mixed sexes. These data are consistent with the concept that both adults and children tend to adopt the helmet-wearing behaviors of their companions. Public health efforts focused on adults should encourage helmet use by adult bicyclists both to prevent head injuries and to provide a role model for children.     

A37 REACTIVITY OF PLATELET AUTOANTIBODIES WITH PAPAIN TREATED PLATELETS AND COMPARISON WITH GLYCOPROTEIN SPECIFICITY.

A1 INFLUENCE OF POSTURE ON REACTIONS IN NEW BLOOD DONORS. A2 A CONFIDENTIAL UNIT EXCLUSION SYSTEM IDENTIFIES DONORS WITH A POTENTIAL FOR HIV INFECTION. A3 A STABLE BLOOD SUPPLY FOR THE FUTURE: THE RECRUITMENT OF 16 TO 18 YEAR OLD DONORS TODAY AND THEI CONTRIBUTION AS COMMITTED REGULAR DONORS OF TOMORROW. A4 APPROACH TO A SUPPLY CRISIS OF HYPERIMMUNE RHESUS PLASMA FOR THE PRODUCTION OF RhD IMMUNOGLOBULIN A5 THE INFLUENCE OF AGE, SEX AND ABO BLOOD GROUP ON THE INCIDENCE OF CMV ANTIBODIES IN SYDNEY BLOOD DONORS. A6 THE INCIDENCE OF CATEGORY VI AMONGST WEAK Rh(D) POSITIVE SYDNEY BLOOD DONORS. A7 A MODIFIED METHOD FOR DETECTING HIGH TITRE ANTI-A AND ANTI-B IN GROUP O DONORS A8 IMPROVING THE CLINICAL SPECIFICITY OF ALANINE AMINO TRANSFERASE (ALT) TEST RESULTS WITHIN THE NORMAL BLOOD DONOR POPULATION OF QUEENSLAND. A9 EXTRACTION OF HCV RNA USING A GUANIDINE ISOTHIOCYNATE METHOD. A10 HEPATITIS C VIRUS (HCV) ANTIBODY DETECTION IN TASMANIAN BLOOD DONORS. A11 EFFECTIVE INTERNAL QUALITY CONTROL FOR ENZYME IMMUNOASSAYS A12 DETECTION OF ANTIBODY TO NON-PATHOGENIC RETROVIRUSES (SPUMAVIRUSES) IN HUMAN SERUM A13 DETECTION OF ANTIBODY TO NON-PATHOGENIC RETROVIRUSES (SPUMAVIRUSES) IN HUMAN SERUM A14 A NOVEL BLOOD BAG SYSTEM WITH POTENTIAL, FOR THE ASIA-PACIFIC MARKET. A15 DESIGN OF CONTAINERS SUITABLE FOR THE TRANSPORT OF RED CELL, PLATELET AND FROZEN PLASMA PRODUCTS. A16 EVALUATION OF INDICATOR LABELS FOR QUALITY ASSURANCE OF IRRADIATION PROCEDURE OF BLOOD PRODUCTS. A17 MOLECULAR TYPING FOR UNUSUAL ABO TYPES. A18 AN EXAMPLE OF THE RARE ABO SUBGROUP, A19 RFLP ANALYSIS OF A RH NULL BLOOD DONOR. A20 A RELATIONSHIP BETWEEN LEWIS ERYTHROCYTE PHENOTYPES AND COLORECTAL CANCER. A21 PATERNITY TESTING USING SINGLE LOCUS DNA PROBES: OBSERVATIONS ON THE REFERENCE DATA BASE SIZE A22 USE OF FAMILY AND POPULATION STUDIES TO DETERMINE THE SPECIFICITY AND INHERITANCE OF NEUTROPHIL ANTIGENS DEFINED BY PLANT LECTINS. A23 SAMPLING PLANS: IS THERE RELEVANCE FOR BLOOD COMPONENT QC? A24 QUALITY MANAGEMENT: HOW DO WE DO IT IN A STATE THE SIZE OF QUEENSLAND? A26 THE ENERGY METABOLISM OF CIRCULATING CELLS. A27 ACETATE UTILISATION RATES AND THE EFFECT OF GLUCOSE-FREE PLASMA IN PLATELET CONCENTRATE STORED IN A MIMIMAL MEDIUM (MPM). A28 IMPROVED LEVELS OF 2,3 DJPHOSPHOGLYCERATE IN RED CELL SUSPENSIONS PREPARED FROM BLOOD COLLECTED INTO DEXTROSE-FREE ANTICOAGULANT. A29 EVALUATION OF RED CELL FREEZING METHODS AS A PRELUDE TO ADOPTING -80° C FREEZING IN HIGH GLYCEROL IN ROUTINE PRACTICE. A30 CLUMPING IN PLATELET CONCENTRATES - AN UNSOLVED PROBLEM. A31 AUTOLOGOUS BLOOD: SAFE FOR OTHERS OR NOT? A32 ESTABLISHMENT OF AN AUSTRALIAN HAEMOPHILIA TREATMENT CENTRE DATA BANK. A33 EXPERIENCE IN THE USE OF ROBOTICS AND MICROPLATE TECHNOLOGY TO SEMI-AUTOMATE A ROUTINE HOSPITAL BLOOD BANK. A34 AN ANTI-IgAl/IgA2 ELISA ASSAY FOR THE INVESTIGATION OF HYPESENSITIVITY TRANSFUSION REACTIONS. A35 THE INFLUENCE OF IgG AGGREGATES AND FRESH NORMAL SERUM ON THE MONOCYTE MONOLAYER ASSAY A36 DETECTION OF Rh(D) POSITIVE FETAL CELLS IN PREGNANT Rh(D)-NEGATIVE WOMEN BY FLOW CYTOMETRY. A38 HAEMOSTAT-IX: A HIGH PURITY FACTOR CONCENTRATE FOR THE TREATMENT OF PATIENTS WITH HAEMOPHILIA B. A39 GRAVITY FILTRATION OF PLASMA FROM DONOR BLOOD UTILISING A HOLLOW FIBRE FILTER MEMBRANE DEVICE A40 The Therapeutic Device Problem Reporting Scheme, and the Victorian Red Cross Blood Bank A43 HIGH FREQUENCY ANTIBODIES AND THE ADVANTAGES OF MANUAL POLYBRENE. A44 FACTS AND FANTASY IN THE DEVELOPMENT OF PLATELET ADDITIVE SOLUTIONS. A45 LACK OF EFFECT OF STORAGE CONTAINER ON STORAGE OF PLATELETS PREPARED FROM DEXTROSE-FREE BLOOD, A46 PLATELETS PREPARED FROM DEXTROSE-FREE BLOOD MAY BE STORED WITHOUT AGITATION. A47 QUALITY OF BED CELL CONCENTRATE IN HOSPITALS COMPARED TO THE BLOOD BANK A48FLOW CYTOMETRIC CHARACTERISATION OF LEUCOCYTE - DEPLETED RED CELL CONCEHTRATES. A49 PRODUCTION AND CHARACTERISATION OF HUMAN MONOCLONAL ANTI-D ANTIBODIES. A50 CD55 AND CD59 SUSCEPTIBILITY TO PROTEASE TREATMENT AND THE RESULTANT EFFECT ON COMPLEMENT LYSIS OF RBCs. A51 DIRECT COMPARISON BETWEEN PLATELET STORAGE CONTAINERS - IMPROVEMENT IN STORAGE CHARACTERISTICS OF TUTA PLATELET BAGS OVER THE PAST FOUR YEARS. A52 IMPROVED SOLID-PHASE MIXED PASSIVE HAENAGGLUTININ ASSAY (MPHA) WITH FROZEN PANEL PLATELETS FOR THE DETECTION OF HUMAN PLATELET ANTIBODIES. A53 DEVELOPMENT OF A SOLVENT DETERGENT TREATED THROMBIN CONCENTRATE AS A COMPONENT OF A FIBRIN GLUE KIT. A54 Autologous blood transfusion: a promotional programme A55 AVAILABILITY OF BLOOD PRODUCTS FOR ACUTELY BLEEDING PATIENTS. A56 REMINISCENCES OF 50 YEARS A. A TRANSFUSION ST. A57 A NATIONAL SYSTEM FOR REPORTING TRANSFUSION REACTIONS TO FRACTIONATED BLOOD PRODUCTS. A58 EFFECT OF FLUORESCENT LIGHTING ON THE VISUAL APPEARANCE OF PLATELET CONCENTRATES A59 USING A MICROWAVE OVEN TO THAW FRESH FROZEN PLASMA. A60 COAGULATION CAPACITY OF POOLED PLATELET PLASMA. A61 A COMPARISON OF IMMUNOHAEMATOLOGY SURVEY PERFORMANCE BETWEEN NEK ZEALAND AND AUSTRALIA A62 COMPATIBILITY TESTING: ARE ENZYME TESTS REQUIRED? A63 AN EVALUATION OF THE DIAMED MEROTYPING SYSTEM FOR THE PERFORMANCE OF THE DIRKT ANTIGLOBUDIN TEST. A64 ASSESSMENT OF PERFORMANCE IN BLOOD GROUP ANTIBODY DETECTION. A65 CHARACTERISATION OF MABS TO THROMBIN-HIRUDIN COMPLEXES WITH IMMUNOASSAY POTENTIAL. A66 MONITORING ANTT-HPA-la (P1^A1) PLATELET ANTIBODY LEVELS DURING PREGNANCY USING THE MAIPA TEST. A67 COMPARISON OF PIFT AND MAIPA TEST“ IN THE DETECTION OF ANTI-HPA-la (PI^A1) PLATELET ANTIBODIES. A68 USE OF PLATELET-CROSSMATCHING IN SUPPORT OF A CASE OF MYELODYSPLASIA WTTH A PLATELET SPECIFIC AND B LYMPHOCYTE ANTIBODY A69 The Pattern of Leucocyte Antibody formation in Transfused Patients. A70 DETECTION OF HPA-Ia ANTIBODY IN BREAST MILK A71 ANALYSIS OF PRENATAL SCREENING. A72 DETECTION OF MINOR POPULATIONS OF ERYTHROCYTES A73 MODIFICATIONS TO THE MCNOCYTE-MEDIATED ADCC ASSAY. A74 AN AUTO ANTI-JMH; GAMMA-CLONE POLYSPECIFIC AHG AS A USEFUL TOOL. A75 CLINICALLY SIGNIFICANT ANTI-A1 DERIVED FROM B LYMPHOCYTES FOLLOWING SINGLE LUNG TRANSPLANTATION. A76 CONFIRMATION THAT ANTI-ELO CAUSES HAEMOLYTIC DISEASE OFTHE NEWBORN. A77 ANTI-Do^a STIMULATED BY PREGNANCY. A78 DONOR IgM ANTI-A ASSOCIATED WITH HAEMOLYTIC TRANSFUSION REACTION A79 COLLECTION OF GRANULOCYTES AND PLATELETS USING FENWALL CS 3000 AND HAEMONETICS 30 CELL SEPARATORS - A COMPARISON. A80 APPARENT LYMPHOPENIA IN PLASMAPHERESIS DONORS     

Power Doppler sonography enhances visualization of orbital vessels.

Our study was intended to determine whether power Doppler sonography can be considered superior to color Doppler technique in depiction of normal orbital vasculature. Ten healthy volunteers (20 eyes) were examined with a 10 MHz linear probe; each orbital vessel was recorded with both color and power Doppler methods; the images were reviewed independently by all the observers, who agreed that power Doppler clearly is superior to color Doppler technique for evaluation of the anatomy of orbital arteries and veins.