Potentiation of in vitro synthesis of human IgE by cyclosporin A (CsA).

In this study, we investigated the modulatory effects of CsA on in vitro synthesis of IgE, IgG1 and IgG4 by human peripheral blood mononuclear cells (PBMC). In contrast to its known immunosuppressive effect, we have demonstrated that a low dose of CsA (10(-7) M, 120 ng/ml) potentiated IgE production by up to 40-fold (i.e. from 33 +/- 4.5 to 1346 +/- 290 ng/ml). This potentiation was specific for IgE since no such effect was demonstrable with IgG1 and IgG4. Potentiation of IgE synthesis by CsA in the PBMC cultures was partly due to CsA acting on T cells, as demonstrated by the addition of CsA-treated T cells to T cell-depleted cultures. However, potentiation was also demonstrable in a T cell-depleted, anti-CD40-stimulated culture (four-fold increase from 400 +/- 48 to 1606 +/- 127 ng/ml). Our data therefore suggest that there are at least two mechanisms for CsA-induced potentiation of IgE synthesis, one T cell-dependent and the other T cell-independent. The clinical implications of these findings are discussed with regard to the use of CsA in the treatment of Th2-mediated diseases.     

A cross-cultural comparison of depressive symptom manifestation: China and the United States

This study compared depressive symptomatology among Chinese psychiatric outpatients versus the general Chinese population, and across 3 cultural groups--Chinese, Chinese American, and Caucasian American students--by use of the Center for Epidemiological Studies-Depression Scale (CES-D; L. S. Radloff, 1977) and the Chinese Depression Scale (N. Lin, 1989), translated from the CES-D. Results indicate that Chinese patients (n = 112) endorsed a higher proportion of somatic symptoms than nonpatients (n = 112). The intercultural comparison found that Chinese students (n = 98) had the lowest levels of somatic depressive symptom endorsement compared to both U.S. groups (n = 198). These findings seem to suggest that the tendency toward somatic symptom reporting is not any greater among Chinese populations but may be a function of having a mental illness or of help seeking in China.     

Electron microscopic observations comparing the gastric mucosal damage induced in rats and pigs by benoxaprofen and aspirin,reflecting their differing actions as prostaglandin-synthesis-inhibitors.

The ultrastructural changes in the gastric mucosa induced by oral administration of aspirin (2 x 125 mg/kg/day) were compared with the effects of benoxaprofen (20 mg/kg/day) in pigs and normal and arthritic rats after 10 or 14 days'' treatment respectively. The object was to compare the effects of drugs having different effects on prostaglandin-synthesizing systems on the development of gastric mucosal damage. Benoxaprofen caused less gastric damage than aspirin. There were fewer lesions in benoxaprofen-treated animals and those which were seen were much less extensive. There were qualitative similarities between the effects of the drug treatments. There were also differences in the mucosal changes produced by both drugs in pigs and rats. This included (1) extravasation of erythrocytes which was seen in rats but not pigs, and (2) interstitial changes also seen in rats but not pigs. These interspecies variations may be due to differences in the resistance of the capillaries to drug effects. There were no differences in the mucosal-cell damage seen in normal compared with arthritic rats.     

Detection of fish antigens aerosolized during fish processing using newly developed immunoassays

BACKGROUND: Aerosolization of fish proteins during seafood processing has been identified as a potential route for allergic sensitization and occupational asthma among workers involved in high-risk activities. The aim of this study was to develop immunological assays for the quantification of aerosolized fish antigens in a fish-processing factory. METHODS: Polyclonal antibodies to the main fish species processed in the factory (anchovy and pilchard) were generated in rabbits and compared by ELISA inhibition assay and immunoblotting. These antisera were utilized to develop ELISA assays for the detection of fish antigens. The ELISA inhibition assays were evaluated by analyzing environmental air samples collected from three areas in a fish-processing factory: pilchard canning, fish meal production and lobster processing. RESULTS: By immunoblotting, the rabbit polyclonal antibodies demonstrated IgG antibody binding patterns comparable with IgE antibodies of fish-sensitized patients, particularly in regard to the major fish allergens parvalbumins. The sensitivity of the fish-specific ELISA assays developed was 0.5 microg/ml. The ELISA inhibition assays were able to differentiate between the two different fish species of interest but did not recognize a crustacean species. Notable differences in exposure levels to canned pilchard and anchovy antigens were demonstrated in the three different working areas of the factory, with assays having a detection limit as low as 105 ng/m(3). CONCLUSION: These ELISA-based assays are sensitive and specific to quantify differential exposure levels to fish antigens produced during fish processing, making it possible to investigate exposure-disease response relationships among workers in this industry.     

Activation of the respiratory burst in murine phagocytes by certain guanine ribonucleosides modified at the 7 and 8 positions: possible involvement of a pertussis toxin-sensitive G-protein

The capacity of certain guanine ribonucleosides (modified at the 7 and/or 8 positions) to enhance the respiratory burst of murine peritoneal phagocytes was evaluated. The results show that 8-mercaptoguanosine, 8-bromoguanosine, 7-methyl-8-oxoguanosine and 7-thia-8-oxoguanosine, when injected intraperitoneally into mice, induced peritoneal phagocytes to generate reactive oxygen species as early as 1 h after injection. In vivo administration of the nucleosides induced higher levels of phagocyte activation than in vitro treatment with the same nucleosides. However, the addition of interferon alpha/beta in vitro significantly increased the magnitude of phagocyte activation by the nucleosides, suggesting an important role for cytokines/lymphokines in the nucleoside-induced phagocyte activation in vivo. Furthermore, pre-treatment of phagocytes in vitro with Bordetella pertussis toxin, before treatment with the guanosines, inhibited their capacity to induce the respiratory burst. These observations establish these low-molecular-weight compounds as interesting probes for the study of stimulus-response coupling in phagocytes.     

Eccentric visual acuity in patients with macular disease

A series of cards each containing a two dimensional array of identical Snellen "E's" was used to determine best eccentric visual acuity in patients with macular disease having Snellen visual acuity of 20/70 or worse. Each "full field E" card simultaneously presents the same letter to foveal and parafoveal areas. This test can therefore determine quickly if potentially useful vision is present in any area of the central visual field. In our study of 37 eyes, 70% demonstrated potential visual acuity at least two times better than visual acuity measured by conventional methods, and 20% demonstrated at least a fourfold improvement. This suggests that most patients with macular disease do not spontaneously employ their best remaining area of retina for fixation.     

Presenting statistical uncertainty in trends and dose-response relations.

When one estimates the effects of a polytomous exposure, it is common practice to express all effects relative to a baseline or reference level. Certain authors have challenged this practice and proposed alternatives, which we review here. One alternative, the "floating absolute risk" method, can supply useful statistics and trend graphs, but it does not yield valid confidence intervals for relative risks. All categorical methods have further shortcomings when the exposure is continuous, however. These shortcomings can be addressed by plotting or tabulating confidence limits for points on a flexible curve fitted to the uncategorized data.     

The evaluation and calibration of fan-beam collimators

The aims of this study were (a) to determine the true focal length of a fan-beam collimator and (b) to calibrate image size (mm/pixel) for each collimator to permit inter-comparison of image data acquired on different gamma camera systems. A total of six fan-beam collimators on three dual-head gamma camera systems were evaluated using a set of four cobalt-57 point source markers. The markers were arranged in a line in the transverse plane with a known separation between them. Tomographic images were obtained at three radii of rotation. From reconstructed transaxial images the distance between markers was measured in pixels and used to determine pixel size in mm/pixel. The system value for the focal length of the collimator was modified by up to +/-100 mm and transaxial images were again reconstructed. To standardize pixel size between systems, the apparent radius of rotation during a single-photon emission tomography (SPET) acquisition was modified by changes to the effective collimator thickness. SPET images of a 3D brain phantom were acquired on each system and reconstructed using both the original and the modified values of collimator focal length and thickness. Co-registration and subtraction of the reconstructed transaxial images was used to evaluate the effects of changes in collimator parameters. Pixel size in the reconstructed image was found to be a function of both the radius of rotation and the focal length. At the correct focal length, pixel size was essentially independent of the radius of rotation. For all six collimators, true focal length differed from the original focal length by up to 26 mm. These differences in focal length resulted in up to 6% variation in pixel size between systems. Pixel size between the three systems was standardized by altering the value for collimator thickness. Subtraction of the co-registered SPET images of the 3D brain phantom was significantly improved after optimization of collimator parameters, with a 35%-50% reduction in the standard deviation of residual counts in the subtraction images. In conclusion, we have described a simple method for measurement of the focal length of a fan-beam collimator. This is an important parameter on multidetector systems for optimum image quality and where accurate co-registration of SPET to SPET and SPET to MRI studies is required.     

Nursing education, competency, and role in intravenous conscious sedation

The advent of new hospital policies addressing analgesia and sedation motivates the nursing education department to implement an education plan for training RNs in the safe administration of medications that produce analgesia and sedation according to hospital policies. Learning materials must be procured or written, classroom content delineated, and a plan to precept all RNs who may be involved in IVCS procedures arranged. Our institution faced many obstacles in implementing such a program, including scheduling class time and clinical teaching time for IVCS preceptors, availability of IVCS procedures when preceptors and learners are available, and determining the course of action before a procedure requiring IVCS if the physician had not yet completed physician IVCS training. Obtaining quality monitoring data from these procedures is best initiated when the initial program is introduced. The RN's role in collecting quality monitoring data is crucial. The development of forms that include all required aspects of patient assessment, care, and monitoring promotes compliance with hospital policy.