Immunologic studies of specific mucosal and systemic immune responses in Mexican school children after booster aerosol or subcutaneous immunization with measles vaccine

The purpose of the present study was to compare serum and mucosal immune responses following either aerosol (Aer) or subcutaneous (SQ) measles immunization of Mexican school children. A cohort of 49 children from 6 to 7 years of age received either Aer ( n = 22) or SQ ( n = 27) Edmonston-Zagreb (EZ) measles vaccine. Serum and nasal secretions were collected prior to (Pre), 1 and 3 months (mos) intervals and analyzed for immunoglobulin (Ig) concentrations and measles specific Ig isotype-associated antibody by enzyme immunoassay (EIA). Serum and nasal IgG and IgA antibody responses were stimulated following immunization with live, attenuated EZ measles vaccine administered either by SQ or Aer routes but these responses were significantly greater by the Aer compared to the SQ route. These studies also suggest that the level of antibody in these secretions may serve as an important marker of immunity to measles and lend further support for aerosol immunization as an effective alternative vaccine delivery strategy for measles eradication.     

Psychosocial adjustment and employment outcome 2, 5 and 10 years after TBI

Objective: A patient's return to work has been considered a good indicator of his/her overall adaptation after suffering from TBI. A study has been designed at the Hospital del Trabajador to evaluate patients' psycho-pathological and social situations and to describe evolution and return-to-work predictors. Particular attention was paid to subjects' employment situations 2, 5 and 10 years after TBI.

Method: TBI patients who had also suffered spinal cord injuries, amputations and other physical impairments were excluded. A total of 202 individuals were evaluated by a psychologist and an occupational therapist during clinical interviews using the Hamilton Anxiety and Depression Rating Scale and the Neurobehavioural Rating Scale (NRS-R). Work situations were evaluated by interviewing the subjects and family members and, whenever possible, a patient's immediate supervisor at his or her place of employment.

Results: Unemployed patients presented more severe symptoms of anxiety and depression than those who were working. Significant differences were observed in the NRS-R between employed and unemployed patients. There was no change in the marital status for at least 10 years after TBI.

Conclusion: Factors determining a poor prognosis for adaptation and re-insertion into the workplace are age, a low educational level, a lack of job qualifications and greater cognitive impairments. The significant differences found between the NRS-R of employed and unemployed patients suggest that this variable may be used to predict a subject's ability to return to work.     

Enhanced recovery of gut-associated lymphoid tissue by infusion of buffy coat cells and gut leukocytes in the murine syngeneic bone marrow transplantation model

Ways of accelerating recovery of the mucous membrane immune system in lethally irradiated mice following syngeneic bone marrow transplantation were studied over a 35-day period by quantification of jejunal intraepithelial lymphocytes (IELs) and lamina propria plasma cells. Recovery after a low bone marrow dose allowing 100% animal survival (LBM) was compared with a high (five times minimal) dose (HBM), or a minimal dose augmented with equal numbers of buffy coat cells (LBM + BC) or small gut mucosal lymphocytes (LBM + GL). The maximal decline and subsequent peak repopulation of IELs were: LBM, days 7 through 14, peaking suboptimally by day 28; HBM, day 14, peaking suboptimally but higher than LBM by day 35; LBM + BC, days 11 through 14, peaking at control levels by day 35; and LBM + GL, day 7, peaking at control levels by day 28. The IEL decline was most severe with LBM and HBM treatment and least with LBM + GL. All transplant groups experienced maximal plasma cell decline by day 7. LBM had the most severe depletion, and LBM + GL had the least. Recovery to control levels for the LBM, HBM, LBM + BC and LBM + GL groups occurred by days 28, 21, 21, and 14, respectively. In all instances, greater than 95% of the plasma cells were IgA positive.     

葛根素中4′-甲氧基葛根素的反相高效液相色谱法测定(英文)

本文报道应用反相高效液相色谱法测定葛根素中4′-甲氧基葛根素的含量,以对羟基苯甲醛作内标,在填充以LiChrosorb RP-18(10μm)固定相的不锈钢柱上,以EtOH-H₂O(10:90)作流动相,检测波长为250nm。本法与TLC-UV法比较,测定结果一致,但本法简便、快速、重现性好,可以应用於葛根素原料药及其制剂中葛根素和4′-甲氧基葛根素的含量测定。     

Intrathoracic dislodgement of pleuro-amniotic shunt. Three case reports with long -term follow-up

BACKGROUND: Intrathoracic shunt dislodgement is a rare, although significant, complication of pleuro-amniotic shunting. In a previously reported case, the abnormally located shunt caused constriction of the pulmonary hilum resulting in neonatal death. CASES: Three cases of severe fetal pleural effusion treated by pleuro-amniotic shunting at 33, 26 and 30 weeks of gestation and complicated by dislodgement of the shunt into the fetal chest are presented. These cases were collected from three fetal medicine referral centers, where 15 pleuro-amniotic shunts have been inserted in a total of 13 fetuses (11 unilateral and 2 bilateral procedures), giving prevalence for this complication of 20%. The indication for shunting was severe bilateral pleural effusions and hydrops in one case, and unilateral pleural effusion with marked mediastinal shift in 2 others. Intrathoracic dislodgement was diagnosed by ultrasound at 33, 29 and 39 weeks, and the infants were delivered at 35, 34 and 39 weeks of gestation, respectively. There were no complications associated with the malposition of the shunt within the fetal chest and clinical follow-up from 10 months to 2 years of age has demonstrated asymptomatic infants. CONCLUSION: The complication of intrathoracic dislodgement of a pleuro-amniotic shunt can be recognized prenatally by ultrasound. Prevention of this complication seems difficult, but if recognized, a conservative approach appears to be a sensible management option. Since the material of the shunt is inert, its presence within the pleural cavity is unlikely to be associated with an inflammatory foreign body response and, therefore, it should not cause long-term pulmonary complications.     

Clinicopathological study of gastric carcinoma in high- and low-mortality countries: Comparison between Japan and the United States

Background. Gastric carcinoma is a tumor that shows marked differences in geographic distributions. The incidence of the gastric carcinoma has been falling dramatically in Western countries. In sharp contrast, the incidence in Japan is still quite high. Methods. A comparative clinicopathological study was performed, examining gastric carcinomas in 978 Japanese patients (Tokyo) and 157 United States patients (San Diego), that had been surgically resected over the 11-year period 1980–1991. Results. The median age of US the patients (64.1 years) was higher than that of the Japanese patients (59.0 years). There was no difference in the sex ratios. Forty-five of the Japanese patients had early gastric cancer, while this occurred in 10% of the US patients. In terms of tumor location, 47% were in the upper portion of the stomach in the US patients, while, in contrast, this proportion in Japanese patients was 23%. In association with the marked difference in tumor location, 36.5% of the US patients underwent operations with the thoraco-abdominal approach, while this approach was used in 7.5% of the Japanese patients. The distribution of histological types was similar in the two countries' samples. There was also no significant difference in the distribution of the histological types in the same age groups in the two countries' samples. The rate of the well differentiated type increased with age while the rate of poorly differentiated type decreased. In US patients, 35.8% had marked neural invasion, while this occurred in 8.5% of Japanese patients. Conclusion. This study revealed marked differences in the features of gastric cancer between the US and Japan in terms of tumor location and surgical procedures. Received for publication on February 18, 1998; accepted on May 25, 1998