Comparison of three immunoassays for diagnosing sensitization to latex in children with spina bifida

As natural rubber latex (latex) has become more widespread in our environment, physicians have become increasingly aware of the problem of possible allergic reactions. Many fatal and near-fatal incidents have been reported (mainly during surgery) (1—3) and data has been published on groups frequently exposed to latex, such as patients with spina bifida (4—9), healthcare professionals (10—12) and occupationally exposed persons (13). The incidence of latex allergy in children seems to be increasing (14). Tests are therefore needed which can reliably detect sensitization to latex. Our aim was to compare the diagnostic accuracy of three commercial immunoassays for measuring specific IgE in serum to latex.     

Basophil releasability in severely burned patients.

Thermal injury is known to induce dysregulation of the immune system; however, the precise mechanisms have to be clarified. We investigated the histamine release of basophil granulocytes from severely burned patients (n = 12) after stimulation with anti-IgE or the Ca-ionophore A 23187, respectively. The anti-IgE-induced basophil histamine release of all patients was reduced in comparison to healthy donors beginning at day one postburn (p.b.) (5.0 +/- 2.3% vs. 30.5 +/-3.4%), while the Ca-ionophore-induced release was not decreased before day two p.b. Basophils of patients who finally succumbed to their injuries showed poor responsiveness (to zero levels) over the total time. In contrast, the basophil releasability of surviving patients returned to nearly normal levels (fifth to seventh week p.b.). Already in the second week p.b. there was a significant difference in histamine release between survivors and nonsurvivors [e.g., days 6-9 p.b.: 23.7 +/- 4.0 vs. 6.9 +/- 2.7 (p less than 0.005) after Ca-ionophore stimulation]. The altered basophil histamine release was neither due to a diminished dose- or a delayed time-response to the stimuli nor due to differences in the basophil counts or the cellular histamine content. Our data indicate that the decrease of the basophil releasability, which may be secondary to altered signal transduction pathways in severely burned patients correlates with the clinical outcome.     

Intraoperative angiography in reconstructive surgery of aorto- iliac occlusions

In a group of 182 patients who underwent surgical treatment for aortoiliac occlusions 172 had to be subjected to intraoperative distal angiography. The operative tactics in this case was determined by the degree of affection of the peripheral vessels and the character of collateral circulation, which were appraised from the findings of the operative angiograms. According to this, all patients were divided into 4 groups. Two patients developed complications linked with faulty appraisal of the drainage paths.     

Antilymphocytic antibodies and bone marrow transplantation. XI. Evidence that reduced Thy-1 expression in Thy-1.1 mice prevents suppression of graft-versus-host disease with anti-Thy-1 monoclonal antibodies

Considerable variations in the suppression of graft-versus-host disease with monoclonal anti-Thy-1 antibodies were found to relate to substantial differences noted in the expression of mouse Thy-1 marker on lymph node and spleen cells of Thy-1.1 (AKR/J, C57BL/6.Thy-1.1) and Thy 1.2 (AKR/Cu, C57BL/6) mice. Thy-1.1 mice showed a population of 22% (AKR/J) or 13% (C57BL/6-Thy-1.1) of Thy-1 negative cells among peripheral T cells carrying Ly-1 marker. This was in sharp contrast with Thy-1.2 mice, where as expected practically all peripheral T cells expressed both Thy-1 and Ly-1. Double-marker analysis on FACScan revealed that the Thy-1-/Ly-1+ cell population identified in Thy-1.1 but not in Thy-1.2 mice doubtless represents T cells because they express CD3 and either the L3T4 (CD4) or Lyt2 (CD8) phenotype. Using quantitative fluorescence-measurement techniques, it was found in addition that the Thy-1 antigen-binding sites on Thy-1+ cells from Thy-1.1 mice are considerably fewer than those present in Thy-1.2 mice. In fact, the Thy-1 antigen-binding sites approximate the level of Ly-1 density. Consequences of the reduced expression of Thy-1 became apparent in vivo: (1) lymphnode and splenic T cell areas in Thy-1.1 mice were clearly less depleted when Thy-1.1 and Thy-1.2 mice had been injected with rat IgG2b anti-Thy-1 mAb; and (2) GvHD was prevented completely in fully mismatched mice by anti-Thy-1 mAb if the donor mice expressed Thy-1.2 but was barely delayed if the donors expressed Thy-1.1. Thus the present study provides a transplantation model for comparing differences in T antigen density and their consequences for antibody-induced immunosuppression.     

Structured treatment and teaching of patients with Type 2 diabetes mellitus and impaired cognitive function--the DICOF trial.

BACKGROUND: Patient education is integral part of any diabetes therapy in Germany, but elderly patients are not able to follow the variety of topics comprising standard treatment and teaching programmes (TTP), primarily due to impaired neuropsychological function. This leads to deficits in diabetes knowledge and hindered ability for diabetes self-management. AIM: To evaluate structured TTP for geriatric patients with impaired cognitive function. PATIENTS AND METHODS: A neuropsychological examination was performed on all patients over 54 years [n=102, age 68.6 +/- 8.7 years, diabetes duration 10.3 (0.03-35.4) years, HbA1c 10.3 +/- 1.7% (HPLC, Diamat, NR 4.5-6.3%), cognitive function 87.7 +/- 12.3 IQ points] who took part in TTP for insulin therapy. Patients with impaired cognitive function participated either in the standard TTP of Berger [n = 35, age 67.6 +/- 8.9 years, diabetes duration 9.9 (0.04-35.4) years, HbA1c 10.3 +/- 2.0%] or in the specialized structured geriatric DICOF-TTP [n=33, age 70.4 +/- 8.2 years, diabetes duration 10.4 (0.03-24.9) years, HbA1c 10.7 +/- 1.8%]. RESULTS: After TTP there were no differences in knowledge and ability for diabetes self-management (standard/DICOF: knowledge 11.0 +/- 2.6 vs. 12.2 +/- 2.7 points, P = 0.11; handling 14.9 +/- 3.3 vs. 15.9 +/- 2.5 points, P = 0.18). However, patients who took part in the DICOF programme showed better scores in satisfaction with the education programme [standard/DICOF 44.7 (31-57) vs. 52.5 (45-59) points, P < 0.001]. Six months later the DICOF participants showed better results regarding diabetes self-management (standard/DICOF: handling 12.5 +/- 4.1 vs. 15.9 +/- 3.1 points, P = 0.001). Both groups showed HbA1c decrease (8.3 +/- 1.4 vs. 8.5 +/- 1.3%, P=0.62) and similar incidence of acute complications. CONCLUSIONS: Elderly patients with impaired cognitive function should take part in specialized structured TTP. This leads to both better satisfaction with the education programme and an improved ability for diabetes self-management.     

In vitro studies of the antitumor effect of melphalan and analogous aniline mustard derivatives

Melphalan and analogous aniline mustard derivatives were tested on antitumor activity in vitro. All compounds showed similar antiproliferative effects against melanoma B16, sarcoma 180 and leukemia P388D1. Thus, the singular clinical efficiency of melphalan may not simply be explained by a selective uptake employing amino acid carrier systems of tumor cells.