Comparison between two commercial immunoassays: Dr. Fooke ALLERG-O-LIQ versus Phadia ImmunoCA(R) System in detecting allergen-specific IgE and total IgE values

Objective: Beside patient's history and skin prick testing(SPT) the detection of specific IgE(slgE) represents an important tool of allergy diagnostics. In recent years different technologies for the detection of sIgE have been developed. The objective of this study is the comparison of the ALLERG-O-LIQ with the ImmunoCAP System using seven inhalant and four food allergens. Methods: Sera from patients were collected and tested for sIgE to inhalant(d1, d2, d5, i6, el, e5 and m3) and food allergens(fl, 12, f24, t24) by ALLERG-O-LIQ(Dr. Fooke Laboratorien GmbH) and by ImmunoCAP System(Phadia). Further, samples were also tested for total IgE in both systems. Results: Prevalence of positive test results varied between 0/20(124) and 11/20(e5) for ALLERG-O-LIQ and between 3/18(f23) and 11/20(d1/d5) for ImmunoCAP . The qualitative agreement between both methods was found between 75%(f24) and 100%(d2) depending on the allergen. Overall qualitative agreement for inhalant(n = 140), food(n = 78) and all allergens(n = 218) tested was 92.1%(kappa = 0.84), 83.3%(kappa = 0.58), 89.0%(kappa = 0.77), respectively. Sensitivity, specificity, positive predictive value (PPV), negative predictive value(NPV) and diagnostic efficiency(DE) were found at 88.2%, 95.8%, 95.2%, 89.6%, 92.1%(inhalant allergens), 62.5%, 92.6%, 78.9%, 84.7%, 83.3%(food allergens) and 81.5%, 94.4%, 91.5%, 87.5%, 89.0%(all allergens). Conclusion: Good to excellent qualitative agreement between ALLERG-O-LIQ and ImmunoCAP for the detection of specific and total IgE could be observed. The degree of agreement depended on the allergen and was higher in the group of inhalant allergens. The ALLERG-O-LIQ System represents a reliable test for the detection of specific and total IgE.     

Single and multiple administration of a new triphasic oral contraceptive to women: pharmacokinetics of ethinyl estradiol and free and total testosterone levels in serum

Ethinyl estradiol is part of almost every combined oral contraceptive, and its pharmacokinetic characteristics have been thoroughly investigated in numerous studies. However, little is known about its pharmacokinetics during long-term administration, as compared with single-dose administration. In this study 10 women received a triphasic formulation that contained ethinyl estradiol together with the progestin gestodene over one treatment cycle. Mean area under the curve values of ethinyl estradiol were significantly higher on the last treatment day, as compared with the corresponding values obtained from the same women after single-dose administration. However, the observed increase in area under the curve was within the range of pharmacokinetic accumulation, to be expected on the basis of dosing interval and terminal half-life. Another point of interest was the effect of the triphasic preparation on testosterone concentrations in serum. Both total and free testosterone levels were suppressed by about 60% as compared with pretreatment values, and there was no correlation with corresponding sex hormone-binding globulin levels in the serum.     

Subcortical hyperintensities in Alzheimer's disease: associated clinical and metabolic findings

The authors measured subcortical hyperintensities (SH) on magnetic resonance images (MRI) in 18 patients with probable Alzheimer's disease and examined the relationships of SH severity with cortical metabolic function and clinical symptoms. Severity of SH was not correlated with absolute metabolic rates in cortical lobes. However, anterior SH severity was inversely correlated with frontal/ parietal metabolic ratios after covarying for cognitive impairment. SH severity in some areas was associated with the severity of global neuropsychiatric symptoms, but marked effects on individual symptoms were not apparent. The small sample size and multiple variables limit conclusions that can be drawn. These preliminary findings indicate that subcortical MRI hyperintensities may play a role in the pathophysiology and clinical expression of Alzheimer's disease.     

Aplasia cutis congenita in two sibs discordant for pylori atresia

We report two sibs who were the products of a consanguineous mating, and who had an extensive form of aplasia cutis congenita (ACC). In one of them the generalized skin disorder was manifested by slipping off of the epidermis and mucous membranes with the slightest trauma. This sib also had pyloric atresia and other congenital malformations. Two hypotheses are presented to explain the discordance between the siblings for the abnormalities other than the ACC. One hypothesis assumes varying degrees of severity of the same autosomal recessive disease. The second suggests linkage between the gene for ACC and the gene for an epidermolysis bullosa (EB)-like disorder and pyloric atresia. A recombination event involving the EB-pyloric atresia gene in one carrier parent would then lead to an offspring with only ACC. Prenatal diagnosis is suggested by monitoring α-fetoprotein levels in amniotic fluid.     

Multiple sclerosis: Oligoclonal IgG, ξ-λ light chain distribution and measles antibodies in brain extracts

The presence of measles antibodies in white and grey brain material and in 8 demyelination plaques from 6 patients affected with multiple sclerosis was investigated with the hemagglutination inhibition (HI) and complement fixation (CF) techniques.White and grey matter of 5 controls were run in parallel. No measles antibodies could be detected, except for one plaque, where the answer could be considered as doubtful. The immunoglobulin G (IgG) content and the ξ/λ light chain ratios of all the samples were evaluated. No unique monoclonal immunoglobulin population could be detected, but ξ or λ predominant oligoclonal populations appeared in controls as well as in MS IgG.