Enzyme-linked immunofiltration assay (ELIFA) for the detection of specific antibodies (IgG-IgM-IgA-IgE) in farmer's lung disease

Abstract. Until now the detection of chymotrypsic or polysaccharidic arcs among precipitating systems indicated a positive diagnosis of Farmer's lung disease (FLD). It was shown that the occurrence of chymotrypsic activity is not absolutely correlated with the presence of clinical disease. The presence of different classes of specific precipitating antibodies was looked for and correlated with clinical symptoms in an attempt to find additional positive criteria for the diagnosis of FLD. The enzyme-linked immunofiltration assay (ELIFA) was adapted to detect the different specific antibody classes. 1400 serum samples were studied from 1350 farmers exposed to mouldy hay. Of 1358 samples examined from asymptomatic subjects tested as part of a systematic screening of the profession. 1356 had either no precipitins or have precipitins detected solely against non-chymotrypsic and non-polysaccharidic antigens. Ten specimens with precipitins joined the study. Only two serum samples from two symptomless individuals showed positive serological criteria for FLD as evidenced by the presence of a chymotrypsic band. The remaining forty-two serum samples from twenty-four patients with clinical signs of extrinsic allergic alveolitis had serological criteria for FLD as either chymotrypsic or polysaccharidic arcs. Only specific IgG in asymptomatic subjects was demonstrated, and when a supplementary class of specific antibody (IgM, IgA or IgE) was detected, there was clinical evidence of FLD in all except one case. Thus ELIFA could prove to be a useful tool for the positive diagnosis and prognosis of patients with FLD. In addition this method allows the recognition of a particular functional antigenic fraction of M. faeni by all classes of specific antibodies between different serum samples.     

DL and D Sotalol Decrease Defibrillation Energy Requirements

We examined the acute effects of intravenous DL and D sotalol on the energy requirements for internal defibrillation (DF) in 44 dogs anesthetized with pentobarbital (n = 18), enflurane (n = 8), and fentanyl (n = 18). Multiple shocks of varying energies were applied through left and right ventricular epicardial patch electrodes to relate delivered energy to percent success in DF. The energies required for 50% success in DF (E) were estimated by logistic regression. DL or D sotalol was administered in a loading (4 mg/kg over 10 min) and maintenance (1.5 mg/kg/hr) infusion and the energy--success curve was again measured 30 minutes after drug administration. The effect of DL and D sotalol on E50 was compared to controls given saline. Both DL and D sotalol significantly lowered E50 by 16% +/- 14% (P less than 0.05) and 24.5% +/- 8.2% (P less than 0.05), respectively, in fentanyl anesthetized animals; this was accompanied by a 22% +/- 8% (P less than 0.05) and 16% +/- 5% (P less than 0.01) increase in ventricular effective refractory period (VERP), respectively. In pentobarbital anesthetized dogs, DL and D sotalol decreased E50 by 16% +/- 27% (P = ns) and 11% +/- 16% (P less than 0.05), respectively, and were associated with a 23% +/- 5% (P less than 0.01) and 12 +/- 4% (P less than 0.05) prolongation of VERP. DL and D sotalol decrease defibrillation energy requirements, possibly as a result of their Class III antiarrhythmic drug action.     

Reciprocal and Topographic Connections Between the Piriform and Prefrontal Cortices in the Rat: A Tracing Study Using the B Subunit of the Cholera Toxin

In the present study, the reciprocal connections between the piriform cortex and the prefrontal areas are described on the basis of experiments using the anterograde and the retrograde transport of the cholera toxin B subunit (CTb). Following CTb injections placed in the anterior part of the piriform cortex, retrogradely labeled cells and anterogradely labeled fibers were mainly found in the ventrolateral and lateral orbital areas as well as in the anterior part of the agranular insular cortex. Following injections placed in the posterior part of the piriform cortex, the CTb labeling was primarily observed in the infralimbic area and the posterior part of the agranular insular cortex. Thus, we described a topographical organization of the direct reciprocal connections between the anterior and the posterior parts of the piriform cortex parts and some prefrontal areas. This could support a differential modulation of the olfactory processing along the rostrocaudal dimension of the piriform cortex. Copyright © 1996 Elsevier Science Inc.     

Uptake of Fluoroquinolones in Human Monocytes Isolated from Peripheral Blood

The aim of this study was to develop a technique for separating monocytic cells in suspension from peripheral blood to measure the intracellular penetration of three fluoroquinolones (ofloxacin, ciprofloxacin and sparfloxacin). Mononucleated cells were isolated from the blood on a density gradient with lymphoprep and purified by a specific technique of adhesion and disadhesion on fibronectin. The monocytes were obtained in suspension with 76.8% purity and 97.9% viability. This was a convenient form for measurement of intracellular accumulation by use of the velocity-centrifugation technique. Intra-monocytic penetration of ciprofloxacin, ofloxacin and sparfloxacin was measured at equilibrium after 30-min incubation in the presence of 16 μg mL^?1 antibiotic. The results revealed low intra-monocytic accumulation of ciprofloxacin (intracellular-extracellular = 1.76) and ofloxacin (intracellular-extracellular = 1.42). The penetration of sparfloxacin was significantly higher (intracellular-extracellular = 2.4). This study confirms the important differences between human immunocompetent cells in terms of their ability to concentrate quinolones. It also underlines the importance of monocyte-macrophage cellular differentiation as a determinant of antibiotic penetration.     

When Pacemakers Fail: An Analysis of Clinical Presentation and Risk in 120 Patients with Failed Devices

Although pacemaker recalls are common, the optimal mechanism for risk assessment and triage of patients at risk for sudden loss of device system function is unknown. A retrospective chart review of 120 patients with factory proven failed devices was performed. Logistic regression analysis was used to determine clinical correlates of emergency room versus outpatient clinic presentation at time of device failure. Twenty-two patients (18%) presented to emergency and 98 (82%) to clinic. Sixty-three devices had no device output at the time of presentation. Multivariate logistic regression analysis revealed that antiarrhythmic drug use (odds ratio: 7.4, 95% CI: 2.0–28.0), atrioventricular nodal disease as an indication for pacing (odds ratio: 2.8, 95% CI: 1.2–3.0), and female gender (odds ratio: 2.2, 95% CI: 1.0–4.5) were the only significant correlates of emergency room presentations. Pacemaker dependency (escape heart rate < 40 beats/min) did not correlate with location of presentation even though no device output at the time of presentation was associated with emergency room presentation (odds ratio: 2.5, 95% CI: 1.1–5.8). Neither the presence of structural heart disease nor symptoms at the time of device implantation (syncope or presyncope) were correlated with location of presentation upon unexpected device failure. Although there were no deaths in the 120 failed devices studied, there were 26 deaths in the total group of 227 patients with recalled devices that could not be studied. Antiarrhythmic drug use, electrocardiographic pacing indication, and female gender may be more sensitive predictors of emergency room presentation and significant symptoms in the event of unanticipated pacemaker failure. The inability of any retrospective analysis to accurately assess mortality in the setting of pacemaker system failure underscores the need for prospective databases in recall situations.     

Cervicography

Cervicography in 1992, and probably for the rest of the decade, is the sensitive and accessible routine technique for the early detection of cervical anomalies. Always associated with cytology, it will be able to reduce significanty the unfortunate consequences resuling from the elevated number of 'false negative' smears in conventional gynaecological exaninations. Moreover, it is also the most valuable technique availble today for the derection of cervical anomalies. The epidemiology of CIN(cervical intraepitheial neoplasia) and the elecated number of cytological 'false negatives' no longer allow us to use smear results as the sole basis of the early diagnosis necessary to offer the patient a minimal curative treatment leaving few or no physical and psychological sequelae. Cervicogaphy is a quality standardized technique organized in an international manner. Thanks to it, we can detect uterine cervical cancer and its precursors at an early stage, with little cost in either time or money.     

Correlation of Lymphocyte Transformation and Morphology in the Human Fetal Thymus

A study was made of PHA-stimulatedthymic lymphocyte transformation in 10human fetuses ranging from 12 to 22weeks of gestation. The results werecompared with those obtained using circulating blood lymphocytes of the corresponding fetuses in seven cases. Thedegree of transformation of blood lymphocytes is independent of fetal age. Onthe other hand, thymic lymphocyte transformation is age-related. Until the 18thweek of gestation, the per cent of transformed thymic lymphocytes is comparable to that of blood lymphocytes. Afterthe 18th week of gestation, the per centof transformed thymic lymphocytes diminishes to the level of adult thymiclymphocytes. The significance of thesefindings is discussed.

Submitted on September 10, 1969 Revised on March 9, 1970 Accepted on March 31, 1970