Percutaneous drainage of splenic abscess in typhoid fever--a case report

Salmonella typhi splenic abscesses are a very rare complication of typhoid fever. Splenectomy is the standard surgical treatment for these lesions. But these days, with improvements in imaging techniques, percutaneous drainage of splenic abscesses has been demonstrated to be one of the alternative treatment in selected cases. We report the case of a 7 year-old male, who presented with Salmonella typhi in blood and urine cultures, and a 1: 320 in O titer of Widal test. Ultrasound and computed tomography showed a single splenic abscess, 3 cm in diameter. He was treated with antibiotics, but the symptoms were not relieved. Thus we performed the percutaneous drainage of the splenic abscess under ultrasound guidance. A culture of the aspirated material was positive for Salmonella typhi, and the boy's condition improved. We think that percutaneous drainage of a single lesion was an excellent alternative to surgery, particularly because our patient was young and spleen conservation was desirable.

Pigeon-serum-induced hypersensitivity pneumonitis in the dog

Pigeon serum (PS) is one of the most common causes of hypersensitivity pneumonitis (HP). PS-induced HP was examined in a dog model. The dogs (n = 6) were immunized by i.m. injections of PS, followed by insufflation with aerosolized PS, while all control dogs (n = 3) received saline only. All animals insufflated with PS developed tachypnea 2-4 h after PS inhalation. After PS insufflation, a significant decrease in arterial oxygen tension (PaO2) was detected in sensitized dogs. No change in PaO2 was detected in sensitized dogs after saline or in the controls after PS insufflation. In intradermal skin tests with PS antigen, a positive skin reaction was found in 3/6 dogs in 30 min, and in 5/6 dogs in 6 and 48 h after the PS injections. Sensitized dogs showed a significant increase in PS-specific IgG in serum and lavage fluid (LF). In LF of sensitized dogs, an increase in the percentage of lymphocytes, eosinophils, and neutrophils was detected. Sensitized dogs developed chronic interstitial inflammation with lymphocytes, macrophages, plasma cells, and eosinophils in lungs. Granulomas with lymphocytes, histiocytes, and giant cells were detected in both the interstitium and the bronchiolar wall in the lungs of sensitized dogs. PaO2 was lowest in dogs showing the most severe interstitial inflammation in the lungs. The results indicate that dogs can be successfully used in immunologic and physiologic studies of PS-induced HP.

Stopped lower buffer flow electrofractionation: simple electrofractionation for complex protein mixture

The standard electrofractionation technique simulated the liquid chromatography to create a continuous elution system. Though this continuous lower buffer flow electrofractionation system served as an excellent model for preparative electrophoresis, the restricted current flow caused by electric resistance arising from the column holder prevented the application to the purification of complex protein mixtures. To overcome the electric current problem, the stopped lower buffer flow electrofractionation (SFE) system is designed to work without using a column holder and use prestained markers as the detection tool of protein position during the electrofractionation process. Through this improvement, the SFE system widens the availability of electrofractionation to the purification of complex and low-concentration protein mixtures. In this report, the efficiency of this technique is shown through the partial purification of a 32P-labeled protein in the rat liver microsome.

Latex-induced dermal and pulmonary hypersensitivity in rabbits

BACKGROUND

Natural rubber latex (NRL) causes immediate, IgE-mast cell-mediated reactions in sensitized individuals, especially among health care workers and children with spina bifida. The immunopathogenesis of the reaction is obscure.

METHODS

To study the immunologic mechanisms of NRL allergy, rabbits were sensitized with two nonammoniated and one ammoniated NRL antigens. Subcutaneous and intratracheal injections were used to immunize rabbits. Intradermal skin tests, IgG antibodies against NRL in serum and lung lavage fluid, and pulmonary histologic features were evaluated.

RESULTS

One of nine sensitized rabbits died of anaphylaxis immediately after the third intratracheal injection with nonammoniated NRL. All sensitized rabbits, but not the controls, showed an immediate wheal and flare reaction in intradermal skin testing with NRL antigens. A positive skin reaction was detected 6 and 48 hours after the intradermal injections in four of five sensitized rabbits. A significant increase in NRL-specific IgG antibodies was detected in serum and lung lavage fluid of immunized rabbits. Lung histologic evaluation of NRL-sensitized rabbits showed a granulomatous interstitial and bronchial inflammation with a predominance of eosinophils and histiocytes in both intratracheally and subcutaneously sensitized rabbits. Vasculitis, hypertrophia, and contraction of pulmonary arteries could be detected in sensitized animals.

CONCLUSION

The results of the first NRL rabbit model study indicate that eosinophils and IgE antibodies play a major role in the immunopathogenesis of NRL-induced allergy and anaphylaxis. A wide range of inflammatory responses detected in rabbits injected by subcutaneous route without intratracheal exposure suggests that NRL exposure may pose a risk for a subsequent systemic reaction.

IgE and eosinophil regulation in a murine model of allergic aspergillosis

Exposure of BALB/c mice to Aspergillus fumigatus (Af), the antigen responsible for causing allergic bronchopulmonary aspergillosis in humans, caused elevated levels of serum immunoglobulin E (IgE) and peripheral blood and lung eosinophilia similar to that observed in the human disease. We have investigated the role of interleukin-4 (IL-4), IL-5 and interferon-gamma in regulating IgE and eosinophilia in the mouse model. Animals were immunized by intraperitoneal injections of soluble Af antigens adsorbed to alum. These animals developed elevated IgE and Af specific IgG1 and were then treated with anticytokine monoclonal antibodies before the final exposure to particulate Af antigens by the intranasal route. The results showed that anti-IL-5 abrogated eosinophilia in mice, while those treated with anti-IL-4 retained the same or reduced IgE levels compared to pretreatment levels. All anti-IL-5, anti-IFN-gamma, and control antibody-treated animals showed enhanced IgE levels. Anti-IFN-gamma treatment of mice resulted in marked enhancement of eosinophilia compared to all other groups. Eosinophil numbers observed in the histological sections of the lungs confirmed the eosinophilia detected in the peripheral blood. These results indicate that the increase in IgE and eosinophils after exposure to Af antigens in BALB/c mice are due to Af-induced production of IL-4 and IL-5 and that both IgE and eosinophilia are independently regulated.

Genetic mapping of a locus for multiple epiphyseal dysplasia (EDM2) to a region of chromosome 1 containing a type IX collagen gene

Multiple epiphyseal dysplasia (MED) is a dominantly inherited chondrodysplasia characterized by mild short stature and early-onset osteoarthrosis. Some forms of MED clinically resemble another chondrodysplasia phenotype, the mild form of pseudoachondroplasia (PSACH). On the basis of their clinical similarities as well as similar ultrastructural and biochemical features in cartilage from some patients, it has been proposed that MED and PSACH belong to a single bone-dysplasia family. Recently, both mild and severe PSACH as well as a form of MED have been linked to the same interval on chromosome 19, suggesting that they may be allelic disorders. Linkage studies with the chromosome 19 markers were carried out in a large family with MED and excluded the previously identified interval. Using this family, we have identified an MED locus on the short arm of chromosome 1, in a region containing the gene (COL9A2) that encodes the alpha 2 chain of type IX collagen, a structural component of the cartilage extracellular matrix.

Effects of midazolam and flumazenil on carotid sinus baroreflex control of circulation in rabbits

We have studied the effects of midazolam and flumazenil on the carotid sinus baroreflex, by examining mean arterial pressure (MAP) and heart rate (HR) responses to partial or complete bilateral carotid occlusion (BCO) in 12 conscious rabbits after aortic denervation. In eight rabbits, the responses to complete BCO were evaluated before and after cumulative doses of midazolam 0.5 and 1.0 mg kg-1, and after flumazenil 0.3 mg kg-1 following administration of midazolam. Midazolam and flumazenil had no effect on MAP or HR before complete BCO and neither affected the MAP response to complete BCO. Midazolam 0.5 and 1.0 mg kg-1 decreased the HR response to 60% and 58% of control, respectively. Flumazenil restored the midazolam-induced depression of the HR response to the control level. In the other four rabbits, we examined the MAP and HR responses to partial BCO (carotid artery pressure reduced by 5, 10 and 20 mm Hg) before and after midazolam 0.5 mg kg-1 and after flumazenil 0.3 mg kg-1 following administration of midazolam. The response to partial occlusion showed the same tendency as the response to complete BCO. These results indicate that midazolam attenuated the HR response of the carotid sinus baroreflex, flumazenil restored this midazolam-induced depression and neither drug affected the MAP response.

Urinary methamphetamine concentration following famprofazone administration

A 37-year-old man had a considerable concentration of methamphetamine in his urine, but he denied taking any abused drug. It was found that he took a pain killer that contains famprofazone, a relatively strong analgesic whose metabolites include methamphetamine and amphetamine. The human urinary metabolism of famprofazone was investigated. Immunoassay was used as a preliminary test, and gas chromatography with flame-ionization detection and gas chromatography-mass spectrometry were used for quantitation and confirmation.

Preparation of mixed ligand immobilized artificial membranes for predicting drug binding to membranes

Mixed ligand immobilized artificial membranes (IAMs) are surfaces that contain at least two immobilized membrane phospholipids which are designated as either the primary phospholipid or the secondary phospholipid. The primary immobilized phospholipid refers to the immobilized phospholipid that has the highest surface density. For this work, the primary immobilized phospholipid was a single-chain ether phosphatidylcholine (PC) analog. Four mixed-ligand IAMs were prepared by use of immobilized PC as the primary immobilized phospholipid. The secondary immobilized phospholipid ligand was either phosphatidylethanolamine, phosphatidylserine, phosphatidylglycerol, or phosphatidic acid. All of these secondary phospholipids are bonded at approximately 6-10 mol % relative to the molar amount of immobilized PC. Each secondary phospholipid contains functional groups in the polar head group region that require protecting groups during the immobilization process. The four-step synthetic strategy to prepare mixed-ligand IAMs involves (i) immobilization of the PC analog at high density to silica propylamine (SPA), (ii) immobilization of the second phospholipid (PL) analog at low density, (iii) end capping residual amines with a long-chain anhydride followed by end capping with a short-chain anhydride, and (iv) deprotection of the polar head group protecting groups. The surface density of the mixed PLs bonded to the silica support was approximately 130 mumol of PLs/g of SPA. High-performance liquid chromatography using these mixed lipid IAMs can be exploited to rapidly predict the membrane binding properties of drugs.

Two craniosynostotic syndrome loci, Crouzon and Jackson-Weiss, map to chromosome 10q23-q26

Crouzon syndrome (MIM 123500) is a common autosomal dominant form of craniosynostosis with shallow orbits, ocular proptosis, and maxillary hypoplasia. Jackson-Weiss syndrome (MIM 123150) is another autosomal dominant craniosynostosis with highly variable phenotypic expression. Unlike Crouzon syndrome, Jackson-Weiss syndrome is associated with foot anomalies. We performed two point linkage and haplotype analyses using 13 dinucleotide repeat markers on chromosome 10, spanning a genetic distance of 108 cM. The Crouzon syndrome locus (CFD1) maps to the region of chromosome 10q2, with the tightest linkage to locus D10S205 (Z = 3.09, theta = 0.00). the Jackson-Weiss syndrome locus in the large Amish pedigree in which the condition was originally described was also linked to the chromosome 10q23-q26 region between loci D10S190 and D10S186. The D10S209 locus was most strongly linked (Z = 11.29, theta = 0.00).

Inhibitors of sterol synthesis: synthesis and spectral properties of derivatives of 3 beta-hydroxy-25,26,26,26,27,27,27-heptafluoro-5 alpha-cholest-8(14)-en-15-one fluorinated at carbon 7 or carbon 9 and their effects on 3-hydroxy-3-methylglutaryl coenzyme A reductase activity in cultured mammalian cells

As part of a program to prepare delta 8(14)-15-ketosterols that cannot readily be metabolized to cholesterol or side-chain oxygenated species, we have prepared 3 beta-hydroxy-7 alpha-fluoro-5 alpha-cholest-8(14)-en-15-one (VII) and the 9 alpha-hydroxy (IV), 9 alpha-fluoro (VI) and 7 alpha-fluoro (VIII) derivatives of 3 beta-hydroxy-25,26,26,26,27,27,27-heptafluoro-5 alpha-cholest-8(14)-en-15-one (II). Sterol IV was prepared by oxidation of the delta 8,14 dienol ethyl ether of the 3 beta-acetate of II with m-chloroperbenzoic acid, followed by mild alkaline hydrolysis of the 3 beta-acetate derivative of IV. Treatment of IV with hydrogen fluoride-pyridine gave VI. The 7 alpha-fluoro-15-ketosterols VII and VIII were synthesized by treating the 3 beta,15-bis-trimethylsilyl delta 7,14-dienol ether derivative of the appropriate delta 8(14)-15-ketosterol with N-fluoropyridinium triflate, followed by hydrolysis of residual trimethylsilyl ethers and purification by high-performance liquid chromatography. The combined results of 1H and 13C nuclear magnetic resonance (NMR) chemical shifts, 1H-1H coupling constants, 1H-19F long-range coupling constants and molecular modeling indicated that a 7 alpha-fluoro, 9 alpha-fluoro or 9 alpha-hydroxy substituent has negligible effect on the conformation of the 15-ketosterols. 1H and 13C-NMR data are also given for delta 6,8(14)- and delta 8(14),9(11)-15-ketosterols, synthetic byproducts that could not be detected readily in samples of the fluoro-15-ketosterols by chromatographic methods. Mass spectra of VI and of previously reported 9 alpha-fluoro and 9 alpha-hydroxy-delta 8(14)-15-ketosterols showed abundant M-62 or M-60 ions that appear to correspond to loss of ketene and HF or H2O. The 9 alpha-hydroxy-F7-15-ketosterol IV, the 7 alpha-fluoro-15-ketosterol VII and the 7 alpha-fluoro-F7-15-ketosterol VIII were of equivalent potency to the parent 3 beta-hydroxy-5 alpha-cholest-8(14)-en-15-one (I) in lowering the levels of 3-hydroxy-3-methylglutaryl coenzyme A reductase activity in CHO-K1 cells. The 9 alpha-fluoro-F7-15-ketosterol VI showed high potency but appeared to be slightly less active than I.

Particulate Aspergillus fumigatus antigens elicit a TH2 response in BALB/c mice

BACKGROUND

In order to understand the immunoregulation in allergic aspergillosis, a murine model was developed by exposing animals to particulate and soluble antigens of Aspergillus fumigatus.

METHODS

BALB/c mice were exposed to soluble Aspergillus antigen intranasally. Animals showing moderate levels of IgE were subsequently exposed to soluble antigen or antigen conjugated to polystyrene beads intranasally. The IgE and IgG1 in the sera and the eosinophils in the blood and lungs were studied. The spleen and lung mononuclear cells were stimulated with both concanavalin A and antigen and evaluated for production of interleukin (IL)-4, IL-5, IL-10, and interferon-gamma.

RESULTS

Animals exposed to particulate antigens showed more elevated serum IgE levels and increased numbers of eosinophils in the blood and lungs than those exposed to soluble antigen. Lung cell cultures from animals exposed to particulate antigens when stimulated with Aspergillus produced IL-4 and IL-5, indicating a TH2 type of response. Animals exposed to soluble antigens showed a weaker TH2 response, as evidence by low IgE levels in sera, fewer eosinophils in the blood, and low levels of cytokine production from lung and spleen cells.

CONCLUSION

The results indicate that the physical nature of the antigen may have a major role in determining the type of immune response of the host.

Hyperimmune serum modulates allergic response to spores in a murine model of allergic aspergillosis

Allergic bronchopulmonary aspergillosis (ABPA) is a disease in atopic asthmatics characterized by eosinophilia and elevated levels of immunoglobulin E (IgE) and IgG antibodies to the ubiquitous fungus Aspergillus fumigatus (Af). The role of specific antibodies in the disease process is not clear. In this study, BALB/c mice were injected with hyperimmune serum from syngeneic mice exposed to soluble antigen of Af. These mice were then exposed to either Af spores or soluble antigen. Total IgE, Af-specific IgG1 (enzyme-linked immunosorbent assay) in serum, and eosinophils (eosinophil peroxidase assay) in lungs and bone marrow were measured. Histologic sections of lungs were examined for cellular infiltration and morphologic changes. Results indicate a suppression of increase in levels of antibodies and eosinophilia in mice receiving immune serum and exposed to spores compared with controls receiving phosphate-buffered saline treatment. Spores being the primary source of exposure to Af in ABPA, these results are significant in understanding the role of preexisting specific antibodies in patients.

Latex antigens induce IgE and eosinophils in mice

Hypersensitivity to latex proteins has been reported with increasing frequency in recent years. Elevated levels of latex specific IgE have been detected in the majority of these patients. Severe anaphylaxis and death resulting from latex exposure has also been reported. Nevertheless, the immune mechanism of latex allergy is not fully understood. In this report, we describe a model of latex allergy developed in mice exposed to latex proteins. Animals exposed to latex proteins demonstrated enhanced levels of total IgE, peripheral blood and lung eosinophilia, and elevated levels of serum IL-4 and IL-5. mRNA transcripts of IL-4 and IL-5, but not IFN-gamma, could be demonstrated in spleen lymphocytes. Antibodies to latex belonging to all IgG subclasses were detected in the sera of mice exposed to latex antigens. The histology of the lung showed non-necrotizing granulomas and extensive interstitial chronic inflammatory infiltrates, particularly around bronchioles and small blood vessels. Although this model of latex allergy demonstrates a heterogeneous immunological response, the CD4-positive Th2 cell-mediated response predominated.

Cardiopulmonary resuscitation without intermittent positive pressure ventilation

The purpose of this study was to examine whether tracheal insufflation of oxygen (TRIO) could be used as a substitute for intermittent positive pressure ventilation (IPPV) during cardiopulmonary resuscitation (CPR) in dogs with orotracheal intubation. Twenty-seven anesthetized, paralyzed and intubated dogs were used. The tip of the insufflation catheter was placed 1 cm distal to the top of the endotracheal tube. The effects of TRIO at a flow rate of 10 l/min with or without a continuous positive airway pressure (CPAP) of 5 cmH2O during external cardiac compressions were compared with those managed under the standard CPR. During CPR, TRIO without CPAP maintained adequate gas exchange. Peak airway pressures in the TRIO groups were significantly lower than that in the standard CPR group. No significant differences were observed in arterial, pulmonary artery and diastolic right atrial pressures during CPR among the three groups. However, the coronary perfusion pressures in the TRIO group with CPAP always tended to be low during CPR. The present study suggests that TRIO without CPAP should be a promising substitute for IPPV during CPR when IPPV is not feasible.

The effect of glucose on proteoglycans produced by cultured mesangial cells

Altered proteoglycan metabolism may play a role in the development of diabetic glomerulopathy. This study was conducted to examine the effects of glucose on the production and physical characteristics of proteoglycans generated by rat mesangial cells in culture. Rat mesangial cells were exposed to elevated glucose media (500 mg/dl) or standard glucose media (200 mg/dl) for 8-10 days, and proteoglycan synthesis was determined using 35S-labeling in conjunction with anion exchange and sizing chromatography. Rat mesangial cells generated predominantly chondroitin/dermatan sulfate proteoglycans, with small amounts of heparan sulfate proteoglycans. High glucose did not alter the number of rat mesangial cells after 24 h or after 8-10 days, compared with cells grown under standard glucose conditions. The total amount of glycosaminoglycan generated and the sizes of the major proteoglycans were not different between cultures grown in standard and elevated glucose medium. Levels of mRNA for the proteoglycan, biglycan (as assessed by Northern blot analysis), also were comparable between the standard and elevated glucose conditions. Exposure to media high in glucose did not change the rate of secretion of proteoglycans from the cell layer to the medium, but did result in a greater quantity of radiolabeled proteoglycan deposited in the extracellular matrix. The cell, extracellular matrix and medium proteoglycans isolated from the elevated glucose cultures, consistently eluted from the anion exchange column at a lower [NaCl] compared with those generated under standard glucose conditions, indicating a loss of anionic charges.(ABSTRACT TRUNCATED AT 250 WORDS)

Construction of Minimal n-2-n Encoders for Any n

The encoding problem (Rumelhart and McClelland 1986) is an important canonical problem. It has been widely used as a benchmark. Here, we have analytically derived minimal-sized nets necessary and sufficient to solve encoding problems of arbitrary size. The proofs are constructive: we construct n-2-n encoders and show that two hidden units are also necessary for n > 2. Moreover, the geometric approach employed is general and has much wider applications. For example, this method has also helped us derive lower bounds on the redundancy necessary for achieving complete fault tolerance (Phatak and Koren 1992a,b).

The alterations of cellular metabolism in the contralateral testis following spermatic cord torsion in rats

Cellular metabolic study was performed on the contralateral testis after torsion to delineate early testicular changes. In 9-week-old Sprague-Dawley rats the left testicle was rotated and fixed to the scrotum for 3, 8 and 24 hours in 3 groups (I, II and III). Each group was divided into 3 subgroups (a, b and c) by the length of detorsion of 0, 4 hours and 14 days. We measured adenosine triphosphate, total adenosine nucleotides and adenylate energy charge of the contralateral testis by high performance liquid chromatography. Compared to controls, no subgroups showed differences in the histological parameters. Also in subgroups Ia, Ib, Ic and IIa none of the metabolic parameters were significantly altered. However, subgroups IIb and IIc, and group III and its subgroups showed significantly decreased levels of all metabolic parameters. Therefore, it appears that unilateral testicular torsion (greater than 8 hours) and detorsion affect the contralateral testicular metabolism without gross histological changes in rats, and these changes seem to be reversible in terms of cellular recoverability because the maximally decreased level of adenylate energy charge among all subgroups is only 13% compared to controls. These findings suggest that some systemic mechanisms rather than an immunological or local inflammatory process is involved in this early period after torsion.

Comparison of methods for the Fmoc solid-phase synthesis and cleavage of a peptide containing both tryptophan and arginine

A major side reaction which can occur during the synthesis of Trp-containing peptides is modification of the Trp indole by reactive carbonium ion species released during acidolytic cleavage. [Asn2,Trp4]Dynorphin A-(1-13), a sequence which is very susceptible to Trp modification, was chosen as a model peptide to compare the effectiveness of various methods proposed to minimize Trp modification during Fmoc solid-phase synthesis. The peptide was synthesized with the side chain of Trp unprotected and cleaved by Reagent K [82.5% trifluoroacetic acid (TFA)/5% phenol/5% water/5% thioanisole/2.5% ethanedithiol (EDT)] [King, D.S. et al. (1990) Int. J. Peptide Protein Res. 36, 255-266], Reagent R [90% TFA/5% thioanisole/3% EDT/2% anisole] [Albericio, F. et al. (1990) J. Org. Chem. 55, 3730-3743], TFA containing 20% EDT and 4% water [Riniker, B. & Hartmann, A. (1990) in Peptides: Chemistry, Structure, and Biology (Rivier, J.E. & Marshall, G.R., eds.), pp. 950-952, Escom, Leiden], and TFA containing trialkylsilane, MeOH, and ethylmethyl sulfide [Chan, W.C. & Bycroft, B.W. (1992) in Peptides: Chemistry, Structure, and Biology, Op. cit., pp. 613-614]. Cleavage with Reagent K, Reagent R and TFA containing 20% EDT and 4% water yielded similar results; in addition to the desired peptide, the crude product contained 22-30% of a side product which appeared to result from Trp modification by a Pmc group. Cleavage with the trialkylsilane-containing mixture gave the lowest recovery of the desired peptide and the highest levels of Pmc-containing peptides.(ABSTRACT TRUNCATED AT 250 WORDS)

Urodynamic evaluation in pediatric neurogenic bladder

Urodynamic evaluation in pediatric neurogenic bladder is prerequisite for accurate prediction of prognosis and selection of appropriate treatment modality. We classified normal, hyperreflexic and areflexic bladders by cystometry. Hyperreflexic bladder was subdivided into two groups with or without detrusor sphincter dyssynergia and areflexic bladder into low pressure and high pressure. Among 36 patients with myelodysplasia on whom we performed a videourodynamic study vesicoureteral reflux was found in three of 7 patients with hyperreflexia with detrusor sphincter dyssynergia, two of 6 patients with hyperreflexia without detrusor sphincter dyssynergia and five of 10 patients with areflexia with high pressure. Low pressure areflexic bladder didn't show vesicoureteral reflux. When we evaluated 39 pediatric neurogenic bladder patients with a mean 25.5 follow-up months period, upper tract deterioration was improved and normal findings persisted in all the compliant patients to treatment. In the noncompliant group initial abnormal upper tract findings persisted or aggravated, especially in hyperreflexic bladder with dyssynergia and high pressure areflexic bladder. One of the three hyperreflexic bladders with dyssynergia and two of six high pressure areflexic bladders received augmented cystoplasty. These data show that urodynamic evaluation in pediatric neurogenic bladder provides excellent criteria for selecting high risk groups in pediatric neurogenic bladder.

Aspergillus fumigatus antigen induced eosinophilia in mice is abrogated by anti-IL-5 antibody

A murine model of allergic bronchopulmonary aspergillosis (ABPA), developed by exposure to Aspergillus fumigatus antigens, demonstrated eosinophilia of peripheral blood (PB), bone marrow (BM), and lung. The eosinophilia was abrogated by monoclonal anti-interleukin-5 (IL-5) antibody (TRFK-5) and not by an isotype control antibody (GL 113). Eosinophils in PB were enumerated from stained smears and their relative increase or decrease in cells from BM and lung was determined by an eosinophil peroxidase (EPO) assay (measured in optical density). Intraperitoneal injection of TRFK-5 in mice exposed to A. fumigatus antigen produced a significant reduction in eosinophils (PB 6.6 +/- 1.14% vs. 3.8 +/- 0.8%, P < .01) and EPO production in BM (0.935 +/- 0.03 vs. 0.615 +/- 0.02, P < .001). A similar reduction in EPO production in the lung (0.691 +/- 0.12 vs. 0.495 +/- 0.05, not significant) was also reflected in the histopathology for the different groups of mice. These findings confirming the role of IL-5 in eosinophilia, although not surprising, are significant in elucidating the immunopathogenesis of ABPA in the murine model. We conclude that in this model, eosinophilia may be due largely to the Th2 cytokine -IL-5 induced by A. fumigatus antigens.

Cultural and noncultural factors as determinants of caregiver burden for the impaired elderly in South Korea

This study investigated the determining variables of caregiver burden in caring for impaired older relatives in South Korea. Economic factors, daily caregiving hours, and caregiver's health status emerged as the most important determinants of caregiver burden in Korea. Though not a powerful predictor, caregivers' congruency with the traditional caregiver selection norms remained a statistically significant predictor of certain dimensions of caregiver burden.

Experimental results using nafamostat mesilate as anticoagulant during extracorporeal lung assist for 24 hours in dogs

We report on the experimental application of nafamostat mesilate (NM, 6-amidino-2-naphthyl p-guanidinobenzoate dimethanesulfonate, FUT), a new anticoagulant, to extracorporeal lung assist (ECLA) with an artificial membrane lung. Venovenous ECLA, from the jugular vein to the femoral vein, was performed with a hollow-fiber membrane lung at a blood flow rate of approximate 82 ml kg-1 min-1 for 24 h in 7 dogs under anesthesia and hypoventilation. Heparin (10 U ml-1 in a priming lactated Ringer solution of 140 ml, and 200 U kg-1) was administered before blood access cannulation. After start of ECLA, however, no heparin was used, and nafamostat mesilate was continuously infused into the drainage line of the bypass circuit to control activated coagulation time (ACT) at about 150 to 200 s. To maintain the prolonged ACT, 8.0 +/- 1.7 mg kg-1 h-1 of NM was required. Arterial blood pressure and pulse rate decreased significantly. Though fibrin monomer test revealed hypercoagulability after 6 h of ECLA, platelet counts did not significantly decrease. Total blood loss remained less than 40 g. The artificial membrane lung sustained a good gas exchange and low flow resistance throughout ECLA. Macroscopic examination revealed small spotty thrombi in the artificial lung but no major pathologic changes of the visceral organs in the all dogs at autopsy. High-dose NM administration could control blood coagulation and decrease blood loss during ECLA for 24 h without deterioration of the artificial lung and systemic complication other than mild hypotension and bradycardia.