Perinatal Infections With Ureaplasma

Ureaplasma species are increasingly recognized as relevant pathogens in prenatal, perinatal and postnatal morbidity. They are commonly found as commensals on the mucous membranes of the lower urogenital tract of pregnant women, but when ascending, they can cause bacterial vaginosis, chorioamnionitis, premature birth and postnatal morbidities such as bronchopulmonary dysplasia, and early-onset neonatal sepsis and meningitis. The detection of Ureaplasma species is challenging and is not covered by routine diagnostics, and current empiric antibiotic treatment in neonates suspected of infection is not directed against Ureaplasma species. The aim of this review is to discuss the pathophysiology of Ureaplasma infections, the clinical consequences and the current difficulties in diagnosis and treatment by providing an overview of the current literature.

A sealable ultrathin window sample cell for the study of liquids by means of soft X-ray spectroscopy

A new sample cell concept for the analysis of liquids or solid-liquid interfaces using soft X-ray spectroscopy is presented, which enables the complete sealing of the cell as well as the transport into vacuum via, for example, a load-lock system. The cell uses pressure monitoring and active as well as passive pressure regulation systems, thereby facilitating the full control over the pressure during filling, sealing, evacuation, and measurement. The cell design and sample preparation as well as the crucial sealing procedure are explained in detail. As a first proof-of-principle experiment, successful nitrogen K-edge fluorescence yield near-edge X-ray absorption fine structure experiments of a biomolecular solution are presented. For this purpose, it is shown that the careful evaluation of all involved parameters, such as window type or photon flux, is desirable for optimizing the experimental result.

Lattice QCD phase diagram in and away from the strong coupling limit

We study lattice QCD with four flavors of staggered quarks. In the limit of infinite gauge coupling, "dual" variables can be introduced, which render the finite-density sign problem mild and allow a full determination of the μ-T phase diagram by Monte Carlo simulations, also in the chiral limit. However, the continuum limit coincides with the weak coupling limit. We propose a strong-coupling expansion approach towards the continuum limit. We show first results, including the phase diagram and its chiral critical point, from this expansion truncated at next-to-leading order.

Targeting antigen and adjuvants to DC-SIGN+ skin dendritic cells with glycosylated liposomes in immunotherapy against cancer (P2101)

Cancer immunotherapy requires potent tumor-specific T cell responses, initiated by dendritic cells (DCs). Our aim is to develop a therapy that specifically targets DCs in vivo in human skin using glycosylated liposomes that contain tumor antigen and Toll-like receptor (TLR) ligand. The use of glycans specific for certain C-type-lectin receptors (CLRs) allows directing of the liposomes to specific DC subsets. Targeting the CLR DC-SIGN, which is a potent uptake receptor specifically expressed on human dermal DCs, by using Lewis (Le)X-modified liposomes, resulted in increased internalization of liposomes by human monocyte-derived (mo)DCs. Targeting moDCs with Melanoma antigen MART-1-encapsulated liposomes modified with LeX led to enhanced antigen presentation to CD8+ T cells. For good CD8+ T cell responses, maturation of DCs with LPS was necessary. Incorporation of TLR ligands MPLA, Poly I:C, R848, R837 or Pam3CSK4 into LeX-modified liposomes resulted in maturation of moDCs. Moreover, injection of TLR ligand-glycoliposomes in human skin led to their enhanced uptake by skin DCs and DC maturation. The enhanced uptake of glycoliposomes by skin DCs resulted in enhanced antigen presentation to CD8+ T cells. Our data demonstrate the potency of glycoliposomes as anti-cancer vaccine targeting DC-SIGN+ skin DCs in vivo and inducing tumor-specific T cell responses.

Comprehensive comparison of various techniques for the analysis of elemental distributions in thin films

The present work shows results on elemental distribution analyses in Cu(In,Ga)Se2 thin films for solar cells performed by use of wavelength-dispersive and energy-dispersive X-ray spectrometry (EDX) in a scanning electron microscope, EDX in a transmission electron microscope, X-ray photoelectron, angle-dependent soft X-ray emission, secondary ion-mass (SIMS), time-of-flight SIMS, sputtered neutral mass, glow-discharge optical emission and glow-discharge mass, Auger electron, and Rutherford backscattering spectrometry, by use of scanning Auger electron microscopy, Raman depth profiling, and Raman mapping, as well as by use of elastic recoil detection analysis, grazing-incidence X-ray and electron backscatter diffraction, and grazing-incidence X-ray fluorescence analysis. The Cu(In,Ga)Se2 thin films used for the present comparison were produced during the same identical deposition run and exhibit thicknesses of about 2 μm. The analysis techniques were compared with respect to their spatial and depth resolutions, measuring speeds, availabilities, and detection limits.

CTLs are targeted to kill beta cells in patients with type 1 diabetes through recognition of a glucose-regulated preproinsulin epitope

The final pathway of beta cell destruction leading to insulin deficiency, hyperglycemia, and clinical type 1 diabetes is unknown. Here we show that circulating CTLs can kill beta cells via recognition of a glucose-regulated epitope. First, we identified 2 naturally processed epitopes from the human preproinsulin signal peptide by elution from HLA-A2 (specifically, the protein encoded by the A*0201 allele) molecules. Processing of these was unconventional, requiring neither the proteasome nor transporter associated with processing (TAP). However, both epitopes were major targets for circulating effector CD8+ T cells from HLA-A2+ patients with type 1 diabetes. Moreover, cloned preproinsulin signal peptide-specific CD8+ T cells killed human beta cells in vitro. Critically, at high glucose concentration, beta cell presentation of preproinsulin signal epitope increased, as did CTL killing. This study provides direct evidence that autoreactive CTLs are present in the circulation of patients with type 1 diabetes and that they can kill human beta cells. These results also identify a mechanism of self-antigen presentation that is under pathophysiological regulation and could expose insulin-producing beta cells to increasing cytotoxicity at the later stages of the development of clinical diabetes. Our findings suggest that autoreactive CTLs are important targets for immune-based interventions in type 1 diabetes and argue for early, aggressive insulin therapy to preserve remaining beta cells.

Systemic administration of the propargylamine CGP 3466B prevents behavioural and morphological deficits in rats with 6-hydroxydopamine-induced lesions in the substantia nigra

The ability of CGP 3466B to attenuate the behavioural and morphological consequences of experimentally induced cell death was investigated in a recently updated animal model of Parkinson's disease. 6-Hydroxydopamine was infused bilaterally into the substantia nigra pars compacta of rats that were pretreated with desimipramine. Treatment with CGP 3466B (0.0014-1.4 mg/kg, injected subcutaneously) or its solvent was begun 2 h after the 6-OHDA injection, and maintained twice daily for 14 days. After a washout period of 14 days, changes in motor behaviour were evaluated, using the open field test (analysis of normal and abnormal stepping, e.g.) and the paw test (analysis of retraction time of limbs). Changes in learning and memory were evaluated with the help of the Morris water maze task. Following immunocytochemical staining of tyrosine hydroxylase, the extent of the lesion was quantified using a computerized system. CGP 3466B prevented all deficits produced by 6-hydroxydopamine (6-OHDA), though at different doses. It prevented: abnormal stepping (0.0014-0.014 mg/kg); increased forelimb and hindlimb retraction time (0.014-0.14 mg/kg and 0.0014-0.14 mg/kg, respectively); delayed learning (1.4 mg/kg); and reduced tyrosine hydroxylase immunoreactivity in the substantia nigra (0.0014-0.014 mg/kg). CGP 3466B (0.0014-0.14 mg/kg) induced no deficits in sham-treated rats. CGP 3466B (1.4 mg/kg), however, did not show any benefit on motor deficits in 6-OHDA-lesioned rats, and induced abnormal movements and decreased the tyrosine hydroxylase immunoreactivity in the substantia nigra pars compacta and the ventral tegmental area of sham-lesioned animals. It is concluded that CGP 3466B prevents all 6-OHDA-induced behavioural and immunocytochemical deficits, though at different doses. CGP 3466B is suggested to be a valuable agent for inhibiting the dopaminergic degeneration in patients with Parkinson's disease.

Repair in the rabbit outflow system

An in vivo study was conducted to study repair processes in the injured rabbit outflow system. A uniform injury was produced by raising intraocular pressure (IOP) manometrically to 70 mmHg for 1 h. The recovery process, which was followed clinically for 8 weeks and morphologically for 6 weeks, led to the re-establishment of normal meshwork architecture within this period. The morphological studies included light microscopy, autoradiography and electron microscopy. The initial lesion consisted of large deficits in the meshwork with breakdown of cell-to-cell connections, loss of extracellular materials and disruption of the vessels of the aqueous plexus. There was a significant lowering of IOP in the first week of recovery, which thereafter climbed back to normal. Also in the first week the meshwork became infiltrated with inflammatory cells which cleared by 4 weeks. There was some meshwork cell death by either necrosis or apoptosis. The majority of meshwork cells became activated within the first few days and remained activated for at least the first 2 weeks. Tritiated proline incorporation was maximal between 1 and 2 weeks. Tritiated thymidine labelling was seen throughout, but only after the inflammation subsided was it clear that meshwork cells in all regions of the meshwork were proliferating. Our study provided no evidence that normal meshwork cells have a basal proliferative turnover level. Our injury model involved complete repair of the outflow tissues and that required meshwork cells to become activated, mobilise, undertake synthetic activity and proliferate. This is the first example, other than argon laser trabeculoplasty, where meshwork cells in vivo have been induced to divide. Possible therapeutic implications for glaucoma are discussed.

The effect of finasteride, a 5 alpha-reductase inhibitor, on scalp skin testosterone and dihydrotestosterone concentrations in patients with male pattern baldness

The effects of the 5 alpha-reductase inhibitor, finasteride, on scalp skin testosterone (T) and dihydrotestosterone (DHT) levels were studied in patients with male pattern baldness. In a double blind study, male patients undergoing hair transplantation were treated with oral finasteride (5 mg/day) or placebo for 28 days. Scalp skin biopsies were obtained before and after treatment for measurement of T and DHT by high pressure liquid chromatography-RIA. In 10 male subjects studied at baseline, mean (+/- SEM) DHT levels were significantly higher in bald (7.37 +/- 1.24 pmol/g) compared to hair-containing (4.20 +/- 0.65 pmol/g) scalp, whereas there was no difference in mean T levels at baseline. In bald scalp from 8 patients treated with finasteride, the mean DHT concentration decreased from 6.40 +/- 1.07 pmol/g at baseline to 3.62 +/- 0.38 pmol/g on day 28. Scalp T levels increased in 6 of 8 subjects treated with finasteride. Finasteride decreased the mean serum DHT concentration from 1.36 +/- 0.18 nmol/L (n = 8) at baseline to 0.46 +/- 0.10 nmol/L on day 28 and had no effect on serum T. There were no significant changes in scalp or serum T or DHT in placebo-treated patients. In this study, male subjects treated with 5 mg/day finasteride for 4 weeks had significantly decreased concentrations of DHT in bald scalp, resulting in a mean level similar to the baseline levels found in hair-containing scalp.

Insecticidal and fungicidal compounds from Isatis tinctoria

Tryptanthrin (1), indole-3-acetonitrile (2) and p-coumaric acid methylester (3) were isolated from the aerial parts of Isatis tinctoria L. The compounds show insecticidal and anti-feedant activity against termites (Reticulitermis santonensis), insect preventive and control activity against larvae of the house longhorn beetle (Hylotrupes bajulus) and fungicidal activity against the brown-rot fungus (Coniophora puteana).

A review of the racial differences in the lung function of normal Caucasian, Chinese and Indian subjects

In the clinic, predicted normal values are widely used for routine assessments and, therefore, it is important that the noted differences in lung volumes between the races are recognized. Further epidemiological studies, using comparative methods and standard statistical techniques, are essential in order to quantify apparent differences between the races and to standardize normal values for race, especially with regard to age, with greater accuracy.

A review of the racial differences in the lung function of normal Caucasian, Chinese and Indian subjects

In the clinic, predicted normal values are widely used for routine assessments and, therefore, it is important that the noted differences in lung volumes between the races are recognized. Further epidemiological studies, using comparative methods and standard statistical techniques, are essential in order to quantify apparent differences between the races and to standardize normal values for race, especially with regard to age, with greater accuracy.

Regional distribution of lysosomal enzymes in the canine retinal pigment epithelium

We have investigated the activities of four lysosomal enzymes in RPE cells isolated from three regions of the canine fundus: the tapetal area, the central pigmented area and the peripheral area. The results obtained with freshly isolated cells showed that the activities of acid phosphatase, B-glucuronidase and N-acetyl-B-glucosaminidase were significantly higher in RPE cells derived from the peripheral region when compared to those from the two central regions. In contrast, the activity of cathepsin D was significantly higher in the tapetal region than in the periphery. The regional distribution of both acid phosphatase and B-glucuronidase observed in fresh RPE cells was progressively lost when these cells were grown in culture. Estimations of photoreceptor density per RPE cell from each of the regions indicated that the number of photoreceptors per RPE cell did not vary significantly with retinal location and suggested that variations in enzyme content were not related to differences in photoreceptor cell distribution.

A microsystem to assay lysosomal enzyme activities in cultured retinal pigment epithelial cells

A microsystem to assay the activity of lysosomal enzymes in a small number of cultured RPE cells is described. The activities of acid phosphatase, a-mannosidase, B-glucuronidase and N-acetyl-B-glucosaminidase were estimated in different human RPE cultures of varying passages. Some biochemical characteristics for each of the enzyme assays were studied including the effect of pH, the saturating concentrations of the appropriate substrates and the relationship between the enzyme activity and the number of cells assayed. The method presented is straightforward, avoids complicated tissue fractionation procedures and is able to estimate enzyme activities in as few as 10(4) cells.

Evidence for the presence of serotonergic nerves and receptors in the iris-ciliary body complex of the rabbit

The rabbit iris-ciliary body contains 78 +/- 6 ng/gm serotonin (5-HT) while the amine content in the aqueous humor is less than 0.01 ng/100 microliter. The low levels of endogenous 5-HT in the iris-ciliary body could not be directly detected by immunocytochemistry. However, pretreatment in vivo and in vitro with L-tryptophan and pargyline resulted in the localization of a sparse population of 5-HT fibers. These fibers could not be studied by exposing the tissue to exogenous 5-HT since the amine was taken up by noradrenergic fibers as well. This was confirmed in studies involving superior cervical ganglionectomy. It is concluded that 5-HT is taken up by both serotonergic and adrenergic fibers of the iris-ciliary body. In the presence of lithium, 5-HT stimulated an increase in the 3H-inositol phosphate accumulation in a dose-dependent manner in tissue where the phosphoinositide pool was labeled with 3H-inositol. A variety of agonists and antagonists were used to show that the 5-HT response is mediated, at least partly, by 5-HT2 receptors. The 5-HT-mediated effect on inositol phosphates is unaffected by superior cervical ganglionectomy. The effect of noradrenaline, which also stimulates inositol phosphate accumulation (but via alpha 1-adrenergic receptors in the iris-ciliary body), was elevated following superior cervical ganglionectomy.

Inflammation and the formation of epiretinal membranes

In this review of the literature evidence is provided from clinical, histological and experimental sources that inflammatory processes play a central role in the pathogenesis of contractile epiretinal membranes and proliferative vitreoretinopathy.

Daily glucose and insulin rhythms in diabetic dogs on the artificial beta cell

The circadian periods of plasma glucose, insulin and alpha-amino nitrogen (alpha-AN) were studied in fed and fasting normal and diabetic dogs which were fed either beef or beef supplemented with carbohydrates (CH). The diabetics were either withdrawn from insulin supply or treated with an artificial beta cell (ABC) or infused a constant insulin dose (CI).--There was a significant daily glucose rhythm in normal fasting animals and in fasting diabetics on CI or on insulin withdrawal. In the fed controls, the phase of the rhythms depends on carbohydrate content of food. In CH-free fed controls the insulin maxima were related to alpha-AN but in CH-fed controls they were related to glycemia. Due to the mechanism of ABC-provided insulin dosage, the phases of glucose and of insulin oscillations were correlated in all diabetics on ABC. Thus even if the mean glucose level is normalized by ABC the intrinsic phase relations remain altered.--It is concluded that the daily glucose periodicity is based on endogenous rhythms in glucose production and utilization and is essentially independent of current insulin provision. But it is governed by the meals as main "Zeitgebers" and modified by the actual insulin supply.

The cells of the bovine outflow system in tissue culture

Meshwork cells from the bovine outflow system were grown in culture and their growth characteristics and behaviour in vitro reported. The cells were studied by inverted phase microscopy and time-lapse cinephotomicrography. It was found that plating efficiency was highest for third and seventh passage cells. These cells reached confluence within 2 weeks when plated out at 7.5 X 10(3) cells cm-2 in a conventional culture medium containing 10% serum. Third passage cells were studied in greatest detail. These cells exhibited postconfluence contact inhibition of division. By 2 weeks postconfluence the division rate decreased 10-fold to a level of less than six divisions per thousand cells per day. The contact inhibition was not overcome by increasing the serum content of the medium. On the other hand, a 30-fold increased division rate could be produced after scratching the culture flask. Postconfluent contact-inhibited cultures were considered to be a better reflection of the behaviour and activities of meshwork cells in vivo than cultures which retain a high level of division.

Adenylate kinase activity of cerebrospinal fluid in central nervous system disorders

Adenylate kinase activity was measured in 41 samples of cerebrospinal fluid in 34 patients with various neurological disorders or psychiatric symptomatologies. Activities of the enzyme showed to be linked to clinically estimated acuteness or progression of the changes in the central nervous system at the time of specimen collection. The findings suggest the conclusion that determination of adenylate kinase activity in cerebrospinal fluid is a meaningful tool for the evaluation of progression and/or acuteness of central nervous system disorders.

[Variant creatine kinase isoenzymes: frequency and clinical significance (author's transl)]

To estimate the incidence of variant creatine kinase (CK)isoenzymes, 1,191 unselected patients were screened by means of CK:CK - MB ratio. When CK - MB was higher than 20% of the total CK in the immunoinhibition test, and a myocardial infarction could be excluded, a CK-isoenzyme electrophoresis was performed. We found macro-CK-BB-emia in 13 patients, but only three of them had elevated total CK activity. All patients but two were at the typical age of over 60 years; two males were 2 and 9 years old. The clinical diagnosis in macro-CK-BB-emia was predominantly cardiocerebrovascular insufficiency due to arteriosclerosis. In 16 other patients, the presence of an isoenzyme migrating cathodically to CK-MM was found. In this group, a malignant metastatic tumor was found in eight cases, the rest predominantly suffered from severe liver disease. Presence of both variant CK isoenzymes may lead to diagnostic or therapeutic errors due to the altered CK:CK-MB ratio. According to our studies, a variant CK isoenzyme occurs in 2.6% of hospitalized patients, but this will lead to problems diagnosing acute myocardial infarction only in the group with elevated total CK (0.42% of our patients).

Immunoinhibition and automated column chromatography compared for assay of creatine kinase isoenzyme MB in serum

We examined sera from six different groups of patients for CK-MB activity by means of two commercially available tests, an immunoinhibition method (E. Merck) and the CK-MB test as used with the aca (Du Pont). In the first group of patients (suspicion of myocardial infarction) the correlation between the two methods was good: r = 0.9191, y = 1.068x -- 0.888, x = 18.7 U/L, y = 19.0 U/L. In the second group, patients with high adenylate kinase activity, no interference was detectable on the aca, whereas the immunoinhibition method yielded falsely high CK-MB values. The third group consisted of persons with macro-CK-BB in their serum. In the immunoinhibition test these patients usually showed a high CK-MB:total CK ratio, whereas such results were rarely found for the aca. The fourth group, patients with a different electrophoretic mobility of their CK-isoenzymes (migration of an active band towards the cathode), were detected by the immunoinhibition method (high ratio of CK-MB to total CK), but not with the aca. In the presence of free CK-BB (group five) the immunoinhibition test resulted in "falsely" high CK-MB values, whereas CK-BB was retained on the column of the aca. In skeletal muscle diseases (group six) results by the two methods differed, values for CK-MB on the aca being much higher. It was demonstrated experimentally that this was due to CK-MM with altered surface charge.

Immunoinhibition and automated column chromatography compared for assay of creatine kinase isoenzyme MB in serum

We examined sera from six different groups of patients for CK-MB activity by means of two commercially available tests, an immunoinhibition method (E. Merck) and the CK-MB test as used with the aca (Du Pont). In the first group of patients (suspicion of myocardial infarction) the correlation between the two methods was good: r = 0.9191, y = 1.068x -- 0.888, x = 18.7 U/L, y = 19.0 U/L. In the second group, patients with high adenylate kinase activity, no interference was detectable on the aca, whereas the immunoinhibition method yielded falsely high CK-MB values. The third group consisted of persons with macro-CK-BB in their serum. In the immunoinhibition test these patients usually showed a high CK-MB:total CK ratio, whereas such results were rarely found for the aca. The fourth group, patients with a different electrophoretic mobility of their CK-isoenzymes (migration of an active band towards the cathode), were detected by the immunoinhibition method (high ratio of CK-MB to total CK), but not with the aca. In the presence of free CK-BB (group five) the immunoinhibition test resulted in "falsely" high CK-MB values, whereas CK-BB was retained on the column of the aca. In skeletal muscle diseases (group six) results by the two methods differed, values for CK-MB on the aca being much higher. It was demonstrated experimentally that this was due to CK-MM with altered surface charge.

Agiolax bolus in the esophagus. Report of two cases

Two cases of intermittent obstruction of the esophagus by the laxative Agiolax, proven by endoscopy and barium swallow, are described. The patients took an overdose of one and two tablespoons of Agiolax, respectively; they had no disorders of the esophagus. Symptoms of obstruction subsided spontaneously after 24 and 36 hours respectively.

[Distraneurin (Chlormethiazol) as an anaesthetic for high-risk cases in ophthalmology (author's transl)]

A new anaesthesia, through Chlormethiazol i.v. is described, which is especially used in cataract (lens) operations. There is no excitation during induction and the depth of anaesthesia (stage) depends on dosage-time ratio. Recovery is calm without undesirable side-effects. The intraocular pressure is significantly diminished during anaesthesia.

Evaluation of a new method for the intragastric titration of gastric juice

A new method for the intragastric titration of hydrochloric acid with a pH sensitive telemetric antimone electrode connected via a receiver to an electronic trigger, which regulates a pump for the inflow of 1 M KHCO3 solution, was evaluated in 22 achlorhydric patients by a series of intragastric instillations of 0.1 N HCl. In vitro this procedure presented a high precision (r = 0.99). Under in vivo conditions a significant correlationship (r = 0.84, p = 0.001) between the input of hydrochloric acid and bicarbonate in a range from 1.4 to 16.7 mEq/30 min could be established in non-operated subjects. The average coefficient of variation was 34%. In subjects with partial gastrectomy (Billroth II) overtitration of 100% (y = 2.1 x -1.7, r = 0.78, p = 0.001) was recorded, suggesting an increased loss of bicarbonate related to the accelerated gastric evacuation.