Subject(s)
Bronchitis/diagnosis , Medical History Taking , Respiratory Function Tests , Adult , Aged , Ambulatory Care , Diagnosis, Computer-Assisted , Humans , Middle Aged , Risk FactorsABSTRACT
Thirty-one serum and CSF samples from 21 HIV-antibody-positive patients with neurological deficits were examined to prove or exclude intrathecal production of HIV antibodies. By dilution, sera were adjusted to the IgG concentration of the corresponding CSF samples. Both samples were then serially diluted in log2 steps down to the detection limit and were tested in an anti-HIV ELISA. From the dilution obtained at the cut-off level, a quotient QHIV was derived as an indicator of intrathecal production of HIV antibodies. Six of a total of eight samples with a QHIV value of greater than or equal to 2 were correlated which the clinical diagnosis of AIDS-related dementia complex (ARDC). However, a QHIV less than 1 did not exclude the development of ARDC, as was shown during follow-up in one case. Different methods are compared for the determination of intrathecal production of IgG and anti-HIV. A quotient QHIV greater than or equal to 2 is suggested to be highly indicative of intrathecal production of anti-HIV as well as of the development of ARDC.
Subject(s)
Acquired Immunodeficiency Syndrome/immunology , Antibodies, Viral/biosynthesis , Brain Diseases/complications , HIV/immunology , Spinal Cord/immunology , Acquired Immunodeficiency Syndrome/cerebrospinal fluid , Adult , Aged , Antibodies, Viral/cerebrospinal fluid , Brain Diseases/cerebrospinal fluid , HIV Antibodies , Humans , Male , Middle AgedABSTRACT
An experiment conducted at the University of Liège, Belgium in the computer-assisted teaching of juvenile-type insulin-dependent diabetics is reported. The course was designed to individualize teaching in order to give a minimum of basic information to a maximum of patients. The original computer-assisted instruction system DOCEO II is described; methods and programming techniques are summarized. The course was evaluated on fifty patients who attended the first four lessons. The improvement in knowledge was impressive: scores corrected for guessing were 9.59 +/- 4.43 out of 20 before the course and 17.04 +/- 2.26 out of 20 after the course (paired t test: p less than 0.001). The system was enthusiastically accepted by the patients and is now routinely used in our Institution. Long-term studies are in progress to determine whether increased knowledge leads to better self-care, improved control and, ultimately, reduced incidence of diabetic complications.
Subject(s)
Computer-Assisted Instruction , Diabetes Mellitus/therapy , Patient Education as Topic , Adolescent , Adult , Aged , Audiovisual Aids , Educational Measurement , Female , Humans , Male , Middle AgedABSTRACT
The aim of the study was to achieve the measurement of lecithin : cholesterol acyltransferase (EC 2.3.1.43) activity independent of and uninfluenced by equilibration of lipids between different lipoproteins, their molar ratios or by possible differences in their substrate quality. A mixture of sodium phosphotungstic acid/MgCl2 was added to serum samples to achieve total precipitation of all plasma lipoproteins. The filtrate containing the total plasma lecithin : cholesterol acyltransferase activity, apolipoprotein A-I and major plasma proteins was used for the assay. Liposomes comprised of phosphatidylcholine, cholesterol and dicetylphosphate served as substrate. The decrease in free cholesterol was determined enzymatically after incubation for 60 min at 37 degrees C. The assay followed zero-order kinetics and was linear for more than 60 min. The following Km values for various substrates were obtained: liposomes, 0.43 mM; HDL, 0.63 mM; LDL, 0.0; VLDL, 0.0; abnormal lipoprotein, found in cholestasis, (LP-X), 0.0. Comparison with generally used lecithin : cholesterol acyltransferase assay methods revealed similar activities for healthy controls, but in different forms of dyslipoproteinemia higher values were obtained with our method and, in special cases, the activity could be enhanced by addition of apolipoprotein A-I.
Subject(s)
Phosphatidylcholine-Sterol O-Acyltransferase/blood , Cholestasis/enzymology , Cholesterol/metabolism , Hepatitis/enzymology , Humans , Kinetics , Lipoproteins, HDL/metabolism , Liposomes/metabolism , Methods , Pancreatitis/enzymology , Substrate SpecificityABSTRACT
Apolipoprotein A-I concentration in human serum was determined by kinetic nephelometry. Under optimal reaction conditions and within the normal physiological range the relation between apolipoprotein A-I concentration and measured rate units it approximately linear. The detection limit of the assay lies at 2 micrograms/ml. The coefficient of variation within one series is 1.44%. The correlation coefficient with alpha-cholesterol, as determined by agarose electrophoresis followed by polyanion precipitation, is better than 0.94. Addition of detergent to serum dilutions increases the reaction rate, suggesting that delipidation changes the antigenic expression of apolipoprotein A-I. The magnitude of this change is constant in normal controls, but not in special pathological cases. The described technique can be recommended for routine use in clinical chemistry for measurement of apolipoprotein A-I.
Subject(s)
Apolipoproteins/blood , Animals , Antigen-Antibody Complex , Apolipoprotein A-I , Humans , Immune Sera , Immunoassay , Kinetics , Lipoproteins, HDL/blood , Nephelometry and Turbidimetry/methods , Sheep/immunologyABSTRACT
A method is described for the enzymatic determination of the cholesterol content of serum lipoproteins separated by electrophoresis on agarose. The method shows high precision and correlated well with quantiative lipoprotein electrophoresis based on polyanion precipitation.
