'Leptorapide' - a one-step assay for rapid diagnosis of human leptospirosis.

SUMMARY: Leptospirosis is a globally important zoonotic infection caused by spirochaetes of the genus Leptospira. It is transmitted to humans by direct contact with infected animals or indirectly via contaminated water. It is mainly a problem of the resource-poor developing countries of the tropical and sub-tropical regions of the world but outbreaks due to an increase in travel and recreational activities have been reported in developed and more industrialized areas of the world. Current methods of diagnosis are costly, time-consuming and require the use of specialized laboratory equipment and personnel. The purpose of this paper is to report the validation of the 'Leptorapide®' test (Linnodee Ltd, Northern Ireland) for the diagnosis of human leptospirosis. It is a simple one-step latex agglutination assay performed using equal volumes of serum sample and antigen-bound latex beads. Evidence of leptospiral antibodies is determined within minutes. Agglutination is scored on a scale of 1-5 and the results interpreted using a score card provided with the kit. Validation has been performed with a large sample size obtained from individuals originating from various parts of the world including Brazil and India. The test has shown sensitivity and specificity values of 97·1% and 94·0%, respectively, relative to the microscopic agglutination test. The results demonstrate that Leptorapide offers a cost-effective and accurate alternative to the more historical methods of antibody detection.

[Routine drainage following uncomplicated, elective cholecystectomy? A prospective, randomized study]. / Routinedrainage nach unkomplizierter, elektiver Cholecystektomie? Eine prospektive, randomisierte Studie.

A prospective randomized and controlled study of prophylactic drainage after simple, elective cholecystectomy was carried out. From March 1988 to June 1991 80 patients received an Easy-Flow drain and 80 did not. Operation and perioperative management were standardized. The endpoint of the study was postoperative morbidity, especially postoperative pyrexia and subhepatic fluid collection. The latter was identified by ultrasonography performed daily on postoperative day 1-4. No patient died. The morbidity including postoperative pyrexia revealed no difference between drained and undrained patients. In 19 of the patients with (23.8%) and in 25 of the patients without drainage (31.3%) a subhepatic fluid collection could be demonstrated by ultrasonography. This difference was not statistically significant either. We conclude that prophylactic drainage after elective, simple cholecystectomy is of no use for the patient. As subhepatic fluid collections can be seen in drained as well as in undrained patients it has to be accepted that drainage does not guarantee the removal of subhepatic fluid. Therefore its indicatory function (bleeding) and the ability to prevent the patient having biliary peritonitis or local abscess has to be put in doubt.

[Idiopathic and diuretic-induced edema]. / Idiopathisches und Diuretika-induziertes Odem.

Between may 1987 and may 1989, the case histories of 48 female patients with idiopathic oedema and of 5 female patients with diuretic-induced oedema were evaluated retrospectively at Dr. Asdonks' Feldbergklinik. Prior to and after the termination of the physical anti-oedemic treatment according to Asdonk, the volume of the limbs was determined. The extent of reduction in volume as reflected by lipophagia and decrease in oedema, as well as the regression of complaints were rated as a measure of therapeutic success. On discharge, all patients were free from complaints.

[Changes in plasma amino acids during and following isolated liver perfusion in the human. Brief clinical report]. / Veränderungen der Plasmaaminosäuren während und nach isolierter Leberperfusion beim Menschen. Kurze klinische Mitteilung.

Plasma amino acids have been analysed during isolated perfusion of the liver in dogs. Aromatic amino acids increased, also the branched chain amino acids showed a small rise. Thus no signs of hepatic failure could be detected. To evaluate early signs of hepatic failure in 2 patients scheduled for isolated liver perfusion, the plasma amino acids where analysed. Corresponding to the results obtained in animals, aromatic acids increased, whereas branched chain amino acids remained constant or rose. Even in the postoperative course no signs of deterioration of plasma amino acids could be detected.

Ultrastructural changes in the dog liver cell after isolated liver perfusion with various cytotoxins.

Following isolated liver perfusion with different cytotoxins - 5-fluorouracil (5-FU), methotrexate (MTX), dacarbazine (DTIC) cis-platinum (cis-PT) - liver tissue of dogs was examined with the electron microscope (a) directly after the perfusion and (b) after a survival time of 4 weeks (5-FU and DTIC). Acute disintegration of the granular endoplasmic reticulum and depletion of the glycogen stores occurred after perfusion with 5-FU, MTX, and DTIC, while cis-PT induced disintegration of the granular endoplasmic reticulum accompanied by an accumulation of glycogen. Four weeks after perfusion with DTIC signs of remarkably increased cellular activity were observed, while 4 weeks after perfusion with 5-FU the parenchymal liver cells revealed a well-balanced and moderate recovery of the cellular structures.

[Isolated liver perfusion with 5-fluorouracil (5-FU) in the human]. / Die isolierte Leberperfusion mit 5-Fluorouracil (5-FU) beim Menschen.

In two patients with liver metastases from colorectal cancer an isolated perfusion of the liver with 5-fluorouracil was performed. The primary tumors had been resected 5 weeks and 11 months before the perfusion treatment. By means of special cannulation system the hepatic artery and the portal vein were both arterialized. The patients recovered well after the operation. Sonographic measurements of the metastases showed colliquation areas in the tumours postoperatively.

Synthetic fragment of human growth hormone with hyperglycemic properties: residues 44-77.

Peptides homologous to Cys53 44-77 and Cys53 52-77 of the human growth hormone molecule were prepared by solid-phase synthesis and tested by our acute glucose tolerance test in ob/ob mice. Peptide 44-77, as either the Acm-Cys53 or Cam-Cys53 derivative, adversely affects glucose tolerance at doses of 100 to 150 nmol. Peptide 52-77 is nonhyperglycemic. Other diabetogenic properties are being tested.

Diabetogenic peptide from human growth hormone: partial purification from peptic digest and long-term action in ob/ob mice.

Studies in female ob/ob mice demonstrated diabetogenic properties of human growth hormone (somatotropin) and of a fragment generated therefrom by controlled digestion with pepsin; both the fragment and parent growth hormone produce long-term effects on carbohydrate metabolism; in acute glucose tolerance tests, only the fragment is active. Two nonacidic diabetogenic fractions have been separated from inactive fractions by chromatography on Bio-Gel P-6 followed by ion exchange chromatography at pH 4.3 and gel filtration on Bio-Gel P-2 and/or Sephadex G25; these active fractions exhibited multiple NH2-terminal (Lys, Phe, Leu, and Tyr). Fraction CD has these characteristics: (i) It induces glucose intolerance in fasting female ob/ob mice when injected subcutaneously in a divided dose, 15 min before and concurrently with glucose; mice injected with sufficient peptide exhibit elevated fasting glucose levels as long as 7 months after a single glucose tolerance test. (ii) It is a peptide smaller than that reported to stimulate body growth, but larger than somatostatin. This peptide, as reported earlier, does not crossreact with antiserum to human growth hormone in radioimmunoassay.

A hyperglycemic peptide from pituitary growth hormone: preparation with pepsin and assay in ob-ob mice.

A fragment that induces glucose intolerance in hereditarily obese mice has been prepared from pituitary growth hormone(sheep and human) by controlled digestion with pepsin in 0.05 M sodium acetate buffer, pH 3.7. The digest was purified by column chromatography on Bio-Gel P-6, followed by chromatography on Bio-Rex 70 and Bio-Gel P-2; in each successive step peptide was quantitated with the fluorescamine procedure. The fragment from sheep growth hormone has these characteristics: (1) It induces glucose intolerance in fasted ob/ob female mice when injected subcutaneously in a divided dose 15 min before, and concurrently with, glucose. (2) It is a basie peptide, as judged from its elution behavior on Bio-Rex 70, H(+) form. (3) It does not crossreact with antiserum to human growth hormone in radioimmunoassay. Further purification and initial sequence determinations have been undertaken.