Use of power Doppler in pediatric neurosonography: a pictorial essay.

In pediatric neurosonography, conventional color Doppler imaging has been the primary adjunct to routine gray-scale imaging. Power Doppler sonography is a relatively recent development that does not have the limitations of conventional color Doppler ultrasound. The power Doppler technique measures the energy of moving red blood cells instead of the velocity and direction of flow. Advantages of this technique include increased sensitivity for identifying flow in slow-flow states, more complete evaluation of a vessel, and more accurate evaluation of the course of the vessel. Power Doppler sonography is helpful in evaluation of the neonatal brain in a variety of clinical situations: identifying the exact locations of extraaxial fluid collections, differentiating intraventricular clot from normal choroid plexus, detecting intraventricular hemorrhage, and demonstrating asymmetries in cerebral perfusion. However, in certain difficult cases, use of both conventional color Doppler sonography and power Doppler sonography produces increased diagnostic accuracy because these techniques furnish complementary information.

Fatal cerebral edema and intracranial hemorrhage associated with hypernatremic dehydration.

We report neuroimaging findings of intracranial hemorrhage and cerebral edema in an infant with obtundation and seizures, initially suspected to be secondary to non-accidental trauma but finally attributed to hypernatremic dehydration. Neuroimaging findings due to hypernatremic dehydration have not been previously described in the radiologic literature. Hypernatremia should be included in the differential diagnosis of intracranial hemorrhage in the infant without evidence of nonaccidental trauma.

Gadolinium enhancement in the center of a spinal epidural hematoma in a hemophiliac.

Spinal epidural hematoma (SEH) is an uncommon complication of hemophilia. It is a neurologic and neurosurgical emergency and prompt diagnosis is imperative. The utility of MRI in the diagnosis of hemorrhage is well established. We present a case of an SEH in a hemophiliac patient that demonstrated gadolinium enhancement.

Coupled reverse transcription-polymerase chain reaction (RT-PCR) as a sensitive and rapid method for isozyme genotyping.

We have developed a highly sensitive and rapid coupled reverse transcription-polymerase chain reaction (RT-PCR) technique for detection of alpha-amylase-encoding gene transcripts and for distinguishing between the human salivary (AMY1) and pancreatic (AMY2) gene transcripts. The two genes are 93-94% homologous. However, the AMY1 gene has an additional exon known as exon S, and an extra 32 bp in exon 1. Genotyping of the different AMYs by RT-PCR was based on this unique feature of the AMY1 mRNA sequence. Detection of AMY gene (AMY1 and AMY2) transcripts in cellular RNA was achieved with a set of primers common to both human AMY1 and AMY2 genes and derived from the exon 3-4 regions. In contrast, AMY1 gene transcripts were distinguished from the pancreatic AMY2 gene transcripts by use of primers specific to the exon S-1 regions of the AMY1 gene. To distinguish AMY1 transcripts from a mixture of AMY1 and AMY2, use was made of the differences in the ethidium bromide-stained agarose gel patterns obtained after digestion of the amplified exon 3-4 fragments with TaqI. AMY gene transcripts were detectable by autoradiography in RT-PCR amplified DNA obtained from as little as 5 pg of human pancreatic or parotid total RNA. A comparison of sensitivity of Northern blotting vs. RT-PCR suggested that the RT-PCR method is about 3-6 x 10(3)-fold more sensitive than Northern blotting in detecting AMY gene transcripts in human pancreatic total RNA.

Alpha-amylase gene transcription in tissues of normal dog.

We studied the distribution of alpha-amylase mRNA in normal dog tissues by northern blotting (NB) and reverse transcription-polymerase chain reaction (RT-PCR) with human pancreatic (AMY2) and salivary (AMY1) alpha-amylase cDNA-specific primers. Analysis of poly(A+) RNA from various normal tissues by NB indicated the presence of detectable levels of alpha-amylase mRNA transcripts only in pancreas. Dot-blot analysis of DNA amplified with primers common to both (human) isoamylase mRNAs showed presence of alpha-amylase gene transcripts not only in pancreas but also in liver, small intestine, large intestine and fallopian tube. Traces of amylase gene transcripts were also observed in ovary, uterus and lung. Interestingly, amylase transcripts were not detectable in the parotid gland by NB or RT-PCR. We have also localized alpha-amylase mRNA transcripts to dog pancreas by in situ transcription and in situ hybridization. Our results suggest that there is high degree of homology between the alpha-amylase mRNA sequences in dog and human at least in the exon 3-4 regions of the human gene.

Polyanions inhibit murine macrophage Fc receptor mediated ADCC and binding.

We examined the effect of various polyanions on mouse complement hemolytic activity, Fc receptor (FcR) subclass mediated antibody-dependent cellular cytotoxicity (ADCC) as well as binding by mouse peritoneal macrophages (M phi) of sheep erythrocyte targets. All the polyanions tested (dextran sulfate, carrageenan, polyvinyl sulfate, pentosan polysulfate and polyanethol sulfonic acid) inhibited the hemolytic activity of mouse serum complement to varying degrees. Polyanions inhibited ADCC mediated by either IgG2a or IgG2b in a reversible manner. FcR subclass mediated binding studies at 4 degrees C indicated that the various polyanions compete for FcR binding of sheep erythrocytes opsonized with murine IgG2a, IgG2b and polyclonal IgG. Polyanethol sulfonic acid was uniformly the most potent inhibitor of mouse CH50 and FcR dependent ADCC and binding functions, but did not affect C3b receptor mediated binding.

An analysis of the fluid phase C1q binding assay. The effect of endogenous C1q on the precipitation and detection of an immune complex model.

We examined the effect of endogenous C1q on the sensitivity of the fluid-phase C1q binding assay (C1qBA) in detecting an immune complex (IC) model, heat-aggregated IgG (HAIgG), at concentrations of 10-10,000 micrograms/ml sample. Results in normal human serum (NHS) or plasma (NHP) were compared with those in heat-inactivated NHS (NHS/56) in which most endogenous C1q was depleted by heat denaturation. Higher HAIgG concentrations were required in NHP and NHS to produce the same 125I-C1q precipitation seen in NHS/56. This decreased sensitivity varied from 70% at low HAIgG concentrations to 0% at high concentrations, as predicted for a large pool of endogenous C1q, in equilibrium with 125I-C1q, but in excess of that which could bind to all but the highest concentrations of IC model. In serum depleted of functional C1q on an immunoadsorbant of HAIgG, the precipitation of radiolabeled HAIgG under C1qBA conditions was concentration dependent and generated a saturation curve, showing that only a fraction of IC are usually precipitated in this assay. HAIgG precipitation was enhanced 1.4-fold in NHS/56 (8 micrograms C1q/ml) and three-fold in NHS (67 micrograms C1q/ml) suggesting that IC size is increased by endogenous C1q. In dual label experiments using 131I-HAIgG, the precipitation of 125I-C1q in NHS/56 was directly proportional to IC model precipitation, but markedly discordant in NHP, showing the measurement of IC in heat-inactivated sera superior to that in native serum. A comparison of the C1q:HAIgG ratio in PEG precipitates with that in samples, indicated that equilibrium was established between C1q and IC model. Thus the precipitation of 125I-C1q in the C1qBA represents (1) the fraction of total C1q bound to IC, and (2) the fraction of IC precipitated by PEG.

Effects of inhibitors of C1q biosynthesis on macrophage Fc receptor subclass-mediated antibody-dependent cellular cytotoxicity and phagocytosis.

We examined the effects of the inhibitors of C1q or collagen biosynthesis, 2,2'-dipyridyl (DP), and 3,4-dehydro-DL-proline (DHP) on murine macrophage (M phi) FcR subclass-mediated antibody-dependent cellular cytotoxicity (ADCC) and phagocytosis of sheep erythrocyte targets. Oil-elicited peritoneal M phi from C3HeB/FeJ mice which were cultured for 24 hr with DP (0.08 or 0.10 mM) or DHP (0.8 or 1.0 mM) showed a significant decrease in FcR subclass-mediated ADCC for murine monoclonal IgG2a (FcRI) and IgG2b/IgG1 (FcRII) as well as for heterologous polyclonal IgG. These collagen inhibitors also blocked phagocytosis mediated by both IgG2a- and IgG2b-opsonized erythrocytes. DP was more potent than DHP in blocking FcR effector functions in a reversible fashion and neither inhibitor affected M phi C3b receptor function. Pretreatment of M phi with collagenase resulted in significant reduction in FcR-mediated ADCC and phagocytosis. The inhibition of M phi FcR subclass-mediated ADCC and phagocytosis by collagen C1q synthetic inhibitors or by collagenase treatment further confirms a functional relationship between cell-associated C1q and FcR-dependent functions.

Separation of ferrichromes and other hydroxamate siderophores of fungal origin by reversed-phase chromatography.

Iron(III) chelates of nineteen trihydroxamate siderophores of fungal origin, including ferrichromes, coprogen and triacetylfusarinine C, were separated on a preparative scale with a reversed-phase column using the octadecyl silica gels LRP-1 or LRP-2 as the stationary phase and a water-methanol gradient as the mobile phase. Using this system in combination with silica gel column chromatography, most siderophores can be obtained in pure form. Factors affecting the mobility of these compounds in the reversed-phase system are discussed.

Extracellular siderophores from Aspergillus ochraceous.

A large number of iron-chelating compounds (siderophores) were isolated from supernatants of iron-deficient cultures of a mold isolate, subsequently identified as Aspergillus ochraceous . Siderophores in their iron chelate form were purified to homogeneity by using Bio-Gel P2, silica gel, and C-18 bonded silica gel (reverse-phase) columns. Most of these compounds, as identified by 1H and 13C nuclear magnetic resonance spectroscopy and X-ray crystallography, belong to the ferrichrome family. The organism produces ferrirubin and ferrichrysin as the predominant and the second major compound (62 and 15% of the total siderophores), respectively. Ferrichrysin appears as the first siderophore in the medium on day 2 of growth. Several of the other siderophores are novel and ranged in quantities from 0.2 to 5% of the total. The trivial names asperchrome A, B1, B2, C, D1, D2, and D3 are proposed for these novel compounds, which are all members of the ferrichrome family, and all but the first one contain a common Orn1 - Orn2 - Orn3 - Ser1 -Ser2-Gly cyclic hexapeptide ring with three dissimilar ornithyl delta-N-acyl groups. Another compound which appeared late in the growth period was similar to fusarinine C ( fusigen ). All of these compounds showed growth factor activity to various extents in bioassays with Arthrobacter flavescens Jg-9. None of these compounds showed antibacterial activity against Escherichia coli or Bacillus megaterium.