T-cell cytokine production and endothelial dysfunction in type 2 diabetic patients with nephropathy.

This study assessed changes in serum levels of cytokines IFNgamma and IL-10 (biomarkers of inflammatory changes) and soluble biomarkers sICAM-1 and sE-selectin (biomarkers of endothelial dysfunction) in diabetic patients with and without nephropathy. IFNgamma and IL-10 were significantly elevated in patients with diabetic nephropathy (DN) and end-stage renal disease (ESRD) compared with controls and diabetic patients without DN. IFNgamma and IL-10 levels were significantly increased after haemodialysis. sICAM-1 and sE-selectin were significantly higher in diabetic, DN and ESRD groups compared with controls, and sICAM-1 but not sE-selectin was increased after haemodialysis.

T-cell cytokine production and endothelial dysfunction in type 2 diabetic patients with nephropathy

This study assessed changes in serum levels of cytokines IFNgamma and IL-10 [biomarkers of inflammatory changes] and soluble biomarkers sICAM-1 and sE-selectin [biomarkers of endothelial dysfunction] in diabetic patients with and without nephropathy. IFNgamma and IL-10 were significantly elevated in patients with diabetic nephropathy [DN] and end-stage renal disease [ESRD] compared with controls and diabetic patients without DN. IFNgamma and IL-10 levels were significantly increased after haemodialysis. sICAM-1 and sE-selectin were significantly higher in diabetic, DN and ESRD groups compared with controls, and sICAM-1 but not sE-selectin was increased after haemodialysis

Plasma met-enkephalin, beta-endorphin and leu-enkephalin levels in human hepatic encephalopathy.

To address the role of the opioid system in the pathogenesis of hepatic encephalopathy (HE) we measured plasma met-enkephalin, beta-endorphin and leu-enkephalin in patients with different grades of HE compared to control subjects and patients with cirrhosis. Plasma met-enkephalin levels were significantly higher in patients with cirrhosis and all grades of HE than controls. Plasma beta-endorphin levels were similar in the 3 groups. Plasma leu-enkephalin levels were significantly higher in HE grades II, III and IV than in controls, patients with cirrhosis and HE grade I patients. Our results support data on the involvement of met-enkephalin and leu-enkephalin in the pathogenesis of HE and provide a rationale for the use of opioid receptor antagonists in the treatment of HE.

Serum levels of astroglial S100-beta and neuron-specific enolase in hepatic encephalopathy patients.

To find a reliable, noninvasive method for the diagnosis of cognitive impairment in patients with hepatic cirrhosis we measured serum levels of astroglial S100beta and neuron-specific enolase in cirrhotic patients with and without hepatic encephalopathy (HE). S100beta levels showed a significant increase in groups with HE stage 1 and 2 compared to both control and cirrhosis patients. However serum neuron-specific enolase levels were not significantly different between the studied groups. S100beta levels had a specificity of 91.3% and sensitivity of 51.7% for detection of HE from cirrhosis. Serum S100beta may be a useful surrogate marker for the diagnosis of mild cognitive impairment in cirrhotic patients before they progress to more advanced stages of HE.

Serum levels of astroglial S100-beta and neuron-specific enolase in hepatic encephalopathy patients

To find a reliable, noninvasive method for the diagnosis of cognitive impairment in patients with hepatic cirrhosis we measured serum levels of astroglial S100beta and neuron-specific enolase in cirrhotic patients with and without hepatic encephalopathy [HE]. S100beta levels showed a significant increase in groups with HE stage 1 and 2 compared to both control and cirrhosis patients. However serum neuron-specific enolase levels were not significantly different between the studied groups. S100beta levels had a specificity of 91.3% and sensitivity of 51.7% for detection of HE from cirrhosis. Serum S100beta may be a useful surrogate marker for the diagnosis of mild cognitive impairment in cirrhotic patients before they progress to more advanced stages of HE

Plasma met-enkephalin, beta-endorphin and leu-enkephalin levels in human hepatic encephalopathy

To address the role of the opioid system in the pathogenesis of hepatic encephalopathy [HE] we measured plasma met- enkephalin, beta -endorphin and leu- enkephalin in patients with different grades of HE compared to control subjects and patients with cirrhosis. Plasma met- enkephalin levels were significantly higher in patients with cirrhosis and all grades of HE than controls. Plasma beta levels were similar in the 3 groups. Plasma leu- enkephalin levels were significantly higher -endorphin in HE grades II, III and IV than in controls, patients with cirrhosis and HE grade I patients. Our results support data on the involvement of met- enkephalin and leu- enkephalin in the pathogenesis of HE and provide a rationale for the use of opioid receptor antagonists in the treatment of HE

Assessment of the diagnostic system of Schistosoma infection at rural health unit level, Egypt.

The study sample was 6 rural health units and 405 attendants. Assessment of inputs was done through review of documents, charts, interviews, questionnaires and direct observation. Assessment of accuracy of the techniques was done by cross matching the results of urine and stools examination using different techniques (filtration and sedimentation for urine, and Kato-Katz and direct smear for stools). Results of technicians were compared with that of investigators using the same technique. Two days examinations of urine and stools samples were done by investigators using nucleopore and Kato-Katz, respectively. Environment assessment showed that, political and economic environments were the most influencing components that affect the system of diagnosis. Organization assessment showed that organization structure adapted to a large extent its objectives. However, decentralization and technological development were required. Filtration was more sensitive than sedimentation (82% and 51.3%, respectively). Specificity and PV+ were 100% for both tests. While, PV- and efficiency were 97.6% and 97.8% for filtration, and 93.7% and 94.1% for sedimentation, respectively. Sensitivity of Kato-Katz was higher than direct smear (88.5% and 11.5%, respectively). Kappa coefficient ranged between 0.63 and 1 as regards results of technicians compared to that of investigators. Mean daily workload of urinary examinations per technician ranged between 5.8 and 34.8. That of stools examinations was 5.3 and 32.4. Satisfaction rates ranged between 51.3% and 100% for different rural health units. Strengths and opportunities should be intensified. Weaknesses and threats should be treated.

Hopping and swimming in the leopard frog, Rana pipiens: I. Step cycles and kinematics.

This study presents a model for the step cycle patterns used during both hopping and swimming by the leopard frog, Rana pipiens. The two behaviors are essentially similar in movement pattern and in the ways they are modified from quadrupedal gaits. In hopping, there is marked hind limb extension throughout stance. The swing begins with a suspension equivalent to the leap that occurs in a galloping or bounding quadruped. Following suspension, as the frog descends from the apex of its leap, the hind limbs remain posterior and in line with the spine while they flex. Near the end of flexion, there is a rapid downward rotation of the hindquarters to bring the hind feet underneath the body. This movement utilizes the planted forelimb as a pivot. A similar pattern of movement occurs in swimming; the stance (propulsion) phase involves extension at all hind limb joints. The swing (recovery) phase begins with the hind feet fully extended and includes a protracted gliding phase, equivalent to the suspension in the hop. The hind limb then recovers to its initial position during a flexion phase. Since there is no landing and the hind limbs remain lateral rather than ventral to the pelvis, less flexion occurs in the spine or the limb joints. In both behaviors, the extensor muscles of hip (M. semimembranosus), knee (M. cruralis), and ankle (M. plantaris longus) achieve their longest lengths, when they likely can produce near maximal force, at the beginning of extension. All three muscles shorten during extension, but, because they are multiple-joint muscles, the amount of shortening is relatively small (approximately 15%). Hopping and swimming in frogs are comparable asymmetrical gaits with the same relative contact intervals (25% of stride). The step cycles in both gaits are modified from quadrupedal locomotion in the same ways: by 1) loss of knee and ankle extension toward the ground prior to landing (or end of flexion in swimming), 2) loss of a yield phase on landing (or end of flexion in swimming), and 3) inclusion of extended suspensions in both gaits.

Hopping and swimming in the leopard frog, Rana pipiens: II. A comparison of muscle activities.

Electromyography (EMG) was used to examine muscle activity of the major hip, knee, and ankle extensors during both hopping and swimming in leopard frogs. Chronic EMG electrodes were implanted for periods of 7-10 days. This permitted us to record EMG activities during both hopping and swimming from the same electrode, allowing a direct comparison of the timing and amplitudes of muscle activity between the two behaviors. We could then relate these activities to the kinematics of locomotion. In both behaviors, all three extensors were synchronously activated 30-50 ms before limb extension began. However, the hip extensor turned on relatively earlier in hopping than in swimming when on time was expressed as percent of stride. The hip and knee extensors were activated relatively longer in hopping and the ankle extensor relatively longer in swimming. The amplitudes of the rectified, integrated EMG signals were roughly twice as large in hopping as in swimming for all three muscles, supporting the notion that propulsion in hopping requires more force than in swimming. The EMG burst durations differed little between the muscles or, in relative duration, between the behaviors. As has been found in other quadrupeds, the EMG bursts began before visible movement and ceased at or before hindlimb extension was completed. In our animals, however, we found a consistent, low level (10-30% of maximum amplitude) of EMG activity that continued 60-200 ms past the end of the burst and into the suspension periods in both hopping and swimming. We hypothesize that this unusual activity may be present in frogs so that the hind limb remains aero(hydro)dynamically stable as the frog arches through its leap or glides in swimming following completed limb extension. Thus, the timing and pattern of the EMG bursts are consistent with those present in other tetrapods and support conservatism of neural control. However, the prolonged low-level activity suggests flexibility in the control pattern and variation according to specific behaviors.

Use of Kato and nucleopore techniques for qualitative diagnosis of schistosomiasis.

A comparison on qualitative basis, is attempted between merthiolate-iodine-formaldehyde concentration (MIFC) and Kato thick smear techniques for diagnosis of schistosome eggs in stools. As well, the centrifugation-sedimentation method was compared with the Nucleopore filtration technique for schistosome eggs in urine. Using MIFC and Kato techniques, 149 out of 185 subjects were found to have Schistosoma mansoni infection, 41 of them were diagnosed by Kato alone, while no case was solely MIFC positive. The sensitivity of MIFC compared to kato was 72.3% and both techniques were 100% specific. For diagnosis of S. haematobium infection, 78 out of 103 subjects were positive by centrifugation- sedimentation and/or Nucleopore techniques. 42 of them were diagnosed by Nucleopore alone and none was positive by centrifugation- sedimentation only. The sensitivity of the latter technique was 46.2% and both techniques were 100% specific. The study demonstrates that Kato thick smear and Nucleopore filtration are highly sensitive techniques that can be used for routine qualitative diagnosis of schistosomiasis. Under field conditions, they are qualitatively and quantitatively useful. The Kato technique besides its high sensitivity is very cheap. The only limitation for the Nucleopore technique is its relative high expenses.

Trafficking of immunoglobulin receptors in epithelial cells: signals and cellular factors.

A typical feature of epithelial cells is the polarized distribution of their respective plasma membrane proteins. Apical and basolateral proteins can be sorted both in the trans-Golgi network and endosomes, or in both locations. Inclusion into basolateral carriers in the TGN requires the presence of distinct cytoplasmic determinants, which also appear to be recognized in endosomes. Inactivation of the basolateral sorting information leads to the efficient apical delivery, probably due to the unmasking of a recessive apical signal. Factors associated with the cytosolic face of organelles probably not only recognize these signals to mediate the inclusion of the proteins into the correct transport vesicles, but also target the carriers to the corresponding plasma membrane domain. Our interest has focused on analyzing at the molecular level how epithelial MDCK cells generate and maintain a polarized phenotype, taking advantage of immunoglobulin receptors to study the biosynthetic and endocytic pathways and the corresponding sorting events.

Evaluation of a new reactive solid phase for radioimmunoassay of serum specific IgE against muscle relaxant drugs.

Until now, immunoassays for detection of anti-muscle relaxant IgE in serum have been performed with the drug coupled to epoxy-activated Sepharose or to RAST papers dics. In the present work we have used a quaternary ammonium-Sepharose in which the quaternary ammonium reactive group (choline chloride) was directly coupled to Sepharose via an ether linkage. 50 microliters of the quaternary ammonium solid phase (QAS) was incubated with 50 microliters of serum for 3 h, washed, incubated 18 h with 125I-anti-IgE and washed again. The results were expressed as the percentage of 125I-anti-IgE absorbed onto the solid phase. The results were at 1.3 +/- 0.5% for 20 control sera, with an upper normal limit estimated to 2.3%. The within-run reproducibility ranged from 3.2% to 10.0%. The results were significantly correlated with those obtained with either alcuronium-epoxy-Sepharose, choline-epoxy-Sepharose, the RAST-alcuronium or with the RAST-succinyl choline (respectively, r = 0.66, r = 0.80, r = 0.81, r = 0.40 and r = 0.85). The values obtained with the sera of 83 patients ranged from 0.3 to 38.5%. The sensitivity was estimated at 87.9%, 66.7% and 40.7% with the QAS-RIA, the RAST-succinyl choline and the RAST-alcuronium, respectively. The inhibition of adsorption of specific IgE onto the gel ranged from 13.0 to 90.6% in presence of 130 nmol of soluble muscle relaxants. In 83.3% of 30 cases, the highest inhibition was obtained with the muscle relaxant which was clinically incriminated.(ABSTRACT TRUNCATED AT 250 WORDS)

Simultaneous anaphylaxis to thiopentone and a neuromuscular blocker: a study of two cases.

Two women experienced anaphylactoid reactions after induction of general anaesthesia. Prick tests, intradermal tests (IDT), human basophil degranulation tests (HBDT) and a quaternary ammonium sepharose radioimmunoassay were undertaken several weeks later and repeated together with a leucocyte histamine release (LHR) test after 4 months. Anaphylaxis to suxamethonium was documented by four tests in patient 1 and to pancuronium by four tests in patient 2. Anaphylaxis to thiopentone was shown with IDT, HBDT and LHR in both women. It was concluded that simultaneous anaphylaxis to thiopentone and a neuromuscular blocker had occurred in these patients.

Anaphylaxis to muscle relaxants: cross-sensitivity studied by radioimmunoassays compared to intradermal tests in 34 cases.

Thirty-four patients (31 female and three male patients) with a previous anaphylactoid shock to muscle relaxants were investigated. The seric antimyorelaxant IgE was detected by radioimmunoassay (RIA), and the results were compared to intradermal test (IDR) reactions to dilutions of the commercial drugs. The RIA was carried out with a Sepharose-myorelaxant solid phase and anti-IgE 125I-labeled IgG. The results corresponded to the percentage of labeled anti-IgE bound on the solid phase. The RIA with Sepharose-alcuronium and Sepharose-choline was estimated positive from determination with normal sera (n = 12) when bound IgE was greater than 1.0% and 1.5%, respectively. The RIA and IDR were positive in 43.5% and 75%, respectively, of the cases, with a concordance of 66%. One test at least was positive in 79.4% of the cases. No correlation was found between IgE seric levels and the RIA nor between the cutaneous sensitivity and the RIA. Cross-reactivity with Sepharose-choline and Sepharose-alcuronium was observed in 50%, and it was demonstrated by IDR in only 34.2%. The RIA demonstrated the specificity of IgE to quaternary ammonium compounds as myorelaxant drugs. The positive IDR revealed the bridging of mast cell-bound specific IgE, depending on structural conditions, such as the flexibility of the molecules or the variable specificity of the antibodies, restricted to quaternary ammonium ions or enlarged to a broader part of the incriminated molecules.

[Radioimmunoassay method for the detection of IgE antibodies specific to alcuronium]. / Méthode radio-immunologique de détection des IgE spécifiques à l'alcuronium.

A radio-immunoassay (RIA) was used to screen for specific IgE to myorelaxants. Alcuronium was coupled to epoxy-activated Sepharose. Sixteen patients with anaphylaxis to alcuronium (n = 2), gallamine (n = 2) or suxamethonium (n = 12) were studied. The diagnosis was established by intradermal tests (ID), passive cutaneous anaphylaxis tests and human basophil degranulation tests. The amount of non specific label retained by Sepharose-ethanolamine (with sera of patients) and Sepharose-alcuronium (with sera of 11 control subjects) was estimated. The RIA was positive 10/16 (8/14 patients having reacted to a muscle relaxant other than alcuronium). The RIA seemed to be useful in the diagnosis of anaphylaxis to muscle relaxants. Drug-reactive antibodies were specific of the quaternary ammonium radical, which was the common allergenic determinant of all molecules of muscle relaxants. This test accounted for in vitro cross-reactivity, but had no predictive value for the clinical risk of crossed-anaphylaxis. This risk was best assessed by ID; it was positive in three cases. Although it was not possible to compare ID and RIA, the interpretation of which was different, both tests should be recommended for the detection of sensitivity to muscle relaxants.

Phosphatidylinositol metabolism during fertilization in the sea urchin egg.

Fertilization of the sea urchin egg results in a transient decline in the amount of phosphatidylinositol (PI) to a level equal to about 50% of that present in the unfertilized egg. This response begins as early as 15 seconds after insemination. The level of PI reaches a minimum at 30 seconds post-insemination, and returns to the original value between 2 and 5 min later. Pulse labelling studies with 32PO4 and [3H]-inositol showed that the incorporation of these two isotopes into 1-(3-sn-phosphatidyl)-L-myo-inositol 4,5-biphosphate [PtdIns(4,5)P2] increased as much as 50% within one minute after insemination. This suggests that at least part of the reduction in PI levels represents the phosphorylation of PI to form PtdIns(4,5)P2. We also found that the production of [3H]-labelled 1D-myoinositol 1,4,5 triphosphate [Ins(1,4,5)P3] present in the trichloroacetic acid (TCA) soluble fraction of eggs increased over five-fold during the first 10 min post insemination. The temporal correlation between the early burst of PtdIns(4,5)P2 and Ins(1,4,5)P3 formation and the transient increase in intracellular free calcium known to occur in the fertilized egg suggest that the production of PtdIns(4,5)P2 and ultimately Ins(1,4,5)P3 may be associated with calcium mobilization within the egg.

Improved feeding patterns in the prevention of childhood malnutrition.

In this study simple assessment of the nutritional status and evaluation of the dietary economic and social conditions were done for a sample of urban and rural infants and young children. Home-made diets, supplying the recommended dietary allowances for proteins and calories were suggested. These diets cost the same amount of money, originally spent on foods for the baby. A follow-up study for three months showed that babies reached growth standards better than the original for the same group at similar ages.