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Biomedical subjects

C Alberts

Publications and source records attributed to C Alberts.

14 recordsLinked to original sources

ELISA of complement C3a in bronchoalveolar lavage fluid.

Activated complement factors within the lung may induce several local biological effects. In order to investigate local complement activation we have developed non-competitive two-site ELISAs of C3a and total C3 in bronchoalveolar lavage fluid (BALF). For the assay of C3a, both C3 and C3(H2O) were removed from the samples by precipitation with polyethylene glycol. It was necessary to add carrier proteins to BALF to remove C3 and C3(H2O) fully. The ELISA of C3a has the lowest limit of detection reported thus far, namely 0.045 nM (= 0.405 ng/ml). In BALF from healthy persons (n = 9) the C3a concentration was 0.20 nM (0.12-0.31 nM) (median, range). C3a was higher in BALF from patients with asthma or with sarcoidosis; asthma (n = 10), 0.45 nM (0.20-5.79 nM); sarcoidosis (n = 19), 1.31 nM (0.095-5.65 nM) (Mann-Whitney U test, p less than 0.005). In BALF from patients with Pneumocystis carinii pneumonitis (n = 10) the C3a concentration was 0.18 nM (0.07-0.57 nM). C3a concentrations in BALF may reflect local complement activation in the lung and/or diffusion into the lumen. This was studied by normalizing C3a concentrations in BALF into values for epithelial lining fluid (ELF), and calculating serum-to-ELF quotients of C3a, and C3a/total C3 quotients.

Adolescent

Uveitis and systemic disease.

A prospective study was conducted of 865 patients with uveitis to determine the frequency of associated systemic diseases and to assess the value of limited laboratory screening of these patients. All patients underwent a standard diagnostic protocol followed--when indicated--by special tests and procedures performed in order of likelihood ('tailored approach'). For 628 patients (73%) a specific diagnosis was established based on history, ophthalmologic examination, and laboratory and radiographic studies. A definite association with systemic disease was determined for 220 patients (26%). A relationship with a subclinical systemic disorder could be presumed in 201 cases (23%) and a well-established clinical uveitis entity without a recognisable systemic disorder was present in 207 cases (24%). For 237 patients (27%) a diagnosis could not be determined. The most frequently observed systemic diseases were sarcoidosis (7%) and HLA-B27-associated seronegative spondylarthropathies (6%). Presumed or definite toxoplasmosis was encountered in 10% of cases. HLA-B27-associated acute anterior uveitis was the most common clinical entity (17%). In the majority of cases the presence of a systemic disease was not suspected prior to eye involvement and was only recognised after the subsequent diagnostic procedures.

Adolescent

Surfactant protein A in bronchoalveolar lavage fluid.

We measured surfactant protein A and phosphatidylcholine in the bronchoalveolar lavage fluid from healthy volunteers and several groups of patients with lung diseases to obtain information on surfactant in the lung. We developed three types of enzyme-linked immunosorbent assays that used combinations of polyclonal antiserum and monoclonal antibodies. Phosphatidylcholine was assessed by enzymatic measurement. The median amounts of surfactant protein A in bronchoalveolar lavage fluid determined by the enzyme-linked immunosorbent assay with monoclonal antibodies were as follows: control subjects (n = 10), 2.82 mg/L (range, 0.92 to 5.17 mg/L); patients with asthma (n = 13), 1.89 mg/L (range, 0.45 to 2.95 mg/L); and patients with pulmonary sarcoidosis (n = 20), 2.98 mg/L (range, 0.68 to 7.02 mg/L). The median phosphatidylcholine concentrations in the bronchoalveolar lavage fluid were as follows: control subjects (n = 10), 20 mumol/L (range, 3 to 37 mumol/L); patients with asthma (n = 12), 24 mumol/L (range, 3 to 55 mumol/L); and patients with pulmonary sarcoidosis (n = 20), 26 mumol/L (range, 4 to 76 mumol/L). As a group, the patients with asthma had less surfactant protein A in bronchoalveolar lavage fluid than did the control subjects (Mann-Whitney U test, p less than 0.05). The surfactant protein A levels measured by the enzyme-linked immunosorbent assay with polyclonal antiserum and by a competitive enzyme-linked immunosorbent assay were also lower in bronchoalveolar lavage fluid from patients with asthma than in that from control subjects. The phosphatidylcholine concentrations in all groups were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Sarcoidosis of the heart].

In 2 patients arrhythmias and conduction disorders were the first symptoms at presentation of cardiac sarcoidosis. One patient with severe conduction disorders showed normalisation of the EKG during steroid treatment. The other patient developed an overall cardiomyopathy and the arrhythmia was treated with conventional drugs. The frequency of cardiac involvement in sarcoidosis is much higher than that of clinical symptoms of sarcoid heart disease. Cardiac sarcoidosis is increasingly diagnosed in the last few decades. In most cases, it presents with sudden death, arrhythmia, conduction disorders or cardiomyopathy. The main diagnostic pathological feature is evidence of noncaseating granulomas, but mononuclear cell infiltration and focal interstitial fibrosis have also been found. The basal part of the interventricular septum is particularly prone to involvement. If conventional therapy in clinically important cases proves inadequate, steroid therapy should be added. It is recommended to make an EKG in every patient presenting with sarcoidosis even in the absence of cardiac symptoms. Sarcoid heart disease should be considered in every patient with diagnostic sarcoidosis and heart disease but also in every case of difficult heart disease without an obvious aetiology. Because of the relatively early age at onset, life expectancy is shortened.

Adult

Cochlear implant.

Cochlear implantation to restore some of the hearing in the profound or totally cochlear deaf patient has been briefly presented. An approximate two year follow up has not shown any complications. The Nucleus 22 channel cochlear implant, as presently manufactured, is a very useful device to rehabilitate profoundly or totally cochlear deaf patients.

Cochlear Implants

Comparison of the effectiveness of slow-release propranolol (Inderal LA) 80, 160 and 320 mg orally daily in the treatment of angina pectoris.

Doses of 80, 160 and 320 mg of Inderal LA (slow-release propranolol) were compared in 12 patients with stable angina pectoris. There was an unpredictable and variable individual response to treatment and hence no differences were detected between the effects of the three doses on mean treadmill exercise duration, time to angina, frequency of angina or glyceryl/trinitrate consumption. There was a marked deterioration in two patients whilst on 320 mg Inderal LA. In these patients, the time to angina fell by 2 minutes 50 seconds and 4 minutes 20 seconds on 320 mg daily and 160 mg daily respectively. Given the inter-patient variability in response to Inderal LA, the dose for each patient should be individually titrated according to response. Two patients reported here suggest that some subjects may benefit from lower doses, although further work is required to clarify this point. Possible explanations for this finding are discussed.

Administration, Oral

Risk factors for ocular sarcoidosis.

We reviewed 121 consecutive patients with biopsy-proven sarcoidosis who visited the sarcoidosis clinic of the University Hospital in Amsterdam, to determine the risk factors for the development of ocular manifestations. Of 121 patients 52 (43%) were black. Ocular disease developed in 50 (41%) patients and was more common in female and in black patients. uveitis was the most frequent manifestation of ocular sarcoidosis (29 out of 50 or 58%). There were no differences in the extra-ocular manifestations of the sarcoidosis between patients with and without ocular disease or between uveitis and non-uveitis patients. This study covered a mixed racial population and shows that different types of uveitis are seen in white and black patients. Anterior uveitis was more frequent in black patients (P less than .001), whereas posterior uveitis was more common in white patients (P less than .01). Chronic posterior uveitis with complications occurred most frequently in white female patients with late onset of the systemic disease. Uveitis was an early feature of sarcoidosis (25 out of 29 or 86%); moreover in 9 out of 29 (31%) cases, uveitis preceded the non-ocular detectable signs of sarcoidosis by more than one year. This emphasizes the importance of periodic re-evaluation of uveitis patients for sarcoidosis.

Adolescent

I-125 photon absorptiometric analysis of bone density in patients with regular dialysis treatment.

The density of bone in the distal third of the radius is measured by I-125 photon absorptiometry in 38 RDT (Regular Dialysis Treatment) patients (19 mean and 19 women, age range from 17 to 65 years). In the majority of patients the bone density (BMC/W) is reduced. The clinical follow-up of dialysis patients demonstrates that the incidence and severity of clinical symtpoms do not always correlate closely with the bone density values, nor with the biochemistry and histopathological findings of bone disease associated with dialysis. Despite control of calcium and phosphorus metabolism, decreased mineralization of the appendicular skeleton persists. The advantages as well as disadvantages of bone density measurements in RDT patients are discussed.

Adolescent

Pneumothorax in the Ehlers-Danlos syndrome: consequence of coincidence?

A 25 year-old man, known to suffer from Ehlers-Danlos syndrome, developed a left-sided pneumothorax. At thoracotomy, pulmonary blebs and bullae were found at the apex of the lung. Bullectomy with removal of adjacent lung tissue was performed. The histological and ultrastructural findings in the lung tissue must be regarded as non-specific. These findings do not reflect a direct cause-and-effect relationship, even in the presence of the inheritable connective tissue disorder.

Adult

Renovascular hypertension as a cause of cerebrovascular accident in childhood: a case report.

Report on a 10 year-old boy with acute hemiplegia after an ischemic cerebrovascular accident, provoked by an unilateral renovascular disease with malignant hypertension, for which nephrectomy was carried out. The few publications pertinent to cerebrovascular complications in children with hypertension and the value of comprehensive diagnostic operations, are the basic motives for this report.

Cerebrovascular Disorders

99m-Tc pertechnetate uptake in the thyroid measured with a scintillation camera: a parameter of thyroid function.

A 99mTc pertechnetate thyroid uptake procedure, using a scintillation camera and a data storage system, is described. After comparison of extrathyroidal activity in several regions below the thyroid, activity in the clavicular regions was preferred for correction of the thyroid uptake measurement. No pertechnetate uptake curve obtained over the initial 15 min after injection was found to be representative of a specific thyroid function, and regional thyroid uptake curves gave only quantitative differences. The 15-min pertechnetate thyroid uptake measurement, with correction for clavicular extrathyroidal activity, correlates well with 131I uptake and is a good parameter of thyroid function, especially in the distinction of euthyroidism and hyperthyroidism.

Humans