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Biomedical subjects

G Kellner

Publications and source records attributed to G Kellner.

At least 19 recordsLinked to original sources

Respiratory tract infections due to different rhinovirus serotypes and the influence of maternal antibodies on the clinical expression of the disease in infants.

Rhinoviruses were isolated from nasopharyngeal secretions of 49 children hospitalized because of severe respiratory tract infection. The isolates were typed using 90 type-specific antisera. No obvious relation between certain serotypes and the severity of illness was found. Serum samples were drawn from all children simultaneously with the nasopharyngeal secretions and screened for the presence of type-specific neutralizing antibodies. Children aged 1 week to 6 months had higher neutralizing antibody titers and revealed a lower degree of morbidity than older children. The decline of neutralizing serum antibodies with increasing age was correlated with a higher incidence of severe disease in those aged 7-12 months. Nevertheless, also in this age group children with mild clinical courses of disease were observed despite a low concentration or an absence of neutralizing serum antibodies. This indicates that not only neutralizing serum antibodies, but other factors also influence the clinical expression of RHV-induced disease.

Antibodies, Viral↗

Surveillance of viral respiratory tract infections over a one year period in mainly hospitalized Austrian infants and children by a rapid enzyme-linked immunosorbent assay diagnosis.

In order to obtain more information on viral respiratory tract infections in Austrian infants and children, nasopharyngeal secretions from 1432 infants and children, collected from October 1984 to October 1985, were screened for the presence of respiratory syncytial virus (RSV), adenoviruses, parainfluenza virus type 1, 2, and 3, and influenza viruses type A and B, by enzyme-linked immunosorbent assay (ELISA). The results obtained were analyzed with respect to incidence, seasonal distribution and clinical syndromes associated with the different viral pathogens investigated and also with the practicability of ELISA diagnostics over long distances. A viral etiology of acute respiratory tract infection was confirmed in 372 (26%) infants. RSV was detected in 286 (20%) of the nasal secretions and was thus the most frequently encountered agent. RSV infections occurred mainly in the winter months and were often associated with bronchitis, bronchiolitis, and pneumonia. Only sporadic infections were found with one of the other viruses investigated.

Adenoviruses, Human↗

Immunoglobulin-class-specific immune response to respiratory syncytial virus structural proteins in infants, children, and adults.

The protein specificities of IgG, IgM, and IgA antibodies induced during respiratory syncytial virus (RSV) infection in 74 patients (4 weeks to 81 years of age) were investigated using the technique of immunoblotting. Although the pattern of antibody reactivity varied among patients, most of the humoral immune response in all age groups was directed against the 48, 42, 35, and 27 K proteins. An infant's own antibody response was discernible in 55 of the 57 children below 1 year of age, despite the presence of maternally derived antibodies. Antibody against the 90 K surface glycoprotein was not detectable in those less than 1 year of age. Primary RSV infection induced antibodies only against a subset of RSV proteins. Although a broadening of the antibody response occurred with increasing age and in the course of reinfection, an immune response to all the viral structural proteins was observed rarely.

Adolescent↗

Clinical manifestations of respiratory tract infections due to respiratory syncytial virus and rhinoviruses in hospitalized children.

From September 1984 to May 1986, nasopharyngeal secretions were obtained from 519 children with some form of respiratory tract infection. The nasal secretions were screened for respiratory syncytial virus (RSV), rhinoviruses, adenoviruses, parainfluenza virus types 1, 2, 3, influenza virus types A and B, and enteroviruses by tissue culture virus isolation technique and/or enzyme-linked immunosorbent assay. A uniform questionnaire gave information about age, sex, individual signs and symptoms, findings of the physical examination and clinical diagnosis of the patients. RSV was detected in 119 (23%) specimens and was thus the most frequent causative agent of respiratory infections. After RSV, rhinoviruses were the most frequently recovered pathogens accounting for 60 (12%) cases of acute respiratory disease. A comparison of the individual signs and symptoms, the findings of the physical examination and the clinical diagnosis of RSV and rhinovirus infected children revealed that there was no characteristic clinical pattern associated with either of the two viral respiratory pathogens. According to our results, rhinovirus infections were a major cause of lower respiratory tract infections in hospitalized children less than or equal to 3 years old.

Child, Preschool↗

Contribution of rhinoviruses to respiratory viral infections in childhood: a prospective study in a mainly hospitalized infant population.

A prospective study was carried out to investigate the contribution of rhinoviruses to respiratory viral infections in children and to investigate the influence of age, passive smoking, and educational level of the head of the family on the clinical course of viral respiratory disease. Nasopharyngeal aspirates from 519 infants (90.8% inpatients, 9.2% outpatients) were screened for the presence of rhinoviruses, respiratory syncytial virus (RSV), adenoviruses, parainfluenza virus types 1, 2, 3, influenza virus types A and B, and enteroviruses by tissue culture isolation procedure, enzyme-linked immunosorbent assay, and/or indirect immunofluorescence method. The total detection rate was 42.4%. The rate decreased with increasing age. Higher detection rates were observed in specimens from children suffering from a more severe respiratory disease, and the highest rate of virus-positive specimens was found in those aged 0-6 months. Second to RSV (23.1%), rhinoviruses were the most frequently recovered pathogens found in 11.8% of children with acute respiratory tract infections (RTI). In the age group 0-6 months the majority of severe respiratory illnesses was due to RSV. In infants aged 6 months to 1 year a decrease in the number of severe illnesses caused by RSV and an increase in the number of children suffering from a more severe RTI caused by rhinoviruses was found. With the possible exception of one group of children infected with rhinoviruses, a negative effect of passive smoking on the incidence and severity of viral RTI could not be established. A beneficial effect of breast feeding on the severity of viral RTI could not be definitely demonstrated.

Austria↗

Assessment of motor blockade during epidural anesthesia.

Motor blockade during epidural anesthesia was assessed using dynamometry to measure the maximum force of plantar flexion, and the Bromage score method. In a randomized double-blind study, 40 orthopedic patients received one of the following four local anesthetics epidurally: 0.5% bupivacaine-HCl (n = 10), 0.5% bupivacaine-CO2 (n = 10), 1.0% etidocaine (n = 10), and 1.5% etidocaine (n = 10), all without addition of a vasoconstrictor. The decrease of force, measured by dynamometry, followed an e function. This function permits the description of motor blockade development using one single number, its half-life. This finding corresponds to the increase of motor nerve fiber blockade due to diffusion of the local anesthetic into the nerve. Dynamometry was more precise than the Bromage score in describing motor blockade. Both the Bromage score and dynamometry produced roughly comparable results of onset, rate of development, and maximum intensity of motor blockade. These parameters of motor blockade were superior after both etidocaine solutions compared to both bupivacaine solutions. Neither carbonization of bupivacaine nor increased concentration of etidocaine significantly improved motor blockade produced by these drugs. Dynamometry is a time consuming and costly method for accurate quantification of motor blockade during epidural anesthesia; the Bromage score is more practical under clinical considerations and provides useful information.

Adolescent↗