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Biomedical subjects

J Dembinski

Publications and source records attributed to J Dembinski.

15 recordsLinked to original sources
PubMed2004

Modification of cord blood IL-6 production with IgM enriched human immunoglobulin in term and preterm infants.

Pro-inflammatory cytokines contribute significantly to the morbidity of premature infants. IL-6 and IL-8 are involved in the pathogenesis of pulmonary and cerebral tissue injury. The effect of human immunoglobulin preparations on cytokine production in preterm infants has not been studied. We investigated the influence of immunoglobulin on LPS stimulated IL-6 and IL-8 production in cord blood of healthy preterm neonates. Ten non-infected preterm infants delivered by cesarean section and 5 healthy term neonates were included. In the preterm infants, significant IL-6 production was observed in the absence of immunoglobulin after 4 h [median 113 (39-725) pg/ml], 8 h [375 (234-1795) pg/ml] and 12 h [360 (248-2765) pg/ml] of LPS incubation. IL-6 concentrations were significantly lower after incubation with LPS+immunoglobulin after 4 h [median 38 (5-568) pg/ml; p=0.005], 8 h [178 (10-1830) pg/ml; p=0.001] and 12 h [182 (29-2530) pg/ml; p=0.002]. Cultures from term infants produced IL-6 levels approx. 4 times of those from premature infants unaffected by immunoglobulin. IL-8 production also correlated to gestational age and was not affected by immunoglobulin in both groups. Human immunoglobulin preparation may modify IL-6 production in cord blood cultures from premature infants.

Cells, Cultured↗
PubMed2004

Lipopolysaccharide binding protein in preterm infants.

OBJECTIVE: To assess serum concentrations of lipopolysaccharide binding protein (LBP) in preterm infants with neonatal bacterial infection (NBI). METHODS: Blood samples were analysed of 57 preterm (28(+1) to 36(+6), median 33(+2) weeks gestation) and 17 term infants admitted to the neonatal intensive care unit within the first 72 hours of life with suspicion of NBI. Samples were obtained at first suspicion of sepsis and after 12 and 24 hours. Diagnosis of NBI was confirmed by raised concentrations of C reactive protein and/or interleukin 6. The influence of gestational age and labour was analysed. RESULTS: Maximum LBP concentrations in infants with NBI were greatly increased compared with infants without NBI (13.0-46.0 microg/ml (median 20.0 microg/ml) v 0.6-17.4 microg/ml (median 4.2 microg/ml)). LBP concentrations in infected infants were not yet significantly raised when NBI was first suspected. The LBP concentrations of preterm infants were comparable to those of term infants. Regression analysis revealed no significant effect of labour or gestational age on LBP. CONCLUSIONS: Raised LBP concentrations indicate NBI in preterm and term infants. Preterm infants of > 28 weeks gestation seem to be capable of producing LBP as efficiently as term infants. Neonatal LBP concentrations are not influenced by labour. LBP may be a useful diagnostic marker of NBI in preterm infants.

Acute-Phase Proteins↗
PubMed2003

Long term follow up of serostatus after maternofetal parvovirus B19 infection.

BACKGROUND: Maternofetal parvovirus B19 infection may result in fetal hydrops or abortion. Chronic infection has been associated with long term complications (polyarthritis, persistent aplastic anaemia, hepatitis). In pregnancy maternal immunosuppression caused by a TH2 dominant response to viral antigens has been observed. There is little information on long term reactivity to intrauterine infection. AIMS: To assess the serological status in children and their mothers after maternofetal parvovirus B19 infection and development of fetal hydrops. METHODS: A total of 18 children and their mothers, and 54 age matched control infants were studied. Main outcome measures were parvovirus B19 DNA, specific IgM and IgG against the virus proteins VP1/VP2, and NS-1 in venous blood. RESULTS: Parvovirus B19 DNA and antiparvovirus B19 (IgM) were undetectable in all sera. A significant larger proportion of maternal sera compared to study children's sera contained IgG against the non-structural protein NS-1. Mean levels of VP1/VP2 IgG antibodies were significantly lower in the children than in their mothers (48 (36) v 197 (95) IU/ml). There was no history of chronic arthritis in mothers and children. Five women had subsequent acute but transient arthritis postpartum, which was not correlated with antibodies against NS-1. CONCLUSIONS: Serological evidence of persistent infection after maternofetal parvovirus B19 disease could not be detected. Increased maternal prevalence of anti NS-1 (IgG) and increased levels of antiparvovirus B19 (IgG) may reflect prolonged viraemia compared to fetal disease.

Antibodies, Viral↗
PubMed2003

Increased serum levels of interleukin 6 are associated with severe intraventricular haemorrhage in extremely premature infants.

BACKGROUND: Intraventricular haemorrhage (IVH) and periventricular leucomalacia (PVL) in premature infants presumably have many causes. It has been proposed that inflammatory processes in the fetomaternal unit play an important role in the pathogenesis of these lesions. OBJECTIVE: To study the correlation of postpartum serum interleukin 6 (IL6) concentration as a marker of inflammation and neonatal cerebral morbidity in preterm infants < 28 weeks of gestational age. METHODS: A total of 88 infants were grouped according to maximum serum IL6 levels within 12 hours post partum: group A (n = 50), < or = 100 pg/ml; group B (n = 38), > 100 pg/ml. Ultrasound studies and clinical assessment were performed routinely. RESULTS: IVH was noted significantly more often in group B (24/38; 63%) than in group A (19/50; 38%) (p = 0.02). In a multiple logistic regression model, raised serum IL6 independently predicted development of severe IVH (odds ratio 8.4; 95% confidence interval 2.85 to 24.9; p = 0.0001). CONCLUSIONS: Raised serum IL6 may serve as a marker for severe IVH in infants < 28 weeks of gestational age. Although cerebral morbidity in premature infants is determined by different variables, the identification of systemic inflammation can help to define the need for anti-inflammatory strategies to prevent cerebral morbidity.

Catecholamines↗
PubMed2002

Endotoxin-stimulated production of IL-6 and IL-8 is increased in short-term cultures of whole blood from healthy term neonates.

To assess the stimulated production of Interleukin-6 and Interleukin-8 in healthy term neonates compared to adults, and to study the effect of labour on the capacity of cytokine secretion, 20 healthy term neonates (11 delivered by elective caesarean section, (ECS) group; 9 vaginally delivered, (VD) group) were included in the study, and five healthy adult volunteers served as controls. Spontaneous and lipopolysaccharide (LPS)-stimulated IL-6 and IL-8 secretion in short-term umbilical whole blood cultures was determined. Spontaneous IL-6 (IL-8) secretion was detected in only a few samples with maximum levels of 14 (23) pg/ml. After 4 h of LPS incubation median IL-6 levels increased to 2026 (339-2547) pg/ml (VD group) and 1670 (704-2037) pg/ml (ECS group). Median IL-8 concentration after LPS stimulation was 2142 (738-4053) pg/ml in the VD group and 1483 (1036-2934) pg/ml ECS group. Interleukin-6 and IL-8 levels following LPS-stimulation in both groups markedly exceeded the values of adult controls. Stimulated cytokine secretion showed no significant difference between VD and ECS groups. Spontaneous cytokine production in cord blood is variable and related to individual cytokine expression and regulation. The pro-inflammatory response to endotoxin as determined by ex vivo LPS-stimulation of short-term whole blood cultures of term neonates, in contrast to spontaneous cytokine secretion, exceeds adult levels and appears to be independent of the mode of delivery and labour.

Cells, Cultured↗
PubMed2002

Neurodevelopmental outcome after intrauterine red cell transfusion for parvovirus B19-induced fetal hydrops.

OBJECTIVE: To assess long term neurodevelopmental outcome of children after intrauterine intravascular red cell transfusion (JUT) for Parvovirus B19-induced fetal hydrops. DESIGN: Data of study children were investigated retrospectively. Neurodevelopmental evaluation was performed by appropriate standard tests (Griffiths, Snijders-Oomen, Kaufmann Assessment Battery for Children tests). SETTING: Tertiary care university teaching hospital. SAMPLE: Twenty children who had Parvovirus-induced fetal hydrops and intrauterine transfusion of packed red blood cells (IUT). METHODS: Retrospective chart analysis and standard neurodevelopmental testing. MAIN OUTCOME MEASURES: Developmental quotient (DQ) and intelligence quotient (IQ) according to the age at testing. RESULTS: Twenty survivors of Parvovirus B19-induced fetal hydrops successfully treated by IUT were followed until 13 months to nine years of age. On clinical follow up, no neurologic sequelae were evident. Neurodevelopmental scores of all children ranged within two standard deviations of a normal population (median 101, range 86-116) and exceeded one standard deviation in three children. There was no significant neurodevelopmental delay. CONCLUSION: Children having survived successful IUT for Parvovirus B19-induced fetal anaemia and hydrops have a good neurodevelopmental prognosis. Our results support the use of IUT for correction of Parvovirus B19-induced fetal anaemia and subsequent hydrops.

Blood Transfusion, Intrauterine↗
PubMed2002

CT imaging of pulmonary lobar interstitial emphysema in a spontaneous breathing preterm infant.

Pulmonary interstitial emphysema (PIE) is a well-recognized severe complication of neonatal respiratory distress syndrome (RDS). However, its occurrence under spontaneous breathing conditions has been described rarely. We present a case of PIE of the left upper lung lobe in an extremely low birth weight infant. Recurrent episodes of spontaneous pneumothorax led to the diagnosis, which was confirmed by histopathology. Plain chest X-ray did not show typical signs of PIE, whereas extra-alveolar air accumulation could be visualized by helical computed tomography (CT)-scan. We stress the role of predispositional factors increasing the risk of PIE development in spontaneous breathing preterm infants.

Adult↗
PubMed2002

Cell-associated interleukin-8 in cord blood of term and preterm infants.

To assess the effect of gestational age and labor on the interleukin-8 (IL-8) concentration in whole cord blood and serum, IL-8 levels were determined simultaneously in cord blood serum and lysate in 134 infants. Following the elimination of some of the samples due to exclusion criteria, the data for 99 uninfected infants (71 term and 28 preterm) and 9 infants with neonatal bacterial infection delivered either vaginally or by elective or emergency cesarean section were analyzed. The effects of labor and gestational age were tested by analysis of variance. IL-8 was not detectable in the serum of 25 infants, whereas IL-8 levels in whole blood were measurable in all of the samples. The median IL-8 conncentrations in whole cord blood lysate were 106 pg/ml (range, 20 to 415 pg/ml) in preterm infants and 176 pg/ml (range, 34 to 1,667 pg/ml) in term infants. In contrast to the IL-8 levels in serum, IL-8 levels in whole blood were reduced after ECS. Gestational age had no independent effect on the IL-8 concentrations in either serum or whole blood; these concentrations increased in infected infants after labor. We conclude that the neonatal proinflammatory response to labor stress was more evident in the concentrations of IL-8 in whole blood than in serum. The levels of IL-8 in whole-blood lysate reflect proinflammatory stimulation in neonates and may be a useful diagnostic tool for the early diagnosis of neonatal infection.

Cesarean Section↗
PubMed2001

Thyroid function in healthy and sick very-low-birth-weight infants--thyrotropin and free thyroxine levels until the sixth week of age.

Hypothyroxinemia in preterm infants without congenital hypothyroidism is associated with developmental delay. Longitudinal information on thyroid function in very-low-birth-weight (VLBW, <1,500 g birth weight) infants is limited: we present data on thyroid function in sick and healthy VLBW infants until 6 weeks of age. Free T(4) and TSH levels routinely obtained on days 14-21 and days 35-49 in 92 consecutive VLBW infants were correlated retrospectively with neonatal morbidity. Free T(4) levels were positively correlated with gestational age; an independent effect of neonatal disease on thyroid function was not detectable.

Aging↗
PubMed2000

Thyroid function in very low birthweight infants after intravenous administration of the iodinated contrast medium iopromide.

BACKGROUND: Thyroid function disorders have often been observed in preterm infants after intravenous administration of iodinated contrast medium. The effect on thyroid function depends on the dosage, but the choice of the contrast medium may be equally important, as there are appreciable pharmacological differences between them. METHOD: Thyroid function was analysed in 20 very low birthweight infants of gestational age less than 30 weeks after injection of iopromide, a monomeric non-ionic iodinated contrast medium. Levels of free thyroxine and thyroid stimulating hormone were compared with those in 26 control infants. RESULTS: Free thyroxine levels in all study infants ranged from 9.0 to 25.7 pmol/l (days 14-21) and 9.0 to 23.2 pmol/l (days 35-49), and thyroid stimulating hormone levels ranged from 0.13 to 0.26 mU/l (days 14-21) and 0.26 to 11.11 mU/l (days 35-49). These levels were not altered after injection of iopromide. CONCLUSION: The risk of transient hypothyroidism or hyperthyrotropinaemia may be reduced with the use of iopromide compared with other contrast media.

Case-Control Studies↗
PubMed2000

Determination of total interleukin-8 in whole blood after cell lysis.

BACKGROUND: It has been shown that a high percentage of interleukin-8 (IL-8) in blood is cell associated. Recently, a simple method for determination of cell-associated IL-8 in whole blood after cell lysis has been described. The purpose of this study was to evaluate this method, to examine the influence of preanalytic sample handling, and to establish the concentration range of total IL-8 and its relation to age and sex in healthy subjects. METHODS: Total IL-8 content of whole blood was determined after lysing blood cells with Milenia((R)) cell lysis solution. IL-8 in the resulting blood lysate was measured with the IMMULITE((R)) IL-8 immunoassay. RESULTS: When freshly drawn blood was stored up to 48 h on ice, no significant changes in total IL-8 were measured in the subsequently prepared lysate, whereas with storage at room temperature, total IL-8 increased after 3 h from 94 +/- 13 ng/L to 114 +/- 16 ng/L (n = 10). In lysate stored for 48 h at 4 degrees C, marginal changes of the IL-8 concentration were noted, with storage at room temperature, only 76% +/- 5% (n = 12) of initial concentration was recovered. From lysate frozen at -20 and -80 degrees C, respectively, 84% +/- 4% and 93% +/- 2% of initial IL-8 was recovered after 70 days (n = 10). IL-8 was measured with comparable precision in plasma (CV, 3. 2-4.2%) and blood lysate (CV, 3.7-4.1%). When plasma was diluted with cell lysis solution, a slightly overestimated recovery (125% +/- 3%) was observed; for lysate specimens with a cell lysis solution content >/=75%, the recovery after dilution was 98% +/- 2%. In lysate prepared from 12 blood samples with exogenous IL-8 added, IL-8 recovery was 104% +/- 2% (recovery from plasma <35%). The median total IL-8 in blood lysates from 103 healthy subjects (22-61 years) was 83 ng/L of blood (2.5-97.5 percentile range, 49-202 ng/L of blood). In females but not in males, total IL-8 increased significantly with advancing age (P: <0.002). We found grossly increased total IL-8 in six pregnant women with amniotic infection syndrome. CONCLUSIONS: The evaluated method allows the assessment of total IL-8 in blood with good performance when appropriate conditions of sample pretreatment are considered. The values in healthy volunteers all were above the detection limit of the IL-8 assay; therefore, slight changes of total IL-8 could be noted. Thus, the present method is a suitable tool to study the diagnostic relevance of total IL-8 in blood.

Adult↗
PubMed1999

Congenital intrapulmonary bronchogenic cyst in the neonate--perinatal management.

Approximately 50% of all congenital lung malformations are pulmonary and mediastinal bronchogenic cysts (BC). Therefore, their diagnosis and management is of clinical importance. Usually asymptomatic in the first months of life, bronchogenic cysts are frequently clinically inapparent even adulthood. Early diagnosis and elective surgery can prevent late complications such as pneumothorax, pulmonary hypertension, and recurrent infections; prognosis after surgery is excellent. If mediastinal shifting is present, fetal thoracocentesis is indicated to prevent cardiovascular insufficiency. We report a case of a prenatally diagnosed intrapulmonary BC of the right lung. Following in utero thoracocentesis of the cyst and transient spontaneous regression postnatal onset of severe clinical symptoms due to rapidly developing hyperinflation and mediastinal shifting within the first days of life required early surgical intervention.

Bronchial Diseases↗
PubMed1997

The Cantrell-sequence: a result of maternal exposure to aminopropionitriles?

The characteristic features of the Cantrell-sequence--anterior thoraco-abdominal wall defect with ectopia cordis and diaphragm, sternum, pericardium, and heart defects--have been observed in animals following maternal administration of beta-aminopropionitrile, a toxic amino-acid derivative. We report on an unusual case of the Cantrell-sequence in a premature infant with associated dysmelia, aplasia of the right kidney, cerebellar hypoplasia and circumscribed aplasia of the cutis, which has not been reported previously. Maternal history suggested an occupational exposure to aminopropionitriles prior to pregnancy. Prenatal ultrasound, differential diagnosis, perinatal management, and the teratogenic role of aminopropionitriles in this rare genetic disorder are discussed.

Abnormalities, Multiple↗