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Transient myopia with severe chemosis associated with exacerbation of disease activity in systemic lupus erythematosus.

A 46-year-old woman with systemic lupus erythematosus (SLE) developed bilateral transient myopia and periorbital edema with severe chemosis. Her myopia was ascribed to a refractive abnormality that was caused by curvature change and anterior displacement of the lenses and the ciliary bodies due to anterior ocular edema. The conditions were not associated with systemic edema or abnormality in the fundi and responded well to the systemic administration of corticosteroid. The course of the ocular symptoms paralleled changes of serum CH50 and anti-dsDNA antibody levels. Thus it was concluded that her ocular symptoms were closely related to activity of her SLE and may be considered a feature of SLE.

Antibodies, Antinuclear↗

[The determination of the antibodies and the somatic O-antigen of Salmonella group B by using the complement-bound lysis of liposomes].

A simple and sensitive method for the determination of group B Salmonella O-antigen and specific antibodies to group B Salmonella by means of the complement-dependent lysis of liposomes sensitized with S. typhimurium lipopolysaccharide (LPS) is proposed. The factors affecting the sensitivity of the method during the determination of antibodies and free antigen have been studied. The method permits the determination of soluble LPS antigen in concentrations of 0.5-200 micrograms/ml.

Antibodies, Bacterial↗

[Hydrolytic and haemolytic activity of Klebsiella pneumoniae and Klebsiella oxytoca].

Hydrolytic enzymes and haemolysins are important extracellular substances produced by many bacteria. We investigated 57 K. pneumoniae strains and 40 K. oxytoca strains isolated from clinical materials. We estimated the ability to produce: proteases hydrolyzing milk powder, caseinase, gelatinase, elastase, lecithinase, lipases, DNase and haemolysins on human, sheep and horse erythrocytes on TSA medium with or without 5% Egg Yolk. We detected that K. oxytoca strains produced proteases hydrolyzing milk powder (37.5%), caseinase (15.0%) and gelatinase (17.5%) more frequently than K. pneumoniae strains (respectively 21.0%, 5.3%, 8.9%). None of the analysed Klebsiella spp. strains produced elastase. Only K. pneumoniae strains produced lecithinase (5.3%). Lipases hydrolyzing Tween were produced from 3.5% (for Tween 60 and 80) to 7.0% (for Tween 20). Among K. oxytoca strains only one (2.5%) hydrolyzing Tween 20. DNase was produced by 38.6% of K. pneumoniae strains and by 27.5% K. oxytoca strains. Haemolytic properties on human erythrocytes were detected in 5.3% K. pneumoniae strains on TSA medium and 29,8% on medium with Egg Yolk. In K. oxytoca strains haemolytic properties on human erythrocytes were detected only on medium with Egg Yolk (12.5%). Haemolytic properties on sheep erythrocytes were detected respectively in 21.0% and 22.8% K. pneumoniae strains and in 7.5% K. oxytoca strains on each medium. Haemolytic properties on horse erythrocytes were detected respectively in 33.4% and 52.6% K. pneumoniae strains and in 15.0% and 20.0% K. oxytoca strains.

Animals↗

[Effect of nizofenone on the symptomatic vasospasm after aneurysmal subarachnoid hemorrhage and its relationship to the levels of serum complements (CH50, C3 and C4)].

Serum complements (CH50, C3 and C4) after aneurysmal subarachnoid hemorrhage were measured in 42 patients over 2 to 3-week period. Nizofenone, an anti-vasospasmotic agent, was administered to 11 patients. In the nizofenone-treated group, 8 patients showed decreased serum C4 levels 5 days after the onset of subarachnoid hemorrhage, but among them, only 2 patients showed symptomatic vasospasm. Considering our previous data (majority of patients who showed decreased serum C4 levels presented with symptomatic vasospasm), these results suggest a favorable effect of nizofenone on the symptomatic vasospasm after aneurysmal subarachnoid hemorrhage.

Adult↗

Immunology of chronic generalized periodontitis. 2. Estimation of total hemolytic complement (CH 50) and its fractions C3 and C4.

The total hemolytic complement activity (CH50) and its fractions C3 and C4 were determined in forty patients with chronic generalized periodontitis (CGP). The values were compared with an equal number of age and sex matched periodontally healthy controls. Total hemolytic complement activity was expressed as number of CH50 units per ml of blood, while C3 and C4 levels were assessed by radial immunodiffusion and expressed as mg%. The observations showed a significant increase in CH50, C3 and C4 levels in the sera of patients with CGP. The study reveals the role of complement system in the pathogenesis of chronic generalized periodontitis.

Adult↗

Isotypic distribution of antibody responses in lines of mice selected for high or low immunoresponsiveness.

1. The isotype distribution of antibody (Ab) responses to Salmonella antigens (Ag) was investigated in high (H) and low (L) Ab responder lines of mice from Selections III and IV carried out for responsiveness to flagellar (f) and somatic (s) Ag, respectively. 2. Primary immunization resulted in higher Ab titers of all isotypes in response to both Ag in H mice from both selections and was confirmed after booster injections. The interline difference (H-L) in response to the distinct isotypes ranged from 3.0 to 7.0 log2 to Ag f in Selection III and from 2.0 to 5.1 log2 to Ag s in Selection IV. 3. Comparison of isotype production to 3 Ag in Selections I, II, III and IV demonstrated that: 1) the highest responses in all mice are those against the selection Ag, 2) the isotypic pattern depends on both the Ag injected and the host's genetic constitution, and 3) the presence or lack of a multispecific effect is not due to isotype-restricted regulation.

Animals↗

[Hereditary angioedema, a rare cause of recurrent abdominal pains. A report of 2 clinical cases and comments of a general nature].

Two clinical cases of recurrent abdominal pain are reported. These led to the unusual diagnosis of hereditary angioedema due to deficiency of C1 esterase inhibitor (C1-INH). The difficulties of identifying this genetic disease were caused by the variability of its clinical expression: the alteration of an autosomal dominant gene triggers angioedema attacks that may strike the cutaneous, gastroenteric and respiratory apparatus with differing intensity. Various subjects suffering from hereditary angioedema were found in the genealogical trees of the two patients, but all had extraintestinal symptoms of very variable intensity. Measurement of C4 and C1-INH made it is possible to identify in the first family a functional defect of C1 esterase inhibitor and in the second a quantitative defect in the same inhibitor.

Abdominal Pain↗

Humoral immune response of normal rhesus monkeys during primaquine administration.

Humoral immune response of normal rhesus monkeys was studied after giving a standard dose of primaquine. The drug did not effect the level of complement (C3) and its haemolytic activity. Levels of Immunoglobulin i.e. IgG, IgM & IgA and number of immunoglobulin secreting cells also remained unaffected. Results of this study suggested that primaquine did not suppress the immune status of the host and could be given safely to the malaria patients.

Animals↗

Urinary neopterin in patients with systemic lupus erythematosus.

Concentrations of neopterin were measured in urine specimens from 35 patients with active and eight with inactive systemic lupus erythematosus (SLE). Compared with those of apparently healthy controls, neopterin concentrations were higher in patients with active disease (P less than 0.001) and with inactive disease (P less than 0.01), those in patients with active disease being significantly higher than those in patients with inactive disease (P less than 0.001). The correlation between the neopterin concentration and evidence of disease activity was good. All of the patients with clinically active SLE had increased neopterin, but for only 37.5% (three of eight) did the neopterin concentration exceed the upper normal limit during clinical remission. The increase in neopterin concentration did not correlate with clinical courses or severity of renal function. Moreover, serial determinations of neopterin in active SLE patients showed a rapid decrease of initially high concentration, paralleling a decline of clinical activity after initiation of medical therapy. Thus, urinary neopterin may be a useful marker for monitoring disease activity in SLE patients.

Adolescent↗

[Parameter in fulminant hepatitis].

Serum complement hemolytic activities (CH 50) and plasma prothrombin time (PTT) of patients with fulminant hepatitis (FH, 11 cases of acute type and 11 cases of subacute type), severe acute hepatitis (AH-S, 9 cases) and typical acute hepatitis (AH-T, 20 cases) were examined. AH-S was diagnosed as AH patients with PTT under 40% and without hepatic coma. Survival rates were 100% in AH-S, 45.5% (5/11) in acute type of FH and 9.1% (1/11) in subacute type of FH. The mean levels of CH 50 on their admission were 42.6 U/ml in AH-T, 28.8 U/ml in AH-S and 13.1 U/ml in FH. CH50 levels in acute hepatitis decreased in parallel to the severity of the disease and correlated with PTT (r = 0.809). In many cases of FH and almost all cases of AH-S, CH50 levels changed more slowly than those of PTT. The patients with AH-S and subacute type of FH showed a prolonged PTT and the normal levels of CH 50 in their acute phase. These results indicate that CH50 and PTT could be useful markers differentiating subacute type from acute type of fulminant hepatitis.

Acute Disease↗

[Comparison of the yield of indirect hemagglutination reaction and complement fixation reaction in the diagnosis of neurocysticercosis].

Two variations of an indirect hemagglutination test (IHAT) and a complement fixation test (CFT) for the diagnosis of human cysticercosis were compared and evaluated. For the IHAT, a cysticerci crude total saline extract (SE) and a cysticerci lyophylized and delipidized veronal bicarbonate saline buffer (VBS) extract were used, comparing their diagnosis yieldings with that of a CFT in 57 confirmed cysticercosis patients: 45 serum samples and 32 cerebrospinal fluid (CSF). Sera and CSF from 29 patients with other neurological diseases and 25 sera from healthy volunteers were also compared. Both types of methods presented an overall average concordance of 91.5% and 97.0% with CSF and sera respectively. With respect to the sensitivity observed with CFT was 85.2% and 93.3% for CSF and sera, whereas that of IHAT was 96.9% in CSF and 97.8% in sera, when SE antigen was used; with the VBS antigen for IHAT 96.9% and 95.6% were detected in CSF and sera respectively. In order to determine the specificity of the IHAT, besides the study in healthy volunteers, in patients with other neurological diseases and in 156 serum samples from individuals with other parasitoses, such as hydatidosis (43), trichinosis (56), fascioliasis (31) and Chagas' disease (26) were also tested. A high reactivity with the hydatidosis group was found. The specificity, using a titre > or = 1:16 as a diagnostic value and without considering hydatidic sera was 99.4% for RHAI (SE), 100.0% for RHAI (VBS). The use of IHAT and CFT in diagnosis of human cysticercosis is discussed.

Central Nervous System Diseases↗

[Epidemiology of toxoplasmosis in Chile. VII. Prevalence of human infection investigated by means of indirect hemagglutination reaction in the regions X, XI and XII].

In pursuing the studies on the epidemiology of toxoplasmosis in Chile, a recent series of surveys have been undertaken in 1983-1990 in 4 urban and 22 periurban-rural localities from regions X, XI and XII of the country (39 degrees 38'-56 degrees 00' South lat.). An indirect hemagglutination test (IHAT) for toxoplasmosis was performed to 6,438 randomly selected apparently healthy persons. The age of the surveyed persons (2,779 males and 3,659 females) varied between 1 and 93 years. The number of examined persons represents a 0.61% of the total population of the three studied regions. IHAT titers of 1: > or = 16 were considered as positive. The general prevalence for positive IHAT was 46.3% (47.4% in men and 45.4% in women). Similarly to other regions, a higher proportion of positive reactors was detected in urban sections (49.0%) than in periurban-rural ones (40.3%). An increase of prevalence with age was also observed. Only 8 (0.12%) persons presented IHAT titers higher than 1:1000.

Adolescent↗

[The indirect hemagglutination reaction in the diagnosis of trichinosis].

An indirect hemagglutination test (IHAT) for trichinosis using a Melcher's antigen was evaluated and compared with a precipitin test (PT) and a bentonite flocculation test (BFT). One hundred and forty eight serum samples from patients from the whole country confirmed or suspected to have trichinosis by clinical or epidemiological evidences were studied: 117 (79.1%) samples resulted positive by IHAT, 138 (93.2%) by PT and 65 (43.9%) by BFT. Sixty three serum samples from patients with strong clinical suspect of trichinosis presented the PT and the BFT positive and were compared with the IHAT for sensitivity study. IHAT was positive in 60 (95.2%) serum samples. In order to determine the specificity of IHAT 25 serum samples from healthy volunteers and 124 serum samples from individuals with other parasitoses, such as cysticercosis (48), hydatidosis (45) and fascioliasis (31) were studied. The specificity, using a titre > or = 1:16 as a possible diagnostic value was 96%. The use of IHAT with RP and BFT in the diagnosis of human trichinosis is discussed.

Complement Hemolytic Activity Assay↗

Value of C-reactive protein in reflecting the magnitude of complement activation in children undergoing open heart surgery.

The kinetics of C-reactive protein (CRP) were studied prospectively in 30 children (aged 21 days - 16 years) undergoing open heart surgery. CRP was related to the kinetics of total haemolytic complement, complement C3a and postoperative complications. Two (7%) patients died and ten (33%) had postoperative complications. The patients with complications were younger (p less than 0.035), underwent longer perfusions (p less than 0.001) and had longer aortic cross-clamping times (p less than 0.003). The mean peak CRP level after surgery (108 mg/l) was reached, on the average, in 43 h. No statistical difference in CRP concentrations was found between the complication and non-complication groups. Extensive complement activation was seen in every patient. CRP did not reflect the magnitude of complement activation induced by cardiopulmonary bypass. The patient sample was too small to draw reliable conclusions about the value of CRP in detecting postoperative complications after open heart surgery in children.

Adolescent↗

Total hemolytic complement (CH50) and its fractions (C3 and C4) in the sera of patients with premalignant and malignant lesions of the oral cavity.

Total hemolytic complement (CH50) and its fractions (C3 and C4) were estimated in the sera of 50 patients with oral leukoplakia, 50 patients with oral submucous fibrosis and 50 oral cancer patients. The values were compared with that of 50 normal controls. No significant alterations in the values of CH50, C3 or C4 were observed in the sera of patients with either leukoplakia or oral submucous fibrosis whereas the values were found to be altered significantly in oral cancer (P less than 0.001). In the case of oral submucous fibrosis the mean complement levels were slightly lower than those of normal controls and leukoplakia. Age and sex had no influence either on the total complement activity or its fractions (C3 and C4). The serum complement levels may be useful as a biological marker for the early detection of tissue dysplasia.

Adult↗

[Components of human complement system. Testing and isolation of C4].

A modified reagent for testing the hemolytic activity of human complement component C4 has been obtained. Reagent R4 was obtained by treatment of human blood serum pools with 0.075 M solution of hydrazine hydrate. This reagent was found to be rich in the serum fraction obtained by chromatography on DEAE-cellulose DE-52 and containing an active complement C3 component. To test the sensitivity and specificity of the reagent, component C4 was subjected to purification. This procedure resulted in a hemolytically active, electrophoretically and immunoelectrophoretically homogeneous component C4. DEAE-cellulose DE-52, DEAE-Sephacel, Ultragel AcA-34 and, again, DEAE-Sephacel were used consecutively as purification agents. The activity yield of component C4 with regard to the initial serum level was 20%.

Chromatography, Gel↗

Pleiotropic changes in the activities of extracellular toxins of Pseudomonas aeruginosa protease-deficient mutants.

Protease-deficient mutants of Pseudomonas aeruginosa obtained by ethyl methane sulphonate treatment were found to show pleiotropic effect on various extracellular toxin activities. Of eight mutants five were completely deficient in lecithinase and four in collagenase activity. The decreased hemolytic activity was obtained in five mutants and enterotoxin activity in seven mutants as compared to parent strain.

Complement Hemolytic Activity Assay↗