Autochthonous Human Dirofilaria repens Infection in Austria

PURPOSE

This report describes a rare autochthonous case of human D. repens infection in Austria. Dirofilariosis is a mosquito-borne parasitic infection that predominantly affects dogs. Human D. repens infections have primarily been reported in Mediterranean countries, but are emerging throughout Central and Northern Europe.

METHODS

The worm was removed surgically and identified using PCR and DNA sequencing. The consensus sequences were compared against reference sequences of Dirofilaria repens from GenBank.

RESULTS

The 56-year-old woman acquired the infection, which presented as a subcutaneous nodule, in Vienna, Austria. This is the second autochthonous case of human D. repens infection in Austria.

CONCLUSION

The reasons for the emergence of D. repens and other parasitic infections in Central and Northern Europe are manifold, including climate change and globalization. This case demonstrates that with the growing number of D. repens infections, health care professionals must place further emphasis on emerging infectious diseases to ensure appropriate diagnostics and treatment in the future.

Design and synthesis of novel antibacterial agents with inhibitory activity against DNA polymerase III

4-Substituted 2-amino-6-(anilino)pyrimidines have been found to be selective inhibitors of DNA polymerase III, a replicative enzyme known to be essential in the DNA synthesis of Gram-positive bacteria. Among the analogues, 18 displayed an IC(50) of 10 microM against DNA polymerase III from Staphylococcus aureus.

Proctocolitis in breast fed infants: a contribution to differential diagnosis of haematochezia in early childhood

Dietary protein induced proctocolitis in exclusively breast fed infants is rarely taken into consideration as a cause of rectal bleeding or blood streaked stool in the neonatal period and early infancy. Eleven babies are presented in whom it is believed that bleeding through the rectum was due to proctocolitis as a result of allergy triggered by cows' milk protein transferred to the infants via the breast milk. Colonoscopy was performed in five infants, revealing benign eosinophilic proctocolitis. Standard treatment was the exclusion of the allergen from the mother's diet. Resolution of visible rectal bleeding took place within 72 to 96 hours after elimination of the offending protein from the mother's diet.

Polypoid fibro-haemangioma of the kidney in a child with gross haematuria

We present a case of gross haematuria in a 5-year-old boy caused by a fibro-haemangioma of the lower part of the pelvis of the right kidney. Pathology of this rare condition and differential diagnosis from other uncommon renal pelvic lesions occurring in childhood are discussed.

[Congenital oesophageal stenosis due to tracheobronchial remnants]

This paper presents the authors' experience with congenital oesophageal stenosis (= CES) in three patients who had CES due to tracheobronchial remnants. Difficulties with feeding started at 6-9 months of age, which corresponded with the introduction of solids. Contrast studies showed stenosis at the junction of the mid and distal thirds of the oesophagus. Limited resection of the oesophageal stenosis and primary anastomosis was performed in all three patients with good results. CES should be suspected if all other causes of oesophageal stenosis have been excluded by upper gastrointestinal examinations, endoscopy, oesophageal pH monitoring and oesophageal manometry.

Sonographic management of infantile clavicular fractures

A new method for radiation-free management of infantile clavicular fractures is presented. Forty-nine infants with clavicular fractures were examined radiologically and sonographically by independent examiners. The two imaging techniques were compared with regard to practicability, diagnostic results, and assessment of the healing process. The paired t-test showed no significant difference between X-ray and ultrasound (US) for the criteria of practicability and primary diagnostic results. With regard to assessment of the healing process, a highly significant advantage in favor of US was registered. One week before radiographs revealed any sign of bone healing, stress-resistant, stable healing of tissue is seen on US. Even consolidation disorders such as early signs of pseudarthrosis are detected very early by US. This enormous diagnostic advantage reduces the duration of immobilization, the frequency and number of follow-up examinations, and last but not least, provides a cost-effective method of treatment without exposure to ionizing radiation.

Transient pseudohypoaldosteronism in obstructive renal disease

The cases of two patients with transient pseudohypoaldosteronism due to an up to this point unrecognized obstructive renal disease are reported. Both girls presented with a severe salt-losing episode in early infancy mimicking congenital adrenal hyperplasia. Extensive endocrinologic work-up revealed markedly elevated plasma-aldosterone levels. Clinical and laboratory data were consistent with transient pseudohypoaldosteronism. Sonographic and radiological investigation showed in both children a vesicoureteral reflux of differing grades. After therapy of the electrolyte-imbalance and recovery, one of the children required surgical treatment of vesicoureteral reflux.

Dysphagia and regurgitation in a 10-year-old child

Images

Appendicitis in children with a ventriculoperitoneal shunt

The presentation of an acute abdomen in children with a ventriculoperitoneal shunt requires skillful diagnostic workup. Apart from complications caused by the shunt, primary abdominal pathological conditions must be taken into consideration, particularly in the older child. A series of 6 children with a ventriculoperitoneal shunt had to be treated surgically for appendicitis. Their medical records were analyzed retrospectively. Despite difficulties with the initial diagnosis, the time from admission to final diagnosis and operation was relatively short. An accurate history, careful evaluation of the clinical signs and, above all, ultrasound of the abdomen were helpful in decision making. During the operation the shunts were left in place. Only 1 patient developed a cerebrospinal fluid pseudocyst in the early postoperative period, which made a conversion into a ventriculoatrial shunt necessary. No ascending infection occurred, even when the abdominal tip of the shunt came in close contact with the focus of inflammation. An acute abdomen due to shunt infection should be managed conservatively and by removal of the shunt from the abdomen, thus avoiding an unnecessary laparotomy. On the other hand, a primary intraabdominal disease requires surgical treatment, during which the shunt system can be left in place.

Serum retinol concentrations and Schistosoma mansoni, intestinal helminths, and malarial parasitemia: a cross-sectional study in Kenyan preschool and primary school children

Parasitic determinants of serum retinol concentrations were studied in 159 preschool (0.25-5.1 y) and 695 primary school (9.2-17 y) children in western Kenya. Mean serum retinol was 0.63 micromol/L in preschool and 0.94 micromol/L in primary school children; 62% and 24%, respectively, had serum retinol < 0.70 micromol/L. Serum retinol was lower in boys than in girls among both preschool (P = 0.04) and primary school children (P = 0.0001). Schistosoma mansoni, Ascaris lumbricoides, hookworm, and Trichuris trichiura egg output and malarial parasitemia were determined and their relation with serum retinol assessed. Among preschool children, sex, elevated serum concentrations of C-reactive protein, and malarial parasitemia were significant predictors of serum retinol. Among the 63 children from whom stool samples were available, none of the helminth infections were significant predictors of serum retinol. For primary school children, age, sex, and S. mansoni egg output were predictors of serum retinol. Malarial parasitemia among nonimmune preschool children may contribute to low serum retinol, whereas malarial parasitemia did not have any effects in semiimmune primary school children. In contrast, the inverse relation between S. mansoni and serum retinol found in primary school children could be due to an effect of infection on serum retinol or an increased susceptibility to infection among children with low serum retinol. Although parasitic infections may contribute to poor vitamin A status in children, they do not explain the age and sex differences.

Inhibition of rat alpha-reductases by finasteride: evidence for isozyme differences in the mechanism of inhibition

The mechanism of inhibition of the rat types 1 and 2 5alpha-reductase by finasteride was investigated using recombinantly expressed enzymes. These studies revealed that finasteride is a potent, reversible inhibitor of the rat type 1 5alpha-reductase with Ki=10.2+/-1.3 nM. Finasteride is a potent inhibitor of the rat type 2; however, in this case the compound binds to the type 2 isozyme-NADPH complex to form a ternary complex with Ki=1.19+/-0.10 nM, which then rearranges to a high affinity complex (E:I) with a pseudo first order rate constant of 1.62+/-0.22 x 10(-3)/s. The second order rate constant is k3/Ki=1.37+/-0.31 x 10(6) M/s. Heat denaturation of the (type 2 enzyme:inhibitor) complex releases dihydrofinasteride and presumably the NADP+-adduct previously identified with the human 5alpha-reductases. The effects of finasteride were also studied in intact COS cells transiently expressing the rat types 1 and 2 5alpha-reductase. Results with whole cell assays confirm differences in mechanism of inhibition of rat types 1 and 2 5alpha-reductase by finasteride.

Renal pyelectasis in fetuses and neonates: diagnostic value of renal pelvis diameter in pre- and postnatal sonographic screening

OBJECTIVE

Pre- and postnatal pyelectasis detected by sonographic screening is of questionable pathologic importance. Therefore, we defined the natural course and diagnostic value of renal pelvis diameter (RPD) during fetal life and the neonatal period as such dilatation was revealed on routine sonography.

MATERIALS AND METHODS

Routine sonography in pregnant women was obtained between gestational weeks 22 and 30. Sonograms were obtained for 1021 fetuses, of which 15 could not be followed up as neonates. The remaining 1006 fetuses also underwent neonatal sonography. All neonates with an RPD larger than 5 mm were followed up sonographically. Neonates with an RPD larger than 9 mm or persistent widening (> 5-9 mm) were examined by voiding cystourethrogram, radionuclide renogram, or both.

RESULTS

Thirty fetuses (3%) had an RPD larger than 5 mm. Nine of these fetuses also had an RPD larger than 5 mm as neonates. Of these nine neonates, one had bilateral grade II vesicoureteric reflux (VUR) and two had urinary tract obstructions (one posterior urethral valve and one ureteropelvic junction obstruction). Forty-nine neonates whose results on fetal sonograms had been normal showed an RPD larger than 5 mm on neonatal sonograms. Grade III VUR was found in one boy, and ureteropelvic junction obstruction was found in two boys. The kidneys of 54 neonates who showed an RPD larger than 5 mm without urinary tract obstruction were followed up until an RPD of 0-5 mm was evident. RPD normalized within 1 year of birth, whether VUR was present or not. Symptomatic urinary tract infection was diagnosed in 17 infants who had no renal pelvis dilatation seen on pre-or postnatal screening during the observation period. Seven of the 17 neonates had VUR. Conversely, none of the infants with pre- postnatal dilatation presented with symptomatic urinary tract infection. However, in one neonate an asymptomatic urinary tract infection without VUR was diagnosed by routine urinalysis.

CONCLUSION

In our study, we linked renal pelvis dilatation on pre- and postnatal sonograms to obstructive uropathies rather than to vesicoureteric reflux. Prenatal sonography proved less sensitive than postnatal sonography in revealing obstructive uropathies. An RPD smaller than 10 mm on neonatal sonography was of no pathologic significance because renal collecting systems normalized spontaneously in all infants within 1 year of birth. These neonates and infants had no significant risk for urinary tract infection and did not need further evaluation.

BCG osteomyelitis as a rare cause of mediastinal tumor in a one-year-old child

A one-year-old child with BCG osteomyelitis of the upper spine is reported. The child was admitted because of viral infections of the upper respiratory tract. A lateral x-ray examination of the lung showed what was thought to be a mediastinal tumor. The preoperative diagnostic problems are discussed, because the etiology in our case was unknown until the histological report arrived. The knowledge of the complication, of osteomyelitis after vaccination, is small although the first case was published more than 40 years ago. Since then about 300 cases have been reported in the literature. The disease is seen in the first five years of life in otherwise healthy children. Most cases are localized near the epiphysis of the long bones. A localization in the spine, as described in our case, has been published only three times before. The highest frequency of BCG osteomyelitis is reported in Finland and Sweden with about 40 cases per 1 million vaccinations.

The importance of multiple endocrine neoplasia syndromes in differential diagnosis

In the differential diagnosis of endocrine symptoms, the autosomal dominant multiple endocrine neoplasia (MEN) syndromes are rare but important. We found seven index cases of MEN-I in 176 patients with adenomas of the anterior pituitary and 26 patients with primary hyperparathyroidism. Of 23 cases of medullary thyroid carcinoma and eight cases of pheochromocytoma, 14 patients are classified as MEN-IIa and one as MEN-IIb. Family screening identified six MEN-I and seven MEN-II cases among 32 individuals examined. Because of autosomal dominant inheritance and sometimes-delayed manifestation of the complete syndrome, screening of healthy and affected family members should be repeated at least every other year.

Electroresection with a new endotracheally applicable resectoscope

Besides dilatation, cryotherapy, laser and surgical resection, the technique of endoscopic, endotracheal electroresection provides an alternative in the treatment of endotracheal stenoses. The instrument is similar to the resectoscope used in urology, but additionally equipped with a longer action range and respiration facility. It is insulated at the tip of the shaft. The electroresectoscope was employed on 64 occasions at our institution in three indications: endotracheal diseases, granulomas following tracheostomy; and short subglottic membrane stenoses, partly secondary to long-term intubation. Indications, advantages and drawbacks of the method are discussed.

[Rehabilitation measures in patients following recovery in myocarditis and dilated cardiomyopathy]

In the frame of the attendance to patients with specific myocardial diseases differences are found in contrast to groups of patients, in particular of older age. The complex diagnostic clarification, including myocardial biopsy, is recommended. Convalescent treatment is of priority. Because of the bad prognosis of patients with impaired left-ventricular function, in particular patients with normal or slightly impaired left-ventricular ejection fraction should be mobilised using complex rehabilitative measures (psychologist, welfare worker) only after some longer convalescent treatment. Decisions as to sanatorium treatment or on further special therapeutic principles have to be made individually.

[Rehabilitative measures in elderly patients]

The age structure of the population shows an increase in older people. In particular cardiovascular diseases become manifest prevailingly beyond the 65th year of life. So, the percentage of care for this age group with cardiovascular diseases will continue to rise in the years to come. Herein measures of rehabilitation with older patients have to be thought over again and put into practice. The comprehensive rehabilitation in this group of patients with a higher percentage of more severely sick patients aims at the maintenance and stabilisation of the physical and psychic capability and at support with social problems. The physician should remain in connection with the older patient in the process of mastering his/her disease and thus contribute to reaching his/her mental balance.

[Ultrasound sonographic diagnosis of myocarditis using quantitative texture analysis of 2-dimensional echocardiography images]

In a prospective study we tested the possibility to differentiate myocardial tissue by means of the quantitative texture analysis of two-dimensional echocardiographic images. 12 patients with a bioptically ascertained myocarditis and 12 healthy patients of a control group were echocardiographically examined. The results demonstrated that the echocardiographic image texture in myocarditis is characterized by an increase of the texture parameters entropy, second difference moment and long-run emphasis as well as by a decrease of the parameters angular second moment, inverse difference moment and run-length nonuniformity as well as by different values of the ring and sector sums of the power spectre. The digital image processing of echocardiography images seems thus to open a new way to the noninvasive diagnostic of myocarditis.

[Therapeutic principles in myocarditis]

The incomplete aetiopathogenetic knowledge, the non-uniform clinical and diagnostic criteria as well as the course of the myocarditis which is prognostically not to be foreseen cause controversial therapeutic consequences. In the first place of the treatment is the causal treatment of the factors evoking or maintaining the inflammation. By means of immunosuppression an improvement of the findings is obtained in approximately 50% of the patients with myocarditis. Thus the immunosuppressive therapy cannot be recommended in general. It is sought for new active agents. The disturbed haemodynamics is, apart from medicamentous measures, positively influenced above all by convalescent treatment. Individually reconciled measures of the complex rehabilitation are accompanyingly necessary and render possible an improvement of the quality of life at long sight. In individual cases only the heart transplantation may have a favourable influence on the prognosis of the in most cases young patients.

[Diagnostic error in the clinical area. A discussion contribution]

Regarding the great number and the possible consequences for the patient it's surprising that there is almost no discussion concerning wrong diagnoses in medicine. Based on the experience of a working team at a center for general pediatric surgery we tried to recognize the most common mechanisms leading to wrong or insufficient diagnoses. For better illustration we describe the histories of six patients; in their cases the diagnostic errors could probably have been avoided by an exact examination procedure. One way to decrease pitfalls in daily medicin life seems to be the reflexion upon the errors and try to minimize them and their sources.

External fixation of femoral fractures. Indications and limitations

The role of external fixation in the management of femoral shaft fractures is reviewed based on a study of 24 femoral fractures managed by either an AO or a Wagner external fixator during 1983-1986. Indications included open fractures with soft-tissue injury (13 patients), comminuted shaft fractures (six patients), and unstable operative candidates (five patients). In 14 patients, external fixation was a temporary method (Group I), while in ten patients it was the definitive method of stabilization (Group II). Twenty-one patients achieved solid union, two developed a delayed union, and one had a nonunion. Three patients developed pin-tract infections, and one developed osteomyelitis after intramedullary fixation in Group I. Two patients in Group II developed shortening (2.1 cm and 3.2 cm). Loss of motion occurred in 11 patients, averaging 56 degrees. It is suggested that external fixation be considered in the following types of femoral fractures: open fractures for aggressive management of soft-tissue injuries; closed fractures in severely traumatized, burn, or head injury patients; fractures about the knee resulting in floating knees; and infected femoral nonunions and pseudarthroses.

Implantation of a silastic balloon for reduction of radiation injuries of the bowel in two children with neuroblastoma

Two children with stage IV neuroblastoma died from severe reactions of the bowel due to radio-chemotherapy. This led to the suggestion of protecting the bowel by implantation of a silastic balloon to push the bowel away from the treatment volume. This procedure was tried in two children with stage IV neuroblastoma and resulted in excellent tolerance of the high-dose radiotherapy.

Investigations of patients allergic to the house dust mite Dermatophagoides pteronyssinus by crossed radioimmunoelectrophoresis using purified mite bodies and whole mite culture extracts

Sera of 20 patients allergic to the house dust mite Dermatophagoides pteronyssinus were investigated by crossed radioimmunoelectrophoresis (CRIE) using extracts prepared from purified mite bodies (PMB) and whole mite culture (WMC). By CRIE, different allergen patterns and different numbers of allergens were detected in the two extracts. By summarizing the values of the CRIE patterns of the 20 patients' sera into allergograms, 6 out of 16 allergens in PMB and 5 out of 10 allergens in WMC extracts could be identified as major allergens. These diverging results, together with the published literature, emphasize the necessity to reevaluate the International Standard for D. pteronyssinus.

A manufacturer's criteria for in-house reference preparations for RAST inhibition

Reagents employed for RAST-inhibition need careful characterization. An allergen reference preparation was produced from carefully selected raw materials. After immunochemical and biochemical characterization, the reference preparation was used to produce allergen reference paper disks. Their quality was controlled by the amount of bound protein and serum titration, which should yield an S-shaped dose-response curve and specific binding of IgE of at least ten times more than background binding. In parallel, the biologic activity of the allergen reference preparations was established in quantitative skin prick tests in at least 20 allergic patients. From these patients, serum samples were collected and pooled after careful characterization. All three necessary reagents for RAST-inhibition (extract, disks, and serum pool) were stabilized by freeze-drying. The reproducibility of the assay procedure itself was checked by documenting the 50% inhibition value of the reference preparation, accepting only values within +/- 2 SD. By employing such reagents we could measure the activity of alum-adsorbed grass pollen extracts with sufficient precision, ie, the coefficient of variation of the mean potency of 12 batches was less than 40%.

Allergenic activity of short ragweed pollen (Ambrosia elatior) from different years and/or suppliers: criteria for the selection of an in-house allergen reference preparation

We have investigated dialyzed extracts (A-F) of short ragweed pollens (Ambrosia elatior) from six consecutive production years and four different companies by protein nitrogen units, high performance liquid chromatography, isoelectric focusing, SDS-PAGE, RAST inhibition, crossed radioimmunoelectrophoresis, and antigen E contents. Extract A showed lowest yields in all quantitative assays. Isoelectric focusing, SDS-PAGE, crossed immunoelectrophoresis, and crossed radioimmunoelectrophoresis showed comparable patterns for all extracts except for extract A. Apparently, the activity of short ragweed pollens depends on the year of production and/or the skill of the producer. These findings are in contrast to similar examinations of other pollen species.

[Stress-induced changes in the R amplitude in the ECG in patients with arterial hypertension and chronic ischemic heart disease and following aortocoronary venous bypass]

76 patients after aortocoronary venous bypass operation, 34 patients with essential arterial hypertension at stage I or II (WHO) and chronic ischaemic heart disease, 96 patients with a chronic ischaemic heart disease of different degree of severity and 20 persons with healthy heart were examined concerning their behaviour of the R-amplitude in the exercise electrocardiogram. In all patients a standardized bicycle-ergometric exercise sitting and a coronarography as well as a ventriculography were performed. There is no statistically significant difference in the behaviour of the R-amplitude between patients with chronic ischaemic heart disease and persons with healthy heart. Indeed, hypertensives with chronic ischaemic heart disease significantly differ in their behaviour of the R-amplitude from persons with healthy heart, in the hypertensives with chronic ischaemic heart disease, however, the behaviour of the R-amplitude is indifferent, so that it is concluded that the criterion of the R-amplitude for the diagnosis of the chronic ischaemic heart disease in hypertensives cannot be used. An insufficient individual reproducibility supports this conclusion.

[Clinical value of ethinyl estradiol sulfonate (Turisteron)--long-term results of a randomized compound study]

In a randomized compound study the therapy effect of ethinylestradiol sulfonate (Turisteron) is tested. As comparative groups serve patients with chemotherapy and Turisteron in combination with chemotherapy. The cumulative 5-year survival rate under the therapy of Turisteron was 61.2%. The comparative groups do not achieve this high survival rate. In connection with the slight stress of the patients (application form, side effects) ethinylestradiol sulfonate (Turisteron) is an effective estrogen in the long-term treatment of the advanced carcinoma of the prostate gland.

High-performance liquid chromatographic molecular weight determination of allergen extracts. Examination of the influence of the column material on allergenic activity and allergen patterns

To investigate whether the column material employed in size-exclusion high-performance liquid chromatography (HPLC) influences the allergenic activity and antigen/allergen patterns of allergen extracts, the molecular weights of a mite and a birch pollen allergen extract were determined using a Bio-Sil TSK 250 column with a guard column. The allergenic activities were measured by RAST inhibition and the antigen/allergen patterns were determined by crossed (radio)immunoelectrophoresis. The original extracts and the corresponding eluates after HPLC runs showed the same allergenic activity and the same number of antigen/allergen precipitation lines. Only slight differences in the peak heights of some precipitates were observed.

Circulating committed and pluripotent haemopoietic progenitor cells, in infants

Circulating CFU-GM, BFU-E and CFU-MIX were assayed in 21 infants aged between 1 day and 44 weeks. Compared to 15 adults, progenitor cells of all types were increased until 10 weeks following birth and approached the respective ranges of adults thereafter. The mean increases of progenitor cells in infants aged between 1 day and 10 weeks were 26-fold for CFU-GM, 7-fold for BFU-E and 5-fold for CFU-MIX. Our results demonstrate that not only committed progenitor cells (CFU-GM, BFU-E), but also early progenitor cells with the capacity for self-renewal (CFU-MIX), are increased in early infancy. These data further support the hypothesis that high levels of blood progenitor cells in very early stages of life reflect the colonization process of developing bone marrow by circulating progenitor cells and demonstrate the terminal phase of this process during the first 10 weeks after birth.

Kinetics of allergen release from house dust mite Dermatophagoides pteronyssinus

Purified bodies of Dermatophagoides pteronyssinus were extracted over different extraction times. The release kinetics of proteins, carbohydrates, and allergens were assessed by different methods. Additional attempts have been made to elucidate the extraction process also on a molecular basis. For this purpose the extracts were analyzed by isoelectric focusing, SDS gel electrophoresis, crossed radioimmunoelectrophoresis, and an immunoprint technique. Carbohydrates, proteins, and allergens were released immediately from the mite bodies but demonstrated different release kinetics. The release of carbohydrates and proteins was linear up to 48 hours but demonstrated different slopes. The major allergen P1 demonstrated steady release up to 48 hours, whereas the overall allergenic activity as determined by RAST inhibition demonstrated typical saturation kinetics reaching a plateau after 4 to 5 hours of extraction. It was demonstrated by parallel-line assay of the RAST-inhibition curves that the allergenic determinants remained unchanged up to 48 hours. Different electrophoretic methods demonstrated that all relevant proteins and allergens were released immediately from the mite bodies. The electrophoretic patterns changed only slightly up to 4 hours. Prolonged extraction times up to 48 hours did not affect the patterns. This makes a loss of proteins or allergens by degradation unlikely.

Quality of timothy pollen (Phleum pratense) from different pollen seasons and different suppliers

We investigated seven batches of timothy (Phleum pratense) pollen from four different pollen seasons and three different manufacturers in the USA and Europe by several biochemical and immunochemical methods. By measuring the contents of hexoses, proteins and the total allergenic activity using RAST inhibition we could not find any significant differences in quality between pollen of different seasons, different geographical origin and different manufacturers. There were only slight differences in the staining of some protein bands and in peak height of some antigens in isoelectric focusing (IEF), SDS-PAGE and crossed immunoelectrophoresis. These differences in IEF and SDS-PAGE patterns seem to be specific for the pollen samples from the USA and Europe, respectively. We also observed minor differences in IEF immunoprint patterns, mainly for some basic proteins. The allergen patterns in crossed radioimmunoelectrophoresis were very similar, with only minor differences in concentration of the basic allergens. It appears that timothy pollen from different years can be produced in different geographical areas by different manufacturers with fairly constant allergenic activity.

Comparison of classical Lowry, modified Lowry and a dye-binding assay for the estimation of protein in allergen extracts and influence of different parameters on the modified Lowry assay

Protein values of dialysed allergen extracts determined by Lowry, modified Lowry (trichloroacetic acid precipitation of the proteins) and dye-binding assay were compared. The influence of different parameters on the modified Lowry was examined. The reproducibility of the modified Lowry was checked with three independent measurements. For the examination of recovery a constant amount of 6-grass pollen allergen proteins was added to the samples of the standardized human serum albumin prepared for the calibration curve. The samples were measured by modified Lowry. The mean of the ratio between the protein values of the dialysed allergen extracts obtained by modified Lowry and those obtained by classical Lowry was 3.59 (coefficient of variation Cv = 45%). The mean of the ratio between the protein values of the allergen extracts obtained by modified Lowry and dye-binding assay was 1:0.71 (Cv = 31%). Phenol interfered with the modified Lowry. Phenolic allergen extracts showed higher "protein values" than non-phenolic allergen extracts. This influence could be reduced by a second precipitation of the dissolved precipitate. The precipitation of non-phenolic dialysed aqueous allergen extracts was complete after the first trichloroacetic acid precipitation. By incubating samples with the Folin-Ciocalteu's reagent at 55 degrees C in a waterbath, the time necessary for developing the colour could be reduced from 45 min to 5 min. Protein measurements by modified Lowry of a 6-grass pollen allergen extract in three different laboratories showed good reproducibility. For these extract 785 micrograms protein/ml (Cv = 4%) could be measured.(ABSTRACT TRUNCATED AT 250 WORDS)

[Follow up studies of young adults following multiple tic symptoms in childhood]

24 probands with multiple tic symptoms in childhood were controlled as young adults. Only 1/3 of the probands were without symptoms, 5 showed further on multiple tics. Due to anamnestic and catamnestic data we tried to demonstrate the possible causes for the tic symptoms.

Leukocyte histamine release and humoral changes during oral and subcutaneous hyposensitization of grass pollen allergic children

Thirty-one children with seasonal hay fever, sensitive to rye grass by skin test, RAST, and leukocyte histamine release, received preseasonal hyposensitization with a rye grass pollen extract either subcutaneously (cumulative dose 40,000 PNU) or orally (cumulative dose 400,000 PNU). While there was a significant (p less than 0.005) increase in specific serum IgG-antibodies and a decrease (p less than 0.005) of leukocyte sensitivity in the subcutaneously treated group, oral treatment with an aqueous pollen extract could not be demonstrated to be immunologically effective.

Comparison of three variations of the radioallergosorbent test-inhibition assay for measuring allergenic activity of grass pollen extracts

Three variations of the radioallergosorbent (RAST)-inhibition assay (RI) have been compared for measuring the allergenic activity of grass pollen extracts. The main difference between the three assays consisted in the solid supports to which the allergens were coupled. These supports were paper disks, microcrystalline cellulose, and Matrex. It could be demonstrated that all three variations of RI yielded almost identical results as expressed by their F value (F0). Correlations between the three methods were highly significant (P less than 0.001). Three independent valid assays showed an excellent reproducibility of each test system (P less than 0.01). Three different preparations of each of the supports yielded highly reproducible F0 (0.76 +/- 3% SD). Evaluation of the 50% inhibition values achieved with the different assays based on protein showed differences between the three supports. Provided the same allergen extract is coupled to the different solid supports and the results are related to a reference preparation, different laboratories using different forms of RI will be able to compare their results.

[The effect of combined step-by-step rehabilitation on work capacity of patients who had myocardial infarction (a USSR-East Germany cooperative study)]

The effect of combined rehabilitation on the recovery of working capacity was studied in 304 post-infarction patients in Moscow and 294 in Berlin. All the patients were male and below 65 years of age. Combined stepwise rehabilitation promoted the recovery and maintenance of working capacity in myocardial infarction survivors. A number of factors, such as middle and old age, occupations involving moderate and hard physical work, aggravated course of myocardial infarction, and first-class or fourth-class ECG changes by the Minnesota Code were shown to have negative effects on working capacity.