Showing papers on "Blood serum published in 1979"

A Comparison of Amphotericin B Alone and Combined with Flucytosine in the Treatment of Cryptoccal Meningitis

Abstract: We compared amphotericin B therapy for cryptococcal meningitis with a newer regimen containing both amphotericin B and flucytosine. In 50 patients with 51 courses of therapy adherent to the protocol, 27 courses were with amphotericin B and 24 with the combination. Even though the combination regimen was given for only six weeks and amphotericin B for 10 weeks, the combination cured or improved more patients (16 vs 11), produced fewer failures or relapses (three vs. 11), more rapid sterilization of the cerebrospinal fluid (P less than 0.001) and less nephrotoxicity (P less than 0.05) than did amphotericin B alone. The number of deaths was the same (five) with each regimen. Adverse reactions to flucytosine occurred in 11 of 34 patients but were not life threatening. We conclude that combined flucytosine-amphoericin B therapy is the regimen of choice in cryptococcal meningitis.

Toxocariasis: serological diagnosis by enzyme immunoassay.

Abstract: An enzyme-immunoassay was developed to measure the concentration of serum antibody specific for the secretory antigens released by migrating toxocaral larvae. This technique was evaluated by testing sera from healthy UK adults, and from patients with and without toxocariasis. In 922 healthy adults, 2.6% were found to have elevated specific antibody levels. Elevated values were observed twice as frequently in males as in females but showed no significant regression with age between 20 and 65 years. Of 62 patients with non-toxocaral helminthic infections, all had antitoxocaral antibody levels within the range of values observed in healthy controls and had a mean level which was not significantly elevated. All of 13 patients with clinical toxocariasis had enzyme-linked immunosorbent assay (ELISA) antibody levels above the 100th percentiles of both the healthy population and the helminth-infected group and had a significantly high mean value (p less than 0.001) more than 12 times that of the healthy or infected controls. The high degree of sensitivity and specificity of the toxocariasis enzyme-immunoassay indicates that this new test should be useful in reference immunodiagnostic applications and in large-scale seroepidemiological surveys.

Radioimmunoassay of hair for determining opiate-abuse histories.

Abstract: Heroin and morphine metabolites can be detected in hair with the use of commercially available radioimmunoassay reagents and with minor sample preparation. Hair samples obtained from morphine-treated mice and heroin users contained nanogram levels of the drug per milligram of hair (single human hair). The results of the hair analyses for all subjects admitting the use of heroin were positive, whereas the results of only 30% of thin-layer chromatographic urinanalyses of these same subjects were positive. In addition, differences in drug concentration for sections of hair near the scalp and near the distal end correlated with the length of time the drug had been used. These results exemplify the potential advantages of the use of hair analysis over urine and serum analyses in terms of accessibility, sample stability, and long-term retention of information.

Changes in coronary risk factors during comprehensive five-year community programme to control cardiovascular diseases (North Karelia project).

Abstract: A comprehensive community programme to control cardiovascular diseases (CVD) in North Karelia, Finland, was carried out during 1972-7. The central intermediate objective of the programme was to reduce the prevalence of smoking, the serum cholesterol concentration, and raised blood-pressure values among the population of the area. The effect was evaluated by examining independent representative population samples in 1972 and 1977 in both the county of North Karelia and a matched control county. Over 10 000 subjects were studied each time, the participation rate being around 90%. The decrease that occurred in the risk factors, especially in men, was in general greater in North Karelia compared with the control county. When a multiple logistic function was used for the three risk factors an overall mean net reduction of 17% among men and 12% among women was observed in the estimated risk for coronary heart disease in North Karelia. This community programme effectively reduced the levels of the three main risk factors for CVD in the population, and thus mortality and morbidity from CVD should fall. This is assessed in further studies.

Prevention of reactivated herpes simplex infection by human leukocyte interferon after operation on the trigeminal root.

Abstract: Microneurosurgical procedures on the trigeminal-nerve root are often followed by reactivation of herpes simplex virus infection, manifested by herpes labialis or oropharyngeal herpesvirus shedding or both. In a double-blind study of the ability of human leukocyte interferon to prevent this reactivation, patients with a history of herpes labialis were given 7 X 104 U of interferon per kilogram of body weight per day or placebo for five days beginning on the day before operation. In 18 patients treated with placebo, herpes labialis developed in 10, and virus shedding in the oropharynx in 15. In 19 patients treated with interferon, lesions developed in five, and shedding in eight. The frequency of reactivation as measured by lesions or positive throat cultures or both was significantly reduced by interferon (P<0.05). Of 127 daily throat-wash cultures in the placebo group, 42 per cent were positive for herpesvirus, but of 134 in the interferon group, only 9 per cent were positive (P<0.001). We conclu...

Indirect immunofluorescence test for serodiagnosis of Legionnaires disease: evidence for serogroup diversity of Legionnaires disease bacterial antigens and for multiple specificity of human antibodies.

Abstract: Evidence obtained by others who used direct immunofluorescence staining to demonstrate serological differences among strains of Legionnaires disease bacterium prompted this study of parameters influencing the ability of the indirect immunofluorescence test to detect human antibodies to Legionnaires disease bacterium. A total of 25 Legionnaires disease bacterium strains, representing four serogroups, were used as immunofluorescence antigens to test selected human sera. The use of diethyl ether in preparing the antigens was discontinued when it was found that titers against ether-killed group 2 (Togus 1-like) antigens were impossible to determine. Instead, heat-killed suspensions of Legionnaires disease bacterium in 0.5% buffered normal chicken yolk sac were used to show the serogroup diversity of the strains and the serogroup specificity of the antibody response of some, but not all, patients with serological evidence of Legionnaires disease. These studies suggest that multiple antigens should be used in serological tests for Legionnaires disease. Furthermore, the fact that some sera contain antibodies that bind equally well to strains of all four serogroups implies that demonstration of a fourfold increase in titer of paired sera when tested with a single antigen should not be interpreted as evidence of infection with a strain of the same serogroup.

Working with ion-selective electrodes

Abstract: 1 Fundamentals of Potentiometry.- 1.1 Electrode Processes.- 1.2 The Nernst Equation.- 1.3 Potential-Determining Ions.- 1.4 Ion-Selective Electrode Materials.- 1.5 The Potentiometric Selectivity Coefficient as a Quantitative Indication of the Electrode Selectivity.- 2 Electrode Potential Measurements.- 2.1 Reference Electrodes.- 2.2 The Standard Hydrogen Electrode as a Primary Reference Electrode.- 2.2.1 Preparation.- 2.2.2 Characteristics.- 2.3 The Liquid Junction Potential.- 2.3.1 Origin.- 2.3.2 Calculation.- 2.3.3 Salt Bridge Electrolytes.- 2.3.4 Construction of the Salt Bridge Electrolyte/Sample Solution Contact Zone.- 2.3.5 Cells Without Liquid Junction.- 2.4 Secondary Reference Electrodes.- 2.4.1 Silver/Silver Chloride.- 2.4.1.1 Preparation.- 2.4.1.2 Characteristics.- 2.4.2 Thallium Amalgam/Thallium (I) Chloride (Thalamid(R)).- 2.4.2.1 Characteristics.- 2.4.3 Mercury/Mercury (I) Chloride (Calomel).- 3 Ion-Selective Electrodes.- 3.1 General Construction Principles.- 3.2 Solid-State Membrane Electrodes.- 3.2.1 Glass Membrane Electrodes For Li+, Na+, K+, Rb+, Cs+, NH4+, NR4+, Ag+, Tl+ Ions.- 3.2.1.1 Construction.- 3.2.1.2 Characteristics.- 3.2.1.3 Handling.- 3.2.1.4 Sample Preparation.- 3.2.2 Homogeneous Solid-State Membrane Electrodes For Ag+, Cd2+, Cu2+, Pb2+, S2-, F-, Cl-, Br-, I-, SCN-, CN- Ions.- 3.2.2.1 Principles.- 3.2.2.2 Construction.- 3.2.2.3 Preparation of Solid-State Membrane Electrodes Based on Ag2S.- 3.2.2.4 Characteristics.- 3.2.2.5 Handling.- 3.2.2.6 Sample Preparation.- 3.2.3 Heterogeneous Solid-State Membrane Electrodes For Ag+, Cl-, Br-, I-,CN-, SCN-, S2- Ions.- 3.2.3.1 Construction.- 3.2.3.2 Preparation.- 3.2.3.3 Characteristics.- 3.2.3.4 Handling.- 3.3 Porous and Nonporous Supported Ion Exchanger and Neutral Carrier Membrane Electrodes.- 3.3.1 Ion-Exchangers For Ca2+, Me2+ Cations and Cl-, ClO4-, NO3-, BF4- Anions.- 3.3.2 Neutral Carrier Compounds For Li+, Na+, K+, Rb+, Cs+, NH4+, NR4+, Ca2+ and Ba2+ Cations.- 3.3.3 Construction.- 3.3.4 Preparation of PVC Membrane Electrodes.- 3.3.5 Characteristics.- 3.3.6 Handling.- 3.3.7 Further Electro-Active Phases.- 3.4 Solid State Electrodes with Electroactive Coatings.- 3.5 Gas Sensors For CO2, NH3, SO2, NO2, HF, H2S, HCN, etc..- 3.5.1 Principles.- 3.5.2 Construction.- 3.5.3 Characteristics of Gas-Sensitive Electrodes.- 3.5.4 Handling.- 3.5.5 Sample Preparation.- 3.6 Bio-Sensors.- 3.6.1 Principles.- 3.6.2 Construction.- 3.6.3 Preparation of Enzyme Electrodes.- 3.6.4 Characteristics of Bio-Sensors.- 3.6.5 Sample Preparation with Bio-Sensors.- 4 Measuring Techniques with Ion-Selective Electrodes.- 4.1 Equivalent Circuit for a Cell with Liquid Junction.- 4.2 Measuring the EMF of an Electrochemical Cell.- 4.3 Choosing an EMF Measuring Device.- 4.4 Characteristics of Electrometer Amplifiers.- 4.4.1 Resolving Power.- 4.4.2 Insulation Problems.- 4.4.3 Charging Phenomena.- 4.4.4 Ground Loops.- 5 Analysis Techniques Using Ion-Selective Electrodes.- 5.1 Calibration Curves.- 5.1.1 Determination of Activity Using an Activity Calibration Curve.- 5.1.2 Determination of Concentration Using a Concentration Calibration Curve.- 5.2 Direct Indication on the pH or plon Scale of an Instrument.- 5.3 Titration Procedures for Determining Concentrations.- 5.3.1 Prerequisites.- 5.3.2 Titration Errors.- 5.3.3 Sample Preparation for Titrations.- 5.3.4 Titration to a Pre-determined EMF Value.- 5.3.4.1 On the Basis of a Titration Curve.- 5.3.4.2 On the Basis of a Concentration Cell Set-Up.- 5.3.5 "Chemically Linearized" Titration Curves (One Point Titration).- 5.4 Concentration Determinations with the Help of a Standard Addition with a Known Electrode Slope S.- 5.4.1 Measuring the Change in EMF upon Addition of a Standard Solution to the Sample Solution.- 5.4.2 Measuring the Change in EMF upon Addition of the Sample Solution to a Standard Solution.- 5.5 Concentration Determinations with the Help of a Standard Addition with an Unknown Electrode Slope S.- 5.5.1 Method of Double Standard Addition.- 5.5.2 Method of Standard Addition with Subsequent Dilution.- 5.6 Practical Example of the Addition Method: Sodium and Potassium Determination in Blood Serum.- 5.7 Concentration Determinations with the Help of a "Mathematically Linearized" Titration Curve.- 5.8 Practical Example of the Gran Extrapolation Method: Determination of Chloride in the ppm Range.- 5.8.1 Principles.- 5.8.2 Preparatory Work.- 5.8.3 Blank Determination.- 5.8.4 Chloride Content Determination of the Sample Solution.- 5.9. Determination of Some Characteristic Electrode Parameters.- 5.9.1 Determination of the Detection Limit.- 5.9.2 Determination of the Selectivity Coefficient.- 6 Applications of Ion-Selective Electrodes.- 6.1 Physiology, Biology, Medicine.- 6.1.1 Measurements in Extracellular Fluids.- 6.1.1.1 In-vitro Measurements.- 6.1.1.1.1 Sample Preparation.- 6.1.1.1.2 The Indicating Electrode.- 6.1.1.1.3 The Reference Electrode.- 6.1.1.2 In-vivo Measurements.- 6.1.2 Measurements of Intracellular Ion Activities.- 6.1.2.1 Preparation of Ion-Selective Microelectrodes.- 6.1.2.2 Guarded Signal Wires for Extremely High Ohmic Electrodes.- 6.1.2.3 Reference Microelectrodes.- 6.1.2.4 Special Amplifiers for Microelectrode Applications.- 6.2 Continuous Measurements in Industry and Environmental Research.- 6.2.1 Flow-thru Cells.- 6.2.1.1 Influence of Grounding.- 6.2.1.2 Influence of Temperature.- 6.2.1.3 Analysis Techniques with Flow-thru Measurements.- 6.2.1.4 Flow-thru Measurements without Reference Electrodes.- 6.2.1.4.1 Direct Potentiometry.- 6.2.1.4.2 Concentration Determination through Standard Solution Addition.- 6.2.1.4.3 Indirect Concentration Determination.- 6.2.1.4.4 The Cyanide Monitor as an Example of Industrial On-Line Measurements.- 6.2.2 Concentration Determination Via a Continuous Titration.- Outlook.- A.1 Concentration, Activity and Activity Coefficient.- A.1.1 Preparing Accurate Activity Calibration Solutions.- A.2 Survey of the Temperature Dependence of Commonly Used Reference Electrodes.- A.3 Table for Evaluation Using Analysis Technique 5.4.1.- A.4 Table for Evaluation Using Analysis Technique 5.4.2.- A.5 Table for Evaluation Using Analysis Technique 5.5.1.- A.6 Table for Evaluation Using Analysis Technique 5.5.2.- A.7 Evaluation Table for Standard Addition + 1:1 Dilution.- A.8 Ion-Selective Electrode Manufacturers and/or Dealers.- Literature.- Index of Symbols Used.

Association of Respiratory Tract Colonization with Adherence of Gram-Negative Bacilli to Epithelial Cells

Abstract: Factors that promote oropharyngeal colonization of seriously ill patients with gramnegative bacilli are as yet poorly understood. In this investigation, 34 subjects who required intensive care were studied; 18 (53%) were colonized with gram-negative bacilli. Oropharyngeal epithelial cells of all colonized patients contained adherent bacilli. Fewer a-hemolytic streptococci but greater numbers of Pseudomonas aeruginosa and Klebsiella pneumoniae (P ~ 0.01) adhered in vitro to buccal epithelial cells from colonized patients than to cells from noncolonized patients. Adherence of bacilli to buccal cells was inhibited in vitro by concanavalin A but not by bovine serum albumin or phytohemagglutinin. Brief exposure of buccal cells to trypsin increased adherence of bacilli. Prior adherence of one species of bacilli inhibited subsequent adherence of a second species. These findings suggested that epithelial cells of the upper respiratory tract contain binding sites for gram-negative bacilli. Factors associated with serious illness appear to increase the availability of these binding sites, thus facilitating colonization of the upper respiratory tract with gram-negative bacilli. Pneumonia due to gram-negative bacilli remains a significant threat to seriously ill patients. The event that initiates these infections appears to be colonization of the respiratory tract by gram-negative bacilli; in one study, pneumonia occurred in 23% of colonized patients as compared with 3% of noncolonized patients, and prior colonization by bacilli was demonstrated in 91% of patients who developed nosocomial pneumonia [1]. Attempts to prevent colonization by bacilli of the respiratory tracts of seriously ill patients by enforcing rigid aseptic techniques of airway management [2] or by instillation of antimicrobial

Effect of Clozapine on Human Serum Prolactin Levels

Abstract: The authors determined serum prolactin levels in 13 patients receiving clozapine, an antipsychotic drug that does not produce extrapyramidal side effects. Morning serum prolactin levels, 11 hours after the last dose, were not elevated during chronic treatment with clozapine in any subject despite its therapeutic effects. Serum prolactin levels were moderately increased between 90 minutes and 4 hours after administration of very high doses of oral clozapine in 4 patients but were smaller than those produced by chlorpromazine in other subjects. The authors suggest that clozapine in other subjects. The authors suggest that clozapine may achieve its antipsychotic effect differently than do classical neuroleptics and that sustained prolactin increases are not essential for antipsychotic action.

Serum levels of selenium, calcium, copper magnesium, manganese and zinc in various human diseases.

Abstract: Serum selenium as well as serum zinc, copper, magnesium, calcium and manganese were investigated in a control group of adult males and in 11 groups of patients in various disease states Not only the change of each trace element but also the possible association between elements was studied in the various groups All patients were fasting when sampled and studied only after the acute phase of the disease was corrected Trace metal determinations were performed by atomic absorption spectrophometry (Mg, Ca, Cu, Zn) and by neutron activation analysis (Se, Mn) All patients showed low serum zinc when compared to controls Cirrhotic patients had a low serum selenium level as well as low calcium, magnesium and zinc Emphysemia and cancer patients had an elevated serum copper concentration while copper and manganese levels were elevated in congestive heart failure, infection and pschoses To our knowledge this is the first time low serum selenium values have been demonstrated to be associated with the low serum zinc, calcium and magnesium levels found in cirrhotic patients

Chloroquine serum concentration and side effects: evidence for dose-dependent kinetics.

Abstract: Serum concentrations of chloroquine were determined fluorometrically in 100 rheumatoid patients who had been treated with 0.25 gm daily for at least 2 mo. The total dose varied between 3.7 and 400 gm. No patient received more than 75 gm annually. In 15% of the patients side effects were noted. There was a relationship between serum concentrations and side effects but not with the total dose administered. Chloroquine displayed dose-dependent kinetics, which may indicate that close monitoring of serum concentrations is an aid to the safe and rational use of the drug.

Rotavirus infection in adults. Results of a prospective family study.

Abstract: To study the epidemiologic and clinical features of rotavirus infections, we enrolled 98 families in a prospective study of diarrhea in households with newborn children. Families were seen at three-month intervals and whenever ill. The mean follow-up period was 16.4 months. Rotavirus infections were documented by electron microscopy of feces, indirect fluorescent-antibody assays in serum or both. The 43 infections identified in adults represented an attack rate of 0.17 per adult per year. Ninety-three per cent of these infections occurred from November through May. Seventeen adults had gastrointestinal symptoms, most often diarrhea (in 14) or abdominal cramps (in 11). Rotavirus infections occurred in 36 of 102 adults whose children had rotavirus infection, as compared with four of 86 without infected children (P<0.001). Serum rotavirus antibody did not correlate with a reduced risk of infection or symptomatic disease. Rotavirus is a mild but common infection in parents of young children. (N Engl ...

SErum Amyloid a Protein in Amyloidosis, Rheumatic, and Neoplastic Diseases

Abstract: Serum levels of amyloid protein A (SAA) have been shown to be elevated in different types of amyloidosis and in rheumatic diseases by radioimmunoassay using 125 iodine labeled AA and anti-AA. SAA levels were elevated in both primary and secondary amyloidosis, but there were highly significant differences between these levels. In heredofamilial amyloid, SAA levels were within normal limits. While the mean SAA level was elevated in persons over 70 years, the fact that some persons in this age group had normal levels suggested that marked elevation after age 70 may be due to occult inflammatory or neoplastic disease. High SAA levels in patients with rheumatoid arthritis correlated, in most cases, with physician evaluation of disease activity and Westergren ESR. SAA levels in patients with systemic lupus erythematosus were lower than those in patients with rheumatoid arthritis, and most patients with degenerative joint disease had normal levels. Very high levels of SAA were found in patients with neoplastic diseases. Patients with carcinoma of the lung and bowel had much higher levels than patients with carcinoma of the breast. Determination of SAA levels may be of value in evaluating different forms of systemic amyloidosis, assessing the activity of rheumatic disease, and screening for occult inflammatory or neoplastic disease.

Opportunistic lung infection due to "Pittsburgh Pneumonia Agent".

Abstract: Eight immunosuppressed patients had pneumonia due to Pittsburgh Pneumonia Agent (PPA), a gram-negative, weakly acid-fast bacterium cultivatable only in embryonated eggs and guinea pigs and distinct from Legionella pneumophila. The diagnosis was established by isolation of the agent from lung or visualization of the organism in lung tissue. The clinical presentations, radiographic abnormalities and pathology were not specific. The most consistent feature associated with the disease was the recent institution of daily high-dose corticosteriod therapy in all patients. Five of the eight patients died despite broad-spectrum antibiotic and antituberculous therapy. Anti-microbial activity against PPA was demonstrated for sulfamethoxazole combined with trimethoprim, for rifampin and for erythromycin with an egg-protection assay. Serologic studies with an indirect fluorescent-antibody technic suggested that seroconversion or high titers may be a sensitive test for PPA disease. PPA appears to be a newly recognized cause of life-threatening bacterial pneumonia in immunosupressed patients.

Membrane-bound antibodies to bloodstream trypanosoma cruzi in mice: strain differences in susceptibility to complement mediated lysis.

Abstract: The Y, CL and other strains of Trypanosoma cruzi display different morphological and immunological characteristics. Such observations are here extended to the interaction of bloodstream forms of different strains of T. cruzi with components of the complement system. We demonstrate that the bloodstream forms of the Y and B strains, but not those of the CL strain, are lysed by normal human serum. Lysis is mediated by combined activities of the alternative and classical complement pathways. These activities are triggered by antibodies on the surface of the parasites as shown by: (a) binding of fluorescein or radiolabelled anti-mouse immunoglobulin to the parasite's membrane and (b) the finding that bloodstream forms from lethally irradiated mice can be sensitized and rendered susceptible to complement-mediated lysis by incubation with sera from acutely infected animals. Bloodstream forms of the CL strain also bear surface immunoglobulin and sensitizing antibodies are present in the sera of mice infected with this strain. However, CL trypomastigotes from acutely infected mice fail to be lysed by human or mouse complement unless the parasites are pre-incubated with sera from chronically infected animals. The basis of the different interactions between CL and Y trypomastigotes with antibodies and the complement system, and their biological significance are discussed.

Immunoreactive somatomedin A in human serum

Abstract: A RIA has been developed for somatomedin A (SM-A) utilizing Sepharose-bound antibodies. This assay, measuring SM-A, the insulin-like growth factors 1 and 2, and somatomedin C, allows determination in serum samples. In comparison with a serum standard, the mean serum levels in patients with acromegaly or GH deficiency and healthy subjects were 8.7 %/- 0.7 (n = 25), 0.24 +/- 0.02 (n = 25), and 1.15 +/- 0.11 U/ml, respectively. The correlation coefficient between immunoreactive SM-A and SM-A by radioreceptor assay was highly significant (r = 0.93), although the potency ratio of SM-A between the two groups of patients was higher in the RIA than in the radioreceptor assay. Gel chromatography revealed that SM-A in acromegalic serum is bound to a carrier protein which is absent in patients with GH deficiency. After gel chromatography at low pH, 90% of applied immunoreactive SM-A was recovered in the low molecular weight fraction and consisted mainly of neutral polypeptides.

The events leading to the death of patients with pemphigus and pemphigoid.

Abstract: SUMMARY This paper is based upon a study of all available records of patients certified as having died in hospital from pemphigus and pemphigoid in England and Wales from 1962 to 1969. The results differ from most published series in that many of the 210 patients died still with extensive skin lesions and with biochemical abnormalities, such as low serum albumin, sodium and chloride, which were secondary to this. Side-effects of treatment, such as diabetes, peptic ulceration, and infections, were also important but the commonest immediate causes of death were respiratory tract infections and pulmonary embolism.

A Solid-Phase Radioimmunoassay for Detection of IgM Antibodies to Hepatitis A Virus

Abstract: The conditions for a sensitive and specific solid-phase radioimmunoassay (RIA) for the detection of IgM antibodies to hepatitis A virus (HAV) were optimized, and the RIA was used to assay sera from patients with hepatitis IgM antibodies to HAV reached highest concentrations between one and three weeks after onset of icterus and were measurable in follow-up sera for at least 12 months after infection To prove the specificity, the IgG antibodies were separated from patient sera by sucrose densitygradient centrifugation The remaining IgM antibodies, after treatment with p-mercaptoethanol, did not bind in the RIA, and, when the anti-IgM antibody bound to the solid phase was replaced with anti-IgG, a negative result was obtained with incubation of IgM antibody to HAV Also, the presence of IgG was shown not to interfere with measurement of IgM antibody to HAV Finally, as a further specificity control, 50 sera positive for rheumatoid factor or from patients infected with hepatitis B virus, cytomegalic inclusion disease, infectious mononucleosis, influenza A virus, rubella, or measles were tested, and all of these sera were negative for IgM antibody to HAV During the last few years, etiologic diagnosis of hepatitis infection by the detection of seroconversion or a diagnostically significant increase in antibody to hepatitis A virus (HAV) [1-7] has become possible Furthermore, Locarnini et al [8], Bradley et al [9], and we [10] found antibody to HAV in the IgM fraction of serum early in the disease process As in other viral diseases, a fast and easy-to-perform test for the separate determination of IgM antibodies to HAV would be of high diagnostic value In this communication, we report on the development and diagnostic results of such a test, a radioimmunoassay (RIA) that can be performed without prior sep

Deficient Serum Bactericidal Activity Against Escherichia Coli in Patients with Cirrhosis of the Liver

Abstract: The serum bactericidal activity (SBA) of cirrhotic patients was compared with that of normal individuals using the release of (51)Cr from radiolabeled Escherichia coli as the assay method. 80% (22/27) of patients were found to have deficient SBA against at least one of three smooth, serum-sensitive test strains of E. coli. Cirrhotic patients were found to have normal levels of serum lysozyme. Although some patients were mildly hypocomplementemic, this abnormality did not correlate with the presence of a bactericidal defect. Bactericidal antibody in normal and cirrhotics' sera was limited to the immunoglobulin (Ig)M class. Purified IgM from patients with deficient SBA against E. coli 0111 had lower concentrations of bactericidal antibody for that E. coli than did IgM from normal sera; the calculated bactericidal activity of total serum IgM was also lower. The bactericidal defect in cirrhotic serum could be completely corrected by either human antiserum to the homologous strain of E. coli or by purified, normal human IgM. However, because higher concentrations of IgM were required to restore normal SBA to a cirrhotic's serum than to agammaglobulinemic serum, there may be an inhibitor of bactericidal antibody in addition to a deficiency of bactericidal IgM antibody to E. coli in the serum of patients with cirrhosis. The bactericidal activity of the alternative complement pathway was also assessed. Sera from cirrhotic patients had no deficit in SBA attributable to the alternative complement pathway. In fact, in some, the activity of the alternative complement pathway was supernormal, compensating in part for the deficit in IgM-mediated SBA.