Basal and gonadotropin releasing hormone-stimulated gonadotropin secretion in patients with chronic uremia

In 11 patients with chronic uremia both the basal and stimulated levels of LH and FSH in serum were determined by RIA. After renal transplantation the investigations were repeated in 2 cases. The basal levels of LH were unphysiologically increased whereas FSH was found in the normal range. The stimulation of LH by GnRH was adequate in 6 patients and in 5 there was no response. As a result of renal transplantation there was a drop of LH in serum. It is supposed that the unphysiological increase of LH in patients with chronic uremia is the cause for the disturbances of the menstrual cycle.     

Development of Affinity Microparticles for Extracorporeal Blood Purification Based on Crystalline Bacterial Cell Surface Proteins

Abstract: In this article, the development of specific adsorbents for extracorporeal blood purification are described. Affinity microparticles were prepared by linking Protein A to crystalline cell surface layers (S‐layers) from Thermoanaerobacter thermohydrosulfuricus l111‐69. S‐layers were used in the form of cell wall fragments obtained by breaking whole cells by ultrasonification, resulting in cup‐shaped structures (average size 0.5 × 1μm) completely covered with S‐layer protein. Protein A was covalently bound to carboxylic acid groups of the S‐layer protein after activation with 1‐ethyl‐3,3'(dimethylamino)‐propylcarbodiimide. In batch adsorption experiments with fresh frozen human plasma, the resulting S‐layer based affinity microparticles showed a high adsorption capacity for IgG (40 mg IgG were bound per g wet pellet of S‐layer based affinity microparticles). Fractions eluted from the microparticles were subjected to sodium dodecyl sulfate‐polyacrylamide gel electrophoresis. They contained only IgG demonstrating that adsorption was specific. In biocompatibility tests, preparations of the S‐layer microparticles showed no low‐density lipoprotein‐reactivity, no cytotoxicity, and no cytokine inducing activity.     

Behavior of the hypothalamo-hypophyseal unit to stimulation with arginine, GnRH and TRH in patients with chronic uremia

In 11 women aged from 20 to 47 years (average age 33,1 years) with chronic uremia, treated by hemodialysis, a sequential stimulation test (SST) with 0.5 g arginine hydrochloride per kg body weight, 25 micrograms GnRH and 200 micrograms TRH was performed to examine the responsibility of the hypothalamo-pituitary unit. For evaluation of basal and stimulated secretion of PRL, LH, FSH, TSH, and HGH the corresponding serum levels were determined by RIA. 10 of the 11 women showed a galactorrhoea. No correlation between levels of PRL and creatinine could be found. Menstrual disorders in women with chronic uremia are discussed in the context of basal LH serum levels nearly always unphysiologically increased. In a few cases disturbances of basal secretion of TSH and HGH, respectively, could be observed.     

Stimulation of particle-induced chemiluminescence in human granulocytes by various Escherichia coli strains.

The patterns of neutrophil chemiluminescence stimulated by groups of E. coli strains opsonized with pooled normal human serum were compared. All strains of E. coli were obtained from patients with chronic pyelonephritis. ''O'' serovars which lacked capsular (K) antigen produced significantly higher chemiluminescence than strains possessing a variety of K antigens. Chemiluminescence produced by a range ''O'' serovars bearing the K1 antigen did not differ significantly from those containing other K antigens. The lowest chemiluminescence values were obtained with a group of O2:K1 strains. Rough strains containing K1 antigen were also poor stimulators of chemiluminescence.     

Novel online infusate-assisted dialysis system performs microbiologically safely

Administration of adequate amounts of commercial infusion fluids renders modern convective dialysis modalities, such as hemodiafiltration, labor-intensive and costly. Preparation of infusate by cold sterilization of dialysis fluid, which is abundantly available, and its immediate (online) use, in contrast, enables a large volume fluid exchange in a cost-effective manner. Recent developments aimed at more hygienic and user-friendly online systems with increased operational flexibility. As a result the novel ONLINEplus system does not only provide online prepared infusate for convective dialysis therapy, but also for priming and rinsing of the extracorporeal blood circuit, for intradialytic bolus administration, and for re-infusion of patients' blood as well. Production of infusate from potentially impure dialysis fluid containing endotoxins and other pyrogens raises severe concerns of affecting the patients' well-being. To assess its safety, the online system was challenged with microbially contaminated dialysis fluid. Despite high levels of microbial counts (7.5 x 104 +/- 105 CFU/ml), endotoxin concentration (14.1 +/- 7.7 IU/ml and 9.265 +/- 3.000 IU/ml, as measured turbidimetrically and chromogenically, respectively) and cytokine-inducing activity (20,827 +/- 3,082 pg IL-1Ra/Mio WBC), we failed to detect contaminants in the final infusate during a 5 week laboratory testing period. In addition, infusate samples complied consistently with the European Pharmacopeia test for sterility. The present online system is comprehensive, operates user-friendly, and provides microbiologically safe infusate in large quantities. In this way, both patients and dialysis staff will benefit from improved dialysis therapy and reduced treatment-related labor burden, respectively. Moreover, convective dialysis modalities will become less expensive.     

Clonal analysis of Escherichia coli serotype O6 strains from urinary tract infections.

A total of 36 Escherichia coli urinary tract isolates (UTI) of serotype O6, with different combinations of capsule (K) and flagellin (H) antigens, were analysed according to the outer membrane pattern (OMP), serum resistance properties, mannose-resistant hemagglutination using various types of erythrocytes, and also for the genetic presence and the expression of P-fimbriae, S fimbriae/F1C fimbriae, Type 1 fimbriae, aerobactin and hemolysin. Twenty selected strains were further analysed by pulsed field gel electrophoresis (PFGE), elaborating genomic profiles by XbaI cleavage and subsequent Southern hybridization to virulence-associated DNA probes. It could be shown that O6 UTI isolates represent a highly heterogeneous group of strains according to the occurrence and combination of these traits. Relatedness on the genetic and the phenotypic level was found for some of the strains exhibiting the same O:K:H:F serotype. DNA long-range mapping further indicated some interesting features, according to the copy number and the genomic linkage of virulence genes.     

Immunostaging of patients with chronic pancreatitis. I. A study of humoral and cell-mediated immunity (author's transl)

Immunostaging was performed in patients with chronic pancreatitis of different etiologic groups. Immune responifveness was assessed by immunoglobulin serum levels, non specific autoantibody formation, C3 levels, antistreptolysin reaction, antibody titer against Toxoplasma gondii, E. coli, Herpes simplex-, Mumps- and Cytomegalovirus and screening for soluble immune-complexes (PEG precipitation assay), number of T- and B-lymphocytes, lymphocyte responsiveness to PHA, PPD, tetatoxoid and mumps-antigen in a whole blood assay, skin testing with candidin, trichophytin, tuberculin and streptokinase and HLA-typing. In some cases we found a depressed cell-mediated immune responsiveness. Patients were divided into two groups based on this main finding. Cellular hyporesponsiveness was correlated to the severity of the disease and a high incidence of HLA-B5 but not to any etiologic factor of the disease.     

In Vitro Cell Culture Systems as the Basis for an Extracorporeal Blood Purification Strategy In Multiorgan Failure Treatment

Multiorgan failure (MOF) based on septic processes is very common but prognostically an extremely severe disease that has to be treated exclusively under intensive care conditions. Extracorporeal blood purification (ECBP) using specific and efficient systems such as the microspheres based detoxification system (MDS) (Artif Organs 1996;20:420) could improve significantly the situation of MOF in terms of the efficient removal of endotoxins as well as key mediators such as tumor necrosis factor alpha (TNFα). The purpose of the study was to test the effectiveness of endotoxin and cytokine removal to blunt cellular response. In terms of the in vitro principle methodology, isolated peripheral blood mononuclear cells (PBMC) were incubated with endotoxins and a selective endotoxin adsorbent, which was added at various times (immediately or 30, 60, 120, 240, or 360 min) after the onset of incubation. TNFα release of monocytes was measured following a standard procedure after 20 h. Human TNFα was incubated with cultured human endothelial cells with and without a specific TNFα adsorbent (polyclonal antibodies coated on polystyrene particles). The results showed that after the initial addition of endotoxins, the activation of monocytes can be stopped within 120 min by addition of endotoxin adsorbents. In addition, specific TNFα adsorbents are able to prevent intercellular adhesion molecule 1 (ICAM-1) expression of endothelial cells, therefore avoiding activation of endothelial cells. In conclusion, cell culture models are suitable to simulate cell interaction in MOF. Specific adsorbents are able to reduce or block pathophysiologically relevant cell interactions, and the time frame for effective ECBP seems to be very short, and therefore, efficiency must be high.