Acute Stage Of Disease Research Articles

Estimation of ascorbic acid levels in blood and urine in cases of allergic rhinitis

Sixty cases of Allergic Rhinitis were studied in this series. Forty of them were of acute stage while 20 were of quiscent stage of disease. Half of acute stage and 20 cases of quiscent stage were given 500 mg. of Ascorbic acid daily for 7 days, the remaining 20 cases of acute stage were given 1000 mg. of Ascorbic acid daily for 7 days. Ascorbic acid levels in blood and urine were estimated before and after supplementation of ascorbic acid. These levels were compared with 20 healthy individuals. In this series blood and urine levels were found to be below normal levels which denotes unsatenated state of body which is also confirmed by noting the increased utilization of ascorbic acid after supplementation. This unsatenated state of body was more in acute stage of disease as compared to quiscent stage.

Variations in Expression of Markers by Populations of Adherent Cells from Trypanosoma cruzi‐Infected Mice1

The kinetics of differentiation and maturation of phagocytic cells during the acute and chronic stages of experimental Chagas' disease was examined by monitoring changes in expression of peroxidase (PO), nonspecific esterase (NSE), C3b receptors (CR), Fc receptors (FcR), and phagocytic ability of cells in the blood, spleen, and peritoneal cavity. The significant changes recorded in the blood were: marked increases in the percentages of CR- and FcR-positive adherent cells during both the acute and chronic phase; Ia-positive cells increased two-fold in the acute period and remained elevated in the chronic stage. In the spleen, the major alterations recorded during both the acute and chronic stages were: two- to three-fold increases in the percentages of NSE- and PO-positive adherent cells and three- to four-fold increases in the proportions of CR- and FcR-positive cells. In addition, Ia-positive cells increased from 70% to approximately 90% of the adherent cell population. In the peritoneal cavity, a two- to four-fold elevation in the percentages of both PO- and NSE-positive cells was observed. The number of Ia-positive cells increased from 10% before infection to 85-90% during the acute phase and to 96-98% during the chronic period. All of the changes described above occurred in the absence of noticeable increases in phagocytic ability except for an elevation in the percentage of circulating latex-ingesting cells seen during chronicity. These results indicate that infection with Trypanosoma cruzi alters the pathways of differentiation of cells of the mononuclear phagocyte lineage.

Experimental Aujeszky's disease in pigs: excretion, survival and transmission of the virus.

Airborne Aujeszky's disease virus was recovered from looseboxes containing groups of pigs infected with virus strains from England, Northern Ireland and Denmark from days 1 to 7 after infection. Pigs sampled individually excreted most airborne virus on days 2 and 3 after infection. On a 24 hour basis the maximum amount of airborne virus excreted per pig was log10 5.3 TCID50. Subclinical infection was transmitted from a clinically affected group of pigs to a seronegative group held in separate looseboxes when air was drawn through ducting connecting one box with the other. Tissues taken from pigs killed at varying times after infection showed that the main sites of virus replication were in the head and neck region. Aujeszky's disease virus was detected for up to 40 days in a range of tissues taken from pigs at the acute stage of disease and stored at -20 degrees C.

Natural and acquired resistance to Trypanosoma cruzi.

Since the identification in 1909 of Trypanosoma cruzi as the causative agent of Chagas’ disease, a large body of literature has arisen relating to the nature of the disease. Two observations in particular initially stimulated my interest in the immunology of Chagas’ disease. The first was that the severity of the disease that occurs following the initial infection with T. cruzi (called the acute stage of the disease) can range from asymptomatic to lethal (1). This variation in what can be termed natural resistance may be the result of multiple genetic and environmental factors, but it is easy to imagine how differences in the immune responses made by individuals could be critical for influencing the ensuing course of the disease.

Medical and surgical management of the pelvic abscess.

A pelvic abscess is the end stage in the progression of a genital tract infection and is frequently an unnecessary complication. Intensive medical management including the use of broad-spectrum antibiotics, posterior colpotomy, and major surgery involving a hysterectomy and bilateral salpingo-oophorectomy, all have their place in the management of this condition. Such surgery, however necessary, is associated with profound physical and emotional effects in addition to the economic consequences associated with such therapy. It is hoped that with a better understanding of the epidemiology of PID and with the advent of improved diagnostic and therapeutic modalities for early genital tract infection, a pelvic abscess will eventually become a great rarity on gynecology services.

Ultrastructural cell wall modifications in secondary xylem of American elm surviving the acute stage of Dutch elm disease: vessel members

Modified vessel wall layers and their ultrastructural characteristics in branches of artificially inoculated elm (Ulmus americana L.) trees surviving the acute disease stage and of naturally infected, chronically diseased trees are described. Walls of large early-wood vessels in zones where disease action was prevalent have a strong stain reaction and may be uniformly or locally three to four times thicker than normal.In smaller vessels (some including vessel tracheids), an extra lignified-like, often discontinuous layer may be present. This layer is generally demarcated from the normal by a dense band. Pit membranes and vessel end plates are likewise much thickened through the presence of an opaque material similar to that of the pit membrane. This material differs from that forming the coating layer which like tyloses is generally present inside the thickened or extra vessel wall layer.The possible significance of these observations, particularly in relation to disease development and tree resistance, is discussed.

Complement requirement for virus neutralization by antibody and reduced serum complement levels associated with experimental equine herpesvirus 1 infection.

Pony foals, negative for detectable serum-neutralizing antibody to equine herpesvirus 1 by the standard tube-culture virus neutralization test, were experimentally infected with equine herpesvirus 1. Complement-requiring (CR) and non-complement-requiring (NCR) serum-neutralizing antibodies were evaluated in preinfection and postinfection sera by means of a complement-enhanced plaque reduction assay. Low levels of CR antibodies were found in the preinfection sera of only group II ponies. Upon infection, CR antibodies were detected by day 2 postinfection and reached peak titers between 7 and 14 days postinfection in the antisera of all ponies. NCR antibodies were detected later than CR antibodies and at levels approximately 40 to 150 times lower than the latter. CR/NCR ratios indicated that complement requirement was greatest early in the acute stages of disease and that this requirement decreased during the convalescent phase. Fractionation of 1-week and 2-week postinfection antisera of group I ponies indicated the CR antibody activity resided in both the 7S and 19S fractions. Total serum complement levels of the ponies were quantified throughout the infection with an equine anti-goat erythrocyte hemolytic system. In vivo, complement levels were depressed for all ponies during the first 2 weeks of infection. A decline in complement levels was seen as early as day 2, and they decreased to an average of 35% of preinfection levels on day 10 postinfection for all ponies.

The correlation between electroencephalographical and neuropathological findings in acute stage of cerebrovascular disease.

A study was conducted on the electroencephalographical and neuropathological correlations on 96 cases of cerebrovascular disease in order to elucidate the reasons why EEGs are often misleading in the diagnosis of location and size cerebrovascular lesions. The study showed that EEG findings are particularly misleading when the lesions were in the locations as follows: 1) subcortical deep infarctions, 2) cortical infarctions occupying a small proportion of cerebral convexity, or involving an entire hemisphere, or affecting the right hemisphere, 3) basilar thrombosis and infratentorial hemorrhage (primary or secondary to supratentorial lesions). The pathophysiological significance of these results has been discussed.

Possibly specific immune complexes in sera of patients with untreated acute myelogenous leukemia

Eleven patients with acute myelogenous leukemia (AML) in the acute stage of the disease were studied. Sera of seven patients were assayed for complement-dependent cytotoxicity to autochthonous AML cells and sera of four patients were tested with allogeneic target cells before and after ultrafiltration at low pH. No specific cytotoxic activity could be detected in any untreated sera. Ultrafiltration at low pH led, however, to the appearance of a significant cytotoxic activity in all of seven autochthonous and in three of four allogeneic combinations. Identical treatment of control AB sera did not result in any similar activity. The results show that potentially cytotoxic antibodies to leukemia-associated antigens are present in the acute stage of acute myelogenous leukemia. However, they do not express complement-dependent cytotoxicity in untreated sera. After ultrafiltration at low pH significant complement-dependent cytotoxicity was detectable in most of the sera. One possible explanation is that cytotoxic antibodies to leukemia-associated antigens are present in the form of circulating immune complexes. Splitting of them at low pH and elimination of the antigen component might result in an increased amount of free cytotoxic antibodies.

Sonographie in der Diagnostik der Ileitis terminalis Crohn

In order to check the value of sonography in the diagnosis of Crohn's disease, 81 patients who suffered from Crohn's disease were examined by means of real-time B-mode ultrasound. Bowel wall infiltration along the terminal ileum that could be shown to involve the coecum as well, appeared to be a reliable parameter in the diagnosis of Crohn's disease. This finding was most pronounced in acute disease whereas in chronic or mild disease, characteristic signs of Crohn's disease were absent. Among the complications of Crohn's disease formation of intraabdominal abscesses can be demonstrated by sonography. From our results we propose to employ diagnostic ultrasound in the acute stage of disease. After remission the diagnosis should be confirmed by endoscopy and X-ray examinations.

The antiheparin effect of alpha 1-acid glycoprotein, evaluated by the activated partial thromboplastin time and by a factor Xa assay for heparin.

The heparin-antagonizing effect of human alpha 1-acid glycoprotein (alpha 1-acid GP) was studied by activated partial thromboplastin time (APTT) and by a factor Xa assay for heparin using a chromogenic substrate for factor Xa. The antiheparin effect of alpha 1-acid GP in the APTT system was similar to the effect on heparin thrombin clotting time (HTCT), and the effect in the factor Xa assay system corresponded well with the effect in a heparin cofactor assay system using chromogenic substrate for thrombin instead of factor Xa. It is concluded that alpha 1-acid GP contributes to the reduced anticoagulant effect of heparin observed in various acute stages of disease, when assayed not only by HTCT but also by so-called 'global' coagulation tests, such as the activated partial thromboplastin time.

脳血管障害における糖代謝異常に関する研究

In order to clarify the incidence mechanism of the disturbance of glucose metabolism recognized during the acute stage of cerebrovascular disease, a study was made by performing an intravenous glucose tolerance test, and the relationship between the clinical symptoms and glucose metabolism disturbance was investigated. Moreover, rabbits were used as experimental animals, and cerebral hemorrhage was produced experimentally by the cold injury method deviced by Klatzo. The levels of the blood glucose (B. G.), insulin, and cortisol were examined periodically. Furthermore, the influence of β-adrenergic blockade (propranolol) on the blood glucose level measured on the rabbits with experimental cerebral hemorrhage was investigated, and the following results were obtained.Through the clinical observations on the cases of cerebrovascular diseases, the disturbance of glucose metabolism was severe in the cases of cerebral hemorrhage, particularly intraventricular hemorrhage, in comparison to that of cerebral infarction. Those with poor prognoses such as severe disturbance of consciousness, high C.S.F. -pressure, and intraventricular hemorrhage revealed severer than all the others. That is, the more intense stress on the brain caused the severer disturbance of glucose metabolism.In the experimental cerebral hemorrhage, the group of severe injury revealed higher B.G. level, that is hyperglycemic response curve. In the same group, the cortisol level in blood was recognized higher. The hyperglycemic response curve was controlled by administering propranolol. Also, the B.G. level of the internal carotid vein on the damaged hemisphere during the earlier stage of the injury was lower than the other. This means that the glucose uptake in the brain was increasing on the damaged hemisphere.The above results explain that the disturbance of glucose metabolism in cerebrovascular disease is due to the higher cortisol level resulted from the active function of pituitary adrenocortical system and also to the β-adrenergic receptors by epinephrine. This hyperglycemia is possibly related to biological reaction to repair cerebral injury and the lowered function of the brain.

ASSESSMENT OF THE VALUE OF POSITIVE PRESSURE BREATHING APPARATUS IN INDUCING COUGH

In the last decade, numerous papers have discussed what has been called the indiscriminate use of intermittent positive pressure breathing therapy (IPPB) for the treatment of obstructive airways disease (Curtis et al., 1968; Loke and Anthonisen, 1974; Cheney et al., 1976; Baker, 1974; Murray, 1974; Barach and Segal, 1975; Sheldon and Gold, 1976; Dolovich et al., 1977). These papers have all failed to show any advantage of positive pressure breathing therapy, either in the acute or chronic stages of obstructive airways disease. IPPB apparatus is expensive, requires careful maintenance and cleaning and may lead to patient dependence. However, physiotherapists in this hospital gained the impression that patients who were receiving nebulisation with positive pressure appeared to cough more frequently, and to produce greater volumes of sputum, suggesting that IPPB apparatus may be a useful adjunct of physiotherapy. Therefore a study was designed to compare the effectiveness of nebulisation therapy, with and without positive pressure, on the production of cough and sputum volume in patients with chronic obstructive airways disease.

MITOGEN STIMULATION AND DISTRIBUTION OF T‐ AND B‐LYMPHOCYTES DURING NATURAL RUBELLA INFECTION

The phytohaemagglutinin (PHA) response of lymphocytes from seven patients with natural rubella infection was investigated during the acute, early and late convalescence stages of disease. When the lymphocytes were cultured in autologous serum, a moderate depression of the response, following stimulation with PHA in both optimal and suboptimal concentrations was obtained two weeks after the onset of exanthema (early convalescence). Two months later (late convalescence), the lymphocyte stimulation response had returned to almost normal values. On the other hand, lymphocytes incubated in pooled homologous serum reacted normally to PHA in optimal concentrations at all three stages. Determination of T- and B-lymphocytes did not reveal any change in the relative proportion of T-lymphocytes during the course of the disease. However, in late convalescence, a significant decrease in the relative number of B-lymphocytes was recorded.

Furosemide in Hyaline Membrane Disease

In a randomized clinical trial designed to evaluate the effect of diuresis on infants with hyaline membrane disease, seven infants were treated with furosemide (2 mg/kg intravenously) and five received 5% dextrose water in 0.225% sodium chloride (control group). Arterial blood gas analyses performed before and during the six hours after treatment showed no significant difference between control and treated infants. Urine output and urine sodium and calcium loss were significantly increased (P less than .05) in the infants receiving furosemide. The diuresis seemed to have no effect on left atrial size determined echocardiographically, whereas measurements of dynamic skinfold thickness suggested mobilization of subcutaneous water. One infant became seriously dehydrated and hypotensive secondary to a massive diuresis. We concluded that furosemide had a potent diuretic effect in infants with hyaline membrane disease but does not improve cardiorespiratory function acutely. This may be because of failure to mobilize pulmonary interstitial fluid in the time period tested. It may also be possible that the presence of pulmonary interstitial fluid does not play an important role in the impairment of gas exchange in the acute stage of hyaline membrane disease.

PERITONEAL DIALYSIS IN CHRONIC RENAL FAILURE

The long-term results of intermittent peritoneal dialysis in long-term treatment of renal disease have yet to equal those of intermittent hemodialysis. However, further exploration and refinement of this technique is justified. Performed in acute stages of disease, both peritoneal dialysis and hemodialysis relieve the symptoms of uremia and specifically "buy time" for the patient so that proper medical or surgical therapy may be instituted. In acute situations, peritoneal dialysis is the procedure of choice, and is an important adjunct to more conventional treatment for chronic renal disease. It may be useful sometimes even in chronically hemodialyzed patients-for example, when the hemodialysis cannula for one reason or another is inaccessible because of clots, replacement, or infection. It is especially valuable when the hemorrhagic complications of uremia contraindicate hemodialysis treatment. Its use in chronic uremia remains sharply limited in time, but for brief periods chronic peritoneal dialysis appears to be a reasonably satisfactory means of prolonging life while awaiting homotransplant or decision for maintenance hemodialysis therapy.

Trypanosoma cruziin the Cerebrospinal Fluid during the Acute Stage of Chagas' Disease

THE extent of Central-nervous-system involvement in Chagas' disease is not known.1 The only well recognized neurologic complication during the acute infection is meningoencephalitis. In patients so affected the cerebrospinal fluid contains excess protein and lymphocytes,2 and intracellular Trypanosoma cruzi can be found in the brain and in the reticular cells of the leptomeninges.3 When neurologic manifestations are absent during acute infection, the cerebrospinal fluid has been reported to be normal,4 normal except for the presence of antibody to T. cruzi, 5 or as showing elevated levels of protein and increased numbers of lymphocytes.6 In these cases direct examination revealed no T. . . .

Quantitative comparison between xenodiagnosis and haemoculture in the detection of Trypanosoma (Schizotrypanum) cruzi in experimental and natural chronic infections

Results of xenodiagnosis and haemoculture of 44 different animal and human subjects were compared quantitatively by linear logistic analysis. Both diagnostic methods were carried out simultaneously on each test subject: results of xenodiagnosis and haemoculture were compared among the following groups of subjects: (i) 14 laboratory mice with chronic experimental infections of Trypanosoma cruzi (Bahia isolates); (ii) eight opossums ( Didelphis azarae) naturally infected in Bahia, Brazil; (iii) six patients in the acute stage of Chagas's disease; (iv) 16 patients in the chronic inapparent stage. For xenodiagnosis of the different subjects fifth-instar Rhodnius prolixus, first-instar and fourth or fifth-instar Panstrongylus megistus, and fifth-instar Triatoma infestans were used. The number of each species and instar used in xenodiagnosis varied between five and 40 on each subject: mean intake of blood by batches of bugs was obtained by weighing each group before and after feeding. Whilst xenodiagnosis was carried out, each subject was bled and 1 to 2 ml of blood inoculated into two to nine tubes of culture media, most frequently Warren's medium, but in some instances 4N medium. Quantities of 0·1 to 0·2 ml blood were inoculated into each 5 ml of culture media. Cultures were incubated at ambient temperature (23 °-28 °C) and observations of primary cultures were continued fortnightly up to six months post-inoculation. The detailed results were subjected to statistical analysis and are discussed and compared with those obtained by other workers. Aspects of both xenodiagnosis and haemoculture are discussed, with particular reference to the fact that most previous workers have found xenodiagnosis superior to haemoculture in the diagnosis of chronic T. cruzi infections. It is concluded that, in principle, haemoculture is no less sensitive than xenodiagnosis in the diagnosis of chronic infections, and that indeed haemoculture has several advantages, particularly in regard to potential future improvement and standardization of techniques. Cultural methods require further refinement in order to make haemoculture a practicable alternative method for routine diagnosis.

Transmission studies with African swine fever virus: Infections of pigs by airborne virus

Eight recipient pigs developed African swine fever (ASF) after exposure to air drawn through ducting from 2 loose-boxes containing 16 donor pigs inoculated with ASF virus. A group of 6 pigs kept continuously on a platform 2·3 m above a group of 10 infected donor pigs also developed ASF. Of three pigs kept for 48 h on a platform above infected donor pigs which had been inoculated 3 to 5 days previously, one developed ASF. Recipient pigs exposed to donors at an earlier stage of incubation did not become infected, but all those exposed for 48 h to donor pigs in the later stages of acute disease became infected. After exposure for only 24 h, pigs did not develop ASF. The clinical signs in recipient and donor pigs were indistinguishable. Airborne virus was not detected by either biological or mechanical sampling procedures. The source of airborne virus was not determined. The failure of ASF virus to spread to sentinel control pigs housed in adjacent loose-boxes and other loose-boxes in the isolation unit suggests that the airborne spread of ASF is only likely to be a problem in intensive housing systems.

Acute terminal ileitis and Yersinia enterocolitica infection.

Diarrhea, moderate to high fever and pain in the RLQ associated with a tender mass or swelling of the terminal ileum arouse suspicion of acute terminal ileitis. Will diagnostic of the disease be laboratory data compatible with acute inflammatory disease and radiological findings of the terminal ileum, i.e., thickening of mucosal folds, round filling defects on the mucosa indicative of swelling of lymphoid tissue and fine irregularities of the margin without narrowing of the lumen. Yersinia infection was demonstrated in 7 of 10 patients whose stool and/or serum were examined. Yersinia enterocolitica was found to be an important causative agent of acute terminal ileitis. Its detection will be useful for differentiating the disease from acute stage of Crohn's disease.