IgM-enriched solution BT086 improves host defense capacity and energy store preservation in a rabbit model of endotoxemia.

INTRODUCTION: The therapeutic value of intravenous immunoglobulin (IVIG) as an adjuvant therapy in sepsis remains debatable. We hypothesized that intravenous administration of BT086, a predominantly IgM IVIG solution, would improve host defense in an established rabbit model of endotoxemia and systemic sepsis. METHODS: New Zealand white rabbits were randomized into the following four groups: (1) the negative control group without lipopolysaccharide (LPS, control), (2) the positive control group with LPS infusion (LPS group), (3) the albumin-treated LPS group (ALB+LPS group), and (4) the BT086-treated LPS group (BT086 + LPS group). A standardized amount of E. coli was intravenously injected into all of the animals. The vital parameters, the concentration of E. coli in the blood and other organs, the residual granulocyte phagocytosis activity, and the levels of the inflammatory mediators were measured. Histological changes in the lung and liver tissue were examined following autopsy. RESULTS: The elimination of E. coli from the bloodstream was expedited in the BT086-treated group compared with the LPS- and albumin-treated groups. The BT086 + LPS group exhibited higher phagocytic activity of polymorphonuclear neutrophils (PMNs) than the control and ALB+LPS groups. The liver energy stores were higher in the BT086 + LPS group than in the other groups. CONCLUSION: Our data suggest that the IgM-enriched IVIG has the potential to improve host defense in a rabbit model of endotoxemia. Studies using different animal models and dosages are necessary to further explore the potential benefits of IgM-enriched IVIG solutions.

[The effect of sports activities in children and adolescents on the calcaneus--an investigation with quantitative ultrasound]. / Einfluss sportlicher Aktivität von Kindern und Jugendlichen auf den Kalkaneus -- Eine Untersuchung mit quantitativem Ultraschall.

PURPOSE: To determine whether quantitative ultrasound (QUS) parameters speed of sound (SOS) and broadband ultrasound attenuation (BUA) on the calcaneus are different between athletic children and a reference population. PATIENTS AND METHODS: From a college of physical education, 177 children and adolescents (121 boys and 56 girls, age range from 11 to 18 years) were included in this study. QUS was performed on the calcaneus using the Saharatrade mark device (Hologic, USA). SOS and BUA were estimated. Regional reference values of 3299 children were used to determine significant differences between athletes and reference population. The influence of activitiy level, age, height, and weight was estimated using correlation analysis. RESULTS: Sportsmen showed significant (p < 0.05) higher values of the QUS parameters (SOS 1581.1 m/s; BUA 69.7 dB/MHz) compared to the reference data (SOS 1563.9 m/s; BUA 64.2 dB/MHz). Significant correlation was observed between BUA and the level of activity, age, weight, and height (p < 0.01) and between SOS and weight and height (p < 0.05). In the group of soccer players and athlets, significant correlation was found between BUA vs. age and BUA vs. weight (p < 0.05). Furthermore, significant corelation was observed between BUA vs. age and weight in judokas and wrestlers. For the level of activity, a significant correlation to BUA was only found in the group of judokas and wrestlers (p < 0.01). CONCLUSION: An increase in quantitative ultrasound parameters on the calcaneus occurs in children and adolescents with increased physical activity.

[Early results of ultrasound based calculation of broadband ultrasound attenuation and speed of sound in children and adolescents suffering from asthma]. / Erste Ergebnisse der ultraschallbasierten Bestimmung der Schallabsorption und Schallgeschwindigkeit bei Kindern mit Asthma bronchiale.

PURPOSE: To determine broadband ultrasound attenuation (BUA) and speed of sound (SOS) on the os caicis in asthmatic children. To correlate these findings with sex, age, weight and height, topical steroid intake, and asthma severity grade (ASG). PATIENTS AND METHODS: 178 children (ASG 1 - 3)/(98 m, 80 f; mean age 11.9 +/- 3.1 y) were consecutively chosen from 4/00 to 9/01. Children with any other chronic disease were excluded. BUA and SOS were measured using SAHARA (Hologic lnc. Waltham, USA). Regional normative BUA and SOS data of 3 299 children (obtained with the same system), were used to calculate age-, weight- and height-matched standard-deviation-scores (SDS) for both sexes. Asthma severity grade and steroidal intake were determined. The highest topical steroid dosage was 500 micro g Fluticasone or 800 micro g Budesonide per day. RESULTS: 10/178 children were small and 7/178 tall per age (5.6 %/3.9 %), 11/178 children were light (6.2 %) and 9 heavy per age (5.0 %). 19 and 45 children had reduced BUA and SOS values, respectively. The following rates of reduced values were observed: girls: BUA 15.0 % (12/80), SOS 25.0 % (20/80); boys: BUA 7.1 %, SOS 25.5 % (7/98 and 25/98). Sexual differences were not significant. Reduced SOS-values were associated with higher severity and occurred significantly more frequent at children under steroidal intake (0.09 vs. 0.25 [BUA] and - 0.37 vs. - 0.07 [SOS]). CONCLUSION: Following our results an increase incidence of reduced speed of sound occurs in asthmatic children which is attributed to asthma severity and seems to be negatively influenced even by topically applied low dose steroids. This could be attributed to a steroid induced collagen synthesis deficiency followed by a reduced bone elasticity. Further studies, especially using a longitudinal study design are required to verify these findings.

Ultrasound bone densitometry of the os calcis in children and adolescents.

The aim of the present investigation was to evaluate reference data and to examine whether there were weight-, height-, age-, and sex-related differences of the quantitative ultrasound bone parameters for healthy children and adolescents. A total of 3299 healthy Caucasian children and teenagers (1623 girls and 1676 boys), age range from 6-18 years (mean age 11.4 +/- 3.4 years for boys and mean age 11.5 +/- 3.3 years for girls) were examined by quantitative ultrasound densitometry (QUS) using the bone sonometer SAHARA (Hologic Inc., Waltham, MA, USA), a waterless, dry system. The parameters broadband ultrasound attenuation (BUA) [dB/MHz] and speed of sound (SOS) [m/second] were evaluated on the right heel in relation to age, sex, weight, and height. There is no correlation between the ultrasound bone parameter SOS and age, height, and weight. BUA increases with age, height, and weight. Significant differences in SOS and BUA between girls and boys were found to probably be caused by the different onset of growth phases and the onset of puberty. SOS and BUA are influenced by changes of bone mineral density. But BUA is dependent on bone size, too. In conclusion, ultrasound bone densitometry is a useful measuring method showing the physiological bone development in childhood and adolescence. The presented results can be used as reference data. Further studies in children with disorders influencing bone metabolism will show in what way various patterns of osteopenia in childhood can be detected.