Association of the leukocyte immunoglobulin G (Fcgamma) receptor IIIa-158V/F polymorphism with inflammatory myopathies in Dutch patients.

Leukocytes are involved in the pathogenesis of idiopathic inflammatory myopathies (IIMs). Immunoglobulin G (IgG) receptors (FcgammaR) link the specificity of IgG to the effector functions of leukocytes. Several FcgammaR subclasses display functional polymorphisms that determine in part the vigour of the inflammatory response. FcgammaRIIIa genotypes were differentially distributed among 100 IIM patients compared with 514 healthy controls with a significant increase of the homozygous FcgammaRIIIa-V-158 genotype (3 x 2 contingency table, chi(2) = 6.3, P = 0.04). Odds ratios (ORs) increased at the addition of each FcgammaRIIIa-V-158 allele, in particular among patients with non-specific myositis and dermatomyositis {OR 2.1 [95% confidence interval (CI) 1.1-4.3] and 2.7 (95% CI 1.1-6.4) for FcgammaRIIIa-V/F158 and FcgammaRIIIa-V/V158 genotypes, respectively, using FcgammaRIIIa-F/F158 as a reference group}. These data suggest that the FcgammaRIIIa-V-158 allele may constitute a genetic risk marker for IIM.

Development and evaluation of a new ELISA for the detection and quantification of antierythropoietin antibodies in human sera.

Assays for the analysis of antierythropoietin antibodies (anti-EPO Abs) currently suffer from a high degree of nonspecificity or are cumbersome and time consuming to perform. They are therefore not well suited for the analysis of large numbers of human sera samples, a task that has become increasingly important due to an increase in the number of patients developing anti-EPO Abs. The objective of this study was to develop and validate a sensitive and specific ELISA for the determination of anti-EPO Abs that would suit these purposes. In this new double antigen bridging ELISA, anti-EPO Abs bind via one site to recombinant human erythropoietin (rhEPO)-biotin immobilized to streptavidin-coated microtiter plates (MTPs) and by a second site to rhEPO labelled with digoxigenin (DIG). The amount of bound antibody is determined using an anti-DIG antibody coupled to peroxidase. A rabbit polyclonal anti-EPO Ab purified by immunoadsorption is used as reference antibody preparation. The dynamic range of this ELISA was 1-75 ng/ml per assay calibrated with the reference antibody preparation. The assay was specific for anti-EPO Abs and did not react with other immunoglobulins (Ig) present in human serum. The lower limit of detection (LLD) of the assay was 0.5 ng/ml, and the lower limit of quantitation (LLQ) was 1.0 ng/ml. Anti-EPO Abs could be detected in the sera of pure red cell aplasia (PRCA) patients. In contrast to previous reports, no anti-EPO Abs could be detected in the sera of patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjogren's syndrome (SS), or in the sera of dialysis patients.

[Results of percutaneous transhepatic drainage of the bile ducts]. / Ergebnisse der perkutanen transhepatischen Gallengangsdrainage.

From September 1980 to December 1986, 72 percutaneous transhepatic cholangiography drainages (PTCD) were performed in 64 patients (58 palliative in malignant obstructions, 14 temporary). The median duration of drainage was 26.8 days (2-183 days). The median survival time in 37 patients with palliative tumour drainage was 55.3 days (7-473 days). 9/37 patients survived longer than 3 months (max. 15.5 months). Complications occurred in 29.5% (10.3% severe). 3/64 patients (4.7%) died. Patients with palliative transpapillary drainages (23), especially with endoprostheses (14), survived longer, and the complication rate was lower. Therefore, we prefer the endoscopic transpapillary approach. PTCD patients must be selected carefully.

HPLC determination of doxorubicin, doxorubicinol and four aglycone metabolites in plasma of AIDS patients.

A high-performance liquid chromatographic (HPLC) assay has been developed for the determination of the anticancer drug doxorubicin and the metabolites doxorubicinol, doxorubicinone, 7-deoxydoxorubicinone, doxorubicinolone and 7-deoxydoxorubicinolone in plasma of AIDS patients. Samples can be heated at 60 degrees C for 30 min to inactivate the human immunodeficiency virus. The sample pre-treatment involves a liquid-liquid extraction of the buffered plasma sample (pH 9) with a chloroform-1-propanol (4:1, v/v) mixture. The chromatographic analysis is performed on a Lichrosorb RP-8 (5 microns) column and by isocratic elution with a mobile phase of acetonitriletetrahydrofuran-phosphate buffer (pH 2.2) (800:5:200, w/w/w) with fluorescence detection (excitation wavelength: 460 nm; emission wavelength: 550 nm). The proposed method has been validated and, subsequently, implemented in a pharmacokinetic study of doxorubicin in AIDS patients with Kaposi's sarcoma who are treated with the combination regimen doxorubicin, vincristine and bleomycin.

[Arterial hypertension in renin-producing retroperitoneal leiomyosarcoma]. / Arterielle Hypertonie bei reninsezernierendem retroperitonealem Leiomyosarkom.

A case report of an extrarenal retroperitoneal metastatic leiomyosarcoma with associated paraneoplastic renin production is presented. Due to the renin excess syndrome, accelerated hypertension was present combined with the signs of secondary hyperaldosteronism, hypokalemia, and alkalosis. In contrast to other publications of extrarenal malignoma with paraneoplastic renin activity, this case elucidates a histologically close relationship to epitheloid muscle cells of kidney vasa afferentia and derived benign tumors. The retroperitoneal tumor and its brain metastase were morphologically identical. In contrast to histological criteria only the primary tumor exhibited high renin activity, no activity could be detected in the metastase.

Significance of amniotic fluid phospholipid determination for the prediction of neonatal respiratory distress syndrome.

198 amniotic fluid samples, obtained from 14-42 weeks of 158 patients were assessed for amniotic fluid phospholipids (total phospholipids, lecithin, sphingomyelin, lecithin/sphingomyelin ratio). The TPLP and Lec-concentrations show significant rises in concentration after 34th week whereas the sphingomyelin concentration remains virtually constant during pregnancy. L/S ratio remains relatively constant smaller than or equal to 2 prior to 32 weeks and smaller than or equal to 3 between 32 and 34 weeks but shows then a steep rise. The amount of Lec (expressed as percentage of total phospholipid concentration) rises from 30-40% at 30 weeks to 70-80% at term whereas the amount of Sph declines from 30-40% to less than 10%. In 12 cases neonatal RDS occurred. With L/S ratio treshold values of 3 correct prediction of RDS was made in 83% of cases, whereas probability of RDS occurrence was 63%. With L/S ratio values greater 3 RDS can be excluded in 95% of cases. The corresponding figures for Lec and TPLP concentration are described too. The range of different results in the literature is discussed.