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ABSTRACT: Gastroenteritis is a common cause of hospitalization and is associated with high morbidity in children. C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) are primary mediators of inflammation, and have been implicated in many infectious and non-infectious inflammatory diseases. The main objective of this study was to identify serum markers in viral and bacterial gastroenteritis.
Thirty-one patients admitted to a pediatric infection ward with gastroenteritis and definite pathogens were enrolled in the study: 17 patients had viral gastroenteritis and 14 bacterial gastroenteritis. Serum levels of TNF-alpha, IL-10 and CRP were measured in these 31 patients, and in a control group of 15 healthy children.
Serum concentrations of TNF-alpha and CRP were significantly greater in patients with bacterial gastroenteritis than in patients with viral gastroenteritis and healthy controls (p < 0.001). Concentrations of IL-10 were increased, but not significantly, in patients with viral or bacterial gastroenteritis (p = 0.577 vs controls). Regarding diagnosis, the measurement of TNF-alpha and CRP levels was 78.6% and 92.0% sensitive, respectively; and 88.2% and 58.8% specific, respectively.
Serum TNF-alpha concentration may be a useful marker for distinguishing between viral and bacterial gastroenteritis.
Journal of the Chinese Medical Association 06/2005; 68(6):250-3. · 0.79 Impact Factor
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ABSTRACT: Cytokine-mediated interactions among the inflammatory cells may play a role in the pathogenesis of bronchial asthma. Interleukin-5 (IL-5) is a major cytokine in the recruitment of neutrophils to the area of inflammation. Serum IL-5 is a marker of disease activity and treatment efficacy in bronchial asthma. To understand the role of IL-5 in disease activity in acute asthma, changes in serum concentrations of IL-5 elaborated by activated eosinophil before and after prednisolone therapy with clinical improvement were determined in the present study. Circulating levels of IL-5 in 16 normal control subjects and in sera from 22 allergic asthmatic children with acute exacerbation and in stable condition were determined by using commercially available assay kits. The mean concentration of serum IL-5 was higher in patients with acute exacerbation (6.30 +/- 2.21 pg/mL) and in stable asthmatics (5.55 +/- 2.23 pg/mL) compared to control group subjects (4.81 +/- 0.54 pg/mL; p > 0.05). However, the difference was not statistically significant between the acute exacerbation and stable asthmatics groups (p > 0.05). Serum IL-5 is a poor indicator of disease activity in acute asthma; therefore, monitoring serum IL-5 concentration is of limited value. The clinical value of serum IL-5 as a marker of disease activity remains to be established.
Journal of Asthma 05/2005; 42(4):297-300. · 1.52 Impact Factor
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ABSTRACT: It has been suggested that longitudinal rather than cross-sectional growth standards be used to assess individual growth patterns. Thus, the aim of this study was to follow boys and girls throughout their pubertal years, so that a mixed longitudinal growth curve of height, weight, sitting height, arm span, skinfold thickness, body mass index (BMI), and the ratio of sitting height or arm span to stature, could be obtained.
A defined group of 1,139 healthy schoolchildren (570 boys and 569 girls) from the Shih-Pai district of Taipei were followed longitudinally for 4 years. Anthropometric measurements of height, weight, sitting height, arm span, skinfold thickness, and BMI, were obtained for each child.
Peak sitting-height velocities of 6.1 cm/year (boys) and 6.3 cm/year (girls) were seen at 8.5 years. The second peak of sitting-height velocity occurred at a mean age of 12.5 years for boys and 11.5 years for girls. Sitting-height velocity for the whole year covering the second peak was 4.6 cm in boys and 3.2 cm in girls. Peak arm-span velocity was seen at 13.5 years for boys and 8.5 years for girls, and arm-span velocity for the whole year covering this peak was 8.4 cm/year for boys and 8.1 cm/year for girls.
These data provide growth patterns for Chinese children aged 8-18 years living in a Taipei district, with percentile charts for sitting height, arm span, BMI, and skinfold thickness.
Journal of the Chinese Medical Association 02/2005; 68(1):16-20. · 0.79 Impact Factor
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ABSTRACT: The mechanisms of migration of neutrophils into the airway lumen are crucial in the development of airway injury of acute bronchiolitis and are mediated by adhesion molecules. In this study, we have attempted to evaluate the role of serum concentrations of the soluble form of intercellular adhesion molecule-1 (sICAM-1) in the disease activity in acute bronchiolitis and in respiratory syncytial virus (RSV) infection. Circulating levels of sICAM-1 in sera from 10 normal control subjects, and from 47 hospitalized acute bronchiolitis patients at admission, and from 25 patients on the day of discharge were determined by use of commercially available enzyme-linked immunosorbent assay kits. The mean serum level of sICAM-1 in bronchiolitis patients was significantly higher than in the 10 healthy control infants (345.8 +/- 99.7 microg/mL vs 237.1 +/- 81.7 microg/mL; p<0.05). However, the mean sICAM-1 concentration was similar between RSV-positive and RSV-negative patients (337.5 +/- 99.6 microg/mL vs 350.9 +/- 101.1 microg/mL; p=0.65). Although the mean clinical severity score of RSV-positive patients was significantly higher than that of RSV-negative patients (5.94 +/- 1.83 vs 3.48 +/- 1.70; p<0.05). The improvement of clinical severity score was not well correlated with the change of sICAM-1 level (r=0.22). This study provides evidence that serum levels of sICAM-1 are increased in acute bronchiolitis and further confirms the role of adhesion molecules involved in the pathogenesis of the disease. However, the serum concentrations of the soluble adhesion molecules could not reliably reflect the clinical severity of the disease.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 06/2004; 37(3):153-6. · 0.99 Impact Factor
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ABSTRACT: It has been pointed out that longitudinal rather than cross-sectional growth standards should be used to assess individual linear growth. The purpose of this study is to investigate the growth characteristics of school boys and girls living in Shih-Pai district in Taipei.
A defined group of 1,139 healthy school children (570 boys and 569 girls) from the Shih-Pai district of Taipei city were followed longitudinally for 3 to 4 years. Anthropometric measurement of height and weight and physical development in each child were obtained. The annual increments were calculated every 6 months to map the peak height velocity (PHV), height velocity curve (HVC), peak weight velocity (PWV) and weight velocity curve (WVC).
The age at peak velocity was taken as 12.5 years for boys and 10.5 years for girls, and the whole year PHV as 8.0 cm/yr in boys and 7.0 cm/yr in girls. The mean PHV was less than 1 cm in boys and girls of about 17 years and 15 years, respectively, with mean heights of 170.8 cm and 158.7 cm, respectively.
Our preliminary results were actually calculated from the combination of longitudinal data and cross-sectional data pools. Since this is only a pilot study design, we expect that a longer follow-up period of the same cohorts would give more exact growth characteristics.
Journal of the Chinese Medical Association 03/2004; 67(2):67-72. · 0.79 Impact Factor
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ABSTRACT: Pulmonary abscess is a rare but critical problem in childhood. We did a retrospective review of 23 children with documented lung abscess who had been admitted and treated at the Taipei Veterans General Hospital over a 20-year period from April 1982 to April 2002. Among the 23 children, 11 cases were primary lung abscess, and 12 were secondary lung abscess. The pathogens were isolated in 16 patients (69.6%), and blood cultures yielded in only 3 patients (13.0%). The most common microorganism isolated in this series was Streptococcus pneumoniae. The 2 patients (8.7%) that died in our series had secondary lung abscess. We herein report the presenting symptoms, bacteriology, clinical management, and outcome of these 23 cases.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 03/2004; 37(1):45-9. · 0.99 Impact Factor
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ABSTRACT: Infections cause significant mortality and morbidity in neonates, especially the premature ones. Although there are various antibiotics can be used to combat neonatal infection, resistant strains have subsequently emerged. In an epidemiological survey, we analyzed bacterial isolates and their antibiotic susceptibilities for cases of bacteremia in a neonatal intensive care unit (NICU) of a teaching hospital.
From November 1999 to October 2001, 623 neonates admitted to the NICU were enrolled. The incidence and incidence density of bacteremia, morbidity and mortality of sepsis, as well as antibiotic susceptibility, were investigated.
Totally, 754 blood cultures were done on 623 patients. Fifty-eight patients experienced 85 episodes of bacteremia, with 87 isolates cultured. The incidence of bacteremia in our NICU was 9.31% (58/623) with an incidence density of 10.98/1000 patient-days. The overall mortality rate was 7.22%. The case fatality rate of bacteremia was 20.7% (12/58). The bacterial pathogens encountered, in order of frequency, were coagulase-negative Staphylococcus (29%), Staphylococcus aureus (22%), and Enterobacter cloacae (17%). All of the gram-positive bacteria were susceptible to vancomycin, while the gram-negative bacteria were susceptible to imipenem, amikacin and ciprofloxacin. Oxacillin-resistant S. epidermidis, oxacillin-resistant S. aureus, and multi-drug resistant enterobacteriae were the leading microorganisms causing bacteremia in our NICU.
It is an endless struggle to combat neonatal infection. Periodic evaluation of bacterial antibiotic susceptibility is necessary. More judicious selection of antibiotics and rotating antibiotic regimens should be kept in mind to reduce the resurgence of multidrug resistant strains.
Journal of the Chinese Medical Association 02/2004; 67(1):15-20. · 0.79 Impact Factor
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ABSTRACT: Fungi are well-known as sources for allergens that cause allergic rhinitis and allergic asthma. The aim of this study was to evaluate the prevalence of sensitization to airborne fungi in allergic diseases in children.
The presence of IgE antibodies to common allergens in serum samples from 77 atopic and 5 non-atopic children was determined by multiple allergosorbent (MAST) chemiluminescent assay. The allergic extracts, Penicillium notatum, Penicillium oxalicum, and Aspergillus fumigatus, were prepared. IgE-binding fungal components were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE)-immunoblotting, using sera from the above-mentioned patients.
The MAST data demonstrated that 62 (81%) of the 77 sera tested showed IgE antibodies to both Dermatophagoides pteronyssinus and Dermatophagoides farinae. Only 2 and 1 of the 77 atopic sera were positive to Penicillium and Aspergillus, respectively. However, 13 (17%) sera showed positive IgE-immunoblotting. Eight and 6 of them demonstrated IgE antibodies to more than 10 different components of P. notatum and P. oxalicum respectively. Ten of the 13 sera showed IgE-immunoblot reactivity to A. fumigatus, and only 1 of the 10 positive samples showed a positive MAST of class I to Aspergillus. All the other sera showed negative results in the MAST test to Aspergillus. The discrepancy observed between the results of IgE-immunoblotting using self-prepared extracts and the commercial MAST test of the serum samples tested may be due to the variations in the fungal strains and the allergenic extracts used, and the different assay systems employed.
The results confirmed the importance of airborne fungi in association with allergic disorders in children.
Journal of the Chinese Medical Association 09/2003; 66(8):453-9. · 0.79 Impact Factor
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ABSTRACT: This study was performed to determine the serum concentrations of interleukin-6 (IL-6) during the early course of bacterial infections disease in children, and to evaluate the usefulness of IL-6 as a diagnostic test alone and in combination with C-reactive protein (CRP).
We measured serum IL-6 values in 3 groups of children on their first day of admission, from January 2001 to December 2001: group 1, patients with clinical and microbiological evidence of sepsis (n = 13); group 2, patients with clinical and chest radiographical evidence of pneumonia (n = 18); and group 3, patients with no signs of infection (control group) (n = 16). Kruskal-Wallis tests were used to compare the difference of IL-6 values between groups and control subjects.
IL-6 values were significantly higher in groups 1 and 2 compared with those in the control group (p < 0.001). No significant differences were found between the groups 1 and 2. As a diagnostic test, IL-6 (> or = 20 pg/mL) alone yielded a sensitivity of 68%, a specificity of 88%, a positive predictive value of 71%, and a negative predictive value of 58%. A combined parameter of IL-6 (> or = 20 pg/mL) and CRP (> or = 1 mg/dL) yielded a sensitivity of 94%, a specificity of 63%, a positive predictive value of 79%, and a negative predictive value of 87%.
IL-6 levels increase in children with sepsis. In combination with CRP, IL-6 seems to be a valuable parameter in the early diagnosis of pediatric infections.
Journal of the Chinese Medical Association 09/2003; 66(9):523-7. · 0.79 Impact Factor
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ABSTRACT: Penicillium species are prevalent airborne fungi. However, the prevalence of allergic sensitization to Penicillium antigens and the true impact of these ubiquitous fungi on atopic respiratory disorders remain to be determined.
The purpose of this study was to analyze the prevalence of immunoglobulin (Ig)E and IgG antibodies against Penicillium chrysogenum (Pen ch 13), the alkaline serine protease major allergen of P. chrysogenum, in asthmatic patients of different age groups.
Pen ch 13 was purified from a culture medium of P. chrysogenum. The reactivity of IgE and IgG antibodies to Pen ch 13 in the serum samples of 212 asthmatic patients was analyzed by immunoblotting methods.
Sixty-nine (33%) of the 212 sera analyzed showed IgE and/or IgG immunoblot reactivity to Pen ch 13. Significant differences in the prevalence of IgE and/or IgG antibody reactivity to Pen ch 13 were found among eight different age groups of 212 asthmatic patients. The frequency of IgE-binding reactivity to Pen ch 13 increased significantly with the age of the patients. It was 7% for the group less than 10 years old and 42% for the group older than 70 years old. In addition, a significant difference between the prevalence of IgE (7%) and IgG (33%) antibodies against Pen ch 13 in the group aged 10 or less was also found.
Our study demonstrates that IgE and IgG antibodies specific for Pen ch 13 were detected in approximately one-third of the 212 asthmatic patients analyzed. Our results suggest that allergic sensitization to Pen ch 13, and possibly to other airborne Penicillium species, is more common in older asthmatic patients.
Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 03/2003; 90(2):248-53. · 2.83 Impact Factor
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ABSTRACT: Coagulase-negative staphylococci (CoNS) are the most common microorganisms isolated from blood cultures in childern, and determining whether there is true bacteremia or merely contamination is a clinical dilemma. A total of 67 episodes of CoNS-positive blood cultures in pediatric and neonatal intensive care units were evaluated during a 3-year period in order to find the possible risk factors involved and the antimicrobial susceptibility of CoNS isolates. In this study, 37 episodes were judged to be infections as opposed to 30 that were not. In comparison with individuals without infection, patients with true infection of CoNS stayed longer in the hospital (32 +/- 32.9 vs 10.7 +/- 9.3 days, p = 0.001), had more surgical procedures (32.4% vs 6.7%, p = 0.014), received more antibiotic treatments in the recent 2 weeks (37.8% vs 0%, p < 0.001), underwent more central venous catheter insertions (86.4% vs 10%, p < 0.001), received more parenteral nutrition (37.8% vs 3.3%, p = 0.001), had higher C-reactive protein profiles (4.8 +/- 5.4 vs 0.6 +/- 0.9 mg/dL, p < 0.001), and had higher neutrophil proportion (58.1% vs 44.3%, p = 0.001). However, there were no significant differences in corticosteroid therapy, hemoglobin level, total leukocyte count, and platelet count. All strains of the infection group were resistant to cefazolin, cefotaxime, penicillin, and erythromycin. Nonetheless, all isolates were susceptible to vancomycin. The percentage of multiple-resistant CoNS in the infection group was 96.9%. Empirical therapy with vancomycin for CoNS bacteremia in critically ill children is therefore recommended.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 03/2003; 36(1):51-5. · 0.99 Impact Factor
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ABSTRACT: This retrospective study assessed the parameters of ventriculoperitoneal shunt infection and malfunction found in 129 children with hydrocephalus who had undergone a ventriculoperitoneal shunt placement at Taipei Veterans General Hospital from January 1997 to June 2001. The clinical characteristics and differences among these patients were reviewed to determine the potential predictors of shunt infection and malfunction. Fever (60%, 6/ 10) and seizure (40%, 4/10) occurred significantly more often in the infection group than in the malfunction and control groups (p < 0.05). A higher blood C-reactive protein level was noted in the infection group than in the malfunction and control groups (p < 0.05). Examination of the cerebrospinal fluid of infected patients showed significantly higher white blood cell count and neutrophil count, higher protein concentration, and lower glucose levels compared with the other 2 groups (p < 0.05). However, the number of patients with cerebrospinal fluid eosinophilia was significantly higher in the malfunction group (p < 0.05). The diagnostic usefulness of laboratory parameters in patients with ventriculoperitoneal shunt infection is as follow: cerebrospinal fluid white blood cell count over 100/mm3, 96% specificity and a positive predictive value of 0.55; and cerebrospinal fluid neutrophils over 10%, 90% sensitivity and a negative predictive value of 0.99. In conclusion, Fever, seizure, high blood C-reactive protein, combined with leukocytosis, neutrophil over 10%, low glucose level, and high protein level in the ventricular fluid are factors that may help in distinguishing shunt infection from shunt malfunction.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 03/2003; 36(1):47-50. · 0.99 Impact Factor
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ABSTRACT: A multicenter, single-blind, randomized, controlled clinical study was conducted in healthy 15-18-month-old children in order to assess the immunogenicity and reactogenicity of three consecutive lots of a new measles- mumps-rubella (MMR) vaccine, GSK MMR.
A total of 500 enrolled subjects were randomized into four groups to receive either a single dose of one of the three lots of GSK MMR (three groups--125 subjects in each group) or Merck MMR vaccine (125 subjects). Once clinical consistency had been demonstrated, the data were pooled and compared with the widely used Merck vaccine. Solicited local and general symptoms were recorded using diary cards, and antibody levels were determined using ELISA assays.
No differences in the incidence of local and general symptoms or seroconversion rates were seen in the groups receiving different lots of GSK MMR. Compared with Merck MMR, there was a significantly lower incidence of local pain (P<0.001) and swelling (P=0.038) in infants receiving the GSK MMR vaccine. The incidences of all other solicited local and general symptoms were comparable between the two groups. No signs of suspected meningitis were reported. No serious adverse events were reported by the investigator to be related to vaccination. Equivalent seroconversion rates and postvaccination GMTs were observed in the groups receiving the two MMR vaccines. In conclusion, the new GSK MMR vaccine administered in measles-primed children demonstrated satisfactory immunogenicity and safety profiles as good as the Merck MMR vaccine.
International Journal of Infectious Diseases 09/2002; 6(3):202-9. · 1.94 Impact Factor
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ABSTRACT: Penicillium citrinum and Aspergillus fumigatus are prevalent indoor airborne fungal species that have been implicated in human respiratory allergic disorders. It is important to understand the allergenic profile of these fungal species. The purpose of the present study is to characterize a newly identified enolase allergen from P. citrinum and A. fumigatus.
Fungal proteins were separated by two-dimensional (2D) gel electrophoresis and blotted onto polyvinylidene difluoride membranes. Protein spots that reacted with IgE antibodies in serum samples from asthmatic patients were identified and the N-terminal amino acid sequences were determined by Edman degradation. The peptide sequences obtained were utilized in cloning the cDNA of the allergen genes by reverse transcriptase-polymerase chain reaction and the 5'- and 3'-rapid amplification cDNA end reactions.
Our results from 2D immunoblotting identified a 47-kD IgE-reactive component in the extracts of P. citrinum and A. fumigatus. The N-terminal amino acid sequences of the 47-kD proteins are homologous to those of fungal enolases. The corresponding enolase cDNA from P. citrinum contains 1,552 bp and encodes a protein of 438 residues. In A. fumigatus, the isolated enolase cDNA has 1,649 bp and contains a 438-amino acid open reading frame. The deduced amino acid sequences of these two enolases have 94% identity. These enolases from P. citrinum and A. fumigatus were expressed in Escherichia coli as a His-tagged protein and designated as rPen c 22 and rAsp f 22, respectively. Sera from 7 (30%) of the 23 Penicillium-sensitized asthmatic patients showed IgE binding to the 47-kD P. citrinum component (Pen c 22) and rPen c 22. In addition, six of seven Pen c 22-positive serum samples have IgE immunoblot reactivity to the 47-kD A. fumigatus component (Asp f 22) and rAsp f 22. A polyclonal rabbit antiserum generated against the N-terminal peptide of Pen c 22 can react with Pen c 22, rPen c 22, Asp f 22 and rAsp f 22. In addition, the presence of IgE cross-reactivity between rPen c 22 and rAsp f 22 and between enolases from A. fumigatus and Alternaria alternata was also detected by immunoblot inhibition.
These results demonstrated that a novel enolase allergen from P. citrinum (Pen c 22) and A. fumigatus (Asp f 22) was identified. In addition, IgE cross-reactivity between enolase allergens from A. fumigatus and P. citrinum and between enolases from A. fumigatus and A. alternata was also detected. Results obtained provide more information on fungal enolase allergens.
International Archives of Allergy and Immunology 04/2002; 127(3):181-90. · 2.40 Impact Factor
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ABSTRACT: Infiltration of cells into the lung in asthma is regulated by several expressions of cell adhesion molecules (CAMs) on cells present in the airways, and may play a role in the pathogenesis of bronchial asthma. We sought to evaluate the role of serum concentrations of the soluble forms of intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), and E-selectin (sE-selectin) in the control of disease activity in acute asthma. Circulating levels of sICAM-1, sVCAM-1, and sE-selectin in sera from 15 normal control subjects and from 20 allergic asthmatic children with acute exacerbations who had returned to stable condition were determined by using commercially available enzyme-linked immunosorbent assay kits. The mean concentration of serum sICAM-1 levels was significantly higher during an acute exacerbation of asthmatic children than in those with stable asthma (19.41 +/- 10.65 ng/mL vs. 13.46 +/- 5.44 ng/mL; P < 0.001) or in control subjects (9.83 +/- 2.02 ng/mL; P < 0.001). For sVCAM-1 and sE-selectin, the mean serum concentration of sVCAM-1 was slightly higher in children during an acute exacerbation asthma than when stable. However, the differences did not reach statistical significance. The mean serum concentrations of sVCAM-1 and sE-selectin in acute asthma or stable asthma were significantly higher than in control subjects. This study provides further evidence that serum concentrations of sICAM-1, sVCAM-1, and sE-selectin are increased in acute asthma. These findings further confirm that leukocyte endothelial adhesion plays a role in inflammatory airway disease.
Pediatric Pulmonology 04/2002; 33(4):249-54. · 2.53 Impact Factor
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ABSTRACT: Obesity impairs performance in most athletic events. The prevalence of obesity in Taiwan has increased over the past decades. It is important to understand any alterations in cardiopulmonary responses to exercise in obese children. The purpose of this study is to evaluate the cardiorespiratory response to graded treadmill exercise testing protocol in obese children.
Twenty obese and 10 control children between 8 to 12 years of age were recruited among patients at Pediatric Clinics. The treadmill was set at a grade of 10% to perform continuous treadmill walking. Measures of cardiopulmonary responses were recorded. Height, weight and body mass index were determined before testing.
Cardiopulmonary responses including heart rate (HR), systolic pressure (SP), rate-pressure product (RPP) and forced vital capacity (FVC) were significantly different between obese children and normal children during and after exercise. The correlations of cardiopulmonary function to age, sex, height, body weight, triceps and biceps skinfold thickness were assessed, and a significant correlation was found between HR and age (r = 0.5, p < 0.05), as well as biceps skinfold thickness (r = 0.5, p < 0.05). There was also a good correlation between predicted values of FVC and age (r = -0.5, p < 0.05). The HR (r = 0.79, p < 0.05) was in correlation with tricep skinfold thickness in normal healthy children.
In conclusion, there appears to show a relatively less efficient cardiopulmonary response in obese children. Regular exercise that improves fitness and body composition should have a favorable effect on obese children.
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed 02/2002; 65(2):79-82.
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ABSTRACT: Rhodotorula mucilaginosa (also known asR. rubra) is among the most commonly found yeast strains in our environment. However, allergens fromR. mucilaginosa have not yet been characterized at the molecular level. The purpose of this study was to characterize the enolase allergen fromR. mucilaginosa and examine the allergenic/antigenic cross-reactivity among fungal enolases. The full-length cDNA encoding theR. mucilaginosa enolase was isolated through the reverse transcriptase-polymerase chain reaction in conjunction with the 5-end and 3-end rapid amplification cDNA end reactions. The corresponding natural enolase fromR. mucilaginosa was identified using two-dimensional gel electrophoresis and N-terminal amino acid sequence analysis. The results showed that the enolase fromR. mucilaginosa is a protein of 439 residues and is encoded by a cDNA of 1,497 bp. It shares high sequence identity with enolase allergens fromCandida albicans (85%),Saccharomyces cerevisiae (76%),Penicillium citrinum (76%),Aspergillus fumigatus (76%),Cladosporium herbarum (76.5%), andAlternaria alternata (74%). A 47-kD component in theR. mucilaginosa extracts was found to react with IgE or rabbit anti-enolase antiserum and has an N-terminal amino acid sequence identical to that deduced from the isolated enolase cDNA. Sera from three (21%) of 14 allergic patients sensitized toR. mucilaginosa showed IgE binding to this 47-kDR. mucilaginosa component and the His-tagged recombinant enolase. A rabbit antiserum against theP. citrinum enolase and a monoclonal antibody (MoAb; Afueno 8) against theA. fumigatus enolase reacted with all 5 fungal enolases tested. However, an MoAb (E2a) generated by using theSaccharomyces enolase as antigen could only recognize the immunizing enolase. In addition, heterogeneity in immunoblot profiles of IgE antibodies in serum samples from 9 allergic patients against 5 different fungal enolases tested was also observed. The presence of IgE cross-reactivity among enolase allergens fromR. mucilaginosa, C. albicans andP. citrinum was detected by immunoblot inhibition. In conclusion, a new and cross-reactive enolase allergen fromR. mucilaginosa (Rho m 1) was identified. Although enolases are highly conserved allergens among different fungal species, most of the allergic patients examined in this study differed in their IgE reactivity to the 5 different fungal enolases tested. The results obtained will be of value in understanding the role of enolase allergen in clinical mould allergy.
Journal of Biomedical Science 01/2002; 9(6):645-655. · 2.01 Impact Factor
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ABSTRACT: Certain cytokines may contribute to the sequence of events that lead to meningeal inflammation in bacterial meningitis. The purpose of this study was to determine the levels of cytokines in the cerebrospinal fluid (CSF) of children with bacterial meningitis and aseptic meningitis of different etiologies. We determined the concentrations of interleukin-1 (IL-1#) and tumor necrosis factor (TNF-!) in the CSF of 171 specimens of 144 patients whose cases were classified as follow: bacterial meningitis (n=23), aseptic meningitis (n=26) and non-meningitis (n=95). The detectable IL-1# concentration (â‚€ pg/ml) in the bacterial meningitis, aseptic meningitis and non-meningitis groups were observed with 78.3%, 3.8%, and 8.4%, respectively. Significantly higher serum IL-1# concentrations were detected in those with bacterial meningitis than those with aseptic meningitis (538.93눥.32 pg/ml vs 2.52ᆟ.57 pg/ml; P<0.001) or among non-meningitis subjects (2.90ᆟ.91 pg/ml; P<0.001). The mean TNF-! concentration was 148.74넚.77 pg/ml. There was significantly more TNF-! than aseptic meningitis (6.85ᆥ.93 pg/ml; P<0.001) or non-meningitis (7.67ᆤ.07 pg/ml; P<0.001). With regard to diagnosis, measurement of IL-1# and TNF-! levels showed sensitivities of 78% and 74%, respectively; specificities of 96% and 81%, respectively. It is suggested that the levels of these cytokines, especially IL-1# and TNF-!, are useful markers for distinguishing bacterial meningitis from aseptic meningitis.
Child s Nervous System 07/2001; 17(8):453-456. · 1.54 Impact Factor
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ABSTRACT: For hyperbilirubinemic infants treated according to the higher criterion for a blood exchange transfusion (BET), auditory brainstem response (ABR) was performed to evaluate whether the treatment was adequate. Twenty hyperbilirubinemic infants were collected as the study group. They were divided into 2 groups; group A consisted of 17 infants receiving intensive phototherapy only, while group B consisted of 3 infants receiving BET plus phototherapy. Fourteen healthy neonates were collected as the control group. Language development was evaluated with "language/communication development milestone: infancy through school-age" at the age of 5 months to 3 years old. Wave V at 30 dB HL was clearly identified in all infants in group A and in the control group. There was no significant difference in the latency between them (p > 0.05). In group A, peak bilirubin levels of 16 cases reached the former criteria for BET Their ABRs were normal. Language development was normal in 12 cases, while 4 cases were lost to follow-up. In group B, 2 cases had abnormal ABRs, while the third had normal ABR and language development. By analyzing the condition of these babies, we could conclude that in addition to peak bilirubin level and age, other factors such as anemia, the duration of hyperbilirubinemia, and the decline rate of bilirubin in response to intensive phototherapy should also be taken into consideration. For infants with borderline bilirubin levels for BET, we suggest performing BET if they have severe anemia or if intensive phototherapy fails to produce a proper decline in bilirubin.
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi 43(2):86-90.
