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Aim To determine the urinary tetranor-prostaglandin E2 metabolite in healthy infants and in hospitalised infants with upper and lower respiratory tract as well as gastrointestinal infections. Methods A prospective cross-sectional study to determine baseline concentrations of urinary tetranor-prostaglandin E2 metabolite was conducted in 81 healthy infants aged one week to one year and in 142 hospitalised infants with infections. Prostaglandin metabolite levels were measured by liquid chromatography tandem mass spectrometry. Results In healthy infants, urinary prostaglandin E2 metabolite levels decreased with age and did not differ between girls and boys. Infections of the lower respiratory (n = 78) and gastrointestinal tract (n = 12) correlated with increased levels of the prostaglandin E2 metabolite. In contrast, infants hospitalised with upper respiratory tract infections (n = 23) exhibited similar levels as healthy, age-matched controls. Lower prostaglandin E2 levels were found after treatment with acetaminophen in hospitalised children. Prostaglandin E2 metabolite levels did not correlate with length of hospitalisation or need for respiratory support. Conclusion This study first provides normal levels of urinary prostaglandin E2 metabolite in infants and secondly demonstrates elevated levels in hospitalised children with lower respiratory tract and gastrointestinal infections.

Children with cerebral palsy (CP) and acquired brain injury (ABI) commonly develop muscle contractures with advancing age. An underlying growth defect contributing to skeletal muscle contracture formation in CP/ABI has been suggested.The biceps muscles of children and adolescents with CP/ABI (n = 20) and typically developing controls (n = 10) were investigated. We used immunohistochemistry, quantitative real-time polymerase chain reaction, and Western blotting to assess gene expression relevant to growth and size homeostasis.Classical pro-inflammatory cytokines and genes involved in extracellular matrix (ECM) production were elevated in skeletal muscle of children with CP/ABI. Intramuscular collagen content was increased and satellite cell number decreased and this was associated with reduced levels of RNA polymerase I transcription factors, 45s pre-rRNA and 28S rRNA.The present study provides novel data suggesting a role for pro-inflammatory cytokines and reduced ribosomal production in the development/maintenance of muscle contractures, possibly underlying stunted growth and perimysial ECM expansion. Muscle Nerve 58: 277-285, 2018.

A nasal spray formulation containing an extract of Artemisia abrotanum L. was developed for therapeutic use in patients with allergic rhinitis and other upper airway disorders. The nasal spray preparation used contains a mixture of essential oils (4 mg/ml) and flavonols (2.5 microg/ml), of which some components have been shown to possess antiinflammatory, expectorant, spasmolytic as well as antiseptic and antimicrobial activities. The most important constituents in the essential oil fraction of the preparation are 1,8-cineole, linalool and davanone, while the flavonol fraction contains centauredin, casticin and quercetin dimethyl-ethers. No trace of thujon was observed in the essential oil of the Artemisia abrotanum L. genotype "Tycho" used for the manufacture of the nasal spray preparation. In 12 patients with diagnoses of allergic rhinitis, allergic conjunctivitis and/or bronchial obstructive disease, the nasal spray was given immediately after the appearance of characteristic allergic nasal symptoms. In 10 of the 12 patients, allergic rhinitis with nasal congestion, sneezing and rhinorrhea was dominant. After administration of the nasal spray, all patients experienced a rapid and significant symptom relief of nasal symptoms, comparable to the effect of antihistamine and chromoglicate preparations which several of the patients had used previously. The effect was present within 5 minutes after the administration and lasted for several hours. In 7 of the 10 rhinitis patients with concomitant symptoms of allergic conjunctivitis, a significant subjective relief of eye symptoms was also experienced. In 3 of the 6 patients who had a history of characteristic symptoms of endogenous, exogenous or exercise induced bronchial obstructive disease, there was a bronchial symptom relief by the nasal spray preparation which was experienced as rapid and clinically significant. It is concluded from the present proof of concept study, that a nasal spray formulation containing an extract characterised by a mixture of essential oils and flavonols from the Artemisia abrotanum L. genotype "Tycho", appears to be clinically useful and suitable for the prophylactic and therapeutic management of patients with allergic rhinitis and adjuvant symptoms.

Background and aims: Dextran sulfate sodium (DSS) induced colitis exhibits a predominantly NF-κB dependent proinflammatory cytokine profile and shares similarities with human inflammatory bowel disease (IBD). Lamina propria macrophages of IBD patients display elevated levels of NF-κB p65. Knowing the role of NF-κB in IBD, we investigated the beneficial cellular mechanisms underlying the lasting effect of a single p65 antisense treatment in DSS-colitis mice. Methods: One local dose of p65 antisense oligonucleotides was administered in DSS colitis mice. Ten days later the mice were killed and examined at cellular and biochemical levels. The level of p65 in lamina propria cells was determined by electrophoretic mobility shift assay and by intracellular immunofluorescent staining of nuclear p65 levels, using laser scanning cytometer. Results: FACS analysis demonstrated a considerable drop in infiltrating lymphocytes and a drastic reduction in CD14+ cells in mice treated with p65 antisense oligonucleotides. Moreover, abrogation of inflammation extended all the way to the cecum in treated mice. Treatment was correlated with decreased DNA binding activity of NF-κB. Conclusions: Our data strongly support a model in which p65 antisense treatment possesses the capacity to disrupt the pathogenic autocrine loop propagated by NF-κB at the chronic phase of IBD.

We have investigated one mechanism by which pooled human IgG preparations for intravenous use (i.v.Ig) selectively down-regulates lymphokine synthesis. Effects of i.v.Ig on cytokine production were quantified at a cellular level by using an immunocytochemical staining technique. Pure T-lymphocyte preparations (from the peripheral blood of healthy adults) were separated by the use of magnetic beads and were then used in parallel experiments with unfractionated mononuclear cells (MNC). Cell activation was induced either by a combination of the protein kinase C activator, phorbol 12-myristate 13-acetate (PMA), and the calcium ionophore, ionomycin, or by direct ligation of the T-cell receptor, using immobilized anti-CD3 monoclonal antibody (MoAb). Cells were cultured in the presence or absence of i.v.Ig and subsequently harvested and stained for the following cytokines: interleukin-2 (IL-2), interferon-gamma (IFN-gamma), tumour necrosis factor-beta (TNF-beta) and granulocyte-macrophage colony-stimulating factor (GM-CSF). Assessment of the frequencies of positively stained cells was performed by manual microscopy and by computerized image analysis. Activation by PMA/ionomycin or by immobilized anti-CD3 MoAb induced substantial lymphokine production in both MNC and in purified T cells. Addition of i.v.Ig led to a diminished synthesis of all of the T-cell products studied in unfractionated MNC preparations, whereas production was maintained or occasionally increased in the purified T-cell preparations. These findings indicate that the immunomodulatory effect by i.v.Ig on T-cell activation and lymphokine production was dependent on accessory cells.

Aim Acute anoxic exposure rapidly increases prostaglandin E2 (PGE2) production and release in neonatal mice brains. We hypothesize that PGE2 is released in human cerebrospinal fluid (CSF) during perinatal asphyxia and that it might be used as a biomarker for perinatal asphyxia. Methods In full-term infants with lumbar puncture performed within 72 h of birth (n = 35), CSF was analysed for prostaglandin E2 metabolite (PGEM) using an enzyme immunoassay. Term infants with suspected but unverified infections were used as controls (n = 11). Hypoxic–ischaemic encephalopathy (HIE) was classified as mild, moderate or severe (HIE I-III). Neurological assessment of surviving patients was performed at 18 months of age. Results Prostaglandin E2 metabolite levels correlated to a low Apgar score at 5 min (p

Background Activities and diet during the postpartum period are culturally dictated in many Southeast Asian cultures, and a period of confinement is observed. Plants play an important role in recovery during the postpartum period in diet and traditional medicine. Little is known of the Kry, a small ethnic group whose language was recently described, concerning its traditions and use of plants during pregnancy, parturition, postpartum recovery and infant healthcare. This research aims to study those traditions and identify medicinal plant use. Methods Data were collected in the 3 different Kry villages in Khammouane province, Lao PDR, through group and individual interviews with women by female interviewers. Results A total of 49 different plant species are used in women's healthcare. Plant use is culturally different from the neighboring Brou and Saek ethnic groups. Menstruation, delivery and postpartum recovery take place in separate, purpose-built, huts and a complex system of spatial restrictions is observed. Conclusions Traditions surrounding childbirth are diverse and have been strictly observed, but are undergoing a shift towards those from neighboring ethnic groups, the Brou and Saek. Medicinal plant use to facilitate childbirth, alleviate menstruation problems, assist recovery after miscarriage, mitigate postpartum haemorrhage, aid postpartum recovery, and for use in infant care, is more common than previously reported (49 species instead of 14). The wealth of novel insights into plant use and preparation will help to understand culturally important practices such as traditional delivery, spatial taboos, confinement and dietary restrictions, and their potential in modern healthcare.

Background Fundamental in traditional postpartum recovery in Lao PDR is the use of hotbeds, mother roasting, steam sauna and steam baths. During these treatments medicinal plants play a crucial role, but little has been published about how the treatments are carried out precisely, which species are used, the medicinal properties of these species, and the medicinal efficacy of their chemical constituents. Methods Sixty-five interviews, in 15 rural villages, with women of 4 different ethnic groups were conducted to survey confinement rituals, and postpartum plant use and salience. Essential oils from the main species used were extracted using steam distillation and the main chemical constituents characterized using gas chromatography-mass spectrometry (GC-MS). Results A total of 10 different species were used by three or more of the ethnic groups included in this study. All species were used in steam sauna and bath, but only 3 species were used in hotbed and mother roasting. Essential oils of Amomum villosum, Amomum microcarpum and Blumea balsamifera were found to contain significant amounts of the following terpenes: β-pinene, camphor, bornyl acetate, borneol, linalool, D-limonene, fenchone, terpinen-4-ol and α-terpinene. Conclusions Many of these terpenes have documented antimicrobial and analgesic properties, and some have also synergistic interactions with other terpenes. The mode of application in hotbed and mother roasting differs from the documented mechanisms of action of these terpenes. Plants in these two practices are likely to serve mainly hygienic purposes, by segregating the mother from infection sources such as beds, mats, stools, cloth and towels. Steam sauna medicinal plant use through inhalation of essential oils vapors can possibly have medicinal efficacy, but is unlikely to alleviate the ailments commonly encountered during postpartum convalescence. Steam sauna medicinal plant use through dermal condensation of essential oils, and steam bath cleansing of the perineal area is possibly a pragmatic use of the reported medicinal plants, as terpene constituents have documented antimicrobial, analgesic and anti-inflammatory properties.

The safety, tolerability and efficacy of iodixanol 270 mg I/ml were compared to those of iohexol 300 mg I/ml in a double-blind, randomized, parallel abdominal intra-arterial DSA phase III trial. Fifty-nine patients were included in the trial; 39 patients received iodixanol and 20 received iohexol. The mean volume of iodixanol administered was 235.8 ml (0.93 g I/kg b.w.) while the mean volume of iohexol was 254.7 ml (1.10 g I/kg b.w.). No differences in diagnostic information and radiographic density were apparent in spite of the difference in the concentration of iodine. No serious adverse events occurred. Four patients (10%) in the iodixanol group and 2 (10%) in the iohexol group experienced adverse events. Eight percent of the injections of iodixanol promoted discomfort, compared to 12%) of the injections of iohexol. An increase in S-urea and S-creatinine was seen with both agents the first day after injection, but appeared to be less pronounced with iodixanol than with iohexol. Other serum tests revealed no changes of clinical importance. Both iodixanol and iohexol were found to be effective, safe and well tolerated contrast media for abdominal intra-arterial DSA.

OBJECTIVE—The objective of this study was to quantify selected features of chronic synovial tissue inflammation by computerised image analysis and to validate the results by comparison with conventional microscopic measurements. METHODS—Synovial biopsy samples were obtained from the knee joints of patients with chronic arthritis and prepared for immunohistochemical analysis using standard techniques. Following the development of special software, four parameters of chronic synovial inflammation were evaluated: intimal layer thickness, CD3+ cell infiltration, CD8+ cell infiltration and vascularity. Intimal layer thickness was expressed in microns. The intensity of CD3+ and CD8+ cell infiltration was expressed as the percentage area of the tissue section occupied by positively stained cells. Vascularity was expressed as the percentage area occupied by blood vessels. Conventional quantitative microscopic analysis was also undertaken and the results from both methods compared. RESULTS—Seventy eight tissue sections were selected for study. Measurements of intimal layer thickness by both techniques correlated strongly: r = 0.85, p = 0.0006. Measurements of CD8+ cell infiltration, usually widely dispersed, also correlated well: r = 0.64, p = 0.005. Measurements of CD3+ cell infiltration, often densely aggregated, correlated less well: r = 0.55, p = 0.02. Measurements of vascularity demonstrated no statistically significant correlation: r = 0.41, p = 0.07. Proficiency in the use of computerised image analysis was readily acquired. CONCLUSION—Computerised image analysis was successfully applied to the measurement of some features of synovial tissue inflammation. Further software development is required to validate measurement of blood vessels of variable size.

On conventional ascending phlebography of the leg the deep femoral and pelvic veins are poorly visualized or not visualized at all. These veins are presumed to be the site of thrombosis and a source of pulmonary embolism in many instances. Diagnostic images of deep femoral and pelvic veins were obtained in 4 patients using injection of 30 ml of iopromide 300 mg I/ml into the iliac artery and DSA imaging of the venous phase of the angiogram.

Twenty-three patients with ischemic disease of the legs referred for routine preoperative angiography were examined with intra-arterial DSA and high resolution ultrasonography with duplex-Doppler to detect inguinal lymph nodes. None of the patients had evidence of malignant or lymphomatous disease and only 3 had skin ulceration on the foot. DSA detected nodes in 9 patients (39%). In 3 cases the nodes were highly vascularized. Ultrasonography detected lymph nodes in 16 patients (70%). In all but 2 nodes a high velocity arterial flow was recorded. It is concluded that DSA and particularly duplex-Doppler ultrasonography are sensitive methods to detect vascularized lymph nodes and that such nodes are found in many patients with no evidence of malignancy or infection.

Clinical 16 mm cinefluorography and 70 mm camera fluorography were compared in 30 unselected patients undergoing coronary arteriography. Accuracy in detecting coronary arterial stenosis and collateral vessels and in assessing the degree of stenosis was similar with the two techniques. With both methods, there were significant inter- and intraobserver differences in estimating the degree of stenosis. These differences indicate that coronary arteriography is only a semiquantitative method for making decisions about treatment, prognosis and follow-up of patients. The use of more than one observer increases the likelihood that stenotic lesions will be detected. Interobserver variation in detecting collateral circulation is small.

In experimental studies using a 0.1 mm focal spot tube, rare-earth screens, Cronex 4 film and diluted contrast agent (120 mgI/ml), 6 × magnification showed detail in the walls of major arteries that could not be identified with standard radiography or 3 × magnification. The method is applicable to studies of arteriosclerotic changes in the wall of the femoral artery in patients.

Polymeric, water-soluble, iodine-containing contrast agents have been synthesized and tested in renal angiography and thoracic aortography in rabbits and in femoral arteriography in dogs. Good filling of the arteries and also of the veins was obtained.

The case of a 55-year-old man with an apical coronary artery aneurysm is presented. The aneurysm was in communication with the dilated descending branch of the left coronary artery. There was no shunt. The physical findings suggested aneurysm with a fistula to the left ventricle. Coronary angiography demonstrated a localized aneurysm in the wall of the left ventricle, but no fistula. The aneurysm was surgically obliterated and the patient made a good recovery. This seems to be the first described case of coronary artery aneurysm without fistula to be fully diagnosed prior to surgical exploration.

In a double blind study in 20 patients a newly synthesized contrast agent Ph DZ 59B was found to give significantly less subjective adverse effects than a metrizoate preparation when compared at the same iodine concentration in carotid arteriography. This is in agreement with our results of earlier double blind studies in peripheral arteriography and angiocardiography.

In 8 patients with scoliosis and marked thoracic deformity osteoplastic thoracoplasty was performed to locally reduce the thoracic deformity. Subjectively the results were satisfactory in all but one case. Roentgenological studies including transversal tomography also demonstrated reduction of the thoracic deformity in 7 of the 8 cases.

In a series of 20 patients being routinely examined by angiocardiography or thoracic aortography as part of a preoperative evaluation for cardiac disease, a newly synthesized contrast agent Ph DZ 59B was compared with methylglucamine diatrizoate.When compared in a double blind study at the same iodine concentration, Ph DZ 59B was found to give less subjective adverse effects and also significantly less changes in heart rate and systolic blood pressure than methylglucamine diatrizoate.

In a small group of 5 cases where pericardial outflow prosthesis of the right ventricle and pulmonary artery was used, a significant dilatation was found at the follow up in three cases. In one of these an aneurys-matic formation of the degenerated and calcified pericardial tissue was found thus necessitating a reoperation. Therefore the dacron arterial grafts are preferred for the use as outflow prosthesis in cases of tetralogy of Fallot.The use of the patient's own pericardium has been recommended by Gross for outflow prosthesis of the right ventricle and the pulmonary artery. In a small group of 5 cases with Fallot's tetralogy the follow-up, however, showed dilatation of the free pericardial graft in 3 cases. In one of these already after 2 years the degeneration with calcific deposits within the pericardium caused a massive aneurysm necessitating reoperation.

Thirteen cases with mitral valve disease were operated upon with implantation of aortic pig hetero-grafts, mounted on a stainless steel ring covered with Da-cron. There were 3 early deaths, due to myocardial failure, aortic dissection, and myocardial haemorrhage, respectively. There were 3 late deaths, one due to an embolus, probably from the left atrium, one to graft failure with severe mitral regurgitation and marked haemolysis, and one to sepsis. The cause of the graft failure is unknown. There was no endocarditis in the case with sepsis. The remaining 7 cases were re-investigated with heart cathete-rization and left ventricular angiography. All cases were improved and there was no diastolic gradient over the grafts. In four there were physical or angiographical signs of minimal mitral regurgitation. Among the seven survivors only one presented laboratory findings suggestive of haemolysis.Since the time of re-investigation, an additional four heterograft valve failures have occurred among ths survivors.

(1957). Pulmonary changes following bronchography with dionosil oily (animal experiments) Acta Radiologica: Vol. 47, No. 3, pp. 177-180.

A new contrast agent has been synthesized and tested in double-blind studies on 36 patients in peripheral arteriography. When compared with some other contrast media in current use at the same or near the same iodine concentration, this new agent gave angiograms of comparable quality, with significantly less subjective adverse effects in the form of pain and sensation of heat. The increase in heart rate after injection of this new agent was also less than after similar injections of the other contrast media.

Fifty-nine proven, operated cases of coarctation of the aorta in children from I month to 15 years of age have been analyzed from the findings on standard chest roentgenograms, which were correlated with those of biplane angiocardiograms.The presence of the usually reported signs in adults is apparently directly related[See Figure in the PDF file]to the development of collateral circulation, and, as a result these signs are generally absent in the young and increase in incidence with age. Rib notching, the most valuable sign other than descending aortic or left mediastinal contour deviation, was present in 49 per cent of the cases, the youngest being 4 years of age.The diagnosis of coarctation of the aorta from standard roentgenograms is very difficult in patients under 6 years of age but over that age an 85 per cent accuracy may be expected.

Good visualization of the veins of the leg in the dog were obtained simply by increasing the dose to ca. 2 ml per kg tissue weight of contrast agent containing 282-300 mg I/ml. This is equivalent to the dose used in celiac, cerebral and coronary arteriography in man. Moderate increase in flow induced by injection of roentgen contrast agents gave some improvement in the visualization of the veins. Infusions of bradykinin and attempts at reactive hyperemia did not improve the visualization of the veins.

In a blind study of 184 standard chest roentgenograms and based on seven simple criteria, the pulmonary artery pressure was correctly diagnosed as normal or moderately elevated due to increased left atrial pressure or elevated due to increased pulmonary flow in 88%, 90%, and 78% of the cases respectively.

A new contrast medium Ph DZ 59B when used for selective coronary arteriography was found to give significantly fewer electrocardiographic changes than a currently used metrizoate preparation. The preparations were examined at the same iodine concentrations in patients. The findings confirm earlier results from comparative studies in peripheral arteriography, carotid arteriography and angiocardiography that this newly synthesized agent gives less adverse effects than other contrast agents currently used.

The effects of carotid artery injections of some roentgen contrast agents on the EEG have been studied in unanaesthetised dogs. The results support earlier clinical studies that the new contrast agent Ph DZ59B is suitable in carotid arteriography

A new dimeric contrast medium, Ph DZ 59B, was injected into the subarachnoid space in experimental animals. Excellent films were invariably obtained. Ph DZ 59B was well tolerated by dogs and cats and relatively well by monkeys.