Defects in bile pigment metabolism causing jaundice

The excretion of bilirubin and therefore the relief of jaundice is dependent upon at least three factors. First, the bilirubin must be conjugated and thus converted into a water soluble compound: this means its conversion to an ester glucuronide although other conjugates may also be formed. Secondly, there is the problem of the transport of bilirubin through the hepatic cell. A defect in either the up-take of bilirubin or the secretion of conjugated bilirubin may result in jaundice such as is seen in the various types of familial hyperbilirubinemia. Thirdly, there is the possibility of alternative catabolic pathways for bilirubin: this approach to the problem has, however, not yet received the attention of investigators.</p

Observations on the use of protein hydrolysates in medical and surgical cases

There can be little doubt that an enzymic hydrolysate of casein is an adequate source of protein food; the indications for its administration in preference to those of whole protein are, however, more difficult to find.The complexity of the changes in salt metabolism which result from operation is obvious. It is, there -fore, not surprising that no simple chemical estimation is of use in indicating the salt requirements of the patient at this time. The chloride concentration of the blood may give an erroneous impression, since salt retention has been observed with both raised and depressed values. Lack of salt in the urine is likewise no indication that the patient has not been given an adequate salt intake, since, for a variety of reasons, the patient is unable to excrete salt in the immediate post - operative period. A further knowledge of the problems involved is, therefore, required before a simple procedure can be found which will give the clinician a clear idea of his patients' salt requirements

Low-cost, smartphone-based instant three-dimensional registration system for infant functional near-infrared spectroscopy applications

Significance To effectively apply functional near-infrared spectroscopy (fNIRS)/diffuse optical tomography (DOT) devices, a three-dimensional (3D) model of the position of each optode on a subject’s scalp and the positions of that subject’s cranial landmarks are critical. Obtaining this information accurately in infants, who rarely stop moving, is an ongoing challenge. Aim We propose a smartphone-based registration system that can potentially achieve a full-head 3D scan of a 6-month-old infant instantly. Approach The proposed system is remotely controlled by a custom-designed Bluetooth controller. The scanned images can either be manually or automatically aligned to generate a 3D head surface model. Results A full-head 3D scan of a 6-month-old infant can be achieved within 2 s via this system. In testing on a realistic but static infant head model, the average Euclidean error of optode position using this device was 1.8 mm. Conclusions This low-cost 3D registration system therefore has the potential to permit accurate and near-instant fNIRS/DOT spatial registration

Die Insuffizienz der intraabdominellen Infektabwehr bei der eitrigen Peritonitis

Despite a high concentration of serum proteins and intact phagocytes peritonitis exudates contain a large number of viable, pathogenic bacteria. The reason for this biological paradox is unknown. Our investigations reveal a pronounced defect in humoral opsonization of foreign particles in peritonitis exudate. We evaluated a modified chemiluminescence system allowing the determination of opsonic activity in serum and exudate. In serum we found a close correlation between opsonic activity and immunologically measurable levels of C3-complement and IgG. In purulent peritonitis exudates, however, the actual opsonizing activity was much less than expected according to the opsonin concentrations. We found a pronounced difference between immunologically determined opsonin levels and impaired opsonic function. Employing crossed immunoelectrophoresis massive C3-splitting into smaller fragments could be demonstrated in peritonitis exudates. In these exudates we found very high concentrations of granulocyte proteolytic (elastase) and oxidative (myeloperoxidase) enzymes which may lead to a functional destruction of opsonins followed by impaired opsonization in peritonitis exudate. The great number of bacteria and foreign particles in addition can cause a pronounced physiological consumption of complement components. The almost complete breakdown of intact C3-complement in intraabdominal exudate explains the deficient host defence in patients with severe peritonitis

DR-bearing T lymphocytes in thoracic duct lymph

T cells having DR antigens were shown to be present in high numbers in the thoracic duct lymph of patients undergoing long-term drainage. As drainage progresses the proportion of T DR cells in the lymph increases to levels as high as 70% at 6 weeks. These cells were demonstrated by showing that T cells isolated by sheep red cell rosetting were killed by the action of rabbit anti-B-cell sera and of HLA-DR antisera. The HLA-DR specificities found on the T cells corresponded with those on the patients’ B lymphocytes