Eugene Ainbender

Radioautographic Studies of Poliovirus Binding by Human Immunoglobulins.

Summary (1) By techniques of radioimmunoelectrophoresis and radioimmunodiffusion using radioactive poliovirus, it was shown that the quantity of poliovirus antibodies in a serum and the immunoglobulin class of these antibodies can be determined. (2) By these techniques it was shown that adult human serum contains A Immunoglobulin (IgA) poliovirus antibodies as well as G Immunoglobulin (IgG) polio antibodies. (3) Some sera contain a higher concentration of A Immunoglobulin (IgA) polio antibodies than G Immunoglobulin (IgG) polio antibodies.

Production of O and H agglutinins by a newborn infant infected with Salmonella st. paul

It has been shown previously that newborn infants vaccinated with killed Salmonella organisms produce little or no antibody against the somatic (O) antigen. However, a newborn infant who suffered an illness caused by Salmonella st. paul did produce a high titer of specific O and H agglutinins, both of which were IgM globulins.

A paper chromatoelectrophoresis method for the determination of bilirubin binding to serum protein.

Summary: A technique is described in which paper chromatoelectrophoresis is used to measure the bilirubin binding capacity of albumin in scrum. It is equivalent to the Sephadex G-25 method and its results are highly reproducible. From a single pool of serum, multiple determinations indicated the mean bilirubin binding capacity to be 23.7 ± 0.76 (SD) mg/dl and the greatest difference between any two values was 2 mg/dl. This new technique can determine the bilirubin binding capacity of a serum sample in 15 min. Highly skilled technicians are not needed and very small quantities of serum are required, which gives it a definite advantage over the Sephadex G-25 method.Speculation: Paper chromatoelectrophoresis is a simple, rapid, and inexpensive technique which can be used to measure the bilirubin binding capacity in very small volumes of serum. It appears to have sufficient accuracy and reliability to be applied as a clinical guide to the severity of unconjugated (indirect acting) hyperbilirubinemia in the newborn infant. If further experience with the method supports this report, decisions regarding phototherapy and exchange transfusion to treat infants with unconjugated hyperbilirubinemia might be made on a more rational basis.The technique could be made much more sensitive by using radioactive bilirubin. In this way, it could become a useful research tool in the study of bilirubin metabolism.

Enhancement of Resistance in Mice to Staphylococcal Infection by Preliminary Treatment with a Staphylococcal Extract.

Summary An extract from the supernate of an epidemic strain of staphylococcus which was not an endotoxin was injected intra-abdominally in mice. Twenty hours later the systemic resistance of these mice was significantly enhanced to lethal infections with homologous and heterologous strains of staphylococci and a toxogenic strain of E. coli. This effect was demonstrable in suckling, young and old mice.

COMPARISON OF MEASURED AND CALCUIATED SERUM BILIRUBIN BINDING CAPACITY |[lpar]|BBC|[rpar]|-A DANGER EXPOSED

We devised a paper chromatoelectrophoresis technique to measure serum BBC which compares favorably with results from Sephadex G25 chromatography. We measured serum BBC and total protein (TP) concentration in 27 infants of various gestational ages who required no special care (normal) and 51 infants with various problems who received treatment beyond routine(abnormal). The mean ± 1 SD of the BBC/TP ratio is 3.92 ± 0.47 (range 3.20-5.40) and 3.59 ± 0.74 (range 1.50-5.29) respectively for the normal and abnormal infants (p<0.05). If normal and abnormal infants are grouped together, the mean of the ratio is 3.75, which is similar to the derived value of 3.7 presented in some textbooks of neonatology. Many use that value together with a patients serum TP in grams/dl to calculate an artificial BBC which then becomes the serum bilirubin concentration in mg/dl used to determine the need for exchange transfusion. If that process were applied to our subjects, 27% of normal and 18% of abnormal infants would receive an unnecessary exchange transfusion and the risk of bilirubin encephalopathy would be increased in 22% of normal and 51% of abnormal infants because they would not have received an exchange transfusion before the primary protein binding sites for bilirubin were saturated. It is clear that measuring the BBC of each infants serum is imperative for accurate and reliable information. A calculated value based on a fixed ratio such as 3.7 appears to be unsafe.

The Difference in Elutability of Poliovirus and SV40 from a DEAE Column

Summary The differences in avidity for a DEAE cellulose ion exchange column exhibited by polioviruses and SV40 virus make it possible to reduce the content of SV40 virus in a mixture of the 2 viruses to a trace at most. SV40 virus has a much greater avidity for a DEAE cellulose ion exchange column than do polioviruses. This fact permits the freeing of poliovirus from detectable SV40 virus.

SEPTICEMIA IN THE ABSENCE OF CRP ELEVATION

At the Childrens Center of the Mount Sinai Hospital quantitative measurements of serum C-reactive protein (CRP) are frequently made. We have performed more than 30,000 such tests since 1974. A serum CRP determination is made whenever a blood culture is obtained. This practice made it possible for us to assess the value of quantitative CRP measurement in the prediction of septicemia.Over a three-year period, 127 positive blood cultures were identified. In 18 episodes of septicemia in 17 patients (ages 2 weeks to 17 years) the initial CRP was ≤ 1.5 mg/dl. In 14 of these 18 episodes, it was ≤ 1 mg/dl. Three children (4 episodes) were on chemotherapy for malignancy. Three children died the day of the determinations. The remaining children had serious infections with a variety of different agents, including H. influenzae, S. pneumoniae, S. aureus, Ps. aerugenosa, group B streptococcus, salmonella species, K. pneumoniae, E. cloacae and candida species.Our data illustrate that a normal initial CRP value is not inconsistent with septicemia. Physicians using CRP measurements for diagnostic purposes should be aware of this.

Letter to the Editor: Reply to Dr. Stern

The paper by Ainbender and colleagues (A Paper Chromatoelectrophoresis Method for the Determination of Bilirubin Binding to Serum Protein) in Pediatric Research, volume 1 I, pages 808-81 I, proposes a method of determination of bilirubin binding capacity, which, although it does represent a newer technologic approach to the utilization of the system, is dependent upon the original observation made by our Czech colleagues (1, 2) a number of years ago, regarding-the possibility of separating free from albumin-bound bilirubin on the basis of differential migration on electrophoretic paper. One would have liked to see reference to their earlier publications in this area, since while granting that the current description represents a more sophisticated application of these principles, credit for the idea upon which this is based should

POSTNATAL DECLINE OF SERUM ALPHA FETOPROTEIN |[lpar]|AFP|[rpar]| CONCENTRATION

The concentration of serum AFP of 35 newborn infants was measured serially during the first 3 to 12 weeks of life. In general, the concentration at birth was found to be inversely related to gestational age. However, the wide range of values makes the use of the serum AFP concentration at birth of little value in establishing the duration of gestation.The individual curves of decline of serum AFP concentration are classified into 3 groups. Group I has a rapid regular fall with a half-life of 4.5 ± 0.8 days. The 14 infants in this group are AGA term and AGA preterm with uncomplicated postnatal courses. Group II has a slow regular fall with a half-life of 8 to 14 days. This group is made up of 2 very small AGA preterm infants with marked respiratory difficulties and 1 SGA preterm infant. Group III is characterized by serial values which decline irregularly with spikes and plateaus so that the half-life cannot be determined. Of the 18 members of this group, 1 AGA term infant had asphyxia and seizures, and 17 preterm infants had a variety of problems including SGA, sepsis, severe RDS and shock.The curves of Groups II and III may be the result of continued postnatal AFP synthesis by the liver in response to chemical, circulatory or toxic hepatic injury. Several infants in this group had prolonged hyperbilirubinemia and 1 infant had marked cholestasis with hepatic failure.