Fever has been recognized as a cardinal feature of disease since antiquity, but only recently has the pathophysiology of fever come to be understood. It became clear that the ultimate cause of fever is not a bacterial product (a so-called exogenous pyrogen) but a product of host inflammatory cells (i.e., an endogenous pyrogen). Many studies have demonstrated that mononuclear phagocytes are the principal source of endogenous pyrogen and that a variety of mononuclear cell products can mediate the febrile response. Cytokines are also important as mediators of the acute-phase response to infection and inflammation.
Acute-Phase Reaction ; Cytokines ; Fever* ; Inflammation ; Phagocytes

OBJECTIVETo study the diagnostic value of determinations of serum acute phase reaction protein, such as complement 3 (C3), complement 4 (C4), prealbumin (PA) and C-reactive protein (CRP), etc., in patients with severe acute respiratory syndrome (SARS).

METHODSSerum levels of C3, C4, PA and CRP were determined by turbidimetry in 54 cases of SARS, 20 of other pneumonia and 30 normal persons.

RESULTSSerum concentrations of C3, C4, CRP and PA were (1.18 +/- 0.42) g/L, (1.15 +/- 0.56) g/L, (10.52 +/- 8.77) mg/L and (107 +/- 54) mg/L in SARS patients, (1.30 +/- 0.46) g/L, (0.57 +/- 0.31) g/L, (0.88 +/- 0.43) mg/L and (291 +/- 76) mg/L in patients with other pneumonia, and (1.11 +/- 0.56) g/L, (0.38 +/- 0.26) g/L, (0.42 +/- 0.26) mg/L and (376 +/- 74) mg/L in normal persons, respectively. Serum level of PA was significantly lower and levels of C4 and CRP significantly in patients with SARS higher than those in patients with other pneumonia and normal persons (P < 0.01). There was no significant difference in serum level of C3 between the three groups (P > 0.05).

CONCLUSIONDetermination of serum level of C4, CRP and PA in suspected patients is beneficial to early differential diagnosis for SARS.

Acute-Phase Proteins ; analysis ; Acute-Phase Reaction ; blood ; Adult ; Aged ; C-Reactive Protein ; analysis ; Complement C3 ; analysis ; Complement C4 ; analysis ; Female ; Humans ; Male ; Middle Aged ; Prealbumin ; analysis ; Severe Acute Respiratory Syndrome ; blood

PURPOSE: Most surviving pediatric osteosarcoma patients experience osteoporosis, bone pain, and pathologic fracture during and after therapy. The aim of this study was to evaluate the efficacy and side effects of pamidronate therapy in these patients. METHODS: Nine osteosarcoma patients (12.8±1.6 years of age; 5 boys and 4 girls) who had a history of nontraumatic fracture or severe pain after completing chemotherapy were included. Intravenous pamidronate (1.5 mg/kg) was given every 6 weeks for 4 to 6 cycles. Bone mineral density (BMD) of the lumbar spine was measured by dual-energy x-ray absorptiometry. Clinical outcomes including acute side effects were also evaluated. RESULTS: After pamidronate treatments, all patients experienced decreased pain. Seven of 9 patients could walk without a crutch. The BMD of lumbar spine was increased by 0.108±0.062 mg/cm2 after 8.4±1.0 months (n=8, P=0.017) and the mean z-score improved from -2.14±0.94 to -1.76±0.95 (P=0.161). Six patients (67%) had an acute-phase reaction, and 2 patients had symptomatic hypocalcemia. CONCLUSION: Pamidronate appears to be safe and effective for the treatment of osteosarcoma in children with low BMD and bone pain.
Absorptiometry, Photon ; Acute-Phase Reaction ; Bone Density* ; Child ; Drug Therapy ; Fractures, Spontaneous ; Humans ; Hypocalcemia ; Osteoporosis ; Osteosarcoma* ; Spine

OBJECTIVE: Bisphosphonates are the most commonly prescribed medications for the treatment of osteoporosis. This study was designed to analyze the rate of acute phase reaction (APR) following Zoledronate 5 mg administration in patients with osteoporosis who were treated with prior oral bisphosphonate for at least 2 weeks and to compare naive IV 5 mg Zoledronate. METHODS: Between July 2009 and October 2010, 27 patients with osteoporosis who were treated with prior oral bisphosphonate for at least 2 weeks, and maximum 52 weeks (average 18.5 weeks) and were between 42-and 85-year-old at the time of study participation. We prospectively evaluated APR, including fever, flu-like symptoms, headache, arthralgia, and myalgia, after 5 mg zoledronate by questionnaire. Additionally we assessed a visual analogue scale (VAS) by 4-point categorical scale. RESULTS: In this study of 27 patients with osteoporosis, the frequency of APR, flu-like symptom and myalgia were 14.8% and 7.4% and fever, arthralgia, and headache were 3.7% respectively. In VAS, all reactions were mild. The rate of APR rate in this study was statistically decreased compared to previous reports with zoledronate 5 mg IV in bisphosphonate-naive patients. CONCLUSION: Prior oral bisphosphonate administration for at least 2 weeks could significantly reduce the APR of IV zoledronate 5 mg.
Acute-Phase Reaction ; Aged, 80 and over ; Arthralgia ; Diphosphonates ; Fever ; Headache ; Humans ; Imidazoles ; Osteoporosis ; Prospective Studies ; Surveys and Questionnaires

PURPOSE: Laparoscopic gastrectomy is widely used to treat early gastric cancer. The advantages of totally laparoscopic distal gastrectomy (TLDG) are unproven, and some concerns remain regarding the early surgical outcomes due to its technical difficulty. We compared the early surgical outcomes and acute inflammatory response between patients undergoing TLDG and laparoscopy-assisted distal gastrectomy (LADG) for treatment of early gastric cancer. METHODS: We performed a retrospective study on 212 consecutive patients who underwent laparoscopic distal gastrectomy for gastric cancer between January 2008 and June 2014. A total of 179 LADG cases and 33 TLDG cases were included. After age, sex, body mass index, and American Society of Anesthesiologists physical status score were matched using propensity score matching (PSM), we compared the short-term surgical outcomes between the LADG and TLDG groups. RESULTS: The TLDG group had a shorter hospital stay (9.5 days vs. 11.0 days, P = 0.046) and less blood loss (116.6 mL vs. 141.5 mL, P = 0.031) than those in the LADG group. There were no differences in the preoperative WBC count and CRP level and the other clinical data between the two groups after PSM. Postoperative WBC count, serum CRP level, and decrease rate of WBC count in the TLDG group were significantly lower than those in the LADG group. CONCLUSION: The short-term outcomes of TLDG revealed better than that of LADG in this study. Therefore, TLDG is one of the safe and feasible procedure for the treatment of early gastric cancer.
Acute-Phase Reaction ; Body Mass Index ; Gastrectomy* ; Humans ; Laparoscopy ; Length of Stay ; Propensity Score ; Retrospective Studies ; Stomach Neoplasms*

BACKGROUND: More than 90% of dialysis patients respond in a dose-dependent manner to erythropoietin(EPO) administration and the others are resistant. The causes of EPO resistance are iron deficiency, vitamin deficiency, severe hyperparathyroidism, aluminum toxicity, and inflammation. Much literature has been published concerning iron deficiency and its role in EPO resistance. However little attention has been given to the contribution of inflammation to the EPO-resistant anemia observed in hemodialysis patients. METHODS: In the present study, we examined the contribution of parathyroid hormone levels, iron idices, normalized protein catabolic rate(nPCR), Kt/Vurea, albumin, and C-reactive protein(CRP) to erythropoietin resistance index(weekly rhEPO dose/body weight/hematocrit; ERI) in clinically stable 48 hemodialysis patients. RESULTS: The factors correlated with ERI were CRP(R=0.608, p< 0.01), ferritin(R=0.460, p< 0.01) and serum albumin(R=-0.359, p< 0.05). In stepwise multiple regression analysis, the independent factor affecting on ERI was CRP(beta=0.620, p< 0.01). Comparing high CRP group(> or =0.4 mg/dL) with normal CRP group(<0.4 mg/dL), there were significant differences in serum albumin, creatinine, ferritin, and ERI. CONCLUSION: Acute-phase response, assessed by the level of CRP, was the most important predictor or EPO resistance in stable hemodialysis patients.
Acute-Phase Reaction ; Aluminum ; Anemia ; Avitaminosis ; C-Reactive Protein ; Creatinine ; Dialysis ; Erythropoietin* ; Ferritins ; Humans ; Hyperparathyroidism ; Inflammation ; Iron ; Parathyroid Hormone ; Renal Dialysis* ; Serum Albumin

BACKGROUND: NF-kappaB is a characteristic transcriptional factor whose functional activity is determined by post- translational modification of protein and subsequent change of subcellular localization. The involvement of the NF- kappaB family of the transcription factors in the control of such vital cellular functions as immune response, acute phase reaction, replication of certain viruses and development and differentiation of cells has been clearly documented in many previous studies. Several recent observations have suggested that the NF-kappaB might also be involved in the carcinogenesis of some hematological and solid tumors. Investigating the possibility that members of the NF- kappaB family participate in the molecular control of malignant cell transformation could provide invaluable information on both molecular pathogenesis and cancer-related gene therapy. METHOD: To determine the expression patterns and functional roles of NF-kappaB family transcription factors in human lung cancer cell lines NCI -H792, NCI-H709, NCI-H226 and NCI-H157 were analys ed by western blot, using their respective antibodies. The nuclear and the cytoplasmic fraction of protein extract of these cell lines were subsequently obtained and NF- kappaB expression in each fraction was again determined by western blot analysis. The type of NF-kappaB complex present in the cells was determined by immunoprecipitation. To detect the binding ability of cell- line nuclear extracts to the kappaB consensus oligonucleotide, electrophoretic mobility shift assay(EMSA) was performed. RESULTS: In the cultured human lung cancer cell lines tested, transcription factors of the NF- kappaB family, namely the p50 and p65 subunit were expressed and localized in the nuclear fraction of the cellular extract by western blot analysis and immunocytochemistry. Immunoprecipitation assay showed that in the cell, the p50 and p65 subunits made NF- kappaB complex. Finally it was shown by Electrophoretic Mobility Shift Assay(EMSA) that nuclear extracts of lung cancer cell lines are able to bind to NF-kappaB consensus DNA sequences. CONCLUSION: These data suggest that in human lung cancer cell lines the NF-kappaB p50/p65 complex might be activated, and strengthen the hypothesis that NF-kappaB family transcription factors might be involved in the carcinogenesis of human lung cancer.
Acute-Phase Reaction ; Antibodies ; Base Sequence ; Blotting, Western ; Carcinogenesis ; Cell Line* ; Consensus ; Cytoplasm ; Genetic Therapy ; Humans* ; Immunohistochemistry ; Immunoprecipitation ; Lung Neoplasms* ; Lung* ; NF-kappa B* ; Transcription Factors

OBJECTIVETo investigate optimal time for early escharectomy after severe scald in minipigs.

METHODSMinipigs inflicted with 35% TBSA full thickness burn were employed in the study, and they were randomly divided into A (n = 7, with escharectomy at 6PSH), and B (n = 7, with escharectomy at 24 PSH) groups. The hemodynamics indices, hemorrheology, and the serum levels of cytokines in the two groups were determined before burns and at 6, 8, 16, 24 and 72PSH.

RESULTSThe hemodynamics indices in A group obviously improved compared with those in B group. The cardiac output (CO, 2.28 +/- 0.03 L/min) and right arterial pressure (RAP, 4.54 +/- 0.04 mmHg) in A group recovered to the pre-injury levels at 48 PSH. There was no difference of the hemorrheology indices between the two groups (P > 0.05). The serum contents of cytokines in A group declined to the pre-injury level on 1 PBW, while those in B group were significantly higher than those before injury and those in A group (P < 0.05 or P > 0.01).

CONCLUSIONEscharectomy during 6 PBH might be safe and feasible, thus preventing long-term complications effectively.

Acute-Phase Reaction ; Animals ; Atrial Function, Right ; Burns ; physiopathology ; surgery ; Cardiac Output ; Cytokines ; blood ; Disease Models, Animal ; Hemorheology ; Swine ; Swine, Miniature

OBJECTIVETo determine the safety and efficacy of fresh frozen plasma (FFP) infusion for the treatment of hereditary angioedema (HAE).

METHODSThe medical records of patients with HAE admitted to Peking Union Medical College Hospital who had received FFP infusion during 2004 and 2010 were reviewed and PubMed database from 1966 to the present were searched using the following hereditary angioedema and fresh frozen plasma. The patient's age, sex, body location of HAE attacks, the dose of FFP infusion, time of beginning to improvement, time to complete remission, complication, C1 inhibitor activity, and outcome were analyzed.

RESULTSA total of 13 enrolled patients (7 male and 6 female) received 16 times of FFP infusion, including 2 patients undergoing FFP infusion in Peking Union Medical College Hospital and 11 patients reported in the literature. The mean dosage of FFP infusion was 586∓337 mL. Two cases suffered from worsening abdominal pain and one case experienced skin rash. Only 1 patient had no improvement in symptom owing to transfusion related reaction. There was a definite improvement in symptom 49∓19 minutes after beginning FFP infusion. The remission time decreased from 61.7∓27.0 hours to 3.3 (2.0, 12.0) hours after FFP infusion. FFP infusion was effective for both type I and type II HAE.

CONCLUSIONFFP seems to be safe and effective for acute attacks of HAE.

Acute-Phase Reaction ; therapy ; Adolescent ; Adult ; Aged ; Angioedemas, Hereditary ; blood ; therapy ; Blood Transfusion ; methods ; Child ; Female ; Humans ; Male ; Middle Aged ; Plasma ; physiology ; Retrospective Studies ; Transfusion Reaction ; Treatment Outcome ; Young Adult

The purpose of our study was to investigate changes in immunological parameters induced by weaning stress (including milk restriction) in calves. Fifteen Holstein calves were subjected to weaning at 6 weeks of age. Blood samples were collected at -14, -7, -2, 1, 3, and 5 days post-weaning (DPW; 0 DPW = 42 days). Weaning caused significant (p < 0.01) increases in the neutrophil (NE):lymphocyte (LY) ratio at 5 DPW with a significant (p < 0.05) reduction of LYs. The concentration of acute-phase proteins (haptoglobin and serum amyloid A) also increased significantly (p < 0.05) at 3 and 5 DPW compared to -2 DPW. Levels of the iron-binding protein lactoferrin decreased significantly (p < 0.05) after weaning. Serum tumor necrosis factor-alpha and cortisol levels were elevated (p < 0.05) at 3 DPW, while those of serum interferon-gamma decreased (p < 0.05) at 1 and 3 DPW compared to levels observed before weaning. Weaning significantly (p < 0.05) decreased the percentage of CD25+ T cells in the peripheral blood. In conclusion, weaning stress affected the NE:LY ratio along with the levels of acute phase proteins, lactoferrin, cortisol, and inflammatory cytokines in the peripheral blood of calves. Weaning stress may induce an acute phase response possibly through the elevation of cortisol production and modulation of inflammatory cytokines.
Acute-Phase Proteins/*immunology/metabolism ; Acute-Phase Reaction/immunology/*veterinary ; Animals ; Cattle/*immunology ; Female ; Flow Cytometry ; Haptoglobins/analysis/immunology ; Hydrocortisone/blood/immunology ; Interferon-gamma/blood/immunology ; Lactoferrin/analysis/immunology ; Leukocyte Count/veterinary ; Leukocytes/cytology/*immunology ; Male ; Serum Amyloid A Protein/analysis/immunology ; Stress, Physiological/*physiology ; Tumor Necrosis Factor-alpha/blood/immunology ; Weaning