Effect of undernutrition on the immune response to rotavirus infection in mice

The effect of moderate and severe undernutrition on the immune response to EDIM rotavirus was studied in mice. A moderate state of undernutrition was produced by feeding weanling mice either 15 or 30% less diet than the control group had eaten on the previous day, for 7 weeks. After 6 weeks, mice were given 30 microliters/mouse of EDIM rotavirus orally and the antibody production was measured 1 week later. The delayed-type hypersensitivity (DTH) response to picryl chloride (PC) was measured as an index of cell-mediated immunity. For severe undernutrition, weanling mice were fed either 30 or 50% less diet than the control group had eaten on the previous day, for 12 weeks. After 11 weeks of feeding, animals were given 30 microliters/mouse of EDIM rotavirus either orally or intramuscularly and the antibody production was measured 1 week later. In moderate undernutrition, the serum antibody levels specific to rotavirus and the DTH response to PC were normal in all dietary groups compared with the control group. In severe undernutrition, the antibody levels following oral challenge of rotavirus were similar in all dietary groups. There was a significant impairment of serum antibody levels following intramuscular challenge in the group fed 50% less than the control group. It is concluded (1) that a balanced reduction in food intake does not impair the immune response, unless severe restriction is maintained for a long period of time, and (2) that the antibody response varies with the route of immunization.

Monoclonal antibody MAC 387 recognizes a myelomonocytic antigen shared by epithelial cells in inflammatory skin diseases

The monoclonal antibody MAC 387 recognizes an antigen expressed by human macrophages and granulocytes. Normal epidermis does not react with the antibody, but the inflamed epidermis may react. In this immunocytochemical study we have investigated the intracytoplasmic expression of the MAC 387 antigen in biopsies of a variety of skin disorders. In lichen planus the basal cells were usually negative, whilst suprabasal cells were positive. In the majority of other inflammatory dermatoses studied, there was positive staining of basal and suprabasal cells. A parallel frozen- and paraffin-section study of biopsies of cutaneous T-cell lymphomas and inflammatory conditions failed to demonstrate HLA Class II expression in the cytoplasm of keratinocytes. Expression of the MAC 387 antigen in the epidermis is directly associated with cell-mediated activity in the papillary dermis, but is not related to HLA Class II expression.

Phenotypic changes in a CD4+ lymphocyte subset correlate with a conversion from suppressor to helper inducer function

The monoclonal antibodies WR16 (CD45RA) and WR19 were used to isolate two reciprocal subsets of CD4 lymphocytes by negative selection. The CD4+/WR16-/WR19+ subset exhibited helper-inducer activity in a pokeweed mitogen (PWM)-driven Ig secretion assay, whereas the CD4+/WR16+/WR19- subset showed suppressor activity. When the CD4+/WR16+/WR19- subset was cultured in phytohaemagglutinin (PHA) or purified protein derivative (PPD) there was increased expression of the antigen binding WR19 but the cells remained WR16 negative. Cultures of CD4+/WR16+/WR19- lymphocytes with PHA or PPD induced a phenotypic change that resulted in a population which was CD4+/WR16-/WR19+. Investigation of the functional activity of the CD4+/WR16+/WR19- subset, before and after activation and phenotypic change to WR16-/WR19+, indicated that the change in phenotype correlated with a functional conversion from suppressor to helper-inducer activity. These results suggest that the CD4+/WR16+/WR19- suppressor subset comprises cells that differentiate to WR16-/WR19+ helper-inducer cells after exposure to antigen or mitogen.

Winter feed production and grain yield in mixtures of spring and winter wheats

The possibility of combining the early rapid growth of extreme spring (express) wheat cultivars with the high grain-producing ability of long-season types as a dual-purpose crop (fodder and grain) for the high-rainfall zone of E. Australia was investigated in an experiment at Canberra in 1985. Mixtures of cv. Sunset, an express wheat, and Isis, a winter wheat, in the proportions of 1:3, 1:1 and 3:1, were compared with 4 long-season and 2 short season wheat cultivars, oats and pastures (Lolium rigidum/Trifolium subterraneum with and without N fertilizer), all sown at the end of summer. Cereals and pastures were cut monthly from 3 different starting dates. Cereals were cut until their developing ears were above ground, and pastures were cut until the trial ended in Nov. In a 4th treatment, cereals were left uncut. An early start to cutting allowed all long-season wheats to be harvested several times for fodder, but in general the total amount harvested was greatest from the latest initial cutting date treatment. The greatest amount of DM harvested (9 t/ha) came from the express wheat Sunset and from Sunset/Isis mixtures, 2 t/ha more than from Isis alone. As well as producing considerably greater amounts of DM during winter, the Sunset/Isis mixtures yielded as much grain (3.4 t/ha from the latest initial cutting date treatment) as Isis alone. DM and grain yields of mixtures were stable across the range of ratios used. It was concluded that grazing of crops sown for winter feed in cool environments should be delayed as long as possible without endangering ears, thereby providing max. amounts of fodder and effectively smothering weeds. Under this regime, mixtures of express and winter wheats should provide at least as much feed as a pasture treated similarly. If cutting started early, both would be less productive, and the crop could be inferior to the pasture.

Gliosarcoma: an immunohistochemical study

Gliosarcomas contain both neuro-ectodermal and mesenchymal elements. Its histogenesis has been much debated and endothelial and adventitial fibroblast origins have been suggested, as has a "histiocytic" origin following the demonstration of antiprotease activity. Eight gliosarcomas have been examined with a panel of ten monoclonal and polyclonal antibodies to investigate the origin of the sarcomatous element. Glial fibrillary acid protein expression showed a sharp distinction between gliomatous and sarcomatous tumour components. Contrary to some previous reports factor 8-related antigen and Ulex europeus agglutinin stained vascular luminal endothelium but no tumour cells. Vimentin and fibronectin expression was extensive and confined largely to sarcomatous areas. Desmin and neurofilament protein could not be demonstrated in any of the cases. Numerous cells, particularly in the sarcoma areas, expressed alpha-1-antitrypsin and -chymotrypsin. A proportion of these stained for the monocyte/macrophage marker MAC 387. Four cases focally exhibited a true storiform pattern and this and the immunohistochemical results suggest analogies with the fibrous histiocytomas. These tumours contain reactive histiocytes but are now thought to be derived from fibroblasts or from pluripotent mesenchymal cells in perivascular adventitia. This resembles the pattern exhibited in the sarcomatous component of gliosarcomas.

An outbreak of nitrogen dioxide-induced respiratory illness among ice hockey players

During February 1987 an outbreak of nitrogen dioxide-induced respiratory illness occurred among players and spectators of two high school hockey games played at an indoor ice arena in Minnesota. The source of the nitrogen dioxide was the malfunctioning engine of the ice resurfacer. Case patients experienced acute onset of cough, hemoptysis, and/or dyspnea during, or within 48 hours of attending, a hockey game. One hundred sixteen cases were identified among hockey players, cheerleaders, and band members who attended the two games. Members of two hockey teams had spirometry performed at 10 days and 2 months after exposure; no significant compromise in lung function was documented. Nitrogen dioxide exposure in indoor ice arenas may be more common than currently is recognized; only three states require routine monitoring of air quality in ice arenas, and the respiratory symptoms caused by exposure to nitrogen dioxide are nonspecific and easily misdiagnosed.

The effect of testosterone replacement on plasma lipids and apolipoproteins

Ten men with Klinefelter's syndrome were studied to assess the effect of testosterone replacement on plasma lipids and apolipoproteins. Measurements taken before the insertion of a testosterone ester implant were compared with those obtained 1 week and 4 weeks later. Mean plasma testosterone, androstenedione, total cholesterol and calculated LDL-cholesterol increased significantly after 1 and 4 weeks. No significant changes were seen in total plasma concentrations of HDL-cholesterol, HDL-cholesterol subfractions 2 and 3 or in apoplipoproteins A-I, A-II or B. A significant correlation was seen between total cholesterol and plasma oestradiol concentrations (Rs = 0.61; P less than 0.001). A significant negative correlation was seen between the concentrations of total testosterone and total triglyceride (Rs = -0.56; P less than 0.005) but not with the other lipid parameters. Testosterone replacement is associated with slight but potentially adverse changes in plasma cholesterol levels.

Calgranulin expression in inflammatory dermatoses

We have used monoclonal antibodies to study the expression of calgranulins by keratinocytes in inflammatory dermatoses. Calgranulins are intracellular calcium binding proteins which have inflammatory cytokine activity and are composed of at least two different chains, calgranulin A and B. Antibody CF 145 and CF 557 identify calgranulin A and B, respectively. MAC 387 recognizes a molecule probably containing both calgranulins. Keratinocytes in normal skin did not contain these molecules. The keratinocytes in 52 cases of different inflammatory dermatoses showed expression of both calgranulin chains in lesional but not in non-lesional skin. Keratinocytes in inflammatory dermatoses therefore express an intracellular calcium binding protein which has cytokine activity.

Leucocyte common antigen expression on T cells in normal and inflamed human gut

The expression of the 220,000 MW (p220) glycoprotein component of the leucocyte common antigen (LCA) family by intestinal mucosal lymphocytes was studied using the CD45R monoclonal antibody WR16. In normal intestine, a proportion of CD3+ mucosal T cells were WR16+ and this population resided predominantly in the mid-villus and crypt region of lamina propria. In the inflammatory infiltrates of both coeliac disease and Crohn's disease the CD3+, WR16+ population was markedly reduced. The monoclonal antibody UCHL1 identifies the 180,000 MW member of the LCA family and is expressed on T cells and in macrophages. CD3+ lymphocytes expressing this marker were widespread in normal lamina propria and epithelium. In contrast with WR16, UCHL1+ cells remained at a high level in coeliac disease and Crohn's disease. Our results support the view that loss of the p220 molecule occurs upon T-cell activation in inflammation.

An outbreak of giardiasis in a nursing home with evidence for multiple modes of transmission

During a 6-w period from 20 April through 7 June 1986, an outbreak of giardiasis occurred in residents and employees of a nursing home and children participating in day care at the nursing home. Eighty-eight cases of giardiasis (defined by presence of clinical symptoms or results of stool examination) were identified from groups associated with the nursing home including 35 in nursing home residents, 15 in children in day care, and 38 in employees (including kitchen staff and child care providers). Multiple modes of transmission of Giardia lamblia, including food-borne and person-to-person transmission, occurred for these groups. Evidence of transmission by food included a significant association between sandwich consumption and illness in nursing home staff (P = .04) and a significant lack of illness among nursing home residents who consumed only a pureed diet (P = .007), where all food items are cooked before serving. The primary case among the food handlers, whose illness began in mid-April, had an infected child in the day care center. Person-to-person transmission is supported by a significant association between illness and physical contact with children from the day care facility through an "adopted grandparent" program (P = .03). This is the first reported outbreak of giardiasis in a nursing home, and these findings have implications for disease control in other facilities that combine child day care and care of the elderly.

Trouble on the border: international health problems merge at the Rio Grande

"Mosquitoes don't have green cards", Laurance N. Nickey, MD, says. That is Dr Nickey's way of saying that disease and environmental pollutants do not recognize the political boundary that separates Texas from Mexico. Dr Nickey, director of the El Paso City-County Health District and chairman of Texas Medical Association's Council on Public Health, is a native and lifelong resident of the city. He is an expert on the public health problems that plague El Paso and the other cities along the international border, all of which are exacerbated by abject poverty and a burgeoning population. Dr Nickey works tirelessly to bring these problems to the attention of Texas physicians, legislators, and other opinion leaders because, as he says, "Out here, we feel like we're the forgotten Texans."

Bacterial keratitis after radial keratotomy

The authors identified nine patients with culture-proven keratitis after radial keratotomy (RK). Three patients became infected in the immediate post-operative period, and six patients had delayed-onset keratitis. Gram-negative rods were the predominant pathogens in late-onset keratitis (4 of 6 infections). Gram-positive cocci were implicated in all three postoperative infections. The inferior corneal quadrants were involved in seven of nine patients. Two episodes of late-onset keratitis were associated with contact lens wear. Five of these patients had transverse incisions or greater than eight radial cuts. All six patients regained visual acuity of 20/40 or better. Two additional cases of early-onset and six cases of late-onset keratitis with many features similar to these cases have been reported previously.

Antigenic heterogeneity of renal endothelium

We have identified several antibodies which in immunocytochemical experiments reveal antigenic heterogeneity in renal vascular endothelium. In the renal vascular endothelium, blood group antigen H type II was carried in a sialylated form on an endogalactosidase resistant molecule. The glomerular reactivity was sensitive to digestion by this enzyme. Monoclonal antibodies of the CD 39, CD 14, and CD 11C leucocyte differentiation clusters bind to renal vascular endothelium but not to glomerular capillaries. In fetal kidney, the developing glomerular endothelium has the same phenotype as the remainder of the vascular tree with respect to these markers. There are therefore antigenic differences among renal endothelial cells and these arise during renal organogenesis.

Fulminant hepatic failure

Most cases of fulminant hepatic failure (FHF) are related to viral hepatitis or to drugs and toxins. With improvement in supportive intensive care, the overall survival has increased, but specific forms of temporary hepatic support pending hepatic regeneration have been disappointing. With the widespread availability of orthotopic liver transplantation, this has become a viable option for those patients with FHF who are unlikely to survive with conservative treatment, although patient selection and timing of transplantation still presents a clinical dilemma.

The devil or the sea? Transfer regs create a dilemma

With the advent of strict federal regulations, physicians considering whether to transfer patients seeking emergency treatment can find themselves between the devil and the deep blue sea. Do they spar with the diabolical guidelines and follow their best medical instincts and training? Or, do they abandon their instincts and training and depend on a regulatory life preserver to keep their heads above water? Victoria obstetrician/gynecologist Michael L. Burditt, MD, embodies this unenviable dilemma. After he ordered the transfer of an indigent pregnant patient from Victoria to Galveston, the federal government accused him of knowingly making an inappropriate decision to transfer. Dr Burditt appealed the government's ruling, and the confrontation eventually led him to the courtroom in the nation's first test of the 1986 law that prohibits patient "dumping." Dr Burditt came close to settling the case, but, with assistance from the Texas Medical Association, the Victoria-Goliad-Jackson County Medical Society, and the American Medical Association, he's still in the fight. At the heart of the case is the issue of guaranteeing physicians due process in the review system for transfers. (Due process, the physician's right to be heard before fines or sanctions are imposed, is guaranteed in Medicare's quality review procedures, but not in transfer reviews). The case is in the hands of an administrative law judge, who is expected to hand down a decision in June. This article examines Dr Burditt's case in light of developments that brought hospital transfers under federal scrutiny.

Identification of peanut agglutinin binding glycoproteins restricted to Hodgkin's disease-derived cell lines

Peanut agglutinin (PNA) binding glycoproteins from four Hodgkin's disease (HD)-derived cell lines and a variety of cell lines/peripheral blood cells representative of the lymphoid and myeloid lineages were identified by probing nitrocellulose membranes of SDS-PAGE separated NP40 solubilized cellular glycoproteins with [125I]-labelled PNA. The two Hodgkin's cell lines Ho and L428 demonstrated the most heterogeneous glycoprotein profiles each expressing 15 PNA binding glycoproteins, respectively. The two remaining Hodgkin's lines Co and L591 expressed only four glycoproteins each and these were all also commonly expressed by Ho and L428. Comparative analysis with all other cell types studied revealed the expression of five glycoproteins restricted to Ho (gp42, gp40, gp38, gp24 and gp22) and six restricted to L428 (gp180, gp75, gp40, gp38, gp24 and gp22). Four of these, gp40, gp38, gp24 and gp22 were commonly expressed by both Ho and L428. Of cell lines of myeloid lineage studied only the erythroleukemia cell line K562 expressed detectable glycoproteins also expressed by some of the Hodgkin's cell lines (gp110, gp96, gp50 and gp45). Only one glycoprotein, gp20 expressed by Ho was also commonly expressed by normal peripheral blood granulocytes. This limited study has thus succeeded in demonstrating for the range of cell types studied, that some glycoproteins with terminal D-galactose beta (1----3) N-acetyl galactosamine oligosaccharide sequences are apparently restricted to two of the HD cell lines. Moreover, the heterogeneous glycoprotein profiles obtained for the HD cell lines Ho and L428 suggests that galactosylation processes in these two cell lines is aberrant.

Is the Hodgkin cell a T- or B-lymphocyte? Recent evidence from geno- and immunophenotypic analysis and in-vitro cell lines

The cellular derivation of Hodgkin (H) and Reed-Sternberg (RS) cells remains a controversial issue. A large body of conflicting results in the literature led to a variety of discordant speculations. The application of immunophenotyping, molecular biology and tissue culture provided additional means for investigations on the nature of H-RS cells. Using immunoenzymatic staining with monoclonal antibodies (McAbs) at the single cell level, H-RS cells from many, albeit not all cases, were shown to be positive for T- and/or B-cell markers; none of the cases were labelled by anti-myeloid or anti-monocyte/macrophage McAbs. A common feature of the otherwise heterogeneous immunoprofile is the expression of activation and proliferation antigens besides HLA-DR class II antigen and the X-hapten. Clonal rearrangements of T-cell receptor or immunoglobulin chain genes were found in 22 per cent of cases. The low frequency of positive samples might be due to the commonly low number of H-RS cells in the total population which can lay below the threshold of sensitivity for genotypic analysis. Several cell lines containing H-RS-like cells have been established. These cell lines have geno- and immunophenotypic characteristics of T- or B-cells, but lack properties of myeloid cells or monocytes/macrophages. In the absence of evidence in support of an origin from monocytes/macrophages or other non-lymphoid cells the here reviewed data, which are based on geno- and immunophenotypic analysis of fresh and cultured H-RS cells, provide a lead to a lymphoid derivation of H-RS cells.

Acute hydrops in pellucid marginal corneal degeneration

Three patients had pellucid marginal corneal degeneration complicated by corneal edema. The corneal edema appeared to be a result of a break or detachment of Descemet's membrane as a result of increasing corneal ectasia. The disruption in Descemet's membrane began just above the inferior, crescent-shaped area of stromal thinning. Therapeutic modalities initially included hypertonic solution to determine whether corneal edema would resolve spontaneously, apparently by endothelial migration with healing over the break in Descemet's membrane. One patient required thermokeratoplasty and another penetrating keratoplasty for persistent stromal edema. Acute hydrops can occur with pellucid marginal corneal degeneration by a pathogenesis similar to other noninflammatory corneal thinning disorders such as keratoconus.

Help wanted: nurses, nurses, nurses!

Want ads with a desperate tone are filling classified advertising sections of newspapers throughout Texas. The state's shortage of nurses is there for all to see, spelled out in big, bold type. "Take a new direction." "Built for the future. Designed for your career.... Take your career into the next century." Hospitals lure nurses with a choice of working hours, subsidized transportation, tuition reimbursement, educational programs, bonus programs, relocation assistance, temporary housing, and more. Still, the problem persists. In the worst case scenario, it has reached crisis proportions. In May 1988, in a highly publicized move prompted by the shortage, one Texas hospital was turning away ambulance-borne patients from its emergency room and came to the brink of losing Medicare and Medicaid funding. The Texas Legislature's Special Committee on Post-Secondary Medical, Dental, and Allied Health Education has documented the administrator's problem. According to the committee's report, issued in December 1988, "There is one Texas registered nurse for every 418 people in the general population; the national average is one RN for every 200 people." Physicians, nurses, and hospital administrators are vitally concerned with the situation's serious implications for the quality of patient care, and all three groups are searching for solutions. The following article explores the history, causes, and proposed solutions for the problem.

Correlation between histology and immunophenotype in a series of 322 cases of non-Hodgkin's lymphoma

The non-Hodgkin's lymphomas (NHL) are a heterogeneous group of lymphoid neoplasms displaying a wide variation in cell morphology, histological patterns, immunological phenotype and prognosis. In this paper we compare the results of phenotypic investigation of 322 tissue biopsies with the histology based on the Kiel classification. Immunological analysis revealed that 81 per cent of these tumours were of B cell origin, 12 per cent of T cell origin and the remaining 7 per cent could not be characterized as representing either cell lineage. This last group included a number of cases which had received a histological diagnosis of true histiocytic lymphoma. The original morphological diagnosis, based on routine haematoxylin and eosion sections correlated with the immunologically determined phenotype in 86 and 93 per cent of the T- and B-cell cases respectively. The B cell tumours were phenotypically heterogenous with respect to immunoglobulin (Ig) heavy chain and B lymphocyte subset marker expression. IgG was most often found associated with NHL of cb/cc histology and a small subgroup of lymphocytic NHL. IgA expression was uncommon and occurred in combination with IgD and G in three cases and alone in two cases of NHL. The most common immunoglobulin isotype expressed was IgM this isotype occurred with IgD most often in lymphocytic and centrocytic NHL and less often in tumours of cb/cc histology. Whilst greater than 90 per cent of the lymphocytic NHLs expressed the CD5 antigen, between 20 and 75 per cent of B-cell tumours of other histologies also expressed this epitope. The CD10 antigen and the epitope recognized by the monoclonal reagent FMC7 were widely distributed on tumour cells from all histologies. TdT expression commonly regarded as a marker for immature cells was found in one case of follicle centre cell lymphoma. All cases of T cell NHL displayed marked heterogeneity for both pan T and T subset antigens which is significant in terms of the routine diagnosis of T NHL and with regard to the rational classification of node based T NHL. Unlike resting peripheral blood T cells, MHC class II, OKT 10 and CD25 epitopes were expressed reflecting activation of tumour populations.(ABSTRACT TRUNCATED AT 400 WORDS)

Immunoglobulin and T-cell receptor gene rearrangements in Hodgkin's disease and Ki-1-positive anaplastic large cell lymphoma: dissociation between phenotype and genotype

We have determined the tumor cell immunophenotype and the rearrangement configuration of immunoglobulin and T-cell receptor genes in 39 cases of Hodgkin's disease (HD), six HD-derived cell lines and 22 cases of Ki-1-positive anaplastic large cell lymphomas (Ki-1-ALC). Rearrangements were observed in 11/39 HD cases, 15/22 Ki-1-ALC, and all cell lines. Epstein-Barr virus DNA was found in five HD cases, one cell line, and one Ki-1-ALC. Both HD and Ki-1-ALC frequently displayed a dissociated genotypic and phenotypic maturation status, i.e. an immature genotype in association with late activation markers. We postulate that the tumor cells in many cases of HD and some cases of Ki-1-ALC may be derived from immature lymphoid cells by a transformation process that superimposes characteristics of mature activated lymphocytes on these cells.

Fungal keratitis in contact lens wearers

In a retrospective review from 1972 through 1987 of patients with microbial keratitis, fungal infection occurred in four (4%) of 90 cosmetic or aphakic contact lens wearers and in four (27%) of 15 patients using a therapeutic soft contact lens. Predisposing factors included improper lens care by the refractive lens wearers and a chronic epithelial defect with topical corticosteroid use among the therapeutic lens wearers. The responsible organisms in the refractive lens group were Fusarium solani (two patients) and Cephalosporium and Paecilomyces (one patient each), and in the therapeutic lens group Candida (three patients) and Aspergillus (one patient). Filamentous fungi were more likely to be associated with cosmetic or aphakic lens wear, whereas yeasts were more frequently found with therapeutic lens use.