Modulation of suppressor mechanisms in allergic contact dermatitis: 2. Inhibition of suppressor T-lymphocytes by Corynebacterium parvum

Pretreatment of BALB/c mice with Corynebacterium parvum inhibited the induction of tolerance to the contact sensitizing agent 2,4-dinitrofluorobenzene induced by intravenous injection of DNBSO3. The suppressive effect on tolerance induction has further been analyzed by adoptive transfer experiments. Injection of C. parvum intraperitoneally (0.7-2.8 mg/mouse) before injection of the tolergen inhibited the generation of T-suppressor cells as shown by transfer of spleen cells from the tolerized donor to naive recipients. Pretreatment of the recipients of the suppressor T-cells from tolerized animals with C. parvum also inhibited the function of these cells in the recipient animals. Time-kinetic experiments suggested that more than one mechanism appeared to be responsible for the tolerance induced by DNBSO3; C. parvum (probably via activated macrophages) suppressed tolerance which is mediated by T-suppressor lymphocytes. These results suggest that T-suppressor lymphocytes may--similarly as T-helper cells--be modulated by an activated monocytic-phagocytic system.

Duodenal ulcer, suicide, psychopathology and alcoholism

The incidence of suicide in a consecutive series of 1,000 patients, who underwent Billroth II resection for duodenal ulcer, has been estimated. After an observation period of 21-29 years 13.7% of those who had died had committed suicide. The psychiatric morbidity in this ulcer group was found to be very high. Among the psychiatric diseases alcoholism was dominating, but also non-psychotic conditions such as neurosis and psychopathy were frequent. Fifty per cent of the persons who had committed suicide were alcoholics, and the alcohol abuse seemed to develop after surgery. Gastric resection for duodenal ulcer may have pathogenetic importance in the development of alcoholism, which is known as a predictor of suicide. The importance of considering psychiatric disturbances in the postoperative follow-up is stressed.

Modulation of suppressor mechanisms in allergic contact dermatitis: 1. Effect of C. parvum on the induction phase of contact allergy

The effect of a pretreatment with corynebacterium parvum (C. parvum) on contact allergy in BALB/c mice was studied. Mice sensitized with 50 microliter (supraoptimal dose) 2.4-dinitrofluorobenzene (DNFB, 0.5%) showed a suppressed response as measured by ear swelling after painting the right ear with 0.3% DNFB in comparison to an allergic response obtained with an optimal sensitization dose (15 microliter DNFB 0.5%). By transfer of spleen cells from donors sensitized with a supraoptimal or an optimal dose to recipients either challenged ro sensitized shortly afterwards with DNFB it could be shown that less functionally active immune T-lymphocytes of the delayed hypersensitivity type and significantly more suppressor T-cells were induced in supraoptimally sensitized mice in comparison to the optimally sensitized animals. Intraperitoneal injection of C. parvum (2.8 mg/mouse) one week before sensitization enhanced the contact allergic response in mice sensitized with a supraoptimal dose of DNFB, with little effect on the response in optimally sensitized animals. Further analysis of this enhancement in transfer experiments showed that C, parvum selectively suppressed the generation and/or functional expression of T-suppressor cells and, probably by this mechanism, increased the number of functionally active T-immune lymphocytes. It is proposed that possibly by activation of the immune system C. parvum will suppress suppressor cells in contact allergy and by this mechanism might facilitate sensitization to the contact allergen.

Deconvolution analysis of 99mTc-methylene diphosphonate kinetics in metabolic bone disease

The kinetics of 99mTc-methylene diphosphonate (MDP) and 47Ca were studied in three patients with osteoporosis, three patients with hyperparathyroidism, and two patients with osteomalacia. The activities of 99mTc-MDP were recorded in the lumbar spine, paravertebral soft tissues, and in venous blood samples for 1 h after injection. The results were submitted to deconvolution analysis to determine regional bone accumulation rates. 47Ca kinetics were analysed by a linear two-compartment model quantitating short-term mineral exchange, exchangeable bone calcium, and calcium accretion. The 99mTc-MDP accumulation rates were small in osteoporosis, greater in hyperparathyroidism, and greatest in osteomalacia. No correlations were obtained between 99mTc-MDP bone accumulation rates and the results of 47Ca kinetics. However, there was a significant relationship between the level of serum alkaline phosphatase and bone accumulation rates (R = 0.71, P less than 0.025). As a result deconvolution analysis of regional 99mTc-MDP kinetics in dynamic bone scans might be useful to quantitate osseous tracer accumulation in metabolic bone disease. The lack of correlation between the results of 99mTc-MDP kinetics and 47Ca kinetics might suggest a preferential binding of 99mTc-MDP to the organic matrix of the bone, as has been suggested by other authors on the basis of experimental and clinical investigations.

[Intermittent hydronephrosis]

An intermittent hydronephrosis was observed in a 40-year old patient. The disease pattern is due to an incongruity between the formation of urine and the transport capacity in the ureteropelvic junction. The latent impediment of flow becomes manifest with increased urine secretion. Irreversible renal damage can be the result of the repeatedly occurring hydronephrotic crises.

Eosinophilic pustulosis with pemphigus-like antibody

A 75-year-old male with eosinophilic pustulosis Ofuji complicated by superinfection with Pseudomonas aeruginosa and Proteus mirabilis is described. This is the first case of eosinophilic pustulosis with an antiepidermal antibody. This antibody was directed against the intercellular substance of the lower epidermis and it was detected by direct immunofluorescence in the patient's normal and lesional skin. As revealed by indirect immunofluorescence the patient's serum reacted with intercellular substance of human lower epidermis but not with guinea pig esophagus. Possibly the detected autoantibody is not characteristic for eosinophilic pustulosis Ofuji but rather an accompanying feature of this case similar to the antiepidermal antibodies found in patients with drug reactions and burns.

Effect of Vibrio cholerae neuraminidase on the mitogen response of T lymphocytes. I. Enhancement of macrophage T-lymphocyte cooperation in concanavalin-A-induced lymphocyte activation

Vibrio cholerae neuraminidase (VCN) enhances the immune response of lymphocytes in various systems, such as antigen- and mitogen-induced blastogenesis, mixed lymphocyte culture (MLC) and tumor-cell response. We used macrophage-depleted and reconstituted murine lymph-node T-cells to investigate the effect of VCN on macrophage-T-lymphocyte co-operation in Con-A-induced lymphocyte activation. In unfractionated lymph-node cells VCN enhanced the Con-A-induced lymphocyte activation as measured by 3H-thymidine (3H-dThd) incorporation. Removing macrophages from the cells resulted in a significantly diminished response. In addition the enhancing effect of VCN was greatly reduced. Reconstitution of the lymphocyte cultures with macrophages in increasing numbers and from various sources rstored the lymphocyte response and the enhancing effect of VCN. VCN proved to be most efficient in cultures reconstituted with normal peritoneal macrophages. Some effect was also observed using bone-marrow-derived (BM) macrophages. However, higher numbers of normal PE macrophages in the presence of VCN inhibited lymphocyte activation, and inhibition by thioglycollate-broth-induced macrophages was considerably increased by VCN. These results suggest that VCN acts by increasing the efficiency of macrophage-T lymphocyte interaction.

Data structures for medical documentation

The paper describes a method to construct data base structures for patient-related documentation. The data base structures are formed over suitable classes. Functional dependences are only investigated regarding these classes. Structuring items by means of arbitrary relations are possible, too. The results are well-formed flexible data structures which can serve as a common functional basis for many documentation projects.

Influence of various macrophage populations on Con-A induced T-cell proliferation

The effect of different macrophage populations and supernatants derived from these macrophages on Con-A induced lymphocyte activation in macrophage depleted lymph node cells has been investigated. All macrophage populations tested were able to restore the lymphocytic response to Con A. Macrophages of different origin and differently elicited were heterogeneous with respect to the lymphocyte-activating and inhibitory activity. Bone marrow macrophages, cultured from 6 to 14 days or obtained from animals stimulated in vivo by BCG were quite inefficient in restoring the lymphocyte proliferation and showed no inhibitory activity up to the percentage per culture tested. Normal or BCG or proteose-peptone induced peritoneal macrophages were quite efficient stimulators, thioglycollate-broth elicited peritoneal macrophages were less efficient in this respect, but very efficient inhibitors. This is reflected to some degree in the supernatants derived from these macrophages which contain T-lymphocyte activating factor (TAF) and inhibitory factors, most likely low molecular weight inhibitory factors. Bone-marrow derived macrophages do not produce either factors in amounts measurable in this assay. These results demonstrate that macrophages, depending on their origin and possibly influenced by external activation signals, are heterogeneous with respect to their function in T-cell proliferation.

Bone calcium exchange in primary hyperparathyroidism as measured by 47calcium kinetics

A 2-compartmental analysis of 47Ca kinetics was carried out in 21 patients with primary hyperparathyroidism (pHPT) and 7 healthy control subjects. The results were compared with serum concentrations of calcium, inorganic phosphorus, alkaline phosphatase, and immunoreactive parathyroid hormone (iPTH). The well known increase in exchangeable calcium was found to be not uniform in its subcompartments and with a marked predominance of the osseous fraction. The most important result was the increase of calcium efflux from osseous into extraosseous exchangeable calcium in agreement with the results of Talmage et al. studying PTH actions on calcium flux rates between blood and bone in rats. The increased calcium efflux in pHPT was the only kinetic parameter correlated with serum iPTH. Neither increased calcium accretion indicating high bone turnover, nor serum calcium concentrations and exchangeable calcium fractions correlated with serum iPTH. These results lead to the following conclusions: radiocalcium kinetics provides valuable parameters of bone calcium turnover (osseous exchangeable calcium, bone-calcium efflux, and calcium accretion). Calcium efflux from exchangeable bone calcium, determined kinetically, might be related to PTH induced calcium transport from bone fluid compartment to extracellular fluids according to the concept of Talmage 1977.

Darstellung charakteristischer Parameter der Tracerkinetik von Niere und Schilddrüse in Funktionsbildern

Es wird ein Verfahren zur Auswertung von Sequenzszintigrammen beispielhaft für Nieren und Schilddrüse dargestellt. Es beruht darauf, daß aus dem gemessenen zeitlichen Aktivitätsverlauf des Tracers im Blut und im Organ die Reaktion des Organs auf einen zeitlich sehr kurzen (δ-funktionsförmigen) Aktivitätsstoß eines Tracers in das Blut errechnet wird. Der zeitliche Verlauf dieser Antwortfunktion (Response Function) führt zu organspezifischen Parametern wie Aufnahme- und Clearanceraten oder Transitzeiten. Sie werden örtlich für das gesamte Aufnahmefeld der Gamma-Kamera berechnet, als Grau- oder Farbstufen abgebildet und ergeben Funktionsbilder des jeweiligen Parameters. Es werden die apparativen Voraussetzungen für das Verfahren und die Möglichkeit seiner klinischen Anwendung im Vergleich zur konventionellen szintigraphischen Auswertung erörtert.

[Reversible myocardial ischaemia or irreversible myocardial fibrosis? Differentiation by biphasic 201thallium scintigraphy (author's transl)]

The results of biphasic 201thallium (201Tl) scanning were compared with those of coronary arteriography, left ventricular angiogarphy and stress ECG in 56 patients with coronary artery disease and six with no evidence of heart disease. There were 104 201Tl defects, 50 of them reversible. The defects were always located in the area supplied by a critically stenotic coronary artery. Correlation of regional wall motion with 201Tl activity demonstrated that in all forms of abnormal wall motion there was either ischaemia or fibrosis. The resting LV angiogram thus does not make it possible to distinguish between myocardial ischaemia and fibrosis. Taking the LV angiogram as a standard, the rate of false-positive 201Tl scintigrams was 5%, that of false-negative ones 23%. The biphasic 201Tl scintigram was more sensitive than the stress ECG in detecting myocardial ischaemia. It furthermore made it possible to localize the ischaemic (or fibrotic) region within the LV and to estimate its size.

[Short-term localized myocardial ischaemia and its consequences in Prinzmetal angina pectoris (author's transl)]

In a 45-year-old female patient with Prinzmetal angina pectoris coronary angiograms and a 201thallium scintigram were performed during an ergotamine-induced episode of angina. The spontaneous and the ergotamine-induced attacks were characterized by transient ST elevation in the posterior wall ECG leads. The coronary angiogram during the attack showed spasm of the circumflex branch of the left coronary artery. In the 201thallium scintigram a large defect in myocardial thallium uptake was noticed in the posterior wall of the left ventricle. Angina and ECG abnormalities disappeared within 4 minutes. However, the scintigraphic defect disappeared only after 6 hours. The slow recovery of myocardial thallium uptake is thought to represent an alteration of the myocardium after a brief 4 minute interruption of regional coronary arterial blood flow. The diagnostic approach in patients with Prinzmetal angina is discussed.

Effect of Vibrio cholerae neuraminidase on the phagocytosis of E. coli by macrophages in vivo and in vitro

The mechanisms by which Vibrio cholerae neuraminidase VCN acts as an adjuvant is unclear. We have studied the effect of VCN on the phagocyotsis of E. coli 0111 K58 by macrophages in vivo and in vitro. (1) Using and in vivo intraperitoneal clearance test we have shown that prior injection of VCN (50 units/mouse) into the peritoneal cavity of mice enhances the clearance of the bacteria as efficiently as an optimal amount of opsonizing antiserum. We have also shown that the enhancement of intraperitoneal clearance by VCN is due to phagocytosis and intracellular killing of the organisms by macrophages. (2) VCN does not enhance the i.v. clearance of E. coli o111 K58. (3) VCN promotes the attachment of the organisms to and phagocytosis by peritoneal macrophages in vitro. Data are provided which suggest that the promotion of attachment and phagocytosis by VCN cannot be explained by a mere increase of passive absorption of the bacteria to the cell wall.

Stimulatory effect of Vibrio cholerae neuraminidase on the antibody response to various antigens

Vibrio cholerae neuraminidase (VCN) splits off peripheral sialic acids from cell membranes. Treatment of tumour cells with VCN increases their immunogenicity and it has been suggested that VCN may unmask hidden tumour specific antigens. On the other hand, it has been shown that VCN can affect the cell-cell interactions of immune cells in vitro and it seems possible that the enzyme may have a direct effect on the immune response to antigen in vivo.

The present report describes the effect of VCN on the antibody response of mice to SRBC, to antigens which do not contain peripheral neuraminic acid such as certain bacterial vaccines and rubella virus, and to the soluble antigen BSA.

VCN injected i.m. or i.p., but not i.v., together with the antigens increases; (1) the PFC response to SRBC, (2) the antibody response to various bacteria (E. coli, V. cholerae, S. typhimurium), (3) the antibody response to rubella virus, and inhibits tolerance induction by aggregate free BSA.

The optimal dose required to stimulate the antibody response is between 0.5 and 50 units per animal. Possible mechanisms of the adjuvant activity of VCN are discussed.

The effect of intraportal and peripheral infusions of glucagon on insulin and glucose concentrations and glucose tolerance in normal man

The effect of peripheral and intraportal infusions on 0.86 pmol/kg-min-1 of glucagon on plasma glucose, plasma insulin, and glucose tolerance was examined in four normal subjects. Peripheral glucagon concentrations increased by 60--90 pmol/1 during intraportal and 70--180 pmol/1 during peripheral infusions. The infusions caused increases in plasma glucose levels of approximately 1 mmol/1, and in plasma insulin levels of 75--100%, regardless of route of administration. Intravenous glucose tolerance tests carried out during the glucagon infusions showed that glucose tolerance remained within the normal range and was uninfluenced by the route of administration.

Psychopathology in adopted and nonadopted daughters of alcoholics

This report completes a series of studies conducted in Denmark comparing drinking patterns and psychopathology in adopted and nonadopted children of alcoholics. Sons of alcoholics had higher rates of alcoholism than controls, whether raised by their alcoholic parents or by foster parents. They did not have more psychopathology otherwise. Daughters of alcoholics, adopted and nonadopted, had a higher rate of alcoholism than was the expected frequency in the general population, but so did controls in the adopted group; neither group had higher rates of other psychopathology, eg, depression. However, daughters of alcoholics raised by their biological parents had significantly more depression.

Alcoholism and depression in adopted-out daughters of alcoholics

Forty-nine daughters of alcoholics were compared to 47 daughters of nonalcholics; both groups of women (average age, 35 years) had been adopted by nonrelatives early in life. Two women in each group were alcoholic or problem drinkers. Although this is above the expected rate of alcoholism among women, the numbers are too small to draw definite conclusions. Almost all were light drinkers. Daughters of alcoholics had no more depression than controls, indicating that alcoholism in the biological parents did not increase the risk of depression in daughters raised by foster parents. Environmental factors may be important in both alcoholism and depression in women, since both tended to be correlated with psychopathology in the foster parents.

Suppression of growth of Vibrio cholerae in the intestine of immunized mice

In ligated intestinal loops of actively immunized adult mice, growth of V. cholerae 569B was suppressed approximately seven fold when compared to bacterial growth in non-immune animals. Similarly, growth of V. cholerae 569B was reduced in mice immunized with a hybrid vibrio strain, NCV569B-165, which shares only flagella antigens with V. cholerae 569B. Immunofluorescence studies of intestinal loop contents and intestinal sections indicated that, in non-immune mice, vibrios coated the intestinal mucosa. In contrast, the intestinal mucosa of immune animals was almost free of bacteria. The vibrios were found agglutinated in the intestinal lumen contents of immune animals. It was concluded that immunization suppressed the growth of V. cholerae in the intestinal lumen and the possibility that bacterial agglutination mediates this growth suppression is discussed.

Antibody cross-linking as a factor in immunity to cholera in infant mice

Several antibody preparations were tested for their ability to reduce adsorption of Vibrio cholerae to isolated intestinal epithelial cells, and this ability was related to agglutination and protective activity in infant mice. The results demonstrate that (1) the reduction in adsorption of V. cholerae to epithelial cells correlates with the degree of agglutination for given antibody preparation; (2) intact tantibodies protect infant mice from cholera only at concentrations that agglutinate the bacteria; and (3) purified antibodies to flagellar antigens protect infant mice from cholera. These results indicate that cross-linking of bacteria by antibody causes a reduction in the number of organisms adsorbed to the intestinal wall. Thus antibody cross-linking plays an important role in immunity to cholera in infant mice.