Successful nonsibling bone marrow transplantation in severe combined immunodeficiency

Severe combined immunodeficiency (SCID) was diagnosed in a girl immediately after birth; her older brother had SCID and was successfully reconstituted by bone marrow transplantation from his uncle. She was isolated in a laminar air flow bench and decontaminated. The father differed by one HLA-A antigen but was HLA-Dw2 homozygous like the patient; his lymphocytes showed a slight response to the patient's cells in mixed lymphocyte culture (MLC). At the age of 2 1/2 months and again at 5 months, she was given a bone marrow transplant from the father. During the entire course the patient had no infections, and apart from a transient eosinophilia she had no signs of graft-versus-host reaction. Immunological reconstitution was nearly complete at 9 months of age, when she was recontaminated. One year later plasma immunoglobulin concentrations are in the low normal range (IgG and IgM) or decreased (IgA); tests of cell-mediated immunity are normal. Apart from slight upper respiratory infections, the patient has been healthy. Physical and psychological development have been normal.

Severe aplastic anaemia with complete autologous marrow reconstitution following treatment with antithymocyte globulin. Report of a case and review of the literature

In a patient with end-stage acquired aplastic anaemia, unsuccessful treatment with splenectomy, prednisone, pyridoxine and anabolic steroid was followed by administration of antithymocyte globulin (ATG). This therapy soon led to a gradual improvement and after 12 months, complete remission was obtained. The possible mechanism of action of ATG and the general principles of treatment are discussed.

Treatment of the aged mentally ill: further unmasking of the effects of a diagnosis of chronic brain syndrome

Six elderly persons with a diagnosis of "chronic brain syndrome," who resided in a home for the aged, received bi-weekly sensory stimulation and group therapy for three months. This pilot project demonstrated that the symptoms used to classify "chronic brain syndrome" are flexible and can improve with such treatment. Not only does this cast doubt on the accuracy of this diagnosis are used, but it provides further evidence of the utility of such treatment for this type of patient. Since group therapy and sensory stimulation over a relatively short period can result in clinical and testable improvement, the diagnosis of "chronic brain syndrome" in the elderly should not be allowed to preclude the provision of appropriate psychiatric therapy.

Incidence of mental illness in the aged: unmasking the effects of a diagnosis of chronic brain syndrome

A combination of three psychiatric screening tests was used to uncover the extent of affective-psychotic symptoms, the indications of "chronic brain syndrome," and the perceptual limitations among two selected populations of elderly persons. It was found that 25% of 48 residents in a home for the aged, and 9% of 45 members in a social club, had four or more affective-psychotic complaints. In the former group, 75% had symptoms of moderate to severe "chronic brain syndrome," versus 7% in the latter group. Among the residents of the home, 10% had serious disturbances as measured by all three tests. The significant number of affective-psychotic symptoms found in this population with extensive manifestations classifiable as "chronic brain syndrome" indicates that this diagnosis should not be allowed to preclude regular psychiatric evaluation of these elderly patients. When a specific diagnosis is established, available treatment modalities should be provided as needed.

Karyotypes in infectious mononucleosis

Using a trypsin-Giemsa banding procedure, chromosome analysis was performed on blood from 21 consecutive patients hospitalized for infectious mononucleosis. Mitoses were harvested after 2 and 24 h in vitro incubation without PHA and after 48 h with PHA. No abnormalities were seen.