Mechanism of resistance of mice to syngeneic methylcholanthrene induced fibrosarcomas

Mice become resistant to challenge with certain fibrosarcomas when bearing a tumor graft (concomitant immunity) or after injection of a low, non-tumorigenic dose of cells (sinecomitant immunity). Resistance to footpad challenge was depressed or abolished by treatment with carrageenan, niridazole or reserpine, or by sublethal irradiation, all of which also depressed delayed-type hypersensitivity (DTH) reactions. Immune lymphocytes initiating tumor-suppressive reactions in the feet of non-immune mice were Thy-1+, Ly-1+, Ly-2- and Ly-3-. Injection of tumor cells into the peritoneal cavities of immune mice specifically elicited an influx of macrophages. There was evidence of macrophage stimulation in tumor-immune mice. In vitro, anti-tumor effector cells lacking individual tumor specificity could be detected among the resident peritoneal cells of tumor-immune mice and among peritoneal exudate cells of non-immune mice. The expression of acquired resistance to some tumors may involve reactions akin to DTH in which a specific reaction triggers an accumulation of nonspecific effectors.

Lead exposure in stained glass workers

To evaluate lead exposure in stained glass workers, we measured blood lead levels in 12 professional glass workers, in 5 hobbyists, and in 4 workers' family members. Professional workers lead levels (mean 20.7 micrograms/dl) were higher than hobbyists' (11.6 micrograms/dl) (P = 0.02) or family members' (11.3 micrograms/dl). Levels increased with years worked, hours worked per week, and percentage of work involving lead. The mean lead concentration in settled dust samples from a stained glass workshop was 11,000 parts per million. Stained glass workers are at increased risk of lead exposure.

The nutritional status of poor children in London

Concern for the growth and development of poor inner-city children prompted an investigation of the relationship of growth to diet, health and sociological background. Between 1973 and 1976, 1000 households in poor areas of London were screened for at-risk children between the ages of one and 12 years. Two hundred and thirty-one children from 112 families qualified for the survey. Of the white children, 21 per cent fell below the 10th percentile for height. The mean energy intake of the shortest children was 72 per cent of the RDI. Half the families spent 4.80 pounds or less per person per week on food, and 33 per cent of the children fell below the 10th percentile for height. A remedial feeding programme may be of benefit to these and similar children.

Extradural lumbar cryptococcosis. Case report

An 85-year-old woman presented with back and leg pain. Plain films showed destruction of the posterior elements of L-5 and myelography demonstrated a large extradural mass at that level. Exploration revealed a huge gelatinous extradural mass with invasion of the paraspinal muscles. Fungal stains showed that the mass consisted of innumerable Cryptococci. There was no evidence of cryptococcal involvement elsewhere.

Macrophages and resistance to tumours: influence of agents affecting macrophages and delayed-type hypersensitivity on resistance to tumours inducing concomitant immunity

Early, specific concomitant immunity to each of four tumours was inhibited by treatment with silica or carrageenan. Late, non-specific concomitant immunity was, with one exception, not inhibited by these agents. Treatment of non-immune mice with silica at certain critical periods before challenge promoted the growth of four of six syngeneic methylcholanthrene-induced tumours in their feet. Treatment with carrageenan was much less effective. Early and late concomitant immunity were inhibited by one or more agents inhibiting delayed-type hypersensitivity: irradiation, niridazole and reserpine. Irradiation of non-immune mice did not effect the growth of tumours in their feet. Treatment of non-immune mice with niridazole or reserpine actually inhibited the growth of some tumours. It is suggested that (a) mice offer some natural resistance to tumour growth, macrophages perhaps being effectors; (b) some tumour isografts may survive only if an inflammatory reaction occurs; (c) mechanisms akin to those of delayed-type hypersensitivity operate in the expression of concomitant immunity; (d) macrophages are important in early, specific concomitant immunity, but perhaps less so in the late non-specific phase.

Macrophages and resistance to tumours. I. Inhibition of delayed-type hypersensitivity reactions by tumour cells and by soluble prducts affecting macrophages

Mice were injected in the footpads with mixtures of an antigen (sheep red blood cells) to which they had developed delayed-type hypersensitivity (DTH) and syngeneic fibrosarcoma cells. DTH reactions were associated with depression of subsequent tumour growth compared with that in control animals. The degree of depression was proportional to the intensity of the reactions. Conversely, the presence of fibrosarcoma cells was associated with depression of the DTH reactions. Serum-free culture supernatants of all tumours tested (mouse, human and rat) depressed DTH reactions in mice, depressive activity being apparent even at dilutions greater than 1:100. Supernatants from cultures of nonmalignant cells had little or no depressive activity. Protein synthesis, but not DNA synthesis, was required for the production of the factor(s) responsible. in vitro, the active supernatants markedly inhibited macrophage migration, either spontaneously or in response to a chemotactic factor, but had much less effect on mitogen-stimulated or unstimulated lymphocyte cultures. The activity was decreased or lost after treatment with proteolytic enzymes, ribonuclease, neuraminidase or hyaluronidase. The supernatants were separated by membrane filtration into fractions of M.W. greater than, or less than 10,000. The fractions differed from each other in their effects in vivo and in vitro. Injection of concentrated supernatants from tumours together with fibrosarcoma cells led to more rapid initial tumour growth.

Effects of rise in food costs on hemoglobin concentrations of early school-age children, 1972-75

In a hematologic survey conducted in 1972, microcythemia in school children was found to be associated with microcythemia in other family members. The association of cultural characteristics of chronic poverty with reduced red cell volume suggested nutritional iron deficiency. A resurvey of families was made in 1975. For 39 children between the ages of 3 and 10 years at the time of both surveys, mean hemoglobin concentration (HGB) decreased from 21.0 g/dl to 10.8 g/dl. Thirteen infants, 6 months to 3 years of age in 1972, in the resurveyed families had mean HGB of 11.5 g/dl as compared to 10.4 g/dl for 9 similarly aged children newly born into the resurvey families. The rate of somatic growth was unchanged during the interval between survey. During the interval between 1972 and 1975, food costs rose nationally, and the purchase of meat products decreased both nationally and (as found in this study) locally. The data suggest that the high cost of foods rich in micronutrients may increase the prevalence of iron deficiency in an impoverished community.

Spectinomycin versus tetracycline for the treatment of gonorrhea

Spectinomycin and tetracycline are alternative drugs to penicillin in the treatment of gonorrhea. To compare the efficacy of these agents and their propensity to select resistant gonococci, we treated 4043 patients randomly with either 2 or 4 g of spectinomycin once or 9 g of oral tetracycline for four days. Minimum cure rate for anogenital gonorrhea was 94 per cent with either drug. Oropharyngeal infection responded poorly to spectinomycin in men, with failure of therapy in six of 11. Postgonococcal urethritis in men was less common after tetracycline than after spectinomycin (P less than 0.005). Spectinomycin failure was not related to drug resistance. Tetracycline failure correlated with resistance (P less than 0.0002); one fifth of the isolates resistant to 1.0 mug per milliter of tetracycline were not eradicated. For several reasons, including the appearance of beta-lactamase-producing gonococci, it is no longer clear that penicillin G is the "drug of choice" for gonorrhea. Spectinomycin and tetracycline are equally acceptable alternatives, each with distinct advantages and disadvantages.

Evaluation of a serologic test for gonorrhea in a low-risk female population

This is a report of an evaluation of a new serologic test for gonorrhea--the Gonosticon Dri-Dot Test--as compared to the standard Thayer-Martin culturing technics in a low-risk female population. The Gonosticon Dri-Dot Test detected only 50% of the gonorrhea cases discovered by the conventional culture method. Furthermore, the serologic technic accounted for 17% false-positives, indicating that a reactive Gonosticon test is not necessarily consistent with active gonococcal infection. The efficacy of the Thayer-Martin culture plate diagnostic procedure for uncomplicated gonorrhea in women was reaffirmed by this study.

Abnormal cervical cytology in the teen-ager: a continuing problem

Abnormal cervical cytology is being discovered in an alarming number of sexually active teen-agers. Over an 18 month period, cytology consistent with mild dysplasia or worse was noted in 188 of 2,655 teen-agers screened. This represents a rate of 70.8 per thousand. Colposcopically directed biopsies in 65 patients revealed 15 cases of severe dysplasia-carcinoma in situ. Cryosurgery was the principle method of treatment and, combined with colposcopy, is a safe and effective means of managing these patients.

Depressive effect of serum from patients with leprosy on mixed lymphocyte reactions. Influence of anti-leprosy treatment

Mixed leucocyte cultures, from two normal donors, were set up in media containing human serum from one of the following sources: (a) a pool of normal group AB donors; (b) Chinese, Malay or Indian patients with untreated leprosy; (c) the same patients after effective anti-leprosy treatment; (d) control Chinese, Malay or Indian subjects. Transformation was estimated by measuring the incorporation of tritiated thymidine in the last 24 hr of a 7-day culture period. Transformation was impaired in sera from treated lepromatous patients, but was less impaired or not impaired at all in sera from treated lepromatous patients. The loss of depressive activity after treatment was more marked in Chinese and Indian than in Malay patients. Transformation was also impaired, though to a lesser extent, in sera from patients with untreated tuberculoid leprosy; it was still impaired in sera from treated tuberculoid patients. There was no evidence of specificity in impairment of mixed lymphocyte reactivity and lymphocytotoxic antibodies appeared to play no role. The incidences of hepatitis B antigen and antibody and of anti-nuclear factor were not notably high.

Non-hodgkin's lymphoma in children. Correlation of CNS disease with initial presentation

The clinical and histopathological findings in 26 children with non-Hodgkin's lymphoma without initial marrow involvement are reviewed. A marked male predominance similar to that observed in previous series was noted. Biopsy material was classified according to the recommendations of Rappaport in 22 cases. All have diffuse lymphomas, and 16 of 22 patients had involvement of the mediastinum as part of their initial presentation. Of these 12, 5 developed lymphomatous involvement of the central nervous system prior to the development of leukemic transformation of the bone marrow. This observation suggests that prophylactic therapy against CNS relapse be considered for children with mediastinal non-Hodgkin's lymphoma, even in the absence of initial marrow involvement.

Effects on serum complement of normal and pre-eclamptic pregnancy and of oral contraceptives

The complement system was studied in normal gestation and puerperium, in pre-eclampsia and in women taking oral contraceptives. In 12 normal pregnancies, CH50 titres, C4, C3, C6 and C7 were increased throughout pregnancy; the serum concentration of C1 inhibitor was decreased in the last 2 quarters but greatly raised after delivery. Oral oestrogen-progestogen contraceptives also raised C3 but in contrast to pregnancy lowered CH50, C6 and C7. The different effects of pregnancy and of oral contraceptives may be due to materno-foetal immune reactions. In 9 patients with pre-eclamplsia, complement levels showed a wider scatter and a significantly higher C3 level than in normal pregnancy. Conversion of C3 to C3i was found in 2 of these patients.

Air-rinsing after dialysis. A mode of transmission of hepatitis virus

During a recent outbreak of hepatitis B among patients receiving dialysis, georgraphic and temporal distribution of cases in the absence of exposure to blood products suggested patient-to-patient transmission. The patients who contracted hepatitis used Kiil dialyzers with a single-pass dialysate system, while patients who used hollow-fiber dialyzers appeared to be protected. Blood was returned to patients after Kiil dialysis by the air-rinse technique with the use of a nonsterile plastic tube attached to a manometer bulb. Laboratory experiments demonstrated that Staphylococcus aureus and poliovirus became widely distributed throughout the Kiil dialyzer when introduced during the rinse phase by contaminating the air-rinse tubing.

Comparison of trimethoprim-sulfamethoxazole with penicillin and tetracycline in the treatment of uncomplicated gonorrhea in women

In a collaborative prospective study 327 women with uncomplicated gonococcal cervicitis or proctitis were randomly assigned to one of four treatment groups: (1) aqueous procaine penicillin G, 4.8 million units IM in one session plus 1.0 g probenecide; (2) tetracycline HCI, 9 g over 4 days; (3) trimethoprim, 80 mg-sulfamethoxazole, 400 mg (TMP-SMX) six tablets once daily for 3 days; (4) TMP-SMX, six tablets wtice on 1 dat at a 6-hour interval. They were re-examined 4 to 8 days and 10 to 15 days after completion of therapy. There was no significant difference between the results of the four regimens in the 4- to 8-day period (P greater than 0.36). However, at the 2-week point the results of TMP-SMX given for 3 days were less effective (P smaller than 0.05) than those obtained by penicillin plus probenecid. There was no significant difference between the results of the other regimens at this latter period.

An automated passive haemagglutination technique suitable for the detection of hepatitis B virus antigen and antibody in blood donors

A method is described for preparing purified hepatitis B antigen (HB Ag) viral antigen without density gradient centrifugation. A method for sensitizing human group O red cells with this preparation is given, together with the technical details of an automated passive haemagglutination technique suitable for the mass screening of blood donors for HB virus and anti-HB antibody.

Phytohaemagglutinin-induced lymphocyte transformation in leprosy

Blood lymphocytes from Malay, Indian and Chinese patients with leprosy, and from race-matched controls, were cultured in the presence of phytohaemagglutinin. Cells from Malays and Indians with lepromatous leprosy and from Malays with tuberculoid leprosy transformed as well as cells from normal controls when cultured in normal (reference) serum. Cells from lepromatous Malays and Indians transformed significantly less well than cells from normal controls when cultured in autologous serum. Normal lymphocytes transformed significantly less well when cultured in serum from lepromatous or tuberculoid Malays or from lepromatous Indians than when cultured in serum from normal controls.

Lymphocytes from lepromatous Chinese transformed significantly more extensively than those from normal Chinese, whether cultured in normal (reference) or autologous serum. The ratio of transformation in autologous serum to transformation in reference serum was significantly depressed for lepromatous Chinese. Although lepromatous Chinese serum, compared with normal Chinese serum, did not depress the response of lymphocytes from one donor, there was evidence of depression when cells from another donor were used. Cells and sera from Chinese patients biopsied for suspected nasopharyngeal carcinoma behaved similarly to those from lepromatous Chinese, and not to those of normal Chinese, whether or not nasopharyngeal carcinoma was found.

Lymphocytes from patients with disease classified as stable, regardless of other criteria, transformed significantly less well in either normal or autologous serum than did cells from patients with downgrading (rapidly progressive) disease. This was true of all races. In the case of Malays and Indians with stable disease the cells also transformed less well than normal cells in reference serum.

The difficulties in design, execution and interpretation of studies of lymphocyte transformation in disease and the importance of humoral factors are emphasized.

Eosinophil granule lysis in vitro induced by soluble antigen-antibody complexes

A simple test system is described, for the demonstration of antigen—antibody reactions capable of causing eosinophil granule lysis in vitro. The antigen preparations used were extracts of the nematode Amplicaecum robertsi and body fluid of Ascaris suum. Antisera were obtained from rats infested with Amplicaecum. Eosinophils were obtained from the peritoneal cavity of normal rats. Centrifugation of the cells to form a cell button was an essential step in the procedure. Lysis of eosinophils occurred with antiserum obtained from the animals between the 12th and 32nd days of infestation with Amplicaecum, and was accompanied by vacuole formation in macrophages and mast cell disruption. The reaction was most pronounced during the 3rd week. Serum from adrenalectomized infested animals caused the most marked changes in eosinophils. Serum from cortisonetreated infested animals failed to cause eosinophil changes.

Attempts at purification of the antigen in Ascaris body fluid resulted in two fractions with marked activity in the test system. The same two fractions were found to form precipitin lines on agarose gel diffusion against rat antiserum.

It is postulated that antigen—antibody complexes soluble in low concentration were responsible for the changes observed in the eosinophils, macrophages and mast cells. One or more labile factors in the serum were found to be necessary for eosinophil granule lysis. The evidence, though incomplete, would favour the suggestion that both labile antibody and complement were necessary.