A proposed criteria for diagnosis of systemic lupus erythematosus used in Veterans General Hospital

An eight-point diagnostic criteria for SLE was proposed and evaluated at the Veterans General Hospital (VGH), Taipei. It consists of 8 points and 12 items, 3 points being required for an accurate diagnosis. All of 94 cases of SLE whether they could or could not be diagnosed with the ARA criteria fulfilled 3 or more points of the VGH criteria. None of the 17 cases of rheumatoid arthritis fulfilled 3 or more points of the VGH criteria.

[A follow-up survey on airborne fungal spore counts in the Taipei area (author's transl)]

The airborne fungal spore count was determined daily from 1975 to 1979 at six different stations in the Taipei Area. The count per year was 5656/cm2 in average. More than 75% of the spores could be identified microscopically and classified into 14 genera. The spore season was found from May to October in the Taipei Area. The count per month during this period reached 632/cm2. Only 311/cm2/month was found from November to April. Data collected from the six stations differed slghtly, the count was low in the city (4853/cm2/year) and high in the suburbs (8801/cm2/year). The counts were very close in the first four years (4325-4677/cm2/year), but dropped dramatically in the fifth year (2017/cm2/year). The spore count was influenced by temperature, humidity, rainfall as well as wind velocity. Among the 14 genera found by the slide method, six could not be isolated by the plate culture method. Other 24 genera isolated with plates did not appear on the slides.

[Factors contributory to suppressive effect of human suppressor T cells in vitro (author's transl)]

Factors affecting induction and expression of human blood suppressor cells including the concentration of concanavalin A (Con A), the exposure time of lymphocytes to Con A, and the ratio of suppressor cells and responder cells, were studied in Con A induced lymphocyte transformation by both the tube method and the microplate method. The most optimal concentration of Con A for suppressor cell induction was found to be 40 micrograms/ml (tube method) or 40 micrograms/well (microplate method). However, a range from 10 micrograms to 40 micrograms/ml or 10 micrograms to 80 micrograms/well was almost equally effective. At least 16 hr of incubation with Con A was required for generation of suppressor cells, but 2 hr incubation with Con A followed by 22 hr without Con A was also effective. As far as the effect of the ratio of suppressor cells to responder cells on the expression of suppressive effect is concerned, 1:1 was enough but 2:1 was more effective. There was no marked difference in results obtained by both methods. However, the microplate method is simple, quick and economic and, therefore, is highly recommended in our country.

Subnormal inhibition of active E rosette formation by isoproterenol in bronchial asthma

Three different groups of patients were studied: group A was on active attacks of asthma with bronchodilator therapy; group B was also on active attacks of asthma but free of any treatment; and group C was of remissive asthma due to hyposensitization, and free of any other treatment. Active E rosette forming populations of all the three groups showed much less reduction by beta-adrenergic agonist isoproterenol as comparing to normal controls, but had equal degrees of inhibition by cAMP and theophilline to normal subjects. Dysfunction of beta-adrenergic receptors in bronchial asthma, as presented in this study, was in accordance with Szentivanyi's theory of beta-adrenergic blockage. Therapy with sympathomimetic bronchodilators might have desensitizing effect on beta-adrenergic receptors. Symptom-relieving hyposensitization could'nt restore the beta-receptor functions in asthmatic patients. The significance of beta-receptor dysfunction in bronchial asthma was discussed.

The granulomatous response of leprosy patients to lepromin and killed BCG

The volunteers studied included 6 tuberculoid and 11 lepromatous leprosy patients (Ridley and Jopling). Each received intradermally 0.1 ml of lepromin (Wade method) and 0.1 ml of autoclaved BCG (grown on Dubos medium) at 2 separate sites on the left upper arm. Observations were made at weekly intervals, and biopsy specimens were taken at the fourth wk. Within 3 to 4 wk all 6 tuberculoid patients responded to lepromin with typical granulomas (5 of which measured 5 mm or more in diameter) composed of epithelioid cells, lymphocytes and giant cells. In contrast, 8 of the 11 lepromatous patients remained negative; the other 3 developed tiny papules less than 3 mm in diameter which disappeared after 2 wk. Biopsy specimens taken from injection sities at the fourth wk showed essentially normal histology. All 1 patients developed typical granulomas to heat-killed BCG (non were less than 5 mm in diameter and most were larger) consisting of epithelioid cells, many lymphocytes and a few giant cells. The reaction in tuberculoid leprosy was stronger than that in lepromatous leprosy and the reaction to BCG in tuberculoid leprosy was stronger than that to lepromin, but the differences were not very remarkable.

[Tissue typing of blood lymphocytes in normal Chinese and diseases (author's transl)]

The histocompatibility antigens were determined in 170 normal Chinese by a modified micro-lymphocytotoxicity test of Terasaki using 26 typing sera obtained from Behring Laboratories and Stanford University, and the data were compared with those obtained from 36 systemic lupus erythematosus, 30 rheumatoid arthritis, 17 ankylosing spondylitis as well as 45 leprosy patients. In normal individuals HLA-A2,A11 and A9 were dominant in locus A, the frequency were 42.35%, 41.76% and 32.35% respectively. HLA-Bw17, B13 and B5 were dominant in locus B, the frequency were 55.29%, 19.41% and 14.70% respectively. In systemic lupus erythematosus, the frequency of B8, Bw38 and A3 were slightly higher than normal (relative risk > 2); the frequency of Bw21 and B7 were little lower (risk of Bw21 < 0.5, frequency of B7 > 5% in normals but none in patients). In rheumatoid arthritis, the frequency of A28 and A10 (Aw25+26) were slightly lower than normal (risk < 0.5). In ankylosing spondylitis, the frequency of B27 was extremely high (risk = 44.92), Aw24 was also rather high (risk > 2); the frequency of B5, Bw35 and A10 (Aw25+26) was low (risk < 0.5), Bw15 and Bw21 > 5% in normals but none in patients. In leprosy, the frequency of B18 was relatively high (risk > 2); A3, Aw30+31+32, B27 and Bw35 were somewhat low (risk < 0.5). Because of the small sample size, however, the differences were not significant by Chi square analysis except the high frequency of B27 in ankylosing spondylitis (corrected P < 0.001).

Conversion of reactions to leprolin and lepromin in patients with lepromatous leprosy by the transfer factor

Conversion of leprolin and early lepromin reactions was achieved by two injections of transfer factor made of lymphocytes from lepromin-positive tuberculoid leprosy patients. However, the late reaction to lepromin remained unchanged. The importance of the degree of sensitivity of the cell donor was demonstrated, and a booster dose was also found to be useful. The feasibility of using transfer factor in treatment of lepromatous leprosy is briefly discussed.

[The value of serum salicylate determination in patients with rheumatoid arthritis (author's transl)]

Thirty-one patients with rheumatoid arthritis in the Veterans General Hospital from July 1978 to June 1979 were treated with acetylsalicylic acid. The serum salicylate level was determined twice a week. The dose of acetylsalicylic acid was adjusted to keep the serum salicylate level around 15-30 mg%. All patients were started with an initial dose of 65 mg/kg/day. The serum salicylate levels at the 4th day varied greatly from 5.6 to 29.5 mg%. Tinnitus was noted in 24 patients. It occurred when the serum salicylate level reached 28.41 +/- 1.84 mg%. Abnormal liver function was noted in 19.35% (6/31) patients during treatment. It returned to normal after withdrawal of acetylsalicylic acid in 3 cases, after decrease of the dosage in 2 cases and on the same dosage in 1 case. Patients with positive FANA and RF were more prone to develop abnormal liver function during treatment. Monitoring of serum salicylate level may decrease the incidence of hepatic toxicity and maintain the dosage of acetylsalicylic acid in optimal range.

The effect of infant death on subsequent fertility in Korea and the role of family planning

This paper studies the effect of infant death on subsequent fertility in a developing country, examining spacing of children and additional births following the survival or death of the preceding infant. The material is provided by the 1971 National Fertility Survey of Korea, 23,635 retrospective birth records of 6,285 women. The findings suggest that prior to the introduction of a national family planning program, the influence of infant death was limited to the biological effect resulting from a shortened lactational period. Since fertility regulation methods have been made available throughout the country, motivational effects to replace the lost child appeared to emerge. The proportion of excess births attributable to infant deaths has increased in recent years. However, because of the lowered infant mortality, the overall impact of infant death on the national fertility level appears to be small.

Factors contributing to impairment of the mixed lymphocyte reaction in leprosy

Whereas the mixed lymphocyte reaction was essentially normal in inactive lepromatous leprosy and tuberculoid leprosy, it was severely impaired in active lepromatous leprosy. The impairment was found to be contributed by certain unknown factors in their plasma and subnormal reactivity of their T lymphocytes. The plasma derived from active lepromatous leprosy patients depressed the reaction of normal cells and normal plasma enhanced the reaction of active lepromatous lymphocytes. The cellular factor was studied by using a one-way reaction in which one of the two lymphocyte preparations was inactivated with mitomycin C. The impairment of blastogenesis of active lepromatous lymphocytes was partially reversed by substituting inactivated normal cells for similarly treated leprous cells, and conversely the response of normal allogeneic lymphocytes was depressed by substituting inactivated leprous lymphocytes as the stimulator cells.

[Factors contributing to the impairment of cellular immunity in cancer patients (author's transl)]

Factors contributing to the impairment of cell-mediated immunity in cancer patients were studied. Normal plasma enhanced the PHA-induced transformation of cancer lymphocytes. Cancer plasma suppressed the transformation of normal lymphocytes. The plasma factor(s), which might play an important role in the impairment of cell-mediated immunity in cancer, was further characterized to be heat-labile, being completely destroyed at 56 degrees C for 30 minutes. It was present on the surface of T lymphocytes, and was partially removable by digestion with 0.05% Bacto-trypsin. Moreover, the percentage of T cells in the peripheral blood of cancer patients was lower than that of normal as determined by the anti-human thymocyte serum cytotoxicity test and the spontaneous rosette forming test.

Pyocyanine production by Pseudomonas aeruginosa

Dextrose enhanced the growth of P. aeruginosa but suppressed the biosynthesis of pyocyanine. The preformed pigment could be released from dead cells. Pigmentation was not correlated directly with number of viable organisms in the culture. High concentration of maltose likewise inhibited pyocyanine production. Maltose contained in medium used for pyocyanine production by P. aeruginosa should be kept in low concentration or omitted.

[Lymphokine production in the cell-mediated immune response (author's transl)]

In response to tuberculin, lymphocytes derived from BCG-sensitized guinea pigs elaborated soluble materials capable of inducing some reactions in vitro which correlated with the cell-mediated immune response in vivo. The lymphokine activity of these soluble materials was demonstrated by the following biological effects: macrophage migration inhibition, macrophage aggregation, cytotoxicity to HeLa cells and skin reaction.

[Cytotoxic effect of antihuman thymocyte serum on T lymphocytes]

The rabbit human thymocyte serum had a selective cytotoxicity on human T lymphocytes. In the presence of guinea pig complement, 23.8% of the otal blood leukocytes were killed by the heterologus antiserum and only 4.2 % were killed by normal rabbit serum. On average 28.2% of the leukocyte preparation obtained by dextran sedmentation were lymphocytes. According to the above figures, 72.3% of the circulating lymphocytes were identified as T cells. The data were comparable to those obtained from other conventional methods used in laboratory animals. The cytotoxicity test was found to be a reliable technique for identifying human T lymphocytes.