Lymphoma of the vitreous associated with renal transplantation and immunosuppressive therapy

A renal transplant patient presented with a uveitis unresponsive to high doses of steroids. A pars plana vitrectomy was performed for diagnosis. Light and transmission electron microscopy confirmed the diagnosis of lymphoma of the vitreous. Six percent of the renal transplant recipients develop tumors. This frequency is 100 times greater than the general population. Reticulum cell sarcoma is the predominant type being 350 times more common in renal transplant recipients than in the general population. The patient was taking immunosuppressive drugs which depress the immunologic surveillance. Antigenic neoplastic cells may arise by somatic mutations and may proliferate producing neoplasms with loss of the surveillance mechanism. The case presented illustrates that persons immunosuppressed may develop an eye tumor presenting as uveitis.

Effects of a meal and gut hormones on plasma motilin and duodenal motility in dog

Cyclic increases in the motilin level that coincided with phase III activity of interdigestive myoelectric activity of interdigestive myoelectric activity of the duodenum produced varied plasma motilin concentrations in a fasting dog. Ingestion of a meat meal not only abolished the cyclic increases in motilin concentrations, but also resulted in a significant decrease in the plasma motilin level that was accompanied by phase II-like myoelectric activity of the duodenum, a so-called digestive pattern. Although intravenous gastrin or cholecystokinin octapeptide (CCK-OP) or a combination of gastrin, CCK-OP, and secretin converted the interdigestive myoelectric activity to a digestive pattern, the cyclic increases in plasma motilin levels coulc not be changed by these hormones. This study indicates that a cyclic increase in motilin concentration occurs during the interdigestive period, but not during the digestive period. Instead, a significant decrease occurs. These changes in plasma motilin levels do not appear to be produced by three known gut hormones that are released after ingestion of a meal.

A simplified procedure for preparing innervated gastric pouches

Conventional innervated gastric pouches can be technically difficult to construct, and fistula formation between the pouch and the main stomach cavity is a common problem. This paper describes the method of construction of a small pouch on the lesser curvature (LC pouch) which we have found to be relatively free of these difficulties. Compared with the Pavlov-type pouch, this pouch gives a stronger acid secretory response to a meat meal. Furthermore, the acid secretory response was prompt to insulin hypoglycemia and sham feeding.

Polymorphism of DNA sequence in the beta-globin gene region. Application to prenatal diagnosis of beta 0 thalassemia in Sardinia

We used a restriction endonuclease to analyze the beta-thalassemia gene in Sardinia. When we digested human DNA with the restriction enzyme Bam HI, the beta-globin gene split into a 5' portion contained in a fragment of DNA 1.8 kb in length and a 3' portion in a fragment 9.3 kb in length. In some subjects, a variation in the nucleotide sequence affecting the site recognized by this enzyme on the 3' side of the beta-globin gene resulted in a different fragment, 22 kb in length, which contained the 3' portion of the beta-globin gene. In Sardinians without beta-thalassemia, the frequency of the 9.3-kb fragment was 0.67, and that of the 22-kb fragment was 0.33. In contrast, all the beta 0-thalassemia genes were associated exclusively with the 9.3-kb fragment. Thus, the beta 0-thalassemia lesion in Sardinians apparently arose on a chromosome that had the 9.3-kb Bam HI fragment. This observation can be used in prenatal diagnosis of beta 0-thalassemia in Sardina, since demonstration of the 22.0-kb fragment would indicate the normal beta-globin genotype and exclude the beta 0-thalassemia lesion on that chromosome. (N Engl J Med 302:185-188, 1980).

24-Hour plasma secretin level and pancreatic secretion in dog

Plasma secretin concentrations were determined and duodenal pH was recorded continuously for a period of 24 hours after ingestion of a meal in 3 dogs with gastric cannula and duodenal cannula and in 4 dogs with pancratic fistulae. The mean plasma secretin concentration increased significantly after a meal and it remained elevated for the first 12-hour period (peak at 30 min). Duodenal pH frequently decreased below 4.5 during the first 12-hour postprandial period, but it remained above 5.0 during the second 12 hours. Pancreatic secretion peaked during the first hour of meal ingestion and remained elevated until the end of 12 hours. The increased plasma secretin level in pancreatic fistula dog during the postprandial period was significantly greater than that of duodenal cannula dog, but the trends of increase in the secretin levels were quite identical. The present study indicates that: (1) plasma secretin concentration increases significantly within 30 min after a meal and remains increased during the first 12-hour period, (2) duodenal pH frequently decreaded below 4.5 during the same 12 hours but more frequently during the first 6 hours, and (3) a significant increase in pancreatic water, HC03- and protein occurred during the same time period.

Clinical and pathological features of six cases of sarcoidosis presenting with renal failure

Six patients with biopsy-proven renal sarcoidosis presented with renal failure of unknown origin; in none was the diagnosis of sarcoidosis initially considered. The serum creatinine concentration at the time of presentation ranged from 265 to 1380 mumol/l (3.0 to 15.6 mg/dl), with a mean of 787 mumol/l (8.9 mg/dl). Although only two patients were hypercalcemic at the time of presentation, the 24-hour urinary excretion of calcium was increased in three of the four patients in whom it was measured, and renal calculi were present in one case. Renal biopsy revealed interstitial nephritis and tubular atrophy in all cases, as well as nephrocalcinosis in three cases and noncaseating granulomas negative for acid-fast bacilli in four cases. In each patient steroid therapy led to a rapid improvement in renal function (mean post-treatment serum creatinine level 274 mumol/l [3.1 mg/dl]). The follow-up period ranged from 8 months to 8 years (mean 3.0 years). In three patients renal function remained stable with low-dose steroid therapy. In two cases recurrent hypercalcemia and deteriorating renal function accompanied steroid withdrawal but resolved with its reinstitution. In one additional case reversible deterioration in renal function accompanied tapering of the steroid dose; however, there was no hypercalcemia.This report emphasizes the importance of considering sarcoidosis in the differential diagnosis of acute renal failure of unknown origin. Long-term follow-up of such patients is essential, as relapse is common.

Influence of the vagus nerve on release and action of secretin in dog

1. The role of cholinergic nerve on plasma concentration of immunoreactive secretin and pancreatic bicarbonate secretion was investigated in conscious and anaesthetized dogs. 2. In conscious dogs with gastric and pancreatic fistulae, I.V. administration of 2-deoxy-D-glucose (2-DG) potentiated the pancreatic bicarbonate secretion stimulated by duodenal acidification. 3. In conscious dogs with same preparation, I.V. administration of atropine inhibited the pancreatic bicarbonate secretions stimulated by duodenal acidification or exogenous secretin. 4. Neither 2-DG nor atropine had any effect on endogenous release of secretin. 5. In anaesthetized dogs, pancreatic bicarbonate secretion stimulated by duodenal acidification was decreased by bilateral cervical vagotomy. However, plasma secretion concentration achieved by duodenal acidification was not different from that of pre-vagotomy state. 6. The data indicate that the changes of cholinergic tone do not affect release of endogenous secretin but alter the exocrine pancreatic bicarbonate secretion stimulated by secretin.

Capillary column gas chromatographic profile analysis of volatile compounds in sera of normal and virus-infected patients

Using a transevaporator sampling technique, the volatile profiles from 70 microliter of serum were obtained by capillary-column gas chromatography. The complex chromatograms were interpreted by a combination of manual and computer techniques and a two-peak ratio method devised for the classification of normal and virus-infected sera. Using the K-nearest neighbor approach 85.7% of the unknown samples were classified correctly. Some preliminary results indicate the possible use of the method for the assessment of virus susceptibility.

Severe hypertension after ingestion of an appetite suppressant (phenylpropanolamine) with indomethacin

Severe systemic hypertension developed in a patient who took indomethacin shortly after ingesting an appetite suppressant ('Trimolets') containing phenylpropanolamine. The hypertension was attributed to a drug interaction whereby the inhibition of prostaglandin synthesis by indomethacin exacerbated the sympathomimetic effects of phenylpropanolamine. It is suggested that withdrawal of preparations containing phenylpropranolamine from general use should be considered in view of their potential for adverse reactions with other commonly used drugs and their doubtful therapeutic value.

Enhancement of human neutrophil bactericidal activity by chemotactic factors

Neutrophils are important effector cells in the defense against microorganisms. They migrate into infected sites and then phagocytose and kill bacteria. Chemotactic factors may be important for initiating neutrophil migration. We investigated whether chemotactic factors might also influence an event subsequent to chemotaxis, namely bacterial killing. It was found that preincubation (20 min at 37 degrees C) of human leukocytes with chemotactic substances such as zymosan-activated serum, a C5a-containing fraction of zymosan-activated serum, N-formyl methionyl phenylalanine or N-formyl methionyl-leucine-phenylalanine, enhanced leukocyte killing of Staphylococcus aureus, Escherichia coli, and Streptococcus faecalis in a dose-dependent fashion. The concentration of chemotactic factor required to enhance killing was similar to that required to induce neutrophil chemotaxis. In addition, zymosan-activated serum, C5a fraction, and the two N-formyl methionyl peptides increased the hexose monophosphate shunt activity of resting and phagocytosing neutrophils by two- to threefold. In contrast, bacterial killing by sodium azide-treated neutrophils and neutrophils from a patient with chronic granulomatous disease was not increased by any chemotactic factor. These findings suggest that chemotactic factors stimulate neutrophil oxygen-dependent microbicidal pathways. These observations illustrate another important contribution of biologically active molecules to effector cell function and host defense.

Plasma secretin concentrations in fasting and postprandial states in dog

In four dogs with a modified Herrara pancreatic fistula and gastric cannula and three dogs with two duodenal cannulas, ingestion of a meat meal resulted in a significant and sustained increase in the mean plasma immunoreactive secretin concentrations, from mean fasting levels of less than 10 pg/ml to 25--55 pg/ml. This increase in the plasma secretin concentration coincided with a marked increase in pancreatic bicarbonate output and frequent decreases in the mean proximal duodenal pH to less than 4.5 from the range of 6.5 in the fasting state. Intravenous administration of cimetidine, 150 mg, produced a marked suppression of postprandial increases in both pancreatic bicarbonate output and plasma secretin concentration. Moreover, the postprandial duodenal pH rarely reached below 5.0 after cimetidine administration. These studies indicate that plasma secretin concentration does increase significantly after a meal. The postprandial increase in plasma secretin concentration appears to depend on the gastric acid delivered in the proximal duodenum. A possible physiological role of secretin in the pancreatic secretion after a meal is indicated by these findings.

Crystal structure and molecular interactions of tropomyosin

The three-dimensional structure of tropomyosin filaments has been determined by X-ray crystallography. The ends of the molecules were located by reference to the single pair of cysteine residues. Departures from the alpha-helical-coiled coil conformation may occur in localised domains along the molecule as well as at the overlapping ends.

Simultaneous determination of antiarrhythmia drugs by high-performance thin-layer chromatography

A method is described for the determination of antiarrhythmia drugs in serum by high-performance thin-layer chromatography. Baseline separations are achieved for all the drugs and clozapine, an internal standard, in two developments with solvents of different polarity. Lidocaine and diphenylhydantoin are scanned at 220 nm after the first development. Procainamide, propranolol and quinidine are scanned at 290 nm after the second development. The relative standard deviation of the determination varies between 3 and 14% depending on the nature of the drug and its concentration.

Effects of motilin and octapeptide of cholecystokinin on antral and duodenal myoelectric activity in the interdigestive state and during inhibition by secretin and gastric inhibitory polypeptide

In conscious dogs prepared with gastric cannulae and antral and duodenal electrodes, intravenous administration of synthetic porcine motilin and CCK-OP in varying doses resulted in significant increases in the mean percent frequency of spike potentials on slow waves. Motilin was a more potent stimulant than CCK-OP. Motilin-stimulated spike potentials in both antrum and duodenum were significantly suppressed by either natural porcine secretin or synthetic porcine GIP. Secretin suppressed the spike potentials of the antrum stimulated by CCK-OP but not those of the duodenum. The spike potentials stimulated by CCK-OP could not be suppressed by GIP in the dosages employed.

Effect of metal ions on growth and sporulation of Clostridium perfringens in a synthetic medium

All cells, whatever their origin, function in an essentially inorganic environment. In this environment, metal cations play an important role. Attempts were made in the present study to determine if different amounts of five metal ions (MG++, Fe++, Mn++, Zn++, Ca++) are needed for secondary metabolism of Clostridium perfringens than are needed for primary metabolism. Both the vegetative growth stage (primary metabolic stage) and spore stage (secondary metabolic stage) of Clostridium perfringens were studied. Endeavors were made to detect the effects of metal ions, if any, on growth and sporulation of the organisms. Mg++ was required for growth of vegetative cells and maintenance of normal cellular morphology, Fe++ was needed for sporulation as well as for vegetative growth, but the amount needed for spore formation was higher than that needed for growth. Ca++ was essential to refractility and heat-resistance of spores. Zn++ inhibited both growth and sporulation, if the Mg++ concentration was low. Mn++ was required for neither growth nor sporulation. For maximum heat-resistance of the spores, Ca++ plus unidentified organic substances were required.

The nature of molybdenum-cofactor

In vitro assembly of Neurospora crassa NADPH-nitrate reductase (EC1.6.6.2) could be effected by combing the nitrate induced Neurospora crassa mutant nit-1 with the extract of any known molybdenum-containing enzyme. The process involves the participation of a molybdenum-cofactor contributed by the molybdenum-enzyme fraction. This paper emphasizes two points: Firstly, the indispensable role played by EDTA in the viability of Mo-cofactor and secondly, the nature of Mo-cofactor predicated by our previous work is supported by concrete experimental results. Recent experiments with Chelax-100 column provide evidence that the in vitro formation of Neurospora NADPH-nitrate reductase involves EDTA and the latter may take part in the formation of a molybdenum, labile sulfide and EDTA complex. In addition to 10(-2) M sodium molybdate, both EDTA and reducing agent are required to activate the cofactor in the Chelax-100 column eluate. The cofactor is of low molecular weight and devoid of protein as was predicated. To substantiate those predications, concrete experimental results are provided.