Prolonged remission of accelerated phase Philadelphia chromosome negative chronic myeloid leukemia following autologous recovery of normal hematopoietic elements after busulfan/cyclophosphamide and allogeneic marrow transplantation

We describe here a patient with accelerated phase Philadelphia chromosome (Ph1) negative chronic myelogenous leukemia without BCR gene rearrangement, who received an allogeneic bone marrow transplant following a conditioning regimen consisting of busulfan (BU) and cyclophosphamide (CY). Hematopoiesis was restored following splenectomy performed 1 month post-transplant. There were no distinguishing cytogenetic differences between donor and host. Five years post-transplant the patient relapsed with the original disease. Restriction fragment length polymorphism (RFLP) studies performed at that time exhibited host specific DNA markers suggesting recurrent leukemia of host origin. RFLP analysis of the cells cryopreserved immediately post-transplant also revealed all cells to be of host origin. This patient experienced 5 years of remission with autologous hematopoietic recovery from an aggressive myeloproliferative disorder after high dose BU and CY without engraftment of donor hematopoietic cells.

An investigation for determining the optimum length of chopsticks

Chopsticks are one of the most simple and popular hand tools ever invented by humans, but have not previously been investigated by ergonomists. Two laboratory studies were conducted in this research, using a randomised complete block design, to evaluate the effects of the length of the chopsticks on the food-serving performance of adults and children. Thirty-one male junior college students and 21 primary school pupils served as subjects for the experiment. The results showed that the food-pinching performance was significantly affected by the length of the chopsticks, and that chopsticks of about 240 and 180 mm long were optimal for adults and pupils, respectively. Based on these findings, the researchers suggested that families with children should provide both 240 and 180 mm long chopsticks. In addition, restaurants could provide 210 mm long chopsticks, considering the trade-offs between ergonomics and cost.

Influence of the mobile phase on salmon calcitonin analysis by reversed-phase liquid chromatography

The retention properties of calcitonins on a reversed-phase column are examined using salmon calcitonin as the model compound. The effect of the concentration of organic modifier, buffer strength, pH of the mobile phase, and ion-pair reagent are studied. In the absence of an ionic modifier in the eluent the calcitonin peak shapes are not symmetrical. The addition of 0.1% trifluoroacetic acid (TFA), however, results in good peak characteristics without the need to add nonvolatile salts. The retention of the calcitonins was found to be very sensitive to the concentration of the organic modifier (acetonitrile) present in the mobile phase. A change of pH between 2 and 5 has only a slight effect of the k' of salmon calcitonin, but the k' increases significantly at higher pH values. The addition of a phosphate buffer to the mobile phase and an increase in the buffer concentration (0-0.2 M) causes a decrease in the retention of salmon calcitonin. Evidence shows that reproducible, quantitatively measurable data can be obtained using reversed-phase chromatography if the ion-pairing reagent and organic modifier concentrations are carefully controlled. The system also shows a good selectivity for the calcitonin series. Therefore, both highly selective methods (qualitative) as well as quantitative methods for analytical, pharmaceutical, and manufacturing use can be developed by adjusting the high-performance liquid chromatography (HPLC) conditions as discussed.

Compliance effect on patency of small diameter vascular grafts

The compliance mismatch hypothesis as a cause of failure of small diameter grafts was investigated using 4 mm internal diameter, 5 cm long Biolized polyurethane grafts. The luminal surface of 0.5 mm thick Biomer sponge grafts was covered with 100 microns of crosslinked gelatin. Compliance matched, and noncompliant grafts had in vivo compliance values of 13.5 +/- 2.89 and 1.0 +/- 0.7 X 10(-2%) per mmHg, respectively. In vivo compliance defined as 2 X dD/dP X 1/Do was measured in situ using the ultrasonic Hokanson probe. Compliance values of compliant grafts equaled that of the canine carotid artery at 100 mmHg mean arterial pressure. Grafts were implanted using an end-to-end anastomosis in 14 dogs for 6 wk. Patency rates for compliant vs. noncompliant grafts were 64% (9/14) and 50% (7/14). Compliance values for compliant grafts decreased to a mean of 7.14 X 10(-2%) per mmHg. Anastomotic intimal hyperplasia at the proximal and distal ends of compliant and noncompliant grafts measured 239.9 +/- 128, 197 +/- 129 microns, 338.9 +/- 273.6, and 304.3 +/- 179.3 microns, respectively. There were no significant differences in localized anastomotic intimal hyperplasia at either graft end for either graft type. This study did not show any positive effects of graft compliance.

Determination of a new inotropic agent in human plasma by high-performance liquid chromatography

A new orally active inotropic agent, 6-[3,4-dihydro-3-methyl-(2H)-2-oxoquinozolinyl)]-4,5-dihydro-3- (2H)-pyridazinone (I), is currently under investigation. In support of clinical studies, a HPLC assay for the analysis of compound I in human plasma has been developed. The method involved a solid-phase extraction using C18 cartridge columns washed with methanol-water (20:80) and eluted with acetonitrile-water (70:30). The eluate was then extracted with dichloromethane. A reversed-phase alkylphenyl-bonded column was used as the analytical column. The mobile phase was a mixture of methanol, acetonitrile, 2-propanol and phosphate buffer (pH 4.6). A wavelength of 311 nm was used for detection. The limit of detection of the assay was 2 ng/ml, and the limit of quantitation was 5 ng/ml. A linear calibration range of 5 ng/ml to 1200 ng/ml was obtained with a correlation coefficient less than 0.99. The precision and accuracy were evaluated by analyzing samples of three different concentrations (n = 5), 40, 200 and 800 ng/ml in plasma. The coefficients of variation and the differences from nominal values were less than 10%. The average recovery for 5, 50 and 100 ng/ml of analyte in plasma was about 90%. This assay has been applied to clinical studies with satisfactory performance and to plasma of different species in preclinical studies.

Identification and quantitation of trenbolone in bovine tissue by gas chromatography-mass spectrometry

Identification and quantitation of trace amounts of trenbolone in bovine tissue by capillary gas chromatography-mass spectrometry-selected-ion monitoring (GC-MS-SIM) has been developed. Three-phase liquid-liquid extraction using a mixture of water-acetonitrile-dichloromethane-hexane was utilized for the sample extraction from tissue. Target compounds were extracted from the tissue into the acetonitrile layer. The residue from this extraction was then subjected to solid-phase extraction by C18 and silica gel disposable cartridges using methanol-water and benzene-acetone as eluents. To overcome extensive matrix interferences, preparative reversed-phase high-performance liquid chromatographic separation was used with an octadecyl-bonded column using methanol-water as mobile phase for sample clean-up prior to GC-MS analysis. A structural analogue of trenbolone, 19-nortestosterone, was chosen as the internal standard for quantitation by GC-MS. The sample was co-injected with N,O-bis (trimethylsilyl) trifluoroacetamide-1-(trimethylsilyl) imidazole (95:5, v/v) for flash heater derivation. Identification and quantitation were simultaneously carried out by SIM of characteristic ions of the trimethylsilyl derivatives of trenbolone and 19-nortestosterone. The limit of detection for trenbolone and epitrenbolone was 0.5 ppb in muscle and liver tissue. A comparison of sensitivity and specificity between GC-MS under electron ionization in addition to positive- and negative-ion chemical ionization conditions using methane reagent gas is also discussed.

HLA-D restriction of "naturally occurring" MLR suppressor cells in acquired common variable hypogammaglobulinemia

Cells with capacity to suppress the mixed lymphocyte response (MLR) were detected in two patients with acquired common variable hypogammaglobulinemia (ACVH). No specificity with respect to the stimulating HLA type was observed. In one case of ACVH available for extensive study, there was evidence for HLA-D restriction of the suppressor cells. The patient's lymphocytes specifically suppressed the MLR of subjects who carried the same HLA-D type. Family studies confirmed that the suppressor activity was restricted to HLA-D, not DR, and segregated with the appropriate HLA haplotype. These observations suggest that an immune suppressor gene mapping in the HLA region may be involved in the pathogenesis of common variable hypogammaglobulinemia.

Mixed-mode hydrophobic ion exchange for the separation of oligonucleotides and DNA fragments using HPLC

Hydrophobic anion exchangers were formed by cobonding both ionic and hydrophobic ligands to silica gel. These phases were used to separate single-stranded oligonucleotides and double-stranded DNA restriction fragments. By varying the ratio of n-octyldimethylsilane and either 3-chloropropyldimethylsilane or 4-chlorobutyldimethylsilane added during silanization a series of mixed-ligand or mixed-mode stationary phases was created. Concentration and ratio of bonded ligands were determined using a new gas chromatography fluorination method. Total ligand coverage was found to approach 2.1 ligands nm-2 for n-octyldimethylsilane. Bonding reproducibility for mixed-mode phases was good. Nucleic acid separations were achieved under gentle mobile phase conditions by using the stationary phase as an easily modifiable variable.

Quantitative retention relationships as a function of mobile and C18 stationary phase composition for non-cogeneric solutes

Twelve non-homologous solutes with a wide range of functional groups were chromatographed on a series of well-characterized stationary phases with a range of methanol-water mobile phases. Retention correlations were found for quantum mechanically calculated molecular parameters. These parameters, the total molecular energy, and the maximal excess electronic charge difference, were found to be better descriptors of retention than the dipole moment or fragmental constants. The implication of these results in terms of retention mechanisms on reversed-phase materials are discussed.

Cells homozygous for two HLA-DR7-associated HLA-D specificities express highly similar DR molecules but different DQ molecules

The Ia molecules expressed by cells homozygous for two distinct HLA-DR7-associated HLA-D specificities, Dw7S and Dw11L, were compared. The complete Ia phenotypes of these cells are DR7, DRw53, DQw2, Dw7S, DPw4 and DR7, DRw53, DQw3, Dw11L, DPw4, respectively. Immunofluorescence analysis revealed that three DQ-specific monoclonal antibodies (Leu-10, 33.1, and HK-19), which detect polymorphic DQ determinants that do not correspond to known serologic specificities, are nonreactive with DR7, Dw7S cells but are reactive with DR7, Dw11L cells. The DR molecules isolated from Dw7S and Dw11L cells are very similar and comigrate when analyzed together by two-dimensional gel electrophoresis. In contrast, the DQ molecules isolated from these cells are structurally distinct: the DQ beta chains of DQw2-bearing molecules from Dw7S cells are very basic, while those of DQw3-bearing DQ molecules from Dw11L cells are more acidic. The finding that two DR7, D-different cells express indistinguishable DR molecules and structurally distinct DQ molecules documents a unique pattern of Ia molecular organization which is different from those previously described for the DR2-, DR4-, or DRw8-associated HLA-D specificities.

Genetic control of immune response to the L-Glu, L-Lys, L-Phe terpolymer in man

We have demonstrated that human lymphocytes can respond to the synthetic polypeptide GLPhe upon in vitro challenge by the antigen similar to that of (H,G)-A--L, (T,G)-A--L, (Phe,G)-A--L, and GAT. Family studies further support our postulation that responses to these synthetic polymers are under dual gene control. Three families with intra-HLA-A/B recombinants provided mapping information for Ir-GLPhe genes. The response phenotype of the recombinant of family 21 localized the Ir-GLPhe genes toward the HLA-B of D regions, whereas recombinants of family 24 and 27 placed the Ir-GLPhe genes distal to HLA-B, toward the A region. This discrepant gene assignment can be explained by assuming that recombination occurred at different positions between HLA-A and HLA-B. In family 21, crossover occurred distal to the Ir genes, while for the other two, proximal to them. A second possibility is that as in the mouse the two complementing genes are situated in different regions of the human major histocompatibility complex (MHC) and all three of the crossovers occurred between them with the putative Ir-GLPhe-1 located near the HLA-A region and Ir-GLPhe-2 on the HLA-D region or vice versa. A third possibility is that immune response required interaction between a complete HLA-D-like molecule encoded in the A region and another encoded elsewhere, perhaps in HLA-D.

Immunochemical and genetic studies of Amb.t. V (Ra5G), an Ra5 homologue from giant ragweed pollen

Giant ragweed pollen allergen Amb.t. V (Ra5G), a homologue of short ragweed pollen Amb.a. V (Ra5S), was isolated in ultrapure form from a 16-min extract of ragweed pollen by a combination of molecular sieving through an Amicon hollow fiber cartridge (H1P5), cation-exchange chromatography, and gel filtration. The size was found to be 4400 daltons (D) by amino acid analysis and 6000 D by SDS-PAGE, and the pI was 8.3 as determined by isoelectric focusing. There was no cross-reactivity detected between the two Amb. V antigens by immunodiffusion and IEP with the use of hyperimmune antisera raised against crude or highly purified antigens. Cross-reactivity between the two Amb. V antigens was further investigated by inhibition double antibody radioimmunoassay by using the sera of nine selected ragweed-allergic patients who had recently been immunized with either mixed short-giant ragweed pollen extract or with short ragweed extract alone and who had IgG antibodies (Ab) to Amb.t. V and generally to Amb.a. V. Unlabeled Amb.t. V did not inhibit the binding of 125I-Amb.a. V to the IgG Ab in any of the sera tested. Conversely, unlabeled Amb.a. V produced some inhibition of the binding of 125I-Amb.t. V to the patients' IgG Ab, primarily in those patients who had received immunotherapy with short ragweed alone. This weak cross-reactivity was probably a result of the primary structural homology between the two protein allergens. The sera from two groups of ragweed-allergic individuals were investigated for the presence of IgG and IgE Ab to Amb.t. V. The presence of IgG Ab was found to be associated both with previous (or current) immunotherapy with giant ragweed extract and with HLA-Dw2. The HLA association is of interest in view of the previously established association between Dw2 and response toward the homologue Amb.a. V. The result suggests the existence of a similar genetic control at the primary level of antigenic recognition of the two Amb. V antigens.

Immunochemical and genetic studies of Amb.t. V (Ra5G), an Ra5 homologue from giant ragweed pollen

Giant ragweed pollen allergen Amb.t. V (Ra5G), a homologue of short ragweed pollen Amb.a. V (Ra5S), was isolated in ultrapure form from a 16-min extract of ragweed pollen by a combination of molecular sieving through an Amicon hollow fiber cartridge (H1P5), cation-exchange chromatography, and gel filtration. The size was found to be 4400 daltons (D) by amino acid analysis and 6000 D by SDS-PAGE, and the pI was 8.3 as determined by isoelectric focusing. There was no cross-reactivity detected between the two Amb. V antigens by immunodiffusion and IEP with the use of hyperimmune antisera raised against crude or highly purified antigens. Cross-reactivity between the two Amb. V antigens was further investigated by inhibition double antibody radioimmunoassay by using the sera of nine selected ragweed-allergic patients who had recently been immunized with either mixed short-giant ragweed pollen extract or with short ragweed extract alone and who had IgG antibodies (Ab) to Amb.t. V and generally to Amb.a. V. Unlabeled Amb.t. V did not inhibit the binding of 125I-Amb.a. V to the IgG Ab in any of the sera tested. Conversely, unlabeled Amb.a. V produced some inhibition of the binding of 125I-Amb.t. V to the patients' IgG Ab, primarily in those patients who had received immunotherapy with short ragweed alone. This weak cross-reactivity was probably a result of the primary structural homology between the two protein allergens. The sera from two groups of ragweed-allergic individuals were investigated for the presence of IgG and IgE Ab to Amb.t. V. The presence of IgG Ab was found to be associated both with previous (or current) immunotherapy with giant ragweed extract and with HLA-Dw2. The HLA association is of interest in view of the previously established association between Dw2 and response toward the homologue Amb.a. V. The result suggests the existence of a similar genetic control at the primary level of antigenic recognition of the two Amb. V antigens.

Genetic control of major histocompatibility complex-linked immune responses to synthetic polypeptides in man: poly(L-phenylalanine, L-glutamic acid)-poly (DL-alanine)--poly(L-lysine) and L-glutamic acid, L-alanine, L-tyrosine (60:30:10)

Vigorous lymphoproliferative responses to synthetic polypeptides poly(L-phenylalanine, L-glutamic acid)-poly(DL-alanine)--poly(L-lysine) [( Phe,G)-A--L], and L-glutamic acid, L-alanine, L-tyrosine (60:30:10) (GAT) were observed in cells from 92 unrelated subjects. Thirty-three percent responded to (Phe,G)-A--L and 77% to GAT. No HLA association was observed with responses to these two antigens. Family studies indicated that two complementary immune response (Ir) genes are required for response to each antigen. Eleven matings were informative for linkage analysis between HLA and these Ir genes. Families in which the complementary genes are in coupling gave maximal lod scores (log of the odds) of 4.50 for (Phe,G)-A--L and 7.57 for GAT for 0 = 0. In a HLA-B/D recombinant family, the Ir- PheGAL genes are mapped towards the HLA-D region. The localization of Ir-GAT genes close to HLA-B was provided by a HLA-A/B recombinant.

Clinical and immunogenetic subsets of psoriatic arthritis

Relationships between clinical features of psoriatic arthritis and HLA antigens were examined in 60 patients. HLA-B locus antigens, Bw38, B17, B27 and possibly Bw39 were significantly increased, while HLA-D and DR specificities were not. Cw6 was not studied. The relative risk for disease was doubled in patients having B27 plus a psoriatic HLA antigen. HLA-Bw38 correlated with young age of onset for psoriasis and arthritis, asymmetrical peripheral involvement, and, along with B27, combined peripheral/axial disease. While B17 was also associated with young onset psoriasis, arthritis onset was later and symmetrical in pattern. Certain clinical subsets of psoriatic arthritis may relate to HLA status, and disease susceptibility appears to lie closer to HLA-B than to HLA-D.

Multiclonal origin of polyps in Gardner syndrome

Electrophoretic analysis of glucose-6-phosphate dehydrogenase was performed on polyp tissue from three black female patients with Gardner syndrome and who are heterozygous for the A and B forms of this enzyme. Polyp tissues from the three patients displayed the AB phenotype. This finding suggests a multiclonal origin of polyps in Gardner syndrome. Studies of tumors originating from such polyps may provide information about the sequence of cellular events leading to malignant transformation.

Primary and secondary MLR characterization of three allelic variants of HLA-Dw7 segregating in a single family

Three of four parental haplotypes of a kindred from the Old Order Amish religious isolate carried HLA-DR7 and specificities of the HLA-Dw7 "cluster." Intrafamily primary and secondary mixed lymphocyte responses clearly distinguished the three Dw7-related allelic specificities. Two of the specificities fall within the Dw11 crossreacting group, designated here as Dw11 "short" (Dw11S) and Dw11 "long" (Dw11L), while the third is more closely related to Dw7. Reaction patterns in this family illustrate the complexity of antigen recognition in primary and secondary mixed lymphocyte responses and the important role played by the responder cell in generating discriminatory primed lymphocyte typing reagents.

Rheumatoid arthritis in a Chippewa band. II. Field study with clinical serologic and HLA-D correlations

We present an in-depth study of rheumatoid arthritis (RA) in a Chippewa band. Of the 227 band members, 168 (74%) were evaluated. The unusually high prevalence of RA was confirmed in 7.1% of those studied or, minimally, 5.3% with a 100% completion rate without additional cases found. Seropositivity in those with clinically definite RA was 92% relative to rheumatoid factor and 75% for ANA. Despite the high prevalence (68%) of HLA-DR4 in this closed population, there was a significant correlation of DR4 with RA (100%). The implications of these observations in this population isolate are discussed.

HLA-Dw2: a genetic marker for human immune response to short ragweed pollen allergen Ra5. II. Response after ragweed immunotherapy

After artificial immunization (immunotherapy) with ragweed antigens, specific immunoglobulin G (IgG) antibody (Ab) response to Ra5 was significantly associated with HLA-Dw2 (P less than 0.0001). From a total of 61 treated patients, all 22 Dw2+ subjects made good IgG Ab responses to Ra5 by year 2 of therapy (21 by year 1), even though 8 of them had no detectable IgG Ab and 9 had no detectable IgE Ab before therapy. The prevalence of IgG Ab response among 39 Dw2- subjects was markedly lower; only 11 (28%) responded well after 1-9 yr of therapy. Both by univariate and multivariate statistical analysis, Dw2 was also found to be strongly associated with the quantity of IgG Ab produced. In particular, both the strength and significance of the association between Dw2 and log[IgG Ab] response to Ra5 increased over a 3-yr period of ragweed therapy (P = 10(-9) by year 3). Multiple regression analysis also revealed a weak association with HLA-B13, which became apparent only after year 2 of therapy. Genetic hypotheses for these findings are discussed. In particular, the possibility of a second Ir gene, Ir-Ra5', separate from HLA-Dw2 and possibly located elsewhere in the genome, is considered.

HLA-Dw2: a genetic marker for human immune response to short ragweed pollen allergen Ra5. I. Response resulting primarily from natural antigenic exposure

Ultra-pure short ragweed pollen allergen Ra5 (5,000 mol wt) was used to investigate the relationship between human leukocyte antigen (HLA) type and IgE and IgG antibody (Ab) responses to Ra5 in two groups of Caucasian subjects, totaling 447 people. Using highly sensitive radioimmunoassay procedures to measure serum IgE and IgG Ab, qualitative responses to Ra5 in both groups were found to be strongly associated with HLA-Dw2 (P less than 0.0001). For example, 95% of 38 people with IgE Ab vs. 22% of 139 ragweed-allergic persons having no detectable IgE Ab to Ra5 were Dw2+. Quantitative log [IgE Ab] and log[IgG Ab] responses to Ra5 were highly correlated with Dw2 (P = 10(-5) to 10(-14)) in four separate multiple regression analyses, examining the relationship between HLA type (and other variables) and Ab levels in the two study groups. Further studies showed that the primary association of Ra5 response was with Dw2 rather than DR2 and that various combinations of A3, B7, and Dw2 were less strongly associated than Dw2 alone.

Heterogeneity of HLA-DR4 in the rheumatoid arthritis of a Chippewa band

A high frequency of both rheumatoid arthritis (RA) and HLA-DR4 was found in a Chippewa Indian population. Multiple immunogenetic "variants" of HLA-DR4 were demonstrated, each showing a different response in mixed lymphocyte culture which corresponded to a serologic pattern of reactivity to a panel of non-DR4 B cell alloantisera. No DR4-bearing HLA haplotype or DR4 "variant" was common to subjects with RA, all of whom were DR4-positive. The implications are discussed.

HLA-DR characterization of a Chippewa Indian subpopulation with high prevalence of rheumatoid arthritis

The adult population (N = 227) of a Chippewa Indian reservation in central Minnesota is characterized by a high prevalence of arthropathy with 7.1% having rheumatoid arthritis (RA). In a prospective study 168 reservation residents (74%) were evaluated. Complete HLA typing identified 57 haplotypes, many of which probably arose via HLA-A/B or B/D recombination. The number of founder haplotypes appeared to be about 20. The population frequency of DR4 (including DRw9, formerly designated 4 X 7) was 67%; for RA it was 100% (p less than 0.05). Apparent DR4 homozygotes, a number of the RA patients, and family members were selected for further study in a mixed lymphocyte culture (MLC) test and with 8th International Workshop cellular and serologic reagents. In MLC with homozygous typing cells (HTC), non of the DR4+ cells typed for any known HLA-D specificity, although they reacted to all DR4 antisera on the local panel. However, 8th International Workshop DR antisera revealed patterns of reactivity with non-DRf4 reagents consistent with the MLC. A minimum of three DR4 variants, one DRw9 variant, and a specificity related to both DR4 and DR2 are required to explain both the cellular and serologic reactions. For the present, we are designating the antigens as DR4.1chip, DR4.2chip, DR4.3chip, DR9chip, and DR(2 X 4)chip. No single variant of DR4 was characteristic of the RA patients in this Amer-indian population.