Distinct short-lived and long-lived antibody-producing cell populations

This report analyzes the life span of Ig-containing cells (IgCC) in different sites of antibody production. The experimental approach was based upon the observations that most IgCC are derived from proliferating precursors while IgCC themselves are mainly nondividing end cells. Rats were given a continuous infusion of [3H] thymidine via an osmotic pump inserted in the peritoneal cavity. At intervals of 1, 3, 5 or 10 days after starting infusions, tissues were taken and analyzed by a combination of immunohistology and autoradiography to identify the proportions of IgCC which had gone through S phase of the cell cycle during the period of infusion. After 3 days infusion the median and (range) percent-labeled IgCC in the medullary cords of mesenteric and cervical lymph nodes and the red pulp of the spleen were, respectively, 88 (81-90), 75 (66-77) and 88 (82-93). Conversely that for IgCC in bone marrow was only 13 (11-17) and that in the lamina propria of the jejunum 47 (33-68). The rate of increase in labeling of bone marrow IgCC with length of infusion was approximately linear. Extrapolation of this slope suggests that bone marrow IgCC have a life span in excess of 3 weeks. The slopes of increase in IgCC labeled with time for lymph nodes and spleen were clearly biphasic suggesting that while most IgCC in these tissues have a life span of less than 3 days, there is also a minor population of long-lived IgCC. The lamina propria appears to have approximately equal proportions of long and short-lived IgCC. The life span of IgCC, with the exception of IgMCC, appears to be a feature of the site of antibody production rather than the Ig class produced. Almost all IgM-containing cells were found to be short lived.

An antigenic study of human plasma cells in normal tissue and in myeloma: identification of a novel plasma cell associated antigen

A mouse monoclonal antibody named BU11 which detects an antigen strongly expressed on human plasma cells is described. The antibody stains plasma cells in tonsil sections, fresh and cultured plasmacytoid cells from the bone marrow of patients with multiple myeloma and cells of the plasmacytoid cell line RPMI 8226 used as the immunogen. In vitro studies of pokeweed mitogen (PWM) stimulated peripheral blood B cells and Epstein-Barr virus (EBV) stimulated tonsil B cells show that the antigen is present mainly on cells coexpressing the OKT10 antigen and containing cytoplasmic immunoglobulin (cIg). The BU11 antigen is expressed weakly on some normal B cells and is not present on T cells, monocytes or granulocytes. The antigen is of molecular weight 58kD under reducing conditions and is biochemically distinct from previously described plasma cell antigens.

Effects of potassium chromate on atherosclerosis prevention and regression in rabbits

The effect of intraperitoneal injections of potassium chromate on prevention and regression of atherosclerosis was observed in New Zealand White rabbits. In rabbits fed a 1% cholesterol diet for 90 days, potassium chromate injection was not associated with a significant difference in weight, serum cholesterol, total cholesterol content per 8.5 cm aorta, cholesterol content per gram of aorta or percent intima covered with plaque compared to controls. Similarly, significant differences were not seen in rabbits fed a 1% cholesterol diet for 90 days followed by 60 days of potassium chromate or distilled water injections and a standard diet. These results are in keeping with recent studies suggesting a more limited role for chromium in a variety of lipid-related disorders.

Hemorrhagic changes in experimental spinal cord injury models

Early hemorrhagic changes in the spinal cord were compared in three experimental spinal cord injury models in the rat in order to determine the nature and consistency of spinal cord hemorrhage following specific and quantitated forces of injury. The spinal cords were injured by weight-dropping, aneurysm clip and extradural balloon compression techniques. Hemorrhagic changes were assessed quantitatively by the image analyser at 1 and 3 hours after injury. Tissue damage was assessed by determining the percentage of total cross sectional area containing hemorrhage. The extent of hemorrhage at site of injury in the clip and balloon preparations was equal, but several times lower in the weight-drop induced injury. Within each experimental group no appreciable differences were observed at the site of injury between the 1 and 3 hours preparations. The variability of damage within experimental groups was most in the weight-dropping and balloon and least in the clip preparations. Differences were also indicated with respect to the distribution of hemorrhage in grey versus white matter. These findings may be of significance when functional recovery is considered in various experimental acute spinal cord injury models.

Complications of cirrhosis of liver in some hospitalised population

A total of 323 cases of cirrhosis of liver with various complications in some hospitalised population were studied. Microcytic anaemia was found to be the commonest (46.43 percent) complication. Next common (21.05) complication was protosystemic encephalopathy (PSE). Gastrointestinal haemorrhage and primary carcinoma of liver constituted 12.37 percent and 9.28 percent respectively. In view of the nature of complications of liver, it was felt necessary that these type of patients should be exposed to facilities for the specialised management whenever possible. Development of primary carcinoma of liver emphasises the need for the prevention of hepatitis B virus infection for which preventive vaccine is now available.

CSF shunt complications: an analysis of contributory factors

The complications arising from 195 shunting procedures are described and correlated with patient and operative variables. Neither the patient's age, sex, type of hydrocephalus, length of surgery, nor the use of prophylactic antibiotics correlated significantly with subsequent shunt complications. However, the surgeon performing the procedure and the type of shunt used were highly significant correlates.

False aneurysm of the internal iliac artery with involvement of the reproductive tract. A case report

A case of rupture of a false internal iliac artery aneurysm is discussed and the known urological and neurological presenting symptoms are reviewed. Therapy is also briefly reviewed. In addition, the first documented case of involvement of the reproductive tract is recorded. The rarity of the condition often leads to misdiagnosis. The most probable cause of the rupture in this patient was syphilis.

Relation of intra-splenic migration of marginal zone B cells to antigen localization on follicular dendritic cells

Injection of heat-killed Escherichia coli into rats results in massive loss of IgM + ve, IgD - ve B cells from the marginal zones of their spleen within 4 hr. This is matched by a concomitant increase of cells with this phenotype in the splenic follicles. The marginal zone remains depleted and the follicles distended for about 16 hr, but the histological picture returns to normal within 24 hr. Surface marker analysis of blood and spleen B lymphocyte populations throughout the course of the migration suggest that there is intrasplenic migration of IgM + ve cells from marginal zone to follicles rather than via the circulation. Factors inhibiting localization of immune complex on follicular dendritic cells were assessed for their influence on marginal-zone B cell migration. Immune complex, injected 5 hr post-endotoxin administration localized poorly on follicular dendritic cells. While C3 depletion, by cobra venom, has no effect on marginal-zone B cell migration induced by endotoxin, it completely inhibits transport of heat-aggregated human gammaglobulin to follicular dendritic cells.

Widespread distribution in human tissues of an antigenic determinant of granulocytes

The monoclonal antibodies AGF4 .48 and AGF4 .36 have previously been shown to distinguish human granulocyte lineage cells from other peripheral blood and bone marrow cells. The AGF4 .48 antigen, which is carbohydrate in nature, together with similar antigens described by numerous investigators have been considered specific differentiation antigens of myeloid cells. In immunohistological studies of a wide range of normal tissues, the AGF4 .48 antibody selectively stained cells in several apparently unrelated tissues. These included proximal tubules and descending thin limbs in the kidney, parietal cells in the stomach, a variety of other epithelial cells, astrocytes in the brain, and cells in the anterior pituitary containing adrenocorticotrophic hormone. The AGF4 .36 antibody gave similar results on kidney, stomach and pituitary. These findings emphasise the importance of assessing the binding of monoclonal antibodies, which appear unique in their reactivity with blood cells, to non-haemopoietic tissues before assigning specificity to reagents. The distribution of cells expressing the AGF4 .48 and AGF4 .36 antigen correlates with the occurrence of the 3-fucosyl-N-acetyllactosamine carbohydrate structure in various secreted glycoproteins.

Subdural empyema: a retrospective study of 15 patients

Subdural empyema is a surgical emergency, which, if not recognized and managed promptly, is rapidly fatal. The clinical features, diagnosis, infecting organisms, treatment and results in 15 patients with subdural empyema admitted to the University and Saskatoon City hospitals between 1956 and 1982 are evaluated. There were 11 males and 4 females; 80% were under 50 years of age. Paranasal sinusitis in six patients was the most common cause of the condition. The most frequent presenting features were fever, headache, vomiting, seizures and motor deficit. Preoperative diagnostic methods included skull roentgenography, cerebrospinal fluid studies, electroencephalography, cerebral angiography and computerized tomography. Cultures of the pus were positive for bacteria in 13 of the 15 patients. Drainage of the empyema was accomplished through multiple burr holes, craniotomy and craniectomy. Follow-up ranged from 1 month to 15 years. Eleven patients recovered with minimal or no neurologic deficit, 2 patients had permanent major deficits and 2 died. Successful management of subdural empyema depends on early diagnosis, prompt evacuation of the pus and appropriate antibiotic therapy.

The antischistosomal activity of substituted indoles

5-Bromoindole carboxylic acid and substituted indoles were administered parenterally to hamsters infected with an Egyptian strain of S. mansoni, to assess their antischistosomal activity. 5-Bromoindole showed a significant hepatic shift in 59 percent of treated hamsters. The results suggest that modification of the indole nucleus may produce a series of antischistosomal agents.

The Syed-Neblett interstitial template in locally advanced gynecological malignancies

Twenty-eight patients with locally advanced malignancies of the cervix and vagina were treated with a combination of external radiation therapy and afterloading Syed-Neblett iridium template. There were 22 patients with squamous cell cancer and two patients with adenocarcinomas of the cervix. Four patients with squamous cell cancer of the vagina were treated with this method. Only patients with locally advanced disease (cervical lesion greater than 4 cm in diameter) and poor vaginal anatomy were selected for this modality of therapy. In our series the incidence of distant failures of 39% seems to confirm the significance of local volume of disease as a prognostic indicator; despite a local control rate of 59%, only 33% of our patients are alive from 25-51 months. Complications occurred in 12 patients (42%). Six patients (22%) developed severe rectal stricture or rectovaginal fistula necessitating diverting sigmoid colostomy; five patients (18%) developed hemorrhagic proctitis with diarrhea and tenesmus; one patient developed vaginal vault necrosis. Complications occurred 7 to 24 months following therapy. Six of the 12 patients developing complications are dead of disease. On the basis of this study and because of the low cure rate and high incidence of complications, the value of the Syed-Neblett template in locally advanced gynecologic malignancies should be reconsidered.

Correlation of computed tomography with surgical diagnosis in lumbar disc disease

The lumbar spines of one hundred patients with suspected lumbar disc herniations were analysed with computed tomography. The results are compared with the patients' surgical diagnosis and with myelography. CT scanning is with few exceptions the diagnostic procedure of choice in investigating lumbar disc disease.

Massive cerebellar infarction: "conservative" management

Eleven patients with large cerebellar infarctions were admitted recently to our service. Eight of them showed evidence of hydrocephalus on the CT scan examination. Five were treated with controlled external ventricular drainage and six were managed conservatively. One death, most likely due to progressive brainstem infarction, occurred. The outcome was favorable in the other patients. It is suggested that prompt treatment of the acute obstructive hydrocephalus may obviate the need for posterior fossa decompression in patients with massive cerebellar infarction.

Acute spinal cord injury in the rat: comparison of three experimental techniques

Three techniques to produce experimental spinal cord injuries in the rat are compared; 1) the weight dropping method, 2) the aneurysm clip compression method and 3) the extradural balloon compression method. In principle, different forces were used in technique one, while a constant force for different durations is maintained in techniques two and three. The relationship between these different types of injuries and subsequent clinical recovery was assessed quantitatively by the inclined plane method of Rivlin and Tator. The weight dropping technique was found unreliable for experimental spinal cord injury in the rat while the aneurysm clip compression technique resulted in consistent cord injuries with respect to subsequent clinical recovery. The extradural balloon compression method invariably resulted in complete recovery after three and five minutes but no recovery after seven minutes of 0.1 cc air inflated balloon compression of the cord indicating a steep dose--response curve. However, using a 0.2 cc air inflated balloon, no recovery was noted after one minute compression. The major factor in the pathogenesis of spinal cord injury produced by the weight dropping technique is believed to be mechanical, while both mechanical and vascular factors seem to operate in the clip and balloon compression techniques.

Emergency room thoracotomy for penetrating cardiac injuries

The results of emergency room thoracotomy (ERT) and cardiorrhaphy for 91 patients with penetrating cardiac injuries admitted in extremis to Lincoln Medical and Mental Health Center from 1963 to 1981 are reviewed to determine criteria for selection of patients for this procedure. Four groups were defined based on the severity of the effects of their injuries. The survival rates were 32.1 and 33.3%, respectively, for Group I ('fatal') and Group II ('agonal') patients. There were no survivors in Group IV ('D.O.A.') patients for whom ERT is a fruitless procedure. Survival in Group III ('profound shock') patients was only 40%, which might have been improved if ERT had been performed without delay. We conclude that ERT is essential for patients with 'fatal' and 'agonal' wounds and advise prompt ERT for patients in 'profound shock' who do not respond immediately to rapid volume infusion.

Hypertension in the rural population of Bangladesh--a preliminary survey

A total of 5,026 persons constituting 75% of the total population of a village of Bangladesh were screened for elevated blood pressure. Three hundred thirty seven (6.7%) showed diastolic blood pressure of 90 mm Hg or above. Those with diastolic blood pressure of 95 or above constituted 2% of the population. 74% of the hypertensives were asymptomatic while 86.3% of the cases were undetected and therefore remained untreated. Our findings indicate the need for early detection and control of elevated blood pressure to prevent complications. It is recommended that a large scale community survey programme may be undertaken for detection and early treatment of hypertension which helps prevention of total complications.

Sexual abuse of young children

For an 18-month period, all sexual abuse cases were referred to a project social worker. From her initial interview and the medical records, data were analyzed for 113 children who were 12 years of age or younger. It was found that half were five years or younger and three-fourths of the cases were female children. Reasons were discussed as to why females are more likely to be identified as sexually abused cases. A higher than average rate of gonorrhea was found among the pediatric group studied. While only 44 per cent of abusers were relatives of the abused, almost all (93%) were known to the family. If a relative were the alleged abuser, there was a high probability that it was a father, stepfather, or uncle.