Heterogeneity of T-lymphocyte chronic lymphatic leukaemia (CLL). Study with conventional surface markers and monoclonal antibodies

Lymphocyte surface markers (E-SRBC, EAC, EA gamma and SmIg) and monoclonal antibodies (OKT3, OKT4, OKT8 and OKIa) were used to characterise the blood and bone marrow lymphocytes of T-cell CLL (8 patients). The diagnosis of T-cell CLL was made primarily as the majority of blood lymphocytes formed E-SRBC in each patient. Other markers-EAC, EA gamma and SmIg--showed different patterns of association with E-SRBC. These findings considered together described 4 different phenotypes amongst these patients: (a) E+ (3 patients), (b) E+, EAC+ (1 patient), (c) E+, EA gamma + (2 patients), and (d) E+, SmIg+ (2 patients). Similarly, 4 different groups were defined with the help of monoclonal antibodies. Helper T-cell (3 patients) and suppressor T-cell (1 patient) CLL showed predominantly helper T- and suppressor T-lymphocytes respectively. Mixed T-cell CLL (1 patient) comprised an equal proportion of both subpopulations, while the remaining 3 patients, with excess of one or other subpopulations along with a considerable proportion of Ia antigen-bearing lymphocytes, formed the indeterminate cell type CLL.

Consecutive repair of complex congenital heart disease using hypothermic cardioplegic arrest--its results and ultrastructural study of the myocardium

Cold potassium cardioplegia was used in 78 consecutive patients undergoing correction of complex congenital heart disease between 1977 and 1982. Ages ranged from 4 weeks to 21 years (mean 6.7 years). The anatomical diagnoses were: tetralogy of Fallot (33), common AV canal (12), pulmonary atresia with ventricular septal defect (VSD) with previous shunts (5), transposition of great arteries (5), total anomalous pulmonary venous return (3), complex VSD (4), and complex anomalies (16). There were 3 deaths (4%). Electron microscopy was performed on biopsy specimens taken from the hypertrophied or volume-loaded cardiac chamber (1) before perfusion, (2) after cardioplegia, and (3) 30 minutes after cardioplegia. It showed near normal myocardial ultrastructure after cardioplegic arrest, however there was minimal mitochondrial and intracellular edema after reperfusion. Post-operatively, 80% of the patients had spontaneous defibrillation and only 10% required brief inotropic support. The operative exposure was excellent. No patient developed heart block during repair.

A pilot study of epidoxorubicin (NSC 256942) in combination treatment of acute leukaemia and non-Hodgkin's lymphoma

Epidoxorubicin (EDX) was administered to a group of 26 patients with acute leukaemia or lymphoma, replacing either daunorubicin or doxorubicin (DXR) as a component of multiple-chemotherapy regimens. In 10 patients with acute non-lymphocytic leukaemia treated at presentation, 5 complete and 4 partial remissions were obtained. All patients with lymphoma of different types responded at least partially: in a group of 14 cases, 8 in relapse and 6 at presentation, there were 10 complete and 4 partial remissions. It is of interest that such results were obtained in patients of high median age with dosages of EDX much lower than those employed for DXR.

Effects of papain treatment of lymphocytes on the expression of their membrane surface markers

Surface marker characteristics of normal and CLL lymphocytes were often considerably modified by treatment with papain. E-SRBC of normal lymphocytes were markedly increased while those of the CLL lymphocytes remained unchanged except in occasional instances. By comparison, EA gamma of normal lymphocytes were unaffected while those of the CLL lymphocytes were markedly increased in most instances. These changes were consistent with reclustering of these receptor sites induced by papain. EAC and E-MRC were destroyed in both groups but SmIg remained unchanged.

Cardiac valvular replacement in carcinoid heart disease

A woman with tricuspid regurgitation due to carcinoid heart disease underwent successful tricuspid valvular replacement. This was performed as soon as the patient became symptomatic, enabling her to return to a normal life untroubled by slowly growing liver metastases. Few early valvular replacements have been undertaken in this disease. This case report demonstrates its usefulness.

Long-term changes in canine vein graft after infusion of cardioplegic solution

We have studied the effects of cardioplegic solution (CS) on angiographic and histologic anatomy of bilateral vein grafts interposed into the carotid arteries of 10 dogs for up to 1 year. One vein (exp) was infused with cardioplegic solution (pH 7.7, K + 25 mEq/l, temperature 12 degrees C) every 15 min four times at pressures up to 80 mm and then interposed into the carotid system. The other vein (con) was kept in cold Ringer's lactate (12 degrees C) before interposition. Six weeks and up to 1 year after bypass, angiograms showed 80% graft patency of exp and con grafts. Immediate histologic examination showed no detectable differences among veins before and after perfusion and con veins. Histologic examination at 1 year showed enlargement of the grafts, smooth muscle hyperplasia, and increase in collagen, as well as disorientation of muscle fibers; cytoplasmic vacuolation occurred with equal frequency in both exp and con veins. Perfusion of the vein segment with cardioplegic solution did not appear to be detrimental to vein patency or histologic appearance so that this can be considered a safe method for delivery of cardioplegia in jeopardized ischemic myocardium at the time of bypass surgery.

Degradation of myelin proteins by brain endogenous neutral protease

A proteolytic enzyme isolated from calf brain cytosol, degraded purified myelin basic protein in the presence of Ca2+ at pH 7.0 (Singh, I. and Singh, A.K., Trans. Amer. Soc. Neurochem., 13 (1982) 119). This proteolytic enzyme also degrades basic proteins when incubated with intact myelin in the presence of Ca2+ at a neutral pH. Three hour treatment of purified myelin with this protease resulted in degradation of large basic protein and small basic protein by 73 and 89%, respectively. This proteolytic activity was inhibited by EDTA, leupeptin and low pH (pH 4.0), but was not affected by phenylmethylsulfonylfluoride, p-nitrophenylguanidinobenzoate and pepstatin A. Purified myelin preparations also contain small amounts of Ca2+-activated proteolytic activity. The fact that this is a neutral protease, endogenous to the brain, suggests that it may play a role in the degradation of myelin under physiological and pathological conditions.

Measurement of K cell activity: use of human OR1R1 red cells and anti-D to study the role of different leucocytes as effector cells

A method for quantitative assay of K cell activity (KCA) with an allogenic combination of human OR1R1 red cells and anti-D (IgG, incomplete antibody) as target cells is described. Lymphocytes alone have been shown to cause lysis of these target cells. Fc receptor-bearing lymphocytes appear to be the chief mediators of KCA. This sub-population is a heterogeneous mixture of sub-sets of other sub-populations defined on the basis of different surface markers and likely to show variable expression of Fc receptors by the EA gamma rosette method. Monocytes and neutrophils (and possibly eosinophils), most of which bear Fc receptors, are ineffective as effector cells. Monocytes may in some instances have an inhibitory effect on the expression of KCA of lymphocytes. The method described has the advantage of simplicity (easy availability of OR1R1 cells and anti-D) and a high degree of sensitivity (marked lysis at low L/T ratio) and appears suitable for routine use in clinical practice.

Adult polio-like syndrome following Enterovirus 70 conjunctivitis (natural history of the disease)

During the Indian EV 70 conjunctivitis epidemic in 1981, 79 patients with neurological complications were evaluated by clinical, electrophysiological, histopathological and virological studies. The disease was heralded by an attack of conjunctivitis and was followed, after a variable latent period, by a pre-paralytic, paralytic, and post-paralytic stage of slow recovery. The above events occurred in an orderly sequence. The paralysis affected the cranial nerves, limbs or both. The clinical course closely simulated poliomyelitis, without any evidence of radiculopathy or myelopathy. Cranial nerve palsies were seen in approximately half of the patients. The electrophysiological and histologicl studies pointed towards the affection of anterior horn cells. The raised neutralizing antibody titres to Enterovirus 70, confirmed the aetiology of the disease. On the available data, we believe that this nosological entity should be considered under the general title of "polio-like syndrome" following EV 70 conjunctivitis. On account of two epidemics in 1971 and 1981 with unfavourable prognosis and high resultant disability, and because of lack of specific therapy, it has become imperative to develop, as a top priority, a vaccine for immunization.

Colchicine ultrasensitivity of lymphocytes in chronic lymphocytic leukaemia

It has been previously reported that, in comparison with normal lymphocytes, the lymphocytes in chronic lymphocytic leukaemia (CLL) are ultrasensitive in culture to the cytocidal action of colchicine. In this report the results of 240 colchicine studies in 87 patients with CLL are presented and analysed in terms of the diagnostic, clinical and haematological significance of colchicine ultrasensitivity (CUS) in CLL. All patients with CLL showed very significantly increased CUS of lymphocytes. The CUS did not vary with clinical and haematological status or time and only very rarely with treatment. There was no correlation between % CUS and subsequent course or survival. The results in CLL and in other forms of lymphocytosis and in non-Hodgkin's lymphoma are compared. It is concluded that the test is of considerable diagnostic value, particularly in identifying low-count and treated CLL and in the exclusion of non-CLL lymphocytosis. It appears to have no prognostic value but may have future application in monitoring treatment which selectively eliminates the abnormal cell population.

Coronary circulatory dynamics before and after successful coronary angioplasty

The hypothesis that successful percutaneous transluminal coronary angioplasty restores normal coronary circulatory dynamics was tested. Regional coronary blood flow, myocardial oxygen consumption and lactate extraction were measured at rest and during sustained pacing tachycardia. Before angioplasty, tachycardia stress was associated with an attenuated blood flow and oxygen consumption response and the induction of anaerobic metabolism. After successful angioplasty, blood flow and myocardial oxygen consumption increased during tachycardia stress and aerobic metabolism was sustained. The influence of basal alpha-adrenergic tone in modifying the time course of blood flow response to abrupt pacing was also assessed. Patients with normal coronary arteries demonstrated delayed increase in blood flow after alpha-adrenergic blockade. Alpha-adrenergic blockade did not affect the time course of blood flow response in patients with coronary artery disease, suggesting that alpha-adrenergic tone was chronically withdrawn. In patients undergoing coronary angioplasty, flow response before angioplasty was delayed, consistent with withdrawal of basal alpha-adrenergic tone. After coronary angioplasty, a brisk flow response was observed, indicating that basal alpha-adrenergic tone had been restored. Thus, successful coronary angioplasty restores the normal responsiveness of the coronary circulation.

A rapid tube ELISA for human IgG in body fluids using Staphylococcus aureus

An ELISA was designed for measurement of human IgG in urine and CSF using protein A containing Staphylococcus aureus as sorbent. This assay was performed in test tubes. An OD difference of approximately 1.0 was developed between non-specific binding and 10 micrograms/ml IgG solution. The method has a sensitivity of 70 ng IgG/ml. The test is simple and rapid and does not require concentration of samples. Once prepared S. aureus reagent is stable for at least one year. The merits of this method in comparison to radial immunodiffusion (RID) are discussed.

Clinical evaluation of the interpulse low resistance microporous membrane oxygenator

The Interpulse microporous membrane oxygenator has been used in 100 patients for cardiac surgery. This oxygenator features transverse furrows in the membrane and a back and forth motion of the blood as it flows between the membranes. This pulsing motion causes secondary flows or vortices to occur in the furrows of the membrane. These secondary flows promote mixing of the blood in the film. This oxygenator has been used in a single pump circuit for perfusions for up to 343 minutes at a flow rate up to 5.9 l/min. Oxygen saturation has always been 98% or greater. The pulser rate of the oxygenator influences oxygen transfer, and the pulser rate has been regulated between 80 and 225 pulses per minute to achieve a mean arterial PaO2 of 207 mmHg. Carbon dioxide transfer is affected by the oxygen flow through the device and has been adjusted to between 0.2 and 7 l/min to obtain a mean PaCO2 of 40 mmHg in this series. This device has proved to be safe and effective in perfusions for cardiac surgery.

Tissue ammonia and amino acids in rats at various oxygen pressures

The amino acid and ammonia profiles in various tissues of the rat exposed to different pressures of pure oxygen have been studied. Well-defined changes in behavioral activity accompanied a profile of increasing pressure, culminating in convulsive activity in each group of exposed animals. After an initial depression of ammonia, in all tissues studied at 0.68 atm oxygen ammonia increased significantly at higher oxygen pressures. A rise in tissue ammonia took place in the absence of undue muscular activity on the part of the exposed animals. A significant increase in ammonia occurred first in brain and liver at 3.40 atm. Ammonia concentration was high in all tissues after convulsions occurred at 4.08 atm. Between 0.68 and 2.72 atm oxygen, tissue ammonia concentration was generally low and brain glutamate and gamma-aminobutyric acid were high. At pressures higher than 2.72 atm oxygen, tissue glutamate declined and glutamine increased. Alanine became significantly elevated in serum and muscle at high oxygen pressure, and aspartate was depressed in heart, liver, and muscle. These pressure-course experiments on ammonia accumulation in tissue confirm previous serial time course observations that ammonia accumulates in the brain and several tissues of the rat even in the absence of undue muscular activity during high-pressure oxygen exposure and is a significant factor in inducing convulsions.

Utilization of wild relatives in genetic improvement of Arachis hypogaea L. : Part 2: chromosome complements of species in section Arachis

The chromosome complements of 12 taxa in section Arachis were karyotypically and meiotically analysed. In taxa with 2n=20 the arm ratio of the respective pair of chromosomes was taken as an independent quantitative character and statistically analysed by Mahalanobis D(2). Two clusters were formed, one represented solely by A. batizocoi and the other consisting of the remaining 11 taxa. This grouping was confirmed by canonical analysis. In the larger group of species, A villosa and A. correntina were closely related karyotypically and on D(2) distance, while A. cardenasii forms a distinct subgroup. A. cardenasii lacks the short "A" chromosome recorded in other species of this group, and A. batizocoi is no longer the only species to have a pair of chromosomes with a secondary constriction. The taxa with 2n=40, A. monticola and A. hypogaea, are karyotypically very similar, though there is a difference in the number of chromosome pairs with a secondary constriction. On the basis of karyomorphological affinity, especially in relation to marker chromosomes, A. cardenasii is probably one of the ancestors of the tetraploid species studied.