Depression of Con A proliferative response of immune cells by in vitro hyperoxic exposure--protective effects of thiol compounds

Time dependent response for hyperoxic exposure was determined in vitro on ConA proliferative response of rat splenocytes, peripheral blood mononuclear cells and thymocytes. The proliferative responses were evaluated after different lengths of hyperoxic exposure (12-72 h, FiO2 = 0.95). After 24 h oxygen exposure, the spleen cell viability assessed by dye exclusion was normal but DNA synthesis was markedly suppressed in the above three types of cells. Total or partial protection of the mitogenic response to ConA was obtained by 2-mercaptoethanol, reduced glutathione or L-cysteine addition in culture medium; only selenomethionine had no protective effect. Thymic cells showed a different response-curve: after 6 h exposure to normobaric oxygen DNA synthesis was decreased and was not restored by any of the thiol compounds tested. In this respect, these cells demonstrated different susceptibility to an oxidant injury, i.e. exposure to high oxygen concentration. From a pharmacological point of view O2 exposure and altered immune response could be proposed as a useful model for screening the antioxidant drug activity.

High concentrations of oxygen modulate in vitro Con A responses of rat lymphoid cells. Effect of 2-mercaptoethanol

The effects of different normobaric oxygen concentrations (40, 60 and 95%) on the survival and the proliferative response to Con A of rat lymphoid cells were studied. Spleen, thymus and peripheral blood mononuclear cells were tested. We found that oxygen concentrations modulated the proliferative response independently of cell survival. The addition of 2-mercaptoethanol (2-ME) partially prevented the toxic effects of hyperoxia but the population of thymocytes which responded to Con A stimulation appeared to be less sensitive to the protective action of 2-ME. The relationship between oxygen concentrations and the lymphoid proliferative response could be used as a model of oxidant immunodepression for evaluating pharmacological effects of antioxidant compounds.

Life change stress, psychiatric symptoms, and natural killer cell activity

Previous research has linked stress with adverse health change; however, the immunologic mechanisms mediating these changes remain poorly understood. To test whether "stress" was associated with alterations in cell-mediated immunity, we examined the correlations of self-reported life change stress (LCS) and psychiatric symptoms with natural killer cell activity (NKCA) among 114 healthy undergraduate volunteers. Although the bivariate correlation between LCS and NKCA was not significant, subjects reporting few psychologic symptoms in the face of large amounts of LCS ("good copers") had significantly higher NKCA than those experiencing high levels of both symptoms and LCS ("poor copers"). Furthermore, self-reported psychiatric symptoms were found to inversely correlate with NKCA, suggesting that symptoms such as anxiety and depression may negatively affect immunity.

HLA antigens in Guillain-Barré syndrome

We compared Guillain-Barré syndrome (GBS) cases reported from cities in the United States in 1976-1977 with spouse or associate controls to detect possible HLA associations. HLA-A11 was somewhat less common among 92 cases than among 100 controls (p = 0.04). The 38 patients and 42 controls vaccinated against A/NJ/76 differed slightly in overall distribution of B locus antigens (p = 0.06), but the individual HLA-B antigen associations were more easily explained by chance. The 54 unvaccinated cases showed no apparent relation to HLA type. These findings should encourage further immunogenetic study of etiologically related GBS cases.

Characterization of immunological depression in mice exposed to normobaric oxygen

Immunological cell functions were evaluated during 24, 48 and 96 h O2 exposure in C57Bl/6 mice. A normobaric O2 exposure resulted in depression of delayed type hypersensitivity (DTH) to oxazolone and Staphylococcus aureus antigens. This effect was proportional to the duration of O2 exposure. The antibody response of splenic cells was more rapidly (24 h O2 exposure) and markedly depressed using a T-dependent antigen (sheep red blood cell, SRBC) than with a T-independent antigen (trinitrophenylated lipopolysaccharide, TNP-LPS). While mitogen-induced proliferative responses of spleen cells to Con A and PHA were inhibited after 72 h of O2 exposure, proliferative responses to LPS were inhibited after 96 h. A dissociated antigen and mitogen responses was observed after a short time of O2 exposure (48 h): the antigen specific responses were impaired with a more pronounced effect on T lymphocytes, whereas the DNA synthesis in response to mitogen remained normal.

Successful parathyroid gland autotransplantation after total parathyroidectomy in dialysis patients

Secondary hyperparathyroidism is one of the major complications encountered in patients on maintenance dialysis. Medical management is frequently unsuccessful, and there is often a need to perform a parathyroidectomy. Recurrent clinical secondary hyperparathyroidism may occur as a sequela of subtotal parathyroidectomy and necessitate a reexploration of the neck. Total parathyroidectomy followed by autotransplantation of parathyroid tissue into the patient's forearm bypasses the need for a second operation, and it provides a simple ambulatory procedure, under local anesthesia, for the removal of hyperplastic parathyroid tissue. The results in six patients indicate that this new procedure should be considered the treatment of choice for this condition.

The watery diarrhea syndrome with hypercalcemia--a symptomatic response to phosphate buffer

Two patients with the watery diarrhea, hypokalemia, achlorhydria syndrome are described. Both had hypercalcemia, hypophosphatemia and suppressed parathyroid hormone activity. On repeated occasions the diarrhea was controlled by oral or intravenous phosphate buffer. An exhaustive search by sophisticated non-invasive methods and by celiac arteriography failed to demonstrate a pancreatic tumor. Yet, in both cases fairly large pancreatic non-beta-cell adenomas were found at laparotomy. The removal of these tumors was followed by complete recovery.

Altered protein synthesis and creatine kinase in breast muscle cell cultures from dystrophic chick embryos

The total protein synthesis (TPS), myosin synthesis (MS) and creatine kinase (CK) levels in muscle cell cultures obtained from 400 normal (strain 454) and 400 dystrophic chick embryos (strain 455) were investigated. The cultures were obtained from breast muscles of 12 day chick embryos by dissociation in 0.25% trypsin, preplating and plating of 5 x 10(5) floating cells on gelatin coated dishes in Minimal Essential Medium, 10% horse serum and 2% chick embryo extract. After 6 days, when electron-microscopic studies demonstrated good muscle differentiation, cell cultures were labeled with [3H]leucine. TPS and MS, respectively, showed 85% and 65% increases in breast muscle cell cultures from dystrophic chick embryos. The half-life times for total protein and myosin from dystrophics were 19 and 32 hr, respectively as compared with 36 and 48 hr from controls. Noncollagen protein content (NCP) showed 27% decrease in postfusion stage (12 days) of cell cultures from dystrophics. The CK level showed 30% lower values in the cells from dystrophics but 50% higher values in their culture medium. The addition of leupeptin plus pepstatin (50 microgram/ml) to these cultures resotred NCP content, total protein and myosin turnover to normal values and significantly increased TPS and MS. The addition of diphenylhydantoin (DPH) (20 microgram/ml) to cell cultures from dystrophics did not change the NCP content nor the turnover for total protein and myosin but significantly increased TPS, MS and CK while medium CK significantly decreased. The addition of leupeptin plus pepstatin or DPH to muscle cell cultures from normal chick embryos also significantly stimulated TPS and MS.

[Malignant melanoma, leukoderma and vitiligo]

We report about two patients with malignant melanoma, who developed vitiligo at a site distant from the primary melanoma after surgery and during consecutive immunotherapy. In two patients a leucoderma was observed within the area, where metastatic lymphnodes had been excised, as also reported in the literature. These depigmentations may be due to an immunologic defense mechanism, but there is no evidence, if they represent a favourable sign in the course of malignant melanoma.

Propagation in a weakly anisotropic waveguide

In this communication we have considered propagation in a weakly anisotropic dielectric waveguide. It is shown that for a positive anisotropy the fractional power carried by the guide core increases over the isotropic case and that the anisotropy has an increasing effect as cutoff is approached. For negative anisotropy the effect is reversed. The increase in the fractional power varies linearly with the value of anisotropy with slope increasing as cutoff is approached. The degeneracy between the HE(n+1,m) and EH(n+1,m) modes present in the isotropic weakly guiding approximation is broken, and it is physically significant to distinguish between EH and HE modes. The anisotropy in retinal receptors (considered as dielectric waveguides) increases the stability of modal power with variation of the wavelength, although the effect is too small to explain the observation.

Cholecystectomy without drainage, nasogastric suction, and intravenous fluids

A comparative study was made between 60 patients in whom drainage of subhepatic space was performed after uncomplicated cholecystectomy and 60 patients in whom no drainage was performed. In addition, 30 patients were treated without drainage, nasogastric suction, or intravenous fluids. After operation the patients were evaluated as to postoperative pyrexia, wound infection, lung atelectasis, thrombophlebitis, and postoperative stay in hospital. Fever and wound infection occurred in fewer patients without drainage than those with drainage, but omission of nasogastric suction and intravenous fluids did not influence the incidence of wound infection. Postoperative stay in hospital was shorter in the patients without drainage and shortest in those treated without drainage, nasogastric suction, and intravenous fluids. Nasogastric suction and intravenous fluids are not needed postoperatively, as the degree of the paralytic ileus is very slight and they may be harmful, causing lung atelectasis and thrombophlebitis. Uncomplicated cholecystectomy may be performed safely without drainage, postoperative nasogastric suction, and intravenous fluids.

Perforation of hydatid cyst into the common bile duct; report of four cases

Four cases of hydatid cysts which perforated into the common bile duct are presented. Jaundice was the presenting symptom in three cases. The operative treatment consisted of choledochotomy, evacuation of the daughter cysts and the membrane of the mother cyst and drainage through the T-tube. In one case, it was possible to open the mother cyst, evacuate its contents and drain it externally.

Axillary sympathectomy for upper extremities

Among the several various surgical approaches to the cervico-dorsal sympathetic system, the axillary approach seems to us the operation of choice. The operation is simple, gives excellent access to the required sympathetic ganglions, including the lower part of the stellate ganglion, down to the fifth thoracic ganglion. In all cases the sympathectomy was clinically complete. The postoperative course was mostly smooth, and the few cases of transient Horner's Syndrome, pneumothorax and hemothorax could have been avoided.