[Encephalitis of the basel ganglia associated with mumps]

Two weeks after epidemic parotitis a 10-year old boy developed an acute extrapyramidal syndrome together with pyramidal tract signs but without impairment of consciousness. The CSF showed mild pleocytosis. The CT of the brain exhibited a well defined circumscribed and symmetrical swelling and hypodensity of the basal ganglia and of the internal capsule. Only slight and transient dysrhythmia was to be found in the EEG. Therapy with Prednisolone, Biperidene and Tiapride resulted in regression of symptoms. But one year later rigor and pyramidal tract signs remained evident in spite of intensive physiotherapy and logopaedic measures. Residual symmetric atrophia of the basal ganglia became evident in the CT by dilatation of the anterior horns of the lateral ventricles caused by lacking of the vault of the caudate nuclei heads.

Self-healing reticulohistiocytosis: a clinical, histologic, and ultrastructural study of the fourth case in the literature

A case of self-healing reticulohistiocytosis is reported. Our case differed from those previously reported in that tumors developed 17 days after birth (instead of at birth) and all tumors disappeared rapidly within three weeks (instead of two to three and one-half months). Hematologic abnormalities such as absolute neutropenia, marked lymphocytosis with many atypical cells, and atypical monocytes in bone marrow in association with this disease have not previously been reported. The patient had palpable liver which persisted with absolute neutropenia for about a month. The diagnosis of self-healing reticulohistiocytosis was confirmed by characteristic histology and by the demonstration of Langerhans' cells with typical granules in the tumor cells.

T-cell response to B-cells and Epstein-Barr virus antigens in infectious mononucleosis

After Epstein-Barr virus (EBV) infection in vivo, B-cells with latent virus infection persist indefinitely through life. These cells grow in vitro on explanation and can be established as immortal B-cell lines. To reconcile the unlimited growth potential in vitro with the maintenance of a low proportion of B-cells infected by EBV in vivo, a strict in vivo control mechanism has to be postulated. Certain aspects of this control are apparent when the primary infection is followed by infectious mononucleosis. This is characterized by lymphocytosis and the presence of activated T-cells. The T-cell proliferation is probably the manifestation of the immune response against EBV antigens. However, the reaction of T-cells upon encounter of B-blasts is also likely to contribute to the events. At present, it is difficult to detect an EBV-specific component in the action of the T-cells in the acute phase of mononucleosis exerted on B-cells. However, for the clinical course of the disease the activation of T-cells is important. The activated T-cells may control and also eliminate the B-cells infected by EBV. In addition to the immunity which develops during the disease, th immunoregulatory mechanism is likely to have a role in the inhibition of B-cell proliferation.

Prevalence of cytomegalovirus infection in homosexual men

Cytomegalovirus (CMV) was cultured from the urine of 14 of 190 homosexual but none of 101 heterosexual men attending a venereal disease clinic (P less than 0.005). Viruria was confined to men less than 30 years of age and was present in 14% of this group. Antibody to CMV was measured in the sera of 139 homosexual and 70 heterosexual men attending the same clinic and in 103 male volunteer blood donors. Titers were found in 94% of homosexual patients but in only 54% of heterosexual patients (P less than 0.005) and 43% of male volunteer blood donors (P less than 0.005). The data suggest that sexual transmission is an important mode of spread of CMV among adults and the homosexual men are at greater risk for CMV infections than are heterosexual men. Homosexual men might considered candidates for the evaluation of the efficacy of CMV vaccines in preventing horizontal transmission of infection.

Lymphoid interstitial pneumonia

A case of lymphoid interstitial pneumonia in a 43-year-old woman is reported. Following a clinical evolution of two years, not influenced by the treatment applied, a pulmonary biopsy puncture was performed to determine the diagnosis. The histological examination furnished evidence of diffuse interstitial infiltration with adult lymphocytes and perivascular, juxtavascular and juxtabronchic cellular cuffs and nodules. Another fragment revealed large lymphoid nodules including reorganized pulmonary structures. Various aspects concerning the differential diagnosis of this pulmonary disease are discussed.

The in vitro effects of Bordetella pertussis lymphocytosis-promoting factor on murine lymphocytes. IV. Generation, characterization, and specificity of cytotoxic lymphocytes

Cytotoxic effector lymphocytes were induced in cultures of mouse spleen or lymph node cells by lymphocytosis promoting factor (LPF). The LPF-activated cytotoxic cells: (a) were not generated unless proliferation occurred; (b) sedimented in the lighter density fraction of a bovine serum albumin gradient; (c) were large, blast-like cells; and (d) were lysed by Thy-1.2 antiserum plus complement and, therefore, were T cells. Neither LPF alone nor supernates from stimulated cultures were cytotoxic. Unlike the situation with concanavalin A and phytohemagglutinin P, LPF-stimulated cytotoxic effector lymphocytes required no further addition of mitogen for maximal cytotoxicity. The effector cells displayed specificity, destroying only allogeneic but not syngeneic normal cells; in the case of tumor cells, both allogeneic and syngeneic cells werelysed in the absence of added mitogen. The reason for differentiated cytotoxicity toward syngeneic tumor and normal cells is not clear but may have some relevance to in vivo tumor rejection initiated by Bordetella pertussis.

Lymphocytosis-promoting factor of Bordetella pertussis: isolation, characterization, and biological activity

The leukocytosis and lymphocytosis-promoting factor (LPF) of Bordetella pertussis has been isolated in apparently pure form. LPF is a protein essentially free of lipid and carbohydrate with an estimated molecular weight of 67,000-73,600 daltons. Purified LPF induced both histamine sensitization and refractoriness to epinephrine-induced hyperglycemia and was a murine thymus-derived (T-) cell mitogen. Adenyl cyclase activity also appeared to be associated with LPF.

Effect of corticosteroids on exercise-induced lymphocytosis

Eight subjects ran on a treadmill at 8 miles per hr for 10 min. All developed lymphocytosis with predominant effect on the B cells. This was repeated 5 hr after receiving 60 mg of Prednisone. The lymphocytosis of both T and B cells were suppressed. When this was repeated 2 hr after receiving Prednisone, only lymphocytosis of the T subpopulation was suppressed. It was concluded that corticosteroid administration could suppress entry of lymphocytes into the circulation, with preponderant effect on the T subpopulation.

Studies on lymph humoral factor. Biological characteristics of a lymphocytopoietic factor in rat thoracic duct lymph

The biological characteristics of a lymphocytopoietic factor obtained from rat thoracic duct lymph (Yamashita, Fukumoto & Miyamoto, 1976) were further investigated. The lymph extract from normal rats failed to stimulate both large pyroninophilic cell-proliferation and mitotic response in the spleen and lymph node of the thymectomized, irradiated and marrow reconstituted rat (B rat). This suggests that target or responsive cells for the factor are not marrow-derived (B) cells, but thymus-derived (T) cells. On the other hand, the lymph extract from the lymphopenic lymph-drained B rats showed similar high lymphopoietic activity to those of normal rats, indicating that the existence of a thymus is not essential for the production or secretion of the factor. The fact that lymphocytotic rats produced by syngeneic lymphocyte transfusion are most sensitive to the lymph extract suggests that liver endogenous level of this factor and the responsiveness of target cells are regulated by the number of circulating T lymphocytes.

Microscopically and chemically detected haemolacria

Two methods have been developed for the detection of occult haemolacria (occult blood in tears): 1) Microscopy of conjunctival fluid aspirated by means of the quantitative pipette method. 2) Chemical stix method employed on a sample of conjunctival fluid transferred to cotton-wool plug. Double samples from 306 eyes were subjected to microscopy, and chemical tests were performed on samples from303 other eyes. Microscopy has been found to disclose occult blood in 13 per cent of normals (greater than or equal to 100 erythrocytes/3.1 mm2 in 3 per cent of normals), while blood is detected chemically in 3 percent. Occult blood is most frequently found in cases of acute infectious conjunctivitis (65 per cent microscopically and 21 per cent chemically), less frequently in subacute and chronic infectious conjunctivitis (26 and 20 per cent respectively). Haemolacria is most feequently seen in relation to neutrophilia (45 per cent), less frequently with lymphocytosis (35 per cent), and even more rarely in the absence of both neutrophilia and lymphocytosis (11 per cent). Ciliary congestion is an unlikely cause of haemolacria. Postoperatively blood is present for two or three days, wheras blood instilled into the conjunctival sac of a normal eye disappears in less than one hour. The protein concentration in tears is raised in association with haemolacria.

Relapses after withdrawal of proguanil treatment in tropical splenomegaly syndrome

After the remission of symptoms and reduction in spleen size while on proguanil therapy four patients with the tropical splenomegaly syndrome defaulted from treatment. The withdrawal of proguanil caused a recrudescence of original symptoms, splenomegaly, and a return of the initially raised serum IgM. Complete return to normal values was again effected with proguanil therapy.The role of the spleen in the tropical splenomegaly syndrome in the production of the raised serum IgM is discussed. These patients should be educated as to the nature of their disease and the importance of continued medical treatment.

Interaction of lymphoid and nonlymphoid cells with the lymphocytosis-promoting factor of Bordetella pertussis

The activity of soluble lymphocytosis-promoting factor (LPF) from Bordetella pertussis decreased after brief in vitro incubation with lymphoid cells or erythrocytes. The LPF activity was found to be associated with the cells used, and injection of the cells produced a leukocytosis and lymphocytosis which completely accounted for the loss of soluble activity. Attachment of LPF to cells was found to be reversible in vitro. It is suggested that reversible binding occurs in vivo.