Origin and immunological hyporeactivity of canine alveolar lymphocytes

Autochthonous canine thoracic duct lymphocytes were isolated, labelled with 111indium and injected intravenously. Direct sampling showed that the label passed from blood to lymph within 25 hr. By gamma camera imaging, the initial accumulation of 111In the liver and spleen was followed by a striking increase in lymph node associated activity between 24-36 hr. Although initial lung-associated counts were low, a bicarbonate-induced non-specific inflammation of the right lung induced a rapid and selective accumulation of labelled lymphocytes (ratio right to left lung 8:1). Cell suspensions lavaged from the alveolar surface showed only a 9% response to phytohaemagglutinin (PHA) compared to peripheral blood lymphocytes (PBL). The addition of unfractionated lavage cells to PBL caused a macrophage-dependent suppression of mitogen responsiveness. However, macrophage depletion of alveolar lavage cells did not restore the lymphocyte response to PHA. Similarly, the frequency of alloreactive precursors of cytolytic lymphocytes (CTL) was almost 10-fold less in alveolar lymphocytes compared to PBL. Thus, bronchoalveolar lavage provides a technique by which viable cells may be recovered in significant numbers from the alveoli and should be invaluable for the investigation of lung allograft rejection.

Plasma bile salt levels in patients presenting with generalised pruritus: an improved indicator of occult liver disease

Fasting plasma bile salt concentrations were measured in 26 patients presenting to a Skin Department who had generalised pruritus without primary skin disease, as part of a screening investigation for systemic causes of pruritus. The results were compared with conventional tests of hepatic function. Plasma-conjugated cholate measurements identified all patients with hepatobiliary disease. Conventional liver function tests were abnormal in these patients but also in five patients with no other evidence of hepatic dysfunction. Fasting conjugated-cholate measurements offer a useful screening test for identifying hepatobiliary disease in patients presenting with generalised pruritus.

An analysis of in vivo cell migration during teleost fin morphogenesis

In the teleost embryo the pectoral fin bud initially displays an apical ectodermal ridge along its entire distal margin. The ridge subsequently becomes transformed into an apical fold as the distal ectodermal epithelium grows and folds to enclose an extracellular space between the apposed basal surfaces of the epithelium. Collagen fibrils up to 2 micron in diameter, termed ‘actinotrichia’, are deposited along the proximo-distal axis in two (dorsal and ventral) arrays. The actinotrichia are aligned parallel to one another with a regular spacing along the greater part of their length. Mesenchymal cells migrating distally from the base of the fin bud encounter the dorsal and ventral arrays of actinotrichia and move between them apparently using the fibrils as a substratum. The entire structure is transparent and, using the killifish Aphyosemion scheeli, we have investigated the migration of the mesenchymal cells between 135 and 220 h of development, using Nomarski interference contrast microscopy and time-lapse video recording. The number of cellular processes per cell increased significantly during the period of observation. These processes could be graded according to their diameters. Processes of diameter greater than 2 micron were not usually aligned along actinotrichia and arose at any aspect of the cell body. In contrast, processes with diameters less than 2 micron appeared to be confined to the distal aspects of the migrating cells and showed an increasing tendency to become aligned as development progressed. Time-lapse video recordings revealed that such aligned processes move faster (mean speed 17.98 (+/− 2.25) micron/h) than non-aligned processes (mean speed 4.66 (+/− 0.67) micron/h). Whole cell translocation was generally slower than rates of process movement: the lowest mean value (1.52(+/− 0.36) micron/h) was recorded between 135 and 160 h of development rising to a maximum mean rate (4.72(+/− 0.42) micron/h) between 195 and 220 h; the period of the fastest rate of cell translocation correlated with maximum process alignment along actinotrichia. Thin 1 micron plastic sections revealed that, generally, aligned processes were in close association with the surface of the actinotrichial fibrils and not the spaces between them.

Intravenous cyclosporine kinetics in renal failure

Kinetics of the novel immunosuppressive cyclosporine were determined in four patients with terminal renal failure. After a short intravenous infusion (2.05 to 3.5 mg/kg in 4 hr), blood and plasma concentrations were measured (HPLC and radioimmunoassay [RIA] up to 36 hr. After infusion, concentration curves of the drug were characterized by a rapid initial fall (t 1/2 alpha 0.10 +/- 0.03 hr), followed by a biphasic elimination phase with corresponding t 1/2s of 1.08 +/- 0.25 hr (t 1/2 beta) and 15.8 +/- 8.4 hr (t 1/2 gamma). The volumes of distribution, calculated from whole blood concentrations (HPLC), were 0.140 +/- 0.48 l/kg (volume of the central compartment) and 3.49 +/- 2.65 l/kg (volume of distribution at steady state), whereas systemic clearances were 0.369 +/- 0.08 l/hr/kg. Blood levels measured by RIA exceeded the HPLC values after the fourth hour by up to 100%, indicating the production of cross-reacting cyclosporine metabolites. Plasma concentrations were considerably lower than in whole blood. Elimination of unchanged cyclosporine in patients with renal failure appears to be of the same order as in those with normal kidney function. Modification of the initial dosage regimens is therefore probably not required.

Lectin-dependent and lectin-independent activities of human mononuclear cells that modulate the growth of human synovial cells

Human peripheral mononuclear cells (MC) secrete 2 soluble activities that modulate the growth of human synovial fibroblastic cells. A growth-suppressive, lectin-dependent activity is elaborated by the non-adherent population and its secretion begins before DNA synthesis is initiated in concanavalin-stimulated MC cultures. The elaboration of this activity is partially dependent on the presence of serum and it appears to be distinct from virus-induced human leukocyte interferon. The second activity is secreted spontaneously by the MC, under a variety of culture conditions including supplementation with homologous human plasma, and it enhances the growth of synovial fibroblasts. The rate of secretion of the growth-enhancing activity by the nonstimulated MC approximately parallels that of the inhibitory activity from the stimulated MC cultures. MC from patients with rheumatoid arthritis and from nonaffected individuals secrete similar concentrations of growth-stimulatory activity for the synovial fibroblasts.

Biofeedback and relaxation in the treatment of migraine headaches: comparative effectiveness and physiological correlates

Twenty-seven migraine headache patients were divided into three equal groups which received thermal biofeedback, frontalis EMG biofeedback, or relaxation training. Training was given under "massed" practice conditions (nine sessions per week) and consisted of 18 training sessions and six test-generalisation sessions. While improvements in headaches were observed in all groups, the best improvements took place in the thermal biofeedback group, which had almost complete elimination of migraine attacks by the end of training, and maintained that performance as long as six months after training. Examination of the patterns of skin temperature and EMG changes in the three groups over the course of training also points to a relationship between skin temperature control and reduction in migraine headache symptomatology, and suggests that this relationship is worthy of further investigation.

Evidence for a slowing in trimethoprim resistance during 1981--a comparison with earlier years

Two thousand seven hundred bacterial strains, isolated during 1981 from urine specimens both from patients in hospital and general practice, were examined for resistance to trimethoprim. The incidence of such resistance was 13% in the hospital isolates and 5.8% in the general practice strains. High level resistance (MIC greater than 1 mg/ml) was present in 75-90% of the resistant strains. With the exception of Staphylococcus epidermidis and Proteus mirabilis, almost all the trimethoprim-resistant strains were also resistant to sulphonamide. In 410 strains from sputum specimens the incidence of resistance was 5.4%. Disc testing for the determination of sensitivity of urine isolates is best carried out using a 5 micrograms disc, while for sputum isolates our present experience indicates that a 1.25 micrograms disc is most appropriate. Our results indicate that the rate of increase in the acquisition of resistance to trimethoprim appears to have slowed down compared with the period 1975-1977, and that almost all this resistance is now high level. The introduction of trimethoprim alone for therapeutic use appears to have little if any effect on the incidence of trimethoprim resistance.

Distinctive patterns of cAMP-binding proteins and their relationship to hemopoietic cellular differentiation

In order to clarify distinctions among cAMP-binding protein patterns present in hemopoietic cells of the various major lineages, we have studied extracts from 18 human cell lines by photoaffinity labelling with 8-azido [32P]cAMP, followed by SDS-polyacrylamide gel electrophoresis and autoradiography. Four major cAMP-binding protein bands were noted. These occurred in five recognizable patterns of combinations, each of which was restricted to cells of particular lineages. A distinctive pattern was found in the pluripotent stem cell line K562, confirming its unusual nature compared with other lines committed to myeloid or lymphoid differentiation. Three patterns were noted among the pre-B and early and late B cell lines studied, which may thus define sequential stages of differentiation of this series. These studies indicate the utility of cAMP-binding proteins as a biochemical differentiation marker system. The variety of phenotypes noted further suggests a role for them in the development or expression of specialized cellular functions.

Assessment of liver function using fasting bile salt concentrations in psoriasis prior to and during methotrexate therapy

To determine if fasting bile salt concentrations are an accurate indicator of pre-existing and methotrexate-induced liver disease in patients with psoriasis, the plasma concentrations of conjugated cholate, chenodeoxycholate and sulpholithocholate were measured in 18 patients being assessed for methotrexate therapy and 21 receiving long-term therapy. The results were compared with other liver function tests and liver histology. The liver function tests were a poor indicator of occult liver disease and, whilst fasting bile salts appeared more sensitive, they were still unreliable and inadequate for the clinical assessment of the hepatopathy associated with psoriasis. The reasons for these discrepancies are discussed.

Pharmacokinetic study of methyl glyoxal-bis-guanylhydrazone (methyl-GAG)

Using a paired ion exchange high pressure liquid chromatographic assay, pharmacokinetic evaluation of methyl glyoxal bis guanylhydrazone (methyl-GAG) was performed in nine male New Zealand albino rabbits following administration of a single intravenous bolus dose of 50 mg/kg B.W (550 mg/m2 BSA). Blood samples were collected before and at intervals of 5, 10, 15, 30 min and 1, 2, 3, 4, 6, 8, 12, 18, and 24 h after administration of the drug. The analysis of experimental data indicates a three compartment open model with first order elimination from the central compartment described by the equation Cpt = A.e-alpha t + B.e-beta t + C.e-gamma t, where A, B, C, are 107.985, 4.785, and 0.763 micrograms/ml, respectively. alpha, beta, gamma, are 5.466, 0.487, and 0.030 h-1, respectively, and T1/2 alpha, beta, gamma are 7.6, 85.3 min and 23.1 h, respectively. The mean volume of distribution in the central compartment Vc was 0.44 liters (1)/kg, volume of distribution Vdarea 30.326 1/kg, and the total body clearance 0.9097 1/kg/h. The existence of a long terminal plasma half life of methyl-GAG reported previously in human studies was also confirmed in experimental animals and may explain the cumulative toxicity of this drug.

Early pectoral fin development and morphogenesis of the apical ectodermal ridge in the killifish, Aphyosemion scheeli

Using scanning electron microscopy it has been found that in the killifish the distal epithelium of the pectoral fin bud forms a morphologically distinct apical ectodermal ridge along its entire distal margin. This ridge is a relatively more prominent feature than its counterpart in various tetrapod systems. At a later stage the ridge becomes folded internally and elongates distally marking the transformation of the ridge into a fin fold. By continued distal growth the fin fold develops into a semicircular swimming-paddle. Collagenous rays or actinotrichia differentiate in a highly ordered arrangement close to the epithelial basement membrane within the space enclosed by this elongating fin fold and apparently support the early swimming-paddle. During the ridge-to-fold transition the fin bud displays a dorsal deflection of approximately 45 degrees and a caudalward rotation about the axis of the fin itself. This change in orientation results in close apposition of the developing fin structure to the flank.

VM-26 with prednisone and vincristine for treatment of refractory acute lymphocytic leukemia

Fifty-six children with refractory acute lymphocytic leukemia (ALL) were assessed for remission-induction responses to VM-26 (250 mg/m2 per week) in combination with prednisone (40 mg/m2 per day) and vincristine (1.5 mg/m2 per week). Each child had been treated intensively with steroids, vincristine, daunorubicin and L-asparaginase. In fact, all patients had failed to respond to previous reinduction therapy with prednisone-vincristine or had relapsed while receiving vincristine. Our intent in this study was to test whether or not addition of VM-26 to prednisone-vincristine would overcome clinical resistance to these established agents. Complete remissions were induced in 17 patients (0.30) over 4 to 6 weeks. Five of these children, all clinically unresponsive to prednisone-vincristine alone, had complete remissions that lasted longer than 1 year; two remain in remission for 2 1/2 years and both are now off therapy. Myelosuppression, the most serious treatment complication, was documented in 20 of 26 evaluable patients. The median time to recovery of normal marrow function was 15 days. These results demonstrate further the potential of VM-26 in combined-drug treatment of refractory ALL. Whether the effectiveness of this combination represents potentiation of prednisone and vincristine activity by VM-26 or some other, as yet unidentified interaction, remains to be determined.

Inhibitory effects of sodium and other monovalent cations on human platelet adenylate cyclase

Both basal and prostaglandin E1 (PGE1)-stimulated human platelet adenylate cyclase activity are inhibited by Na+ and other monovalent cations. Inhibition occurs when the cations are present in concentrations of 20 to 120 mM. Inhibition of basal activity by epinephrine requires the presence of GTP but not Na+. In the presence of epinephrine and GTP, Na+ further reduces basal activity, and the combined effects of all three ligands results in a 70% reduction of basal activity. Sodium, however, does not increase the fractional inhibition of basal activity attributable to epinephrine. Sodium increases the concentrations of epinephrine and of PGE1 required for half-maximal inhibition and stimulation of adenylate cyclase but does not alter the apparent km for Mg2+ or ATP. The rate and extent of adenylate cyclase activation by the GTP analog guanyl-5'-yl imidodiphosphate is reduced by Na+, although the cation does not prevent the acceleration of activation by guanyl-5'-yl imidodiphosphate induced by PGE1. Other monovalent cations also inhibit the platelet cyclase with an order of potency of Na+ greater than Li+ greater than K+ greater than choline+. In addition to demonstrating that Na+ is not required for hormonal inhibition of platelet adenylate cyclase, these studies demonstrate the multiple inhibitory effects which can be induced by Na+ and other monovalent cations. The pattern of these effects suggests that the cations interfere with functional coupling between receptors, guanine nucleotide binding units, and catalytic units of the adenylate cyclase complex.

Effect of soluble products from lectin-stimulated lymphocytes on the growth, adhesiveness, and glycosaminoglycan synthesis of cultured synovial fibroblastic cells

Human blood mononuclear cells exposed to concanavalin A or phytohemagglutinin secrete a soluble factor that arrests the growth of human synovial fibroblastic cells in culture. Once the growth-inhibitory effect is initiated it cannot be reversed by washing the fibroblastic cells, by refeeding with nonconditioned fresh serum-containing medium, by trypsinization, EDTA treatment, or a combination of these procedures. Media from nonstimulated mononuclear cells, fibroblastic cells, or the lectins themselves do not contain similar inhibitory activity that can be detected by the present culture systems. This lectin-dependent, growth-inhibitory activity does not have a cytotoxic effect on the fibroblasts but increases their adhesiveness to plastic or glass surfaces, and the cells tend to assume a less fibroblastic morphology. The growth-inhibitory activity is stable in the cold and is nondialyzable or ultrafilterable, but the activity is rapidly lost at temperature between 60 degrees and 70 degrees C and at pH 2.0. The growth-arrested cells secrete more glycosaminoglycan per cell in the medium and synthesize more cell surface glycosaminoglycan than the controls. However, the increased glycosaminoglycan synthesis cannot be explained as being entirely secondary to a cell density effect as it is also observed when adjustments are made for the differences in growth rates.

VM-26 and cytosine arabinoside combination chemotherapy for initial induction failures in childhood lymphocytic leukemia

Combination chemotherapy with VM-26 and ara-C was given to 14 children with acute lymphocytic leukemia who had not responded to initial treatment with prednisone, vincristine, daunomycin, and asparaginase. Nine of these patients had also received ara-C. At diagnosis, five children were classified as having standard prognostic features and nine as being at high risk for treatment failure. The drug combination was administered by vein twice a week for four weeks at dosages of 165 mg/m2 for VM-26 and 300 mg/m2 for araC. Nine complete remissions, five in patients with high-risk leukemia, were induced with acceptable toxicity; all 9 subsequently were given continuation therapy with oral mercaptopurine and methotrexate. Four of the 9 patients have relapsed at 2--21 months. All treatment was stopped in 2 patients after 30 months of complete remission. Combinations of VM-26 and ara-C represent an alternative remission induction treatment for patients who fail to attain initial remission with agents of established effectiveness. These agents may especially benefit patients with prognostic features indicating a high risk of treatment failure.

Long-term neurological implications of somnolence syndrome in children with acute lymphocytic leukemia

A longitudinal study of 49 children with acute lymphocytic leukemia (ALL) assessed the long-term effects of central nervous system (CNS) prophylaxis on brain function. From 10 to 12 electroencephalograms (EEGs) were done before and at intervals during after 30 months of treatment that included 2,400 rads of CNS irradiation plus intrathecal methotrexate therapy. None of the children had CNS leukemia, and all remained in first complete remissions. All 49 had abnormally slow EEG background frequencies during the four-year study, and 29 (60%) developed somnolence syndrome six to eight weeks after CNS prophylaxis. During this syndrome, EEG background frequencies decreased more than 3 standard deviations below the expected mean values for normal children. Thereafter, 7 of the 29 began to show signs of learning disabilities and 7 developed recurrent seizures. Of the 20 children who did not have the syndrome, none showed later evidence of CNS dysfunction. Somnolence may be an early indicator of long-term neurological sequelae after cranial irradiation.

RNA synthesis in germinating embryonic axes of soybean and wheat

The rate of synthesis of RNA during early germination of wheat and soybean embryos was investigated by ascertaining the incorporation of radioactive uridine into RNA. In wheat embryos, where the lag period preceding rapid growth is 5.5 hours, there is a 2-fold increase in RNA synthesis between 1.5 and 5.5 hours, with half of the increase occurring by 3.5 hours. In soybean axes, where the lag period is 9.5 hours, the increased rate of RNA synthesis is 5.5-fold between 1.5 and 9.5 hours, with three fourths of this increase occurring after 4 hours.Analysis of the ratio of radioactivity incorporated into the 18S and 26S rRNAs of the germinating embryos provided a further measure of the increased rates of RNA synthesis. With wheat embryos, the 26S/18S ratio increased from 1.0 at 1.5 hours to 1.5 at 3.5 hours, while with the soybean axes, distinct ribosomal patterns were obtained only after 4 hours and the 26S/18S rRNA ratio increased from 0.4 at 4 hours to 1.0 at 9 hours. The extent of methylation of the rRNA synthesized at 4 and 9 hours in the soybean axes was similar, indicating that the methylating capacity of the axes is probably not rate limiting to rRNA synthesis. In both seed embryo systems the level of UTP increased 2 to 3-fold during the lag phase of germination. With wheat embryos, the time course of the increase in UTP correlated approximately with the change in the rate of RNA synthesis. With the soybean axes, however, the increase in the rate of RNA synthesis occurred predominantly after the rise in the level of UTP.

Combined VM-26 and cytosine arabinoside in treatment of refractory childhood lymphocytic leukemia

On the basis of previous findings at this institution, VM-26 and Cytosine Arabinoside (ara-C) were used in combination to treat 33 children with refractory acute lymphocytic leukemia (ALL). Chemotherapy was given by vein twice a week for four weeks at dosage of 300 mg/m2 for ara-C and 50, 75, 110, 165, or 200 mg/m2 for VM-26. Ten marrow remissions (nine complete and one partial) were induced, with hypotension (2/33) and bone marrow hypoplasia (20/33) the most significant side effects observed. Therapeutic responses were obtained with each dosage of VM-26 except 75 mg/m2; myelosuppression developed at all dosages, being most prolonged at 200 mg/m2. Ten of the 23 non-responders did not complete their planned courses of therapy. The significance of this information is that combinations of VM-26 and ara-C were effective in patients who were either in late stages of their leukemia or had never achieved an initial remission. All had been previously treated with prednisone, vincristine, daunomycin and L-asparaginase. In addition, seven of the 10 responders had previously received ara-C in other drug combinations. The use of VM-26 and ara-C in combination may be warranted for newly diagnosed patients who are at high risk for treatment failure with first-line drugs.

Regulation of human platelet adenylate cyclase by epinephrine, prostaglandin E1, and guanine nucleotides. Evidence for separate guanine nucleotide sites mediating stimulation and inhibition

A method for preparing human platelet membranes with high adenylate cyclase activity is described. Using these membranes, epinephrine and GTP individually are noted to inhibit adenylate cyclase slightly. When present together, epinephrine and GTP act synergistically to cause a 50% inhibition of basal activity. The epinephrine effect is an alpha-adrenergic process as it is reversed by phentolamine but not propranolol. The quasi-irreversible activation of adenylate cyclase by Gpp(NH)p is time, concentration, and Mg2+-dependent but is not altered by the presence of epinephrine. Adenylate cyclase activated by Gpp(NH)p, and extensively washed to remove unbound Gpp(NH)p, is inhibited by the subsequent addition of Gpp(NH)p, GTP, and epinephrine. This effect of epinephrine is also an alpha-adrenergic phenomenon. In contrast to epinephrine which inhibits the cyclase, PGE1 addition results in enzyme stimulation. PGE1 stimulation does not require GTP addition. PGE1 accelerates the rate of Gpp(NH)p-induced activation. Low GTP concentrations (less than 1 x 10(-6) M) enhance PGE1 stimulation while higher GTP concentrations cause inhibition. These observations suggest that human platelet adenylate cyclase possesses at least two guanine nucleotide sites, one which interacts with the alpha-receptor to result in enzyme inhibition and a second guanine nucleotide site which interacts with the PGE1 receptor and causes enzyme stimulation.

Glycosaminoglycan synthesis and glucose uptake by rheumatoid and nonrheumatoid fibroblastic cells in culture. The effect of nutritional factors

Glycosaminoglycan (GAG) synthesis and glucose uptake by rheumatoid (R) and nonrheumatoid (NR) synovial cells were studied at the second subculture during four different sets of nutritional conditions and at sequential, defined intervals of the growth cycle. Synovial fibroblastic cells in monolayer cultures secrete both hyaluronic acid and sulfated GAGs in a ratio of about 8 : 1. With increasing cell density the ability to sulfate GAGs appears to decrease. No significant differences in GAG synthesis between rheumatoid and nonrheumatoid lines on a per cell basis could be detected during any interval in the growth cycle. Similarly, no significant differences of glucose uptake per cell could be demonstrated between rheumatoid and nonrheumatoid lines under the various protocols applied throughout the growth cycle. The most important factor determining glucose uptake per cell is the availability of glucose in the medium which is in turn closely correlated with cell number.

Childhood acute lymphocytic leukemia: study VIII

This controlled study of children with ALL was designed to test the efficacy and toxicity of one-, two-, three- and four-drug therapy during remission and whether more aggressive therapy in the first eight weeks prolongs remission in patients with features associated with a particularly poor prognosis. After inducing remission with prednisone, vincristine and asparaginase, patients received cranial irradiation and IT methotrexate and were randomized to receive: 1--methotrexate alone; 2--methotrexate plus mercaptopurine; 3--same as in group 2 plus cyclophosphamide; and 4--same as in group 3 plus arabinosyl cytosine. Patients with CNS leukemia at diagnosis received IT methotrexate weekly during the induction period and a higher dose of CNS irradiation. Patients with anterior mediastinal enlargement at diagnosis received radiotherapy to the mass during the induction period. Patients who failed to attain bone marrow remission after four weeks of therapy were given daunorubicin and prednisone for 2--4 additional weeks. Of the 282 patients entering this study between January 1972 and November 1975, 268 (95%) attained complete remission and 228 (85%) were randomized to receive continuation chemotherapy with 1, 2, 3 or 4 drugs. In Group 1 (methotrexate alone), 14 of 20 patients relapsed and 9 developed leukoencephalopathy without antecedent CNS leukemia apparently due to higher doses of intravenous methotrexate; in Groups 2, 3 and 4 the results were equivalent, but without leukoencephalopathy in initial CR. The addition of cyclophosphamide and arabinosyl cytosine increased toxicity and complications without demonstrably increasing the leukemocidal effect. In the 40 patients given additional early therapy, the modalties employed in this study did not prolong remission.

The growth kinetics of synovial fibroblastic cells from inflammatory and noninflammatory arthropathies

The growth kinetics of subcultured human synovial fibroblasts from 16 patients with inflammatory and noninflammatory arthropathies were studied in antibiotic free media. The experimental design allowed a clear distinction between the growth rates and final saturation densities achieved. The effects of refeeding and of the serum concentration were evaluated for each line. Inflammatory lines achieved significantly higher final saturation densities and growth rates than noninflammatory lines for most protocols, but the differences between rheumatoid and nonrheumatoid groups were less marked. Inflammaroty fibroblasts demonstrated a greater independence to nutritional and growth stimulatory factors in their microenvironment than noninflammatory fibroblasts.

The child with cancer on immunosuppressive therapy. Implications for nursing

Improved therapeutic approaches to childhood cancer not only have produced remarkable extensions in survival, but also have introduced major new problems into the field of pediatric oncology nursing. Care of the patient whose normal immune responses have been suppressed by irradiation and prolonged chemotherapy is one problem. The immunosuppressed child is highly susceptible to infections, and the nurse must devise a plan of care that is designed to reduce the risks that lead to these infectious complications. Because of the stresses associated with aggressive cancer therapy the patient may experience serious emotional difficulties that require the nurse's attention. Most important, the nurse's attitude toward the childhood cancer patient must be broadened to include the concept that many of these children are possibly cured of their cancer and should be encouraged to lead normal lives.

A preliminary report on experienced closed-circuit television users

In an attempt to describe the use and usefulness of closed-circuit televisions (C.C.T.V), a preliminary follow-up study of 27 veterans was undertaken by the Western Blind Rehabilitation Center. The veterans had been loaned C.C.T.V.'s by the Veterans Administration and represented a wide range of ages, backgrounds, and pathologies. On the basis of the present data, it is concluded that C.C.T.V. significantly improve the functioning of the majority of users and that this improvement appears to be a long-term benefit.

The influence of gibberellic Acid on the permeability of model membrane systems

Gibberellic acid increases the permeability of model membranes composed of various plant-source lipids, a sterol, and dicetyl phosphate. As a result of hormone treatment, the flux of uncharged molecules such as glucose or sucrose, or charged ions such as chromate, through the model membranes (liposomes or micelles) is increased. The revelance of this finding to the in vivo effects of the hormone is briefly discussed.