Environmental surveys conducted in the Gulf region following the Gulf War to identify possible neurobehavioral consequences

During the 1991 Gulf War, the Iraqi army set Kuwait oil wells on fire. Wells and some oil refineries were burned, resulting in Kuwait and the surrounding Gulf region being exposed to toxic gases. The oil fires reached their peak in February 1991. On March 7, the fires in some fields were still burning at peak strength. Sulfur dioxide, particulates, carbon monoxide, and nitrogen oxides were emitted into the atmosphere. All of these substances can cause adverse health effects, which vary according to concentration and duration of exposure. A survey conducted in Kuwait clinics and emergency rooms showed an increase in upper respiratory irritation consistent with environmental air sampling results, indicating occasional high levels of particulates. Patient visits related to gastrointestinal illness, heart disease, psychiatric illness, chronic bronchitis and emphysema, and bronchiectasis increased during the period following the burning of the oil wells. There was no documented evidence of an increase in visits for acute upper and lower respiratory infections or asthma. Public health workers must recognize the high priority of collecting long-term health data and developing public health systems to assess those data.

Activation by estrogen of the number and function of forbidden T-cell clones in intermediate T-cell receptor cells

When estrogen (1 mg/mouse) was subcutaneously administered once into mice, the number of liver MNC increased but the number of thymocytes decreased profoundly from Day 3 to Day 20. Phenotypic characterization revealed that the proportion of intermediate (int) TCR cells with IL-2 receptor beta-chain (IL-2R beta) was elevated in both the liver and the thymus. Attention was then focused on how forbidden clones were distributed among various T-cell subsets, including IL-2R beta+ int TCR cells and IL-2R beta-high TCR cells. IL-2R beta+ int TCR cells are generated through the extrathymic pathway in the liver and an alternative intrathymic pathway, whereas IL-2R beta- high TCR cells are generated through the mainstream of T-cell differentiation in the thymus. It was demonstrated that forbidden clones, V beta 3+ and V beta 11+ cells, in BALB/C mice (Mls-1b2a) were confined to IL-2R beta+ int TCR cells, irrespective of the administration of estrogen. Interestingly, the proportion of forbidden clones among int TCR cells increased in the liver but decreased in the thymus after the administration of estrogen. Liver MNC that contained a high level of forbidden clones showed unexpected high levels of spontaneous proliferation and of the proliferative response to immobilized anti-V beta mAb (even in the combination of forbidden clone stimulations). The present results reveal that the levels of both int TCR cells and forbidden clones that induce hepatocyte damage preferentially increase in the liver, one of the prime target organs in autoimmune diseases, when estrogen is administered.

A comparison of proliferative response to IL-7 and expression of IL-7 receptors in intermediate TCR cells of the liver, spleen, and thymus

It is well established that IL-7 supports the earliest differentiation of both T and B cells in fetal and adult life. On the other hand, mature lymphocyte subsets tend to decrease the response to IL-7 in case of T and B cells. In a recent study, NK1.1+ T cells in the thymus are also found to efficiently respond to IL-7 and express IL-7 receptors (IL-7R). This population is generated through an alternative intrathymic pathway. A similar population, namely, T cells with intermediate levels of TCR (i.e., int TCR cells) are known to be generated through extrathymic pathways. In this respect, the proliferative response to IL-7 and the expression of IL-7R in int TCR cells of various organs were compared. Whole liver MNC and isolated int TCR cells from the liver were found to proliferate in response to IL-7. Moreover, a considerable population of int TCR cells in both the liver and thymus were found to carry a higher density of IL-7R on the surfaces than high TCR cells. More precisely, the intensity of IL-7R on int TCR cells in the thymus was the highest but those on int TCR cells in other organs were slightly lower (i.e., int TCR cells in the thymus greater than int TCR cells in the liver greater than high TCR cells). Taken together with the result of expression of IL-7 mRNA by hepatocytes and thymic tissues, it is concluded that IL-7 is one of the most important growth factors for int TCR cells both in the liver and thymus.

Case Report: amyopathic dermatomyositis associated with transformed malignant lymphoma

Amyopathic dermatomyositis is a disease of unknown origin characterized by the specific skin lesions of dermatomyositis but without clinical or laboratory evidence of myopathy. During the past 15 years, a great controversy between the different reports concerning a possible association of dermatomyositis with malignancy has been noted. In this report, the authors describe a patient with amyopathic dermatomyositis who presented first with a benign hyperplasia of the lymph node, which finally transformed into frank malignant lymphoma. In addition to follow-up care, screening tests to search for occult malignancy in patients with amyopathic dermatomyositis (or dermatomyositis) are recommended.

Suppression of fluid accumulation following pericardial inflammation in a patient with primary chylopericardium

The patient was a 50-year-old woman with primary chylopericardium. Triglyceride rich chyloid fluid was continuously drained from the pericardial space through an indwelling catheter. A surgical procedure was scheduled since a medium chain triglyceride diet was insufficient to control the fluid accumulation. Before the operation, inflammatory signs were apparent around the indwelling catheter and the catheter was removed immediately. The inflammation was easily treated with antibiotics, and the pericardial effusion no longer accumulated during a follow-up period of 10 months. The inflammatory process may have caused fibrin production and tissue adhesion in the pericardial cavity, and these might have prevented an accumulation of chyloid fluid and occluded the connection between the thoracic duct and the pericardial cavity.

Intermediate TCR cells with self-reactive clones are effector cells which induce syngeneic graft-versus-host disease in mice

It has been established that, even after syngeneic bone marrow transplantation, animals treated with immunosuppressive drugs may suffer from graft-versus-host disease, showing autoimmune-like symptoms. Although the major effector cells are known to be T-cell subsets, detailed characterization of such T cells remains to be investigated. In the present study, we characterized them, especially as to whether they are thymus-derived T cells or extrathymic T cells, and how self-reactive clones were distributed among the above T-cell subsets. BALB/c mice (Mls-1b2a) were irradiated (9 Gy), subjected to bone marrow transplantation, and then treated with cyclosporin A (CsA) for 6 weeks. From 2 weeks after the cessation of CsA, these mice displayed signs of GVH disease. The major target organs included the liver and colon. Two-color staining for CD3 and IL-2R beta was applied to identify CD3-IL-2R beta+ NK cells, CD3-intermediate +IL-2R beta+ cells (i.e., intermediate CD3 or TCR cells of extrathymic origin) and CD3-high+IL-2R beta- cells (i.e., high CD3 cells of thymic origin). It was demonstrated that the major expanding lymphocytes were intermediate TCR cells and that self-reactive clones (V beta 3+ and V beta 11+ cells in this strain of mice) were confined to this population. Interestingly, these self-reactive clones had ability to respond to immobilized anti-V beta 3 and anti-V beta 11 mAbs. Liver MNC in mice with GVH disease which contained the highest proportion of intermediate TCR cells were able to mediate the adoptive transfer of GVH disease to other irradiated (6.5 Gy) mice. Intermediate TCR cells also showed potent cytotoxic activity against syngeneic leukemia cells. These results suggest that intermediate TCR cells are the major effector cells for the induction of syngeneic GVH disease.

Enhanced elimination of Ph+ chromosome cells in vitro by combined hyperthermia and other drugs (AZT, IFN-alpha, TNF, and quercetin): its application to autologous bone marrow transplantation for CML

Autologous bone marrow transplantation (ABMT) for chronic myelogenous leukemia (CML) is limited because of the difficulty in purging Ph chromosome positive cells from bone marrow cells (or peripheral blood stem cells). Combining hyperthermia with certain drugs that affect Ph+ cell growth in vivo and in vitro may enhance the killing (apoptosis) of CML cells in vitro. In this study, we chose such drugs (i.e., azidothymidine [AZT], interferon-alpha [IFN-alpha], tumor necrosis factor [TNF], and quercetin) and tested this hypothesis using two CML-derived cell lines in vitro, K562 and KU812, to enhance the killing of CML cells with heat. Our results indicate that the optimal hyperthermic purging effect is achieved by heating at 42 degrees C for 1 hour with IFN-alpha (100 U/mL) and AZT (0.5 microM/L) or with quercetin (50 microM) [corrected], depending on the sensitivity of the CML cells eliminated in vitro. K562 cells were significantly eradicated by a combination of IFN-alpha and AZT, while KU812 cells were significantly inhibited by quercetin at the temperature and drug concentrations above. This combined effect may enhance apoptosis of CML cells in vitro.

Spiny keratoderma of the palms and soles

Six cases of a dermatosis characterized by "music box spine" keratotic papules limited to the palms and soles have been reported. The names that have been used for this type of dermatosis most commonly incorporate the term porokeratosis; for example, "porokeratosis palmaris et plantaris," or "punctuate porokeratotic keratoderma." We suggest the name "spiny keratoderma of the palms and soles," because the clinical, histologic, and electron microscopic features of this entity are distinct from porokeratosis. In addition, unlike porokeratosis, this entity has not shown malignant potential. We report a case of "spiny keratoderma of the palms and soles" and show that topical 5-fluorouracil is an effective treatment.

Effects of exposure to lead among lead-acid battery factory workers in Sudan

Health effects of occupational exposure to lead were investigated among 92 exposed workers in lead-acid battery factory and 40 nonexposed workers serving as a control group from an oil mill in Khartoum North industrial area. The two groups were closely similar in age, stature, body weight, and socioeconomic conditions. A highly significant increase (P less than .01) was recorded in blood lead, urinary coproporphyrin, and basophilic stippled red blood cells of the exposed group in comparison to the control group. Central nervous system symptoms (insomnia, fatigue, weakness, and drowsiness) were reported by 50% and other symptoms such as abdominal colic and constipation were reported by 41% of the exposed group. Blue line on the gum was detected only on 2% of the exposed group. Strong associations between exposure to lead and the prevalence of central nervous system symptoms, abdominal colic, and constipation were recorded. Exposure to exceedingly high levels of lead in the working environment causes adverse health effects.

Byssinosis: environmental and respiratory symptoms among textile workers in Sudan

This study has been carried out to investigate the prevalence of byssinosis and other respiratory symptoms among 311 Sudanese workers in different sections of the Khartoum Weaving and Spinning Company. The prevalence of byssinosis was 67% among blowers, 40% in carders and draw-frame workers, 42% in simplex workers and 37% in ring-frame workers. The prevalence of chronic bronchitis ranged between 29 to 47% in all groups. A significant fall in FEV1 was recorded in carders and draw- and ring-frame workers. There was also a statistically significant decrease in FVC after shift in all groups except in the ring-frame group. The result of the present study revealed that the prevalence of byssinosis was very high in mills processing coarse cotton. Application of control measures and the early detection of exposure effects will reduce the prevalence of byssinosis and other respiratory impairments.

Effectiveness of praziquantel against the South African strains of Schistosoma haematobium and S. mansoni

A total of 137 Black children from two schools in Natal, infected with either Schistosoma haematobium or S. mansoni, or both, were treated with praziquantel (Biltricide; Bayer-Miles) at a dosage of 40 mg/kg body weight. Dramatic reductions in egg output occurred within a matter of days and high cure rates (greater than or equal to 97%) were obtained in both S. haematobium and S. mansoni infections. Side-effects were of short duration and not serious.

Exposure to pesticides in agriculture: a survey of spraymen using dimethoate in the Sudan

There is a need for objective data on the exposure of spraymen to pesticides in agriculture in order to assess minimum requirements for practicable protection in tropical areas. To provide data, a survey was carried out in the Sudan on spraymen using dimethoate. No cholinesterase depressions were found and the calculated dose received by each man per day was within safe limits in the circumstances of this survey. Respiratory exposure was only a minor part of total exposure. The methodology of such surveys is discussed and the need for the use of a standard protocol is emphasized.