Incidental and purposeful random donor blood transfusion. Sensitization and transplantation

We conducted a prospective study to gauge the frequency and degree of sensitization by transfusion and/or pregnancy in 797 candidates for first renal transplants. Sensitization was proportional to the number of blood transfusions. Multiple transfusions or a history of pregnancy without transfusions had similar effects on sensitization. The combination of transfusion and prior pregnancy resulted in sensitization of 1/3 of the candidates. Patients who were not sensitized and were accepted for 1-haplotype living-related donor grafts or first-cadaver donor grafts were transfused to receive a total of 5 units of packed red blood cells. Parous patients had an undue rate of antibody formation and alternate means of selecting and managing parous women are described. Nonparous candidates had a low rate of sensitization (8%) that did not prove an impediment to obtaining a transplant. Only 2% of prospective LRD graft recipients developed antibody against their intended donor. Transplant patients were generally managed with azathioprine and prednisone. One-haplotype LRD graft survival of protocol patients was 93.7% one year posttransplant, and 82.1% at 5 years. One-year CD graft survival was 77%. There was no reduction in graft survival when the interval between transfusion and transplantation exceeded one year. Random donor transfusion is effective in improving renal graft survival. Some recent multiinstitutional reports indicate a reduction or absence of the transfusion effect with current immunosuppression. Discarding blood transfusion as a preparation for transplantation may be ill-advised pending a prospective study.

Evaluation of traditional plant treatments for diabetes: studies in streptozotocin diabetic mice

Seven plants and a herbal mixture used for traditional treatment of diabetes were studied in streptozotocin diabetic mice. The treatments were supplied as 6.25% by weight of the diet for 9 days. Consumption of diets containing bearberry (Arctostaphylos uva-ursi), golden seal (Hydrastis canadensis), mistletoe (Viscum album) and tarragon (Artemisia dracunculus) significantly reduced the hyperphagia and polydipsia associated with streptozotocin diabetes, but bayberry (Cinnamomum tamala), meadowsweet (Filipendula ulmaria), senna (Cassia occidentalis) and the herbal mixture did not alter these parameters. Bearberry, mistletoe and tarragon retarded the body weight loss but none of the eight treatments significantly altered plasma glucose or insulin concentrations. These studies suggest that bearberry, golden seal, mistletoe and tarragon may counter some of the symptoms of streptozotocin diabetes without, however, affecting glycemic control.

Clinical and pharmacologic correlations in cyclosporine-induced gingival hyperplasia

Cyclosporine-induced gingival hyperplasia was investigated in a clinical study of 100 patients over a period of 2 1/2 years. Seventy percent of the patients exhibited at least mild gingival hyperplasia. For doses within the therapeutic range, no direct correlation was found between the oral dose or the serum trough concentration of cyclosporine and the severity of gingival hyperplasia. The presence of dental plaque was found to be related to the presence of gingival hyperplasia, but only a weak correlation existed between the abundance of plaque and the severity of gingival hyperplasia. Children and especially adolescents had a greater risk of developing cyclosporine-induced gingival hyperplasia than adults had. In 21 patients followed for 1 to 18 months after cessation of cyclosporine therapy, induced gingival hyperplasia was found to be clinically reversible.

Presentation and evaluation of sexual misuse in the emergency department

Children who have been sexually abused develop a variety of emotional and physical complaints, often unrelated to the genital area. Emergency department records of children diagnosed as being sexually abused were reviewed for the period covering January 1984 through June 1985. Of 26,000 patients seen, 300 cases of sexual abuse were identified. Of these, 57 were patients who presented with initial complaints other than sexual abuse. The data were analyzed for age, sex, chief complaint, time of presentation, physical findings, and person accompanying the child. The most common presenting complaints of these 57 patients were abdominal pain (26%) and vaginal symptoms (26%) The latter included pruritus, discharge, and bleeding. Other complaints included rectal bleeding or constipation (9%), chronic urinary tract infection (5%), straddle injury (4%), and suicide attempt (2%). The remaining 26% included fever, respiratory infections, sore throat, asthma, bronchitis, obesity, mastoiditis, and weight loss. Because resident physicians are instructed to conduct complete anal and genital examinations on all patients, sexual misuse was often diagnosed with seemingly unrelated complaints. A protocol developed for use in the emergency department is described.

Role of adrenal glands in the development of abnormal glucose and insulin homeostasis in genetically obese (ob/ob) mice

This study evaluates the role of adrenal hormones in the development of hyperinsulinaemia and impaired glucose homeostasis in genetically obese hyperglycaemic C57BL/6J ob/ob mice. Lean (+/?) and obese mice were bilaterally adrenalectomised or sham operated at 5 weeks of age, and glucose tolerance was examined after 7 and 14 days. Adrenalectomy temporarily reduced food intake and body weight gain in lean mice, and improved glucose tolerance without a significant change in plasma insulin concentrations at both intervals studied. In obese mice adrenalectomy permanently reduced body weight gain and food intake to values comparable with lean mice. Glucose tolerance was improved in adrenalectomised obese mice at both intervals studied, resulting in plasma glucose concentrations similar to adrenalectomised lean mice. Plasma insulin concentrations during the tolerance tests were reduced in adrenalectomised obese mice, but remained higher than in lean mice. Adrenalectomy did not improve the poor insulin response to parenteral glucose in obese mice. The results indicate that adrenal hormones play an important role in the development of glucose intolerance and contribute to the hyperinsulinaemia in obese (ob/ob) mice, in part by promoting hyperphagia.

Electron microscopic localization of cell-surface markers in tissue sections using monoclonal and gold-conjugated antibodies

We describe a method for the ultrastructural localization of surface markers on cells in intact tissue sections. Using a primary monoclonal antibody to a surface marker followed by a second stage gold-labelled antibody, surface antigens can be specifically localized. This enables cellular interactions to be studied in solid tissues.

Cerasee, a traditional treatment for diabetes. Studies in normal and streptozotocin diabetic mice

Cerasee, a wild variety of Momordica charantia is traditionally prepared as a tea for the treatment of diabetes mellitus in the West Indies and Central America. To investigate a possible hypoglycaemic effect, concentrated aqueous extracts of cerasee were administered to normal and streptozotocin diabetic mice. In normal mice, intraperitoneal administration of cerasee improved glucose tolerance after 8 hr, and in streptozotocin diabetic mice the level of hyperglycaemia was reduced by 50% after 5 hr. Chronic oral administration of cerasee to normal mice for 13 days improved glucose tolerance. The cerasee extracts did not significantly alter plasma insulin concentrations, suggesting that cerasee may exert an extrapancreatic effect to promote glucose disposal.

Isoenzyme pattern of HPRT in murine erythrocytes: control by an autosomal locus

A locus on chromosome 7 controls the electrophoretic mobility of hypoxanthine phosphoribosyltransferase (HPRT) isoenzymes in mouse erythrocytes, but not in several other tissues. This locus is designated Hma (HPRT mobility alteration) and maps very close to the Hbb locus. The A/J, AKR/J, AU/SsJ, BALB/cJ, CBA/J, C3H/HeJ, DBA/2J, LP/J, RF/J, SEA/Gn, ST/BJ, and 129/J strains and our population of Swiss albino mice have the Hmaa allele. Hmaa is dominant to Hmab, which is found in the C57BL/6J, C57BL/KsJ, C58/J, LT/Sv, MA/MyJ, SJL/J, and SWR/J strains. Both alleles are found in feral Mus musculus. In our conditions, homozygotes for Hmab have two major bands of HPRT activity after electrophoresis of extracts of erythrocytes and of other tissues. Heterozygotes and Hmaa homozygotes have three bands in erythrocyte extracts but two band in other tissues.