A validated photonumeric scale for infraorbital dark circles and its application in evaluating the efficacy of a cosmetic treatment product in a split-face randomized clinical trial

OBJECTIVE

As a result of their complex aetiology and periodicity, dark circles are difficult to characterize and measure, with current assessment techniques relying on specialist equipment, image analysis or proprietary grading scales. There is therefore a need to develop and validate a photonumeric scale for assessing infraorbital dark circles, which can provide an objective and consumer relevant tool for evaluating this condition and the efficacy of treatment products and procedures.

METHODS

A panel of expert clinical evaluators reviewed approximately three thousand facial photographs collected over a 5-year period and selected images representing a dynamic range of dark circles. A 10-point photonumeric scale was created, with corresponding descriptors and images for each grade of the scale. To rigorously validate the scale, linearity, sensitivity and precision were assessed by colorimetry and in-clinic evaluation. Reproducibility was assessed photographically with both experienced and inexperienced clinical evaluators, whereas intragrader repeatability was assessed live in-clinic. The scale was then employed in a split-face randomized clinical trial on 58 subjects to evaluate the efficacy of a cosmetic treatment product over 8 weeks.

RESULTS

Colour analysis of the images showed the scale was linear, with statistically significant correlations observed when colour data (CIElab; Individual Typology Angle) were plotted against the corresponding grades (r > 0.9, P < 0.001). Colour difference (Delta E) was calculated between the infraorbital zone and the surrounding skin, and when data were plotted against the grades, a statistically significant correlation was observed (r = 0.99, P < 0.01). The magnitude of the Delta E suggested that changes in grade are visibly perceptible to the human eye, and therefore, the scale is sensitive and clinically relevant. Intergrader reproducibility showed strong correlation (0.96) and >90% agreement between experienced evaluators, whereas intragrader repeatability assessment showed >90% perfect agreement between grades. Use of this scale in a clinical trial demonstrated the efficacy of a cosmetic product, with a mean statistically significant (P < 0.001) decrease in grade of 0.74 compared to baseline, and 0.59 versus the untreated control, after 8 weeks of treatment.

CONCLUSION

Our photonumeric scale for infraorbital dark circles is sensitive and robust and provides an objective and easy-to-use tool to evaluate dark circles and their treatment.

The Canadian Neuromuscular Disease Registry 2010-2019: A Decade of Facilitating Clinical Research Througha Nationwide, Pan-NeuromuscularDisease Registry

We report the recruitment activities and outcomes of a multi-disease neuromuscular patient registry in Canada. The Canadian Neuromuscular Disease Registry (CNDR) registers individuals across Canada with a confirmed diagnosis of a neuromuscular disease. Diagnosis and contact information are collected across all diseases and detailed prospective data is collected for 5 specific diseases: Amyotrophic Lateral Sclerosis (ALS), Duchenne Muscular Dystrophy (DMD), Myotonic Dystrophy (DM), Limb Girdle Muscular Dystrophy (LGMD), and Spinal Muscular Atrophy (SMA). Since 2010, the CNDR has registered 4306 patients (1154 pediatric and 3148 adult) with 91 different neuromuscular diagnoses and has facilitated 125 projects (73 academic, 3 not-for-profit, 3 government, and 46 commercial) using registry data. In conclusion, the CNDR is an effective and productive pan-neuromuscular registry that has successfully facilitated a substantial number of studies over the past 10 years.

Implementation of intersectoral community approaches targeting childhood obesity: a systematic review

The implementation of intersectoral community approaches targeting childhood obesity (IACO) is considered challenging. To help overcome these challenges, an overview of the evidence to date is needed. We searched four databases to identify papers that reported on the determinants of successful implementation of IACOs, resulting in the inclusion of 25 studies. We appraised study quality with the Crowe Critical Appraisal Tool and the Quality Framework; reported implementation outcome indicators were reviewed via narrative synthesis. Quality of included studies varied. The most frequently reported indicators of implementation success were fidelity and coverage. Determinants related to the social-political context and the organization were most often cited as influencing implementation, in particular, 'collaboration between community partners', 'the availability of (human) resources' and 'time available for implementation'. The association between determinants and implementation variability was never explicated. We conclude that although some insights into the effective implementation of IACOs are present, more research is needed. Emphasis should be placed on elucidating the relationship between determinants and implementation success. Research should further focus on developing a 'golden standard' for evaluating and reporting on implementation research. These actions will improve the comparison of study outcomes and may constitute the cumulative development of knowledge about the conditions for designing evidence-based implementation strategies.

The relationship of the orientation of the transverse acetabular ligament and acetabular labrum to the suggested safe zones of cup positioning in total hip arthroplasty

BACKGROUND

There is a need to develop and validate a method for establishing cup orientation that is patient specific and independent of the anterior pelvic plane. It is our hypothesis that the transverse acetabular ligament and acetabular labrum can be used to do this. The objective of this study is to define the orientation of the plane formed by the transverse acetabular ligament and acetabular labrum and to examine whether these local landmarks lie within the limits of acceptance for cup positioning.

METHODS

Twenty-five consecutive patients, who were being investigated for labral tears with a MRI arthrogram of the hip, were enrolled in this prospective study. The orientation of the transverse acetabular ligament-labrum plane was determined by manually selecting points on the transverse acetabular ligament and labrum. The best-fit plane through these points was determined and its operative orientation expressed with respect to a constructed pelvic coordinate system.

RESULTS

The operative anteversion of the transverse acetabular ligament-labrum plane ranged from 5.3-36.1 inverted exclamation mark (mean 23.0 inverted exclamation mark + or - 7.4 inverted exclamation mark standard deviation). The inclination ranged from 38.4-50.3 inverted exclamation mark (mean 45.6 inverted exclamation mark + or - 3.2 inverted exclamation mark standard deviation).

CONCLUSIONS

The transverse acetabular ligament and acetabular labrum offer a possible solution to the many difficulties involved in cup placement during total hip arthroplasty. This paper highlights the variation in the orientation of these local acetabular landmarks and questions the logic of a set target for cup positioning.

Interaction between a synthetic polypeptide, TIGAL, and Fc receptors on non-bursa-derived chicken lymphoid cells

Autoradiographic studies have shown that radioiodinated TIGAL binds in vitro to a small but varying fraction of lymphoid cells from bursectomized, agammaglobulinemic chickens, whereas no binding of radioiodinated TGAL or a variety of other radioiodinated antigens can be observed. The binding of [125I]TIGAL is inhibited by antigen-antibody complexes. Radioiodinated antigen-antibody complexes are bound to a similar proportion of the lymphoid cells from bursectomized chickens, and this binding is inhibited by preincubation of the cells with unlabeled TIGAL but not with TGAL. These results indicate a cross-reaction at the level of Fc receptors between determinants on TIGAL and on IgG.

A case of pseudoarthrosis of the lateral talar process and distal fibula in a professional athlete

We report a case of osteoarthritis of a pseudoarthrosis between the tip of the fibula and the lateral process of the talus. This was treated by excision of pseudoarthrosis with lateral ligament reconstruction.

Genetic and functional analyses of FH mutations in multiple cutaneous and uterine leiomyomatosis, hereditary leiomyomatosis and renal cancer, and fumarate hydratase deficiency

Germline mutations of the fumarate hydratase (FH, fumarase) gene are found in the recessive FH deficiency syndrome and in dominantly inherited susceptibility to multiple cutaneous and uterine leiomyomatosis (MCUL). We have previously reported a number of germline FH mutations from MCUL patients. In this study, we report additional FH mutations in MCUL and FH deficiency patients. Mutations can readily be found in about 75% of MCUL cases and most cases of FH deficiency. Some of the more common FH mutations are probably derived from founding individuals. Protein-truncating FH mutations are functionally null alleles. Disease-associated missense FH changes map to highly conserved residues, mostly in or around the enzyme's active site or activation site; we predict that these mutations severely compromise enzyme function. The mutation spectra in FH deficiency and MCUL are similar, although in the latter mutations tend to occur earlier in the gene and, perhaps, are more likely to result in a truncated or absent protein. We have found that not all mutation-carrier parents of FH deficiency children have a strong predisposition to leiomyomata. We have confirmed that renal carcinoma is sometimes part of MCUL, as part of the variant hereditary leiomyomatosis and renal cancer (HLRCC) syndrome, and have shown that these cancers may have either type II papillary or collecting duct morphology. We have found no association between the type or site of FH mutation and any aspect of the MCUL phenotype. Biochemical assay for reduced FH functional activity in the germline of MCUL patients can indicate carriers of FH mutations with high sensitivity and specificity, and can detect reduced FH activity in some patients without detectable FH mutations. We conclude that MCUL is probably a genetically homogeneous tumour predisposition syndrome, primarily resulting from absent or severely reduced fumarase activity, with currently unknown functional consequences for the smooth muscle or kidney cell.

Synovial chondromatosis of the pisotriquetral joint

Images

Prevalence of the Chiari/hydrosyringomyelia complex in adults with spina bifida: preliminary results

AIM

To establish the prevalence of Chiari malformations and hydrocephalus (HS) in adults with spina bifida (SB).

INTRODUCTION

Adults with SB have recently been shown to be at risk from significant deterioration arising from the C/HS complex. Little is known about the prevalence of these malformations in adulthood, their natural history, risk factors for deterioration and optimum management.

MATERIALS AND METHODS

Patients are recruited from a clinic for adults with SB and hydrocephalus, routinely questioned about recent changes in neurological symptoms and a full neurological examination performed. Functional assessments include: Barthel Index; Nottingham EADL; Nine Hole Peg Test; 10 metre timed walk test. Sagittal T1 and TSE (turbo spin-echo) magnetic resonance images (MRI) of the cranio-cervical junction and spinal cord are obtained using a 1.0-T MRI system with a phased-array surface coil. Scans are reported blindly.

RESULTS

76 patients have been assessed, 40 female, 36 male, mean age 27.5 years. Of these, 48 (63.2%) have symptoms +/- signs compatible with C/HS, but only 18 (23.7%) have reported new, potentially relevant, neurological symptoms over the previous 12 months. Of 25 patients undergoing MRI so far, 19 (76%) have had Chiari malformations and 12 (48%) have had HS. None of those with a negative scan have had signs/symptoms suggestive of the C/HS complex but a negative clinical evaluation has been unable to exclude such pathology.

CONCLUSIONS

These early results suggest that the prevalence of the C/HS complex is high in adults with SB and cannot be predicted by neurological examination alone. Given past experience, the need for continued neurological follow up in a large proportion of the SB population throughout adulthood is likely to be essential.

Group therapy for spouses of aphasic patients

The setting, course, and results of a counseling and a therapeutic group for relatives of chronic aphasic patients are reviewed. Generally, providing and discussing information on the illness, its consequences, and medical and social services are greatly appreciated by group members. Counseling and group psychotherapy, as conducted by us, did not result in measurable improvements of relatives' perceptions of personal, social, and familial burdens. We assume, however, that group therapy does lead to more realistic attitudes toward burdensome and severely straining situations and may help with coping. Further research into psychotherapeutic strategies for relatives of disabled persons, who themselves suffer from psychological and social handicaps, is needed.

Left leg paralysis in a renal transplant

The postoperative course of renal transplant patients is often complicated by opportunistic infection. Up to 4% of posttransplant infections are caused by Nocardia species. We present an unusual case of a nocardial spinal cord abscess that caused left leg paralysis.

ENGELMANN’S DISEASE

We report a 45-year follow-up of a patient with Engelmann’s disease previously described in 1950, showing progression of the disease with unique involvement of the femoral capital epiphyses. The case is compared with others to add some information about the later stages of a disease which is not fully understood

Engelmann's disease: a 45-year follow-up

We report a 45-year follow-up of a patient with Engelmann's disease previously described in 1950, showing progression of the disease with unique involvement of the femoral capital epiphyses. The case is compared with others to add some information about the later stages of a disease which is not fully understood.

Nonrandom abnormalities of chromosome 9p in childhood acute lymphoblastic leukemia: association with high-risk clinical features

To assess the frequency and significance of nonrandom abnormalities of chromosome 9p in childhood acute lymphoblastic leukemia (ALL), we analyzed our experience with 398 consecutive cases with completely banded karyotypes. Forty cases (10%) with abnormalities of 9p were identified: 26 with deletions, nine with unbalanced translocations resulting in the loss of 9p material, and five with apparently balanced reciprocal translocations. As compared with children with ALL lacking 9p abnormalities, these 40 cases were significantly older, had higher initial circulating WBC counts, more "lymphomatous" disease characteristics (including presence of a mediastinal mass in 15%. T-cell phenotype in 26%, splenomegaly greater than 8 cm in 25%), an increased failure rate in the first 2 to 3 years after diagnosis, and a higher incidence of extramedullary relapse. Conversely, lymphomatous ALL cases were twice as likely (19% v 8%) to have an abnormality of chromosome 9p than ALL cases lacking lymphomatous features (P = .01). The finding of an abnormal chromosome 9p, however, was not specific for lymphomatous ALL or T-cell lineage, because most cases were neither lymphomatous nor T-cell, and the overall Kaplan-Meier distribution of treatment failures for abnormal 9p cases was not statistically significantly different from control ALL cases receiving the same treatment who lacked abnormalities of 9p (P = .06, by log-rank test). We conclude that nonrandom abnormalities of chromosome 9p, especially a breakpoint in 9p21-22, occur with increased frequency in childhood ALL in association with some high-risk clinical features. Despite this association, the chromosome anomaly is nonspecific in its syndrome delineation and confers no major adverse consequence on long-term survival of childhood ALL treated with modern therapy. However, due to an apparently increased hazard of involvement of the CNS (eight of 17 failures), it may be inadvisable to lessen the intensity of CNS preventive therapy for this group of patients.

Synovial chondromatosis

We reviewed 53 cases of synovial chondromatosis and compared their clinical, radiological and pathological features. A radiological diagnosis is possible with increasing frequency as the disease progresses; in the early phase arthrography is helpful. Radiologically the disease may be classified as either extra-articular, or intra-articular; the intra-articular variety may be localised or generalised. Recurrence after operation was seen in 11.5% and was much the same after either synovectomy or simple removal of loose bodies. A protocol for treatment is proposed.

Dosimetry in phototherapy cabinets

Many skin diseases can be treated with phototherapy. The dose of ultraviolet radiation received at the skin surface should be recorded to guide subsequent treatment doses as well as to monitor cumulative dose. In order to see if a single reading from an electric dosimeter accurately reflected the dose of ultraviolet radiation received at the skin surface, 212 photoresponsive dosimeter badges were affixed at various sites to the skin of one side of a female volunteer. The volunteer was then exposed to ultraviolet A (UVA) radiation in a UVA light treatment cabinet. The monitors were then removed and the received dose recorded. Portions of the body facing the lights directly received the most irradiation. Areas inclined to the plane of the lamps, shaded areas, and anatomic areas near the top and bottom of the cabinet received the least. Dosimetry as recorded by an electronic monitor in the center of the cabinet decreased when a subject stood next to it. Evidently a single measurement of dose by an electronic monitor in an empty treatment cabinet does not necessarily reflect the amount of ultraviolet radiation received at any given anatomic site by a patient undergoing phototherapy.

The chicken erythrocyte-specific MHC antigen. Characterization and purification of the B-G antigen by monoclonal antibodies

Mouse monoclonal antibodies with B-G antigen (major histocompatibility complex class IV) specificity were obtained after immunization with erythrocytes or partially purified B-G antigen. The specificities of the hybridoma antibodies were determined by precipitation of B-G antigens from 125I-labeled chicken erythrocyte membranes (CEM) followed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and autoradiography. The B-G antigen had an approximate molecular mass of 46-48 kd in reduced samples, depending on the haplotype, and in unreduced samples contained either dimers (85 kd), when labeled erythrocytes were the antigen source, or trimers (130 kd), when B-G was purified and precipitated from CEM. The B-G antigen was unglycosylated as studied by in vitro synthesis in the presence or absence of tunicamycin, binding experiments with lectin from Phaseolus limensis, and treatment of purified B-G antigen with Endoglycosidase-F or trifluoromethanesulfonic acid. Two-way sequential immunoprecipitation studies of erythrocyte membrane extracts with anti-B-G alloantisera and monoclonal antibodies revealed only one population of B-G molecules. Pulse-chase experiments have shown B-G to be synthesized as a monomer, with dimerization taking place after 20-30 min. No change in the monomer's molecular mass due to posttranslational modifications was revealed. The antigen was purified from detergent extract of CEM by affinity chromatography with a monoclonal antibody, and then reduced and alkylated and affinity-purified once more. Finally, reverse-phase chromatography resulted in a pure product. The B-G antigen was identified in the various fractions by rocket immunoelectrophoresis. The final product was more than 99% pure, as estimated by SDS-PAGE analysis followed by silver stain of proteins. The yield from the affinity chromatography step was 3-4 micrograms B-G/ml blood, calculated from Coomassie-stained SDS-PAGE of B-G using ovalbumin standards. The monoclonal antibodies were also used to identify the B-G (class IV) precipitation arc in crossed immunoelectrophoresis. No common precipitate with the B-F (class I) antigen was observed.

Isolation and characterization of chicken and turkey beta 2-microglobulin

Chicken and turkey beta 2-m were isolated from citrated plasma in sequential use of three chromatographic steps: affinity chromatography, gel filtration chromatography and anion-exchange chromatography. The purified protein was identified as beta 2-m by reaction with a beta 2-m specific monoclonal antibody and by the ability to recombine with the chicken MHC class I heavy chain. The purity was estimated by SDS-PAGE and IEF. The pI was between 5.1 and 5.3 for chicken beta 2-m and 4.7 and 4.8 for turkey beta 2-m, which fact is reflected in their different electrophoretic mobilities in agarose gel (turkey migrates in the alpha and chicken migrates in the beta region). The mol. wt of both chicken and turkey beta 2-m was 14,500 estimated by SDS-PAGE whereas calculations based on the amino acid compositions gave mol. wts of 11,000. EM280 was 15.9 for chicken beta 2-m and 16.4 for turkey beta 2-m. The amino acid compositions and sequences of the two avian beta 2-m molecules have been compared with earlier data from the literature. The sequence of the 23 N-terminal amino acids was found to be identical in our preparations from both chicken and turkey, namely DLTPKVQVYSRFPASAGTKNVLN, and is incompatible with a previously published sequence also thought to be from turkey beta 2-m. Reasons for our opinion that the molecules isolated and sequenced in this paper are the correct ones are given.

Analysis of chickens for recombination within the MHC (B-complex)

In an attempt to further map the chicken MHC (the B complex), a systematic search for genetic recombinants within the B complex was performed by serotyping the progeny from F2 crosses of chickens by means of specific anti-class I, anti-class II, and anti-class IV alloantisera. Two recombinant B-haplotypes (B21r and B15r) were found by analysing 2,656 F2 chickens representing 5,312 informative typings. In either case, the B-G (class IV) allele was recombined with both the B-F and B-L alleles of the opposite haplotype. MLC typings, tests for direct compatibility by GVH reactions, and absorption analyses confirmed the original serological typing of the two recombinant B haplotypes. No recombination between B-F (class I) and B-L (class II) loci was found. This very low frequency of recombination within the B complex as compared with recombination frequencies found in mammalian MHC's is discussed.

The major histocompatibility complex of outbred chickens. I. Analysis of the B13 haplotype by serology and cellular reactions

The F antigens, which are serologically defined Class I gene products of the major histocompatibility complex in chickens (the B complex), were analysed in outbred birds. Private specificities of the F13 antigen from the inbred CC strain were detected in 20 outbred chickens by a haemagglutination technique. In the GVH-inhibition-release test F13 antigens from outbred and inbred chickens were identical. The L antigens, which are the Class II antigens of the B complex, were detected with specific anti L13 alloantisera by indirect immunofluorescence. Antisera defining the L13 antigen(s) of the inbred CC line reacted with all F13 positive outbreds. As a test of one-way direct compatibility of the inbred and outbred animals typing F13, graft versus host reactions were performed, injecting blood of F13 positive outbreds into inbred B13/13 eggs. No GVH stimulation attributable to MHC determinants was found. In MLR, responder cells from outbred MHC heterozygous chickens, which typed F13/x, were stimulated by inbred F13/13 homozygous typing cells, and weak, but significant, reactions were found. Further analysis in the accompanying paper, however, revealed no difference in the lymphocyte activating determinants (Lads) of inbred and outbred birds typing F13 and L13. No individual has yet been found which carries one of these antigens in the absence of the other.

Specificities of anti-rabbit VH antibodies in mammalian and fowl antisera

Antibodies against rabbit VH-determinants were produced by immunizing mammals and birds with rabbit IgG, IgA or VH. Most of the anti-VH produced in mammals was specific for allotype VH-determinants, but small amounts of antibody against non-allotype VH-determinants were also produced. By contrast the immunization of chickens led to the production of predominantly non-allotype VH antibody. Further analysis of the antibody specificity revealed the production of antibody against VH-determinants available in the intact immunoglobulin (H- + L-chain) as well as antibody reacting with determinants only accessible in the absence of L-chain. Antibody of the latter specificity prevailed after immunization with VH. The purified VH was not deficient in antigen determinants when compared with VH in the intact immunoglobulin (IgA). Unexpectedly, none of our chicken anti-rabbit VH antisera showed crossreactivity with VH from other mammalian species.

The MHC haplotypes of the chicken

The major histocompatibility complex (MHC) of Gallus gallus is the B complex of which three classes of cell-membrane antigens have been clearly defined by serological, histogenetic, and biochemical methods. Two of these classes are homologous to classes I and II of mammals (B-F and B-L, respectively), while the third (B-G) is a differentiation antigen of the erythroid cell-line; the mammalian homologue of this class is still undefined. The B haplotypes comprise at least one gene of each class that displays linkage disequilibrium of a remarkable strength. The present work is the first systematic comparison by serological and histogenetic methods of the allelic products (allomorphs) of 15 haplotypes, including all of the 11 that were accepted as "standard" B haplotypes at the recent international Workshop on the chicken MHC in Innsbruck, Austria. The analysis has revealed many similarities, but only four pairs of probable identities: G2 and G12, F4 and F13, L4 and L13, L12 and L19. It appears therefore that the B-G locus is comparable in its degree of polymorphism to the class I (B-F) locus. The "standard" haplotypes are almost all of White Leghorn derivation, and preliminary typings of other breeds of chickens, and of wild chickens, indicate the existence of a much wider spectrum of allomorphs.

[Results of an open study and a controlled comparative study of feprazone and naproxen in patients with rheumatoid arthritis or osteoarthrosis (author's transl)]

The so-called non-steroid antirheumatics have considerable significance in medical armamentarium for controlling polyetiological complexes of diseases. The numerous new developments are designed to reduce the side effects, some of which seem inevitable with increased efficacy. In this two-part study the authors deal with the new Feprazone. Prior to a double-blind randomized comparative study against Naproxen, an open study on effect and tolerance was performed in ten rheumatic patients over three months. In the second part a controlled study was carried out in 30 patients for four weeks following this treatment. The patients half of whom were each given 600 mg Feprazone or 750 mg Naproxen showed a definite improvement in the rheumatic symptoms as compared with their initial situation. A difference in therapeutic efficacy and tolerance was only noticeable in a slight trend in favour of Feprazone.

The still elusive T cell receptor: on the possibility of a common V-gene pool for B- and T-cell-antigen receptor molecules

The contention that VH constitutes a part of T-cell receptors for antigens was probed by purifying rabbit T cells and analysing these cells for non-immunoglobulin VH, i.e. VH not associated with L chain. A number of anti-VH antisera were employed for this purpose, the most important being goat antiserum, reacting with common a1 allotype determinants (allotype determinants expressed on free VH and H chain as well as on intact immunoglobulins), rat antibody against common non-allotype VH determinants (VH framework determinants expressed on VH and H chain as well as on intact immunoglobulins) and chicken antibody against unmasked non-allotype determinants (VH determinants accessible only in the absence of L chain). VH and L chain was quantified by radioimmunoassays on extracts and supernatants from unstimulated T cells as well as from T cells stimulated by concanavalin A and by allogeneic cells. Absolute depletion of Ig-containing and -producing cells was not achieved but in no case was an excess of VH over L chain observed. This indicated that all detected VH originated from cells of the B lineage. The cells were also cultured in the presence of labelled amino acids followed by analysis of detergent extracts and supernatants by immunoadsorption and sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) fluorography. Again, no evidence for T-cell VH could be found. Affinity purified anit-VH antibody was used to label viable rabbit T cells through the use of secondary fluorescence-labelled anti-immunoglobulin antibody. No VH-specific labelling of T cells could be observed. Mixed lymphocyte cultures were carried out in the presence of affinity-purified anti-VH antibodies. No inhibition of the reaction could be discerned. The failure to detect T-cell VH is in agreement with the recent finding that the VH-genome in T cells is not rearranged in a functional manner similar to that in B cells.

B-L antigens (Ia-like antigens) of the chicken major histocompatibility complex

This paper reviews the present knowledge of B-L antigens encoded by the chicken B complex as regards to the following aspects: (1) identification and cellular expression, (2) structural studies, (3) evidence for two distinct populations of B-L antigens, (4) mapping of B-L loci of the B complex, (5) B-L and immune response, and (6) the role of the B-L antigens for the control of mixed lymphocyte reactions (MLR) and graft-versus-host (GVH) reactions. It is concluded that B-L antigens of the chicken exhibit extensive homology with mammalian Ia antigens. A genetic map of the B complex is presented.

Eggs: conveniently packaged antibodies. Methods for purification of yolk IgG

Eggs from immunized chickens may provide a convenient and inexpensive source of antibodies. We describe two simple and efficient methods for purification of IgG from yolk. The antibody is rendered useful for most currently employed immunological techniques. Amounts of antibody corresponding to almost half a litre of antiserum may be recovered from a chicken in one month.

Evidence for two populations of B-L (Ia-like) molecules encoded by the chicken MHC

Two specific alloantisera detecting B-L (Ia-like) antigens on chicken lymphocytes of the B6 and B15 haplotypes were found to cross-react strongly. Anti-B-L6 and anti-B-L15 alloantisera both reacted with B-L molecules on B6 and B15 lymphocytes as demonstrated by immunofluorescence and SDS-PAGE analysis of 125I-labeled B-L antigens isolated by incubation with anti-B-L alloantisera. Absorption studies showed that the anti-B-L alloantisera reacted with at least two kinds of antigenic determinant, one set shared by B-L6 and B-L15 molecules and another set specific for each haplotype. In spite of the absence of genetic evidence for more than one B-L locus in the chicken B complex, it was shown by sequential antibody incubations that these two different B-L antigenic determinants are associated with at least two separate species of B-L molecules, indicating the presence of at least two B-L loci within the MHC of the chicken.

Allo-aggression in chickens. II. Cellular expression of the AA gene products

B1-anti-B2 and B2-anti-B1 allo-antisera were raised by i.v. immunization of homozygous B1/1 and B2/2 chickens, respectively, with B1/2 cells of the following sources: peripheral blood leucocytes (PBL), erythrocytes, thymus cells and bursa cells. Purified suspensions of these all produced anti-B allo-antibodies which could both haemagglutinate red blood cells and strongly inhibit the GVH reactivity of blood lymphocytes of the original donor type. Absorption studies of the sera using cells of the same four sources showed that they could all completely remove the GVH inhibitory antibodies. A fact of particular importance is that B-haplotype determined antigens which are common to erythrocytes and lymphocytes seem to include the gene products of the allo-aggression locus, as earlier defined (Simonsen 1975).

Antigen binding by non-bursa-derived chicken leukocytes

Antigen-binding peripheral blood leukocytes (PBL) from normal and bursectomized agammaglobulinemic chickens were labeled by incubation in vitro with radioiodinated antigen at 4 degrees C in the presence of sodium azide. [125I]TGAL-binding cells could be detected by autoradiography of PBL from normal, unimmunized chickens at a frequency of 1 to 4 labeled cells per 10(4) leukocytes. No [125I]TGAL-binding cells were found in PBL from bursectomized chickens, even after incubation with 25 mug/ml of labeled antigen followed by prolonged autoradiographic exposure. The binding to normal PBL was specific as judged by inhibition with unlabeled TGAL but not with unlabeled TIGAL. The binding was, furthermore, inhibited by preincubation with rabbit anti-chicken L chain antibody but unaffected by normal rabbit IgG. [125I]TIGAL was, in contrast, found to bind to PBL from both normal and bursectomized chickens at a frequency of 6 to 80 labeled cells per 10(4) leukocytes. The labeling was specific, since it was inhibited by cold TIGAL but not by cold TGAL. The binding of [125I]TIGAL to PBL from bursectomized chickens showed from none to slight inhibition on preincubation of the cells with anti-L chain antibody, whereas preincubation with normal rabbit IgG resulted in almost complete inhibition. To our knowledge this is the first demonstration of antigen binding to PBL from agammaglobulinemic chickens.