THE EFFECT OF BLOOD LEUCOCYTES FROM PATIENTS WITH HASHIMOTO''S DISEASE ON HUMAN THYROID CELLS IN MONOLAYER CULTURE

Peripheral blood leucocytes from healthy subjects (control leucocytes) and from patients with Hashimoto's thyroiditis or idiopathic myxoedema, were incubated with 2-3-day-old human thyroid cells in monolayer cultures. After 5-6 days the Hashimoto leucocytes appeared to induce more thyroid cell destruction than control leucocytes. Thyroid cell function (measured by cell to medium (C/M) ratios of ¹³¹I) was reduced in cultures incubated with Hashimoto leucocytes, compared to those incubated with control leucocytes. This effect was not mediated by liberation of thyroid antibodies into the medium, but rather from a direct leucocyte/thyroid cell interaction with a resultant liberation of lysozymes. Preliminary observations indicated that the effect of the Hashimoto leucocytes on thyroid cells could be prevented by prior incubation of the former with anti-thymocyte globulin; this suggested that sensitized lymphocytes may be directly responsible for the thyroid tissue injury of Hashimoto's disease, perhaps with the adjunctive cooperation of the non-specific macrophages. Leucocytes from patients with idiopathic myxoedema (with low or absent circulating thyroid antibodies) did not have any effect on the thyroid cells, perhaps because the concentration of peripheral sensitized lymphocytes may possibly have declined in these patients.     

GENERALIZED CYTOMEGALOVIRUS INFECTION IN A PATIENT WITH LUPOID HEPATITIS

A woman aged 18 years had an acute “multisystem disease” of which the major impact was on the liver; the LE cell test was positive. The subsequent course of the illness was that of “autoimmune” lupoid hepatitis: serological tests for antinuclear and smooth muscle antibody were positive, and continued treatment with prednisolone was necessary. Splenectomy was required for thrombocytopenia with bruising. Liver biopsy during the illness showed quiescent hepatitis and no virus inclusions in liver cells. After seven years of illness and two years of treatment with azathioprine, a fatal febrile illness occurred with sharp deterioration of liver function. Autopsy revealed inclusions of cytomegalovirus in liver cells and many other tissues. The discussion is concerned with cytomegalovirus as a cause of liver disease in adults, “latent” cytomegalovirus infection, and the degree to which immunosuppressive therapy in this case predisposed to the fatal illness due to cytomegalovirus.     

LEUCOCYTES CONTAINING BACTERIA IN PLAIN BLOOD FILMS FROM PATIENTS WITH SEPTICÆMIA

A search for infected cells was made with the low power (× 10 or × 20) objective in plain blood films from patients known to have, or suspected of having, septicæmia. It was found that scanning of a film in this way for a short time will detect even small concentrations of infected cells. Infected leucocytes occurred in highest concentration in the first drop of blood issuing from the previously unmanipulated ear lobe. They occurred most frequently in films in which there was also an increase in mononuclear cells containing inclusions of corpuscular origin, and were found whether or not the patient had recently been given apparently effective antibiotic treatment. Consideration is given to the requirements for a diagnosis of septicæmia from the presence of infected cells in blood films and the distinction of bacteria from other structures in leucocytes which may resemble them. A search for infected leucocytes in a plain blood film of the first drop of blood from the ear lobe appears to be a useful procedure in routine investigation of patients who may have septicæmia.     

THE ASSOCIATION OF THE GUILLAIN-BARRE SYNDROME WITH INFECTIOUS MONONUCLEOSIS: WITH A REPORT OF TWO FATAL CASES

Infectious mononucleosis in which death was due to associated ascending paralysis, indistinguishable from that in Guillain-Barré syndrome, was encountered in2. cases at the Army Institute of Pathology. Study of the data from these casesstrongly suggests that infectious mononucleosis is one of the many diseases oragents which may precipitate or give rise to the Guillain-Barré syndrome.

     

原发性高血压患者血压昼夜节律与细胞因子的相关性研究

目的观察昼夜血压呈杓型、非杓型分布的高血压病患者血浆中细胞因子的变化,探讨细胞因子与血压昼夜节律的相关性。方法经动态血压监测将84例高血压病患者分为杓型组35例,非杓型组49例,采用双抗体夹心ELISA法分别测定血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ),可溶性白细胞介素-2受体(sIL-2R)水平。结果非杓型组与杓型组比较,IL-6、TNF-α、sIL-2R明显升高(P<0.001;P<0.001;P<0.001),IFN-γ明显降低(P<0.01);夜间血压下降与IL-6、TNF-α、sIL-2R负相关[收缩压(SBP)与IL-6:r=-0.347,P<0.01;SBP与TNF-α:r=-0.427,P<0.005;SBP与sIL-2r:r=-0.309,P<0.01;舒张压(DBP)与IL-6:r=-0.292,P<0.05;DBP与TNF-α:r=-0.462,P<0.005;DBP与sIL-2R:r=-0.278,P<0.05];夜间血压下降与IFN-γ正相关(SBP与IFN-γ:r=0.263,P<0.05;DBP与IFN-γ:r=0.241,P<0.05)。多元线性回归分析,IL-6、TNF-α、sIL-2R与夜间血压下降直线相关(SBP:F=6.742,P<0.005;DBP:F=6.138,P<0.005)。结论血压昼夜节律异常的高血压病患者存在细胞因子水平升高,细胞因子可能参与血压昼夜节律的调节。     

ANTI-TSH ANTIBODY WITH HIGH SPECIFICITY TO HUMAN TSH IN SERA FROM A PATIENT WITH GRAVES'' DISEASE: ITS ISOLATION FROM, AND INTERACTION WITH, TSH RECEPTOR ANTIBODIES

A patient with thyrotoxic Graves' disease had an apparent measurable level of serum TSH (2.5 microU/ml) by double-antibody radioimmunoassay (RIA). The serum IgG bound with both [125I]human(h)TSH and [125I]bovine(b)TSH. The [125I]hTSH binding was more effectively displaced by human than bovine TSH, whereas [125I]bTSH binding was displaced exclusively by bTSH. Scatchard analyses revealed that [125I]hTSH binding showed two components, whereas [125I]bTSH binding had only one component. Serum TSH determined by RIA became undetectable 21 months after antithyroid drug treatment with a parallel decrease of [125I]hTSH binding IgG activity. Four thyrotrophin binding inhibitory immunoglobulins (TBII) from other patients did not interfere with the binding of the patient's serum to [125I]h- or bTSH. Furthermore, the in-vitro thyroid stimulating activities of three thyroid stimulating antibodies (TSAb) were not affected by the addition of this patient's IgG. On the other hand, this patient's Ig (3 mg/ml) abolished the in-vitro thyroid stimulation by bTSH (100 microU/ml), but did not affect that by hTSH (100 microU/ml). The anti-hTSH antibody, TSH receptor antibody and anti-bTSH antibody in the serum, which contains TSAb as well as anti-TSH antibodies, could be partially purified by hTSH-agarose and subsequently by guinea pig fat cell membrane affinity absorptions. However, the anti-hTSH antibody fraction obtained had both hTSH binding activity and thyroid stimulating activity, and this fraction did not show any inhibitory effect on the in-vitro thyroid stimulation of autologous TSH receptor antibody or hTSH. The possible significance of anti-TSH antibodies is discussed.     

CYTOMEGALOVIRUS COLITIS MIMICKING COLON CARCINOMA IN AN HIV-NEGATIVE PATIENT WITH CHRONIC RENAL FAILURE

Cytomegalovirus (CMV) colitis is thought to occur almost exclusively in immunosuppressed persons. Colonoscopy in patients with CMV colitis usually shows diffuse or localized ulceration, although mucosal friability, erosions, hemorrhage, and plaque-like pseudomembranes may be observed. We report on a patient with chronic renal failure undergoing hemodialysis therapy who had abdominal symptoms, including bloody diarrhea, along with colonoscopic findings suggestive of carcinoma of the colon. The patient was not infected with the human immunodeficiency virus and had normal lymphocyte subset numbers. He was subsequently found to have invasive CMV disease of the colon. CMV colitis can occur in persons who are not severely immunosuppressed, and its colonoscopic appearance may mimic that of colon cancer.     

兔衣原体病病原体的分离及鉴定

本文报道一起暴发流行的兔繁殖障碍综合征,主要表现为子宫炎、流产、死胎、产弱仔和不孕等。经过鸡胚分离、感染ＭｃＣｏｙ细胞、特异性免疫荧光染色、姬姆萨染色观察包涵体、碘染色、磺胺抑制等试验,初步确认该病原为鹦鹉热衣原体。     

兔衣原体病病原体的分离及鉴定

本文报道一起暴发流行的兔繁殖障碍综合征,主要表现为子宫炎、流产、死胎、产弱仔和不孕等。经过鸡胚分离、感染McCoy细胞、特异性免疫荧光染色、姬姆萨染色观察包涵体、碘染色、磺胺抑制等试验,初步确认该病原为鹦鹉热衣原体。     

THE INFLAMMATORY RESPONSE IN THE SYNOVIUM OF A PATIENT WITH ROSS RIVER ARBOVIRUS INFECTION

Ross River virus has been incriminated in the etiology of many sporadic and epidemic cases of polyarthritis in Australia and the Pacific. Both synovium and synovial exudate fluid recovered from the knee of an epidemic polyarthritis patient showed a predominantly mononuclear leucocyte infiltrate. Infectious virus could not be recovered from the synovial exudate. Functional natural killer cells were detected in the synovial fluid. Their level of cytotoxic activity was similar to that detected in the peripheral circulation. (Aust NZ J Med 1985; 15: 336–339.)     

INFLAMMATORY PSEUDOTUMOR OF THE LIVER IN A PATIENT WITH CHRONIC SCLEROSING CHOLANGITIS

Inflammatory pseudotumor of the liver (IPL) is a rare fibro-inflammatory mass of unknown etiology, resembling a neoplasm. We report the occurrence of such a lesion in a young male Cambodian refugee to Canada who had a history of chronic cholangitis. Imaging studies suggested an intrahepatic abscess. Our report suggests that the lesion in this patient may have resulted from chronic portal pyemia.