多发性骨髓瘤克隆起源的研究

为了解外周血中肿瘤克隆细胞的分化阶段，进一步研究ＭＭ（多发性骨髓瘤）发病机理，采用针对Ｂ细胞不同分化阶段抗原ＣＤ１０、ＣＤ１９、ＣＤ２０、ＣＤ４５ＲＡ、ＣＤ４５ＲＯ、ＣＤ３８的单克隆抗体，用ＡＰＡＡＰ法（碱性磷酸酶抗碱性磷酸酶法）同时检测１７例外周血中不含浆细胞的ＭＭ患者骨髓及外周血的免疫表型，其中１０例外周血表达浆细胞抗原增高（Ｐ＜０．００１）且与骨髓一致。９例外周血表达ＣＤ３８和ＣＤ４５ＲＯ，３例表达ＣＤ３８、ＣＤ４５ＲＡ、ＣＤ４５ＲＯ，１例表达ＣＤ３８、ＣＤ４５ＲＡ、ＣＤ４５ＲＡ和ＣＤ１０。此结果显示ＭＭ患者外周血的Ｂ系抗原表达既与骨髓具有一致性，又具多样性，提示ＭＭ的外周血中存在多分化阶段的肿瘤前体细胞，呈现自早期Ｂ细胞，经活化Ｂ细胞及晚期Ｂ细胞向前浆细胞的持续分化过程，并验证了文献关于ＭＭ发病途径的推测。     

POLYCLONAL ORIGIN OF RHEUMATOID SYNOVIAL T-LYMPHOCYTES

Nineteen T-cell clones from seven patients with RA were obtainedby cloning infiltrating lymphocytes from needle synovial biopsies.Southern blot analysis of the T-cell receptor (TCR) ß-chaingenes in these clones revealed that there were no T-cell cloneswith an identical rearrangement of the TCRß gene.These results do not support the idea that the infiltratingT-lymphocytes in RA are of monoclonal or oligoclonal origin. KEY WORDS: T-cell receptor gene, Rheumatoid synovitis, Clonality     

HYPOKALEMIC PERIODIC PARALYSIS OF THYROTOXIC ORIGIN

Abstract A 50-year-old Vietnamese man suffered recurrent episodes of hypokalemic periodic paralysis during treatment for thyrotoxicosis. Suspected precipitants of the paralysis were oral prednisolone, strenuous exertion and poor compliance with medications. Propranolol prevented the periodic paralysis. Control of the thyrotoxicosis was complicated by a florid skin reaction attributed to carbimazole, and was ultimately achieved using radioiodine.