Viral load,CD4 percentage,and delayed-type hypersensitivity in subjects receiving the HIY-1 Immunogen and antiviral drug therapy

Two trials of subjects inoculated with the inactivated, gp120-depleted HIV-1 Immunogen are reported. In one study, in which 19 subjects received ZDV and 8 subjects received ddI, treatment with the HIV-1 Immunogen did not affect the pharmacokinetic parameters of the antiviral drugs. In another study, 65 subjects who were previously immunized with the HIV-1 Immunogen over a mean period of 4.0 years (range, 1.2–5.4 years) received inoculations at 0 and 6 months. At some point during this 48-week study, 72% of the subjects (47/65) were receiving antiviral drug therapy. The HIV-1 DNA load in CD4 cells and CD4 percentage were found to be stable over the 48-week period. Delayed-type hypersensitivity to HIV-1 antigens increased after two inoculations with the HIV-1 Immunogen. In these two trials, no serious treatment-related adverse events were documented in the subjects. The two studies presented herein are the first to suggest that an immune-based therapy such as the HIV-1 Immunogen can be combined safely with antiviral drugs, supporting further study to evaluate the clinical utility of this approach.     

Autoimmunity related to IgM monoclonal gammopathy of undetermined significance. Peripheral neuropathy and connective tissue sensibilization caused by IgM M-proteins

In eight of 10 consecutive cases of IgM monoclonal gammopathy of undetermined significance (MGUS), the M-protein had specificity towards various tissues as estimated by direct and indirect immunofluorescence studies of skin and/or sural nerve biopsies. Five of the cases had neuropathy. In three of them, including two siblings with a demyelinating peripheral neuropathy, the IgM was bound to the myelin-associated glycoprotein (MAG) of peripheral nerves. One had axonal neuropathy with IgM activity against the peri- and endoneurium, while another case with post-infectious neuritis had IgM activity against structures in the endoneurium but no IgM autoimmunity in the direct fluorescence test. The latter improved clinically in parallel with a decrease in the M-protein indicating a pathogenetic role of the autoantibody. In three other cases, the IgM was bound to connective tissue structures, two of them also had plasma antibodies against the peri- and endoneurium in the indirect fluorescence test. Finally, two cases showed no reaction of the M-protein against any tissue structures. Since an autoimmune pathogenesis is suspected, the HLA types of seven patients are reported.     

Primary lymphadenopathic Kaposi's sarcoma in an immunocompetent 23-year-old man

An aggressive visceral form of Kaposi's sarcoma (KS) has been reported in immunosuppressed populations, most notably in patients with acquired immunodeficiency syndrome (AIDS). This presentation contrasts from the indolent skin lesions on the extremities of older males and is distinct enough in the young adult American population to have been included in the working definition of AIDS. The authors describe a case of primary lymphadenopathic KS in an immunocompetent heterosexual 23-year-old man with no epidemiologic, immunologic, or serologic evidence of AIDS. This report emphasizes that a diagnosis of KS in a young American male is not synonymous with the diagnosis of AIDS.     

Age-related changes of exercise-induced plasma catecholamines and neuropeptide Y responses in normal human subjects.

Age-related plasma noradrenaline and neuropeptide Y were evaluated in seven young (mean +/- SD, 28 +/- 3 years) and seven elderly (64 +/- 8 years) normal subjects during rest and different work loads on a cycle ergometer. In the supine and the sitting position plasma noradrenaline and neuropeptide Y were almost identical in the two groups. Plasma neuropeptide Y did not increase during exercise at 100 W for 15 min. At this load plasma noradrenaline levels were higher in the older subjects (mean +/- SEM, 0.97 +/- 0.12 vs. 0.60 +/- 0.09 ng ml-1). There was a significant correlation between plasma noradrenaline and the relative work load at 100 W (r = 0.794, P = 0.0007). At 75% of maximal work load plasma noradrenaline and neuropeptide Y were higher in the young group (1.84 +/- 0.16 vs. 1.26 +/- 0.13 ng ml-1 (noradrenaline) and 38 +/- 4 vs. 22 +/- 5 pmol l-1 (neuropeptide Y)). In the elderly group plasma neuropeptide Y did not increase during exercise and showed a tendency to fall below basal level 5 min post-exercise. It is concluded, that plasma noradrenaline does not increase more in older subjects during exercise when correcting for the generally lower physical fitness in this group compared to younger subjects, and that plasma neuropeptide Y does not increase during exercise in older subjects, suggesting an age-reduced capacity in this system.     

Antacids in the treatment of duodenal ulcer

Fifty patients with endoscopically proven pyloric-prepyloric ulcers (PU/PPU) and 50 with duodenal ulcers (DU) completed a six-week double-blind clinical trial initially comprising 124 patients. The antacid-treated patients received 10 ml of an antacid suspension seven times a day (buffering 367.5 mmol acid). Healing rate after three weeks of treatment was 74% in the antacid and 42% in the placebo group (p less than 0.01). After six weeks the corresponding figures were 96 and 68% (p less than 0.001). Regarding the PU/PPU and DU subgroups we found significant differences compared to placebo in the PU/PPU group only. Antacids caused a significantly faster and more perceptible pain relief than placebo. We found no significant correlation between ulcer healing and smoking habits. Regression analyses showed that, besides antacids, ulcer size and peak acid output influenced the healing rate significantly.     

Morphometric analysis of the response ofAnabaena flos-aquae andAnabaena variabilis (Cyanophyceae) to selected concentrations of zinc

The toxicological responses of the freshwater cyanophycean algaeAnabaena flos-aquae andA. variabilis, to selected concentrations of the essential cation zinc, were quantified by the techniques of stereological electron microscopic morphometry. The cation concentrations used were 20.6, 52.0, and 114.7 M, which represented the 96-hr EC₅₀ dose forA. variabilis and an equal bisection of a log scale above and below this concentration. The results indicated that the surface area of the thylakoids ofA. flos-aquae were significantly increased after exposure to 114.7 M Zn, and that there was a significant increase in the number of lipid bodies per cell. All test concentrations caused a significant reduction in both the numbers and relative volume of the cell's cyanophycin granules, but resulted in an increase in the cell's membrane limited crystalline inclusions. Both 52.0 and 114.7 M Zn caused a significant increase in the surface area of the thylakoids ofA. variabilis, but only the highest concentration caused an increase in the volume of the interthylakoidal spaces. The relative volume and numbers of lipid bodies ofA. variabilis cells were increased by exposure to 52.0 M Zn, and 114.7 M Zn caused a significant increase in the relative volume and numbers of the cell's polyphosphate bodies. The significance of these results are discussed in terms of potential cellular detoxification mechanisms, which are important in the cell's ability to cope with the anthropogenic introduction into the aquatic environment of metal and industrial pollutants.     

The prospective diagnostic value of real-time cholecystosonography

A series of 82 consecutive patients scheduled for operation, with pre-operatively obtained P.O. cholecystography and in some cases also I.V. cholangiography, is presented. All patients had cholecystosonography performed "blindly" the day prior to the operation (76 had a cholecystectomy and six had a vagotomy). Based upon the operative findings, the diagnostic value of ultrasonic examination for gallstones can be calculated to predictive value of positive test--1.00; predictive value of negative test--0.71. The diagnostic failures are discussed but it is not possible to predict which patients will benefit more from peroral cholecystography rather than from ultrasound. It is concluded that cholecystosonography is a safe alternative to peroral cholecystography.