Effect of storage and ultraviolet B irradiation on CD14-bearing antigen- presenting cells (monocytes) in platelet concentrates

BACKGROUND: Ultraviolet B (UVB) irradiation of platelet concentrate (PCs) reduces platelet alloimmunization, but the mechanism of the effect is unclear. Evidence suggests that UVB may downregulate the expression of surface adhesion molecules on passenger antigen- presenting cells in PCs. STUDY DESIGN AND METHODS: The effect of blood bank storage, platelet preparation from whole blood, and UVB irradiation on the quantitative expression of intercellular adhesion molecule-1 (ICAM-1, or CD54), HLA-DR, CD45, and CD11c on CD14-positive antigen-presenting cells (monocytes) was studied by using two-color flow cytometry. RESULTS: Blood bank storage for 4 days resulted in upregulation of ICAM-1 and HLA-DR and downregulation of CD14 but left the expression of CD11c and CD45 unchanged. Preparation of PCs from fresh whole blood was associated with a rapid increase in CD11c without upregulation of ICAM-1 and HLA-DR. UVB irradiation before storage inhibited the upregulation of ICAM-1 and HLA-DR, resulted in accelerated downregulation of CD14, and was associated with increased loss of monocytes. Agitation of the PC bag during irradiation was of critical importance, since omission of agitation resulted in largely uninhibited upregulation of ICAM-1 but was still associated with significantly higher cell loss than that seen in unirradiated controls. CONCLUSION: UVB exposure nonspecifically affects monocytes in PCs, resulting in downregulation of surface molecules that are important for antigen presentation, as well as in significant cell loss.     

甲氧西林耐药／敏感金黄色葡萄球菌基因分型和毒力基因检测

目的：分析耐甲氧西林金黄色葡萄球菌（金葡菌）（MRSA）和甲氧西林敏感金葡菌（MSSA）临床分离株基因分型及毒力基因分布特征是否存在差异,了解金葡菌耐药性演变与毒力变迁之间的相关性。方法采用脉冲场凝胶电泳（PFGE）方法和多位点序列分型（MLST）方法对呼和浩特地区住院患者中分离的30株 MRSA 和30株 MSSA 进行分子分型,同步采用聚合酶链反应（PCR）方法检测菌株毒力基因。结果60株金葡菌 PFGE 分型共分19个型,MSSA 菌株分布在 I 和 H 型等16个基因型中,而 MRSA 株主要集中分布在 K 和 M 2个基因型中。20株不同 PFGE 型菌株 MLST 分型结果显示,MRSA 株主要为 ST-239型;MSSA 株呈多样性分布特征,主要以 ST-5型、ST-7型、ST-15型为主。毒力基因在 MRSA 和 MSSA 中分布差异显著。MSSA 毒力基因整体携带率明显高于 MRSA（53．9％对40．0％,χ2＝32．7,P ＜0．01）。MRSA 株 sea、cna 和 cap 8基因携带率明显高于 MSSA 携带率（P ＜0．01）,而 sec、seg 、sei、sem、sen、seo、fnbB、ebpS、cap5基因携带率明显低于 MSSA（P＜0．05）。结论呼和浩特地区金葡菌临床分离株基因型呈现多样化分布特点,MRSA 主要以 ST-239型为主。MSSA 毒力基因携带率高,特定毒力因子在 MRSA 和 MSSA 株中呈现一定聚集分布特征,金葡菌特定耐药性的获得可能伴随特定毒力特征的变化。     

ASL在中枢神经系统疾病诊断中的初步应用体会

目的:探讨动脉自旋标记(ASL)MRI灌注成像技术在中枢神经系统疾病中的临床价值.方法:24例颅内病变患者,其中急性脑梗死2例,脑血管畸形7例,胶质瘤4例,淋巴瘤2例,转移瘤4例,脑膜瘤5例.所有病例均经手术病理或随访证实.用ASL技术和动态磁敏感对比成像(DSC)2种方法进行MR灌注成像,分析2种方法对颅内病变的诊断价值.结果:对急性脑梗死患者可以显示灌注缺损区或低灌注区.在评价肿瘤血供方面,ASL与DSC 2种方法所测肿瘤组织rCBF值比较,差异无显著性意义.ASL技术磁敏感伪影明显小于DSC法,对于有出血、钙化的病灶以及颅底病变的显示明显优于DSC法,提高了定量分析的准确性.结论:ASL技术在评价脑组织局部血流灌注方面,具有可重复性高、完全非侵入性、不用注射对比剂等优点.同时对于有出血、钙化或位于颅底的病变,ASL技术明显优于DSC法.     

Leukemia of non-T lineage natural killer cells

An unusual case of an aggressive leukemia of natural killer (NK) cells occurred in a 65-year-old male. Clinical characteristics of this case included hepatosplenomegaly, ascites, marrow infiltrate with leukemic cells, and a WBC up to 82.8 X 10(9) before therapy. One year before his presentation he had been noted to have a WBC of 12.1 X 10(9) with 78% lymphocytes, and 6 months before had noted intermittent fever and weight loss. He and his brother had well documented hereditary cold urticaria. The patient was treated with a modification of ProMACE CYTABOM regimen and had prompt regression of the leukemia with associated acute tumor lysis. Renal, hepatic, and marrow failure predominated during a terminal course that ended 22 days after therapy was commenced, and at autopsy there was no evidence for leukemic cell infiltrate in the liver, spleen or marrow. The leukemic cells were large granular lymphocytes by light and electron microscopic criteria, and had the following immunophenotype: CD2+, DR+, Leu7+, NKH1+, CD11+, CD3-, CD5-, CD4-, CD8-, CD16-. The cells displayed high antibody- dependent cell-mediated cytotoxicity (ADCC) and NK activity, and had a high rate of spontaneous proliferation in vitro that was not augmented by phytohemagglutinin (PHA), concanavalin A (Con A), or pokeweed mitogen (PWM). Southern analysis of DNA from leukemic cells revealed normal germline arrangements for the beta and gamma chains of the T cell antigen receptor and immunoglobulin heavy chain genes. The majority of metaphases were clonally abnormal revealing consistent rearrangements involving extra material attached to the long arms of chromosomes 5 and 11.     

西藏林芝地区性病疫情分析

目的了解当地性病流行状况和趋势。方法通过对当地性病疫情报告卡进行整理、统计,采用前后对比和比例成分分析的方法进行分析。结果林芝地区性病疫情逐年增长,发病率已高于全国和西藏自治区的平均水平,除HIV/AIDS外其它7种性病均有报告。结论林芝地区的性病疫情流行状况和趋势不容乐观,必须采取综合措施加以控制。     

Analysis of Electrophysiological Activity in Koch's Triangle Relevant to Ahlation of the Slow AV Nodal Pathway

Atrioventricuiar junctional reentrant tachycardia (AVfBT) is the most common form of paroxysmal regular supraventricular tachycardia. In patients with disabling, drug refractory AVJBT, catheter ablation has evolved rapidly from a last-resort treatment in the form of interruption of atrioventricular (AV) conduction to selective modification of AV nodal function as an ideal treatment. This article will focus on the frequently unappreciated electrophysiological activities recordable in man in Kach's triangle during ablation of the so-called slow pathway.     

Cluster headache-like headache, Hageman trait deficiency, retrobulbar neuritis, and giant aneurysm

A 56-year-old, previously reported woman with cluster headache-like headache with bouts of unilateral (the side of predominance changing through the years) severe headache had a familial history (three generations) of partial Hageman factor deficiency and bleeding episodes. A giant aneurysm was found to be lodged in the anterior communicating artery on the left side. Clinically, the features were atypical for cluster headache: onset at a young age (14 years), episodes of retrobulbar neuritis appearing at the side of pain, etc. Studies of forehead sweating indicated that the right side was the pathologic one, from an autonomic point of view, as did pupillometric studies. However, during attacks, which were left-sided at the time, forehead sweating was marked laterally on the left side and on the upper eyelid, but not on the right. The "signal" usually reaching the autonomically stigmatized side during attacks of cluster headache, therefore, did not seem to reach the sweat glands on that (the right) side during the attack in the present case. This headache may, therefore, be distinct from cluster headache, both from a clinical and from an autonomic function point of view.     

In vitro and in vivo persistence of reticulocytes from donor red cells

BACKGROUND: Reticulocytes are important in the phenotyping of transfused patients. Reticulocytes can persist in blood units for the shelf life of the unit. STUDY DESIGN AND METHODS: Temperature dependence of reticulocyte persistence was examined in vitro at 4, 24, and 37 degrees C by using thiazole orange staining and flow cytometric analysis. Two-color flow cytometric analysis was used to evaluate the persistence of donor reticulocytes in transfused patients. RESULTS: Flow cytometric analysis using thiazole orange demonstrated that persistence of reticulocytes in units of stored CPDA-1 blood was temperature-dependent. Reticulocytes disappeared over 13 and 6 days at 24 degrees C and 37 degrees C, respectively, but at 4 degrees C the reticulocyte count changed little over 35 days. Two-color flow cytometric analysis of reticulocyte antigens was used to follow donor reticulocytes in 14 transfusion events in nine different patients. Donor reticulocytes persisted through 24 hours in 75 percent of the patients and were detectable at 48 hours in three patients. CONCLUSION: This study demonstrates that reticulocytes persist during refrigerated storage; they are detectable in the circulation of most recipients for the first 24 hours after transfusion and in the circulation of a few recipients after 48 hours. These findings may have relevance for separation techniques based on reticulocyte density in samples drawn shortly after transfusion and for evaluation of reticulocyte counts in patients with hematologic abnormalities.