TCDD inhibits the support of B-cell development by the bursa of Fabricius

The toxic effects produced by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and its congeners include inhibition of lymphoid development. We have previously found an inhibition of B-cell development in the bursa of Fabricius of chick embryos treated with TCDD congeners in ovo. In the present study, the bursae of ten-day-old chick embryos were removed and cultured on filter paper for 24 hr in media with or without TCDD or 3,3',4,4'-tetrachlorazoxybenzene (TCAOB). Following culture, the bursae were transplanted onto the chorioallantoic membrane (CAM) of ten-day-old eggs of the same strain or of a strain expressing a different B-cell surface alloantigen. After 5 days on the CAM the number of B-cells was determined or the grafts were sectioned for subsequent immunohistochemistry. Results were as follows: 1) A lower number of lymphoid cells (dose dependent) was observed in the TCDD-treated transplants amounting to 40-50% of that in the controls at 10(-9) M TCDD. Higher concentrations of TCDD compromised survival of the grafts. A single concentration of TCAOB (10(-8) M) was tested, resulting in a lymphoid cell number of 60% of that of the controls. 2) The bursal epithelium showed relatively normal development even in cases where B-cell development was affected. 3) Lymphoid cells in the grafted bursae originated from the embryo of the host egg. These findings suggest that the TCDD congeners had a direct effect on the bursa of Fabricius, leading to an inhibition of lymphoid development. It is likely that the microenvironment is affected by these compounds, thus resulting in a decrease in the attraction of stem cells and/or in the capacity to induce proliferation of the colonizing cells.     

Tropical pyomyositis

A 22 year old male presented with symptoms of diffuse muscle pain and multiple abnormal laboratory findings that were eventually attributed to tropical myositis. Computed tomography scan was more reliable than ultrasound and served as a guide to needle aspiration and pathologic diagnosis.     

Verbesserte Technik der Stapektomie bei Otosklerose

Ohne Zusammenfassung     

Management of the sensitized cardiac recipient: the use of plasmapheresis and intravenous immunoglobulin

Previously, we reported that the combination of plasmapheresis (PP) and intravenous immunoglobulin (IVIg) allow sensitized patients to undergo orthotopic heart transplantation (OHT), even across a positive crossmatch. In the current study, the effect of that combination, PP+IVIg, on survival of a larger group of such recipients is investigated. The latter group (I) consisted of 35 sensitized patients who received PP+IVIG together with standard immunosuppressive drugs. Rejection was seen in 11 patients, findings strongly suggestive of a vascular (humoral) being identified in five of those cases. Four deaths occurred, two of them in the immediate post-operative period, one after almost six months, and one after almost two yr post-OHT. Follow-up range 4.5 months to 7.8 yr post-OHT (average=1.1 yr). Patient survival was analyzed after generation of a Kaplan-Meier plot. Comparison with a control OHT group (II) given standard immunosuppressive drugs only (N=276) showed enhanced survival of group I (p=0.0414 by log-rank test). We conclude that the combination of PP and IVIG (i) is associated with declines in T- and B-percent-reactive antibody and in crossmatch positivity, and (ii) is very useful in the management of the sensitized cardiac patient undergoing OHT, often allowing a successful outcome to transplantation in the face of a positive crossmatch.