Adult-onset cyclic bicytopenia: a case report and review of treatment of cyclic hematopoiesis

A unique case of adult-onset synchronous cyclic neutropenia and thrombocytopenia occurring at six-week intervals is presented. Periods of cytopenia were associated with fever, myalgias, gastrointestinal symptoms, and mild mucocutaneous bleeding. Alternate-day steroid treatment failed to correct the periodic fluctuations in peripheral blood counts but ameliorated symptoms during cytopenia. The treatment of cyclic hematopoiesis is reviewed.     

Histopathological changes of the nasal mucosa in active and retired nickel workers.

Histological examinations were made on nasal biopsy specimens from the middle turbinate in 318 active and 15 retired nickel workers and in 57 controls, to study the prevalence of nasal carcinoma or possible precancerous mucosal changes in nickel-exposed individuals. The histopathological changes were evaluated according to a point-score scale, and the results were correlated to age, smoking habits, duration and type of nickel exposure and to nickel concentrations in nasal mucosa, plasma and urine. The explanatory values of these factors on the histopathology were estimated by stepwise multiple regression analysis. Two nickel workers from the roasting/smelting department (0.6%), both employed 28 years at the plant, had nasal carcinoma. Epithelial dysplasia was found in about 12% of active and 47% of retired nickel workers. One of the controls, a male carpenter, had dysplasia. These histopathological changes may be precancerous lesions, as they are almost exclusively found in active and retired nickel workers with enhanced risk of nasal carcinoma. Loss of respiratory epithelium and development of squamous epithelium were regarded as unspecific histopathological changes. These changes were seen in all groups, even though in significantly higher incidence in the nickel-exposed groups. Duration of nickel exposure, type of nickel-refining work and tobacco consumption were the independent variable that, taken altogether, had the highest explanatory values for the histopathological changes.     

Cold induced endothelial cell detachment in human saphenous vein grafts

The effect of profound (4 degrees C) and moderate cooling (20 degrees C) on the endothelium of human saphenous vein grafts for aortocoronary bypass was studied. When harvesting the vein, a piece (5-6 cm) was taken for the study and divided in two equal parts. The segments were incubated in cell culture medium for 45 minutes at 4 degrees C and 20 degrees C respectively. They were then perfused with cell culture medium at a flow rate of 100 ml/min, with a pressure of 85 mmHg and a temperature of 20 degrees C. After termination of perfusion the percentage of luminal surface without endothelial cells was determined by morphometry with scanning electron microscopy. The veins that were exposed to 4 degrees C had a significantly higher degree of endothelial cell detachment than those exposed to 20 degrees C (p less than 0.003). This study indicates that cooling to 4 degrees C may be harmful to the endothelial lining of veins which are prepared for grafting into the arterial system. Such cooling should therefore probably be avoided.     

Photosensitivity and allergy to aromatic lichen acids, Compositae oleoresins and other plant substances

Sixteen patients with verified light sensitivity to both UVB and UVA wavebands showed allergic reactions to various lichen plants ( Parmelia spp., Hypogymnia spp. Pseuodovernia spp., Cladonia spp. Platismatia spp., Physcia spp. Umbilicaria spp. and Cetraria spp. ). Among the aromatic lichen compounds, atranorin was observed to be the most frequently involved allergen, but also several oilier isolated lichen acids were immunologically active: d-usnic, evernic, stictic, fumarprotocctraric, lobaric, salazinic, diffractaic and physodic/physodalic acid. Several patients showed allergy to other plant substances from other sources such as seven different species from the Compositae family, alantolactone, balsam of Peru, colophony and wood tars. Sensitivity to known photosensitizers was observed in four patients. Aromatic lichen acids are UV-absorbing substances and several are evidently able to photosensitize human skin.     

Incorporation of precursors into sterols and proteins in liver biopsies from patients with liver disorders

Incorporation of 14C-acetate into 3-beta-OH sterols and of 3H-leucine into proteins was examined in liver biopsies from patients with liver disorders. Biopsies obtained from patients in whom no liver disease was found served as controls. Reduced 14C-acetate incorporation into sterols was found in biopsies from patients with chronic active hepatitis and primary biliary cirrhosis. Stimulated incorporation of 3H-leucine into proteins was demonstrated in patients with alcoholic liver cirrhosis and in patients with ulcerative colitis associated with liver disease. No correlation could be established between serum proteins and lipids, respectively, on the one hand, and between incorporation of precursors into proteins and sterols, on the other. 'Incorporation parameters' were also inferior to conventional liver tests when used in the differential diagnosis between different liver disorders by discriminant analysis. Our findings may suggest, however, that hepatic sterol synthesis is frequently decreased in patients with chronic active hepatitis and primary biliary cirrhosis.     

Meditation: a modulator of the immune response to physical stress? A brief report.

OBJECTIVE: To test the hypothesis that stress reducing techniques such as meditation alter immune responses after strenous physical stress. METHODS: The hypothesis was tested by studying six meditating and six non-meditating male runners in a concurrent, controlled design. After a period of six months with meditation for the experimental group, blood samples were taken immediately before and after a maximum oxygen uptake test (VO2max). RESULTS: The increase in CD8+ T cells after VO2max was significantly less in the meditation group than in the control group (P = 0.04). The amount of CD2+ cells doubled after VO2max, mainly because of a rise in the CD8+ fraction. CONCLUSIONS: Meditation may modify the suppressive influence of strenous physical stress on the immune system.