A Family with Hemoglobin I

Hemoglobin I was recently found in a Negro family. The amino acidsubstitution was shown to occur in the sixteenth residue of the chain (lys asp) and to be identical with hemoglobin I described by Murayama.¹⁰ Theminor component, I₂, was demonstrated by agar gel electrophoresis.

Submitted on January 9, 1963 Accepted on April 3, 1963     

Mast cell degranulation and parenchymal cell injury in the rat mesentery.

OBJECTIVE: The objective of this study was to explore the degree of parenchymal cell injury after mast cell degranulation by application of compound 48/80 (CMP 48/80) in the absence of adherent leukocytes in the rat mesentery. METHODS: Rats were rendered leukopenic by injection of an antibody against leukocytes, and the mesentery was superfused with CMP 48/80 during intravital microscopy. The extent of cell injury was determined using a fluorescent cell-viability indicator, propidium iodide (PI). In an additional group, mast cell degranulation with CMP 48/80 was prevented by using the mast cell stabilizer Ketotifen. RESULTS: After a reduction in the number of circulating leukocytes, mast cell degranulation produced a mild increase in parenchymal cell injury. The injury levels significantly increased when individual regions of the mesentery were compared. Stabilization of the mast cells with Ketotifen reduced the injury to below baseline values. CONCLUSIONS: In the absence of leukocyte adhesion to the endothelium, mast cell degranulation contributes to parenchymal cell injury in the mesentery.     

Tumour cell killing using chemically engineered antibody constructs specific for tumour cells and the complement inhibitor CD59

Immunotherapy using MoAbs is inefficient due to limited activation of human effectors by mouse antibodies and multiple protective mechanisms available to host cells against autologous complement. We have used chemically engineered antibody constructs and human complement in vitro to specifically target and kill neoplastic B lymphoid cells (Raji). Fab′γFcγ² chimaeric antibody (specific for human CD37) was used to activate the classical pathway of human complement on Raji cells, whilst CD59 was neutralized using one of two different bispecific F(ab′γ)² antibody constructs which contained both cell-targeting (anti-CD19 or anti-CD38) and CD59-neutralizing moieties. When either bispecific construct was used to neutralize CD59, 15–25% of cells were lysed. If CD55 was also neutralized using specific antibody, Raji cells were efficiently killed (70% lysis). When added to a mixture of target (Raji) and bystander (K562) cells, one bispecific antibody (anti-CD38 × anti-CD59) could be specifically delivered to Raji, avoiding significant uptake on CD59-expressing bystander cells (K562). The second bispecific antibody (anti-CD19 × anti-CD59) bound equally well to either cell type. Cell-specific targeting was dependent upon combination of a low-affinity anti-CD59 Fab′γ with a high-affinity anti-tumour cell Fab′γ. When Raji and K562 cells were mixed and incubated with a combination of the engineered constructs and anti-CD55 antibodies, Raji cell lysis (30–40%) was observed in the absence of K562 killing. We propose that combinations of these constructs may be of use for treatments such as ex vivo purging of autologous bone marrow or in vivo targeting of tumour cells.     

Cost-analysis of neonatal intensive and special care

Abstract In the present economic climate and with increasing expenditure on neonatal intensive care, there has been a demand for economic evaluation and justification of neonatal intensive care programmes. This study assesses the inhospital costs of neonatal intensive care. Fixed and variable costs were calculated for services and uses of an Intensive/Special Care Nursery for the year 1985 and corrected to 1987 Australian dollar equivalents. Establishing a new neonatal intensive care unit of 43 cots in an existing hospital with available floor space including operating costs for a year were estimated in Australian dollars for 1987 at $6 408 000. Daily costs per baby for each level of care were $1282 ventilator, $481 intensive, $293 transitional and $287 recovery, respectively. The cost per survivor managed in the Intensive/Special Care Nursery in 1985 showed the expected inverse relationship to birthweight being $2400 for > 2500 g, $4050 for 2000–2500 g, $9200 for 1500–1999 g, $23 900 for 1000–1499 g and $63 450 for < 1000 g. Further analysis for extremely low birthweight infants managed in 1986 and 1987 demonstrated costs per survivor of $128 400 for infants < 800 g birthweight and $43 950 for those 800–999 g. This methodology might serve as a basis for further accounting and cost-evaluation exercises.     

Single daily dose ceftriaxone therapy in epiglottitis

Ceftriaxone as a single daily intravenous dose for 5 days was used to treat seven patients with proven Haemophilus influenzae epiglottitis. All children responded favourably. The serum levels achieved exceeded the MIC by up to 1500 times at the trough level during and for up to 24 h after the completion of the treatment. Side effects were mild and transient and did not disrupt the continuity of the treatment. Ceftriaxone potentially offers a number of clinical and economic advantages in the management of epiglottitis.     

CARDIAC ARRHYTHMIAS DURING ANAESTHESIA FOR LAPAROSCOPY

Fifty-six patients undergoing elective laparoscopy were allocatedrandomly to two groups. Group H received alcuronium and wereventilated artificially using 0.5% halothane and nitrous oxidein oxygen. Group E breathed spontaneously a mixture of enfluraneand nitrous oxide in oxygen. Arterial pressure, heart rate,tidal volume, respiratory rate and end-tidal carbon dioxidetension (PE_CO²) were monitored. The electrocardiogram (ECG)was recorded continuously using mogni-rir tape, from beforeinduction until the patient left the insufflated carbon dioxidehad been removed from the abdomen. Spontaneous ventilation withenflurane anaesthesia is a simple and safe technique for routinelaparoscopy, providing the intra-abdominal pressure does notexceed 25 mm Hg