IL-6 acts on endothelial cells to preferentially increase their adherence for lymphocytes

Using a quantitative monolayer adhesion assay, the current report shows that treatment of human umbilical vein endothelial cells (HUVEC) with IL-6 increases their adhesiveness for blood lymphocytes, particularly CD4⁺ cells, but not for polymorphonuclear cells and monocytes. This effect, which was most pronounced when using low concentrations of the cytokine (0.1–1.0 U/ml) and a short incubation period (4 h), was also apparent with microvascular endothelial cells and a hybrid endothelial cell line. Skin lesions from patients with mycosis fungoides contain high levels of IL-6, and blood lymphocytes from patients with this disorder also exhibited an enhanced adhesion to IL-6-treated HUVEC. The cytokine enhanced intercellular adhesion molecule-1 (ICAM-1) expression and induced the expression of vascular cell adhesion molecule-1 (VCAM-1) and E-selectin on endothelial cells. Antibody blocking studies demonstrated that the vascular adhesion molecules ICAM-1, VCAM-1 and E-selectin and the leucocyte integrin LFA-1 all contributed to lymphocyte binding to endothelium activated by IL-6. It is proposed that IL-6 may be involved in the recruitment of lymphocytes into non-lymphoid tissue.     

Alcohol Use and the American Indian--some Socio-Cultural Lessons about the Nature of Alcoholism

Recent research findings on alcoholism involving a number ofAmerican Indian tribes are reviewed and compared with thoseobtained in a study of Sioux drinking in the 1960's. Many ofthe behavioural symptoms of alcoholism characteristic of Anglo-Saxonpopulations are absent among Indian groups. Such symptoms areless reliable as indicators of alcoholism because they are lessculture free. It is concluded that the behavioural symptomsof alcoholism must be evaluated in the cultural context in whichthey occur.     

Phenytoin–induced toxic epidermal necrolysis: a case report

We present a case of phenytoin-induced toxic epidermal necrolysis resulting in 60–70% skin involvement. Systemic corticosteroids and prophylactic antibiotics used initially were discontinued, and subsequent management concentrated on intensive supportive treatment. The patient survived, but is left with disabling ocular complications.     

Multiple endocrine neoplasia type 1 presenting as rosacea

We present a ease of malignant carcinoid initially diagnosed as rosacea. This patient was later found to have an additional functioning parathyroid tumour. Although a pituitary tumour was nor identified, the association represents a probable case of multiple endocrine neoplasia type 1 (MEN 1). This autosomal dominant syndrome is characterized by tumours of the pancreas, parathyroid and pituitary. Inoperable carcinoid rumour is best treated with a long-acting somatostatin analogue, octreotide. A diagnosis of MKN I has important connotations for the proband's first-degree relatives, who should be entered into an appropriate screening programme.     

Cytokeratin expression in cervical epithelium: an immunohistological study of normal, wart virus-infected and neoplastic tissue

In this study using a panel of anticytokeratin antibodies and an indirect immunoperoxidase method, we examined cervical squamous epithelia including mature stratified epithelium, immature squamous metaplasia, CIN 1, 2 and 3, wart virus infection and squamous carcinoma. Changes from the normal patterns of staining were inconsistently seen in CIN 1 and 2, but in CIN 3 the changes were more marked, and consisted of a loss of stratification of the staining pattern and a patchy reduction in staining. Invasive carcinomas showed a similar staining pattern to CIN 3 lesions.     

An Assessment of Laparotomy in the Management of Patients with Hodgkin's Disease

Planned laparotomy and splenectomy has been a safe investigationfor sixty patients with clinical Stage I, II or III Hodgkin'sdisease. Twenty-four of the 60 patients (40 per cent) changedstage and 18 patients had their treatment altered as a consequenceof the procedure. Forty-three per cent of patients without apalpably enlarged spleen had unsuspected disease when the organwas examined pathologically, although a false positive spleenwas uncommon. Eight of 55 patients (14·5 per cent) hadintra-abdominal disease which was not detected by lymphangiography.Intra-abdominal disease occurred with all histological sub-typesand was found in two patients who had clinical Stage I diseaseand lymphocyte predominance in their node histology. Sarcoid-like granulomata were found in ten patients, seven inthe spleen, one in the liver and spleen, one in the skin andone in the original node biopsy. In the majority of patients,granulomata were associated with nodular sclerosing or mixedcellular histology. In all ten patients the Hodgkin's diseasewas suppressed by appropriate chemotherapy and disease has notrecurred. No patient has shown any clinical evidence of sarcoidosisand the Kveim test done in three patients was negative. Our experience encourages us to recommend staging laparotomyfor all adult patients with Hodgkin's disease which does notshow obvious generalized spread beyond lymph nodes.     

Pharmacological properties of betabeta-di-methyl-acryloylcholine and some other beta-substituted acryloylcholines

The mammalian pharmacology of a new naturally occurring ester of choline, betabeta-dimethylacryloylcholine (DMAC), has been studied, mainly in the cat, together with that of two synthetic beta-substituted acryloylcholines, crotonoylcholine and pent-2-enoylcholine. Comparisons have been made with the reduced form of DMAC, isovalerylcholine, with another naturally ocurring beta-substituted acryloylcholine, murexine (urocanoylcholine), and with suxamethonium. DMAC has been shown to be a ganglion stimulating and neuromuscular blocking agent generally similar, in potency and properties, to murexine. It is also a powerful respiratory stimulant. The other unsaturated esters behaved similarly but were less potent.