In vitro immunization of human tonsilar lymphocytes: effects of PWM and rIL-6

We previously described a system for the in vitro immunization of human tonsilar lymphocytes under serum-free conditions in the presence of muramyl dipeptide and rIL-2 (1). Further studies with this system reveal possible roles for PWM and rIL-6 in the immunization process. The addition of these factors led to an increase in the levels of antibody produced in lymphocyte cultures. The time of addition of these factors was found to be important in determining the extent of their effects on the overall yields of antigen-reactive cells.     

Human islet isolation and allotransplantation in 22 consecutive cases.

This report provides our initial experience in islet isolation and intrahepatic allotransplantation in 21 patients. In group 1, 10 patients underwent combined liver-islet allotransplantation following upper-abdominal exenteration for cancer. In group 2, 4 patients received a combined liver-islet allograft for cirrhosis and diabetes. One patients had plasma C-peptide greater than 3 pM and was therefore excluded from analysis. In group 3, 7 patients received 8 combined cadaveric kidney-islet grafts (one retransplant) for end-stage renal disease secondary to type 1 diabetes mellitus. The islets were separated by a modification of the automated method for human islet isolation and the preparation were infused into the portal vein. Immunosuppression was with FK506 (group 1) plus steroids (groups 2 and 3). Six patients in group 1 did not require insulin treatment for 5 to greater than 16 months. In groups 2 and 3 none of the patients became insulin-independent, although decreased insulin requirement and stabilization of diabetes were observed. Our results indicate that rejection is still a major factor limiting the clinical application of islet transplantation in patients with type 1 diabetes mellitus, although other factors such as steroid treatment may contribute to deteriorate islet engraftment and/or function.     

The globalization of capital, the welfare state, and old age policy.

A new political economy is shaping the lives of present and future generations of older people. The key change has been the move from the mass institutions that defined growing old in the period from 1945 through the late 1970s to the more individualized structures--privatized pensions, privatized health and social care--that increasingly inform the current period. The authors examine the role of international governmental organizations in promoting this trend, with examples drawn from the work of the World Bank, World Trade Organization, and Organization for Economic Cooperation and Development, and the relationship between international governmental organizations and the state. The article concludes with an assessment of the changes to citizenship that accompany globalization and the implications for political organization among older people themselves.     

t(12;17)(p13;q21) in early pre-B acute lymphoid leukemia.

Structural rearrangements involving the short arm of chromosome 12 occur in 10% of cases of childhood acute lymphoid leukemia. The translocation t(12;17)(p13;q21), an uncommon 12p abnormality, was identified in five of 2620 cases (0.2%) successfully karyotyped by the Pediatric Oncology Group or St Jude Children's Research Hospital. All five cases were classified as early pre-B; however, CD10 (common acute lymphoblastic leukemia antigen) was expressed at lower levels than other markers of B-cell lineage. Two cases also expressed the myeloid-associated antigen CD33. Leukemic cells were pseudodiploid in four cases, with an extra chromosome 21 in the fifth case. All of these patients achieved complete remission. Two relapsed during subsequent therapy, and three remain in continuous remission for greater than or equal to 20 months.     

Diagnosis of placenta previa during the third trimester: role of transperineal sonography.

Placenta previa can be difficult to diagnose with transabdominal sonography during the third trimester of pregnancy, because of difficulties in imaging the cervix late in pregnancy. Although transperineal sonography offers an additional view of the cervix, its value in the diagnosis of placenta previa has not been studied. Accordingly, we performed transperineal sonography on 164 patients who had had transabdominal scans that had shown placenta previa or had been inconclusive during the third trimester of pregnancy. Transabdominal sonograms had been inconclusive for placenta previa in 157 of these patients because the cervix was not visualized. The remaining seven patients had transabdominal scans that showed placenta previa. Transperineal sonography successfully visualized the internal surface of the cervix in all 164 patients, allowing determination of the presence or absence of placenta previa in all cases. Transperineal sonograms showed absence of placenta previa in 154 patients. At delivery, none of these patients had evidence of placenta previa. Transperineal sonography showed placenta previa in 10 patients. In nine of these patients, placenta previa was confirmed at delivery. The 10th patient did not have clinically significant placenta previa at delivery. Our study shows that transperineal sonography is a valuable technique to complement transabdominal sonography for detection of placenta previa during the third trimester of pregnancy. Use of transperineal sonography should be strongly considered when a definitive diagnosis regarding placenta previa is not possible by transabdominal sonography because the cervix is not visualized. In such cases, transperineal sonography will usually show the internal surface of the cervix without overlying placental tissue, allowing confident exclusion of placenta previa. Occasionally, however, transperineal sonography will show a placenta previa that was not seen with transabdominal sonography.     

Primary adenocarcinoma of the temporal bone. A case with 40-year follow-up

Adenomatous tumors of the temporal bone are rare neoplasms. This article records the 40-year course of a patient with adenocarcinoma of the temporal bone and reviews the literature pertinent to the biologic behavior, histologic appearance, prognosis, and treatment of this group of tumors.     

Effects of yohimbine, an α2-adrenoceptor antagonist, on experimental neurogenic orthostatic hypotension

Summary— Yohimbine has been proposed for the treatment of neurogenic orthostatic hypotension; however, no controlled trial has been performed in experimental models of orthostatic hypotension or in patients with autonomic failure. The aim of the present study was to compare the effects of yohimbine (0.05 mg/kg, intravenously [iv]) and placebo (saline) in a new model of neurogenic orthostatic hypotension obtained by sinoaortic denervation (SAD) in chloralose-anaesthetized dogs. Blood pressure, heart rate, noradrenaline plasma levels and systolic blood pressure and heart rate short-term variabilities (calculated on low frequency [40–50 MHz] and high frequency [390–490 MHz] bands) were measured in supine position and after a 10 min 80° head-up tilting. The drugs were administered in a double-blind cross-over randomized fashion. The head-up tilting performed in normal animals increased diastolic blood pressure (+12 ± 4 mmHg), heart rate (+39 ± 12 beats per minute [bpm]), the low frequency band of systolic blood pressure and noradrenaline plasma level, without changing systolic blood pressure or heart rate variability. In SAD dogs, a marked fall in systolic (-80 ± 11 mmHg) and diastolic (-43 ± 4 mmHg) blood pressures was observed within 1 min after placebo, without modification in heart rate, systolic blood pressure and heart rate short-term variabilities and noradrenaline plasma levels. In SAD dogs, yohimbine (0.05 mg/kg, iv) delayed the blood pressure fall elicited by head-up tilting, but failed to modify its magnitude. These results show that, in the model of orthostatic hypotension obtained by SAD, yohimbine, at an α₂-adrenoceptor selective dose (0.05 mg/kg), delays the fall in blood pressure elicited by head-up tilting. The effect of yohimbine can be explained by an increase in sympathetic tone.     

The effect of in vivo ethanol consumption on cyclic AMP and δ-opioid receptors in mouse striatum

In this study the effect of in vivo ethanol consumption on cyclic AMP (cAMP) and [

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-Ala²,

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-Leu⁵]enkephalin (DADLE) inhibition of forskolin-stimulated cAMP production was examined in mouse striatum. Effects of ethanol on striatal δ-opioid receptor (DOR) density and mRNA were also examined. Mice had unlimited access to 7% (v/v) ethanol alone or water for 1 or 7 days and were then sacrificed and striatum removed for analysis. There was no difference in basal cAMP formation between water and ethanol-treated mouse striatum following 7 day treatment, and a small, but statistically significant increase in basal cAMP in the ethanol group following 1 day treatment. Both 1 day and 7 day ethanol treatment did not significantly alter the percentage increase in cAMP following treatment with 10 μM forskolin. There was a significant effect of ethanol treatment on the maximum inhibitory effect of DADLE on forskolin-stimulated cAMP formation following both 1 and 7 day ethanol treatment. The DADLE IC₅₀ was unaffected by ethanol treatment. Saturation binding studies ([³H]Deltorphin II) indicated no effect of ethanol on B_max or K_d in striatum. Similarly, no difference between water and ethanol-treated was observed for DOR mRNA in striatum. These data indicate that ethanol consumption can alter opioid regulation of cAMP formation. However, this effect is not related to changes in any δ-opioid receptor parameters that were examined.