Splenocyte response to T cell-derived cytokines in thymectomized Xenopus.

A miniaturized, “hanging-drop” bioassay reveals that splenocytes from earlythymectomized (Tx) Xenopus can respond (by enhanced thymidine incorporation) to thymicdependent “cytokines” generated in PHA- or alloantigen-stimulated cultures. Preliminary evidence, using fluorescence activated cell sorting, indicates that surface IgM⁻ splenocytes, rather than sIgM⁺ cells, from Tx toads are sensitive to the crude, splenocyte-derived, active supernatants. Although these responsive cells display residual, but low, reactivity to PHA, their thymus independence is suggested by flow cytometric observations using the anti-T cell monoclonal antibody XT-1. The development of “T-like” cells in Tx Xenopus is discussed.     

Immunophenotyping of childhood acute lymphoblastic leukemia in Saudi Arabia: Second look

Geographical variations in the incidence of disease are of considerable theoretical and practical importance. It has been claimed that the distribution of acute lymphoblastic leukemia (ALL) phenotypes in Saudi Arabia is different from that recorded in the Western literature. One hundred and twelve (112) patients under 15 years of age, diagnosed as ALL between January 1992 and May 1994 had immunophenotypes performed on their blast cells. Common ALL (cALL) together with pre-B-ALL, formed 86.5% of the total; B-cell 3%, T-cell 6% and null cell 4.5%. These figures are not significantly different from the Western literature. A previous claim from this institution in 1990, that both null and B-cell ALL were significantly increased compared with elsewhere, is not supported by the present figures. Age and sex distribution, and FAB classification, L1 77%, L2 20% and L3 3%, were also of the same order as described elsewhere and, in particular, there was no increase in the frequency of L3 subtype.     

Fungal infections of the bones and joints

Osteoarticular complications may occur with a variety of invasive fungal infections, and seem to be increasing with growing use of prosthetic joints and as the immunosuppressed patient population increases. Epidemiology, pathogenesis, presentation, and management strategies differ somewhat among the different fungal species. This review focuses on recent developments in diagnostic and management approaches for patients with osteoarticular mycoses, and outlines specific treatment strategies for the different species.     

Sinonasal surfactant protein A1, A2, and D gene expression in cystic fibrosis: a preliminary report.

OBJECTIVE: To measure alterations in SPA1, A2, and D gene expression in various forms of inflammatory chronic rhinosinusitis (CRS). STUDY DESIGN AND SETTING: Sinus mucosal biopsies were performed in patients with allergic fungal rhinosinusitis (AFS), CRS with nasal polyposis, cystic fibrosis (CF), and controls. SP mRNA was measured with quantitative polymerase chain reaction. RESULTS: Patients with CF (n = 4) showed significantly increased SPA1 (82-fold), SPA2 (100-fold), and SPD (47-fold) mRNA (P < 0.05) when compared with controls (n = 5). Patients with CRS with nasal polyposis (n = 5) also demonstrated elevated SPA1 (27-fold), SPA2 (13-fold), and SPD (13-fold). Patients with AFS (n = 7) had increased SPA1 (5-fold), SPA2 (9-fold), and SPD (17-fold), but were not statistically significant. CONCLUSION: SPA1, A2, and D are upregulated in various forms of CRS, but are significantly elevated in cystic fibrosis CRS. SIGNIFICANCE: Understanding the role of SPs in CRS will help develop novel treatment approaches for sinonasal pathoses.     

Acute volvulus of the right colon: An analysis of 69 patients

Sixty-nine patients with acute volvulus of the right colon have been analyzed; the overall mortality was 19%. Nonviable colon was present in 20 patients; the mortality rate in these patients was 40%. When the cecum is viable, a combination of simple cecopexy and tube cecostomy was as effective as resection in preventing long-term recurrence. Cecopexy alone was followed by recurrence in 20%. In the presence of cecal perforation or a large area of confluent gangrene, resection with the formation of an ileostomy and a distal mucous fistula is the procedure of choice; resection with primary anastomosis should be avoided. When the gangrene is patchy, resection and primary anastomosis appears to be a safe procedure.

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Resumen El vólvulo agudo del colon derecho es una emergencia quirÚrgica no comÚn, la cual representa menos del 2% de todos los casos de obstrucción intestinal en el adulto. El manejo operatorio es motivo de controversia; varios autores favorecen la resección, mientras otros abogan por el tratamiento que no implique resección. Muchas de las series previamente publicadas han estudiado pequeños nÚmeros de pacientes sin seguimiento adecuado. Sesenta y nueve pacientes con vólvulo agudo del colon derecho admitidos a cuatro hospitales docentes de Escocia e Irlanda del Norte en el curso de 12 años fueron analizados. La mortalidad global fue de 19%. Colon no viable fue hallado en 20 pacientes; la mortalidad en ellos fue de 40%. Cuando el ciego aparece viable, la combinación de la simple cecopexia con cecostomía de tubo probó ser un procedimiento tan efectivo como la resección en cuanto a prevenir recurrencias a largo plazo. La cecopexia realizada como Único procedimiento resultó en una tasa de recurrencia de 20%. En presencia de perforación cecal o de una extensa área de gangrena confluente, el procedimiento de elección es la resección con ileostomía y fístula mucosa distal; debe evitarse la resección con anastomosis primaria. Cuando la gangrena se presenta en parches, la resección con anastomosis primaria parece ser un procedimiento seguro.

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Résumé Les auteurs rapportent une série de 69 volvulus aigus du colon droit qu'ils ont observés. La mortalité globale a été de 19%. Chez 20 malades le colon n'était pas viable; la mortalité a été de 40%. Quand le caecum est viable la coecopexie associée à la coecotomie sur drain donne des résultats identiques à ceux de la résection mais elle est suivie de récidive dans 20% des cas. En présence d'une perforation caecale ou d'une large zone de sphacèle du colon la résection suivie d'une iléostomie est de la mise à la peau de l'extrémité colique d'aval représente l'opération de choix. C'est seulement lorsque la zone sphacélée est limitée que la résection suivie du rétablissement immédiat de la continuité constitue une méthode dénuée de danger.