Treatment of donor T cell-mediated hematopoietic suppression after haploidentical bone marrow transplantation by T cell modulation in a patient with severe combined immunodeficiency.

An 8-month-old male patient with severe combined immunodeficiency syndrome was transplanted with maternal, haploidentical T cell-depleted bone marrow without prior conditioning therapy. Acute graft-versus-host disease developed 2 weeks post bone marrow transplantation (BMT) and was successfully treated with cortisone. After cortisone withdrawal the patient developed myeloid and B cell depression concomitant with T cell activation. For specific T cell modulation, treatment with the T cell receptor (TCR) alpha beta chain-binding MoAb BMA031 was initiated in combination with cyclosporin A. GM-CSF was given to enhance myeloid reconstitution. About 1 year post BMT, B cell and granulocyte counts were within the normal range with stable chimerism in both lineages. B cell proliferation tests were normal and first signs of in vitro immunoglobulin synthesis occurred.     

Neuroactive amino acids in organotypic slice cultures of the rat hippocampus: an immunocytochemical study of the distribution of GABA, glutamate, glutamine and taurine.

Antisera raised against protein-glutaraldehyde-amino acid conjugates were used to study the light and electron microscopic distribution of GABA, glutamate, glutamine and taurine in organotypic slice cultures of rat hippocampi. In the stratum oriens and radiatum, glutamate-like immunoreactivity was particularly concentrated in nerve endings establishing asymmetric junctions with dendritic spines. Mossy fiber terminals in CA3 and the dentate hilus were also strongly labeled. A quantitative immunogold analysis of the glutamate-immunolabelled profiles showed a pattern that was highly reminiscent of that previously observed in perfusion-fixed hippocampi, including a correspondingly sparse labeling of glial processes and of presynaptic elements in symmetric synapses. GABA-like immunoreactivity was localized predominantly in interneurons and in presynaptic terminals contacting dendritic shafts and neuronal cell bodies, while immunoreactivities for glutamine and taurine were found mainly in astroglial cells and pyramidal cells, respectively. Our data indicate that the major intrinsic fiber systems of the cultured hippocampi have retained their normal transmitter phenotypes.     

Pathways to Disability Income among Persons with Severe, Persistent Psychiatric Disorders

Persons with psychiatric disorders comprise the largest diagnostic group of disabled recipients of Supplemental Security Income (SSI) and Social Security Disability Income (SSDI). A 32-month prospective cohort study of pathways to application for and receipt of SSI and SSDI was conducted among 169 people with major psychiatric disorders who were at an early stage of their illness and who had never applied for or received disability income. Of the three pathways that formed the conceptual basis for the investigation—labeling, impairment, and needs/resources—the latter two emerged as significantly associated with receipt. Individuals with more severe symptoms who were African American, and who were psychologically dependent in a primary relationship and financially dependent on their families, were more likely to become recipients. Enabling and disabling aspects of disability income receipt suggest that it may be replacing prolonged hospitalization as the most enduring social role of persons with severe, persistent psychiatric disorders.     

Amniotic sac,fetal heart area,fetal curvature,and other morphometrics using first trimester vaginal ultrasonography and color Doppler imaging.

Ultrasonographic morphometric measurements were obtained with transvaginal ultrasonography from 121 patients with first trimester singleton pregnancies. Amniotic and gestational sac diameters, fetal heart area, and fetal length increased in a linear rate relative to crown-rump length, whereas the amniotic and gestational sac volumes increased at an exponential rate. The yolk sac exhibited a biphasic growth pattern with a peak at a crown-rump length of 3.5 cm. The ratio of crown-rump length to anteroposterior dimension increased over the first trimester, suggesting less curvature in older fetuses. In conclusion, vaginal ultrasonography permits accurate measurement of many new morphometric parameters.     

Postcesarean Section Pain Prediction by Preoperative Experimental Pain Assessment

Background: Postcesarean section pain is a common cause of acute pain in obstetrics, yet pain relief and patient satisfaction are still inadequate in many cases. The present study was conducted to determine whether preoperative assessment of experimental pain perception by quantitative sensory tests could predict the level of postcesarean section pain.

Methods: Fifty-eight women who were scheduled for elective cesarean section were enrolled in the study. Heat pain threshold and magnitude estimation of suprathreshold pain stimuli at 44[degrees]-48[degrees]C were assessed for both algosity (the sensory dimension of pain intensity) and unpleasantness 1 or 2 days before surgery. The day after the operation, the women reported the level of pain at the surgical wound on a visual analog scale at rest and during activity. Regression analysis was performed to evaluate the usefulness of preoperative scores in predicting postcesarean section pain.

Results: Postoperative visual analog scale scores at rest and during activity significantly correlated with preoperative suprathreshold pain scores at 44[degrees]-48[degrees]C (r = 0.31-0.58 for algosity and r = 0.33-0.74 for unpleasantness). The stimulus of 48[degrees]C was found to be the best predictor of postoperative pain for both conditions (r = 0.434-0.527;P < 0.01). In contrast to suprathreshold pain stimuli, pain threshold was not correlated with postoperative pain.     

Catecholamine-induced cardiac hypertrophy: significance of proto-oncogene expression

The effect of β- and α-adrenergic stimulation on cardiovascular function and development of cardiac hypertrophy was studied in rats by measuring the heart weight/body weight and cardiac RNA/DNA ratios. β-Receptor stimulation with isoproterenol over 3 days induced an increase in the biosynthesis of cardiac adenine nucleotides, myocardial protein synthesis, and the heart weight/body weight ratio. The isoproterenol-induced metabolic effects were prevented by simultaneous β-adrenergic blockade with propranolol. α-Adrenergic stimulation with norfenephrine for 3 days induced an increase in heart rate, total peripheral resistance, the myocardial RNA/DNA, and left ventricular weight/body weight ratio. The calcium antagonist verapamil prevented the hemodynamic changes but did not influence the development of cardiac hypertrophy. The α-adrenergic blocker prazosin reversed the norfenephrine-induced functional changes and prevented cardiac hypertrophy. Norepinephrine was infused into isolated perfused working rat hearts to elucidate some molecular biological changes that precede the development of cardiac hypertrophy. It increased transiently and sequentially the mRNA of c-fos and c-myc. This enhancement occurred at about the same time as that induced by elevation of pre- and afterload but was more pronounced. These findings were compared with those obtained in other studies assessing the effects of catecholamines on proto-oncogene expression. Combination of norepinephrine with pre- and afterload elevation induced the c-fos mRNA signal to appear earlier, to be more pronounced, and to persist for a longer period of time. Similar results were obtained in regard to the c-myc mRNA. These findings indicate that the combination of two hypertrophy-inducing stimuli which may cause a higher degree of cardiac hypertrophy in vivo induce an earlier, more pronounced, and longer lasting expression of the proto-oncogenes c-fos and c-myc.     

Sudden blindness in an AIDS patient. Simultaneous infection with cytomegalovirus and herpes simplex viruses and development of malignant non-Hodgkin lymphoma]

A 50 year old patient with non-diagnosed HIV-infection at onset of his illness developed impairment of vision and temporary double vision combined with severe hemianopsia. With normal fundus and suspicious Herpes simplex iritis therapy with Acyclovir was started. Primarily the patient showed a good response to the therapy and loss of vision could be prevented. After 4 weeks CMV-retinitis developed. In spite of Gancyclovir therapy manifestation of total loss of vision after 6 weeks. Autopsy demonstrated signs of simultaneous a CMV-infection of the retina and a herpes simplex-infection of the optic nerve combined with a Non-Hodgkin-Lymphoma of the optic tract.     

Leisure activity and well-being among the elderly in Taiwan: Testing hypotheses in an Asian setting

Studies conducted in Western nations suggest hypotheses regarding the relationship between leisure activity and well-being among older adults. For instance, leisure activity is found to increase feelings of emotional well-being, and there are gender differences in both the types of activities in which elders tend to engage and their subsequent influences. This study attempts to verify these relationships among a sample of 4,049 Taiwanese elders (age 60+). Analyses show that men participate in most leisure activities with greater frequency than women; physical activity has the strongest positive influence on emotional well-being; contemplative activity, the only pursuit in which women out-participate men, displays a negative effect for women, and; the impact of different activity types vary by gender. These results both substantiate and refute hypotheses developed in the West, suggesting cultural variation in the impact of activity. Gender differences are explained in the context of role expectations and self-concept development. jg]Key words gw]Life satisfaction gw]Well-being gw]Activity participation gw]Leisure activity gw]Taiwan gw]ElderlyPopulation Studies Center and Department of Sociology, University of Michigan, and Centre on Aging, University of Victoria     

Radioimmunoimaging of human small cell lung carcinoma with I-131 tumor specific monoclonal antibody

In this study, an IgM monoclonal antibody (MAb600D11) directed against human small cell lung cancer (NCI-H69) was radiolabeled with iodine-131, and the biodistribution and image quality of the radiolabeled antibody was evaluated. Radiolabeling was achieved in a solid-phase system consisting of 1,3,4,6-tetrachloro-3a,6a-diphenylglycoluril. Labeling efficiencies and protein purification were accomplished using gel exclusion chromatography while radioimmunoreactivity was determined using a solid-phase radioimmunoassay procedure. The biodistribution of I-131-labeled MAbs was determined in Sprague-Dawley rats up to 7 days after injection. Highest organ concentrations were observed in liver (3.91 +/- 0.47 (SD) and 0.17 +/- 0.04 (SD) mean percent injected dose at 1-7 days after injections) and in thyroid (5.33 +/- 0.71 (SD) and 5.32 +/- 2.01 (SD) mean percent injected dose at 1-7 days after injection). Nude mice, bearing either a small cell lung tumor (NCI-H69) or a nonspecific tumor (adenocarcinoma), were injected with 400-800 microCi of I-131 labeled monoclonal antibody. Optimum tumor visualization was observed 2-4 days after injection with tumor concentrations as high as 10.4% of the initial injected dose. The results demonstrated that radioimmunoimaging of human small cell lung carcinoma was feasible with the tumor-specific IgM I-131-labeled MAb.