Depletion of CD34+ CD4+ cells in bone marrow from HIV-1-infected individuals.

Pancytopenia as a consequence of bone marrow abnormalities is commonly seen in HIV-infected individuals. To examine the effect that HIV-1 has on hematopoietic cells, we compared hematopoietic properties of bone marrow samples from HTV+ patients at various stages of disease with bone marrow samples from uninfected donors. While the absolute number of recovered CD34+ cells and the cloning efficiency of these cells did not differ significantly in HIV+ donors, the percentage of CD34+ CD4+ cells was significantly depleted in late-stage HIV+ patients. We observed a direct correlation between the numbers of CD34+ CD4+ cells in the bone marrow and the peripheral CD4 count. Further characterization of the CD34+ CD4+ subpopulation demonstrated that these cells expressed lower levels of HLA-DR on their surface compared with CD34+ CD4- cells, suggesting an immature phenotype. We also found evidence for expression of HIV-1 coreceptors CXCR-4 and CKR-5 message and protein in CD34+ bone marrow cells. While this finding suggested that hematopoietic cells might be susceptible to HIV infection at an early stage of maturation, thus affecting different cell lineages as they matured, we did not find any evidence for infection of HIV in these cells. These data suggest that HIV affects early hematopoietic progenitor cells either directly or indirectly, and in particular CD34+ CD4+ cells. This finding has important implications for disease pathogenesis and for application of gene therapy approaches that use CD34+ hematopoietic cells.     

Endometrial morphology in asymptomatic postmenopausal women

Few data are available regarding endometrial histologic features in asymptomatic perimenopausal and postmenopausal women. This study encompasses endometrial biopsy specimens obtained from 801 such women before enrollment in a multicenter study of estrogen-progestin replacement. One endometrial cancer was found (0.13%); four additional biopsy specimens showed atypia (total 0.63%). The endometrium was atrophic in 373 (46.9%), proliferative in 133 (16.7%), secretory in 54 (6.8%), and hyperplastic in 41 (5.2%). Insufficient tissue for diagnosis was obtained in 195 (24.5%). We conclude that the yield for neoplasia is so low that screening endometrial biopsy is not justified in asymptomatic perimenopausal and postmenopausal women.     

Night cough counts and diary card scores in asthma.

A tape recording system for recording night cough in asthmatics at home is described. Objective cough counts and half hour periods containing cough did not correlate with diary card scores awarded to eight children on seven nights each. Night cough diary scores may mislead in the assessment of symptom severity.     

Effects of prior administration of steroids upon recovery from lethal sepsis

The effects upon survival of large doses of steroid administered to dogs prior to challenging them with lethal sepsis was evaluated in this study. Dogs were given 30 milligrams per kilogram of body weight per day of methylprednisolone sodium succinate for one, two or eight days and then were infused with 9.72 +/- 0.35 X 10(9) Escherichia coli per kilogram of body weight. All dogs in group 1 (n equals six) not given steroid died within 25 hours. Of the dogs in group 2 (n equals 12) given one or two doses of steroid previously, 42 per cent permanently survived (more than seven days). All dogs in group 3 (n equals five) given eight daily doses of steroid prior to infusion of Escherichia coli died within 17 hours. Dogs in group 4 (n equals six) were given eight daily doses of steroid prior to infusion of Escherichia coli and treated on the day of infusion of Escherichia coli with a regimen of methylprednisolone and gentamicin sulfate which results in a 100 per cent survival rate when given to dogs that have not received prior treatment with steroid. Thirty-three per cent of the dogs in group 4 permanently survived. One or two daily large doses of steroid did not detrimentally affect survival of the dogs. Eight days of steroid administration suppressed endogenous cortisol production. When the dogs were treated with six hours of steroid-antibiotic therapy, survival benefits were limited.     

Correlation of high-resolution computed tomography and gross anatomic sections of the temporal bone: II. Vestibular apparatus

High-resolution computed tomography (CT) of isolated temporal bones was performed in the transaxial, coronal, and sagittal planes at 1.5-mm intervals. The temporal bones were then sectioned at 2.0-mm intervals in planes parallel to the CT scans. The structures making up the vestibular apparatus were identified, and the planes in which each is best visualized were selected for the illustrations. The vestibule, oval window, tympanic cavity, and tympanic portion of the facial nerve are best seen in the transaxial and coronal planes; the arch of the superior semicircular canal in the transaxial plane and its limbs in the coronal plane; the arch of the posterior semicircular canal in the coronal and sagittal planes and its limbs in the transaxial plane; and the common crus in the sagittal plane. The horseshoe-shaped lateral semicircular canal is displayed in the transaxial plane, and the relationship of its lateral limb to the tympanic segment of the facial nerve is best demonstrated in the sagittal plane. The ampullae of all three canals can be appreciated equally well in all three planes.     

SHORT COMMUNICATION: Inhibition of rat mammary tumorigenesis by dietary cholesterol

The effects of dietary cholesterol and oxidized cholesterolon mammary tumor development were examined in female Sprague-Dawleyrats exposed to the carcinogen N-methyl-N-nitrosourea (MNU).Animals were administered 50 mg/kg MNU at 50 days of age andfed either a control (AIN-76) diet or the control diet supplementedwith 0.3% cholesterol or 0.3% oxidized cholesterol for up to26 weeks. The oxidized cholesterol was prepared by heating cholesterolat 110°C for 48 h. Gas chromatographic analysis of the oxidizedcholesterol revealed a 2% yield of oxidation products in additionto a large amount of unchanged cholesterol (>96%). Tumorincidence in the cholesterol group (67%) was significantly lowerthan in the control group (96%, P <0.05), but the oxidizedcholesterol group (79%) was not significantly different fromthe control or cholesterol groups. Average number of tumorsper animal was lower in the cholesterol group (1.5) than inthe control (2.8) or oxidized cholesterol groups (2.3, P <0.005).Serum low density lipoprotein (LDL) cholesterol was greaterin the cholesterol (185± 38 mg/dl) and the oxidized cholesterolgroups (160± 34 mg/dl) than in the control (55±4 mg/ dl, P <0.05), although there was no difference betweenthe cholesterol and the oxidized cholesterol groups. These resultsshow that dietary cholesterol inhibits mammary tumor developmentin this model. Elevated serum LDL cholesterol may inhibit denovo cholesterol synthesis in preneoplastic and/or tumor cells,thereby inhibiting their proliferation.     

Development of normal ocular alignment

Ocular alignment was examined in a large population of normal infants to determine the prevalence of various motility findings at ages ranging from birth to 10 months. Exodeviations were frequently seen up to the age of 6 months. Esodeviations were occasionally seen in infants who did not go on to develop congenital esotropia, but not after 2 months of age. It is unclear whether precursors of pathologic strabismus, such as congenital esotropia, can be distinguished from these transient ocular deviations seen in normal infants. However, any strabismus persisting after the ages listed above should be considered abnormal and receive ophthalmologic evaluation.     

Long-term effects of early kwashiorkor compared with marasmus. II. Intellectual performance

Intellectual performance including IQ (Wechsler Intelligence Scale for Children-Revised) and conservation was measured at ages 11-18 years in a follow-up study of Barbadian girls and boys who had histories of kwashiorkor (n = 53) or marasmus (n = 55) in their first year of life. They were compared with healthy neighborhood children matched by sex and age who had normal patterns of growth in early childhood (n = 58). On both IQ and conservation tests, children with previous kwashiorkor or marasmus had similar scores, which were significantly lower than scores of healthy comparison children. These findings were examined in relationship to current environmental conditions, which were similar in children with histories of kwashiorkor or marasmus and somewhat less advantaged than those of the comparison children. The effect of early malnutrition and related conditions at the time of episode still emerged as significant even when the current environmental factors were controlled for.     

Etiology of recurrent pregnancy losses and outcome of subsequent pregnancies

Prospective evaluation of 155 couples with two or more consecutive pregnancy losses disclosed uterine morphologic abnormalities in 27%, chromosomal abnormalities in 21 individuals (7.7%, or 15.4% of the couples), and at least one abnormal diagnostic test suggestive of a cause for recurrent pregnancy losses in 106 (68%). A positive test for antinuclear antibody was found in 7.5% of the women, whereas the expected rate in a population of this age is less than 2%. Cervical cultures for Ureaplasma urealyticum (T-strain mycoplasma) were positive in 48% of the women, and 28% of these women had a genetic or uterine abnormality to explain their pregnancy losses. Thyroid function profiles and cervical cultures for Mycoplasma hominis provided no significant information in the evaluation in these couples. With the exception of women with a positive antinuclear antibody, the overall prognosis for later pregnancies was quite good whether the diagnostic evaluation of the couple was normal (77% subsequent live births) or abnormal (71% subsequent live births). The significance of the positive antinuclear antibody in these women is unclear, but further studies and long-term evaluation are necessary to determine the relationship between recurrent pregnancy losses and later development of collagen-vascular diseases.