The estimation of the lymphocyte percentage by the Coulter Counter Model S Plus III

Summary. The accuracy of the Coulter Counter Model S Plus III in determining lymphocyte percentage was assessed. In ‘routine’ adult blood counts accuracy was satisfactory but in infectious mononucleosis, and in chronic lymphocytic leukaemia and other lymphoproliferative disorders, there was a high rejection rate and an often considerable underestimation of the lymphocyte percentage. The S Plus III lymphocyte percentage was of no use in neonates because of inaccuracy and a high rejection rate. In infants the relationship with lymphocyte percentages based on manual differential counts was non-linear, and there was underestimation of some high percentages. The white cell size histogram was useful in alerting staff to abnormalities, and also suggested that lymphocytes of neonates and infants were larger than those of adults, with plots being very similar to those of some adults with lymphoproliferative disorders. The S Plus III lymphocyte percentage was useful in reducing the need for differential counts in adult patients but did not replace examination of a blood film or a manual lymphocyte percentage in patients with chronic lymphocytic leukaemia or a lymphoproliferative disorder.     

Poliomyelitis: what are the prospects for eradication and rehabilitation?

The World Health Organization (WHO) estimates that 74% of theworld's children were fully immunized against poliomyelitisby early 1990; even so, the disease is still paralysing almosta quarter of a million individuals each year and killing perhaps25 000. This paper - one of a series undertaken on specificdiseases for the World Bank's Health Sector Priorities Reviewon diseases of major importance in the developing world - reviewsavailable evidence on the cost-effectiveness of polio prevention(by immunization) and on case management of polio to minimizeand rehabilitate disability. The power of available vaccinesand the characteristics of the disease suggest the technicalfeasibility of eradication of disease from polio (but not ofthe polio virus) as a goal for the year 2000. With sustainednational and international support, it is thus reasonable tohope for eradication by that year (or soon thereafter). Rehabilitationof individuals disabled from polio (and other causes) has beenneglected both by most governments and by the internationalcommunity. Although hard evidence on cost and effectivenessremains to be assembled, what is known strongly suggests thateffective rehabilitation programmes could be implemented atmodest cost and with economic and welfare benefits far exceedingcost.     

Comparison of high and low doses of suxamethonium

In a double-blind study, 67 young adult patients undergoing anaesthesia for dental extractions were allocated at random to receive either 0.5 mg/kg or 1.5 mg/kg suxamethonium. A greater increase in arterial pressure was seen following induction in the 1.5 mg/kg group, although overall intubating conditions were similar in the two groups. Suxamethonium-associated muscle pains were significantly more common in the group which received the larger dose (p less than 0.05).     

Additive scoring of reported symptoms: Validity and item bias problems in morbidity scales

The objective of this study was to validate a symptom scalebased on additive scoring of self-reported symptom data foruse in multivariate analyses in a cross-sectional interviewsurvey investigation of an urban sample of persons over 65 yearsof age. The majority of the sample members reported 1 to 3 symptomepisodes, but over one-third of the sample reported 4 or moreepisodes and 50 persons (9% of the sample) reported 7 or moresymptoms. A 20 item symptom scale was validated with Kern responsetheory methods based on the binary Rasdi model, a 1 parameterlogistic model, plus procedures developed for checking the model.The Rasdi logistic test result of Z=52.9 and p=0.000 providedstrong evidence against the hypothesis that the items representeda unldimensional symptom scale. A series of negatively correlatedKerns suggested the presence of 2 or more dimensions in thedata. Subsequently, 2 different morbidity variables satisfyingminimum requirements for scaling data were identified. Kernsfalling on both scales were found to be gender biased, meaningthat the scales could only be used validly in gender-specificanalyses. The findings illustrate multidimensionality and itembias hidden in additive symptom scales, problems that couldseriously distort the findings of multivariate analyses usingsuch scales.     

BOVINE PROTHROMBIN FRAGMENT 1, SEGMENT 1–10

The N-terminal decapeptide methyl ester, H-Ala-Asn-Lys-Gly-Phe-Leu-Gla-Gla-Val-Arg-OCH₃ (16) of bovine prothrombin fragment 1 has been prepared by standard solution techniques, via a fragment coupling strategy. Hexapeptide Boc-Ala-Asn-Lys^e(Boc)-Gly-Phe-Leu-OBzl (9) was obtained by coupling Boc-Ala-Asn-Lys^e (Boc)Gly-OH (6) to the trifluoroacetate salt of H-Phe-Leu-OBzl (8). Hydrogenolysis of (9) followed by coupling to HCl-H-Gla^γ (O^tBu)₂-Gla^γ (O^tBu)₂-Val-Arg(HCl)-OCH₃ (14) gave the fully protected decapeptide (15). Treatment of 15 with 90% trifluoroacetic acid followed by ion exchange chromatography yielded the methyl ester (16). The decapeptide 16 labeled with¹²⁵I using the Bolton-Hunter reagent, did not bind to antibodies specific for the calcium ion-induced conformation of bovine fragment 1.     

Changes in CD44 isoform expression during inflammatory skin disease

The CD44 family of cell surface glycoproteins is widely-expressed in epithelial, mesothelial and haemopoietic tissues and is thought to function primarily as adhesion molecules. The molecule has an intracellular, a trans-membrane and an extracellular domain. The membrane proximal region of the extracellular domain is of variable structure depending on which of 10 variable exons are involved in coding for this region. Both in vitro stimulated T cells and cytokine stimulated keratinocytes are known to express certain isoforms. In this study we have investigated whether specific isoforms of the CD44 molecule are expressed on epithelial cells and lymphocytes in the course of two inflammatory skin diseases, namely lupus erythematosus and lichen planus. Monoclonal antibodies, specific to the epitopes of the CD44 molecule encoded by v3, v4/5, v6 and v8/9 variable exons and a pan CD44 marker, were used on 10 lupus and 8 lichen planus frozen skin samples and compared with normal skin from 9 different body sites. Results failed to show detectable levels of variant isoforms of CD44 on lymphocytes in either inflammatory skin disease, despite evidence of T cell activation. All CD44 variant isoforms were reduced on the keratinocytes in some sections of lupus and lichen planus. The results are discussed in the context of the current models for the role of CD44 in the immune response.