Differential Expression of VLAβ1 (CD29) on Monocytes From Patients With Endometriosis

PROBLEM : Previous studies have established that in vitro proliferation of endometrial cells is enhanced by peripheral blood monocytes (PBM) and suppressed by peritoneal macrophages (PM) from patients with endometriosis but only suppressed by PBM and PM obtained from normal subjects. The functional activity of PBM and PM is influenced by the engagement of numerous cell surface receptors with their respective physiological ligands. METHOD : In this study, PBM and PM from fertile women (Group 1), women with unexplained infertility (Group 2), and women with limited (Group 3) or severe (Group 4) endometriosis were isolated in order to analyze these cells for the expression of CD54, CD58 and HLA-DR (immunoglobulin supergene antigens) CD18 and CD29 (integrins) and CD44 (an addresin). These cell surface antigens are involved in monocyte/macrophage trafficking, activation, signal transduction and/or adhesion. RESULTS : No differences were detected in the percentage of PBM expressing CD18, CD44, CD54, CD58, or HLA-DR among the four groups of subjects. Furthermore, the density of these antigens expressed on PBM was identical in patients and control subjects. In contrast, the percentage of PBM expressing CD29 (also known as VLAβ1) and the density of CD29 expressed per cell were significantly reduced (P < 0.01) in patients with limited endometriosis compared to controls and patients with severe disease. Interestingly, although the percentage of CD29+ PBM from women with severe endometriosis was not statistically different from the percentage of CD29+ PBM from controls, the density of CD29 expressed per cell was significantly elevated among patients with severe disease. Analysis of PM from the four subject groups revealed no differences in CD29 expression or density. However, the percentage of PM expressing CD18 was significantly decreased in patients with limited (but not severe) endometriosis. CONCLUSION : Since both CD18 and CD29 play a role in cell trafficking and/or adhesion, alterations in their expression among patients with endometriosis suggest that these integrin β chains may play a role in the pathogenesis of the disease.     

Chemical synthesis of insulin-like growth factor II

Human insulin-like growth factor II (IGF-II) with 67 amino acids and three disulfide bridges has been synthesized by the solid-phase method. The synthetic hormone is shown to be homogeneous in high performance liquid chromatography (HPLC), high performance partition chromatography (HPPC), and chromatofocusing. It is indistinguishable from natural hormone in HPLC, peptide map of thermolysin digests, amino acid composition and radioreceptor binding assay. Thus, synthetic and natural IGF-II are identical.     

Serum Complement Activity in Pre-Term Pregnancies: Relationship to Duration of Ruptured Membranes and Clinical Infection

ABSTRACT: Physiologic changes occurring during the latent period of prematurely ruptured membranes (PRM) are poorly understood. Indicators predicting maternal and neonatal infectious morbidity do not correlate well with clinical outcomes. A previous report suggested that in vivo complement consumption occurred in response to the event of membrane rupture. In this prospective study, complement activity was measured serially throughout the latent period in cases of preterm PRM. In addition to total hemolytic complement activity (CH₅₀), C3-proactivator (C3PA), a primary component of the alternate complement pathway, was measured in maternal and cord sera. As with CH₅₀, cord serum C3PA levels are significantly less than those in matched maternal samples. Neither maternal nor cord serum complement activity correlated with either the duration of the latent period or maternal-neonatal infection.     

FUNCTIONAL SIGNIFICANCE OF IDIOPATHIC ADRENAL CALCIFICATION IN THE ADULT

Two young adults with idiopathic adrenal calcification are described. In one patient the calcification was probably secondary to adrenal haemorrhage in the neonatal period. Neither patient exhibited clinical features suggestive of adrenal cortical insufficiency, and baseline serum cortisol levels were normal. The corticosteroid responses to ACTH administration and to other provocative tests indicated that both glucocorticoid and mineralocorticoid reserve was normal. One patient showed an appropriate epinephrine response to insulin-induced hypoglycaemia. We conclude that even extensive adrenal calcification may be compatible with completely normal adrenal function. Since, however, little is known of the natural history of this condition, lifelong follow-up of such patients is advised.     

Superior Mesenteric Artery Syndrome Simulating Acute Pancreatitis

A case of infrapapillary duodenal obstruction secondary to the superior mesenteric artery syndrome is reported. The clinical picture and laboratory data simulated acute pancreatitis but no evidence of pancreatic disease was noted at surgical exploration. A review of the causative factors and treatment of the superior mesenteric artery syndrome is presented along with the differential diagnosis of infrapapillary duodenal obstruction.     

Disseminated superficial actinic porokeratosis*

A family is analysed in which disseminated superficial actinic porokeratosis (DSAP) occurred in five members. All three children of one generation are affected. Clinical, histopathological and genetic aspects of DSAP are discussed. Disseminated superficial actinic porokeratosis appears to be a clinical variant of porokeratosis of Mibelli. Since DSAP is a genodermatosis inherited as an autosomal dominant it can occur in any geographical location; however excess sunlight can definitely exacerbate the condition.     

Relation Between Severity of Anemia and Erythropoietin Titer in Human Beings

Patients with severe hematologic disorders may have elevated erythropoietintiters in plasma or urine at higher hemoglobin concentrations than those associated with elevated titers in experimental animals or patients anemic as aresult of simple blood loss. Patients with "primary" hematologic disease mayhave a measurable titer of erythropoietin in the plasma and urine at hemoglobinconcentrations up to 8 Gm./100 ml., but patients with iron-deficiency anemiashow elevated titers in the urine only with hemoglobin concentrations at orbelow 4 Gm./100 ml. and in the plasma below 5 Gm./100 ml. The abruptnesswith which the titer rises and the severity of the anemia required beforemeasurable titers appear are similar in man and in rabbits, sheep and dogs.The fact that no measurable erythropoietin titer can be demonstrated whenthe hemoglobin concentration is well below that required for intense stimulation of erythropoiesis and the abruptness of the rise at hemoglobin concentration of 4 Gm./100 ml. or less suggest that erythropoietin may not bean important factor in the control of erythropoiesis except in extreme circumstances. On the other hand, these facts may be explained more simply by theinsensitivity of the assay methods used.

Submitted on March 13, 1961 Accepted on May 6, 1961     

Evaluation of a New Chemotherapeutic Agent in Patients with "Advanced Refractory" Acute Leukemia. Studies of 6-Azauracil

6-Azauracil was studied in patients with "advanced" acute leukemia, refractory to standard chemotherapy. Under the conditions of the study thiscompound was found to have no significant antileukemic activity. As a result,these data have defined the natural history of this phase of acute leukemia. Asignificant proportion (30 per cent) of these patients showed objective hematologic improvement even in the absence of effective specific therapy, whichmight be ascribed to a prospective new agent. The median survival from theonset of the study of this group of patients was two months, and survivalpatterns for adults and children were similar.

Submitted on December 23, 1959 Accepted on February 20, 1960     

EPIDURAL ANALGESIA IN BRITISH OBSTETRICS

Experiences with 300 continuous and 62 single-shot epiduralblocks administered during labour are presented. The main indicationsfor continuous epidural analgesia were inco-ordinate uterineaction, severe pre-eclampsia and failure of orthodox analgesicdrugs to produce satisfactory pain relief. The method can alsobe used with benefit in selected cases of cardiac and respiratorydisease. In hypertonic inco-ordinate uterine action graphicalanalysis of labour demonstrates an increased rate of cervicaldilatation after epidural block in 70 per cent of cases. Inpre-eclampsia a satisfactory reduction of systolic and diastolicblood pressure is produced. Analgesia is virtually completeand the complication rate is acceptably low in experienced hands.Single-shot epidural analgesia is excellent for forceps deliveryand blood loss at delivery is reduced. Epidural analgesia hasa valuable therapeutic role in obstetrics and is one of thebenefits which result from the introduction of a 24-hour residentobstetric anaesthetic service.     

ACID-BASE BALANCE DURING EPIDURAL ANALGESIA

Capillary blood pH, Pco₂ and standard bicarbonate were measuredin twenty unpremedicated patients before and after inductionof epidural analgesia to the level of the fourth thoracic dermatomeor higher. Twelve patients had normal respiratory systems andeight had chronic bronchopulmonary disease. No patient developedany significant degree of respiratory acidosis and it is concludedthat alveolar ventilation is unimpaired by epidural blockadeas performed here. These results provide further evidence thatepidural block can produce effective analgesia and muscularrelaxation without impairing respiratory function. ^* This work was carried out while the authors were members ofthe Department of Anaesthetics, Stobhill General Hospital, Glasgow.