Microcapillary agglutination assay for detection of specific antileukocyte reactivity in neutropenic patients

Serum leukoagglutinating activity against the leukocytes of four patients with neutropenia was demonstrated using a modified microcapillary agglutination test. Cells from a panel of donors proved useful in attempting to define the identity of the antigens involved. In one instance anti-HLA-A9 activity could be demonstrated in a patient possessing HLA-A9. In the other three individuals no definite antigen assessment to HLA Series A and B antigens or the Lalezari series of neutrophil antigens could be made. Two of the patients' sera showed cross-reactivity and may be reactive with the same antigen or antigenic group. The microcapillary agglutination test appears to be useful in the evaluation of possible cases of autoimmune neutropenia.     

The problem of loneliness in the elderly in the community: characteristics of those who are lonely and the factors related to loneliness

Two samples of patients aged over 70 years were selected, one sample from a large urban general practice and one from a randomized rural general practice. Patients were interviewed in order to assess their mental, physical and social well-being. Included in the interview were questions on subjective feelings of loneliness.

More patients in the urban practice than in the rural practice reported feeling lonely, the proportion increasing with age in both samples. More women than men experienced feelings of loneliness; widowhood was closely associated with loneliness, particularly recent widowhood. Feelings of loneliness were consistently associated with disability in both study areas.

     

Low-dose systemic doxorubicin in combination with regional hepatic hyperthermia

The influence of regional liver hyperthermia in conjunction with systemic doxorubicin administration was examined in a rabbit VX2 tumour model. Hyperthermia was delivered by 2450MHz microwave generator to the exteriorised livers of the rabbits to provide a thermal dose equivalent of 43 degrees C for 30 minutes. Animals receiving doxorubicin infusion were treated with a total of 1.2 mg/kg over a 3 day protocol through an ear vein. Rabbits were divided into 4 groups; a no treatment control, hyperthermia alone, doxorubicin alone and hyperthermia immediately preceded by doxorubicin. The tumour mass, 10 days post treatment was significantly (P less than 0.0001) reduced in all treatment groups. However, the mean tumour mass in the combination treatment group was also significantly lower than both treatments alone (P less than 0.001). This increased response was not accompanied by any signs of increased systemic or local toxicity associated with any treatment.     

The rabbit autoperfusing heart-lung preparation

The autoperfusing heart-lung preparation holds promise as a method for extended organ preservation. Further understanding of the hemodynamics, metabolism, and quality of tissue preservation of this preparation may increase the number of available organs for heart-lung transplantation. We describe the materials and operative technique for a small animal model of the autoperfusing heart-lung preparation. The method is easy to learn, the materials and animal subjects are inexpensive, and the preparation is fully monitored to provide consistent and reproducible data. The rabbit autoperfusing heart-lung preparation is an excellent vehicle for the investigator studying warm organ preservation.     

Folate and cobalamin in psychiatric illness

The linkage of cobalamin and folate deficiency to psychiatric illness has been studied and debated since these vitamins were first discovered in the 1940s. The clinical relevance of these deficiencies remains the subject of investigation and scholarly discussion. This article reviews case reports and studies derived from a MEDLINE search for English-language articles related to folate, cobalamin, and psychiatric illness. Emphasis is given to clinical research and recent developments. Preclinical evidence for direct effects of folate and cobalamin on brain functioning is compelling, and numerous associations of their deficiencies to psychiatric illness are evident. These vitamin deficiencies may typically present initially with psychiatric symptoms, but any direct causal relationship to specific neuropsychiatric illnesses are not well defined. The relationship of these vitamins in dementia is significant, but they may only rarely be a cause of truly reversible dementia. Folate deficiency appears most tightly connected with depressive disorders, and cobalamin deficiency with psychosis. Contrary to intuition, vitamin deficiencies appear to occur infrequently with eating disorders. Other diagnoses have been investigated much less extensively. The diagnosis and management of these deficiencies in the context of neuropsychiatric illness is still a matter of discussion. The quality of clinical research in this area is improving, but there are many unanswered questions that affect clinical practice. Clinicians should remain vigilant to the possibility of deficiencies of folate and cobalamin in diverse psychiatric populations. Normal hematological indices do not rule out the deficiencies. Further study is needed to refine the detection and clinical management of these vitamin deficiencies in psychiatric populations.     

Cytoarchitecture and somatic sensory connectivity of thalamic nuclei other than the ventrobasal complex in the cat

This study is a re-examination, using autoradiographic and axonal degeneration methods, of the distribution of spinal, dorsal columnlemniscal and cortico-thalamic fibers within the thalamus of the cat. The emphasis was placed upon making an exact cytoarchitectonic delineation of regions outside the ventrobasal complex which receive spino-thalamic fibers and corticofugal fibers arising in the sensory-motor regions of the cerebral cortex. It is concluded, in agreement with Boivie ('70, '71a,b) that spino-thalamic fibers arising below the level of the lateral cervical nucleus terminate, not in the ventrobasal complex, but in a recognizable portion of the ventrolateral complex adjacent to the ventrobasal complex. This region appears to be also the thalamic relay for Group I muscle afferents. Combined experiments in which, in the same animal, the dorsal column-lemniscal path was labeled autoradiographically and the spino-thalamic path by the Nauta method, indicate virtually no overlap of the two systems in the ventral nuclear complex. Spinal fibers also end in the medial division of the posterior group (Pom), which extends posteriorly as a small-celled zone along the ventromedial aspect of the magnocellular medial geniculate nucleus. Reports of spinal terminations in the magnocellular nucleus proper may result from a failure to recognize the extent of Pom. A third part of the thalamus receiving spinal fibers consists of a posteriorly situated group of large, deeply staining cells belonging to the central lateral nucleus which lie mainly posterior to the internal medullary lamina and which, as Mehler ('69) has mentioned, have previously been confused with the centre médian and parafascicular nuclei. Corticofugal fibers arising in the somatic sensory cortex terminate in both the ventrobasal complex and the spinal part of the ventrolateral complex as well as in the central lateral nucleus and Pom and this confirms the work of Rinvik ('68a). Those arising in the motor cortex terminate only in (a different part of) the ventrolateral complex and in the centre médian nucleus.     

Cystosarcoma phyllodes. Effective therapy with cisplatin and etoposide chemotherapy

Cystosarcoma phyllodes is an unusual breast neoplasm that rarely metastasizes. Most series report chemotherapy, radiation, and hormonal therapy to be ineffective. Three patients were treated with cisplatin and etoposide combination chemotherapy with effective palliation in two patients. Radiation therapy was effective in controlling symptomatic metastasis in all three patients. Hormonal therapy was ineffective in two patients despite the presence of positive hormone receptors. Chemotherapy and radiotherapy may be more effective in the treatment of this tumor than has been reported, although there is no apparent role for hormonal therapy. Functional hormone receptors are probably not present.