Gamma (immune) interferon production by leukocytes from a patient with a TG cell proliferative disease

We report a patient with a disease characterized by proliferation of T cells with Fc receptors for IgG (TG). However, unlike lymphoid cells from normal individuals or from patients with other lymphoid malignancies, the patient's lymphocytes spontaneously produced gamma interferon (IFN-gamma) in vitro. The peripheral lymphocytes consisted of 95% TG cells, which exhibited the morphological characteristics of T- cell chronic lymphocytic leukemia (CLL) and were normal on cytochemical and chromosome analysis. The majority of TG cells were OKT3+, OKT8+, and OKT4-, 3A1-. These cells failed to express suppressor cell activity and displayed depressed levels of natural killer activity, but mediated antibody-dependent cell-mediated cytotoxicity. The spontaneous production of IFN-gamma by human peripheral lymphoid cells as demonstrated in this study may serve as a probe for studying the relationship between IFN-gamma and the proliferation of human T-cell subsets.     

Elevated expression and altered pattern of activity of DNA methyltransferase in liver tumors of rats fed methyl-deficient diets

DNA methyltransferase (MTase) activity in nuclear extracts from neoplastic and preneoplastic livers of rats fed a methyl-deficient diet (MDD) is elevated compared with that seen in the livers of control rats. Nuclear proteins were prepared in the presence of protease inhibitors including trans-epoxy succinyl-L-leucylamido-(4- guanido)butane and were fractionated by isoelectric focusing. In normal, control liver, two distinct MTase fractions were observed. In MDD-induced malignant liver, a third fraction, in addition to the previous two, was also seen. Both the DNA substrate and the cytosine site specificities of the third MTase fraction differ from those of the other two fractions. The distinct MTase activity in liver tumor has significantly more de novo MTase activity than do the MTase fractions of normal, control liver. Thus, normal and neoplastic rat livers differ in DNA MTase fractionation patterns and site specificities. The altered DNA MTase activity observed in rat liver tumors caused by MDDs may be one of the critical factors contributing to cancer formation through abnormal DNA methylation.      

Use of the Complete Rockall Score and the Forrest Classification to Assess Outcome in Patients with Non-variceal Upper Gastrointestinal Bleeding Subject to After-hours Endoscopy: A Retrospective Cohort Study

Objectives:

To evaluate the usefulness of the Forrest classification and the complete Rockall score with customary cut-off values for assessing the risk of adverse events in patients with upper gastrointestinal bleeding (UGI-B) subject to after-hours emergency oesophago-gastro-duodenoscopy (E-EGD) within six hours after admission.

Methods:

The medical records of patients with non-variceal UGI-B proven by after-hours endoscopy were analysed. For ''high risk'' situations (Forrest stage Ia–IIb/complete Rockall score > 2), univariate analysis was conducted to evaluate odds ratio for reaching the study endpoints (30-day and one-year mortality, re-bleeding, hospital stay ≥ 3 days).

Results:

During the study period (75 months), 86 cases (85 patients) met the inclusion criteria. Patients ''age was 66.36 ± 14.38 years; 60.5% were male. Mean duration of hospital stay was 15.21 ± 19.24 days. Mortality rate was 16.7% (30 days) and 32.9% (one year); 14% of patients re-bled. Univariate analysis of post-endoscopic Rockall score ≥ 2 showed an odds ratio of 6.09 for death within 30 days (p = 0.04). No other significant correlations were found.

Conclusion:

In patients with UGI-B subject to after-hours endoscopy, a ''high-risk'' Rockall score permits an estimation of the risk of death within 30 days but not of re-bleeding. A ''high-risk '' Forrest score is not significantly associated with the study endpoints.     

Anthropometry of Malawian live births between 35 and 41 weeks of gestation

The aim of this analysis was to construct cross-sectional gestational age specific percentile curves for birthweight, length, head and mid-arm circumference for Malawian babies, and to compare these percentiles with reference values for babies born to women with normal pregnancies, from a developed country. A cross-sectional study which enrolled pregnant women attending two study hospitals between March 1993 and July 1994 was undertaken. Data on maternal socio-economic status, newborn anthropometry, previous obstetric history and current pregnancy were collected. Smoothed percentile values were derived using the LMS method. Malawian reference percentiles were constructed for fetal growth from 35 weeks’ gestation for singleton births. Mean birthweight, length and head circumference were lower at all gestational ages for Malawian compared with Swedish newborns. Fetal growth per completed gestational week was higher by 60?g in weight, 0.5?cm in length and 0.2?cm in head circumference in Swedish compared with Malawian babies. Growth restriction was present from 35 to 41 weeks’ gestation. The pattern for the 10th percentile suggested that this was occurring from well before 35 weeks’ gestation in a proportion of babies.

Résumé. Le but de cette analyse est de construire des courbes transversales de percentiles spécifiques de l’âge gestatif pour le poids à la naissance, la longueur du corps, la circonférence de la tête et du bras chez des nourrissons du Malawi et de comparer ces percentiles avec ceux de bébés nés de femmes ayant eu une grossesse normale dans un pays développé. Un étude transversale a incorporé des femmes enceintes qui fréquentaient deux centres hospitalo-universitaires entre mars 1993 et juillet 1994. Des valeurs lissées de percentiles ont été établies par la méthode des plus petits carrés moyens. Les percentiles de référence du Malawi ont été construits pour des croissances f?tales de 35 semaines d’enfants non gémellaires. Le poids de naissance moyen les circonférences de la tête et du bras sont plus bas à tous les âges gestatifs chez les les nouveaux-nés Malawiens que chez leurs pairs suédois. La croissance f?tale par semaine de gestation achevée est plus élevée chez les suédois de 60?g en poids, 0,5?cm en longueur et 0,2?cm en circonférence de la tête que chez les malawiens. Des restrictions à la croissance ont été présentes entre la 35^ème et la 41^ème semaine de gestation. L’allure du 10^ème percentile suggère que ceci se produit longtemps avant la 35^ème semaine de gestation pour une partie des bébés.

Zusammenfassung. Das Ziel dieser Analyse war, Schwangerschaftsdauer-spezifische Querschnittsperzentilkurven für Geburtsgewicht, Länge, Kopfumfang und Umfang des mittleren Armes für Säuglinge aus Malawi zu konstruieren, und diese Perzentilen mit Referenzwerten für Säuglinge aus normalen Schwangerschaften aus einem entwickelten Land zu vergleichen. Mit schwangeren Frauen, die sich zwischen März 1993 und Juli 1994 in zwei Studienkrankenhäusern vorgestellt hatten, wurde eine Querschnittstudie gemacht. Daten betreffend den mütterlichen sozio-ökonomischen Status, Neugeborenenmaße, frühere geburtshilfliche Anamnese und die jetzige Schwangerschaft wurden gesammelt. Mit LMS-Methode wurden geglättete Perzentilwerte gerechnet. Referenzperzentilen wurden für fetales Wachstum von Einlingen aus Malawi ab der 35. Gestationswoche konstruiert. In allen Altersgruppen waren das mittlere Geburtsgewicht, die Länge und der Kopfumfang von Neugeborenen aus Malawi niedriger als von Schwedischen Neugeborene. Mit jeder vollendeten Schwangerschaftswoche waren Schwedische Neugeborene um 60?g schwerer, um 0,5?cm länger und hatten einen um 0,2?cm größeren Kopfumfang als Neugeborene aus Malawi. Gehemmtes Wachstum fand sich von der 35 bis zur 41 Schwangerschaftswoche. Der Verlauf der 10 Perzentile legte nahe, dass dies bei einem Teil der Kinder bereits deutlich vor der 35 Schwangerschaftswoche bestanden hatte.

Resumen. El objetivo de este análisis fue construir curvas percentilares transversales, específicas para la edad gestacional, para el peso al nacimiento, longitud, circunferencias de la cabeza y del brazo medio, en niños de Malawi, y comparar estos percentiles con los valores de referencia para niños nacidos de mujeres con embarazos normales de un país desarrollado. Se emprendió un estudio transversal que incluía mujeres embarazadas que acudían a dos hospitales estudiados entre Marzo de 1993 y Julio de 1994. Se recogieron datos sobre el nivel socioeconómico materno, la antropometría del recién nacido, la historia obstétrica previa y el embarazo actual. Los valores percentilares suavizados se derivaron mediante el método LMS. Los percentiles de referencia de Malawi se construyeron para el crecimiento fetal a partir de la semana 35 de gestación para los nacimientos simples. En Malawi, los valores medios del peso al nacimiento, longitud y circunferencia de la cabeza fueron menores a todas las edades gestacionales, comparados con los recién nacidos suecos. El crecimiento fetal por semana de gestación completada fue 60?g mayor para el peso, 0,5?cm para la longitud y 0,2?cm para la circunferencia de la cabeza en los niños suecos comparados con los de Malawi. La restricción del crecimiento estaba presente desde la semana 35 a la 41 de gestación. El patrón del percentil 10 sugería que esto ocurría ya antes de la semana 35 de gestación en una cierta proporción de bebés.     

Comparative efficacy of chloroquine and sulphadoxine--pyrimethamine in pregnant women and children: a meta-analysis

OBJECTIVE: To compare the efficacy of chloroquine and sulphadoxine-pyremethamine against Plasmodium falciparum infection in pregnant women and in children from the same endemic areas of Africa, with the aim of determining the level of correspondence in efficacy determinations in these two risk groups. METHODS: Meta-analysis of nine published and unpublished in vivo antimalarial efficacy studies in pregnant women and in children across five African countries. RESULTS: Pregnant women (all gravidae) were more likely to be sensitive than children to both chloroquine (odds ratio: 2.07; 95% confidence interval: 1.5, 2.9) and sulphadoxine-pyrimethamine (odds ratio: 2.66; 95% confidence interval: 11.1, 6.7). Pregnant women demonstrated an almost uniform increased sensitivity for peripheral parasite clearance at day 14 compared with children. This finding was consistent across a wide range of drug sensitivities. Primigravidae at day 14 showed lower clearance to antimalarial drugs than multigravidae (P<0.05). There was no significant difference between parasite clearance in primigravidae and in children. CONCLUSION: The greater drug sensitivity in pregnant women probably indicates differences in host susceptibility rather than parasite resistance. Parasite sensitivity patterns in children may be a suitable guide to antimalarial policy in pregnant women.