Concurrent measurements of blood flow and transcapillary transport in xenotransplanted human gliomas in immunosuppressed rats

Neonatal Fischer 344 rats were immunosuppressed with antithymocyte serum and later were given an injection intracerebrally of cells from the human glioma permanent line D-54MG. Symptomatic tumor-bearing rats were studied with double-label quantitative autoradiography to concurrently measure blood flow and a unidirectional blood-to-tissue transfer constant (K) for alpha-aminoisobutyric acid (AIB). A net extraction fraction (En) was calculated from the measured values for blood flow and K. Mean whole tumor blood flow was 53.5 +/- 4.9 ml/100 g/min (mean +/- SEM), which was significantly less than the blood flow to the tumor-free cortex (198 +/- 15.5 ml/100 g/min) but not significantly different from the blood flow in the tumor-free corpus callosum (50.6 +/- 4.3 ml/100 g/min). Mean whole tumor K-value for AIB was 5.8 +/- 0.5 ml/100 g/min, approximately 30 times the K-value for tumor-free brain. The calculated mean whole tumor En was 0.2 +/- 0.09, nearly 100 times the value for the tumor-free brain. Regionally, blood flow was lower in the tumor center and higher in its tumor periphery, although the difference was not significant. Both K- and En-values were significantly higher for the tumor center and decreased radially for the areas from center out. The values for K and En of AIB in the D-54MG gliomas are the highest of any experimental brain tumor model studied to date and indicate that in some tumor regions in this model, blood-to-tissue transport of the water-soluble compound AIB may be dependent on blood flow as well as on the permeability-surface area product of the tumor capillaries.     

Focal cerebral vasculitis associated with circulating immune complexes and brain irradiation

In this report we describe a patient with a benign glioma treated with surgery and radiation. After a period of stability he developed subacute bacterial endocarditis, and deteriorated neurologically. Computed tomographic scans did not show recurrent tumor. An angiogram showed vasculitis restricted to the previously irradiated area. Secondary to subacute bacterial endocarditis was the presence of high levels of circulating immune complexes. His neurological status was unchanged after antibiotics, but improved after treatment with dexamethasone. We interpret the clinical course as an immune-complex-mediated vasculitis superimposed on a subclinical radiation vasculitis. This case supports the hypothesis that immune mechanisms may be involved in delayed radiation injury to the nervous system.     

Water-related nosocomial pneumonia caused by Legionella pneumophila serogroups 1 and 10

Between August 1978 and November 1983, 21 cases of pneumonia caused by Legionella pneumophila occurred in the Leiden University Hospital, mainly among immunocompromised patients. A new serogroup of L. pneumophila, designated serogroup 10 (prototype strain Leiden 1), was isolated from bronchial secretions of four patients, and five patients had serological evidence of infection with this organism. Nine patients had a culture-confirmed infection with L. pneumophila serogroup 1. L. pneumophila serogroups 1 and 10 were also isolated from the hot potable water supply in the building to which 19 of the 21 patients had been admitted. The isolates of L. pneumophila serogroup 1 from patients and the hot potable water were identical in studies with monoclonal antibodies and had the same plasmid profiles. These findings provide further evidence that in our hospital potable water contaminated with L. pneumophila is a source of infection, mainly in immunocompromised patients.