Reduction in CD4 Central Memory T-Cell Subset in Costimulation Modulator Abatacept-Treated Patients With Recent-Onset Type 1 Diabetes Is Associated With Slower C-Peptide Decline

We previously reported that continuous 24-month costimulation blockade by abatacept significantly slows the decline of β-cell function after diagnosis of type 1 diabetes. In a mechanistic extension of that study, we evaluated peripheral blood immune cell subsets (CD4, CD8-naive, memory and activated subsets, myeloid and plasmacytoid dendritic cells, monocytes, B lymphocytes, CD4⁺CD25^high regulatory T cells, and invariant NK T cells) by flow cytometry at baseline and 3, 6, 12, 24, and 30 months after treatment initiation to discover biomarkers of therapeutic effect. Using multivariable analysis and lagging of longitudinally measured variables, we made the novel observation in the placebo group that an increase in central memory (CM) CD4 T cells (CD4⁺CD45R0⁺CD62L⁺) during a preceding visit was significantly associated with C-peptide decline at the subsequent visit. These changes were significantly affected by abatacept treatment, which drove the peripheral contraction of CM CD4 T cells and the expansion of naive (CD45R0⁻CD62L⁺) CD4 T cells in association with a significantly slower rate of C-peptide decline. The findings show that the quantification of CM CD4 T cells can provide a surrogate immune marker for C-peptide decline after the diagnosis of type 1 diabetes and that costimulation blockade may exert its beneficial therapeutic effect via modulation of this subset.     

Lentogenic field isolates of Newcastle disease virus isolated in Canada and Hungary are identical with the vaccine type used in the region.

Lentogenic field isolates of Newcastle disease virus were examined by restriction enzyme analysis of RT-PCR products generated from the matrix protein gene that discriminates between strains LaSota and B-1, the two most widely used lentogenic vaccine viruses. Isolates were derived from regions where, exclusively or predominantly, only one type of vaccine was employed. Viruses collected in Hungary for two decades were exclusively of LaSota-type while the Canadian collection predominantly included B-1, which corresponded to the vaccine types used in the regions. Isolation of vaccine type lentogenic viruses from unvaccinated flocks supports the occurrence of area spread of these lentogenic viruses.     

Clinical symptomatology and drug compliance in schizophrenic patients

The differences in the psychopathologic status of 26 complaint and 32 noncomplaint schizophrenic patients were evaluated on the basis of rating scales used at discharge. Noncomplaint patients had significantly higher scores for grandiosity, lack of feeling of illness and insight into it. Their score for global psychopathological state and disturbance in social adjustment was also significantly higher. The compliant patients had significantly higher score for self-rated depression.     

Normal serum albumin transfer from blood to small intestine and its role in albumin breakdown.

131I-albumin transfer into isolated segments of the small intestine has been determined following the intravenous injection of human 131I-albumin in 23 dogs. The importance of different intestinal segments in the normal degradation of albumin has been established. The slope of the serum disappearance curve was unaltered with proves that the applied technique had no damaging effect. Albumin leakage was not uniform in the whole length of the small intestine. It was highest in the duodenum (0.241 +/- 0.014 ml/10 cm intestine/hour). This was followed by the jejunum (0.142 +/- 0.022 ml/10 cm intestine/hour), and the smallest vally quantity of albumin leakage corresponded to a plasma volume of 14.49 ml in the duodenum, 27.16 ml in the jejunum, and to 23.76 ml in the ileum. The relationship of albumin leakage and catabolism revealed that protein bound activity (transferred and regained) in the dudodenum, in spite of the shortness of this section of the intestine, was responsible for 11.72 +/- 1.70% of total catabolism, that in the jejunum for 21.28 +/- 3.69%, and that in the ileum for 19.24 +/- 3.64%. The sum of the catabolism of the three intestinal segments yielded 52.26 +/- 6.65% of the total catabolism. After correction with a proteolytic factor, this value was 68.44%. Our examinations have established that the small intestine is the main region of normal albumin breakdown.     

The most effective dosage in the administration of PGF2-alpha for interruption of pregnancy during the 2d trimester

Artificial interruption of pregnancy contains too many risks from the 12th week of pregnancy. The authors have been working at finding the most suitable and effective dosage of prostaglandin for the interruption of pregnancy during the 2nd trimester. The new dosage experimented was 25 mg of prostaglandin F2alpha, followed by another 25 mg 6 hours later. The clinical efficiency of this dosage was tested. This procedures was used in 45 cases. The efficiency of the method was compared to the efficiency of the previously used dosage, which was 25 mg of prostaglandin F2alpha, followed by 25 mg 24 hours later. The new dosage was evaluated 91% efficient, while the previous dosage was found to be 75% efficient. The side effects were rated as acceptable by the patients. There was no case of infection. Two undeniable advantages were found with this new dosage: the duration of the actual procedure is considerably reduced, and the method appears to be much safer. The authors conclude that this new procedure offers numerous clinical advantages.     

Primary carcinoma of the appendix

Primary adenocarcinoma of the appendix is a rare tumor. Fewer than 200 cases are on record. Correct preoperative diagnosis is virtually nonexistent. Two patients with adenocarcinoma of the appendix are described. Although appendectomy appears to be adequate treatment for carcinoid, right hemicolectomy is, in our opinion, the treatment of choice for mucinous cystadenocarcinoma, while it is mandatory in cases of adenocarcinoma of the colonic type.