Human T-lymphocyte rosette formation: inhibition by cytochalasin B.

The effects of cytochalasin B, colchicine and vinblastine on the rosette formation of human T lymphocytes with neuraminidase-treated human erythrocytes (nHRBC) and with sheep red blood cells (SRBC) have been studied. Pretreatment of the lymphocytes with cytochalasin B which affects microfilament action reversibly inhibits both nHRBC and SRBC rosette formation. Colchicine and vinblastine known to interact with microtubules causes no major reduction in rosette-forming cells. The results suggest that normally functioning microfilaments are necessary for nHRBC and SRBC rosetting, whereas microtubules are not essential for the blinding of the erythrocytes to the lymphocytes.     

Impact of digital subtraction angiography on carotid evaluation

Impact of digital subtraction angiography by intravenous injection (DSAV) was examined in a private neurology clinic. In the evaluation of threatened stroke, advent of DSAV was associated with reduced use of both traditional noninvasive tests (from 100% of patients to 36%), and conventional arteriograms (from 29% to 4%). Less compelling indications were often prescreened with noninvasive tests; more compelling symptoms usually had initial DSAV. Conventional arteriograms were done for compelling indications and negative or inadequate DSAV. The average cost of evaluation was increased slightly in patients treated medically and reduced greatly in those having surgery. While cost and convenience might support such utilization, issues of quality of evaluation require consideration.     

A proposed network to improve access to high-quality health care for medicaid-eligible families

There is today both a need and an opportunity to develop and test a variety of models—organizational and financial—for improving the delivery of health care services. This article describes the structure and functioning of one such model and highlights the organizational problems expected to arise during its implemèntation. The proposed health plan is intended to facilitate the access of Medicaideligible, inner-city families to already available health services. The central hypothesis is that in low-income urban areas the elementary schools offer an organizational focus for the development of a health plan. As a prepaid, community-based model, this plan is designed to address the issues of accessibility, equity, accountability, continuity of care, and consumer participation, primarily through the development of a coordinating agency, the health plan office (HPO), which assures the linking of consumers and providers of health care. Adapted from the Kaiser-Permanente model, the HPO also assumes responsibility for marketing, enrollment, coordination of services, consumer advocacy, and quality surveillance.Dr. Bosch is Professor and Deputy Chairman of the Department of Community Medicine, Mount Sinai School of Medicine, New York City 10029. Dr. Merino is Assistant Professor, Mrs. Daniels is Coordinator of Community Program Planning, and Ms. Fischer is a Technical Associate in the Department. Dr. Rosenthal is Director of Dental Services, East Harlem Council for Human Services Neighborhood Health Center. The work reported in this article was conducted under a grant from the Robert Wood Johnson Foundation.     

Therapy results in hairy cell leukemia]

20 patients with hairy cell leukemia were treated between 1966 and 1978. All modalities of treatment for lymphoproliferative disorders have been used in at least some patients. Besides prednisone, vincristine, cyclophosphamide and their combinations as well as irradiation of enlarged spleens, cell depletion was achieved by splenectomy and leukapheresis. Cytostatics had no beneficial effect. Cytostatic therapy exposed some patients to the hazards of severe infections. On the contrary splenectomy lead to the improvement of some blood parameters. Leukapheresis seemed to work nearly identically. The survival of the splenectomized patients was longer than of controls. Because of the variability of the duration of the disease no definite statement could be made concerning the survival of both groups. 12 patients died during the observation period. Splenectomy was followed by one death, 11 patients died of septicemia.