Antibody-dependent cytolysis of the human leukemia cell line K-562 in the absence of effector cells or complement

K-562 human leukemia cells grown in the presence of specific goat anti- K-562 gamma globulin, F(ab)'2, Fab', or Fab showed a decrease in DNA and protein syntheses and a loss of cell viability within several hours. Eventually all cells died and lysed within 2-5 days. These events occurred in the absence of added effector cells or complement. The effect on the cell was not due to proteolytic or other external lytic activity generated at the cell surface, since 51Cr-labeled bystander cells or antibody-sensitized bystander cells (chicken erythrocytes or K-562 cells) were not lysed when added to cultures of K- 562 cells incubated with immune globulin. The anti-K-562 gamma globulin was not observed to patch or cap on K-562 cells, but the ability of bound immunoglobulin to fix complement decreased markedly (50% in 60 min), so that no complement-mediated cytolysis could be observed at 2 hr. However, the immunoglobulin, at least portions of it, reacted with fluorescein--labeled rabbit anti-goat gamma globulin for about 16 hr. 125I-labeled immune globulin appeared to be internalized and released into the medium as small degradation products. 125I-labeled Fab did not appear to be internalized, since it was released intact and more rapidly from cells than the intact globulin.     

Fractionated proton beam irradiation of pituitary adenomas

PURPOSE： Various radiation techniques and modalities have been used to treat pituitary adenomas. This report details our experience with proton treatment of these tumors. METHODS AND MATERIALS： Forty-seven patients with pituitary adenomas treated with pro- tons, who had at least 6 months of follow-up, were included in this analysis. Forty-two patients underwent a prior surgical resection; 5 were treated with primary radiation.     

Leukoagglutinin Studies as a Routine Procedure in Blood Banking

For the past four years, the method presented here for the detection of leukoagglutinins has been successfully integrated into the routine procedures of a community blood bank. Patients' sera are tested against leukocytes from 12 Group O donors. White cell suspensions are prepared from defibrinated blood using 4 per cent polyvinylpyrrolidone (PVP) as a sedimenting agent. Tests have been performed on 276 patients, among whom 89 (32 per cent of the total) were found to possess leukoagglutinins. Of the 89 individuals in whose sera leukoagglutinins were demonstrated, 85 had a reported history of febrile transfusion reactions, frequently accompanied by chills, occasionally with urticaria. These 85 patients made up 57 per cent of 150 cases who had been reported as experiencing nonhemolytic febrile reactions shown by several workers to occur in patients with leukoagglutinins.
Also described are methods used for the preparation of leukocyte-poor units requested for patients whose sera have been shown to contain leukoagglutinins.     

Prevalence of ABO Maternal-Infant Incompatibility in Asians, Blacks, Hispanics and Caucasians

Previous studies suggest that race is a risk factor in ABO hemolytic disease of the newborn (ABO-HDN). In order to compare the prevalence of ABO-HDN in Asian, Black, Hispanic and Caucasian infants, we studied 10,611 consecutive births at one hospital over a 6-year period. Among group A infants born to group O mothers, the prevalence of positive DAT differed among the four groups (p = 0.007), and was highest in Asians (50%) and lowest in Caucasians (31%). However, the proportions of infants who required exchange transfusion were not different (p = 0.351). Among group B infants born to group O mothers, the prevalence of positive DAT was not different among the four groups (p = 0.26) and none of these 166 group B infants with a positive DAT result required exchange transfusion. Our findings suggest that there are small ethnic differences in the prevalence of positive DAT results in group A infants born to group O mothers, but the prevalence of clinical disease which requires exchange transfusion does not differ significantly among Asian, Black, Hispanic and Caucasian infants.     

Strategies for the avoidance of bacterial contamination of blood components

Gram staining and bacterial culturing methods were used to determine the incidence of bacterial contamination of cellular blood components at the time of transfusion reactions. Over a 5-year period, 2208 (4.3%) of 51,278 transfusions were complicated by reactions. Overall bacterial contamination occurred in 5 (0.03%) of 17,928 transfusions of single- donor apheresis platelets, 1 (0.14%) of 712 transfusions of pooled random-donor platelet concentrates, 1 (0.003%) of 31,385 transfusions of red cells, and 0 of 1253 transfusions of fresh-frozen plasma. Gram staining done at the time of positive cultures was positive in three of six cases. Although six of seven recipients of contaminated components suffered no clinical sequelae, contaminated transfusions may have been a contributing cause of death in one case. Attempts were made to avoid the transfusion of contaminated cellular blood components by performing routine bacterial cultures: 0 of 341 quality control cultures were positive. To avoid the transfusion of contaminated platelets by identifying bacteria, Gram staining was performed in all single-donor apheresis platelet units collected on open systems and daily in platelets stored > 48 hours: 8 (0.15%) of 5334 smears done on 3829 platelet units were interpreted as positive, and those units were not transfused, but only two of eight units were culture positive. These studies suggest that bacterial contamination can result in adverse clinical sequelae in transfusion recipients and that both culturing and Gram staining are poor methods of screening for contaminated units. More sensitive and specific methods of generalized screening for bacterial contamination are needed.     

In men older than 70 years, total testosterone remains stable while free testosterone declines with age. The Health in Men Study

OBJECTIVE: An age-related decline in serum total and free testosterone concentration may contribute to ill health in men, but limited data are available for men > 70 years of age. We sought to determine the distribution and associations of reduced testosterone concentrations in older men. DESIGN: The Health in Men Study is a community-representative prospective cohort investigation of 4263 men aged > or = 70 years. Cross-sectional hormone data from 3645 men were analysed. METHODS: Early morning sera were assayed for total testosterone, sex hormone binding globulin (SHBG) and LH. Free testosterone was calculated using the Vermeulen method. RESULTS: Mean (+/- s.d.) serum total testosterone was 15.4 +/- 5.6 nmol/l (444 +/- 162 ng/dl), SHBG 42.4 +/- 16.7 nmol/l and free testosterone 278 +/- 96 pmol/l (8.01 +/- 2.78 ng/dl). Total testosterone correlated with SHBG (Spearman's r = 0.6, P < 0.0001). LH and SHBG increased with age (r = 0.2, P < 0.0001 for both). Instead of declining, total testosterone increased marginally (r = 0.04, P = 0.007) whilst free testosterone declined with age (r = -0.1, P < 0.0001). Free testosterone was inversely correlated with LH (r = -0.1, P < 0.0001). In multivariate analyses, increasing age, body mass index (BMI) and LH were associated with lower free testosterone. CONCLUSIONS: In men aged 70-89 years, modulation of androgen action may occur via an age-related increase in SHBG and reduction in free testosterone without a decline in total testosterone concentration. Increasing age, BMI and LH are independently associated with lower free testosterone. Further investigation would be required to assess the clinical consequences of low serum free testosterone, particularly in older men in whom total testosterone may be preserved.