Low retention of white cell fragments by polyester fiber white cell- reduction platelet filters

BACKGROUND: There is intense interest in the potential of current white cell (WBC)-reduction filters to prevent the alloimmunization of patients by the residual donor WBCs in filtered blood components transfused to them. Little attention has been paid to the capacity of current synthetic fiber filters to remove WBC membrane fragments bearing detectable leukocyte antigens. STUDY DESIGN AND METHODS: Fluorescein isothiocyanate-conjugated monoclonal antibody to a universal WBC membrane antigen (CD45) and high-speed centrifugation coupled with ficoll-hypaque differential sedimentation were used to quantitate low-density WBC fragments in single-donor platelet components before and after filtration to determine if a polyester fiber filter retained WBC fragments. RESULTS: Prefiltration measurements in 25 single-donor platelet components indicated that WBC fragments increased with length of storage up to 5 days at room temperature (p < 0.0001). When fragments in eight components were measured before and after filtration, absolute values for differences were insignificant (p = 0.15). CONCLUSION: WBC fragments were poorly retained by these polyester fiber WBC-reduction filters. The antigenicity of WBC fragments could contribute to the WBC alloimmunization of some recipients of WBC-reduced blood components.     

CD7+, CD4-, CD8- acute leukemia: a syndrome of malignant pluripotent lymphohematopoietic cells

Following our initial observation of in vivo conversion of CD7+, CD4-, CD8- acute lymphoblastic leukemia (ALL) cells from lymphoid to myeloid lineages (Proc Natl Acad Sci (USA) 81:253, 1984) we have studied eight additional cases of ALL with this leukemic cell phenotype. The CD7+, CD4-, CD8- phenotype was associated with a distinct clinical entity with those affected predominantly male (either less than 35 years or greater than 65 years of age), with frequent mediastinal and/or thymic masses, skin and CNS disease, high peripheral WBC counts, and bone marrow blasts that were morphologically L1 or not ascribable to a specific lineage. These patients did not respond to conventional chemotherapeutic regimens for either acute lymphoid or myeloid leukemias. No common karyotype or T-cell gene rearrangement pattern could be defined. Importantly, seven of eight patient's leukemic cells studied were capable of multilineage (myeloid, erythroid, monocytoid, megakaryocytoid, and lymphoid) differentiation in vitro. Data is presented suggesting that CD7+, CD4-, CD8- leukemias, in many instances, are leukemias of immature hematopoietic cells. The development of novel therapeutic approaches to this form of leukemia will be necessary to alter its poor prognosis.     

Phenotypic characterization of human bone marrow granulocyte-macrophage forming progenitor cells

Cell surface antigens of the human bone marrow CFU-C have been studied. Human marrow cells were incubated with a variety of monoclonal antisera and complement prior to culture in semisolid media. By using indirect immunofluorescent studies, the percentage of bone marrow cells binding the antibodies was determined. The CFU-C phenotype is HLA+, la+, 4F2+, 3A1-, and DUALL-1-. This study provides information that is useful in the study of myeloid cell ontogeny and necessary for the use of some of these reagents in the treatment of bone marrow cells prior to human bone marrow transplantation in various clinical settings.     

Nonionic versus ionic contrast media in intravenous urography: clinical trial in 1,000 consecutive patients

A double-blind clinical trial was performed in 1,000 consecutive patients to compare the safety and efficacy of intravenously administered nonionic (iohexol) and ionic (metrizoate) urographic contrast media. The patients ranged in age from 10 to 80 years. The incidence of mild to moderate adverse effects was 7.7% with iohexol and 31.2% with metrizoate. No serious reactions were recorded with either of the contrast media. Urography with iohexol was found to give better parenchymal opacification, pelvocalyceal opacification, and overall quality. The sum of examinations with good and excellent overall quality was 97.8% with iohexol and 91.1% with metrizoate. The frequency of poor overall quality urograms was 1.6% with iohexol and 7.5% with metrizoate. The data suggest that iohexol is safer and more frequently produces urograms of better quality.     

Steroid receptor status difference in recurrent intracranial meningioma and breast cancer in the same patient

The authors report a case of multiple recurrent intracranial meningioma associated with breast cancer in a menopausal woman. High affinity estrogen (ER) and progestin receptors (PR) were assayed independently in the meningioma and the tumor. ER were found to be very low in the meningioma and high in the breast tumor. On the contrary PR were found to be high in the meningioma and could be not detected in the breast tumor. This unique case suggests that meningioma and breast cancer are not under the same type of hormonal influence.     

Measuring health and well-being effects in family caregivers of children with craniofacial malformations

Purpose  

This research explores the sensitivity of three generic instruments for preference-weighting health states of family caregivers of children with craniofacial malformations (CFM). We also examine the construct validity of the new CarerQol instrument measuring caregiver burden and general quality of life.     

Magnetic resonance imaging of the heart: a review of the experience in 172 subjects

Gated magnetic resonance (MR) imaging was used to evaluate central cardiovascular anatomy in 172 subjects, 31 of whom were healthy volunteers. Using the spin-echo technique, images of diagnostic quality were obtained in 93% of cases with TE = 28 msec and in 65% of cases with TE = 56 msec. Transverse multisection sequences encompassing most of the left ventricle required approximately 6-8 minutes. Corroborative studies were available in 134 of 141 patients who had cardiovascular disease; two dimensional echocardiograms and angiography in 133 and 100 patients, respectively. Gated MR demonstrated the wall thinning and complications caused by prior myocardial infarctions and high signal intensity of the myocardium at the site of acute myocardial infarctions. MR accurately demonstrated anatomic abnormalities owing to hypertrophic and congestive cardiomyopathies, congenital abnormalities of the heart and great vessels, rheumatic heart disease, pulmonary hypertension, and cardiac and paracardiac masses. Depiction of cardiovascular anatomy and pathoanatomy was attained without the use of any contrast media. Consequently, gated MR is an effective technique for cardiac diagnosis. The short time required for tomographic examination of the entire heart using the multisection technique renders this a practical cardiac imaging modality.     

p21-Activated kinase 1 coordinates aberrant cell survival and pericellular proteolysis in a three-dimensional culture model for premalignant progression of human breast cancer

Overexpression of p21-activated kinase 1 (PAK1) occurs during the progression of human breast cancer. We have investigated the role of PAK1 in the premalignant progression of the MCF10 series of human breast epithelial cell lines. Levels of PAK1 expression and activation increased with premalignant progression, and expression of dominant-negative (DN) PAK1 reduced both cell proliferation and migration/invasion. In three-dimensional (3D) overlay cultures in reconstituted basement membrane, the MCF10 series produced an in vitro model for premalignant progression. MCF10AneoT cells formed a hyperplastic morphology in which some spheroids developed abnormal lumens. The MCF10.AT1 line exhibited an atypical hyperplastic morphology of abnormal spheroid clusters that did not form lumens. The MCF10.DCIS cells exhibited dysplastic growth. Expression of DN-PAK1 promoted lumen formation in 3D-cultured MCF10A, NeoT, and AT1 structures, suggesting partial reversion of the premalignant phenotype, but did not affect the atypical budding of AT1 structures or the dysplastic growth of ductal carcinoma in situ structures. Aberrant proteolysis is another important characteristic of breast cancer progression and invasion. DN-PAK1 or knock-down of PAK1 reduced pericellular proteolysis of DQ-collagen IV in the 3D cultures. Treatment of cells with an inhibitor of Rac1 also reduced pericellular proteolysis, and this reduction was reversed by the expression of activated PAK1. Our conclusion is that overexpressed and activated PAK1 may be a key coordinator of aberrant cell survival and proteolysis in breast cancer progression.     

Significance of elevated serum thyrotropin during treatment of congenital hypothyroidism

Serum thyrotropin concentrations are frequently elevated during treatment of children with congenital hypothyroidism. It is unclear if elevated thyrotropin during early treatment indicates non-optimal treatment. In a cohort of 49 children with congenital hypothyroidism, we studied the decline in serum thyrotropin concentration after initiating L-thyroxine treatment, the relationship between elevated thyrotropin and treatment variables, and non-compliance with the treatment as a possible cause of elevated thyrotropin. The initial mean dose of thyroxine was 8.5 (SD 3.3) μg/kg body weight/day: 71 % of the serum samples obtained 15-21 days after the start of treatment had serum thyrotropin concentrations < 10 mU/1. Six children had no samples with serum thyrotropin < 10 mU/1 during the first 3 months of treatment. These children had a lower thyroxine dose prescribed, and serum thyrotropin was normalized when the dose was sufficiently increased. During treatment, from 6 weeks of age, serum thyrotropin > 10 mU/1 was related to a lower dose of thyroxine and lower serum thyroxine, and was not due to non-compliance with treatment.