Crossreaction of monoclonal Anti-T-cell antibodies: Implications for classifying B-cell leukemias

Summary Cell samples from 62 patients with B-cell leukemias (33 CLL, 8 IC, 6 PLL, 4 HCL, 2 ALL and 9 other NHL) were tested with a series of monoclonal antibodies (A50, T101, Lyt2, Leu1, M203) directed against T cells and shown to crossreact with B-CLL. The results demonstrate a heterogeneity of B-cell leukemias as all typical cases of CLL were reactive whereas most other cases were negative. Using the fluorescence-activated cell sorter, a somewhat stronger reaction was seen in early or benign cases of CLL, compared to advanced cases. All B-cell leukemias tested expressed the Ia antigen.     

Safety and efficacy of larger ASD devices in small children of less than 2 years

We herein report our single center experience of safety and efficacy of device closure of large sized ostium secundum atrial septal defects (OS ASD) in small children with less than 2 years of age performed over the period of 10 years from 2009 to 2019.148 symptomatic children with ASD size of more than 8 mm were included in our study. We obtained a high rate of successful deployment (98 %) with no major complications.     

Health Services Research in Rehabilitation and Disability—The Time is Now

Policy drives practice, and health services research (HSR) is at the intersection of policy, practice, and patient outcomes. HSR specific to rehabilitation and disability is particularly needed. As rehabilitation researchers and providers, we are uniquely positioned to provide the evidence that guides reforms targeting rehabilitative care. We have the expertise to define the value of rehabilitation in a policy-relevant context. HSR is a powerful tool for providing this evidence. We need to continue building capacity for conducting rigorous, timely rehabilitation-related HSR. Fostering stakeholder engagement in these research efforts will ensure we maintain a patient-centered focus as we address the “Triple Aim” of better care, better health, and better value. In this Special Communication we discuss the role of rehabilitation researchers in HSR. We also provide information on current resources available in our field for conducting HSR and identify gaps for capacity building and future research. Health care reforms are a reality, and through HSR we can give rehabilitation a strong voice during these transformative times.     

Development and validation of a prognostic nomogram based on objective nutritional indexes in ischemic stroke patients with large vessel occlusion undergoing endovascular thrombectomy

Background and aimsPreserved nutritional status in acute ischemic stroke patients with large vessel occlusion (LVO) undergoing endovascular thrombectomy (EVT) is important but lacks an effective evaluation method. We aimed to investigate the prognostic value of objective nutritional indexes (ONIs) in LVO patients after EVT that were validated by studies in patients with other vascular diseases receiving intervention therapy and to develop a functional prediction nomogram for better stroke management.Methods and resultsLVO patients undergoing EVT from 2016 to 2020 were retrospectively enrolled and randomly classified into training and validation cohorts at a ratio of 7:3. The ONIs, including the Controlling Nutritional Status (CONUT) score, Nutritional Risk Index (NRI), and Prognostic Nutritional Index (PNI), were calculated. A stepwise logistic regression model for 3-month poor functional outcome based on the smallest Akaike information criterion was employed to develop the nomogram, and the nomogram's determination and clinical use were tested by area under the curve (AUC), calibration plots, and decision curve analysis and compared with three earlier prognostic models. A total of 418 patients were enrolled. The CONUT independently related and increased the risk of 3-month poor functional outcome with an OR of 1.387 (95% CI: 1.133–1.698, p = 0.002). A nomogram including CONUT and other seven factors (AIC = 274.568) was developed. The AUC of the nomogram was 0.847 (95% CI: 0.799–0.894) and 0.836 (95% CI: 0.755–0.916) in the training and validation cohort, respectively, with better predictive performance and clinical utility than previous models.ConclusionThe CONUT independently related to the poor functional outcome, and the newly established nomogram reliably predicted the functional outcome in LVO patients after EVT.     

Effects of L-leucine on the insulin production,oxidative metabolism and mitochondrial ultrastructure of isolated mouse pancreatic islets in tissue culture

Summary This study was performed to evaluate whether L-leucine is able to relieve the structural and functional alterations previously described in pancreatic islets exposed in vitro for a prolonged time to a subnormal glucose concentration (3.3 mM). It was found that both the impairment of secretion and the decreased rate of biosynthesis of insulin characteristic, of islets cultured for one week in 3.3 mM glucose were prevented by adding 15 mM L-leucine to the culture medium. Furthermore, the rates of tritiated water production and glucose or leucine oxidation were significantly enhanced after culture in the presence of L-leucine. The rate of DNA synthesis as estimated by the incorporation of tritiated thymidine was, however, unchanged by the presence of L-leucine in the culture medium. Leucine cultured islet cells displayed ultrastructural signs of high functional activity. A detailed morphometric examination revealed fewer but hypertrophic mitochondria. The present results suggest that L-leucine can replace glucose in several respects as a long-term stimulus of the pancreatic B-cells, possibly by acting as a metabolic substrate.Presented in part at the Congresses of the European Association for the Study of Diabetes, Munich, 1975 and Helsinki, 1976     

Analysis of T-cell subsets in B-cell chronic lymphocytic leukemia: a correlation with the stage of disease

T-cell subsets were determined by the Leu monoclonal antibodies in the peripheral blood and/or bone marrow of 52 patients with B-cell chronic lymphocytic leukemia (B-CLL) not on therapy at the time of study. The diagnosis of B-CLL required that the leukemic cells expressed surface receptors for "la-like" antigen, Fc fragment of IgG, mouse red blood cells (MRBC), C3-coated red cells (EAC), and low density of monoclonal surface immunoglobulin. The Leu-3a+/2a+ ratio was applied to define the balance between the helper/suppressor subsets in the residual T-lymphocytes. Most patients showed a decrease in the Leu-3a+/2a+ ratios at all stages of disease. The decrease in ratio was mainly related to a decrease in the Leu-3a+ T-cell subset. The more advanced stages of B-CLL were associated with lower Leu-3a+/2a+ ratio, higher total white cell and percent lymphocyte counts. There was no correlation between the proportion of EAC or MRBC rosetting cells and stages of B-CLL. This analysis further suggests that B-CLL is an immunosuppressed state that becomes more pronounced in the advanced stages and is characterized by a progressive decrease in the Leu-3a+ (helper) T-cell subset.