In vivo and in vitro correlates of food allergy.

Sera of 86 patients clinically sensitive to foods were tested by passive sensitization of human and/or monkey lung (127 tests) and the radioallergosorbent test (RAST) (72 tests), using whole-food antigens; the results were compared with skin (prick) testing. Results of the prick test correlated with history in 76% of cases; lung sensitization correlated with history in 37% and with prick test in 57%; and RAST correlated with history in 54% and prick test in 72%. It is concluded that a very large percentage of adverse reactions to foods are IgE-mediated. The prick test is of use in diagnosis, particularly when combined with RAST; the lung sensitization test is technically impractical and not a reliable indicator. The best diagnostic method is careful history with food challenge and withdrawal and rechallenge; the latter is safe except in patients with a history of violent reaction.     

Karyotypic evolution in Ph-positive chronic myeloid leukemia in relation to management and disease progression

In a prospective study of 32 patients with chronic myeloid leukemia the frequency of chromosome abnormalities in addition to the Philadelphia chromosome (Ph) increased when the disease progressed. Before metamorphosis, 10 patients (31%) had developed additional abnormalities. Such abnormalities were present in three of them at the time of diagnosis; in the other seven, they were detected late in the chronic phase. New clonal abnormalities heralded or accompanied a more malignant phase of the disorder, usually a blastic leukemia. During metamorphosis, 78% of the patients had additional abnormalities, which in 68% of these cases comprised at least one of +8, +22q- or i(17q). Clones with additional abnormalities disappeared in eight cases, either spontaneously or in association with cytostatic therapy during the chronic or blastic phase. Involvement of chromosome #8, usually in the form of a trisomy, was found in 7 of 12 patients treated with busulfan, but was not found in any of the 10 hydroxyurea-treated patients, of whom 8 were splenectomized early during the chronic phase. Cells from the spleen, obtained by fine needle aspiration or splenectomy were cytogenetically examined in 18 cases during the chronic phase, but abnormalities in addition to the Ph were noted in only one patient, who was examined in the late chronic phase. The same abnormalities were present in bone marrow cells of this patient.     

Constitutional C-band pattern in patients with adenomatosis of the colon and rectum

The pattern of polymorphism in the C-band-positive constitutive heterochromatin of chromosomes #1, #9, and #16 was studied in fibroblasts from 23 unrelated patients with adenomatosis of the colon and rectum and in peripheral lymphocytes from 78 control persons. The parameters of the heterochromatic regions analyzed were relative size, symmetry-asymmetry within homologous chromosome pairs, and frequency of inversions. The polyposis coli patients had a significantly higher frequency (p less than 0.05) of partial and total heterochromatin inversion on chromosome #9 than the control group (37.0% compared with 21.8%). In the other parameters studied, no significant differences were found between patients and controls.     

Keratin proteins and carcinoembryonic antigen in synovial sarcomas: an immunohistochemical study of 24 cases

Twenty-four synovial sarcomas were examined for the presence of keratin proteins by an indirect immunoperoxidase method with paraffin-embedded tissues. Keratin proteins were identified in 16 of 24 cases (67 per cent). Both the pseudoglandular and spindle cell areas of all eight of the biphasic synovial sarcomas and the spindle cells of eight of the 16 monophasic synovial sarcomas contained keratin proteins. In spindle cell areas, staining was observed in single cells and small cords and clusters of cells in the absence of cleft formation or other evidence of a pseudoglandular component. The predominant cytologic staining pattern in all cases was peripheral, with localization of staining to the cell membrane or adjacent areas, but diffuse and focal cytoplasmic staining patterns were also observed. No staining for keratin proteins was seen in 101 control cases, including 52 sarcomas of various types. Carcinoembryonic antigen was also identified in four of the 24 synovial sarcomas by an indirect immunoperoxidase technique. The identification of keratin proteins may be helpful in the pathologic diagnosis of synovial sarcoma, particularly the spindle cell monophasic variant.     

Effect of bronchodilator therapy administered by canister versus jet nebulizer

Bronchodilator efficacy of metaproterenol sulfate aerosol therapy delivered either by canister or jet nebulizer was compared in 25 patients, 13 with severe asthma and 12 with COPD. Treatment was carried out in double-blind crossover fashion on 2 days and consisted of either metaproterenol sulfate solution 15 mg in 2.3 ml administered from a jet nebulizer or three puffs of metered-dose metaproterenol sulfate (total 1.95 mg) inhaled sequentially. FVC and FEV1 were monitored before and after therapy for 2 hr. In 13 asthmatic patients, FEV1 increased from a baseline mean of 0.83 L to 1.57 L at 2 hr after jet nebulizer therapy and increased from 0.84 L to 1.52 L after canister therapy. In 12 patients with COPD, FEV1 increased from 0.58 L to 0.78 L after jet nebulizer therapy and from 0.57 L to 0.76 L after canister therapy. FVC also increased similarly after each form of therapy. The two types of aerosol therapy were equally effective and were without side effects. Canister therapy has the advantage over jet nebulizer therapy by being convenient and cheaper.     

A case of dysmyelopoietic syndrome with hypotetraploid karyotype

We present a patient with dysmyelopoietic syndrome and with a complex, hypotetraploid karyotype with numerous structural aberrations.     

Trichosporon beigelii endocarditis as a complication of peritoneovenous shunt

Trichosporon is a common cause of superficial mycotic infection but has rarely been associated with endocarditis. The case of a patient who had a peritoneovenous shunt for chronic intractable ascites due to Laennec liver cirrhosis is described. The shunt was revised on several occasions, and the last procedure was complicated by a draining skin sinus wound. To the authors' knowledge, this is the first reported case of Trichosporon endocarditis complicating a peritoneovenous shunt.     

Anaphylaxis following psyllium ingestion

Psyllium is a hydrophilic agent found in many bulk laxative preparations. We report the occurrence of an anaphylactic reaction in a patient after ingestion of a psyllium-containing laxative. IgE mediation of the reaction was suggested by a positive immediate skin test to psyllium, positive passive transfer skin test, lack of skin response during passive transfer with heat treated serum, and an elevated IgE (RAST) to psyllium seed.     

癌瘤患者骨髓细胞c－erbB和c－erbA的基因异常

本文在大系列研究造血系统恶性肿瘤-白血病和白血病前期的基础上，对３１例恶性肿瘤患者骨髓进行血液学、细胞和分子遗传学研究。发现恶性肿瘤患者骨髓有与白血病前期骨髓相似的病态造血（Ｍｙｅｌｏｄｙｓｐｌａｓｉａ）和相关基因异常即ｃ－ｅｒｂＢ基因重排、扩增和ｃ－ｅｒｂＡ缺失。它们不仅同骨髓红系病态造血相关，也同巨核系病态造血相关。骨髓巨核系病态造血及其相关基因异常可能代表急性淋巴细胞白血病等多种恶性肿瘤的早期病变。而ｃ－ｅｒｂＢ重排及其相关的骨髓巨核系异常增生可能是肿瘤发病的遗传背景。