Testis Lesions and Cellular and Humoral Immune Responses Induced in Rats by Immunization With Laminin

ABSTRACT: Sixty-six percent of rats immunized with laminin isolated from a mouse Engelbreth-Holm-Swarm (EHS) sarcoma developed moderate lesions in the testis characterized by multiple foci of seminiferous tubules with different degrees of sloughing of the germinal epithelium or atrophy intermingled with normal histological areas. Interstitial mononuclear cell infiltrates were seen in the epididymis. By electron microscopy, pathological changes in the basement membranes of the seminiferous tubules, such as splitting and focal thickenings of knob-like projections toward the epithelium, were observed. Moreover, Sertoli cell cytoplasm showed dilated smooth endoplasmic reticulum and large vacuoles. By electron microscopy with the immunoper-oxidase technique, staining for in vivo-bound rat IgG was detected along the walls of the seminiferous tubules as a bright linear immunofluorescence and as a dense reaction product on the basal lamina. High titers of circulating antilaminin antibodies were detected by ELISA in all the rats immunized with laminin. As revealed by the skin test, a delayed type hypersensitivity reaction to laminin was observed in these rats.     

The Use of Cost‐Effectiveness Analysis for Pediatric Immunization in Developing Countries

Context: Developing countries face critical choices for introducing needed, effective, but expensive new vaccines, especially given the accelerated need to decrease the mortality of children under age five and the increased immunization resources available from international donors. Cost‐effectiveness analysis (CEA) is a tool that decision makers can use for efficiently allocating expanding resources. Its use in developing countries, however, lags behind that in industrialized countries. Methods: We explored how CEA could be made more relevant to immunization policymaking in developing countries by identifying the limitations for using CEA in developing countries and the impact of donor funding on the CEA estimation. We conducted a comprehensive literature search using formal search protocols and hand searching indexed and gray literature sources. We then systematically summarized the application of CEA in industrialized and developing countries through thematic analysis, focusing on pediatric immunization and methodological and contextual issues relevant to developing countries. Findings: Industrialized and developing countries use CEA differently. The use of the Disability‐Adjusted Life Year (DALY) outcome measure and an alternative generalized cost‐effectiveness analysis approach is restricted to developing countries. In pediatric CEAs, the paucity of evaluations and the lack of attention to overcoming the methodological limitations pertinent to children's cognitive and development distinctiveness, such as discounting and preference characterization, means that pediatric interventions may be systematically understudied and undervalued. The ability to generate high‐quality CEA evidence in child health is further threatened by an inadequate consideration of the impact of donor funding (such as GAVI immunization funding) on measurement uncertainty and the determination of opportunity cost. Conclusions: Greater attention to pediatric interventions and donor funding in the conduct of CEA could lead to better policies and thus more worthwhile and good‐value programs to benefit children's health in developing countries.     

ANTIBODY TO GASTRIC INTRINSIC FACTOR IN BLOOD DONORS AND HOSPITAL PATIENTS

Antibody to gastric intrinsic factor was detected in the serum of five of 700 hospital patients (0·7%) aged over 50 years, but in none of 400 hospital patients aged below 50 years and in none of 500 blood donors aged below 60 years. Four of these five patients were further investigated : all four had latent pernicious anæmia and two of the patients had extremely low serum levels of vitamin B₁₂ (30 and 60 pg. per millilitre). It is suggested that the presence of circulating intrinsic factor antibody in five of 700 hospital patients could indicate an overall incidence of latent pernicious anæmia in the vicinity of 1% in hospital patients aged over 50 years.