[Electron spin resonance tomography of the musculoskeletal system].
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Biomedical subjects
Publications and source records attributed to A J Veerman.
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Determinations of mononuclear cell subsets in cerebrospinal fluid (CSF), using monoclonal antibodies against surface antigens which identified pan T-cells, helper/inducer T-cells, cytotoxic/suppressor T-cells and Ia-positive cells, were performed in patients with multiple sclerosis (MS), other neuroimmunological diseases (NID), infectious diseases (INF) of the central nervous system and with other neurological diseases. Whereas there was an elevated helper T/suppressor T ratio in CSF of patients with NID (Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, cerebral vasculitis), no other significant differences could be detected between the different groups of patients. Our results suggest that analysis of these mononuclear cell subsets in CSF is not helpful in discriminating between MS and other neurological diseases and that in MS patients changes in disease activity are not clearly indicated by fluctuations in the different CSF cell subsets. Further studies will be needed to confirm our findings in NID patients and to understand the diagnostic and theoretical implications.
We studied the prognostic value of the enzymes acid alpha-naphthyl acetate esterase (ANAE) and acid phosphatase (AP) in 89 children with acute lymphoblastic leukemia (ALL). Follow-up data were available for 61 out of 67 cases of non T- non B-ALL, which were treated in different hospitals according to the same protocols. Sex, age, initial white blood cell count (WBC) and number of high risk patients (WBC above 25 X 10(9)/l) were comparable between enzyme-positive and -negative cases. The probabilities of complete continuous remission (CCR) were virtually identical in the AP+ and AP- group. For the ANAE+ group the probability of CCR was lower than for the ANAE- group, but this difference was not statistically significant (0.10 greater than p greater than 0.05). Within the common-ALL group (n = 32), no difference was found in probability of CCR between the AP+ and AP- group but ANAE+ cases had a significantly lower probability of CCR than ANAE- cases. This study is a contribution to the view that the cytochemical profile of ALL cells may have prognostic value.
In this study, nasal mucociliary clearance is investigated in patients with primary ciliary dyskinesia, patients with other respiratory tract infections and healthy persons. Mucociliary clearance is established with a drop of albumen labelled with 99m-Tc. From this study it appears that measurement of mucociliary clearance in the nose can serve as a reliable screening method. If a patient with respiratory tract infections shows a normal mucociliary clearance rate there is no primary ciliary dyskinesia, and a biopsy of ciliated epithelium is not necessary. If, after repeated examinations, a normal clearance rate cannot be demonstrated, a biopsy of ciliated epithelium should be taken for studying ciliary activity and ciliary ultrastructure.
Motility of leukemic cells was measured in a three-dimensional collagen matrix assay. Leukemic cells from 16 children with acute lymphoblastic leukemia (ALL) and normal peripheral blood lymphocytes (NPBL) from 6 healthy volunteers, were allowed to migrate into this collagen matrix for 48 h at 37 degrees C. NPBL migrated much further (300-600 micron) than leukemic cells (0-200 micron). Among the leukemic cases, only common ALL and one case of null ALL showed some migration (0-200 micron). T-All cells did not migrate at all under the circumstances of this experiment.
A case of hypertrophic osteoarthropathy is reported in a 3-year-old Turkish girl. She had combined immunodeficiency, later shown to be the bare lymphocyte syndrome, and chronic pneumonia. Lung biopsy showed cytomegalovirus. The child developed painful elbow and knee joints and hypertrophic osteoarthropathy was demonstrated radiologically.
Capping of leukemic cells with a monoclonal antibody against HLA A,B,C determinants was studied in 53 cases of childhood acute lymphoblastic leukemia (ALL). Determination of the percentages of capped cells after different times of incubation with anti-HLA A,B,C show that T ALL and common ALL do have quite different kinetics of HLA capping. In T ALL all cases reach levels of percentage of capped cells above 30%, in common ALL only 11 of 31 cases cap well. Dilution of the antiserum in 6 common ALL cases results in an increase of capped cells, but the original kinetics of the common ALL capping remain. ALL cases with capping curves above 30% have a worse prognosis (shorter continuous complete remission) than cases with capping curves below 30% in the total group as well as in the non-high-risk group.
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The effect of cryopreservation on human nasal mucosal biopsies was evaluated by determining the frequency and coordination of the ciliary beat. Samples were cryopreserved in a medium containing 80% Gey's balanced salt solution, 10% dimethyl sulfoxide, and 10% fetal calf serum. After thawing, the samples were put in a solution of 90% Gey's balanced salt solution and 10% fetal calf serum. Video recordings of the samples before and after cryopreservation were compared using a semiquantitative method. All the frequencies and coordination patterns seen before cryopreservation could be found in the sample after cryopreservation. It is concluded that ciliated epithelial biopsies can be stored in liquid nitrogen with the maintenance of ciliary beat frequency. In the recorded ciliated cells the ciliary beat coordination was slightly reduced; a lack of coordination was present in 20% of cells after cryopreservation as compared to 10% before cryopreservation.
The immunological phenotype of cells in the cerebrospinal fluid (CSF) was determined with immunoperoxidase techniques. A medium was used which allowed cells to stand at room temperature for 24 h without appreciable loss of cells. From 62 patients a total number of 208 CSF specimens were analysed. It proved possible to perform 4 determinations and a control reaction on 2.5 ml of CSF: cell count, cytology, E-rosetting and staining with a monoclonal antibody, provided that more than 1 cell per mm3 were present. This study focussed on the presence of the common acute lymphoblastic leukemia marker (cALL, determined with the monoclonal antibody J5). All 21 CSF specimens containing more than 5% cALL positive cells were from patients with an initial diagnosis of common ALL, 8 of these samples were considered to be normal and 3 uncertain by standard cytological criteria. Six of the 8 samples which were cytologically normal, were from patients who had clear meningeal involvement at diagnosis, or developed a relapse later. There were no patients who developed a meningeal relapse on cytological criteria that was not detected by immunocytology. In one patient a cytological diagnosis of meningeal relapse was not confirmed by immunocytology, this patient is disease free 2 yr later without cytostatic treatment. Immunoperoxidase methods to detect cALL positive cells in CSF are an invaluable aid to the diagnosis of meningeal leukemia.
5'-Nucleotidase (5'NT) is an enzyme found on the surface membrane of leukemic cells with the c-ALL phenotype. We studied 79 children with acute lymphoblastic leukemia (ALL). Thirty six of them had the c-ALL phenotype. Within this c-ALL group, ten had 5'-NT positive leukemic cells. Clinical data were available in 33 c-ALL cases. Sex, age and initial white blood cell count were comparable between 5'NT positive and 5'NT negative c-ALL cases. In the 5'NT positive group the probability of complete continuous remission was significantly lower than in the 5'NT negative group (p less than 0.05).
The value of serial determination of the cerebrospinal fluid (CSF) beta-2-microglobulin (Beta 2m) level for early detection of acute lymphoblastic leukemia (ALL) in the central nervous system (CNS) has been prospectively studied in 30 children. Beta 2m was determined by micro-ELISA assay. Results demonstrated a sensitivity of 40% (95% confidence interval, 5.3-85.3%) and a predictive value of 8% (95% confidence interval, 1.0-26.0%). In post-irradiation syndrome, as well as in viral infection with cytopathological changes of white cells in CSF, beta 2m values proved to be significantly higher than in incipient CNS relapse, and these conditions, or an unknown cause, are more often associated with beta 2m elevation than CNS relapse. No relation was found between CSF white cell counts and beta 2m levels. It is concluded that beta 2m is not an appropriate test for early detection of CNS involvement in children with acute lymphoblastic leukemia.
In 96 cases of childhood acute lymphoblastic leukemia (ALL), handmirror cells (HMCs) were counted in cytospin preparations of washed lymphoblasts obtained at diagnosis. HMC counts were significantly lower in T-ALL as compared to C-ALL (p less than 0.001). In T-ALL and pre-T-ALL 2/35 cases had more than 10% HMCs; in C-ALL 22/41 cases had more than 10% HMCs. In two cases of B-ALL 19% and 36% HMCs were found. Thus, HMC expression in ALL is related to the immunological phenotype, especially found in ALLs originating along the B-cell lineage.
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The density of HLA determinants on the cell surface was studied in relation to HLA capping in childhood acute lymphoblastic leukemia (ALL). Analysis was performed with flow cytometry (FACS) and a subjective labeling score. These two methods gave comparable results. In T-ALL high percentages of capped cells were related to low numbers of HLA determinants. In c-ALL we found the opposite. This study shows that capping capacity and number of HLA determinants in childhood ALL are inversely related.
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Peanut agglutinin (PNA) binding was studied in cells from 74 children with acute lymphoblastic leukemia (ALL). PNA positivity occurred in 50% of T-ALL (12 of 24) and was rare in other types of ALL. There was no clear relationship between PNA and initial white blood cell count, French-American-British classification, stage of differentiation of leukemic cells, hand mirror cells, and organomegaly at diagnosis. Prognosis, however, was significantly better (continuous complete remission, death) in the PNA-positive T-ALLs. It seems that PNA is a useful marker for a subgroup of T-ALL with a better prognosis.
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