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Biomedical subjects

C R Taylor

Publications and source records attributed to C R Taylor.

At least 235 records · Page 13Linked to original sources

Kaposi's sarcoma and autoimmune thrombocytopenia.

Outbreaks of Kaposi's sarcoma, opportunistic infections, and autoimmune thrombocytopenia among homosexual men have recently been described. We report here a case with the combination of Kaposi's sarcoma and autoimmune thrombocytopenia. Our patient presented with Kaposi's sarcoma limited to the integument and autoimmune thrombocytopenia diagnosed by elevated platelet bound IgG. Characteristics of immunosuppression included lymphocytopenia and a reversed blood helper:suppressor T lymphocyte ratio. Immunohistochemical evaluation of skin biopsy specimens revealed tumor cells to contain Factor VIII-related antigen (a vascular endothelial cell marker). In addition some tumor cells stained positively with a monoclonal antibody directed against a cytomegalovirus antigen.

Adult↗

Mononuclear lymphoid populations infiltrating the microenvironment of primary CNS tumors. Characterization of cell subsets with monoclonal antibodies.

Mononuclear cell infiltrates are found to varying degrees in 30% to 60% of primary human central nervous system (CNS) gliomas. To explore the immunological importance of this, six operative glial tumors, eight non-glial tumors, and three normal brain specimens were studied. Utilizing an immunoperoxidase method, the authors examined frozen sections for lymphoid infiltrates expressing suppressor/cytotoxic and helper phenotypes, as identified with the Leu-1,2,3 monoclonal antibodies. Four of six gliomas demonstrated lymphoid infiltrates: three tumors exhibited a predominant suppressor/cytotoxic cell phenotype and the fourth showed mixed staining of suppressor/cytotoxic and helper cell phenotypes. Varying degrees of lymphoid infiltration characterized four out of eight non-glial primary CNS tumors. Two cases exhibited a prevalence of suppressor/cytotoxic phenotype cells, while two cases demonstrated a more heterogeneous pattern of phenotype expression. Normal brain sections revealed little or no evidence of mononuclear infiltrates. The immunobiological significance of these findings is discussed in the context of tumor-host interaction within the CNS.

Antibodies, Monoclonal↗

Development of B-cell lymphoma in homosexual men. Clinical and immunologic findings.

Serious infections, neoplasms, and immunologic abnormalities have been found in homosexual men. We describe the development of malignant lymphoma in six such patients, three of whom had persistent, generalized lymphadenopathy. In biopsies done before the lymphoma developed, the lymphadenopathy was characterized morphologically by a distinctive pattern of B-cell follicular hyperplasia. All lymphomas were of B-lymphocytic origin, including B-cell immunoblastic sarcoma; small noncleaved, Burkitt-like lymphoma; and plasmacytoid lymphocytic lymphoma. Extranodal presentation with B symptoms occurred in five patients. Median age of our patients was 33 years. Three patients had histories of repeated systemic infections. The peripheral blood lymphocyte count was depressed in four, with depression of OKT 4+ (helper phenotype) cell levels and reversal of the T-helper: T-suppressor ratio in all. We conclude that these patients are at risk for the development of abnormalities of the B-lymphocytic system, manifested by abnormal hyper-B-cell response in enlarged reactive lymph nodes and aggressive, extranodal B-cell lymphomas.

Adult↗

In situ identification of cells in human leprosy granulomas with monoclonal antibodies to interleukin 2 and its receptor.

Leprosy is a chronic granulomatous disease with an immunologic spectrum in which lepromatous leprosy patients have defective cell-mediated immune responses, in comparison to tuberculoid leprosy patients. Immunoregulatory aspects of this spectrum were investigated by using monoclonal antibodies to interleukin 2 (IL 2), IL 2 receptors (Tac), and T lymphocyte subpopulations with immunoperoxidase techniques on frozen sections of skin biopsy specimens from 10 tuberculoid and 10 lepromatous patients. A comparison of IL 2+ cells revealed markedly fewer IL 2+ cells in lepromatous specimens (lep. 0.028% +/- 0.02 vs tub. 0.46% +/- 0.28, p less than 0.001). These IL 2+ cells were large, exhibited cytoplasmic staining, and on double immunostaining were Leu-4+, Leu-3a+, Leu-2a-, Tac-, and OKT6-, consistent with the fact they are IL 2 producers. Equivalent numbers of Tac+ cells were observed in both lepromatous and tuberculoid granulomas (lep. 1.5% +/- 0.5 vs tub. 2.1% +/- 0.7, p, NS), suggesting that the responder cells are present in both conditions. The tuberculoid granuloma was highly organized, composed of a central core of mature macrophages, Leu-3a+ and Tac+ cells with a surrounding mantle of Leu-2a+, Leu-3a+, IL 2+, Tac+, and OKT6+ cells. In lepromatous granulomas, Leu-2a+, Leu-3a+, Tac+, and rare IL 2+ cells were randomly admixed with bacilli-laden macrophages. The defective cell-mediated immune responses in lepromatous leprosy appears to be associated with diminished IL 2 production and disorganization of the granuloma.

Antibodies, Monoclonal↗

Granuloma annulare. Identification of cells in the cutaneous infiltrate by immunoperoxidase techniques.

To characterize the immunopathologic process of granuloma annulare, frozen sections of eight specimens were evaluated with monoclonal antibodies directed against T lymphocytes and the monocyte-macrophage series, in conjunction with immunoperoxidase techniques and with histochemical staining. The predominant lymphocyte was an activated T lymphocyte (Leu 1+, HLA-Dr+) with an excess of helper-inducer phenotype (Leu 3a+), as compared with suppressor-cytotoxic phenotype (Leu 2a+). OKT-6+ Langerhans' cells were observed in the epidermis, and numerous OKT-6+ cells were observed in the perivascular and granulomatous infiltrate. The use of four monoclonal antibodies, having specificity against peripheral blood monocyte antigens, revealed three different staining patterns in the granulomas. Finally, mast cells were present in perivascular and granulomatous infiltrates. Our results demonstrate that the cutaneous infiltrate of granuloma annulare contains all of the principal cell types that characterize cell-mediated immune responses.

Antibodies, Monoclonal↗

Immunohistochemical study of the expression of human milk fat globule membrane glycoprotein 70.

Human milk fat globule membrane, which is said to derive from apical plasma membrane of secretory epithelial cells in breast, was analyzed by sodium dodecyl sulfate-two:dimensional gel electrophoresis. More than 35 components were detected in the gels. One of the major glycoproteins with an apparent molecular weight of 70,000, human milk fat globule membrane glycoprotein, was purified to homogeneity. The pattern of distribution of this glycoprotein in tissues was studied using polyclonal rabbit antibodies to the purified component. The localization of the antigen was accomplished by an indirect immunoperoxidase staining method. Normal mammary epithelial cells display this antigen mostly on the apical plasma membrane, whereas poorly differentiated breast carcinoma cells retained it predominantly in the cytoplasm. These observations suggest that the proper insertion of this glycoprotein into an apical membrane domain may be impaired in malignant tumor cells. In addition, a small population of tumor cells in each case examined failed to express detectable amounts of this component, indicating the presence of antigenic heterogeneity among the tumor cell population.

Antigens↗

Ontogeny of B cell markers in the human fetal liver.

Human fetal liver was examined during various stages of gestation for the presence of B cells by using immunoglobulin isotype markers and monoclonal B cell antibodies. Frozen sections were studied with the use of single and double staining methods. The B cell monoclonal antibodies used were BA1, which defines both mature and immature B cells; B1, which identifies mature B cells; and B532, which binds to activated mature B cells. The data indicate that both BA1 and mu+ cells are present at 12 wk gestation, and increase in frequency with age. Delta and B1-bearing cells are detected only later in fetal life. Phenotypically identifiable T cells are present at low frequencies in the fetal liver throughout the time period examined (12 to 21 wk). At 12 to 13 wk gestation, the numbers of kappa- and lambda-chain-positive cells are two to three times greater than the number of mu+ cells. Based on morphology and staining with OKM1, these light chain-bearing cells appear to be non-lymphoid, most likely cells of macrophage origin that have phagocytosed maternal IgG. Our results show that the monoclonal antibodies reacting with subsets of B cells in adults can also be used to define distinct subsets of B and pre-B cells in the fetal liver.

Antibodies, Monoclonal↗

T-lymphocyte subsets in lymph nodes from homosexual men.

To evaluate further the immunodeficiency of homosexual men, blood and lymph node specimens were obtained from five homosexual men with lymphadenopathy and from seven homosexual men with Kaposi's sarcoma. Monoclonal antibodies were used to identify T-lymphocyte subsets in blood by cytofluorometry and in frozen sections of nodes by immunoperoxidase techniques. The homosexuals with Kaposi's sarcoma had a T-helper/suppressor ratio in blood of 0.7; the homosexuals with lymphadenopathy had a ratio of 0.6, compared with controls of 2.1. Control lymphoid tissue had a ratio of 3.0 in the interfollicular areas compared with the reactive lymph nodes in the homosexuals with lymphadenopathy, which was 0.7, and nodes from patients with Kaposi's sarcoma, 0.9. The nodes from homosexual men had evident numerous suppressor cells in the follicular center and mantle regions, locations in normal lymphoid tissue where suppressor cells were uncommon.

Flow Cytometry↗

Acute and long-term hemodynamic effects of oral pirbuterol in patients with chronic severe congestive heart failure: randomized double-blind trial.

In 20 patients with severe congestive heart failure (CHF), we studied the effects of the beta-adrenergic agonist pirbuterol compared to placebo in both an acute double-blind randomized trial and after long-term treatment. Acutely, pirbuterol patients (n = 10) demonstrated a significant rise in cardiac index (2.2 +/- 0.14 to 3.2 +/- 0.32 L/min/m2), stroke index (26 +/- 2.6 to 35 +/- 2.9 ml/beat/m2), stroke work index (22 +/- 2.4 to 30 +/- 2.7 gm X m/m2), and ejection fraction (22 +/- 4 to 30 +/- 5%). These hemodynamic variables did not significantly change in placebo patients (n = 10). After 3 weeks of pirbuterol therapy, 14 patients (70%) were symptomatically improved and were continued on the drug for another 3 weeks; 13 of 14 patients who were symptomatically improved underwent restudy. Compared to pretreatment baseline, there was continued improvement in cardiac index (2.5 +/- 0.16 to 3.2 +/- 0.24 L/min/m2), stroke index (30 +/- 2.5 to 38 +/- 2.9 ml/beat/m2), stroke work index (26 +/- 2.3 to 35 +/- 3.1 gm X m/m2), and ejection fraction (24 +/- 1 to 28 +/- 4%). Patients more frequently improved were those with nonischemic cardiomyopathy and those with higher initial ejection fractions. These results demonstrate the acute beneficial effects of oral pirbuterol versus placebo in a double-blind randomized trial. Improvement was maintained during long-term therapy in the majority of CHF patients.

Administration, Oral↗

Effect of trimazosin on serum lipid profiles in hypertensive patients.

Abnormalities in the serum lipid profile correlate strongly with the presence and severity of atherosclerosis. Increases in serum lipids and a reduction in high-density lipoprotein (HDL) cholesterol have been demonstrated following treatment with some beta blockers and diuretics, either alone or in combination. A new alpha-1-adrenoceptor antagonist, trimazosin, was studied to determine its effects on serum lipids. Ninety-six hypertensive patients were randomly assigned in double-blind fashion to trimazosin or placebo for 8 weeks. Trimazosin was associated with a significant reduction (p less than or equal to 0.01) in total cholesterol when compared with the placebo group. This effect was seen in all patients regardless of whether or not they were taking a diuretic concomitantly. In addition, a 9-month, double-blind parallel comparison was made of trimazosin and propranolol. Trimazosin was found to be superior to propranolol in its effect on HDL cholesterol and the HDL/total cholesterol ratio. These studies have demonstrated that, in contrast to placebo and propranolol, trimazosin lowers total serum cholesterol without undesirable effects on other serum lipid fractions. When polythiazide is given concomitantly, it diminishes the favorable effects of trimazosin and accentuates the opposite, adverse effects of propranolol.

Antihypertensive Agents↗

Profile of trimazosin: an effective and safe antihypertensive agent.

Trimazosin, a selective alpha-1-adrenoceptor-blocking agent, has been extensively evaluated in over 1000 patients. In hypertensive patients, reduction in elevated blood pressure in both supine and standing positions, consequent to a reduction in systemic vascular resistance, persisted in long-term therapy. Progression of hypertension target organ damage did not occur. Improvement in blood lipids with decreased total serum cholesterol was noted in long-term therapy. In long-term studies, 74% of patients responded at a trimazosin dose of 300 mg/day or less; the maximum dose was 300 mg/day or less in 52% of patients and 200 mg/day or less in 36%. Most patients received twice a day therapy. The side effect profile of trimazosin was comparable to placebo and significantly better than that of either methyldopa or propranolol. Concomitant disease or therapy did not adversely affect the trimazosin safety profile. Hematology, clinical chemistry, and urinary parameters did not indicate deleterious effects. Because of its excellent safety and toleration profile, trimazosin may be particularly suitable in first-line therapy of patients with mild or moderate hypertension.

Antihypertensive Agents↗

Maximal oxygen consumption and pulmonary diffusing capacity: a direct comparison of physiologic and morphometric measurements in canids.

The purpose of this study was to check the validity of the morphometric model for estimating physiological conductances for gases, DL. We make a direct comparison between the lung's conductance for carbon monoxide, measured physiologically using the single breath method, DLCO (sb), and that measured morphometrically using the previously published model, DLCO(mm). We also make a direct comparison between the maximum rate of oxygen uptake by the lung during exercise, VO2max, and the lung's conductance for oxygen DLO2(mm). We made these measurements on four species of canids (foxes, coyotes, dogs and wolves). We find a direct proportionality between morphometric and physiologic DLCO measurements, the morphometric being consistently larger by a factor of two. We also find that both DLCO and DLO2 increase more steeply with body mass than VO2max, the difference between the allometric slopes being the same as we had found previously in a wide range of mammalian species ranging from 2 g to 700 kg, although the slopes themselves were different. We conclude that the discordant scaling of DLO2 and VO2max with respect to body mass is not an artifact of the model for calculating DLO2 from morphometric data.

Animals↗

Immunohistologic diagnosis of 2 cases of metastatic prostate cancer to breast.

We report 2 cases of primary prostatic carcinoma with subsequent carcinomatous lesions in the breast. Prostatic origin of these carcinomas was confirmed by immunocytochemical demonstration of prostatic acid phosphatase and prostate specific antigen within paraffin sections. Previously, only 20 cases of prostatic carcinoma metastatic to the breast have been reported in the literature. In most of these cases the designation of the breast lesion as prostatic carcinoma has been made on morphologic and clinical grounds only.

Acid Phosphatase↗

T lymphocyte subsets in the skin lesions of patients with leprosy.

Lymphocyte subsets in the tissues of fourteen patients with leprosy were studied using monoclonal antibodies and a modified immunoperoxidase technic. Two immunohistologic patterns were observed. In tuberculoid leprosy, helper-inducer cells were present among the aggregates of mononuclear phagocytes (epithelioid cells), but the suppressor-cytotoxic cells were predominantly in the lymphocytic mantle surrounding the epithelioid cell aggregates. In reversal reaction and lepromatous tissues, the helper-inducer and the suppressor-cytotoxic cells were both distributed among the mononuclear phagocytes (histiocytes). In tuberculoid specimens the Langerhans cells of the epidermis were increased in number as compared to lepromatous and normal tissues. The technic used appears to be of value in studying some of the cellular components of the immune response in situ.

Antibodies, Monoclonal↗

Kaposi's sarcoma in homosexual men: an immunohistochemical study.

A recent outbreak of disseminated Kaposi's sarcoma has been recognized in homosexual men in New York, San Francisco, and Los Angeles. Biopsy specimens of skin lesions were obtained from nine of these homosexual men in Los Angeles and San Francisco. T lymphocyte subset antigens, factor VIII-related antigen, and HLA-Dr antigen were evaluated in situ in frozen sections using immunoperoxidase technics. Factor VIII-related antigen and HLA-Dr antigen were present on tumor cells, supporting a vascular endothelial origin of this neoplasm. Langerhans cells and T lymphocytes were present in numbers similar to that of normal skin in skin specimens from seven patients with Kaposi's sarcoma with visceral dissemination, but were increased in specimens from two patients with only cutaneous involvement.

Antigens↗