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Biomedical subjects

E Naparstek

Publications and source records attributed to E Naparstek.

At least 127 records · Page 7Linked to original sources

Diagnosis of iron deficiency anemia in a rural population of children. Relative usefulness of serum ferritin, red cell protoporphyrin, red cell indices, and transferrin saturation determinations.

The diagnostic usefulness in iron deficiency anemia of serum ferritin, red cell protoporphyrin (Epp), mean corpuscular volume, mean corpuscular hemoglobin (MCH), and transferrin saturation measurements has been studied in a population of 294 children aged 1 to 6 yr. Of the children studied 19% had hemoglobin below 11 g/dl. Iron deficiency, diagnosed by at least two abnormal independent laboratory parameters, was the cause of anemia in all except two cases. The Pearson correlation coefficient for hemoglobin was highest with MCH, followed in decreasing order of magnitude by MCV, Epp, transferrin saturation, and finally by ferritin. Sensitivity and specificity were highest for MCH and lowest for ferritin. Of anemic, iron deficient individuals 97 to 100% could be identified by low MCH, 88 to 100% by transferrin saturation, 66 to 83% by ferritin, and 61 to 74% by Epp. In contrast, only 0 to 6% of normal, nonanemic individuals had low MCH, 0 to 4% had high Epp, but 21 to 39% had low transferrin saturation and 25 to 39% had low ferritin. Although reduced serum ferritin in anemic individuals is good evidence of iron deficiency, a significant proportion of anemic iron-deficient patients is missed by this procedure rendering it less useful than other, less expensive laboratory methods.

Age Factors↗

Establishment in continuous culture of a T-lymphoid cell line (HD-Mar) from a patient with Hodgkin's lymphoma.

A new cell line, HD-Mar, was established from a pleural effusion of a patient with Hodgkin's lymphoma. Formation of E rosettes, sensitivity to anti-T serum, elevated terminal deoxynucleotidyl transferase activity, presence of T-cell and the common ALL membrane antigens, morphology, and cytochemical staining indicate that the HD-Mar line is of thymic derivation. Absence of any immunoglobulin determinants, the lack of EBNA or any other EBV-associated antigen or function are also characteristics associated with established T-cell-derived lymphoma cell lines. Karyotype analysis indicated a tetraploid origin of the cell line.

Adult↗

Anemia among Druze children in the Golan Heights.

The prevalence and causes of anemia were studied in 294 Druze children aged 10 months to six years. The hemoglobin level was less than 11.0 g/dl in 19%; none of these anemic children had folate deficiency. Iron deficiency, diagnosed on the basis of abnormal values for at least two independent laboratory parameters, was the cause of anemia in all but two cases. The Pearson correlation coefficient for hemoglobin was highest with mean corpuscular volume, erythrocyte protoporphyrin, serum iron, transferrin saturation, total-iron-binding capacity, and serum ferritin. Mean corpuscular hemoglobin and transferrin saturation were abnormal in greater than 90% of anemic children, whereas serum ferritin and total-iron-binding capacity were abnormal in only 70%. In view of its limited sensitivity, serum ferritin appears to be a less useful diagnostic aid in iron-deficiency anemia than other, less expensive laboratory methods.

Anemia, Hypochromic↗

Cytogenetic investigation of leukemic and preleukemic disorders.

Banding chromosome analysis was performed on 35 bone marrow aspirates from patients with various leukemic and nonleukemic hematologic disorders. Of these, 24 had normal karyotypes, while 11 demonstrated various chromosomal abnormalities. Several of the abnormalities have been previously observed and support the concept of nonrandom involvement of specific chromosomes in aberrations associated with hematologic conditions. In addition, some unique abnormalities were demonstrated in three cases: monosomy 1, trisomy 22, and premature chromosome condensation.

Adult↗

Acute lymphoblastic leukemia. Its occurrence with hypereosinophilic syndrome' and bilateral spontaneous pneumothorax.

A patient with acute lymphoblastic leukemia had an unusual prodrome, including clinical features of "hypereosinophilic syndrome," pulmonary infiltrates, and bilateral spontaneous pneumothorax, which preceded the onset of leukemia by four months. The mechanism for the production of eosinophilia may have been related to the production of eosinopoietic factors by the leukemic cells.

Adolescent↗

Granulocyte transfusion therapy: a clinical trial in patients with acute leukemia and sepsis.

The effect of granulocyte transfusions on the course of infection in patients under treatment for acute leukemia was evaluated by comparing 19 febrile episodes in 15 patients receiving antibiotics alone with 18 febrile episodes in 13 patients receiving antibiotics in combination with granulocyte transfusions from ABO-matched donors. Both groups had a similar age, sex distribution and duration of disease prior to the febrile episode. About two-thirds of the patients in both groups had acute myeloblastic leukemia. 94% of the patients in the transfused group and 74% of the control group survived the febrile episode. In patients with positive blood cultures all transfused patients survived as compared to only 57% in the control group (p=0.05). In patients with persistent bone marrow failure 92% of the transfused patients survived as compared to 73% in the control group. Granulocyte transfusions had no effect on the outcome of febrile episodes in patients with negative blood cultures or early recovery of marrow function. These data appear to support the contention that granulocyte transfusions are beneficial in patients with blood culture-proved sepsis with persistent neutropenia.

Adult↗

Idiopathic pericarditis and pregnancy.

The association of idiopathic pericarditis and pregnancy is described in 3 patients. The disease preceded the onset of pregnancy in 2 patients and appeared during the sixth month in the third. All pregnancies reached term and the deliveries were uneventful. One patient had mild heart failure before the pregnancy. This deteriorated slightly during its course. The remaining 2 patients had no signs of heart failure and none of the 3 had arrhythmias or embolic phenomena. Two patients were treated with aspirin and prednisone and one was treated for heart failure only. All patientts are still symptomatic and require treatment 9 months, 1 year and 21 years after the pregnancy. Two of the patients underwent partial pericardiectomy.

Adult↗

Multiple myeloma terminating in lymphocytic leukemia with B-lymphocyte membrane markers.

The development of lymphocytic leukemia with a rapidly fatal clinical course is reported in a patient with kappa light-chain multiple myeloma treated with alkeran. The leukemic cells lacked the ultrastructural features of plasma cells but bore readily detectable B-cell markers and resembled lymphocytes under the light, transmission, and scanning electron microscopes. The leukemic phase is perhaps best defined as lymphocytic and probably represents a variant of plasma cell leukemia, in which the cells showed a degree of dedifferentiation from plasma cells to B lymphocytes. The possible relation between these 2 proliferative processes is discussed and the nature of leukemias developing in cases of plasma cell myeloma is briefly reviewed.

B-Lymphocytes↗

Time-related increase in leucocyte yields by continuous-flow centrifugation (CFC) leukopheresis.

Continuous flow centrifugation leukopheresis lasting 3 to 4 h was performed 18 times on 16 normal donors. The total yield of leucocytes collected was 1.59 +/- 0.14 x 10(10) (mean +/- SE). Comparison of leucocyte yields on the first, second, third and fourth hour of leukopheresis indicated a progressive increase with time in 15 out of 18 procedures, with 3.6 times more leucocytes collected within the last hour of leukophoresis as compared to the first hour. This increase was independent of the volume of leucocytes collected per unit time, since an equally significant increase was found when calculated per 100 ml of leucocyte concentrate. Although the mechanism of this improvement in yield with time is unknown, the present data indicate, that moderate prolongation of the duration of leukopheresis may result in an increase in efficiency which is comparable to that produced by the use of hydroxyethyl starch, etiocholanolone or corticosteroids.

Blood Transfusion↗

Alveolar rhabdomyosarcoma presenting as subacute intravascular coagulation.

A patient with rhabdomyosarcoma is described in whom the presenting clinical and laboratory features were those of disseminated intravascular coagulation. The patient's rapid downhill course was primarily expressed by haemorrhagic tendency. An alveolar rhabdomyosarcoma, affecting many organs, including vascular and cardiac lumina, was found at necropsy and was considered to be the cause of the consumption coagulopathy.

Adult↗

Fluidity of membrane lipids and lateral mobility of concanavalin A receptors in the cell surface of normal lymphocytes and lymphocytes from patients with malignant lymphomas and leukemias.

Lymphocytes isolated from the peripheral blood of patients with nonmalignant and malignant disorders were studied for fluidity of membrane lipids and lateral mobility of concanavalin A (Con A) receptors. The degree of fluidity of the surface membrane lipid core was monitored quantitatively by fluorescence polarization analysis using the probe 1,6-diphenyl-1,3,5-hexatriene embedded in lipid regions of the surface membrane of intact cells. Mobility of Con A surface receptors was determined by the cap-forming ability after binding of fluorescent Con A. The present studies were performed on lymphocytes from 28 patients with malignant lymphomas, 22 patients with leukemia, 28 individuals who either were healthy or had nonmalignant disorders, and 5 patients with carcinoma. The results showed that lymphocytes and mononuclear cells from patients with malignant lymphomas and leukemias have a more fluid lipid layer in their surface membrane than do lymphocytes obtained from healthy individuals or from patients with other malignant and nonmalignant disorders. This increase in membrane fluidity was less pronounced in lymphocytes isolated from leukemic patients in clinical remission and from leukemic patients receiving treatment with steroids. The results also show a marked difference in the cap-forming ability of lymphocytes from patients with malignant lymphomas or leukemia as compared with lymphocytes from patients with non-malignant disorders or carcinoma. Lymphocytes isolated from lymphoma and chronic lymphatic leukemia patients during remission stages of the disease exhibited a higher cap-forming ability. The cap-forming ability of cells from patients with chronic lymphocytic leukemia was unaffected by treatment with steroids. The present results, which are in line with previous observations, have shown that normal lymphocytes can be characterized by a low degree of lipid fluidity but a high degree of mobility of Con A receptors, whereas leukemic lymphocytes are characterized by a high degree of lipid fluidity but a low degree of mobility of Con A receptors. These results confirmed our general hypothesis on the dynamic interrelation between membrane lipids and membrane protein receptors, and they indicate that the widely accepted term "membrane fluidity" requires better consideration for different membrane components.

Carcinoma↗

Donor lymphocyte infusions to displace residual host hematopoietic cells after allogeneic bone marrow transplantation for beta-thalassemia major.

PURPOSE: Donor lymphocyte infusion (DLI) was used to reverse relapse after allogeneic bone marrow transplantation (BMT) in a patient with beta-thalassemia major. PATIENTS AND METHODS: The patient with unstable mixed chimerism after BMT was treated with graded increments of donor lymphocytes (10(5) T cells/kg to 5 x 10(7) T cells/kg) to displace residual hematopoietic host cells. RESULTS: DLI resulted in complete donor-derived reconstitution of the hematopoietic compartment. The patient developed mild graft-versus-host disease (GVHD) that could be controlled by steroid treatment. CONCLUSIONS: This case report shows that DLI can effectively eradicate host stem cells in mixed chimeras after BMT in nonmalignant hematopoietic diseases.

Bone Marrow Transplantation↗

New approaches for the prevention of rejection and graft-vs.-host disease in clinical bone marrow transplantation.

The two major barriers to successful allogeneic bone marrow transplantation (BMT) in animals and man are graft-vs.-host disease (GVHD) and the risk of graft rejection. GVHD is the result of alloreactivity of mature donor T-lymphocytes present in the graft-vs.-host tissues and can be completely prevented by pregraft depletion of T-lymphocytes. Graft rejection results from residual host immunocompetent lymphocytes that survive heavy chemoradiotherapy prior to allogeneic BMT. Host resistance to allograft cannot be eradicated even by conventional conditioning with high-dose cyclophosphamide (120 mg/kg) and lethal whole body irradiation (1,200 rad). In the present report we have utilized two new techniques to overcome GVHD and graft rejection following allogeneic BMT. GVHD can be prevented by a new monoclonal rat antihuman lymphocyte antibody, CAMPATH-1, which binds human complement, enabling donor serum to serve as the source of complement. Prevention of rejection of T-lymphocyte-depleted marrow allografts can be achieved by the application of total lymphoid irradiation (TLI) in addition to conventional chemoradiotherapy, prior to allogeneic BMT. TLI causes potent immunosuppression with minimal side effects. A combination of TLI for overcoming host resistance to allograft, and CAMPATH-1 for overcoming GVHD, leads to a relatively smooth posttransplant outcome with no evidence of GVHD and with no need for posttransplant immunosuppression.

Antilymphocyte Serum↗