Granulocyte transfusions in relation to HLA antigens [proceedings].
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Biomedical subjects
Publications and source records attributed to M Dietrich.
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The influence of the bacterial flora of the intestine and of cytostatic drugs on the intestinal xylose and glucose absorption in the rat is studied by a perfusion technique in vivo. Conventional, germfree and decontaminated animals show no different xylose absorption rates while the galactose absorption is decreased in germfree and decontaminated animals compared to conventional rats. Three days after a single injection of cytostatic drugs the xylose absorption is diminished in conventional and decontaminated animals compared to untreated rats. In germfree rats no effect of cytostatics on the xylose absorption can be proved. The galactose absorption is unchanged after cytostatics in conventional and decontaminated animals, but increased in germfree rats.
Hemoperitoneum as a result of spontaneous rupture of the liver occurred in a 28-year-old woman who had been takingoral contraceptives for 7 years. The hemorrhage occurred between a benign tumour and the liver and was treated by left hepatic lobectomy. The pathologic aspects of this tumour are discussed and the current literature is reviewed. Conservative excision compatible with hemostasis is the recommended treatment.
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Bone-marrow transplantation (BMT) from an unrelated, HL-A-phenotype-identical, MLC-negative donor was performed in a 31 year old woman with severe longlasting aplastic anemia. In vitro assays failed to demonstrate humoral or cellular sensitization of the recipient against donor-type antigens. Following conditioning with cyclophosphamide, prompt but only transient engraftment of the transplant occurred accompanied by signs of mild graft-versus-host-disease (GVHD) of the liver. The results of a second bone marrow transplantation from the same donor cannot be evaluated due to early death of the recipient. It is concluded that bone marrow from unrelated, HL-A and MLC-identical donors may engraft without severe GVHD. Rejection of the graft in our patient may have been related to greater antigenic differences that can be expected to exist between HL-A and MLC-identical unrelated individuals than between HL-A and MLC-identical siblings. However, insufficient preparative immunosuppression with cyclophosphamide due to severe hepatic hemosiderosis appears equally likely as the cause of graft rejection. The possibly increased risk of graft rejection or severe GVHD should not preclude the use of unrelated HL-A and MLC-identical marrow donors, when histocompatible sibling donors are not available; but more potent immunosuppressive regimens than the cyclophosphamide protocol may be necessary to ensure permanent engraftment.
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Human lymphoid cells grown in long-term tissue culture have been used to study the cytotoxic effects of the combination of vincristine and prednisolone. The potentiating effects of this drug combination in vitro cannot be consistently shown if the drugs are addeded without attention to the growth rate of the cultured population. If the cultured cells have achieved maximum density and have remained at this density for more than 24hr, they are readily killed by vincristine alone and no further kill is achieved by adding prednisolone. Rapidly growing cell cultures, however, are relatively ristant to vincristine. The addition of prednisolone to such cultures restores their sensitivity to vincriestine, but the combination is no more effective than is vincristine alone in stable cell populations. These findings indicate that the effects of vincristine on the mitotic spindle, which produce metaphase arrest, do not account entirely for its ability to destroy cells. A second mechanism of action of vincristine at low concentrations is proposed.
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Immunological responses are divided into those mediated by humoral antibody (B-Cells) and those by cells (T-Cells). Both depend upon the activity of small lymphocytes which become thymus or bursa analogue dependent during embryonic development. Primary immundeficiencies are therefor defects of lymphocytes attributed in most cases to gene defects. Early diagnosis is the necessary prerequisit for possible treatment. Tests for assessing the cellular immune status are: skin testes and in vitro tests. Clinical syndroms are: lymphocytopenia, hypoplasia, deficiency of lymphocytes in lymphatic tissues normal cortical germinal centres. Recurrent infections with viruses, candida or pneumocystis carinii are common. Tests for assesing the humoral immune status are: measurement of immunglobulin levels in serum, isohaemagglutinins, tests for antibody formation following active immunization, in vitro tests. Clinical syndroms are: no germinal centres in lymphnodes, no plasma cells. Recurrent bacterial infections. Treatment of B-cell deficiencies: immunglobulin replacement therapy. Treatment of T-cell deficiencies by grafting of thymus transplants. Combined immune deficiencies are treated with bone marrow transplants from matched donors. For bone marrow transplantation germfree state seems to be the ideal situation to protect the patient against infection before the therapeutic maneuver and for prevention of graft versus host reaction in the posttransplantation period.
Three "indirect-type" slide tests utilizing the principle of hemagglutination inhibition and one new "direct-type" slide test employing direct agglutination were evaluated for their sensitivity in detecting human chorionic gonadotropin (HCG) in urine. The results of positive tests in a group of woman in very early pregnancy were correlated with the "days after last menses". In this series the direct slide test was the most accurate. A control must be used with each direct test to indicate interfering substances and when such are present a different test must be used. All tests were found to be of the relative sensitivity stated by the manufacturer.
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