[Second malignancy: is it really a complication of chemotherapy?].
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Biomedical subjects
Publications and source records attributed to M Mittelman.
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The presence of potential murine leukemia and overt leukemia cells in various organs at different phases of leukemogenesis was demonstrated by transplantation experiments and sensitivity to bacteriocin (colicin HSC10). Such correlation was found in three experimental models: AKR mice developing spontaneous T-cell leukemia and BL/6 mice infected with radiation leukemia virus variants inducing a high or low overt T-cell leukemia incidence. The sensitivity to bacteriocin was evaluated by testing the cell cycle perturbation following in-vitro incubation of lymphoid cells with colicin (or Tris buffer as controls) monitored by flow-cytometry. The analysis was based on measuring relative differences in fluorescence intensity of propidium iodide stained DNA in the individual cells. The interaction with colicin of leukemic cells and lymphoid cells containing potential leukemic cells (PLC) resulted in a reduction in the cell number of the G0/G1 and SG2M phases while cells accumulated in the "pre-G1" channels. In contrast, normal lymphoid cells exposed to bacteriocin did not show such changes in the DNA histograms. The distribution pattern of PLC in the thymus and spleen (in the models tested) obtained by transplantation studies coincided with sensitivity of spleen and thymus cells to colicin. However, in most instances, the PLC in the bone marrow were not recognized by colicin, but their leukemogenic potential was reduced following interaction with colicin as shown by PLC transplantation studies. It is thus suggested that colicin might be used for identification and eradication of transformed cells.
Twenty patients with bronchial asthma, on long-term oral therapy with theophylline, demonstrated an increased number of suppressor T-cells and impaired graft vs host reaction. Ten asthmatics on other therapy, not including theophylline, as well as ten normal healthy controls, failed to show similar findings. Elimination of suppressor T-cells corrected the above immunological abnormalities in the theophylline-treated patients, while addition of serum from theophylline-treated asthmatic patients to lymphocytes from normal healthy controls, affected the graft vs host reaction of these lymphocytes. We conclude that theophylline induces quantitative as well as qualitative immunological alterations by increasing the number and activity of suppressor T-cells, which most probably secrete a serum factor, responsible for some of the abnormalities observed.
A tumor excised from the ninth right rib of a patient with chest pains was diagnosed independently by two pathologists as anaplastic carcinoma. Light microscopy of the tumor cells found in the sternal bone aspiration biopsy did not contribute to the diagnosis. When the cells were examined with a transmission electron microscope, the diagnosis of multiple myeloma was established and proved by suitable laboratory tests. Following treatment according to the M2 protocol, the patient is presently in an excellent condition. This case indicates that the electron microscope may serve as an important tool for the diagnosis of diseases difficult to clarify with the light microscope.
Ultrastructural examination of the bone marrow of 3 patients with multiple myeloma--two presenting with Mott cells and one with cells containing numerous Russell bodies--showed that these two types of intracytoplasmic inclusions are different in size and location. The Mott bodies in one patient appeared as clusters of electron dense material with round or oval shape and poorly delineated membrane. In the second, they possessed an amorphous structure, and were not surrounded by membrane. In both cases, they were not located in the endoplasmic reticulum. The Russell bodies were round, with high electron density, surrounded by membrane and located in dilated portions of the endoplasmic reticulum. It is concluded that Mott and Russell bodies are different types of inclusions in myeloma cells, at least from the ultrastructural point of view.
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Patients with chronic lymphocytic leukemia (CLL) have an increased susceptibility to oral and other infections. In a previous study we have shown that normal human saliva contains phagocytosis promoting factor(s). Saliva from healthy subjects enhanced in vitro phagocytosis of latex particles by polymorphonuclear leukocytes (PMNL) and monocytes. Therefore, it was of interest to examine the phagocytosis promoting activity of saliva from patients with CLL. Homologous PMNL and monocytes from healthy subjects supplemented by saliva from patients with CLL demonstrated in vitro a decreased phagocytosis of latex particles, in comparison with cells supplemented by saliva from healthy subjects. This observation suggests that saliva from CLL patients has a reduced phagocytosis promoting ability. This finding may contribute to a further clarification of the increased susceptibility of CLL patients to oral infections.
Esophageal foreign body accompanied by respiratory complications is a rare condition. A few cases have been reported, only two of them in adults. We describe the case of a 34-year-old mentally retarded patient who was hospitalized for aspiration pneumonia and died 48 hours after admission. At autopsy, the prominent finding was a 3 X 3-cm stone impacted into the upper esophagus and compressing the trachea from behind. The possibility of an esophageal foreign body should be included in the differential diagnosis of unexplained respiratory distress or aspiration pneumonia in adults.
The RBCs from vessels supplying the tumors of 14 patients with colorectal carcinoma were examined with the scanning electron microscope. In all of them a great variety of alterations in the shape and the cell membrane were found. Erythrocytes from the vessels of healthy colonic tissue of the patients were found to have a normal appearance. Since fibrin thrombi were present in a few vessels of only six patients, the possibility that the alterations were due to mechanical trauma was not likely. This observation may serve as an additional explanation for the anemia observed in patients with colorectal carcinoma.
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A patient with malignant lymphoma showed severe hypophosphatemia during a blastic crisis. x-Ray microprobe analysis of the cells at this stage revealed a high phosphorus content. Following treatment and a decline in the white cell count the serum phosphorus increased, whereas the cellular phosphorus decreased. The potential prognostic value of serum and cellular phosphorus determinations during the course of malignant disorders of the hematopoietic system is discussed.
A patient with cryoglobulinaemia who developed systemic lupus erythematosus (SLE) 10 years later on is described. The relationship between these 2 conditions and the possibility that cryoglobulinaemia was the early presentation of SLE are discussed.
The case history of a patient heavily infested with Plasmodium vivax is reported. Numerous peripheral red blood cells, containing trophozytes, permitted to observe the parasites with a transmission and scanning electron microscope.