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Biomedical subjects

R O'Reilly

Publications and source records attributed to R O'Reilly.

At least 73 records · Page 4Linked to original sources

Bone marrow transplantation for the therapy of refractory adult T cell acute lymphoblastic leukemia.

Two adult patients with T cell acute lymphoblastic leukemia (ALL) received an intensive multiagent therapeutic regimen and failed to enter remission. Following cytoreduction with cyclophosphamide (60 mg/kg x 2) and total body irradiation (1000 rads) they underwent bone marrow transplantation. One patient received marrow from his identical twin brother and the other from his HLA-matched sister. Both patients promptly went into remission. The identical twin recipient is alive and free of disease at 20+ months, but the allogeneic patient died of P. carinii pneumonia at eight months with no evidence of leukemia. These results suggest that even some refractory patients whose disease has multiple negative prognostic features may respond to pretransplant chemoradiotherapy and attain a clinically useful complete remission. Additional patients with longer follow-up will be necessary before the curative potential of bone marrow transplantation in T cell ALL can be assessed.

Adult↗

Selective IgA deficiency and circulating immune complexes containing bovine proteins in a child with chronic graft versus host disease.

We have previously shown that a selective absence of serum and secretory immunoglobulin A (IgA) may lead to the development of circulating immune complexes which appear to contain bovine milk antigens. We report here that high levels of circulating immune complexes were found in the serum of a child who was treated for severe combined immunodeficiency by bone marrow transplantation but in whom the IgA-producing cells subsequently failed. As increasing amounts of complexes appeared over a two year period, the child had a parallel progression of an apparent chronic graft versus host disease including a Sjögrens syndrome and scleroderma. Very large amounts of complexes were eventually formed but the level fell 77 per cent after milk was excluded from the diet. Chemical studies on the complexes showed that the majority of complexes did contain bovine milk proteins, and fluorescence antibody staining of skin biopsy samples showed the presence of dense deposits of bovine casein in the dermis. The relationship between bovine protein-antigen antibody complexes and the chronic graft reaction remains uncertain.

Antibodies↗

Circulating thymic-hormone activity in congenital immunodeficiency.

Circulating thymic-hormone activity was assayed by measuring Thy 1-2 antigen induction on null lymphocytes from athymic mice incubated with human plasma or serum. Plasma from 19 normal children aged under 10 had inductive activity equivalent to 10-6-16-2 ng thymopoitin/ml. Plasma from 15 infants were severe combined immuno-deficiency, 2 of whom had appreciable immunoglobulin synthesis, and from 2 infants with DiGeorge syndrome had little or no inductive activity. Successful reconstitution with thymus or bone-marrow grafts and with red-cell infusions (if adenosine-deaminase deficiency is present) was followed by a rise in circulating thymic-hormone activity.

Agammaglobulinemia↗

The variation in hospital charges: a problem in determining cost/benefit for cardiac surgery.

Based on 417 itemized bills from 45 American hospitals that responded to a randomized, geographically stratified survey covering January to June, 1976, the middle 50% of hospital charges for cardiac operations ranged between $5,914 and $10,315. Nonitemizing hospitals submitted lower, but less accurate, estimates. As 60% of the itemized bill consisted of high charge/cost items such as laboratory and pharmacy fees, total charges were not lowered merely by increasing case load or decreasing operating room times. Careful individualization of services in 1 hospital, however, reduced charges up to 16%. Charge per day was a poor index of efficiency because patients staying longer had lower average daily charges. The variation in hospital charges and lack of accounting uniformity preclude meaningful quantitation of either the "typical" charge or the numerator of the cost/benefit ratio for cardiac operations.

Cardiac Surgical Procedures↗

Thymic activity in severe combined immunodeficiency diseases.

Thymic function was evaluated by quantitation of circulating thymic factor in patients with several forms of severe infantile immunodeficiency diseases. Direct quantitation of thymic factor in serum of patients with severe combined immunodeficiency revealed heterogeneity of this syndrome by this parameter, as was also shown by study of susceptibility of the marrow cells to differentiation in vitro. Thymic factor was not detectable in one patient with severe combined immunodeficiency, but was present in normal or near-normal concentrations in three others. Circulating levels of this hormonal activity were also not detectable in a patient with DiGeorge athymic syndrome. Following marrow or fetal liver transplantation, which corrected the severe combined immunodeficiency thymic factor levels either increased slightly or did not change appreciably. Fetal thymic transplantation, which together with fetal liver transplantation corrected the immunodeficiency in one patient with severe combined immunodeficiency, was associated with increase of thymic factor to normal levels. Fetal thymus transplantation alone, which was employed to correct the immunodeficiency of DiGeorge athymic syndrome, caused an increase in thymic factor activity to normal or near normal levels in this patient.

Bone Marrow Cells↗

Ontogeny of lymphocyte subpopulations in human fetal liver.

Lymphocytes were isolated from five fetal livers (13-17 weeks) and examined for different surface markers. Immunoglobulin M was found on 0.5-4.0% of lymphocytes. No membrane-bound surface IgD, IgA. or IgG was detected. Mouse erythrocyte rosette-forming lymphocytes ranged from 0.5 to 6.0%. Thymus-processed (T) lymphocytes, which were defined as those forming spontaneous rosettes with sheep erythrocytes, as well as lymphocytes with IgG Fc receptors, were present in a small proportion. No complement-receptor-bearing lymphocytes were found in the two cell populations of fetal liver studied. It is evident that during the ontogeny of bone-marrow-derived (B) lymphocytes IgM is the first surface immunoglobulin to appear. Receptors for the binding of mouse erythrocytes are present at the same time as surface IgM. The slight excess of mouse erythrocyte rosette-forming cells over cells having surface immunoglobulin M could mean that IgM appears later than do the receptors for the binding of mouse erythrocytes.

Animals↗

Effect of human exogenous leukocyte interferon in cytomegalovirus infections.

Human leukocyte interferon was injected into nine patients with cytomegalovirus infections; four of these patients were congenitally infected, and five had acquired infections. In three patients viruria was completely inhibited. In five patients viral excretion in the urine was only transiently inhibited. Viremia was not significantly suppressed. The lymphocyte response to phytohemagglutinin was suppressed in two patients.

Adult↗

Heterogeneity of stem cells in severe combined immunodeficiency.

Two patients with severe combined immunodeficiency disease (SCID) having variable B-cell development have been shown to have marrow precursors of lymphoid cells which can be induced in vitro by thymic factors to express certain T-cell surface characteristics (HTLA+ phenotypes). Their marrow cells could not, however, be induced by these same factors to develop the E-rosette marker or functional activities of T lymphocytes. The marrow of these children also showed, when compared to that of normal adults, a different distribution of cellular elements on density gradient fractionation. The findings support the view that the disorder under study has a different pathogenesis from other forms of SCID previously analysed.

Age Factors↗

Leukocyte migration inhibitory factor (LMIF) profile in primary and secondary immunodeficiency disease.

Lymphocytes from patients with primary and secondary immunodeficiency disease were tested for capacity to produce LMIF after mitogen and antigen stimulation as well as for ability to stimulate and respond in unidirectional MLC-LMIF assay. Different patterns of immune abnormality in vitro were detectable when Con A and Candida albicans antigen were used. In addition, significant abnormalities in LMIF responding and stimulatory capacity were demonstrated in patients with Hodgkin's disease. LMIF production after stimulation with different agents allows for a better characterization of cellular defects in immunodeficiency disease.

Antigens, Fungal↗