Biomedical subjects
Publications and source records attributed to U H Lewinski.
A patient with multiple myeloma in whom the bone marrow plasmablasts showed extensive lobulation is described. In addition to numerous lobes, some of the nuclei had a cerebriform appearance, similar to that observed in Sézary cells. The possible relation of this phenomenon to the expression of the altered function of the malignant cells is discussed.
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The ultrastructural alterations of the peripheral blood mononuclear cells of a patient with Reye's syndrome are reported. The involved cells were lymphocytes which showed marked nuclear changes such as irregular or highly convoluted nuclei, multilobulated nuclei, presence of scanty chromatin, and large nucleoli. Changes of the cytoplasmic organelles involved the mitochondria and dense bodies with well defined surrounding membrane appeared. The possibility that these findings indicate a viral etiology of the disease is discussed.
The effect of a single high dose of Levamisole (200 mg/M2) on delayed-type hypersensitivity (DTH) in vivo and on lymphocyte blastogenesis to mitogens and antigens in vitro was studied in 26 patients with carcinoma. Similar studies were conducted in 24 control patients. Levamisole had a moderate but significant enhancing effect on DTH to Dermatophytin detectable no earlier than eight hours and still present at 48 hours after the drug administration. A moderate but significant enhancing effect on lymphocyte blastogenesis to mitogens and antigens was also demonstrated during the same time sequence. Further clinical trials with Levamisole should be conducted with more attention paid to schedule of drug administration.
Percutaneous liver biopsy is a widely used diagnostic procedure. Severe complications accompanying its performance with Menghini's needle are rare. In one patient, a liver abscess developed one month following a diagnostic biopsy. To our knowledge, this unusual complication has not been mentioned in large series reviewing liver biopsy complications.
A 54-year-old male was hospitalized because of lethargy, weight loss, an upper abdominal mass, hepatosplenomegaly and peripheral blood plasmacytosis of 66%. The diagnosis of acute plasma cell leukaemia was established, and after chemotherapy was initiated, the patient entered complete remission. 6 months later, he developed extramedullary plasmacytoma with involvement of the gastrointestinal tract, right inguinal lymph nodes and right orbit. Response to chemotherapy was poor and he died without evidence of plasma cell leukaemia. The possibility of the existence of extramedullary plasmacytoma at the onset of the disease, expressed by the appearance of plasma cell leukaemia only at the beginning and by extramedullary spreading at the terminal stage is discussed.
Satellitism of platelets to monocytes was observed in 3 patients suffering from polycythaemia vera, a myeloproliferative disorder and chronic lymphocytic leukaemia. This phenomenon occurred on cells in the buffy coat obtained from venous blood anticoagulated with heparin. The existence of platelet satellitism was reported to occur mainly to polymorphonuclears, but the present observation, as well as a previous report from our department, indicated that it may also exist to monocytes. Satellitism was achieved either by adherence of the platelets to monocytes, giving the impression of rosette formation, or by fusion of platelet pseudopodia with the monocyte membrane. The importance of this phenomenon in the evaluation of the platelet count using automatic instruments is discussed.
6 patients with acute leukemia are described. All of them suffered from high temperature and malaise, and showed negative urine and blood cultures. High doses of gentamicin, cephalothin and cerebenicillin failed to lower the fever. The temperature became normal after administration of chloramphenicol (CAP) 2.0 g/day. In 3 out of 6 patients the peripheral blood blast cell count decreased following CAP administration. Incubation of acute lymphoblastic leukemia cells with CAP in vitro showed a marked decrease in the DNA synthesizing activity of the leukemic cells. The role of CAP as an additional tool in the treatment of acute leukemia is discussed.
Endogenous cyclic adenosine and guanosine monophosphate (cAMP, cGMP) levels were studied in human peripheral blood lymphocytes during mixed leukocyte reactions (MLR). cAMP level was consistently elevated in one-way MLR, with good correlation to 3H-thymidine uptake in these reactions. In contrast, cGMP level was practically unchanged. Irradiation of reacting cell populations resulted in inhibition of cyclic nucleotide phosphodiesterase (PDE) activity. These results suggest that metabolic alterations in cAMP may be associated with immune reactions of cellular recognition.
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Lymphocyte cyclic nucleotide content was studied before and after Levamisole administration to cancer patients. Twelve patients with disseminated cancer received 100 mg/m2 on two consecutive days; nine comparable patients with disseminated cancer served as controls. Endogenous cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) were measured in lymphocytes before, 24, and 48 hours after ingestion of the first dose of Levamisole. A statistically significant decline in lymphocyte cAMP level was observed after drug administration and no significant changes were noted in cGMP levels. Further studies will be necessary to correlate this biochemical change in cyclic nucleotides with modulation of the functional level of cellular immune mechanisms.
Examination of the bone marrow of a 63-year-old man who had acute lymphoblastic leukemia revealed a population of cells with 32 chromosomes and another population with 64 chromosomes, the karyotypical exact duplicate of the first clone. The karyotypic evolution was studied and the findings compared with those described in two similar cases previously reported. It is postulated that severe hypodiploidy is associated with reduced capability of cellular survival, promoting a strong tendency for duplication.
A young patient had Burkitt-like leukemia. The diagnosis was based on the presence of numerous vacuoles observed with the light microscope and confirmed by the finding of large lipid droplets and abundant ribosomes in the cytoplasm of the leukemic cells, seen with the transmission electron microscope. Scanning electron microscope examination of the leukemic cells showed the presence of a smaller number of microvilli and ruffles on the cell surface, which distinguished these cells from the blasts of other types of leukemia.
A case of "non-secretory" multiple myeloma is described. The diagnosis was based on the clinical picture, typical radiological findings, and infiltration of the bone marrow by myeloma cells which showed specific immunofluorescence staining mainly with antisera for IgM and kappa light chains. An attempt is made to explain the absence of pathological proteins in the serum, based on the ultrastructural findings of the myeloma cells, which showed "buddings" of the cell membranes containing endoplasmic reticulum and cytoplasmic material. It is suggested that the cells of the "non-secretory" type of multiple myeloma possess a normal excretory mechanism, but the pathological proteins are prevented to be secreted in the serum being surrounded by portions of the cell membrane.
The mechanism of inclusion of the cytoplasmic dense bodies into the nucleus of myeloma cells was studied by transmission electron microscopy. The findings in different cells suggest that the inclusion of the electron-dense bodies is a result of an interaction between the nuclear envelope and the endoplasmic reticulum. The ability of the nuclear membrane to form an extension into the cytoplasm and the connection with the cisternae of endoplasmic reticulum enables the movement of the dense bodies towards the nucleus. The proposed mechanism does not support the concept of a simple invagination of the bodies into the nucleus or that they are produced in the nucleus itself.
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