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Report of a case with chronic myelomonocytic leukemia: demonstration of leukemic monocytes lacking nonspecific esterase by flow cytometry using monoclonal antibodies.

Chronic myelomonocytic leukemia (CMML) is a rare leukemia, which is now included in myelodysplastic syndromes. In a small number of patients with CMML, problems in the diagnosis have been reported, especially when atypical morphological features in both monocytic and granulocytic cells due to dysmyelopoiesis are prominent, or when cytochemical characteristics are lost in the leukemic cells. The case history of a sixty-seven year-old male patient with CMML is described. The diagnosis of CMML in the patient was supported by the following evidence: chronic course of his disease; increased monocyte-like cells without other cause; normocytic anemia; immature granulocytic cells with hypogranular feature and giant platelets were observed in the peripheral blood. The bone marrow showed myeloid hyperplasia. Serum muramidase and vitamin B12 levels were increased, while neutrophil alkaline phosphatase score was low in the peripheral blood. Ph' chromosome was negative. The monocyte-like cells completely lacked nonspecific esterase. However the cells were confirmed as monocytic cells by flow cytometry using monoclonal antibodies to monocytes (OKM5).

Aged↗

Gastrointestinal lymphoid neoplasms.

Primary gastrointestinal lymphomas (PGLs) are the most frequent extranodal non-Hodgkin's lymphomas and involve stomach more commonly than small bowel in Western countries. PGLs need to be differentiated from a variety of tumor-like hyperplastic lymphoid lesions; this may be facilitated by immunotyping of lymphoid cells. In PGLs, large-cell types predominate. Our study of 76 PGLs utilizing the ABC immunoperoxidase technique has led us to conclude that the majority are of B cell origin and that, while true histiocytic PGLs do indeed exist, their incidence is not greater than in nodal lymphomas. An important observation was that 26% of the cases showed an intense admixture of muramidase-positive reactive histiocytes, a feature that could result in an erroneous impression of a histiocytic derivation of the neoplasm. The prognostic significance of immunologic subtypes is currently not known. However, survival in PGL is determined by the clinical stage of the disease and to a lesser extent by the histologic type. Current optimal therapy includes resection of tumor-bearing bowel followed by radiotherapy and/or chemotherapy.

B-Lymphocytes↗

Phospholipase A2 activity in sera and synovial fluids in rheumatoid arthritis and osteoarthritis. Its possible role as a proinflammatory enzyme.

Phospholipase A2 (PLA2) activity was found in the sera and synovial fluids (SF) in rheumatoid arthritis (RA) and osteoarthritis (OA). PLA2 activity in RA SF was 6158 +/- 549 (SEM) U/ml (n = 48) and in RA sera 554 +/- 175 U/ml (normal sera-115 +/- 12 U/ml). In OA SF PLA2 activity was 5069 +/- 542 U/ml (n = 28), and in OA sera 268 +/- 55 U/ml. There was no significant difference between SF PLA2 activity in RA and OA. PLA2 activity in SF did not correlate with muramidase (lysozyme), beta-glucuronidase, total protein or white cell count, which were all significantly higher in RA SF than OA. A positive correlation between PLA2 in SF and matched sera was found in both RA and OA. It may be concluded that significant elevation of extracellular PLA2 occurs in both RA and OA, especially in the SF. The fact that high PLA2 did not correlate with other enzymes such as lysozyme and beta-glucuronidase, which are usually high in RA and low in OA SF, may mean that the handling of PLA2 in the joint space is different from other enzymes.

Arthritis, Rheumatoid↗

The use of iohexol in pediatric urography: a comparative study with meglumine diatrizoate.

In a prospective study the nephrotoxicity of iohexol, a new non-ionic contrast medium, was compared with meglumine diatrizoate. Plasma creatinine, BUN, creatinine clearance, urinalysis and the urinary excretion of N-acetyl glucosaminidase (NAG), gamma glutamyl transpeptidase (GGT) and muramidase (MU) were determined prior to and following intravenous pyelography. A significant rise in the enzyme excretion was observed in patients who received iohexol and diatrizoate. Statistical analysis failed to demonstrate any difference in nephrotoxicity between the two iodinated contrast media.

Adolescent↗

Evidence for significant hematopoiesis in the human thymus.

Earlier studies on fetal thymus suggested that certain of the large pyroninophilic cells found there might have a hemopoietic role, and it was decided to determine the nature of these cells using histochemical and immunohistochemical methods. Thymic tissue from aborted fetuses, stillbirths, and neonatal deaths was examined histochemically using methods for the detection of chloroacetate esterase, peroxidase, and pseudoperoxidase, and by staining techniques for mast cells and eosinophils. Tissue was also examined using the indirect immunoperoxidase method for the presence of hemoglobin A (HbA) and F (HbF), for lysozyme (muramidase) and immunoglobins alpha, mu, gamma, kappa, lambda. Positive staining to some degree was seen in cells in the connective tissue stroma using all methods, and the cells stained corresponded to one or another of the types of pyroninophilic cells present. The finding of large cells with positive chloroacetate esterase and antilysozyme indicates the presence of granulopoiesis. Similarly, the presence of large nucleated cells with pseudoperoxidase and anti-hemoglobin (A and F) staining indicates the presence of erythropoiesis. Plasma cells were present in small numbers.

Antibody Specificity↗

Distribution of lysosome populations in rat cardiac tissue.

The post-nuclear fraction of rat heart tissue was fractionated by isopycnic zonal centrifugation in sucrose gradients, followed by differential centrifugation of the zonal fractions (rho-S fractionation). The distribution of 5 lysosomal acid hydrolases, a protease with neutral and alkaline activity and several marker enzymes for cell organelles (catalase, Ca2+-ATPase, cytochrome oxidase, glucose-6-phosphatase and muramidase) were studied. Three major lysosomal populations were described with equilibrium densities of 1.09, 1.17, and 1.23 gms cc-1 (omega2t = 1.54 X 10(11) rad2 sec-1), and a continuum in the size of these particles at the three different densities.

Adenosine Triphosphatases↗

Histochemical characterization of the naso-labial glands of two species of ruminants (Ovis aries and Bos taurus).

The bovine and ovine naso-labial glands have been examined. In both species these glands are multilobular tubulo-acinar, but the cells of secretory units display differences regarding nuclear shape and location, RER arrangement and secretion pattern. In this paper, histochemical characterization of naso-labial gland secretion was performed using the periodic acid Schiff reaction (PAS), the Alcian blue staining (AB) at pH's ranging between 1.7 and 2.5, the Alcian blue-high iron diamine (HID-AB) method, an immunohistochemical staining for muramidase at the light microscopic level and the periodic acid-thiocarbohydrazide-silver proteinate (PA-TCH-SP) technique at the electron microscopic level. In bovines the secretion is composed of glycoproteins, which are reactive to PAS, but not to Alcian blue staining. In ovines, a large quantity of acidic polysaccharides in association with a small quantity of sulfomucins has been found. Ultrastructural and cytochemical observations show that secretory granules do not have a homogeneous structure. They appear to be formed of a meshwork stained positively with the PA-TCH-SP method immersed in a light background. The particular morphological features of the naso-labial glands and their histochemical features suggest that these glands can be classified as sero-mucous in bovines and mucous in ovines.

Animals↗

[Interrelation between the activity of the lytic enzyme producer Actinomyces recifensis var. lyticus 2435 and its population variability].

Spontaneous variability of Actinomyces recifensis var. lyticus 2435 producing a complex of lytic enzymes was studied. A correlation between the strain activity and the content of the variants of the main morphological type in the population was shown. The carbon sources influenced the proportion of different type variants in the population. Strain 2435 was rather stable with respect to the level of the synthesis of yeast-like enzymes and showed a significant variation with respect to the level of the biosynthesis of the bacteriolytic complex. The population variation of strain 2435 with respect to the staphylolytic (synthesis of specific endopeptidases) and muramidase activity was most pronounced. The high activity levels of strain 2435 and wide lytic spectrum were provided by selection of the variants of the first morphological type with respect to the property of high staphylolytic activity.

Bacteriolysis↗

Establishment and characterization of a transplantable rat myelomonocytic leukemia.

A transplantable myelomonocytic leukemia was established from a leukemia of a WKA/Hok rat which had been inoculated with Rauscher virus at birth. The tumor grew in ascites form in normal syngeneic rats and, after the middle stage of i.p. transplantation, leukemia cells consisting of a mixed population of monocytic and granulocytic cells were observed in the peripheral blood. A complement-dependent cytotoxicity test failed to demonstrate Rauscher virus-related antigen on the tumor cell surface. Membrane marker analysis revealed that most of the tumor cells possessed receptors for both complement and neuraminidase-treated sheep RBC. More than 90% of ascitic tumor cells displayed phagocytic activity and a positive nonspecific esterase reaction. Serum from rats bearing this tumor contained high levels of muramidase. Ultrastructurally, the tumor cells resembled both immature and mature cells of the monocyte-macrophage series. On serial transplantation into the peritoneal cavity, the tumor displayed consistent differentiation from undifferentiated blast cells to monocytes and cells indistinguishable from granulocytes. The karyotype analysis revealed that the modal number of chromosomes of the tumor cells was 81, and no structural abnormalities of chromosomes were observed after quinacrine mustard staining. This transplantable leukemia will provide a useful experimental model for the study of granulocyte-monocyte differentiation and for human myelomonocytic leukemia.

Animals↗

Partial deletion of the long arm of chromosome 16 and bone marrow eosinophilia in acute nonlymphocytic leukemia: a new association.

Recently, several specific chromosomal abnormalities have been associated with distinctive clinical and/or morphological subtypes of acute nonlymphocytic leukemia (ANLL). To further investigate the clinical utility of karyotype analysis in ANLL, we have examined G-banded metaphase chromosomes at diagnosis in 61 consecutive patients. Of the 60 patients who had adequate mitoses, 47 (78%) had a clonal chromosome abnormality. The sole karyotypic abnormality found in 5 patients was a del(16)(q22). The unique pretreatment characteristic of these 5 patients was marrow eosinophilia ranging from 8% to 54%. No other patient had more than 4% marrow eosinophils. Among the patients with eosinophilia, all had Auer rods, serum muramidase was elevated in the 4 tested, and 4 had hepatomegaly at presentation. Both patients who survived initial treatment remain in complete remission at 23+ and 33+ mo. The data suggest that we have identified a new cytogenetic-clinical subtype of ANLL defined by the del(16)(q22).

Adolescent↗

Monocytic leukemia cells in urine a case report.

Report is made of a 66-year-old female who presented with a chief complaint of hematuria. Hematologic studies of peripheral blood and bone marrow revealed a well-differentiated monocytic leukemia; this diagnosis was substantiated by elevated muramidase levels. An intravenous pyelogram showed a left renal mass, raising the question of a transitional cell carcinoma of the renal pelvis or a renal cell carcinoma. Cytologic urine studies failed to show cells suggestive of carcinoma. However, numerous monoblasts were identified cytologically and cytochemically.

Aged↗

[Tissue enzymatic study in the perfusate of cadaveric kidneys for assessing their functional state].

A correlation was found between the level of the tissue enzyme activity in cadaveric kidneys perfusates and the degree of their functional adequacy in the early posttransplantation period. According to the data obtained the level of the activity of leucin aminopeptidase and gamma-glutamyltranspeptidase in the perfusates may be of importance for prognostication of a delayed function of the kidneys after transplantation. An elevated level of activity, in addition to leucin adminopeptidase and gamma-glutamyltranspeptidase, lactatedehydrogenase, aspartataminotransferase, muramidase, acid and alkali phosphatases suggests the transplanted kidney to be not functioning.

Adult↗

An immunoperoxidase study of immunological factors in skin lesions across the spectrum of leprosy.

The immunoperoxidase technique was used to assess the quantity and situation of various immunological factors in 24 skin biopsies which represented the leprosy spectrum from TT to LL. The factors were immunoglobulins (IgG and IgM), complement components (C3, C3d and Clq), plasminogen, muramidase (lysozyme), C-reactive protein and alpha-1-antitrypsin. The results were compared with previous reports on the assessment of these factors in serum. The quantities of these factors in the lesions produced peaks at TT and LL, with a dip in the BT-BB region (C-reactive protein and alpha-1-antitrypsin excepted). The immunoglobulins, present mainly in plasma cells and lymphocytes, correlated in general with reports of serum levels. The complement components were present in appreciable amounts, though the serum levels are depressed; they were seen in young mononuclear cells with a low bacterial load. All factors produced an ascending gradient in active lesions from BT to BL or LL, which correlated with the bacterial load and its viability. In regression (studied only in LL) there was a decrease in all factors. In TT there was an increase in most factors which did not correlate with the antigen load, and which probably resulted in an excess of antibody over antigen. In active LL there is probably an antigen excess. The results suggest the possibility that there is a common defect from BT to LL, in which the generation of immunological factors within the lesion of immunological factors within the lesion is a secondary response to the antigenic load. In TT alone (a rare group) is there an enhanced immunological response unrelated to the antigen load. In support of this was the finding of Ia antigen only in TT lesions.

Complement System Proteins↗

Thymic origin of the prolactin-dependent Nb2 lymphoma cell line.

Blast cells in acute leukemia and lymphoma appear to be "frozen" at various stages of lymphoid cell differentiation. The enzymatic and antigenic phenotypes expressed by these cells often correspond to the gene products of their normal precursors. We have used various immunocytochemical and enzymatic techniques to identify membrane, nuclear, and cytoplasmic markers associated with the prolactin-dependent Nb2 lymphoma cell line. The Nb2 cells, whether stationary or in log-phase growth, did not express any surface immunoglobulin. However, 100% of the Nb2 cells bound both a monoclonal antibody raised to rat thymocyte W3/25-HLK, which specifically binds an antigenic determinant on rat T-helper cells, and second monoclonal antibody OX8-HL, which identifies rat nonhelper T-cells. Transmission electron microscopy showed no evidence of phagocytic vacuoles, and activity of the lysosomal enzyme muramidase was also absent. There was no evidence of the DNA polymerase enzyme terminal deoxynucleotidyl transferase. alpha-Naphthyl acetate esterase activity was indicated in about 50% of the Nb2 cells by a faint particulate cytoplasmic staining similar to that found in thymocytes. Rosette formation with guinea pig erythrocytes, a property of mature rat thymocytes, was not observed with Nb2 cells. The data suggest that the Nb2 tumor may have arisen from a thymocyte at an intermediate stage of differentiation. The presence of Thy-like alpha-naphthyl acetate esterase pattern and the binding of both W3/25-HLK and OX8-HL support the thymic origin and relative immaturity of these lymphoid cells. It is becoming increasingly apparent that a significant proportion of lymphomas and leukemias also originate in undifferentiated thymic cels.

Animals↗

[The M-protein heterogeneity of Streptococcus pyogenes strains isolated from clinically healthy and ill children in an organized collective].

The study of the kinetic curves of the lysis of group A S. pyogenes cell-walls (cells), serovars 29 and 12 M, variants M+ and M-; with endo-N-acetyl-muramidase revealed that the kinetics of the lysis of virulent and avirulent strains was different: variant M- was lyzed faster than M+. This difference in the cell-wall lysis of both variants made it possible to use this method for the identification of M+ and M- states of the strains. 18 group A S. pyogenes cultures were studied. The cultures isolated from healthy and sick children in an organized group belonged to variants both M+ and M-. The pepsin fragments of M-proteins of group A S. pyogenes, type M 1, isolated in dynamics from a carrier and a patient, were studied. Their amino acid compositions were studied, and differences between them were established. The data thus obtained indicate that heterogeneity is characteristic of both the surface structure of streptococci and the individual components of their surface, in particular, M-protein.

Amino Acids↗

[Features of secretion of bacteriolytic enzymes and polysaccharides in bacteria from the Pseudomonadaceae family].

It is shown that secretion of bacteriolytic complex enzymes in a bacterium of the family Pseudomonadaceae begins in the latent and early logarithmic culture growth phases. A maximum of specific bacteriolytic activity falls in the same time interval with a maximum of specific activity of lytic proteinase L2 and muramidase. The activity of concomitant enzymes--non-specific proteinase and neutral phosphatase--peaks in the middle of the logarithmic growth phase. Secretion of exopolysaccharide into the external medium begins in the second half of the logarithmic growth phase and, thus, is not coordinated with secretion of bacteriolytic enzymes. It is shown that relative content of enzymes and polysaccharides depends upon the composition of growth medium for the producer.

Culture Media↗

Pleomorphic large cell hemato-lymphoma (the so-called "malignant histiocytosis"): clinicopathological and immunophenotypic studies in 35 cases.

Thirty-five patients diagnosed with "malignant histiocytosis" from 1984 to 1989 were studied for clinical, laboratory, histopathological features as well as survival and response to therapy, Immunocytochemistry and immunophenotypic studies were performed in 12 cases using the paraffin immunoperoxidase method. The staining included alpha-1 antichymotrypsin, muramidase, immunoglobulins and monoclonal antibodies specific for T, B lymphocytes and macrophage. From the clinical features, responsiveness to therapy and survival, the patients were divided into 2 groups: the non-responders (25 cases) and responders (10 cases) groups. Very short median survival of 1.25 months was found in the non-responders, whereas, longer median survival of 14.15 months was found in the responder group. Important different clinical and laboratory features were observed among these two groups. Unresponsiveness to treatment; rapidly progressive pancytopenia, increased hemophagocytosis, presentation of immature cells in blood with extensive infiltration of malignant cells in the bone marrow; severe jaundice and deterioration of hepatic function accompanied by early extranodal involvement were almost exclusively observed initially in the non-responder group. Satisfactory response to treatment was observed only in the responder group. Similarity of histopathology, cytology and immunophenotype was observed in these two groups. The immunophenotypic study in 12 cases showed 5 cases of B-cell lymphoma, 3 cases of T-cell (with 1 Ki-1 -positive) lymphoma; 1 case of Ki-1 positive non-T, non-B anaplastic large cell lymphoma; and 3 cases of undetermined cell lineage. From this study, so-called "malignant histiocytosis" appears to be a disorder of heterogeneity. The immunophenotypes of malignant cells indicated that their origin belonged mostly to lymphoid cell lineage. Based on their clinical feature of the early hematogenous spread along with the distinct histopathological and immunophenotypic findings, the term "pleomorphic large cell hematolymphoma" is proposed to be used instead of the old misnomer, "malignant histiocytosis" (MH).

Adolescent↗

Studies of the formation of peptide cross-links in the cell wall peptidoglycan of Streptococcus faecalis.

A method was developed to label specifically the glycan chains of the cell wall peptidoglycan of Streptococcus faecalis ATCC 9790 with [14C]acetate. The formation of peptide cross-links (a) during exponential growth, (b) after valine starvation and wall thickening, and (c) during regrowth after 2 hours of valine starvation, was studied using continuous, pulse and pulse-chase labeling of the peptidoglycan with both [14C]acetate and [3H]lysine. After labeling, walls were isolated, digested with the muramidase of Chalaropsis B, and the "free" peptidoglycan fragments (75 to 90% of the total peptidoglycan) were then fractionated on columns of Sephadex G-50, G-50, and G-25 in series into disaccharide-peptide monomer and peptide cross-linked bisdisaccharide-peptide dimer, trisdisaccharide-peptide trimer, and higher oligomer fractions. Peptidoglycan made during valine starvation and wall thickening was found to be slightly more cross-linked than peptidoglycan made during exponential growth. Pulse and pulse-chase experiments indicated that peptide cross-linking continued for an unexpectedly long time after incorporation of precursors into insoluble peptidoglycan.

Acetates↗