Failing transcervical thymectomy in myasthenia gravis. An evaluation of transsternal re-exploration.

Twenty cases of failing transcervical thymectomy are reported. They were selected for transsternal re-exploration from a series of 95 patients who had previously undergone transcervical thymectomy because of myasthenia gravis (MG). A specific method for pre-operative detection of remnants of the non-tumorous thymic gland is lacking, but the applied clinical selection criteria were so far reliable: generalized, disabling, fluctuating MG despite cholinesterase inhibitor and/or immunosuppressive treatment, and no or inconsistent improvement after transcervical thymectomy.

Characterization of malignant and non-neoplastic cell phenotypes in highly malignant non-Hodgkin lymphomas.

Malignant and non-neoplastic cells in 38 cases of highly malignant non-Hodgkin lymphomas: 3 centrocytic anaplastic, 18 centroblastic, 13 immunoblastic and 4 lymphoblastic (according to the Kiel classification) were immunophenotyped in cryosections and cell suspensions by means of monoclonal antibodies. Additionally, cell cycle analysis on cell suspensions was performed by DNA flow cytofluorometry. In 33 (87%) lymphomas the malignant cells expressed monoclonal surface immunoglobulin (Ig), which indicated B-cell origin of tumors.

Solid-phase radioimmunoassay of immunoglobulin G antibodies to Staphylococcus aureus peptidoglycan in patients with staphylococcal infections.

A solid-phase radioimmunoassay (SPRIA) for determination of antibodies against S. aureus peptidoglycan was used for serological diagnosis of staphylococcal infections. Elevated IgG antibody levels were found in 21/21 patients with S.

A clinico-pathological and immunological study of unfavourable non-Hodgkin lymphomas. Comparison of the Rappaport and Kiel classifications.

To evaluate the prognostic information of the Kiel classification a homogeneous material of 63 non-Hodgkin lymphomas of unfavourable Rappaport histology were re-evaluated according to the definitions of the Kiel classification. The patients were selected from a prospective lymphoma study including 775 patients. Only ambiguous histological diagnoses analysed independently by two hematopathologists were accepted.

Correlation of immunophenotype to morphology in unfavourable non-Hodgkin lymphoma.

The relationship between immunological markers and histology according to the Kiel classification was studied in 40 adult non-Hodgkin lymphoma patients of Rappaport unfavourable histology. The membrane-associated and cytoplasmic Ig as well as receptors for sheep erythrocytes, Fc gamma and C3d receptors were analyzed on cryostate sections and in suspension. In some cases, a more precise immunophenotype was achieved by the use of monoclonal antibodies detecting different T and B cell antigens.

Antibody response to alpha- and betahemolysin from Staphylococcus aureus in patients with staphylococcal infections and in normals.

One hundred and nineteen patients with S. aureus infections and 22 patients with non-S. aureus septicemia were investigated for anti-alpha hemolysin antibodies using a radioimmunoassay (RIA).

Blood and lymph node T-lymphocyte subsets in non-Hodgkin lymphomas.

Blood and lymph node T-lymphocyte subpopulations have been studied in untreated non-Hodgkin lymphoma (NHL) patients and healthy controls. T-lymphocytes were determined by the E-rosette technique and by OKT3/LEU4 monoclonal antibodies; OKT4/LEU3 and OKT8/LEU2 monoclonal antibodies were used to identify T-cell subsets with helper/inducer and suppressor/cytotoxic activity, respectively. OKT4+ T-cells were low in patients, while OKT8+ T-cell numbers were normal.

Staphylococcus aureus septicaemia and endocarditis at the University Hospital in Lund 1976-1980.

During the period 1976-1980 Staphylococcus aureus was found in 265 blood cultures from 13 clinics for adult patients at Lund Hospital. Criteria of septicaemia were fulfilled in 169 patients, 65 had transient bacteremia and 31 cases were not evaluable. Concerning bacteriological data no Staphylococcus phage type dominated and strains resistant to antibiotics other than penicillin were very few.

The clinical significance of serological methods in the diagnosis of staphylococcal septicaemia and endocarditis.

In comparison to healthy controls we have found that patients with endocarditis and septicaemia caused by Staphylococcus aureus show significantly higher antibody levels against either S. aureus peptidoglycan, crude staphylococcal antigen or alpha-toxin. The serological methods used in these studies were radio-immunoassays.

Detection of Staphylococcus aureus antibodies in patients with S. aureus infections and in normal persons, using solid phase radioimmunoassay.

One hundred and thirteen patients with S. aureus infections, eight patients with non-S. aureus septicemia and 167 normal controls were investigated by solid-phase radioimmunoassay for staphylococcal antibodies.

Staphylococcus aureus antibodies in patients with staphylococcal septicemia. Comparisons between solid-phase radioimmunoassay and crossed immunoelectrophoresis.

Antibody responses against teichoic acids and other antigens from Staphylococcus aureus in 23 patients with septicemia and 8 patients with endocarditis caused by S. aureus were investigated. Both methods used--solid-phase radioimmunoassay (SPRIA) and crossed immunoelectrophoresis (CIE)--detected significantly higher titres in the endocarditis group.

An EBV-associated, Swedish case of Burkitt-type malignant lymphoma.

Morphological, serological, DNA-homology and immunofluorescence studies of a rapidly fatal malignant lymphoma in a 25-year-old Sweden male revealed most of the characteristics of an EBV-associated Burkitt lymphoma. The various findings are discussed in relation to previously reported observations on endemic (African) and non-endemic Burkitt lymphomas.

An immunohistological study of human lymphoma.

In this study the problems encountered in staining immunoglobulin (Ig) in sections of paraffin-embedded human lymphoma samples have been investigated. It was found that the "masking' of cytoplasmic Ig, which occurs when tissues are fixed in formol saline (the fixative employed in most previous studies), can be avoided by the use of mercury-based fixatives. When non-Hodgkin's lymphoma samples fixed in this way were studied it was found that cytoplasmic Ig labelling of both lymphoid and histiocytic cells is often attributable to non-specific uptake of serum proteins.

Immunological studies on human thymus. Occurrence and distribution of immunoglobulins and immunological receptors in myasthenia gravis and control patients.

Suspended cells and tissue sections from myasthenia gravis (MG) and control thymuses were characterized for surface expression and histological distribution of immunoglobulin (Ig) and receptors for sheep erythrocytes (SE), the Fc part of IgG (Fc gamma) and of IgM (Fc mu) and complement factors C3b and C3d (CR). In sections the cortical areas from both MG and control thymuses expressed SE as well as Fc gamma receptors, whereas medullary areas only showed weak SE binding. In contrast to control patients, MG thymuses also contained Ig+ cells confined to nodular areas of the thymic medulla.

The distribution of HLA on human lymphoid, bone marrow and peripheral blood cells.

The cellular distribution and the differential expression of HLA on cell suspensions and tissue sections has been investigated using the monoclonal antibody W6-32, which reacts with the high molecular weight chain of the major histocompatibility antigen. Lymphocytes and platelets, as assessed by autoradiographic and immunoperoxidase labeling, were the most densely labeled cells. Myeloid precursors showed more labeling than mature neutrophils.

Treatment of anaerobic infections with metronidazole.

Metronidazole (Flagl), a compound widely used in man with minimal side-effects, has been used in the treatment of anaerobic infections caused by Bacteroides fragilis and other Bacteroides species. Seven patients were treated and all were restored to full health. Four of them did not respond to lincomycin or clindamycin which so far have been the drugs of choice against anaerobic infections.