T cell and monocyte requirements for erythropoiesis.

Progenitor cell fractions from normal human marrow have been prepared by a method that enables low numbers of cells to be cultured and results in very little T cell or monocyte contamination. The enrichment of 14- and 21-day BFU-E was similar to that for CFU-GM and the readdition of sheep red blood rosette-forming cells had no effect on BFU-E growth. The significance of the discrepancy in cellular requirements for the growth of blood and bone marrow BFU-E is discussed.

High-dose cyclophosphamide with autologous marrow transplantation as initial treatment of small cell carcinoma of the bronchus.

Sixteen patients with untreated small cell carcinoma of the bronchus received cyclophosphamide in a total dose of 160-200 mg/kg. Autologous marrow transplantation was used to minimise the period of hypoplasia and 2-mercaptoethane sulphonate to prevent urothelial toxicity. The procedure was well tolerated, with predictable and manageable toxicity.

Abnormalities of T-cell subsets in patients with neutropenia and an excess of lymphocytes in the bone marrow.

Morphological, surface-marker and culture studies were performed in three patients who had in common neutropenia and an excess of lymphocytes in the bone marrow, but who differed from each other in certain regards such as age and peripheral lymphocyte numbers. All three patients had an increased proportion of E-rosetting cells bearing Fc receptors for IgG. These cells were shown to be T lymphocytes by staining with monoclonal anti-T-cell sera and their subset phenotype was established as OKT4- OKT8+; in addition, a variable proportion of the cells was Ia+.

Unusual phenotype and function of an expanded subpopulation of T cells in patients with haemopoietic disorders.

We have studied two patients, one with red cell aplasia and the other with neutropenia. Both showed lymphocytosis. In both cases, 90-100% of E rosetting cells were T cells as defined by the monoclonal antibodies UCHT1 and OKT3.

Acquired pure red-cell aplasia associated with an increase of T cells bearing receptors for the Fc of IgG.

A case of steroid-resistant acquired pure red-cell aplasia associated with a relative and absolute increase of TG cells is described. Removal of T cells enhanced erythroid colony and burst formation in vitro, and it is suggested that TG cells may be implicated in the pathogenesis of this case of acquired pure red-cell aplasia.

Isolation of human haematopoietic progenitor cells using monoclonal antibodies.

Studies of the differentiation of human haematopoietic cells have been greatly advanced by the use of in vitro cloning techniques to enumerate the myeloid and erythroid progenitor cells which form colonies in semi-solid medium. The granulocytic/monocytic colony-forming cells (CFU-GM) and erythroid burst-forming cells (BFU-E) are thought to be mononuclear cells, similar in size to medium size lymphocytes, but their ontogenetic relationship to other progenitor cells and the putative pluripotential stem cell remains obscure. This is partly because elucidation of parent-progeny relationships requires the isolation of precursor cells before they acquire mature phenotypic characters.

Ectopic parathyroid adenomas.

Two cases of parathyroid tumours occurring in unusual situations are described. Such cases may cause difficulty in both the diagnosis and the surgical treatment of hyperparathyroidism. The cases described illustrate the importance of a definitive aetiological diagnosis in hypercalcaemia, if appropriate surgery is to be performed.

Rheumatoid aortic valve prolapse requiring emergency aortic valve replacement.

Rapid progression of aortic regurgitation was closely observed in a patient with severe seropositive rheumatoid arthritis. Rheumatoid changes within the aortic valve leaflets resulted in severe prolapse necessitating emergency operation. The postoperative course was satisfactory.

An erythrocyte membrane-protein anomaly in march haemoglobinuria.

In three patients with march haemoglobinuria a well-defined protein abnormality has been revealed by high-resolution sodium-dodecyl-sulphate/polyacrylamide-gel electrophoresis.

Tension pneumoperitoneum complicating cardiac resuscitation.

A case of gastric rupture and tension pneumonperitoneum following cardiac resuscitation is presented. Respiratory embarrassment necessitated emergency decompression by needle puncture of the peritoneal cavity, followed by laparotomy and repair of the gastric tear. The post-operative course has been satisfactory.