Postpartum haemorrhage due to a laceration in the endocervical canal; three case reports.

Three cases of severe postpartum haemorrhage due to a laceration in the endocervical canal at the level of the internal os are described. The cause of the laceration differed in all cases. Whenever postpartum haemorrhage occurs the possibility of a laceration in the internal os must be considered.

The vasa nervorum: microcorrosion casts for scanning electron microscopy.

Studies on the vasa nervorum have a long history, not least because of their beneficial application in surgical practice and in understanding the pathogenesis of some neuropathies. In the present study a method is described for the preparation of microcorrosion casts of the vasa nervorum suitable for examination by scanning electron microscopy. The results confirm the findings of earlier investigations but also demonstrate the advantages of an immediate three-dimensional representation of the vascular architecture together with the additional magnification and resolving power of electron microscopy.

Differential diagnosis of monoclonal gammopathy.

With a large segment of the adult population now undergoing routine screening tests on a periodic basis, findings such as rouleaux when the complete blood count is performed or an elevated total protein and globulin fraction on serum chemistries often lead to the performance of a serum protein electrophoresis. When a monoclonal gammopathy is confirmed, the clinician is faced with a broad differential diagnosis that includes a variety of distinct malignant plasma cell disorders and lymphoproliferative diseases, as well as the high incidence of MGUS in the otherwise healthy adult population. Other benign causes of secondary monoclonal gammopathy, such as underlying inflammatory or infectious disorders or drug reactions, may add to the diagnostic dilemma in some patients.

CD5 positive immunoregulatory B cell subsets.

B-chronic lymphocytic leukemia (B-CLL) is a heterogeneous disease often expressed as a clonal expansion of CD5+ B cells. We report the characterization of CD5+ B cells from two unique B-CLL patients. Cells from patient 1 coexpressed CD5 (leu-1), CD19 (Leu-12), CD20 (B1), and HLA-DR; they were CD10 (J5), CD21 (B2), CD22 (Leu-14), CD25 (IL2-R1), PCA-1, surface, and cytoplasmic Ig negative.

Simian retrovirus D serogroup 1 has a broad cellular tropism for lymphoid and nonlymphoid cells.

Simian acquired immunodeficiency syndrome is a fatal immunosuppressive disease caused by type D retroviruses such as simian acquired immunodeficiency syndrome retrovirus type 1 (SRV-1). The disease is characterized by generalized lymphadenopathy, opportunistic infections, and lymphoid depletion with defects in both humoral and cell-mediated immunity. To understand how SRV-1 infection relates to the immune defect, we studied in vivo-infected lymphocytes from SRV-1-positive macaques with and without clinical signs of immunosuppressive disease.

Adjuvant chemotherapy in premenopausal patients with primary breast cancer; relation to drug-induced amenorrhoea, age and the progesterone receptor status of the tumour.

Adjuvant chemotherapy with cyclophosphamide, 5-fluorouracil and methotrexate (CMF)-induced permanent ovarian suppression in 47 of 77 (61%) premenopausal patients with axillary node positive breast cancer. After a median observation time of 37 months the relapse-free and overall survival times were significantly longer for patients with permanent amenorrhoea. A strongly positive correlation between CMF-induced amenorrhoea and age of the patients, as well as between age and the tumour PgR status, was found.

The blood-nerve barrier: an in vivo lanthanum tracer study.

The permeability of the blood-nerve barrier was investigated using ionic lanthanum as an electron-dense tracer. The rat sural nerve was microinjected in vivo with lanthanum nitrate solution either into the endoneurial space or into the epineurium. Five to sixty minutes after injection the sural nerves were fixed by vascular perfusion or immersion.

Multiple myeloma: an immunologic profile. IV. The EA rosette-forming cell is a Leu-1 positive immunoregulatory B cell.

Patients with myeloma have a depressed capacity to respond to antigenic challenge. Studies in this laboratory have previously described an unclassified lymphoid cell which binds human erythrocytes coated with human immunoglobulin G (IgG) anti-D antibody (EA) as important in the inhibition of Ig synthesis in myeloma patients. Using monoclonal antibodies, two-color fluorescence studies, and flow cytometry, we characterized this EA cell as a Leu-1+ (cluster designation (CD) 5), Leu-12+ (CD 19), Leu-16+ (CD 20), B2+ (CD 21), Leu-14+ (CD 22), and HLA-DR+ B cell.

Initial experience in treating human lymphoma with a chimeric univalent derivative of monoclonal anti-idiotype antibody.

Murine monoclonal anti-idiotype antibody was raised against the surface IgM on the neoplastic cells of a patient with widespread follicular lymphoma. For therapy, a chimeric antibody derivative, FabIgG, was constructed by thioether-linking Fab'gamma, from the monoclonal antibody, to human normal IgG. FabIgG is univalent and thereby avoids rapid antigenic modulation.

Effects of plasmapheresis on peripheral blood mononuclear cell populations from patients with macroglobulinemia.

Effects of plasmapheresis on peripheral blood T-cell, B-cell, monocyte, and natural-killer-cell populations were studied in ten macroglobulinemia patients with hyperviscosity syndrome. Following plasmapheresis, there was a transient decrease in the number of T4+ helper cells and a longer-lasting decrease in the number of Leu-7+ natural killer cells and Mo2+ monocytes. In addition, there was a greater than 50% decrease in the in vitro ingestion capacity of monocytes.

Pathogenesis of simian AIDS in rhesus macaques inoculated with the SRV-1 strain of type D retrovirus.

Type D retrovirus was isolated from rhesus macaques with simian acquired immunodeficiency syndrome (SAIDS) and transmitted to healthy rhesus macaques with tissue culture medium containing the virus. The clinical, immunologic, and lymph node morphologic changes were observed in 9 rhesus macaques for 52 weeks after inoculation. A spectrum of clinical signs developed including early death, persistent SAIDS, and apparent remission.

Hematologic abnormalities in simian acquired immune deficiency syndrome.

Hematologic abnormalities were defined in 31 rhesus monkeys (Macaca mulatta) with simian acquired immune deficiency syndrome (SAIDS). Animals manifested anemia (hypochromic/microcytic), severe neutropenia and progressive lymphopenia, monocytosis and occasional thrombocytopenia. Bone marrow studies showed erythroid hyperplasia with a marked left shift and adequate megakaryocytes.

Captopril in the treatment of renovascular hypertension secondary to Takayasu's arteritis. A case report.

A case of Takayasu's arteritis complicated by renovascular hypertension is described. The hypertension was refractory to conventional medical treatment but responsive to captopril therapy. Deterioration in renal function occurred on initiation of captopril therapy; this resolved on reduction of dosage.

Filipin-sterol complexes at nodes of Ranvier.

Using the filipin-sterol technique, regional heterogeneity in the axonal and Schwann cell plasma membranes was investigated at the node of Ranvier and paranodes. Filipin-sterol complexes were abundant at the nodal axolemma but infrequent throughout the paranodal axolemma. The paranodal Schwann cell plasma membrane was rich in complexes which extended over the nodal Schwann cell microvilli.

Peripheral T-cell lymphoma. A clinicopathologic study of a morphologically diverse entity.

We analyzed the clinicopathologic features of 13 patients with immunologically confirmed peripheral T-cell lymphoma. The lymphomas were classified into poorly differentiated lymphocytic, mixed cell, and large cell types. Marked morphologic heterogeneity was noted within the mixed cell and large cell categories, and the various subtypes are described.

Karyotypic evolution in multiple myeloma.

A patient with IgG kappa multiple myeloma was studied cytogenetically prior to therapy and was found to have a clone of 55,XX cells. After treatment leading to a clinical response, the patient relapsed with a clone of 57,XX cells, which were derivatives of the original neoplastic cell line. This is the first case of demonstrated clonal evolution of myeloma in a patient studied prior to chemotherapy.

Distribution of filipin-sterol complexes in the myelinated nerve fiber.

Using filipin as a cytochemical probe to reveal the distribution of cholesterol, myelinated peripheral nerve fibers were examined in freeze-fracture replicas. Filipin-sterol complexes were most abundant in the Schwann cell and axonal plasma membranes. In the Schwann cell plasma membrane there was no heterogeneity in complex distribution in relation to the subjacent cytoplasmic network.

Cytogenetic evidence that the malignant event in multiple myeloma occurs in a precursor lymphocyte.

Multiple myeloma is traditionally thought of as a disease of plasma cells. Evidence from studies using antiodiotype antibodies, however, suggests that malignant events may take place in a precursor lymphocyte perhaps as early as the pre-B cell. In this study, we present cytogenetic evidence to support the latter view.

Social preferences in stump-tailed macaques (Macaca arctoides): effects of companionship, kinship, and rearing.

Social preferences in the directionality of social behavioral patterns in a heterogeneous group of 26 stump-tailed macaques (Macaca arctoides) were examined to see if kin recognition occurred. Four behavioral measures were analyzed: proximity, contact, grooming, and play. Three independent variables were examined: early companionship, condition of early rearing, and kinship.

Nodes of Ranvier and Schmidt-Lanterman incisures: an in vivo lanthanum tracer study.

The permeability of the tight junctional system of myelin, at the juxtanodal myelin terminal loops and Schmidt-Lanterman incisures, was investigated using the ionic tracer lanthanum (a) in vivo followed by fixation, (b) concurrently with fixation, (c) following fixation. Employing the same methods the juxtanodal membrane complex formed between myelin loops and axolemma was also tested. The results of this study demonstrate that the periaxonal space (between axon and Schwann cell) is apparently accessible to lanthanum via the myelin loop-axolemmal junction, irrespective of the mode of exposure of myelinated fibres to the tracer.

Non-random chromosomal aberrations associated with multiple myeloma.

Myelomatous tissue from 30 patients was assessed for cytogenetic abnormalities and one-third showed chromosomal deletions, additions, and/or rearrangements. Evidence is presented that those cases with only normal cytogenetics represent metaphase cells of nonmyelomatous tissue. The findings of our abnormal cases when added to the 18 reported in two series by others show unique cytogenetic patterns are present in this disease.

Heart rate response to tilting in newborns in quiet and active sleep.

The heart rate response to tilting was investigated in active and quiet sleep in 19 normal newborns (age 1-7 days) and 11 healthy premature infants (age 2-19 days). RR intervals were determined by computer from the ECG for 30-60 s periods immediately before and after each tilt. Term infants had a significant (p less than 0.