Expansion of CD4+ T cells with a cytotoxic phenotype in patients with B-chronic lymphocytic leukaemia (B-CLL).

Abnormal CD4/CD8 ratios and T-cell function have previously been shown in patients with B-chronic lymphocytic leukaemia (B-CLL). We have demonstrated that CD4+ T cells containing both serine esterase and perforin (PF) are increased in the blood of these patients. Using flow cytometry, we have shown that the CD4+ PF+ cells were CD57+ but lacked expression of CD28, suggesting a mature population.

Plasma cortisol, cortisone and urinary glucocorticoid metabolites in preterm infants.

Objective And Methods: In the fetal circulation, there is a low cortisol:cortisone (F:E) ratio ( approximately 0.3) suggesting high activity of 11beta-hydroxysteroid dehydrogenase type 2 (11betaHSD2). The circulating F:E ratio rises after birth in term infants, but little is known about infants born prematurely.

Adrenal function in preterm infants: ACTH may not be the sole regulator of the fetal zone.

The fetal zone of the adrenal gland is known to persist after preterm birth, but there is uncertainty as to how long adrenal fetal zone steroid production continues and how it is regulated. The purpose of this study was to test two hypotheses. First, that the urinary excretion of 3beta-OH-5-ene steroids persists until term, and then declines, as it does in full-term infants.

Drug abuse in pregnancy: obstetric and neonatal problems. Ten years' experience.

Drug abuse is an increasing problem and approximately 80% of female drug abusers are of childbearing age. This retrospective case note study reviews 10 years' experience of the management of pregnant drug abusers (n = 57) in the obstetric hospital of a London teaching hospital. Surprisingly, in view of other reports of high morbidity, no significantly increased rates of obstetric and neonatal problems were found when this group was compared with case-matched controls.

Activity of the adrenal fetal zone in preterm infants continues to term.

In term babies, steroids from the fetal zone of the adrenal gland decline in the blood and urine in the first few weeks after birth. In infants born prematurely, fetal zone steroids (3 beta-OH-5ene steroids) persist but it is not known for how long. The present study set out to address this by examining changes in the synthesis and metabolism of adrenal steroids with postconceptional age, using serial measurements of steroid metabolites in the urine.

Movement disorders in AIDS: Infective, neoplastic and iatrogenic causes.

We present seven cases of movement disorders encountered in patients with AIDS at a national referral centre over a 4 year period. These include cases of chorea athetosis due to cerebral toxoplasmosis, progressive multifocal leucoencephalopathy, cerebral infarction due to Herpes zoster infection and hypoglycaemia secondary to pentamidine therapy, wing beating tremor as a result of primary cerebral lymphoma, and two cases of drug induced akinetic rigid syndrome.

Prospective study of the hypothalamic-pituitary axis in thalassaemic patients who developed secondary amenorrhoea.

Objective: We aimed to prospectively evaluate during 10 years the GnRH-gonadotrophin secretory dynamics in a cohort of 15 menstruating girls with beta-thalassaemia major to determine whether they sustained progressive damage to this axis.

Design: Patients were characterized by 12-hour gonadotrophin profiles (by sampling blood at 15-minute intervals) and assessment of gonadotrophin responses to 100 micrograms GnRH bolus (by sampling blood at 20-minute intervals for 1 hour and at 2 hours) sequentially during the follicular and luteal phases of their menstrual cycles, 12-14 months and 5-6 years after the onset of secondary amenorrhoea.

Subjects: We studied 15 post-menarcheal thalassaemic girls and five age-matched control subjects who were the healthy siblings of the patients.

Production and analysis of IgG monoclonal anti-DNA antibodies from systemic lupus erythematosus (SLE) patients.

This study compares recently devised methods for producing IgG anti-DNA MoAbs from patients with SLE and analyses the antibodies generated from one patient at different phases of disease. Lymphocytes from SLE patients were transformed with Epstein-Barr virus(EBV) and/or fused with a heteromyeloma cell line, CB-F7. Direct fusion with CB-F7 resulted in the highest proportion of IgG-secreting lines, whereas EBV transformation resulted in a high percentage of IgM-secreting lines.

"Cognitive activity" monitored by non-invasive measurement of cerebral blood flow velocity and its application to the investigation of cerebral dominance.

We have developed a method of non-invasively detecting language lateralisation by measuring the increase in middle cerebral artery blood flow velocity occurring during a word association task, using transcranial Doppler ultrasonography. All exclusively right handed subjects (N = 12) showed a relative increase in left sided flow velocity during the task; mean rise was 4.04% on the left, and -0.

Production of human monoclonal antibodies to myeloperoxidase.

Two mouse-human heterohybridomas secreting human antibodies to myeloperoxidase (MPO) were derived from the peripheral blood of a patient who developed microscopic polyarteritis as the result of long-term treatment with hydralazine. Forty-five immunoglobulin-secreting lines were obtained from the fusion of patient lymphocytes with the CB-F7 heteromyeloma cell line. Of these, two antibodies, one IgG and one IgM, bound to myeloperoxidase in solid phase ELISA and gave a perinuclear staining pattern on ethanol-fixed human neutrophil cytospin preparations.

Multiple-fibre low-power interstitial laser hyperthermia: studies in the normal liver.

Multiple four-fibre low-power interstitial laser hyperthermia was performed in the canine liver to establish the parameters with which large areas of thermal necrosis could be made. Using 1.5 W for 670 s (4020 J in total) and a fibre spacing of 1.

Eicosanoid synthesis in duodenal ulcer disease: decrease in leukotriene C4 by colloidal bismuth subcitrate.

The release of immunoreactive prostaglandin E2 (PGE2) and leukotriene C4 (LTC4) from antral and duodenal mucosal biopsy specimens taken from 20 patients with duodenal ulcer disease was measured by radioimmunoassay before and four weeks after treatment with colloidal bismuth subcitrate. Gastroscopic and histological examination showed complete ulcer healing in 15/18 patients and duodenal histology looked normal (n = 15) or improved (n = 3): two patients failed to attend for a second endoscopy. Analysis of the supernatant from incubations of biopsy tissue in vitro showed that unstimulated antral release of PGE2 was significantly more than that from the duodenal mucosa (p less than 0.

Independent analysis of the 16/6 idiotype lupus model. A role for an environmental factor?

The recent description of a lupus-like disease in normal mice after injections of human mAb that bind DNA and carry the common Id 16/6 Id has excited much attention. In an effort to reproduce this model we have performed two experiments using eight human mAb three of which bear the 16/6 Id. Despite using an injection protocol very similar to that of the original authors and waiting for up to 1 yr we were unable to detect any autoantibodies or any evidence of renal disease.

Autoimmunity associated with infection: leprosy, acute rheumatic fever and Lyme disease.

This review examines the links between autoimmunity and three common infectious diseases. These disorders are associated with a variety of clinical and serological autoimmune phenomena. In addition they might conceivably trigger autoimmune diseases themselves.

Liposomal amphotericin B (AmBisome) in the treatment of fungal infections in neutropenic patients.

The use of high-dose chemotherapy and the subsequent prolonged neutropenia in patients with haematological diseases has resulted in an increased incidence of fungal infections. The diagnosis and treatment of these infections in neutropenic patients pose major therapeutic problems. The only drug with proven efficacy in the treatment of deep-seated fungal infections, including invasive aspergillosis, is amphotericin B.

Palliation of proximal malignant biliary obstruction by endoscopic endoprosthesis insertion.

For four years up to December 1987, 190 patients (median age 73 years) with proximal malignant biliary obstruction were treated by endoscopic endoprosthesis insertion. Altogether 101 had cholangiocarcinoma, 21 gall bladder carcinoma, 20 local spread of pancreatic carcinoma, and 48 metastatic malignancy. Fifty eight patients had type I, 54 type II, and 78 type III proximal biliary strictures (Bismuth classification).

Structure of human glutathione S-transferase class Mu genes.

Nucleotide sequencing of a human cosmid clone shows that the exon-intron structures of a glutathione S-transferase multigene family are conserved between man and rat, that the human gene family is clustered and that gene conversion events have occurred within the cluster. In addition, between man and rat, there is a high degree of nucleotide sequence identity not only in exons but also in some introns. These conserved sequences are coincident with homologous sequences subject to gene conversion in both species, and hence the utilization of gene conversion by this gene family has itself been conserved.

Activity and toxicity of carboplatin and iproplatin in relapsed high-grade glioma.

A total of 15 patients with relapsed high-grade glioma were treated with carboplatin (400 mg/m2) or iproplatin (300 mg/m2). All had received previous radiotherapy, and 12 had previously undergone chemotherapy. One of the ten patients treated with carboplatin and one of the five treated with iproplatin achieved a partial remission as determined by repeat computerised tomographic (CT) scan.

Assessment of common idiotype PR4-Id in serial bleeds from lupus patients.

Marked fluctuations in the levels of a common DNA-antibody idiotype, PR4-Id have been found on IgM and IgA antibodies in particular and to a lesser extent on IgG in serial bleeds of 14 lupus patients. Few clear cut examples were found of the PR4-Id levels reflecting disease activity. However, the idiotype expression was not simply related to total immunoglobulin levels and the controlling mechanisms of idiotype expression on different isotypes remain a matter of conjecture.

Role of platelets and antiplatelet agents in cerebrovascular disease. Clues from trials.

Significant reductions in mortality and in the incidence of nonfatal strokes have been shown in many trials of antiplatelet drugs, such as aspirin, in cerebrovascular disease. The limitations of these trials must be considered; however, if the trials are to provide useful information on the role of platelets in thrombotic processes. Difficulties arise because of the variable composition of emboli and the many possible causes of strokes.