[Complications of digestive surgery. Prediction by anergy and not by malnutrition].
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Biomedical subjects
Publications and source records attributed to C Andre.
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The 24-h toxicity of 20 substituted chlorophenols upon Lebistes reticulatus has been determined. The biological results have been tentatively connected with several of the following six parameters: logarithm of the octanol-water partition coefficient (log P); index of molecular connectivity (1 chi v); molecular refraction (RM); perimeter of the efficient section of the molecule (sigma D); constants of HAMMET (sigma); and melting point (F). A correlation is achieved using sigma D and sigma D2 with a correlation coefficient of 0.943.
The sera of 131 patients with anti-liver-kidney microsome antibodies (anti-LKM) detected between 1973 and 1979 in two different laboratories were re-examined. (1) Eighty-six anti-LKM corresponded to the description given by Rizzetto, Swana & Doniach (1973), with a pattern of fluorescence predominating on the 3rd portion of the proximal tubules (P3). This group comprised 45 cases of idiopathic chronic hepatitis or idiopathic cirrhosis and one case of halothane-induced hepatitis. (2) Forty-five anti-LKM gave a different pattern on male mouse liver and male rat kidney: (a) fluorescence was greater on centrolobular than on periportal hepatocytes; (b) the first and second portions of proximal tubules (P1 and P2) predominated over P3; (c) P1 fluorescence was equally intense as P2 and (d) P3 cells were heterogeneous with one cell out of 20 more positive than the rest. Absorption tests confirmed that the corresponding antigen was also present in the liver microsomal fraction. A retrospective clinical study discovered tienilic acid-induced hepatitis in all cases. We suggest naming this new antibody 'anti-LKM2'.
The phenotype of fresh and cultured leukemic cells from patients with hairy cell leukemia was studied using a panel of monoclonal antibodies in addition to the detection of peroxidase activity under electron microscopy. In fresh samples, the leukemic cells from 11 patients displayed predominantly a B phenotype, as judged by their reactivity with the B1 monoclonal antibody and surface immunoglobulin expression. Ultrastructural peroxidase activity, characteristic of hairy cells, was observed in all cases studied. When hairy cells were cultured in the presence of phytohemagglutinin and irradiated T cells, their phenotype converted from surface Ig+, B1+, OKT3-, OKT11- to surface Ig-, B1+, OKT3-, OKT11+. In contrast, the peroxidase activity remained unchanged. Some hairy cells were also OKM1+, but no conclusion could be made about the MO2 antigen, a more specific marker of monocytes. The variability of the phenotype in vivo and in vitro indicates that reliable markers are required for identifying hairy cells. When studied together, the staining by B1 monoclonal antibody and the ultrastructural detection of peroxidase, enable the identification of hairy cells with certainty.
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A new T-cell disorder has recently emerged: the so-called adult T-cell lymphoma leukemia (ATLL) initially described in Japan. Subsequently, ATLL cases were recognized in patients from the Caribbean. We summarize the clinical and hematological features of 19 published cases from Western countries, in addition to a new case we encountered. The leukemic cells display characteristic morphological features and a T3+T4+T8-T6- surface antigenic phenotype. Overall survival is of short duration, but remission could be obtained in our case despite a subsequent relapse in skin and CNS. Geographic clusters of ATLL cases have led to the discovery of the possible role of a new retrovirus, HTLV, in the genesis of this rare malignancy.
Human T lymphocytes require the cooperation of accessory cells to generate lymphocyte colonies in agar culture under PHA stimulation. Various hairy cell enriched fractions, as well as normal monocytes, have been found to be able to initiate colony formation by normal lymphocytes. Leukemic monocytes from CMML patients were also effective, but not the leukemic lymphocytes from CLL patients. The phenotype expressed by HC in agar colonies was further studied using cell surface and enzymatic markers. We have concluded that HC in agar culture in the presence of both normal T lymphocytes and PHA lose the B phenotype that they express in vivo and function like an accessory cell in contrast to normal or leukemic B lymphocytes.
The theory of an allergic participation in the pathogenesis of gastric erosions occurring in varioliform gastritis and in peptic ulcer was tested in humans. Biopsies were obtained from the edges of gastric and duodenal ulcers and from the erosion edges of varioliform gastritis as well as from surrounding duodenal, antral and fundic mucosae. Intracellular immunofluorescence staining was used to identify mucosal plasma cells. The lesion edges were characterized by a marked increase of IgE cells. These features justify new therapeutic orientations.
The lymphocyte colony forming capacity of peripheral blood mononuclear cells from normal controls and from two patients with chronic OKT8+ lymphocytic leukaemia was determined in agar culture under PHA stimulation. The number and size of the colonies in patients were reduced compared to normal. The lymphocytic phenotype of colony cells was studied with monoclonal antibodies in colonies harvested from agar culture and in colonies expanded in liquid culture in the presence of TCGF. This study was performed in individual colonies and in pooled colonies. Colonies from normal controls contained a mixture of the OKT4+ and OKT8+ lymphocyte subsets. In contrast, colonies from the two patients contained essentially OKT4+ lymphocytes. The data indicate that, in the patients, progenitors of the OKT8+ subset are unresponsive to normal proliferative and/or differentiative stimuli under the present culture conditions.
Plasma exchange, together with oral immunosuppressive drugs and various doses of adrenal steroids, were used in the treatment of ten patients with pemphigus. Initially plasma exchange decreased the intercellular antibody (IC Ab) level in all patients and induced a clinical improvement in the conditions of eight of ten patients. This improvement was sustained for the six patients who received simultaneously 0.5 mg/kg/day or more of prednisone. Among the eight patients, four previously corticoresistant patients had perfect control of their disease. Conversely the other four patients, treated with low doses of prednisone, experienced a posttreatment rebound in IC Ab level and showed no or only transient clinical improvement. Plasma exchange may be useful in bringing corticoresistant pemphigus under control but it is not to be used without accompanying high doses of adrenal steroids.
Beta-Adrenergic agonists cause adenylate cyclase activation via a conformational change of their receptor. This was earlier revealed by the use of N-ethylmaleimide as a structural probe: agonist-bound receptors are rapidly inactivated by 0.1 mM N-ethylmaleimide while free and antagonist-bound receptors remain unaffected. Furthermore, the beta-adrenergic receptors only change conformation when coupled to the guanine nucleotide regulatory component of the adenylate cyclase system. It is shown in this report that treatment of turkey erythrocyte membranes with the sulphydryl-specific agent 2,2'-dinitro-5,5'-dithiodibenzoic acid and elevated concentrations of N-ethylmaleimide (1-10 mM) do not affect the total receptor number, but prevent the ability of beta-adrenergic agonists to mediate conformational changes. This effect is mimicked by GTP. These three compounds cause also a two- to four-fold decrease in agonist affinity. Both phenomena may be explained by the ability of the reagents to prevent, and of GTP to reverse, the functional coupling between the receptors and the regulatory component of the adenylate cyclase system. Removal of Mg2+ from the incubation medium (i.e. presence of 1 mM EDTA) produces a similar decrease in agonist affinity, but does not impair the ability of agonist/N-ethylmaleimide to inactivate the receptors. This suggests that Mg2+ increases the agonist affinity for the receptor-regulatory component complex, but is not required for its formation.
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Glomerulopathies associated with non-Hodgkin's malignant lymphomas have been observed rarely. Previous reports have never determined the cell type of the lymphoproliferative disorder. This report documents a case of nephrotic syndrome in a patient with T-cell derived non-Hodgkin's lymphoma. The neoplastic cell was studied in terms of cell-surface markers, cytochemical staining, and ultrastructural morphology. Nephrotic syndrome occurred shortly after the apparent onset of the lymphoma. The kidney biopsy specimen was examined by light, fluorescence, and electron microscopy. Histologic findings were consistent with the diagnosis of mild focal and segmental glomerulosclerosis. Such an association, reported here for the first time, may support the hypothesis of a pathogenetic link between acquired T-cell abnormalities and glomerular diseases with minimal histologic injury.
The ability of 11 laboratory parameters to reflect the degree of activity of Crohn's disease, using a clinical index as reference point was compared by means of multiple stepwise regression analysis. Activity was best defined in decreasing order by orosomucoid, sedimentation rate, C reactive protein, alpha-1-antitrypsin, albumin, haematocrit, IgM, circulating immune complexes, serum iron, IgG, and IgA. The haematocrit, the only laboratory measurement in the Crohn's disease activity index developed by the National Cooperative Study Group in the USA, is less discriminant than acute phase reactants. Only three parameters-namely, orosomucoid, sedimentation rate, and C reactive protein-have a significant weight and should be complementary to a simple clinical index.
Vitamin B12 Urinary excretion, stool weight, fecal fat excretion, fecal 14C glycocholate excretion and 14CO2 output after I-14C glycocholate ingestion, were measured in 13 patients with non-operated ileal Crohn's disease (NOC), 14 patients with ileal resection for ileal Crohn's disease, with or without right colectomy (RC), and 11 patients with ileal resection with or without right colectomy for pathology other than Crohn's disease (RNC). A positive linear relationship was found between stool weight and 14C glycocholate fecal excretion. The logs of fecal fat and 14C glycocholate excretions were related to the extent of the ileal lesion of resection; a similar but negative relationship was observed for vitamin B12 urinary excretion. Fecal fat excretion and respiratory 14CO2 output were significantly higher in patients with right colectomy.
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