Boyce Bennett

Mechanism of a Reaction in Vitro Associated with Delayed-Type Hypersensitivity

The cell type responsible for inhibition by antigen of migration in vitro of peritoneal exudate cells obtained from tuberculin-hypersensitive guinea pigs was studied. Exudate populations were separated into component cell types, the lymphocyte and the macrophage. Peritoneal lymphocytes from sensitive donors were the immunologically active cells in this system, the macrophages, being merely indicator cells which migrate. Sensitized peritoneal lymphocyte populations, upon interaction with specific antigen in vitro, elaborated into the medium a soluble material capable of inhibiting migration of normal exudate cells.

Cis‐platin based combination chemotherapy for advanced ovarian cancer. High overall response rate with curative potential only in women with small tumor burdens

Thirty‐eight women with advanced ovarian cancer were given monthly cycles of intravenous cyclophosphamide, Adriamycin (doxorubicin) and cis‐platin, and oral hexamethylmelamine. Of 26 with tumor which would be evaluated for response, 42% had complete remission and 50% partial remission. Median time to disease progression from entry for all 38 patients was 13 months, and median survival 23.5 months. The bulk of tumor at the time chemotherapy was begun was the only significant prognostic factor for time to disease progression and survival. Of the seven women surviving free of disease a median of three years later, five had no mass > 2 centimeters in diameter at entry. Toxicity was predominantly myelosuppression and vomiting, with mild peripheral neuropathy in 27% and no significant renal or cardiac toxicity. The response rate of 92% is much higher than that previously reported with melphalan, and the survival considerably longer. The toxicity is acceptable, given the substantial improvement in results.

Xanthogranulomatous Pyelonephritis: Detailed Analysis of 29 Cases and a Brief Discussion of Atypical Presentations

AbstractA detailed review of 29 cases of xanthogranulomatous pyelonephritis is presented. Focal involvement of the kidney was noted in 5 instances. An accurate preoperative diagnosis of xanthogranulomatous pyelonephritis is difficult because of its clinical and radiological similarities to various other renal lesions. Bilateral xanthogranulomatous pyelonephritis is extremely rare and segmental excision of the kidney, when technically feasible, may be curative.

Studies On The Migration Inhibitory Factor Associated With Delayed-type Hypersensivity: Cytodynamics And Specificity

Peritoneal lymphocytes obtained from tuberculin sensitive guinea pigs, when cultured with purified protein derivative, elaborate into the medium a substance, presumably a protein, capable of inhibiting the migration of normal macrophages. This migration inhibitory factor appears to possess immunologic specificity, since specific antigen enhances its activity. Sensitized cells upon interaction with antigen continuously produce this factor for up to 4 days. Concomitantly, sensitized lymphocytes undergo those morphologic alterations recognized as “blast-cell” transformation.

THE PHAGOCYTOSIS OF TUMOR CELLS IN VITRO.

The phagocytosis of tumor cells by peritoneal macrophages from mice was demonstrated in vitro following opsonization with isoanti-body. Phagocytosis of tumor cells occurred in the presence of isoimmune serum prepared in either H-2 compatible or H-2 incompatible strains. After ingestion, the tumor cells were destroyed by the engulfing macrophages. Normal mouse serum contained nonspecific factors that enhanced phagocytosis in the presence of specific isoimmune serum. Peritoneal macrophages from immunized animals had no inherent, specific ability to phagocytize tumor cells in vitro, apart from that due to the presence of humoral antibody in the medium. Their ability to phagocytize tumor cells was abolished by washing the peritoneal cells, but was restored by the addition of a medium containing isoantibody. Peritoneal macrophages collected from animals that had been given an i.p. injection of starch phagocytized tumor cells in greater numbers than did peritoneal macrophages from normal animals. In contrast to viable tumor cells or cells killed by prolonged storage, tumor cells killed by methanol or heat were phagocytized in the absence of isoantibody.

The significance of focal sclerotic lesions of glomeruli in children

To establish the relationship between the type of focal sclerotic lesion of glomeruli and the development of progressive renal disease, the clinical courses of 20 children with focal segmental and 7 with focal global sclerosis were analyzed. Only five patients, all of them with focal segmental sclerosis, did not have the nephrotic syndrome, although all had proteinuria. Results suggest that patients with focal global sclerosis have a course identical to that of children with the minimal lesion form of nephrotic syndrome: onset in early childhood, response to steroid therapy, and a relapsing, nonprogressive course. Focal segmental sclerosis, in constrast, is characterized by older age at onset, high incidence of nephritic symptoms, lack of response to steroid therapy, and a progressive course with histologic and functional deterioration. Since most published reports have not distinguished between these two entities, a more favorable prognosis in focal segmental sclerosis may be inferred than is actually the case.

Sequential occurrence of IgA nephropathy and Henoch-Schönlein purpura : support for common pathogenesis

We report a patient who developed Henoch-Schönlein purpura (HSP) 13 years after he presented with IgA nephropathy (IgAN). In both HSP and IgAN renal biopsy most commonly reveals focal proliferative glomerulonephritis on light microscopy and immunofluorescence displays mesangial IgA deposits. In addition, patients with HSP or IgAN have elevated serum IgA levels, circulating IgA immune complexes, IgA-bearing lymphocytes, immunoglobulin-producing cells, and binding of IgG to glomerular components of similar molecular weight. The occurrence of both diseases in the same patient or the same families and the presence of immune abnormalities compatible with HSP or IgAN in relatives of patients with these diseases suggest a common pathogenesis.

Significance of accessory ductal structures in hernia sacs.

The finding of ductal structures resembling a vas deferens during pathological examination of a hernia sac specimen has significant medical and legal implications. A method of distinguishing these accessory structures from an inadvertently transected vas has been lacking and is needed. Between July 1989 and January 1990 we examined 147 hernia sacs from 105 consecutive prepubertal and adolescent boys to determine the incidence and salient histological features distinguishing these ductal structures from a true vas deferens. Luminal diameters of the ductal structures were compared with published normal age-related established vas deferens diameters and with those measured during hernia repair in 10 of our youngest patients. Among the 147 specimens 6 hernia sacs (4.1%) contained ductal structures. We found that the mean ductal diameter (0.263 mm.) was significantly smaller than that of a normal vas deferens (0.69 to 1.5 mm.). Furthermore, the surrounding mantle of tissue of these ductal structures lacked muscle tissue when studied with Masson trichrome stain. We conclude that duct diameter and trichrome staining are simple ways of differentiating these structures from a true vas deferens.

1 – THE ASSAY OF INHIBITION OF MACROPHAGE MIGRATION AND THE PRODUCTION OF MIGRATION INHIBITORY FACTOR (MIF) AND SKIN REACTIVE FACTOR (SRF) IN THE GUINEA PIG*

Publisher Summary The capillary tube method for studying the inhibition of macrophage migration in vitro has been widely shown to be a useful correlate of delayed-type hypersensitivity in experimental animals. Recent reports indicate its potential usefulness in man. In animal studies, the technique has been successfully applied for the detection of transplantation antigens and cell-associated tumor antigens, as well as soluble tumor antigens. It has been shown that this reaction is mediated by a soluble factor, produced by sensitized lymphocytes upon stimulation by specific antigen, that is, migration inhibitory factor. Culture supernatants containing this factor have been found to produce indurated reactions in the skin of normal guinea pigs that resemble histologically active delayed-type hypersensitivity reactions, the activity responsible for this being denoted as skin reactive factor. This biologic activity provides support for the view that factors produced by antigen-stimulated lymphocytes in vitro may be mediators of delayed hypersensitivity reactions in vivo. This chapter describes a method to analyze the inhibition of macrophage migration and the production of migration inhibitory factor and skin reactive factor in the guinea pig.

Renal allograft rejection in children and young adults : the Banff classification

In the Banff classification, arteritis and tubulitis are regarded as the principal histological lesions indicating acute renal allograft rejection. To test this claim, we examined 51 biopsies obtained from 21 children and young adults with transplant rejection. Two reviewers, blind to the clinical course, graded the biopsies according to the Banff scheme. In patients without significant tubulitis (borderline changes), rejection tended to be reversed easily (88%), often with methylprednisolone pulse (52%). In patients with arteritis or significant tubulitis (Banff I–III), rejection was reversed in only 23% (P < 0.001), in 9% with steroids, and in 14% with OKT3. Salvage of the graft was achieved in 26 of 35 (74%) with a score < 5 but in only 1 of 12 (8%) with a score ≥5 (P < 0.001). All 6 patients with vasculitis lost their grafts despite methylprednisolone pulse and OKT3. We conclude that the Banff classification predicts accurately the outcome of renal allograft rejection in children and may aid in choosing appropriate therapy.