No abstract

Human mononuclear leukocytes generate the procoagulant material tissue factor (TF) following stimulation by endotoxin, mitogens, or antigens in vitro. We have examined tissue-factor generation by mononuclear cell subpopulations prepared in a variety of ways in order to determine the cell of origin of mononuclear cell TF and the conditions necessary for maximal in vitro TF generation. We have also examined the relationship between in vitro TF generation and in vivo or in vitro measures of delayed hypersensitivity in response to identical antigen stimulation. Our results demonstrate that the monocyte is responsible for the bulk of mononuclear cell TF generation in vitro and that adhesion alone is not sufficient stimulation for significant.

Peripheral blood T and B lymphocytes were quantitated in 42 patients with untreated Hodgkin's disease and the results compared with the response to phytohemagglutinin (PHA) stimulation and delayed hypersensitivity skin testing. T lymphocytes were identified by an in vitro cytotoxicity assay employing a specific anti-T-cell serum and by spontaneous rosette formation with sheep erythrocytes (E rosettes). The percentage of T cells in the patients was similar to that of normal subjects as judged by the cytotoxicity assay (65 to 90%). In addition, absolute T-lymphocyte counts were normal in 63% of the patients and were generally reduced only in those with lymphopenia. The percentage of T lymphocytes determined by the E-rosette assay was similar to that determined by the cytotoxicity assay i n normal controls, but was significantly lower than that determined by the cytotoxicity assay in the patients. Moreover, the decreased response to PHA stimulation in the patients was directly correlated with the decrease in E-rosette formation. These findings suggest that T lymphocytes in the peripheral blood are not generally diminished in untreated Hodgkin's disease. However, a proportion of these cells exhibits altered surface interactions that may account for some aspects of their impaired immunologic function.

For moderate to severe symptoms of diabetic gustatory sweating, topical application of glycopyrrolate is safe, effective, well tolerated, and convenient.

No abstract

The relative effectiveness of six nonsteroidal anti-inflammatory agents was studied in 33 patients with rheumatoid arthritis and 32 patients with ankylosing spondylitis in a double-blind, randomized, prospective study employing a six-way multiple crossover design with six-week trials of each agent. In ankylosing spondylitis, naproxen, indomethacin, and fenoprofen calcium were the most effective agents. In rheumatoid arthritis, relatively little mean difference between drugs was found. Most of this difference could be attributed to compliance factors, which favored drugs that required only a small number of pills daily. Despite the small differences in effect, patients had strong preferences. More than 85% of patients were still taking their preferred medication after a mean follow-up period of one year.

Peripheral blood lymphocytes from 20 patients with systemic lupus erythematosus (SLE) and 21 normal donors were incubated with pokeweed mitogen in order to assess in vitro terminal-differentiation of B lymphocytes into cells synthesizing intracytoplasmic immunoglobulin (Ig). Although the percentage (mean k SEM) of B lymphocytes bearing surface Ig in the initial cell suspensions was not statistically different in SLE than in normal subjects (15 f 2.2% versus 16 f 1.9%, respectively), the frequency of cells containing intracytoplasmic Ig per lo3 mononuclear cells was significantly lower in mitogen-stimulated cultures derived from the patients than from the normal controls (10 f 2.3 versus 56 f 13.0 for IgM, P < 0.01; 21 f 3.6 versus 63 f 10.4 for IgG, P < 0.01; 13 f 3.1 versus 24 f 3.8 for IgA, P < 0.05 respectively).Coculturing active SLE lymphocytes with cells from nor- Submitted for publication April 28, 1977; accepted May 19. 1977. ma1 subjects resulted in a significant (P < 0.05) increase in the frequency of cells containing intracytoplasmic IgG when stimulated with pokeweed mitogen. Moreover, culturing SLE lymphocytes in cell-free media derived from activated normal lymphocytes also resulted in a significant increase in the frequency of IgG-containing cells. These results suggest that B-lymphocyte differentiation in vitro is depressed in SLE and may, at least partially, be reversed by products derived from normal lymphocytes.

Acral cutaneous vesiculobullous eruption is an uncommon adverse drug eruption due to simvastatin, one of many different patterns possible. A high level of suspicion for an unexplained cutaneous eruption in an older individual on statins is important to identification of the disorder and discontinuation of the offending medication.