Peripheral blood leucocytes and their phagocytosis-associated metabolic activity were studied in 65 patients after elective surgery representing similar degrees of surgical trauma. Halothane (group A) or neurolept (group B) anaesthesia were given to 50 patients. Fifteen patients had extradural blockade only (group C). Leucocytosis was observed immediately after surgery in group B: patients in groups A and C responded more slowly. The higher 2nd-day values were followed by a decrease in leucocyte numbers on the 5th day. Although patients in groups A and B showed immediate decreases in nitroblue tetrazolium reduction, recovery was noted only in group B on the 5th day after operation. It is postulated that leucocytes with damaged membranes and receptors are probably lacking in the necessary functional integrity to fight invading microorganisms.
Anaesthesia and surgery are known to depress granulocyte function in the early postoperative period, leading to deterioration of the immune defence against infection. Carbohydratelectin interactions may play an important role in the activities of phagocytic cells in that theyGeneral anaesthesia and surgery are known to influence immune cell function. The consequent impairment of defence mechanisms leads to a higher risk of postoperative infection. The clinical manifestation is dependent on several factors, i.e., inherited conditions of the immune system, secondary immunodeficient states due to malnutrition, underlying malignant disease, immunosuppressive therapy as well as the degree of surgical trauma, the length of operation and the type of anaesthetic technique used.Peripheral blood polymorphonuclear leukocytes (PMNL) are involved in the first line defence against invading microorganisms. The depressive effect of nitrous CAN J ANAESTH 1992 / 39:2 / pp 143--50
Protein-carbohydrate recognition may be involved in an array of molecular interactions on the cellular and subcellular levels. To gain insight into the role of proteins in this type of interaction, surgically removed specimens of human endomyocardial tissue were processed for histochemical and biochemical analysis. The inherent capacity of these sections to bind individual sugar moieties, which are constituents of the carbohydrate part of cellular glycoconjugates, was assessed using a panel of biotinylated neoglycoproteins according to a standardized procedure. Together with appropriate controls, it primarily allowed localization of endogenous lectins. Differences in lectin expression were observed between layers of endocardial tissue, myocardial cell constituents, connective-tissue elements, and vascular structures. The endocardium proved to be positive with beta-galactoside-bearing probes; with neoglycoproteins carrying beta-xylosides, alpha-fucosides, and galactose-6-phosphate moieties; and with probes containing a carboxyl group within the carbohydrate structure, namely sialic acid and glucuronic acid. In contrast, only fucose-and maltose-specific receptors were apparent in the elastic layers of the endocardium. Aside from ascertaining the specificity of the protein-carbohydrate interaction by controls, i.e., lack of binding of the probe in the presence of the unlabelled neoglycoprotein and lack of binding of the labelled sugar-free carrier protein, respective sugar receptors were isolated from heart extracts by using histochemically effective carbohydrates as immobilized affinity ligand. Moreover, affinity chromatography using immobilized lactose as affinity ligand as well as the use of polyclonal antibodies against the predominant beta-galactoside-specific lectin of heart demonstrated that the lactose-specific neoglycoprotein binding was due to this lectin. Remarkably, the labelled endogenous lectin, preferred to plant lectins for detecting ligands of the endogenous lectin, localized ligands in tissue parts where the lectin itself was detected glycohistochemically as well as immunohistologically. This demonstration of receptor-ligand presence in the same system is a further step toward functional assignment of the recorded protein-carbohydrate interaction. Overall, the observed patterns of lectin expression may serve as a guideline to elucidate the precise physiological relevance of lectins and to analyze pathological conditions comparatively.
Inhalation anaesthetic agents are known to depress phagocytic functions such as mobilization, attachment, chemotactic motility, engulfment and intracellular killing. Mannose-specific sugar receptors on the surface of leukocytes are involved in a series of phagocytosis-related activities. To investigate the effect of anaesthesia on the expression of this type of sugar receptor, mice were anaesthetized with halothane, enflurane and isoflurane. The presence of mannose-binding receptors on peripheral blood polymorphonuclear leukocytes was examined glycocytochemically using the biotinylated neoglycoprotein mannosylated bovine serum albumin. Prolonged administration of inhalation anaesthetic agents, especially halothane, markedly depressed expression of mannose-specific receptors. This reduction may possibly contribute to postoperative immunodepression, resulting from the impaired cellular interaction which is involved in the phagocytic function of granulocytes.
Contralateral haemothorax developed as a late complication of subclavian vein cannulation following gradual erosion of the wall of the superior vena cava by the tip of the catheter. The use of a relatively rigid catheter and a left-sided approach may have contributed to this rare, but potentially fatal complication.
Different carrier-immobilized carbohydrate moieties were employed as tools to detect respective binding sites glycohistochemically and glycobiochemically. Besides ascertaining their presence the pattern of endogenous sugar receptors (lectins) in different regions of the human central nervous system was mapped to reveal any non-uniform expression. A strong and specific staining with biotinylated neoglycoproteins, exposing different sugar moieties as ligands, indicated the presence of sugar receptors in the nuclei, neuronal pathways and accessory structures such as ependyma cells, plexus chorioideus, intra- and extracerebral vessels and leptomeninges localized in the mesencephalon, in the pons, in the medulla oblongata and in the cerebellum. Significant differences were seen for various neuroanatomical regions like nerve cells in the basal and central regions of the nuclei pontis in the glycohistochemically detected level of expression of endogenous sugar receptors (lectins). The used approach with carbohydrate constituents of cellular glycoconjugates as ligands in search of specific receptors complemented studies on the localization of glycoconjugates with sugar-specific tools like plant lectins. Exemplary glycobiochemical investigations on the medulla oblongata and cerebellum were performed to investigate the molecular nature of sugar receptors detected glycohistochemically. Despite notable overall similarities, carbohydrate-binding proteins of differing molecular weight can be isolated from these two regions of the central nervous system, namely in the case of receptors with specificity to beta-galactoside termini, to N-acetyl-D-galactosamine and N-acetyl-D-glucosamine and to D-xylose. These combined glycohistochemical and glycobiochemical results serve as a guideline for exploring the physiological relevance of the detected regional differences.
A combined test for the detection of both T and B lymphocyte surface markers has been described by Chapel & Ling (1977) who observed that in T-cell acute lymphoblastic leukaemia and in lymphosarcoma patients a signlfcant number of peripheral blood lymphocytes exhibit both E and C, surface receptors. The authors assume that in some lymphoid malignancies these cells may represent a distinct non-malignant subpopulation of T cells of unknown significance.It is known that in the fetal thymus a high percentage of cells are C, receptor positive, a B-cell feature, and that the number of these cells decreases during fetal life in parallel with an increase in the number of cells forming spontaneous rosettes with untreated sheep erythrocytes, a T-cell feature (Gatien et al, 1975). It is also assumed that during thymus development a number of cells may bear both T and B cell markets, representing an early cell population in T-cell differentiation, prothymocytes, and that malignant lymphomas with a higher number of double-labelled lymphocytes may be a malignant proliferation of such cells
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