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After mice had been treated with serum thymic factor (FTS), we observed an increase or a decrease in the NK activity, depending on the duration of treatment and mouse strain: an increase of C57BL/6, BALB/c, A, and nu/nu, and a decrease for NZB and CBA mice. The fact that treatment of C57BL/6 mice with FTS produces the same effects as thymectomy--that is, an increase--on the NK activity and returns the augmented NK activity of thymectomized mice to normal levels suggests that FTS has multiple effects with different results depending on the level of differentiation of the target cells. Different mechanisms of action of FTS on NK cells are discussed.

Using monoclonal antibodies (OKT3, OKT4, OKT8) peripheral blood lymphocyte subsets were determined in 40 normal primiparous pregnant women and compared with those of 31 nonpregnant controls. In pregnant women plasma concentrations of estradiol, progesterone, human placental lactogen (HPL), beta subunit of human chorionic gonadotropin (beta HCG), and alpha-fetoprotein were measured by means of radioimmunoassay. We studied if correlations between peripheral lymphocyte subsets and plasma hormone levels might exist. We observed in pregnant women from 10 to 40 wk of amenorrhea a decrease in the percentage of OKT3 and OKT8 cells, and during the course of pregnancy an increase in the percentage of OKT4 cells. This increase inversely correlated with plasma beta HCG levels and directly correlated with plasma HPL levels.

Thirty five patients, operated upon with an aorto-coronary by-pass graft to left anterior descending artery and to a major diagonal branch, were prospectively analysed. The patients were divided into two comparable groups, in whom a single graft technique and a sequential graft technique was used respectively. Flows through the by-passes were measured electromagnetically during the operation. Flow to left anterior descending artery was significantly higher through an isolated by-pass than through a sequential by-pass. Flow to diagonal branch showed no significant difference in the two groups. The resistance of the intramyocardial coronary bed of the left anterior descending artery was lower with single than with sequential by-pass technique, while no difference existed between the resistance of intramyocardial coronary bed of the diagonal branch with both techniques. Blood velocity was higher in single by-pass to the left anterior descending artery than in the peripheral segment of sequential vein graft directed to the anterior descending artery.

A purification procedure of synctiotrophoblast plasma membrane (STPM) has previously been described. We now report a further characterization of their associated components. By immunochemical analysis two groups of proteins were found. The first fraction solubilized by chaotrope treatment was made up with a complex of IgG, albumin, transferrin and alpha-fetoprotein. The second fraction, insolubilized by KCl-treatment but by detergents, did not react with antisera to human proteins; it contained human chorionic gonadotropin and placental lactogen. The amino acid, carbohydrate and lipid content of STPM were determined. High galactosyl- and sialyl-transferase activities were found in purified STPM. The role of these various components on the acceptance of the fetal allograft is discussed.

Electrode fracture is a serious late complication of pacemaker implantation. This complication was observed in 33 patients within 3 years whereby the interval between electrode implantation and fracture was on average 35 (12--113) months. The cause lay partly in the electrodes themselves--in all cases singly wound spiral electrodes--and partly in technical deficiencies in the extrathoracic loop formation. Attention is drawn to the fact that fracture has never occurred in the Elema electrode type 588 used routinely by the authors.

The immuno-enzymatic method permits the separate study of rheumatoid factors (RF): IgM as well as IgG, IgA, IgE, IgD. In 43 patients with rheumatoid polyarthritis (RP), classic or definite, we have studied the correlations between the various parameters of articular and extraarticular activity of RP and the levels of each isotype of RF. A statistically significant correlation of the articular activity was found with RF IgG (p less than 0.01), RF IgA (p less than 0.01). As compared to RP without rheumatoid nodule, RPs with rheumatoid nodules presented a level of RF IgM (p less than 0.05), RF IgG, IgA, IgE (p less than 0.01) which was statistically higher; a statistically significant correlation was found between haptoglobin levels and those of RF IgG (p less than 0.01). A negative correlation, statistically significant, was found between CH 50 and the levels of RF IgM. This study confirms previous studies which were carried out with an immuno-enzymatic method of detection of RF isotypes.

The first patient suffered from a very severe atopic dermatitis with intense pruritus and thickened skin. He had also recurrent infections, particularly related to Staphylococcus coagulase +, and axillary and inguinal lymphodermopathy. The use of tetracosactide given intramuscularly allowed controlling the evolution of his atopic dermatitis. After several months of treatment, the skin became less infiltrated, lymphodermopathy disappeared and no severe infection had happened. The second patient had a less severe atopic dermatitis and recurrent infections without any particular severity. Topical corticosteroids allowed to control the atopic dermatitis. These two patients had high levels of circulating IgE and an important deficiency of polymorphonuclear chemotaxis which was evaluated by migration through boyden room. Study of the family showed atopic manifestations in several members, but with lower levels of IgE. The most characteristic abnormality of this syndrome is the according to considerable increase of IgE. The deficit in polymorphonuclear chemotaxis may vary according to time and even become normal. The prognosis over long periods remains to be determined.

Selective intracoronary thrombolysis with streptokinase was successful in 72 of 84 (86%) patients admitted to the hospital with definitive signs of acute transmural myocardial infarction due to complete occlusion of either the left anterior descending coronary artery, the right coronary artery, or the circumflex artery. The average time between onset of acute symptoms and medically induced reperfusion was 241 +/- 90 minutes (SD). Reperfusion resulted in prompt relief of pain, regression of cardiogenic shock, and normalization of electrocardiograms. Follow-up treatment was either medical or surgical. The 32 medically treated patients had a high reocclusion rate, with 6 fatal (19%) and 9 nonfatal (28%) reinfarctions. In order to the reduce the risk of reinfarction, additional simultaneous transluminal balloon angioplasty was done in a recent series of patients with stenoses accessible to this technique. The best early and long-term results were achieved in 17 patients who underwent coronary artery bypass grafting within three days after successful thrombolysis. There was no operative mortality, and subsequent bleeding has not been a problem. It is concluded that early operation is the treatment of choice in all patients suitable for such intervention who have undergone successful intracoronary thrombolysis within 4 hours after onset of acute myocardial infarction. Late coronary bypass operation should be reserved for symptomatic patients who have definitive signs of infarction in spite of successful thrombolysis.

A method allowing simultaneous isolation of Rabbit alomerular and tubular basement membranes has been perfected. Rabbit tubular basement membrane has also been obtained by tryptic digestion of the renal cortex. Electron microscopic observation and biochemical analysis show that the contamination of the membrane preparations by cellular components is negligible.

The natural killer (NK) reactivity of mouse spleen cells is controlled by the left brain neocortex and not by the right symmetrical brain area. The finding strongly suggests direct relationships between the central nervous system and the immune system, both involved in biological adaptation for the maintenance of homeostasis and body integrity in relation to the external environment.

After a review of the histology and the biochemical structure of the glomerular basement membrane, the authors discuss the role of its diverse antigenic components in the origin and course of several types of glomerulonephritis. In addition, they deal with the problem of biochemical modifications of glomerular basement membrane during some experimentally induced or naturally occuring pathological states.

A nephropathy affecting both tubules and glomeruli has been induced in Rabbits by the injection of an heterologous immune serum directed against Rabbit tubular basement membrane. It differs from experimental antiglomerular basement membrane nephropathy by the fixation of antibodies and C3 on tubular basement membrane and by the occurrence of glucosuria.

A group of 111 patients with mitral valve disease was studied by M-mode and two-dimensional echocardiography. Five left atrial thrombi were demonstrated, two of which had probably been the source of previous embolic events. Two-dimensional echocardiography was superior to M-mode in providing spatial orientation. Using multiple cross-sections the exact localisation and the size of the thrombus formation could be estimated. Thrombus localisations at the upper, lateral, and septal atrial walls, normally inaccessible to the single-beam technique, were successfully imaged. Even two-dimensional echocardiography, however, constitutes an imperfect method. By comparison with the findings at surgery only one-third of confirmed thrombi could be detected non-invasively. According to their localisation seven clots in the appendage were missed by the ultrasound method. One further thrombus fixed to the upper left atrial wall near the entrance of the upper pulmonary veins was also undetected by echocardiography. Despite these limitations, the information provided by echocardiography can be most helpful in patient management. M-mode, in combination with two-dimensional echocardiography, is therefore recommended in all patients with mitral stenosis before diagnostic or therapeutic procedures are undertaken.

The results of mitral surgery between 1961 and 1971 are presented. Pure or predominant mitral stenosis outnumbered combined mitral valve disease and mitral incompetence by two to one. Surgical treatment comprised 291 closed mitral commissurotomies, 145 open reconstructions and 81 replacements of the mitral valve. One month mortality was 2,4% for commissurotomy, 4,8% for reconstruction, and 25% for replacement. Early mortality of the latter operation decreased to 7% since 1971. For patients with no more than slight preoperative symptoms life expectany remained unaffected for 10 years after closed commissurotomy. For patients with significant preoperative limitation or symptoms at rest 5 and 10 years life expectancy after successful surgery was 93 and 79% resp. for commissurotomy, 94 and 73% for reconstruction and 79 and 53% resp. for mitral valve replacement. In spite of a higher rate of reoperations and late deterioration of valve function the reparative operations deserve preference to the replacement of the mitral valve whenever feasible.

We have observed that the intensity of the direct antibody-dependent cell-mediated cytotoxicity (ADCC) response after an inoculation of foreign tumour cells varies with the strain of mice studied. The inoculation of a human lymphoblastoid cell-line into CBA/J, BALB/c, or DBA/2 mice gives rise to a good cytotoxic response by the host K cells armed with specific antibodies. In contrast, A/J, B10.A, C57BL/6 and B10.S mice respond poorly under the same conditions. The high response is dominant in F1 hybrids between high and low responders and is also expressed among F2 backcrosses with the H-2 phenotype of low responders, suggesting that non-H-2 genes are also implicated in the regulation of ADCC. The genetic control is not exerted at the level of antibody secretion but at that of K-cell activity, since sera from high or low responders are equally effective in arming an ADCC reaction, whereas K cells from low-responder strains are less efficient than those from high-responder strains. The natural killer (NK) activity of the same strains has been screened. The results show a good correlation with some high- and low-responder strains, such as CBA and DBA/2 or A/J and SJL, respectively, but not with C57BL/6, B10.S or B10.A strains. Thus, in addition to common genes controlling both lytic functions, there are specific genetic factors influencing the balance between NK and K cells. These findings confirm the general view that NK and K cells represent only partially identical subsets.

1. The authors have studied changes of glucosyl-, galactosyl- and sialyl-transferase activities in the sera of women during pregnancy and the early post-partum period, and in neonates from birth to 1 yr of age. 2. Galactosyl- and glucosyl-transferase activities throughout pregnancy were high in comparison to control values, and increased with advancing gestation. In the early post-partum period, the activities of these enzymes decreased markedly, reaching values similar to those of control subjects. 3. There were no variations, however, in serum sialyl-transferase activity at any stage of pregnancy or the post-partum period. In newborn infants, serum glucosyl- and sialyl-transferase activities were identical to control values. 4. Galactosyl-transferase activity was high at birth, decreased progressively and returned to the normal range only after 1 yr. 5. The physiological significance of these glycosyl-transferases in the sera of pregnant women and newborn infants is discussed.

The serum thymic factor (FTS) and one of its structural analogues have been administered to adult normal Mice for 2 to 12 weeks. This treatment induced a significant increase in spleen cell natural killer (NK) activity, evaluated by a cytotoxicity assay against YAC cells.

Percutaneous transluminal coronary angioplasty (PTCA) was performed in 21 patients with acute myocardial infarction (AMI) treated by intracoronary infusion of streptokinase within 8 hours after the onset of symptoms. Streptolysis therapy began a mean of 3.6 +/- 1.2 hours (+/- SD) after the onset of symptoms. The vessel was occluded in 14 patients and highly stenosed in seven. After the infusion of 67,300 +/- 63,200 IU of streptokinase over 26.1 +/- 21.5 minutes, patency of the occluded vessels was reached. PTCA as performed 20-60 minutes after the end of streptokinase treatment in 19 patients and 24 and 31 hours after treatment in two patients. The dilation was successful in 17 patients (81%). The degree of vessel obstruction was reduced from 90.2 +/- 7.3% to 58.6 +/- 19.5% (area method) and from 71.4 +/- 12.4% to 39.2 +/- 19.7% (diameter method). The improvement was 31.5 +/- 18.4% and 32.2 +/- 19.3%, respectively. No reocclusion was induced by PTCA. Twenty patients were discharged. One died during hospitalization; at autopsy, the treated vessel was still patent. During the follow-up period, two reinfarctions and one asymptomatic reocclusion occurred. The clinical findings during the hospital course and the follow-up period were compared with those of a control group of 18 patients with AMI and comparable coronary stenoses who were treated only with streptokinase infusion. Four of these patients had a reinfarction during the hospital course, and three died during the follow-up period. PTCA can be performed safely and successfully immediately after intracoronary infusion of streptokinase in patients with AMI. By reducing the subtotal stenosis, this treatment contributes to the reperfusion of the ischemic myocardium, diminishes the risk of a reocclusion and seems to improve the prognosis.

In this brief note, which is a preliminary report, the authors investigated systematically the variations, during normal and complicated pregnancies, of the concentrations of alpha-1-antitrypsin, orosomucoid, transferrin and alpha feto-protein, simultaneously in maternal serum, fetal serum and amniotic fluid. There exists during normal pregnancies a difference between the concentrations of alpha-1-antitrypsin and of orosomucoid found for primigravidae and for multigravidae. The role of these glycoproteins in preventing the mother from rejecting the fetus is discussed. In addition for Rhesus isoimmunization the clinical value of the variations in the levels of transferrin is discussed.

The authors investigated systematically the variations during normal pregnancies of the concentrations of alpha-1-antitrypsin, orosomucoid, transferrin and alpha-fetoprotein simultaneously in maternal serum, fetal serum and amniotic fluid. The role of certain factors such as the gestational age birth weight, placental weight and pairty were studied with regard to variations in the concentrations of each of these proteins. This research permitted the definition during pregnancy of the normal concentrations for these four proteins and allowed us to learn more about protein exchanges between fetal blood, maternal blood and amniotic fluid. There exists a difference between the concentrations of alpha-1-antitrypsin and of orosomucoid found for primigravidae and for multigravidae. The role of these glycoproteins in preventing the mother from rejecting the fetus (insofar as the fetus may be considered as an allograft) is discussed.

We report the case of a 56-year-old woman with a saccular aneurysm of the right coronary artery, which was resected. Aneurysmatic coronary artery disease mostly has an arteriosclerotic origin and occurs in patients with coronary artery disease with a frequency of 0.3-4.9%. In the affected patients myocardial infarction is more frequent, but their 5-year survival rate is not diminished. The therapy of choice is, as indicated, aortocoronary bypass grafting.

In this article, which is a preliminary report, the authors determined amniotic fluid levels of alpha-I-antitrypsin, orosomucoid, transferrin and alpha-fetoprotein during complicated pregnancies with gestational ages of 31 to 42 weeks. These levels were compared with those observed during normal pregnancies. The clinical value of the variations of the glycoprotein levels is discussed.

A complete automation of the determination of triglycerides is described which replaces the manual extraction and the final determination with an autoanalyzer chain, based on the method of Royer et al. For the automation of triglyceride extraction, we have modified the sampler, by incorporating a magnetic stirrer under the sample table. The sample table has two rows of holes. The sera, which are taken from the inner row and diluted with sulphuric acid, are reacted quantitatively with the extraction reagent in the beakers of the outer row, which contain a magnetic follower. After stirring, the upper phase is quantitatively removed and the determination is started. The problem of phasing the individual steps of the analysis is thus solved.

In a previous article, we cited studies which have allowed us to isolate diverse glycoproteins of the rat glomerular basement membrane (GMB) and to study their biochemical structures and antigenicity. This present study attempts to examine, using the heterologous nephrotoxic nephritis model (Masugi's nephritis) the nephrotoxicity of immune sera prepared from three of these glycoproteins: one fairly rich in collagen-like structures (A3), another lacking collagen-like structures (A1), and a third of intermediate composition (A2). The results obtained are discussed in relation to those already published concerning the nature of the GBM antigen(s) responsible for the nephrotoxicity of the sera.

A highly sensitive and reproducible radioimmunoassay was established to detect transferrin in human fluids. By this technique, applied to seminal fluid, transferrin levels (micrograms/ml) were found in normozoospermic individuals (64.49 +/- 25.41) at level higher than in oligozoospermic (38.93 +/- 21.35), azoospermic (19.49 +/- 10.23), or vasectomized (19.61 +/- 8.95) subjects. A relationship between transferrin and spermatozoid concentration in sperm was shown. These results reinforce previous findings that seminal transferrin can be used as a reliable clinical marker of Sertoli Cell function.

Sodium diethyldithiocarbamate ( imuthiol ), a non-antigenic and non-carcinogenic compound, devoid of toxic effects at immunostimulant doses, shows distinctive properties in recruitment and activation of T cells. Studies on its mode of action disclosed unsuspected links between the immune system, the endocrine liver and the central nervous system. Evidence was obtained indicating that the brain neocortex modulates T-cell mediated events, most likely via control of specific hormonal synthesis by the liver. The influence of imuthiol is determined at the level of the brain neocortex.

Ventricular septal rupture is the fourth-common cause of death after cardiac arrhythmia, acute congestive failure and rupture of the cardiac wall in acute myocardial infarction. Generally it can be easily diagnosed by a systolic jet sound in the 4th and 5th intercostal space parasternally on the left side. Differential diagnostic difficulties occur in the acute phase of infarction regarding papillary muscle rupture. Myocardial rupture does not occur immediately after the onset of the pectanginous state and not within the first day of illness, but generally within the first week. Vasodilatory treatment permits only short-term stabilisation of vascular problems, however, time is made available for diagnostic measures, usually catheterisation of both sides of the heart and coronary angiography. Immediate operation and occlusion of the defect, if necessary accompanied by a saphenous vein bypass, is presently considered treatment of choice. Out of the three patients with this complication the ruptured site could be occluded surgically in two, one of whom had severe cardiogenic shock. Shock symptoms regressed immediately and the postoperative course was unremarkable. In the third patient no operation was performed due to his age of 77 years and general vascular sclerosis. He died of cardiogenic shock 11 hours after admission to hospital.

During the five-year period between March 1980 and February 1985 selective intracoronary thrombolysis with streptokinase was performed in 469 patients with clinical and ECG signs of acute transmural myocardial infarct. Coronary arteriography prior to thrombolysis showed the infarct related vessel still or again patent in 21% of the patients. Among 372 patients with complete occlusion streptokinase infusion was successful in 87%, but failed in 13%. Due to the high risk of reocclusion, early bypass surgery was performed in 69 patients (18.5%) of the successfully reperfused group. Indication was based primarily on an ischemic time interval of less than 4 hours between the acute onset of clinical symptoms and reperfusion. Early mortality was 1.5% in this surgically treated group and actuarial survival was 92% at 5 years with all but 3 patients in functional class I or II. Marked but non-fatal early congestive heart failure was more significant when patients underwent operation within the first 2 days after thrombolysis than thereafter. Late recatheterization studies in 29 patients showed a slight but statistically insignificantly higher occlusion rate for vein grafts to the infarct vessel (14%) than to concomitantly grafted arteries (6%). No correlation was found between the initial ischemic time interval and graft patency. Late left ventricular function was excellent or minimally impaired in 52% of these patients while 48% had significantly reduced LV function. Again, no correlation was found between the ischemic time interval and late LV function. LV aneurysm, however, occurred only in patients with an ischemia of more than 3 hours. Thrombolysis combined with early bypass surgery represents the optimal therapy for acute myocardial infarct.(ABSTRACT TRUNCATED AT 250 WORDS)

Continuous low-dose gamma-irradiation of mature rats induced a progressive degeneration of the germ cells. Blood FSH increased by 127, 176 and 214%, respectively, after 55, 70 and 85 days of treatment when compared to FSH levels in control rats (8.50 +/- 0.60 ng/ml); conversely, serum LH and testosterone levels were unchanged. The Sertoli cell function was affected by the treatment from 70 days on, as attested by androgen binding protein (ABP) and transferrin secretions which diminished 35-40%. Serum ABP levels were not altered, whatever the duration of irradiation, even though epididymal ABP contents (as well as concentrations) diminished 34-60% when compared to those of the controls. Moreover, in purified Leydig cells, LH-stimulated intracellular cAMP levels, which were decreased by seminiferous tubule medium (STM) from control rats, were enhanced in presence of STM from treated animals. Testosterone output was stimulated 9-fold in presence of oLH and further increased (46-76%) from stages XIV-V by STM prepared from control and irradiated rats, respectively. After 85 days the STM effects on both cAMP and testosterone syntheses were zero. These results demonstrate a probable alteration of Sertoli cell function after irradiation, but also a role of the germ cells in the regulation of the synthesis of ABP, transferrin and Sertoli cell paracrine factors.

Regional cardiac free fatty acid metabolism of 41 patients with coronary artery disease (CAD) and of 10 controls with normal coronary arteries was studied by means of I-123 phenylpentadecanoic acid (IPPA), a radioiodinated palmitic acid analog, and sequential single photon emission tomography (SPECT). All patients and controls underwent symptom--limited bicycle exercise, with the tracer being injected at peak stress. More than 99% of left ventricular segment of controls showed homogeneous tracer uptake and release, indicating homogeneous free fatty acid turnover in normal myocardium. Homogeneous postexercise uptake was followed by decreasing segmental activity in 75.1% of normally perfused segments in patients with CAD. Sixty-five percent and 88.6% of segments, assigned to the perfusion bed of 50%-75% and greater than 75% obstructed vessels had decreased IPPA release and/or reduced IPPA uptake. Patients with exercise induced ischemia had focal metabolic abnormalities in jeopardized myocardium for significantly longer time than clinical or electrocardiographic signs of ischemia (p less than 0.01). All patients with CAD and a negative stress test had metabolic abnormalities, but exhibited, compared to ECG--positive patients, less pronounced segmental metabolic aberrations. These findings indicate reduced cardiac utilization and delayed oxidation of IPPA, associated with exercise-induced ischemia in CAD. The metabolic changes suggest a marked sensitivity to ischemia as well as prolonged postischemic abnormalities of cardiac fatty acid metabolism in jeopardized myocardium.

Sodium diethyldithiocarbamate (imuthiol), a nonantigenic, nontoxic and noncarcinogenic compound, evinces distinctive properties in recruitment and activation of T cells, and no direct influences on B cells or macrophages. The biological attributes of imuthiol (destruction of neoplastic cells, bacteria, fungi and parasites; a detoxifying influence against carcinogens or agents toxic for the liver) could strengthen its activity as a biological response modifier. Preliminary clinic testings show that imuthiol restores T cell activities and regulates the ratio among T cell subsets in cancer patients, without untoward side effects.

An electroimmunodiffusion method for the simultaneous determination of C1q and C3 levels in human serum is proposed. The reproducibility is good, and an excellent correlation is observed between electroimmunodiffusion and radial immunodiffusion. This simple, fast, and accurate method is suitable for clinical investigation.

The aim of this serial study was to define variations in T-lymphocyte populations during the first weeks of pregnancy. Results obtained with 14 women pregnant after artificial insemination show that the CD4+ population decreased significantly as soon as the fourth week. This decrease was concomitant with the HCG peak and could be compatible with certain immunological mechanisms participating in tolerance to the fetal graft.