Rare provisional entity: primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma in a young woman.

Primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma is a rare and provisional entity, characterised by cutaneous involvement and aggressive clinical behaviour. The case is here presented of a young woman with concurrent cutaneous and systemic involvement. Despite multi-agent chemotherapy, only partial remission could be achieved, and the patient died from therapy-resistant respiratory and circulatory failure. This case report is intended to add to the data collected on this rare entity, with only about 20 cases as yet described.

Expression of syndecan-1 in human B cell chronic lymphocytic leukaemia.

Syndecan-1 is considered an important transmembrane proteoglycan in cell-microenvironment interactions, but its exact function in normal or in transformed B cells is still unknown. In this study, RNA was isolated from peripheral cells of chronic lymphocytic leukaemia (B-CLL) and 'normal', non-leukaemic patients, as controls. Reverse PCR showed no or very low syndecan-1 mRNA expression in controls, while in 11/13 B-CLL the circulating leukaemic cells expressed syndecan-1. Similar results were obtained for interleukin-1 beta (IL-1 beta) and interleukin-6 (IL-6). Furthermore, syndecan-1 protein was detected in the majority of circulating B-CLL cells by flow cytometry and immunocytochemistry using anti-syndecan-1 MAb. Control cells were practically negative. Further study is required to understand the biological significance of syndecan-1 on B-CLL cells.

[Intravascular hemolysis caused by intravenous glycerin infusion in a patient with artificial mitral valve]. / Intravénás glycerininfúzió okozta intravascularis haemolysis mitrális mübillentyüvel élö betegben.

The case history of a sixty two years old patient is presented by the authors. The patient with an artificial mitral valve was admitted to the hospital because of sudden onset of left sided hemiparesis. The cerebrovascular accident which occurred because of a cerebral embolus as well as the heart murmurs and intravascular haemolysis were thought to be present because dysfunction of the artificial valve. Transthoracal and transesophageal echocardiography revealed a thrombus in the right atrium and a patent foramen ovale, however did not prove artificial valve dysfunction. A paradox embolus from the right atrium caused the hemiparesis. The intravascular haemolysis was caused by the 10% glycerol infusion used for the treatment of the cerebrovascular accident. The authors discuss the observations on the glycerol induced intravascular haemolysis and it has been pointed out, that all kinds of parenteral glycerol use can cause intravascular haemolysis. No Hungarian publication was found on glycerol induced haemolysis.

[Diagnostic value of the determination of serum alpha2-HS-glycoprotein]. / A szérum alpha 2-HS-glycoprotein meghatározások diagnosztikus értékéröl.

Opsonic glycoprotein, alpha 2-HS-glycoprotein concentration was studied in the serum of 753 patients with various hematological, malignant, immunological, metabolic, endocrine and liver diseases and 68 healthy controls. Decreased serum alpha 2-HS-glycoprotein levels were detected in patients with acute leukemias, chronic granulocyte and myelomonocyte leukemias, lymphomas, myelofibrosis, multiple myeloma, metastatizing solid tumors, systemic lupus erythematosus, rheumatoid arthritis, acute alcoholic hepatitis, fatty liver, chronic active hepatitis, liver cirrhosis, acute and chronic pancreatitis, and Crohn's disease. Elevated levels were measured in patients with B and NANB/C hepatitis. Further decreased levels were observed in some groups with secondary infections. Serum alpha 2-HS-glycoprotein levels are affected by many factors, influencing the synthesis and elimination of the protein. The detection of serum alpha 2-HS-glycoprotein concentration has no specific diagnostic value as a marker for tumors or other diseases, however, its determination can be useful for the assessment of a non-specific regulator of the host defence.

Serum alpha 2-HS glycoprotein concentration in patients with hematological malignancies. A follow-up study.

We observed significantly reduced serum alpha 2-HS glycoprotein concentrations in patients with acute lymphocytic, acute nonlymphocytic, chronic granulocytic and chronic myelomonocytic leukemias, Hodgkin's and non-Hodgkin's lymphomas, myelofibrosis, and multiple myeloma, but not in patients with chronic lymphocytic leukemia and polycythemia vera, as compared with healthy controls. We followed the serum level of the protein for 18 months. Patients with infectious complications, those receiving cytostatic treatment, and those in the preterminal period had further reduced serum alpha 2-HS glycoprotein levels. The reduction of serum alpha 2-HS glycoprotein concentration was primarily due to decreased production caused by infiltration of the liver, a hepatotoxic effect of cytostatic treatment, and, to a lesser degree, to increased consumption. We found statistically significant negative correlations between serum alpha 2-HS glycoprotein concentration and erythrocyte sedimentation rate, serum aspartate aminotransferase and alkaline phosphatase activities, and IgG and IgM concentrations. The determination of the alpha 2-HS glycoprotein concentration is useful for the assessment and follow-up of the clinical status and therapy of patients with hematological malignancies and also has prognostic significance.

Bone scanning and radiography in the evaluation of patients with malignant lymphoma.

The diagnostic value of bone scintigraphy and radiography in the detection of lymphomatous bone involvement, and the role of bone scintigraphy in the evaluation of lymphomatous bone marrow involvement, were investigated in 41 patients with malignant lymphoma. 10 patients had lymphomatous bone involvement. Whereas scintigraphy detected all the 10 cases, radiography was false negative in 2 cases. The lytic bone lesions on radiography were in most cases not detected by scintigraphy. Scintigraphy is insensitive for the detection of early bone marrow metastases. The simultaneous use of bone scanning and x-ray, however, seems to be helpful in the detection of lymphomatous bone involvement and consequently in the clinical management of patients with malignant lymphoma.

[Determination of plasma fibronectin in myeloproliferative and lymphoproliferative diseases and other malignancies]. / Bestimmung der Plasmafibronektin-Konzentrationen in myeloproliferativen und lymphoproliferativen Erkrankungen und anderen Malignomen.

Plasma fibronectin concentration was determined by electroimmunodiffusion and laser nephelometry in 40 healthy persons and 321 patients with myelo- and lymphoproliferative diseases and other malignancies. Decreased fibronectin concentrations were found in patients with leukemia, Hodgkin's and non-Hodgkin's lymphomas, myelofibrosis, polycythaemia rubra vera and angioimmunoblastic lymphadenopathy. Elevated fibronectin level was detected in patients with multiple myeloma. In patients with cancer of the lung, stomach and colon, fibronectin level was found in the normal range. Decreased fibronectin concentration was observed in patients with cancer of the breast and prostate. Lower plasma fibronectin concentrations were detected in all groups of patients with infectious septical complications as compared to the patients without infections.

Cell surface fibronectin on peripheral blood lymphocytes in normal individuals and in patients with acute and chronic lymphocytic leukemia and non Hodgkin's lymphoma.

Fibronectin was detected by immunofluorescence on the surface of one fraction of separated normal peripheral blood lymphocytes using FITC-conjugated anti-human fibronectin antibodies. Approximately one fifth of isolated B cells and 7% of O cells contained surface bound fibronectin but T cells failed to stain. There were no detectable free receptors for fibronectin on the surfaces of the lymphocytes in the different subsets isolated from healthy controls as studied using FITC-labelled purified fibronectin. The per cent of B and O cells bearing surface bound fibronectin was markedly decreased in patients with acute and chronic lymphocytic leukemias and non Hodgkin's lymphoma, only 1-4% of B and 1-2% of O cells stained with FITC-labelled antifibronectin immunoglobulins. FITC-conjugated fibronectin was not bound to the different lymphoblasts isolated from patients with leukemia and lymphoma. Treatment of cells with trypsin and EDTA removed fibronectin bound to the cell surfaces. Fibronectin attached to the surfaces of lymphocytes may have an immunoregulatory function.

Fibronectin on the surface of human lymphocytes.

Fibronectin was detected by immunofluorescence technique on the surface of one part of separated normal peripheral blood lymphocytes by using FITC-conjugated anti-human fibronectin antibodies. Approximately one-fifth of isolated B cells and 7% of O cells contained surface-bound fibronectin but T cells failed to stain. There were no detectable free receptors for fibronectin on the surface of lymphocytes of different subsets as it was studied with FITC-labelled purified fibronectin. The percent of B and O cells bearing surface bound fibronectin was markedly decreased in patients with acute and chronic lymphocytic leukemias.

Fibronectin in cryoimmunoglobulinaemias.

Isolated and washed cryoimmunoglobulins from 15 patients were studied for the presence of fibronectin by immunodiffusion tests. Two of the isolated cryoglobulins proved to the pure monoclonal immunoglobulins (IgGl kappa and IgGl lambda), nine contained both monoclonal IgM kappa and polyclonal IgG and four were composed of polyclonal IgG, IgM and IgA by immunoelectrophoresis. Double immunodiffusion analysis detected the presence of fibronectin in each of the separated cryoimmunoglobulins. In a solid phase radioimmunoassay, I125 labelled purified fibronectin proved to bind to isolated human monoclonal myeloma proteins of IgGl kappa and IgG3 lambda subclasses. Fibronectin seems to be present not only in mixed polyclonal but also in mixed monoclonal-polyclonal and in monocomponent cryoimmunoglobulins, and it may be bound to one of the immunoglobulin components of the cryoglobulins.

A comparative dynamic study of the effectiveness of gastric cytoprotection by vitamin A, De-Nol, sucralfate and ulcer healing by pirenzepine in patients with chronic gastric ulcer (a multiclinical and randomized study).

The gastric cytoprotective effects of vitamin A, De-Nol and sucralfate were compared with the effectiveness of pirenzepine in healing ulcer in patients with chronic gastric ulcer. A total of 100 patients was randomized into different groups: the patients were treated with antacids, vitamin A (3 X 50.000 IU), De-Nol liquid (4 X 5 ml), sucralfate (4 X 1 g) or pirenzepine (3 X 50 mg). The treatment was continued for 4 weeks. At the beginning, 2 and 4 weeks after starting treatment the patients were subjected to endoscopy and the size of the ulcer was measured planimetrically. The ulcer-healing effect of De-Nol liquid was significantly better than that of the antacids (p less than 0.01). Ulcer size was reduced significantly in all groups (p less than 0.01), however, at the end of the study the gastric ulcers were smallest in the De-Nol treated group (p less than 0.001). The dynamics of ulcer healing in the second week was most favourable in the patients receiving vitamin A (p less than 0.01). The present data point to the cytoprotective effects of De-Nol liquid, vitamin A and sucralfate and to their ability of healing chronic gastric ulcers.

Cytoprotective effect of vitamin A and its clinical importance in the treatment of patients with chronic gastric ulcer.

The effects of vitamin A were studied on the basal and maximal gastric secretory responses of 12 patients; and on healing in 60 patients with chronic gastric ulcer. The effect of vitamin A on ulcer healing was evaluated by a multiclinical, multicentre, randomized, prospective study in which the patients were divided into three groups. In group A the patients were treated with antacids only; in group B the patients were given antacids plus vitamin A (in doses of 3 X 50.000 U orally); and in group C the patients received antacids, vitamin A plus cyproheptadine (in doses of 3 X 4 mg orally). The treatment lasted four weeks. At the beginning and the end of treatment endoscopies were performed and ulcer sizes were measured planimetrically. Various other parameters such as ulcer index, antacid consumption and laboratory parameters were also evaluated during the four-week treatment. It was observed that: (i) vitamin A (given in doses of 100.000 U i.m.) decreased neither basal nor maximal gastric secretory responses; (ii) the number of patients with completely healed gastric ulcer was significantly higher (P less than 0.05) in groups B and C than in group A; (iii) the extent of ulcer reduction was significantly higher (P less than 0.01) in groups B and C than in group A; (iv) no significant changes were observed in ulcer index and antacid consumption during the four-week treatment in the different groups of patients; (v) the reduction of ulcer size was significantly greater (P less than 0.01) in the group treated with antacids plus vitamin A than in the group treated with antacids only, at two weeks of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)