Ability of lymphokine-activated killer cells to lyse mycobacteria-infected cells.

Lymphokine-activated killer (LAK) cells were generated by interleukin-2 activation of peripheral blood lymphocytes obtained from lepromatous leprosy (LL) patients and healthy individuals. The ability of LAK cells to lyse targets (macrophages and T-24, a bladder carcinoma cell line) infected with mycobacteria (Mycobacterium leprae and mycobacterial strain ICRC) was assessed in a 51 chromium-release assay. It was observed that LAK cells generated from LL patients and healthy individuals could preferentially lyse M. leprae or ICRC-pulsed macrophages and T-24 cells, compared to non-pulsed targets. The ability of LAK cells to kill intracellular mycobacteria was demonstrated in colony forming assays. These results indicate a promising role for LAK cells in immunotherapy of leprosy.

Use of intra-amniotic urea as a second trimester abortifacient.

PIP: The use of intraamniotic instillation of hypertonic saline with/without oxytocin in midtrimester abortion can sometimes lead to a fatal complication in the form of intravascular coagulopathy. Intraamniotic urea is used for the same purpose and has a similar mode of action. It decreases the circulating progesterone level and increases prostaglandin release. It can also cause fetal death. One of its major advantages is the lack of significant complications with inadvertent intravenous infusion of urea. 70 cases of midtrimester pregnancies were terminated by injection of 200 ml of urea (40%) intraamniotically between the period 8/77 to 8/78. The patients ranged in age from 20 to 35 years. No relationship was found between the induction-abortion interval and gestation period. Success rate was 88.7%; there were 8 failures. Average induction-abortion interval was 30.7 hours, with maximum abortions occurring between 24-48 hours. There were no major complications. Urea is also used intravenously in sickle cell crisis and neurosurgical procedures.^ieng

Extra-amniotic mannitol for pregnancy termination (preliminary report).

PIP: Period of gestation varied from 11 to 20 weeks in 40 patients. Antiseptic vaginal tablets were used twice a day for 5 days before admission. Antibiotics were given during the treatment. A 14-gauge Foley catheter was introduced through the cervix into the space outside the amniotic membrane. Inflation of the bulb of the catheter prevented escape of the fluid. A 20% mannitol solution was used. In patients with gestation periods of 11-15 weeks, the 1st dose was 200 ml in divided doses of 35-50 ml half hourly. A 2nd dose of 150 ml was given 4 hours later in divided doses. A 2nd dose was not injected if the patient had not passed at least 60 ml of urine per hour. When needed, doses were repeated after 30 hours after the 1st injection. In patients with a period of gestation of 15 weeks or more, 350 ml in divided doses of 60 ml were used and repeated after 24 hours when needed. When patients started aborting, pitocin, 2 units, was given im every 1/2 hour for 4 doses. 86.8% of patients aborted in 48 hours and 63.1% in 36 hours. Labor usually started within 24 hours. The longest induction-to-abortion interval was 72 hours. Only 1 patient had a retained placenta. In 12 cases, dilatation and curettage was done and a few bits of tissue were removed. When more than 350 ml of mannitol had been injected, patients were given potassium citrate twice daily. There were no undesirable side effects. The success rate was 95%. In the 2 cases which failed to respond labor had been started and the catheter was expelled. Both aborted within 48 hours with pitocin drip. Proper diuresis is essential. The method merits extended further trial. The study is being continued.^ieng