ABSTRACT
A patient presented with the unique clinical picture of diffuse cutaneous and mucosal leishmaniasis caused by Leishmania tropica. Elevated serum levels of several cytokines including interleukin (IL) 2, interferon gamma (IFN-gamma), and tumor necrosis factor alpha were found. All cytokine levels returned to normal during therapy. No IL-10 or IL-4 levels were detectable. In whole blood cultures, induction of IFN-gamma by lipopolysaccharide (LPS) was completely negative, even after therapy. Concanavalin A (Con A)-induced release of IFN-gamma, like Con A-induced release of the other cytokines, was only initially impaired but returned to normal during therapy. Induction of the other cytokines by LPS was never impaired. The low expression of human leukocyte antigen DR on monocytes increased during IFN-gamma therapy but dropped when IFN-gamma treatment was ceased. We conclude that in this patient one or more of the routes of IFN-gamma production was impaired, thus resulting in insufficient IFN-gamma production in the infected lesions (although IFN-gamma was systemically present).
Subject(s)
Cytokines/blood , Leishmania tropica , Leishmaniasis, Diffuse Cutaneous/blood , Adolescent , Animals , Cytokines/biosynthesis , Humans , Leishmaniasis, Mucocutaneous/blood , MaleSubject(s)
Plague/prevention & control , Animals , Botswana/epidemiology , Humans , Insect Control , Namibia , Plague/epidemiology , Rodent Control , SiphonapteraABSTRACT
The prevalence with which alcoholic pancreatitis is associated with alcoholic liver disease is unclear. To investigate this association further, we have reviewed the autopsy findings of 1022 patients who died from alcoholic liver disease and compared these findings with those from 352 patients who died from cardiac or pulmonary disease. All patients who died from liver disease had a history of chronic alcoholism with clinical and biochemical evidence of severe liver damage. Death resulted from hepatic coma, gastrointestinal bleeding, or infection. Liver disease patients were classified into two groups: (1) those with cirrhosis (77%) and (2) those without cirrhosis but with acute and/or chronic sclerosing hyaline necrosis (23%). Anatomic and histopathologic changes characteristic of chronic pancreatitis were found in 203 patients in approximately the same frequency (20% and 18%, respectively) in both groups. Acute pancreatitis without chronic lesions was observed in 8% and 10% of both groups, respectively. In the control group of 352 autopsies (122 cardiac and 230 pulmonary patients), the overall prevalence of pancreatitis, at 2.6%, was significantly (P less than 0.001) lower than that observed in the alcoholic liver disease groups. A total of 22 cases (50%) dying from acute or chronic sclerosing hyaline necrosis had severe chronic calcifying pancreatitis compared to 29 patients (18%) (P less than 0.001) dying from cirrhosis. By contrast, dense fibrosis was significantly (P less than 0.001) more commonly observed in patients with cirrhosis. We conclude that pancreatitis occurs frequently in patients dying from alcoholic liver disease but is an uncommon finding in patients dying from other causes.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Alcoholism/complications , Liver Diseases, Alcoholic/complications , Pancreatitis/etiology , Adult , Aged , Autopsy , Biliary Tract Diseases/etiology , Calcinosis/etiology , Humans , Liver Cirrhosis, Alcoholic/complications , Middle Aged , Pancreas/pathology , Pancreatitis/pathology , Retrospective StudiesABSTRACT
Three years experience with post operative BCG adjuvant immunotherapy in stage II malignant melanoma is reported. Compared to a historical control group (35 cases), 23 melanoma patients showed a significantly improved remission duration and survival rate. It appears that patients with weak initial BCG reactions, which become gradually positive after several immunizations, get more benefit from the adjuvant immunotherapy than do patients with strongly positive initial BCG reactions.
Subject(s)
BCG Vaccine/therapeutic use , Melanoma/therapy , Skin Neoplasms/therapy , Adult , Female , Humans , Lymphatic Metastasis , Male , Melanoma/immunology , Middle Aged , Remission, Spontaneous , Skin Neoplasms/immunology , Time Factors , Tuberculin TestABSTRACT
23 "high risk" melanoma patients treated with BCG-AIT are compared with a non-randomized control group of 35 Stage II melanoma patients receiving other treatment. The results are discussed. It has been noted that patients with weak initial BCG reactions survived longer than patients with strongly positive first BCG reactions. This observation could be interesting for the choice of immunotherapy.
Subject(s)
BCG Vaccine/therapeutic use , Melanoma/therapy , Skin Neoplasms/therapy , Adult , Female , Humans , Immunotherapy , Male , Melanoma/immunology , Middle Aged , Mycobacterium bovis/immunology , Skin Neoplasms/immunology , Skin TestsABSTRACT
Gm allotype markers were determined in sera from 71 melanoma patients and 400 control persons. There was no significant difference between both groups in Gm distribution. The results were compared to a recent report. Furthermore, in 25 malanoma patients the capacity of serum to interfere with cell-mediated cytotoxicity (CMC) of autologous lymphocytes was determined and related to the Gm allotype.
