Justification of CT scans using referral guidelines for imaging.

This study analyses the efficiency of the justification of individual computed tomography (CT) procedures using the good practice guide. The conformity of the CT scans with guide's recommendations was retrospectively analysed in a paediatric emergency hospital in Romania. The involved patient doses were estimated. The results show that around one-third of the examinations were not prescribed in conformity with the guide's recommendations, but these results are affected by unclear guide provisions, discussed here. The implications of the provisions of the revised International Atomic Energy Agency's Basic Safety Standards and of the Council Directive 2013/59/EURATOM were analysed. The education and training courses for medical doctors disseminating the provisions of the good practice guide should be considered as the main support for the justification of the CT scans at the individual level.

Practitioners education on medical exposure justification.

The knowledge of practitioners on justification of the individual medical exposure was assessed during education and training programmes. A survey containing questions on this issue was used. The results show that the Good Practice Guide should be disseminated and studied by radiation protection training programmes and such kind of training must be extended to prescribers because they have to be involved in the justification process.

Coexistence of autologous antibodies and decay-accelerating factor, an inhibitor of complement, on human renal tumor cells.

Autologous immunoglobulin was detected on the cell surface of tumor cells freshly isolated from cancerous kidneys of patients with renal cell carcinoma by flow cytometry after staining with murine anti-human IgG monoclonal antibodies. Cells isolated in parallel from macroscopically normal regions of the tumorous kidneys were not specifically stained with the anti-human IgG reagents. In further studies, tumor cells were stained with an antibody to decay-accelerating factor (DAF), a known inhibitor of complement. Flow cytometry of these cells revealed that nearly all tumor cells expressed DAF, and that the intensity of staining with the anti-DAF monoclonal antibody correlated with the staining of cells with anti-IgG. The results suggest that tumor cells coated with autologous antibody may be resistant to complement-mediated cytotoxicity in vivo through the expression of high levels of DAF.

Sensitive competitive-binding ELISAs for quantifying free kappa and lambda light chains in cerebrospinal fluid.

Simple, sensitive, and fully standardized solid-phase enzyme-linked competitive binding immunoassays to quantify free kappa and lambda immunoglobulin light chains are described. The assays were developed to measure the concentration of free light chains in cerebrospinal fluid (CSF), in part because elevated levels of free kappa light chains have utility as a diagnostic marker for multiple sclerosis (MS). Polyclonal rabbit antibodies raised against pooled Bence Jones proteins are bound to solid-phase Staphylococcal protein A and used as the primary antisera in this assay. A pool of Bence Jones proteins isolated from the urine of 10 individuals with multiple myeloma are used as a biotin-labeled ligand and to develop a standard curve. The assays as described are sensitive to the low nanogram range and are specific for free kappa or lambda light chains. The assays were found to have acceptable precision, and results correlated highly with concentrations determined using competitive-binding radioimmunoassays previously described.

Cyclosporin A is an adjuvant in murine IgE antibody responses.

Cyclosporin A (CsA) is an undecapeptide fungal metabolite and is generally regarded as a new generation of immunosuppressive drugs. We uncovered a novel immunomodulatory property of CsA as a potent immunologic stimulator in the murine IgE antibody system. The enhancement of IgE responses was observed in mice receiving as few as three daily i.m. injections before Ag priming. Our studies demonstrate the three points listed below. First, CsA potentiates murine IgE responses regardless of Ag specificities in inbred mice. A hierarchy of immunopotentiation by CsA follows the order of low, intermediate, and high IgE responder mice. Second, CsA, when administered along with Ag, exerts a thorough and long lasting impact on the Ag-specific IgE antibody response, and leads to an Ag-specific breakthrough of IgE antibody synthesis in mice rendered tolerant in the IgE antibody system by soluble Ag pretreatment or neonatal IgE treatment. Third, IgE enhancer cells become sensitive to a low dose of irradiation. Two enhancer cellular components are identified, those of the Th cells and B cells, which appear to favor the induction of IgE responses. Understanding the cellular basis of the immunopotentiating effect of CsA will provide further insight into the murine IgE antibody system.