Carbon monoxide poisoning: potentially preventable cases.

UNLABELLED: The objective of the study was to describe epidemiological and clinical data regarding acute carbon monoxide (CO) poisoning in an urban area of North Italy. 95 consecutive adult patients admitted to Milan and Turin Poisons Control Centres (PCC) for CO poisoning between October 1993 and March 1995 were enrolled into the study. Epidemiological and medical parameters were recorded in a standardised collection data sheet, which included age, sex, circumstances of poisoning, severity grading (0-3), blood HbCO level upon admission. RESULTS: 86 cases of CO poisoning (90.5%) were due to accidental exposures, 9 to intentional suicide attempts. A majority of cases occurred in late autumn through winter months, from October to February. The highest proportion of accidental CO poisoning cases (92%) occurred in the household setting. In 57 cases the acute severity grading was higher than 1 (median 2); blood HbCO level upon admission was 40% in 16% of the cases (mean 31.6%--median 32.7%). CONCLUSIONS: Carbon monoxide exposure represents a significant cause of severe but potentially preventable accidental poisoning. The study indicates the need for public education campaigns aimed to warn people against the silent killer at home, and to promote preventive measures. The clinical course of CO poisoning is often severe. A standardised collection data system, to record all the cases of acute CO intoxication in Emergency Departments, can help evaluate the real incidence and clinical significance of this poisoning.

[The reappearance of gastrointestinal tuberculosis in general surgery]. / La ricomparsa della tubercolosi gastrointestinale in chirurgia generale.

Gastro-intestinal tuberculosis (TB) continues to give rise to diagnostic and therapeutic challenges. Its increasing incidence and multiple and non-specificity of symptoms and signs require special attention to establish a prompt diagnosis and not to delay treatment. The authors describe on case of colonic TB presenting with multiple episodes of subocclusion suggesting a stenosing neoplasm of the caecum.

The synergistic anti-proliferative effect of gamma-interferon and human lymphotoxin.

Highly purified preparations of rHuIFN-gamma and HLT synergistically inhibit the in vitro proliferation of WI38VA13 cells, a SV40 virus-transformed derivative of the human cell line W138. The growth of nontumorigenic WI38 cells, established from normal diploid embryonic lung tissue, was not inhibited under identical incubation conditions; rMuIFN-gamma and HLT have the same in vitro effects on the murine melanoma B16. Thus, the combination of rMuIFN-gamma and HLT synergistically inhibits the growth of B16 cells, although incubation with either lymphokine alone has no significant anti-proliferative effect. Flow cytometric analysis of the cell cycle of asynchronous cells indicates that when B16 melanoma cells are treated with rMuIFN-gamma and HLT in combination, more cells accumulate in the G0/G1 phase than when the cells are treated with rMuIFN-gamma alone. It appears that populations of rapidly proliferating tumor cells, which normally contain a large percentage in the S+G2+M phases of the cell cycle, become arrested in the quiescent G0/G1 phase by the combination of IFN-gamma and HLT, resulting in the inhibition of cell growth.

Surface Ig isotypes on cells responding to lipopolysaccharide by IgM and IgG secretion.

Using the fluorescence-activated cell sorter (FACS), we have investigated the Ig isotypes present on murine B cells, which can be polyclonally activated by lipopolysaccharide (LPS) in low cell density cultures. The LPS response was partly inhibited as a result of staining with anti-IgD and anti-IgM reagents, but not with anti-IgG reagents. The IgM+, IgD+, or IgG- fractionated cell populations gave both an IgM and an IgG response comparable to controls, whereas the response of the IgM-, IgD- cells was 5- to 20-fold lower. IgG- cells separated 1 day after LPS stimulation could still mount an IgM and IgG response indistinguishable from controls at the peak of the response. It is concluded that IgM+, IgD+, IgG- cells constitute the major LPS-sensitive cell population in the low cell density culture system and that IgG is not a necessary cell surface isotype for precursors of IgG-secreting cells.

The relationship between surface immunoglobulin isotype and immune function of murine B lymphocytes. III. Expression of a single predominant isotype on primed and unprimed B cells.

We determined whether primed and unprimed B cells in the spleen of (BALB/c x C57BL/Ka)F(1) mice contain subpopulations that express a predominant surface Ig isotype. Spleen cells were stained for surface isotypes and sorted on the fluorescence-activated cell sorter (FACS) in order to obtain B cells bearing predominantly IgM (mup cells), IgD (deltap cells), or IgG (gammap cells). Each population was assayed for its capacity to restore the adoptive primary and secondary anti-bovine serum albumin (BSA) antibody response in irradiated syngeneic recipients. In addition, the adoptive response restored by isotype-predominant cells was compared to that restored by isotype- positive cells (B cells bearing a given surface isotype alone or in combination with others). The experimental results show that mup cells restore the adoptive primary and secondary IgM and IgG responses to BSA, and gammaP cells restore only the primary and secondary IgG response. Deltap Cells restored the adoptive secondary IgG response, but failed to restore the adoptive primary response at the cell doses tested. GammaP Cells but not deltap cells suppressed the IgM response of the mu(+) and delta(+) cells. The contribution of isotype-predominant cells to both the adoptive primary and secondary anti-BSA response was smaller than that of B cells bearing a combination of surface isotypes. Differences in the Ig isotype pattern expressed on the surface of primed and unprimed B cells are discussed.