RESUMO
An important new approach to curative treatment of leukemia is vigorous treatment of autologous marrow to remove residual abnormal cells in vitro prior to reinfusion. This in vitro 'purging' must destroy the malignant cells while preserving sufficient normal precursors to allow re-establishment of normal in vivo function. We have confirmed that cortivazol (CVZ), a glucocorticoid with an unusual structure, can kill dexamethasone (DEX)-resistant leukemic cells and have examined its ability to purge DEX-sensitive (CEM-C7) and -resistant (ICR-27) human leukemic blasts artificially mixed with normal marrow mononuclear cells in vitro. By carefully defining time and dose, we established a 'therapeutic window' that allowed 'cure' of the artificial remission marrow. A sufficient number of viable normal myeloid precursor cells (CFU-GM) remained to suggest that normal marrow precursors adequate for successful marrow transplantation could survive such treatment. CVZ could be a useful drug for in vitro purging of bone marrow for autologous transplantation in patients with acute lymphoblastic leukemia or non-Hodgkin's lymphoma, sensitive or resistant to standard glucocorticoid.
Assuntos
Purging da Medula Óssea/métodos , Linfoma não Hodgkin/terapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Pregnatrienos , Antineoplásicos Hormonais/farmacologia , Dexametasona , Relação Dose-Resposta a Droga , Esquema de Medicação , Resistência a Medicamentos , Feminino , Granulócitos , Humanos , Ensaio Tumoral de Célula-TroncoRESUMO
We have previously shown that leukemia/lymphoma (LL) cells adhere to marrow stromal cells (MSC), and MSC induce clonal growth of LL cells. Even though CD11a/18 and CD54 are important in leukocyte and endothelial cell interaction, the literature suggested that these adhesion proteins are not involved in adhesion of hematopoietic stem cells to MSC. We therefore utilized a unique ICAM-1- murine MSC line (MLT) to evaluate the mechanisms of adherence of LL cells (L5178Y and L1210) to MLT. Adherence of LL cells to extracellular matrix (ECM) proteins was also examined. L1210 cells attached to collagen types III and IV, laminin, and fibronectin, but not to collagen type I. L5178Y cells did not attach to any of the ECM proteins tested. The adherence of both L1210 and L5178Y to MSC was unaffected by rat monoclonal antibodies to murine CD11a, CD11b, and CD18. Neoglycoprotein probes, mannosyl-bovine serum albumin (BSA) and galactosyl-BSA, inhibited the adherence of L5178Y and L1210 cells to MSC by 34%-63% of controls at concentrations of 10(-3) and 5 x 10(-3) M. In contrast, fucosyl-BSA had no inhibitory effect on LL cell adherence of MLT. These data suggest that 1) LL cells may adhere to MSC by a lectin mechanism with mannosyl and galactosyl specificities; and 2) other mechanisms of adherence, not yet defined, are also important in this system.
Assuntos
Células da Medula Óssea , Moléculas de Adesão Celular/metabolismo , Leucemia L1210/patologia , Leucemia L5178/patologia , Animais , Adesão Celular , Proteínas da Matriz Extracelular/metabolismo , Galactose , Glicoproteínas/metabolismo , Molécula 1 de Adesão Intercelular , Manose , Camundongos , Camundongos Endogâmicos DBARESUMO
Where an unfavorable frenum is present, the technique of frenectomy plus free graft is perceived as an efficient, predictable procedure to improve the prognosis of a complete or partial denture.
Assuntos
Retenção de Dentadura , Freio Labial/cirurgia , Mucosa Bucal/transplante , Prótese Total , Prótese Parcial , HumanosRESUMO
Dental practice frequently requires close cooperation between the dentist and physician. The medical consultation request is extremely valuable in achieving this cooperation. The request must contain sufficient information to enable the physician to understand the dentist's findings, the patient's anticipated dental treatment needs, and the specific reasons for the consultation request. To ensure completeness, accuracy, and to provide a clear record from a medico-legal standpoint, the medical consultation request should be in writing.
Assuntos
Odontologia , Encaminhamento e Consulta , Adulto , Idoso , Diagnóstico , Diagnóstico Bucal , Feminino , Humanos , Hipertensão/diagnóstico , Masculino , Pessoa de Meia-Idade , Planejamento de Assistência ao Paciente , RedaçãoRESUMO
A discussion has been presented and examples provided to illustrate some of the complications that may be encountered in conjunction with free grafts of masticatory mucosa. The clinical problems presented are seen infrequently, but the clinician must be aware of the possibility of their occurrence when counseling patients on the possible sequelae of such surgical procedures. A knowledge of complications that may occur in free soft tissue grafting procedures, and of the underlying mechanisms causing these problems, may aid the clinician in anticipating and avoiding similar experiences.
