Dose-dependent selective priming of Th1 and Th2 immune responses is achieved only by an antigen with an affinity over a certain threshold level.

Helper CD4+ T lymphocytes can be divided into two subsets, Th1 and Th2. The types of Th subsets activated during the adaptive immune response inductiondetermine the efficacy of immune responses against thee antigens introduced. Selective differentiation of subsets of CD4+ T lymphocytes has been known to be influenced by several factors, such as the cytokine environment around the T cells, the specificity of antigen recognition bythe T cell receptor, the expression of costimulatory molecules, and/ or the dose of the antigen applied to stimulate the T cells. In this study, we tried to determine the influence of the antigen dose on the selective priming of T lymphocytes when an inefficient antigen was applied since all the conclusions drawn from previous experiments were based on experiments with immune systems which responded well against the antigens introduced. When the recombinant hen egg-white lysozyme (HEL) was used too stimulate immune responses in HEL low-responder C57B3L/6 mice, dose-dependent selective priming of immune responses was not observed. However, when the variant antigen, which had been characterized as an efficientantigen in anti-HEL immune response induction in the low-responder mice, was applied, dose-dependent selective priming of Th immune responses was clearly demonstrated. These results suggested that dose-dependent selective priming of Th immune responses could be achieved only by the antigens with an affinity over a certain level.

Increased production of tumor necrosis factor-alpha and release of soluble CD4 and CD8 molecules, but decreased responsiveness to phytohemagglutinin in patients with nasopharyngeal carcinoma.

Twelve patients with nasopharyngeal carcinoma (NPC) were studied for spontaneous and phytohemagglutin (PHA)-stimulated production of cytokines, soluble markers and [3H] thymidine incorporation by mononuclear cells. The same number of patients with skin cancer and healthy subjects were used as control groups. Our results showed that the NPC group produced much more tumor necrosis factor-alpha (TNF alpha), soluble CD4 (sCD4) and CD8 (sCD8) in PHA-stimulated mononuclear cell supernatants than those in the other two groups. The levels of soluble interleukin-2 receptor (sIL-2R) and gamma-interferon (IFN gamma) in PHA-stimulated supernatants were at the same high level in the NPC and healthy subjects groups while the concentrations were much lower in the skin cancer group. We also noticed that the early stage group in NPC patients had higher levels of interleukin-1 alpha (IL-1 alpha), TNF alpha, IFN gamma and sIL-2R in both spontaneous and PHA-stimulated mononuclear cell supernatants. The stimulation index of PHA-responsiveness was 155, 5.2 and 37, respectively, in the healthy subjects, skin cancer and NPC groups. The PHA-responsiveness was depressed in both the NPC and skin cancer groups. It seems that cancer patients have an impaired T cell mitogenic response after mitogen stimulation. NPC patients had better immune response than skin cancer patients in immune factor release or PHA-responsiveness.

The effects on basal anterior pituitary hormone concentrations by cranial irradiation in patients with nasopharyngeal carcinoma.

Hypopituitarism occurring in patients who received external cranial radiation therapy (RT) have been increasingly recognized. Fourteen healthy patients were collected as control Group I, and 25 patients with nasopharyngeal carcinoma (NPC) were enrolled as Group II. Another 18 NPC patients were enrolled as Group III. Blood was sampled from Group I, Group IIB (before RT), Group IIA (one week after RT) and Group IIIA (1 to 1.5 years after RT). The basal samples were taken for growth hormone (GH), adrenocorticotropic hormone (ACTH), cortisol, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), thyrotropin (TSH), triiodothyronine (T3) and thyroxine (T4). The results showed the T3 level was statistically low in Group IIB compared with Group I. The serum GH and FSH (male only) levels were higher and with statistical significance in Group IIA compared Group IIB. Both GH and ACTH levels decreased and PRL increased with statistical significance in Group IIIA compared with Group IIA. The ACTH decreased with statistical significance in Group IIIA compared with Group IIB. Clinical damage to the pituitary is usually manifested months to years after RT. Therefore, a careful exclusion of these glands from radiation treatment fields is recommended whenever possible.

The effect of adjuvant chemotherapy for nasopharyngeal carcinoma: a preliminary report.

In the past, radiation therapy was the main treatment modality in nasopharyngeal cancer, but recently, combined induction chemotherapy has become a trend. In this study patients with NPC were divided into two groups. In Group I, 46 cases were treated with chemotherapy (Cisplatin + 5-Fu) and radiation. In Group II, 49 cases were given radiation only. The side effects of chemotherapy were tolerable except for 2 dropouts due to intractable vomiting and semi-coma respectively. Only 17 cases got leukopenia and one case was graded I in BUN evaluation. All of the cases were within normal limits in the platelet and creatinine evaluation. Nine cases acquired hyponatremia. The response rate was 72.7% in the primary site which included 22.7% of the complete response and 50.0% of the partial response with a 80.0% response rate in neck site, which included 56.7% of complete response and 23.3% of partial response. But after the consecutive radiation, the differences of response rate did not show any significance between the two groups. The difference in the response rate between non-keratinizing and undifferentiated carcinoma were significant.

Internal jugular phlebectasia.

Phlebectasia, defined as abnormal venous dilation, may occur in a number of different sites. Two cases with definite diagnosis of internal jugular phlebectasia were reported. The first case was a 6-year-old girl with a bulging mass on right neck for 3 years. Angiography and CT scan showed definite diagnosis, and the bulging mass was resected from the internal jugular vein (IJV). The second case was a 66-year-old female patient, also complained of a bulging mass on her right neck. Sonogram and CT scan also showed the same diagnosis. Because it did not bother the patient, she was just under close observation. From the three kinds of diagnostic modalities, we found sonography is an effective technique because of its clarity, safety and low cost.