Fulminant Plasmodium falciparum infection treated with exchange blood transfusion.

A 48-year-old physician, who was not undergoing malaria chemoprophylaxis, contracted Plasmodium falciparum while working in eastern Thailand. In the hospital, he had a peak parasitemia of 72% RBCs infected, associated with CNS dysfunction. As an adjunct to chemotherapy, a double-volume whole-blood exchange transfusion was performed on the first hospital day, dropping the parasitemia to less than 1% within 32 hours. The patient's clinical condition improved, with a prompt reversal of CNS, hepatic, and renal complications. These results, combined with those in previously reported cases, suggest that exchange transfusion should be considered more generally as a life-saving procedure in P falciparum infections.

Proton imaging for medical applications.

In order to demonstrate the potential advantages of proton imaging for medical use, a 205-MeV proton beam was developed using the Argonne National Laboratory Booster I synchrotron. Data were taken using a narrow scanning beam and an electronic detector system. The dose reduction and an improved mass resulution over the radiographs. The images also show significant differences in the proton stopping power of different tissues, thus demonstrating considerable potential in soft-tissue imaging. The development of a proton tomographic scan system is also briefly discussed.

The role of lymphotoxin in target cell destruction induced by mitogen-activated human lymphocytes in vitro. II. The correlation of temperature and trypsin-sensitive phases of lymphotoxin-induced and lymphocyte-mediated cytotoxicity.

The in vitro destruction of phytohemagglutinin (PHA) coated Beta L cells by non-immune human lymphocytes was resolved into two distinct phases--lymphocyte dependent and lymphocyte independent. The initial or lymphocyte-dependent phase occurred within the first 2 hr and proceeded equally well at 34 and 37 degrees C. The amount of lymphotoxin (LT) secreted by PHA-activated human lymphocytes in vitro to PHA stimulation was the same at 34 and 37 degrees C. Antiserum and complement inactivation of the aggressor lymphocytes at various intervals revealed that target cell lysis was lymphocyte independent. However, the latter phase was temperature dependent, i.e., proceeding at the permissive temperature of 37 degrees C, but inhibited at the restrictive temperature of 34 degrees C. Further experiments revealed that LT-induced destruction had the same temperature sensitivity as target cell cytolysis occurring during the lymphocyte-independent step. Trypsin treatment of target cells during an early period of the lymphocyte-independent phase protected the target cell from subsequent death, indicating the aggressor lymphocyte has deposited a cytotoxic effector material on its surface. These results suggest the lymphocyte-dependent stage involves the processes required for the induction of LT synthesis and secretion. The actual cytolysis occurring during the lymphocyte-independent stage may be caused by LT or LT-like material(s) deposited on the target cell surface by the mitogen-activated human lymphocyte.