Prediction of outcome in patients with acute variceal haemorrhage.

Prediction of outcome in 87 patients following acute bleeding oesophageal and gastric varices due to portal hypertension from chronic liver disease was studied at our hospital over a 30-month period. The overall mortality rate was 26 per cent (23/87), with the operative mortality rate (50 per cent) being more than triple the non-operative mortality rate (14 per cent). The initial prothrombin time ratio (PTR) alone was significantly different in survivors and non-survivors both in the operated and non-operated patients. The only survivor in the whole material with a PTR greater than or equal to 2.2 was a patient who was transferred and underwent successful liver transplantation elsewhere. Among operated intensive care unit (ICU) patients, the Glasgow predictor gave a mean probability of discharge of 0.81 (s.d. 0.15) in 13 survivors and of 0.35 (s.d. 0.35) in the 15 non-survivors (P less than 0.001). In the 11 non-operative ICU patients, who had failed sclerotherapy, the Glasgow predictor could not be validated. Fourteen ICU deaths were associated with significant hypotension defined as a systolic blood pressure less than 90 mmHg for greater than 1 h.

A natural killer cell assay for the mink using a mouse lymphoma as the target cell line.

A natural killer cell assay was developed for the mink (Mustela vison) using mink peripheral mononuclear cells as effector cells and a mouse lymphoma cell line as targets. Baseline levels of natural killer cell activity were established in fertile mutation mink, primary infertile dark mink and secondary infertile dark mink with autoimmune orchitis. Blood samples were taken from dark mink at the end of March and from mutation mink during the first 2 weeks in April. Statistically significant differences in activity were noted between color phases and among groups. The possibility of genetic and/or seasonal differences in natural killer cell activity is discussed.

Immune abnormalities in patients with autism.

We have begun an investigation on the immune systems of patients with autism in attempt to determine if immune mechanisms are involved in the development of this severe developmental disorder. A study of 31 autistic patients has revealed several immune-system abnormalities, including reduced responsiveness in the lymphocyte blastogenesis assay to phytohemagglutinin, concanavalin A, and pokeweed mitogen; decreased numbers of T lymphocytes; and an altered ratio of helper to suppressor T cells. Immune-system abnormalities may be directly related to underlying biologic processes of autism, or these changes may be an indirect reflection of the actual pathologic mechanism.