Donor bone marrow response to immunosuppressive treatment

An 8-year-old male with idiopathic severe aplastic anemia was successfully treated with allogeneic bone marrow transplantation in June 1980. However, he had a severe aplastic recurrence on the donor marrow after 3 years of sustained and complete engraftment. An alternative immunosuppressive treatment was attempted as a second bone marrow transplantation could not be performed. Consecutive immunosuppressive courses with antithymocyte globulin, antithymocyte globulin plus ciclosporin A and ciclosporin A alone elicited good but transient responses. At present he needs uninterrupted ciclosporin A treatment to maintain normal donor hemopoiesis. An immune-related and persisting pathogeneic mechanism for the aplasia is suspected that responds to diverse and continuous immunosuppression.

[Kidney autotransplantation]

Five cases are presented in which an autotransplantation of the kidney was performed. Four patients had a renovascular hypertension and one an extended injury of the ureter. In one case postoperatively appeared an arterial thrombosis which led to nephrectomy.

Two cases of dysfibrinogenemia characterized by abnormal FPB release: fibrinogen Madrid I & II

Congenital dysfibrinogenemia was found in two non related and asymptomatic families. Low levels of plasma fibrinogen were found using a chronometric assay but normal levels were found using both an immunologic method and a method to measure the fibrin formed after two hours incubation with thrombin. Kinetic analysis of fibrinopeptide release revealed a delay in the thrombin catalyzed release of fibrinopeptide B from both abnormal fibrinogens. Timed release of fibrinopeptide A was normal. Analysis of fibrinopeptides by high-performance liquid chromatography showed the same retention times in both normal and abnormal fibrinogens. Polymerisation of fibrin monomers and the sialic acid content per mol of fibrinogen were normal. Although these cases seem similar, until their structural defects are determined, it is proposed to provisionally designate them fibrinogens Madrid I & II.

[A model of clinical intervention in a mental hospital]

The purpose of this paper is to present a clinical model of intervention in a mental hospital which refers to a psychosocial treatment and rehabilitation program for acute hospitalized psychotic patients. A method of applied research was utilized for the development of the model. The theoretical framework, objectives and areas of the program are described as well as the research and treatment team, the structure and functioning of the program. Some preliminary results and conclusions are also included.

[Leopard syndrome with hypertrophic obstructive cardiomyopathy and cerebral arteriovenous malformation. Report of a case]

We report a case of a 27-year-old woman with Leopard syndrome in which we observed the association of hypertrophic obstructive cardiomyopathy with arteriovenous cerebral shunt. This association has not been reported previously in the literature.

Characterization of a human pararotavirus

A virus isolate with the properties of a pararotavirus was found after routine analysis by RNA electrophoresis of 658 samples of diarrheic feces from hospitalized infants and young children in Mexico City. Of the patients included in this survey, which was initiated in 1977, 29% excreted rotaviruses which were detected by their characteristic RNA pattern after gel electrophoresis. The morphology and sedimentation coefficient of this pararotavirus, which was the apparent cause of a diarrhea with moderate dehydration in a 2-year-old male infant, were indistinguishable from those of rotaviruses, but its buoyant density in CsCl was slightly higher than that of simian rotavirus SA11. By electron microscopy, the viral particles showed a regular pattern of cavities or holes that constituted the 5- and 6-coordinated units of the virion with a structure characteristic of T = 12. The virion also was apparently composed of protein classes similar to those found in rotaviruses. Seroconversion in the patient and presence of anti-pararotavirus antibodies in most of the members of the family of the patient was shown by immunoelectron microscopy. Of the sera from 12 healthy adults which were examined by this technique, seven were negative, three were slightly positive, and only two were strongly positive.

Isolation and immunological reactivity of soluble fractions from rat seminiferous tubule basement membrane

A preparation rich in basement membranes isolated from rat testes (STBM) was exposed to pepsin, collagenase, trypsin, and pronase to obtain soluble fractions. The immunological reactivity of these fractions was studied by gel immunodiffusion or by passive hemagglutination tests against an anti-STBM serum. All fractions reacted with the antiserum, but the highest titer was detected when the antiserum was reacted with a fraction that contained only traces of hydroxyproline (fraction 1), whereas low titers were obtained with collagen or collagen fragments isolated from STBM. Antibodies in the anti-STBM serum were mainly directed to the glycoproteins of STBM not related to collagen. Fraction 1, obtained by subsequent collagenase and trypsin digestion of STBM and purification by Sephadex G-200, was a high molecular weight glycoprotein that was free of half-cystine and methionine, had only traces of hydroxyproline, and contained 7.2% neutral sugars, 0.26% sialic acid, and 8.7 residues of glucosamine per 1000 residues of amino acids.

Presence of two distinct types of rotavirus in infants and young children hospitalized with acute gastroenteritis in Mexico City, 1977

Between December 1976 and January 1978, infection with rotavirus was detected by electron microscopy in 61 (25%) of 242 infants and young children hospitalized with acute gastroenteritis at two hospitals in Mexico City. This type of infection was more frequent in autumn than in winter. The presence of virus could also be detected by the electrophoretic pattern of its segmented, double-standed ribonucleic acid (RNA) in the stool samples taken from 52 (85%) of the 61 patients who were shown by electron microscopic examination to excrete rotavirus. Two distinct patterns, previously called 2s and 21, were observed, which were distinguishable by the relative migration of the second, 10th, and 11th viral RNA segments in gel electrophoresis; the 21 pattern was observed much more frequently than with the 2s pattern.

[The Landry-Guillain-Barré-Strohl syndrome]

Landry-Guillain-Barré-Strohl syndrome or polyradiculoneuritis in children is becoming more common. The clinical picture is variable, it may be manifested by motor and sensory findings or by a combination of peripheral and cranial nerve signs and symptoms. This is a report of 60 patients observed at the DIF Children's Hospital between 1971 and 1977. The most significant early predictor of eventual incomplete recovery was the time required for improvement to begin after the maximum involvement was reached.

[Existence of 2 types of Rotavirus associated with acute gastroenteritis in children]

Rotaviruses found in the stools of different infants, hospitalized in the Hospital del Niño del DIF, may be grouped into at least two types according to their RNA composition. The viral RNA composition was analyzed by electrophoresis in agarose gels. The different types can be distinguished by the mobility of the second larger of the 11 segments that make up the viral RNA.

[Diagnosis of Rotavirus using viral RNA electrophoresis]

Rotavirus has emerged as a major agent of acute enteritis of infants. A rapid and simple technique has been developed for its detection, based on the visualization of the viral RNA electrophoretic pattern. This technique takes advantage of the large amount of rotavirus present in the stools and the high sensitivity for detection of RNA obtained with ethidium bromide.

[Epidemiological aspects of gastroenteritis dut to Rotavirus]

During December 1976 to January-March 1977, 13/53 children less than 5 years of age were admitted with acute enteritis caused by rotaviruses to the Hospital del Niño, DIF. There is already convincing evidence that this new virus will prove to be the most important etiological agent of sporadic acute enteritis in young children.

[Pleuropulmonary lesions due to Haemophilus influenzae]

Empyema due to Hemophilus influenzae has been reported only rarely. This report describes the cases of ten children with empyema due to this organism. Diagnosis was made through growth of the organism in pure culture from pleural effusion. H. influenzae empyema may occur in older children as well as in infants and, in contrast to certain other infections with this organism, empyema due to H. influenzae may be more common than is generally suspected.

[Treatment of chronic osteomyelitis]

Levels of Cephaloridine and Cefazoline were measured in serum, pus and bone in 20 patients with chronic osteomyelitis and the efficiency of these drugs in the treatment of osteomyelitis was evaluated.

[Neonatal meningoventriculitis]

Clinical and autopsy data indicate that ventriculitis persists despite parenteral and intralumbar antibiotic therapy. In the present study, ventriculitis was documented as postmortem examination in nine newborns. These studies indicate that ventriculitis occurs commonly in neonates with meningitis, particularly when there is delayed sterilization of CSF culture, A clinician has to bear in mind the diagnosis of ventriculitis when: 1) There is poor clinical and/or laboratory response to the usual therapy. 2) He has a critically ill patient with lethargy, convulsions and bulging fontanels. 3) He culture an unusual organism. 4) He faces a suspected complication of meningitis: subdural effusion, ventriculitis or abscess. 5) A CSF from ventricular puncture with more than 150 WBC, glucose less than 50 mg. and protein more than 200 mg.

[Cryptococcosis of the central nervous system]

The steps for diagnosis and treatment and the clinical course followed in three patients with Cryptococcus meningitidis are discussed. One of them was treated with 5-flurocytosine alone. Two consecutive patients were treated with a combination of 5-flurocytosine and amphotericin B. The objectives of the study were: a) to achieve a therapeutic response better than that which might be obtained with either drug alone, b) to use lower doses of 5-fluorocytosine and amphotericin B in order to reduce toxicity, c) to extend treatment only for a period of four weeks, thus decreasing the period of hospitalization. None of the patients has relapsed. A shorter time of hospitalization and reduction in toxicity, suggests that combined therapy is a safe and effective alternative to other regimens.