Development of ISB 1442, a CD38 and CD47 bispecific biparatopic antibody innate cell modulator for the treatment of multiple myeloma

Antibody engineering can tailor the design and activities of therapeutic antibodies for better efficiency or other advantageous clinical properties. Here we report the development of ISB 1442, a fully human bispecific antibody designed to re-establish synthetic immunity in CD38+ hematological malignancies. ISB 1442 consists of two anti-CD38 arms targeting two distinct epitopes that preferentially drive binding to tumor cells and enable avidity-induced blocking of proximal CD47 receptors on the same cell while preventing on-target off-tumor binding on healthy cells. The Fc portion of ISB 1442 is engineered to enhance complement dependent cytotoxicity, antibody dependent cell cytotoxicity and antibody dependent cell phagocytosis. ISB 1442 thus represents a CD47-BsAb combining biparatopic targeting of a tumor associated antigen with engineered enhancement of antibody effector function to overcome potential resistance mechanisms that hamper treatment of myeloma with monospecific anti-CD38 antibodies. ISB 1442 is currently in a Phase I clinical trial in relapsed refractory multiple myeloma.

[Orbital MALT lymphomas: clinicopathological correlation]

BACKGROUND

Extranodal MALT lymphomas are slow growing tumors of B-cell origin which may be found in the orbit. They are associated with mucosa and epithelial structures.

PATIENTS AND METHODS

We present eight patients with biopsy confirmed orbital MALT Lymphomas. The diagnostic imaging techniques are described. Histopathological and immunohistological analysis showed typical findings of MALT lymphomas.

RESULTS

After staging six patients had radiation therapy. Two patients refused treatment due to lack of discomfort.

CONCLUSIONS

MALT lymphomas should be considered in the differential diagnosis of orbital tumors. While ultrasonography and MRI are needed to determine the extension of these tumors, their identification requires excision or biopsy with histological/immunohistochemical analysis, especially in view of new treatment options.

[Localized argyrosis 58 years after strabismus operation--an ophthalmological rarity]

BACKGROUND

A pigmented episcleral lesion may have several etiologies. We describe the rare occurrence of a localized argyrosis secondary to former strabismus treatment.

HISTORY

A 70-year old female patient was referred to our clinic for diagnosis and treatment of a pigmented episcleral process near the insertion of the left lateral rectus muscle which was noticed on a routine control by her ophthalmologist. The patient was free from ocular symptoms. There was a history of strabismus surgery on the left eye at the age of twelve. Due to the suspicious appearance of the lesion the possibility of a conjunctival malignant melanoma was considered. A ultrasound exam could not exclude this suspicion and therefore a biopsy was performed. Silver deposits and rests of a suture could be found.

CONCLUSION

Silver deposits are a rare cause of a pigmented localized episcleral lesion. Several possibilities of silver contamination in our patient are discussed. The most likely explanation is the use of silver containing suture material in strabismus surgery performed 58 years ago. A localized argyrosis secondary to past strabismus surgery should therefore be included in the differential diagnosis of a pigmented episcleral lesion.

New anilinophthalazines as potent and orally well absorbed inhibitors of the VEGF receptor tyrosine kinases useful as antagonists of tumor-driven angiogenesis

The sprouting of new blood vessels, or angiogenesis, is necessary for any solid tumor to grow large enough to cause life-threatening disease. Vascular endothelial growth factor (VEGF) is one of the key promoters of tumor induced angiogenesis. VEGF receptors, the tyrosine kinases Flt-1 and KDR, are expressed on vascular endothelial cells and initiate angiogenesis upon activation by VEGF. 1-Anilino-(4-pyridylmethyl)-phthalazines, such as CGP 79787D (or PTK787 / ZK222584), reversibly inhibit Flt-1 and KDR with IC(50) values < 0.1 microM. CGP 79787D also blocks the VEGF-induced receptor autophosphorylation in CHO cells ectopically expressing the KDR receptor (ED(50) = 34 nM). Modification of the 1-anilino moiety afforded derivatives with higher selectivity for the VEGF receptor tyrosine kinases Flt-1 and KDR compared to the related receptor tyrosine kinases PDGF-R and c-Kit. Since these 1-anilino-(4-pyridylmethyl)phthalazines are orally well absorbed, these compounds qualify for further profiling and as candidates for clinical evaluation.

PTK787/ZK 222584, a novel and potent inhibitor of vascular endothelial growth factor receptor tyrosine kinases, impairs vascular endothelial growth factor-induced responses and tumor growth after oral administration

PTK787/ZK 222584 (1-[4-chloroanilino]-4-[4-pyridylmethyl] phthalazine succinate) is a potent inhibitor of vascular endothelial growth factor (VEGF) receptor tyrosine kinases, active in the submicromolar range. It also inhibits other class III kinases, such as the platelet-derived growth factor (PDGF) receptor beta tyrosine kinase, c-Kit, and c-Fms, but at higher concentrations. It is not active against kinases from other receptor families, such as epidermal growth factor receptor, fibroblast growth factor receptor-1, c-Met, and Tie-2, or intracellular kinases such as c-Src, c-Abl, and protein kinase C-alpha. PTK787/ZK 222584 inhibits VEGF-induced autophosphorylation of kinase insert domain-containing receptor (KDR), endothelial cell proliferation, migration, and survival in the nanomolar range in cell-based assays. In concentrations up to 1 microM, PTK787/ZK 222584 does not have any cytotoxic or antiproliferative effect on cells that do not express VEGF receptors. After oral dosing (50 mg/kg) to mice, plasma concentrations of PTK787/ZK 222584 remain above 1 microM for more than 8 h. PTK787/ZK 222584 induces dose-dependent inhibition of VEGF and PDGF-induced angiogenesis in a growth factor implant model, as well as a tumor cell-driven angiogenesis model after once-daily oral dosing (25-100 mg/kg). In the same dose range, it also inhibits the growth of several human carcinomas, grown s.c. in nude mice, as well as a murine renal carcinoma and its metastases in a syngeneic, orthotopic model. Histological examination of tumors revealed inhibition of microvessel formation in the interior of the tumor. PTK787/ZK 222584 is very well tolerated and does not impair wound healing. It also does not have any significant effects on circulating blood cells or bone marrow leukocytes as a single agent or impair hematopoetic recovery after concomitant cytotoxic anti-cancer agent challenge. This novel compound has therapeutic potential for the treatment of solid tumors and other diseases where angiogenesis plays an important role.

Selective labelling of cell-surface polyamine-binding proteins on leukaemic and solid-tumour cell types using a new polyamine photoprobe

Polyamine transport is an active process which contributes to the regulation and maintenance of intracellular polyamine pools. Although the biochemical properties of polyamine transport in mammalian cells have been extensively studied, attempts to isolate and characterize the actual protein(s) have met with limited success. As one approach, photoaffinity labelling of cell surface proteins using a polyamine-conjugated photoprobe may lead to the identification of polyamine-binding proteins (pbps) associated with the transport apparatus and/or other regulatory responses. In a previous study [Felschow, MacDiarmid, Bardos, Wu, Woster and Porter (1995) J. Biol. Chem. 270, 28705-28711], we demonstrated that the photoprobes N4-ASA-spermidine and N1-ASA-norspermine [where the ASA (azidosalicylamidoethyl) group represents the photoreactive moiety] competed effectively with polyamines for transport and selectively labelled two major pbps at 118 and 50 kDa on the surface of murine and human leukaemia cells. In the present study, a new and more potent polyamine-conjugated photoprobe, N1-ASA-spermine, has been synthesized and used to develop a method based on detergent lysis for identifying putative cell-surface pbps on solid-tumour cell types. Transport kinetic assays showed that the new photoprobe competed with spermidine uptake with an apparent Ki of 1 microM, a value 20-50-fold lower than those of earlier probes. In L1210 cells, the new probe identified pbp50 and pbp118 thus reaffirming their identity as pbps. Two new bands were also detected. In A549 human lung adenocarcinoma cells, N1-ASA-spermine identified pbps at 39, 62, 73 and 130 kDa, the latter believed to be a size variant of pbp118. The presence of pbp130/118 in two very different cell types suggests the generality of the protein among mammalian cell types as well as its importance for further study. The high affinity of the photoprobe for the polyamine-transport system strongly suggests that at least some of the identified pbps may be associated with that function.

Use of a pharmacophore model for the design of EGF-R tyrosine kinase inhibitors: 4-(phenylamino)pyrazolo[3,4-d]pyrimidines

In the course of the random screening of a pool of CIBA chemicals, the two pyrazolopyrimidines 1 and 2 have been identified as fairly potent inhibitors of the EGF-R tyrosine kinase. Using a pharmacophore model for ATP-competitive inhibitors interacting with the active site of the EGF-R protein tyrosine kinase (PTK), the class of the pyrazolo[3,4-d]pyrimidines was then optimized in an interactive process leading to a series of 4-(phenylamino)-1H-pyrazolo[3,4-d]-pyrimidines as highly potent inhibitors of the EGF-R tyrosine kinase. The most potent compounds 13, 14, 15, 17, 19, 22, 26, 28, and 30 of this series inhibited the EGF-R PTK with IC50 values below 10 nM. High selectivity toward a panel of nonreceptor tyrosine kinases (c-Src, v-Abl and serine/threonine kinases (PKC alpha, CDK1) was observed. In cells, EGF-stimulated cellular tyrosine phosphorylation was inhibited by compounds 13, 15, 19, 22, and 23 at IC50 values below 50 nM, whereas PDGF-induced tyrosine phosphorylation was not affected by concentrations up to 10 microM, thus indicating high selectivity for the inhibition of the ligand-activated EGF-R signal transduction pathway. Compounds 15 and 19 inhibited proliferation of the EGF-dependent MK cell line with IC50 values below 0.5 microM. In addition, two compounds, 9 and 11, showing satisfactory oral bioavailability in mice after oral administration, exhibited good in vivo efficacy at doses of 12.5 and 50 mg/kg in a nude mouse tumor model using xenografts of the EGF-R overexpressing A431 cell line. From SAR studies, a binding mode for 4-(phenylamino)-1H-pyrazolo[3,4-d]pyrimidines, especially for compound 15, at the ATP-binding site of the EGF-R tyrosine kinase is proposed. 4-(Phenylamino)-1H-pyrazolo[3,4-d]pyrimidines represent a new class of highly potent tyrosine kinase inhibitors which preferentially inhibit the EGF-mediated signal transduction pathway and have the potential for further evaluation as anticancer agents.

In vitro trypanocidal activities of new S-adenosylmethionine decarboxylase inhibitors

A series of novel aromatic derivatives based on the structure of methylglyoxal bis(guanylhydrazone) (MGBG) was examined for in vitro antitrypanosomal activities and cytotoxicities for human cells. One-third of the compounds tested showed trypanocidal activity at concentrations below 0.5 microM after an incubation period of 72 h. Structure-activity analysis revealed that bicyclic compounds with homocyclic rings and unmodified termini were the most active compounds. Results obtained in three laboratories employing different methods and trypanosome populations consistently ranked compound CGP 40215A highest. This compound had a 50% inhibitory concentration of 0.0045 microM for Trypanosoma brucei rhodesiense, was also active against other trypanosome species, including a multidrug-resistant Trypanosoma brucei brucei, and was significantly less toxic than other compounds tested for a human adenocarcinoma cell line, with a 50% inhibitory concentration of 1.14 mM. The effect of CGP 40215A was time and dose dependent, and low concentrations of the compound required exposure times of > 2 days to exert trypanocidal activity. Compounds were inactive against Leishmania donovani and Trypanosoma cruzi amastigotes in murine macrophages in vitro.

Acute and long-term effects of prostaglandin E1 assessed by clinical and microcirculatory parameters in critical limb ischemia: a pilot study

We treated 14 patients suffering from critical limb ischemia (CLI) as defined by the Consensus Document, and in whom possibilities of surgical or percutaneous arterial reconstruction were excluded, by PGE1 60 micrograms i.v. daily during 3 weeks. Effects were evaluated by clinical, macrocirculatory and microcirculatory parameters during a follow-up of 1 year. After treatment with PGE1, we noted a significant reduction in analgesic use and in pain score. The average tcpO2 values on the forefoot in the supine and sitting positions, with or without inhalation of O2 through a face mask, showed a significant improvement after 3 weeks, as well as capillary stage. Laser Doppler flux did not change, but was significantly higher in diabetic patients than in nondiabetics with CLI. In 4 patients (28%) no improvement could be found after 3 weeks' treatment. Although in 6 patients the improvement lasted for up to 4 months, the legs eventually deteriorated. In 4 patients (28%) the legs were preserved after 1 year without further active therapy. No patient with initial tcpO2 values above 40 mm Hg in the supine and 100 mm Hg in the sitting positions during O2 inhalation lost a leg. Although other effects like local care could have influenced the outcome favorably, we noticed a beneficial albeit transient effect of PGE1 for the majority of our patients with CLI. TcpO2 measurements with O2 inhalation might be a valuable predictor of a positive long-term result.

4-Amidinoindan-1-one 2'-amidinohydrazone: a new potent and selective inhibitor of S-Adenosylmethionine decarboxylase

Two isomeric amidino-2-acetylpyridine amidinohydrazones, 11 and 12, and 4-amidinoindanone amidinohydrazone, 17, have been synthesized and tested for inhibition of S-adenosylmethionine decarboxylase (SAMDC) and diamine oxidase and for antiproliferative activity against T24 human bladder carcinoma cells. Compound 11 inhibited SAMDC with an IC50 of 10 nM and was 140- and > 500-fold more potent than methylglyoxal bis(guanylhydrazone) (MGBG) and 12, respectively. The difference in potency between 11 and 12 was interpreted with the help of molecular modeling and appeared to be associated with two different low-energy conformations of the compounds. Compound 17 which represents a conformationally constrained analogue of 11, was superior to the latter and MGBG with respect to selective inhibition of SAMDC and antiproliferative activity, and is of interest as a potential anticancer agent and a drug for the treatment of protozoal and Pneumocystis carinii infections.

Pharmacological properties of the ornithine decarboxylase inhibitor 3-aminooxy-1-propanamine and several structural analogues

Analogues of 3-aminooxy-1-propanamine proved to be highly potent and selective inhibitors of ornithine decarboxylase (ODC). The compounds competed with ornithine for the substrate binding site of ODC, but resulted in progressive and apparently irreversible inactivation of the enzyme. Diamine oxidase was inhibited by these compounds to a lesser extent than ODC; the compounds were not metabolized by this enzyme. Several derivatives were growth-inhibitory for human T24 cells and for other mammalian cells, the most active compound being 3-aminooxy-2-fluoro-1-propanamine (AFPA). Growth-arrested cells were largely depleted of putrescine and spermidine. Cellular growth arrest could be antagonized by supplementation with spermidine. Selection for resistance against AFPA led to cells with amplified ODC genes and overexpression of the message. Some of the derivatives were tumoristatic at well-tolerated doses in mice bearing solid T24 tumours. The antiproliferative activity of these compounds appears to be mediated by polyamine depletion.

Interlaboratory study of the IFCC method for alanine aminotransferase performed with use of a partly purified reference material

We present the results of a study on performance of a reference material for alanine aminotransferase (ALT, EC 2.6.1.2) and the corresponding IFCC-approved method in an interlaboratory trial involving 13 laboratories. The ALT material was partly purified from pig heart (specific activity, 150 kU/g) and was essentially free of six potentially contaminating enzyme activities, including aspartate aminotransferase (EC 2.6.1.1). The partly purified ALT was lyophilized in a triethanolamine-buffered matrix, pH 6.4, containing bovine serum albumin and saccharose. Under these conditions, the predicted yearly loss of activity was 0.02% at 4 degrees C and < 0.01% at -20 degrees C. The final blank-corrected results of the accepted set of data gave a mean (SD) of 128.5 (5.1) U/L. The among-laboratory SD was 4.6 U/L and the within-laboratory SD was 2.0 U/L. The certified ALT catalytic concentration in the reconstituted material was 129 U/L with a 0.95 confidence interval of +/- 4 U/L.

Interlaboratory Study of the IFCC Method for Alanine Aminotransferase Performed with Use of a Partly Purified Reference Material

We present the results of a study on performance of a reference material for alanine aminotransferase (ALT, EC 2.6.1.2) and the corresponding IFCC-approved method in an interlaboratory trial involving 13 laboratories. The ALT material was partly purified from pig heart (specific activity, 150 kU/g) and was essentially free of six potentially contaminating enzyme activities, including aspartate aminotransferase (EC 2.6.1.1). The partly purified ALT was lyophilized in a triethanolamine-buffered matrix, pH 6.4, containing bovine serum albumin and saccharose. Under these conditions, the predicted yearly loss of activity was 0.02% at 4 degrees C and &lt; 0.01% at -20 degrees C. The final blank-corrected results of the accepted set of data gave a mean (SD) of 128.5 (5.1) U/L. The among-laboratory SD was 4.6 U/L and the within-laboratory SD was 2.0 U/L. The certified ALT catalytic concentration in the reconstituted material was 129 U/L with a 0.95 confidence interval of +/- 4 U/L.

[Cerebral complications and general anesthesia]

Postoperative cerebral dysfunction is usually assumed to be a consequence of anaesthesia. Temporary postoperative confusion is quite common. This review points out that the anaesthetic technique is clinically relevant for mental dysfunction only in the few hours immediately following operation. Of primary importance are the preoperative state of the patient, the drugs used in the perioperative period, the type and duration of the operation, the technique of postoperative analgesia and sedation and the postoperative clinical course of the patient. Cerebral infarction is a very severe but rather rare complication which occurs mainly after the operation. The incidence of perioperative cerebral infarction is about 1% in 65-year-old patients and increases with higher age. An asymptomatic preoperative carotid bruit is not a risk factor; therefore, invasive investigations are not warranted. The most frequent cause for cerebral insults are emboli. Intraoperative hypotensive periods are very rarely responsible for cerebral insults. Peripheral and central nervous lesions due to positioning of the patient for the operation occur not frequently and are certainly an avoidable neurologic complication. Hypoxic cerebral damages are usually the consequence of anaesthetic mismanagement. Today they are very rare, due to modern monitoring techniques.

Methylprednisolone for acute spinal cord injury

Treatment with high-dose intravenous methylprednisolone is safe and may be associated with significant neurologic improvement in acute spinal cord injury patients. Accurate calculation and administration of the prescribed therapy and identification and assessment of complications should be incorporated into the overall standard of care for the acute spinal cord injury patient.

2-substituted 3-(aminooxy)propanamines as inhibitors of ornithine decarboxylase: synthesis and biological activity

1-Amino-3-(aminooxy)-2-propanol (6a) has been synthesized and found to inhibit rat liver ornithine decarboxylase (ODC) with an IC50 in the nanomolar range. Compound 6a served as a basis for the design of new enzyme inhibitors, which led to the identification of 3-(aminooxy)-2-fluoropropanamine (15) as a new powerful enzyme blocker. Compound 15 inhibited ODC at 3 times lower concentrations than 6a and 3-(aminooxy)propanamine (APA), and it was superior to APA as an antiproliferative agent in inhibiting the growth of human T24 bladder carcinoma cells in vitro.

High-dose methylprednisolone in the treatment of spinal cord injuries

The Second National Acute Spinal Cord Injury Study (NASCIS II), published in 1990, illustrated the benefits of high-dose steroids in the treatment of acute spinal cord injury. Research into the use of high-dose steroids is reviewed, and proposed mechanisms of action are addressed. Implications for nursing include method and timing of administration and expected complications. A case study is also provided.

Evaluation of desferrithiocin and its synthetic analogues as orally effective iron chelators

Desferrithiocin, a novel microbial siderophore isolated from cultures of Streptomyces antibioticus DSM 1865, and a number of its derivatives and analogues are evaluated for their ability to promote iron clearance. The compounds have been designed with the objective of identifying the structural features of desferrithiocin which render this ligand an orally effective iron chelator. The desferrithiocin aromatic hydroxyl and the thiazoline ring carboxyl group are shown to be central to desferrithiocin's activity. The ligand's methyl and the aromatic nitrogen play little role in the compound's efficacy. The animal model chosen for this study, the bile duct cannulated rat, provides information regarding both the chelator-induced total iron output and the kinetics of both biliary and urinary iron excretion.

Amiodarone. Therapeutics and guidelines

Amiodarone, a newly marketed Type III antiarrhythmic, is indicated in the treatment of life-threatening ventricular dysrhythmias, including sustained ventricular tachycardia and ventricular fibrillation. Nurses who specialize in the treatment of cardiac patients should familiarize themselves with the general pharmacology of amiodarone. Specifically, nurses should be knowledgable of the considerable side effects of amiodarone and be able to translate to their patients pertinent information about prevention, detection, and management of potential side effects.

Activation of the human neutrophil respiratory burst by an anion channel blocker

We found that 4,4'-diisothiocyano-2,2'-disulfonic acid (DIDS), an anion channel blocker in erythrocytes, caused a concentration-related stimulation of oxygen radicals in human neutrophils, as measured by luminol- and lucigenin-amplified chemiluminescence. The DIDS-elicited oxygen radical burst followed the kinetic pattern of other stimuli with a lag period of 20 seconds, reaching a maximum after 12 to 15 minutes. Washing neutrophils that had been pretreated with DIDS did not reverse neutrophil activation. DIDS was found to strongly stimulate lactate production and did not block the efflux of this anion. Cytochalasin B completely abolished the chemiluminescence responses when added before DIDS stimulation. It also inhibited lactate production, however, only in a glucose-containing medium. Modulation of oxygen radical production by DIDS may reveal an additional transductional pathway for neutrophil activation.

Dialyzed polymorphonuclear neutrophil oxidative metabolism during dialysis: a comparative study with 5 new and reused membranes

Dialyzed neutrophils were isolated at time 0, 5, 15 and 60 min after the onset of hemodialysis in patients successively treated on 5 new and reused membranes, that is cuprophan (CU), cellulose acetate (CA), polysulfone (PS), polycarbonate (PC) and polyacrilonitrile (PAN). Production of oxygen radicals was monitored by luminol and lucigenin-enhanced chemiluminescence (CL). During dialysis with CU and PC, cells remaining in circulation at the maximum neutropenia showed a significant decrease of luminol-enhanced CL, whether stimulated with opsonized zymosan or phorbol myristate acetate. This defect was transient and the responses normalized at 60 min or upon reuse of the membranes. Among the other membranes tested, only cells collected during the first use of PS showed an impaired CL response to phorbol myristate acetate, but not to opsonized zymosan. CL again normalized upon reuse. At 5 min of dialysis with each membrane, a plasma factor appeared that was able to stimulate oxygen radical production by autologous dialyzed and control cells. A dissociation between the oxidative responses of dialyzed neutrophils and neutropenia was observed depending on the nature of the membranes, suggesting that neutropenia is a multifactorial process in which oxygen radical production appears as an early disturbance.

[Severe, acute bleeding ulcer: which criteria are decisive for therapeutic procedures?]

Prognostic and therapeutic implications of acute severe gastrointestinal bleeding were retrospectively analyzed, on the basis of history, clinical and endoscopic findings, in a group of 50 consecutive patients with endoscopically documented ulcer of the stomach or duodenum. In patients with hemorrhagic shock and a history of melena and/or hematemesis represents the most important indication for urgent action. In this setting the surgical approach remains the therapy of choice if other measures (endoscopic coagulation, somatostatin application) are unable to prevent further bleeding. Except in situations with acute arterial bleeding, the endoscopic finding itself is not decisive in selecting the therapeutic procedure.

The polycarbonate hemodialysis membrane: neutrophil, platelet, complement and chemiluminescence kinetics during first and second use

In a clinical comparative cross-over study of 12 chronically hemodialyzed patients, the polycarbonate hemodialyzer membrane disclosed the following features: A drop in neutrophil count to 45 +/- 11% predialysis values occurred 15 min after the start of dialysis. Plasmatic C3d increased at the initiation of dialysis simultaneously with the nadir of neutropenia but also towards the end of dialysis when neutrophil count was normal. An inhibition of chemiluminescence of neutrophils isolated 5 and 15 min after the start of dialysis was noted. Reuse of the membrane induced during the second use a significant aggravation of neutropenia (36 +/- 23% at 15 min), a drop in platelet count (91 +/- 10% at 15 min) and a return to normal of chemiluminescence. When compared to the results observed with cuprophane and polyacrilonitrile membranes in the sam patients, the polycarbonate membrane seems to possess intermediate biocompatibility properties.

Oxygen metabolism of phagocytosing human polymorphonuclear leucocytes in diabetes mellitus

Zymosan stimulated oxygen metabolism was investigated in polymorphonuclear leucocytes (PMN) from 6 diabetic patients. Oxygen uptake and superoxide production were continuously measured in the presence of autologous or control serum and non-opsonized zymosan, or in the absence of serum and preopsonized zymosan. The only significant impairment in the diabetic cells studied was a lower oxygen uptake in the presence of autologous serum. This defect was normalized by addition of control serum or by omitting the serum and stimulating with opsonized zymosan. In the absence of serum, the oxygen consumption was markedly diminished in only one subject, whereas two subjects showed a decrease of superoxide production in the presence of control serum. An inverse correlation between fasting glucose concentration and oxygen uptake could be demonstrated. However, exposure of normal PMN to hyperglycemic glucose concentration in vitro did not significantly alter their oxygen metabolism, suggesting that glucose alone could not be the only factor responsible for the impaired oxygen consumption in diabetic cells.

[Arterial aneurysm of the liver with arterio-portal fistula: treatment using embolization]

Aneurysms of the hepatic artery are rare and may present multiform clinical pictures. Prompt diagnosis is important because life threatening complications can be treated by relatively simple measures. A case of posttraumatic intrahepatic aneurysm of the hepatic artery with arterioportal fistula and successful transcatheter embolisation is reported. The present state of the art is outlined and indications for diagnosis and therapy are presented.

Cuvette and flow system for simultaneous determination of optical density and oxygen concentration

The major components of the device for semiautomatic measurement of oxygen consumption and optical density changes are a thermostated glass reservoir of 50-250 ml for the reaction mixture, a roller pump to transport the reaction mixture from the reservoir into the measuring cuvette, and a stoppered glass cuvette equipped with a Clark type electrode. The glass cuvette (0.525 ml) is square shaped (the interior section 6 X 6 mm). The lower part housing the magnetic stirrer has a side aperture for the oxygen electrode. The upper part of the cuvette is cylinder shaped. The stopper is fitted in this part. The stopper made of lucite protrudes 15 mm into the cuvette. The access and the removal of the reaction mixture to/from the cuvette is ensured by three different channels machinated into the body of the stopper. The device adaptable to Eppendorf spectralline photometer may be used in the study of oxidative phosphorylation on intact mitochondria or submitochondrial particles, or of any oxygen consuming system in which one reagent or reaction product can be monitored photometrically.

Energetic metabolism of leukocytes. XI. Presence and function of creatine kinase in leukocytes

Creatine kinase activity could be demonstrated in the cytosol of macrophages and polymorphonuclear leukocytes from guinea pig peritoneal exudates, in circulating mononuclear cells of blood donors and of a preleukemic patient, but not in human circulating polymorphonuclear cells. According to immunoinhibition assays most of the creatine kinase activity of human monocytes (preleukemic patient) and lymphocytes can be assigned to the MM and BB isoenzymes, respectively. Both isoenzymes have been observed in human lymphocytes by electrophoresis; with the help of the same procedure the predominance of creatine kinase BB has been demonstrated in the cells of guinea pig peritoneal exudates. The possible function of creatine kinase in leukocytes is discussed.