Comparison of artificial tooth position in dentures fabricated by heat curing and additive manufacturing

BACKGROUND

The purpose of this study was to compare the displacement of tooth arrangement in dentures fabricated by additive manufacturing (AM) and heat curing.

METHODS

Three-dimensional (3D) scanning was performed for edentulous jaw models. After the teeth were arranged, 3D scanning for the wax denture was performed. Heat-cured dentures were fabricated with heat-cure polymer resin. Based on data obtained by subtracting the model data from wax denture data, AM dentures were fabricated from ultraviolet-cured acrylic resin. Accuracy was verified by superimposing heat-cured and AM dentures on the tooth region data from the wax dentures and measuring displacement of the tooth arrangement.

RESULTS

In the maxillary dentures, the amount of tooth displacement for the heat-cured dentures and for the AM dentures ranged from -0.08 to +0.06 mm and from -0.25 to +0.06 mm respectively. A significant difference was observed between two dentures. In the mandibular dentures, the amount of tooth displacement for the heat-cured dentures and for the AM dentures ranged from -0.09 to +0.07 mm and from -0.03 to +0.07 mm respectively. No significant difference was observed between two dentures.

CONCLUSIONS

The artificial teeth of the maxillary dentures fabricated by AM showed a greater displacement compared to those by heat curing.

Accuracy of Le Fort I osteotomy with combined computer-aided design/computer-aided manufacturing technology and mixed reality

The aim of this study was to verify the reproducibility and accuracy of preoperative planning in maxilla repositioning surgery performed with the use of computer-aided design/manufacturing technologies and mixed reality surgical navigation, using new registration markers and the HoloLens headset. Eighteen patients with a mean age of 26.0 years were included. Postoperative evaluations were conducted by comparing the preoperative virtual operation three-dimensional image (Tv) with the 1-month postoperative computed tomography image (T₁). The three-dimensional surface analysis errors ranged from 79.9% to 97.1%, with an average error of 90.3%. In the point-based analysis, the errors at each point on the XYZ axes were calculated for Tv and T₁ in all cases. The median signed value deviation of all calculated points on the XYZ axes was -0.03mm (range -2.93mm to 3.93mm). The median absolute value deviation of all calculated points on the XYZ axes was 0.38mm (range 0mm to 3.93mm). There were no statistically significant differences between any of the points on any of the axes. These values indicate that the method used was able to reproduce the maxilla position with high accuracy.

Reappearance of cardiac presynaptic sympathetic nerve terminals in the transplanted heart: correlation between PET using (11)C-hydroxyephedrine and invasively measured norepinephrine release

Previously, sympathetic reinnervation of the transplanted heart has been described using invasive catheterization techniques and noninvasive radionuclide imaging techniques. However, little is known about the agreement between these 2 methods. Thus, correlation between (11)C-hydroxyephedrine (HED) PET and invasively measured norepinephrine (NE) release was investigated in transplant recipients in this study.

METHODS

Using PET and the catecholamine analog HED, 17 patients were studied between 2 mo and 13.6 y after transplantation. Based on results in completely denervated hearts, areas with HED retention >7%/min were defined as reinnervated. Additionally, transcardiac NE release induced by intravenous tyramine (55 microg/kg) was measured by coronary sinus and aortic catheterization within 1 wk of the PET study. NE levels between coronary sinus and aortic root, DeltaNE(CS-AO), were calculated at baseline and after tyramine administration. Differences of more than 3 SD of baseline (>163 pg/mL) were interpreted as reinnervation.

RESULTS

HED retention indicated reinnervation in 10 patients. Maximal HED retention ranged from 4.3%/min to 16.4%/min. DeltaNE(CS-AO) 1 min after tyramine administration ranged between -10 pg/mL and 1157 pg/mL, and 8 patients were above the reinnervation threshold. Fisher's exact test demonstrated good agreement between results of PET and DeltaNE(CS-AO) measurements (P = 0.002). Maximal HED retention was also significantly correlated with NE release (r = 0.69; P = 0.001).

CONCLUSION

Results of invasively measured NE release and noninvasive (11)C-HED PET are well correlated. This study further supports the usefulness of PET as a noninvasive approach for detection of reappearance of catecholamine uptake sites after heart transplantation.

Efficient gene activation in cultured mammalian cells mediated by FLP recombinase-expressing recombinant adenovirus

A recombinant adenovirus (rAd) expressing Cre recombinase derived from bacteriophage P1 has already been extensively used for the conditional gene activation and inactivation strategies in mammalian systems. In this study, we generated AxCAFLP, a rAd expressing FLP recombinase derived from Saccharomyces cerevisiae and carried out quantitative comparisons with Cre-expressing rAd in both in vitro and in cultured cells to provide another efficient gene regulation system in mammalian cells. In the in vitro experiments, the relative recombination efficiency of FLP expressed in 293 cells infected with FLP-expressing rAd was approximately one-thirtieth that of Cre even at 30 degrees C, the optimum temperature for FLP activity, and was approximately one-ninetieth at 37 degrees C. Co-infection experiments in HeLa cells using a target rAd conditionally expressing LacZ under the control of FLP showed that an FLP-expressing rAd, infected at a multiplicity of infection (MOI) of 5, was able to activate the transgene in almost 100% of HeLa cells whereas the Cre-expressing rAd was sufficient at an MOI of 0.2. Since an MOI of 5 is ordinarily used in rAd experiments, these results showed that the FLP-expressing rAd is useful for gene activation strategies and is probably applicable to a sequential gene regulation system in combination with Cre-expressing rAd in mammalian cells.

Global and regional functional measurements with gated FDG PET in comparison with left ventriculography

The purpose of this study was to validate the measurement of global and regional left ventricular cardiac function with ECG-gated fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) by comparison with the corresponding indices from X-ray left ventriculography (LVG). Twenty-six patients (23 men, 3 women, mean age 60.4 years) underwent LVG and ECG-gated (eight frames/cycle) FDG-PET within an interval of 10.2+/-6.8 days. A volumetric sampling approach was used to obtain both global (EF: ejection fraction) and regional [%WT: relative regional count increase from end-diastolic (ED) to end-systolic (ES) phase] functional parameters. The gated PET parameters were compared with the corresponding findings of LVG in seven myocardial segments. EF(gated PET) and EF(LVG) did not differ significantly (30%+/-10% vs 32%+/-10%, P=NS). The two EF values correlated significantly, showing no significant systematic measurement bias [EF(gated PET) = 2.61+0.86 x EF(LVG), R=0.84, P<0.0001]. Inter- and intra-observer reproducibility for EF were R=0.95, P<0.0001 and R=0.92, P<0.0001, respectively. Regional function was evaluated with LVG in 144 myocardial segments comprising 35 normokinetic, 70 hypokinetic and 39 a/dyskinetic segments. Visual analysis of LVG and gated PET correlated significantly (P<0.001), with an overall concordance ratio of 58% (83/144, kappa=0.35). Gated PET overestimated the regional function in 27% (39/144) and underestimated it in 15% (22/144). %WT showed significant differences between each pair of groups (a/dyskinesis, 13.2%+/-9.3%; hypokinesis, 17.1%+/-8.8%; normokinesis, 21.8%+/-10.9%). Inter- and intra-observer reproducibility was significant for %WT (R=0.77, P<0.0001 and R=0.79, P<0.0001, respectively). In conclusion, gated FDG PET permits assessment of global left ventricular cardiac function. In addition, assessment of regional function is feasible using the visual or the quantitative parameters.

Role of relative myocardial perfusion reserve for evaluating stenosis severity in patients with single-vessel coronary artery disease using

A statistically significant correlation was observed between the severity of anatomic stenosis and coronary flow reserve in experimental animals. A similar correlation in human coronary artery disease (CAD) was shown using positron emission tomography (PET) and pharmacologic vasodilator stress. The present study tested whether the concept of relative myocardial perfusion reserve (MPR) might be superior to absolute MPR in correlating coronary stenosis determined by quantitative coronary arteriography in patients with single vessel CAD using [13N]ammonia and PET. The study group comprised 21 patients (62 +/-10 years old; 15 men, 6 women) with normal left ventricular function who underwent angioplasty for isolated left anterior descending coronary artery stenosis. Absolute MPR, the ratio of dipyridamole-induced hyperemic blood flow to baseline blood flow by [13N]ammonia PET, and relative MPR, the ratio of MPR in regions supplied by stenosed coronary arteries to MPR in remote regions, were measured before and 3 months after angioplasty. The percent diameter stenosis was also quantified on coronary arteriograms just before the angioplasty and again at 3 months after. The study found that absolute MPR (r=0.755; p<0.0001) and relative MPR (r=0.814; p<0.0001) were inversely and nonlinearly correlated with the percent stenosis on angiography. The fitting curve of the correlation between relative MPR and coronary stenosis on angiography was identical to that observed in animal models. Therefore, relative MPR measured by [13N]ammonia PET more accurately and specifically describes stenosis severity in patients with CAD compared with absolute MPR, probably because of its independence from hemodynamic variations and the effects of coronary risk factors.

Non-invasive assessment of the effect of cardiac sympathetic innervation on metabolism of the human heart

The role of cardiac sympathetic nerves in the regulation of myocardial metabolism is not well defined. Owing to the presence of incomplete reinnervation, heart transplant recipients provide a unique model to study the effects of efferent sympathetic innervation. Using this model, we sought to determine the influence of cardiac sympathetic signals on substrate utilisation and overall oxidative metabolism. In 21 transplant recipients, positron emission tomography was applied to determine sympathetic innervation with the noradrenaline analogue carbon11 hydroxyephedrine, oxidative metabolism with carbon11 acetate (n=14), and glucose utilisation with fluorine-18 fluorodeoxyglucose (n=7). The reinnervated area comprised 22% +/- 20% of the left ventricle. Oxidative metabolism was similar in denervated and reinnervated myocardium [0.06 +/- 0.01 vs 0.06 +/- 0.01/min for k(mono)], while glucose uptake was significantly higher in denervated myocardium (6.9 +/- 6.6 vs 6.0 +/- 6.2 micromol/min/100 g; P=0.03). Reinnervation mainly occurred in the territory of the left anterior descending artery, where retention of 11C-hydroxyephedrine (6.8 +/- 2.7%/min) was higher compared with territories of the left circumflex (4.1 +/- 1.7%/min; P<0.01) and right coronary (3.8 +/- 1.1%/min; P<0.01) arteries. Oxidative metabolism was similar in all three territories, but compared with the reinnervated territory of the left anterior descending artery (53% +/- 16% of maximum), relative FDG uptake was higher in territories of the left circumflex (76% +/- 6%, P<0.01) and right coronary (67% +/- 10%, P<0.05) arteries. Similar degrees of regional heterogeneity were not observed in normals. Thus, while overall energy production through oxidative metabolism remains unaffected, cardiac utilisation of glucose in the fasting state is increased in the absence of catecholamine uptake sites. Innervated myocardium, however, may preferentially utilise free fatty acids, suggesting a role for sympathetic tone in substrate utilisation.

Effects of disopyramide and verapamil on renal disposition and nephrotoxicity of cisplatin in rats

PURPOSE

The purpose of this study was to determine the effects of disopyramide and verapamil on the renal handling of cisplatin (CDDP) and nephrotoxicity in rats. The stereoselective effect of verapamil was also studied.

METHODS

CDDP was administered to rats by i.v. bolus injection or by infusion at a constant rate with or without concomitant administration of racemic disopyramide, racemic verapamil, or each verapamil enantiomer. The concentrations of CDDP in plasma and in the kidney and liver were determined by HPLC. In separate experiments, CDDP was administered as described above, and blood urea nitrogen (BUN) was monitored for 7 days.

RESULTS

The BUN level after administration of CDDP was significantly reduced by coadministration of either disopyramide or verapamil. Renal accumulation of CDDP was significantly reduced by these drugs, whereas accumulation into the liver was not significantly changed. The relationship between the BUN levels and the area under the curve of CDDP concentration in the kidney versus time (AUCk) was analyzed using a sigmoid Emax model; this showed that the reduced BUN levels were explained by the AUCk. Furthermore, verapamil showed stereoselective inhibition of the renal accumulation of CDDP.

CONCLUSIONS

The renal accumulation of CDDP was inhibited by disopyramide and verapamil, and this inhibition resulted in the amelioration of nephrotoxicity.

Discrepancy between brain magnetic fields elicited by pattern and luminance stimulations in the fovea: adequate stimulus positions and a measure of discrepancy

A conventional equivalent current dipole estimation provides one of the quantitative measures to evaluate the discrepancy between two single-dipole-like magnetic field patterns, though there is one problem; all stimulus positions in the visual field do not necessarily contribute to the generation of a single-dipole-like magnetic field. Another important problem occurs when the field pattern is complex and cannot be approximated by a dipole. This makes it difficult to evaluate the discrepancy between two magnetic field patterns by the dipole parameters. In this paper, we determined the stimulus positions adequate for generating single-dipole-like magnetic field patterns by evaluating the magnetic field's goodness-of-fit to the field generated by a single dipole. We propose to use a similarity (SIM) as a quantitative measure of the discrepancy between two complex magnetic field patterns. The SIM is defined as an angle between two magnetic field vectors. We evaluated the discrepancy between the 100 ms post-stimulus responses to pattern-reversal (Rv) stimulus, pattern-onset (Pat) stimulus, and luminance-onset (Lumi) stimulus. The following results were obtained: (1) Stimulation of some of the octants in the fovea, far from the vertical meridian, elicited a single-dipole-like magnetic field pattern at a latency of 100 ms, though stimulation of the central part of the fovea, and stimulation of the octants along the vertical meridian, did not elicit a single-dipole-like magnetic field pattern; (2) The discrepancy between responses was quantitatively evaluated by the SIM even if the field patterns were complex; (3) The SIM analysis showed that the discrepancy between the responses to the Rv and the Lumi stimuli, as well as that between the responses to the Pat and the Lumi stimuli, were greater than that between the responses to the Rv and the Pat stimuli.

Effects of epidermal growth factor on neonatal growth of rat intestines

The effects of epidermal growth factor (EGF) on neonatal intestines were examined in the rat. In 5-day-old rats, sucrase, trehalase, alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (gamma-GTP) activities in the small intestines were significantly increased after subcutaneous injection of EGF for 3 days (1 microgram/rat/day). gamma-GTP activity was also accelerated after oral EGF administration (2 micrograms/rat/day). Small intestines of 12-day-old rats injected with EGF for 10 days (1 microgram/rat/day) were significantly heavier than those of controls. These results suggest that EGF influences neonatal growth improving enlargement and functional development of their intestines.

Effects of epidermal growth factor on mouse fetal growth

The effects of epidermal growth factor (EGF) on fetal growth were examined in mice. EGF is synthesized in large amounts by the mouse submandibular glands. On the 18th day of gestation, the body weight of fetuses whose mothers had undergone sialoadenectomy (excision of the submandibular glands) was significantly lower than that of controls. However, the maternal-plasma EGF concentration was not significantly affected by sialoadenectomy. The body weight of fetuses whose mothers were injected with EGF for 7 days during pregnancy was significantly higher than that of controls. Sialoadenectomy altered the blood amino acid concentrations in adult female animals, especially the levels of leucine and isoleucine. These results suggest that EGF influences fetal growth mainly by regulating maternal nutrition.

Multichannel measurements of magnetic compound action fields of the median nerve in man

Magnetic compound action fields (CAFs) evoked by electrical stimulation of the median nerve at the wrist were recorded with 7-channel 2nd-order SQUID gradiometers. CAFs measured over the elbow and upper arm were biphasic with field patterns and polarities corresponding to the depolarization and repolarization fronts of the action potential volley.

Describing head shape with surface harmonic expansions

Surface harmonic expansions are used to represent boundaries between regions of different conductivity in the human head. This facilitates calculation of the electric potential and magnetic field generated by neural current sources using discretized integral equations.

[Clinical efficacy of ifosfamide for liver metastasis of breast cancer]

Chemotherapy for liver metastasis of breast cancer has rarely been found effective. We devised a new regimen of chemotherapy for recurrent breast cancer mainly using ifosfamide. It was found clinically applicable and particularly effective for liver metastasis. The tumor decreased in size and the levels of various tumor-markers markedly decreased following drug administration. This treatment has made for longer survival for some patients. Side effects could be well controlled with steroid hormones and Na-bicarbonate.

Nonspecific suppressor T cells cause decreased mixed lymphocyte culture reactivity in bone marrow transplant patients

Decreased reactivity in mixed lymphocyte culture (MLC) was observed in patients within 1 yr after allogeneic and autologous bone marrow transplantation. Suppressor activity of peripheral blood mononuclear cells (PBMC) from transplant patients was studied by adding these cells as modulator cells to a bidirectional MLC with cells from normal individuals. PBMC from transplant patients markedly suppressed MLC reactivity in a dose-dependent manner. Suppressor activity was present in cells forming rosettes with sheep erythrocytes. Treatment of modulator cells with monoclonal antibodies against T cell differentiation antigens (OKT8, OKIa1) and complement completely abolished suppression of MLC. Suppressor activity was unaffected by 30 Gy irradiation. Suppressor activity declined gradually after transplantation and was inversely correlated with MLC reactivity of each patient at a significant level (p less than 0.01). These observations suggest that OKT8+ Ia+ radioresistant suppressor T cells play a role in the development of decreased MLC reactivity observed during the early post-transplant period.

Nonspecific suppressor T cells cause decreased mixed lymphocyte culture reactivity in bone marrow transplant patients

Decreased reactivity in mixed lymphocyte culture (MLC) was observed in patients within 1 yr after allogeneic and autologous bone marrow transplantation. Suppressor activity of peripheral blood mononuclear cells (PBMC) from transplant patients was studied by adding these cells as modulator cells to a bidirectional MLC with cells from normal individuals. PBMC from transplant patients markedly suppressed MLC reactivity in a dose-dependent manner. Suppressor activity was present in cells forming rosettes with sheep erythrocytes. Treatment of modulator cells with monoclonal antibodies against T cell differentiation antigens (OKT8, OKIa1) and complement completely abolished suppression of MLC. Suppressor activity was unaffected by 30 Gy irradiation. Suppressor activity declined gradually after transplantation and was inversely correlated with MLC reactivity of each patient at a significant level (p less than 0.01). These observations suggest that OKT8+ Ia+ radioresistant suppressor T cells play a role in the development of decreased MLC reactivity observed during the early post-transplant period.

Effect of activated lymphocytes on the regulation of hematopoiesis: enhancement and suppression of in vitro BFU-E growth by T cells stimulated by autologous non-T cells

Autologous mixed lymphocyte culture (AMLR) is an immunologic response with memory and specificity and plays a role in immune regulation. Effects of T cells activated by AMLR were studied in the regulation of in vitro erythropoiesis. AMLR-activated T cells were cocultured with autologous non-T, nonphagocytic peripheral blood mononuclear cells for assaying erythroid progenitor cells (BFU-E). T cells activated for 3 days in AMLR showed significant enhancement of in vitro colony growth by BFU-E. In contrast, activated T cells from day 7 AMLR caused significant suppression of BFU-E growth. Both enhancing and suppressing activities of AMLR-activated T cells were mediated by an la-positive and radiosensitive population within the OKT4+ subset. These observations suggest that AMLR-activated T cells may play a role in the immune-mediated regulation of in vitro erythropoiesis. It is also suggested that heterogeneous T-cell subsets may exert regulatory functions in the regulation of in vitro hematopoiesis.

Enhancement of in vitro erythropoiesis by peripheral blood mononuclear cells from allogeneic marrow recipients in the early post-transplant period

The effect of peripheral blood mononuclear cells (PBMCs) from bone marrow recipients on in vitro growth of erythroid burst-forming units (BFU-E) was studied. PBMCs were obtained from 5 allogeneic, 1 syngeneic and 1 autologous bone marrow recipient(s) at different intervals after transplantation. The number of BFU-E was significantly increased when donor bone marrow cells were co-cultured with PBMCs obtained from allogeneic marrow recipients in the early post-transplant period. No effect was observed using PBMCs obtained in the later post-transplant period, PBMCs from a syngeneic marrow recipient, or PBMCs from an autologous marrow recipient. The BFU-E enhancing activity was present among T cells and was abolished by treating them with OKT3 or OKT4 antibody and complement. These observations suggest that chimeric T lymphocytes, probably of the helper/inducer subset, from allogeneic marrow recipients in the early post-transplant period have a potent enhancing effect on in vitro erythropoiesis.

Effect of activated lymphocytes on the regulation of hematopoiesis: suppression of in vitro granulopoiesis and erythropoiesis by OKT8+ Ia- T cells induced by concanavalin-A stimulation

The effects of activated lymphocytes were studied in the regulation of in vitro hematopoiesis. Peripheral blood lymphocytes stimulated by concanavalin A (Con A) were cocultured with normal bone marrow cells in the assay system of hematopoietic stem cells. Con-A-stimulated lymphocytes and their supernatants showed significant suppression of in vitro growth of myeloid and erythroid progenitor cells (CFU-C, CFU-E, and BFU-E). Suppressive activity detected in the T-cell fraction was completely abolished by treatment with OKT3 or OKT8 monoclonal antibody and complement and 20 Gy radiation but not OKT4 or OKIa1 antibody and complement. These observations indicate that peripheral blood lymphocytes can be induced by Con-A stimulation to become suppressor T cells for myeloid and erythroid progenitor cells that are OKT8 positive, Ia negative, and radiosensitive. Together with our previous observation that CFU-C suppressor cells induced by alloantigen stimulation are radioresistant and OKT8- and Ia-positive T cells, it is suggested that in vitro hematopoiesis may be regulated by heterogeneous subpopulations of activated T-lymphocytes.

Immunological reconstitution after allogeneic and autologous bone marrow transplantation

Immunological reconstitution was studied with regard to T cell subsets and their functions in patients who received intensive therapy and autologous or allogeneic marrow transplantation. One of the distinct features was the imbalance of T cell subsets. Long-standing inversion of the OKT4/OKT8 ratio was characteristic in both autotransplant and allotransplant patients. Significant differences were observed in recovery of T cell subsets and mitogenic responses between autotransplant and allotransplant patients and between transplant patients and normal controls. In contrast, low reactivities of mixed lymphocyte culture (MLC) recovered to normal levels within 1 yr in both groups of patients. Then the role of suppressor cells was investigated. During early posttransplant periods, MLC suppressor cells were operative in association with the development of low MLC reactivities because suppressor activity was inversely correlated with MLC reactivities at a significant level. Characterization of these MLC suppressor cells revealed that they were an OKT8- and Ia-positive, radioresistant T cell subset of peripheral blood lymphocytes from autologous and allogeneic marrow recipients. These observations suggest that the imbalance of T cell subsets and their abnormal reactivities may by responsible for the development of immunodeficiency and immunodysregulation in bone marrow transplant patients.

T lymphocyte reconstitution in long-term survivors after allogeneic and autologous marrow transplantation

T cell subsets and their immune reactivities were studied in long-term survivors after bone marrow transplantation and the results of autotransplanted and allotransplanted patients were compared. These two groups of patients (4 autotransplants and 4 allotransplants) were roughly comparable in terms of their underlying diseases, pretransplant conditioning regimens, supportive care, and posttransplant sampling days for immunological studies. Significant differences were observed between autologous and allogeneic marrow recipients in the total number of OKT3-, OKT4-, OKT8-, and OKIa1 -positive cells. Similar differences were observed between transplant patients and normal controls. Decreased OKT4 cells and increased OKT8 cells resulted in inversion of the OKT4:OKT8 ratio, which was significantly lower in allotransplanted compared with autotransplanted patients, and both groups of transplant patients showed depressed responses in comparison with normal controls. In contrast, there were no significant differences in MLR reactivities between transplanted patients and normal controls. When mitogenic responses were analyzed in relation to T cell subsets, phytohemagglutinin responsiveness showed a significant correlation with OKT4:OKT8 ratios (P less than 0.01) and the proportions of cultured OKT4 cells (P less than 0.01). These observations suggest that T lymphocyte reconstitution is still incomplete or abnormal in long-term survivors regardless of the type of graft. Furthermore, abnormalities observed in these long-term survivors were characterized by an imbalance of T cell subsets that was more profound in allotransplanted than in autotransplanted patients.

Controlled study of therapeutic granulocyte transfusions in granulocytopenic patients with severe infections

The effectiveness of therapeutic granulocyte transfusions was studied in a controlled trial involving 75 granulocytopenic patients with severe infections. Patients who had granulocyte counts of less than 200/mm3 and no response to antibiotic therapy were assigned to receive antibiotic therapy alone or granulocyte transfusions plus antibiotic therapy. Granulocytes were collected by filtration leukapheresis (FL), intermittent flow centrifuge leukapheresis (IFCL) or continuous flow centrifuge leukapheresis (CFCL). Therapeutic effects of granulocyte transfusions were evaluated on the basis of 20-day survival after entry into the study. The patients were divided into three groups: 1) 22 patients received antibiotic therapy alone for 29 infectious episodes (control group); 2) 27 patients received 131 transfusions of granulocytes collected by FL for 31 infectious episodes (FL group); 3) 26 patients received 139 transfusions of granulocytes collected by IFCL and CFCL for 27 infectious episodes (IFCL & CFCL group). The overall survival of the transfused patients was not significantly different from that of the untransfused patients. Similarly, there was no significant difference in survival between the transfused and untransfused patients when the data concerning septicemia were analyzed. When patients showed bone-marrow recovery, which was indicated by recovery of granulocytes to 500/mm3 or more during the study, 20-day survival was observed in 13 of 14 untransfused patients and in all of 26 transfused patients. In contrast, the survival rate for the patients without bone-marrow recovery was 13% (2/15) in the control group, 39% (7/18) in the FL group and 57% (8/14) in the IFCL & CFCL group respectively. Thus, the survival rate was significantly higher for the transfused than for the untransfused patients. These observations suggest that therapeutic granulocyte transfusions may be of limited value in improving the outcome of severe infections in persistently granulocytopenic patients. Since bone-marrow recovery is a critical factor for the prognosis of severe infections, therapeutic granulocyte transfusions do not provide any beneficial effects in granulocytopenic patients whose bone-marrow function will recover.

Effect of activated lymphocytes on the regulation of hematopoiesis: suppression of in vitro granulopoiesis by OKT8+Ia+T cells induced by alloantigen stimulation

We studied the effects of alloantigen-stimulated lymphocytes in the regulation of hematopoiesis. Alloantigen-stimulated lymphocytes were harvested on days 2 to 3, days 6 to 7, or days 9 to 10 of MLC and were tested for their effects on granulocyte/macrophage progenitor cells (CFU-C). Dose-dependent suppression of CFU-C was observed when alloantigen-stimulated lymphocytes from days 6 to 7 and days 9 to 10 MLC were added to the cultures of autologous or allogeneic bone marrow cells for CFU-C assays. Suppressive activity was detected in the T cell fraction but not in the non-T cell fraction. For further characterization of these CFU-C/suppressor cells, alloantigen-stimulated lymphocytes were treated with radiation (2000 rad) or with monoclonal antibodies against T cell subsets and complement (C) before culture. Suppressive activity was completely abolished by treatment with OKT8 or OKIa1 antibodies and C whereas suppression was retained after radiation treatment. These observations suggest that CFU-C/suppressor cells can be induced by alloantigen stimulation in MLC and that they are radioresistant OKT8+ and Ia+ T cells.

Effect of activated lymphocytes on the regulation of hematopoiesis: suppression of in vitro granulopoiesis by OKT8+Ia+T cells induced by alloantigen stimulation

We studied the effects of alloantigen-stimulated lymphocytes in the regulation of hematopoiesis. Alloantigen-stimulated lymphocytes were harvested on days 2 to 3, days 6 to 7, or days 9 to 10 of MLC and were tested for their effects on granulocyte/macrophage progenitor cells (CFU-C). Dose-dependent suppression of CFU-C was observed when alloantigen-stimulated lymphocytes from days 6 to 7 and days 9 to 10 MLC were added to the cultures of autologous or allogeneic bone marrow cells for CFU-C assays. Suppressive activity was detected in the T cell fraction but not in the non-T cell fraction. For further characterization of these CFU-C/suppressor cells, alloantigen-stimulated lymphocytes were treated with radiation (2000 rad) or with monoclonal antibodies against T cell subsets and complement (C) before culture. Suppressive activity was completely abolished by treatment with OKT8 or OKIa1 antibodies and C whereas suppression was retained after radiation treatment. These observations suggest that CFU-C/suppressor cells can be induced by alloantigen stimulation in MLC and that they are radioresistant OKT8+ and Ia+ T cells.

Hematologic recovery following autologous and allogeneic bone marrow transplantation

Posttransplant hematologic recovery was compared between 9 autologous and 11 allogeneic marrow transplant patients who received similar marrow-lethal chemoradiotherapies before transplantation. Although the autotransplant patients were infused with much lower marrow doses compared with the allotransplant patients, they showed adequate hematologic recovery with acceptable risk. Regardless of marrow doses, delayed platelet recovery and failure of platelet recovery were observed in 7 patients. All of these patients experienced early transplantation-related complications before engraftment. Despite the limited number of patients, a number of myeloid progenitor cells (CFUC) infused correlated significantly with the period for recovery of polymorphonuclear cells in autologous marrow recipients while there was no significant correlation found between marrow dose and hematologic recovery in both groups of patients. Furthermore, autotransplant patients showed a characteristic recovery pattern of peripheral blood lymphocytes in an early posttransplant period, whic was not observed in allotransplant patients.

[Autologous bone marrow transplantation in the treatment of nasopharyngeal carcinoma--report of 2 cases]

Two patients with nasopharyngeal carcinoma (NPC) were treated with "marrow-lethal" chemoradiotherapy and infusion of cryopreserved autologous marrow. Patient AUT 04 (unique patient number), a 28-year-old male, was referred to us because of the right cervical lymphadenopathy. He was diagnosed NPC at stage II (T1N2M0). A trial of combined-modality therapy using autologous bone marrow transplantation (auto-BMT) was scheduled for possible cure. Before auto-BMT, he was treated with a conventional dose of radiation to the nasopharyngeal and bilateral cervical areas. For the pretransplant marrow-lethal therapy, he received high-dose cyclophosphamide (CY), 120mg/kg, and 1,000 rad total body irradiation (TBI). Within 24 hr after TBI, previously cryopreserved-thawed autologous bone marrow cells (1.37 X 10(8)/kg) was infused to the patient. Rapid and complete hematologic recovery was observed and he is now alive in a disease-free remission state 28 months after transplantation. Patient AUT 08, a 18-year-old female, was referred to us for the treatment of head and neck tumor with auto-BMT. She was diagnosed NPC at stage IV (T4N2M0). After cryopreservation of bone marrow, she was treated with local radiation and doxorubicin (80mg X 2d). Then she was conditioned with high-dose CY and upper half body irradiation and received auto-BMT (marrow dose: 1.2 X 10(7)/kg). Successful engraftment was obtained with tumor response but she developed recurrence of the disease 12 months after transplantation. Although the data are too preliminary, auto-BMT is evaluated as one of the favorable treatment approaches for some selected patients with NPC.