[Cloning of solid tumors in double agar (human tumor stem cell assay]. / Cloning von soliden Tumoren im Doppelagar (human tumour stem cell assay).

62 specimens from 37 patients with solid malignant tumours were cloned by the human tumour stem cell assay (HTSCA). The growth rate, the use of two different disaggregation methods and their influence on vitality and plating efficiency were analyzed as well as the cloning rate from different tumour regions and metastases. The growth rate was 68%, and there was a significant difference in the vitality, depending on which mode of disaggregation was used. Enzymatic disaggregation showed a higher vitality than the mechanical method, although there was no difference in plating efficiency (PE). There was a marked heterogeneity in the PE of specimens from different sites of the same tumour and lymph node metastases (variation coefficient 0.507 and 2.093 respectively). The possibilities and limitations of the HTSCA are discussed with respect to our own results and those in the literature.

Impaired T cell proliferation, increased soluble death-inducing receptors and activation-induced T cell death in patients undergoing haemodialysis.

Haemodialysis is a widespread option for end-stage renal disease (ESRD). Long-term success of dialysis is, however, limited by a high rate of serious bacterial and viral infections. We compared T cell functions in ESRD patients undergoing haemodialysis (n = 20), or were not dialysed and received conventional medical treatment (n = 20). Healthy volunteers (n = 15) served as controls. The T cell phenotype was examined by immunofluorescence using fluorochrome-labelled monoclonal antibodies and FACS analysis. The concentration of soluble CD95/Fas and of tumour necrosis factor-alpha receptor type 1 (sTNFR1) in the sera was quantified by ELISA. Activation-induced programmed T cell death was triggered by anti-CD3/CD28 antibodies and measured by 7-AAD staining. All immunological tests were performed at least 1 month after dialysis initiation. T cell proliferation in response to phytohaemagglutinin or anti-CD3 monoclonal antibodies was moderately diminished in non-dialysed patients and markedly reduced in haemodialysis patients compared to healthy controls (P < 0.01 and P < 0.001, respectively). In a mixed lymphocyte culture the proliferative response of T cells from dialysed patients was significantly diminished (P < 0.001). T cells of both non-dialysed and dialysed patients have augmented CD95/Fas and CD45RO expression, increased sCD95/Fas and sTNFR1 release and spontaneously undergo apoptosis. Culture of T cells from haemodialysis patients with anti-CD3/CD28 antibodies increased the proportion of CD4(+) T cells committing activation-induced cell death by a mean 7.5-fold compared to T-helper cells from non-dialysed patients (P < 0.001). Renal failure and initiation of haemodialysis results in a reduced proliferative T cell response, an aberrant state of T cell activation and heightened susceptibility of CD4(+) T cells to activation-induced cell death.

Death-inducing receptors and apoptotic changes in lymphocytes of patients with heart transplant vasculopathy.

The specific role of lymphocyte apoptosis and transplant-associated atherosclerosis is not well understood. The aim of our study was to investigate the impact of T cell apoptotic pathways in patients with heart transplant vasculopathy. Amongst 40 patients with cardiac heart failure class IV who have undergone heart transplantation, 20 recipients with transplant-associated coronary artery disease (TACAD) and 20 with non-TACAD were investigated one year postoperative. Expression of CD95 and CD45RO, and annexin V binding were measured by FACS. Soluble CD95, sCD95 ligand (sCD95L), tumour necrosis factor receptor type 1 (sTNFR1), and histones were measured in the sera by ELISA. The percentage of cells expressing CD3 and CD4 was significantly reduced in TACAD as well as in non-TACAD patients as compared with control volunteers. Interestingly, the proportion of CD19+ (B cells) and CD56+ (NK) cells was increased in TACAD groups (versus non-TACAD; P < 0.01, and P < 0.001, respectively). In contrast to sCD95, the expression of CD95 (APO-1/Fas) and CD45RO (memory T cells), and sCD95L were significantly increased in non-TACAD and TACAD patients. T cell activation via CD95 with consecutive apoptosis was increased in both groups. The concentration of sTNFR1, IL-10 and histones was significantly elevated in sera from TACAD than non-TACAD patients, and in both groups than in healthy controls. These observations indicate that the allograft may induce a pronounced susceptibility of CD4+ T cells to undergo apoptosis and antibody-driven activation-induced cell death. This data may suggest a paradox immune response similar to that seen in patients with autoimmune diseases.

Cancer del pancreas. / Pancreatic neoplasms

Se revisan 22 casos de cancer del pancreas diagnosticados por la clinica y la biopsia. Se estudian la sintomatologia y los metodos diagnosticos, de laboratorio y radiograficos. En la serie presentada son mas frecuentes los tumores situados en la cabeza y para su diagnostico precoz se considera que lo mas util es la valoracion de una serie de sintomas inespecificos y los hallazgos radiologicos. Son pocos los casos, en los que la cirugia, unico tratamiento por ahora eficaz, puede ser beneficiosa. La mayoria de las intervenciones fueron paliativas. Se destaca que en esta serie en solo 2 casos pudo hacerse duodenopancreatectomia y que esos 2 enfermos han tenido una mayor sobrevida que la obtenida en el resto de los casos sometidos a operaciones paliativas