Sequential evaluation of immunoreactivity in patients with melanoma undergoing surgery and adjuvant therapy.

The immunologic profile of 15 patients undergoing surgery and adjuvant chemoimmunotherapy for cutaneous melanoma was studied for a mean period of 18 months. In vivo cellular immunity was assayed by evaluation of delayed hypersensitivity response (DHR) to primary antigen and a panel of recall antigens. In vitro cellular immunity was evaluated to means of total and T-lymphocyte counts in peripheral blood and by the lymphocyte blastogenic response to phytohemagglutinin stimulation. Humoral immunity was assayed by determining the serum levels of IgG, IgA and IgM and of complement components C3c, C4 and Factor B. Phagocytic activity was studied by testing leukocyte chemotaxis, neutrophil phagocytosis and leukocyte random migration. The in vitro parameters were determined preoperatively at diagnosis, 6 times during the first 2 postoperative weeks, and then every month during adjuvant therapy. No correlation was found between DHR and clinico-pathologic stage of tumor, or with subsequent clinical course. Significant depression of total lymphocyte and T-lymphocyte count and blastogenic response of lymphocytes was found at diagnosis. The lymphocyte response to PHA decreased significantly in the early postoperative period but returned to preoperative levels one week after surgery. Periodic fluctuations of lymphocyte blastogenic response and progressive decrease of total lymphocyte counts and T-lymphocyte counts were observed during the 18-month follow-up. No significant alterations of immunoglobulin levels were recorded at diagnosis or during the postoperative period. Complement levels were within normal values preoperatively; in the early postoperative period a transient increase of C3c, C4 and Factor B was recorded, then complement levels progressively decreased. Parameters of phagocytic activity were normal at diagnosis and fluctuated within the normal range throughout the whole period of study.

[Solitary fibrous mesothelioma of the peritoneum. Considerations of a clinical case in our observation]. / Il mesotelioma fibroso solitario del peritoneo. Considerazioni su un caso clinico giunto alla nostra osservazione.

The authors report a case of so-called solitary fibrous peritoneal mesothelioma which was successfully operated on. Their case is compared with the few cases reported in the literature. Analysis of findings shows the fibrous peritoneal mesothelioma to be a solitary well defined tumor, generally of considerable size at the time of the diagnosis, very similar to the fibrous metothelioma of the pleura. It is believed to originate in the sub-mesothelial connective tissue. Surgery provides a definitive cure.

The effects of total parenteral nutrition on immunodepression due to malnutrition.

An experimental study was performed in 16 dogs to investigate the effects of sub-acute malnutrition on humoral and cellular immunity and phagocytic functions and, subsequently, to investigate the ability of total parenteral nutrition (TPN) to restore abnormal immunological variables. Deficiencies of IgG, C3, primary immune response to sheep red blood cells (SRBC),lymphocyte counts, lymphocyte response to phytohemagglutinin (PHA), and neutrophi chemotaxis were found to be caused by malnutrition. Nutritional repletion by means of TPN resulted in a return to normal or supranormal serum concentrations of IgG, IgM, and C3, and the primary immune response to SRVC was prompter and higher. Moreover, TPN resulted in restoration of normal neutrophil chemotactic responses. TPN did not improve lymphocyte response to PHA in these experiments. The study demonstrates that subacute malnutrition results in broad based deficiencies of the immunological response of the type that predispose to infection and that the proper use of TPN can correct most of these abnormalities.

[Effect of the association of inhibitors of the H 1 and H 2 histamine receptors in the mechanism of rupture of the gastric barrier in the dog in vivo]. / Effetto dell'associazione di inibitori dei recettori H1 e H2 dell'istamina nei meccanismi di rottura della barriera gastrica del cane "in vivo".

Two specific inhibitors of histamine receptors, H1 mepiramine (Mp) and H2 cimetidine (Cm), were used in combination to define the role of histamine in the mechanisms of gastric barrier rupture in the dog "in vivo". A gastrolesive substance butyric acid (Ac.B. 75 mM) in hydrocloric acid solution (HCl 75 mM) was perfused through Heidenhain pouches in the presence or absence of Mp (10 mg/Kg i.m.) and Cm (1 mg/Kg/h i.v.). The results obtained showed: 1) Ac.B. caused a remarkable increase in H+ and Na+ fluxes, enhanced K+ secretion and decreased transparietal potential difference (D.P.). 2) Histamine inhibitors in combination uneffected changes of the ionic fluxes and D.P. produced by Ac.B. 3) Reversal to normal of both ionic fluxes and D.P. was not accelerated by the combination of Mp and Cm. The conclusion was reached that in the initial phase of gastric barrier rupture damage of gastric mucosa occurs by mechanisms non histamine-dependent.

Histopathological studies on dog lymphoid structures during malnutrition and total parenteral nutrition.

Lymphoid tissues of six malnourished dogs were histologically evaluated and compared to the same lymphoid structures of dogs nutritionally repleted by means of total parenteral nutrition (TPN). The results show that thymus, spleen, lymph nodes and Peyer's patches are markedly atrophic and severely cell depleted in malnourished dogs, and provide evidence that subsequent TPN therapy stimulates and supports lymphoid cell prolipheration, leading to cell repopulation of previously depleted lymphoid structures.