- Email: [email protected]
A GENETIC THEORY OF INFLAMMATORY POLYARTHRITIS
47
hasmopoietic tissues, were modified in structure and assumed forms similar, in some ultrastructural aspects, to normal medullary cells.7 De Carvalhohas shown that, by injecting into the medullary cavity of leukasmic patients R.N.A. obtained from haemopoietic cells of normal subjects, the leuksemic picture is improved locally. We have confirmed this,9 using R.N.A. obtained from hxmopoietic cells of animals. On the basis of these results we treated two patients with myeloid chronic leukaemia with large doses of R.N.A. obtained from hsemopoietic animal cells. The R.N.A. was obtained by the method previously described.9 200 mg. of 100 mg. R.N.A. a day was administered intravenously. was injected in 10 minutes, and the remaining 100 mg. immediately afterwards by means of slow infusion over a period of 2 hours. This was done in order to maintain a high blood concentration of the substance for as long as possible. This treatment was continued for 15 days. The behaviour of the white cells in the peripheral blood was as
the myelopoiesis in the bone-marrow. In that event a reduction in the total number of white blood-cells would be observed. We cannot yet state whether, in leukaemic patients, R.N.A. causes normalisation of the myelopoiesis or only stimulates cell maturation. This will only be revealed by prolonged further study of the patients under treatment.
S. P. B. L.
Medical Clinic, University of Pavia, Italy.
ESPOSITO FORNAROLI CASTELLI BUSCARINI.
A GENETIC THEORY OF INFLAMMATORY POLYARTHRITIS
follows: Case 1.-Before treatment: 64,500 per c.mm. (promyelocytes 10%, myelocytes 34%, metamyelocytes 14%, young mature granulocytes 27%, lymphocytes 8%, After treatment: 65,200 per c.mm. (myelo-
granulocytes 5%, monocytes 2%). cytes 10%, metamyelocytes 9%, young granulocytes 36%, mature granulocytes 40%, lymphocytes 4%, monocytes 1%). Case 2.-Before treatment: 71,000 per c.mm. (promyelocytes 24%, myelocytes 30%, metamyelocytes 16%, young granulocytes 4%, mature granulocytes 19%, lymphocytes 6%, monocytes 1%). After treatment: 62,500 per c.mm. (myelocytes 11%, metamyelocytes 15%, young granulocytes 29%, mature granulocytes 39%, lymphocytes 5%, monocytes 1%).
In neither of the cases were significant modifications of the erythrocytes, reticulocytes, or platelets, registered. The behaviour of the granuloblastic cells of the bonemarrow is summarised in the accompanying table. PROPORTION OF GRANULOBLASTIC CELLS IN 2 PATIENTS WITH CHRONIC MYELOID LEUKAMIA BEFORE AND AFTER TREATMENT WITH R.N.A.
(%)
Immunochemistry Unit for Cancer Research, Department of Bacteriology, University of Liverpool.
R. AUGUSTIN.
Department of Theoretical
Physics,
Clarendon Laboratory, Oxford.
J. A. SPIERS.
SHINGLES RECONSIDERED
SIR,—Your interesting reviewof Dr. R. E. HopeSimpson’s Albert Wander lecture prompts me to record that about ten years ago a young man of my acquaintance developed typical shingles on the trunk. Within a day or two a footballer friend of his two lads shared a football
had the
trouble. These changing-room and shower facilities with a third friend who had developed shingles about a fortnight previously. None of the team had chickenpox at that time, but they all thought they had had it in childhood. same
Public Health Laboratory, Town Hall, Edmonton, London, N.9.
MAIR THOMAS.
SEIZURES IN PSYCHOTIC CHILDREN
These results show that the
R.N.A.
obtained from
hxmopoietic animal cells stimulates the maturation of leukaemic cells, when administered intravenously in large doses. The appearance of a high percentage of mature cells both in the bone-marrow and in the peripheral blood is not, however, accompanied by a corresponding drop in the total number of white blood-cells. We believe that this phenomenon is due to the fact that in leuksemic patients the R.N.A. acts on a vast territory of myeloid tissue. All the cells of this tissue are stimulated maturation but are not reduced in number. This agrees with present notions about the action on cells of exogenous R.N.A.: this substance in fact acts on cytodifferentiation and not as an antimitotic or cytolytic drug. Theoretically, if the R.N.A. had caused" normalisation " of the leukaemic cells, the extramedullary myelopoiesis function should, as a result, diminish on account of those mechanisms which, in a normal subject, localise
to
7. Esposito, S. Experientia, 1964, 20, 69. 8. De Carvalho, S. Nature, Lond. 1963, 197, 1077. 9. Esposito, S., Fornaroli, P., Buscarini, L., Castelli, B.
(in the press).
Hœmatologica
SIR,-Dr. Boardman’simputations are interesting, and if proved generally acceptable may occasion some critical reappraisal of current psychiatric diagnosis. His contention that " some psychotic children and adults with , convulsive ’ E.E.G.S form a separate group " merits inquiry along the following lines: 1. What are the characteristic distinguishing psychiatric features of this group which are often found ? 2. What significant minor neurological abnormalities may
they display ? 3. Does the
upon clinical or the latter, in what this group is there
diagnosis depend mainly both ? With respect
findings proportion of patients designated E.E.G.
or
to
to
correlation between the two ? 4. What is the estimated incidence of this " separate group " of adults encountered in ordinary mental hospitals and outpatient psychiatric practice ? 5. What is the possible aetiology of the condition ? I have often wondered how much importance should be attached to E.E.G. findings alone, and I would be most interested to ascertain whether Dr. Boardman or others have observed 1. Lancet, 1964, i, 1391. 2. ibid. p. 1280. 3. ibid. p. 1376. 4. Boardman, R. H. ibid.
p. 1443.
hasmopoietic tissues, were modified in structure and assumed forms similar, in some ultrastructural aspects, to normal medullary cells.7 De Carvalhohas shown that, by injecting into the medullary cavity of leukasmic patients R.N.A. obtained from haemopoietic cells of normal subjects, the leuksemic picture is improved locally. We have confirmed this,9 using R.N.A. obtained from hxmopoietic cells of animals. On the basis of these results we treated two patients with myeloid chronic leukaemia with large doses of R.N.A. obtained from hsemopoietic animal cells. The R.N.A. was obtained by the method previously described.9 200 mg. of 100 mg. R.N.A. a day was administered intravenously. was injected in 10 minutes, and the remaining 100 mg. immediately afterwards by means of slow infusion over a period of 2 hours. This was done in order to maintain a high blood concentration of the substance for as long as possible. This treatment was continued for 15 days. The behaviour of the white cells in the peripheral blood was as
the myelopoiesis in the bone-marrow. In that event a reduction in the total number of white blood-cells would be observed. We cannot yet state whether, in leukaemic patients, R.N.A. causes normalisation of the myelopoiesis or only stimulates cell maturation. This will only be revealed by prolonged further study of the patients under treatment.
S. P. B. L.
Medical Clinic, University of Pavia, Italy.
ESPOSITO FORNAROLI CASTELLI BUSCARINI.
A GENETIC THEORY OF INFLAMMATORY POLYARTHRITIS
follows: Case 1.-Before treatment: 64,500 per c.mm. (promyelocytes 10%, myelocytes 34%, metamyelocytes 14%, young mature granulocytes 27%, lymphocytes 8%, After treatment: 65,200 per c.mm. (myelo-
granulocytes 5%, monocytes 2%). cytes 10%, metamyelocytes 9%, young granulocytes 36%, mature granulocytes 40%, lymphocytes 4%, monocytes 1%). Case 2.-Before treatment: 71,000 per c.mm. (promyelocytes 24%, myelocytes 30%, metamyelocytes 16%, young granulocytes 4%, mature granulocytes 19%, lymphocytes 6%, monocytes 1%). After treatment: 62,500 per c.mm. (myelocytes 11%, metamyelocytes 15%, young granulocytes 29%, mature granulocytes 39%, lymphocytes 5%, monocytes 1%).
In neither of the cases were significant modifications of the erythrocytes, reticulocytes, or platelets, registered. The behaviour of the granuloblastic cells of the bonemarrow is summarised in the accompanying table. PROPORTION OF GRANULOBLASTIC CELLS IN 2 PATIENTS WITH CHRONIC MYELOID LEUKAMIA BEFORE AND AFTER TREATMENT WITH R.N.A.
(%)
Immunochemistry Unit for Cancer Research, Department of Bacteriology, University of Liverpool.
R. AUGUSTIN.
Department of Theoretical
Physics,
Clarendon Laboratory, Oxford.
J. A. SPIERS.
SHINGLES RECONSIDERED
SIR,—Your interesting reviewof Dr. R. E. HopeSimpson’s Albert Wander lecture prompts me to record that about ten years ago a young man of my acquaintance developed typical shingles on the trunk. Within a day or two a footballer friend of his two lads shared a football
had the
trouble. These changing-room and shower facilities with a third friend who had developed shingles about a fortnight previously. None of the team had chickenpox at that time, but they all thought they had had it in childhood. same
Public Health Laboratory, Town Hall, Edmonton, London, N.9.
MAIR THOMAS.
SEIZURES IN PSYCHOTIC CHILDREN
These results show that the
R.N.A.
obtained from
hxmopoietic animal cells stimulates the maturation of leukaemic cells, when administered intravenously in large doses. The appearance of a high percentage of mature cells both in the bone-marrow and in the peripheral blood is not, however, accompanied by a corresponding drop in the total number of white blood-cells. We believe that this phenomenon is due to the fact that in leuksemic patients the R.N.A. acts on a vast territory of myeloid tissue. All the cells of this tissue are stimulated maturation but are not reduced in number. This agrees with present notions about the action on cells of exogenous R.N.A.: this substance in fact acts on cytodifferentiation and not as an antimitotic or cytolytic drug. Theoretically, if the R.N.A. had caused" normalisation " of the leukaemic cells, the extramedullary myelopoiesis function should, as a result, diminish on account of those mechanisms which, in a normal subject, localise
to
7. Esposito, S. Experientia, 1964, 20, 69. 8. De Carvalho, S. Nature, Lond. 1963, 197, 1077. 9. Esposito, S., Fornaroli, P., Buscarini, L., Castelli, B.
(in the press).
Hœmatologica
SIR,-Dr. Boardman’simputations are interesting, and if proved generally acceptable may occasion some critical reappraisal of current psychiatric diagnosis. His contention that " some psychotic children and adults with , convulsive ’ E.E.G.S form a separate group " merits inquiry along the following lines: 1. What are the characteristic distinguishing psychiatric features of this group which are often found ? 2. What significant minor neurological abnormalities may
they display ? 3. Does the
upon clinical or the latter, in what this group is there
diagnosis depend mainly both ? With respect
findings proportion of patients designated E.E.G.
or
to
to
correlation between the two ? 4. What is the estimated incidence of this " separate group " of adults encountered in ordinary mental hospitals and outpatient psychiatric practice ? 5. What is the possible aetiology of the condition ? I have often wondered how much importance should be attached to E.E.G. findings alone, and I would be most interested to ascertain whether Dr. Boardman or others have observed 1. Lancet, 1964, i, 1391. 2. ibid. p. 1280. 3. ibid. p. 1376. 4. Boardman, R. H. ibid.
p. 1443.