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Primary Lymph. Node Pathology in AIDS and AIDS- Related Lymphadenopathy
665
MISCELLANEOUS
isoelectric point of 15.5. Polyclonal antibodies were raised specifically to microgram quantities of electrophoresed, excised and eluted prostate secretory protein 15. Western immunoblot analysis using these antibodies showed that they not only react with prostate secretory protein 15 but cross-react with simian prostatic and human seminal fluid proteins of similar molecular weight. Two-dimensional gel immunoblots strongly suggest that the seminal protein and prostate secretory protein 15 are the same, thereby providing a more accessible source of protein. However, the antibody to human prostate secretory protein 15 cross-reacted with neither prostatic fluid from the ventral lobe of the rat prostate nor the prostatic fluid from the beagle dog. N. V. R. 8 figures, 13 references
Primary Lymph Node Pathology in AIDS and AIDSRelated Lymphadenopathy
E. P. EWING, JR., F. W. CHANDLER, T. J. SPIRA, R. K. BRYNES AND W. C. CHAN, Division of Host Factors, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, United States Department of Health and Human Services, Atlanta, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
Arch. Path. Lab. Med., 109: 977-981 (Nov.) 1985 The acquired immunodeficiency syndrome (AIDS) is now known to be caused by a lymphotropic retrovirus first described by French investigators and later by investigators in the United States. Since AIDS was first recognized in 1981, it has become clear that this syndrome represents the most severe form of a broad-spectrum disease. A much more prevalent manifestation of the disease is the lymphadenopathy syndrome, in which there are generalized lymphadenopathic conditions that persist for 3 or more months. Like AIDS, the lymphadenopathy syndrome has occurred predominantly in homosexual men, intravenous drug abusers, Haitians and hemophiliacs. While AIDS usually is fatal, the outcome of the lymphadenopathy syndrome is variable and not yet fully known. Some patients with the lymphadenopathy syndrome have suffered AIDS and died, while many more have survived up to several years without further progression of the disease. The AIDS virus, human T-cell lymphotropic virus type Ill/ lymphadenopathy-associated virus, specifically infects and kills certain T-helper lymphocytes, the cells that may be moderately depleted in the lymphadenopathy syndrome and profoundly depleted in AIDS. The lymph node is a focus of interest in the lymphadenopathy syndrome and AIDS because of its major role in the normal immune system, its conspicuous enlargement in the lymphadenopathy syndrome and the likelihood that it is an anatomical site of destruction of T-helper lymphocytes by the AIDS virus. Lymph nodes of patients symptomatically infected with the AIDS virus show a spectrum of morphological changes ranging from marked lymphoid hyperplasia to marked lymphocytic depletion. These changes can be grouped into 3 distinct patterns. The type I pattern features follicular and paracortical hyperplasia, and is associated with chronic lymphadenopathy. The type II pattern, which shows diffuse lymphoid hyperplasia but loss of germinal centers, signifies evolution of chronic lymphadenopathy to AIDS. The type III pattern shows marked lymphocytic depletion and represents the end-stage lymph node
seen in fatal cases of AIDS. These histological patterns are correlated closely with the clinical and immunological status of patients infected with the AIDS virus. W. W. H. 4 figures, 49 references
MISCELLANEOUS The Rising Popularity of Cocaine: How Serious a Problem?
S.
KATZ, Toronto, Ontario, Canada
Canad. Med. Ass. J., 133: 682-685 (Oct. 1) 1985 Cocaine is a white powder refined from the leaves of the bush Erythroxylon coca, which grows wild in Peru, Colombia, Bolivia and Ecuador. It is a central and sympathetic nervous system stimulant, and a potent local anesthetic. The effects of cocaine are experienced almost immediately as feelings of being strong, active, wide awake and happy. This reaction is accompanied by constriction of the blood vessels, and increased blood pressure, breathing and heart beat rates, as well as dilation of the pupils and a discernible pallor. The most common form of ingesting cocaine is by snorting, although habitual users will inject the drug intravenously or "freebase" it. Cocaine currently is regarded as a highly addictive drug, second only to marijuana. Heavy cocaine use can cause physical dependence, paranoid psychosis and death. The Bureau of Dangerous Drugs in Ottawa, Ontario reported that the number of cocaine convictions increased from 44 in 1972 to 1,390 in 1983. According to the United States National Institute on Drug Abuse hospital emergency room admissions for cocaine problems increased 75 per cent between 1981 and 1983. It is estimated that 25 million Americans have tried cocaine and that an additional 5 to 10 million use it once a month or more. W ashton, who is a cofounder of the 1-800-COCAINE hotline, reported that in a recent 12-month period the hotline received 350,000 calls from cocaine users. Several animal studies suggest that the craving for cocaine is stronger than for any other drug. With continued heavy use the initial pleasant and mild effects are replaced by irritability, hostility, paranoia, total insomnia, rambling and incoherent speech, anorexia, absence of libido, tremors, twitching, convulsions, nasal congestion and nosebleeding. The Addiction Research Foundation in Toronto, Ontario recently surveyed cocaine users who volunteered to be included in the study. The 111 users surveyed (average age about 30 years) were using the drug for an average of 7 years and generally were highly educated with a comfortable income, and more than half were single. Of these subjects 27 per cent were classified as light users, 41 per cent as moderate users and 32 per cent as heavy users. A majority of the users (66 per cent) stated that cocaine had little, if any, effect on their lives while 10 per cent stated that cocaine had a negative impact, such as psychological dependence, financial burden, lost jobs, and loss of drive and ambition. About 23 per cent of the users commented that cocaine use had a positive impact on their lives, offering them new personal and social experiences. The consensus was that cocaine use would continue to increase because generous supplies of the drug will continue to be available. The ultimate solution was suggested to lie in decreasing the demand in Canada, educating the public about the hazards of cocaine, improving law enforcement and increasing the price. F. T. A. 3 figures
MISCELLANEOUS
isoelectric point of 15.5. Polyclonal antibodies were raised specifically to microgram quantities of electrophoresed, excised and eluted prostate secretory protein 15. Western immunoblot analysis using these antibodies showed that they not only react with prostate secretory protein 15 but cross-react with simian prostatic and human seminal fluid proteins of similar molecular weight. Two-dimensional gel immunoblots strongly suggest that the seminal protein and prostate secretory protein 15 are the same, thereby providing a more accessible source of protein. However, the antibody to human prostate secretory protein 15 cross-reacted with neither prostatic fluid from the ventral lobe of the rat prostate nor the prostatic fluid from the beagle dog. N. V. R. 8 figures, 13 references
Primary Lymph Node Pathology in AIDS and AIDSRelated Lymphadenopathy
E. P. EWING, JR., F. W. CHANDLER, T. J. SPIRA, R. K. BRYNES AND W. C. CHAN, Division of Host Factors, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, United States Department of Health and Human Services, Atlanta, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
Arch. Path. Lab. Med., 109: 977-981 (Nov.) 1985 The acquired immunodeficiency syndrome (AIDS) is now known to be caused by a lymphotropic retrovirus first described by French investigators and later by investigators in the United States. Since AIDS was first recognized in 1981, it has become clear that this syndrome represents the most severe form of a broad-spectrum disease. A much more prevalent manifestation of the disease is the lymphadenopathy syndrome, in which there are generalized lymphadenopathic conditions that persist for 3 or more months. Like AIDS, the lymphadenopathy syndrome has occurred predominantly in homosexual men, intravenous drug abusers, Haitians and hemophiliacs. While AIDS usually is fatal, the outcome of the lymphadenopathy syndrome is variable and not yet fully known. Some patients with the lymphadenopathy syndrome have suffered AIDS and died, while many more have survived up to several years without further progression of the disease. The AIDS virus, human T-cell lymphotropic virus type Ill/ lymphadenopathy-associated virus, specifically infects and kills certain T-helper lymphocytes, the cells that may be moderately depleted in the lymphadenopathy syndrome and profoundly depleted in AIDS. The lymph node is a focus of interest in the lymphadenopathy syndrome and AIDS because of its major role in the normal immune system, its conspicuous enlargement in the lymphadenopathy syndrome and the likelihood that it is an anatomical site of destruction of T-helper lymphocytes by the AIDS virus. Lymph nodes of patients symptomatically infected with the AIDS virus show a spectrum of morphological changes ranging from marked lymphoid hyperplasia to marked lymphocytic depletion. These changes can be grouped into 3 distinct patterns. The type I pattern features follicular and paracortical hyperplasia, and is associated with chronic lymphadenopathy. The type II pattern, which shows diffuse lymphoid hyperplasia but loss of germinal centers, signifies evolution of chronic lymphadenopathy to AIDS. The type III pattern shows marked lymphocytic depletion and represents the end-stage lymph node
seen in fatal cases of AIDS. These histological patterns are correlated closely with the clinical and immunological status of patients infected with the AIDS virus. W. W. H. 4 figures, 49 references
MISCELLANEOUS The Rising Popularity of Cocaine: How Serious a Problem?
S.
KATZ, Toronto, Ontario, Canada
Canad. Med. Ass. J., 133: 682-685 (Oct. 1) 1985 Cocaine is a white powder refined from the leaves of the bush Erythroxylon coca, which grows wild in Peru, Colombia, Bolivia and Ecuador. It is a central and sympathetic nervous system stimulant, and a potent local anesthetic. The effects of cocaine are experienced almost immediately as feelings of being strong, active, wide awake and happy. This reaction is accompanied by constriction of the blood vessels, and increased blood pressure, breathing and heart beat rates, as well as dilation of the pupils and a discernible pallor. The most common form of ingesting cocaine is by snorting, although habitual users will inject the drug intravenously or "freebase" it. Cocaine currently is regarded as a highly addictive drug, second only to marijuana. Heavy cocaine use can cause physical dependence, paranoid psychosis and death. The Bureau of Dangerous Drugs in Ottawa, Ontario reported that the number of cocaine convictions increased from 44 in 1972 to 1,390 in 1983. According to the United States National Institute on Drug Abuse hospital emergency room admissions for cocaine problems increased 75 per cent between 1981 and 1983. It is estimated that 25 million Americans have tried cocaine and that an additional 5 to 10 million use it once a month or more. W ashton, who is a cofounder of the 1-800-COCAINE hotline, reported that in a recent 12-month period the hotline received 350,000 calls from cocaine users. Several animal studies suggest that the craving for cocaine is stronger than for any other drug. With continued heavy use the initial pleasant and mild effects are replaced by irritability, hostility, paranoia, total insomnia, rambling and incoherent speech, anorexia, absence of libido, tremors, twitching, convulsions, nasal congestion and nosebleeding. The Addiction Research Foundation in Toronto, Ontario recently surveyed cocaine users who volunteered to be included in the study. The 111 users surveyed (average age about 30 years) were using the drug for an average of 7 years and generally were highly educated with a comfortable income, and more than half were single. Of these subjects 27 per cent were classified as light users, 41 per cent as moderate users and 32 per cent as heavy users. A majority of the users (66 per cent) stated that cocaine had little, if any, effect on their lives while 10 per cent stated that cocaine had a negative impact, such as psychological dependence, financial burden, lost jobs, and loss of drive and ambition. About 23 per cent of the users commented that cocaine use had a positive impact on their lives, offering them new personal and social experiences. The consensus was that cocaine use would continue to increase because generous supplies of the drug will continue to be available. The ultimate solution was suggested to lie in decreasing the demand in Canada, educating the public about the hazards of cocaine, improving law enforcement and increasing the price. F. T. A. 3 figures