Wayne State University School of Medicine - Yearbook (Detroit, MI)

Page 158 text:

DELAYED HYPERSENSITIVITY REACTIONS IN PATIENTS WITH MALIGNANT DISEASE It is well known that in severely debilitated patients from whatever cause, for example, old age, infections and malignan- cies, there is a marked decline in the delayed hypersensitivity reaction. However, little work has been done to determine whether this decreased response Chypoergy or anergyj is non- specific. In other words, it has not been clearly shown if the immunological competence of patients is compromised by the specific disease process or the non-specific effects of debility. This question has been of more interest because there is evidence to suggest that cancer patients may suffer from a poor delayed hypersensitivity reaction due to a primary action ofthe malignancy on the immunological system. Hughes and MacKay have shown that depressed tuberculin response in cancer pa- tients have reversed themselves after curative treatment from surgery. They also correlated a depression in the tuberculin response with the early stages of cancer, when there was no detectable systemic spread of the tumor. It was thought worthwhile, therefore, to investigate the delayed hypersensitivity reactions to tuberculin, mumps, C. albicans, and dinitrobenzene in cancer patients contrasted with those in matched patients with no malignancy. Peter P. Wong V. Vaitkevicius, MD. 156

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A HISTOCHEMICAL STUDY OF MITOCHONDRIAL AND LYSOSOMAL ENZYMES IN THE DISEASED MYOCARDIUM This study was undertaken on portions of human myocardi- um obtained from fresh postmortem specimens. The tissue was subjected to a wide spectrum of histochemi- cal stains for mitochondrial and hydrolytic lysosomal enzymes. Mitochondrial enzymes studied were lactic, malic, succinic, NADH, and alcohol dehydrogenase. They were studied by the formazan technique. The following hydrolytic enzymes were studied: B-glucosidase, aminopeptidase, esterase, and alkaline phosphatase. A 5-bromo-4-chloro-indolyl substrate was util- ized. Hydrolysis of these substrates yields a highly insoluble indigo at the enzyme site. The myocardial diseases studied include arteriosclerotic cor- onary artery disease, hypertension, beriberi, alcoholic heart disease, brown atrophy, post-perfusion necrosis, cor pulmon- ale, acute and healed myocardial infarction and hypertrophy secondary to various causes. Abnormalities noted include: Alcoholic heart disease charac- terized by a marked decrease in zinc-dependent enzymes such as alcohol and NADH dehydrogenases, and esterase activity increase in brown atrophy of the heart. Loss and intracellular shifting of mitochondrial and lysosomal enzymes occurred in beriberi, myocardial infarct and post-perfusion necrosis. Gordon Beute Paul Wolf, M.D. 157