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This study was undertaken to clarify the role of Limulus amebocyte lysate reactive material (LAL-RM) in the activation of complement in patients during hemodialysis with cuprophan membranes. The authors measured LAL-RM and complement C3a levels predialysis and at 15 and 60 minutes of dialysis in 16 patients dialyzed for 8 weeks on cuprophan membranes and then for a succeeding 8 weeks on cellulose acetate membranes. Patients' symptoms on dialysis with each membrane were assessed. The LAL-RM levels of these patients were compared to those of six patients dialyzed on cellulose acetate membranes only. The LAL-RM and C3a levels rose significantly in the 16 patients while on dialysis with cuprophan membranes, but there was no correlation between the LAL-RM and C3a levels. C3a levels rose significantly in the 16 patients while on dialysis with cellulose acetate membranes, but there was no rise in LAL-RM levels. C3a levels were significantly lower while the patients were on dialysis with the cellulose acetate membranes. The six patients on dialysis with the cellulose acetate membranes only had no detectable LAL-RM in their blood. Patients' symptoms were less while on dialysis with the cellulose acetate membrane, but the difference did not achieve statistical significance. We conclude that LAL-RM plays a very minor role, if any, in the complement activation caused by cuprophan membranes and that cellulose acetate membranes do not release LAL-RM.

Tuberculosis cases are increasing in the United States, partly because of the emergence of AIDS and the rise in the homeless population. Faster culture methods usually allow identification within two weeks. Research is being done on serologic and recombinant nucleic acid methods of detecting tuberculosis in various body fluids and secretions. A six-month treatment regimen for tuberculosis has proved to be effective, as have shorter courses of prophylactic therapy for tuberculin skin test converters.

The value of serum lactate dehydrogenase (LDH) levels and bone scan results in predicting marrow involvement in small-cell carcinoma of the lung (SCCL) was studied. Records of 79 patients with SCCL who had undergone 92 bone marrow examinations were reviewed. None of 25 patients with marrow involvement had a normal LDH and a negative bone scan, compared with 23 of 59 in the uninvolved group. We conclude that patients with SCCL with both negative bone scans and normal LDH values have a less than 5% chance of marrow involvement.