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The Saw-scaled or Carpet Viper (Echis carinatus) whose range extends from Senegal to Bengal probably bites and kills more people than any other species of snake. One hundred and fifteen patients with poisoning caused by its bite were studied in the savanna region of Nigeria, where victims of this snake may occupy 10 per cent of hospital beds. Patients showing no signs of envenoming were excluded. All patients had local swelling at the site of the bite. Other features included local blistering (13 per cent), local necrosis (11 per cent), incoagulable blood (93 per cent), and spontaneous systemic bleeding (57 per cent). There was evidence of disseminated intravascular coagulation in all cases; fibrinogen was severely depleted, fibrin degradation products were increased (mean 1711 +/- 904 micron per ml), but significant thrombocytopenia (less than 103 000 per mm3) was seen in only ten severe cases. Clotting factors V, VIII, II and XIII were depleted, while X and VII were usually normal. Fibrinolytic activity was rarely increased, so it seems likely that a procoagulant action (direct activation of prothrombin) is principal effect of E. carinatus venom on blood coagulation in man. Development of the haemostatic defect was observed as early as 75 minutes and as late as 27 hours after the bite. Spontaneous haemorrhage is clinically the most important effect of E. carinatus venom, causing the five deaths in this series. The relative importance of procoagulant and haemorrhagic components of the venom in causing haemorrhage is discussed. Complement activation via the classical and alternative pathways may have contributed to vascular damage. Mortality was reduced from the untreated level of between 10 and 20 per cent to 2.8 per cent in a group of 107 patients treated with 10 to 110 ml of specific antivenom. The dose was controlled using a simple clotting test. Blood coagulability was restored in two to 39 (mean 12) hours after the first dose of antivenom. Immediate-type serum reactions were observed in 21 per cent of cases. Additional treatment included blood transfusion for patients in haemorrhagic shock and ealry surgical débridement of necrotic tissue at the site of the bite.

Thymocytes adoptively transferred into syngeneic irradiated recipients can be primed with antigen (KLH) to generate two types of helper function termed 'specific' and 'non-specific'. Low doses of KLH given without adjuvant generate high levels of non-specific compared to 'specific' helper T cells. Large doses of KLH given in adjuvant (FCA) generate high levels of both types of helper T cell. Explantations for this observation are discussed.

Objectives: To investigate body image and psychosocial adjustment among competitive bodybuilders, non-competitive weight trainers, and athletically active men. Methods: Participants were 40 men in each of the three groups who were assessed on body composition and multiple facets of body image evaluation, investment and anxiety, eating attitudes, and social self esteem. Results: Relative to the other two groups, competitive bodybuilders had greater body mass due to fat-free body mass. Although groups did not differ in their situational body image discomfort, competitive bodybuilders and weight trainers had a more positive global appearance evaluation and were more psychologically invested in their physical appearance. Compared with active controls, men in both weightlifting groups were more satisfied with their upper torso and muscle tone. Competitive bodybuilders reported more mid torso satisfaction than the other two groups. Competitive bodybuilders also wished to be significantly heavier than controls did and reported higher social self esteem but greater eating disturbance. Conclusions: The findings suggest that competitive bodybuilders as a group are not more “muscle dysmorphic” than either non-competitive weight trainers or physically active men who do not train with weights.

The factors affecting the immunogenicity of a humanized gamma 1 CD3 monoclonal antibody (mAb) were investigated in transgenic mice that express the human CD3 antigen epsilon polypeptide (the mAb target antigen). Two derivatives of the mAb were employed, one with a normal, glycosylated Fc region (gamma 1 CD3 mAb), and the other with an aglycosylated Fc region (aglycosyl gamma 1 CD3 mAb). Comparisons of the antiglobulin responses elicited by the two derivatives in transgenic and nontransgenic mice demonstrated that Fab-mediated cell binding activity, dependent on target antigen expression, was a major positive determinant of CD3 mAb immunogenicity. A second positive factor was mAb Fc region glycosylation. At low dose levels the gamma 1 CD3 mAb consistently produced a higher antiglobulin response than the aglycosyl gamma 1 CD3 mAb. This was probably a result of the nonspecific, in vivo T cell activating property of the gamma 1 CD3 mAb, a consequence of its ability to cross-link T cells to Fc gamma receptor-bearing cells. (The aglycosyl gamma 1 CD3 mAb has a reduced Fc binding affinity for Fc gamma receptors and so does not activate T cells in vivo.) In support of this hypothesis, the gamma 1 CD3 mAb was able to nonspecifically enhance humoral immunity to an unrelated, coadministered antigen, whereas the aglycosyl gamma 1 CD3 mAb was not. The lower immunogenicity of the aglycosyl gamma 1 CD3 mAb correlated with a longer in vivo half-life and an improved capacity to block the target CD3 antigen. These results suggest that, as well as reducing the cytokine-induced side effects normally associated with CD3 mAb therapy, the nonactivating aglycosyl gamma 1 CD3 mAb will be less likely than the activating gamma 1 CD3 mAb to stimulate a neutralizing antiglobulin response.