Nodular sclerosing Hodgkin's disease is characterized by dense collagen fibrosis. Although transforming growth factorbeta (TGF-fl) is an important bifunctional growth factor for fibroblasts and is stored and released by many cells, it requires acidification to pH 2.0-3.0 before it becomes a biologically active growth factor. We show here that the L428 Hodgkin's cell releases a high molecular weight TGF that competes for the TGF-ft cell membrane receptor but not the TGF-a receptor. This growth factor is most active at physiologic pH and is 97% inactivated by acidification. Hodgkin's TGF is also inactivated by proteases and can be preserved by protease inhibitors. The Hodgkin's TGF can be separated from an autocrine growth factor using either column chromatography or electroelution from gels and is shown to have a molecular weight of -350,000. Incubation of the Hodgkin's TGF in SDS releases a 25,000-D protein with reduced biological activity but which cross-reacts with anti-TGF-ft IgG. We propose that L428 nodular sclerosing Hodgkin's disease fibrosis is mediated by a potent high molecular weight TGF-,B which, unlike 8 characterized to date, is secreted in a form most active at physiologic pH.

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We report on six cases of sepsis caused by Serratia marcescens in patients with neutropenia. Four cases showed an additional involvement of the upper respiratory and digestive tract with oral and pharyngeal mucositis, haemorrhagic laryngo-tracheo-bronchitis, and oedematous swelling of the face. One patient showed a Serratia marcescens carrier state in the pharynx over a period of months without neutropenia. The isolated strains showed a broad spectrum of resistance against antibiotics; only aztreonam and amikacin were effective in vitro against all isolates.

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A 69-year-old man without previous cardiac disease was found over the last 9 months to have a markedly elevated erythrocyte sedimentation rate (ESR: 120 mm/1. h), haemolytic anaemia (haemoglobin 8.2 g/dl, lactate dehydrogenase 304 U/l), markedly reduced exercise tolerance, backache and weight loss of 5 kg. Radiological, biochemical and endoscopic examinations failed to provide a diagnosis. Nine blood cultures grew, at normal body temperature, Cardiobacterium hominis, a rare Gram-negative organism which can cause endocarditis. Echocardiography revealed endocarditis of the aortic valve with regurgitation. Despite protracted and high-dosage antibiotics (4 times daily 10 million U penicillin G for 6 days, followed by four times 5 million U penicillin G for 6 days, followed by four times 5 million U daily for five weeks, and three times daily 60 mg gentamycin for 10 days), as well as treatment of extensive chronic parodontitis, anaemia, haemolysis and increased ESR have now persisted for over a year, with negative blood cultures. Immune-complex phenomena are thought to be the reason for the persistence of signs of infection.