Showing papers in "Wiener Klinische Wochenschrift in 1983"

Vitamin K deficiency in the newborn

Abstract: Newborns have low levels of the vitamin K dependent clotting factors. Early studies were suggestive of vitamin K deficiency. Recently these findings were questioned by studies that failed to detect signs of vitamin K deficiency in the clotting system of newborns using more specific methods, while other studies did find signs of vitamin K deficiency using the same methods. The question was finally solved by direct measurement of vitamin K showing very low levels of the vitamin in the serum of newborns immediately after birth. Whether vitamin K supplementation to the mother reduces the incidence of vitamin K induced changes in the clotting system of newborns remains to be elucidated. In the meantime it seems prudent to administer parenteral vitamin K prophylactically to all newborns immediately after birth.

Endoscopic intraabdominal surgery in gynecology

Abstract: Modern technique leads to abdominal surgery under "miniature" conditions. The combination of electrically monitored pneumaperitoneum, cold light optic, new mini-instruments, the newly developed hemostatic procedure "endocoagulation" (the patient is not in contact with the electrical current) and intraabdominal ligation techniques allows a new spectrum of operative procedures to be performed in gynecology. The following endoscopic gynecological operations have become routine: adhesions, ovario- and fimbriolysis, sharp and blunt opening of the ampulla tubae (sterility-operations), enucleation of pedunculated subserous myomas, conservative and radical tubal therapy of ectopic pregnancy, ovarian biopsy, ovarian cyst enucleation, ovarectomy ("3-sling-technique"), coagulation of endometriosis, tubal ligation. As examples of non typical gynecological operations in general surgery, omental adhaesiolysis, lysis of bowel adhesions and appendectomy can be mentioned. These new operative techniques have been developed in more than 10,000 pelviscopies. They stand for laparotomy in up to 80% of all cases in tubal and ovarian surgery. The complication rate lies in the area of 2%. Hospitalization has diminished by more than 50%, the period of reconvalescence by more than 75%.

Modification of suprapubic prostatectomy using a biological gluing technic

Abstract: Fibrinogen cryoprecipitate, thrombin solution and factor XIII concentrate were used for gluing in suprapubic transvesical prostatectomy. The fibrin glue was applied to an absorbable collagen velour placed in the prostatic bed. Postoperative blood loss was significantly smaller than in a control group. The gluing technique resulted in a sparing of the number of blood transfusions, a reduction in disturbances of wound healing and a shortening of postoperative hospital stay. Negative consequences of this gluing technique have not so far been observed.

Celery allergy (celery contact urticaria syndrome) and relation to allergies to other plant antigens

Abstract: Comparative study of 13 patients (group A) with severe attacks of angio-oedema and urticaria after eating celery and 143 atopics with hypersensitivity to mugwort-pollen (group B). Due to the severity of the reactions (group A) no oral provocation tests were performed. Scratch chamber tests with raw and cooked celery (and related plants) confirmed the case histories. RAST answers to celery were compared for both groups. RAST inhibition indicated that celery and mugwort-pollen and also celery and birch-pollen allergens cross-react. Whether or not the reactions (in group A) are type I allergic or non-specific reactions is discussed. The term celery-"contact urticaria syndrome" should be used (Maibach and Johnson, 1975).

Epidermal Langerhans cells in mycosis fungoides and Sézary syndrome.

Abstract: The purpose of the study was to examine whether apposition between epidermal Langerhans cells and atypical lymphoid cells is a constant finding in mycosis fungoides (MF) and whether it also occurs in the Sezary syndrome (SS) Biopsies of 8 patients with MF and 2 patients with SS were examined by transmission electron microscopy In both cases of SS and in 7 cases of MF appositions between the 2 types of cells were observed The appositions were less frequently seen in stage III MF lesions than in MF stage II The cell membranes of the Langerhans cells and the apposed atypical lymphoid cells formed gap junction-like structures in several instances Our results indicate that the phenomenon of cellular interaction between epidermal Langerhans cells and atypical lymphoid cells is a constant finding in cutaneous T-cell lymphomas

[Oxytocin- and prostaglandin plasma concentrations before and after spontaneous labor: evidence of involvement of prostaglandins in the mechanism of placental separation].

Abstract: The concentrations of oxytocin and PGE, PGF, and 13,14-dihydro-15-keto-PGF2 alpha (PGFM) in maternal peripheral plasma were measured in serial samples taken at full cervical dilatation and 5, 30 and 120 minutes postpartum. The prostanoid levels were also measured in serial samples of umbilical cord blood taken from the placental end in 4 instances. At full dilatation, plasma PGFM, but not PGE and PGF, was significantly raised over control (no labor) values. Just before or at the time of placental separation (5 minutes postpartum), the concentrations of PGF and PGFM were maximal, about twice the level at full dilatation. The level then decreased but at a slower rate than the metabolic clearance rates, indicating that considerable PGF production occurs in decidua and myometrium in the early postpartum period, after fetus, placenta, and the membranes are expelled. The rapid increase in the prostanoid concentrations in the umbilical cord blood draining the placenta after delivery of the infant suggests that the surge of prostaglandins 5 minutes postpartum originates in the placenta, and probably contributes to uterine contraction and placental separation and expulsion. Plasma OT was significantly raised over prelabor values at full cervical dilatation, and during the third stage, but dropped to control levels 30 minutes postpartum. Exogenous oxytocin infusions begun at delivery of the infant caused a marked increase in plasma OT and maintained the PGFM concentrations at a higher level than in the parturients not receiving oxytocin 2 hours postpartum.

Pharmacotherapy of Amanita phalloides poisoning using silybin

Abstract: A total of 18 cases of Amanita phalloides poisoning was treated by combined chemotherapy during 1980 and 1981. After attempted primary elimination of the toxin all patients received silybin as basic therapy mainly by infusion and, in two instances, silymarin orally. In order to investigate the effect of silybin therapy a retrospective study of the followed-up case records was made. The cases were arbitrarily classified into three groups of severity (light, medium and severe) according to clinical and laboratory findings. A close relationship was found between the severity of the intoxication and the time elapsed before commencement of silybin therapy. The time interval between mushroom intake and the commencement of the silybin administration averaged 71.5 hours in the "severe" group compared with 46 and 33.8 hours, respectively, in the "medium" and "light" groups. The mean silybin dosage was 33 mg/kg body weight/day; the mean duration of silybin therapy was 81.6 hours. With the exception of one fatality in a particularly high dosage suicidal intoxication, all patients survived. Administration of silybin within about 48 hours after mushroom intake seems to be an effective measure to prevent severe liver damage in Amanita phalloides poisoning.

[Transfer factor as adjuvant immunotherapy in invasive cervix cancer. Report of a double-blind study].

Abstract: From 1977 to 1982 a prospective randomized double-blind study comparing transfer-factor (TF) versus placebo was conducted in invasive cervical cancer patients after radical surgery and irradiation. The husbands of the cancer patients were selected as leukocyte donors for TF preparations. 60 patients entered the study; 28 patients received placebo and 32 patients received TF. The comparability of both collectives was excellent concerning age and tumor stage. One patient treated with TF died intercurrently. The rate of recurrence of cancer was 5 in the 31 TF-treated patients and 11 in the 28 patients receiving placebo, which was significantly different (p less than 0,05). This difference was even greater when only patients treated for at least 3 months were compared (3 recurrences in the TF-group and 11 recurrences in the placebo-group). Further aspects of this clear clinical results are discussed.

Swallowing the psyche

Abstract: Various swallowing disorders have been viewed to be psychogenic and an altered contractile activity of the oesophagus has been reported to occur during emotional stress. Non-propulsive activity and "cardiospasm" were suggested to represent a symbolic revulsion, referring to deep, unconscious conflict or an ambivalent attitude towards incorporation (Kronfeld, 1934; Weiss, 1944; Alexander, 1950). However, these concepts were not corroborated by subsequent research. "Globus hystericus" was shown to result from webs and folds in the hypopharynx or from gastrooesophageal reflux, whilst the term "cardiospasm" has even become obsolete: there is no spasm of the lower oesophageal sphincter but an "achalasia", i.e., a failure to relax upon swallowing, which is not induced by psychic factors, but by lesions affecting the intrinsic and extrinsic innervation. On the other hand, it has been shown that the oesophagus reacts with non-propulsive contractions not only emotional tension, but also to cold or hot food and even to stimuli not related to ingestion such as intense short sounds, and that these contractions are likely to form part of the defence reaction of the healthy organism. Despite this responsiveness of the oesophagus and the fact that strategies aimed at inducing relaxation and reassurance can help patients to cope with their swallowing disorders, the psychosomatic concept that "exaggerated" oesophageal responses can lead to organic diseases has remained purely speculative. Present knowledge of the physiology and pathophysiology of the oesophagus clearly indicates that disorders such as globus sensation, achalasia, and diffuse oesophageal spasm should not be treated by psychotherapeutic but by appropriate surgical, or medical, means.

Accidental fatal formaldehyde poisoning

Abstract: A previously healthy man accidentally swallowed 20 to 50 ml of Formalin (25%). Relevant clinical findings after the accident were: severe metabolic acidosis, severe disseminated intravascular coagulation and renal failure. He died 7 hours after formaldehyde ingestion-presumably from toxic pulmonary oedema. Relevant post-mortem findings were: massive pulmonary damage (toxic oedema), leather-like thickening of the gastric wall and multiple subendocardial haemorrhages. The treatment of formaldehyde poisoning is briefly discussed.

1-Deamino-8-D-arginine-vasopressin--an alternative in the management of mild haemophilia A and von Willebrand's disease.

Abstract: Intravenous administration of 0.4 micrograms DDAVP/kg body weight in 16 normal controls, 34 patients with haemophilia A and 30 patients with von Willebrand's disease (vWd) was followed by an increase in FVIII: C from 230 to 410%, in FVIIIR:Ag from 160 to 260% and FVIIIR:RC of from 160 to 320%. Additionally, in the patients with vWd, a shortening of the bleeding time and improvement in platelet retention was observed. In 7 haemophiliacs with pretreatment levels of FVIII: C ranging from between 11 and 43% dental extractions were performed successfully after DDAVP whereas in 2 patients with FVIII: C levels of 5 and 6%, respectively, severe bleeding necessitated administration of factor VIII concentrates. In 8 haemophiliacs (FVIII: C between 6.5 and 50%) and 2 patients with vWd (FVIII: C 18 and 36%, respectively) DDAVP enabled minor surgery and successful therapy of spontaneous or traumatic bleeding complications. However, severe postoperative bleeding after stomach surgery in 2 haemophiliacs (FVIII: C 23 and 40%, respectively) and severe menstrual bleeding in one patient with vWd (FVIII: C 15%) required administration of factor VIII concentrates. At present DDAVP therapy should be restricted to minor surgery and non-life-threatening, spontaneous or traumatic bleeding complications in patients with pretreatment FVIII: C levels higher than 10%.

[The leopard syndrome, a cardio-cutaneous syndrome].

Abstract: A patient with the "leopard" syndrome presented with cardiomyopathy and a large arteriovenous shunt of the left renal vessels. The skin manifestations included multiple lentigines, junctional naevi, blue naevi, and one malignant lentigo. This syndrome is a rare entity, but in all patients with multiple lentigines the possibility of associated cardiovascular changes should be considered. In addition, regular monitoring of the pigmented lesions should be performed because of the increased risk of development of malignant melanoma.

[Biometry--an exact method for the measurement of the axial length of the eye].

Abstract: High-frequency ultrasound, using a 10 MHz sound probe and an immersion technique, enables the measurement of the axial length of the eye to within an accuracy of 0.1 mm. The total axial length of the anterior surface of the cornea to the vitreoretinal interface is measured by ultrasound. Many authors add a retinal thickness factor to the echographic data. Addition of this retinal factor lowers the accuracy of axial length measurements. Biometry of both eyes can detect unilateral high-grade myopia as the only reason for unilateral exophthalmos. Accurate measurements of anterior chamber depth, lens thickness and axial length are of great diagnostic importance in glaucoma and are useful in the therapeutic management of this condition. Accurate biometry and preoperative calculation of intraocular lens power are indispensable procedures in obtaining optimal post-operative results in patients subjected to intraocular lens implantation.

Treatment of Amanita phalloides poisoning with silybin in combination with penicillin and cortisone

Abstract: A report is presented of Amanita phalloides poisoning in a family of 3 members admitted with acute gastrointestinal symptoms after eating a meal of various self-picked mushrooms. A latent period of 11 hours preceded the onset of symptoms, a typical feature of this form of poisoning. There was an enormous increase in liver-specific enzymes in two of the cases. The clinical picture was markedly mitigated by the early initiation of silybin therapy, in combination with penicillin and cortisone. The patients made a rapid symptomatic recovery and the liver parameters were sufficiently improved by the 12th day so that the patients could be discharged.

Effect of chloroquine diphosphate on the superhelix structure of DNA and protein synthesis in synovial cells in chronic polyarthritis

Abstract: The influence of chloroquine diphosphate on protein synthesis in synovial fluid cells was investigated in 8 patients suffering from rheumatoid arthritis. Intraarticular injection of chloroquine diphosphate at a dose of 25 mg and 50 mg is followed a small decrease in incorporation of 3H-marked amino acids into the synovial fluid cells. Above a dose of 100 mg the protein synthesis is significant reduced. In a second experiment the supercoiled structure of DNA under C1Q was lost. After 2 hours the chain breaks were repaired.

[Extrinsic allergic alveolitis: comparison of 2 methods (Ouchterlony gel precipitation and ELISA) for antibody detection in routine diagnosis].

Abstract: Sera from 58 patients with suspected extrinsic allergic alveolitis (EAA) were tested in parallel by the double diffusion test and the "enzyme-linked immunosorbent assay (ELISA)" using 10 different antigen solutions (extracts from thermophilic actinomycetes, various mycetes, pigeon serum, pigeon droppings and the wheat weevil sitophilus granarius). The ELISA technique was more sensitive than the double diffusion test in detecting antibodies to the panel of antigens used. However, by using several antigen dilutions the number of sera positive sera with the double diffusion test increased and an overall correlation of 93.1% with the ELISA was achieved. The results of the study are discussed with regard to the advantages and disadvantages of both test systems for the in vitro diagnosis of EAA.

Vertical transmission of hepatitis B. Results of a prospective study 1978 to 1981

Abstract: From June 1978 until August 1981 4400 pregnant women were consecutively investigated in Vienna for the presence of hepatitis B. 23 women (0.52%) were HBs-antigen positive; 15 of these were foreigners (from Yugoslavia, Turkey, Philippines, Rumania),22 pregnant women were healthy HBs-antigen carriers. One woman had an unspecific reactive hepatitis. Three pregnant women were HBe-antigen positive, 18 anti-HBe positive. Hepatitis B infection was detected in three children of HBs-positive mothers. The highest risk of infection existed in children of HBe-antigen positive mothers. There was no connection between the infection of the children and HBs-antigen in cord blood, delivery and breast-feeding habits. Hepatitis infection took a different course in the three children: one child was an HBs-antigen carrier with a healthy liver, whilst in two children seroconversion took place and anti-HBs was formed without clinical-biochemical signs of hepatitis. Measures for the prevention of vertical hepatitis B transmission are discussed.

[lst report: Alternatives to cortisone therapy. lst clinical experiences with a carnitine-betamethasone combination for the stimulation of fetal lung maturity].

Abstract: In the recent past criticism has been voiced with regard to the efficacy and possible side effects of corticosteroid prophylaxis of fetal respiratory distress syndrome (RDS). Apparently the efficacy of this treatment has been over-estimated and the spectrum of possible side effects has not received enough critical attention. In view of the multiple indications that the fetal metabolism, above all, may be altered by this type of therapy, it seems necessary to search for other methods of surfactant stimulation. This paper presents the first clinical study on the use of carnitine (4 g for 5 days in combination with twice 8 mg beta-methasone versus twice 8 mg betamethasone alone). The patients on combination therapy showed a more marked increase in surfactant content of the amniotic fluid. Lung compliance determination in infants born within 72 hours of completion of therapy also revealed better results in the combination therapy group. There were also fewer clinically demonstrable RDS cases in this group. More research will be necessary to definitely establish the value of this new form of therapy.

[Non-enzymatic glycosylation of hemoglobin and serum protein in children with galactosemia].

Abstract: Non-enzymatic galactosylation has been investigated by in vitro incubation of red cell haemolysate, a HbAo-preparation and of GBM of healthy children. The effects of non-enzymatic galactosylation of haemoglobin has been studied by high pressure liquid chromatography, the effects of GBM galactosylation by immunoelectrophoresis. Subsequently, the occurrence of elevated values for HbAIa-c and GSP was evaluated in 14 galactosaemic children (11 transferase deficiency, 3 galactokinase deficiency), as well as urinary acid glycosaminoglycae excretion and GBM immunoelectrophoretic mobility in 6 of these 14 children measured. The results were compared to the respective values of healthy control children. After exclusion of significant non-enzymatic glucosylation by measuring postprandial blood glucose values the galactosaemic children showed significantly increased values for HbAIa-c (8.85 +/- 2.0% versus 7.7 +/- 0.3%; p less than 0.02), for GSP (0.43 +/- 0.13 mmol 5-HMF/mg protein versus 0.32 +/- 0.07 mmol 5-HMF/mg protein; p less than 0.005) as well as for urinary acid glycosaminoglycane excretion (45.3 +/- 23.4 micrograms/mg kreatinine versus 9.9 +/- 2.3 micrograms/mg Kreatinine; p less than 0.01). 3 out of the 6 children showed alpha 1-immunoelectrophoretic mobility of GBM antigens which was found also after incubation of GMB with galactose. The other 3 children had alpha 2-immobility, which was found in the healthy controls as well as in the control incubations. The impact of galactose on increased non-enzymatic glycosylation in children with galactosaemia as well as the significance of this finding for diagnostic purposes or for clarifying pathophysiological aspects of the disease remains to be studied further.

[Neopterin, a new biochemical marker for the detection of activated T lymphocytes].

Abstract: In this review evidence is summarized indicating that the pteridine compound, neopterin represents a new and clinically useful biochemical tool to detect activated T-lymphocytes. T-cells stimulated in vivo or in vitro by allogeneic or virally or chemically modified autologous cells produce large amounts of this molecule. Other mononuclear blood cells, in contrast, lack this capacity. These findings suggested that evaluation of neopterin levels might represent a means for the biochemical monitoring of disease states mediated by or associated with activated T-cells. Our clinical data obtained on patients suffering from allograft rejection, viral disease, or autoimmune states strongly support this concept.

Primary gallbladder cancer

Abstract: 118 surgically-treated patients with gall bladder carcinoma and 407 autopsies recording this diagnosis were reviewed and analysed with a view to investigating the reasons for the bad prognosis of this disease. An early tumour stage was seen in only 5.9% of the surgical patients. A possible reason for the bad results even at an early tumour stage is undertreatment by simple cholecystectomy. In advanced stages of gall bladder carcinoma palliative operations have a better prognosis than diagnostic laparotomies. Prevention of gall bladder carcinoma through prophylactic cholecystectomy in the case of documented lithiasis failed to prevent gall bladder carcinoma in our group of patients because only 9% of the patients with gall bladder carcinoma had been diagnosed as having lithiasis in time to consider cholecystectomy as a preventive measure.

Medullary thyroid cancer

Abstract: This paper attempts to review current opinions on medullary thyroid carcinoma. Histologically described for the first time in 1951 belongs to the endocrine-secreting group of tumours (APUD). It can be sporadic as well as hereditary. The histological classification nowadays is increasingly performed immunohistologically via calcitonin. Clinically the tumour ranges from the very small, but hormonally highly active form, to the aggressive, mostly undifferentiated form. According to this the therapy must be radical. Our study group recommends thyroidectomy and functional neck dissection, followed by radio-chemotherapy. A close interdisciplinary follow up of the patients is necessary. Our surgical department treated 1048 thyroid malignancies between 1949 and 1982. 26 patients (2.4%) were diagnosed to have medullary thyroid carcinoma. Follow up time was between 1 month and 17 years. The recurrence--free interval was 4.5 years. The 5 and 10 year survival rate was 52% and 26%, respectively.

Combined treatment of malignant gliomas

Abstract: A controlled study of 226 age-matched patients with histologically proven grade 3 and 4 supratentorial gliomas with maximum feasible tumour resection, postoperative Karnofsky performance over 50 and minimum survival of 8 weeks compares the results of supportive care (45 cases), high-dose irradiation of 40 to 66 Gy (59 cases), COMP protocol (CCNU, procarbazine, vincristine, methotrexate, prednisone in 15 day cycles-42 cases) and simultaneous irradiation and COMP chemotherapy (80 cases including 30 survivors). Median recurrent-free intervals in the treatment groups (7 to 11.7 months) were significantly longer than after supportive care (4.4 months). Median survival with supportive care (6.7 months) was significantly shorter than after radiation or COMP treatment (11.7 and 12.3 months) and 14.9 to over 19.9 months with combined treatment, where the two-year survival rates were 33 and 67% (for survivors), and the 3-year survival rates 13 to 30%. Toxic side effects of multimodality treatment were more frequent than after chemotherapy. In addition to space-occupying intracranial cysts often simulating tumour recurrence (12%) and rare radiation necrosis, about 15% of long-term survivors developed progressive intellectual dysfunction with brain atrophy, in the absence of tumour regrowth. Despite some promising results of multimodality approaches towards the management of malignant supratentorial gliomas, the overall results are unsatisfactory and need further optimization.

[Poly-(ADP ribose) synthesis and regulation disorders in disease].

Abstract: Poly(ADP-ribose) is a polyanion involved in the regulation of the DNA metabolism of cells. DNA repair, semiconservative DNA-synthesis, differentiation- and trans-formation functions are connected to changes in the activity of the poly(ADP-ribose)-polymerase. The incidence of most cancers shows a steady increase with age while the PAR-synthesis decreases linear in certain cells with age. In some diseases abnormalities could be detected in PAR-synthesis and binding to nuclear proteins.

[Alcohol and changes in the hematopoietic system; an epidemiological contribution to the problem of alcoholic anemia].

Abstract: In the course of the "Vienna Health Study 1979" 1261 males and 1548 females divided into 3 age categories (25, 40 and 60 years), were investigated for serum iron level, RBC, leucocytes, haemoglobin, haematocrit, MCH, MVC, MCHC, GOT, GPT and AP These parameters were evaluated in correlation to the drinking habits of each proband Significant correlations were found between alcohol consumption and serum iron (elevation in most cases), RBC (decrease), MCV (elevation) and GOT (elevation)

[Reactive arthritis--clinical aspects and course].

Abstract: Post-enteritis reactive arthritis-mainly caused by Yersinia enterocolitica-has succeeded rheumatic fever as the most frequent postinfection arthritis in Northern and Central Europe. Aetiologically important are infective diseases-produced by "arthritogenic" bacteria--as a trigger, and genetic predisposition, indicated by a high incidence of HLA-B27 (80%). Over a period of 5 years 51 cases of post-enteritis reactive arthritis were diagnosed in our clinic; the patients--after the first examination--were followed up for several years. The typical clinical findings initially were an asymmetric oligoarthritis, mainly affecting knees, ankles and toes. Transitory low-back pain and heel pain were the most important concomitant findings. Transient liver involvement was indicated by pathological laboratory tests in 12 cases. Acute primary disease was determined at latest within one year (average duration 6.5 months). In the follow-up period 7 patients developed symptoms of a chronic seronegative spondylarthritis. Thus, post-enteritis reactive arthritis may often represent the first manifestation of a chronic disease of the seronegative spondylarthritis group, e.g. Reiter's syndrome.

[Somatosensory evoked potentials: normal values and methodological problems in various recording technics].

Abstract: In order to optimize the method of examination, somatosensory evoked potentials (SSEP) were studied in 27 healthy subjects, as recorded during stimulation of the median nerve at the wrist. The study shows that recordings with surface electrodes produced better results than with needle electrodes, owing to lesser disturbance from muscle artifacts. The SSEPs of each subject were recorded taking a fixed position of the active electrode placed over the contralateral sensory "hand field", and a reference electrode positioned for the first recording mid-frontally and for the second recording at the contralateral ear or vice versa. The first 3 positive and the first 3 negative peaks were studied. Exact identification of each peak was more often possible when recordings were made with the reference electrode placed mid-frontally than placed at the contralateral er. Normal values were evaluated for the latency P15, P25, P45, N30, N35 and N55, for the amplitudes P15-N20, N20-P25, P25-N35, N35-P45 and P45-N55 and for the latency intervals P15-N20, N20-N35, N35-N55, P15-P25 and P25-P45, with the reference electrode in different positions. In addition, the side difference for each subject was determined. Statistical analysis (T-test for independent variables) revealed a significant difference, depending on the position of the reference electrode: with the reference electrode placed at the contralateral ear, the latency P15 was shorter, the amplitude P15-N20 was increased and the amplitude N20-P25 was decreased as compared with a reference electrode placed mid-frontally.(ABSTRACT TRUNCATED AT 250 WORDS)

[Radiation vasculopathy--caused by a change in vascular prostacyclin synthesis?].

Abstract: Earlier investigations revealed morphological damage of the vascular wall after radiotherapy. The present investigation was undertaken to determine whether vascular prostacyclin synthesis plays a causative role in the genesis of vasculopathy. Rabbits were exposed to a focal radiation dose of between 500 and 5000 rad over various time intervals. Vascular PGI2-synthesis increased significantly immediately after radiation, with a subsequent decrease over the following days to levels below the starting values. Each repeated radiation dose induced a significant increase in PGI2-synthesis again. These observations were paralleled by severe morphological alterations, mainly localized in endothelial cells and elastic material. The findings suggest that a deterioration in PGI2-synthesis plays a key role in the genesis of radiation-induced vasculopathy.

[In vitro differentiation of leukaemic promyelocytes (HL-60): effect on beta-adrenergic receptors and adenylate cyclase activity].

Abstract: In the present study, the expression of beta-adrenergic receptors, the activity of the enzyme adenylate cyclase (AC), and the intracellular concentration of cyclic adenosine 3',5'-monophosphate (cAMP) were investigated in HL-60 cells before and after their differentiation to monocytic or more mature granulocytic cells. Treatment of the HL-60 promyelocytes with 12-O-tetradecanoylphorbol 13-acetate or human interleukin 2 resulted in the appearance of cells with monocytic characteristics (morphology, non-specific esterase, adherence, reaction with a monocyte-specific monoclonal antibody). Induction with retinoic acid resulted in differentiation to cells with typical features of mature granulocytes (morphology, peroxidase, nitro-blue tetrazolium reduction). During maturation to monocytes, the density of beta-adrenergic receptors decreased, whereas it remained constant during maturation to granulocytes. In comparison with normal circulating monocytes or polymorphonuclear granulocytes, expression of beta-adrenergic receptors on the surface of the differentiated HL-60 cells was low. Activation of AC by the hormones isoproterenol, prostaglandin E1, and histamine generally decreased with HL-60 maturation and enzyme activities were markedly below those measured in normal peripheral leukocytes. In the induced monocytic HL-60 cells, the weak effectiveness of isoproterenol was due to the loss of beta-adrenergic receptors. In the induced granulocytic HL-60 cells, the reduced hormonal AC activation could be explained by the impaired coupling between hormone receptors and catalytic enzyme unit. The concentration of intracellular cAMP after differentiation of HL-60 cells reflected the increase in basal AC activity and the decrease in hormone stimulation of the enzyme. Our data indicate that HL-60 cells induced to differentiate possess some monocyte- and granulocyte-like properties, but do not meet several important functional criteria of their new cell identities.

Hepatitis B contamination of Viennese hospital personnel

Abstract: Blood samples of 975 Viennese hospital staff members were tested for the presence of hepatitis B antigen and antibodies; a prevalence of 26% was found. It is estimated at 20% for the entire hospital personnel in Vienna. The prevalence of hepatitis B antigen and antibodies indicates the risk of infection and varies markedly with the type of hospital department; it is, however, significantly higher in every department than in the ambient population. There were no substantial differences between occupational groups, e.g. doctors, nurses, cleaning personnel etc. However, a close correlation was found to on-job time and to age. Hepatitis B vaccination after virological-serological testing is recommended for the entire hospital personnel.