Pilot study of teniposide in combination chemotherapy for small cell lung cancer

Teniposide is one of the most active agents in small cell lung cancer (SCLC). Because of the experimental evidence of synergistic activity between teniposide and methotrexate and between vincristine and methotrexate, 34 SCLC patients were treated with a combination of teniposide, vincristine, methotrexate and cyclophosphamide. Chest radiotherapy was given to responding patients with limited disease and prophylactic cranial irradiation was given to complete responders only. Most patients had extensive disease and good performance status. The main side-effects were myelosuppression, mucositis and peripheral neuropathy, which were all common and often severe. A response rate of 78% with 22% complete responses was obtained in 32 evaluable patients. Median durations of responses and survival were 252 and 311 days, respectively. Patients with limited disease had a median survival of 556 days while extensive disease patients had a median survival of 240 days. 2 patients with limited disease have been in continuous complete remission for more than 2 years from start of treatment.

Achalasia of the oesophagus: results of treatment

Achalasia of the oesophagus is an uncommon neuromuscular disorder characterized by symptoms of dysphagia and regurgitation of undigested food. The results of treatment of 43 patients with achalasia over 10 years are presented. Clinical data on presenting complaints and duration, and all subsequent treatments, were recorded. Patients were contacted to assess their current symptomatic status.

The standard Romanowsky-Giemsa stain in histology

A new and technically simple Romanowsky-Giemsa (RG) stain is proposed as a standardized technique for use in histology. An RG stock solution (pure azure B 7.5 g/l, eosin Y as eosinic acid 1.2 g/l in dimethylsulfoxide) is diluted to form the working solution with HEPES-buffer, pH 6. Staining time is 30-90 min after formol-calcium solution (or 2-4 hr after formaldehyde-organic acid mixtures). The resulting overstained sections are to be differentiated. A tannic acid-acetic acid combination in an isopropanol-water mixture was found to give optimum results within 100 sec. Subsequent dehydration is in isopropanol only. The staining pattern obtained is polychrome. The distribution of colors in detail is influenced by the modes of pre- and posttreatment. Of practical interest is the development of green and greenish blue colors on collagen fibrils which contrast strongly against the pink of sarcoplasm. For this and other reasons, this RG stain version seems suitable to replace the trichrome Gomori-type trichrome stains under appropriate processing conditions.

Infrared spectroscopy of phytochrome and model pigments

Fourier-transform infrared difference spectra between the red-absorbing and far-red-absorbing forms of oat phytochrome have been measured in H2O and 2H2O. The difference spectra are compared with infrared spectra of model compounds, i.e. the (5Z,10Z,15Z)- and (5Z,10Z,15E)-isomers of 2,3,7,8,12,13,17,18-octaethyl-bilindion (Et8-bilindion), 2,3-dihydro-2,3,7,8,12,13,17,18-octaethyl-bilindion (H2Et8-bilindion), and protonated H2Et8-bilindion in various solvents. The spectra of the model compounds show that only for the protonated forms can clear differences between the two isomers be detected. Since considerable differences are present between the spectra of Et8-bilindion and H2Et8-bilindion, it is concluded that only the latter compound can serve as a model system of phytochrome. The 2H2O effect on the difference spectrum of phytochrome supports the view that the chromophore in red-absorbing phytochrome is protonated and suggests, in addition, that it is also protonated in far-red-absorbing phytochrome. The spectra show that protonated carboxyl groups are influenced. The small amplitudes in the difference spectra exclude major changes of protein secondary structure.

K-antigen identification, hemolysin production, and hemagglutination types of Escherichia coli O6 strains isolated from patients with urinary tract infections

Serotyping of 1918 Escherichia coli strains isolated in significant cell numbers from the urine of patients with urinary tract infections (UTI) revealed the presence of 117 O6 strains. The K antigens were identified by means of K-specific phages and serological methods. The phages used included a K1 phage pool (phi 1, A-E) and the separate phages phi 2, phi 5, phi 7, phi 12 and phi 13. The presence of H antigens, type 1 fimbriae formation, hemolysin production and mannose-resistant hemagglutination (MRHA) ability with human A, sheep, calf and pig erythrocytes were also analyzed. Six different MRHA types were defined and discussed in relation to the O6:K:H serotype. Remarkably, E. coli O6 strains were found to possess a whole arsenal of virulence factors (K antigens, MRHA, hemolysin). The most common serotypes - O6:K2:H1/H- (26), O6:K5:H1/H- (35) and O6:K13:H1/H- (20) - differed from each other in some cases in both MRHA type and hemolysin production.

Suppression of blastogenic transformation of lymphocytes by Bacteroides fragilis in vitro and in vivo

Bacteroides species and Enterobacteriaceae are known to cause synergistic infections. However, the mechanisms behind this synergy are not completely understood. Several authors have shown that Bacteroides species may inhibit the phagocytosis of Enterobacteriaceae by polymorphonuclear leukocytes as well as by macrophages. With the present study we have addressed the question of whether Bacteroides fragilis (BF) is also capable of suppressing specific immune functions. When incubated together with murine lymphocytes, BF significantly inhibited the blastogenic transformation of these cells stimulated by Escherichia coli-lipopolysaccharide (LPS) or concanavalin A. This effect was dose dependent and was not mediated by prostaglandins. Other bacteria such as E. coli or Listeria monocytogenes did not show such an extensive suppression, while Streptococcus pneumoniae was equally active. BF also inhibited the pokeweed mitogen induced blastogenic transformation of human lymphocytes. Moreover, lymphocytes from BF-injected animals obtained 3 to 12 hours after infection proved to be partly refractory for LPS-stimulation. Finally, BF injections also affected T-cell dependent immunity as judged from the aggravation of an experimental listeriosis in mice.

Vasoactive intestinal polypeptide in the PMSG-primed immature rat ovary and its effect on ovulation in the isolated rat ovary perfused in vitro

The immature rat ovary contains VIP immunoreactive nerve fibres sparsely distributed around blood vessels, in the interstitial gland and around follicles. The VIP concentration, measured radioimmunologically, decreased significantly after PMSG treatment (10 i.u.), probably due to ovarian enlargement and oedema, while the total VIP content (total of 0.12 pmol in both ovaries) did not change after PMSG priming. The ovulatory effect of VIP was studied using in-vitro perfused ovaries from immature 28-day-old rats primed with 10 i.u. PMSG. In all ovaries perfused, VIP (10(-7) M) induced ovulations with a rate of 2.33 +/- 0.56. The ovulation rate was significantly lower than that of ovaries stimulated by LH (0.1 microgram/ml) (5.20 +/- 0.86 ovulations per ovary). No synergistic effect on the ovulation rate was seen when LH and VIP were administered together (5.20 +/- 0.49 ovulations per ovary). The results suggest that the neuropeptide VIP may represent one of the local factors involved in the ovulation process.

[Microbial colonization of the upper respiratory tracts of day care children in relation to acute morbidity episodes]

The upper respiratory tracts of 20 children attending a crèche were studied for bacteria up to the 128th day of crèche attendance. To this end nose and throat swabs as well as double blood withdrawals were to determine antibodies against various respiratory viruses. The germ spectrum thus obtained was correlated with the acute pathological processes occurring during the period of investigation. In addition to the normal flora, the nasopharynx of infection-stable children was, with one exception, only populated with gram-positive pathopotent bacteria during the first four months of crèche attendance. In infection-labile children, however, gram-negative pathopotent bacteria, blastomycetes of the Candida group as well as Mycoplasma, virus and mixed infections were discovered apart from gram-positive bacteria. This broad germ spectrum should be taken into wider consideration in the chemotherapy of respiratory infections.

Amiodarone--efficacy and late potentials during long-term therapy

This prospective study was intended to examine the influence of long-term amiodarone therapy on the parameters of the signal averaged ECG and their relation to simultaneously derived Holter monitoring data. For this purpose 27 patients with angiographically confirmed dilated cardiomyopathy or coronary heart disease and highgrade ventricular arrhythmias, in whom an average of four class I antiarrhythmic drugs had proven ineffective, were stabilized on amiodarone. Before the beginning of therapy, as well as after two months and subsequently every three months if possible, a resting ECG, a signal averaged ECG by the method of Simson and Holter monitoring were performed. Compared to the initial measurement we found a significant increase in the duration of the total filtered QRS complex, while the change in the voltage did not reach the significance level. The incidence of late potentials remained largely constant under amiodarone. In the long-term follow up Holter monitoring showed a relatively high responder rate of between 46 and 81% under amiodarone. No relation could be detected between the results of the signal averaged ECG and those of 24-h Holter monitoring.

[The medical careers of the Nikolsburg Seligmann brothers in Vienna of the 19th century: Romeo (1808-1892), Franz (1809-1889) and Leopold (1815-1897)]

The achievements of two medical officers in the Austrian imperial military forces in the second half of the 19th century are enumerated and honoured. The distinguished services rendered by the brothers Franz and Leopold Seligmann in connection with the "Novara" expedition (1857-1859) and the prevention of a cholera epidemic (1873) are described in this paper to prevent their attainments from falling into oblivion. The eldest brother, Romeo Seligmann, founded the Chair of the History of Medicine at Vienna University in 1848 and was the first professor of this discipline.

[Experience after one year's computer-assisted determination and evaluation at the alcohol dehydrogenase laboratory]

The processing of blood alcohol measurements by alcohol dehydrogenase method (ADH) was improved by using a tailored software program. The program is written in Turbo BASIC and requires an IBM Personal Computer (PC/XT/AT) or compatible with at least 640K memory and a graphic adapter (EGA or Hercules). All features of the program are available from the menu bar with pull down menus. The program stores on disk or harddisk the optical density values measured with an HITACHI spectrophotometer. After the measurement the calculation of alcohol concentration is accomplished by the program. The results can be transferred and further handled with database systems (e.g. DBASE III). Stored values are used to calculate the reproducibility of calibration and the precision of single determinations.

[Sonographic assessment of gastric emptying. Reliability and validity of the antrum sagittal surface method for fluids]

The reliability and validity of sonographic measurements of gastric emptying employing sagittal antral planimetry were investigated. The intraindividual reproducibility of this procedure was examined in 15 healthy volunteers, who ingested 400 ml of water on two separate study days. Simultaneous studies of gastric emptying by ultrasound and scintigraphy were performed on 17 of 20 patients with suspected gastroparesis (16 diabetics and one patient with disseminated encephalomyelitis), using a caloric liquid test meal (20 g Biloptin-fatty meal in 300 ml water at 37 degrees C, radiolabeled with 0.5 mCi 99mTc-colloid). The expansion of the antral area with increasing amounts of ingested fluid and the emptying times showed a good intraindividual reproducibility from day to day (r = 0.94 vs. r = 0.81). There was a significant correlation between the relative residual volumes calculated by scintigraphy and by ultrasound (r = 0.82). These results imply that the ultrasonic sagittal antral area method is reliable and valid in the assessment of gastric emptying rates in humans.

Non-uniform influence of transforming growth factor-beta on the biosynthesis of different forms of small chondroitin sulphate/dermatan sulphate proteoglycan

The influence of transforming growth factor-beta (TGF-beta) on the expression of different forms of small proteoglycans was investigated in human skin fibroblasts and in a human osteosarcoma cell line. TGF-beta was not found to act as a general stimulator of small proteoglycan biosynthesis. In both cell types, an increased expression of the core protein of proteoglycan I was found. However, there was a profound decrease in the expression of a 106 kDa core protein, and either no alteration or a small decrease in the biosynthesis of the collagen-binding small proteoglycan II core protein. These results show that the production of individual members of the small proteoglycan family is differentially regulated.

Influence of collagen lattice on the metabolism of small proteoglycan II by cultured fibroblasts

Small dermatan sulphate proteoglycan II from cultured human skin fibroblasts interacts with type I collagen in vitro and in vivo. When fibroblasts are maintained in a type I collagen lattice the proteoglycan remains exclusively within the lattice, and its association with fibrils can be demonstrated immunocytochemically. On the basis of [35S]sulphate incorporation, small proteoglycan II comprises about 80% of total proteoglycans secreted by cells in monolayer culture. In a collagen lattice, fibroblasts down-regulate its synthesis to the level of large chondroitin sulphate/dermatan sulphate and of heparan sulphate proteoglycans, the synthesis of which remains unaffected. Compared with the product from monolayer cultures, small proteoglycan II from collagen gels contained a longer polysaccharide chain which is characterized by a larger proportion of disulphated and a smaller proportion of monosulphated glucuronic acid-containing disaccharides. The half-life varied between 60 and 110 h. It is suggested that the compositional differences between the proteoglycan from monolayer cultures and from cells in a collagen lattice are related to the slower intracellular trafficking of the proteoglycan under the latter culture conditions.

[Value of blood alcohol concentration in the assessment of legal responsibility]

We analysed the files of an Amts- and Landgericht from the years 1982/83. Among about 4000 cases we found 148 condemnations, in which sections 20/21 StGB were discussed. Each offence included 207 variables. 63 cases were left to be evaluated: 10 cases with section 20, 43 cases with section 21, 10 cases with refused section 21. Most of the delinquents lived alone, drank much alcohol very often, were socially unadaptable, previously convicted, unemployed and little qualified. Due to lack of findings of facts and diverging testimonies of psychic findings we found no significant correlation between level of blood alcohol concentration, psychic findings and degree of decreased condemnability.

[Urolithiasis in 2,8-dihydroxyadeninuria: presentation of 3 additional cases]

To the now 17 case reports in caucasian patients of an urolithiasis in a rare purine metabolism disorder 2,8-dihydroxyadeninuria due to missing activity of adenine phosphoribosyltransferase 3 further cases are presented. Firstly, a monozygotic twin pair is afflicted (13-year-old boys). All calculi be composed of pure 2,8-DHA, except a mixed calculus in a 38-year-old man containing of 80% 2,8-DHA and 20% calcium oxalate. The actual literature is reviewed.

Extracellular haemolysin of Proteus penneri coded by chromosomal hly genes is similar to the alpha-haemolysin of Escherichia coli

Extracellular haemolysin of four Proteus penneri strains was characterized as a polypeptide of approximately 110 kD. The chromosomal DNAs of these strains cleaved with Hind III showed three fragments hybridizing with a DNA probe containing cloned haemolysin (hly) genes of Escherichia coli. The results presented here suggested that the haemolysin of P. penneri strains is chromosomally determined and similar to the alpha-haemolysin of E. coli.

Effects of Escherichia coli hemolysin on human monocytes. Cytocidal action and stimulation of interleukin 1 release

This study reports on the potent cytocidal and interleukin-1 releasing properties of Escherichia coli hemolysin (ECH) on human monocytes. Nanomolar concentrations of purified ECH (250-2,000 ng/ml) caused rapid and irreversible depletion of cellular ATP to levels below 20% of controls within 60 min. Subcytocidal doses (10-200 ng/ml) of ECH induced rapid release within 60-120 min of large amounts of interleukin 1 beta (IL-1 beta) from cultured monocytes. IL-1 beta release occurred in the presence of actinomycin D and cycloheximide, and was thus probably due to processing and export of intracellular IL-1 beta precursor. Incubation of toxin-producing E. coli at ratios of only 0.3-3 colony-forming units per monocyte evoked approximately 50% depletion of total cellular ATP within 90 min. Toxin producers also stimulated synthesis and release of large amounts of interleukin 1, but not of tumor necrosis factor within the same time span. In contrast, non-toxin producers caused neither cell death nor rapid interleukin 1 release. Stimulation of rapid interleukin 1 release coupled with potent cytocidal effects on cells of monocytic origin may represent pathogenetically significant events incurred by bacterial strains that produce ECH and related cytolysins.

Ultrasensitive enzymatic radioimmunoassay using a fusion protein of protein A and neomycin phosphotransferase II in two-chamber-well microtiter plates

A new sensitive method for antigen detection employing a phosphorylation reaction is described using human serum albumin as a model. The antigen is initially bound to the surface of polystyrene microtiter plates and reacted with an antibody (rabbit). A microbiologically produced bifunctional fusion protein of protein A and neomycin phosphotransferase II (NPT II) serves as a second immunological reagent by virtue of its protein A component. The detection is based on the phosphorylation of an aminoglycoside antibiotic by the NPT II moiety of the fusion protein using [gamma-32P]ATP as a cosubstrate. This reaction is performed in solution and the evaluation is accomplished by dotting aliquots of the reaction mixture onto phosphocellulose paper, washing with water, and autoradiography. Microtiter plates with a specially designed 10 microliter-volume reaction chamber are particularly advantageous for this procedure. The sensitivity of detection is currently 10 fg (1 pg/ml) of antigen.

Histaminergic effects on the isolated rat ovarian artery during the estrous cycle

Histamine may play a role in many of the events occurring in the ovarian tissue and leading to ovulation. To elucidate the histaminergic influence on the ovarian vasculature, the mechanical response of the isolated rat ovarian artery to histamine and histamine agonists was investigated. Histamine relaxed the precontracted vessel segments in a concentration-dependent way, amounting to 82.7 +/- 4.3% of the papaverine-induced relaxation. This relaxant effect was counteracted by both the H1 antagonist, pyrilamine, and the H2 antagonist, cimetidine. That the effect of histamine was mediated by both histamine receptor subtypes was further confirmed by the relaxant effect produced in the presence of either of the H1-specific agonists, 2-pyridylethylamine and 2-methylhistamine on the one hand, and the H2-specific agonists, impromidine and 4-methylhistamine on the other. The H1 receptor-induced relaxation was mediated via an effect on the endothelium, whereas the H2 receptor-mediated relaxation was mostly a direct effect on the smooth musculature in the vessel wall. No major differences in the mechanical response of the rat ovarian artery were seen during the different stages of the estrous cycle, although at late proestrus, just before ovulation, the maximum relaxation induced by histamine was particularly high, in spite of a low sensitivity of the receptors for the amine.