[Immune status in a case of thyroid gland sarcoidosis--selected parameters]

On the basis of a case of sarcoidosis and the thyroid gland selected immunological parameters were examined and they were compared with the findings in pulmonary sarcoidosis. While the examination of the immunoglobulins in the present case did not show any characteristic changes, in the examination of the cellular immunity the hyporeactivity of the peripheral lymphocytes typical for the pulmonary sarcoidosis was found. The inclusion of immunological parameters is an enlargement of the possibilities for the differential diagnostic clarification of granulomatous inflammations of the thyroid gland.

[Experimental bone replacement with resorbable calcium phosphate ceramic (author's transl)]

Compact cylindrical implants (5 x 15.5 mm) of seven calcium phosphate ceramics of different formulations that had been implanted for 6 weeks without fixation in the tibia of dogs were examined histologically. The tissue compatibility of the implant turned out to be dependent on the mineralogical and chemical composition of the material: the ceramic material was biocompatible at a CaO/P2O5 ratio between 2:1 and 4:1, the optimum ratio being about 3:1 (tricalcium phosphate). In addition, cylindrical tetracalcium phosphate implatns with an entirely porous structure were implanted in the same manner. After 6 months, they were resorbed to a minor extent. Implants of different calcium phosphate mixtures, on the other hand, were resorbed to a large extend after the same time. The ceramic material was replaced by mineralised bone tissue which had formed directly on the ceramic implant as well as within the pores. There were no foreign body reactions. Investigations with segment-shaped implants which were implanted in the tibia of dogs and fixed with AO-plates or splints extra-cutaneously for about 8-10 weeks, provided information abouth the maximum stress that can be borne by the implants. While implants with a porosity of 75 percent did not sustain the stress after the fixation had been removed, those with a porosity of 45 percent could be subjected to physiological stress after removal of the splints.

[Possibilities of the immunological in vitro-diagnostic in nonspecific lung diseases (author's transl)]

Immunological in vitro-methods can be used in the improved diagnostic of nonspecific lung diseases. A short review is given about the recommended tests in the diagnostic of the four types of immunological reactions responsible for allergic disorders of the lungs (IgE-mediated immediate-reaction, cytotoxic-reaction, Arthus-reaction and cell-mediated hypersensitivity), the alpha1-antitrypsin deficiency and the immunological defence in the bronchial mucosa.

[Quantitative determination of alpha1-antitrypsin in lung tissue from adults with emphysema and newborns with respiratory-distress-syndrome (author's transl)]

In a small number of patients, lung emphysema can be attributed to a remarkable deficiency of alpha1-antitrypsin. Concentrations reduced about 50% of the normal value represent a predisposing factor. In most cases of newborns with respiratory-distress-syndrome the concentration of alpha1-antitrypsin is decreased. Its determination can be used for the early diagnosis of the respiratory-distress-syndrome.

Nephropathy associated with sickle cell anemia: an autologous immune complex nephritis. II. Clinicopathologic study of seven patients

A variety of renal structural and functional abnormalities have been associated with sickle cell disease. To define the relationship between the hemoglobinopathy and glomerular disease, clinicopathologic correlations, renal morphologic, ultrastructural immunohistologic and functional studies were performed on seven patients with clinical and laboratory evidence of glomerular disease. In addition, immunologic studies including isolation and characterization of cryoprecipitable immune complexes, and determination of immunoglobulin, total complement and complement component levels, and antibody titers to several antigens were performed in an attempt to define the etiologic and pathogenic mechanisms of the renal disease and its relationship to sickle cell anemia. Proteinuria was presnet in all patients. The nephrotic syndrome, hypertension, hematuria and renal insufficiency were found in more than one half the patients. All patients had membranoproliferative glomerulonephritis of varying degree; glomerular basement membrane splitting, electron dense deposits in the glomerulus; interstitial fibrosis, tubular atrophy and hemosiderin deposits were frequent. Immunoglobulin complement components (classif complement pathway) and renal tubular epithelial antigen were distributed in a granular pattern along the glomerular basement membranes of all patients studied by these methods. Cyroprecipitable complexes of renal tubular epithelial antigen-antibody to renal tubular epithelial antigen as well as antibody to renal epithelial antigen were detected in the circulation of some patients. There was no serologic evidence of activation of the alternate complement pathway. These studies demonstrated an immune deposit normocomplementemic nephritis associated with sickle cell anemia; they further support our hypothesis that the relationship is more then coincidental, and is mediated by glomerular deposition of immune complexes of renal tubular epithelial antigen-antibody to renal tubular epithelial antigen, the antigen possibly released after tubular damage secondary to oxygenation and hemodynamic alterations related to sickle cell disease.

[The relationships between left ventricular volumes and ejection fraction in mitral and aortic regurgitation (author's transl)]

In 2 groups of patients with mitral valvular incompetence (MI, n equals 20) and aortic valvular incompetence (AI, n equals 22) intracardiac pressures as well as left ventricular volumes (enddiastolic volume, endsystolic volume, stroke volume, ejection fraction, regurgitant volume) were determined during routine left heart catheterization and left ventriculography. Data obtained were compared with a normal group (N, n equals 20). 1. Enddiastolic volume was increased by 32 per cent (MI) and 180 per cent (AI) respectively in comparison to normal. Endsystolic volume was increased by 85 per cent (MI) and 113 per cent (AI). Total stroke volume exhibited increases by 11 per cent (MI) and 86 per cent (AI) respectively. Regurgitant volume averaged 64 per cent (AI) of total stroke volume, and 47 per cent in MI. Left ventricular ejection fraction was reduced in both groups by about 12-14 per cent. 2. enddiastolic volume was significantly dependent on the amount of regurgitant volume in both groups (MI, AI). Likewise total stroke volume increased with increments in enddiastolic volume. This increase was far mor pronounced (up to 250 per cent of normal) in AI in comparison to MI and may be referred to an effective contribution of the Frank-Starling-Straub-mechanism, induced by increased preload following regurgitation. There existed no correlation between enddiastolic volume or regurgitant volume and the effective forward stroke volume and other parameters of forward pump function (effective cardiac output, cardiac index, external cardiac work). Left ventricular compliance, as determined by diastolic pressure-volume relationships, was nearly the same in the 3 groups (N, MI, AI). 3. Left ventricular ejection fraction was nearly unchanged with increments in enddiastolic volume over a range of enddiastolic volumes up to 400 ml. At higher enddiastolic volume (is greater than 400 ml) decreases were found. In the failing heart with AI left ventricular ejection fraction was reduced even at low enddiastolic volume, exerted by decreases of fibre shortening and contractility. In contrast, in MI ejection fraction decreased with increments of enddiastolic volume over the whole range investigated. The increase in total stroke volume in both groups therefore was produced by increases of enddiastolic volume and to a very small extent by an increase of the ejection fraction. 4. The large contractility reserve in compensated AI may be referred to the altered contraction mechanism in aortic valvular regurgitation associated with i) decrese of isovolumic pressure development and increase of isotonic contraction, ii) increase of diastolic fibre stretch (preload) and iii) decrease of mean wall tension. Contractility reserve was essentially influenced by myocardial contractility. With decreases of contractility consecutively decreases of the total and the effective pump function of the left ventricle may occur despite unchanged contraction form and left ventricular dimensions.

[Hemodynamics, left ventricular volumes and compliance in 167 patients with congenital and acquired heart disease (author's transl)]

In 167 patients with congenital and acquired heart disease (ventricular septum defect (VSD), atrial septum defect (ASD), mitral stenosis (MS), mitral insufficiency (MI), combined mitral stenosis and insufficiency (MV) aortic stenosis (AS), aortic insufficiency (AI), combined aortic stenosis and insufficiency (AV), idiopathic hypertrophic subaortic stenosis (HOK) hemodynamic measures (arterial pressure, right and left heart pressures, cardiac output, cardiac index, stroke volume, cardiac work), left ventricular volumes (endiastolic volume, endsystolic volume, ejection fraction, regurgitant flow) and diastolic pressure-volume relationships (on the basis of diastolic pressure-volume changes) were determined during routine right and left heart catheterization and left ventriculography. 1...

Transrectal needle method for biopsy of the prostate: review of 90 cases

Eighty-three patients undergoing a total of 90 transrectal procedures for obtaining prostatic tissue for biopsy were reported. All were done without preparation or later use of retention catheter. Tetracycline was administered for two or three days before the procedure and continued for a total of five days after. Most patients were hospitalized for this procedure, but we do not think this is necessary or ideal. A complication rate of 9.3 per cent-5.4 per cent for sepsis and 3.9 per cent hematuria-was encountered. Only four false negative results were obtained. We believe that the transrectal procedure is a safe and accurate method for diagnosis carcinoma of the prostate. We would also recommend use of a broad-spectrum antibiotic, preferably before and after operation, but at least after for a minimum of five days.

Transformation of Montmorillonite to Kaolinite during Weathering

Extensive deposits of kaolinite in Florida are formed by transformation of montmorillonite during low-temperature supergene weathering. The transformation occurs by intracrystalline leaching of interlayer cations and tetrahedral silica layers. Interposition of stripped layers within montmorillonite creates a regular 1:1 mixedlayered montmorillonite-kaolinite, a new clay structure. Kaolin-like layers are nourished by lateral epitaxy, as the iron-rich montmorillonite decomposes. Hexagonal outgrowths of new kaolinite develop at the edges of montmorillonite flakes and nucleate new vertical growth. Kaolinitic sands impregnated with goethite are ultimately formed, and the released silica enriches groundwater and forms secondary chert.