[T-lymphocyte subgroups and the activity of human natural killer cells in non-Hodgkin lymphoma of moderate and high malignancy]

T-lymphocyte subgroups and the percentage and the activity of Human Natural Killer cells (HNK) were investigated by the authors in their 24 patients suffering with low grade and 24 with high grade malignancies of non-Hodgkin lymphoma (NHL). According to their observations, the ratio of CD3, CD4, Leu-7, and HNK cells as well as the release by HNK cells of 51Cr bound to target cells decreased, depending on the pathological stage. The tests were performed with monoclonal antibodies. A significant change could also be observed in the reactivity of bone marrow cells to monoclonal sera, which showed complete correspondence in character with the behavior of lymphocytes isolated from peripheral blood. No significant changes could be observed in the quantitative relations of immunoglobulins. Discussing the supposed immunological relation in detail, the role of plasma factor that reduces the formation of T-lymphocytes, is assumed to have primary importance in this phenomenon.

[Surgical complications in colorectal tumors]

Complications of elective surgery on 510 colo-rectal cancer patients are reported. Mortality rate of the operations was 4.9% and complications were observed in 10% of the cases. Intraoperative and early postoperative (10%) as well as late (8.6%) complications have been differentiated. Causes and possibilities for preventing complications are analyzed.

[Diagnosis and therapy of metastatic and recurrent colorectal tumors]

77 patients were treated by the authors because of recurrent or metastatic colorectal cancers. Follow-up protocol of elective surgery is discussed with respect to the two different types of surgery that is those performed because of colon and rectal cancer, respectively. The diagnostic and therapeutic principles as well as the results gained by the authors are discussed in details in case of the different types of recurrent and metastatic tumours (anastomotic recurrence, metachron tumour, local recurrence, hepatic, pulmonary, lymph node and osseal metastasis). In contrast to the previous principles a more active surgical therapy is advised by the authors in case of recurrence and metastases of colorectal cancers.

[The prevalence of disseminated sclerosis in the Carpathian region]

The authors investigated the incidence of multiple sclerosis in the Carpathian region. It is concluded on the basis of a statistical analysis that the incidence of multiple sclerosis in this region is influenced by environmental factors.

Urinary Escherichia coli infection presenting with jaundice

A 53-year-old man with lupus erythematosus (LE) developed an acute hemolytic crisis. Alpha-hemolytic Escherichia coli were isolated from the patient's urine and feces, and high titer anti-alpha-hemolytic antibodies appeared in his serum. The hemolytic crisis could be controlled by specific antibiotic treatment of the urinary tract infection. It is assumed that the patient's basic disease -- and the steroid therapy applied -- facilitated the progression of the urinary tract infection, and before starting with adequate antibiotic treatment his erythrocytes must have been subjected to the effect of massive amounts of alpha-hemolysin. The idea that alpha-hemolysin might contribute to the development of severe hemolysis in man is discussed. It is also assumed that harbouring alpha-hemolytic E. coli in the gut may represent a special risk for the immunocompromised host.

A new model for inducing transient cerebral ischemia and subsequent reperfusion in rabbits without craniectomy

An artificial ball removable by an attached fiber was injected into the middle cerebral artery (MCA) of 16 rabbits, allowing the study of transient (5, 10, 15, or 30 minutes) cerebral ischemia without craniectomy. Measurements of available oxygen (aO2) in the ischemic core (the ventral part of the temporal area) followed by histologic examination verified the embolization. Electroencephalographic power spectra and steady (direct current) potentials were recorded bilaterally on the convexity remote from the actual lesion but still supplied by the MCA. Local cerebral blood flow and aO2 in the border zone between the anterior cerebral artery and the occluded MCA were measured. Embolization caused typical ischemic changes ipsilaterally and alterations characteristic of diaschisis contralaterally. Extreme border zone hyperemia developed without significant aO2 changes in the same region. Restoration of circulation via the circle of Willis induced gradual normalization. Our model for controlled embolization and recirculation proved suitable for detailed studies of the complex changes in brain function caused by transient ischemia.

Akinetic mutism associated with bicingular lesions: clinicopathological and functional anatomical correlates

The clinical symptoms and neuropathological findings of three patients suffering from akinetic mutism were summarized. The patients showed almost absolute mutism and immobility and were unable to communicate in any way. The neurological signs varied from case to case. The pathological features common to all of the cases were bilateral lesions of the rostral part of the anterior cingulate gyri which overlapped onto the neighboring supplementary motor area, while differing as regards other damage. With the help of more recent neurobiochemical findings we tried to analyze the pathomechanism of akinetic mutism on the basis of the structures damaged. There seems to be an anatomic correspondence between the mesolimbocortical dopaminergic system and the circumscribed bilateral lesions of the medial prefrontal cortex. The study suggests that damage of the mesolimbocortical dopaminergic terminal fields in the anteromedial frontal cortex is essential for this specific type of akinetic mutism.

Cerebral ischaemia produced by homologous blood clot emboli in rabbit

In 40 rabbits cerebral ischaemia was induced by autologous blood clot emboli injected into the middle cerebral artery. Autologous blood clot formed spontaneously (within 2 h) in a catheter fixed in the internal carotid artery. The effects of embolization were investigated on arterial blood pressure, respiration, local cerebral blood flow, locally available O2 (aO2), steady (DC) potentials and EEG. After embolization the blood pressure and the frequency of respiration decreased transiently. On the embolized side the local cerebral blood flow, aO2, the frequency and amplitude of the EEG diminished markedly and the DC potentials shifted to negative. Similar but less marked and short-lasting changes could be seen on the contralateral side. Pathological examination of the brains revealed extensive infarction with haemorrhagic components. The technique is a promising method for inducing stroke experimentally and offers various ways for its thorough investigation.

Bronchial papillomas of various origins

There were five cases of solitary papillomas and three of chronic infectious papillomatosis induced by a foreign body, one caused by broncholithiasis. The five isolated papillomas had verrucous appearances. The common opinion, that the solitary papilloma is likely to be a pedunculary tumor, seems untrue. Squamous or cylindric epithelium covering the same tumor may vary from region to region. We believe that multiple polyps caused by inhalation of hot, burning, and corrosive gases are of inflammatory origin. Once the causative factor (eg, a late diagnosed foreign body) is removed, the inflammatory papillomatosis may resolve spontaneously. After the removal of a benign papilloma, recurrence is usually caused by lack of operative radicality rather than by malignancy. Laser technique and other coagulation methods make it possible to remove most tumors by performing bronchoscopy with only little risk. Papillomas showing the signs of atypia and peribronchial spreading require later surgery.

Anatomical patterns of hypoplastic posterior communicating arteries and their implications for cerebrovascular diseases

A total of 114 undersized posterior communicating arteries (PCoA-s, external diameter less than 1 mm) and 126 larger ones were investigated histologically. Microscopic examination of hypoplastic PCoA-s revealed five different structural patterns. Two of them showed microscopic appearances characteristic of intracranial arteries seen in adults or newborns without vascular disease. Two other types resembled the histologic picture of Moya Moya disease. The last type was thin-walled and dilated. All PCoA-s larger than 1 mm displayed the adult pattern. The PCoA-s with the Moya Moya-like structure and the thin-walled, dilated pattern contained unusually few reticular fibers. It is supposed that Moya Moya disease may be restricted to the PCoA-s. Further, the types of hypoplastic PCoA-s with reticular fiber deficiency are most probably the source of the so-called unexplained subarachnoid hemorrhage regardless of the presence of infundibular widening. The latter statement stems from the observation that the structure of junctional dilatation does not differ from that of other segments of the artery that exhibit this alteration.