[Rapidly progressing glomerulonephritis. Microangiitis associated with antibodies against the glomerula membrane]

A 53 year old man first presented with a mild anti-neutrophil cytoplasmic antibody (ANCA), type (MPO-ANCA) associated microscopic polyangiitis. Approximately one year later, he presented with fatigue, fever, cough, sore muscles and erythrocyturia. At admission he was uraemic. Kidney biopsy showed in LM extracapillary glomerulonephritis and in immunofluorescence microscopy linear deposition of IgG along the glomerular basement membrane (GBM). MPO-ANCA was still positive, but antibodies against GBM were now also present. Retrospective analysis revealed the presence of anti-GBM antibodies nine months before clinical illness. Pr3-ANCA (C-ANCA) was negative during the whole course. In spite of decreasing anti-GBM antibody levels during treatment, his condition aggravated, and he died from complications. Thus, coexisting anti-GBM antibodies may explain suddenly deteriorating renal function in patients with ANCA associated vasculitis.

[Technique of induced abortion, abrasion and vacuum extraction. Clinical trial of Ambu Twin Pump 1000]

Ambu Twin Pump 1000 is a suction pump designed for pharyngeal and tracheal suction in emergency situations. The pump can be operated by foot or by hand. The object of this test was to evaluate the applicability of the pump in performing legal abortion (before 13th. week), suction curettage and vacuum extraction, in places where electricity is not available; thus especially for use in Third World countries. The evaluation of the pump concerned the suction capacity, the stability on the support and finally ease of dismantling and cleaning. It is concluded that Ambu Twin Pump 1000 are easy to use and has sufficient suction capacity for the mentioned purposes. For induced abortion the pump was provided with a 200 ml reservoir for cleaning purposes.

Multinucleated stromal giant cells of the uterine cervix

A prospective clinicopathological study including 100 consecutive hysterectomies and 100 consecutive cone specimens to investigate the frequency and pathogenesis of multinucleated stromal giant cells (SGCs) in the uterine cervix is presented. Sections containing SGCs were analyzed by immunohistochemical methods for the presence of cytokeratin, S-100 protein, factor VIII, desmin, muramidase, alpha 1-antichymotrypsin, and vimentin. Tissue for electron microscopy was punched out of four paraffin blocks from four different cases. SGCs were not found in patients < 30 years old, but their incidence increased with age until the sixth decade, at which time they were found in 42% of patients. We found at the same time that the incidence of SGCs declines in the seventh decade. SGCs were not related to any inflammatory or granulomatous lesion, and their presence was independent of other clinical parameters, such as hormonal therapy, history of trauma on the uterine cervix, pregnancy, or parity in general. Immunohistochemical and ultrastructural analyses support the concept of a fibroblastic-histiocytic origin of SGCs. SGCs in the uterine cervix may reflect a physiological tissue reaction during the transition from the fertile to the postmenopausal state.