Ninth International Histocompatibility pre-workshop testing of Dw6 HTCs. Two subtypes of Dw6

In the scope of the cellular part of the 9th International Histocompatibility Workshop, the offered homozygous typing cells (HTCs) of several specificities have been screened in a pre-Workshop. In Leiden and Seattle all HTCs typing for "HLA-Dw6" have been tested. This implied that in both laboratories mixed lymphocyte culture (MLC) matrices were performed between the Dw6 HTCs and that all HTCs were tested as stimulator cells against a panel of heterozygous responder cells. The results clearly demonstrated that "HLA-Dw6" as defined by the different participating laboratories can be split into two major groups, Dw6.a and Dw6.b. This observation confirms and extends previous reports. None of the 9th Workshop B-cell sera could discriminate between the two presently described subgroups of HLA-Dw6.     

The effect of a live vaccine on the horizontal transmission of Mycoplasma gallisepticum.

The effect of a live Mycoplasma gallisepticum vaccine on the horizontal transmission of this Mycoplasma species was quantified in an experimental animal transmission model in specific pathogen free White Layers. Two identical trials were performed, each consisting of two experimental groups and one control group. The experimental groups each consisted of 20 birds 21 weeks of age, which were housed following a pair-wise design. One group was vaccinated twice with a commercially available live attenuated M. gallisepticum vaccine, while the other group was not vaccinated. Each pair of the experimental group consisted of a challenged chicken (10(4) colony-forming units intratracheally) and a susceptible in-contact bird. The control group consisted of 10 twice-vaccinated birds housed in pairs and five individually housed non-vaccinated birds. The infection was monitored by serology, culture and quantitative polymerase chain reaction. The vaccine strain and the challenge strain were distinguished by a specific polymerase chain reaction and by random amplified polymorphic DNA analysis. In both experiments, all non-vaccinated challenged chickens and their in-contact 'partners' became infected with M. gallisepticum. In the vaccinated challenged and corresponding in-contact birds, a total of 19 and 13 chickens, respectively, became infected with M. gallisepticum. Analysis of the M. gallisepticum shedding patterns showed a significant effect of vaccination on the shedding levels of the vaccinated in-contact chickens. Moreover, the Cox Proportional Hazard analysis indicated that the rate of M. gallisepticum transmission from challenged to in-contact birds in the vaccinated group was 0.356 times that of the non-vaccinated group. In addition, the overall estimate of R (the average number of secondary cases infected by one typical infectious case) of the vaccinated group (R = 4.3, 95% confidence interval = 1.6 to 49.9) was significantly lower than that of the non-vaccinated group (R = infinity, 95% confidence interval = 9.9 to infinity). However, the overall estimate of R in the vaccinated group still exceeded 1, which indicates that the effect of the vaccination on the horizontal transmission M. gallisepticum is insufficient to stop its spread under these experimental conditions.     

Effect of prostaglandin E2 and 3-morpholinosydnonimine (SIN-1) on arachidonic acid metabolism in fMLP-stimulated rat neutrophils and on thrombin-induced human platelet aggregation

The effects of prostaglandin (PG) E₂ and the nitric oxide (NO) donor SIN-1 on leukotriene (LT) release from formyl-methionyl-leucyl-phenylalanine (fMLP) (100 nM)-stimulated rat peritoneal neutrophils (RPN) and on thrombin-induced aggregation of washed human platelets were investigated. Both PGE₂ (1–100 nM) and SIN-1 (30–300 M) inhibited release of LTB₄ and cysteinyl-LT from RPN in a concentration-dependent manner. The combined effects of PGE₂ and SIN-1 were not greater than expected by summation. On the other hand, the inhibitory effect of SIN-1 (0.5 or 1.0 M) on platelet aggregation was potentiated by PGE₂ (0.3–5 M) in a concentration-dependent manner, while PGE₂ alone in the concentrations used had only marginal effects. The results suggest differential regulation of platelet and leukocyte functions by the mediators PGE₂ and NO, which could be relevant for various physiological and pathophysiological conditions.     

Endokrin aktive Tumoren des Ovars

Zusammenfassung Die wichtigsten Vertreter der hormonal aktiven Ovarialtumoren sind in der Gruppe der Keimstrang-Stromatumoren zusammengefasst. Sie machen weniger als 5% der Ovarialgeschwülste aus. Die Mehrzahl der Keimstrang-Stromatumoren besitzt die Fähigkeit zur Biosynthese von Steroidhormonen. Die pathologische Hormonbildung bewirkt spezifische Effekte an den hormonsensitiven Organen. Die klinischen Befunde sind abhängig von Art und Intensität der Hormonproduktion und vom Lebensalter der Patientin. In der Dignität stehen die Keimstrang-Stromatumoren als fakultativ maligne Geschwülste zwischen den nichtinvasiven (Borderline-) und den invasiven epithelialen Tumoren des Ovars. Neben den speziellen zur Hormonbiosynthese befähigten Ovarialgeschwülsten (Keimstrang-Stromatumoren, Steroidzelltumoren) können benigne und maligne Ovarialtumoren verschiedenen Typs aufgrund einer Vermehrung und/oder Stimulation von nicht-neoplastischen Zellen im Ovarialstroma endokrine (östrogene oder androgene) Aktivität aufweisen.

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261. Lavage oder Ultraschall beim stumpfen Bauchtrauma

Zusammenfassung 453 Patienten mit nachgewiesenem oder vermutetem stumpfen Bauchtrauma wurden geschallt. In 71% wurde kein pathologischer Befund, in 11% eine freie Blutung, in 8% eine retroperitoneale Blutung and in 7% eine Organeinblutung gefunden. In 2% fand sich eine Thoraxverletzung bzw. einmal eine Herzbeuteltamponade. Bei 111 Patienten erfolgte zusätzlich die Lavagierung. Bei einer Prävalenz von 37% and Spezifit von 97% betrug die Sensitivität für den Ultraschall 88% and für die Lavage 93%.     

Anastomotic insufficiency in small bowel surgery —incidence and treatment

Summary In the period 1977–1981 234 small bowel anastomoses were constructed in 143 patients. Eight anastomoses showed leakage (3.4%) and from nine anastomoses a fistula developed (3.8%): a total rate of disturbed healing of small bowel anastomoses (7.3%). In the presence of intra-abdominal infection this rate was 14.8%, in the absence of infection 0.8%. The results of treatment with oversewing and with resection and immediate anastomosis were disappointing. Better results were obtained by dismantling of the anastomosis, establishment of a split-enterostomy and reestablishment of continuity in a second stage. Mortality was 3/17 (18%). The literature is reviewed.

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Insuffizienz von Dünndarmanastomosen — Ineidenz und Therapie

Zusammenfassung In dem Zeitraum 1977–1981 wurden bei 143 Patienten 234 Dünndarmanastomosen angelegt. Acht Anastomosen zeigten eine Nahtleckage (3,4%), bei neun entwickelte sich eine Fistel (3,8%): die Gesamthäufigkeit von Wundheilungsstörungen bei Dünndarmanastomosen war 7,3%. Bei gleichzeitigem Vorliegen intraabdominaler Infektionen betrug die Häufigkeit 14,8%, ohne diese 0,8%. Die Resultate einer Therapie durch Übernähung oder Resektion mit sofort anschließender Reanastomosierung waren enttäuschend. Befriedigendere Ergebnisse wurden durch Aufheben der Anastomosen, Anlage einer split enterostomy unter Wiederherstellung der Kontinuität in einer zweiten Sitzung erzielt. Die Mortalität betrug 3/17 (18%). Ein Literaturüberblick wird gegeben.

     

173. Gibt es bakteriologische Diagnosekriterien des perforierten Gastroduodenalulcus?

Zusammenfassung Die entscheidenden Kriterien für die Prognose einer Ulcusperforation sind Alter, die Zeitdauer bis zur operativen Versorgung sowie das Geschlecht der Patienten. In der eigenen Klinik wurden von 1974 bis 1985 85 Patienten versorgt. Dies erfolgte mit der Tendenz zum kleinstmöglichen Eingriff. Eine synchrone definitive Operation der jeweiligen Ulcuskrankheit war die Ausnahme. In einer seit 1981 durchgeführten prospektiven Studie wurden Keimart, Keimzahl, Zellzahl, pH-Wert sowie der Nachweis von Toxinen untersucht. Es ergab sich keine Relation zur Letalität des Einzelfalles.     

Correction to: How to support dental students in reading radiographs: effects of a gaze‑based compare‑and‑contrast intervention

Advances in Health Sciences Education -     

Role of x-ray computed tomography in the preoperative evaluation of aneurysm of the abdominal aorta

The authors have studied the files of 50 consecutive patients (1987-89) operated for abdominal aortic aneurysm (AAA) and examined with CT. The criteria for inclusion were surgical features. CT can be made more accurate for the study of AAA: Thus the location of the neck of the aneurysm relative to the renal arteries was defined in 94% of all cases. In addition, CT yields information about the wall of the aneurysm, whether it be thickened (3 inflammatory aneurysms were properly diagnosed) or, mor importantly, weakened (solution of continuity in the wall in the "prior-to-rupture" appearance). Owing to the quality of its performances and to its noninvasive character, the authors regard CT with contrast injection as an essential technique for the preoperative assessment of abdominal aortic aneurysm in most cases. The examination must be carried out strictly, especially for the contiguous sections of the renal arteries and their extension to the crural arch. As it demonstrates weakened areas more easily, a more accurate study of the aneurysmal wall with CT might increase the surgical indications for some smaller aneurysms, the potential evolution of which does not seem to be associated with their diameter only.