Experience with uretero-neocystostomy in 338 kidney transplantations]

In 338 consecutive human kidney transplants since 1972 uretero-neocystostomy was performed in a typical manner. The technique is a modification of Leadbetter's ureterosigmoid anastomosis and it is used for all cases of ureteral reimplantation at our institution. The rate of operative complications belonging to the urinary tract is 4.8%. In 29% out of 31 reexamined patients a vesico-ureteral reflux to the transplant appeared. We believe that the demonstrated method is useful for reconstruction of the urinary tract in renal transplants.     

Expression of melanoma-associated antigens in rapidly dividing human melanocytes in culture

Conditions were established to induce rapid clonal growth of melanocytes from newborn foreskin. Surface antigen expression was analyzed using monoclonal antibodies derived by immunization of mice with melanoma cell, melanocyte, and placental membrane preparations. Unlike resting melanocytes in normal skin, cultured melanocytes expressed most major melanoma-associated antigens tested, e.g., nerve growth factor receptor, proteoglycan, transferrin-related Mr 97,000 protein antigen, Mr 120,000 protein, and gangliosides 9-O-acetyl GD3 and GD3. HLA-DR antigen and ganglioside GD2 were expressed at very low levels or not expressed. After several subpassages, most melanocyte cultures, including clones and melanocytes, initially sorted by rosetting with monoclonal antibody to nerve growth factor receptor, lost their characteristic bipolar morphology and expression of nerve growth factor receptor and Mr 97,000 antigen but continued to express high molecular weight proteins such as proteoglycan, Mr 130,000/105,000 and 120,000 antigen. The few melanocyte cultures that did maintain their characteristic bipolar to spindle morphology continued to express all melanoma-associated antigens and even began to express HLA-DR antigens. Melanocytes cultured in the presence of the phorbol ester 12-O-tetradecanoylphorbol-13-acetate also maintained their bipolar morphology, were often pigmented, and continued to express melanoma-associated antigens for several passages; they did not express HLA-DR antigen. Our studies indicate that rapidly proliferating melanocytes in culture undergo antigenic changes associated with malignancy.     

Molecular cloning of cDNA for the human tumor-associated antigen CO-029 and identification of related transmembrane antigens.

The human tumor-associated antigen CO-029 is a monoclonal antibody-defined cell surface glycoprotein of 27-34 kDa. By using the high-efficiency COS cell expression system, a full-length cDNA clone for CO-029 was isolated. When transiently expressed in COS cells, the cDNA clone directed the synthesis of an antigen reactive to monoclonal antibody CO-029 in mixed hemadsorption and immunoblot assays. Sequence analysis revealed that CO-029 belongs to a family of cell surface antigens that includes the melanoma-associated antigen ME491, the leukocyte cell surface antigen CD37, and the Sm23 antigen of the parasitic helminth Schistosoma mansoni. CO-029 and ME491 antigen expression and the effect of their corresponding monoclonal antibodies on cell growth were compared in human tumor cell lines of various histologic origins.     

Assessment of pretransplant prognosis in patients with cirrhosis

The objective of this prospective study was to assess the prognostic value of dynamic liver function tests and traditional methods of evaluating liver function in potential candidates for hepatic transplantation. Patients who underwent orthotopic liver transplantation within the follow-up period of 120 days were excluded. The study included 107 adult and 57 pediatric patients with cirrhosis. Postnecrotic cirrhosis was present in 107 and biliary cirrhosis in 57 of 164 patients. During the follow-up period, 26 of 164 patients died of their liver disease. At the time of inclusion, we recorded monoethylglycinexylidide (MEGX) formation from lidocaine, indocyanine green (ICG) half-life, bilirubin and albumin serum concentration, activity of cholinesterase and alkaline phosphatase, prothrombin time, the clinical complication of ascites, and--in adults--the Pugh score also. These variables were subjected as covariates to a survival analysis (Cox proportional hazards regression model) using separately the data from adults, pediatric patients, all patients with postnecrotic cirrhosis, and all patients with biliary cirrhosis. In all of these four subgroups there was a significant relationship between MEGX and ICG test results and the 120-day survival. In the stepwise analysis, none of the remaining parameters contributed to a further relevant improvement of our predictive ability when added to the values of ICG and MEGX. Our results suggest that the ICG and the MEGX test are superior to conventional liver function tests and the Pugh score in assessing short-term prognosis in cirrhotics independently from the etiology of the underlying liver disease. These findings may have important implications for determining the optimum timing of transplantation.     

Der Ca-K-Ionenantagonismus bei konstant gehaltenem Ca-K-Verhältnis untersucht an Herzfrequenz und Elektrokardiogramm

Zusammenfassung In etwa 120 Versuchen wurden die Wechselbeziehungen zwischen den Calcium- und Kaliumionen bei relativ gleichem Konzentrationsverhältnis in ihrer Wirkung auf die Frequenz, den Aktionsstrom und das Verhältnis zwischen Frequenz und Aktionsstrom geprüft.Auf Grund der Ergebnisse ist festzustellen, daß der Begriff Ionenantagonismus hinsichtlich einer Salzlösung nur für einen ganz bestimmten Konzentrationsbereich gilt, der vor allem nach oben begrenzt ist und nicht weit über den Ca-K-Spiegel der Ringerlösung hinausgeht. Im allgemeinen zeigt sich bei einem CaCl₂/KCl-Quotienten von 2 deutlich das Überwiegen der Wirkung des Kaliums. Dieses Überwiegen nimmt mit steigendem Ca-K-Gehalt in der Lösung zu. Nach kurzer Zeit, meist nach 1–3 Min. Einwirkungsdauer, verstärken sich die Wirkungen beider Ionen. Als deutliche Zeichen der toxischen Wirkung beider Ionen besonders bei höheren Konzentrationen nehmen Frequenz und Aktionsstromdauer sehr schnell ab.Bezüglich der Verwendbarkeit von Salzlösungen mit herabgesetztem Ca-K-Gehalt ist zu sagen, daß bereits geringere Mengen Calcium und Kalium als in der Ringerlösung vorhanden genügen, um das isolierte Herz lange lebensfähig zu erhalten.Mit 7 Textabbildungen     

First trimester prenatal diagnosis of congenital rubella: a laboratory investigation

Acute primary maternal infection with rubella virus during pregnancy often, but not invariably, leads to the congenital rubella syndrome. Diagnosis by detection of virus specific IgM in the mother is not always possible, and in those cases in which IgM is detected the fetus has not necessarily also been infected. A method for direct, prenatal detection of fetal infection would allow more accurate early diagnosis of congenital rubella syndrome. In this study a case of suspected preconception rubella infection that was not referred until 14 weeks after the appearance of a rash was studied to determine whether a retrospective serological diagnosis of primary rubella could be made, and whether direct evidence of fetal infection could be obtained from a chorionic villus biopsy specimen by detecting virus specific antigens or ribonucleic acid (RNA) sequences. Monoclonal antibodies and a cloned complementary deoxyribonucleic acid probe were used successfully to detect antigens to rubella virus antigens and RNA sequences in the chorionic villus biopsy specimen, which was taken at 15 weeks' gestation. This method should serve as a new approach to the diagnosis of congenital rubella syndrome in utero.