SPECIFIC AND NONSPECIFIC STRUCTURES DEVELOPING IN INFLAMMATORY RHEUMATIC DISEASES

The specific morphological substrate of rheumatic fever is the Aschoff's granuloma. However, the process may also take a purely exudative course, showing no morphological characteristics whatever. The clinical picture of primary chronic polyarthritis (PCP) is determined by the exudative processes taking place in the joints and in other mesodermic cavities. The inflammation is quite noncharacteristic from a morphological aspect. Contrary to this, necrotic foci with surrounding histiogenic palisade structure should be considered specific. The substrate of necrosis may be: tendon, synovial tissue, myocardium, or arterial wall. The special immunological conditions existing in such cases are marked by the rheumatic factor being always positive. Retrospectively, the muscle-aggressive form of rheumatic fever again gains in significance: here, morphological and immunological parallels seem to exist between rheumatic fever and PCP, two diseases that otherwise are entirely different from an etiological point of view. In either case, an auto-aggressive immuno-mechanism leads to local necrosis and to subsequent environmental reaction of exactly histogenous but different nature. While being only one out of many possibilities for the origination of capillary affection and exudation, the immuno-mechanism plays the leading part in the formation of primary tissue necrosis. This is why morphological specificity in similar immuno-mechanisms is dependent on the structure of the substrate affected in each particular case: Capillary defect means nonspecific exudation, tissue defect means specific necrosis.     

Untersuchungen am ermüdeten und gelähmten oberen Cervicalganglion

Zusammenfassung Nicotin und Cytisin heben schon in bemerkenswert kleinen Dosen (10 bzw. 2–5 /kg) die Ermüdung des Ganglion cervicale superius bei präganglionärer Dauerreizung teilweise auf.Auch die durch Cocain, Parpanit, My 301 und (in schwächerem Maße) durch Chinin verursachten Ganglien-Lähmungen lassen sich mit ähnlichen Dosen von Nicotin und Cytisin in begrenzter Weise antagonistisch beeinflussen. Gegen Tetraäthylammoniumbromid, Hexamethoniumbromid, Pendiomid, Arfonad sowie gegen Atropin, Banthin und Buscopan waren Nicotin und Cytisin unwirksam.Die mutmaßlichen Ursachen dieser unterschiedlichen Ansprechbarkeit gegenüber Nicotin werden diskutiert.Mit 3 Textabbildungen.     

Phosphoraufnahme von Plasmocytomund normalen Knochenmarkzellen in vitro

Ohne Zusammenfassung     

PATHOLOGICAL SYSTEM CONCEPT OF RHEUMATOID ARTHRITIS

Rheumatoid arthritis is a disease of the mesodermal germ layer. It is based on two totally different patho-mechanisms; a) an exudative-inflammatory process, and b) a primary necrosis of various mesodermal tissues. The exudative-inflammatory processes take place in the mesodermal spaces; the primary necrotizing processes occur in the interior of various mesodermal tissues. Whereas the lining cell tissue inflammation is non-characteristic, and the necrosis in rheumatoid arthritis can be taken as specific. The presence of the rheumatoid factor is optional in the lining cell tissue inflammatory processes; it is obligatory in necrosis.
Consequently, rheumatoid arthritis is a disease of the mesodermal germ layer which can occur at two levels. On the first level, the process takes place at the border of mesodermal spaces. On the second level, in which the rheumatic factor is obligatory, the process becomes more complicated, since various kinds of mesodermal tissue structures, including heart muscle and vascular walls, die initially. The clinical picture of rheumatoid arthritis is thereafter characterized by the visceral processes.     

Synovial tissue levels in comparison with synovial fluid and serum concentrations following a single daily administration of 20 mg piroxicam (Felden)

Serum, synovial fluid and synovial tissue was taken from a total of 25 patients of both sexes on whom a synovectomy had been performed, after a 1, 3, 5, 6 or 7 day treatment with a daily administration of 20 mg Piroxicam (5 patients in each group) and the concentration of Piroxicam (Felden) determined. Parallel to this a part of the synovial tissue taken was histologically examined and classified. The analytical results presented here show that in the mean appr. 33% of the Piroxicam passed from the serum into the synovia, appr. 26% into the non or partially florid synovial tissue and appr. 32% into the florid or highly florid synovial tissue. Felden 20 (Piroxicam) thus fulfills the requirement of a good acting, non-steroidal, antiinflammatory substance (NSAID), namely of being available at the location of the inflammatory process.     

Cochlear Implantation in Patients with Chronic Otitis: Indications for Subtotal Petrosectomy and Obliteration of the Middle Ear

Normally, active chronic suppurative otitis media is regarded as a contraindication for cochlear implantation. In case of a radical cavity after surgical treatment for cholesteatoma, the electrode covered by the epithelial lining of the mastoid will likely become exposed or extruded. Under these circumstances we suggest the subtotal petrosectomy, obliteration of the middle ear cleft with abdominal fat, and the blindsac closure of the external ear canal before cochlear implantation.

Fourteen patients with chronic otitis media were successfully implanted with an intracochlear multichannel cochlear implant. After an average follow-up of 28 months a temporary facial palsy in one patient and an insufficient closure of a retroauricular fistula over the mastoid cavity in two cases were observed as postoperative complications. One patient with a tumefactive inflammatory pseudotumor developed a massive inflammation in the implanted ear 2 months after surgery which could not be controlled by conservative treatment. The implant had to be removed and after administration of cyclophosphamide she could be successfully reimplanted 7 months later.

Implantation of a foreign body in a potentially infected space which communicates with the endocranium means a surgical challenge which can be managed by obliteration of the middle ear. In case of massive inflammation we prefer a two-stage procedure.

     

Multimerization: Association and aggregation, 14. Distinction between open and closed associations

Open and closed molecule-based associations with experimentally incompletely accessible concentration dependencies of the apparent molecular weights can be distinguished by plotting the apparent weight average molecular weight, (M_w)_app, versus the inverse apparent number average molecular weight, (M_n). For closed associations, straight lines are observed for theta-systems and concave ones for non-theta-systems of associating rods. Open associations in these cases give convex lines for both, theta and non-theta-systems. Loops can be expected for both types of associations for non-theta-systems at high concentrations. A similar plot can be based on apparent z and weight average molecular weights.     

Inhibition of interleukin 3 function by a fragment of the third component of complement

A C3d-like (C3d-1) fragment of 33 kDa was isolated and its biological activity studied. The fragment was generated from guinea pig C3b by porcine pancreas kallikrein and purified by fast protein liquid chromatography. The C3d-like fragment inhibited interleukin (IL) 2-dependent T lymphocyte proliferation. The suppressive activity of the described C3d-1 fragment was not restricted to lymphocytes as targets but inhibited in addition the proliferation of a nonlymphocyte mast cell line which was strictly IL3-dependent in its proliferative capacity. Kinetic studies implied early stages of cellular proliferation to be influenced. Furthermore, the C3d-1 fragment was not only an inhibitor of cellular proliferation but was also a potent inducer of leukocytosis.     

Voltage-gated calcium channels are not involved in generation and propagation of spreading depression (SD) in the brainstem of immature rats

Spreading depression (SD) can be elicited in the brainstem of rats younger than 13 days when excitability is enhanced by acetate superfusion [F. Richter, S. Rupprecht, A. Lehmenkühler, H.-G. Schaible, Spreading depression can be elicited in brain stem in immature but not adult rats, J. Neurophysiol. 90 (2003) 2163--2170]. To investigate whether voltage-gated calcium channels (VGCCs) modify initiation and propagation of SD in this type of tissue, we applied specific blockers to L-, T-, P/Q-, and N-type VGCCs locally or systemically. SD-related d.c. potentials and concomitant increases in extracellular potassium concentration ([K(+)](e)) were unaffected by the L- and T-type VGCC blocker flunarizine that was applied either systemically (up to 2mg/kg body weight) or by superfusion onto the brainstem (40 microM). In addition, local application of the P/Q-type VGCC blocker omega-agatoxin (1 microM) or of the N-type VGCC blocker omega-conotoxin (1 microM) to the brainstem surface did not influence SD. The results indicate that VGCCs do not modify the generation or propagation of SDs in the brainstem of the immature rat. Blockade of N-type VGCCs disturbed the normal breathing rhythm. Application of alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) (250-1000 microM) that elicited SD in the immature cortex, failed to elicit SD in the immature brainstem. In summary, it is likely that K(+) initiates and propagates brainstem SDs.