Preparation of cells from pig gastric mucosa

Cells were isolated from pig gastric mucosa by a combination of mechanical and enzymatic treatment. Isopycnic centrifugation on linear density gradients of Percoll provided a simple and rapid procedure for obtaining highly enriched parietal cells and chief cells. Their densities were 1.06 and 1.10 g/ml, respectively. Isolated mucosal cells attached to Petri dishes coated with fibronectin or collagen. Both parietal cells and chief cells adhered more readily to fibronectin than collagen. Mucosal cells and cells from the Percoll gradients were maintained for up to one week as primary cell cultures. The ability of free parietal cells to produce acid was tested by the ¹⁴C-aminopyrine accumulation technique. Maximal accumulation was 2.5 pmol aminopyrine per 10⁴ parietal cells after incubation for 45 min at 10^-4 M histamine. The EC₅₀ for histamine was 5times10^-6 M.The accumulation of aminopyrine at 10^-6 M carbachol and 10^-7 M pentagastrin were for both secretagogues about 0.9 pmol per 10⁴ parietal cells.     

A Prospective Study of HL-A Antigen Phenotypes and Lymphocyte Abnormalities in Hodgkin's Disease

In a prospective study, sixty-five histologically verified Swedish cases of Hodgkin's disease were HL-A typed. The antigen frequencies in the patient group did not deviate from a group of normal controls. The frequency of HL-A8 was slightly increased in patients over 40 years ( P < 0.05). HL-A12 was markedly increased in patients below 40 years with a favourable histopathology ( P < 0.001). No association between sex or clinical stage and distribution of HL-A phenotypes was observed.
The number of T-lymphocytes in blood and the spontaneous DNA synthesis and DNA synthesis induced by concanavalin A, pokeweed mitogen, phytohemagglutinin and PPD antigen in blood lymphocytes in vitro were determined in 60 patients. A significant increase of HL-A28 was noted in patients with advanced disease ( P < 0.01) and in patients responding poorly to PPD ( P < 0.001) and PWM ( P < 0.01). No correlation between HL-A antigen distribution and T-lymphocyte counts was observed.     

INTRAPROSTATIC TEMPERATURE MONITORING DURING TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA

Purpose

We evaluated whether the results of transurethral microwave thermotherapy improve using high intraprostatic temperature of 55C or greater.

Materials and Methods

We accrued 30 men 58 to 85 years old (mean age 69) from the waiting list for transurethral prostatic resection in whom maximum urinary flow was less than 13 ml. per second and Madsen score was greater than 8. According to the Abrams-Griffith nomogram all but 1 patient had obstruction. Before treatment 3 thin temperature probes, each containing 5 sensors in a row, were introduced into the prostate from the perineum and positioned using transurethral ultrasound guidance. The microwave power of the transurethral microwave thermotherapy equipment was set based on the actual temperature in the prostatic tissue. A temperature of at least 55C and often more than 60C was reached at the hottest spot. Treatment duration was 1 hour. Postoperatively an indwelling catheter remained in place for 2 weeks. Patients were followed for 6 months with the first followup after 3 months.

Results

At the 3-month followup mean maximum urinary flow had increased from 7.4 to 12.5 ml. per second and the mean Madsen score had decreased from 12.6 to 2.9. At the 6-month followup mean maximum urinary flow was 12.2 ml. per second and the mean Madsen score was 3.4. Using pressure-flow data we divided the patients into responders and nonresponders. In the 18 responders maximum urinary flow had increased from 7.2 to 14.6 ml. per second (103%), the Madsen score had decreased from 12.5 to 1.4 (89%) and detrusor pressure had decreased from 9.2 to 6 kPa. (35%).

Conclusions

High energy transurethral microwave thermotherapy relieved bladder outlet obstruction in 60% of the patients and had a good effect on symptoms. Compared with a previous multicenter study with 40% responders, using the same criteria there were 60% responders in our series. Our results indicate that better control of intraprostatic temperature provides better results, approaching those after transurethral prostatic resection.     

THE TREATMENT OF INTERSTITIAL CYSTITIS WITH SUPRATRIGONAL CYSTECTOMY AND ILEOCYSTOPLASTY: DIFFERENCE IN OUTCOME BETWEEN CLASSIC AND NONULCER DISEASE

Purpose

Interstitial cystitis is a chronic debilitating condition that mainly affects women. Accumulated evidence indicates that interstitial cystitis is a heterogeneous syndrome. The nonulcer type seems to respond less favorably to various conservative treatments than the classic type. Supratrigonal cystectomy with ileocystoplasty is established treatment for interstitial cystitis refractory to conservative treatment. We evaluate whether classic interstitial cystitis responds differently than nonulcer disease to subtotal bladder resection and ileocystoplasty.

Materials and Methods

We evaluated 13 patients 27 to 79 years old with interstitial cystitis who underwent supratrigonal cystectomy and ileocystoplasty due to failure to respond to conservative treatment.

Results

In all 10 patients with classic interstitial cystitis symptoms were relieved after ileocystoplasty. In the 3 patients with nonulcer interstitial cystitis pain remained, while the frequency of voiding somewhat decreased. In these patients trigonal resection and urinary diversion with a Kock pouch resolved the symptoms.

Conclusions

Our study confirms that supratrigonal cystectomy with ileocystoplasty results in a good outcome in classic interstitial cystitis. However, this method seems to be unsuitable for nonulcer disease. Identification of the relevant subtype of interstitial cystitis is of crucial importance for selecting the appropriate method of lower urinary tract reconstruction.     

Global Repolarization Sequence of the Ventricular Endocardium: Monophasic Action Potential Mapping in Swine and Humans

The aim of this study was to evaluate the global sequence of repolarization over the ventricular endocardium. Disturbances in myocardial repolarization are associated with the genesis of arrhythmias. However, little is known about the global sequence of repolarization. Monophasic action potentials (MAPs) were recordedfrom 61 +/- 18 LV and/or RV sites in ten healthy pigs and from 43 +/- 15 LV or RV sites in eight patients using the CARTO system. Local activation time (AT), end-of-repolarization (EOR) time, and MAP duration were calculated and three-dimensional global maps of AT, EOR, and MAP duration constructed. LV maps were obtained from all ten pigs and RV maps from three pigs. Five RV maps and five LV maps were obtained from the eight patients. (1) EOR sequence was recognizable in 12 of 13 pig maps and in all the patient maps. (2) EOR followed the sequence of activation in 12 of 13 pig maps and 8 of 10 patient maps. (3) The longest MAPs were recorded in or near the earliest activation area, and the shortest ones in or near the latest activation area in all the pig maps and in nine often and eight often patient maps, respectively. (4) In all maps, MAP duration and AT were negatively correlated, and EOR and AT positively correlated. In conclusion, repolarization gradients exist over the pig and the human ventricular endocardium. The activation sequence is a determinant for the repolarization sequence. The magnitude of the progressive MAP shortening with progressively later activation, relative to local AT, is a critical factor governing the direction and pattern of the EOR.     

Neutrophil migration in tonsils

Recent studies have indicated the existence of an active cellular defence in the secretion on the tonsillar surface. This defence seems to consist partly of physiologically active neutrophils and is present in health and during disease. The present study was undertaken to examine the migration of these neutrophils to the secretion on the mucosal surface. Tonsils from 6 patients with acute tonsillitis and 5 patients with snoring problems were removed and sectioned. Sections were stained immunohistochemically against CD15 to visualise neutrophils. Other sections were stained with acridine orange to detect bacteria. Clusters of neutrophils were frequently seen in tonsils both from patients with acute tonsillitis and from snorers. They were observed to be accumulated within the tonsillar epithelial layer. Streaks of neutrophils could be observed running not only from vessels mainly near or within the epithelium to the epithelial surface, but also from vessels far from the epithelium through the extrafollicular areas to the epithelial surface. Bacteria were not present in the epithelium. We consider that the findings indicate an active physiological migration of neutrophils to the tonsillar surface.     

Prevalence,phenotypic and genetic characteristics of prolyliminopeptidase‐negative Neisseria gonorrhoeae isolates in Sweden during 2000–2007

Johansson E, Fredlund H, Unemo M. Prevalence, phenotypic and genetic characteristics of prolyliminopeptidase‐negative Neisseria gonorrhoeae isolates in Sweden during 2000–2007. APMIS 2009; 117: 900–4. In Neisseria gonorrhoeae culture diagnostics, species confirmation is commonly performed using commercial biochemical tests relying on prolyliminopeptidase (PIP) activity. It was previously shown that one PIP‐negative strain was mainly globally transmitted during 2000–2004. The aims were to investigate the prevalence and phenotypic and genetic characteristics of PIP‐negative N. gonorrhoeae isolates in Sweden during 2000–2007. Gonococcal isolates (n = 1230) cultured in Sweden during 2000–2007 were characterized using PIP screening, antibiogram, serovar determination, pip and porB gene sequencing, and N. gonorrhoeae multiantigen sequence typing (NG‐MAST). Fifteen (1.2%) of the isolates were PIP‐negative. Of those, 13 (87%) were indistinguishable to the previously described globally transmitted strain, i.e. displayed serovar IB‐4 (Bpyvut), similar antibiograms, ST210 (n = 10)/ST292 (n = 3) and contained an identical single nucleotide pip gene deletion. Wherever high reliance is placed on PIP activity for N. gonorrhoeae species confirmation, changes in the diagnostic strategies may need to be considered and/or monitoring of the PIP activity is crucial.     

Health-state utilities in a general population in relation to age, gender and socioeconomic factors

Background: This study examined health-related quality of lifein a general population in relation to different socioeconomicvariables. Method: The study was cross-sectional and was conductedin Uppsala county, Sweden, which had approximately 290,000 inhabitantsin 1995. The study was based on a self-administered postal questionnairesent to a random sample of 8,000 inhabitants aged 20–84years, with a response rate of 68%. Health-related quality oflife was measured on a 0 (dead) to 1 (full health) cardinalscale by two methods used to measure health-state utilitiesin economic evaluations, i.e. the rating scale method and thetime trade-off method. Results: The mean age was 46 years andapproximately 54% were women. Almost 70% were married or cohabitors.Approxiamtely 33% of the respondents had less than high-schooleducation and 26% had a university degree. The mean income wasSEK 13,000 per month and the proportion unemployed was 4.5%.The proportions of blue-collar workers, white-collar workersand self-employed were 40, 50 and 10% respectively. With therating scale method, the mean health-state utility decreasedfrom 0.86 in the youngest age group (20–29 years) to 0.63(80–years) in the oldest age group and from 0.94 to 0.61with the time trade-off method. Quality of life increased withincome, education and social group and decreased with beingsingle and unemployed. Conclusion: These methods are usefulin assessing health-related quality of life in the general populationand that quality of life varies substantially among differentsodoeconomic groups.     

IMPERFORATE ANAL MEMBRANE - THE ANATOMY AND FUNCTION OF THE SPHINCTERS OF THE ANAL CANAL*

An undamaged specimen of an imperforate anal membrane, including the rectum, anal canal and its sphincters became available for serial histological sections. The membrane was diaphanous, the internal, and the external sphincters were defective, but the puborectalis muscle though modified by the deformity, was well developed. In living patients, the rectal continence which ensues on division of the membrane is effective because of the presence of an efficient puborectalis muscle.     

Adsorption of tuberculin to glass

Dilutions of the purified tuberculin RT 19-21 (Statens Seruminstitut, Copenhagen) have been found to be subject to unsystematic variations in potency. Preliminary investigations suggested that adsorption of tuberculin on to the container might be the cause. This possibility has been further explored in a series of experiments on guinea-pigs that is reported in the present paper.