Evaluation of the Role of Fcγ and Complement Receptors in the Decreased Phagocytosis of Hereditary Haemochromatosis Patients

Hereditary haemochromatosis (HH) monocytes have a decreased antibody mediated phagocytosis of rabbit erythrocytes and Staphylococcus aureus compared to control monocytes. In order to investigate whether this decrease could be attributed to a different level of expression of Fcγ receptors (FcγR) or complement receptors (CR), which cooperate even in the absence of complement, the surface expression of these receptors was determined on monocyte-enriched suspensions. In contrast to what was expected, HH monocytes displayed a significantly higher level of FcγRI and FcγRIIa as compared to healthy donor monocytes, but these differences were very small. The expression of the other receptors studied were similar for both groups. The heat-inactivated mouse serum used for opsonizing the erythrocytes mainly contained mouse IgG1. Two genetically different forms of FcγRIIa are known, each with a different affinity for mouse IgG1 antibodies. Therefore, the FcγRIIa polymorphism in monocytes (MN) of both groups was also investigated. A similar distribution was found for patients and healthy donors. In addition, the extent of erythrophagocytosis of both donors and patients was independent of FcγRIIa allotype. Our results indicate that the altered phagocytosis by HH monocytes cannot be attributed to a different level of expression of receptors involved in phagocytosis or to FcγRIIa polymorphism.     

Andrology: Transrectal electroejaculation in combination with in-vitro fertilization: an effective treatment of anejaculatory infertility after testicular cancer

Treatment of non-seminomatous testicular cancer often leadsto infertility due to anejaculation/retrograde ejaculation andpoor sperm quality. In these men spermatozoa may be obtainedby transrectal electroejaculation (TE), but the optimal strategyfor assisted procreation in these couples is not known. Ouraim was to examine whether TE and conventional in-vitro fertilization(IVF) would be successful. A total of 10 couples, with long-standinginfertility due to anejaculation or retrograde ejaculation aftertreatment for testicular cancer 5–14 years earlier, werereferred to our unit. All men underwent diagnostic TE undergeneral anaesthesia. Spermatozoa were recovered in nine cases.The antegrade fraction was prepared and used for IVF. Spermquality was variable and conventional IVF was considered impossiblein three cases. Altogether six IVF treatment cycles in six couplesresulted in five pregnancies, of which four resulted in a deliveryand one resulted in a spontaneous abortion. One additional pregnancyis ongoing after transfer of cryopreserved embryos. The fertilizationrate was 54% (33/61) and the cleavage rate was 97% (32/33).No complications relating to the procedure have been encountered.     

The “Biplanar” forehead lift

A new technique of forehead rhytidectomy is presented that combines the best features of the coronal incision with those of the anterior hairline incision. The plane of dissection is formed by an anterior subcutaneous plane dissecting a lateral subgaleal plane. This approach is particularly valuable in patients with high foreheads, severe static wrinkling, and asymmetrical eyebrows.Presented in part at the Annual Meeting of the American Society of Aesthetic Plastic Surgeons, Boston, MA, 1984     

Pyloromyotomy of Ramstedt: experience of a nonspecialized centre

In a general hospital over a period of 6 years 57 infants with congenital hypertrophic stenosis underwent a Ramstedt pylorotomy. In most cases a surgical resident-in-training performed the operation under the direct supervision of a general surgeon. There were no complications of anesthesia, no deaths and no substantial morbidity. The majority of infants left the hospital within 48 hours. The results in this series compared favourably with those reported from more specialized centres.     

Organization of gallbladder lithotripsy with the MPL-9000 at the Zurich university hospital. Initial results

Gallstone shock wave therapy at the University Hospital of Zurich is a joint venture between the Medical Clinic, Medical Policlinic and Surgical Clinic. Patients with symptomatic cholecystolithiasis willing to submit themselves to a long period of treatment, were accepted for ESWL, should no contraindications be present. From October 1988 through May 1989 we treated 48 patients. In approximately two thirds of our patients we were successful with one ESWL alone, in one third 2 sessions and in two patients even 3 sessions were needed. In 42 patients course after therapy was as planned. Six had to be cholecystectomized later on. Best results were achieved in patients with single gallstones. In 2 of 5 cases there was disagreement between the number of gallstones found sonographically and the intraoperative findings. Histologic examination of gallbladders after ESWL showed no pathologic changes.     

The glycosaminoglycans of the gubernaculum during testicular descent in the fetus

Tissues were obtained from 387 male pig fetuses ranging from 60 to 120 days of gestation. The relative wet mass and water content of the gubernaculum increased during and decreased after the period of testicular descent. The extracellular glycosaminoglycans (GAG) were assayed to determine whether these polyanionic macromolecules are responsible for the increased water content of the gubernaculum. The total GAG/wet tissue mass in the gubernaculum decreased during and increased after descent, while the total GAG/dry mass decreased during and after descent, indicating an accumulation of water during descent, with a loss of water and an increase in less hydrated tissue components after descent. The major GAG fraction in the gubernaculum was dermatan sulfate, but the percentage hyaluronate in the gubernaculum was two times higher than in striated muscle or umbilical cord, indicating that this GAG fraction may be responsible for the increased water content of the gubernaculum, which probably serves to dilate the inguinal canal and scrotum, thus facilitating descent.     

The fate of the remaining bladder following supravesical diversion

A retrospective study of 30 adults who underwent supravesical diversion for a variety of benign and malignant conditions was done with special attention to the fate of the residual bladder. Diversion was performed for diverse conditions, including radiation cystitis, cyclophosphamide cystitis, interstitial cystitis, incontinence and trauma. All groups experienced significant morbidity from the remaining in situ bladder. Over-all, 80% of the patients experienced at least 1 complication, chief among which were pyocystis (67%), hemorrhage (23%), severe pain (13%), and unremitting feelings of incomplete emptying and spasm (17%). Complications of sufficient severity to require rehospitalization occurred in 43% of the patients. Several patients required multiple rehospitalizations. Reoperation requiring general or regional anesthesia was necessary in 9 patients (30%) and included 4 cystectomies. Serious consideration should be given to performing primary cystectomy at the time of supravesical diversion in any patient in whom subsequent undiversion is not anticipated.     

Microbiological and immunological indicators in patients with acute cholecystitis

The causative agents of acute destructive cholecystitis and wound complications are various pyogenic bacteria including staphylococci, enterococci, Escherichia, Proteus, and anaerobes among which certain varieties, serogroups, and phagocytes predominate. Most bacteria, with the exception of anaerobes, are resistant to penicillin, streptomycin, and chlortetracycline but retain sensitivity to antibiotics of the neomycin series and other chemotherapeutic agents. In most patients with phlegmonous cholecystitis specific antibodies accumulated in the blood during the disease irrespective of one another, while the intensity of their increase was determined by the duration of treatment and the patients' age. The dynamics of changes of the specific antibody titres may confirm the etiology of cholecystitis and be an indirect sign of the prognosis of the disease.