Die homologe Transplantation des Ureters

Zusammenfassung Gekreuzte homologe Transplantationsversuche am Kaninchen, die das überleben eines von Niere und Blase getrennten denudierten Ureters nach Einhüllen in das gro?e Netz zum Ziel hatten, verliefen nach Vorbehandlung mit Spenderantigen, Thioamphenicol und Kortikosteroiden und Weiterbehandlung mit Azathioprin durch 4 Wochen erfolgreich.

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Summary Homologous transplantation of the ureter of the rabbit were carried out to investigate survival of the ureters separated from the kidney and the bladder and wrapped into the omentum majus. Transplantations were successful in animals pretreated with donor antigen, Thioamphenicol and corticosteroids and receiving postoperative Azathioprin medication.

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Auszugsweise vorgetragen auf der 17. Tagung der ?sterreichischen Gesellschaft für Chirurgie, Salzburg, 27. bis 29. Mai 1976.     

Der Wert der bakteriologischen Untersuchung von Redon-Drainspitzen bei der Erkennung post-operativer Wundinfektionen in der Traumatologie

Zusammenfassung Bericht über bakteriologische Untersuchungen von 100 Redon-Drainspitzen, die nach 100 aseptischen Operationen auf dem Gebiet der Traumatologie durchgeführt wurden. Keimbefall war in 13 F?llen (13%) nachweisbar. Es trat keine Wundheilungsst?rung oder Infektion auf. Das positive Bakteriogramm von Redon-Drainspitzen berechtigt nicht zur Annahme einer Wundinfektion und erm?glich keine spezifische antibiotische Therapie.

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Summary 100 tips of removed Redon-suction-drainage-tubes were examined bacteriologically, following 100 aseptic operations. Germs were found in 13 cases (13 per cent). In none of these 100 successive patients wound healing was disturbed, no infection was seen. Therefore a positive bacteriogram obtained from the tips of removed Redon-tubes is neither evidence for a wound infection nor an indicator for a specific antibiotic treatment.

     

Chirurgische Eingriffe bei Schrittmacherträgern

Zusammenfassung Es wird über 6 Patienten mit totalem Herzblock berichtet, bei welchen nach einer Schrittmacherimplantation ein allgemeinchirurgischer Eingriff ausgeführt wurde. An Hand der eigenen F?lle wird auf die Problematik solcher Eingriffe eingegangen.

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Summary A report is given about 6 patients carrying implanted pacemakers for complete heartblock, who had to undergo different major surgical procedures. The problems involved are discussed.

     

Posttransplant adenoviral enteropathy in patients with small bowel transplantation

Transplant patients on immunosuppression represent a risk group for opportunistic infections, including adenoviral infections. The clinical and histopathologic findings of posttransplant adenoviral enteropathy in 3 adult intestinal transplant patients are described. The histopathologic pitfalls for the differential diagnosis between intestinal adenoviral enteropathy and acute rejection are discussed. Adenoviral enteropathy is an opportunistic infection that may follow aggressive treatment for small bowel allograft rejection, but which may require no specific treatment. It is associated with mild mixed inflammation in the lamina propria and slight increase of crypt apoptosis, resembling low-grade acute rejection. The identification of characteristic viral inclusions in the surface or crypt epithelium points to the diagnosis of adenoviral enteropathy, in spite of the increased crypt apoptosis.     

Antidiabetic and haematological effect of aqueous extract of stem bark of Afzelia africana (Smith) on streptozotocin-induced diabetic Wistar rats

Objective

To investigate the antidiabetic properties of aqueous extract of stem bark of Afzelia africana (A. africana) and its beneficial effect on haematological parameters in streptozotocin induced diabetic rats.

Methods

A total of 30 rats including 24 diabetic and 6 normal rats were used for this study. Diabetes was induced in male Wistar rats by intraperitoneal injection of streptozotocin. After being confirmed diabetic, animals were orally treated with distilled water or extracts at 100 or 200 mg/kg body weight daily for 10 days. The haematological parameters including red blood and white blood cells and their functional indices were evaluated in diabetic treated groups compared with the controls.

Results

The extract significantly reduced the blood glucose levels while the best result was obtained at 200 mg/kg body weight. The feed and water intake in diabetic rats were significantly reduced while weight loss was minimized at both dosages. Similarly, the levels of red blood, white blood cells and their functional indices were significantly improved after extract administration at both doses.

Conclusions

It can be concluded that the aqueous extract of bark of A. africana possesses antihyperglycemic properties. In addition, the extract can prevent various complications of diabetes and improve some haematological parameters. Further experimental investigation is needed to exploit its relevant therapeutic effect to substantiate its ethnomedicinal usage.     

Distinct mechanisms of action of anti‐CD154 in early versus late treatment of murine lupus nephritis

Objective

Treatment with anti‐CD154 antibody is known to ameliorate murine lupus nephritis when given early in the disease. The aims of this study were to identify the mechanism of this early effect, to determine whether late anti‐CD154 treatment could halt established nephritis, and, if so, to examine potential mechanisms of late efficacy.

Methods

We studied the effects of anti‐CD154 treatment on autoantibody production and immune complex deposition, renal pathology, survival, and renal cytokine and chemokine messenger RNA (mRNA) expression both in (NZB × NZW)F₁ mice (BW mice) and in NZM.2410 mice.

Results

Early treatment with anti‐CD154 produced long‐term survival in BW mice, with abrogation of renal immune complex deposition for months after treatment was stopped. Late anti‐CD154 treatment, started after development of nephritis, could halt disease in ∼40% of mice. In some mice, proteinuria could be reversed repeatedly with sequential courses of anti‐CD154 antibody. The remissions induced by late treatment with anti‐CD154 occurred despite ongoing renal immune complex deposition. In preliminary studies, responding mice had rapid reductions in renal mRNA for transforming growth factor β, interleukin‐10, and tumor necrosis factor α.

Conclusion

Amelioration of murine lupus by anti‐CD154 therapy is mediated by distinct mechanisms in early versus late intervention. We postulate that anti‐CD154 therapy prevents autoantibody production and renal immune complex deposition in the early, induction phase and limits secondary tissue damage in situ in the late, effector phase. These data demonstrate that CD40–CD154 interactions are critical for the maintenance of autoimmunity and suggest a potential role for anti‐CD154 as a therapeutic agent in established human lupus.

     

Protease inhibitors partially overcome the interferon nonresponse phenotype in patients with chronic hepatitis C

The outcome of triple therapy with protease inhibitors (PI) depends on the intrinsic response to interferon. Interferon‐stimulated gene (ISG) expression differs by cell type in the liver and is a strong predictor of interferon responsiveness. Patients who respond well to interferon have low/absent ISG expression in hepatocytes but significant ISG expression in macrophages. Nonresponders (NRs) show the opposite pattern. We aimed to determine the association between cell‐type‐specific ISG staining and treatment outcome with PI‐based triple therapy. Liver biopsy tissue from consecutive patients treated with boceprevir or telaprevir with peginterferon and ribavirin was stained for myxovirus A (MxA). Staining was scored 0–3 in macrophages (M‐MxA) and hepatocytes (H‐MxA), and IL28B genotyping was performed. Of 56 patients included 41 achieved SVR (73%) (sustained virological response), 2 (4%) relapsed, 10 (18%) were NRs, and 3 (5%) were lost to follow‐up. Median M‐MxA staining was stronger and H‐MxA staining was weaker in patients who achieved SVR. MxA staining correlated with IL28B genotype and with the HCV RNA decline during lead‐in phase. However, unlike with dual therapy, the negative predictive value (NPV) of absent or weak M‐MxA staining was poor (42%), while the positive predictive value improved (93%). Although by multivariable logistic regression M‐MxA staining was significantly associated with SVR (OR 4.35, 1.32–14.28, P = 0.012), the predictive ability was inadequate to withhold therapy. The interaction between macrophages and hepatocytes plays a critical role in interferon responsiveness; however, the addition of a PI at least partially overcomes the interferon nonresponse phenotype making the predictive ability of ISG staining less clinically useful.