Einzelreferate und Buchbesprechungen

Ohne Zusammenfassung     

Über ausgleichende Vorgänge beim Absterben lebender Systeme

Zusammenfassung Es wird ein früher (1920) vom Verfasser aufgestelltes biologisches Prinzip genau formuliert, so daß dasselbe einer quantitativen, experimentellen Prüfung zugänglich ist. Das Prinzip beansprucht Allgemeingültigkeit für alle lebenden Systeme und nur für lebende Systeme.Am Beispiel des Konzentrationsausgleiches bei den absterbenden roten Blutkörperchen wird das Prinzip quantitativ geprüft und bestätigt.Der Verlauf des Diffusionsausgleiches der Ionen beweist, daß die Konzentrationsdifferenz außen und innen, nicht durch ein Donnansches Membrangleichgewicht bedingt wird, sondern das Resultat einer elektrochemischen Arbeit ist, die zur Aufladung der Membran dient.     

Die Nosologische Stellung der Akroparästhesien

Zusammenfassung Die bisher als einheitliche Krankheitsgruppe betrachteten Akroparästhesien sind in schärferer Weise als bisher in eine echt vasomotorische und eine rein sensible Form zu trennen. Letztere ist durch elektrische und mechanische Übererregbarkeit ausgezeichnet, während vasomotorische Erscheinungen fehlen. Sie steht symptomatologisch der Tetanie nahe; das Zustandekommen der Übererregbarkeit wird auf den physiologischen oder pathologischen Ausfall der Sexualdrüsen bezogen.     

Zur Logik und Psychologie des Okkultismus

Ohne Zusammenfassung     

Die periarteriellen Eisen- und Kalkinkrustationen in der Milz

Ohne ZusammenfassungMit 9 Textabbildungen.     

Die aus dem Studium Über die Chemische Blutbeschaffenheit bei Hautkrankheiten Sich für Dieselben Ergebenden Therapeutischen Richtlinien

Ohne Zusammenfassung     

Induction of immune tolerance in patients with hemophilia A and inhibitors treated with porcine VIIIC by home therapy

Home therapy with porcine factor VIIIC was safe and effective when administered to five hemophilic patients over periods of 8 1/2, 6, 4, 3 1/2, and 2 years. No significant transfusion reactions occurred. Before treatment with porcine factor VIIIC, all five had high-level, high- responding anti-human VIIIC inhibitors initially lacking anti-porcine factor VIIIC activity. Although specific anti-porcine VIIIC inhibitors arose in all patients, these were generally transient, and only one patient became refractory to treatment. We believe that porcine factor VIIIC is the treatment of choice in patients whose inhibitors do not cross-react. All five patients lost their original anti-human VIIIC inhibitors after starting treatment with porcine VIIIC, permitting the reintroduction of human VIIIC in three of them. There has been no recurrence of anti-human VIIIC inhibitor activity during 2 to 3 years of regular treatment with human VIIIC in these patients. This suggests that tolerance to human VIIIC has arisen as a result of treatment with porcine VIIIC. Porcine VIIIC may have a role in the desensitization of some factor VIIIC inhibitor patients.     

Management of emergencies in adults with congenital cardiac disease

The aim of the study was to assess the quantity and nature of emergencies affecting adults with congenital cardiac disease (CCD) and evaluate infrastructural requirements for adequate management. There is an increasing number of adults with CCD requiring specialized complex care. This multicenter study evaluated all emergency admissions to 1 of 5 centers for adults with CCD within 1 year. Within 1 year, there were 1,033 admissions of adults with CCD, and 201 (160 patients; age 16 to 71 years) were emergencies. Underlying cardiac anomalies were univentricular heart (22%), complete transposition (14%), tetralogy of Fallot (21%), and others (43%). Seventy percent of patients had undergone previous cardiac surgery. The main reason for acute admission was cardiovascular (arrhythmia, heart failure, syncope, aortic dissection, and endocarditis). Diagnostic procedures most often assigned were echocardiography (n = 223), chest x-ray (n = 95), Holter electrocardiography (n = 85), cardiac catheterization/electrophysiologic study (n = 39), and others (n = 143). Forty-six patients underwent surgery (cardiovascular n = 41, general n = 5) or electrophysiologic treatment (n = 41). One hundred twenty-six of 201 emergencies (63%) required cooperation with another specialized department: surgery (n = 46), internal medicine (n = 42), neurology (n = 12), ophthalmology (n = 6), otorhinolaryngology (n = 5), gynecology (n = 5), psychiatry (n = 4), radiology (n = 3), dermatology (n = 2), and orthopedics (n = 2). In conclusion, physicians and consultants attending adult patients with CCD need a high degree of specialized experience concerning the cardiac anomaly to manage emergencies properly. Furthermore, a wide range of noncardiac diagnostic and therapeutic procedures must be available. Data support the demand for a multidisciplinary approach in specialized centers for adequate care of adults with CCD.     

Rapid increase of bile salt secretion is associated with bile duct injury after human liver transplantation

BACKGROUND/AIMS: Biliary strictures are a serious cause of morbidity after liver transplantation. We have studied the role of altered bile composition as a mechanism of bile duct injury after human liver transplantation. METHODS: In 28 liver transplant recipients, bile samples were collected daily posttransplantation for determination of bile composition. Hepatic expression of bile transporters was studied before and after transplantation. Histopathological criteria as well as biliary concentrations of alkaline phosphatase (ALP) and gamma-glutamyltransferase (gamma-GT) were used to quantify bile duct injury. RESULTS: Early after transplantation, bile salt secretion increased more rapidly than phospholipid secretion, resulting in high biliary bile salt/phospholipid ratio (BA/PL). In parallel with this, mRNA levels of the bile salt transporters NTCP and BSEP increased significantly after transplantation, whereas phospholipid translocator MDR3 mRNA levels remained unchanged. Bile duct injury correlated significantly with bile salt secretion and was associated with a high biliary BA/PL ratio. CONCLUSIONS: Bile salt secretion after human liver transplantation recovers more rapidly than phospholipid secretion. This results in cytotoxic bile formation and correlates with bile duct injury. These findings suggest that endogenous bile salts have a role in the pathogenesis of bile duct injury after liver transplantation.