Blinded, Externally Controlled Multicenter Evaluation of Light Microscopy and PCR for Detection of Microsporidia in Stool Specimens

The quality parameters for the detection of microsporidia in identical sets of 50 stool samples were determined for six laboratories where technicians used light microscopy and for six laboratories where technicians used PCR. The average overall sensitivities were 67% (89% for patient samples only) for the PCR laboratories and 54% (80% for patient samples only) for the light microscopy laboratories. Specificities were 98 and 95%, respectively. Differences in results were most apparent between the individual laboratories rather than between the two major methods used.     

Tumor Vascularity Is Not a Prognostic Factor for Malignant Melanoma of the Skin

Tumor vascularity has been proposed as a prognostic indicator for a number of solid tumors. Although a correlation between microvessel number and metastatic behavior has also been suggested for cutaneous melanoma, the small number of cases studied to date allows one to draw only preliminary conclusions. In this study, we have assessed tumor vascularity in cutaneous melanoma by comparing 60 cases of metastasizing and non-metastasizing tumors matched for tumor thickness, age, sex, and anatomic site. Ulex europaeus agglutinin I appeared to be the most suitable vascular marker for this study. Our results indicate that there was no statistically significant difference between the two groups with regard to tumor vascularity. Even after identifying 15 cases of thin (<1.0 mm thick) melanoma, there was no significant difference in the number of microvessels between metastasizing and non-metastasizing tumors. Comparison of patterns of vascular microarchitecture also failed to discriminate between the two groups. Thus, our results indicate that tumor vascularity may not be an independent prognostic factor for cutaneous melanoma.     

Effect of amiloride on electrolyte concentrations and rubidium uptake in principal and mitochondria-rich cells of frog skin

The role of mitochondria-rich cells (MR cells) in transepithelial Na transport was investigated by determining electrolyte concentrations and Rb uptake in individual cells of frog skin epithelium using electron microprobe analysis. Measurements were performed under control conditions and after blocking the transepithelial Na transport with amiloride. Under control conditions, Na and Cl concentrations of MR cells scattered much more than those of principal cells and ranged from a few up to more than 30 mmol/kg wet weight. Rb uptake from the basal side into individual MR cells also showed a large variation and was, on the average, much less pronounced than into the principal cells. In principal cells, amiloride reduced the Na concentration and Rb accumulation. In contrast, no effect was observed upon electrolyte concentration and Rb uptake of MR cells. Rb uptake was correlated to the Na concentration of MR cells both under control conditions and after amiloride. It is concluded that, in contrast to the principal cells, MR cells are not involved in amiloride-sensitive transepithelial Na transport and that their Na/K-pump activity is very low.     

Die durch Argas (Persicargas) persicus-Larven bedingte Paralyse der Hühner

Zusammenfassung Bei der durch Argas (Persicargas) persicus-Larven bedingten Zeckenparalyse der Hühner handelt es sich um eine generalisierte Affektion des peripheren Nervensystems, wobei es zu einer funktionellen Schädigung der schnell leitenden Nervenfasern kommt.Bei 12 Tieren mit schwersten Paralysen waren die maximalen motorischen Nervenleitungsgeschwindigkeiten, bei gleichzeitig erforderlicher Erhöhung der motorischen Schwellen- bzw. Supramaximalreize, auf 55% herabgesetzt sowie die Reizantwortpotentiale aus der distalen Muskulatur auf 15–30% abgefallen. Die distalen Überleitungszeiten verlängerten sich dabei nur geringfügig. Bei repetitiver distaler Nervenreizung kam es zu einem deutlichen Amplitudenabfall. 3 Tage nach klinischer Restitution hatten sich die neurophysiologischen Veränderungen noch nicht zurückgebildet.Bei 8 Tieren mit mittelgradigen Paresen war die Schädigung des peripheren Nervensystems nicht so stark ausgeprägt. Die maximalen motorischen Nervenleitungsgeschwindigkeiten waren nur auf 70% vermindert, während die motorischen Schwellen- und Supramaximalreize leicht erhöht waren. Die Werte für die Amplituden der Summenpotentiale waren im Vergleich mit den schwerst gelähmten Tieren bedeutend größer, die distalen Latenzzeiten blieben dagegen unverändert. Bei repetitiver Nervenreizung verminderten sich die Amplituden der Antwortpotentiale nur geringfügig. 3 Tage nach der klinischen Rekonvaleszenz waren bei allen Tieren die neurophysiologischen Veränderungen, bis auf eine noch bestehende Verminderung der Summenpotentiale, wieder völlig zurückgebildet.

---

Tick paralysis in chickens caused by Argas (Persicargas) persicus-Larvae

Summary In tick paralysis caused by Argas (Persicargas) persicus-larvae a generalized affection of peripheral nervous system especially of fast conducting nerve fibres was found.In 12 animals with severe paralysis maximal motor conduction velocity slowed down to 55% of the initial value and the amplitudes of evoked compound muscle action potentials decreased to 15–30% of the initial value. Simultaneously motor threshold resp. supramaximal stimuli to the nerves were increased. Distal latencies changed only a little. By repetitive distal nerve stimulation muscle action potential amplitudes showed a decrement. Three days after clinical restitution neurophysiologically an affection of peripheral nerves to a small extent could be shown. The affection of peripheral nerves in 8 animals with moderate pareses was less pronounced. The reduction of motor conduction velocity went down only to 70% of the initial value whereas threshold and supramaximal stimuli were only slightly increased. There were in comparison with the severe paralyzed animals higher amplitudes of evoked compound muscle action potentials. Distal latencies remained unchanged. By repetitive nerve stimulation only a small decrement of muscle action potential amplitudes could be stated. Three days after clinical restitution neurophysiologically only a slight reduction of the amplitudes of the evoked muscle action potentials could be measured.

     

Plasmareninaktivität nach Orthostase und nach Diazoxid bei primärer und renaler Hypertonie

Zusammenfassung 1. Nach Blutdrucksenkung durch schnelle intravenöse Injektion vonDiazoxid kommt es bei 35% der Kranken mit primärem Hochdruck zu einem Anstieg der Plasmareninaktivität. Das Ausbleiben des Reninanstiegs bei der Mehrzahl der fortgeschrittenen primären Hypertonie wird, ebenso wie die abgeschwächte Stimulierbarkeit der Reninsekretion durch Natriummangel, auf eine (adaptiv) verminderte Empfindlichkeit der intrarenalen Receptoren zurückgeführt. Die Blutdrucksenkung durch Diazoxid ist bei positiv und negativ reagierenden Kranken gleich groß.2. Nach einer definiertenOrthostase von 60 min Dauer bei 70° Schräglagerung fehlt ein Plasmareninanstieg bei 63% der untersuchten Patienten mit primärer Hypertonie, wofür ebenfalls eine herabgesetzte Ansprechbarkeit intrarenaler Receptoren verantwortlich gemacht werden muß. Eine Orthostase-negative Reaktion wird ebenso wie eine solche nach Diazoxid häufiger bei primärer Hypertonie in einem fortgeschrittenem, aber auch schon in einem frühen Stadium beobachtet, in dem der Plasmareninanstieg auf Natriumentzug noch intakt ist.3. Die Reninsekretion verhält sich beiprimärer Hypertonie nach Diazoxid, Orthostase und Natriumentzug nicht übereinstimmend, was für die Existenz verschiedener intrarenaler Mechanismen spricht, die die Reninfreisetzung im iuxtaglomerulären Apparat beeinflussen. Patinten mitrenalem Hochdruck weisen dagegen ein übereinstimmendes positives oder negatives Verhalten der Reninsekretion nach Diazoxid und nach Orthostase auf.4. Für diedifferentialdiagnostische Abgrenzung einer funktionell wirksamen Nierenarterienstenose von einer primären Hypertonie ist weder der Diazoxidtest noch — ohne gleichzeitigen Natriumentzug — in der durchgeführten Versuchsanordnung der Orthostasetest geeignet. Zum Nachweis einer funktionell wirksamen Nierenarterienstenose empfiehlt sich die getrennte Plasmareninbestimmung in den Nierenvenen oder als Suchmethode die Doppelstimulation durch 3tägigen Natriumentzug und Orthostase am letzten Tag der Natriumrestriktion.

---

Summary 1. After blood pressure reduction by rapid intravenous injection of diazoxide plasma renin activity is increased in 35% of primary hypertension. The absence of plasma renin increase in the majority of advanced primary hypertension is explained by an (adaptive) diminished sensibility of the intrarenal receptors. The reduction of blood pressure is equal in diazoxide responsive and unresponsive patients.2. A plasma renin increase failed in 63% of primary hypertension after upright posture by tilting to 70° for 60 minutes. This result is also explained by a diminished sensibility of the intrarenal receptors for renin secretion. An unresponsive reaction to upright posture and diazoxide is more frequent in advanced primary hypertension, but is observed also in an early stage, in which plasma renin stimulation by sodium deficiency is maintained.3. The stimulation of the renin secretion in primary hypertension is not equal after upright posture, diazoxide and sodium restriction supporting the existence of several intrarenal mechanism controlling the iuxtaglomerular apparatus. In renal hypertension on the contrary, there is a corresponding positive or negative reaction of renin secretion after diazoxide and upright posture.4. For the differential diagnosis of a functional renal artery stenosis neither the diazoxide test nor — without sodium restriction — the orthostase test is suitable. For the evidence of the functional significance of a renal artery stenosis the separated estimation of plasma renin activity in both renal veins or as a sreening test the double stimulation by sodium restriction for 3 days and upright posture is recommended.

     

T-cell-mediated autoimmunity: novel techniques to characterize autoreactive T-cell receptors

Histological samples of autopsy or biopsy tissue provide the best available evidence that autoreactive T cells are involved in the immunopathogenesis of many autoimmune diseases. However, morphology alone does not provide information on the antigen-specific T-cell receptor (TCR) of these cells, let alone on their antigen specificity. In this review article we discuss a number of emerging possibilities for identifying TCR sequences directly from biopsy tissue. We also review the methods for expressing presumably autoreactive TCR molecules and speculate on how the expressed TCR might be used to identify target antigens. Such information should eventually provide new insights into disease pathogenesis which lead to better therapies.     

Serum-induced chronic pancreatitis

Summary Clinical research into patients with idiopathic chronic pancreatitis points to a possible immunopathogenetic process in a number of cases.In order to examine the behaviour between the exocrine pancreas under the influence of anti-rat-pancreas immune serum produced in rabbits, a 1.00 ml immune serum is administered once a week over a maximum 26 week period into Wistar-rats by intraperitoneal injection. By electrone-microscopy a much reduced production of enzymes apparently takes place, though to differing extent. There is also destruction of the basal membrane of acinocytes; the production of interstitial oedema, the new formation of collagen fibres and the proliferation of connective tissue cells. Under a conventional light microscope the first changes become noticeable after 8-12 weeks of study. These take the form of localised cell decay, deterioration and lysis of acinocytes; and an increasing non-specific inflammation. There is also the new formation of connective tissue. After 20–26 weeks the exocrine pancreas is characterised by reduction of parenchyma, acino-ductal metaplasia, chronic inflammatory infiltrates of differing density, fibrous and irregular calibres of the smaller and larger ducts.The findings are almost identical to the structural changes of chronic idiopathic pancreatitis in human beings. The results support the view of an immuno-pathologic aetiology for human chronic idiopathic pancreatitis.Supported by Deutsche Forschungsgemeinschaft     

The Resistance of Certain Tissues to Invasion: Penetrability of Explanted Tissues by Vascularized Mesenchyme

If puppy tissues are explanted onto the chick chorioallantoic membrane, those tissues which normally have a blood supply are rapidly invaded by vascularized mesenchyme of host origin. Hyaline cartilage, a tissue virtually devoid of blood vessels, is impenetrable by proliferating mesenchyme of the host, while calcified cartilage, which normally is vascularized, is penetrable. The stroma of the cornea, another normally avascular tissue, is readily penetrable, but Descemet's membrane forms a barrier to invasion by host tissues. The experimental system used permits the design of experiments in which the study of factors responsible for the resistance of tissues such as cartilage to invasion can be undertaken.