Intracoronary thrombolysis: Organizational prerequisites,technique, and results

Reestablishing myocardial perfusion during evolving myocardial infarction may limit the ultimate extent of infarction if viable myocardial tissue is present when recanalization of the occluded vessel is achieved. This will result in improved left ventricular function and decreased mortality. In addition to their therapeutic benefits, recanalization procedures have contributed greatly to our knowledge of acute myocardial infarction. It has been demonstrated that myocardial infarction most often occurs after thrombotic occlusion of a coronary artery. This has settled a controversy that has preoccupied cardiologists for decades. Selective intracoronary administration of fibrinolytic agents is followed by recanalization in approximately 80% of cases. Therapeutic failures are attributable to occlusion caused by other factors, to inactivation of streptokinase by high antibody concentrations, and to insufficient concentrations of streptokinase at the thrombus as a results of unfavorable flow conditions. This study is dedicated to Prof. Dr. Med. Horst Schmutzler on the occasion of his 60th birthday.     

Alteration in the pattern of macrophage subtypes in chronic osteomyelitis compared with acute joint infection

Summary Macrophage subtypes were detected in cryostat sections of biopsies from patients with chronic osteomyelitis, acute joint infections and normal bone marrow, using monoclonal antibodies against different macrophage populations. The resident macrophage subtype 25F9, the glucocorticoid-inducible macrophage RM 3/1 and the inflammatory type 27E10 were found in abundance in acute infections. They were also present in tissue sections of uninflamed bone marrow. By contrast, in about 50% of the biopsies from patients with chronic osteomyelitis a reduced number of macrophage subtypes, or even the lack of one or more macrophage subpopulations was found. The unusual absence of macrophage phenotypes seems to be restricted to the area of osteomyelitis because in the tissues of inflamed sinuses in these patients, the macrophage subtypes were present. These findings suggest a disturbance at the level of the macrophages which may contribute to the persistence of the inflammatory process in osteomyelitis.

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Résumé L'utilisation d'anticorps monoclonaux contre différentes sous-populations de macrophages a permis de mettre en évidence, à l'examen de coupes cryostatiques, des sous-types de macrophages. Ces derniers ont été retrouvés dans les moelles osseuses normales comme dans les biopsies provenant de malades atteints d'ostéomyélite chronique et d'arthrite aiguë. Le sous-type résident 25F9, le macrophage glycocorticoïde inductible RM 3/1 et le sous-type inflammatoire 27E10 ont été trouvés en abondance dans les infections aiguës. Ils étaient également présents dans des coupes de moelle osseuse non inflammatoire. Inversement dans près de 50% des cas le nombre de ces sous-populations était considérablement diminué, et même certaines d'entre elles avaient complétement disparu, sur les pièces biopsiques d'ostéomyélite chronique. L'absence inhabituelle de certains types de macrophages semble être limitée à la zone ostéitique car on les retrouve dans le tissu inflammatoire des fistules. Cette étude semble montrer que l'atteinte de ces sous-populations serait responsable de la chronicité de l'ostéomyélite.

     

The influence of pentoxifylline on motility and viability of spermatozoa from normozoospermic semen samples

In order to evaluate the effects of pentoxifylline on sperm motility and longevity, a controlled in-vitro study was conducted on normozoospermic donor semen samples using the Cellsoft automated system for sperm motility analysis. After incubation and selection, pentoxifylline was found to improve the recovery of spermatozoa and to increase their velocity. In the subgroup of progressively motile spermatozoa, curvilinear velocity was also enhanced. It is concluded that pentoxifylline has an effect on the vigour, but not on the pattern, of sperm motion. Pentoxifylline did not improve the motility characteristics of senescent spermatozoa in normozoospermic sperm samples. Sperm survival, as shown by supra-vital staining, and motility longevity both decreased with time after pentoxifylline treatment.     

Autoimmune reactions in patients with M-component and peripheral neuropathy.

A study of 17 patients with autoimmune axonal or demyelinating peripheral neuropathy in combination with M-component is described. The M-component was associated with MGUS (monoclonal gammopathy of undetermined significance) in 12 patients, CLL in one patient, WaldenstrÖm's disease in one patient, and myeloma in three patients. Immunohistological examination with direct and indirect fluorescence showed binding of antibodies to nerve structures of the same class and light chain as seen in the M-component. In five cases of IgM M-component, the demyelinating neuropathy was caused by binding of the IgM M-protein and complement C3b to myelin-associated glycoproteins (MAG). In 12 cases with axonal neuropathy, binding of IgG to the connective tissue of the peri- and endoneurium was found in 50% of cases, IgM in five cases, and IgD in one case. None of the patients had central nervous system (CNS) symptoms. The clinical and therapeutic difficulties are discussed; only two patients with an acute course responded to immunosuppression. A marked co-expression of other autoimmune phenomena is interpreted in the light of cross-reactions between the autoantibody and similar tissue autoantigens.     

In vivo effects of OK-432, inosine pranobex and its salt components on macrophage subpopulations in spleen and peritoneum of mice during the primary humoral immune response.

Subsets of macrophages (BM 8-, la- and esterase-positive subtypes) in the spleen and the peritoneum of mice were affected differently by immunomodulators during the humoral immune response. I.p. application of inosine pranobex (INPX), as well as of its salt moiety (DIPPACBA) and its dimethylaminopropanol (DIP) and acetamidobenzoic acid (PACBA) components, increased the number of nonspecific esterase-bearing cells in the peritoneum on day 3. INPX and DIPPACBA stimulated the la+ macrophage on day 3, DIPPACBA the BM 8+ macrophage only on day 1 and DIP on day 5. In spleen, DIP and PACBA had marked effects on the la+ subset in addition to a marginal effect on the BM 8+ phenotype on day 1. DIPPACBA also influenced the BM 8+ macrophage slightly on day 1. In contrast, the microbial product OK-432 stimulated BM 8+ and la+ macrophages in spleen markedly on day 1, but only marginally on days 3 and 5. However, it exerted a strong effect on both subtypes in peritoneum on days 3 and 5. OK-432 was found to be without any influence on esterase-bearing macrophages. The results show that the heterogeneity of macrophages is not only represented by subset markers, but also by their susceptibility to immunomodulators in different organs and stages of the immune response.