Prenatal radiographic diagnosis of alpha-fetoprotein positive malformations in early pregnancy

Early diagnosis of two malformed fetuses with positive alpha-fetoprotein test of the amniotic fluid with the aid of amniography is reported. Radiographic, diagnostic and prognostic aspects are discussed.     

FUNCTION OF THE RETICULOENDOTHELIAL SYSTEM : II. PARTICIPATION OF A SERUM FACTOR IN CARBON CLEARANCE

Reticuloendothelial clearance of carbon particles is inhibited by injection of heat-aggregated albumin. The possibility that this inhibition might involve a serum component has been explored. Evidence that such a serum factor does participate in carbon clearance inhibition by heat-aggregated albumin derives from the fact that prior treatment of the carbon with homologous serum eliminates the blockade; and also, if serum previously absorbed with carbon is mixed with the carbon particles no restoration of "blockade" by albumin occurs. A method for extracting the component from serum using barium sulfate adsorption is described which allows concentration of the factor and sensitive assay for its presence. It is concluded that while large or multiple carbon injections may bring about a saturation of the phagocytic cell, this saturation masks an underlying factor which protects against acute inhibition of carbon phagocytosis by denatured albumin when subsaturating carbon doses are used.     

DNA flow cytometry in human testicular cancer

DNA flow cytometry revealed aneuploid tumour stemlines in 19 of 20 primary testicular cancers without significant difference of the ploidy values between seminomas and non-seminomas. In 7 of 8 analyzable histograms the S-phase activity was 22-51%. A metastatic mature teratoma had 6% cells in S-phase. These results support the clinical observation that testicular cancer is usually a rapidly growing human tumour. The high percentage of aneuploidy in testicular cancer may be of clinical value in the diagnosis of this malignancy.     

Prevalence and pattern of unstable urethral pressure in one hundred seventy-four gynecologic patients referred for urodynamic investigation

Simultaneous urethrocystometry was performed in 174 gynecologic patients who complained of lower urinary tract symptoms. Thirty-five patients (20%) had a urethral pressure that fluctuated 20 cm H₂O or more at two or more registrations. The degree of instability varied during urethrocystometry and from recording to recording in the same patient. No statistical difference was found between urethral pressure variation at 100 ml bladder volume, during bladder filling, or at bladder capacity. The prevalences of unstable urethral pressure in sensory urge incontinence and stress incontinence were 56% and 12%, respectively. The difference is highly significant. The prevalence of unstable urethral pressure in motor urge incontinence was 29%, and that in mixed incontinence was 22%. Three patients had unstable urethra, and six patients had unstable urethral pressure as the only sign. Thus, unstable urethral pressure can be considered to be a permanent sign that is recorded relatively often in patients with urinary incontinence. It may be an important part of the underlying mechanism in sensory urge incontinence and may, perhaps, be considered to be a clinical condition in itself.     

Impaired low-density lipoprotein receptor activity in chronic B-lymphocytic leukaemia cells

Cellular degradation of ¹²⁵I-labelled low-density lipoprotein (LDL) was analysed in freshly isolated blood mononuclear cells from 26 patients with chronic B-lymphocytic leukaemia (CLL) and 8 healthy subjects, and in cells following 1, 2 and 3 d of culture in medium containing 10% human lipoprotein-deficient serum (LPDS). Fresh CLL cells had lower LDL degradation rates than mononuclear cells from healthy subjects (p < 0.01). The LDL degradation rates increased during culture (p < 0.001), but to a lesser degree in CLL cells than in normal blood mononuclear cells (p < 0.001). The cellular degradation rate of ¹²⁵I-LDL was markedly inhibited by an excess of unlabelled LDL, indicating that most of the ¹²⁵I-LDL that was degraded had been internalized following binding to the high-affinity cell surface receptor. There was a positive correlation between the LPDS-induced LDL degradation of CLL cells and the thymidine uptake in CLL cell cultures with (r = 0.70, p < 0.001) and without (r = 0.59, p < 0.01) the B cell mitogen, Epstein-Barr virus. The results indicate that LDL receptors might be involved in the regulation of CLL cell proliferation.     

Die Beziehungen zwischen Durchblutung und Sauerstoffverbrauch bzw. arterio-venöser Sauerstoffdifferenz in der Hundeniere

Zusammenfassung 1. Der O₂-Verbrauch der Niere bei Hunden von 9–18 kg beträgt bei genügender Zirkulation 0,03–0,09 ml O₂/g × min. Die O₂-AV-Diff. ist dann 0,7–3,9 Vol-% O₂.2. Erniedrigung der Prozent-O₂-Sättigung sowie Manipulationen an der Niere erhöhen den O₂-Verbrauch.3. Die O₂-AV-Diff. in der Niere ist im Gleichgewichtszustand durchblutungsabhängig. Nur als Sonderfall wird eine konstante O₂-AV-Diff. bei Stromstärkeänderungen beobachtet. Der O₂-Verbrauch der Niere ist also wie die Wärmebildung bei genügender Zirkulation unabhängig von der Durchblutung.Mit 5 Textabbildungen     

Stress as a cause of chronic recurrent vulvovaginal candidosis and the effectiveness of the conventional antimycotic therapy

Chronic Candida vulvovaginitis cannot, at present, be treated effectively with local or oral antimycotic medication. Göttlicher & Meyer [Vulvovaginalmykose. Klinische Ergebnisse einer epidemiologischen Langzeitstudie, Thieme, Stuttgart (1998); Mycoses 41 (1998) 49] formulated a hypothesis to explain this fact. They say that stress is the main cause of vulvovaginal mycosis, and that frequently cited predisposing somatic risk factors are not causing the illness. Two research projects were carried out to test this hypothesis. The first project was conceived to provide direct evidence for two empirical statements derived from the Göttlicher–Meyer hypothesis: (i) stress as a predictor of vulvovaginitis is least valid as the commonly assumed somatic factors and (ii) combinations of factors that reliably discriminate index women from symptom‐free women point to aspects of psychosocial development, particularly stress, and not to somatic factors. Between March and November 1999, 309 successive patients were randomly chosen from those successively treated in one in‐patient and two out‐patient settings. Of those chosen, 117 had had at least one episode of vaginal candidosis within the 2 years prior to enlistment in the study. The remaining 192 patients had experienced no such illness. For the 117 index patients both of the above empirical statements were confirmed by statistical analyses. The second project was designed to test predictions concerning the ineffectiveness of traditional antimycotic treatment derived from the Göttlicher–Meyer hypothesis. Three different empirical statements were derived from the hypothesis – each based on the assumption of a Poisson distribution of relapses that remains uninfluenced by treatment attempts. Each of the statements was tested and confirmed in independent samples – the first in the sample used in project one, the second in a sample of 206 women insured by public Healths Management Organizations (HMOs) and the third in a sample of 179 women insured by private HMOs. Each patient had evidenced Candida albicans vulvovaginitis at least once in the time interval between 1996 and 2000. Statistical analyses confirmed each of the empirical statements, thereby substantiating the Göttlicher–Meyer hypothesis. The authors conclude that (i) psychosocial factors, particularly stress, are the primary causes of Candida albicans vulvovaginitis. Accompanying somatic factors are of little statistical significance in explaining occurrence and relapse. (ii) Traditional antimycotic treatment influences only the symptoms of the illness, not its causes, and has no effect on the probability of a relapse. Increased treatment effectiveness can be achieved only at the cost of a complete re‐orientation concerning the causes of vaginal mycosis. Interventions designed to strengthen the patients’ immune response are among the most promising.     

Pathogenetische Sonderheiten des weiblichen Larynxcarcinoms

Ohne ZusammenfassungMit 5 TextabbildungenHerrn Professor Dr.W. Albrecht, Tübingen, zum 75. Geburtstag.