[Primary cutaneous Ki-1-lymphoma]

With the help of immunohistochemical techniques and new antibodies developed in the last few years, we were able to identify 2 cases of nodular tumors of the skin as highly malignant Ki-1 lymphomas. The clinical course was characterized by the development of multiple skin tumors without any evidence of systemic involvement. After the excision of several skin tumors; we performed chemotherapy with the MACOP-B regimen. In one of our patients, however, this treatment could not prevent the occurrence of further tumors. Possibly, the cutaneous anaplastic Ki-1 lymphomas presented here are closely related to or even identical with mycosis fungoides d'emblée.

Percutaneous peripheral atherectomy: angiographic and clinical follow-up of 60 patients

The Simpson atherectomy catheter was used to treat 60 patients with a total of 94 lesions comprising 63 stenoses (mean length 1.1 +/- 0.5 cm) and 31 occlusions (4.2 +/- 2.9 cm) of the superficial femoral (n = 77), popliteal (n = 8), iliac (n = 8) and anterior tibial (n = 1) arteries. The immediate angiographic success rate was 90% for both occlusions and stenoses, and clinical success was obtained in 82% of patients. The stenoses were reduced from 83 +/- 13% to 17 +/- 18% acutely and to 31 +/- 26% at 6 months; the occlusions were reduced from 100% to 9 +/- 9% initially and to 60 +/- 34% at 6 months. Angiographic restenosis was found in 24% of lesions: 23% in concentric and 11% in eccentric lesions and 47% in total occlusions. At 1 year, 72% of patients had clinically patent arteries with maintained Doppler index and walking distance. Three of four patients undergoing repeat atherectomy had a second restenosis. In summary, the procedure was found to be safe and effective in the treatment of peripheral vascular disease. It appears to be particularly beneficial in the treatment of eccentric stenoses and is not limited by the presence of calcification.

Dermal glands of Xenopus laevis contain a polypeptide with a highly repetitive amino acid sequence

Mature dermal glands of Xenopus laevis contain storage granules with a characteristic ellipsoid shape. These granules contain, as a minor component, a heat-stable, acidic polypeptide with an apparent molecular mass of 75 kDa. Using antibodies against this protein, positive clones were isolated from a cDNA expression library prepared from skin of X. laevis. One of the cloned cDNAs encodes a pre-protein with a typical signal sequence and a mature part of 396 amino acids. The protein contains 33 copies of the sequence Gly-Gly/Glu-(Ala-Pro)2-4-Ala-Glu. Using the single-letter code for the four predominant amino acids, we have termed this polypeptide the APEG protein. Near its carboxy-terminus, one segment has been found with an amino acid sequence similar to that of spasmolytic polypeptide from porcine pancreas and to the human protein pS2.

Interleukin-2 determinations for monitoring the renal allograft

Our results show that worsening of renal function dependent on cyclosporin, or caused by acute renal insufficiency of postrenal origin, can be distinguished from viral infection and rejection reactions by the determination of interleukin-2 (IL-2) in plasma, which functions as an early indicator or follow-up parameter. A definite differentiation between steroid-sensitive rejection reactions and virus infection does not yet seem to be possible by interleukin-2 determination.

Percutaneous transcatheter occlusion of cystic duct stump in postcholecystectomy bile leakage

Postoperative cystic duct fistula is an uncommon complication after cholecystectomy. Nonoperative management includes endoscopic retrograde or percutaneous transhepatic biliary drainage, and percutaneous catheter drainage of fluid collections. Transcatheter occlusion of the leaking cystic duct remnant proved a valuable alternative treatment when biliary stenting failed for technical reasons.

[Percutaneous drainage treatment of abscess and fluid retention following abdominal surgery]

61 patients with abdominal abscesses and fluid collections as a postoperative complication underwent percutaneous drainage. 60 abscesses, 11 haematomas, 3 steril seromas and 3 bile collections were drained. The fluid collections were associated with biliary or enteric fistulae in 16 cases. The percutaneous drainage was successful in 69%, additional surgery was required in 15%. The overall mortality rate was 13%. Reasons for drainage failure were infected clots, phlegmonic abscesses and pancreas involvement of the abscesses.

Subtracted versus non-subtracted digital imaging in peripheral angiography

Digital subtraction angiography (DSA) plays an important role in the management of vascular diseases of the lower extremities. A disadvantage is the lack of an automatically moving table top. We used a 1,024 x 1,024 matrix with a large-screen intensifier system and an automated "stepping" facility. In 161 examinations of the arteries of the lower extremity digital peripheral arteriography was performed with and without the subtraction technique. We compared the influence of different iodine concentrations in DA and DSA. Peripheral DA proved to be equal to peripheral DSA in the region of the pelvis, thigh and knee, with no adequate contrasting being obtained merely in the region of the lower leg arteries in about 45%. It is necessary to use contrast medium at a concentration of 300 mg I/ml. The installation of an automated "stepping" facility reduces the amount of contrast medium needed and the exposure time.

Percutaneous cholecystostomy in acute acalculous cholecystitis

Percutaneous cholecystostomy was performed in 8 poor-surgical-risk patients with acute acalculous cholecystitis. Seven patients had had previous laparotomy, 1 patient a coronary bypass operation. A transhepatic approach was used in all patients. Insertion of the drainage catheters was guided by ultrasound and fluoroscopy. Percutaneous drainage was successful in all patients, with no need for further surgical intervention. Two patients died, for reasons unrelated to the gallbladder disease. Percutaneous cholecystostomy may be definitive treatment for acute acalculous cholecystitis in the critically ill patient.

[Centrofacial hyalinosis]

The changes to the center facial skin of a 65-year-old patient caused by hyalinosis were largely reversed by excising the hyaline material. There has been no remission so far. In this case the histological and electron-microscopical findings suggest that poor vascular circulation was primarily responsible for the formation of hyalin.

Angiography of segmental pancreatic transplants

Arteriography was routinely performed in patients with suspected vascular complications after pancreas transplantation. Dysfunction of the grafts was suggested by 99mTc-DTPA scanning and metabolic tests. Thirty arteriograms obtained in 25 patients were evaluated. Nineteen conventional film angiograms and 11 intraarterial DSA were performed. Five different angiographic patterns were observed: normal vascular anatomy, low-flow phenomenon, arterial or venous thrombosis, and venous neovascularity. On the basis of the angiographic findings, various reasons for graft failure were identified. Recipient venous collaterals or well-functioning grafts without angiographically detectable blood supply were observed in 9 cases, and must be considered to represent neovascularisation by donor and recipient vessels.

Aspirin acetylates fibrinogen and enhances fibrinolysis. Fibrinolytic effect is independent of changes in plasminogen activator levels

In addition to its antiplatelet effect, aspirin has been reported to have fibrinolytic and hypoprothrombinemic effects. The objective of this study was to investigate possible mechanisms underlying the enhanced fibrinolysis after aspirin. Five healthy subjects received 650 mg of aspirin every 12 hr for 5 days. Blood samples were collected before aspirin (control), and immediately before (0 hr) and 2 hr after (2 hr) the last dose for determinations of clot lysis time, time course of thrombin-induced fibrin aggregation, tissue plasminogen activator activity, intrinsic pathway fibrinolytic activity, plasminogen, fibrinogen, aspirin and salicylic acid, and the coagulation tests activated partial thromboplastin time, thrombin time and prothrombin time. Clot lysis time was shorter after aspirin, control: 9.1 +/- 12.4 min (mean +/- S.D.); 0 hr: 4.6 +/- 4.0 min; 2 hr: 5.7 +/- 6.2 min (P: .04) and the fibrin aggregation curves showed increased relative absorbance at 10 min, control: 8.4 +/- 2.2; 0 hr: 11.2 +/- 0.2; 2 hr: 13.3 +/- 5.4 (P: .02). Control values of tissue plasminogen activator (0.11 +/- 0.04 IU/ml), intrinsic pathway fibrinolytic activity (2.20 +/- 0.54 IU/ml), plasminogen (10.9 +/- 1.0 mg/dl), fibrinogen (288 +/- 37 mg/dl) and the coagulation tests were not different from those after aspirin. Aspirin concentration was below detection limits at 0 hr and 1.63 +/- 0.97 micrograms/ml at 2 hr, whereas salicylic acid concentration was 55.0 +/- 35.8 and 136 +/- 71.9 micrograms/ml at 0 and 2 hr, respectively. In vitro studies using fibrinogen-free plasma and added acetylated fibrinogen showed an inverse relationship between the extent of acetylation and clot lysis time.(ABSTRACT TRUNCATED AT 250 WORDS)

The constituents of storage granules in the dermal glands of Xenopus laevis. Structure of a basic polypeptide deduced from cloned cDNA

Mature dermal glands of Xenopus laevis contain storage granules with a characteristic ellipsoid shape. A few major proteins are present in these granules, including two with the same amino-terminal sequence and apparent molecular masses of 26 and 28 kDa. Using antibodies against these proteins, positive clones were isolated from a cDNA expression library prepared from skin of X. laevis. One cDNA encodes a preprotein with a typical signal sequence and a mature part of 187 amino acids. The protein shows internal homology at both the amino and carboxyl end. The latter part has a very high content of basic amino acids.

[Percutaneous cholecystostomy in treating acute cholecystitis in patients at risk]

Percutaneous cholecystostomy was performed in 17 poor surgical risk patients. 16 patients developed acute acalculous cholecystitis postoperatively in the intensive care unit, 1 patient had an acute cholecystitis with calculi. Diagnostic imaging using CT and US was specific for acute cholecystitis in 58% only. Percutaneous cholecystostomy was the definitive treatment in 69% of the patients. Additional cholecystectomy was required in 3 patients with complicated cholecystitis, in 1 patient with bile leakage after catheter dislocation and in 1 patient with gallbladder calculi. 3 patients died, 2 of them from reasons unrelated to the gallbladder disease. Radiology-guided percutaneous cholecystostomy performed by a transhepatic approach is a safe and effective procedure for acute cholecystitis in high-risk patients.

Increased frequency of spontaneous and X-ray-induced chromosomal aberrations in lymphocytes from neonates and the influence of caffeine--an in vitro study

We have examined lymphocytes from human preterm (PT) and fullterm (FT) babies for an effect of gestational age (GA) on chromosomal aberrations either occurring spontaneously or induced by treatment with X-rays (1 Gy) alone; or with caffeine (1,3,7-trimethylxanthine) supplementation (5 X 10(-4) M), in comparison to the lymphocytes of healthy adults (AD). Percent of abnormal cells (%Abn) was used as an indicator of chromosome sensitivity to the different treatments. PT babies had significantly higher spontaneous and X-ray-induced %Abn values than AD, but were comparable to FT. After X-irradiation + caffeine the yield of aberrations in any 2 groups was not significantly different. Chromosomal sensitivity may result from factors other than GA. This in vitro model may permit study of the mechanisms of chromosomal damage repair and prevention of free radical damage of DNA during the perinatal period.

[Percutaneous drainage of fistula-associated abscesses and biliary fistulas]

33 abdominal abscesses associated with fistulae in 31 patients were treated by percutaneous drainage. 19 of these patients had had surgery immediately preceding the drainage. In 64% the percutaneous drainage led to a diagnosis of an internal fistula. Additional therapeutic measures, because of the fistula, were necessary in 45% (operation, biliary drainage, repositioning of catheter). The average duration of drainage was 29 days. 77% of those abscesses which could be drained were treated successfully. Mortality in the entire series was 19%.

[Percutaneous drainage treatment of primary liver abscesses]

28 primary liver abscesses, including 9 amoebic abscesses, in 24 patients were drained percutaneously. Indication for drainage in amoebic abscesses was imminent rupture and clinical symptoms as pleural effusion, lung atelectasis and pain. 95% of the primary abscesses were cured by percutaneous drainage and systemic antibiotic treatment. There was one recurrence of abscess, which was managed surgically. Reasons for drainage failure were: tumour necrosis and tumour perforation with secondary liver abscess.

Generalized cutaneous hyperpigmentation in hairless mice induced by topical dimethylbenzanthracene

The skin of hairless (Ng/Bln) mice topically treated with dimethylbenzanthracene (DMBA) was investigated by light microscopy, histochemistry, electron microscopy and autoradiography in order to gain some insight into the mechanisms by which the DMBA-induced cutaneous hyperpigmentation is mediated. The results of the present study indicate that this phenomenon is due to the DMBA-induced stimulation of both the tyrosinase system and the mitotic activity of dopa-inactive dormant melanocytes.

Influence of cosmic radiation and/or microgravity on development of Carausius morosus

Eggs of Carausius morosus were exposed to spaceflight conditions in two spaceflight missions, the German 7 day Spacelab Mission D1 and the Soviet 12.56 day Biosatellite Mission "COSMOS 1887". During spaceflight the eggs continued their development. Eggs of five different ages representing different sensitivity to radiation and different capacity to regeneration were used to investigate the influence of cosmic radiation and/or microgravity on insect development. Using the Biostack concept--eggs in monolayers sandwiched between nuclear track detectors--and the 1 g reference centrifuge of BIORACK in D1 we were able to separate effects of heavy ions of the cosmic radiation from microgravity effects and also from combined effects of these two factors in space. After retrieval, hatching rates, embryonic and larval growth kinetics and anomaly frequencies were determined. Microgravity leads to a reduced hatching rate of eggs exposed in the early stages of development. Hatching was normal in eggs which were exposed on the 1 g reference centrifuge. Hits by heavy ions caused body anomalies. The combined action of heavy ions and microgravity resulted in an unexpectedly high frequency of anomalies. These results obtained from the Spacelab Mission D1, were confirmed in an experiment onboard of COSMOS 1887. In addition to the previous analysis, embryonic development before hatching was followed which showed no major difference between flight and the ground control specimens. Since a reconfirmation of reduced hatching rates was observed in COSMOS 1887, too, the above results suggest some microgravity induced functional impairment of the hatching activity, rather than blockage in embryonic development.

[Attempt at in vitro decalcification of aortic valves using various types of lasers]

The effects of three types of laser were studied in vitro on calcified aortic valves removed in the course of valve replacement. These were: 1) argon laser; 2) Nd-YAG laser with a long (1 ms) impulse, and 3) Nd-YAG laser with a short (10 ns) impulse. With the first two types of laser, lesions of carbonization and fragments detached from the areas treated were observed. With the 10 ns ND-YAG laser, a mean energy of 100 mj per shot excavated the calcified valves by drilling holes that were 0.5 to 1.5 mm in diameter and had clear-cut non carbonized borders. No residue was found during the procedure: the substance was simply vaporized. The splitting of several calcareous nodules on a valve made it more pliable. If it were possible to transfer this high peak energy onto a flexible optic fibre, the aortic valves could be decalcified by interventional catheterization.