Percutaneous nephrostomy: experience in 107 kidneys

We were successful using percutaneous nephrostomy to relieve upper urinary obstruction in 98 of 107 kidneys. In two thirds of our patients obstruction was due to neoplasm, with prostatic cancer the leading cause. Percutaneous nephrostomy proved to be ideally suited for drainage of pyonephrosis and in azotemic patients. Its use can obviate surgical nephrostomy and prolonged ureteral catheter drainage. We also are encouraged by our early experience with extensions of percutaneous nephrostomy, including percutaneous ureteral stenting, renal stone dissolution, and percutaneous pyelolithotomy.

Pregnancy-specific beta 1-glycoprotein as a prognostic indicator in complications of early pregnancy

Pregnancy-specific beta 1-glycoprotein (SP-1) was measured by radioimmunoassay in patients admitted to the hospital with a clinical diagnosis of hemorrhage in early pregnancy. The results were compared with a normal range and were analyzed for their predictive value in determining prognosis. Six of the total study goup of 54 patients were subsequently proved not to be pregnant and had SP-1 levels below 10 microgram/L, the lower limit of sensitivity for pregnancy detection. Twenty-nine patients had SP-1 levels below the normal range for pregnancy and all had an abnormal outcome (ectopic pregnancy or abortion). The SP-1 level was normal in 29 cases, of which 10 had an abnormal outcome and 19 continued normally beyond the twentieth gestational week. Low SP-1 levels were found in all of the abnormal and none of the continuing pregnancies and may be taken as predictive of an unsuccessful outcome.

A comparison of assay methods for pregnancy specific beta 1 glycoprotein (SP-1)

Three methods were compared for the assay of pregnancy specific beta 1 glycoprotein (SP-1): radical immunodiffusion (RID), electroimmunodiffusion (EID) and radioimmunoassay (RIA). There was a significant correlation between EID and RIA. A lower, but still significant correlation was found between EID and RID, but wide discrepancies were seen in some cases. This finding suggests heterogeneity of SP-1 molecule(s). The data indicate that EID is the method of choice for assay of SP-1 after the tenth week of pregnancy, while the more sensitive RIA should be reserved for use before that stage.

Immunological parameters in gestational trophoblastic neoplasia

Immunological function were studied in 22 patients with hydatidiform mole and 29 patients with malignant trophoblastic disease before and after treatment; normal pregnant and post-pregnant women served as controls. The only significant abnormality in hydatidiform mole was a low granulocyte chemotaxis before evacuation. In malignant trophoblastic disease the total lymphocyte counts, T-cell counts. B-cell counts, lymphocyte responses to mitogens and serum IgA levels were significantly lower than in normal women 6 wk after pregnancy. In those who responded to chemotherapy, these indices rose to the levels of post-pregnancy controls. An 'immune profile score' based on these indices was found to be a useful prognostic index. All patients with hydatidiform mole who had a score of 7 or less developed malignant trophoblastic disease, while the two patients with malignant trophoblastic disease who died had the lowest scores of the series.

The effect of maternal cardiac disease and digotoxin administration on labour, fetal weight and maturity at birth

One hundred and twenty-two patients with cardiac disease were compared with 250 controls with respect to the duration of pregnancy and labour, birth weight percentile and Apgar score. The babies of the patients with cardiac disease were light-for-dates (18% below the 10th percentile); the mothers, if multiparous, delivered at an earlier gestational age. The patients with cardiac disease did not have shorter labours than the control group. Digoxin administration and the severity of heart disease had no significant effect on these variables.

Proliferative diabetic retinopathy in patients with defects of platelet function

A 71-year-old woman had von Willebrand's disease, an inheritable abnormality of platelet activity, and developed diabetic retinal neovascularization. A 59-year-old man had a myeoloproliferative disorder with thrombocythemia but may have had retinal changes before the development of his platelet dysfunction. The occurrence of diabetic proliferative retinopathy in patients with reduced platelet activity suggests that platelet induced microcirculatory abnormalities may not be required for neovascularization.

Human colostral cells: phagocytosis and killing of E. coli and C. albicans

Cells from human colostrum, collected from mothers within 48 hours of delivery, were examined for their capacity to phagocytose and kill Eschericia coli and Candida albicans. The phagocytic power of colostral cells was comparable to that of blood leukocytes from the same individuals. In contrast, the capacity of colostral cells to kill microorganisms was significantly less than that of blood leukocytes. Preincubation of blood leukocytes with colostrum supernatant did not reduce phagocytic indices, but reduced E. coli killing by 40% and C. albicans killing by 66%. The role of colostral cells in protecting the neonate from infection is discussed in the light of these findings.

Idiopathic late-onset immunoglobulin deficiency with associated defect in cell-mediated immunity

An 8-year-old boy presented with idiopathic late-onset immunoglobulin deficiency manifested principally by recurrent suppurative chest infections and chronic diarrhoea with malabsorption. Nodular lymphoid hyperplasia and giardiasis were shown on small bowel biopsy. Investigation of the immune system showed low serum levels of IgG, IgM, and IgA, negative skin tests to four recall antigens, absent mixed lymphocyte reactivity, and impared lymphocyte responses to mitogens in vitro. Serum complement and granulocyte function studies were normal. Maintenance therapy with gammaglobulin and antibiotics gave a good response.

Kinetics of corneal epithelial regeneration. II. Epidermal growth factor and topical corticosteroids

The kinetics of rabbit corneal epithelium regeneration were studied to determine if topical corticosteroid has an adverse effect on corneal epithelial wound healing, and if epidermal growth factor (EGF) can abrogate any adverse effect of topical corticosteroid. Healing of standardized 7 mm. central corneal epithelial wounds was determined by serial standardized color photography of the flourescein-stained defects and planimetry of the projected photographs. It has been found that topical application of 16 drops per day of vehicle or Decadron decreased the epithelial healing rate, as compared to saline drops four times daily. Decadron 0.1 per cent given hourly (16 drops daily) was no more detrimental to corneal epithelial healing rate than the vehicle similarly applied. EGF exhibited no capacity to alter the corneal epithelial healing rate when hourly drops of either the vehicle or Decadron 0.1 per cent were given. Under the conditions of these experiments, no adverse effect on corneal epithelial healing rate could be attributed to Decadron 0.1 per cent.

Reconstruction of inhomogeneous scattering objects from holograms

An experiment is reported in which the one-dimensional scattering potential along a line through a semitransparent bar with nonuniform index of refraction is determined from holographic measurements of scattered monochromatic light waves. The experiment is performed using an inhomogeneous bar for the first time in order to test quantitatively a recently developed inverse scattering theory. This theory suggests a method by which the three-dimensional structure of a semitransparent, weakly scattering object can be determined by means of light scattering experiments. The structural data obtained in this experiment agree with known object parameters to within errors of the order of a few percent. In addition, a problem that occurred in earlier experiments concerning the presence of an unwanted background is analyzed. A method for removing the background is described, which is employed in the present experiment and is applicable for use with all objects that scatter light only into directions that make small angles with the direction of incidence.