Renal allograft rupture: surgical treatment by renal corsetage with lyophilized human dura

We report 5 cases of renal allograft rupture in which diagnosis was established early through clinical data, laboratory tests and echography. Immediate surgery confirmed the suspicion in all cases. Acute rejection was present in 4 patients and in 1 the previous surgical puncture from the perirenal collection demonstrated serohematic fluid with a biological character similar to that of lymph. This latter case seemed to confirm the suspicion that any process associated with edema in a kidney with obstructed lymphatic tracts (meticulous lymphatic ligatures during donor extraction) is capable of causing a rupture. Conventional surgical treatment is dangerous and insecure on an edematous and friable kidney, resulting in a nephrectomy rate of 55.7 per cent and a postoperative death rate of 8 per cent. Hematoma evacuation, hemostasis by local compression and tridimensional containment of the ruptured areas should be the principles of this operation. By means of renal corsetage with lyophilized human dura these principles can be achieved. This surgical technique, which is simple and secure, its variations and future possibilities are described. In 3 of our 5 patients corsetage with lyophilized human dura was applied. All 5 grafts have taken. Renal function is good in 3 cases and acceptable in 2 at followup between 2 and 15 months.

Renal artery stenosis in transplanted kidney: management and results in six patients

Severe hypertension and a decrease of renal function, with or without oliguria, suggest renal artery stenosis in the transplanted kidney. 6 renal artery stenoses were observed in 100 transplanted kidneys followed up for more than 3 months. In 4 patients, percutaneous transluminal angioplasty was performed. 1 patient required a new percutaneous transluminal angioplasty 3 months later and a 2nd patient was submitted to surgery after 14 months. Surgery was performed in 2 more cases, with failure in 1. It seems that the endoarteric lesion during cold perfusion could be the main etiopathological factor, when associated with rejection episodes. Percutaneous transluminal angioplasty is the treatment of choice in the management of renal artery stenosis in transplanted kidneys. Surgery must be reserved when it fails.

Phosphate diesters for dermatological use

Synopsis A new formulation for dermatological use and hair care was studied. Phosphate diesters of the nonyl-phenol type in association with cocoimidazoline derivatives are compared with four commercial formulations. Foaming capacity, eye and skin irritation, keratin solubilization and defatting properties were studied. The mixture was the best foamforming formulation and the best defatting agent. Also, it was non-irritant for skin and eyes at adequate dilutions and did not dissolve keratin. It is a good formulation for dermatological use and hair care, due to its detergent properties. It ranks high among safe products.

Production and properties of a bacteriocin from Myxococcus coralloides D

Myxococcus coralloides D was found to produce a substance with a narrow range of antibacterial activity. This substance was produced during the exponential growth phase and was not inducible by ultraviolet light or mitomycin C treatment. The bacteriocin was precipitable by ammonium sulphate, and showed resistance to heat (100 degrees C for 10 min), trypsin, lysozyme, beta-glucuronidase, DNase, RNase, acetone, ethyl ether, urea and mercaptoethanol; it was partially destroyed by pronase and inactivated at extreme pH values. Electron microscopy did not reveal any phage-like particles associated with bacteriocin activity.

[Giant cell arteritis: temporal arteritis, rheumatic polymyalgia]

Fourteen patients have been diagnosed for Giant Cell Arteritis by temporal biopsy or clinical criteria in the last five years. Two of them started with atypical symptoms. Polymyalgia Rheumatica was the commonest symptom (71%). Two patients (14%) had an irreversible blindness in eye one. Histologic changes of arteritis were shown by temporal biopsy in 8 cases, one of which had no cranial manifestations. A raised ESR was a constant finding (100%) followed by a alpha-2 globulin increase (93%) and anaemia (57%). One patient had rare complication of this disease: an aortic arch syndrome. The whole group responded well to the treatment.

DNA/protein ratio as an index of oestrogen receptor content in human breast cancer

The nuclear DNA/cytoplasmic protein ratio was related to the oestradiol receptor content in both cytoplasmic (ERc) and nuclear (ERn) fractions in 165 cases of breast cancer. The patients under study were divided into groups according to whether their biopsies contained functional (ERc/ERn = +/+), abnormal (+/0) or non-detectable receptor (0/0). The mean microgram DNA/mg protein ratio was significantly decreased in both the abnormal and receptor-negative groups, with means of 30.4 and 30.2 respectively, when compared to the mean of 52.8 for the receptor-positive group. When the DNA/protein ratio for each patient was related to age, a discriminant line which clearly differentiated the ER +/+ group from the other two groups was obtained. It may be concluded that an increased DNA/protein ratio is related to the presence of ERn. Furthermore, since the DNA content per cell is higher in ER-negative tumours, an increase in cellularity must exist in ER-positive tumours.

Polyclonal activation of human peripheral blood B lymphocytes by formaldehyde-fixed Salmonella paratyphi B. I. Immunoglobulin production without DNA synthesis

A "new" polyclonal activator of human peripheral blood B cells, formaldehyde-fixed Salmonella paratyphi B, is described. This bacterium does not stimulate cell proliferation as measured by incorporation of tritiated thymidine but does stimulate a subpopulation of B cells to secrete large amounts of IgM, IgG, and IgA in 7-day cell cultures. The immunoglobulins (Ig) produced by cells responding to S. paratyphi B are not specific antibodies against the bacterial antigens. In comparison with other B cell activators (pokeweed mitogen, Staphylococcus aureus Cowan I, and lipopolysaccharide), S. paratyphi B stimulation produced greater amounts of IgM but less IgG than pokeweed mitogen (PWM) or S. aureus Cowan I; lipopolysaccharide failed to stimulate significant Ig production on day 7 in most cases. In addition, the response to S. paratyphi apparently did not require T cell collaboration. These results suggest that the B cell subpopulation(s) responding to S. paratyphi B may be more differentiated B cells than those responding to either PWM or S. aureus Cowan I. Peripheral blood mononuclear cells from five patients with common variable immunodeficiency without evidence of abnormal suppressor T cells or monocytes failed to respond to S. paratyphi B, whereas cells from two of the same patients responded well to S. aureus Cowan I and partially to PWM. Thus, S. paratyphi B appears to be superior to other B cell activators for studies of B cell function in normal and abnormal states.

Induction and suppression of immunoglobulin synthesis in cultures of human lymphocytes: effects of pokeweed mitogen and Staphylococcus aureus Cowan I

The synthesis and secretion of immunoglobulins by human peripheral blood mononuclear cells in cultures stimulated with pokeweed mitogen or Staphylococcus aureus Cowan I were evaluated by enumeration of cells containing cytoplasmic immunoglobulins and cells actively secreting immunoglobulins, and by quantitation of immunoglobulins released into culture supernatants. The two mitogens caused comparable stimulation of immunoglobulin production; however, in contrast to pokeweed mitogen, S. aureus was active in cultures depleted of T lymphocytes, and its stimulatory effects were resistant to the influence of suppressor T cells generated by co-stimulation with concanavalin A or by preincubation without mitogenic stimulus. These results indicate distinct pathways of induction and suppression of immunoglobulin synthesis for these two polyclonal B cell activators, and suggest that stimulation by S. aureus is less thymus dependent than that induced by pokeweed mitogen.

Induction and suppression of immunoglobulin synthesis in cultures of human lymphocytes: effects of pokeweed mitogen and Staphylococcus aureus Cowan I

The synthesis and secretion of immunoglobulins by human peripheral blood mononuclear cells in cultures stimulated with pokeweed mitogen or Staphylococcus aureus Cowan I were evaluated by enumeration of cells containing cytoplasmic immunoglobulins and cells actively secreting immunoglobulins, and by quantitation of immunoglobulins released into culture supernatants. The two mitogens caused comparable stimulation of immunoglobulin production; however, in contrast to pokeweed mitogen, S. aureus was active in cultures depleted of T lymphocytes, and its stimulatory effects were resistant to the influence of suppressor T cells generated by co-stimulation with concanavalin A or by preincubation without mitogenic stimulus. These results indicate distinct pathways of induction and suppression of immunoglobulin synthesis for these two polyclonal B cell activators, and suggest that stimulation by S. aureus is less thymus dependent than that induced by pokeweed mitogen.

Assay of immunoglobulins in supernatants of lymphoid cell lines by conventional laser nephelometry

An adaptation of the nephelometric assay for serum immunoglobulins has been developed for detection and quantitation of extracellular immunoglobulins in cultures of lymphoblastoid cell lines. This assay employs the standard equipment for laser nephelometry and commercial reagents for immunoglobulin quantitation. By adjusting dilutions of controls and sample volumes of culture supernatants, amounts of IgG and IgM below 1 microgram/ml can be detected in culture supernatants. At concentrations between 1 and 4 microgram/ml, day-to-day and within-run variations for IgM assays were 16 and 11% respectively. The possibility of measuring immunoglobulins secreted by cell lines by conventional laser nephelometry opens several areas of application in the study of the functional activity of B cells and of cell-cell interactions.

Gastric cancer in Colombia. II. Case-control epidemiologic study of precursor lesions

Endoscopic surveys in the Department of Narino (Colombia) showed that natives of areas of very high risks for stomach cancer have a higher prevalence of atrophic gastritis and intestinal metaplasia than do persons born in other parts of Narino. In these surveys, diets were compared between individuals with and without evidence of these suspect precursor lesions of stomach cancer and between individuals born in the areas designated as high and low risk for stomach cancer. The composite evidence from the comparisons indicated lettuce to be negatively associated with stomach cancer and raised the possibility to a positive association for corn. The relationship of these findings to other epidemiologic evidence and the implications for applying the epidemiology of stomach cancer to the epidemiology of precursor lesions were examined.