[The effect of basic therapeutic procedures on the immunoregulatory T-cell apparatus in patients with chronic polyarthritis]

Five by five patients with rheumatoid arthritis were treated with gold salts, D-penicillamine and cyclophosphamide. The T-lymphocyte subpopulations were measured. In patients, treated with gold salts or D-penicillamine, we did not find alterations of the number of TG- and TM-lymphocytes. The daily treatment with 100 mg cyclophosphamide will result in a significant reduction of TG-lymphocytes.

Hamartomas of the tuber cinereum and precocious puberty

5 cases of true precocious puberty (TPP) of cerebral origin are presented. The clinical and radiological features and the protracted follow-up allow, also in view of the literature, a highly presumptive diagnosis of a hamartoma of the tuber cinereum. The high incidence of these lesions in cases of TPP is emphasized, together with the importance of early neuroradiological assessment.

Various effects of the CO2-, the neodymium-YAG-, and the argon-laser irradiation on bladder tissue

Application of lasers as cutting or coagulation instruments is based on the conversion of light energy into heat in the irradiated tissue. The extent and degree of the thermal action depends on the beam geometry and the energy of the incident light, as well as on the optic and thermal properties of this tissue. The extinction behavior in the tissue differs for the various laser systems employed in medicine. A comparison of the effects on bladder tissue of rats and rabbits is made with Neodymium-YAG laser and the argon and CO2 lasers to demonstrate the advantages of the Neodymium-YAG laser, especially for the therapeutic irradiation of bladder tumors.

Natural and antibody-dependent cellular cytotoxicity in tumour-adherent T lymphocytes: expression of Fc receptors and of a human T-subgroup-specific antigen

Adherence of human lymphocytes to allogeneic tumour cell monolayers was found to depend on the presence of monocytes. Adherent lymphocytes could be separated from tumour cells by treatment with lidocaine followed by nylon wool passage. Tumour-adherent cells (70% E-RFC, 45% Fc gamma-R, 23% Fc mu-R, 5% monocytes) exhibited enriched natural killer (NK) activity not only against the tumour cell line used for isolation but also against seven other targets. When T cells were isolated subsequently as E-rosettes by density gradient centrifugation through Percoll, the enrichment in cytotoxicity was even more pronounced. Tumour-adherent T cells were severalfold enriched in both NK and antibody-dependent cell-mediated cytotoxicity (ADCC) activity. However, this enrichment was not paralleled by a concomitant increase in the number of T gamma cells (tumour-adherent T cells: 17% T gamma, 40% T mu ; tumour-nonadherent T cells: 12% T gamma, 60% T mu). Marked differences could be observed by staining with a monoclonal antibody that was raised against human leukaemic T gamma cells of high NK and ADCC activity. This antibody (T 8-11) stained 60% of tumour-adherent T cells, 20% of nonadherent T cells and 29% of T-cell controls. These results indicate that the spontaneous cytotoxic activity of human T cells resides within a small population, most of which are characterized by a specific surface antigen but not by conventional Fc gamma receptors.

Endoscopic Neodymium-YAG laser application for destroying bladder tumors

302 bladder tumors to a size of a thumb tip were treated with a Nd: YAG laser. 196 large bladder tumors were removed by transurethral resection combined with laser irradiation 1 week later. In all cases tumors were classified as pTA to pT3a, No, Mo tumors. 8 weeks after treatment we found local recurrences in 9% using the rigid laser endoscopes. On the contrary, the local recurrence was 2.1% using laser endoscope with modified Albarran insert. In proven cases the Nd:YAG laser application is an effective and careful procedure to destroy bladder tumors.

Efficient separation of human T lymphocytes from venous blood using PVP-coated colloidal silica particles (percoll)

In a comparative study, human peripheral T lymphocytes were separated as E rosettes by density centrifugation through various gradient media. Sheep red blood cells (SRBC) were removed by dissociation of the E rosettes at 37 degrees C with subsequent centrifugation on a similar density gradient prewarmed to 37 degrees C. In particular, gradients made of Ficoll Urovison were compared with Percoll gradients with regard to both separation steps. Using Percoll gradients, a maximal T cell recovery of 75% was obtained, whereas Ficoll separation yielded only 46%. T lymphocytes separated with Percoll exhibited equal viability compared to Ficoll isolated cells and consisted of 98% EAET-RFC. No inhibition of cellular function by Percoll treatment was detected, whereas Ficoll treatment led to an impaired mitogenic response. An inherent mitogenicity of Percoll was not observed. The method described results in considerably shortened centrifugation times due to the low viscosity of the Percoll medium and simultaneously seems to be less harmful to the rather fragile rosettes. Reproducibility was found to depend on careful control of density and osmolarity of the Percoll medium.

Arachnoid cysts of the middle cranial fossa: a clinical and radiological study of 25 cases treated surgically

Arachnoid cysts of the middle cranial fossa are probably not so infrequent as previously thought. Twenty-five cases are reported together with the most relevant clinical and radiological findings. The authors emphasize the importance of computerized tomography (CT) in providing pre- and postoperative anatomical and physiopathological information. The potential morbidity of these lesions is stressed and surgical indications are discussed with preference for a radical craniotomy rather than a shunt procedure.

Clinical value of early exercise testing after myocardial infarction

The clinical utility of predischarge exercise ECGs was assessed prospectively in 47 patients 17 +/- 2 days after myocardial infarction. The graded-interval ergometric exercise protocol was terminated at 450 kilopond-m/min (kpm/min), a heart rate greater than 75% of predicted maximum, or for established clinical indications. Prior to testing, the attending physician and resident indicated their clinical impressions with regard to anticipated (1) angina, (2) exercise capacity, (3) arrhythmias during limited exercise, as well as anticipated discharge medications and activity prescriptions. Ratings were compared to exercise results and consequent alterations in management noted. No complications were noted during the evaluations. Nine patients noted anginal pain during exercise; five were unsuspected by the attending physician or resident. Ten patients demonstrated significant ventricular arrhythmias. Four were receiving antiarrhythmic therapy. Severe limitation of exercise capacity (< 300 kpm/min) was noted in six patients, unanticipated in four. Where not contraindicated, routine use of predischarge exercise ECG testing is recommended.

Subacute and chronic extradural hematomas: a study of 30 cases

The authors report 30 cases of extradural hematomas with prolonged course: the interval between injury and development of clinical signs was more than 48 hours. Twenty-nine were operated upon. These delayed cases have a mild clinical course and a better prognosis than the acute. Contrary to the reports that many subacute and chronic epidural hematomas are located other than temporally, the present series shows the high incidence (83%) of temporal lesions. Of the patients 74% recovered and returned to their previous occupations: the two deaths were from causes not directly related to the injury and hematoma. We conclude that most subacute hematomas arise from various, often combined, low-tension sources of bleeding. The importance of recognizing gradual neurologic deterioration and performing craniotomy in these patients is emphasized.

[A-scsan sonography for the measurement of the thickness of the bladder wall]

The A-mode ultrasonography is especially qualified for measuring tissue thickness. By using high frequencies (8--10 MHz) upper layers can be measured with an accuracy of approximately 0.15 mm. This accuracy in measurement is required in connexion with optimization of dose during therapy of urinary bladder tumors by way of the Neodymium-YAG laser. The newly developed 8 MHz-endo-transducer makes possible intravesical measurement of bladder-wall thickness under cystoscopoic view. This method presents itself as a new opportunity for staging urinary bladder tumors.

[Selective percutaneous thermorhizotomy in the surgical treatment of facial pain: personal considerations in light of 180 patients treated]

The purpose of this paper is to report the experience of the authors regarding the treatment of the primitive and secondary facial pains by Percutaneous Selective Thermorhizotomy (P.S.T.), 180 patients having been treated in the period of two years. The immediate postoperative control has obtained 156 good results (86,6%), 10 medium results (5,5%) and 14 (7,7%) unsuccessful. The failure of the P.S.T. in the treatment of the post-zosterian neuralgias, in the atypical and in the vascular pains is stated. The P.S.T. appears resolutive in the "tic doloreux" and secondary painful syndromes. A far follow up was performed (4 months-2 years) on 94 patients and a good result was kept at 64,2% among all of them. The shortage of the postoperative not expected collateral effect is also stated. The causes of unsuccessful and poor results (mistaking in the choice of the patient or tecnical mistaking) are discussed. It is finally suggested a careful personal value of the patient candidated to operation, in order to reduce the poor results and therefore improve the successful ones.

[A new laser endoscope for irradiation of bladder tumors]

A new endoscopic laser tool is presented consisting of a urethrocystoscope with Albarran-tray. Because of the flexibility of the new guide light fibres it is possible to irradiate any spot of the bladder wall, the bladder neck and the fascia prostatae. Advantages are apart from the flexibility--the simplifying of the equipment, the good working conditions under water and the higher efficacy using the same power output as the usual laser endoscopes.

Vaccination immunity to selected diseases in chickens fed the androgen analog mibolerone

Chickens fed the androgen analog mibolerone during the first 7 weeks of life regress their bursa of Fabricius but can be properly immunized by vaccination against avian pathogens of major economic importance such as Newcastle disease virus, infectious laryngotracheitis virus, avian encephalomyelitis virus, infectious bronchitis virus, fowl pox virus, Marek's disease virus, and Pasteurella multocida, the pathogen causing fowl cholera. These findings on immunocompetence to infectious agents are important because we have previously shown that the administration of mibolerone prevents the development of lymphoid leukosis tumors.

Immune responses of chickens fed the androgen analog mibolerone

Mibolerone, an androgen analog (17 beta-hydroxy-7-alpha, 17-dimethylestr-4-en-3-one), induces a slow but progressive involution of the bursa of Fabricius when fed to chickens at microng levels during the first 7 weeks of life. Chickens receiving mibolerone remained immunologically competent, evidenced by: 1) their antibody response to nonreplicating antigens and infectious antigens; 2) the number of antibody-producing cells in their spleens; 3) the stimulation of their peripheral leukocytes with the plant mitogen phytohemagglutinin; and 4) their capacity to resist challenge with Marek's disease virus and Newcastle disease virus after vaccinations with turkey herpes-virus and the B-1 LaSota strain. This, coupled with the fact that it prevents experimental lymphoid leukosis, makes mibolerone a potential agent to be used under field conditions for the control of lymphoid leukosis.