[Phlebography (author's transl)]

The article discusses the limitations of conclusive information supplied by different phlebographic methods. Particular attention is drawn to the insufficient staining properties, partly of the deep veins of the lower leg, the vena femoralis profunda and gastrocnemius veins. When assessing the course of acute phlebothromboses, conclusive information on the extent of thrombus formation is limited in complete obstruction of deep veins as well as in the reformation of thrombi in vessels which have already undergone post-thrombotic changes. Observation of the valvular function can supply essential information on the extent of fibrinolytic effects. Besides the conventional phlebographic techniques, the article also explains methods for the visualisation of rare angiomatoses with osseous involvement, using transosseous pelvic phlebography.

[Colonic stenosis after pancreatitis]

In 5 out of 35 patients with acute, acute relapsing and chronic pancreatitis, barium enema revealed partial colonic stenosis at the splenic flexure. In 3 patients laparotomy disclosed colonic perforation with abscess, adhesions between colon and pancreas or a marked pancreatic edema. In two patients barium enema follow-up 3-6 months later showed spontaneous resolution of the stenosis. Comparison with 35 cases in the literature shows that colonic stenosis after pancreatitis is usually incomplete, located at the splenic flexure and due to adhesions between the colon and the pancreas. Spasmodic pains in the upper abdomen, increasing constipation and often rectal bleeding or positive guaiac test of the stool may indicate colonic stenosis. Spontaneous resolution is possible, but if operation is indicated the adhesions should be carefully dissected in order to obviate resections of the colon or the pancreas.

[Phlebography of the lower limb (author's transl)]

Description of the techniques of ascending phlebography and retrograde pressure phlebography of the leg and of means of showing insufficient perforating veins with selective percutaneous or intra-operative injection of contrast-media. Misinterpretation of the deep veins owing to muscular contraction for insufficiently continuous filling is explained. Phlebographic diagnosis of recent phlebothromboses, taking into accout isotope diagnosis, is particularly important for the recognition of post-traumatic so-called masked thromboses. The effectiveness of phlebography for the clarification of neurosegmental angiomatoses is discussed.

[Sterno-costo-clavicular hyperostosis: a hitherto undescribed entity (author's transl)]

Persistent pulling pain in the sternum, clavicles and both first ribs, especially during cold and wet weather, necessitated medical investigations and treatment in 3 patients. Externally a cylindrical or spindle-shaped swelling of the clavicles was noticeable and two patients had signs of superior caval obstruction in addition. X-rays showed hyperostosis of the sternal and middle part of the clavicle, synostosis of the sternoclavicular joints with involvement of the two first ribs as well as a thickening and increase in breadth of the sternum. In one patient there were additional swellings of the first to fourth ribs bilaterally. During the period of observation there was no radiological progression of the bone disease. Apart from a consistently raised erythrocyte sedimentation rate blood chemistry was normal. The sterno-costo-clavicular hyperostosis led to bilateral occlusion of the subclavian veins with resulting upper venous congestion in two patients. Histology of the biopsy samples showed a characteristic hyperostotic spongiosclerosis in all three cases. The cause of this sterno-costo-clavicular hyperostosis is unknown. Clinical, radiological and histological findings indicate that it is a uniform disease which has not previously been described.

Isoantigens A, B and H in benign and malignant lesions of breast

Eighty-five specimens of breast tissue were grouped and investigated by the technic of mixed cell agglutination reation (MCAR) for studying isoantigens A, B and H (O). MCAR was found to be strongly positive at the epithelium of acini in all the 25 subjects with benign lesions (10 fibroadenomas, 10 cystic mastitis and 5 gynecomastias). On the other hand, all the subjects with diagnosis of primary carcinomas in breast (45 subjects) and their metastases (15 subjects) were found to be uniformly negative for any agglutination reaction. In view of these findings, it seemed that the isoantigens in primary and metastatic malignancies of breast are always lost, while in the benign lesions isoantigens are always present. Although the exact mechanism is not understood, it seems that, in malignancies with a glandular differentiation, some differences exist when these are compared to malignancies with a squamous differentiation. The various possibilities are discussed in the light of previous studies.

Loss of isoantigens A, B and H in prostate

Formalin-fixed tissues from 65 prostates were grouped and investigated by the technic of mixed cell agglutination reaction (MCAR) for studying isoantigens A, B and H. The results of this study indicated that the MCAR was strongly positive at the epithelium of the acini in the majority of patients with benign prostatic hyperplasia. On the other hand, patients with primary carcinomas and metastatic carcinomas of prostates were found to be uniformly negative for any agglutination reaction. Prostates from a group of younger individuals only showed a patchy distribution of the MCAR at the epithelium of the acini. In view of these findings, it seemed that the traces of isoantigens in normal prostates show a considerable increase when the disease process of BPH becomes manifest in this organ, while in cases of primary and metastatic carcinomas the isoantigens are totally lost. In the light of previous studies on similar lines, the various possible mechanisms for this sudden transition are discussed.

A comparative immunohistochemical study of splenic arterial hyalinosis in health and disease

Hyaline deposits in arterioles and arteries of spleen were studied immunohistochemically. Hyaline lesions in arteriosclerotic heart disease were characterized by significant deposits of IgG, IgM, beta1C-beta 1A-globulins and beta-lipoproteins. These corresponded to histochemically stained deposits of acid mucopolysaccharides and microscopic areas of musculoelastic tissue damage in the hyaline masses. While, in young adults and a few other cases of other diseases, an occasional granular to linear deposit of IgG, IgM, beta1C-beta 1A-globulin and beta-lipoprotein was noted, no localization of IgA, rabbit antihuman fibrin and rabbit antihuman fibrinogen was seen. A variety of other histochemical staining reactions were found to be negative. These findings suggest that: a) hyaline deposits in splenic arterioles and arteries occur with greater severity in patients with hypertensive and arteriosclerotic heart disease; b) a possible abnormality related to filtration defects in arteries and arterioles, resulting in the trapping of plasma proteins, appears likely; c) increased localization of acid mucopolysaccharides and destruction of musculoelastic tissue is not an uncommon feature in hyaline masses; d) fibrin is not a component of these deposits and e) further study of other organs is necesary to observe the composition of hyaline in arterioles and arteries.