High-dose intravenous immunoglobulins in HIV-1-infected adults with AIDS-related complex and Walter-Reed 5.

The influence of high-dose intravenous immunoglobulins (HD-IVIG) on the clinical status and T4 cell count of adults with AIDS-related complex (ARC) and Walter-Reed 5 (WR5) was evaluated in a randomized double-blind longitudinal study. Inclusion criteria were: (1) T4 cells less than 400/microliters and (2a) oral thrush or cutaneous anergy or (2b) two clinical ARC criteria (fever, diarrhea, weight loss, fatigue, night sweats). Thirty patients [28 males, 2 females, median age 41 (24-64) years] with ARC (n = 8), WR5 (n = 12) and both (n = 10) were stratified according to their T4 cell count (greater than or equal to vs. less than 300/microliters). Fifteen patients received 0.4 g/kg body weight IVIG and 15 placebo (albumin 0.03%) every other week for 26 weeks with follow-up for another 26 weeks. The clinical status was defined as a score consisting of fever, diarrhea, night sweats, fatigue, weight loss, oral candidiasis and mucosal or cutaneous herpes simplex. Clinical examination and routine laboratory assessments were performed before initiation of the study and before each administration, lymphocyte phenotyping every 4 weeks and cutaneous reaction, serology and lymphocyte stimulation every 12 weeks. Both groups were comparable in initial clinical symptoms and laboratory values. Seven patients developed AIDS (treatment group: 3, placebo group: 4), 1 patient died by homicide. After 26 weeks, the clinical score (particularly fatigue and fever) was significantly improved in the treatment group, while the T4 cell count and other clinical and immunological parameters remained unaltered. This limited effect was still evident at termination of the study after 52 weeks. In conclusion, HD-IVIG can improve the clinical status of patients with advanced HIV-1 infection without obviously correcting the underlying impaired cellular immunity. The substitution of intact antibodies in the state of functional hypogammaglobulinemia is suggested as possible therapeutic mechanism.

[Detection of fibrinolytic split products in patient collections with disordered hemostasis. I. In pathologically verified lung cancer. II. In thrombotic/embolic occurrences]. / Uber den Nachweis fibrinolytischer Spaltprodukte bei Patientenkollektiven mit gestörter Hämostase. I. Bei pathologisch veriffizierten Lungenkarzinomen. II. Bei thrombotisch/embolischen Geschehen.

56 patients afflicted with pathologically-histologically ensured carcinoma of the lungs and bronchial system as well as 15 patients with thrombotic/embolic processes under streptokinase therapy were examined for defects in their coagulation system and for fibrinogen split products by using methods of reptilase time (RPZ) and staphylococcal clumping test (SCT). 1. Quantitatively more split products could be identified in patients after surgery and in those without any specific therapy than in patients under irradiation and chemotherapy. 2. With growing tumour expansion a more and more diminishing fibrinolytic activity could be observed in all therapy forms. 3. After initiating cytostatic chemotherapy with adriamycin, the highly molecular split products X and Y increasingly appeared at the initial stage. They disappeared with progressing therapy. 4. Under streptokinase therapy a characteristic redistribution of the FSP-pool from predominantly highly molecular fragments at the initial stage to lower molecular ones could be observed with falling SCT values and constant RPZ after approximately 48 hours.

[The demonstration of HL-A antigens on thrombocytes under various conditions]. / Der Nachweis von HL-A-Antigenen an Thrombozyten unter verschiedenen Konditionen

Platelets of healthy test persons were gained according to the method of Aster (avital cells) and according to the procedure of BUBE and GMURZYNSKI (vital cells). Because of their tendency towards aggregation vital cells do bind any HL-A antibodies and whereas avital cells will fix antibodies and complement depending on the height of the titre. Thrombocytes stored in the own serum will respond less to the micro-C'-fixation test at + 4 degrees C as well as--196 degrees C, whereas storage in NaN3/NaCl and under the conditions of the own serum will reveal no differences up to--196 degrees C in each case.

[The relevance of schizocyte demonstration for the diagnosis of rejection in patients with transplanted kidneys]. / Uber die Relevanz des Schizozytennachweises für die Erkennugn der Rejektion bei nierentransplantierten Patienten

Schizocytes may be obtained, if erythrocytes are being pressed through glassfibre threads under pressure. For the purpose of explaining the different mechanisms of schizocytes origin, model tests were made in the haemoresistometer according to Fleisch and in the shaking water bath. As schizocytes can easily be identified, they will yield valuable differential-diagnostical informations and will give a high evidence in checking the progress of transplanted patients.

[The effext of papain, neuraminidase and AET on the behavior of lymphocytes in cytotoxicity tests]. / Uber den Einflubeta von Papain, Neuraminidase und AET auf das Verhalten von Lymphozyten im zytotoxischen Test

The influence of papain, neuraminidase and AET to lymphocytes is reported. All three substances strengthen the lymphocytotoxic reaction in low concentrations or by short incubation time and lower it in higher concentrations or longer incubation since. Membrane changes by these three substances are reversible under defined conditions.

[Changes in transplantation antigens of the dog due to cerebral ischemia and their demonstration using the cytotoxic test]. / Hirnischämisch bedingte Veränderungen der Transplantationsantigene des Hundes und ihr Nachweis im cytotoxischen Test

Experiments were performed on 19 mongrel dogs. Changes of transplantation antigens by anesthesia and by brain ischemia were identified in cytotoxic tests. Brain ischemia was responsible for the significant alterations in 5 antigens, anesthesia alone induced significant changes in 3 antigens.