Germinal center derived malignant lymphoma in cystadenolymphoma.

Two cases of malignant non-Hodgkin's lymphoma arising in an Albrecht-Arzt-tumour are reported. In the first case a centroblastic-centrocytic lymphoma in a palatinal cystadenolymphoma of a 64-year-old female is described. In the other case a centroblastic lymphoma developed in an Albrecht-Arzt-tumor of the submandibular region in an 82-year-old man. The occurrence of a high-grade malignant lymphoma in cystadenolymphoma has not been reported in the literature so far.

[Angiographic and isotopic studies following pole resection of kidneys in dogs and hemostasis performed by infrared-contact-coagulation (author's transl)]. / Angiographische und nuklearmedizinische Untersuchungen nach Polresektion von Hundenieren und Blutstillung mit dem Infrarotkontaktkoagulator.

It has been shown in an animal experiment that alterations of the renal vasculature and parenchyma after hemostasis performed by Infrared-Contact-Coagulation are best shown by intravital magnification angiography (magnification factor 2.22). Following pole resection and hemostasis the final morphologic state is reached 6 weeks postoperatively. The resulting scar penetrates into the parenchyma up to 1 cm. The loss of function corresponds to the parenchymal defect. There was no additional loss of renal function or damage to the parenchyma on nuclear medicine or histologic examinations.

Blood transfusion-induced facilitation of kidney graft survival in rats (congenic-resistant strains).

The correlation between the degree of histoincompatibility and kidney graft survival after active sensitization by blood transfusions has been investigated in congenic resistant strains of rats with MHC (H-1)-restricted incompatibility as compared to standard strains. It has been found that the beneficial effect of transfusions for graft survival becomes most evident when compatibility for the so-called minor non-H-1-antigens exists. H-1-congenic rats with MHC differences alone show indefinite graft survival irrespective of the interallelic combination. Donor-specific sensitization is the treatment of choice. Third-party blood is by far inferior. H-1-identical, but non-H-1-different blood, with respect to the recipient strain genotype, is ineffective in the facilitation of H-1-different grafts. The facilitation effect does not increase with the number of blood injections. As early as 1 week after blood treatment, there is permanent survival of grafted kidneys, but there is a definite loss of graft-protecting factors with time.

Transplantation-induced immune complex kidney disease in rats with unilateral manifestation in the allografted kidney.

Kidney transplantation between major histocompatibility system-identical rat strains LEW.1N (donor) and BN (recipient) is regularly followed by serious immune complex (membranous) glomerulonephritis. The disease localizes in the transplant only and spares the recipient's own contralateral kidney. The recipients develop both circulating immune complexes, as well as circulating antibodies against an allogeneic, tubular epithelial antigen of the donor. Antibodies eluted from the diseased kidneys display the same specificity. The transplant disease, therefore, is not autoimmune glomerulonephritis but an alloimmune, organ-specific illness unrelated to the usual histocompatibility system.

[Immunsuppression by vitamin B6-antagonists. Prolonged survival of inbred rats with renal transplants (author's transl)]. / Immunsuppression durch Vitamin B6-Antagonisten. Verlängerte Uberlebenszeit von Inzuchtratten mit Nierentransplantaten.

The combined effect of Vitamin B6 free diet and 4-Desoxipyridoxin (a potent Vitamin B6-Antagonist) on the rejection reaction of inbred rats after renal transplantation was investigated. More than 90% of the control animals without Vitamin B6-deficiency died between 7 and 13 days with uremia due to an acute transplant rejection, where as the Vitamin deficient and successfully transplanted animals (n=38) showed a significantly prolonged survival time. In 17/38 rats survival was longer than 35 days. Vitamin B6-deficiency, induced by Desoxipyridoxin and Vitamin B6-deficient diet offers the possibility of an effective and reversible immunosuppression in renal transplantation.

Periarteritis nodosa and thrombotic thrombocytopenic purpura with serous retinal detachment in siblings.

Periarteritis nodosa and thrombotic thrombocytopenic purpura in siblings is reported. In both patients a localised serous retinal detachment and lesions of the retinal pigment epithelium had developed owing to choroidal vascular obstruction. These cases support the suggested possible relationship between the two conditions.

[Renal perfusion during experimental hyper-acute rejection. 133-xenon perfusion compared with microscopy and angiography (author's transl)]. / Nierenperfusion bei hyperakuter xenogener abstrssung im Tierversuch. 133-Xenon-Durchblutung im Vergleich zur Mikroskopie und Angiographie.

Twenty-two cat kidneys and 11 pig kidneys were incorporated into canine circulatory systems. The delayed hyper-acute and hyper-acute rejections produced by these models were studied with respect to blood flow and blood distribution with an intra-arterial 133-xenon wash-out technique at intervals of 7-30 minutes until the death of the kidney at 40 minutes to twelve hours. In addition, magnification angiograms and serial cortical biopsies were obtained for continuous histological study of the rejection phenomenon. At the beginning of the rejection process, there is a reduction in blood-flow through the cortex. During delayed hyper-acute rejection, cortical flow could no longer be demonstrated 180 minutes after the period of flow maximum. After A.L.G. treatment of dogs, rejection could be delayed for ten to twelve hours. Magnification angiograms showed characteristic changes consisting of irregular segmental and interlobar arteries, occlusion of small cortical vessels and focal contrast accumulation in the renal cortex. The changes in blood-flow and blood distribution measured with 133-xenon and the vascular findings on the angiogram could be correlated with the microscopic findings. Serial estimations of blood flow and blood distribution with the xenon blood wash-out technique permit differentiation between shock kidney and rejection following renal transplantation.

[Birth analgesia: late effects on newborn infants? (author's transl)]. / Geburtsanalgesie: Spätwirkungen beim Kind?

Based upon scanty literature we discuss, whether unexpected fatal apneic spells of two full-term, apparently vigorous newborn infants at an age of 3 and 37 hours, respectively, may be related to Pethidine (+ Levallorphane) given to their mothers shortly before birth.

[Organ tolerance and incomplete bone marrow chimera in dogs]. / Organtoleranz und inkompletter Knochenmarkchimärismus beim Hund.

Cyclophosphamide-induced chimeras develop organ tolerance as do radiation chimeras, as long as hemopoietic cells of donor origin are detectable, independent of the degree of chimerism (n = 7). 4 of 7 dogs with reversion of chimerism rejected their kidney grafts within 11 to 29 days. Three of them, however, retained their kidney grafts permanently indicating that a transient chimerism of a few months duration may be sufficient for induction of tolerance to marrow donor organs in Cy-chimeras. The results suggest that the reversion of chimerism in Cy-chimeras may be due to different mechanisms either immunological rejection or a non-immunological substitution of the grafted marrow by the host's own hemopoiesis.

Kidney transplantation following treatment with cyclophosphamide and bone marrow grafting.

Canine cyclophosphamide (CY) chimeras permanently accept kidney and skin grafts as do radiation chimeras. Three of five dogs with reversion of chimerism rejected their kidney grafts within 11-16 days, while two of them retained their kidney grafts permanently. These results suggest that the reversion of chimerism in CY chimeras may be due to different mechanisms, either immunologic rejection or a nonimmunologic substitution of the grafted marrow by the host's own hemopoiesis.

[The infrared contact coagulator for hemostasis in the renal parenchyma (author's transl)]. / Blutstillung am Nierenparenchym mit dem Infrarot-Kontakt-Koagulator

Investigations on hemostasis with the infrared contact coagulator (ICC) after renal pole resections in dogs with and without clamping of the renal vessels are reported. Clamping the renal vessels led to less bleeding, but the coagulation time was distinctly prolonged. In addition the use of ICC in renal pole amputations in humans is described in two cases of urogenital tuberculosis. In both cases we were able to stop the bleeding quickly and satisfactorily without clamping the renal vessels. The results of animal experiments and the significance of using the ICC in man are discussed.

Vascular transplant rejection of rat renal allografts across strong histocompatibility barriers.

Sixty-one rat renal allografts were studied by light microscopy and in 18 cases also by immunohistology. Donor and recipient differ at a major histocompatibility locus in the one group (n = 37), and by an additional weak histocompatibility antigen in the other (n = 24). The mean survival time is 10.4 days and 8.3 days, respectively. A semiquantitative grading of the histologic findings shows that in both groups the rejection is predominantly manifested by lesions of extraglomerular and glomerular vessels, whereas mononuclear cell infiltration appears to be of less significance. The essential findings are necrosis of arteries and arterioles, necrosis of glomerular cells with mesangiolysis, and focal tubular necroses. This morphologic rejection type is interpreted as the result of a mixed humoral and cellular immune response, although the constant participation of circulating antibodies in the vascular damage could not be established. Since the tubular necroses correlate well with the degree of vascular alterations, but not with the mononuclear cell infiltration it would seem reasonable to conclude that these necroses are secondary to ischemia produced by vascular lesions. Finally, there is no significant difference in the degree of rejection between the two donor/recipient groups, and, therefore, there is no morphologic evidence for an increase of the rejection process by additional weak histoincompatibility in the examined strain combinations.

[Renal blood flow investigations with 133xenon and the Anger scintillation camera in the hyperacute xenograft rejection of the rabbit kidney (author's transl)]. / Durchblutungsmessung mit 133Xenon und der Anger-Szintillationskamera bei der hyperakuten xenogenen Abstossungsreaktion (HXAR) der Kaninchenniere

The aim of this study was to demonstrate the advantage and validity of 133Xe-washout externally monitored by the scintillation camera. Until now there were no reports on quantitative blood flow studies in Hyperacute rejection of transplanted kidneys using a scintillation camera. Within 35 minutes after e-vivo hemoperfusion of rabbit kidneys by cats we found a simultaneous progressive decrease of renal blood flow, renal cortical blood flow as well as of the intrarenal distribution of renal cortical blood flow in all cases. The hyperacute rejection of xenografts could be verified in every case histologically. Using the scintillation camera we were able to detect regional perfusion defects caused by artifical air embolism as well as by preexisting cortical infarction.

Dominant role of complement in the hyperacute xenograft rejection reaction.

Xenotransplantation in distantly related donor-recipient systems is rejected within minutes. According to present theories, hyperacute rejection is due to preformed antibodies. However, our results suggest that a nonimmunologic reaction plays a dominant role in the hyperacute rejection reaction. To analyze the hyperacute rejection reaction, a previously described model of isolated in vitro xenohemoperfusion was used in which rat kidneys were perfused with dog blood at constant pressure. Rejection criterion was cessation of xenograft perfusion flow rate with constant perfusion pressure and histologic findings of aggregation of thrombocytes and endothelial lesions. In our experimental approach, the donor kidney was perfused with separate cellular and humoral components of the recipient blood with redetection of the rejection activity in one of the recipient blood components. Each blood component was tested for preformed antibody before hemoperfusion. In control studies, xenoperfusion of rat kidneys with whole blood from the dog always resulted in hyperacute rejection. In contrast, allogenic perfusion with whole blood caused no rejection. In three groups, typical hyperacute rejection occurred. Perfusion with whole blood from newborn dogs; no preformed antibodies in vitro; perfusion with reactivated dog whole blood containing no preformed xenohemoagglutinating antibodies, which had been eliminated by adsorption, and perfusion with reactivated dog whole blood containing no preformed xenocomplement fixing antibodies also eliminated by adsorption, all resulted in hyperacute rejection. Whole blood from newborn dogs and reactivated, adsorbed antibody-free whole blood from dogs contained active complement. Perfusion of rat kidneys with heat decomplemented, antibody-containing or antibody-free dog blood showed no hyperacute rejection reaction. The addition of fresh complement to these last two groups resulted in typical hyperacute rejection.

Xenogeneic skin and kidney transplants in a closely related canine system, fox-dog.

Fox kidney and skin grafts were transplanted into dog recipients. Fox kidneys, transplanted en bloc into untreated dogs, survived 6.2 +/- 0.4 days. The skin transplants survived 5.9 +/- 1.4 days. The grafted kidneys showed almost normal function before rejection. Both skin and kidney rejection were mediated through a cellular mechansim. Performed natural antibodies against donor tissue were not present in the serum of the recipients. These results combined with absorption studies suggested a close relationship between fox and dog, but different number and morphology of chromosomes, immunoelectrophoretic patterns of serum proteins, and disparities of the transplantation antigens proved that the fox is a species quite separate from the dog. It was concluded that the fox-dog system, with its similarity to the chimpanzeeman relationship, offers a unique model to study clinically applicable methods of managing xenografts between closely related species.