Multidirectional interactions in vitro between lymphoid cells from Mls-disparate strains.

Chromosome 1 of the mouse carries a number of genes for alloantigens which can be recognized by T cells, among those the mixed lymphocyte stimulation (Mls) locus and the lymphocyte stimulating determinant (Lsd) locus have been described. The Relationship between the antigens coded for by these two loci has been further analyzed using a B10.BR anti C3H/Tif T cell clone E11. Segregation analysis was done with 167 individuals from backcrosses of (BALB/c (Mlsb, Lsd-) x DBA/2 (Mlsa, Lsd+] F1 animals into BALB/c mice. The analysis of the backcross data and of a limited number of recombinant inbred (RI) strains did not allow the segregated of the two loci, despite the fact that stable clusters were obtained in cluster analysis of the segregation data. The reasons for this failure are discussed. Parallel to the genetic analysis, we have studied the functional properties of the E11 T cell clone. First, there is the proliferation of the E11 T cells upon stimulation by macrophages or B cells of Mls-disparate stimulator strains. Second, there is an induction of differentiation of B cells of stimulator strains, requiring the direct interaction between E11 T and stimulator B cells. Third, there is an inhibitory influence of E11 T cells on the production of a mediator by Mls-disparate spleen cells presumably by their macrophages. We propose that the Mls antigen is a receptor regulating macrophage differentiation and transmitting a signal influencing the production of a mediator. This signal could be either the down regulation of the production of a stimulatory monokine or the induction of the production of an inhibitory monokine. Our presented data demonstrate that the anti Mls response is more complex than hitherto anticipated. It involves a multidirectional interaction between the Mls-disparate cell partners.

The pattern of the mononuclear infiltrate as a prognostic parameter in flat superficial spreading melanomas.

The mononuclear cell infiltrate of 90 superficial spreading melanomas (SSM) of less than or equal to 1.5 mm thickness was analyzed at different locations around and within the tumors. All patients had been followed for at least 5 years, and 20 (22%) had developed metastases. A correlation between the overall inflammatory response in the histologic sections and the prognosis was not observed, nor could a significant distinction be made between metastasizing and nonmetastasizing melanomas when the mononuclear cell infiltrate was analyzed at different locations. A significant clustering of metastasizing tumors was, however, observed in the subgroup with a relatively strong infiltrate within the tumor compared with the overall infiltrate. From this observation, a semiquantitative description of the pattern of the infiltrate was established. It provides an additional parameter for prognostication in flat SSMs and it raises new questions about the role of the local host-tumor interaction.

[Results of the marketing research study "Acceptance of physician's office computer systems"]. / Ergebnisse der Marktforschungsstudie "Akzeptanz von Arztpraxis-Computersystemen".

We report on a market research study on the acceptance of computer systems in surgeries. 11,000 returned questionnaires of surgeons--user and nonuser--were analysed. We found out that most of the surgeons used their computers in a limited way, i.e. as a device for accounting. Concerning the level of utilisation there are differentials of Men-Women, West-East and Young-Old. In this study we also analysed the computer using behaviour of gynaecologic surgeons. As a result two third of all nonusers are not intending to utilise a computer in the future.

Evaluation of systemic tolerance of 42.0 degrees C infrared-A whole-body hyperthermia in combination with hyperglycemia and hyperoxemia. A Phase-I study.

PURPOSE: In September 1965, Manfred von Ardenne presented in the Heidelberg Cancer Research Centre the concept of his so-called systemic Cancer Multistep Therapy--a combined modality treatment including whole-body hyperthermia. At the time, whole-body hyperthermia was attained by a warm water bath plus induced hyperglycemia and a high dosage application of oxygen. After 25 years of basic research, methodical processing and further development of a practical infrared-A hyperthermia technology, the therapy achieved clinical maturity. Within the framework of a clinical phase-I study that was carried out in 1991, we set out to prove the systemic tolerability of systemic Cancer Multistep Therapy. PATIENTS AND METHODS: 103 patients, who had been previously treated with virtually all forms of conventional treatment in its most extensive form and who were in a stage of uncontrollable progression with metastasis growth and/or recurrent primary tumors, were treated within the framework of a clinical phase-I study with the objective of reaching a palliative progression stop. Body core temperatures of 41.8 +/- 0.2 degrees C were attained by means of a special infrared-A machine named IRATHERM 2000 with the aim of reaching a plateau phase of 60 to 70 min. A high dosage of glucose (10% glucose solution, 500 to 700 ml/h, blood glucose level 410 +/- 90 mg/dl) was administered intravenously to intensify lactacidosis and thereby the thermal sensitivity of the malignant tumors to be treated. Using a laminar flow applicator (up to approximately 30 l/min O2 flow), the arterial oxygen partial pressure paO2 was increased to 163 +/- 50 mm Hg. For premedication and neuroleptic analgesia, a combination of dehydrobenzperidol and fentanyl was used. Blood pressure, ECG, oxygen saturation, blood-gas status and hematocrit were monitored continuously and changes in blood electrolyte concentrations were corrected by appropriate intravenous infusions. In terms of systemic tolerability, systemic Cancer Multistep Therapy (whole-body hyperthermia+hyperglycemia+hyperoxemia) induced pathophysiologically no obviously toxic or otherwise detrimental effects. In isolated cases, sporadic erythemas on low perfused skin areas or occasional emesis were observed after the end of the treatment. RESULTS: The good systemic tolerability of the systemic Cancer Multistep Therapy with only minimal side effects has thus been proven. The hyperthermic IRATHERM machine used to attain the extreme whole-body hyperthermia showed that it was a reliable and practical unit. When UICC criteria and other criteria defined for integrated tumor therapies of systemic character were applied, over 50% of the patients treated had a positive therapeutic response. CONCLUSION: The good systemic tolerability of the systemic Cancer Multistep Therapy on the one hand, and the positive therapeutic influence on the course of the illness on the other hand, justify the intensified continuation of studies on the effectiveness of systemic Cancer Multistep Therapy.

[The importance of radio-allergo-sorbent-test in comparison with intracutaneous test in diagnosis of allergic diseases].

A comparison of clinical skin-tesing using the prick-test and the intracutaneous test with the radio-allergo-sorbent-test (RAST) in 167 patients with different immediate-type allergies showed concordant results in 75.7 per cent of the cases. In 20 per cent of the cases, the skin-test was positive while the simultaneous RAST was negative. Results in male and female patients did not show any important difference. The two test methods agreed well with selected antigens, e.g. grass-pollen, animal-epithelium, fungi and egg white; whereas, the two methods showed considerably different results using tree pollen and housedust as antigens.

[Vegetative disorders in children with cerebral palsy. Results of an inquiry of parents]. / Vegetative Störungen bei zerebralparetischen Kindern. Ergebnisse einer Elternbefragung

Many of the disturbances resulting from dysregulations in the autonomous nervous system of children with cerebral palsy are rarely discussed in the doctor's praxis. Nevertheless, they are causes of trouble and worry for the parents. For this reason we started an inquiry into this matter. Questionnaires were sent to the parents of 452 C.P. patients. 374 were answered with sufficient care. The following factors were evaluated: sleep, bladder and bowel activity, temperature regulation, vomiting, sweating, blood circulation, growth. The C.P. children were compared to their own siblings especially to the next younger ones. The diagnoses were as follows: Spastic tetraplegia 197 patients. Spastic hemiplegia 44 patients, Athetosis 33 patients, Mixed cases of spasticity and athetosis 82 patients, Other 15 patients. The degrees of handicap in terms of motor development were: severe (unability to sit unsupported) 166 cases, moderate (unability to kneel or walk unsupported) 118 cases, mild (ability to kneel and/or walk unsupported) 87 cases. Summarized, the statements of the parents gave the following results: sleep disturbances: 169 cases (46%), constipation: 145 cases (39%), tendency towards temperature dysregulation: 112 cases (30%) , tendency towards increased vomiting: 91 cases (25%), sweating increased or decreased: 110 cases (30%), irregular and frequent voiding of bladder: 92 cases (25%), unstable regulation of blood circulation: 101 cases (27%), cold skin: 264 cases (71%), body-length deficit: 119 cases (32%), low-weight: 177 cases (48%), feet too small for age: 252 cases (68%). Results are related to diagnosis and severeness of handicap. In addition, it is discussed, whether there are relations between several of the investigated factors. The influence of the patients sex is discussed.