The effect of synthetic peptides corresponding to Fc sequences in human IgG1 on various steps in the B cell activation pathway.

The influence of synthetic peptides comprising sequences in the exposed positions of the Fc region of human IgG 1 was tested on B lymphocyte activation. CH 2 domain peptides having an inhibitory effect on antibody-dependent cellular cytotoxicity, as well as the whole Fc fragment, induced the appearance of the early signs of activation on resting B lymphocytes such as increase in cell volume and HLA-DR antigen expression or leukocyte migration inhibitory factor production. The peptides did not induce proliferation of resting B cells even when B cell growth factor (BCGF)-containing supernatants were added. Exposure to Fc fragment, however, induced a weak proliferation which was significantly enhanced by BCGF. On the other hand, both the Fc fragment and the CH 2 or CH 3 domain peptides enhanced the IgM synthesis of human blood mononuclear cells when a suboptimal dose of pokeweed mitogen was present. This effect was lost when Fc fragment or the peptides were added on the third day of culture. These results suggest that the early steps of B cell activation can be induced by Fc fragment and by small molecular weight Fc peptides, which are potential ligands of Fc receptors. The Fc fragment activates B cells to the state where they respond to BCGF, but the peptides do not possess this activity. Furthermore, both Fc fragment and Fc peptides are able to enhance the IgM synthesis, when accessory cells and the appropriate differentiating factors are present.

The significance of x-ray examinations of limb musculature in neuromuscular diseases with special regard to childhood diseases.

On the basis of examinations performed on 29 children suffering from various muscular diseases, the authors give a detailed discussion of the application, indication and advantages of muscles x-rays in diagnosing neuromuscular diseases. With the help of x-rays of the musculature an inside view can be obtained in vivo, in a non-invasive manner, of structural changes in the muscles, and the progress of the disease can be followed up objectively. The method opens up new possibilities of diagnosis and promotes a more thorough knowledge of the pathological processes.

[Appearance of striations in muscle shadows - experimental studies]. / Uber das Auftreten der Streifenzeichnung im Muskelschatten - Experimentelle Untersuchungen.

The authors have been able to prove by means of phantom roentgenographs that the striations seen in x-ray films of muscle soft parts have their origin in an extremely thin layer situated close to the film. These striations are a true image of the conditions obtaining in muscular structure.

X-ray diagnostic sign for the differentiation of neurogenic and primary muscular diseases.

The authors give an account of x-ray examinations of the limb musculature of 70 patients suffering from neurogenic muscular diseases, 42 suffering from primary muscular diseases and 45 suffering from senile degeneration of the muscles. Different degree of damage to different parts of the same muscle could only been observed in one case of neurogenic atrophy (in the post-poliomyelitic state) and in two cases of senile degeneration, while it was found in 11 cases (20%) for the other muscular diseases. In the latter cases the more severe muscle damage, which could be demonstrated radiographically, was always found in the part of the muscle adjacent to a tendon. On the above reasons the authors consider that radiographically demonstrable partial or uneven damage to any particular muscle can be used as a new diagnostical information in distinguishing muscular diseases from neurogenic muscular atrophy.

Radiographic examination of the large tendons of the knee and ankle joints.

The authors present some interesting cases to illustrate the diagnostic potential of soft tissue radiography on the knee and ankle joints. Radiographs using the special soft tissue technique provide significant diagnostic assistance to estimate the morphologic alterations and give an objective basis for determining the disability of the patient.

Dose reduction in the low-energy X-ray diagnostics of extremities.

The authors determined the surface absorbed dose (Ds = 67-68 mGy) and the average absorbed dose (Dav = 13-15 mGy) by means of non-screen film radiography of the extremities. The authors recommend the use of xeroradiography (with a tungsten anode tube) or, first of all, a rare-earth screen - film combination (e.g. Kodak min-R + Nuklearmedizin NMB film). The two methods permit the dose values to be decreased by a factor of about 4 and 15, respectively. The dose values are smaller, at least for the 8 cm thick tissue equivalent phantom, when a tungsten anode is used instead of a Mo anode.

[Information on the X-ray morphology of muscle atrophies (author's transl)]. / Angaben zur Röntgenmorphologie der Muskelatrophien.

Using a special soft ray roentgenograph technique, the authors examined in 46 patients the musculature of extremities which was compulsorily inactivated. Inactivity in adults leads to reduction of volume in the muscle, not, however, to striation which would indicate fiber destruction. Congenital or early acquired restriction of mobility will necessarily produce lack of further development of the muscles concerned. If movement is completely excluded, striation indicating fiber destruction will be noticed in the atrophied muscles. The authors quote a case where the changes in the soft parts and bones of the extremities were noticeable as a result of congenital parietal lesion. The roentgenography of the musculature, as described in this article, permits the physician to arrive at new conclusions regarding the differentiation of the various kinds of muscular atrophy.

[Age-related radio-morphologic changes in the extremity muscles]. / Altersbedingte röntgenmorphologische Veränderungen der Extremitätenmuskulatur.

The authors examined the limb musculature of 133 individuals of various ages using a special soft tissue X-ray technique. In individuals under 45 years of age the broad striping indicative of group fibre necrosis in the musculature or of secondary interstitial lipomatosis was not observed at all. In older individuals, apart from a decrease in the volume of the calf musculature, diffuse striping was also characteristic, but not the rule. In certain cases fatty tissue proliferation was also observed in patches. Pathological changes in the musculature of the upper limbs due to old age were considerably rarer and less varied. The authors discuss the possible reasons and explanations for the pathological changes.

Use of X-ray techniques to demonstrate electively increased damage to certain muscles in patients suffering from muscular diseases.

In X-ray examinations on 38 patients suffering from muscular diseases the authors demonstrated electively pronounced damage to certain muscles in 18 cases. The decay of muscle fibres within a single muscle is not always uniform and is often bilaterally asymmetrical. Before biopsy or EMG examinations it is advisable to take an X-ray of the damaged musculature.

Roentgenmorphological aspects of muscular pseudohypertrophy.

Using special soft tissue X-ray investigations the authors have found that the increase in volume of the calf musculature in progressive muscular dystrophy does not seem to be in complete accordance with the criteria of pseudohypertrophy. It has been demonstrated that this structural alteration of the musculature does not damage the various muscles to an equal extent. It has been shown that in two cases of motoneurone lesions the total decay of the calf musculature was not followed by loss of muscle bulk. The volume of the damaged musculature remained unchanged, or increased, in consequence of the enormous increase in the fat and connective tissue. This structural alteration corresponds to the generally accepted definition of pseudohypertrophy.

Roentgenmorphological muscle changes in anterior horn cell lesions.

The author examined muscles in the extremities of 42 poliomyelitis patients using a special roentgenological technique. This method made it possible to objectively determine the size of the muscles in the soft tissues of the extremities. The volume and distribution of the increased amounts of fatty tissue in the muscle and the volume of normal muscle tissue led to draw conclusions regarding the histological state of the muscle. Roentgenmorphological changes are closely linked to muscle dysfunction. Roentgenological examination of the soft tissue provides a useful supplement to a muscle biopsy and to electromyographic examinations and is of value for the rehabilitation of the patients.

The Ehlers-Danlos syndrome causing lacerations in tendons and muscles.

A case of a 20 year old patient with an Ehlers-Danlos syndrome is described, in which a rupture of the Achilles tendon is repaired by a segmental tendon homograft. The function of the triceps surae returned to normal gradually and the plantar flexion was even weaker after 2 years. The technique and importance of the special radiography of the soft tissue is discussed with regard to the clinical diagnosis. Radiographs, histomorphologic and histologic results illustrate the course of the healing.

Radiographic diagnosis of closed muscle and tendon injuries of the upper arm.

The authors report their experiences with a special radiographic diagnostic technique with 74 closed muscle injuries. They discuss the normal anatomy and the possibility of verifying pathologic alterations with soft X-rays. This technique not only allows a diagnosis of the trauma, but also provides a basic background for estimation and evaluation of partial and total disability.

[The part taken by X-ray investigation for closed soft tissue injuries on the extremities (author's transl)]. / A röntgenvizsgálat szerepe a végtagok fedett lágyrészsérüléseinek diagnosztikájában.

Special X-ray pictures taken of soft tissues for the treatment of closed soft tissue injuries on the extremities, give valuable diagnostic advises. Rupture on the surface of muscles, the lesion to the tendon Achilles and the lig. patellae proprium, tumours, muscle waisting following plexus or periferial nerve lesions etc. by X-ray investigation can be exactly delineated and the site, extension and type of damage defined.

[Roentgenological findings in muscular alterations of extremities (author's transl)]. / Uber die Röntgenmorphologie der Veränderungen der Extremitätenmuskulatur.

A survey of roentgenological findings in muscular alterations of extremities based on the author's experiences and on the literature is presented. Following a description of the normal roentgen anatomy, the alterations in different diseases of interstitial lipomatosis are demonstrated. By roentgenological examinations different muscular lesions of the extremities can be differentiated and the clinical follow-up verified.