[Rehabilitation of the patient with myocardial infarct].
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Biomedical subjects
Publications and source records attributed to G Naumann.
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By means of the indirect haemagglutination reaction we examined for antibodies against the enterobacterial common antigen 113 sera of blood-donors and 588 sera of patients with chronic pyelonephritis. It could be shown that this antigen is not suitable for the proof of antibodies and thus for the serodiagnostics of a chronic pyelonephritis. Also the combination with the results of the antibody determination against the O-antigen of the homologous strain of the urine is without diagnostic relevance.
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A simple microscopic method for the quantitative determination of bacteria, leucocytes and epithelial cells was tested on 24 healthy subjects and 75 patients with the diagnosis of periodontal disease. It was found that the microscopic picture is on principle, in correlation with exact clinical data, suited for detecting periodontal disease.
A differentiation of E. coli rough strains is generally not well established in bacteriological urine diagnosis although these strains are relatively often isolated from urine samples of patients with urinary tract infections (see table 2). An exact characterization of rough strains seems to be necessary especially for the distinction between recurrent and reinfection during therapy and follow-up studies. The application of phage typing for characterization of E. coli rough strains isolated from urine is reported in the following paper, using a set of 13 phages (A-M) introduced by Marsik and Parisi (8). Out of 284 E. coli rough strains 166 (58.4 per cent) were found to be typable. Altogether 56 different phage patterns were observed. The most common phage patterns are presented in table 1. It is evident that GHK is the most frequent pattern occurring in 7 per cent of the strains investigated. The next most common patterns are M and BCDEIJLM (4.9 and 3.5 per cent, respectively). These, together with AM (3.2 per cent) and F (3.2 per cent) account for 21.8 per cent of all the rough strains tested. From the results it is concluded that phage typing may be a valuable tool for differentiation of E. coli rough strains.
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Urinary sediments of 64 pregnant women with significant bacteriuria which has been demonstrated several times before, have been investigated for the presence of antibody coated bacteria. Antibody titers were determined in the corresponding serum samples in addition and the results were compared with the clinical diagnosis. In 50% of pregnant women with pyelonephritis antibody coated bacteria could be demonstrated, while 60% of them had elevated serum titers. Taking into account both results in 80% of the pregnant women the clinical diagnosis of pyelonephritis could be confirmed. Pregnant women with asymptomatically significant bacteriuria never gave positive results, whereas pregnant women with cystitis mainly did have negative results. The demonstration of antibody coated bacteria in the urinary sediments of pregnant women with significant bacteriuria as well as the detection of elevated serum antibody titers with the indirect immunofluorescence technique against the urinary strain were found to be of importance for the valuation of a significant bacteriuria.
Urine (24-hour-specimen, 100-fold concentrated) and serum samples from adults with chronic pyelonephritis have been investigated for O antibody against the strain isolated from the urine by means of the indirect hemagglutination and indirect immunofluorescence technique. Using the hemagglutination technique about one third of the urine showed the presence of O antibody. The highest titer demonstrated was 1:16. O antibody determined by the immunofluorescence technique could be demonstrated in 54.9% of the urine samples. Titers up to 1:256 were found. Serum O antibody corresponded to those found in adults with chronic pyelonephritis. In general there was no correlation between urine and serum O antibody. The diagnostic and prognostic value of the results is discussed.
Microbiological methods occupy an important place in the diagnosis of pyelonephritis. Taking into consideration still open problems, the principles of the bacteriological and serological diagnosis of infections of the urinary tract are discussed.
A solid adenoma of the pigmented ciliary epithelium was removed by 9.0 X 6.0 mm "block-excision" (postoperative visual acuity 1.0). The black lesion with a velvety surface consists of very large cells packed with melanin granules of abnormal and variable density, structure and size. Striking intracellular vacuoles contain acid mucopolysaccharides, particularly sialomucins. The literature on tumors of the pigmented ciliary epithelium is reviewed. Criteria for the separation of adenomas for adeno- "carcinomas" (8 cases, all without metastases) from reactive hyperplasia (6 cases) are proposed. The histologic, histochemical and electronmicroscopic findings of our tumor show striking similarities to those of an adenoma of the retinal pigment epithelium.
A 68-year-old man died 18 days after the onset of ischemic optic neuropathy caused by histologically proven giant-cell arteritis. On histopathologic study of the eye, ischemic necrosis of the prelaminar and retrolaminar optic nerve was seen, along with the massive presence of acid mucopolysaccharides sensitive to testicular hyaluronidase. This finding was interpreted as an intrusion of vitreal material resulting from breaks in the internal limiting membrane and the pressure gradient from intraocular to extraocular tissues, an analogy to Schnabel degeneration in acute glaucoma.
Using the direct immunofluorescence technique antibody-coated bacteria were demonstrated in urine samples from 49 of 57 patients with the clinical diagnosis of chronic pyelonephritis, but were not observed in urines from 11 patients with cystitis. A correlation rate was found between the presence of antibody-coated bacteria in the urine seidment and elevated serum antibody titers in the pyelonephritis group as determined by the indirect immunofluorescence technique. Patients with elevated serum antibody titers without antibody-coated bacteria in the urine, and vice versa, were also found. Patients with cystitis did not have elevated serum antibody titers against the homologous strain isolated from the urine. The clinical diagnosis of chronic pyelonephritis could be confirmed in 86.5% of patients taking into account the presence of antibody-coated bacteria and/or elevated serum antibody titers.
Indirect immunofluorescence was used for the measurement of serum antibody titers against the hemologous urinary strain of infecting organism in patients with a clinical diagnosis of chronic pyelonephritis. The passive hemagglutination technique was employed for comparison. The antibody response of the patients was followed-up for a period of two to four years. In contrast to titers determined by hemagglutination, antibody titers determined by immunofluorescence were found to be persistently elevated, and the indirect immunofluorescence technique is considered a sensitive and reliable method for the serological diagnosis of chronic pyelonephritis.
Attempts were made to find out, if Trichinella (Tr.) spiralis could be detected by means of immunofluorescence. An applicable Trichinella antigen was prepared by applying pepsin digestion to trichinous muscular tissue of experimentally infected guinea pig. Different quantities of Trichinae were orally administered to guinea pig and rabbit, and even parenteral infection of rabbit was attempted, with the view to obtain immune sera. Oral infection was followed by the occurrence of antibody titres, between the tenth day from infection and the sixtieth day, when the experiment was disrupted. Highest antibody titres were established in the fourth through sixth weeks after infection. Titres in excess to 1:64 could not be recorded by means of indirect immunofluorescence. No antibody were detected by fluorescence serology after parenteral immunisation. The detection of Trichinella spiralis by fluorescence microscopy was somewhat problematic. When the preparations were evaluated, some secondary fluorescence was observed. It had been caused by remnants of undigested muscular fibrils, contaminants, and cell detritus not removable by the authors' method of preparation and, therefore, also recorded. That secondary fluorescence, however, was eliminated by secondary staining, using methylen blue. Hence, fluorescence should not pose any obstacle to automatic reading of the reaction. Some five or six hours were required to detect by means of indirect immunofluorescence Trichinella antigen as extracted from test animals. Yet, in practice carcass processing would go on in that time. The above results, consequently, appear to suggest that for detection of Trichinella spiralis immunofluorescence cannot even replace trichinoscopy under the condition that the time of antigen preparation was shortened.
The technique of H-antibodies determination in serodiagnosis of listeriosis used at present is capable of detection not only H-antibodies but also flagellar somatic antibodies in the sera. An attempt was made to increase the specificity of H-agglutinins. An experience in the preparation of pure H-antigen is described. However, it is impossible to detect positive H-agglutination either with the aid of a mixture of flagellae and latex or with pure H-antigen. After determination of H-antigen by the classic Widal reaction 405 sera sent to Rostok Institute of Medical Microbiology and Epidemiology because of suspected listeriosis were subjected to absorption with O-somatic antigen of listeria; as a result of which in 85.9% of the sera the amount of H-agglutinins decreased by 1-3 dilutions. Whereas before the exhaustion 90 sera had the H-titre of 1:321 and higher, only 15 such sera remained after the exhaustion.
A total of 165 sera and 142 eluates from filtration papers impreggnated with whole blood were examined in reaction of complement fixation against A/Hong Kong 1/68 (H3N2) and B/Johannesburg 3/56 virus. To perform HIT 152 sera and 155 eluates were used. The results obtained were elaborated statistically. The method of filtration papers does not seem to be suitable for HIT, whereas the CFT was in several cases practicable.
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