In order to study the physiological regeneration of the endothelium, "Hautchen", preparations of aortic endothelium were produced from 15 rabbits of different ages and studied autoradiographically. By determining the number of 3H-thymidine-labelled cells, the mitotic rate and the total number of cells per 0.12 mm2, we arrived at the following conclusions: (1) The mean generation time of endothelial cells increases with advancing age. The extension of the mean generation time of the endothelial cells, as deduced from the decrease in the 3H-thymidine labelling index and in the mitotic rate, mainly occurs during the first four months of life. (2) Neither between topologically different aortic segments nor between such portions of the aorta as are exposed to different flow-mechanical stresses could any considerable differences with regard to the reproduction rate of their endothelial cells be detected. The raised endothelial turnover in the area of the iliac bifurcation requires further studies.

Aging↗

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Acute salpingitis and thiamphenicol: a microbiologic and therapeutic study.

Eighty-five sexually active women with clinically suspected adnexitis and illness severe enough to require hospitalization were studied. The clinical diagnosis, based on anamnestic data and physical and pelvic examination, was confirmed by laparoscopy and by cultures for aerobic and anaerobic bacteria and for Chlamydia in both cervical canal and intraperitoneal secretions. A ten-day course of thiamphenicol was begun on an empirical basis after laparoscopy. The results showed that fever, an elevated erythrocyte sedimentation rate, and leukocytosis are unreliable diagnostic parameters and that laparoscopy in conjunction with microbial cultures is the only method by which a definite etiologic diagnosis can be established. Positive results of cultures of specimens from the cervical canal are sufficient for the diagnosis of infection due to Neisseria gonorrhoeae, whereas positive culture results for specimens from the intraperitoneal cavity are necessary for the diagnosis of infection caused by Chlamydia trachomatis. Primary treatment with thiamphenicol was successful in 77 (91%) of the 85 patients. Thus, thiamphenicol proved to be effective in the treatment of acute adnexitis.

Acute Disease↗

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Initial lesions of vascular aging disease (arteriosclerosis).

BACKGROUND: In contrast to the well-known morphologic lesions of arteriosclerosis, the initial changes of the disease are less obvious. Commonly, functional disturbances of the endothelium, endothelial dysfunction, are suggested. On the other hand the significance of age-dependent changes in the extracellular matrix with their important role in vessel wall permeability and other features associated with arteriosclerosis should not be overlooked. New topics deal with possible infectious factors, the genetic basis of the disease and the particularities of the unstable atheroma. OBJECTIVE: Alterations in nitric monoxide and endothelin-1 balance of the endothelium are the key events in the initiation of arteriosclerosis induced by oxidized lipoproteins, cigarette smoking and endotoxin. This frequently supposed mechanism contrasts with earlier opinions on the primary alterations in glycosaminoglycan metabolism and other components of the extracellular matrix against atherogenic factors like hypertension, stress and physical inactivity. Based on a survey of the literature and our own experimental experiences, these changes in connection with the morphometrically determined age-conditioned increase in vascular wall thickness and the above-mentioned new topics on arteriosclerosis were analyzed. CONCLUSION: The initial lesions of arteriosclerosis starting in youth seem to be fundamentally different from those beginning in old age. The first step in the development of fatty streaks in the arteries of young people is endothelial dysfunction with a decreased formation of nitric monoxide and an increased expression of adhesion molecules. In comparison the genesis of arteriosclerosis in advanced age is characterized by metabolic changes in the endothelium combined with age-conditioned alterations in the extracellular matrix resulting in faster progression of the disease in old age. The multicausal genesis of arteriosclerosis cannot be doubted even if cooperation with infectious factors cannot be excluded. The histopathologic peculiarities of unstable atheroma are described.

Aged↗

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Can atherosclerosis regress? The role of the vascular extracellular matrix and the age-related changes of arteries.

BACKGROUND: Previous extensive clinical studies, using angiography or ultrasound, investigated the influence of alimentary, medicamentous and other antiatherosclerotic measures on the degree of atherosclerosis. The following signs of regression were found: clinical improvement, changes in tonus of vascular walls, formation of collateral vessels or reduced occurrence of circulatory disturbances. Evidence of a diminution of plaque size was hardly ever produced from appropriate procedures in human pathology. A clear differentiation of regression and stop of progression was generally not possible. OBJECTIVE: Causes of the difficulties arising in the evaluation of the atherosclerotic process are analyzed based on a review of the current literature. Prospects of regression in different forms of atherosclerosis were discussed. CONCLUSIONS: The strength of imaging diagnostics is limited above all by the remodeling of vascular walls, interfering age-related changes in arteries and the heterogeneity of atherosclerotic lesions in addition to the extremely protracted course of atherosclerosis matched by a corresponding extremely slow regression. Early lesions up to the preatheroma as classified by Stary et al. [Arterioscler Thromb Vasc Biol 1995;15:1512-1531] are considered reversible. Advanced lesions can probably be stabilized by antiatherosclerotic measures. Knowledge of collagen composition, proteoglycans, matrix metalloproteinases and other constituents of the vascular extracellular matrix as well as the histoarchitecture of atherosclerotic plaques using magnetic resonance tomography opens up new prospects for the assessment of regression of atherosclerosis.

Aging↗

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[Acardius in twin pregnancy].

The acardius is a rare but severe congenital anomaly. It occurs only in the context of multiple pregnancies and vascular anastomosis between the involved fetus and a multiple in cases of monochorionic placenta. The prenatal diagnosis of an acardius always has to be presumed in a multiple pregnancy within which a twin pair grow whenever cardiac activity can not be proved echographically. We present an acardius in a spontaneous twin pregnancy and discuss--based upon literature research--pathogenetic mechanisms, pathologic-anatomic and echographic conditions as well as therapeutic approaches in favor of the healthy multiple.

Abnormalities, Severe Teratoid↗

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[Late results of xenon photocoagulation of retinal diabetic lesions (author's transl)].

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Adult↗

PubMedDate not supplied

[Amniotic fluid and blood coagulation].

A study was made of the incidence and activity of coagulation factors in normal amniotic fluids. According to the results, two groups of amniotic fluid can be distinguished. To group A belong those that are transparent, showing an activity similar to Russell's viper venom. To group B belong the fluids that are milky and translucent. In this second category, factor VIII seems to be a necessary component in order to obtain maximal coagulation activity. The clinical consequences of these facts are discussed.

Amniotic Fluid↗

PubMedDate not supplied

Treatment of advanced pancreatic cancer with mistletoe: results of a pilot trial.

Pancreatic cancer is a devastating disease with poor prognosis. It is characterized by its unresponsiveness to chemo- and/or radiotherapy. Therefore, many patients demand alternative drug therapy such as mistletoe treatment. However, there are no controlled data available analyzing the effect of mistletoe treatment in pancreatic cancer. In the present phase I/II study we evaluated the effect of mistletoe (Eurixor) treatment in 16 patients (7 women, 9 men) with histologically verified ductal pancreatic carcinoma. At the time when the patients were enrolled nine patients had lymph node metastases (stage III), and in 7 patients distant metastases (stage IV) were present. Mistletoe was administered twice a week by subcutaneous injection in a dosage of 1 ng per kg body weight. Monthly follow-ups included clinical status, multidimensional evaluation of quality of life, contrast enhanced computed axial tomography scan (CT scan) or ultrasonography, and determination of the tumor markers carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9). Apart from one anaphylactic reaction, which necessitated suspension of treatment for a few days, no severe side effects were observed. No partial or complete remission was seen. Eight patients (50%) showed a CT-verified status of "no change" according to World Health Organization criteria for at least 8 weeks. Median survival time in all patients was 5.6 months (range 1.5 to 26.5 months). Analysis of multidimensional evaluation of quality of life showed a stable course of disease in 7 patients. All except two patients claimed that mistletoe had a positive effect on their quality of life, with an obvious decline only during the last weeks of life. These results indicate that mistletoe is not able to significantly influence tumor growth in advanced pancreatic carcinomas. However, mistletoe treatment can stabilize quality of life, and therefore may help patients to maintain adequate life quality in their few remaining months.

Aged↗