Biomedical subjects
Publications and source records attributed to M A Koch.
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A case of primary hepatocellular carcinoma (HCC) in a 17-year-old pregnant primigravida diagnosed during the 32nd week of pregnancy is presented. A live infant was delivered after induction of labour during the 33rd week. The mother, although still alive 3 months postpartum, had ongoing spread of the malignancy. Only 7 cases of primary liver cancer in pregnancy have been reported to date, with 100% maternal mortality and only 3 live infants. The literature and the diagnosis and management are discussed.
The ECP Working Group on AIDS has evaluated data on seropositivity to LAV/HTLV-III supplied by members in II Western European countries. The period covered is 1981-84. The rise in LAV/HTLV seropositivity parallels the incidence of cases of AIDS in the different countries. LAV/HTLV now spreads freely within Europe and spread has become less dependent upon promiscuity. The epidemic is about to enter Eastern Europe. Intravenous drug abusers appear to be the risk group experiencing the most rapid spread at present. Furthermore, seropositivity in males and females outside the traditional risk groups seems on the rise, and as in the US the percentage seronegative in individuals with PGL is quite high. AIDS is rapidly becoming a major cause of cancer in young adults. A coordinated European preventive effort is urgently needed.
Tissue samples were taken from a 20-week old foetus in a mother with positive LAV/HTLV-III reaction without clinical or immunological signs of AIDS. These samples were used for cocultivation of LAV/HTLV-III. This resulted in inducing in MT-2 cells a cytopathic effect characteristic for LAV/HTLV-III infections, induced by thymus, spleen, lungs and brain tissue of the foetus after cocultivation with umbilical cord lymphocytes; in H-9 and MT-2 cells this led to the expression and release of antigens reacting with LAV/HTLV-III-specific anti-bodies. This observation shows that intrauterine infection of the foetus must have occurred already before the 20th week of gestation; the same target cells are involved via uterine transmission as via postnatal infection, i.e. cells of the lymphatic system and of the CNS.
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Staining of lymphocytes from scrapie-infected STU mice with FITC-labelled anti-mouse Ig revealed disturbances in the capping process when compared with lymphocytes from mock-infected animals. Quantitative evaluation indicates that 10-15% of cells from scrapie-infected animals show an altered capping behaviour. These phenomena are discussed with special reference to the role of the lymphoreticular system in early scrapie agent replication.
Lumbar epidural anaesthesia was used as an anticonvulsant in a series of 1 106 patients with hypertension in labour, including 7 patients with eclampsia. Six of the 1 074 patients in whom epidural analgesia was successful subsequently had convulsions. Of these 4 had convulsions after delivery, which took place at least 2 1/2 hours after the last dose of local anaesthetic, and the 2 others within 5 minutes of receiving the first dose of bupivacaine. We conclude that before it wears off epidural anaesthesia is an effective way of preventing eclampsia and that other anticonvulsant therapy is not required, although the latter may be necessary before the procedure. The possible mechanism of the anticonvulsant action is discussed.
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