SPARGANOSIS. A NEW CASE IN THE UNITED STATES AND REVIEW OF THE LITERATURE.
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Adult guinea pigs develop a delayed hypersensitivity to intradermally injected neoarsphenamine. If the animals are treated intravenously with high doses of this compound before sensitization, a specific and permanent immunological tolerance develops. Permanent tolerance is also obtained in previously sensitized animals when an intravenous injection of neoarsphenamine isfollowed 6 hours later by an intradermal one. When, however, the interval between the two injections is extended to 7 or 14 days, no tolerance is observed.
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Paul Ehrlich's experiments in staining techniques at the end of the nineteenth century resulted in many discoveries which help to form the basis of present research work. Ehrlich's chemotherapy research led to his formulating the arsenic compound, Salvarsan, which was used in the treatment of syphilis during the first half of this century until it was superseded by penicillin.
On March 14th of this year, the birthday of Paul Ehrlich, the great German researcher and 'founder of chemotherapy', returned for the 150th time. Interestingly, his later colleague Emil von Behring was born one day later in 1854. Both were coworkers in Robert Koch's laboratory and became Nobel Prize laureates (for their work in immunology), making great contributions to antiinfectious treatments. Emil von Behring's approach was through the use of immunological agents, while Ehrlich favored an approach of antiinfectious treatment by chemical agents. Through an ingenious concept that was a clear continuation of his early days in research with dyes, he found the first chemotherapeutic agents. From his dye work, he had concluded the following: if there are dyes that one can use to stain cells, why not develop pharmacological agents that, like stains, also attach to a structure in the living pathogen and kill them. He gave these agents the emotionally charged name 'magic bullets'. This introductory review will initiate a series of papers on the occasion of Ehrlich's 150th birthday and the 'World Conference on Dosing of Antiinfectives: Dosing the Magic Bullets', which is going to be held in Nürnberg, Germany, from September 9 to 11, 2004 (see www.ehrlich2004.org). Apart from the conference topic, this conference will also commemorate a real science giant of the last century and yet a modest human being whom, as Robert Koch put it, 'one had to like'. This article recalls Ehrlich's ingenious concepts, including modern syphilis treatment, one-dose treatment ('therapia magna sterilisans') of Helicobacter pylori infections and introduction of an arsenic compound, arsenic trioxide, as well as experiments and new exciting data on Congo red, a well-known 'non-Ehrlich dye'.
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From a historical standpoint, the problems of ototoxicity came in two major stages. The first, in the nineteenth century, indirectly resulted from the chemical extraction, purification and, sometimes later, synthesis of the active components of traditional drugs, which led to their use in larger doses. The second stage, in the twentieth century, derived from the drive to find more and more effective antibacterial agents, which often had damaging side effects on the inner ear. These effects were highlighted by the development of more sophisticated techniques to detect and measure the ototoxic actions of drugs. The present brief account traces some early reports of ototoxicity from the time of Richard Morton (1692) onwards.
The paper reviews the life of Paul Ehrlich and his biomedical accomplishments in immunology, cancer research, and chemotherapy. Ehrlich achieved renown as an organic chemist, histologist, hematologist, immunologist, and pharmacologist. He disliked the formality of school but managed to excel in Latin and mathematics. His role model was an older cousin, Carl Weigert, who became a lifelong friend. Ehrlich studied medicine at Breslau, Strasbourg, Freiburg, and Leipzig, coming under the influence of Wilhelm Waldeyer, Julius Cohnheim, Rudolf Heidenhein, and Ferdinand Cohn. As a medical student, Ehrlich was captivated by structural organic chemistry and dyes. When he was 23, his first paper was published on selective staining. His doctoral thesis, "Contribution to the Theory and Practice of Histological Staining" contained most of the germinal ideas that would guide his future career. Most of his early work was centered in Berlin at Charite Hospital, where he did pioneering studies on blood and intravital staining, and at Robert Koch's Institute for Infectious Diseases, where he undertook important investigations in immunology. Ehrlich became an authority on antitoxin standardization and developed the "side-chain theory" of antibody formation for which he was later awarded the Nobel Prize. He became director of an Institute for Experimental Therapy in Frankfurt where he continued research in immunology and carried out routine serum testing. He developed new lines of investigation in cancer research and originated the field of chemotherapy. Using principles developed in his early work with dyes, he successfully treated certain experimental trypanosomal infections with azo dyes. His crowning accomplishment was discovering that the compound Salvarsan could control human syphilis. Ehrlich's legacy in immunology and chemotherapy is discussed and an intimate portrait is drawn of Ehrlich the person.
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