Pathologic changes associated with the common arthritides and their treatment.
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A number of new acyl and imidoderivatives of 2-amino-4-p-chlorophenylthiazole-5-acetic acid (II) and its methyl ester (VII) were synthesized. Methyl ester VII heated in benzene solution with acid anhydrides was transformed into adequate acyl derivatives (VIII, IX, X, XIII, XVI). Some of them (X, XIII, XVII) by heating with acetic anhydride underwent cyclization and were transformed into the imido derivatives (XI, XIV, XVIII). Compounds XI, XIV and XVI heated with diluted aqueous solution of sodium hydroxide underwent selective hydrolysis giving the respective dicarboxylic acids XII, XV, XVII. Pharmacological analysis revealed that some of the synthesized preparations exert an anti-inflammatory effect and allow to draw limited relations between chemical structure and pharmacological activity in this group of compounds.
A number of 2-N-aralkylidene, 2-N-aralkyl and 2-N-aralkyl-alpha-sulphoderivatives of 2-amino-4-p-chlorophenylthiazole-5-acetic acid (I, R = H) and its methyl ester (I, R = CH3) were synthesized. As a result of condensation of methyl ester I with various aromatic aldehydes in boiling benzene solution, the Schiff-bases (anils) II--VIII were obtained. After reduction with NaBH4 compounds II--VIII were transformed into adequate amino esters IX--XV. Esters IX--XV heated with diluted aqueous solution of sodium hydroxide underwent selective hydrolysis giving the respective amino acids XVI--XXII. Some of Schiff bases (II, III, V, VII, VIII) reacted with aqueous alcoholic solution of sodium bisulphite after its several (XXIII--XXVII). alpha-sulphoderivatives had been obtained. Several tests were performed in order to detect the anti-inflammatory and immunosuppressive activity of the compounds. The pharmacological analysis allowed us to draw conclusions concerning the relationship between chemical structure and biological activity in this group of compounds. The most efficacious immunosuppressive and anti-inflammatory activity exhibited 2-aralkyl-alpha-sulphoderivatives.
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A series of 1 270 Multiload Cu-250 intra-uterine contraceptive devices inserted in clinics of the Cape Divisional Council is described, spanning 1 024,6 woman-years. The continuation rate was 85,4% and the unplanned pregnancy rate was 1,17 per 100 woman-years of use. The implications are discussed.
Of 187 patients with silicone breast implants 14% developed a capsular formation as late complication needing surgical therapy. Apparently neither the volume and type of prosthesis nor the operative proceeding had any influence on the formation of a constrictive capsule. No significant difference between augmentation plasty by hypo- and aplasia respectively and breast reconstruction after subcutaneous or radical mastectomy could be noticed. There has been no explanation for unilateral hypertrophic capsule formation after simultaneously performed bilateral prosthesis implantation. Compared with other authors we had a smaller incidence of the IIIrd and IVth stage capsular formation. This is caused by: 1. The advantage of a two-stage proceeding over the simultaneous one after subcutaneous mastectomy or subsequently to reconstruction by a flap plasty after radical mastectomy. 2. Systematic drainage of the bed of the prosthesis to avoid any hematoma or big liquid accumulations. Diffusion of silicone in the tissues by spontaneous rupture of the prosthesis as further late complication is discussed in 2 cases.
During the last two years, 16 severe explosion injuries of the hand have been treated with plastic microsurgery in our hospital. The injury had arisen in seven cases from the mixture sugar + sodium chlorate (C12H22O11 + NaClO3). This substance mixture may already be caused to explode by slight vibrations and the warmth of the hands. In explosion injuries, there is mechanical, chemical and thermal tissue damage. The postoperative course is therefore complicated in almost all cases. However, by meticulous removal of the disseminated foreign particles, excision of necrotic tissue and extensive reconstruction of the interrupted vascular and nerve supply, it is possible in a few cases to preserve functionally important parts of the hand. Later plastic procedures are made more difficult by tissue fibrosis and foreign body granulomas.
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Evidence for a causal connection between Schistosoma haematobium-infection and carcinoma of the urinary bladder is discussed. A group relationship of schistosomiasis cancer to cancers as+sociated with asbestosis, foreign body implants, and cicatrization is suggested on the basis of several criteria. Results of experimental foreign body tmuorigenesis in mice are presented and elaborated in relationship to schistosomiasis cancer. Carcinogenic development at the cellular level is discussed with emphasis on the essential role of tissue-environmental conditions, especially fibrotic changes and macrophage quiescence.
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An injection of suspended PVC particles in the caecal vein of mice induces a foreign-body portal granuloma reaction in the liver. Plastic casts of the portal system, after PVC particles implantation, show modifications in the portal bed and are compared with plastic casts obtained in mice infested by Schistosoma mansoni. This technique can be useful to study the cellular dynamics of the portal granuloma and can be a model for schistosomal eggs induced liver pathology.
Demineralised homologous bone-matrix implant was used to bridge a large circumferential osteoperiosteal gap in the diaphysis of the ulna of rabbits. Periodic observations of the graft were made clinically, radiologically, histologically and by tetracycline fluorescence up to forty-two weeks. By the twelfth week after operation 81 per cent of the animals revealed bone formation in the implant and complete bridging of the gap. The new bone was laid on the surface and in the substance of the matrix, suggesting that the inductive principle was acting locally. The bone, once formed, remodelled to the texture of a mature tubular bone and did not undergo absorption during a long follow-up period. Demineralise bone-matrix proved to be a highly osteoinductive and readily osteoconductive material. The graft did not evoke any appreciable local foreign-body or immunogenic reaction. The high degree of success in bridging massive bone defects justifies further serious studies and hopes for a useful substitute for massive autologous bone grafts.
Foreign-body and delayed hypersensitivity granulomas were induced in mice; and the dynamics of macrophages isolated from dispersed, 1--4-week-old lesions was delineated. The size and histologic complexity of the lesions increased as shown: adjuvant greater than schistosome egg greater than methylated bovine serum albumin greater than bead. Esterase staining, spreading on glass, and the percentage of Fc-receptor--bearing macrophages present in the various granulomas reflected the same gradient. The Fc receptors were examined by rosetting with rabbit-antibody--SRBC complex (EA). Whereas more than 90% of the population of macrophages of the dermal adjuvant granuloma contained undiminished numbers of receptor-bearing macrophages throughout the 4 weeks, the percentage of macrophages that displayed receptors in pulmonary foreign-body (40%) and delayed hypersensitivity granulomas (70%) peaked at 1 week and subsequently declined. The EA rosetting of the foreign-body and delayed hypersensitivity granuloma macrophages was strongly inhibited by monomeric IgG2a-specific and weakly by aggregated IgG2b-specific mouse myeloma proteins. Also, macrophages of the delayed hypersensitivity granulomas rosetted in higher percentages with SRBCs coupled with monomeric IgC2a than with those coupled with aggregated IgG2b myeloma proteins. Macrophages of the foreign-body lesion did not react with aggregated IgG2b--SRBC. Rosetting with monomeric IgG2a--SRBC or aggregated IgG2b--SRBC could not be cross-inhibited by the myeloma proteins. Both the monomeric IgG2a--SRBC and aggregated IgG2b--SRBC complexes were readily phagocytized. Trypsin treatment of the macrophages inhibited rosetting with EA or myeloma-protein--coupled SRBCs. The display of Fc receptors on the granuloma macrophages seems to be related to the etiology of the lesion and the intensity and duration of the inflammatory reaction.
A study was carried out on the pathology of trichinosis in human muscle biopsy sample and comparatively in experimental trichinosis in the rat, by current microscopic techniques and Troitsky's method of block silver impregnation of the nerve endings. Stress is laid upon the incipient changes in the parasitized muscle fibers, the sarcolemmic origin of the parasite capsule, the myogenic nature of certain periparasitary but intracapsular clear cells of precocious appearance and other associated, non-specific lesions, such as common myositis changes or giant myogenic foreign-body cells. The intimate relationships between parasitized muscle fibres, cellular interstitial reactions, local new-growth vessels and proliferation of the nerve endings are also described. The morpho-functional significance of such morphological synergic manifestations is discussed as an adaptation to the new local conditions brought about by the appearance of the peculiar muscle fibre-parasite unit in trichinosis.
Transepidermal elimination is a phenomenon which occurs spontaneously in certain skin disorders in which effete connective tissue or foreign materials is expelled via the epidermis to the exterior. In order to learn how this phenomenon is effected and what factors control it, we have attempted to produce an animal model for the process. When charcoal particles are deposited subepidermally in guinea-pig flank skin transepidermal elimination occurs within 4 days and we believe that this mimics the disorder seen in man. The hair follicles became hyperplastic and were intimately involved in the reaction, some of the particles actually being expelled via the follicular lumina. The reaction has some similarities to the wound healing response.