[Thrombolytic therapy with special reference to old venous occlusions]. / Klinische Ergebnisse der Thrombolysetherapie unter besonderer Berücksichtigung alter Venenverschlüsse.

It is reported on own results and experiences in 53 thrombolyses with the streptokinase preparation Awelysin. In the greater part of the 46 patients with phlebothrombosis the cases in question were late thromboses (n = 32). In 7 cases an arterial lysis was performed. The author enters in detail the questions of dosage and side-effects as well as complications. By reason of the phlebographic and clinical findings before and after therapy also in older thromboses may be still reckoned with complete or extensive recanalisation in 65.5% and with a clinical symptom-free state in 71%. In comparison to reports on results in early lysis the findings got do not show essential deviations in late lysis.

Stimulation of erythroblast formation in suspension cultures of murine marrow by a factor in normal mouse serum, and its relationship to erythropoietin.

Addition of normal mouse serum to liquid suspension cultures of murine marrow cells resulted in dose-related increases in the number of heme-synthesizing erythroid cells. Removal of late normoblasts and reticulocytes by differential immune lysis prior to culture greatly enhanced the difference in heme synthesis between cultures with or without added mouse serum, permitting detection of as little as 1 microliter/l.5 ml of medium. Cell counts on these cultures indicated that the mouse serum factor actually stimulated formation of late normoblasts through proliferation and maturation of their precursors. The effect required either the presence of Ep in the medium, or the presence in the to be cultured cell suspensions of proerythroblasts which had been induced by or had contact with Ep prior to collection of the marrow.

In vivo erythropoietin requirements of regenerating erythroid progenitors (BFU-e, CFU-e) in bone marrow of mice.

Erythroid progenitors (B-8, B-4, CFU-e) in the femoral marrow of polycythemic mice were measured by in vitro culture assays after a single administration of BCNU or Myleran. BCNU reduced pluripotent stem cells to 40% and erythroid progenitors to less than 5% of normal. B-8, the earliest erythroid progenitors, regenerated without erythropoietin (Epo) completely within 5 days. At 14 days after BCNU, intermediate progenitors (B-4) attained 60% of their normal numbers and CFU-e attained approximately 30%. Daily injections of Epo promptly restored normal B-4 numbers and near-normal CFU-e numbers in BCNU-treated mice. After Myleran, CFU-s remained below 2% of normal for 14 days, and no regeneration of the B-8 occurred with or without daily Epo injections. The findings suggest that regneration of B-8 was dependent on cell inflow from the pluripotent stem cell compartment but was independent of the presence of Epo. Intermediate progenitors (B-4) required Epo and the presence of B-8 for complete and permanent regeneration. CFU-e were the most Epo-dependent of the three progenitors. B-4, recruited by Epo, required after their formation a second exposure to the hormone in order to progress into the CFU-e stage.

[Determination of glycogen phosphorylase B--a contribution to the enzymatic diagnosis of acute myocardial infarct]. / Die Bestimmung der Glykogenphosphorylase b--ein Beitrag zur Enzymdiagnostik des akuten Myokardinfarktes.

On the basis of a small number of patients with the tentative diagnosis acute myocardial infarction the diagnostic valency of the glycogen phosphorylase was tested. A separation between severe stenocardia and myocardial infarction is possible. After simplification of the methodology the glycogen phosphorylase might substitute in higher specifity the creatinine kinase.

Effect of inflammation on erythroid precursors (BFU-E and CFU-E) in bone marrow and spleen of mice.

Inflammation, induced in mice by a single intramuscular injection of turpentine, caused a long lasting reduction in the number of morphologically unrecognizable CFU-E in the bone marrow. This resulted in marked decreases in marrow erythroblasts and their iron incorporation into heme. The effect is attributed to blood-borne mediators of inflammation which either caused an emigration of progenitors of CFU-E from the marrow or inhibited their proliferation, possibly as the result of increases in marrow myelopoiesis. CFU-S as well as erythroid and myeloid precursors were markedly increased in the spleen during the inflammatory reaction.

Cell kinetics of erythroid colony-forming cells (CFU-E) studied by hydroxyurea injections and sedimentation velocity profile.

Cell kinetic characteristics of murine CFU-E were assessed by measuring femoral marrow CFU-E survival rates after injection of hydroxyurea at from 2 to 48 h before marrow collection. The results are compatible with the concept that the CFU-E represent a homogeneous non-selfsustaining population comprised of cells belonging to a single differentiation stage. Their cell cycle length was estimated to be 10 h. Marrow cells were also subjected to separation by velocity sedimentation, and the effect of preceding hydroxyurea injections on the distribution profile of CFU-E was ascertained. Variations in cell size of CFU-E were interpreted to represent CFU-E in various phases of their cell cycle. CFU-E in either G1, S or G2 at the time of their removal from the marrow were capable of forming erythroid colonies in vitro, but it appears that the CFU-E lost this capacity after completing their cell cycle within the marrow of the intact mouse.

[Value of lymphography within the framework of complex diagnosis of fever of unknown origin]. / Stellenwert der Lymphographie im Rahmen der komplexen Diagnostik unklarer Temperaturerhöhungen.

After comprehensive diagnostics on account of antibiotic-resistant subfebrile temperatures under suspicion of a lymphogranulomatosis a lymphography was performed in a 49-year-old patient. The lymphographic findings are discussed in detail. Since these findings differential-diagnostically allow a tuberculosis of the lymph nodes, a tuberculostatic therapy is performed. 6 months later the patient has an improved general condition and may again work in this former profession.

[The antistreptolysin reaction with and without dextran sulfate addition in various diseases]. / Die Antistreptolysinreaktion mit und ohne Dextransulfatzusatz bei verschiedenen Erkrankungen.

It is reported on the results of determinations of the antistreptolysin titre in patients with infectious hepatitis, renal and essential hypertension, mitral stenosis, acute tonsillitis, scarlet fever, rheumatic fever as well as rheumatoid arthritis according to the usual and the dextran sulphate absorption method in altogether 739 patients. Here as in a former publication in 1,700 normal persons partly considerable significant differences between the antistreptolysin titre with and without dextran sulphate were found. The two techniques are discussed, also the influence of the beta-lipoproteins with their proportion of phosphatide on the result of the antistreptolysin titre. It is possible to absorb beta-lipoproteins and perhaps also phosphatides with the help of the addition of dextran sulphate. The present investigations show unequivocally that the absorption the dextran sulphate is a necessary demand which saves the clinician from diagnostic and therapeutic errors. The antistreptolysin reaction is to be regarded only as one constituent for the clinical diagnosis and must not be overvalued in its importance.

In vivo and in vitro effect of bacterial endotoxin on erythroid precursors (CFU-E and ERC) in the bone marrow of mice.

Erythropoietin injection raised within 24 hr. the number of CFU-E in the femoral marrow of polycythemic mice by 837 percent. Endotoxin given at 0 to 24 hr. before erythropoietin nearly abolished this CFU-E increase. Endotoxin in the culture medium did not inhibit erythroid colony formation, but in vivo endotoxin suppressed erythropoietin-induced differentiation of proerythroblasts from their precursors. Endotoxin thus suppresses marrow erythropoiesis either by inhibiting transformation of erythroid precursors into CFU-E or by causing the disappearance, perhaps by emigration, of CFU-E from the marrow.

[Antistreptolysin-titre under the use of traditional methods and after saturation with dextran sulfate]. / Der Antistreptolysintiter unter Anwendung der herkömmlichen Methodik und nach Absättigung mit Dextransulfat

1,700 blood samples of healthy test persons without clinically and paraclinically provable streptococcal diseases were examined for their content of antistreptolysin. Beside the usual method parallel determinations were carried out after addition of dextran sulfate. Thus increases of unspecific antistreptolysin titres shall be in most cases excluded, above all by the influence of the lipoproteins. The absorption of dextran sulfate led to the decrease of the antistreptolysin titre by 12.33%. Furthermore could be proved that the average antistreptolysin titre of female test persons is ca. 20 antistreptolysin units below the titre of male test persons, that seasonal variations of the antistreptolysin titre with the highest titres appear in the first and third quarter which may be explained by a bad unspecific defensive condition, that, furthermore, the antistreptolysin titres increase to the 14th year and then continuously decrease and that in new-born children the arithmetic mean value of the antistreptolysin units is significantly higher than in their mothers. Hereby an active influence of the placenta on the transmission of antibodies seems to be possible. Though a slightly increased financial expenditure is necessary for dextran sulfate, temporarily and concerning working technique, however, no larger loads appear, it is justifiable to perform the determination of antistreptolysin titres only by means of dextran sulfate-absorbed sera, since in this way a considerable number of unspecific and misleading reactions can be excluded.

[Immunosuppressive treatment of progressive chronic polyarthritis]. / Immunsuppressive Behandlung bei progressiv chronischer Polyarthritis

After description of forms and possibilities of the immunsuppression the results of this therapy are discussed in 47 own patients with clinically and paraclinically ascertained rheumatoid arthritis. The patients received the sum of 4.0 mg trenimon in combination with altogether 4.0 mg cyclophosphamide by means of 20 infusions with physiological saline solution as carrier substance. Under this treatment in 93.6% of the cases the findings of the examination of joints or the clinical stage improved. As to side effects incompatibilities on the side of the gastro-intestinal tract as well as leucopenias were observed. 18 patients could be after-examined after 6 years. Whilst in every case the clinical stage deteriorated, in the majority the degree of activity remained unchanged. All the results are compared with the results reported in literature. The authors are of the opinion that, when other forms of treatment have no success and contraindication are strongly taken into consideration, the progressing of the rheumatoid arthritis can be retarded by means of immunsuppressives. The pathophysiological processes can, however, scarcely be influenced causally.

[Old and new standardized color test for the determination of aspartate aminotransferase in the differential diagnosis of heart infarct and angina pectoris]. / Alter und neuer standardisierter Farbtest zur Bestimmung der Aspartataminotransferase in der Differentialdiagnose zwischen Herzinfarkt und Angina pectoris

The usability of the new and old standardized colour test for the determination of the aspartate aminotransferase (GOT) (set of test instruments VEB Arzneimittelwerk Dresden) in the differential diagnosis between acute myocardial infarction and angina pectoris are compared. Concerning this problematics the new colour test does not evoke a better separation effect than the old one. Since with the change-over there were connected considerable uncertainties in the clinic it is recommended in case of a future standardisation to publish the regions of reference and first clinical experiences before the change-over.

Stimulation of granulopoiesis by androgens without concomitant increase in the serum level of colony stimulating factor.

The marked enhancing effect of daily injections of 19-nortestosterone decanoate (19-ND) upon granulopoietic recovery of mice made neutropenic by a single dose of BCNU was studeid in regard to the possible regulatory role of CSF. Serum levels of CSF in BCNU-treated mice with or without 19-ND injection were not found to differ significantly from those in normal mice. BCNU treatment with or without 19-ND did not alter the CSF increases in response to endotoxin injection. Increases in dividing marrow granulocytes in the 19-ND mice were preceded by increases in their marrow CFC. The acceleration of granulopoietic regeneration was thus not mediated by the serum colony stimulating factor. It is attributed to a stimulatory effect of 19-ND on proliferation of CFC and/or CFU.