Improvement of clinical and immunological parameters after allergen-specific immunotherapy in atopic dermatitis.

BACKGROUND: Allergen immunotherapy (AIT) is considered a curative treatment in some atopic diseases, but in AD contradictory clinical results exist and the action of AIT has not been elucidated. In the literature, there is no evidence for parallel investigations of permeability barrier, cutaneous and blood immune responses after AIT in AD. OBJECTIVES: The objective was to investigate immune parameters in the blood and skin and to detect clinical and barrier changes after AIT in AD. METHODS: Mild-to-moderate AD patients (n = 14) with concomitant allergic rhinitis to house dust mites were selected. All patients received topical treatment, while eight patients were randomly selected for adjuvant AIT also. At baseline and after 6 months, clinical, barrier and immunological investigations (serum and skin tests) were performed. In selected patients, biopsies from atopy patch tests (APTs) were analysed by immunohistochemistry for AD-relevant immune cells and mediators. RESULTS: In the adjuvant AIT group, clinical parameters and barrier functions improved significantly. Blood immune parameters displayed no significant changes. Post-AIT APT became negative in all patients in the AIT group, but remained positive in the non-AIT group. Cutaneous dendritic cell and T-cell recruitment decreased significantly after allergen challenge in the AIT group, but no significant changes in skin or serum immunoglobulin E levels or prick test (SPT) reactivity were detected. CONCLUSIONS: Allergen immunotherapy is a beneficial adjuvant treatment for sensitized AD patients. AIT improves not only clinical symptoms, but also permeability barrier functions. The effect of AIT on sensitization should be detected by APT, not by SPT.

In vitro interactions between lactobacilli and other microorganisms occurring in the vaginal flora.

The present study shows that certain species of lactobacilli isolated from the human vagina can, on artificial culture media, inhibit growth of other bacterial species recovered from the same site. The antibiosis seems to be mediated by one or more extracellular compounds produced by the lactobacilli acting, over a wide pH-range, on both Gram-positive and Gram-negative aerobic and facultatively anaerobic bacteria as well as yeast fungi. Likewise, certain bacteria suppressed growth of lactobacilli under similar test conditions. In some instances a stimulatory effect of the growth of the lactobacilli was noted. The antibacterial and antifungal principles demonstrated in the present study can not be classified, to the best of our knowledge, as any previously known antibiotic principle of lactobacilli.

Limb circulation in varicosity of various types.

Regulation of limb circulation was studied by the use of the venous isotope dilution technique in 35 patients with leg varicosities. The circulatory parameters of 54 patients with normal limb circulation served as control. The various types of varicosity revealed characteristic circulatory patterns. (i) In the cases of congenital, "juvenile", varicosity limb blood flow is high, the limb AV-O2 difference is very slight and limb O2 uptake is normal. (ii) In secondary varicosity consecutive to thrombophlebitis the limb (total) blood flow is slightly reduced, the limb AV-O2 difference is smaller than normal and O2 uptake by the extremital tissues is diminished. (iii) In non-congenital, primary varicosity, i.e. in the most common form, limb blood flow is normal, the limb vascular resistance is slightly increased. The possibilities of the production of an AV shunt and the clinical implications of the circulatory changes accompanying the various types of varicosity are discussed.

Experimental observations regarding the applicability of calf carotid xenograft in vascular surgery.

The implantation process of Solcograft vascular prostheses in various positions was studied in 50 dogs between 7 and 600 postoperative days. It was shown that in the formation of a continuous endothelial layer, endothelium islets at the graft-vessel border and around ingrowing capillaries are of basic importance. Typical layers of the vessel wall have been formed between 4-6 months. Complications were mostly due to intimal proliferation and thrombosis.

[Factors determining the patency of experimental anastomoses between lymphatic vessels and veins]. / A kísérletes nyirokér-véna anastomosisok átjárhatóságának feltételei.

End-to-end anastomoses between lymph vessels and veins performed under microscopy (magnification lox--20 x) may be useful in the treatment of certain types of lymphoedema. End-to-end anastomosis of the vena profunda femoris and a deeply localized lymph vessel have been performed on the hind-legs of 10 dogs. Scanning electron microscopic investigation of the anastomosis has been carried out at 0h, 48h and 8 days respectively after the operation. Scanning electron micrographs of the inner surface of the anastomosis indicate that blood flow though the anastomosis can be achieved by atraumatic surgical technique (by the use of thin) 10/0) sewing material and needle. Injury to the endothelial surface results in platelet and erythrocyte aggregation. 8 days after the operation the inner surface of the anastomosis is covered by cells (endothelium?). Early development of a new inner cell layer can prevent occlusion of the shunt.

An effective selective medium for Yersinia enterocolitica containing sodium oxalate.

A medium ("Y" medium) is described, which was more efficient for the isolation of Yersinia enterocolitica from experimentally infected faecal specimens than desoxycholate-citrate. McConkey, lactose-sucrose-urea (LSU) agar, and Yersinia selective medium (Wauter's medium). The "Y" medium consists of casein hydrolysate and peptone servings as carbon and energy sources. A high selectivity is achieved by its contents of sodium oxalate and bile salts. The oxalate suppresses growth of gram-negative rods, including members of the family Enterobacteriaceae and of Pseudomonas spp., while the bile salts inhibit growth of gram-positive bacteria. In the few instances coliform rods grew on the "Y" medium, they could easily be distinguished by their fermentation of lactose, included in the medium, and the fact that colonies of organisms were surrounded by an opaque zone of precipitated bile salts. The most optimal condition for the isolation of Y. enterocolitica from stools was achieved at incubation of the "Y" medium at 29 degrees C for 2 days.

[Late results of reconstructive peripheral vascular surgery of the lower limbs]. / Spätergebnisse der an den unteren Extremitäten durchgeführten peripheren, rekonstruktiven Gefässoperationen.

The late results of the first 30 crural bypass operations are presented. The longest follow-up period was 6, the shortest 1 year. At the time of check-ups 14 of the bypasses were penetrable, and 16 were occluded. On 9 of the latter 16 amputation of the thigh had to be performed. Flow conditions and the problems of indication and contra-indication are discussed.

Application of Solcograft in vascular surgery.

Incorporation of Solcograft was studied experimentally and clinically. The graft was found to facilitate the formation of continuous endothelium which starts at the vessel graft boundary and from newly formed capillaries. Transmission and scanning microscopical investigations revealed neointima, neomedia and neoadventitia formation in 3--4 months. Complications such as obliteration were unfrequent. Aneurysm formation did not occur, the potency rate was satisfacory. Experience in 20 clinical cases are reported in detail. As to its usefulness in reconstructive vascular surgery, Solcograft is placed behind the saphenous graft. The graft is particularly suitable for patch plastics.

[Complications of aortoiliac surgery and their postoperative therapy]. / Komplikationen der aortoiliakalen Gefässoperationen und ihre postoperative Behandlung.

Experience in early postoperative treatment of 249 patients who had been subjected to aortoiliacal vascular surgery is reported. The therapeutic principles are outlined and the complications are reviewed. For the prevention of infectious complications the patients are given antibiotic protection, are fed parenterally till passage starts and, to avoid threatening postoperative hypoxaemia in the case of more severe respiratory disorders, prophylactic respiratory therapy is applied, and small doses of heparin are administered to prevent thrombosis. Taking into consideration the high incidence of complications and the advanced age of the patients, it is important to keep these in the intensive ward during the early postoperative period.

Cystic adventitial degeneration.

A case of cystic adventitial degeneration operated upon successfully is described. The literature, and the clinical features of the disease are reviewed.

[Late results of thoracic sympathectomy in various diseases]. / Spätergebnisse der thorakalen Sympathektomie bei verschiedenen Krankheitsbildern.

The late results of 171 thoracal sympathectomies performed on 142 patients in the 20-year period 1952 to 1971 are described. Favourable results were achieved in Raynaud's disease, obliterating endarteritis and other occlusive vascular diseases, and also in hyperhidrosis.

An effective, simplified medium for the culture of Neisseria gonorrhoeae.

A new culture medium for Neisseria gonoorhoeae is described. The frequency of isolation of gonococci was significantly higher when this medium was used than when Thayer-Martin medium containing vancomycin, colistin, and nystatin was used in a study of cervical, urethral, and analy specimens. In a similar comparative study, Thayer-Martin medium containing trimethoprim and polymyxin B as antimicrobial agents gave a significantly lower frequency of isolation of gonococci than did the new medium. A modified McLeod medium containing human placenta was found to have the same high performance as the new medium, but, like the modified Thayer-Martin medium, the modified McLeod medium is more expensive and more difficult to prepare.

The lytic effect of lysolecithin on acholeplasmas and mycoplasmas.

Lysolecithin exhibits a lytic activity on acholeplasmas and mycoplasmas. The acholeplasmas studied, viz. Acholeplasma laidlawii A and B, were found less susceptible than were the mycoplasmas, viz. Mycoplasma gallisepticum and M. pneumoniae. The sensitivity to lysis was found to differ according to species, growth temperature and number of organisms used. Variations in age of the population and the concentration of bivalent ions in the test medium had but little influence. The greatest lytic activity of lysolecithin was found at the optimal growth temperature and decreased with lowering of the temperature. This lytic activity was inversely proportional to the density of the cell suspensions used. The possible mechanism of the lytic effect of lysolecithin is discussed.

[The innominate artery syndrome]. / Uber das A. anonyma-Syndrom.

During to the peculiar morophology and symptomatology of the haemodynamic disturbance following occlusion of the innominate artery, the anonyma syndrome ought to be treated as an independent type of the cerebro-vascular syndrome. The anonyma syndrome is generally a part-symptom of obliterating arteriosclerosis of multiple localization and has therefore an unfavourable prognosis. After a brief survey of the literature the clinical data of patients operated for innominate artery occlusion are reported together with the surgical results.

Visualization of the binding of IgG myeloma proteins to some group A streptococci.

The interaction between streptococci and human IgG, which does not involve the antibody combining sites, was visualized in the electron microscope by the use of human IgG myeloma proteins and ferritin labelled rabbit anti-human IgG antibodies. The streptococci were allowed to react with human IgG myeloma proteins and the human IgG was then marked by addition of ferritin labelled rabbit anti-human IgG antibodies; sections of streptocci studied in electron microscopy showed localization of the ferritin on the surface of the cell wall of all the streptococci of type M 1, M 3, M 12 and M 56 studied. Similar results were obtained if the ferritin labelled rabbit anti-human IgG antibodies alone were allowed to react with the streptococci. The uptake of ferritin labelled rabbit anti-human IgG antibodies could be inhibited by addition of normal rabbit serum.