Evaluation of Ca 12-5 as a tumor marker for gastric and colo-rectal cancer in comparison to CEA and Ca 19-9.

We performed simultaneous measurements of CA 12-5, CEA and Ca 19-9 in the preoperative sera of 87 patients with gastric cancer, 177 patients with colo-rectal cancer and 55 patients with benign diseases. 5.6% of the control patients, 13.8% of the gastric cancer patients and 9.6% of the colo-rectal cancer patients showed Ca 12-5 values of 27.0 U/ml and more. In contrast, the sensitivity of the tumor markers CEA (greater than or equal to 5.0 ng/ml in 17.1% of the gastric cancer and 36.2% of the colo-rectal cancer patients examined) and Ca 19-9 (greater than or equal to 25.0 U/ml in 16.1% of the gastric cancer and 19.8% of the colo-rectal cancer patients) was distinctly higher. The simultaneous determination of three markers on the one hand increased the rate of 'marker-positive' patients (up to 34.5% in gastric cancer and 45.2% in colo-rectal cancer) but on the other hand diminished the specificity (from 96.4% to 89.1%) of the examination.

Depression of cellular immunity after open-heart surgery.

Using a whole blood test system we investigated cell-mediated immunity in 45 patients undergoing open-heart surgery. The peripheral blood lymphocytes were stimulated with the nonspecific mitogens phytohemagglutinin, concanavalin A and pokeweed mitogen, one bacterial recall antigen, tuberculin PPD, and one viral antigen, herpes simplex virus. The patients were tested three times: pre-operatively, and seven days and 2 wks post-operatively. There were no significant differences between a control group of healthy blood donors and the patient group tested preoperatively. However, seven days after operation we observed a clear decrease of the reactions to all stimulants. Two weeks after operation there was an increase of lymphocyte proliferation data in regard to tuberculin PPD and herpes simplex virus. Concerning the nonspecific mitogens PHA and PWM, there was only a tendency of an increase. We believe that two weeks after operation is too short an interval to notice a full normalization of the cellular immune functions. In comparison with the conventional system of isolated lymphocytes, the whole blood technique is advantageous in investigating cell-mediated immunity, particularly if the patient groups are large.

[Effect of intestinal resection on the behavior of mononuclear subpopulations in Crohn disease]. / Einfluss der Darmresektion auf das Verhalten der mononucleären Subpopulationen bei Morbus Crohn.

The literature data about the distribution of mononuclear cells in Crohn's disease are still contradictory. In 50 surgical C.D. patients, clinically classified corresponding to the Crohn's Disease Activity Index (CDAI), the T-lymphocytes and their subsets helper-T- and suppressor-T-lymphocytes (TH/TS) were therefore determined by use of monoclonal antisera, the B-lymphocytes by F(a b)-anti human Ig and the macrophages by uptake of latex microparticles. 37 C.D. patients underwent diseased bowel removal. Blood was drawn from the Crohn-draining mesenteric vein for analysis. Further investigations were performed at the 10th p. op. day as well as after an average period of 7 months (2-18). In comparison the mononuclear cell distribution was examined in 14 patients suffering from chronic osteitis and in 14 patients without any inflammatory disease as controls. C.D. patients showed preoperatively a significantly decreased TH/TS-ratio as well as a significantly increased proportion of macrophages. There was a lymphocytopenia in the peripheral differential blood count. Whereas the distribution of mononuclear subpopulations in the mesenteric blood was identical to the peripheral blood, significant lymphocytosis in the differential blood count of mesenteric blood was found. On the 10th p. op. day the TH/TS-ratio rose almost up to normal, which continued during the follow-up period. The macrophages remained constantly increased in all stages of investigation although during the follow-up none of the patients had signs of disease recurrence. Osteitis patients showed a similar distribution as C.D. patients, even if the changes compared to controls were not as distinct. The proportion of B-lymphocytes was the same in all groups examined. The individual TH/TS-ratios and proportions of macrophages of C.D. patients did not correlate to their clinical data. The changes within the T-cell-subpopulations seem to reflect less M. Crohn's disease itself than its inflammatory complications. Further studies have to be undertaken concerning the impact of the constant increase in macrophages, even after resection of the Crohn bearing bowel segment.

A whole-blood lymphoproliferation assay for measuring cellular immunity against herpes viruses.

A whole blood test system was established to study cell-mediated immunity to cytomegalovirus (CMV) and herpes simplex virus (HSV) in a large number of healthy blood donors. Cellular immunity was measured by the in vitro proliferative response (LP) of peripheral lymphocytes. These responded vigorously to several mitogens. Lymphocytes of most individuals responded to HSV, but only a limited number were reactive towards CMV. In parallel, antibodies against CMV and HSV were measured by an ELISA technique. For HSV, good correlation was observed between serological and lymphocyte proliferation results. For CMV, no clear correlation was obtained, only 21 of 40 donors positive in the antibody test being positive in the LP test. The majority of seronegatives were negative in the LP test. Use of virions purified by sucrose gradient centrifugation, or an additional strain of CMV (strain Davis) did not increase the number of donors positive in the LP test. One explanation might be that individuals possessing antibodies against CMV as measured by ELISA but no capacity to react in the LP test had suffered from a CMV infection a long time before, and now showed waning cellular immunity, but antibody still detectable. Use of the whole blood technique on 108 individuals showed that this very simple test works well with various mitogens and at least some antigens.

Postischemic liver damage in rats: amino acid analysis and morphometric studies.

Normothermic, temporary, total ischemia of the liver was produced for 60-225 min under transient portal decompression with a by-pass between the mesenteric and the femoral vein. Total amino acids in the liver tended to increase after an ischemic period of more than 120 min without reperfusion as compared with control with increasing trends in most of the individual amino acids. In a group undergoing 120 min of ischemia and 60 min of reperfusion, total amino acids and individual amino acids tended to decrease. Total plasma amino acids significantly increased after ischemia of more than 120 min. Without reperfusion, elevations of almost all amino acids except for branched chain amino acids were found, whereas after reperfusion most of the individual amino acids also increased including branched chain amino acids. Molar ratios of branched chain amino acids to tyrosine and phenylalanine decreased only after more than 120 min ischemia without reperfusion. Volume ratios of organelle disintegration on electron micrographs such as mitochondrial degradation and autophagic vacuoles were moderately increased after 90 min ischemia with a further steep rise after more than 120 min ischemia. The survival rates of the animals after 60, 90 and 120 min ischemia were 35% (6/17), 27% (3/11) and 25% (3/12), respectively. The following conclusions were obtained: 1) Pre-necrosis of the hepatocytes with simultaneous protein degradation started after ischemia for about 2 hr. The survival rates of the animals after 60 and 90 min ischemia were very low despite of mild necrosis of the liver. 2) Most of the amino acids in the liver were washed out into the plasma to cause an abnormal plasma amino acid pattern in the acute state. However, the molar ratio of branched chain amino acids to aromatic group was not reduced, in contrast to the ischemic group without reperfusion.

Postischemic liver damage in rats: effect of some therapeutic interventions on survival rate.

The aim of this paper is to elucidate the cause of death after 90 min of normothermic partial (2/3) ischemia of the liver and to examine the effects of glucagon, somatostatin, insulin, prednisolone and oral administration of polymyxin B (PB). The animals 24 hr after partial ischemia for 90 min were divided into two groups; namely, animals with normal appearance and those with moribund state. There were no significant differences in the plasma level of S-GOT, S-GPT, amino acids, NH3 or insulin, or in morphometrically estimated volume ratio of necrotic hepatocytes between the two groups of rats. The blood glucose level, however, was significantly decreased (31 +/- 28 mg/100 ml, n = 6) in the moribund rats with a higher incidence of positive Limulus gelation tests as compared with the rats with normal appearance (149 +/- 19, n = 5). The 1-day and 1-week survival rates of the animals were 42/62 (69%) and 32/61 (53%), respectively. A glucagon injection (1.5 mg/kg, after ischemia) was effective to elevate the 1-day survival rate (14/14), but failed to increase the 1-week survival rate (11/14). On the other hand, a somatostatin injection (100 micrograms/kg, after ischemia) or PB treatment (15 mg/kg/day x 5-9, before ischemia) succeeded to increase the 1-week survival rate (20/22 p less than 0.01 and 17/17 p less than 0.01, respectively), although no significant amelioration in transaminase levels or volume ratio of necrosis was demonstrated. It could be seen that a moribund state after partial ischemia was accompanied by severe hypoglycemic shock, and that the injection of somatostatin after ischemia or the annihilation of gram-negative bacteria by means of oral administration of polymyxin B before ischemia prevented the occurrence of the hypoglycemic shock.

[Post-infectious temporary cold agglutinin disease. A case of delayed formation of antibodies against Mycoplasma pneumoniae]. / Postinfektiöse passagere Kälteagglutininkrankheit. Ein Fall mit verzögertem Auftreten von Antikörpern gegen Mycoplasma pneumoniae.

Following an acute febrile infection of the respiratory tract, a 35-year-old man suffered from livid and painful discoloration of his acral regions even after moderate cold exposure. In his serum, high titers of cold agglutinins with anti-I specificity were present. Cold-related symptoms disappeared within 3 weeks. The clinical features and the finding of anti-I cold agglutinins are compatible with postinfections cold agglutinin disease following an infection with mycoplasma pneumoniae. However, antibodies directed against mycoplasma pneumoniae were only demonstrable after the cold agglutinin-dependent symptoms had disappeared.

Comparison of different methods for the detection of rubella-specific IgM antibodies.

The rubella specific IgM titer in the serum specimens originating from healthy persons and from patients with clinical signs of rubella infection was determined by hemagglutination inhibition or hemagglutination reduction after IgM separation with the following methods: (a) density gradient centrifugation; (b) polyacrylamide agarose gel chromatography; (c) ion exchange chromatography with diethylaminoethyl cellulose columns; (d) solid-phase immunosorbent technique using microplates; (e) solid-phase immunosorbent technique using polyacrylamide microimmunobeads. Alternatively, we removed IgG and IgA by the use of protein A, anti-IgG, and anti-IgA, covalently coupled to controlled-pore glass (f). The titers obtained by the different methods showed qualitatively good correlations when combined with mercaptoethanol reduction. The quantitative measurement of specific IgM titers, however, revealed a lower sensitivity of column chromatography and methods of removal of IgG/IgA.

[ABO crossmatching - the bedside test - with a new system]. / ABO-Identitätssicherung - Bed-Side-Test - mit einem neuen System.

A new system is described to control the ABO-identity immediately prior to bloodtransfusion (Bedside-test). The system allows the ABO-identity to be checked safely, quickly, and simply. The antiserum, in a liquid and ready-to-use form, is enclosed in four sealed compartments. The compartments are covered with a transparent plastic film. Approximately one drop of blood from the patient and the transfusion sample respectively is injected through the film. The result is available within 10 sec.

[Virus-specific IgM proof with routine serologic methods (author's transl)]. / Virusspezifischer IgM-Nachweis mit Routinemethoden.

By the use of a specific immunosorption to insoluble adsorbentia (controlled-pore glass, polystyrene particles) the separation of IgM and IgG is performed in serum specimens, which originate from patients presenting several virus infections (mumps, measles, cytomegalovirus, herpes simplex), for the virus-specific IgM proof with routine serologic methods (CFT, HIT, NT). The results are in a good agreement to them seen in the demonstration of significant titer rises to assure the diagnosis of acute mumps and measles infections by HIT rapidly. While the new technique is also successfully applied for the determination of neutralizing IgM and IgA antibodies to HSV, no sufficient results are available to detect CMV specific IgM antibodies by CFT compared to other methods (IFT, ELISA).

Simple method to detect virus-specific IgM antibodies in patients' serum samples after immunosorption of immunoglobulins G and A.

By absorption with protein A and specific immunosorption using insolubilized adsorbentia (CPG), a method was developed for rapid elimination of IgG and IgA from patients' serum samples. This test technique was examined in the diagnosis of rubella infections, i.e., rubella-specific IgM antibodies. The procedure has proven to be as reliable as determinations carried out with IgM fractions separated on a sucroe density gradient.

Identification of I/i, Pr1-3 and Gd antigens in the human kidney: possible relevance to hyperacute graft rejection induced by cold agglutinins.

Human cold agglutinins (CA) with I/i, Pr1--3 and Gd specificities were tested for reactivity against kidney tissue by immunofluorescent techniques. I/i antigens were found on the epithelia of the Henle's loops and distal tubules. Pr1--3 antigens were demonstrated on the glomerular capillaries. Gd antigens were localized on the endothelia of the glomerular and peritubular capillaries as well as in the kidney interstitium. From these results, it is suggested that hyperacute rejection of renal transplants in recipients with high-titre CA may not only be caused by intravascular erythrocyte agglutination but also by direct cytotoxic damage of the transplant. Since CA occur frequently in potential kidney recipients, pre-operative determinations of CA in these patients should be recommended.