Ultrastructural changes of the human pancreas in acute shock.

Human pancreas tissue was studied electron microscopically during various stages of shock. The subcellular changes of exocrine pancreas affect in particular endoplasmic reticulum (ER), mitochondria, cytoplasm, and nuclei. Alterations correlate with duration and severity of shock, causing cell death in prolonged or severe manifestations of shock. This is obviously due to release of enzymes from zymogen granules; the ensuing damage cannot be distinguished from autodigestive pancreatitis. Lesions of exocrine pancreas cells are of multifactorial origin, arising from general shock-induced hypoxia, but also from local ischemia due to disturbed microcirculation provoking intravasal coagulation. Beyond these main causes, intracellular disorders of metabolism, obstruction of lymph drainage, and nervous factors may be of influence. As the cases surveyed in this paper had no fatal outcome - except for one patient - the changes described can be defined as non-lethal or as reversible.

[So-called malacoplakia of the testis and epididymis]. / Sogenannte Malakoplakie des Hodens und Nebenhodens.

We report on a case of malacoplakia involving testis and epididymis in 63-year-old man. The lesion had a characteristic yellow nodular gross appearance and was composed of histiocytes, neutrophils and plasma cells. Calcospherules (Michaelis-Gutmann bodies) are prominent. The findings are compatible with the generally accepted concept that malacoplakia represents a peculiar inflammatory process of unknown etiology. The relationship between testicular malacoplakia and granulomatous orchitis is discussed.

[Electron microscopic findings in the livers of long-term survivors among child tumor patients after polychemotherapy]. / Elektronenmikroskopische Leberbefunde bei langzeitüberlebenden Tumorpatienten im Kindesalter nach Polychemotherapie.

In 14 children which were treated by combined antineoplastic chemotherapy a postexamination was performed after a mean survival time of 5 years and a post-treatment-interval of two and a half years. In this study also liver biopsies were examined by electron microscopy. Ultrastructural changes of the hepatocytes must be explained as a progressive metabolic efficiency of these cells. There was no direction for a chronic damage of the liver parenchyma induced by the therapy.

[Ultrastructure of rabbit myocardium in experimental histamine shock]. / Elektronenmikroskopische Veränderungen am Kaninchenmyokard beim experimentellen Histaminschock.

The ultrastructure of rabbit myocardium was studied after experimental histamine release by Polymyxin-B-sulphate. As soon as 15 minutes after the histamine release mitochondria and sarcoplasmic reticulum showed alterations with appearance of lysosomes and partial destruction of contractile structures. The sarcolemm formed blistered protrusions with simultaneously expelled cytoplasmic elements. Whereas intramural vessels were inconspicuous, the pericapillar spaces showed a considerable enlargement. On the basis of these findings, we suppose that the changes were induced on the one hand by the increase of the permeability of capillaries produced by histamine and, on the other one, by local and general ischemia as a consequence of shock.

Pancreatic lesions in shock and their significance.

The pancreas was examined histologically in 146 cases of patients dying of shock. The finding of morphological evidence of disseminated intravascular coagulation (DIC) in the pancreas supports the opinion that the pancreas in highly sensitive to disturbances of blood perfusion. The presence of DIC combined with a variety of pathological lesions in the exocrine ad endocrine pancreas was sufficiently characteristic to justify use of the term " shock pancreatitis". The relative scarcity of data hitherto available on pathological changes in the pancreas caused by shock can be ascribed to changes in the management of shock. It is concluded that the pancreatic lesions described in this study could influence the outcome in shock treated by modern methods of resuscitation.

Acute and cutaneous toxicity of beta-chlorovinyl ketones and aldehydes in rodents.

The acute toxicity (LD50, intraperitoneal in the mouse) of beta-chlorovinyl ketones and aldehydes used as intermediates for organic syntheses was determined and their action on the skin of rodents investigated. Ketones of the type Cl-CH-CH-COR prove to be relatively toxic and display a markedly necrotic action after percutaneous absorption. In comparison with this the isomeric aldehydes Cl-CR-CH-CHO have a lower acute and less markedly cutaneous toxicity. As therapeutic counter action after skin contamination by beta-chlorovinyl carbonyl compounds the immediate treatment with an aqueous ethanolic solution of hexamethylenetetramine is recommendable.

[Ultrastructure of liver cells during experimental histamine shock (author's transl)]. / Ultrastrukturelle Veränderungen der Leberzellen beim experimentellen Histaminschock.

An light and electronmicroscopic study of the rabbit hepatocytes during shock after experimental histamine release by Polymyxin-B-sulphate was made. As soon as five minutes after the histamine liberation the endoplasmatic reticulum becomes dissociated and the mitochondria show a spherical transformation. When the shock lasts up to one hour the changes are more intensive. The rest of deteriorated mitochondria and the endoplasmic membranes are expelled from the cells into the sinusoid lumina in form of myelinic figures. The hepatocyte microvilli swell up at first, and later, from the fifteenth minute after the beginning of shock they disappear which results in the flattening of the plasma membrane or its complete dissapearance in some places. Endothelial cells suffer similar alterations and they also acquire cytoplasmic protrusions. The findings lead to the conclusion that the changes of hepatocytes during shock after histamine liberation are primarily due to the direct influence of released histamine, and secondarily to the influence of hypoxia produced during the shock state.

[Acute and subchronic experiments on the effects of microcrystalline cellulose on various pharmacological and biochemical parameters in mongrel rabbits]. / Beeinflussung verschiedener pharmakologischer und biochemischer Parameter am Bastardkaninchen durch mikrokristalline Cellulose im akuten und subchronischen Versuch.

The subchronic intravenous application of microcrystalline cellulose (MCC), in a dose of 5 mg/kg twice weekly for 10 weeks, resulted in servere crystal embolism in the lungs of the animals. The clinical parameters were either unchanged (erythrocyte and leucocyte counts, differential blood picture, osmotic resistance of the erythrocytes, total serum bilirubin, serum protein and serum protein fractions) or slightly pathological (hemoglobin content, hematocrit, GOT and GPT). The results from tests of the liver function (by means of bromosulphthaleine clearance) and of the renal function as well as the ophthalmologic examination were not indicative of damaged parenchyma or disturbed microcirculation. Intra-arterial infusions of MCC affected the peripheral muscular blood supply, blood pressure and heart rate.

[Kidney changes in experimental obesity]. / Nierenveränderungen bei tierexperimenteller Fettsucht.

In a survey renal changes in human obesity as well as in experimental obesity of laboratory animals are discussed. Own results are described about a comparison of biochemical and morphological studies on an experimental model of dietary-induced obesity after long-time feeding of a high-fat diet. Obese rats show normal concentrations of plasma proteins after feeding of a high-fat diet of some weeks. Urea-nitrogen levels are not modified as compared to control animals. Despite the mean levels of creatinine concentration in the dynamic and static phase of obesity are not different, some obese rats show increased creatinine values in the dynamic phase. Our histological studies reveal no pathological abnormalities of renal structures and blood vessels.

[Hemorrhagic erosion as a cause for gastrointestinal hemorrhages]. / Die hämorrhagische Erosion als Ursache gastrointestinaler Blutungen

It is necessary in clinical diagnosis more than hitherto done to take into consideration haemorrhagic erosions as the most frequent cause of gastrointestinal haemorrhages. They are found as concomitant diseases of certain basic diseases, whereby the spectre of causes deviates in adults and children. In adults dominate heart insufficiency and cerebral diseases including skull-brain trauma, in children, however, infections of the respiratory and digestive tract, followed by cerebral affections and haemoblastoses. A differentiation concerning age and sex cannot be proved.