[Scurvy in trisomy 21]. / Skorbut bei Trisomie 21.

We report a case of Down's syndrome in a 22-year-old woman who developed vitamin C deficiency with subsequent appearance of the characteristic joint pains and cutaneous and mucosal lesions of scurvy. A low intake of vitamin C due to peculiar eating habits and reduced absorption due to cardiac insufficiency and treatment with a platelet-aggregation inhibitor were considered to have caused the deficiency. Follicular purpura is a diagnostic skin sign of scurvy.

[Iatrogenic tumor cell implantation in bladder cancer]. / Iatrogenic Tumorzellimplantation beim Blasenkarzinom.

J82 monolayer cell cultures and 647 V multicellular tumor spheroids were incubated in Resectal, urine (pH 5.5; 7.5) and distilled water for 5-30 min. In the case of both monolayers and tumor spheroids inhibition of tumor cell growth was achieved by incubation in distilled water. Transurethral resection (TUR) of a primary superficial bladder cancer was performed in 133 patients (Ta, T1). In 60 of these patients selected biopsies of apparently normal bladder mucosa were taken at the same time. There was no significant difference in tumor recurrence between the groups with biopsy and without biopsy. However, all patients with dysplasia in the selected mucosal biopsies developed a tumor recurrence. Between 1969 and 1984 bladder wall perforation occurred in 12 patients during TUR of Ta, T1 bladder cancer. None of the patients who experienced bladder wall perforation developed extraperitoneal or intraperitoneal metastases. Although our clinical results suggest that iatrogenic tumor cell implantation during TUR of a bladder cancer is rather unlikely, this event could be prevented by the use of distilled water during and after TUR.

Interactions between bladder tumor cells as tumor spheroids from the cell line J82 and human endothelial cells in vitro.

Multicellular tumor spheroids (MCTS) are a reliable model of nonvascularized tumor cell aggregates showing a well defined three-dimensional growth pattern and are comparable with small metastatic cancer cell complexes in blood circulation. In the present study we have established a co-culture system of multicellular bladder tumor spheroids with human endothelial cells on extracellular matrix (ECM) in order to investigate morphological and proliferative changes of endothelial and tumor cells within a defined time of cell-cell interaction. The MCTS--endothelial cell--extracellular matrix complex was observed within coculture periods from 1/2 to seven days. Morphological changes (light microscopy, scanning and electron microscopy) indicated that MCTS are not influenced by cocultured endothelial cells. The tumor cells invaded into the ECM after degradation of endothelial cells in the center of the contact zone. Endothelial cells, however, showed degenerative changes as well as a complex reaction in their proliferation activities. We could recognize an initial increase of proliferation of endothelial cells next to the MCTS. Later on, endothelial cells next to invading tumor cells showed changes in morphological polarity. The model system used has the advantage of using human tumor tissue. It distinguishes between basic cellular mechanisms like adherence, migration, DNA synthesis and proliferation in the study of the contact of tumor cells and vascular endothelial cells as an important event in hematogenous tumor spread.

Multicellular bladder tumor spheroids in coculture with human endothelial cell monolayers.

Multicellular tumor spheroids (MCTS) are avascular spherical tumors grown systematically out of single cells in vitro. The coculture of MCTS of the human bladder carcinoma cell line J 82 with confluent human endothelial cell layers serves as a model to study cell-cell interactions as an important feature in hematogenous tumor spread. Basic information is obtained by phase contrast microscopy and histochemistry. More detailed information is given by the application of scanning and transmission electron microscopy. Immunohistochemistry helps to differentiate endothelial cells from tumor cells (factor VIII-related antigen). The application of this coculture model and of the various methods of evaluation enables us to study cell-to-cell contact phenomena systematically.

[Angiotensin I biosynthesis and electrolytes]. / Angiotensin-I-Bildung und Elektrolyte.

An influence on the production of Angiotensin-I by different ions is demonstrated. Plasma Renin activity was thereby measured by the methods of Boyd et al. (pH 7.5) and of Fyhrquist et al. (pH 6.0) at a concentration of each ion of 50 mmol/L. Ions of different size were used, ranging from Lithium to the Ammonium-ion. A definitive dependency of this effect on the Angiotensin production by the ion size could be shown. With Sodium the concentration in serum was varied at 5 levels (130-170 mmol/L) and Renin measured at Potassium concentrations in low (3.4-3.7 mmol/L) or high (4.8-5.1 mmol/L) so-called normal ranges. A marked increase of the production of Angiotensin-I with increasing sodium concentrations at a low Potassium range was observed and the opposite was true at high Potassium concentrations. These effects have to be taken into account when assaying Plasma Renin activity. In addition, they offer also an explanation of the well-known but unsolved facts of the influence of Sodium and Potassium on the pathogenesis of hypertonia.