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The occurrence of autoimmune phenomena in 28 patients with thromboangiitis obliterans (Buerger's disease) was determined. The following were sought: antineutrophil cytoplasmic antibodies against proteinase 3 (cANCA) and myeloperoxidase (pANCA), antinuclear antibodies, anti-Ro antibodies, anticardiolipin antibodies, and antiendothelial cell antibodies (AECA). For the last, an enzyme-linked immunosorbent assay was developed which verified the presence of the AECA phenomenon with immunofluorescence and confocal microscopy. Seven patients with active disease had AECA titers of 1,857 +/- 450 arbitrary units (AU) compared with 126 +/- 15 AU in 30 normal control subjects (P < 0.001) and 461 +/- 41 AU in 21 patients in remission (P < 0.01). Antibodies from the sera of patients with active disease reacted not only with surface epitopes but also with sites within the cytoplasm of human endothelial cells. AECA may be useful in following disease activity and may play a role in the pathogenesis of thromboangiitis obliterans.

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For the first time efficacy and safety of a new prostaglandin E1 (PGE1) regimen in the treatment of intermittent claudication were evaluated in a randomized, double-blind, placebo-controlled multicenter clinical trial. The study involved 213 outpatients with a maximum walking distance of 50 to 200 m measured on the treadmill (3 km/hr, 12% grade). After a 2-week run-in phase they received a 2-hour intravenous infusion of 60 micrograms PGE1 or placebo 5 days a week for 4 weeks. It was followed by a 4-week interval treatment with the same medication administered only twice a week. Patients were monitored for 3 months when they received no study medication. In the PGE1 group the intention-to-treat analysis (n = 208) revealed an increase in walking distance after 4 weeks of 75% (placebo, 43%). At the end of the interval treatment the walking distance had improved to 101% (placebo, 60%). The results remained virtually constant during follow-up (PGE1, 104%, placebo, 63%). Between-group comparisons showed significant differences in favor of PGE1 for all three time points of measurement (p < 0.05, p < 0.01, and p < 0.05). PGE1 was well tolerated; the rate of adverse reactions related to the treatment was 12.8% (placebo, 7.7%). In summary, these results show that the new PGE1 regimen is effective and safe in the treatment of outpatients with intermittent claudication.

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BACKGROUND: Although a specific etiology for Takayasu arteritis has not been found, the bulk of evidence favors an autoimmune mechanism. We examined the sera of 19 patients with Takayasu arteritis for antineutrophil cytoplasmic antibodies (ANCA), antinuclear antibodies (ANA), anti-DNA antibodies, antibodies to extractable nuclear antigens (ENA), anti-Ro anti-bodies, anticardiolipin antibodies, circulating immune complexes, and anti-endothelial cell antibodies (AECA). METHODS AND RESULTS: We used enzyme-linked immunoassays, immunofluorescence, counterimmunoelectrophoresis, fluorescent-activated cell sorter (FACS) analysis, and confocal microscopy. We found that although no patient had positive ANCA, ANA, anti-DNA antibodies, ENA antibodies, anti-Ro antibodies, or anticardiolipin antibodies, 18 of the 19 patients had AECA. The AECA titers of the patients were 2561 +/- 1458 compared with 126 +/- 15 arbitrary units in a normal group of control subjects (P < .001). To verify the specificity of AECA, we performed cytofluorimetry on human endothelial cells with the sera from patients and control subjects. Two entirely separate patterns of fluorescence intensity were identified. We next performed immunocytochemistry and confocal microscopy with human endothelial cells subjected to patients' sera and to sera from normal subjects. The cells subjected to sera from patients with Takayasu arteritis demonstrated specific immunofluorescent staining of their plasma membrane and cytosol. CONCLUSIONS: AECA are frequently present in patients with Takayasu arteritis. They may play a role in the pathogenesis. Furthermore, they may be useful as an additional diagnostic tool.

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We tested the haemorheological effects of the addition of 3.5% oxypolygelatine, 10% dextran 40, 6% dextran 75 or 5% albumin, respectively, to fresh donor blood of 25 healthy young persons. We examined the aggregation and the viscosity of substituent plasma mixtures in such various, but constant volume relations as may be present during intravenous infusion. Albumin reduced viscosity and aggregation, but especially dextran 75 increased both parameters significantly.

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Four patient groups (n = 28 patients) received in a randomised clinical trial a single intravenous infusion of 500 ml of 10% dextran 40, 3.5% oxypolygelatine, 6% hydroxyethyl starch 200/0.5 or saline solution, respectively. The haemorheological parameters haematocrit, plasma viscosity and erythrocyte aggregation were followed up during 48 hours. In our study oxypolygelatine showed better rheological results than HAES 200/0.5. Dextran 40 especially increased the plasma viscosity and erythrocyte aggregation, so that we cannot recommend this plasma substituent for hypervolemic haemodilution.

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Both photobiological methods haematogenic oxydation therapy (HOT) and therapy by retransfused ultraviolet irradiated own blood (UVB) were compared with regard to its therapeutic efficacy in patients with peripheral arterial occulusive disease of lower extremities in stage II by Fontaine. In parallel to paraclinical and coagulation data, haemodynamic as well as haemorheological parameters were investigated to clarify possible mechanisms of action of these therapies. 15 male patients were enclosed in the corresponding patients groups with a mean walking distance of 178 +/- 108 m (HOT) and 213 +/- 147 m (UVI), respectively. The claudicatio-distances were significantly improved after 10 series of therapy by 94% in the HOT-group and by 83% in the UVI-group, respectively. A significant difference in the improvement of walking distances could not be detected between both therapeutical methods. Significant alterations in observed paraclinical parameters were not observed.

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In 21 patients suffering from obstructive peripheral arterial disease stage II according to Fontaine, therapeutic efficacy of serial whole body irradiations (infrared or ultraviolet radiation) and pretended or real ultraviolet light blood irradiations was evaluated. Before, during and after treatment the following parameters were monitored: walking distance, oxygen partial pressure (quasi-arterial/venous), flow properties of blood (appearant blood viscosity, hemodynamics (peak flow, ultrasonics). There were no significant changes following both modalities of whole body irradiations either by sunshine-like ultraviolet light nor by infrared radiation, nor by pretended blood irradiation. In the same patients mean walking distance was prolonged threefold after ultraviolet irradiation of the patient's own venous blood and subsequent retransfusion. Simultaneously, oxygen utilisation was improved (enlarged arterial/venous difference), lactate concentration was decreased and apparent blood viscosity was diminished, whereas blood flow remained unchanged or only slightly improved. In this way the circulus vitiosus of obstructive peripheral arterial disease can be overcome. As a consequence of blood irradiation walking distance enlarges, providing better chances for physical training, which helps to extend walking distance furthermore.

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Synopsis Substantivity of various (125)I-labelled collagen hydrolysates to virgin or bleached and dyed European hair or human callus was tested under conditions which simulated actual application of such hydrolysates in shampoos or foam baths. Factors which most strongly influence protein substantivity were identified. The molecular properties of the hydrolysate are the most important factor. The hydrolysate which adsorbed best had the lowest overall isoelectric point, the highest pH in solution and the largest content of high molecular weight peptides. The extent of adsorption was also a function of concentration of protein, of the duration of application and of the nature of the components of the formulation. Thus, the combination of shampoo and hydrolysate can be adjusted so that a desired substantivity is attained.

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Fifty extensor digitorium longus muscles of 25 cats were autografted, 33 with and 17 without prior denervation. After 50 days, no significant differences were observed between predenervated and nonpredenervated autografts. Autografted muscles weighed 48% of the weight of control muscles. Few original muscle fibers survived and within 2 wk autografts contained regenerating muscle fibers. The mean cross-sectional area of muscle fibers in the autografts reached 125% of the value for control nontransplanted muscles. The mean percentage of fibers classified high oxidative in autografted muscles was 67% of values for control muscles. SDH activity of autografted muscle homogenates reached 55% of control values. Up to 60 days after surgery autografts had only fast-twitch fibers. At 170 days autografts remained 95% fast twitch in composition. Revascularization began within 4 days, but the capillary to fiber ratio of long term autografts reached only 60% of control values. Although fiber hypertrophy suggests that cats use autografted muscles, lower than control succinate dehydrogenase activity may result from altered recruitment.

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The activities of the transmitter metabolizing enzymes monoamineoxidase and acetylcholinesterase and of succinic dehydrogenase were investigated in the telencephalon of Salmo irideus (teleostei). There is a high reaction intensity of the MAO in the whole telencephalon with graded differences between the various nuclear areas. It is highest in the area dorsalis telencephali; the larger fiber tracts (Tr. olfactorius medialis et lateralis; medial and lateral forebrain bundle) are strong MAO-positive, too. There is an extremely weak AchE-reaction throughout the telencephalon. The only nuclear area which is clearly histochemically demonstrable is the regio Dm2 in the area dorsalis telencephali. The SDH-activity is demonstrable in the whole telencephalon. The activity is higher in the area dorsalis as compared with the area ventralis telencephali. In the ependym there are only a few traces of MAO- and SDH-reaction products. The recent findings may support, from a histochemical view, the hypothesis that the telencephalon of Salmo irideus represents brain structures which show structural and functional similarities with limbic telencephalic structures of higher vertebrates.

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The telencephalon of Salmo irideus (Gibbons) was investigated by means of staining and silver impregnation techniques. It shows the fundamental plan characteristic for teleost species. The neurons in the various telencephalic nuclear areas are, in part, quite different with respect to their density of arrangement,migratory behavior, width of pericaryon and number of spines, inclusively. Neurons exhibiting a high degree of morphological differentiation (i.e. neurons of the stellate and pyramidal like type of differentiation) are located in the area dorsalis telencephali only. This telencephalic region is considered to be a functional homologon of limbic telencephalic structures of other vertebrates.

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The ependyma in the region of the telencephalon of Salmo irideus is composed of a great number of various elements: uni- and bipolar tancytes, ependymal astrogliacytes, ciliated ependymal cells, intraependymal neurons and neuron-like cells exhibiting ventricular contact. There are regional differentiations in the ventricular wall which can be attributed to certain structurally defined nuclear areas. When comparing the various regions of the ventricular wall in the telencephalon of Salmo irideus with appropriate regions of amphibians and reptiles, some, at least partially, far-going morphological similarities can be found. The ependymal differntiations could, thus, be regarded as an additional morphological criterium concerning the question of the homologization of the telecephalic nuclear areas with those of other verebrates. The abundnat occurrence of tanycytes of the bipolar type in the telecephalon appeared surprising; they are discussed to act in a preponderantly resorptive manner, as it is, above all, hitherto known for hypothalamic regions of other vertebrates. The morphological and functional characteristics of the neuronlike structures exhibiting ventricular contact are as yet not clear.

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