Bacteria displaying interleukin-4 mutants stimulate mammalian cells and reflect the biological activities of variant soluble cytokines.

We describe a novel procedure that allows the rapid determination of cytokine activity on cells that express their cognate receptor. The four-helix bundle cytokine interleukin-4 (IL-4) was inducibly expressed as a fusion with the E. coli outer-membrane protein intimin, such that IL-4 was presented on the surfaces of the bacteria.

Histone-specific Th0 and Th1 clones derived from systemic lupus erythematosus patients induce double-stranded DNA antibody production.

Objective: To investigate whether histone-specific T helper (Th) cells that are able to induce anti-double-stranded DNA (anti-dsDNA) antibodies can be isolated from patients with systemic lupus erythematosus (SLE) and to characterize the cytokine secretion pattern of such Th clones.

Methods: Peripheral blood mononuclear cells from SLE patients and healthy donors were stimulated with autologous apoptotic cell material or purified histones, expanded with interleukin-2 (IL-2), and cloned by limiting dilution. Histone reactivity of clones was examined by histone-specific proliferation and cytokine release.

Wallstents versus plastic stents in malignant biliary obstruction: effects of stent patency of the first and second stent on patient compliance and survival.

Objectives: In prospective trials in patients with malignant biliary obstruction, it has been reported that Wallstents prolong stent patency, but this does not translate into a significant survival benefit. Compared with prospective trials, however, survival may be different in clinical practice because of differences in patient compliance. We report on a retrospective, long term analysis comparing Wallstents versus plastic stents.

Preferential recognition of specific DNA motifs by anti-double-stranded DNA autoantibodies.

Although antibodies (Ab) specific for double-stranded (ds) DNA are thought to be involved in the etiopathogenesis of systemic lupus erythematosus (SLE), the fine structure of their DNA targets remains elusive. We have adapted a polymerase chain reaction (PCR)-assisted immunoprecipitation method to define the binding sites in DNA sequences recognized by high affinity anti-dsDNA Ab of SLE patients. SLE sera were used to bind templates from a pool of double-stranded oligonucleotides (ON).

[Endoscopic, biopsy and functional results in irradiated esophageal carcinoma].

83 patients of average age 64 (36-86) years with esophageal cancer were irradiated according to a prospectively defined treatment concept. After 60 Gy, re-endoscopy with biopsy was scheduled. If the tumor was still macro- or microscopically described, a boost to 70 Gy was given.

Cholylsarcosine, a new bile acid analogue: metabolism and effect on biliary secretion in humans.

Background: Cholylsarcosine, the synthetic conjugate of cholic acid and sarcosine, is resistant to deconjugation-dehydroxylation during enterohepatic cycling in rodents and improves lipid absorption in a canine model of intestinal bile acid deficiency caused by distal intestinal resection. Experiments were performed to define its metabolism and effect on biliary secretion in humans.

Methods: The circulating bile acid pool was labeled with [14C]cholylsarcosine, and its turnover rate and biotransformation were determined by sampling bile daily.

[Osteosynthesis in dislocated femoral neck fracture (Garden 3 and 4). Long-term results and treatment concept].

The dislocated fracture of the femoral neck (Garden type 3 and 4) in the young patient is preferably treated by open reduction and internal fixation. In the period 1980-1989 we fixed 49 fractures with a dynamic hip screw, a 130 degrees-angled plate, screws alone, or by a valgisation osteotomy fixed with a 120 degrees-plate (Pauwels osteotomy). 30 fractures were reviewed after 66 months in average.

Risk factors, co-medication, and concomitant diseases: their influence on the outcome of therapy with cisapride.

In a 28-day non-blinded study of 1071 patients with functional dyspeptic symptoms in a general practice setting, 666 presented with mainly typical symptoms of functional dyspepsia and received 5 mg cisapride three times daily, while 405 with predominating symptoms indicative of gastroesophageal reflux received 10 mg cisapride three times daily. On the basis of an anamnestic risk factor analysis for organic lesions, 'low-risk' patients were to be treated directly with cisapride, while for 'high-risk' patients a more thorough gastrointestinal examination was recommended before starting cisapride. Of patients in the dyspepsia group 75% reported a good or excellent response; the corresponding rate was 80% in the reflux group.

Recurrent bleeding after variceal hemorrhage: predictive value of portal venous duplex sonography.

Objective: Risk assessment of recurrent variceal bleeding is essential for therapeutic decisions and is usually performed by endoscopy of the upper gastrointestinal tract. We studied the value of portal venous duplex sonography in predicting subsequent variceal bleeding in patients with cirrhosis.

Subjects And Methods: Thirty patients with cirrhosis who received sclerotherapy because of acute variceal hemorrhage for the first time (hemorrhage group), 30 patients with cirrhosis who had no previous hemorrhage (nonhemorrhage group), and 30 control subjects were examined prospectively.

A new approach to the molecular characterization of the c-ANCA antigen in Wegener's granulomatosis.

Classic anti-neutrophil cytoplasmic antibodies (c-ANCA) specific for constituents of neutrophil primary granules and monocyte lysosomes have been implicated in the pathogenesis of Wegener's Granulomatosis (WG). The revised amino-terminal sequence of Proteinase 3 (PR-3) as ANCA antigen, suggested that PR-3 is identical to myeloblastin (MBN). As it has been proposed that autoantibodies recognize a conformational epitope on c-ANCA, prokaryotic expressed protein might not be recognized by the patients sera.

Analysis of immunoglobulin variable region genes from human IgG anti-DNA hybridomas.

The molecular mechanisms leading to anti-double-stranded (ds) DNA antibody production in systemic lupus erythematosus (SLE) are poorly understood. We describe here the immunoglobulin variable region genes of six human hybridomas secreting IgG anti-dsDNA antibodies derived from three SLE patients. The monoclonal IgG anti-dsDNA antibodies have been shown to be of high affinity and no multireactivity was observed (Winkler et al.

[Cisapride: clinical experience in 1071 patients with non-ulcer dyspepsia or reflux symptoms].

Controlled studies showed that cisapride is effective in non-ulcer dyspepsia. Its prokinetic properties are not complicated by dopamine inhibition. In our study the dose of 5 mg t.

Activation of macrophages for ADCC in vitro: effects of IL-4, TNF, interferons-alpha/beta, interferon-gamma, and GM-CSF.

Macrophages in varying states of activation differ in their ability to perform antibody-dependent cellular cytotoxicity (ADCC) and antibody-independent macrophage-mediated tumor cytotoxicity (MTC). To define further the activation requirements for macrophages to perform various cytolytic functions, we stimulated peptone-elicited peritoneal macrophages, which are only poorly cytolytic, with one of a panel of cytokines and then quantified three distinct cytolytic capacities. The peptone-elicited macrophages, after stimulation with IFN-alpha/beta, IL-4, or TNF, had increased ability to perform both the rapid and slow variants of ADCC but not to perform MTC.

Cytokine stimulation of antibody-dependent cellular cytotoxicity (ADCC) enhances cytolytic but not binding capacity of peritoneal macrophages.

Macrophages in varying states of activation differ in their ability to perform antibody-dependent cellular cytotoxicity (ADCC). To define further the activation requirements for macrophages to perform cytolytic functions, we stimulated peptone-elicited peritoneal macrophages, which exhibit only a low level of ADCC, with a panel of cytokines and then assayed for the macrophages capacity to effect the rapid and slow forms of ADCC, to bind antibody-coated tumor cells, and to secrete H2O2 in response to immune complex or PMA. All four cytokine preparations, at optimal conditions, enhanced both forms of ADCC, but did not appreciably increase tumor cell binding.

Potentiation of cytostatic but not cytolytic activity of murine macrophages after running stress.

The influence of physical exercise on the tumortoxicity of peritoneal murine macrophages (PMM) was investigated. The tumortoxic activity was discriminated into cytostatic and cytolytic effects. Cytostatic activity of PMM on tumor cells in vitro was studied using the proliferation assay of S-180 sarcoma cells.

Human macrophage function and physical exercise: phagocytic and histochemical studies.

Macrophages derived from human connective tissue were assayed for their enzyme content and phagocytic activity after physical exercise. A single exhaustive endurance-running test caused increased phagocytic and enzymatic activities of the macrophages. Thus, an exercise challenge activates the functional status of the cells.

The influence of physical exercise on peritoneal macrophage functions: histochemical and phagocytic studies.

Peritoneal murine macrophages were assayed for their enzyme content and phagocytic activity after physical exercise. An endurance training as well as a single exhaustive exercise bout caused increased enzyme and phagocytic activities. However, a homogeneous activation could not be observed.

[Radiotherapy of esophageal carcinoma. Results checked clinically by radiology, endoscopy, biopsy and autopsy].

Forty-four patients with histologically confirmed esophageal cancer were irradiated with 60 Gy, checked endoscopically and by biopsy, and then followed clinically or radiologically until their death. The findings confirm the local destructibility of esophageal cancer with loosely ionized radiation and a favorable effect on quality of life. Three quarters of the patients were able to take normal food at the end of the radiotherapy, while the remainder were at least able to swallow soft foods.

[Microangiopathic hemolytic anemia, erythrophagocytosis and consumption coagulopathy in vinyl chloride-induced hemangiosarcoma of the spleen and liver].

A case of angiosarcoma of the liver and the spleen following vinyl chloride exposure is described. The main symptoms in clinical diagnosis were microangiopathic hemolysis, disseminated intravascular coagulation, hepatosplenomegaly and exposure to vinyl chloride thirty years ago. It is the first case in which liver and spleen are involved in angiosarcoma due to vinyl chloride exposure.

Presenting characteristics of patients with duodenal ulcer and outcome of medical treatment in controlled clinical trials using cimetidine and diethylamine persilate to treat ulcer attack and diethylamine persilate and placebo to prevent relapses.

A double-blind controlled clinical trial on the medical treatment of the acute episode of duodenal ulcer and the prevention of symptomatic relapses was performed. A total of 164 patients with active duodenal ulcer were either treated with cimetidine 1 g/day (70 patients), diethylaminepersilate (DAP) 1.5 g/day (64 patients) or DAP 2.

Healing and relapse of reflux esophagitis during treatment with ranitidine.

In 108 patients the healing and relapse of reflux esophagitis, defined endoscopically by the presence of epithelial defects (erosions and ulcerations) of the esophageal mucosa, were studied. In the first study, with open treatment of ranitidine, the healing rate after 6 wk was 50%. The most important factor that negatively influenced healing was the extent of esophageal erosions.

[Severe, acute bleeding ulcer: which criteria are decisive for therapeutic procedures?].

Prognostic and therapeutic implications of acute severe gastrointestinal bleeding were retrospectively analyzed, on the basis of history, clinical and endoscopic findings, in a group of 50 consecutive patients with endoscopically documented ulcer of the stomach or duodenum. In patients with hemorrhagic shock and a history of melena and/or hematemesis represents the most important indication for urgent action. In this setting the surgical approach remains the therapy of choice if other measures (endoscopic coagulation, somatostatin application) are unable to prevent further bleeding.