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The Federal Quality Improvement program, (QIO), charged with quality improvement and some case review activities is conducted under a contract with the Centers for Medicare and Medicaid Services (formerly HCFA), now CMS. Every state has one organization which handles this program and in West Virginia, the West Virginia Medical Institute has been responsible for this work for over 30 years. When case review is involved, the conclusions are communicated to individual physicians and hospitals. Occasionally, serious quality of care concerns are encountered. This article explains the case review process and why cases are selected, and also makes suggestions about how individual physicians may appeal or respond. It is designed to help enhance understanding of the program and its goals.

The fluorescence spectra of acidified aqueous solutions of tetracycline (tcH3+) exhibit three components with slightly different degrees of anisotropy: the 'blue' component (lambdad approximately equal to 475 nm) decays on the timescale of a few picoseconds; the second, most intense component (lambdad approximately equal to 530 nm) shows decay times of about 25 (H3O+) and 70 ps (D3O+); the third component (lambdad approximately equal to 650 nm) is longer lived (tau approximately equal to 200 ps). All three fluorescence components appear quasi-instantaneously, thus providing evidence that the relaxation processes which give rise to the unusually large Stokes shifts occur on a (sub-)picosecond timescale. The effect of H/D exchange suggests that these relaxation processes involve excited-state intramolecular proton transfer (ESIPT) of OH10 and/or OH12, but does not exclude a change in the hydrogen-bonding pattern to the solvent molecules. The low overall fluorescence yield of the fully protonated form must be correlated to the presence of a very fast decaying species. In alkaline aqueous solution, the fluorescence of the dianion (tc2-) essentially comprises two components; the decay time of the stronger, shorter-lived component is about 30 ps, that of the weaker, longer-lived one about 160 ps. The relative amplitude of the latter is larger at pH 11 than at pH 8.5, in accordance with the increase in the steady-state fluorescence intensity upon increasing the pH from 8.5 to 11. Complexation of the dianion with divalent metal ions like Mg2+ or Ca2+ leads to a strong enhancement of the steady-state fluorescence. In the time-resolved spectra, the decay time of the major fluorescence component exhibits approximately a five-fold increase in comparison to the major component of the dianion. It is about 150 ps in both types of complexes. The decay times of the minor component are increased to about 500 (Mg2+) and 320 ps (Ca2+). The absence of the ultra-fast component in the fluorescence of the dianion and its metal complexes provides evidence that a reaction of OH 12 must be responsible for the ultra-fast fluorescence component in tcH3+. The existence of a component with a lifetime of several tens of picoseconds in all samples suggests the involvement of hydrogen bonding at OH10 during the formation of the emitting species. DFT calculations for the isolated molecule provide evidence that ESIPT is indeed an energetically allowed relaxation process for those isomers that have only one intramolecular hydrogen bond to O11. The ESIPT process yields primary photoproducts that should emit at much longer wavelengths, thereby explaining the unusually large fluorescence Stokes shift.

This paper presents performance of a compact 3 W HPA (High Power Amplifier) in MMIC and packaged form at 30 GHz. A low cost high power packaged part was achieved by designing a compact MMIC and adopting a laminate substrate approach for a package. TriQuint standard 0.25 /spl mu/m PHEMT production process on 50 /spl mu/m substrate technology was used for a compact MMIC PA design. The output power at P1 dB (CW measurement) of MMIC and packaged parts are 34.9 dBm and 34.5 dBm with associated gain of 21.5 dB. These results are the highest CW-power and gain reported for a single MMIC and packaged part at Ka-band.

This article describes our study of the use of beta blocker drugs in Medicare beneficiaries hospitalized for acute myocardial infarction in West Virginia between 1999 and 2000. We contrasted findings with the responses of practicing cardiologists in the state. The survey asked cardiologists to describe their recent patterns of beta blocker usage, to comment on the severity of generally recognized contraindications to beta blocker administration, and to speculate on reasons why West Virginia's rates of beta blocker use in AMI were lower than rates in most other states. Our study revealed that beta blocker use in AMI declined significantly with patient age, and that rates of use in larger hospitals exceeded those in smaller hospitals. There was little difference attributable to the specialty of the admitting physician. We also observed a positive association between the use of beta blockers in AMI and other appropriate interventions, such as the use of aspirin and revascularization. Cardiologists said they were using more beta blockers in AMI than five years ago, and speculated that high rates of chronic obstructive pulmonary disease and non-specialist physicians were responsible for low rates in West Virginia.

Results are presented on a new rapid method proposed for recovering the carrier frequency of M-PSK and M-QAM modulated signals in six-port based direct digital receivers (SPR) using a reverse modulation loop (RML) technique. The method is valid for hardware and software SPR, avoids the use of mixers, except for a phase-locked loop (PLL), and is suitable for both microwave and millimeter-wave frequencies. Simulations of RML performance are presented, that include measured bit error rate (BER) of receiver sub-circuit at 40 Mbps. Measurements are given for two six-port prototypes fabricated in microwave monolithic integrated circuits (MMIC) and microwave integrated circuits (MIC) technologies.

We extended the sensitivity of Raman correlation spectroscopy in solution to the single-molecule level by applying surface- and resonance-enhanced Raman scattering (SERRS) combined with time-gated, confocal signal detection. The brightness of the SERRS signal of single Rhodamine 6G molecules adsorbed on a single silver nanoparticle is comparable to fluorescence. Rare event analysis reveals the existence of few particles with simultaneous SERRS and fluorescence signal. The observation of a dynamic exchange between heterogeneous binding sites is supported by the existence of multiple SERRS brightnesses in the signal intensity distribution and by signal fluctuations in the 60 μs time range detected by autocorrelation analysis. Finally, polarization-dependent SERRS autocorrelation curves and single-particle analysis allowed us to measure individual rotational diffusion times and to directly analyze the heterogeneity of the ensemble in solution. © 2001 American Chemical Society.

A bill for Advanced Practice Nurse (APN) Prescriptive Authority was introduced into the Michigan state legislature in 1996, and again in 1997. The legislation would add registered professional nurses with specialty certification to the list of health practitioners granted independent prescribing rights. Currently, licensed dentists, medical doctors, osteopathic doctors, podiatrists, certified optometrists and veterinarians comprise the list of prescribers.

The authors report on a successful pregnancy in a young Turkish patient with p and anti-PP1Pk-antibodies. Anti-PP1Pk is considered to cause haemolytic diseases in the newborn and habitual abortions. The patient was treated via plasma exchange and substitution with intravenous immunoglobulin. At 31 weeks of gestation the patient underwent Caesarean section due to growth retardation and pathological signs in the fetal CTG. The child has developed well up to two years after the delivery. Based on our data and a review of the literature, the effectiveness of therapy by plasmapheresis and/or immunoglobulin is discussed.

Three patients with hematologic relapse after bone marrow transplantation for chronic myelogenous leukemia were treated with interferon alpha and transfusion of viable donor buffy coat. All had complete hematologic and cytogenetic remission, which persisted 32 to 91 weeks after treatment. In two patients graft-versus-host disease developed and was treated by immunosuppression. These results are an example of adoptive immunotherapy without cytoreductive chemotherapy or radiotherapy in human chimeras.

Anti-PP1Pk developed by women has been associated with abortion early in pregnancy and hemolytic disease of the newborn. The case of a 19-year-old woman who had had 2 spontaneous abortions in the first trimester is presented. When treated with plasma exchange and substituted with 5% albumin and intravenous immunoglobulin begun at six weeks' gestation and continued until the 30th week, she delivered a viable female infant without anemia. According to our data and review of literature, the effectiveness of therapy by plasmapheresis and/or immunoglobulin is discussed.

We have prepared two-dimensional arrays of hexagonally arranged, monodisperse nickel nanowires embedded in an alumina template. The degree of template filling is nearly 100% using an improved electrochemical deposition technique. Optical transmission measurements in the direction parallel to the long axis of the nickel nanowires show a plasmon-enhanced absorption around 400nm. We observe for typically surface-enhanced Raman spectroscopy (SERS) inactive metals like nickel a strong, but locally strongly inhomogeneous SERS signal during in situ Raman microspectroscopy. Supported by our numerical modeling, we suggest that significant SERS enhancement factors are possible only when nanowires in bundles are touching each other.

Highly ordered two-dimensional arrays of monodisperse coinage metal nanowires embedded in an alumina matrix have been prepared. When light is propagating in the direction of the long axis of the nanowire, plasmon-enhanced absorption and light guidance of the nanowire were observed by optical microspectroscopy and scanning near-field optical spectroscopy and compared to Mie scattering theory. By selectively dissolving the matrix at a constant etching rate, we detected in situ and ex situ the surface-enhanced Raman scattering (SERS) of organic dyes. In contrast to earlier publications, we find that the SERS signal is linearly proportional to the free-surface area of the nanowires that are in contact with the dye. We cannot detect any change in the enhancement factor due to the releasing of the nanowires from the host structure.

A method based on surface-enhanced Raman scattering (SERS) spectroscopy was developed to meet the need for the reliable and rapid identification of illicit drugs such as the ‘designer drug’ XTC, preferably to increase the security of legal certificates. A matrix stabilized silver halide dispersion on a microtiter plate is used as the SERS-active substrate, providing an easy to use system for sample preparation and probing by means of a Raman microscope. The potential of the method is demonstrated by applying it to the identification of the psychoactive ingredients of drug containing tablets which were confiscated by the local police at techno-music events. The samples of interest were 26 different brands of XTC tablets and several pieces of evidence (powders) containing amphetamine. For reference, we show SERS and Raman spectra of pristine amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine, 3,4-methylenedioxymethamphetamine (MDMA) and 3,4-methylenedioxyethamphetamine.

A T cell mitogen derived from the supernatant of cultured mycoplasma arthritidis (MAS) has been recently discovered. Here we show that among a variety of strains, mycoplasma arthritidis was the only one elaborating the mitogen. Pools of MAS obtained at different occasions were quite variable in their biologic activity. Thus, in an attempt to obtain a more uniform preparation, MAS was semi-purified by Sephadex G-150 columns. Biologic activity eluted in a single peak in the molecular weight range of 13,000 daltons. "Nonresponsive" C57BL/6 spleen cells could be reconstituted to respond to MAS by the addition of 2-mercaptoethanol (2-ME). This reconstitutive effect was seen even when 2-ME was added 12 h after MAS. In further experiments, the lymphocyte culture technique was modified. Adherent spleen cells (AC) were grown and repeatedly washed before the simultaneous addition of nylon-purified T cells and MAS. Also in this experimental set-up, 2-ME could be added after the T cells. Finally, AC were cultured in the presence of MAS and after 4 h washed repeatedly. Subsequently, T cells and 2-ME were added. Also under these conditions, C57BL/6 spleen cells were capable of responding to MAS. These data suggest that 2-ME does not act on AC but on T cells. However, nylon-purified T cells in the complete absence of AC did not respond to MAS even in the presence of 2-ME. Thus, in order for the response to MAS to occur in "nonresponsive" C57BL/6 spleen cells, both AC and 2-ME are required. So far, our experiments have failed to conclusively unravel the mode of action of 2-ME. Yet, experiments using monoclonal antibodies against I-E have suggested that the response of "non-reacting" C57BL/6 spleen cells to MAS in the presence of 2-ME is not restricted by the molecule on the cell surface coded for by the I-E region.

Im Rahmen der Arbeitsgemeinschaft Knochenmarktransplantation — Munchen (AG-KMT) wurden vom Marz 1975 bis Mai 1980 insgesamt 12 Patienten wegen schwerer, aplastischer Anamie mit Knochenmarktransplantation (KMT) behandelt. Sechs Patienten uberleben derzeit mit normalem Blutbild und Knochenmark zwischen 10 Monaten und mehr als 5 Jahren nach KMT von HLA-identischen Geschwistern, eine Patientin steht noch in ambulanter Behandlung wegen lokalisierter, chronischer Graft-versus-Host Krankheit (GvHK), funf Patienten sind klinisch gesund. Sechs Patienten starben, ein Patient starb am Tag vor KMT mit Hirnblutung, drei Patienten 32, 40 und 55 Tage nach KMT an den Folgen der Transplantatabstosung, einer an schwerer GvHK 85 Tage nach KMT und einer 87 Tage nach KMT vermutlich an interstitieller Pneumonie nach Hirnblutung. Drei von 6 Patienten, die nur mit Cyclophosphamid (CY) vorbehandelt waren, starben infolge Abstosung des Transplantates. Zwei erwachsene Patienten, die mit CY und „total lymphoid irradiation“ vorbehandelt waren, und drei Kinder, die nach KMT unbestrahlte Leukocytenkonzentrate von Knochenmarkspender erhalten hatten, stiesen das Transplantat nicht ab.

Continuous plasmapheresis with the IBM blood cell separator showed to be a successful therapy in a 26 year old patient with thyroid storm. The patient regained consciousness already during plasmapheresis whereby 5 liters of plasma were exchanged within 3.5 h. Although 633 mug thyroxine (T4) and 13.6 mug triiodothyronine (T3) were removed with the 51 plasma, no fall occurred in total serum T4 and T3 levels, probably due to the rapid reflux of thyroid hormones from the tissue into the intravascular space. Though total T4 and T3 did not change, there was a significant fall in free thyroid hormone levels documented by reduction of T3-uptake test and particularily of urine T4 and T3 excretion. These findings show that the elevation of thyroid hormone binding sites with donor plasma is even more important than the removal of thyroid hormones.

C57BL/6 mice or pure cultures of their macrophages were inoculated with Newcastle disease virus (NDV) or poly(I).poly(C) to induce interferons (IFNs) that were separated on CH-Sepharose 4B columns. The elution profiles of different activity peaks were compared. All preparations induced in vivo showed the same pattern but the relative proportions of the IFN activities varied. In vitro poly(I).poly(C)-induced IFN showed two peaks after separation by the column, and three peaks were found when NDV-induced IFNs were separated. When IFN induced by NDV in vitro was used to determine the molecular weight, activities were observed in three molecular weight ranges. The smallest one with 18,000 daltons was neutralized by anti-IFN-alpha and represented about 7% of the total activity. The activities of molecular weights 24,000 daltons and 29,000-31,000 daltons were neutralized by anti-IFN-beta. Poly(I).poly(C)-induced IFN in vitro showed two molecular weight ranges, 26,000 daltons and 40,000 daltons, and both were neutralized by anti-IFN-beta. IFN induced in serum by NDV at 3 h had molecular weights of 18,000 daltons neutralized by anti-IFN-alpha and 26,000-30,000 daltons neutralized by anti-IFN-beta. Both IFN subtypes were represented at equal quantities. Serum IFN found in the serum after 8 h had three molecular weight ranges: 18,500-19,500 daltons neutralized by anti-IFN-alpha containing 80% of the total IFN amount, 26,000-27,000 daltons, and 38,000 daltons both neutralized by anti-IFN-beta and containing 20% of the IFN.(ABSTRACT TRUNCATED AT 250 WORDS)

Bisherige Schwierigkeiten in der Herstellung spezifischer Antiseren gegen T-Lymphocyten lassen sich durch eine stufenweise Absorptions-und Reinigungsprozedur von Anti-Human-Thymocytenserum uberwinden. Spezifisches Anti-Human-Thymocyten-Globulin (sATG) reagierte mit Thymocyten, thymus-abhangigen Lymphocyten und einer lymphoblastoiden Zell-Linie vom T-Zell-Typ, wahrend keine Aktivitat gegen lymphoblastoide Zell-Linien vom B-Zell-Type nachzuweisen war. Mit Hilfe von sATG, eingesetzt im Cytotoxizitatstest, in der Elektronenmikroskopie, dem Komplementfixationstest und der quantitativen Immunoautoradiographie, wurden funf chronische und drei akute lymphatische Leukamien charakterisiert und mit Lymphocytenpopulationen von Normalpersonen verglichen. Drei chronische lymphatische Leukamien mit niedrigen Spontanrosettenzahlen und hohen Prozentzahlen Membran-Ig-positiver Lymphocyten zeigten nur wenige T-Zell-Antigen-positive Lymphocyten und wurden daher als B-Zell-Leukamien klassifiziert. Die Zellen zweier chronischer lymphatischer Leukamien mit hohen Spontanrosettenzahlen trugen das T-Zell-Antigen, die Antigen-Konzentration jedoch lag niedriger als die von normalen peripheren Blut-T-Lymphocyten. Die T-Zell-Natur zweier akuter lymphatischer Leukamien mit hohen Spontanrosettenzahlen wurde durch eine positive Reaktion der Zellen mit sATG bestatigt. In einem Fall von akuter lymphatischer Leukamie wurden trotz fehlender Spontanrosettenbildung uberwiegend T-Zell-Antigen-positive Zellen gefunden. In den beiden ersten Fallen lag die T-Zell-Antigen-Konzentration hoher als auf normalen Blut-T-Lymphocyten, im letzteren Fall geringfugig darunter. Die Vorteile der Charakterisierung von Leukamien mit sATG im Vergleich mit der Spontanrosettenbildung und die Bedeutung fur die Prognostik werden diskutiert.

Severe microangiopathy has been reported as a rare complication of cyclosporine A (CsA) prophylaxis in allogeneic bone marrow transplantation (BMT). We found morphological and biochemical changes indicative of generalized endothelial damage in 49 of 66 allogeneic marrow graft recipients receiving cyclosporine, but none in 11 patients treated with methotrexate for prophylaxis of graft-v-host disease (GVHD). Changes occurred after engraftment of bone marrow and consisted of intravascular hemolysis with red cell fragmentation and de novo thrombocytopenia. They were preceded by a decrease in activated partial thromboplastin time and fibrinogen indicating activation of coagulation. Endothelial damage as the central lesion of microangiopathy was confirmed by a simultaneous increase of factor VIII related antigen. Severe microangiopathy was observed in ten patients and was fatal in seven. Risk factor analysis revealed a highly significant association of microangiopathy with severity of acute GVHD (aGVHD) (P less than .001) and use of CsA prophylaxis (P less than .001). Our data suggest endothelial damage as a result of cellular activation and subsequent release of cytokines in the course of a aGVHD, which is not inhibited by CsA prophylaxis.

Besides the established T-cell property of producing gamma interferon (IFN-gamma), murine T cells additionally possess the ability to produce IFN-alpha and IFN-beta when appropriate inducers such as 10-carboxymethyl-9-acridanone (CMA) or Newcastle disease virus (NDV) are used. Interleukin 2 (IL-2)-dependent murine T-cell lines, but not purified resting splenic T cells, responded to CMA and NDV with production of IFN-alpha, beta. The IFN production by these T cells was not restricted to a special subset, since T cells expressing the Lyt 1+2- and the Lyt 1-2+ phenotype responded to these inducers with IFN production. After prolonged passaging of the T-cell lines in IL-2-containing medium, the ability to respond to CMA with production of antiviral activity was sustained longer than the ability for concanavalin A-induced IFN-gamma production. Whereas the NDV-induced T-cell supernates contained both IFN-alpha and IFN-beta, the induction with CMA resulted exclusively in the synthesis of IFN-beta by the T-cell lines.

Eleven adults have been transplanted for various reasons between July 1979 and July 1982: 2 with aplastic anemia (AA), 1 with paroxysmal nocturnal hemoglobinuria (PNH), 8 with acute leukemia (AL). Four patients suffered from acute lymphocytic leukemia (ALL) and four from acute non-lymphocytic leukemia (ANLL). Two of them were transplanted in relapse, 1 in a partial remission, and 5 in complete remission. All patients were in their late stage of disease. The PNH-patient had an identical twin, 8 patients had an HLA- and MLC compatible sib, 1 an unrelated donor, and 1 was transplanted from his father. Four patients are alive, 2 more than 3 years: 1 with AA and 1 with ALL who was transplanted in relapse. Six patients died of infectious complications (4 of interstitial pneumonia, 1 of a candidasepsis, 1 of acute toxoplasmosis). Patients living more than 3 weeks had a take. Acute graft-versus-host (GvH) disease did not present a major problem. All patients received methotrexate for GvH-prophylaxis, in three instances the marrow was additionally pre-incubated with anti-T-cell globulin.

The flavonoids of 2 samples of Conocephalum conicum gametophyte tissue have been studied, one from U.S.A. and the other from Germany. Common to both samples were vicenin-2, lucenin-2, the 7- O -glucuronides of apigenin, chrysoeriol and luteolin and the previously unknown 7- O -glucuronide 4′- O -rhamnosides of apigenin, chrysoeriol and luteolin. Additionally the German sample contained the 7,4′-di- O -glucuronides of apigenin and luteolin and a new compound, apigenin 7- O -diglucuronide 4′- O -glucuronide. The North American sample contained, additionally, luteolin 7,3′-di- O -glucuronide, luteolin 7- O -glucuronide 3′,4′-di- O -rhamnoside (a new triglycoside) and 2 further derivatives of luteolin 7- O -glucuronide. Evidence is presented for the existence of geographic faces of C. conicum and for the qualitative invariability of the flavonoid patterns with changing season or environment.

Bei 65 Patienten mit Myasthenia gravis (MG) wurden Antikorper gegen Acetylcholin-Receptoren (ACh-R) in der IgG-Fraktion des Patienten-Serums bestimmt (Immunprazipitations-Assay mit125Jod-α-Bungarotoxin und menschlichem ACh-R als Antigen). Bei 91% der Patienten zeigte sich eine erhohte Antikorper-Konzentration bis zum 500fachen des oberen Referenzbereichs. Eine Kontrollgruppe von 77 Patienten mit anderen gesicherten Autoimmunerkrankungen oder positiven Antikorpern gegen Muskulatur wies in keinem Fall erhohte ACh-R-Antikorper-Konzentrationen auf. Damit ist der in-vitro Nachweis von ACh-R-Antikorpern ein empfindlicher und hochspezifischer Test fur die Diagnostik der MG. Der Test eignet sich ebenfalls fur die Verlaufskontrolle unter Therapie mit Immunsuppressiva oder Plasmapherese. Immunfluoreszenz-Untersuchung auf Antikorper gegen Muskelgewebe ist fur die MG-Diagnostik weniger empfindlich und nicht spezifisch.

Two interconvertible, isomeric, 6,8-di- C -glycosides of 5,7,4′-trihydroxyflavone have been isolated from the liverwort Hymenophytum flabellatum . This result substantiates earlier indications that flavonoids occur in the liverworts (Hepaticae).

A B S T R A C T Natural populations of the diploid species, Tragopogon dubius, T. pratensis and T. porrifolius, the F1 hybrids of these species, and the two amphidiploids, T. mirus and T. miscellus, were obtained from the same localities used for previous morphological and cytological studies of the evolutionary relationships of this complex. Inter- and intra-populational comparisons were made utilizing 2-dimensional chromatograms of these taxa. Members of the complex shared a group of 18 flavonoid-type pattern components, no one of which was completely species specific. Therefore, species patterns were expressed for a population rather than an individual with pattern components being expressed as a frequency. Patterns for F, hybrids and amphidiploids, expressed in the same manner, were relatable to the parental species. Diploid species and F, hybrid patterns were the most variable in areas of greatest sympatry, indicating considerable genetic interchange between species. The distribution of specific components in certain populations was interpreted as chemical introgression. Evidence was presented for separate origins of T. mirus in two localities. The results confirm previous interpretations of the evolutionary relationships in this complex, and when compared to those obtained for Baptisia, they implicate the different breeding systems as important factors in establishing the kind of variation observed.

Die Gesamtaktivitat der neutralen Desoxyribonucleasen (DNasen) in Xeroderma pigmentosum (X.P.) — und in Normalhaut ist gleich. Dagegen ist die Gesamt-DNase-Aktivitat bei pH 5,3 in X.P.-Haut im Vergleich zur Kontrollhaut signifikant geringer.

Es wurden quantitative Bestimmungen des Transferrins, Haptoglobins und des Eisens an 10 Patienten mit Porphyria cutanea tarda durchgefuhrt. Dabei konnte eine statistisch gesicherte Verminderung des Transferrins und Erhohung des Eisenspiegels im Serum bei P.c.t.-Kranken gegenuber gesunden Kontrollpersonen festgestellt werden. Es liegt daher eine relativ gesattigte Eisenbindungskapazitat vor, deren Bedeutung fur die Pathogenese der P.c.t. diskutiert wird.

Das Verteilungsmuster der DNase-Aktivitat1 im Urin von Normalpersonen und X.p.-Patienten wurde mit einem mikro-disk-elektrophoretischen Verfahren untersucht. Bei saurer Inkubation sind 4 distinkte Aktivitatsbanden im Normalurin nachweisbar. Urin von X.p.-Patienten zeigt eine deutliche Verminderung der 2.–4. Bande, wobei die Veranderung der 3. Bande besonders auffallig ist. Es wurde ferner untersucht, wie sich das Verhalten verandert, wenn statt nativer DNA denaturierte als Substrat angeboten und wenn die zweiwertigen Ionen durch EDTA komplexiert wurden. Eine Aktivitatsverminderung ist nicht auf das Auftreten von Inhibitoren zuruckzufuhren, sondern wahrscheinlich durch eine Konzentrationsverminderung an Enzym verursacht.

Der Zusammenhang der Dermatitis ulcerosa mit Storungen des Immunglobulinstoffwechsels ist evident. Bei einer Patientin war erstmals ein IgA-Mangel bei Dermatitis ulcerosa nachweisbar, wahrend bisher nur Paraproteinamien gefunden wurden. Auf die Bedeutung dieses Befundes und die diesbezugliche Literatur wird eingegangen.

Es wurde die Wirkung eines heterologen Antilymphocyten-Serums (ALS) auf das experimentelle Kontaktekzem des Meerschweinchens, hervorgerufen durch Sensibilisierung mit 2,4-Dinitrochlorbenzol (DNCB), gepruft.

Mittels chemischer und immunochemischer Methoden wurde vergleichend der Gehalt an Proteinen in Cantharidenblasen und Blutserum bestimmt. Erstmals werden auch quantitative Untersuchungen von Praalbumin, α2-M-Globulin, Coeruloplasmin, Haptoglobin und Transferrin im Cantharidenblaseninhalt vorgenommen. Dabei fanden sich statistisch gesicherte Unterschiede zwischen Cantharidenblasen- und Seruminhalt im Sinne tieferer Werte in den Blasen bei Gesamteiweis, Praalbumin abs., α2-M-Globulin abs., α2-Globulin abs. und rel.-%, Coeruloplasmin abs., β-Globulin abs., Transferrin abs. und γ-Globulin abs. Albumin abs. und rel.-% wiesen signifikante Unterschiede in Richtung hoherer Werte in den Cantharidenblasen auf. Das Makroglobulin α2-M-Globulin passierte vergleichsweise schwerer die Capillarschranke zwischen Blut und Blaseninhalt als die niedermolekularen Proteine Coeruloplasmin, Haptoglobin und Praalbumin.

1. Wie in Cantharidenblasen ist auch in der Flussigkeit von Blasen, die im Rahmen von Hautkrankheitszustanden auftreten, die BTS-Konzentration gegenuber dem BTS-Spiegel im Blut erhoht. 2. In vitro last sich eine Anderung der BTS-Konzentration in der Blasenflussigkeit und im Blut weder mit Cocarboxylase (unter anderem keine Anderung der Blasenzeit!) noch mit α-Thioctinsaure, die bei der oxydativen Decarboxylierung als wichtiger Teilfaktor angesehen wird, erzielen. 3. Zur Vermeidung von Tauschungen ist die methodische Feststellung beachtenswert, das bei in vitro-Versuchen mit der von Markees modifizierten Bestimmungsweise der BTS die Thioctinsaure (in Anwesenheit von Dinitrophenylhydrazin) eine farbige Verbindung ergibt, welche colorimetrisch die gleiche Absorption aufweist wie das BTS-Hydrazon.

45% der untersuchten Rosaceapatienten zeigten geringgradige bis masiggradige Erhohungen einzelner Fettstoffwechselfraktionen, wobei das Gesamtcholesterin in der Gruppeder Rosaceapatienten statistisch signifikant hoher war als bei einer Kontrollgruppe.

Im Hautwaschwasser von 28 gesunden Personen wurde mittels des Agglutinationshemmungstests bei uber der Halfte der Probanden Albumin und γ-Globulin nachgewiesen. Das deutet darauf hin, das die menschliche Haut im gesunden Zustand auch fur Makromolekule durchgangig ist, welche bei neutralem pH in wasrige Losungen ubertreten konnen.

1. Die nach dem Vorgehen von Markees im Blut und in der Hautblasenflussigkeit colorimetrisch als Brenztraubensaure erfasten Werte stammen nach dem Ausfall vergleichender papierchromatographischer Untersuchungen von identischen Substanzen, sind also quantitativ vergleichbar. 2. Nach einer einmaligen peroralen Glucosebelastung (100 g/400 cm3 Wasser) waren im Vollblut hinsichtlich einer durch mehrmalige Konzentrationsbestimmung erhaltenen Brenztraubensaurekurve drei verschiedene Reaktionstypen festzustellen, von denen namentlich der dritte als abwegig und unter anderem als Hinweis auf einen evtl. latenten VitaminB1-Mangel aufzufassen ist. 3. Bei 30 verschiedenen Hautkranken waren sowohl bei Durchfuhrung der gedoppelten peroralen Glucosebelastung (Staub-Traugott-Versuch) als auch bei Anlage der Brenztraubensaure-Verlaufskurve ungefahr 50% Abwegigkeiten vom normalen Verlauf nachweisbar. Die Resultate der beiden angewandten Methoden stimmten bei 2/3 der Untersuchungsergebnisse uberein und stellen in ihrer klinischen Bedeutung, wie im einzelnen ausgefuhrt wird, eine gegenseitige Erganzung dar. 4. Abschliesend werden dermatologische Gesichtspunkte des “Status pathopyruvaemicus” (Brenztraubensaurekurventyp II und vornehmlich III) kurz erortert.