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21 of 41 patients developed clinically manifest or systemic Candida albicans infection 1-36 months after renal transplantation. Asymptomatic candiduria was diagnosed in all patients even before the onset of clinical symptoms. Fungal stomatitis was the most frequent clinical sign, followed by mycotic changes in the respiratory, genito-urinary (vaginitis) and gastro-intestinal tract. In five cases intrahepatic biliary stasis was diagnosed in the course of a Candida albicans septicaemia. In 12 patients with renal transplants it was possible, by treatment with nystatin, clotrimazole, flucytosine, miconazole and amphotericine B to control a generalized or clinically manifest Candida albicans infection. Three died of the septicaemia or meningoencephalitis, six as the result of bacterial superinfections. Inspection of the mouth is an important means of early diagnosing fungal infections. Antimycotic treatment should be started if fungal cultures from urine are repeatedly positive even if the clinical findings are still negative.

Description of the pathological anatomy of thyroid cancer with classification into carcinomas, sarcomas and special forms of tumors. Concerning the carcinomas of the thyroid gland, the malignant papilloma (papillary carcinoma) and the medullary amyloid- and calcitonin-producing carcinoma deserve special consideration because of their small malignancy and therefore favourable prognosis. Also the proliferating struma Langhans does not come up to "real" carcinomas (organoid structure of the tumor tissue) concerning the growing speed. All other types of carcinomas, as well as sarcomas, are fast growing malignant tumors, which also place metastases early. The metastasizing struma-adenoma is not a malignant tumor in the sense of the term. In addition, it is necessary to refer to the existing difficulties in marking off clearly structurally sarcomatous tumors of the thyroid gland from carcinomas. Besides, one must emphasize, that thyreostatic substances, also ionizing rays (i.e. radioiodine) can produce considerable tissue-changes with cell polymorphia and that a considerable increase in the number of large-cell eosinophilic adenomas (oncocytomas, Hürthle-cell adenomas) exists. The sclerosizing microcarcinoma (Graham's tumor) is not a carcinoma in the sense of the term.

Laboratory studies were made to examine the possibility of transmission of pathogenic fungi through textiles. 1. Dermatophytes were proven to be present in clothing and leather articles worn over areas infected by fungi. In patients known to be infected with Pityriasis versicolor, contaminated scales were obtained from their textiles, the fungi could be demonstrated. 2. Artificially infected textiles were found to harbor dermatophytes and pathogenic yeasts for a number of weeks without limiting the survival capacity of the fungi. 3. At low temperatures, fungi were not affected by various detergents. Under conditions simulating machine washings (30 minutes exposure time) at a temperature of 60 degrees C any washing agent was sufficient to cause irreversible damage. At higher temperatures the time for killing the fungi was diminished. These results were confirmed by experiments with contaminated material from patients (scales, hairs, nail particles).

In this case report the rarity of the causing agent, Candida parapsilosis, and its endothrix growth is accentuated. The unsuccessful application of local and systemic antimycotics required the surgical abrasion of the infected tissue.

Several failures of gonorrhea treatment due to neisseria producing penicillinase (PPNG), resistance against other antibiotics, side effects like allergies, gastrointestinal problems, and other factors are the reasons for continuing trials with new drugs in the treatment of gonorrhea. With regard to modern aminoglycosides, the development of early resistance has not been observed so far. Especially with Netilmicin, no such disadvantages have been reported in the literature. Therefore a single dose schedule was introduced with Netilmicin given to 600 patients suffering from uncomplicated gonorrhea in order to evaluate the efficacy and safety of the drug. 300 mg Netilmicin were administered intramuscularly in a one shot therapy. With all patients, the diagnosis had been confirmed by culture. The efficacy of therapy was controlled by a second culture, which proved to be negative in all 600 cases. Gonorrhea was also clinically cured in all patients.

The stratum synoviale is a sort of central point in the synovial system. That is the reason why we also find corresponding modifications in the stratum synoviale in most of the joint diseases. They will be discussed in the appropriate shortness, summarized in tables and their histological appearance form will also be partly represented.

In a period of 5 years, 8 out of 77 renal transplant patients showed simultaneous fungal, bacterial and viral infections. Candida albicans was found in all cases. The most severe bacterial complications were infections with Klebsiella, Pseudomonas and Staphylococcus aureus. Cytomegalovirus, persistent HBsAg positive hepatitis, herpes zoster, and herpes simplex infections were also found. Seven patients died of bacterial superinfection and miliary tuberculosis. The data presented show that "triple infections" are associated with high mortality and that miliary tuberculosis occurred frequently in immunosuppressed renal transplant recipients.

The brown coloring of the permanent cartilage tissue in old age (demonstrated at the rib cartilage) is to be related to pigment deposition in cartilage cells and ground substance. There is a granular pigment present, which probably is a chromolipid. Unstained histological slides are best suitable for the presentation of pigments. In epiphysial joint cartilage (transitory cartilage tissue) the pigmentation of aging usually is only suggested. The appearance of pigment granulas is accompanied by various regressive alterations of cartilage tissue, especially with eosinophilia of the ground substance.

All of 68 renal transplant recipients (mean observation time 28.4 months after transplantation) showed skin complications. In these subjects fungal infection was found in 51, viral disease in 45 and bacterial infection in 36 cases. Of fungal manifestations candidiasis, onychomycosis, and dermatomycosis were most commonly observed. The most important viral disease was herpes simplex. The main part of bacterial infections was either caused by surgical complications or by super-infection (impetigo) of steroid acne. Non infectious dermatological disorders were usually due to immunosuppressive therapy.

Kinesthesia as a process of transmission of sensation in the joints postulates the existence of receptors for different types of stimuli and apropriate pathways. These are described as briefly as possible, and attention is drawn also to multipolar ganglion cells at the outside of the ligamenta cruciata of human knee joints. Their possible functional importance is the subject of a hypothetic discussion assuming that they may represent the "switchboards" for regulating both quantity and quality of the synovia.

A strain of Trichomonas vaginalis (IR-78), recently isolated from a patient afflicted with recurrent symptomatic trichomoniasis, showed resistance to metronidazole, tinidazole, and nimorazole in vitro as well as in vivo. In a serial dilution test using cysteine monohydrochloride-peptone-liver infusion-maltose medium, T. vaginalis IR-78 was only resistant under aerobic conditions. Under anaerobic conditions it was as susceptible as the normal reference strain. The minimal lethal concentrations of metronidazole, tinidazole, and nimorazole for IR-78 were 100, 50, and 50 mug/ml aerobically and 0.4, 0.4, and 0.2 mug/ml anaérobically, respectively. The efficacy of metronidazole, tinidazole, and nimorazole was assessed in vivo by oral administration to mice simultaneously infected with IR-78 both subcutaneously and intraperitoneally. The CD(50) (dose needed to cure 50% of infections) of each compound was significantly higher for the subcutaneous than for the intraperitoneal infection. In contrast, there was little difference in CD(50) for these infections in mice inoculated with a susceptible trichomonas strain. The CD(50)'s for all three compounds against intraperitoneal and subcutaneous infections with IR-78 were 2 to >70 times higher than for susceptible strain E. Both forms of infection with IR-78 could always be cured with therapeutically acceptable doses of tinidazole and nimorazole; subcutaneous infections could not be cured with tolerated doses of metronidazole.

Experimental inoculations of the pharynx with gonococci were undertaken. In seven volunteers gonococci could be cultivated and identified from 16 hours to 8 weeks following infection. In three cases, it was tried to infect the female genital tract using positive pharyngeal smears. This was successful in one instance and the diagnosis was again confirmed by culture and sugar fermentation.

The minimal inhibitory concentration of metronidazole and tinidazole lies between 4000 micrograms/ml and 7.8 micrograms/ml. Drug levels are present in this range for 2--5 hours in genital discharge following single dose oral therapy with 2 g tinidazole or 1.5 g metronidazole. Therefore, 5-nitroimidazole derivatives exert a bacteriostatic effect in the genital region at least on the more sensitive strains. As shown in our experiments, otherwise reliable laboratory procedures for the demonstration of gonococci may yield false negative results, if specimens for culture are obtained at an inappropriate time.

In vitro-studies concerning the influence of commercially available spermicides on lactobacillus acidophilus as well as on pathogenic organisms of the genital tract revealed, that the preparations had only weak antimicrobial effect on Döderlein's bacteria and pathogenic fungi. However, all four preparations tested, revealed a good inhibition effect on neisseria gonorrhoeae, treponema pallidum and trichomonas vaginalis. Irreversible damage to gonococci and trichomonas vaginalis. Irreversible damage to gonococci and trichomonas was subject to considerable variation, probably due to the different chemical composition of the commercially in Austria available spermicides.

The porphyrin productions of P a.-strains, isolated on the one hand from inlfammatory acne lesions, on the other hand from sebaceous follicle filaments from 10 persons each were compared quantitatively and qualitatively, after the appropriate material had been pooled, With respect to the acne strains one could observe a somewhat increased porphyrin production as well as the discharging of a precentually greater portion of porphyrins to the surrounding material. When separated by TLC the acne material showed a more intense coproporphyrin band.

The in vitro antimicrobial activity of the antieczematic Bay f 4797 was studied. This combination drug contains the three active components acidamfenicol, clotrimazole and dexamethasone (prospective trade name: Baycuten). Various bacterial and fungal species of importance in dermatology served as test organisms. All the bacterial strains examined were found to be moderately susceptible to acidamfenicol; clotrimazole showed good inhibitory values agaisnt all the fungal species and the gram-positive bacterial strains. Additionally it was checked whether a synergistic or antagonistic interaction occurs with respect to the antimicrobial activity. An interference which could lead to impairment of the therapeutic activity was not observed.

Report on a so-called adamantinoma of a right femur (fourth case from available publications) with remarks on the histogenesis of these tumors, which show correlating properties with malignant synovialomas. In other words, the so-called adamantinoma of long bones represents the osseous form of a malignant synovialoma, whereby an intraosseous ganglion has to be considered as a histogenetic criterion (matrix).

58 renal transplant patients were submitted to dermatological check-up investigations at regular intervals over a mean period of 26.2 months after surgery. 98% of the case material showed dermatological complications. In an analysis of the findings in 55 patients with infectious complications, viral infections occurred in 40, bacterial in 30 and mycotic infections in 20 patients. Dermatological manifestations of non-dermatological complications were mainly due to immunosuppressive therapy. The data stress the necessity of optimum cooperation between dermatologists and the attendant physician in the case of renal transplant patients.

Investigations for Chlamydia infections of the genital tract were performed in 270 Viennese registered, as well as in 51 non-registered prostitutes. The results were compared with findings obtained in 56 female patients attending an out-patient STD clinic and 48 pregnant women seeking antenatal care in a department of obstetrics. Diagnosis of Chlamydia infection was the organisms on cultured McCoy cells after treatment with cycloheximide. The highest infection rate (31%) was found in non-licensed prostitutes. In registered prostitutes, 20.4% of the cervical smears proved to be positive for Chlamydia. The control groups showed lower infection rates of 9% and 4%, respectively. These results indicate that women who frequently change their sexual partners are considerably more at risk of contracting Chlamydia infections. Hence, this group of persons should be more regularly investigated and--if necessary--given appropriate treatment in order to prevent further spread of the disease.

The first case of Sipple syndrome in identical twins is reported. It is concluded that the concordant medullary carcinoma of the thyroid is the result of a germinal mutation, whilst the discordant solitary phaeochromocytoma is caused by a somatic mutation according to the two mutation model. The practical conclusion to be drawn from this report is that if one identical twin develops carcinoma of the thyroid or a phaeochromocytoma, the other twin should be throughly investigated and surgical exploration undertaken, even in the absence of clinical evidence of disease.