Subacute Inflammation Research Articles

Rheumatoid factor accentuation of pulmonary lesions associated with experimental diffuse proliferative lung disease.

AbstractA rabbit model of diffuse proliferative lung disease induced by one intravenous injection of complete Freund's adjuvant was used to study the possible phlogistic effects of human anti‐γ‐globulins. When induction of proliferative lung disease was followed by intravenous administration of human γM anti‐γ‐globulins, considerable increment in perigranulomatous inflammation along with alveolar wall and arteriolar anti‐γ‐globulin deposition was noted. Four of 10 animals thus treated showed segmental hemorrhagic pulmonary infarctions. Control animals in which the induction of diffuse proliferative lung disease was followed by administration of serologically inactive normal human γM showed no accentuation of gross or microscopic pulmonary lesions and no specific pulmonary deposition of human γM globulins. These experiments suggest that human γM anti‐γ‐globulins fix in alveoli and arterioles near areas of active subacute or chronic pulmonary inflammation and are capable of accentuating inflammatory response and vascular injury.

Nifumic Acidの薬理学的研究特にFenamate類との比較(第1報)

Anti-inflammatory and analgesic effects of niflumic acid, 2-arylamino-nicotinic acid corresponding to anthranilic anti-inflammatory agents, were studied by a detailed analysis in comparison with fenamates (flufenamic acid and mefenamic acid). Niflumic acid showed similar inhibitory effects on the increased vascular permeability to flufena-mic acid and a stronger effect than mefenamic acid. In the acute edema test induced by various phiogists, niflumic acid had the same potent anti-edematous properties as fena-mates and phenylbutazone. In the subacute edema test induced by mustard, niflumic acid showed an inhibitory effect similar to flufenamic acid which had stronger effect than mefenamic acid. When the inhibitory effects on the proliferation of granulation tissue were tested by cotton-pellet and granuloma pouch methods, niflumic acid was more potent than mefenamic acid, but somewhat less than flufenamic acid and phenylbuta-zone. Niflumic acid had potent inhibitory action similar to fenamates on the ultra-violet erythema, but the effects of niflumic acid and mefenamic acid on the adjuvant arthritis were weaker than that of flufenamic acid. The analgesic action of niflumic acid was similar to that of mefenamic acid which was more potent than flufenamic acid and phenylbutazone. From the above results, niflumic acid was proved to have similar effects to flufena-mic acid and a more potent effect than mefenamic acid on acute inflammation, but similar effects to mefenamic acid and less than flufenamic acid on the subacute or chronic inflammation. Furthermore, it was similar to mefenamic acid and more potent than flufenamic acid regarding analgesic actions. It may, therefore, be considered that niflumic acid has a clinical application similar to mefenamic acid as a non-steroid anti-inflammatory agent.

Gynecologic pathology in the Macaca mulatta: Part I

A review of gynecologic pathology in the Macaca mulatta (rhesus) monkey reveals a glaring lack of information in this popular laboratory species. Accordingly, the reproductive tracts of a large group of females were examined to provide information on the type and prevalence of gynecologic pathology. A wide spectrum of pathologic findings were observed, most notably adenomyosis, ovarian cysts, subacute vaginitis, uterine vascular obliterative fibrosis, subacute and chronic inflammation of squamocolumnar junction, endometrial polyps, cervical dysplasia, and leiomyomas. One case of cervical carcinoma in situ was encountered.

Prespawning Adult Salmon Mortality Associated with a Fungus of the Genus Dermocystidium

A serious outbreak of mortalities occurred among adult salmon held in the Priest Rapids Dam spawning channel in November 1965. Gross examination revealed small, white cysts on and in the gill filaments of otherwise normal-appearing fish. Approximately 25% of the 5000 mature adult salmon in the channel died prior to spawning from this disease caused by a fungus identified as the genus Dermocystidium. This is the first record of an epidemic among fish of North America associated with Dermocystidium. The primary cause of death appeared to be anoxia due to subacute inflammation and granulation of the gill tissue. A description of the histopathology associated with these parasites is given. Chondrococcus columnaris, a pathogen of warm-water fishes, was present as a secondary invader on the gill filaments of several salmon and an unknown fungal or yeast-like organism was present in the testes of the male fish examined.

Recurrent Appendicitis

The treatment of appendicitis is appendectomy. The opportunity to study patients, not subjected to appendectomy after appendicitis, is therefore unusual and ordinarily relegated to those patients with an appendiceal abscess in which the appendix could not be removed safely and to those with inadvertent, incomplete appendectomy. In order to reevaluate the necessity for elective interval appendectomy after appendicitis not treated with appendectomy, we have reviewed the charts of 586 patients treated for acute appendicitis at St. Vincent's Hospital in the past five years. In 49 patients there was localized abscess: the incidence was therefore 8.4% in our series. In 15 of these patients (30%) the appendix could not be excised; only an incision and drainage being performed. One patient was treated expectantly. Ten of the 16 patients returned for their scheduled interval appendectomy; five of the appendices of these patients showed acute or subacute inflammation, four were normal or chronically

The use of local anesthesia in the presence of inflammation

In many cases it is difficult to obtain adequate local anesthesia, especially in the presence of acute or subacute inflammation. Vascular pain due to distention of blood vessels is proposed as a possible contributing mechanism. This may be controlled by constricting the blood vessels with a direct injection into the inflamed area. Whether this is due to the effect of the vasoconstrictor or the pressure of injecting fluid into a confined area has not yet been determined. Unmyelinated nerve fibers, some of which are closely related to blood vessels, have been demonstrated in periapical lesions. The present concept of the inadequacy of local anesthetics when injected into inflamed tissue is questioned.

Discussion on Modern Methods of Salpingostomy

A personal series of tubal reconstruction cases is reported. Results and procedures of 396 consectuvie salpingostomies performed by the author between 1942 and 1959 are considered. 15.2% were called complete successes; 30% showed evidence of failure (reocclusion or stenosis) by insufflation; 5% resulted in ectopic (tubal) pregnancies; and 33% of cases though patent by insufflation produced no pregnancies within a year. Postoperative adhesions occurred at a rate of less than 10%. Results varied with time: from 1942-1951 16.6% resulted in uterine pregnancy (complete success) and 2.2% in extrauterine pregnancies from 1951-1956 11.6% had uterine pregnancies and 7.2% had extrauterine pregnancies; and from 1956-1959 25.9% had uterine pregnancies postoperatively 7.4% had extrauterine pregnancies and 49% showed normal patency. The main difference in rates seems attributable to the use of oral prednisolone postoperatively. 4 absolute contraindications are indicated: 1) any other obvious factor of sterility in husband or wife; 2) women over 37 years old; 3) recent acute or subacute inflammation; and 4) probability of tuberculosi as the cause of occlusion. Salpingostomy techniques are described and 4 main types are outlined: 1) codonolysis; 2) terminal salpingostomy; 3) medio-ampulla salpingostomy; and 4) isthmic salpingostomies. Polyethylene tubing was never used in this series. The postoperative use of prednisolone (Hydrocortancyl for 6 weeks) seems to have increased the efficacy of the operation.

亜急性或は慢性化した顎の化膿性炎症に対する根治的療法について

亜急性或は慢性化した顎の化膿性炎症に対する根治的療法について

Selenium (selsun) in the treatment of marginal blepharitis.

INTRODUCTION The widespread prevalence of blepharitis marginalis, described by Duke-Elder 1 as subacute or chronic inflammation of the margins of the lids, is well known. Its etiology is both complex and manifold and has not been conclusively defined. Classically, this condition can be divided into two broad categories: (1) simple squamous blepharitis and (2) ulcerative blepharitis. The first reflects hyperemia, congestion, and edema of the lid margins with a consequent scaling of the lids. The latter involves the ciliary follicles and associated sebaceous glands of Zeis and sweat glands of Moll. At first, suppurative abscesses develop intrafollicularly, followed by more extensive destructive inflammation and subsequent scarring. The usual complications which follow include chronic conjunctivitis, hordeolum, chalazion, ectropion, entropion, trichiasis, and keratitis. The principal causes to which blepharitis has been attributed * may be classified as those stemming from (1) predisposing factors, including eyestrain, metabolic disorder, vitamin deficiency, and heredity; (2)

The psychiatric aspects of temporal arteritis.

Temporal arteritis, also called giant cell arteritis, or cranial arteritis, was first described in 1932 by Horton and Magath. This syndrome is caused by a reversible inflammation of the cranial arteries, especially the temporal arteries (which are visibly inflamed), causing headache, mental and neurological disturbances as well as general toxic signs, and almost always occurring after the age of fifty-five years.Pathology.—In the arteries involved there is a subacute inflammation of the adventitia and media with focal necrosis of the media, fragmentation and destruction of the internal elastic lamina with gross hypertrophy of the intima, often leading to occlusion of the vessel. In many cases giant cells are found in the media. Besides the cranial arteries other vessels are sometimes involved, e.g., the carotids (Scott and Maxwell 1941; Gilmour 1941), subclavian, coronary and femoral arteries (Cookeet al., 1946), post-auricular (Dick and Freeman 1940).Aetiologyis unknown. There is no evidence of tuberculosis or syphilis. A low-grade bacterial or virus infection of the arteries has been postulated, but repeated bacteriological examinations of the biopsied arteries have failed to isolate any organisms. The predilection which the condition shows for the temporal and cranial arteries is unexplained.

Primary linitis plastica type of carcinoma of the colon.

LINITIS plastica type of carcinoma is an interesting entity, not only from the clinical point of view but from the standpoint of pathologic diagnosis as well. Clinically it is practically never recognized as carcinoma since it tends to mimic certain other diseases, such as ulcerative colitis, or it may elude diagnosis completely. Anatomically it is a diffusely infiltrating carcinoma comparable to a phlegmonous inflammation. Coincident with the spread of tumor cells there is subacute and chronic inflammation, with much new formation of connective tissue. The primary carcinoma, obviously an anaplastic mucin-secreting adenocarcinoma, rapidly infiltrates the surrounding tissues, especially the submucosa and muscularis, leaving only shallow ulcerations in its wake. Because of the fast spread of the inflammatory lesion and of the individual cancer cells, large portions of the stricken organ are often involved. Though the lesion is originally an adenocarcinoma, many of the infiltrating cells form only abortive glandular structures

LOW TEMPERATURE AND RHINITIS (FIRST REPORT)

Relationship between the low temperature and, rhinitis caused by chemicals was studied. Experimentil rhinitis was produced by introducing 0.4c.c. of 5p.c. formalin solution into the rabbit's nose and the rabbit was confined in the low temperature chamber of -25°C--35°C.After 24 hours'stay, no difference was observed between the rabbit kept in the coldroom and the control animal kept at room temperature after the same experimental treatment. After a week, during which time the experimental animal was dayly put into the coldroom to stay during the daytime, it showed definite signs of subacute inflammation persisting, while control animal in the room temperature had already recovered.

The bacteriology of Fallopian tubes removed at operation

This investigation comprises a study of 72 patients from the wards and private service of the Women's Clinic of the Johns Hopkins Hospital. Seven patients had had a previous history of gonorrheal infection, 40 had doubtful histories and 25 had negative histories.In 1921 Curtis isolated the gonococcus from Fallopian tubes removed at operation in 38 of 192 cases, but gross and microscopically these tubes presented a picture of acute inflammation. Curtis also isolated Escherichia coli, streptococci, and anaerobic streptococci from cases of salpingitis and perisalpingitis. Cordua and Keck in 1926, reported isolating paratyphoid B bacillus from an ovarian abscess. In 1931 Worral reported having isolated Staphylococci from infected Fallopian tubes. Caussade and Giullemin, 1934, isolated the colon bacillus from the tubes of a 12-year-old girl. Brown, 1935, isolated Salmonella newport from a case of bilateral pyosalpinx. Studdiford, Casper, and Scadron, in 1938, reported isolating gonococci from the tubes of 16 of 24 cases studied. The organisms were isolated by culturing pieces of tissue and exudate, never from pus, and occasionally were degenerate in form but rapidly assumed the usual characteristics upon subculture. Thirteen of the specimens yielding gonococci showed pathologic evidence of subacute inflammation, two were acute exacerbations of chronic salpingitis, and one showed evidence of chronic or healed salpingitis with marked structual changes in the walls of the tube. According to Cornell, until 1934 there were 71 published cases of actinomycosis of the internal female genitals. American literature reported seven cases, English literature six, and the remainder were in other languages. Since then cases have been reported by Gardiner and Welsh, 1935; Côte and Tudhope, 1936; De Faria and Fiablo, 1937; Auster, 1940; and Ahumada and Chevalier, 1943.

Osteitis pubis following suprapubic prostatectomy: Results with deep roentgen therapy

1. 1. Four additional cases of osteitis pubis following suprapubic prostatectomy are reported. 2. 2. Osteitis pubis occurs most frequently in the third week postoperatively but can occur at any time from two weeks to two months postoperatively. 3. 3. Pathologically, osteitis pubis is a bone inflammation, and microscopically shows subacute inflammation. 4. 4. Osteitis pubis has as its prerequisite trauma to the pubic area and infection. 5. 5. Starting the enucleation of the prostate superiorly as well as retraction against the symphysis pubis may contribute to pubic trauma. 6. 6. The diagnosis is made by the inability of the patient to abduct the legs without pain and roentgen evidence of osteoporosis, fluffiness of the periosteum and separation of the symphysis pubis. 7. 7. The prognosis is always very good but over a long period of time. 8. 8. Treatment by deep roentgen therapy causes marked and rapid amelioration of the symptoms.

Sensory Neuron Degeneration in Pigs: IV. Protection Afforded by Calcium Pantothenate and Pyridoxine: Six Figures

Young pigs fed a ration of crude casein, lard, sucrose and a salt mixture, supplemented with thiamine, riboflavin, nicotinic acid, pyridoxine, choline, calcium pantothenate and cod liver oil developed normally and exhibited no changes in the nervous system during life or at autopsy. Pigs similarly fed but receiving supplements of B vitamins which failed to include either calcium pantothenate or pyridoxine, developed an abnormal gait and showed degenerative changes in the peripheral nerves, the posterior root ganglia, the posterior roots, and the posterior funiculi of the spinal cord. In the animals whose supplements did not contain calcium pantothenate, a subacute inflammation of the colon was found, in addition to the changes in the nervous system. In the animals whose supplements did not contain pyridoxine, epileptiform convulsions and anemia were observed in addition to the above changes in the nervous system. Both the convulsions and the anemia disappeared promptly following the administration of pyridoxine. When thiamine was not furnished with the vitamin supplements no changes in the nervous system were observed although other signs attributable to thiamine deficiency developed. The omission of choline was associated with some abnormality of gait in all of three animals but lesions were observed in the nervous system of only one. These lesions, furthermore, differed from those observed in association with pyridoxine or pantothenic acid deficiency. The results of observations on 118 pigs are summarized and the signs of chronic deficiency of various water soluble vitamins are presented. It is concluded that both pyridoxine and pantothenic acid are necessary in maintaining the integrity of the nervous system in the pig under the conditions of these experiments.

The Roentgen-ray Diagnosis of Inflammatory Disease of the Appendix

ALTHOUGH much has been written concerning the roentgen-ray diagnosis of disease of the appendix, in this paper no attempt is made to review this material, for the reports here are based only on independent, personal observation. I have no doubt that many others have based their diagnoses on similar criteria. Within the past month Moore and Merritt2 have described some of the same findings. Carman, in his book, “The Roentgen Diagnosis of Diseases of the Alimentary Canal,” placed special emphasis on an article by Spriggs and Marxer in The Lancet of 1919. This has undoubtedly formed the basis for much of the best work that has been done in roentgen diagnosis of disease of the appendix. That all of the criteria advanced have been more or less unsatisfactory and unreliable is evident from the multiplicity of methods described, none of which has come into general use. Many surgeons of experience are hesitant to operate in cases in which a diagnosis of disease of the appendix has been made roentgenographically, evidently because previous experience has shown that these findings are unreliable. These same surgeons know that the results of appendectomy in some cases of so-called chronic appendicitis are brilliant, but in a much larger group they are unsatisfactory. Because of this experience they recognize a real need for a type of examination that is dependable and will indicate with reasonable certainty the cases in which surgery is a consideration. I do not believe that this is true of any of the methods now in common use. What are the indications for surgical intervention in disease of the appendix? In my opinion this must be answered from two viewpoints, the first being active inflammatory disease, and the second, mechanical disturbance resulting from previous inflammation in the appendix or other closely related structures. In active inflammation three grades are generally recognized, acute, subacute, and chronic. The characteristics of acute appendicitis are well known and do not require repetition. Spontaneous healing may take place or serious complications result. Subacute appendicitis may be a stage of subsiding acute appendix, which may later be followed by complete healing. On the other hand, there is evidence pointing to the fact that the stage of subacute inflammation may continue over a period of months or possibly years. The term “chronic appendicitis,” a loose one, generally covers any long-standing abnormality of the appendix due to active low grade infection or the result of previous infection. In the above classification it applies only to low grade, active inflammation. It may be a late stage in a subsiding acute appendicitis which will go on to complete repair, or it may continue as a low grade inflammatory condition for years. The indications for surgical intervention in the acute cases are generally recognized. In subacute appendicitis they are not so clear, probably because accurate diagnosis is much less certain.

A preliminary report on temporary roentgen castration in the treatment of subacute pelvic inflammation: by Dr. John O. Polak, Brooklyn, N. Y. (For original article, see October issue, page 580.)

A preliminary report on temporary roentgen castration in the treatment of subacute pelvic inflammation: by Dr. John O. Polak, Brooklyn, N. Y. (For original article, see October issue, page 580.)

A preliminary report on temporary roentgen-ray castration in the treatment of subacute adnexal inflammation

A preliminary report on temporary roentgen-ray castration in the treatment of subacute adnexal inflammation

DRAINAGE OF THE GALLBLADDER

As the technic presented here has never come to the notice of myself or my local friends, it may be of interest to the profession generally. I have used it in cases demanding drainage of the gallbladder when the much preferred operation of cholecystectomy was frankly contraindicated. A man, aged 44, with a typical history of attacks of gallstone colic, was operated on, Aug. 20, 1925, at Mercy Hospital. When the abdomen was opened, the gallbladder looked and felt healthy, except that it contained five stones. The appendix was found to be in a state of subacute inflammation. What was more serious was the finding of the entire pancreas fully 50 per cent. increased in size, the surface being smooth, however. The latter finding decided against removal of the gallbladder, and after the stones were removed, it was drained with three-fourths inch rubber tube, well held in by two rows

"INTESTINAL WORMS AND APPENDICITIS"

To the Editor: —In the editorial, January 27, on Intestinal Worms and Appendicitis, this statement occurs: has been objected that very few of the thousands of appendixes removed are reported to contain parasites. F. K. Noack is quoted as having found nine appendixes out of fifteen infested; the work was evidently done on European patients. It may not be amiss to supplement the editorial with the following note: I recently dissected ninety-six appendixes removed at operation with the express purpose of obtaining some definite percentage figures as to parasitic infestation of the organ. Four of the ninety-six, or 4.16 per cent., harbored Oxyuris vermicularis . The infestation varied widely. The most lightly infested appendix had one large adult female; the most heavily infested had twenty-five worms—larvae, adult males and females. Histologically, the organs showed an acute or subacute inflammation, with many polymorphonuclear leukocytes and a few to numerous eosinophils. No