MEDIBCRAITIOA volunteers, and a British strain in doses ranging from 10' to 106 EID.0 to 30 volunteers. One month later 75 of the vaccinated volunteers were given 104 EID50 of the British vaccine. In addition, 55 volunteers with neutralizing antibody were given 107 EID50 of the Iksha vaccine by drops or spray, and 53 volunteers were given the same dose of vaccine inactivated with formalin.Of the volunteers without antibody 41% had mild respiratory symptoms after the first dose, and 8% after the challenging dose; 9 % of the volunteers with antibody who were given live vaccine had similar symptoms.Virus was recovered from 25% of the volunteers without antibody after the first dose of vaccine, and from 5 % after the challenging dose. Immediately before the challenging dose of vaccine 21% of the volunteers showed fourfold or greater haemagglutination-inhibition antibody response and 21 % a complement-fixation response; two weeks after the challenging dose the proportions were 29% and 19%, respectively.A much higher proportion of volunteers showed an antibody response after live than after inactivated vaccine.A dose of 10' EID50 of the British vaccine gave similar results to that of 106 or 107 EID50 of the Iksha vaccine.
Recurrence of hyperparathyroidism (HPT) following total parathyroidectomy and autotransplantation (APTX) has been reported before. However, no data about the time interval between grafting and relapse and about morphology were given. Only 1 case of primary hyperparathyroidism with APTX has been extensively analyzed.
We have performed autotransplantation in 42 patients with HPT due to chronic renal failure. Implanted parathyroid tissue showed typical chief cell hyperplasia. Within 4–33 months, 6 patients developed recurrent HPT with serum iPTH levels being highest in venous blood of the grafted arm. Grafts had to be removed. Although only 20–40 mg of parathyroid tissue had been implanted, removed grafts weighed from 0.9 to 3.1 g. Explanted grafts were examined by light and electron microscopy. The size and DNA content of nuclei were determined. In all cases the explanted material showed a distinct invasive growth into the adjacent connective tissue and muscles and in 2 cases mitotic figures were demonstrated, a finding resembling malignant neoplasia of the parathyroid.
From our clinical and morphological observations we draw the following conclusions:
Surgical treatment of renal hyperparathyroidism by PTX + Auto‐TX unforeseeably may result in very accelerated growth of grafted tissue.
Because of invasive growth there exists the risk of uncontrolled spread of parathyroid tissue.
Graft removal may turn out to be difficult and possibly necessitate repeated and extensive surgery.
Before the observed phenomenon is totally understood, we no longer recommend PTX + Auto‐TX as an alternative to subtotal PTX in the surgical treatment of renal hyperparathyroidism.
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