Abstract. Vesical calculi are common in spinal cord injury patients. The majority are composed of magnesium ammonium phosphate, a compound readily soluble in the solvent Renacidin. We describe a paraplegic man with recurrent bladder stones in whom cystolitholopaxy was unsuccessful. His calculi were completely dissolved by continuous Renacidin bladder irrigation. We recommend Renacidin for the initial treatment of vesical calculi in selected spinal cord injury patients. Many such stones will completely dissolve and others may be made softer or smaller, facilitating cystolitholopaxy. A significant number of patients will be spared the inconvenience, cost and morbidity of hospitalisation for a surgical procedure.
Lymphocytes comprise up to 30% of the cells present in human bronchoalveolar lavage fluid and thus could participate in host response to infectious Aspergillus fumigatus conidia. We have examined the possibility that lymphocytes might play a role during early infection by either damaging the fungus or interfering with adherence. When incubated with A. fumigatus conidia for 20 h, highly purified 5‐day‐old lymphocytes activated with either IL‐2 or phytohaemagglutinin, but not untreated lymphocytes, were consistently able to reduce residual fungal biomass as estimated by a metabolic assay. T lymphocytes, but not NK cells, appeared to be responsible for this activity. Lymphocytes bound both A. fumigatus conidia and hyphae, and the antifungal activity of the lymphocytes required direct lymphocyte–fungus contact. In a separate set of experiments using release of 51Cr from 51Cr‐loaded fungi as an estimate of fungal damage, lymphocyte‐induced loss of fungal biomass was found to be due to loss of fungal adherence rather than to direct fungal damage. The detached hyphae were also found to be metabolically intact and to have normal morphology by electron microscopy. These data demonstrate that IL‐2‐ and phytohaemagglutinin‐activated lymphocytes exhibit a contact‐dependent ability to reduce adherence of germinating conidia of A. fumigatus to a surface.
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