Factors Contributing to Occasional Failures in Demonstration of Pemphigus Antibodies by the Immunofluorescence Test**From the Department of Microbiology, State University of New York at Buffalo, Buffalo, New York 14214.

ABSTRACTThe failure to demonstrate pemphigus antibodies in sera of some patients with active lesions may be due to their species or organ specificity, to prozones, to interference by other antibodies or to errors in technique. In vivo binding of IgG to the intercellular areas can, however, be demonstrated in sections of biopsies of lesions even when the indirect staining fails to reveal the presence of pemphigus antibodies. The available evidence indicates that all active cases of true pemphigus have pemphigus antibodies

Organ Culture Studies of Pehmphigus Antibodies

The ultrastructural and light microscopic features of acantholysis produced in organ culture were compared with those of human pemphigus lesions. In both, an intraepidermal split was seen and typical suprabasal acantholytic cells were present. These cells contained small bundles of tonofilaments, usually located away from the cell periphery. Desmosomal plaques with inserted tonofilaments frequently remained along the periphery of acantholytic cells and along the upper portion of the periphery of basal cells. The ultrastructural similarity between in vitro and in vivo lesions provides additional evidence to suggest that organ cultures may provide a valid model for studying the dynamics of pemphigus lesion formation

Consensus Statement on Bone Conduction Devices and Active Middle Ear Implants in Conductive and Mixed Hearing Loss

Nowadays, several options are available to treat patients with conductive or mixed hearing loss. Whenever surgical intervention is not possible or contra-indicated, and amplification by a conventional hearing device (e.g., behind-the-ear device) is not feasible, then implantable hearing devices are an indispensable next option. Implantable bone-conduction devices and middle-ear implants have advantages but also limitations concerning complexity/invasiveness of the surgery, medical complications, and effectiveness. To counsel the patient, the clinician should have a good overview of the options with regard to safety and reliability as well as unequivocal technical performance data. The present consensus document is the outcome of an extensive iterative process including ENT specialists, audiologists, health-policy scientists, and representatives/technicians of the main companies in this field. This document should provide a first framework for procedures and technical characterization to enhance effective communication between these stakeholders, improving health care