Patient Blood Management in der Geburtsvorbereitung,Geburtshilfe und postpartalen Phase

Die Anaesthesiologie - Die Implementierung eines Patient Blood Management (PBM) wird zunehmender Standard in der operativen Medizin. Seit einiger Zeit gilt das Interesse auch den vulnerablen...     

Frequency processing at consecutive levels in the auditory system of bush crickets (tettigoniidae)

We asked how processing of male signals in the auditory pathway of the bush cricket Ancistrura nigrovittata (Phaneropterinae, Tettigoniidae) changes from the ear to the brain. From 37 sensory neurons in the crista acustica single elements (cells 8 or 9) have frequency tuning corresponding closely to the behavioral tuning of the females. Nevertheless, one‐quarter of sensory neurons (approximately cells 9 to 18) excite the ascending neuron 1 (AN1), which is best tuned to the male's song carrier frequency. AN1 receives frequency‐dependent inhibition, reducing sensitivity especially in the ultrasound. When recorded in the brain, AN1 shows slightly lower overall activity than when recorded in the prothoracic ganglion close to the spike‐generating zone. This difference is significant in the ultrasonic range. The first identified local brain neuron in a bush cricket (LBN1) is described. Its dendrites overlap with some of AN1‐terminations in the brain. Its frequency tuning and intensity dependence strongly suggest a direct postsynaptic connection to AN1. Spiking in LBN1 is only elicited after summation of excitatory postsynaptic potentials evoked by individual AN1‐action potentials. This serves a filtering mechanism that reduces the sensitivity of LBN1 and also its responsiveness to ultrasound as compared to AN1. Consequently, spike latencies of LBN1 are long (>30 ms) despite its being a second‐order interneuron. Additionally, LBN1 receives frequency‐specific inhibition, most likely further reducing its responses to ultrasound. This demonstrates that frequency‐specific inhibition is redundant in two directly connected interneurons on subsequent levels in the auditory system. J. Comp. Neurol. 518:3101–3116, 2010. © 2010 Wiley‐Liss, Inc.     

Auditory DUM neurons in a bush‐cricket: A filter bank for carrier frequency

In bush‐crickets the first stage of central auditory processing occurs in the prothoracic ganglion. About 15 to 50 different auditory dorsal unpaired median neurons (DUM neurons) exist but they have not been studied in any detail. These DUM neurons may be classified into seven different morphological types, although, there is only limited correlation between morphology and physiological responses. Ninety seven percent of the stained neurons were local, 3% were intersegmental. About 90% project nearly exclusively into the auditory neuropile, and 45% into restricted areas therein. Lateral extensions overlap with the axons of primary auditory sensory neurons close to their branching point. DUM neurons are typically tuned to frequencies covering the range between 2 and 50 kHz and thereby may establish a filter bank for carrier frequency. Less than 10% of DUM neurons have their branches in adjacent and more posterior regions of the auditory neuropile and are mostly tuned to low frequencies, less sensitive than the other types and respond to vibration. Thirty five percent of DUM show indications of inhibition, either through reduced responses at higher intensities, or by hyperpolarizing responses to sound. Most DUM neurons produce phasic spike responses preferably at higher intensities. Spikes may be elicited by intracellular current injection. Preliminary data suggest that auditory DUM neurons have GABA as transmitter and therefore may inhibit other auditory interneurons. From all known local auditory neurons, only DUM neurons have frequency specific responses which appear suited for local processing relevant for acoustic communication in bush crickets.     

Ausgedehnter Abszess der Mamma

A 51-year-old woman presented with an abscess of the left breast. Despite drainage and treatment with ampicillin and sulbactam the patient developed septic conditions. As the chest X-ray and computed tomography (CT) showed air entrapment, immediate surgical treatment was decided. Intraoperatively necrotizing fasciitis extending unilaterally from the clavicula to the pelvic ligament was diagnosed and treated by vast debridement. After surgical redressing many times the patient could finally be discharged after 46 days of hospitalization.