Vergleich deutscher und türkischer Patienten mit ischämischem Schlaganfall

BACKGROUND: Until now no data has been available on possible specific features of the Turkish minority in Germany with respect to stroke. PATIENTS AND METHODS: We compared 20 Turkish stroke patients with matched German controls analyzing risk factors, findings at admission, rehabilitative treatments, and psychosocial aspects. RESULTS: In the Turkish group the interval between onset of symptoms and admission was longer (532 min vs 255 min, P < 0.01). All other findings during acute treatment and rehabilitation were comparable. At follow-up after 22 months, the Barthel index was 90 for the Turks and 100 for the Germans. The Turkish patients reported more consultations with physicians than their German counterparts (68 vs 12 per year, P < 0.01). Scores for quality of life and outcome did not differ. The Turkish patients more frequently required care and had a higher degree of disability. CONCLUSIONS: Turkish stroke patients have a longer time to admission. Risk factors, findings at admission, and treatment in the acute phase and rehabilitation are comparable. Several findings point towards a different health behavior. These results highlight the need for specific education of the Turkish population in Germany.     

Predictive factors for detecting malignancy in central and lateral cervical lymph nodes in papillary carcinoma of the thyroid

Aim: To determine the factors for predicting malignant diagnosis and limitations in ultrasonography guided fine‐needle aspiration cytology of central and lateral cervical lymph nodes in patients with primary differentiated thyroid papillary carcinoma. Methods: Biopsies of cervical lymph nodes were performed in 120 patients, 31 of whom had subsequent surgical diagnoses. Factors examined were patient's age and gender of the patients, location (central and lateral compartments), hypoechogenicity with loss of hilum, microcalcification, cystic feature, minimum and maximum diameters and index value (minimum/maximum diameter). Results: The mean minimum diameter and index value of the lymph nodes were 9.9 ± 4.9 mm and 0.60 ± 0.19, respectively. Microcalcifications and cystic parts were specific findings with rates of 93.9% and 95.1%, respectively. Microcalcification, cystic feature, minimum diameter and index value were poor predictors of malignancy. The predictors were central location (P = 0.031) and hypoechogenicity with loss of hilum in lateral neck (P = 0.019). Central nodes led to a major problem for biopsy success due to postoperative changes and anatomic position. Nondiagnostic (30%) nodes were therefore mostly central. Conclusion: The involvement of the central neck should be a major indication of lymph node biopsy and pathological diagnosis regardless of the imaging findings. In the lateral compartment, hypoechogenicity with loss of hilum, microcalcifications, cystic parts and an index value ≥ 0.51 are indications of a lymph node biopsy to rule out malignancy.     

Effect of 180 Days of Water Storage on the Transverse Strength of Acetal Resin Denture Base Material

Purpose: Acetal resin has been used as an alternative denture base and clasp material since 1986. The manufacturers claim that acetal resin has superior physical properties when compared to conventional denture base acrylic resins. Limited information is available about transverse strengths of acetal resin. The purpose of this investigation was to compare transverse strengths of pink and white acetal resins to transverse strengths of conventional heat‐polymerized polymethylmethacrylate (PMMA) resin in increasing durations of water storage. Materials and Methods: A transverse strength test was performed in accordance with International Standards Organization (ISO) specification No 1567. Twenty 65 × 10 × 2.5 mm³ specimens of each resin were prepared; five specimens of each resin group were subjected to three‐point bending test after 50 hours, 30 days, 60 days, and 180 days of water storage in distilled water at 37°C. Experimental groups’ transverse strengths were compared by three‐way ANOVA and Duncan's multiple range tests. Results: Transverse strength of PMMA denture base material was found to be in accordance with the requirements of ISO specification No 1567. Transverse strengths of white and pink acetal resin could not be calculated in this study, as white and pink acetal resin specimens did not break at the maximum applied force in the three‐point bending test. Flexural strength of acetal resin was found to be within the ISO specification limits. As the water storage time increased, the deflection values of PMMA showed no significant difference (p > 0.05). Both the white and pink acetal resin showed significant increase in deflection as the water storage time was increased from 50 hours to 180 days (p < 0.05). Conclusion: The results of this study indicated that transverse strength values of PMMA were within the ISO specification limit. Water storage time (50 hours, 30, 60, and 180 days) had no statistically significant effect on the transverse strength and deflection of PMMA. Acetal resin suffered from permanent deformation, but did not break in the three‐point bending test. Acetal resin showed significant increase in deflection as the water storage time was increased from 50 hours to 180 days. All materials tested demonstrated deflection values in compliance with ISO specification No 1567.     

Epileptic nystagmus in a patient with nonconvulsive status epilepticus.

Epileptic nystagmus (EN) is a rare form of rhythmic eye oscillations occurring during seizure activity. Not only convulsive states, but also nonconvulsive status may represent with EN and this phenomenon may be the only motor manifestation of seizure activity. Epileptic activation of a cortical saccade region may be distinguished from activation of a cortical pursuit region clinically as activation of pursuit regions results in nystagmus slow phases that bring the eyes across the midline. Horizontal EN results most commonly from seizure activity involving the occipital cortex. In this report, horizontal EN in a patient with nonconvulsive status epilepticus (NCSE) is described with clinical, radiological and electrophysiological findings that occur probably due to posterior leukoencephalopathy syndrome.     

Fluid resuscitation of acute hemorrhage in uninephrectomized rabbits--effects on the early function of the remnant kidney

The aim of this study was to determine the effects of fluid resuscitation of acute hemorrhage on the early function and histopathology of the remnant kidney in uninephrectomized rabbits. Thirty-nine adult rabbits were studied in four groups. Group 1 (n = 8) included healthy controls; Group 2 (n = 10) healthy, bled animals; Group 3 (n = 10) uninephrectomized, non-bled animals; and Group 4 (n = 11) uninephrectomized, bled animals. In the hemorrhage groups, 8 mL kg(-1) of blood was drawn, and replaced with lactated Ringer's solution three times the volume of shed blood. Urine and blood samples were collected after 120-minutes of observation. None of the animals experienced hypotension during the study period. Serum and urinary electrolytes were similar between the Groups (p > 0.05). Urine output was lower in Groups 3 and 4 than in Group 1 (p = 0.001, both). Urinary microalbumin, NAG, fractional sodium excretion and creatinine clearance were similar in all four Groups. Light microscopic evaluation revealed only slight enlargement of the proximal tubule lumen in the renal medulla of the rabbits that were both uninephrectomized and bled. We observed no deleterious effects of well resuscitated hemorrhage on early function and histopathology of the remnant kidney in uninephrectomized rabbits.