In vivo tetracycline labeling of bone: an intraoperative aid in the surgical therapy of osteoradionecrosis of the mandible.

In this technical approach, we demonstrate that preoperative tetracycline administration helps distinguish between viable and necrotic bone in osteoradionecrosis (ORN) during surgery by exciting tetracycline fluorescence by black light. The difficult aspect of the operative approach lies in the decision of the extent of the debridement in order to prevent an iatrogenic fracture or progression of ORN. With this technique, vital bone, in contrast to necrotic bone, showed detectable fluorescence. Therefore, tetracycline fluorescence labeling may be used in attempts to facilitate the intraoperative decision making in the surgical therapy of osteoradionecrosis.     

Adenosine: A Sensitive Indicator of Cerebral Ischemia during Carotid Endarterectomy

Background: For the human brain, there are no data available concerning the significance of adenosine and its metabolites as biochemical indicators of cerebral ischemia. Since adenosine may counteract key pathogenetic mechanisms during cerebral ischemia, its sensitivity and specificity as a marker of cerebral ischemia was investigated in relation to hypoxanthine and lactate.

Methods: Arterial and jugular venous concentration changes of adenosine, hypoxanthine, and lactate were studied in 41 patients undergoing carotid endarterectomy. Cerebral tissue oxygenation was monitored continuously by somatosensory-evoked potentials. A carotid artery shunt (n = 6) was placed only after complete loss of somatosensory-evoked potentials.

Results: Before carotid artery clamping jugular venous concentrations of adenosine, hypoxanthine, and lactate in subsequently shunted patients were 229 +/- 88 nM, 1105 +/- 116 nM, and 0.85 +/- 0.52 mM, respectively (mean +/- SD). In patients who required shunting, carotid artery clamping induced a significant increase in jugular venous adenosine (389 +/- 114 nM) and jugular venous hypoxanthine (1444 +/- 168 nM). In contrast, the increase in jugular venous lactate (0.91 +/- 0.48 mM) did not reach statistical significance. Focal cerebral ischemia was indicated by jugular venous adenosine with a sensitivity and specificity of 0.83 and 0.71, respectively.     

Origin and distribution of enteric neurones in Xenopus.

Summary In Xenopus, we investigated the origin of enteric neurones and their distribution in relation to the extracellular matrix (ECM) components, fibronectin (FN) and tenascin (TN). Enteric neurone precursor cells originate from the anterior trunk neural crest (NC). They migrate along the ventromedial NC pathway (between somites and neural tube/notochord) into the primitive gut (via the dorsal mesentery/lateral plate mesoderm) where they differentiate into enteric neurones. NC cells were identified during their migration and in the gut using the X. laevis — X. borealis nuclear marker system. The neuronal character of NC cells in the gut could be demonstrated immunohistochemically with a monoclonal antibody against the HNK-1 epitope. This antibody is superior to N-CAM and neurofilament antibodies which proved insufficient in Xenopus.In early tadpoles (stage 45), enteric neurones occurred frequently in the mesenchymal lining of the oesophagus, either singly or in groups of two to three cells. In more distal portions of the digestive tract, enteric neurones were rarely found. In metamorphosing tadpoles (stage 62/63), enteric neurones were scattered singly beneath the mucosa, or formed small aggregates between the inner and outer muscle layer throughout the length of the digestive tract. The neurones occurred in positions corresponding to the myenteric and submucosal plexus of higher vertebrates.The distribution of enteric neurones was studied in relation to fibronectin (FN) and tenascin (TN), glycoproteins of the ECM, which support (FN) and inhibit (TN) amphibian NC cell migration. Using immunohisto-chemistry, FN was found during NC cell migration in ECM spaces along the ventromedial pathway, and in the gut between the mucosa and the muscle layers, where it would be able to support adhesion and migration of NC cells. TN, in contrast, appeared much later than FN, both in the dorsal trunk and also ventrally, in the gut. In older tadpoles, TN was present in the mesenchyme and muscle layers of the digestive tract, where it might have an inhibiting influence on the migration of enteric neurones within the gut wall.     

Regeneration statt Reparation

Autogenous bone transfer is still regarded as the "golden standard" for many indications in oral and cranio-maxillofacial surgery. In this overview, the status of the autogenous bone is re-evaluated under consideration of current research results, clinical long-term studies, risks and safety of the patient as well as the costs. Due to the further development of modern bone substitute materials, which reveal in parts superior long-term results for special indications, the routine use of autogenous bone has to be critically reviewed.     

Early cardiac perforation after atrial septal defect closure with the Amplatzer septal occluder

We report a case of aortic perforation after transcatheter closure of an atrial septal defect by an Amplatzer septal occluder. During emergency surgery, perforations of the dome of the right atrium and the noncoronary sinus of Valsalva of the aorta were repaired. Atrial septal defect was primarily closed. A short anterosuperior rim should be considered a risk factor for aortic perforation in transcatheter atrial septal defect closure.     

Untersuchungen zur Habituation des postrotatorischen Nystagmus

Ohne ZusammenfassungMit 3 TextabbildungenNach einem Vortrag, gehalten auf der Jahrestagung der Deutschen Gesellschaft für Neurologie in Düsseldorf, 3.–5. 9. 1964.     

Hemmwirkungen eines Extraktes aus einer menschlichen Hyperspleniemilz in der Knochenmarkkultur

Ohne Zusammenfassung     

Importance of the therapeutic alliance experience for the differential psychotherapeutic indication

The influence of the therapeutic alliance experience on the recommendation for psychotherapy and prognosis was examined in a retrospective study. Three hundred seventy-four of 3270 patients who presented at the psychosomatic-psychotherapeutic outpatient service at the Benjamin Franklin Hospital of the Free University of Berlin between July 1994 and December 1999 were selected based on the fact that they had been examined only by a psychoanalyst and recommended for individual psychoanalytical outpatient therapy, nondirective therapy (according to Rogers) or behavioral therapy. Results of the unifactorial variance analysis: The better the alliance is assessed, the sooner procedures for psychoanalytical therapy are recommended (F = 35.85; p < 0.000) and the better the assessment of the prognosis (r = 0.68; p < 0.000). The results confirm the importance of the therapeutic working relationship and correct the assumption that the indication and prognosis are exclusively diagnosis or patient-related, clearly showing that they are the result of an interactive process.     

The complete nucleotide sequence of RNA-2 of a fungally-transmitted UK isolate of barley mild mosaic bymovirus and identification of amino acid combinations possibly involved in fungus transmission

The complete nucleotide sequence of RNA-2 of a fungally-transmitted UK isolate of barley mild mosaic bymovirus (BaMMV isolate UK-F) was determined and compared with other published sequences, particularly UK-M, an isolate derived from the same source but which has been mechanically passaged for several years, has a deletion of about 1 kb and cannot be fungally transmitted. From an alignment of the BaMMV RNA-2 encoded protein with that for barley yellow mosaic bymovirus (BaYMV), several regions of consistent homology were identified and extensive searches made for similarities with the proteins of other fungally-transmitted viruses, especially amongst the furovirus capsid readthrough proteins which seem especially prone to deletion and which have already been implicated in fungus transmission. The amino acid combinations ER (glutamic acid-arginine) or QR (glutamine-arginine) were found consistently in all of the viruses. They occurred in positions predicted to be on the outside of the protein, and therefore available for interaction with the fungus vector, and were also within the regions prone to spontaneous deletion. In view of the lack of other structural or sequence homologies, it is suggested that these motifs are strong candidates for involvement in fungus transmission.