Juvenile myasthenia gravis: an unusual presentation

Myasthenia gravis is a disease characterized by muscular weakness and fatigability which afflicts 2-10 patients per 100,000 with 20% of cases presenting in childhood. Muscles innervated by cranial nerves are frequently involved with ptosis and diplopia being the most frequent presenting complaints. We review the literature and report a case of a 20-month-old infant presenting with inspiratory stridor and cyanosis, resembling foreign body aspiration.     

Zur Ätiologie der myatrophen Spinalerkrankungen

Ohne Zusammenfassung     

Die pathologische Anatomie der Influenza 1918/19

Ohne ZusammenfassungAus dem pathologisch-anatomischen Institut des Allgemeinen Krankenhauses Barmbek. Prosektor Professor Dr. Fahr.Mit 8 Textabbildungen.     

Lymphocytic meningoradiculitis and encephalomyelitis due to Borrelia burgdorferi: a clinical and serological study of 18 cases.

Clinical features of 18 patients with either lymphocytic meningoradiculitis (n = 17) or chronic encephalomyelitis (n = 1) due to Borrelia burgdorferi are reported. Arthropod bites were recorded in only seven patients. High titres of anti B burgdorferi antibodies were detected in sera from all patients and in CSF from 12 out of 17 patients tested. All patients had CSF abnormalities especially pleocytosis and oligoclonal bands. A falsely positive syphilitic serology was observed in the CSF from the patient with encephalomyelitis.     

Auswirkungen des § 51 StGB. in seiner neuen Fassung vom 24. XI. 1933

Ohne Zusammenfassung Aussprache zum Vortrag Koopmann: HerrMueller- Göttingen wendet sich gegen § 51 Abs. 2 StGB., da er die Rechtssicherheit vermindert. Bei der großen Mehrheit der Amtsärzte gilt noch immer die Psychopathie als Grund für verminderte Zurechnungsfähigkeit.HerrPietrusky-Bonn. tritt für Beibehaltung des § 51 Abs. 2 in Verbindung mit Internierung ein.Auch HerrK. Reuter-Breslau hält den Absatz 2 des § 51 für einen Fortschritt gegenüber den früheren Zuständen im Hinblick auf die Möglichkeit der Sicherungsverwahrung.Ebenso schließt sich HerrRücker-Hamburg dieser Ansicht an. Die früher für Sicherungsmaßnahmen geforderten Zwischenanstalten müßten an die Stelle der Heil- und Pflegeanstalten treten. Die Psychopathen sollen aus dem § 51 grundsätzlich herausfallen.HerrDeutsch-Hamburg vertritt die gleiche Ansicht, daß Psychopathen im allgemeinen nicht unter § 51 Abs. 2 StGB. fallen. Der Begriff erheblich im Absatz 2 muß entsprechend eng ausgelegt werden. Auch für die Heil- und Pflegeanstalten sind sie zum großen Teil nicht geeignet. In Sicherungsverwahrung können sie aber nur unter bestimmten gesetzlichen Voraussetzungen genommen werden (§ 20a und 42 b ff. StGB.).HerrKörtke-Langenhorn betont, daß es darauf ankomme, was man unter Psychopathen versteht. Wenn man die Debilen mit dazu rechnet, fallen natürlich viele unter § 51 Abs. 2. Die Psychopathen im übrigen fallen nicht darunter.HerrTöbben-Münster i. W. macht darauf aufmerksam, daß die verminderte Zurechnungsfähigkeit durch die in § 51 Abs. 2 enthaltene Bemerkung aus einem dieser Gründe eingeengt wird.     

The surgical treatment of skull-base tumors with intracranial extension

As a discipline, skull-base surgery via the transtemporal route has matured since 1975. Previously considered unresectable, skull-base tumors with intracranial extension can now be successfully removed by means of modification of contemporary exposures with neurosurgical collaboration. Between September 1970 and February 1986, 126 skull-base tumors have been operated on by The Otology Group, P.C. Of these, 49 had intracranial extension. In this article, techniques for tumor removal and dural defect reconstruction are outlined. A single-staged procedure is advised. The advantages of and exceptions to this format are described. Techniques that will prevent postoperative cerebrospinal fluid leakage are highlighted. Results and complications of this surgical series are discussed, and team aspects of this surgery are emphasized.     

Personalbedarfsermittlung für eine leitliniengerechte stationäre Qualifizierte Entzugsbehandlung bei Alkoholabhängigkeit

The central element of the “qualified withdrawal treatment” of alcohol dependence is – in addition to physical withdrawal treatment – psychotherapy. The treatment of the underlying addictive disorder that is displayed by intoxication, harmful behaviour and withdrawal symptoms is only possible with a combination of somatic and psychotherapeutic treatment elements. The successfully established multimodal therapy of the “qualified alcohol withdrawal treatment”, postulated in the current S3-Treatment Guidelines, requires a multi-disciplinary treatment team with psychotherapeutic competence. The aim of the present work is to calculate the normative staff requirement of a guideline-based 21-day qualified withdrawal treatment and to compare the result with the staffing regulations of the German Institute for Hospital Reimbursement. The present data support the hypothesis that even in the case of a hundred per cent implementation of these data, adequate therapy of alcohol-related disorders, according to the guidelines, is not feasible. This has to be considered when further developing the finance compensation system based on the described superseded elements of the German Institute for Hospital Reimbursement.     

CTX-M-14 type β-Lactamase producing Escherichia coli isolated from hospitalized patients in Tunisia

Escherichia coli (E.coli) with a CTX-M resistance phenotype was selected from hospitalized patients in a university Hospital of Tunisia between January 2010 and June 2010. PCR analysis and sequencing demonstrated that it harboured CTX-M-14 β-lactamase. Characterization of the regions surrounding the bla(CTX-M-14) showed the ISEcp1 elements located in the upstream region of the bla gene. PFGE and multilocus sequence typing revealed two different types which corresponds to sequence types ST38 complex and ST131. These results reinforce the potential for spreading of this gene among E. coli clinical strains in the coming years in Tunisia.