Isolierter linksventrikul?rer Papillarmuskelabriss: Ein seltenes Ereignis nach stumpfem Thoraxtrauma

Wir berichten über einen 20-j?hrigen Patien-ten, der unter Einfluss von Ecstasy einen Autounfall erlitt. Obwohl er am ?u?eren Thorax keinerlei Verletzungszeichen aufwies, war es bei dem Unfall zu einen isolierten linksventrikul?ren Papillarmuskelabriss gekommen. Wir geben eine Literaturübersicht, aus der die Seltenheit solcher Verletzungen hervorgeht. Die zugrunde liegenden Verletzungsmechanismen, die Diagnose- und Therapiem?glichkeiten sowie die Komplikationen traumatischer Papillarmuskelabrisse werden diskutiert.     

Progressive histopathological changes in pancreatic islets of Zucker Diabetic Fatty rats.

Thus far, histopathological changes in the pancreatic islets of Zucker Diabetic Fatty (ZDF) rats, an animal model of type 2 diabetes mellitus (or non-insulin-dependent diabetes mellitus), have only been studied in male rats and in 18-weeks old rats or younger. In this study, we have examined in both male and female ZDF rats the histopathological changes longitudinally, from 6 to 32 weeks of age. We studied islet architecture and cellular distribution of the various islet hormones both in ZDF and control rats. In the ZDF rats, aging was initially associated with an enlargement of the islets. From 18 weeks onwards, no further enlargement was noted but islet boundaries became increasingly irregular, leading to the appearance of projections of endocrine cells into the surrounding exocrine tissue. At the islet boundaries as well as within the islets progressive fibrosis was observed with increasing amounts of collagen and reticular fibers. In the islets, staining intensity of both insulin and islet amyloid polypeptide (IAPP) increased slightly till 10 weeks of age and thereafter decreased rapidly. In contrast, the staining intensities of glucagon, somatostatin, and pancreatic polypeptide (PP) did not change. Even at the age of 32 weeks, just the beta-cells and not the other endocrine islet cells appear to be affected. In control rats, aging evoked only minor changes. Thus, we observed that during prolonged development of diabetes mellitus in both male and female ZDF rats histopathological changes in the pancreatic islets became progressively more severe, eventually leading to disintegration of the islets.     

The consumption of cigarettes, coffee and sweets in detoxified alcoholics and its association with relapse and a family history of alcoholism.

Thirty male alcohol dependent inpatients without concurrent depressive disorder, 13 of them with a positive family history of alcohol dependence in a first degree relative (PFH), were questioned about their desire and consumption habits with respect to cigarettes, coffee, and sweets while on a three-week inpatient treatment after detoxification from alcohol. Six weeks after discharge from hospital, the patients were reassessed for relapse. Eleven patients (36.6%) had relapsed at follow-up. Relapsers were younger than abstainers. The days until relapse correlated negatively with intensity of desire to drink alcohol, desire to smoke cigarettes, and with a higher consumption of cigarettes. PFH patients did not relapse earlier but they had a stronger desire to drink coffee and eat sweets and had a higher coffee consumption.     

Human infections with Borna disease virus: seroprevalence in patients with chronic diseases and healthy individuals.

Borna disease virus (BDV) is as yet an unclassified infectious agent which causes a neurologic disease in horses and sheep and is transmissible to other animal species. Human sera were tested for BDV-specific antibodies by immunofluorescence and immunoprecipitation. The sera were collected from three thousand subjects in Europe, the USA, and Africa classified by clinical syndromes/infectious diseases, and from healthy controls. In all three continents, positive serum samples were detected which recognized the major BDV antigen of 38/40 KD present in the nuclei of infected cells. In contrast to 2% of seropositives among the normal population, significantly higher prevalences (13-14%) were present among patients with chronic progressive diseases of the brain and the immune system. In children, antibody frequencies were two to four times higher than in adults. The results suggest a latent infection with BDV in humans leading to low antigen expression in healthy subjects and frequent reactivation events in chronically ill patients.     

Successful cryopreservation of microvenous allografts.

Vein grafts are used in approximately 20% of microsurgical cases. Although autogenous veins currently form the major source, they are associated with increased operating time and donor site scars. Cryopreserved allograft veins may serve as an alternative source. To our knowledge, cryopreservation of veins (1 mm or less) has not been reported. In this article we have described the process of cryopreserving rat veins (less than 1 mm in diameter) and their preliminary use as interpositional vein grafts.     

Nursing Research in Chile

A 1989 Pan-American Health Organization (PAHO) study on nursing research trends in seven Latin American countries (Brazil, Colombia, Chile, Ecuador, Honduras, Mexico and Peru) showed that most nursing research is conducted in Brazil, followed by Colombia and Chile ⁸ .     

Binge Drinking and Bone Metabolism in a Young Actively Growing Rat Model

BACKGROUND: Chronic alcohol consumption has been demonstrated to be deleterious to bone health. However, binge drinking is the prevalent form of drinking in young people, which was the impetus for the present study to determine the effect of week-end and week-long binge drinking on bone health in a young actively growing animal model. METHODS: Four-week-old, female, Sprague-Dawley rats were given the amount of 5% alcohol by gavage to be equivalent to a 63 kg woman drinking six beers a day for either 2 or 5 consecutive days per week. RESULTS: There were no changes in the 5-day binge animals, but the 2-day binge animals were hypocalcemic. Similarly, 2-day binge animals had slightly increased bone chemistry and histomorphometric values for both tibia and femur, but only femur length, dry weight, and ash weight as well as femur density, presented either as g/ml or ash weight per unit volume, were increased by a statistically significant level. Cross-section periosteal Mineral Apposition Rate (MAR) was significantly decreased in the 2-day alcohol fed animals. CONCLUSIONS: Actively growing rats given 5% alcohol by gavage for 2 days per week have an increased bone length, bone weight, and bone density. The interpretation of these results must be viewed with great caution because studies of chronic alcohol consumption, and many studies of acute drinking, clearly indicate deleterious effects of alcohol on bone health. Those fed alcohol for 5 days per week showed no change.     

novel Award Third Prize Paper. Assessment of the horizontal,fore-aft component of the ground reaction force from insole pressure patterns by using artificial neural networks.

OBJECTIVE: In this study it was investigated whether an artificial neural network can be used to determine the horizontal, fore-aft component of the ground reaction force from insole pressure patterns. DESIGN: An artificial neural network was applied to map insole pressures and ground reaction forces. METHOD: To train an artificial neural network insole pressure patterns and ground reaction force data were simultaneously determined for a wide range of different speeds (0.9-2.3 m s(-1)) for five subjects. Both intrasubject and intersubject generalizability were evaluated. RESULTS: At the intrasubject level generalizability was good when the speed for which the force was to be predicted was within the range of speeds from which data were used to train the network. Besides in some cases, generalizability to a condition outside the range of training conditions could be demonstrated. At the intersubject level the quality of generalization differed widely over subjects, from poor to good. CONCLUSIONS: It was found that an artificial neural network is able to map the relationship between insole pressure patterns and the fore-aft component of the ground reaction force. RELEVANCE: Good intrasubject generalization of 'knowledge' obtained by an artificial neural network will allow the assessment of the fore-aft component of ground reaction force in condition that cannot be evaluated with force plates, e.g. activities of daily living or real sport situations. Additionally, intersubject generalization will allow shear-force recordings in subjects that are not able to complete a great number of runs to acquire enough force-plate hits.     

Infrarot-Temperaturmessung im Gehörgang mit dem DIATEK 9000 Instatemp und dem DIATEK 9000 Thermoguide Einflußgrößen und Vergleich mit anderen Methoden der Temperaturmessung des Körperkerns

Temperature of the tympanic membrane is recommended as a “gold standard” of core-temperature recording. However, use of temperature probes in the auditory canal may lead to damage of tympanic membrane. Temperature measurement in the auditory canal with infrared thermometry does not pose this risk. Furthermore it is easy to perform and not very time-consuming. For this reason infrared thermometry of the auditory canal is becoming increasingly popular in clinical practice. We evaluated two infrared thermometers – the Diatek 9000 Thermoguide and the Diatek 9000 Instatemp – regarding factors influencing agreement with conventional tympanic temperature measurement and other core-temperature recording sites. In addition, we systematically evaluated user dependent factors that influence the agreement with the tympanic temperature. Materials and Methods. In 20 volunteers we evaluated the influence of three factors: duration of the devices in the auditory canal before taking temperature (0 or 5?s), interval between two following recordings (30, 60, 90, 120, 180?s) and positioning of the grip relative to the auditory-canal axis (0, 60, 180 and 270°). Agreement with tympanic contact probes (Mon-a-therm tympanic) in the contralateral ear was investigated in 100 postoperative patients. Comparative readings with rectal (YSI series 400) and esophageal (Mon-a-therm esophageal stethoscope with temperature sensor) probes were done in 100 patients in the ICU. The method of Bland and Altman was taken for comparison. Results. Shortening of the interval between two consecutive readings led to increasing differences between the two measurements with the second reading decreasing. A similar effect was seen when positioning the infrared thermometers in the auditory canal before taking temperatures: after 5?s the recorded temperatures were significantly lower than temperature recordings taken immediately. Rotation of the devices out of the telephone handle position led to increasing lack of agreement between infrared thermometry and contact probes. Mean differences between infrared thermometry (Instatemp and Thermoguide, CAL-Mode) and tympanic probes were ?0.41±0.67?°C (2 SD) and ?0.43 ±0.70?°C, respectively. Mean differences between the Thermoquide (Rectal-Mode) and rectal probe were ?0.19±0.72?°C, and between the Thermoguide (Core Mode) and esophageal probe ?0.13±0.74?°C. Discussion. Although easy to use, infrared thermometry requires careful handling. To obtain optimal recordings, the time between two consecutive readings should not be less than two min. Recordings should be taken immediately after positioning the devices in the auditory canal. Best results are obtained in the 60° position with the grip of the devices following the ramus mandibulae (telephone handle position). The lower readings of infrared thermometry compared with tympanic contact probes indicate that the readings obtained represent the temperature of the auditory canal rather than of the tympanic membrane itself. To compensate for underestimation of core temperature by infrared thermometry, the results obtained are corrected and transferred into core-equivalent temperatures. This data correction reduces mean differences between infrared recordings and traditional core-temperature monitoring, but leaves limits of agreement between the two methods uninfluenced.