Ventilator-induced pulmonary pseudocysts in preterm neonates

Twenty-three pulmonary pseudocysts were identified in 20 preterm neonates undergoing mechanically assisted ventilation. Most of the pseudocysts occurred in a right parahilar location; cysts were either single (13) or multiple/multilocular (10). The pseudocysts persisted from less than 2 days to longer than 3 months (modal duration, 7 days), and they were commonly associated with generalized pulmonary interstitial emphysema (18 of 20), pneumothorax (18 of 20), bronchopulmonary dysplasia (16 of 20), and pneumomediastinum (six of 20). The reason for the predominantly right parahilar location of these pseudocysts remains uncertain. Pulmonary pseudocysts are almost always right-sided and are associated with pulmonary interstitial emphysema and pneumothoraces; complete resolution usually occurs.     

Koinzidenz von familiär gehäuft auftretendem Plasmozytom,chronischer lymphatischer Leukämie und Rektumkarzinom

Zusammenfassung Es wird über einen 68jährigen Mann berichtet, bei dem sich gleichzeitig eine chronisch-lymphatische Leukämie, ein Leichtketten-Plasmozytom und ein Rektumkarzinom fanden; die Schwester des Patienten ist an einem IgG-Plasmozytom erkrankt. Die Häufigkeit maligner Zweiterkrankungen bei CLL und Plasmozytom wird an Hand der Angaben der Literatur besprochen. Mögliche Zusammenhänge zwischen den drei Krankheiten werden diskutiert; das Plasmozytom und das Rektumkarzinom werden als Folgeerkrankungen der CLL angesehen.

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Summary A case-report of a 68 year old man is given in whom chronic lymphatic leukemia, light-chain multiple myeloma, and carcinoma of the rectum were found simultaneously; the sister of the patient suffers from IgG-plasmocytoma. The incidence of malignancies in CLL and multiple myeloma is reviewed from figures in literature. Junctions between the three diseases are discussed, and multiple myeloma as well as carcinoma of the rectum are taken for sequelae of CLL.

     

Diagnostic imaging in pediatrics: the state of the art

The results of the study panels, both at national and international levels, have shown that much can be done to increase the efficiency and efficacy of diagnostic imaging in all areas of medical practice including pediatrics. Much remains to be done, however. The work that has been done must be expanded into a thorough investigation of the safety, yield, and cost of diagnostic imaging. It is the responsibility of all physicians to continue efforts toward more rational use of diagnostic imaging at all levels of society and to make sure that established guidelines are implemented. Flexibility in attitudes, cooperation between clinician and radiologist, and a willingness to learn and keep up with advances are essential to this process--not only to improve the benefits from diagnostic imaging, but to preserve the ability of society to pay for it. Those who would proclaim that this or that recommendation is the "last word" must realize that half of what is said today may well be proven false 10 years from now, and, further that we have no way of knowing what techniques and imaging approaches will comprise that half, nor should the imaging "standards" be self-serving. Guidelines drawn up in an academic vacuum where all imaging techniques are readily available may have little practical application in pediatric practice and impact on health care in areas of the world where diagnostic imaging, if available at all, will consist only of basic radiographic imaging. At the same time, experience gained in countries using all advanced imaging modalities must be shared with less fortunate nations: such knowledge may have important implications for even the most basic radiographic studies.(ABSTRACT TRUNCATED AT 250 WORDS)     

Computed tomography in ossification of the posterior longitudinal spinal ligament

Summary A patient with cervical myelopathy was found to have extensive ossification within the posterior longitudinal ligament. Computed tomography of the spine was of value for precisely defining the degree of narrowing of the spinal canal. The nature of this disease entity is discussed.     

Microfluidic devices for diagnostic applications

Microfluidic systems have become an attractive platform for diagnostic applications. The technology not only allows drastically decreased assay volumes (down to picoliters), but also accelerates sample processing and readout. In this article we give an overview of the different kinds of systems, ranging from non- or minimally instrumented point-of-care devices for the detection of pathogens to fully-instrumented cutting-edge technologies such as next-generation sequencing and droplet-based microfluidics. We expect that microfluidic systems will have a major impact on future diagnostic (e.g., disposable devices) and therapeutic approaches (e.g., personalized medicine). Here we summarize current trends and critically review the limitations.     

Evidence for redistribution-associated intracellular pK shifts of the pH-sensitive fluoroprobe carboxy-SNARF-1

Properties and peculiarities of the pH-sensitive fluoroprobe carboxy-seminaphthorhodafluor-1 (carboxy-SNARF-1), in view of pH_i measurements in single cells, were evaluated using confocal laser scanning microscopy. It was found that in human malignant glioma cells (U 118 MG) grown in multicellular spheroid culture, intracellular calibration curves (nigericin method) varied from one cell to another despite emission ratioing of the fluorescence signals. In addition, considerable deviations between indicator calibration in cell-free solution and intracellular calibration were observed. Microspectrofluorometric measurements revealed that these deviations are attributable to intracellular pK shifts of the indicator rather than to spectral changes of the fluorescence emission. The observed pK shifts are probably due to intracellular redistribution of the indicator between cytosol and lipophilic cell compartemants, e. g. plasma membrane, since the indicator can even be loaded efficiently into the cells via its active acid form (instead of the acetoxymethyl ester form). An approximate theoretical derivation of a cellular calibration curve confirms that a reversible, pH-dependent intracellular redistribution of the protonated indicator component results in an apparent pK shift of ΔpK = log(1 + ?¸P with P the partition coefficient and ε a factor that depends on the different mean layer thicknesses of the cytosol and plasma membrane. Since the apparent pK shift amounts to about 1 pH unit in tumour cells of spheroids, the intracellular pH measuring range of carboxy-SNARF-1 is almost restricted to alkaline pH values. Further consequences of the redistribution phenomenon are discussed with special respect to intracellular ion imaging.     

Ultrasonic surgery--an alternative way in orthognathic surgery of the mandible. A pilot study

The aim of this report is to present preliminary results and experiences using an ultrasonic bone-cutting device in bilateral sagittal split osteotomies of the mandible (BSSRO) with particular attention to possible damages to the inferior alveolar nerve (IAN). Seven patients with class II or class III malocclusion were treated by BSSRO with a conventional combined orthognathic and surgical approach. The osteotomy was carried out using an ultrasonic bone-cutting device. Subjective neurosensory deficits of the inferior alveolar nerve were assessed on 14 sides. Compared to the conventional techniques using saws, chisels and burs, the use of the ultrasonic device was more time-consuming, but the osteotomies were carried out at a high level of precision. In addition, this procedure offered the advantage of a blood-free surgical field and thus provided good control of the surgical procedure. Subjective neurosensory disturbances of the IAN showed a continuous decrease from 57.1% (eight sides) 2 months after the surgical procedure to 14.3% (2 sides) after 5 months and to 7.1% 7 months after BSSRO. Within the seven patients of this pilot study associated neurosensory disturbances were low. A possible advantage in terms of nerve protection is subject to a prospective study.     

Klinische Untersuchungen zur Pathophysiologie dentogen bedingter Abszesse

In 26 patients with abscesses in the maxillofacial area, the electrolyte concentrations, pH and osmotic and hydrostatic pressures of the pus fluid were measured and calculated. The main cations identified were sodium (134 ± 38 mmol/l) and potassium (37 ± 16 mmol/l) and as anions chloride (183 ± 46 mmol/l) and bicarbonate (10 ± 4 mmol/l). The pH value of the pus liquid was 6.164 ± 0.233. The calculated mean osmotic pressure of the pus liquid was 7910 ± 1455 mm Hg, whereas the measured physical pressure inside the abscess was 49 ± 13 mm Hg. Both pressure types show time-dependent pressure curves. With time, the real pressure inside the abscess cavity increases, whereas the osmotic pressure decreases. There was no relationship between the two pressure types and the different species of microorganisms responsible for the inflammation. The results of the study reveal that abscesses can be regarded as osmotically active systems, and the mechanism by which the abscess is formed might be as follows. After penetration of virulent microorganisms into the tissue space, the area of acute inflammation is walled off by the collection of inflammatory cells. Destruction of tissue by products of the polymorphonuclear leucozytes takes place and results in liquefactive necrosis and a hypertonic abscess cavity. The inwards-directed flow of tissue fluids into the cavity via the abscess membrane causes volume expansion and generates pressure, two facts that can explain the swelling dynamics and typical symptoms of abscesses in the maxillofacial area.     

Biodegradierbare Miniplatten (Lactosorb?) bei Kranioosteoplastik – experimentelle Ergebnisse am schnell wachsenden, juvenilen Miniaturschwein

As a passive intracranial transmission (PIT- effect) has been described for metallic osteosyntheses materials in the infant growing skull. Thereby the use of resorbable plates and screws might be an alernative fixation device in infant craniofacial surgery. For evaluating the biological behaviour, craniotomies were performed in the frontoorbital region of four infant minipigs, six weeks of age and 6.1 kg of weight. After turning and orthotopical repositioning the full thickness bone graft were fixed with resorbable plates and screws made of LactoSorb on the left side after epiperiosteal, on the right side after subperiosteal preparation. The animals were sacrificed after 3, 6, 9 and 18 months. Histologically, a PIT- effect was detected similar to metallic microplates and screws being significant diminished after epiperiosteal preparation and plate positioning. The biodegradation was not affected by intraosseous translocation. Even in case of intrasinuidal transmission no inflammatory reactions werde observed. No contraindications for the clinical use of this specific PLLA-PGA copolymer could be found when implanted in the rapidly growing craniofacial bone surfaces.