Neue und alte Antikoagulanzien im Blickpunkt

In the surgery and therapy of trauma patients, the decision for optimal thromboprophylaxis is often very difficult, although important. In the last 2 years, new anti-thrombotic agents have been developed and are now used in Germany for thromboprophylaxis in patients with hip or knee replacement surgery. This article reviews old (heparinoids and vitamin K-antagonists) and new (fondaparinux and ximelagatran) anticoagulants in perioperative settings of trauma surgery and discusses alternative anticoagulation in patients on therapy with vitamin K-antagonists.     

The predictive value of cranial ultrasound and of somatosensory evoked potentials after nerve stimulation for adverse neurological outcome in preterm infants

Thirty-nine preterm infants were studied to compare the predictive value of somatosensory evoked responses (SEPs) following median-nerve and posterior tibial-nerve stimulation with the predictive value of cranial ultrasound. With regard to the SEP, a normal median-nerve response was by no means a guarantee of a normal outcome. A normal posterior tibial-nerve response, however, almost guaranteed a normal outcome, but the test was very time consuming and the number of false positive responses was high (sensitivity. 95.6%, specificity 50%). The presence of parenchymal involvement, either due to a haemorrhage or cystic leukomalacia predicted cerebral palsy with a sensitivity of 95.6% and a specificity of 68.5%. The combination of an abnormal posterior tibial response and the presence of parenchymal brain lesions had the best predictive value with a sensitivity of 91.3% and a specificity of 81.2%. These results show that, although posterior tibial-rferve responses have a better predictive value than median-nerve responses, these values were lower than that of cranial ultrasound. The best prediction was obtained when a combination of posterior-tibial responses and cranial ultrasound was used.     

A study of ten small supernumerary (marker) chromosomes identified by fluorescence in situ hybridization (FISH)

In seven cases additional minute chromosomes studied by FISH were identified as no. 3, 11, 15, 18, 21 and X. Findings were unexpected except for partial trisomy 21 in an adolescent with minor features of Down's syndrome. Moreover, an i(18p) in a mentally retarded dysmorphic child and an idic(15) in a child with Fallot tetralogy was confirmed. In a child with r(21), a supernumerary marker was shown to be derived from no. 21, while in the mother an additional marker idic(22) was noted.     

Coping in longitudinal perspective: Findings from the bonn longitudinal study on aging

Within the Bonn Longitudinal Study on Aging (BOLSA) 221 women and men, born between 1890–95 and between 1900–05, were tested and interviewed in the year 1965 for the first time. Survivors were followed at seven measurement points until 1980. One of three lengthy interviews was related to the topic of stress and coping. Information on perceived stresses in the areas of housing, income, family and health were rated. Furthermore, responses to these different stress areas were analyzed by an empirically developed classification system. Findings point to a complex system of response patterns even in the group of very old participants. These response patterns were different for the four areas of stress, such as family or health etc. Response patterns related to the same problem area remained consistent over the 15-year span. Cluster analyses point to situation specific as well as person specific response patterns.This paper was originally presented at the XIV International Congress of Gerontology, Acapulco, Mexico, 18–23 June 1989.     

The Lyon effect of the lens: findings in the carriers of X chromosome-linked cataract and in Lowe syndrome

In carrier women for X-linked diseases the random X-inactivation and the subsequent embryonic process of development and differentiation induce characteristic patterns of tissue mosaicism. In the lens, the random mosaic pattern of equatorial epithelial cells and their proliferation oriented toward the posterior pole induce a radial or segmental distribution pattern of clonal cell populations. This can be shown in carrier women for X-linked cataracts. Findings in a carrier woman for X-linked cataract and for Lowe's syndrome respectively are reported.     

Metabolism of myoinositol in avian and mammalian cells infected with naked and enveloped DNA and RNA viruses.

The uptake of 3H-inositol into the pool of free inositol and its incorporation into the lipid phosphatidylinositol have been studied in various avian and mammalian cells infected by different viruses. In all the virus-cell systems investigated, virus infection results in a drastically reduced amount of free 3H-inositol about 3 to 5 h post-infection, demonstrable in the infected cells as compared to the mock-infected controls. In contrast, the incorporation of 3H-inositol into lipid can be enhanced, reduced, or not influenced at all, depending on the virus-cell system under observation.