Impfungen und Impfprogramme—aktuelle Aspekte des Impfwesens in Deutschland

Ohne Zusammenfassung     

A novel mutation (deletion of Aalpha-Asn 80) in an abnormal fibrinogen: fibrinogen Caracas VI. Consequences of disruption of the coiled coil for the polymerization of fibrin: peculiar clot structure and diminished stiffness of the clot.

An abnormal fibrinogen was identified in a 10-year-old male with a mild bleeding tendency; several years later, the patient developed a thrombotic event. Fibrin polymerization of plasma from the propositus and his mother, as measured by turbidity, was impaired. Plasmin digestion of fibrinogen and thrombin bound to the clot were both normal. The structure of clots from both plasma and purified fibrinogen was characterized by permeability, scanning electron microscopy and rheological measurements. Permeability of patients' clots was abnormal, although some measurements were not reliable because the clots were not mechanically stable. Consistent with these results, the stiffness of patients' clots was decreased approximately two-fold. Electron microscopy revealed that the patients' clots were very heterogeneous in structure. DNA sequencing of the propositus and his mother revealed a new unique point mutation that gives rise to a fibrinogen molecule with a missing amino acid residue at Aalpha-Asn 80. This new mutation, which would disrupt the alpha-helical coiled-coil structure, emphasizes the importance of this part of the molecule for fibrin polymerization and clot structure. This abnormal fibrinogen has been named fibrinogen Caracas VI.     

A sports medicine clinic in the community.

We report the attempt to set up a mini sports medicine clinic in a health centre resourced by a Department of Community Medicine. The type of problems seen are similar to those reported by other clinics. On the results of this pilot project, we believe it would be possible to establish similar clinics in health centres elsewhere in the United Kingdom. The National Health Service resources required are minimal, but the benefits to local communities are considerable.     

High tech home care: a look at a success story.

The expansion of technology has allowed patients to receive intravenous therapy at home. This case study discusses the problems of a patient with diabetes mellitus and malignant otitis externa. This patient received intravenous therapy for the last 3 years of his life. In spite of several hospitalizations, he was able to return and remain home until his death. Management of the patient's discharge and home care seemed to be a major factor in his ability to remain in the community.     

Primary megaureter in infants and children: a review.

Primary megaureter is a common cause of obstructive uropathy in children. The imaging studies and records of 75 infants and children with primary megaureter seen at Children's Hospital were reviewed. We describe our findings and illustrate the clinical presentations, diagnosis, and treatment of this entity.     

Call patterns and basilar papilla tuning in cricket frogs. I. Differences among populations and between sexes.

Male cricket frogs (Acris crepitans) produce a broad-band, high frequency advertisement call with a single spectral peak (the dominant frequency). We measured the dominant frequencies of male calls from six populations in central Texas and one from Indiana and compared them to the tuning of basilar papilla afferents in males and females. Averaging over all populations, mean call dominant frequency was 3.69 kHz, mean male basilar papilla tuning was 3.63 kHz, and mean female basilar papilla tuning was 3.17 kHz. Among populations, mean dominant frequency varied from 3.56 kHz to 3.82 kHz. Dominant frequencies were slightly higher in the more eastern Texas populations occupying pine forest habitats than in the more western populations occupying open grassland habitats. Changes in dominant frequency in a population coincided with changes in tuning of both male and female basilar papillae. Furthermore, within populations females were tuned on average lower than males and lower than the mean dominant frequency of calls in their own population. We suggest that the coincident changes in calls and basilar papilla tuning plus the sexual difference in tuning indicate that female mate choice would be directed toward males from her home population with low frequency calls or toward males from foreign populations with average calls lower in frequency than those in her home population. This in turn suggests that any gene flow between populations would be biased from east to west and from forest to open habitats.     

An irritating cough in dialysis patients. A rare differential diagnosis]

Soft tissue calcification is a well-known complication in chronic dialysis patients. These calcifications are mainly located around the large joints. Calcification of the visceral organs also occurs in these patients, even though this fact is far less known. These visceral calcifications are mostly diagnosed post mortem as they tend to be discrete and asymptomatic. In this article, we report on a chronic dialysis patient in whom extensive pulmonary calcifications occurred, leading to clinical symptoms.