Morphological findings during retinal development and maturation in hereditary rod-cone degeneration in Abyssinian cats

The sequence of structural changes involved in postnatal photoreceptor differentiation, maturation and early degeneration was studied in young Abyssinian cats and kittens with hereditary rod-cone degeneration and compared to maturation in normal controls. In affected cats the earliest change seen was disorientation of outer segment discs in the majority of the rods, while other rods appeared to develop and mature normally. Such disorientation of discs (at oblique angles or parallel to the longitudinal axis of the outer segment, or whorls of discs) is considered as 'immaturity', since controls also showed a substantial number of disoriented rod outer segment discs at this young age. At postnatal day 35 the difference between affected animals and controls was marked with a high frequency of immature appearing rod outer segment discs in affected animals, while all rod outer segment discs were adult-like and arranged in an orderly manner in controls. Cones seemed unaffected at this age. More severe changes in affected rod outer segments in the form of disintegration of discs (vacuolization and clumping of disc material, or formation of debris), which we consider to represent degeneration, were first observed at the time when retinal maturation normally occurs in the cat, i.e. 150 days postnatally. Subsequently a drop-out of rods was seen, primarily of rods with disoriented and disintegrated outer segment discs, followed by a slow, progressive degeneration of rods that had developed and matured normally. Cones appeared normal during the time of retinal development and maturation and it was not until the age of 2-3 years (Narfstr?m and Nilsson, 1986, Incest. Ophthalmol, Vis. Sci. 27, 1569-76) that degenerative changes were seen also in cones.     

Articular ossification after malignant neurolepsis. A case of schizophrenia treated with phenothiazines

Following administration of phenothiazines for schizophrenia, a 25-year-old patient developed a malignant neuroleptic syndrome followed by bilateral periarticular ossification of the knees, with severely limited motion. Two years later, the patient regained useful motion after bilateral excision of the ossified tissue and intensive physiotherapy. No recurrence of ossification was observed 3 years after operation, and the patient has maintained almost normal motion.     

Kleiner Fixateur externe bei distalen Unterarmfrakturen und Handgelenkverletzungen

The small external fixator can be used in the treatment of injuries of the wrist and the distal forearm.This fixator is indicated especially when an unstable fracture needs to be treated, when the bone concerned is affected by osteoporosis in an elderly patient,and in the early treatment of polytraumatized patients with severe soft tissue injuries.For reduction of the fracture we prefer the modular three-tube technique, which is very gentle on the soft tissue; in addition we use the advantages of ligamentotaxis.Depending on the fracture type,we use the small external fixator alone or in association with an internal osteosynthesis.With scrupulous followup checks in the outpatient clinic loosening of the Schanz screws and infection around them are very rare.     

Treatment of ulcerative colitis by traditional Chinese medicine and dynamic study of immune functions

The effect of the traditional Chinese medicinal herbs enema and enteric-coated capsules in the treatment of ulcerative colitis (UC) were compared in 260 cases. The immune complexes and the dynamic change of autoantibodies were monitored in 28 out of the 260 cases before and after treatment. The following results were observed. (1) There was no significant difference in the total effective rate between the enema group and the oral capsule group (93.3% and 87.5% respectively), but the recovery rates of purulent hemafecia, mucusfecia and erosion accompanying colitis, etc. in the former group were higher than those in the latter (P less than 0.01). (2) The circulating immune complexes were found 43 times above the normal range in 17 cases with positive rate 60.7%, and tended to decrease as the condition became better after treatment. Antinuclear antibodies were determined by the indirect fluorescent immune method and the indirect enzyme labelling method and the positive rates were 53.6% and 64.7% respectively, both being much higher than those in the controls (P less than 0.01).     

Neonatal reference values for ionized calcium, phosphate and magnesium. Selection of reference population by optimality criteria

Thirty-one full-term newborn babies were investigated in order to establish reference values for ionized calcium. Only children fulfilling certain optimality criteria (with best possible maternal and infant conditions and uncomplicated pregnancy and delivery) were included. All infants were breast fed. Capillary blood for analysis of ionized calcium was collected by heel puncture on day 1 (6-36 h post partum, p.p.), day 3 (60-84 h p.p.) and day 5 (108-132 h p.p.). Ionized calcium was measured with a semi-automatic electrode system ICA 1 (Radiometer A/S, Copenhagen, Denmark). The reference ranges (mean +/- 2 SD) for days 1, 3 and 5 were 1.05-1.37, 1.10-1.42 and 1.20-1.48 mmol/l, respectively. The mean ionized calcium concentration on day 1 was significantly lower than on days 3 and 5. Reference values are also given for total calcium, magnesium and phosphate. We emphasize that it is impossible to calculate ionized calcium from total calcium or vice versa.     

Intrapartum fetal heart rate patterns and neonatal intraventricular hemorrhage

A goal for the obstetrician and neonatologist is to screen for risk factors associated with intraventricular hemorrhage (IVH) in the low-birthweight infant. Perinatal events that lead to neonatal metabolic and cardiovascular derangements seem to provoke IVH, and conflicting reports have implicated labor as being contributory. A fetal heart rate (FHR) abnormality during premature labor may be a predictor of subsequent neonatal IVH. For this reason, 5 years of FHR tracings at two university medical centers were reviewed for inborn infants who were delivered after premature labor and weighed less than or equal to 2000 gm. Sixty-four infants developed IVH, but pre-existing labor with a discernible FHR pattern was recorded in only 38 (59%) cases. Interpretations were reassuring in 17 (45%) cases, suspicious in 7 (18%) cases, and ominous in 14 (37%) cases. This proportion of FHR patterns was not significantly different from a matched group of premature infants without IVH during the same period. Interpretations of intrapartum FHR patterns of low-birthweight infants are limited, especially before 30 weeks gestation, and not useful in predicting neonatal IVH.     

25 years experience of the surgical treatment of phaeochromocytoma.

OBJECTIVE: To assess the outcome of the surgical treatment of patients who had adrenalectomy for phaeochromocytoma. DESIGN: Retrospective clinical study. SETTINGS: University hospital, Germany. SUBJECTS: 87 consecutive patients with phaeochromocytoma who were operated on. INTERVENTIONS: 29 flank and 58 transabdominal adrenalectomies between 1974 and 2000. RESULTS: The mean tumour diameter was 5 cm (range 2-13), and the mean weight 91 g (range 7-550). The postoperative hospital stay was 11 days. The flank incision entailed the shortest operating time (95 minutes). Two of the phaeochromocytomas were malignant. There were two wound infections but no deaths. With a correct selection of patients, a flank incision is safe. Endoscopic retroperitoneal adrenalectomies should be preferred.     

Medizinische Beurteilungskriterien zu bandscheibenbedingten Berufskrankheiten der Lendenwirbelsäule (I)

Occupational diseases Nos. 2108 and 2110 correspond to intervertebral disc-related diseases of the lumbar spine from many years of carrying or lifting heavy loads, occupations in extreme postures of full flexion or oscillation of the whole body when seated, and which compel the cessation of all activities which are or could be the cause for the origin, exacerbation or recurrence of the disease. These occupational diseases came into force at the start of 1993, but there have been considerable problems in their implementation. The present Part I of the contribution is the result of the work of an interdisciplinary study group and contains medical criteria for the assessment of possibly strain-related clinical characteristics and the evaluation of other possible causes. Part II is to be published in Volume 4/2005 and will deal with questions related to forced cessation and to the assessment of the loss of earning ability. Agreement was reached in many areas related to the assessment of occupational claims. This should allow for evidence-based decision making in the future for the occupational diseases Nos. 2108 and 2110.