Der Schlaganfall beim Diabetespatienten

Diabetes and stroke are important clinical conditions from epidemiological and economical points of view. An interdisciplinary approach is always indicated to diagnose and treat these diseases optimally. Diabetes elevates the risk of stroke between two- and four-fold. Diabetic stroke patients need longer in-patient treatment, have a higher mortality rate and recover less well during the rehabilitation process. Approximately 20%-30% of first-ever stroke patients reveal an impaired glucose tolerance or even manifest diabetes. Already in the prediabetic phase, vessel damage can be seen in the form of endothelial dysfunction and early arteriosclerosis. Measurements of microalbuminuria and intima-media thickness of the common carotid artery enable an assessment of the vascular system. Hyperglycemia represents a serious risk during the acute treatment phase, as it diminishes the effect of thrombolysis and worsens the ischemic parenchymal lesion. Specific neurological signs and symptoms complicate the acute phase of stroke treatment, which should always be carried out in a stroke unit. For secondary prevention purposes, risk-adapted platelet inhibition and statins are recommended.     

Effects of triiodothyronine in spontaneously hypertensive rats. Studies on cardiac metabolism,function, and heart weight

Summary We have studied the effects of triiodothyronine (T₃) on heart function,on the myocardial oxidative pentose phosphate pathway, and on heart weight in spontaneously hypertensive (SHR) rats. Another aim was to examine whether these T₃-effects may be reversible. T₃ was administered daily (0.2 mg/kg s. c.) for 14 days. Compared to the untreated SHR controls, T₃ induced an increase in heart rate (beast/min) from 357±10 (n=17) to 553±10 (n=17), in the pressure-rate-product (mm Hg/min) from 78400±4500 (n=15) to 113700±4800 (n=15), and in the heart weight/body weight ratio (mg/g) from 4.2±0.2 (n=20) to 5.8±0.2 (n=19). The activity of myocardial glucose-6-phosphate dehydrogenase, the first and rate-limiting enzyme of the oxidative pentose phosphate pathway (units/g protein), was clevated from 4.2±0.2 (n=9) to 7.0±0.6 (n=9) after 14 days of T₃-treatment while the activity of 6-phosphogluconate dehydrogenase, one of the following enzymes in the pathway, was not altered appreciably. These changes returned to the respective control values when T₃-treatment was discontinued for 14 days. Our results demonstrate that T₃ had a positive chronotropic effect and induced an additional heart enlargement in an animal model with already established cardiac hyperfunction and hypertrophy. The effects on heart function and weight, which were fully reversible, were not as pronounced as in normal Sprague-Dawley rats.     

The description and histopathology of Leptorhynchoides polycristatus n. sp. (Acanthocephala: Rhadinorhynchidae) from sturgeons, Acipenser spp. (Actinopterygii: Acipenseridae) in the Caspian Sea, Iran, with emendation of the generic diagnosis

Of the three known species of Leptorhynchoides Kostylew 1924, two are reported from North American fishes: Leptorhynchoides aphredoderi Buckner and Buckner 1976 and Leptorhynchoides thecatus (Linton 1891) Kostylew 1924. The third species, Leptorhynchoides plagicephalus (Westrumb 1821) Kostylew 1924, is commonly found in the Caspian and Black Sea from at least four species of sturgeons including Acipenser stellatus Pallas 1771 and the Acipenser nudiventris Lovetzsky 1828 from which Leptorhynchoides polycristatus n. sp. was found. No taxonomic work has been reported for L. plagicephalus for the last 90 years. L. polycristatus n. sp. can be readily confused with L. plagicephalus because of many superficial similarities. Such similarities include the general shape of the trunk, proboscis, and organ systems. However, L. polycristatus is clearly distinguished from the other three species primarily by having (1) 19–20 proboscis hooks per row; (2) the shortest hooks are anterior and the longest at the middle; the opposite is true in L. plagicephalus; (3) with a cuticular collar enveloping the base of the proboscis hooks; (4) the surface of its proboscis hooks is ribbed; (5) with a broad collar of multiple rectangular cuticular crests encircling the anterior end of the trunk; this is the only member of Leptorhynchoides with such a structure; (6) with many large ovoid uninucleated cells in the subcuticular layer of the trunk; (7) with paired glandular clusters near the male reproductive opening and of suction cup-like sensory structures on the bursa; (8) with dorsoventral ligament across the vagina; (9) cement glands are in a cluster of eight arranged in two horizontal tiers of four glands each; (10) with female gonopore near terminal; (11) with structures interpreted as possible microtriches on the surface of the trunk; (12) and with thinner eggs. L. polycristatus caused extensive histopathological damage to host intestinal layers. The armed proboscis invades and attaches to the host mucosa causing villi compression and necrosis of the epithelial lining with subsequent hemorrhaging and granulocyte migration. No encapsulation of the acanthocephalan is visible, and the worm can migrate deep into the smooth muscle layers of the muscularis extrema. The presence of L. polycristatus in the lumen of the host intestine obstructs and damages the absorbing surface of the host affecting the nutritional potential. Dead, necrotic host epithelial tissue and remnants of villi and crypts are visible.     

美学区软组织水平和骨水平植体周围骨丧失和牙龈生物型的分析

目的: 植体周围一定程度的骨丧失可能会给牙种植治疗的美观效果带来不利影响。这种情况可能更容易影响软组织水平（Tissue-Level, TL）设计,因此,当强调形态的美观自然性时,骨组织水平（Bone-Level, BL）设计可能更有优势。除了植体的设计,牙龈生物型也被认为是维持牙槽骨稳定的重要因素。本研究拟针对具有不同牙龈生物型的患者,在其美学区域行软组织水平和骨水平牙种植治疗,探究其骨丧失的程度。材料和方法: 对41位患者行20个TL和22个BL种植治疗,术后即刻、术后随访对这42个位点行口内影像学检查;运用计算机技术行牙槽骨高度测量分析;运用TRAN法鉴定患者的牙龈生物型。结果: TL组平均4.9年的存留期里,厚龈型的12颗植体周围平均骨丧失0.21mm（SD：0.43mm）;薄龈型的8颗植体周围平均骨丧失0.05mm（SD：0.47mm;P=0.31）。BL组平均1.9年的存留期里,厚龈型的14颗植体周围骨丧失为-0.03mm（SD：0.38mm）,薄龈型的8颗植体周围骨丧失为+0.09mm（SD：0.32mm;P=0.84）。结论: 分析得到的数据发现,牙槽骨高度的变化与种植设计或是牙龈生物型并无直接相关性。然而在选择种植设计之前,评价软组织的厚度是有利的,其中BL种植设计更能获得自然的外形。为实现以上评价目的,TRAN法是最快速、简易的方法。     

HIV prevalence, attitudes and behaviour in clients of a confidential HIV testing and counselling centre in Uganda.

OBJECTIVE: To describe clients, operation and impact of an African public HIV testing and counselling centre. DESIGN AND SETTING: Analysis of samples from clients attending the AIDS Information Centre (AIC) in Kampala, Uganda in early 1991. SUBJECTS: HIV-1-positive and HIV-negative consecutive clients (250 of each), 86 consecutive couples, and 200 consecutive clients who were HIV-negative in 1990 and were attending for their repeat test. MAIN OUTCOME MEASURES: HIV seroprevalence rates, attitudes, behaviour and behaviour change. RESULTS: HIV-1 prevalence was 28% overall, 24% in men and 35% in women. Reasons for taking the HIV test were a planned marriage or a new relationship (27%; 84% in couples), to plan for the future (35%), distrust of sexual partner (14%) and illness or disease/death (not HIV-specific) of partner (20%). The majority of the reported intentions in response to a positive or a negative HIV test result were positive, demonstrating the ability to cope with this information. Of repeat clients, two (1%) had become HIV-1-positive. The majority of repeat clients reported one sexual partner only (67%) or sexual abstinence (25%). Compared with pre-test information from AIC clients attending for the first time, repeat clients reported casual sexual contacts less often (6 versus 25%) and, of those, the majority used condoms. CONCLUSIONS: Our study demonstrates the demand for and the feasibility of confidential HIV testing and counseling services in Uganda, and illustrates the value of these services in achieving behaviour changes. Such services should be considered an additional approach for the reduction of HIV transmission in Africa, especially in areas with high HIV seroprevalence rates.