Vom Konzept zur Praxis – Aktuelles in der Luftrettung

The 2006, annual meeting of the senior physicians and emergency medical technicians of the German Air Rescue Service (Deutschen Rettungsflugwacht, DRF) was titled “From Concept to Practice”. The themes of security in the air rescue services and the current practice of cardiopulmonary respiration were discussed. In addition, different concepts and networks for treating patients with acute coronary syndrome or severe trauma were presented. The training of emergency technicians and quality assessment using the database of the whole TeamDRF was explained. New helicopter stations as well as long-range transport using normal aviation by the TeamDRF were presented.     

Distribution of spermatogenesis in the testicles of azoospermic men: the presence or absence of spermatids in the testes of men with germinal failure [published erratum appears in Hum Reprod 1998 Mar;13(3):780]

The aim of the study was to determine whether a prior diagnostic testicle biopsy can predict success or failure of testicular sperm extraction (TESE) with intracytoplasmic sperm injection (ICSI) in patients with non-obstructive azoospermia caused by testicular failure, and what is the minimum threshold of sperm production in the testis which must be surpassed for spermatozoa to reach the ejaculate. Forty- five patients with non-obstructive azoospermia caused by testicular failure underwent diagnostic testicle biopsy prior to a planned future TESE-ICSI procedure. The diagnostic testicle biopsy was analysed quantitatively, and correlated with the quantitative findings of spermatogenesis in patients with normal spermatogenesis, as well as with the results of subsequent attempts at TESE-ICSI. Men with non- obstructive azoospermia caused by germinal failure had a mean of 0-6 mature spermatids/seminiferous tubule seen on a diagnostic testicle biopsy, compared to 17-35 mature spermatids/tubule in men with normal spermatogenesis and obstructive azoospermia. These findings were the same for all types of testicular failure whether Sertoli cell only, maturation arrest, cryptorchidism, or post-chemotherapy azoospermia. Twenty-two of 26 men with mature spermatids found in the prior testis biopsy had successful retrieval of spermatozoa for ICSI, 12 of their partners became pregnant, and are either ongoing or delivered. The study suggests that 4-6 mature spermatids/tubule must be present in the testis biopsy for any spermatozoa to reach the ejaculate. More than half of azoospermic patients with germinal failure have minute foci of spermatogenesis which are insufficient to produce spermatozoa in the ejaculate. Prior diagnostic testicle biopsy analysed quantitatively (for the presence of mature spermatids) can predict subsequent success or failure with TESE-ICSI. Incomplete testicular failure may involve a sparse multi-focal distribution of spermatogenesis throughout the entire testicle, rather than a regional distribution. Therefore, it is possible that massive testicular sampling from many different regions of the testes may not be necessary for successful TESE-ICSI.      

Adhesion inhibitory activity of β-lactoglobulin isolated from infant formulae

β-Lactoglobulin was isolated from infant formulae that were ultra high temperature (UHT) -treated, sterilized or spray-dried. The effect of the isolated β-lactoglobulin on SfaII-fimbriae-mediated adhesion of Escherichia coli to human ileostomy glycoproteins was studied in vitro. β-Lactoglobulin isolated from sterilized formulae was found to perform significantly less well than preparations from spray-dried formulae (p = 0:05). Great heterogeneity was observed in the adhesion inhibitory capacity of β-lactoglobulin isolated from UHT-treated formulae. Therefore, no significant difference was observed between UHT-treated and sterilized formulae or spray-dried formulae (p < 0:10). It can be hypothesized that β-lactoglobulin from spray-dried and some UHT-treated infant formulae may affect the colonization of mucous membranes by E. coli strains causing neonatal septicaemia and meningitis.     

Injury of rat renal vessels following extracorporeal shock wave treatment.

The locations of extracorporeal shock wave treatment induced renal vascular injury and the sources of significant renal hemorrhage were determined in a rat model by means of two different vascular casting procedures. Silicone-rubber injected vascular preparations for light microscopy or corrosion casts for scanning electron microscopy were made following gross examination of the treated organs and their contralateral controls. After 1000 shock waves at 18 kV, five out of 20 treated kidneys appeared to be normal or minimally affected, while 15 showed gross evidence of marked vascular injury. Gross interstitial hemorrhage (15/20), subcapsular hematomas (7/20), and hemorrhages into the renal pelvis (5/20) were confirmed by extravasations of casting materials. These could be traced back to their vascular sources in several instances. Disruptions of interlobar and arcuate veins gave rise to most significant interstitial, subcapsular, and renal pelvic extravasations. On a microscopic scale cortical venules were among the most frequently injured vessels. The arterial vasculature was not spared. Arterial injury ranged from complete arcuate occlusion to small afferent arteriolar and glomerular capillary extravasations. The significance of shock wave induced vascular injury is discussed with respect to potential clinical side effects of ESWL.     

Comparison of scleral and corneal Tono-Pen readings.

PURPOSE: To compare scleral Tono-Pen (Medtronic Solan, Jacksonville, FL) readings to corneal Tono-Pen readings. METHODS: Intraocular pressure (IOP) was measured prospectively in 72 eyes of 37 adult patients and in 10 eyes of 5 children. Measurements were taken on the central cornea and on the sclera. Recorded measurements were within 5% confidence levels by Tono-Pen. RESULTS: Corneal IOP ranged from 10 to 28 mm Hg (mean +/- standard deviation, 17.0 +/- 3.8 mm Hg). Scleral measurements ranged from 4 to 99 mm Hg (40.4 +/- 23.0 mm Hg). Scleral measurements ranged from 11 mm Hg lower to 76 mm Hg higher than corneal measurements. CONCLUSIONS: Tono-Pen readings obtained from sclera are of no clinical value and should not be used to approximate corneal IOP.     

Hematological and plasma biochemical disturbances in experimental molybdenum toxicosis in sheep

Two groups of 4 sheep received a daily iv injection of sodium heptamolybdate (100mg/day) or of saline for 2 weeks to study the hematological and plasma biochemical effects of molybdenum toxicosis. In molybdenum-dosed sheep, there was hypercupremia, mild anemia due to the decrease of copper concentration in the liver and moderate hepatocellular damage probably due to a direct toxic effect of molybdenum against the liver.     

Brain tissue heterotopia in the nasopharynx. Contribution of MRI to assessment of extension.

The authors report two cases of brain tissue heterotopia in the nasopharynx, without other malformations and, in one of the cases, with a persistent craniopharyngeal canal opening onto the heterotopia. This exceptional malformation is very similar to brain heterotopia in the nose, or "nasal glioma", which is more frequent and less diversified at histology. The malformation is revealed by obstruction of the pharynx with respiratory distress immediately after birth or during the first weeks of life. Total surgical excision provides cure without sequelae. The diagnosis is based on histology. MRI is essential to the diagnostic and pretherapeutic evaluation, notably to avoid missing an ectopic hypophysis, but it is insufficient to diagnose a sphenoidal meningoencephalocele.     

Mutations in the retinal guanylate cyclase (RETGC-1) gene in dominant cone-rod dystrophy

The dominant cone-rod dystrophy gene CORD6 has previously been mapped to within an 8 cM interval on chromosome 17p12-p13. The retinal- specific guanylate cyclase gene (RETGC-1), which maps to within this genetic interval and previously was implicated in Leber's congenital amaurosis, was screened for mutations within this family and in a panel of small families and individuals with various cone and cone- rod dystrophy phenotypes. A missense mutation (E837D) was identified in affected members of the CORD6 family, as well as a second missense mutation (R838C) in three other families with dominant cone-rod dystrophy. RETGC-1 is only the fourth gene to be implicated in cone-rod dystrophy and this is the first report of dominant mutations in this gene.