Über die Osteochondrosis intervertebralis L V/S I als Ursache der Kreuzschmerzen bei Frauen

Zusammenfassung In der vorliegenden Arbeit wird angestrebt, an Hand der Literatur und eigener Untersuchungen einige vermutlich zur Osteochondrosis intervertebralis L V/S I beitragende Momente zu prüfen.Nach Beschreibung des pathologisch-anatomischen Bildes und des Röntgenbefundes bei Osteochondrosen werden die anatomisch-physiologischen Verhältnisse im Lumbosacralbereich erörtert und die Bedeutung des Lumbosacral- und des Keilformwinkels für das Zustandekommen einer Osteochondrosis intervertebralis L V/S I untersucht und die Resultate dieser Überlegungen mit den sich statistisch ergebenden Werten des an der Universitäts-Frauenklinik Erlangen erhobenen Materials verglichen. Dabei konnte die Ansicht, daß die Osteochondrose eine früher als die Spondylose auftretende Verschleißerscheinung sei, nicht bestätigt werden, da sich bei dem vorliegenden Material ein verstärktes Auftreten der Osteochondrose ebenfalls erst nach dem 50. Lebensjahr ergab. Dagegen darf die Theorie, daß ein abnormer, besonders aber ein verkleinerter Lumbosacralwinkel bei der Entstehung einer Osteochondrose pathogenetisch in Betracht kommt, nach unseren Ergebnissen als wahrscheinlich angesehen werden.Die vom physikalisch-physiologischen Gesichtspunkt aus gesehen als bestehend zu bezeichnende Konstruktion, daß ein abnormer Keilformwinkel zur Schädigung der 5. Lendenwirbelscheibe und daher zur Entstehung einer Osteochondrosis intervertebralis L V/S I wesentlich beitragen müsse, konnte durch unsere Untersuchungen nicht gestützt und damit auch die Ergebnisse der Arbeit von W.-D. Müller nicht bestätigt werden.Mit 7 Textabbildungen (10 Einzelbilder)     

53. Gynäkologische Bemerkungen zum Problem der fehlenden Vagina

Langenbeck's Archives of Surgery - Vor operativer Herstellung eines künstlichen Vaginalrohres muß eine Differenzierung des Krankheitsbildes erfolgen. Ferner muß geklärt...     

The rabbit model serves as a valuable operative experience and helps to establish new techniques for abdominal and thoracic endosurgery

Minimally invasive surgery in infants requires great experience and highly specialised skills. However, in most paediatric surgical departments, the number of patients requiring such surgery is usually small and the personal experience of the surgeon limited. An experimental setting with small animals could improve these training conditions if it adequately simulates the underlying situation and conveys beneficial surgical experiences. The authors implemented an endosurgical training model with New Zealand white rabbits. The mean body weight was 3.3 (range 2.9–3.5) kg. The abdominal cavity had a volume of about 580 ml and the thoracic cavity a volume of about 250 ml, comparable with those of a newborn baby. Several relevant techniques were established (gastrostomy, colostomy, gut biopsies, lung biopsies, and anastomosis of the oesophagus). Overall, the rabbit model served to refine technical skills and operative experience. In paediatric surgical departments with a specific focus on endosurgery in the abdominal and thoracic cavities, this training model could help to introduce new techniques and add valuable educational strategies.     

Common and distinct brain activation to threat and safety signals in social phobia

BACKGROUND: Little is known about the functional neuroanatomy underlying the processing of emotional stimuli in social phobia. OBJECTIVES: To investigate specific brain activation that is associated with the processing of threat and safety signals in social phobics. METHODS: Using functional magnetic resonance imaging, brain activation was measured in social phobic and nonphobic subjects during the presentation of angry, happy and neutral facial expressions under free viewing conditions. RESULTS: Compared to controls, phobics showed increased activation of extrastriate visual cortex regardless of facial expression. Angry, but not neutral or happy, faces elicited greater insula responses in phobics. In contrast, both angry and happy faces led to increased amygdala activation in phobics. CONCLUSIONS: The results support the hypothesis that the amygdala is involved in the processing of negative and positive stimuli. Furthermore, social phobics respond sensitively not only to threatening but also to accepting faces and common and distinct neural mechanisms appear to be associated with the processing of threat versus safety signals.     

CT findings in patients with chronic thrombembolic pulmonary hypertension

Chronic thromboembolic pulmonary hypertension (CTEPH) is thought to be a rare complication of pulmonary embolism. However, it was recently demonstrated that CTEPH is more common than previously thought after pulmonary embolism. Without treatment, CTEPH is associated with a very high mortality rate. Making the correct diagnosis early is essential, because there is a potential curative treatment in the form of pulmonary thromboendarterectomy (PTE). Because of the unspecific clinical symptoms of CTEPH, the different imaging modalities play a crucial role in diagnosis making. Since the introduction of the multidetector CT technology, CT has become an important part in the diagnostic work up of pulmonary embolism and CTEPH and is often used as a first-line diagnostic tool. CT is not only a reliable tool for the diagnosis of CTEPH, but also is helpful in estimating the operability of these patients. PTE is still associated with a mortality rate of about 10%. Particularly an insufficient decrease of the pulmonary vascular resistance after PTE leads to a very high mortality rate. Therefore, it is crucial to correlate the degree of the surgical accessible obstruction of the pulmonary vasculature with the degree of pulmonary hypertension in deciding for or against PTE. The aim of this review is to describe the CT findings in patients with CTEPH and their use in differentiating CTEPH from other diseases like acute pulmonary embolism and primary pulmonary hypertension. Moreover, the correlation of different CT imaging features with surgical success after PTE will be discussed.     

Individual value of brain tissue oxygen pressure, microvascular oxygen saturation, cytochrome redox level, and energy metabolites in detecting critically reduced cerebral energy state during acute changes in global cerebral perfusion

The authors assessed the diagnostic value of brain tissue oxygen tension (PbrO2), microvascular oxygen saturation (SmvO2), cytochrome oxidase redox level (Cyt a+a3 oxidation), and cerebral energy metabolite concentrations in detecting acute critical impairment of cerebral energy homeostasis. Each single parameter as well as derived multimodal indices (arteriovenous difference in oxygen content [AVDO2], cerebral metabolic rate for oxygen [CMRO2], fractional microvascular oxygen extraction [OEF]) were investigated during controlled variation of global cerebral perfusion using a cisternal infusion technique in 16 rabbits. The objective of this study was to determine whether acute changes between normal, moderately, and critically reduced cerebral perfusion as well as frank ischemia defined by local cortical blood flow (lcoBF), brain electrical activity (BEA), and brain stem vasomotor control can be reliably identified by SmvO2, PbrO2, Cyt a+a3 oxidation, or energy metabolites (glutamate, lactate/pyruvate ratio). PbrO2, SmvO2, and Cyt a+a3 oxidation, but not cerebral perfusion pressure, were closely linked to lcoBF and BEA and allowed discrimination between normal, moderately reduced, and critically reduced cerebral perfusion (P < 0.01). Glutamate concentrations and the lactate/pyruvate ratio varied significantly only between moderately reduced cerebral perfusion and frank ischemia (complete loss of BEA and brain stem vasomotor control). Therefore, PbrO2, SmvO2, and Cyt a+a3 oxidation, but not glutamate and the lactate/pyruvate ratio, reliably predict the transition from moderately to critically reduced cerebral perfusion with impending energy failure.     

Transcriptional activators Cat8 and Sip4 discriminate between sequence variants of the carbon source-responsive promoter element in the yeast<Emphasis Type="Italic"> Saccharomyces cerevisiae</Emphasis>

The structural genes for gluconeogenesis in the yeast Saccharomyces cerevisiae are activated by the carbon source-responsive element (CSRE) found in the respective upstream regions. Regulatory genes CAT8 and SIP4 both encode zinc-cluster proteins which can bind to CSRE motifs and activate target genes under conditions of glucose deprivation. In this work, we describe a functional analysis of sequence variants containing single mutations within the strongly activating CSRE(ICL1) motif. While the sequence CCNNNNNNCCG was required as the minimal UAS for gene activation by both Cat8 and Sip4, the activators responded differently to sequence variations in the central part of the CSRE. Our results allowed us to derive a consensus sequence for efficient gene activation by Cat8 (YCCNYTNRKCCG), while a more specific motif is required for activation by Sip4 (TCCATTSRTCCGR). Although their zinc cluster domains are clearly related, Cat8 and Sip4 are not isofunctional. This conclusion is further supported by the finding that biosynthetic derepression of Cat8 in the presence of a nonfermentable carbon source precedes that of Sip4 by about 90 min.     

Detection of nitric oxide synthase (NOS) immunoreactive neurons in the human septal area: a matter of method?

There is a remarkable discrepancy between biochemical and cell morphological findings with regard to the presence of NADPH diaphorase/neuronal nitric oxide synthase (NOS) in the primate septal area. Whereas considerable concentrations of neuronal nitric oxide synthase and high enzyme activities have been measured in postmortem human septal nuclei, histochemical studies were either unable to detect any nitric oxide synthase immunoreactivity in primate septal neurons, or found only a very few nitrergic neurons in this region. This study aimed to investigate the possible presence of nitrergic neurons in human the septal region in greater detail. After having studied a total of 16 postmortem human brains we conclude that the immunohistochemical demonstration of nitric oxide synthase in human septal neurons is largely dependent on the mode of tissue handling: in brain specimens which were fixed en-bloc with paraffin and embedded in paraplast, nitric oxide synthase immunoreactivity is barely detectable, whereas a satisfying immunostaining is obtained on free-floating frozen sections after an immersion–fixation with 4% paraformaldehyde and 0.5% glutaraldehyde, followed by sucrose protection of the specimens. We show herein that there are indeed nitric oxide synthase-containing neurons in the human septum, thus supporting results from previous biochemical studies.