Fibrotic-haemorrhagic reaction to synthetic dural substitute

Summary A case is presented in which a patient developed a complication related to the use of Silastic dural substitute. Ten years after the initial surgery, a fibrotic-haemorrhagic reaction around the graft material was found, mimicking a recurrent meningioma clinically and radiologically. A review of the literature and suggested mechanisms of these complications are reported.     

Honorarzahlungspflicht bei Nichterscheinen des Patienten

Ohne Zusammenfassung     

In vivo imaging of chromogranin A-positive endocrine tumours by three-step monoclonal antibody targeting

The detection of chromogranins (Cg) by immunohistochemistry and serology represents a new in vitro diagnostic tool for endocrine tumours. We have recently reported on the feasibility of targeting chromogranin A (CgA) for in vivo detection of pituitary adenomas by immunoscintigraphy (ISG). The scintigraphic procedure, based on an anti-CgA monoclonal antibody and on the avidin-biotin three-step method (Cg-3S-ISG), was evaluated on a group of 29 consecutive patients with known or suspected endocrine tumours other than pituitary adenomas, i.e. medullary thyroid carcinoma, carcinoid, insulinoma and parathormone- or ACTH-producing tumours. Primary tumours (10) and recurrences (16) were visualised in 26 patients, whereas conventional imaging techniques (planar radiography, computerised tomography, magnetic resonance imaging and ultrasonography) failed to detect the tumour sites in ten of the same (Cg-3S-ISG-positive) patients. Therefore, these preliminary results indicate that Cg-3S-ISG, the first immunological method able to detect endocrine tumours in vivo, has a higher diagnostic accuracy than conventional imaging techniques (93.1% compared with 65.5%).     

Keine Weiterabe zurückgenommener Medikamente in der Arztpraxis (Anm.: M. Riemer)

Ohne Zusammenfassung     

Adult-onset Still''s disease with atypical cutaneous features

INTRODUCTION: The diagnosis of adult-onset Still's disease (AOSD) can be very difficult. There are no specific tests and reliance is usually placed on a symptom complex and the well described typical rash seen in most patients. In recent years, however, other cutaneous manifestations of AOSD have been reported but these are not so well known. OBSERVATIONS: We report a patient with urticaria and fixed plaques and review the other 'atypical' cutaneous findings associated with AOSD. CONCLUSIONS: The diagnosis of AOSD can be made in the absence of the typical Still's rash but in the presence of other atypical cutaneous features.     

Psychotherapie-Vergütung nach Ablehnung durch die GKV

Abstrakt Ein Vertragsarzt darf seine psychotherapeutischen Leistungen bis zur H?he der EBM-Betr?ge bei dem Kassenpatienten liquidieren, wenn die Krankenkasse die erforderliche Zustimmung versagt und der Patient in Kenntnis der Ablehnung die Therapie fortführt. (Leitsatz des Bearbeiters)     

The value of immunoglobulin and complement levels in the early diagnosis of neonatal sepsis

Serum IgG, IgGl, G2, G3, G4, IgM, C3c and C4 concentrations were measured in 24 term neonates with sepsis and 17 healthy normal neonates of similar age, sex and weight (control group). The serum IgG, IgG1, G2, G3, G4, IgM, C3c, and C4 levels were similar in the patients with sepsis and the control group ( p > 0. 05). In the neonates with sepsis, serum IgG, G1, G2, IgM and C4 levels were not significantly different between the 1st and 10th days, while there were significant differences for IgG3, G4 and C3c ( p < 0. 05). We conclude that the serum levels of IgG, IgG1, G2, G3, G4, IgM, C3c and C4 concentrations are of no value for the early diagnosis of neonatal sepsis.