Sp?tmetastase eines Granulosazelltumors bei einer 74-j?hrigen Patientin

Ohne Zusammenfassung     

Über Blutkörperchensenkungsreaktion bei kindlicher Bauchtuberkulose

Ohne Zusammenfassung     

Radiation-induced cataract in astronauts and cosmonauts

BACKGROUND: Opacification of the ocular lens is an important effect of exposure to ionizing radiation. Astronauts and cosmonauts are exposed to relatively high doses of all types of radiation in space, including high-energy particle radiation. A study was initiated to examine the lenses of the eyes of astronauts/cosmonauts to detect signs of radiation-induced cataracts. The aim of this study was to take a first step towards gaining improved, quantitative insight into the risk of radiation-induced cataract associated with long space missions. METHODS: The lenses of 21 former astronauts and cosmonauts were examined, using an upgraded Topcon SL-45 B Scheimpflug camera system. The degrees of opacification in this group of astronauts and cosmonauts were compared with the measurements in a reference group. This reference group was established by examining a cohort of 395 persons using the same Scheimpflug system. RESULTS: Initial results indicated that opacity values in most of the astronauts and cosmonauts were slightly to strongly increased in regions IV (posterior cortex) and V (posterior capsule), compared with the average opacity values for the respective age-group of the reference cohort. CONCLUSION: The aim of this study - to conduct first examinations of astronauts' and cosmonauts' ocular lenses with regard to signs of radiation-induced cataract - was successfully achieved in a total of 21 astronauts and cosmonauts using a Scheimpflug camera system. It is planned to examine a larger group of astronauts and cosmonauts in the future.     

Indikationen für kardiovaskul?re Magnetresonanztomographie

Zusammenfassung   Die kardiovaskuläre Magnetresonanztomographie (CMR) hat sich von einem Nischenverfahren zur Darstellung angeborener Herzfehler, zur Diagnostik großer Gefäße sowie zur Untersuchung von Perikard und Tumoren zu einem breit nutzbaren, hochgradig genauen und schnellen Untersuchungsverfahren entwickelt. Neue Indikationen finden sich insbesondere im Bereich der ischämischen Herzerkrankungen, für deren Erkennung Dobutamin-Stress, Adenosin-Perfusion, Narben- und Vitalitätsdarstellung und zunehmend auch die Koronararteriendarstellung durchgeführt werden können.     

Evaluation of New Software for Angiographic Determination of Right Ventricular Volumes

Objectives: The scope of the study was to evaluate a recent software for angiographic volume determination as compared to cardiovascular magnetic resonance imaging. Background: A new right ventricular analysis software closes a diagnostic gap in quantitative angiography. Cardiovascular magnetic resonance imaging short axis multi slice summation is a validated reference standard. Methods: Right ventricular angiograms were acquired in frontal and lateral projection in 15 pediatric and 17 adult patients. Additional angiograms were acquired in RAO30°/LAO60° projections in 10 adult patients. The tested models comprised area length with different regressions, multi-slice with different regressions, Boak, and pyramid method. Original regressions were used to calculate angiographic right ventricular volume. Right ventricular reference volumes were determined by multi-slice summation from cardiac magnetic resonance short-axis images. Results: Mean inter-observer difference was −1 ml (95% confidence: −35–34 ml) and mean intra-observer difference was 0 ml (95% confidence: −22–22 ml). There was no significant difference (4 ml, 95% confidence: −22–30 ml) between geometric calibration and calibration by a sphere. The area length and multi-slice models demonstrated the best agreement with the cardiac magnetic resonance reference. Performance was best for the Onnasch Lange models. Conclusion: The evaluated software provides acceptably accurate volume estimates for the majority of ventricles. In a few cases larger errors may occur, however. The area length and multi-slice models preferably with Onnasch Lange regressions may be recommended. Inter- and intra-observer agreement were excellent. Geometric calibration using data from DICOM header files may be used.     

Validation of a diffusion chamber as in vitro system for the analysis of compound diffusibility through cartilage tissue.

The validation of a diffusion chamber comprising a donor and a receptor side separated by a cartilage membrane was undertaken according to the basic principles described by Peng et al. (1998). The study had three targets: first to evaluate the chamber as in vitro system by the examination of the diffusibility of compound through bovine cartilage samples; second the analysis of the affinity of compound (RS-130830) to cartilage; third to test the influence of two pre-incubation periods (one or three nights) of the cartilage samples. The validation of the chamber as in vitro system for the analysis of compound diffusibility and affinity to cartilage was performed using membrane slices of fresh bovine cartilage and a hydroxamic acid derivative (RS-130830) known as matrix metalloproteinase inhibitor (MMPI). The influence of the pre-incubation of cartilage was also examined. Compound concentrations in donor, receptor and membrane were determined by high performance liquid chromatography-mass spectrometry (HPLC-MS). Diffusion could be demonstrated after 6 h and finally 24 h incubation: the compound concentration in the receptor increased from 0 to 35 microM (mean) while it decreased in the donor from 200 to 144 microM (mean). We also found compound in the cartilage membrane (approximately 1.2 nmol (mean)). Pre-incubation of cartilage samples in culture buffer is suitable as a storage procedure, since the results on the donor side only were influenced significantly but not for the receptor and the cartilage affinity. Thus, the system could clearly reflect relevant properties of the tested compound with regard to its diffusibility and affinity to cartilage tissue.     

Case reports on emergency treatment of cardiovascular syndromes through heparin-mediated low-density lipoprotein/fibrinogen precipitation: a new approach to augment cerebral and myocardial salvage.

We report the first experiences with HELP apheresis as an emergency treatment for acute cardiovascular syndromes; two patients who were not eligible for lysis therapy and catheter intervention were treated with HELP apheresis instead. Both patients had a most severe, generalized atherosclerosis and reached the hospital too late for conventional measures. In both cases, the use of the apheresis dramatically improved the clinical situation to such an extent that the possibilities of this apheresis system urge further investigation.     

Long-term failure of endoscopic suturing in the treatment of gastroesophageal reflux: a prospective follow-up study

BACKGROUND AND STUDY AIMS: Several endoscopic antireflux therapies have been marketed, but long-term data on their objective and clinical efficacy are sparse. This report presents prospective 1-year follow-up results, including technical, clinical, and functional success rates, for the first of these treatments to be developed, endoscopic gastroplication (EGP). PATIENTS AND METHODS: A total of 43 EGP procedures were carried out in 38 patients with gastroesophageal reflux disease (GERD). Two or three EndoCinch gastroplications were constructed at the level of the gastric cardia in each patient; five patients were treated twice within 6 - 12 months. Each endoscopic suture joined two gastric folds to each other as a double fold, known as a "gastroplication", in order to narrow the esophagogastric junction. Postprocedure data after 2 months and after 1 year were compared with preoperative data, focusing on symptoms, medication requirements, endoscopic findings, and pH-metry results. RESULTS: In contrast to the findings at 2 months (which showed that 72 % of the sutures were present and that there was a reduction in the percentage of time when the esophageal pH was < 4 from 15.4 % to 8.7 %), the results 1 year after EGP were considered to indicate failure of the treatment in all 38 patients because none of them still had all of the initially placed gastroplications in situ (90 % of gastroplications were lost). The percentage of patients who did not require proton pump inhibitor medication decreased from 52 % at 2 months to only 20 % at 1 year and even more patients had evidence of reflux esophagitis at 1 year (56 %) than had initially demonstrated signs of this (41 %). CONCLUSIONS: EGP has some short-term beneficial effects on clinical symptoms and pH-metry. However, mainly due to the loss of the endoscopically placed sutures, these effects were not maintained at the 1-year follow-up. EGP cannot therefore be recommended for routine clinical use. Better endoscopic methods need to be developed, and they should be adequately tested before being marketed.