Malabsorption with progressive weight loss and multiple intestinal ulcers in a patient with T-cell lymphoma.

We describe a 52-year-old woman who presented with severe diarrhea, nausea, intermittent abdominal pain and weight loss of 18 kg within ten months. Jejunal and duodenal ulcers were detected by endoscopy and multiple biopsies revealed villous atrophy of the jejunum. However, neither gliadin nor endomysium antibodies were detected and no clinical and histological improvement was achieved after gluten withdrawal. Despite strong clinical suspicion for intestinal lymphoma many unrevealing biopsies were done. The patient developed intermittent septic fever and diagnostic laparotomy revealed jejunal perforation. Partial jejunal resection was performed and histology confirmed the diagnosis of an intestinal T-cell lymphoma without celiac disease. Malabsorption and all intestinal ulcers disappeared during the course of chemotherapy (six cycles CHOP) and the patient recovered remarkably.     

(Active) stents are no panacea, a déjà-vu.

Bare metal stents (BMS) and drug-eluting stents (DES) were andare going through similar cycles, albeit in reverse order. BMSwent through an initial bashing period only to come out of itworshiped more than really deserved. The opposite happened toDES. They are currently going through their bashing period afterhaving been hailed in as prodigies they not really were. Thepaper of the Basel group is a first commendable effort to putthings back into the places they really belong.¹ BMS first went through an undeserved period of bad reputation(particularly in the US) because their results were not properlyadjusted for the baseline situation. Introduced to prevent abruptclosure in the first place, BMS were initially used exclusivelyfor failed balloon angioplasty cases. Although it was soon knownthat they also     

A 3-month preclinical trial to assess the performance of a new TVT-like mesh (TVTx) in a sheep model

The objective of this study was to evaluate in a sheep model the performance of a new polypropylene mesh (TVTx), which is intended as a less invasive treatment for female stress urinary incontinence. Eight female sheep were used in this study, each one being implanted with eight TVTx samples. At each time-point (weeks 1, 2, 4, and 12) seven TVTx were pulled out, while one TVTx was carefully dissected for histological investigations. One TVTx and one TVT, moreover, were inserted and immediately pulled out for obtaining the initial pullout forces in all sheep. The initial pullout values of TVT and TVTx were overlapping. The pullout forces of TVTx were >5 N (500 g) and increasing from weeks 1 to 12 (p<0.001). Histology revealed good tissue integration of TVTx in the tissue within 12 weeks after implantation. No abnormal histological findings were observed. This data could support the realization of a clinical trial with the TVTx mesh.     

Zulässigkeit von Vereinbarungen der Gesellschafter einer Gemeinschaftspraxis zur Nachbesetzung und zur Hinauskündigung

Ohne Zusammenfassung     

ALTERED TONIC CONDUCTANCES IN AXONS OF TRANSGENIC MOUSE EXPRESSING THE HUMAN NEUROFILAMENT HEAVY GENE: A MOUSE MODEL OF AMYOTROPHIC LATERAL SCLEROSIS

Neurofilaments (NFs; made by copolymerization of three intermediate filament proteins NF‐L, NF‐M, and NF‐H, for light, medium, and heavy) constitute the most abundant cytoskeletal structure in large myelinated axons. The presence of aberrant NF accumulation has been associated with neurodegenerative diseases (such as ALS). The possible causal role of NF in neurodegeneration has been supported by studies on recently available transgenic mice in which expression of human NF‐H (hNF‐H +/+) leads to overt neuropathy. We have examined electrophysiological properties of myelinated axons in hNF‐H +/+ mice using intraaxonal microelectrode recording from isolated sciatic and tibial nerves. Transgenic mice showed several deficits in physiological properties of low threshold myelinated fibers: conduction velocity and resting membrane potential were significantly decreased (20 +/? 1.6 vs 40 +/? 2 m/s; ?71.3 +/? 0.9 vs ?75.5 +/? 0.5 m/s; mean +/? SE; n = 25; 22 degrees C). While the amplitude of action potentials was of comparable size (82 +/? 5 vs 86 +/? 3 mV) duration of action potential (at half‐amplitude, AP/2) in hNF‐H +/+ was significantly prolonged (0.82 +/? 0.02 vs 0.65 +/? 0.02 ms). Voltage‐current properties of axonal membrane indicate a significant decrease in inward and outward rectification. Occasionally, impaled axons of hNF‐H +/+ showed membrane oscillations and repetitive activity (reminiscent of fasciculations) never observed in normal animals. These results are compatible with an imbalance between ion conductances in axons from transgenic animals (an increase in Na+ and a decrease in K+ conductances), in agreement with recent suggestion based on clinical studies on ALS patients (H. Bostock et al., 1995, Brain 118, 217–225). One may hypothesize that these changes could contribute to neurodegenerative processes (i.e., via an increase in [Na+](i)), as well as clinical symptoms (fasciculations) observed in patients with degenerative motor neuron diseases.