Ornithine decarboxylase in motoneurons during regeneration

The activity of ornithine decarboxylase, the rate-limiting enzyme in polyamine synthesis, was assayed in the isolated facial nucleus of the rat at various times after axotomy of the facial nerve. In addition, it was measured 24 h after the second of a series of two lesions (conditioning lesion design) with various times between the first and second operations. Ornithine decarboxylase activity was found to increase 8 h after nerve transection and was maximum after 24 h (300% of control). Thereafter the activity declined to subnormal levels where it remained for several weeks. Ornithine decarboxylase activity did not increase again when a second axotomy was made 2 weeks after the first lesion. However, ornithine decarboxylase did respond to the second axotomy if it was carried out 3 weeks after the first lesion. Histochemical localization of ornithine decarboxylase demonstrated that the increase in enzyme activity was mainly confined to the perikarya of the motoneurons. These data suggest that this enzyme is somehow involved in triggering the "regeneration program" and clearly indicate that at least some aspects of the neuronal response to axotomy are not further stimulated by a conditioning lesion.     

Beeinflußt das geschlecht die zuweisung zur stationären psychiatrischen behandlung?

Zusammenfassung In Mannheim wurde im Jahre 1968 mit dem schrittweisen Aufbau eines gemeindenahen psychiatrischen Versorgungssystems begonnen. Bestandteil dieses Versorgungskonzepts sind Absprachen zwischen den beteiligten stationären Einrichtungen, die die Zuweisung der Patienten zur stationären Behandlung regeln. Eine modellgestützte, multivariate Analyse von Inanspruchnahmedaten einer Kohorte von 126 schizophrenen Patienten weist nach, daß die Ungleichverteilung der Geschlechter auf die Institutionen das Ergebnis dieser Absprache ist; dabei sind Krankheitsdauer und die Art der Zuweisung von entscheidender Bedeutung.Die vorliegende Arbeit entstand im Rahmen eines von der Deutschen Forschungsgemeinschaft geförderten Projekts im Sonderforschungsbereich 116 Psychiatrische Epidemiologie der Universität Heidelberg (Sprecher: Prof. Dr. Dr. M. Schmidt)     

胰腺切除术后出血的诊断与治疗：669例连续胰腺切除术分析

目的：分析胰腺切除术后出血（postpancreatectomy hemorrhage，PPH）的临床病程及预后。背景：PPH是最致命的胰腺术后并发症，但目前仍缺少其标准治疗规程。方法：1992年至2006年，对1524例施行胰腺手术的患者进行了前瞻性研究。根据以下指标进行PPH危险分级：PPH严重程度（轻度，即血红蛋白浓度下降〈3g／dL；重度，即血红蛋白浓度下降〉3g／dL），PPH出现时间（早期，即术后1～5天；晚期，术后第6天），合并胰瘘，肠道内或肠道外出血表现以及存在“复杂的”血管病理变化（腐蚀、假性动脉瘤）。     

Some dietary fibers reduce the absorption of carotenoids in women

Dietary fiber may be partly responsible for the lower bioavailability of carotenoids from food than from purified supplements. Due to the lack of detailed information available, we investigated the effects of different kinds of dietary fiber on the absorption of carotenoids and alpha-tocopherol. Six healthy young women received an antioxidant mixture consisting of beta-carotene, lycopene, lutein, canthaxanthin and alpha-tocopherol together with a standard meal. The meal did not contain additional dietary fiber or was enriched with pectin, guar, alginate, cellulose or wheat bran (0. 15 g. kg body weight(-1)). The increases in plasma carotenoid and alpha-tocopherol concentrations were followed over 24 h, and the areas-under-curves (AUC(24h)) were calculated. The mean AUC(24h) of beta-carotene was significantly (P < 0.05) reduced by the water-soluble fibers pectin, guar and alginate with a mean decrease of 33-43%. All tested fibers significantly reduced the AUC(24h) of lycopene and lutein by 40-74% (P < 0.05). The dietary fiber effect on the AUC(24h) of canthaxanthin was almost significant (P = 0.059) and there was no effect on the AUC(24h) of alpha-tocopherol. We conclude that the bioavailability of beta-carotene, lycopene and lutein given within a mixed supplement is markedly reduced by different kinds of dietary fiber.     

Zum Einfluß der Psychotherapiemotivation auf den Psychotherapieverlauf

The motivational characteristics of psychotherapy inpatients should be of crucial importance for treatment effectiveness. In the present study on 219 patients from two psychosomatic-psychotherapeutic treatment centers, four dimensions of motivation for psychotherapy (illness experience; lay etiology; treatment expectations; openness to psychotherapy) were assessed using the Questionnaire for the Measurement of Psychotherapy Motivation (Fragebogen zur Messung der Psychotherapiemotivation; FMP) and related to pre-post changes in symptomatology. In these analyses, psychological symptoms (SCL-90-R) as well as interpersonal problems (IIP) were considered as indicators of treatment effects. The results support the expectation that (a) a psychosocial causal attribution of illness symptoms and (b) a marked general openness to psychotherapy at the pretreatment interview predict more positive treatment outcomes. Implications of the results for the indication of pretreatment interventions are discussed.     

BDNF, but not NT-3, promotes long-term survival of axotomized adult rat corticospinal neurons in vivo

Axotomy-induced death of corticospinal neurons (CSN) is prevented by intracotrical infusions of BDNF or NT-3 within the first week after axotomy. The present study examined whether this represents merely a delay of CSN death or whether BDNF and NT-3 can promote long-term survival of these neurons in vivo. The neurotrophins were infused for an initial period of 14 days to lesioned CSN which was followed by 28 days without treatment. BDNF was able to promote CSN survival for at least 42 days while NT-3 had no significant effect. These results suggest that initial BDNF treatment induces an endogamous mechanism that promotes survival of axotomized CSN without further exogenous neurotrophic factor supply. These findings may be important for the design of therapeutic strategies for motoneuron disease.     

Proliferation kinetics of the dermal infiltrate in cutaneous malignant lymphomas

Summary To obtain information about the role of local proliferation in the pathogenesis of dermal infiltrate in malignant cutaneous lymphomas, we determined the percentage of ³H-thymidine-labeled infiltrating cells (³H-index).A linear correlation was found between proliferative activity and clinical stage in mycosis fungoides, i.e., the ³H-index is moderately elevated in stage I and high in stage III.The ³H-index is within normal range in dermal infiltrate of Sézary syndrome, diffuse lymphocytic lymphoma, as well as in lymphocytoma benigna cutis.In parapsoriasis en plaques two groups can be distinguished: in the smallplaque variant (chronic superficial dermatitis) the ³H-index is low, whereas the large-plaque variant (prereticulotic poikiloderma) shows strong proliferative activity.Thus, determination of proliferative activity seems to give new insights into the pathogenesis of dermal infiltrate in cutaneous lymphomas.Zusammenfassung Um die Bedeutung der lokalen Zellproliferation im dermalen Infiltrat bei cutanen malignen Lymphomen zu untersuchen, bestimmten wir den Prozentsatz der ³H-Thymidin-markierten Infiltratzellen (³H-Index.Zwischen dem klinischen Stadium der Mycosis fungoides und der Proliferationsaktivität des dermalen Infiltrats besteht eine lineare Beziehung; im Stadium I ist die Proliferation niedrig, im Stadium III sehr hoch.Nicht erhöht ist der ³H-Index im dermalen Infiltrat beim Sézary-Syndrom, diffusen lymphocytischen Lymphom sowie bei Lymphocytoma benigna cutis.Bei der Parapsoriasis en plaques müssen zwei Formen unterschieden werden: bei der kleinfleckigen Form (chronic superficial dermatitis) ist der ³H-Index niedrig, während die großfleckige Form (Präretikulotisches Poikiloderm) eine starke Proliferationsaktivität aufweist.Die Untersuchung des Proliferationsverhaltens gibt neue Einblicke in die Pathogenese des dermalen Infiltrats cutaner Lymphome.     

Intraoperative defect in haemostasis in a child receiving valproic acid

This report describes the development of an intraoperative defect in haemostasis which occurred during surgery for lengthening of the heel cords and release of hip contractures in a patient receiving valproic acid. A review of the literature failed to find any other cases of a valproic acid-induced bleeding disorder occurring under anaesthesia and surgery. While recognized in the non-surgical literature, this case reports the first in which the development of a valproic acid-induced haemostatic defect occurred under anaesthesia. The subsequent course is discussed and some pathophysiological mechanisms are presented. It is suggested that for patients receiving valproic acid preoperative education should include PT/PTT, platelet and fibrinogen counts and bleeding time so that abnormal coagulation states can be recognized.     

Familial Papillary Thyroid Carcinoma: Genetics, Criteria for Diagnosis, Clinical Features, and Surgical Treatment

Hereditable predisposition to papillary thyroid carcinoma (PTC) and multinodular goiter (MNG) without evidence of an association with other malignancies as a distinct entity was recognized only recently. A meta-review of the literature on familial PTC (FPTC) was undertaken, and characteristics of families with frequent occurrence of PTC or MNG (or both) were summarized. A database on thyroid cancer patients maintained in our institution was searched for potential FPTC families. Clinical examinations were performed in 6 of 12 Hannover kindreds identified, and blood samples of all family members were collected for genetic analyses. Clinical presentations and histopathologic features of the FPTC cases were compiled. Based on the FPTC meta-review and own experience, predictive criteria to identify families at risk were developed: Exclusion criteria were previous radiation exposure and coincidence with neoplasia syndromes. Primary criteria for susceptibility to FPTC are (1) PTC in two or more first-degree relatives and (2) MNG in at least three first- or second-degree relatives of a PTC patient. Secondary criteria are diagnosis in a patient younger than 33 years, multifocal or bilateral PTC, organ-exceeding tumor growth (T4), metastasis (N1, M1), and familial accumulation of adolescent-onset thyroid disease. A hereditary predisposition to PTC is considered if both primary criteria or one primary criterion plus three secondary criteria are present. Family history-taking is recommended for all PTC patients to identify FPTC kindreds at risk. Blood relatives of FPTC index patients who harbor MNG should undergo thorough and regular clinical screening. Suspicious lesions should prompt early surgical intervention.