Ultrasonography for the diagnosis of Lyme disease in cases of acute facial paralysis.

Ultrasonography of the parotid gland was introduced in 1989 as part of the diagnostic protocol of every patient treated in our clinics with acute facial paralysis. Ten of 50 patients so tested were found to have unilateral nonpalpable enlarged lymph nodes in the caudal portion of the parotid gland around the stylomastoid foramen. All 10 patients were eventually diagnosed as having Lyme disease. It is suggested that in patients with acute facial paralysis, ultrasonography is an inexpensive tool to improve diagnosis of Lyme disease and may have a more useful purpose in monitoring therapy.     

Cerebellopontine angle lipoma: a rare differential diagnosis

Intracranial lipomas in an infratentorial and extra-axial location are extremely rare. The presented case of an extensive lipoma of the cerebellopontine angle (CPA) represents 0.05% of all CPA tumors operated on in our department from 1978 to 1996. The lipoma constitutes an important differential diagnosis because the clinical management differs significantly from other CPA lesions. The clinical presentation and management of the presented case are analyzed in comparison to all previously described cases of CPA lipomas. The etiology and the radiological features of CPA lipomas are reviewed and discussed. CPA lipomas are maldevelopmental lesions that may cause slowly progressive symptoms. Neuroradiology enables a reliable preoperative diagnosis. Attempts of complete lipoma resection usually result in severe neurological deficits. Therefore, we recommend a conservative approach in managing these patients. Limited surgery is indicated if the patient has an associated vascular compression syndrome or suffers from disabling vertigo.     

Biochemical regulators in cardiac hypertrophy

In recent years research has shown that muscle is capable of reacting to mechanical stimuli by altering biochemical processes. Myocardium is probably the source of a biochemical factor, or factors which activate myocardial protein synthesis. In experimentally induced cardiac hypertrophy adaptive alterations have been shown to occur not only in the adrenal medulla but also in the adrenal cortex. Finally, detection of cross reactivity between digitalis glycosides and a number of steroid hormones has succeeded. We assume that such cross reactivity indicates the existence of an endogenic factor of steroid character, which is produced in the adrenal gland and functions as an endogenic cardiotonic agent. During experimental cardiac hypertrophy its synthesis is possibly increased. We propose the term "endocardin" or "endocardiotonin" for this agent.     

Allgemeines

International Journal of Legal Medicine -     

Zwei Fälle von Darmverletzung

Ohne Zusammenfassung     

Beitrag zur Casuistik der angeborenen Sacralgeschwülste

Ohne Zusammenfassung     

The evaluation and treatment of adolescent overdoses in an adolescent medical service

Aspects of the mental health care provided in an adolescent medical setting are examined. Over a six-month period, 38 patients were admitted to an inpatient adolescent medical unit because of drug ingestion. Following evaluation by the adolescent medical team, psychiatric consultations were requested in 47 percent of the cases. Most patients were referred for follow-up “counseling” in an adolescent clinic. In comparing the “consult” and “non-consult” groups, data are given on the demographics, diagnoses, reasons for the consultation request, lengths of hospital admission, follow-up dispositions, and compliances. Illustrations are given of the counseling process in the adolescent clinic. Patients in both groups had substantial psychosocial problems. Many patients received conduct-disorder diagnoses with varying degrees of subjective distress. It was generally the degree of depression, as assessed by the pediatrician, that determined whether a psychiatric consultation was requested. The acceptance of follow-up recommendations was approximately 50 to 60 percent in both groups.     

Alterations in interleukin-6 production by LPS- and Con A-stimulated mixed splenocytes,spleen macrophages and lymphocytes in prenatally diazepam-exposed rats

Prenatal exposure to diazepam leads to a suppression of mitogen or allogen-induced lymphocyte proliferation as well as to a reduced production of tumour necrosis factor (TNF)- from rat splenocytes during postnatal development of rats. We analysed the secretion of interleukin (IL)-6 which occurs at a later stage of the cytokine cascade. Splenocytes of male offspring from Long Evans rats, treated with a daily dose of diazepam (1.25 mg/kg) from gestational day 14 to 20, were stimulated with lipopolysaccaride (LPS) and concanavalin A (Con A). In response to LPS, IL-6 liberation was significantly lower in mixed splenocytes and spleen macrophages of 2 and 8 week old prenatally diazepam-treated rats than in controls. Spleen lymphocyte preparations of prenatally treated animals exhibited a reduction of IL-6 release at 12 h and an increase at 24 h of incubation. At 2 weeks of age, Con A-induced IL-6 production could only be detected in mixed splenocytes; prenatally treated rats were releasing significantly less IL-6 than controls. In 8 week old rats, IL-6 liberation from mixed splenocytes and spleen macrophages was significantly lower in prenatally treated animals than in controls. Spleen lymphocytes presented a complex response picture depending upon incubation conditions. Our data indicate that in prenatally diazepam-exposed rats, the disturbance of cytokine release also extends to cytokines which play an important role in the later phases of immune responses.     

Etiology and pathogenesis of synovitis villonodosa pigmentosa

Articular pigmented villonodular synovitis is a benign synovial disease of unknown etiology. It is a proliferative disorder of the synovium that can involve the joints, tendon sheaths, and bursae. There is a predilection for involvement of the lower extremities, particularly the knees. There are two histologically similar lesions of pigmented villonodular synovitis: "nodular" and "diffuse" pigmented villonodular tenosynovitis. The typical clinical course consists of progressive and painful swelling of the involved joint. Cystic erosions without sclerosis and invasion of adjacent bone from intra-articular synovial lesions are the typical roentgenographic manifestations. The surgical treatment of the lesions is discussed. A review of the literature is given and our own material on 47 patients is presented to illustrate the different features of the disease.