Vorhofruptur bei Herzklappenfehler

Zusammenfassung Bei einem 67 Jahre alten Mann wurde die Ruptur des linken Vorhofes bei chronischer, rekurrierender Endokarditis und Stenose der Valvula mitralis beobachtet. Die Ruptur wird als Folge mehrerer konkurrierender Veränderungen dargestellt: parietale Endokarditis des Vorhofdaches, hypoxischer, durch Störungen der Kreislaufregulation bedingter Parenchymschaden der Vorhofwand, narbiger und lipomatöser Wandumbau und Steigerung des intraatrialen Blutdruckes. Die Möglichkeit einer zusätzlichen finalen degenerativen Schädigung infolge Noradrenalin-Medikation wird erwogen.

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Mitral valvulitis and rupture of the left atrium

Summary A 67 year old man with chronic recurrent rheumatic fever, mitral stenosis and subacute bacterial endocarditis died because of rupture of the left atrium. The rupture probably resulted from: endocarditis of the atrial wall, circulatory disturbances and hypoxia of the atrial musculature with fatty and fibrous changes, and an increased intra-atrial pressure. Additional damage may have been superimposed terminally by norepinephrine therapy.

     

Darstellung und polymerisation von O-vinylacetalen. Untersuchung von O-, S- und N-vinylverbindungen. VI

Formaldehyde- and acetaldehyde-O-vinylacetals were synthesized by dehydrohalogenation of the analogous β-hydroxyethyl-compounds. If initiated radically the monomers do not homopolymerize well but they form regular alternating copolymers with maleic anhydride. In case of the kationic polymerization the O? CH₂? O-groups act as chain transfer agents. On heating the poly-O-vinyl-acetals especially with LEWIS acids a hydride shift takes place, and polymers with ester-side-chains are formed.     

Multiple Separations in Microfabricated Channels: From Biological Microenvironments to DNA

A continuous sample introduction and separation scheme is presented as an alternative to the current slab gel and microfabricated chip technologies for biological separations. This new technique involves continuous sample introduction via a conventional small bore capillary coupled to a small dimension rectangular channel. Both free zone and size based separations have been carried out in the rectangular channel. Laser induced fluorescence and electrochemical detection schemes have been employed with this technique. Some of the areas this technology has been used to investigate include monitoring dynamic events from microenvironments, monitoring analytes over long periods of time, and performing DNA separations.     

Analysis of the α/β T-cell receptor repertoire by competitive and quantitative family-specific PCR with exogenous standards and high resolution fluorescence based CDR3 size imaging

The characterization of the human T-cell receptor (TCR) repertoire in various physiological and pathological conditions has become an important tool in studies of the immune response. Therefore, a number of PCR based strategies for the semiquantitative analysis of the TCR repertoire have been described. Family specific amplification of TCR cDNA has been employed in a number of studies often with contradictory results. We have developed a strategy utilizing exogenous standards with homologous primer binding sites for the quantitative analysis of the α/β T-cell receptor repertoire. This system allows the detection of even minute differences in T-cell populations based on quantitative PCR (Q-PCR) and competitive PCR (C-PCR). Results presented here demonstrate that expansions of T-cell subsets as defined by the specificity of the variable gene segments can be readily monitored when exceeding 1% of the total repertoire. In addition, the proposed method reveals direct information of CDR3 size heterogeneity and can be used to estimate the T-cell repertoire complexity and monitor clonal expansions. We discuss variables such as cell number and experimental conditions influencing accuracy and reproducibility of the analyses. We have used this protocol based on non-radioactive techniques for characterization of the fine specificity of the T-cell repertoire in peripheral and organ-infiltrating T-lymphocytes. The analyses revealed information about polyclonal or clonal expansion of T-cells in vivo and in vitro following various stimuli such as superantigenic stimulation of T-cell subsets as well as antigen-driven shaping of the α/β T-cell repertoire in autoimmune and infectious diseases.     

Evaluation of the clonidine-suppression test in the diagnosis of pheochromocytoma

Summary In this study we examined the preoperative value of the clonidine-suppression test in 15 patients with surgically proved pheochromocytomas. The result of the clonidine-suppression test was pathological (epinephrine plus norepinephrine above 500 ng/l 3 h after clonidine) in 10 of 15 patients (66%). These patients had relatively large tumors and higher basal norepinephrine plasma levels. Out of the 5 cases without a pathological clonidine test 4 had normal basal plasma catecholamine levels with the result that the clonidine test could not be properly applied and 1 case produced a false negative result. These 5 cases generally had smaller tumors and lower plasma catecholamine levels. Two of these cases had basally raised epinephrine values. The other three cases had either a paradoxical increase or a suspiciously low fall (less than 25%) in norepinephrine within the normal range. We conclude that the clonidine-suppression test is only reliable for the diagnosis of relatively large pheochromocytomas.Abbreviations MIBG metaiodobenzylguanidine - HPLC High-performance liquid chromatography     

Flush solution 2, a new concept for one-to-three-day hypothermic renal storage preservation. Functional recovery after preservation in Euro-Collins, Collins' C2, hypertonic citrate, and F.2 solution

Experiments were performed on the quality of renal functional recovery after 24, 48, or 72-hr hypothermic storage preservation of canine kidneys in Euro-Collins solution (EC), Collins' solution C2, hypertonic citrate solutions (HC, HC-D2O), or our new flush solution 2 (F.2). Clearance tests (inulin, paraaminohippuric acid, and creatinine) and resorption rates for sodium, potassium, and glucose indicated a high superiority in the early functional recovery of F.2-preserved kidneys after all preservation periods tested. The excellent function after preservation in F.2 contrasted especially with the poor or even absent function after 72-hr preservation in HC and HC-D2O or EC. Thus F.2--a hyperosmolar solution containing sucrose with a balanced Na-K relation on the basis of "heavy water" (D2O)--is especially suitable for preservation up to 72 hr if cyclosporine is used for immunosuppression in the recipient. The recipient can be supplied with an organ with immediate good functional recovery because cyclosporine banishes the higher risk for rejection of these well-functioning organs; simultaneously, the possibility for continuous functional supervision allows avoidance of nephrotoxic side effects from the immunosuppressant.     

Computed tomography in the differential diagnosis of the enlarged retrorectal space

The value of computed tomography (CT) in the differentiation of an enlarged retrorectal space was analyzed in 132 cases. Classification of barium enema findings into those with simultaneous mucosal alterations and those without any visible lesions of the rectal mucosa seems to be useful. Computed tomography helps in those cases without mucosal changes to differentiate between retrorectal fibrosis, tumorous masses, and inflammatory diseases of the colon. It also demonstrates the lack of pathologic lesions in equivocal cases of pelvic lipomatosis and so-called "normal variants." If simultaneous mucosal involvement on barium enema--especially in rectal carcinoma or recurrent carcinoma of the rectum--is found, CT may show the perirectal extension of tumorous masses and thus help to clarify local operability.     

Immunohistochemistry and in situ hybridization of the androgen receptor in the developing human prostate

 As it is suggested that the androgen receptor mechanism is required for prostatic development, we attempted to determine the appearance, expression and distribution of the androgen receptor in embryonic, infantile and pubertal human prostate. Using mono- and polyclonal antibodies and a digoxigenin-labeled 713 bp riboprobe, the androgen receptor expression in paraffin sections of fetal, infantile, and pubertal prostates was studied at the protein and RNA level. Under highly standardized conditions, application of the polyclonal antibodies resulted in a weak cytoplasmic and nuclear labeling of the epithelium of fetal glands. No immunoreaction was obtained with monoclonal antibodies. Applying the polyclonal antibody to pubertal and adult specimens, immunoreactivity of the androgen receptor was positive in nuclei of adluminal and basal epithelial cells, in interstitial and vascular smooth muscle cells and vascular endothelium, whereas ganglionic cells and enteroendocrine cells were negative. In situ hybridization with the digoxigenin-labeled riboprobe gave clear positive results already in epithelium of very young fetal specimens. A semiquantitative visual evaluation of in situ hybridizations showed that intermediate intensity of expression was increased in pubertal and adult specimens, whereas strong expression was reduced in prostatic epithelium. Conclusions: The essential findings are: (1) an early expression of androgen receptor mRNA in the fetal prostate; (2) no immunoreaction of monoclonal antibodies against the androgen receptor in the same specimens, (3) a decrease of androgen receptor mRNA expression, but increase in immunoreactivity of the androgen receptor protein with the onset of glandular maturation during puberty. Accepted: 29 September 1997     

Symptomatic native arterial occlusions: early experience with "over-the-wire" thrombolysis

"Over-the-wire" thrombolysis was successfully accomplished in eight patients with symptomatic lower-extremity ischemia. The authors used a 5-F catheter with multiple side holes designed to pulse-spray urokinase directly over the guidance of a 0.035-inch guide wire. The mean occlusion length was 11.5 cm (range, 5-27 cm). Complete thrombolysis was achieved after delivery of a mean of 480,000 IU of urokinase in a mean infusion time of 48 minutes. One embolic complication was successfully treated with the catheter-wire system. No bleeding complications occurred. Over-the-wire thrombolysis is an alternative method of administering urokinase for the treatment of arterial occlusions.