Zur Differentialdiagnose des N.-interosseus-anterior-Syndroms

Zusammenfassung Die Differentialdiagnose einer Ruptur des M. flexor pollicis longus und M. flexor digitorum profundus II zum N.-interosseus-anterior-Syndrom kann schwierig sein und zu Fehlinterpretationen des klinischen Bild führen. Anhand von 2 Fallberichten soll dies aufgezeigt werden. Im ersten Fall fand sich bei klinischem Verdacht auf ein N.-interosseus-anterior-Syndrom eine Spontanruptur des Flexor pollicis longus rechts. In einem zweiten Fall wurde eine operative Exploration der langen Daumen- und tiefen Zeigefingerbeugesehne unter der Annahme einer Ruptur vorgenommen. Hier fanden sich intakte Sehnen. In einer zweiten Operation wurde die Neurolyse des N. interosseus anterior vorgenommen, die zu einer vollst?ndigen Wiedererlangung der Beugefunktion in den Endgliedern des Daumen und Zeigefingers führte.      

Immuno-electronmicroscopic visualization of cell adhesion molecule L1 in adult rat pyramidal tract: localization on neuronal and oligodendrocytic processes.

The immuno-electronmicroscopic localization of cell adhesion molecule L1 is investigated in adult rat pyramidal tract (PT) at the fifth/sixth cervical spinal cord segment, both by pre-embedding on vibratome sections and by immunogold-labelling on ultra-cryosections. L1-immunoreactivity (L1-IR) can be noted not only on the surface of unmyelinated PT axons, the outer axonal membrane, but also within the axoplasm of myelinated PT axons as well as periaxonally between axolemma and compact myelin. Compact myelin is L1-negative. Interestingly, L1-IR is found in between the inner oligodendrocytic mesaxon and compact myelin. Hence, L1 is expressed by this type of glial cell in adult rat PT. In conclusion, L1 is suggested to be important in the adult rat PT, not only with respect to the adhesion between unmyelinated PT axons but also during stabilization of the mature neuron-oligodendrocyte interaction.     

A Fast Method for Processing Biologic Material for Electron Microscopic Diagnosis in Infectious Disease

A fast method for processing biologic material for electron microscopy for precise and specific diagnosis of infectious agents is an increasing necessity. After different, reportedly fast methods were tested, a useful and quick technique was developed that provides well-preserved cellular structures, enabling the etiologic diagnosis of infectious agents even in necrotic tissue or other biologic material such as sputum, bronchoalveolar lavage, and the like. This procedure takes less than 3 hours.     

Liposomal doxorubicin-induced toxicity: Depletion and impairment of phagocytic activity of liver macrophages

Doxorubicin entrapped within conventional liposomes (200 nm in diameter; lip-Dox) has major toxic effects on liver macrophages of the rat for a considerable period of time following i.v. administration, with respect to both specific phagocytic capacity and cell numbers. At different time-points after injection of lip-Dox or free doxorubicin, radiolabeled, negatively charged, “empty” test liposomes were injected. Phagocytic capacity was determined by isolating the liver macrophages and measuring the amount of macrophage-associated radioactivity. Four subfractions of liver macrophages of different cell-size and with intrinsically different phagocytic capacity were isolated. Twenty-four hours after injection of lip-Dox, the phagocytic capacity of the larger-sized liver macrophages was strongly decreased. The relatively low intrinsic phagocytic capacity of the smaller-sized macrophages was only slightly impaired. Phagocytic capacity after injection of lip-Dox was nearly restored to control values after 14 days. Blood clearance of Klebsiella pneumoniae bacteria after pre-treatment with lip-Dox was strongly decreased. Pre-treatment with the free drug and/or placebo liposomes had no effect on phagocytic and bacterial blood-clearance capacity. A major depletion of the liver macrophage population was observed, as revealed by both macrophage isolation and histology. Only 2 weeks after injection of lip-Dox, the number of cells had returned to that seen in control animals. In view of the important host-defense functions of the liver macrophages, especially in the control of tumor growth and infection, the findings reported here should be taken into consideration when lip-Dox is to be administered in anti-tumor therapy. © 1995 Wiley-Liss, Inc.     

Measurement of estrogen and progesterone receptors in abnormal human parathyroid tissue

Summary Estrogen and/or progestin administration to postmenopausal women with primary hyperparathyroidism lowers serum calcium. We measured cytosolic estrogen receptors (ER) and progesterone receptors (PR) by classical hormone-receptor binding techniques in parathyroid tissue removed from 10 men and 20 women, and ER by immunocytochemistry in tissue from an additional one man and seven women in order to ascertain whether these agents might exert a direct effect upon tissue responsible for hyperparathyroidism. ER were negative (<3.1 fmol bound estradiol/10 mg tissue) in all 8 adenomas and 4 of 5 secondary hyperplasias removed from men, and from women in 19 of 22 adenomas, 2 of 3 secondary hyperplasias, and 3 of 4 primary hyperplasias. PR were negative (<10.1 fmol bound progesterone/10 mg tissue) in 7 of 8 adenomas and all 5 secondary hyperplasias removed from men, and from women in 20 of 22 adenomas, all 3 secondary hyperplasias, and all 4 primary hyperplasias. For immunocytochemical studies, quickfrozen specimens were analyzed with a monoclonal antibody (Abbott Laboratory) directed at nuclear ER. All eight samples—five adenoma and three primary hyperplasia—were negative. We conclude that abnormal human parathyroid tissues have nondetectable levels of ER and PR. It is unlikely that estrogen and progesterone exert a direct, ER, or PR-mediated effect upon parathyroid tissue.     

Early morphological features in dominantly inherited demyelinating motor and sensory neuropathy (HMSN type I).

Seventeen cases of dominantly inherited demyelinating motor and sensory neuropathy (HMSN type I) with infantile onset were studied. Not only clinical and electrophysiological data, but also the g ratio (axon diameter to fibre diameter), considered to be a distinguishing feature between HMSN type I and HMSN type III, showed overlap. Morphological and morphometrical investigations already revealed a lack of small and large diameter myelinated axons at an early stage, and a demyelinating process most active in early childhood followed later by axonal loss. It was concluded that the histopathology of HMSN type I cannot be sufficiently explained by axonal atrophy with secondary demyelination.     

The impact of mother-to-mother support on optimal breast-feeding: a controlled community intervention trial in peri-urban Guatemala City, Guatemala.

OBJECTIVE: To assess the impact that a mother-to-mother support program operated by La Leche League Guatemala had on early initiation of breast-feeding and on exclusive breast-feeding in peri-urban Guatemala City, Guatemala. MATERIALS AND METHODS: A population census was conducted to identify all mothers of infants < 6 months of age, and the mothers were then surveyed on their breast-feeding practices, in two program communities and two control communities. Data collection for this follow-up census and survey was carried out between November 2000 and January 2001, one year after a baseline census and survey had been conducted. RESULTS: At follow-up, 31% of mothers in the program communities indicated that counselors had advised them about breast-feeding, 21% said they had received a home visit, and 16% reported attending a support group. Community wide rates of early initiation of breast-feeding were significantly higher in program areas than in the control communities, at both baseline and follow-up. However, the change over time in early initiation in program communities was not significantly different from the change in control communities. Community wide rates of exclusive breast-feeding were similar in program and control sites and did not change significantly from baseline to follow-up. However, of the mothers in the program communities who both received home visits and attended support groups, 45% of them exclusively breast-fed, compared to 14% of women in program communities who did not participate in those two activities. In addition, women who were exposed to mother-to-mother support activities during the year following the baseline census and survey were more likely than mothers exposed before that period to exclusively breast-feed. This suggests that the program interventions became more effective over time. CONCLUSIONS: This study does not provide evidence of population impact of La Leche League's intervention after one year of implementation. In peri-urban Guatemala, long-term community-based interventions, in partnership with existing health care systems, may be needed to improve community wide exclusive breast-feeding rates.