Worldwide epidemiology and modes of transmission of delta hepatitis

Conclusions Since the discovery of HDV in 1977 byRizzetto and collegues (10), several studies regarding the pathogenesis, natural history and epidemiology of this infection have been accumulated. It emerges that HDV is an agent with unusual biologic properties which requires HBV replication for its expression. Given the obligatory association between HDV and HBV, transmission of HDV follows the same routes of HBV transmission. This implies that one expects HDV infection to be much more prevalent in countries with high HBsAg carrier rates. This is true in most areas of the world but not in Far East Asia. Endemicity of HDV is maintained in the community through the network of HBsAg carriers. HDV can be transmitted to HBV positive and negative individuals, but survives only after encountering the carrier. Recent outbreaks of severe epidemics of fulminant hepatitis due to HDV among the Yucpa Indians in Northern Venezuela, pointed out very clearly that HDV superinfection is an ominous risk for all populations where HBV is endemic.     

Percutaneous management of lymphatic fluid collections

Eight lymphatic fluid collections were drained percutaneously. There were no immediate or late complications. Seven patients had follow-up; 1 required surgical drainage of a residual or recurrent lymphocele, and another had reaccumulated fluid in a lymphocele which was detected on autopsy. The remaining lymphatic collections responded to percutaneous drainage. Percutaneous drainage is safe and can be an effective tool in the management of lymphatic collections.     

A comparison of the effects of climbing fiber deafferentation in adult and weanling rats

The climbing fiber input to the cerebellar cortex was destroyed using both electrolytic and chemical (3-acetylpyridine) lesions. The long-term effects of climbing fiber deafferentation on the ansiform lobule of weanling and adult rats were examined at both the light and electron microscopic levels. Image analysis of Golgi-impregnated Purkinje cells indicated a significantly lower number of smooth branches and spiny branchlets following climbing fiber deafferentation of both adult and weanling rats. The results suggest that the lower number of smooth branches and spiny branchlets following climbing fiber deafferentation of the weanling rat is the result of a loss of postnatal growth rather than transneuronal degeneration. Ultrastructural evidence is provided in confirmation of these quantitative findings. Formation of ectopic dendritic spines was found following climbing fiber deafferentation of the weanling rat, but not the adult. It is shown that ectopic spines and the denervated dendritic thorns of these animals were synaptically innervated by the parallel fiber system and basket axons. The formation of ectopic spines on climbing fiber deafferentated Purkinje cells may represent a form of dendritic plasticity. Ultrastructurally, the dendritic arborizations of weanling deafferentated Purkinje cells showed no signs of transneuronal degeneration. However, the primary response to climbing fiber deafferentation in the adult rat was marked transneuronal degeneration of the Purkinje cell dendrites. It is suggested that the inability of the adult Purkinje cell to form ectopic spines and to replace the excitatory postsynaptic potential of the climbing fiber varicosity is directly related to the Purkinje cell's subsequent transneuronal degeneration.     

Differentialdiagnose von Ovarialtumoren — hilft dem Gynäkologen die NMR-Tomographie

Ohne Zusammenfassung     

Choice of an ovarian stimulation protocol according to the follicular puncture method in an in vitro fertilization programme

In order to ascertain the adequacy of ovarian stimulation protocols with a type of follicular puncture, 126 women undergoing in vitro fertilization received either combination clomiphene/hMG or hMG alone according to a randomized test protocol. Within both groups patients for whom a pelvic examination was required had laparoscopies, while others had transvaginal ultrasonically guided punctures as far as possible. Clomiphene/hMG was more efficient than hMG alone as assessed from the cleavage rate (68% vs. 54%; p less than 0.01) and the pregnancy per attempt rate (16% vs. 5%; p less than 0.05). Laparoscopic punctures were more efficient than ultrasonically guided punctures (mean number of recovered oocytes: 4.8 +/- 2.6 vs. 3 +/- 2.5; p less than 0.001), but slightly better results were achieved by this latter method in ongoing pregnancy per puncture rate (18% vs. 8%; NS). With ultrasonically guided punctures, stimulation by clomiphene/hMG allowed better oocyte recoveries (3.8 +/- 2.5 vs. 2.3 +/- 1.9, p less than 0.05). Such results constitute an argument for preferential use of the clomiphene/hMG stimulation protocol with ultrasonically guided punctures.