Plasma levels of D-dimer and circulating endothelial adhesion molecules in veno-occlusive disease of the liver following allogeneic bone marrow transplantation

Abstract: Veno-occlusive disease (VOD) of the liver is a frequent and life-threatening complication of BMT. Recently, successful treatment by t-PA has been reported but has been compromised by fatal bleeding events. Therefore, t-PA application should be restricted to patients with severe VOD. However, moderate and severe forms of VOD are difficult to distinguish in early stages. We analyzed plasma levels of cross-linked fibrin degradation products (D-dimer) and soluble endothelial adhesion molecules such as sE-selectin, sVCAM-1 and sICAM-1 in 10 consecutive patients undergoing allogeneic BMT to evaluate their use in identifying severe forms of VOD. During the observation period, 4 episodes of VOD occurred, 2 of which were fatal due to early onset of multiorgan failure. Concentrations of D-dimer generally increased after transplantation. However, there was an additional significant increase in D-dimer levels during severe VOD. Thus, D-dimer levels above 1000 μg/1 were only found in 2 cases with severe VOD and fatal outcome. When compared with bilirubin concentrations substantial increases of D-dimers appeared earlier during the course of severe VOD. In contrast, VOD episodes were not accompanied by significant increases in sE-selectin, sVCAM-1 and sICAM-1 levels. It is concluded that measurement of D-dimer concentrations may aid accuracy to the early diagnosis of severe VOD.     

Large autogenous osteochondral graft for replacing knee cartilage defect

Summary Major cartilaginous defects of the femoral condyles of the knee joint, caused by chondropathy and chondral trauma can be a precursor to osteoarthritis.Particularly in cases with large defects the therapy often remains unsuccessful. Even the substitution of articular hyaline cartilage by autogenous osteochondral grafts, regarded as superior to other procedures like Pridies's drilling and abrasion arthroplasty, carries the risk of failure by necrosis of the craft and morbidity at the donor side.We present a 10-year follow-up case who had a large autogenous osteochondral graft from the non-weight bearing periphery of the patellofemoral joint that was implanted after necrosis of the medial femoral condyle following immunsuppressive chemotherapy.     

Infundibulopelvic stenosis--evaluation of diagnostic imaging

Infundibulopelvic stenosis is a very rare kidney disease. This congenital disorder must be differentiated from multicystic dysplastic kidney, polycystic kidney disease, simple renal cysts and mega-(poly)-calicosis. Associated abnormalities of the ureter are rare. Ureteric obstruction was associated in our two patients, and in one case agenesis of the bladder and a duplicated genital tract were also present.     

Lymphangitis carcinomatosa

The authors present a 86 years old male patient with gradually developing upper right arm swelling. There were several hyperaemic papules, vesicles and teleangiectases on his arm. The histology revealed a lymphangitis carcinomatosa. There were no signs of any tumor, but multiple isotope accumulations in the bones. Anaplastic thyroid gland carcinoma with multiple metastases were found at autopsy.     

GlutathioneS-Transferase Activity in Aquatic Macrophytes with Emphasis on Habitat Dependence

GlutathioneS-transferase activity of both the microsomal and soluble fractions was determined in a variety of aquatic macrophytes. The examined enzyme extract was prepared from a combination of leaves and shoots. Four different model substrates were used. The highest conjugation rate was obtained for 1-iodo-2,4-dinitrobenzene, followed by 1-chloro-2,4-dinitrobenzene,p-nitrobenzoyl chloride, and 1,2-dichloro-4-nitrobenzene. Comparison of several samples ofNuphar luteaL. from two different lake areas revealed increased glutathioneS-transferase activity in plants from the site contaminated with polyaromatic hydrocarbons.     

Topographie von Endometrioseherden in Abhängigkeit vom Schweregrad der Erkrankung

Ohne Zusammenfassung     

Simultaneous appearance of ovarian and endometrial carcinoma: a therapeutic challenge

We have analyzed 37 cases of simultaneous appearance of carcinoma in the ovary and endometrium. This paper deals with the question of whether they should be considered stage III endometrial carcinomas, stage II ovarian carcinomas or independent primary tumors. The cases were grouped according to their histology as endometrioid ovarian carcinomas with endometrial carcinoma (group A), same carcinoma, but not of endometrial origin in both organs (group B) and histologically different concomitant carcinomas of ovary and endometrium (group C). Although our series was small, the survival was better than could have been expected either for stage III endometrial carcinoma, or stage II ovarian carcinoma. This supports the view that many of those tumors should be considered independent stage I carcinomas. Another fact in favour of this hypothesis is the strong correlation between myometrial invasion and prognosis in these cases, which is comparable to that found in endometrial carcinoma alone.