Distribution of Galanin mRNA Containing Cells and Galanin Receptor Binding Sites in Human and Rat Hypothalamus

The distribution of cells containing galanin mRNA and that of galanin receptor binding sites were investigated using in situ hybridization histochemistry and receptor autoradiography in male rat hypothalamus and in postmortem hypothalamic tissues from control human brains. Oligonucleotide probes labelled with 32P were used for hybridization experiments. The specificity of the hybridization signal was ascertained using several probes, competition assays and Northern blot analysis. High levels of hybridization were found in the paraventricular, supraoptic and arcuate nuclei of rat and human hypothalamus. Human intermediate nuclei and scattered cells of the posterior perifornical nucleus also contained galanin mRNA. Galanin mRNA was also found in the dorsomedial nucleus of the rat. The distribution of galanin receptor sites was investigated by receptor autoradiography using 125I-labelled porcine galanin. The specificity of the binding was assessed by competition with different neuropeptides. While galanin blocked the binding at nanomolar concentrations, the other neuropeptides examined were ineffective at 10-7 M concentrations. The highest densities of galanin binding sites were seen in the preoptic area, ventromedial and lateral nuclei, of rat and human hypothalamus. In contrast, very low densities of binding sites were observed in the paraventricular, supraoptic and arcuate nuclei. Our results show that the distribution of neurons expressing galanin is complementary to that of galanin receptors in the rat and human hypothalamus. This suggests that receptors for galanin are not located on the cell bodies of galaninergic neurons, but are probably presynaptic on or postsynaptic to the processes of these cells.     

Children suffering from atopic eczema and their families. A qualitative investigation of the effects on family and their coping styles

Research in the field of the impact of chronic illness is nowadays often based on concepts such as coping and stress adaptation. From the point of view of the family chronic illness influences family functioning, while coping behavior is influenced by the families resources. There is little research done on this interaction. This article focuses on atopic eczema. METHODS: Qualitative free interviews of more than two hours duration each, had been done with all family members of families with a child suffering from severe chronic atopic eczema until the age of (pre-) puberty. A family interview with all members of the family has also been transcribed. The interpretation of the data is based on the qualitative content analysis and the grounded theory. The results from 5 families (24 interviews) lead to a typology of familial coping. The implications of this typology are discussed.     

Assessment of left ventricular function: comparison between radionuclide angiography and semiquantitative two-dimensional echocardiographic analysis

Measurement of global left ventricular function is important in the follow-up of cardiac patients and is a good prognostic indicator in acute cardiac situations. We compared quantitative measurements of global left ventricular function made with radionuclide angiography (RNA) and contrast cardiac ventriculography (CVG) to visual semiquantitative estimates from two-dimensional echocardiographic images (2D-echo). Three hundred and thirty-nine consecutive patients who underwent RNA were assessed with 2D-echo within 3 months. In addition, 92 of these patients also underwent CVG (correlation of ejection fraction between CVG and RNA:r=0.82;P<0.0001). The RNA mean ejection fractions in the four 2D-echo groups (0=normal, 1=slightly, 2=moderate, or 3=severe reduced left ventricular function) differed markedly (P<0.0001); however, there was overlapping among the groups (2D-echo score/RNA ejection fraction: 0=57.3%±12.8%; 1=46.0%±12.9%; 2=29.6%±12.2%; and 3=24.6%±11.5%) and the difference between 2D-echo scores 2 and 3 was not significant. 2D-echo showed a good concordance in RNA classes (0=505; 1=35%–49%; 2=21%–34%; and 3=520% ejection fraction) 0 (133/166; 80%) and 3 (18/30; 60%) but low concordance in classes 1 (27/82; 33%) and 2 (21/61; 34%). For accurate assessment of global left ventricular ejection fraction, visual semiquantitative judgement of a 2D echocardiographic image is limited in comparison to CVG or RNA, especially in patients with a slight or moderate reduction in left ventricular ejection fraction.     

Possibilities of application of the fixateur externe at the femur - indications, results (author's transl)

Besides the methods of screwing of plates and medullary nailing, the fixateur externe (F.E.) is another method which can be considered for treating bone fractures at the femur, F.E. being an exceptional indication. In fresh fractures of the femur, open fractures of the second and third grade as well as debris and multiple-plane fractures are typical indications for F.E. Over and above, F.E. is almost always indicated as an emergency measure in case of initial inoperability (polytrauma, shock, loss of blood, craniocerebral trauma) or continuing general inoperability. F.E. has been found useful to an even greater extent especially in old fractures, refractures, pseudarthroses and infected pseudarthroses. Combined treatment of the infected pseudarthroses with F.E. and Septopal balls has proved particularly effective. The special advantages of F.E. application at the femur are blood-saving surgery requiring relatively little time and technical equipment, avoidance of surgically conditioned infection risk in the fractured region, avoidance of additional denudation of free fracture fragments, long-term applicability, good external stabilization with selective possibility between compression, distraction and neutral positioning of the fractured area, postoperative treatment without dressing, and free access to the fractured area without interfering with the F.E.; furthermore, exchangeability of the F.E., possibility of correcting the position and axis without surgical intervention, non-fixation of the adjacent joints and maintenance of physiotherapeutic treatment possibilities. F.E. is "panacea" and should not be applied without exact knowledge of the static and mechanical and biomechanical conditions and effects. Before resorting to F.E. this must be carefully weighed against the use of internal osteosynthesis methods. It is not a rival method to plate screwing and medullary nailing but rather an auxiliary system whenever these methods are inapplicable or would entail disadvantages.     

Beurteilung von Schweregrad und Verlauf der chronischen posttraumatischen Osteomyelitis

Zusammenfassung Anhand der anamnestischen Daten von 50 Patienten mit chronischer posttraumatischer Osteomyelitis wird eine Punktebewertung zur Beurteilung des Schweregrades der Erkrankung entwickelt, die neben der Gesamtdauer der Erkrankung den prozentualen Anteil der stationären Behandlung sowie die Anzahl der chirurgischen Eingriffe berücksichtigt. Zur Objektivierung des klinischen Verlaufes wird eine zweite Skala (München-Murnau-Skala) vorgestellt, welche die äußeren Wundverhältnisse, die röntgenologischen Befunde sowie die Blutkörperchensenkungsgeschwindigkeit erfaßt. Anhand einer Autovaccinetherapie bei 18 Patienten wird die Objektivierung des Therapieerfolges mit Hilfe dieser Skala gezeigt.

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Scoring system for evaluation of severity and progress of chronic posttraumatic osteomyelitis

Summary From the anamnestic data of 50 patients suffering from chronic posttraumatic osteomyelitis a severity scoring system was developed, based on the duration of the disease, the time of hospitalization and the number of surgical interventions. The clinical course of 18 patients, undergoing an auto-vaccination treatment, was registered by another scoring system (Munich-Murnau-Scale) regarding wound morphology, bone radiology and erythrocyte sedimentation rate.

     

Noninvasive Tracking of Patient's Head Movements During Computer-Assisted Intranasal Microscopic Surgery

A noninvasive system designed for patient tracking during image-guided intranasal sinus surgery is described. It is based on optical digitizing with a custom-made registration and reference system, locatable surgical instruments, and a self-localizing operating microscope. Experimental and clinical results reveal a high degree of accuracy for the system. A mean spatial error of 0.82 ± 0.31 mm was determined for repositioning of the reference system in a plastic model of the skull. For the positioning of the microscope, a mean error of 2.3 ± 0.83 mm was calculated. Measurements of repositioning accuracy in 24 patients who received surgery for various sinus diseases had a mean spatial error of 1.56 ± 0.76 mm. The 95% error interval for locating intranasal structures using the surgical instrument was 2.05 mm, and it was 4.92 mm using the microscope. These results suggest that the use of our noninvasive registration and reference system may be effective, accurate, and useful for noninvasive tracking of patient movements in computer-assisted intranasal surgery.     

Infants born to narcotic dependent mothers: Physical growth patterns in the first 12 months of life

Objectives: To describe the physical growth patterns of infants born to narcotic dependent mothers (INDM) over a 12 months period and, if possible, to relate the growth to drug taking patterns during pregnancy.
Methodology: The growth of a cohort of 43 INDM was measured during the first 12 months of life. Weight and length measurements were compared with percentile charts and converted to Z scores. Questionnaire data about drug taking practices, demographic variables and the neonatal period (including withdrawal scores) were obtained.
Results: Twenty-four (55.8%) of INDM had evidence of neonatal drug withdrawal requiring treatment with phenobarbitone. At birth, Z scores for weight and length indicated relative intrauterine growth retardation. By 12 months, there had been some catch up growth, but Z scores for weight and length were still below zero. Persistent weight retardation at 12 months was correlated with methadone dosage during pregnancy, but not the need for phenobarbitone therapy.
Conclusions: The growth patterns of INDM in the first 12 months of life indicated that at birth there was evidence of intrauterine growth retardation, but by 12 months the growth was little different from the rest of the community. There appears to be some influence of narcotic agents taken while pregnant on subsequent growth of INDM.     

Are boys better than girls at building a tower or a bridge at 2 years of age?

This study was designed to look at the differences in visuospatial abilities between boys and girls before they can speak fluently. At the mandatory two year follow up visit, children were given the opportunity to build a tower and a bridge. In children whose birth weight was > or = 2500 g, the capacity for erecting a tower was the same in both sexes, but for building a bridge striking differences were noted according to their sex. Among the 376 children of this category, 41 out of 199 boys (21%) were able to build a bridge in comparison with 15 out of 177 girls (8%). This difference is highly significant. In children whose birth weight was < or = 2500 g, no differences were noted either for building a tower or a bridge. By showing that boys outnumber girls among the most skilled toddlers in spatial abilities, this work confirmed the action of a male related factor on cerebral lateralisation.     

Hypoglycémie hyperinsulinémique persistante du nouveau-né et du nourrisson

Persistent hyperinsulinemic hypoglycaemia of infancy (PHHI) is the most frequent cause of hypoglycaemia in infancy. Clinical presentation is heterogeneous, with variable onset of hypoglycaemia and response to diazoxide, and presence of sporadic or familial forms. Underlying histopathological lesions can be focal or diffuse. Focal lesions are characterised by focal hyperplasia of pancreatic islet-like cells, whereas diffuse lesions implicate the whole pancreas. The distinction between the two forms is important because surgical treatment and genetic counselling are radically different. Focal lesions correspond to somatic defects which are totally cured by limited pancreatic resection, whereas diffuse lesions require a subtotal pancreatectomy exposing to high risk of diabetes mellitus. Diffuse lesions are due to functional abnormalities involving several genes and different transmission forms. Recessively inherited PHHI have been attributed to homozygote mutations for the beta-cell sulfonylurea receptor (SUR1) or the inward-rectifying potassium-channel (Kir6.2) genes. Dominantly inherited PHHI can implicate the glucokinase gene, particularly when PHHI is associated with diabetes, the glutamate dehydrogenase gene when hyperammonaemia is associated, or another locus.