Diagnosis of middle ear tuberculosis

Middle ear tuberculosis is underdiagnosed. Clinical suspicion requires extensive diagnostic and therapeutic procedures. Due to a high degree of error in bacteriological and histological examination they must often be repeated. Indications for tentative diagnosis are given.     

Tympanoplasty in children

Tympanoplasty in childhood is not always the same as in adults. This applies to the indication for the operation, to the operation itself and also to the pre- and postoperative treatment. The rapidly growing and expanding juvenile cholesteatoma offers special problems, and probably has a different cause than the slow growing pearl tumour found in adults. Traumatic cholesteatomas also give the impression of growing faster in childhood. The prognosis for tympanoplasty in cases of mesotympanic chronic otitis media must not be too optimistic because the condition of the mucosa in juveniles is different to that in adults. Pre-operative treatment may take a long time and postoperative treatment may be difficult.     

Operationsbefunde bei Mittel-ohrmißbildungen

Ohne Zusammenfassung     

Über den Einfluß gewerblicher Dämpfe auf die Nasenschleimhaut. Ein Tierexperiment am Beispiel des Formalins

Summary Guinea pigs are exposed for this experiment in a special constructed box to formalin vapours. The formalin vapours concentrations are noted exactly, depending on the maximum of concentration at work.The experiments are done in several stages. They shall examine mucosal alteration (of the nose) under different conditions at work (e.g. for anatomists, medical laboratory assistant etc.). Light-microscopy findings are reported from the nose septum and from the turbinal.     

Macroinvertebrate community response to pulse exposure with the insecticide lambda-cyhalothrin using in-stream mesocosms

Pesticides are constantly being applied to agricultural catchments, but little is known about their impact on aquatic biota during natural exposure. In the present study, the impact of the pyrethroid lambda-cyhalothrin was studied in an in-stream mesocosm setup. Twice during the summer of 2002, the natural macroinvertebrate community was exposed in situ to a 30-min pulse of lambda-cyhalothrin. Pyrethroid doses were released through a modified drip set with nominal concentrations of 0.10, 1.00, and 10.0 microg L(-1) during the first exposure and 0.05, 0.50, and 5.00 microg L(-1) in the second exposure. Before, during, and after exposure, drifting macroinvertebrates were caught in nets. Quantitative benthic samples were taken both before and on two occasions after exposure. Macroinvertebrate drift increased immediately after the pulse exposure, with total drift being significantly higher at all concentrations. Gammarus pulex, various Ephemeroptera, Leuctra sp., and Simuliidae were some of the taxa showing the most pronounced drift response. Structural change in the community was found only at 5.00 and 10.0 microg L(-1), and recovery occurred within approximately two weeks. The present study may be valuable in assessing extrapolations based on laboratory results as well as in evaluating pyrethroid impact on natural freshwater environments.     

Successful pregnancy in a liver transplant recipient treated with lamivudine for de novo hepatitis B in the graft

Pregnancy is often successful after liver transplantation, despite the potentially toxic effects of immunosuppressive drug therapy. Liver transplant recipients with recurrent hepatitis C or hepatitis B nonetheless appear to be at risk of a worse graft function in the event of pregnancy, and antiviral drugs are generally contraindicated in pregnancy because of their teratogenic effects. A 33-year-old woman had undergone liver transplantation for Carolis disease 6 years previously. Two years later the patient experienced de novo HBV hepatitis. Lamivudine treatment (100 mg/day) was started and clearance of HBsAg was documented 1 year later. Four years after starting antiviral treatment the patient became pregnant, despite of the risk of teratogenic effects; lamivudine, cyclosporine and azathioprine were not discontinued for risk of break-through hepatitis and acute or chronic rejection. The course of gestation was uneventful and caesarean section was performed after 36 weeks. The newborn infant was a healthy male weighing 3,080 g and measuring 50 cm.