Perianal thrombosis

Two patients who had suffered numerous previous attacks of perianal hematoma were treated by excision of the lesions and adjacent skin (low hemorrhoidectomy). Histology confirmed that these lesions are not hematomas but thrombi lying within the thin-walled vessels of the external anal plexus. Excision of the perianal skin and underlying venous plexus, leaving anterior and posterior skin bridges, is indicated in patients who have multiple recurrences of this painful condition, which should be renamed "perianal thrombosis."     

Drainagen in der Gallenwegschirurgie — Ja oder Nein?

Ohne ZusammenfassungVerantwortlicher Herausgeber: Proú. Dr. J. R. Siewert, München     

Quantification of motor deficit in Parkinson's disease with a motor performance test series

Summary It was the purpose of the present study to quantify the expected motor deficit in parkinsonian patients with the computer assisted Motor Performance Test Series (MPS), version 05.87 by Schuhfried (1987) and to examine which of the motor test variables found correlate at a significance level of p<0.01 with items of motor examination recorded at neurological examination and activities of daily living of the Unified Parkinson's Disease Rating Scale (UPDRS), version 3.0.38 patients with idiopathic Parkinson's disease (PD) stages I–IV according to Hoehn and Yahr, aged 41 to 73 years were studied. The study design, i.e. initial rating by the physician followed immediately by testing of motor function with MPS was strictly adhered to in each patient.Physician's rating of rigor and the scores of the semiquantitative tests (finger taps, hand movements and alternating movements) as expression of hypokinesia and the activities of daily living correlated with the 3 factors of the Motor Performance Test Series at a highly significant level independent of disease stage. Tremor is only partly and never significantly reflected in the motor data measured. Stages I–II and II–IV (Hoehn and Yahr) differ significantly in the representative data of the Motor Performance Test Series.The results of the study support the assumption that MPS is a valid instrument for quantitative measurement of the motor deficit in parkinsonian patients, but that only some subtests are pathognomonic.     

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Ohne Zusammenfassung     

Zum Problem des Nachweises antithrombocytärer Autoantikörper

Zusammenfassung Blutproben von 161 Patienten (davon 63 Patienten mit einer Thrombocytopenie unter 90000/mm³ und 98 Patienten mit normalen Thrombocytenzahlen) wurden mit dem direkten und/oder indirekten Antiglobulin-Konsumptionstest (AGKT) und dem direkten und/oder indirekten Fluorescenz-Antiglobulintest (FT) under Verwendung von Thrombocyten untersucht. Ohne Berücksichtigung der klinischen Diagnose wurde gefunden, daß thrombocytopenische Patienten in 37% einen positiven dir. AGKT, in 18% einen positiven dir. FT, in 27% einen positiven indir. AGKT und in 28% einen positiven indir. FT aufwiesen. Bei Patienten ohne Thrombocytopenie betrug der Anteil positiver Ergebnisse für den dir. AGKT 30%, für den dir. FT 16%, für den indir. AGKT 7%, für den indir. FT 9%. — Mit Thrombocyten von gesunden Blutspendern waren die Ergebnisse fast ausnahmslos negativ. — Unsere Untersuchungen lassen vermuten, daß der Ausfall der Tests zum Nachweis von antithrombocytären Autoantikörpern stark von nicht-immunologischen Faktoren beeinflußt wird. Beziehungen zu den Plasmaeiweißverhältnissen spielen dabei wahrscheinlich eine wichtige Rolle.

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Summary The blood of 161 patients with different internal diseases was investigated with the direct and/or the indirect antiglobulin consumption test (AGCT) and with the direct and/or indirect fluorescence antiglobulin test (FT) on platelets. 63 patients revealed thrombocytopenia (platelets less than 90000 per mm³) in the course of various diseases, the remainder had normal platelet counts.Irrespective of clinical diagnosis positive results were found in the thrombocytopenic group in 37% with the direct AGCT, in 18% with the direct FT, in 27% with the indirect AGCT and in 28% with the indirect FT. Patients with normal platelet numbers showed positive tests in 30% (direct AGCT), in 16% (direct FT), in 7% (indirect AGCT) and in 9% (indirect FT). Control examinations on thrombocytes of healthy blood donors were almost regularly negative under the same conditions.These results suggest that the tests used for the detection of antiplatelet autoantibodies are severely influenced by non-immunologic factors. There seem to exist correlations between the results of the tests and the level of gammaglobulins in the plasma.

     

On the isolation of mast cells from human adenoids and tonsils

Human adenoids and tonsils were disintegrated mechanically and the cells dispersed by passage through a stainless-steel screen in EDTA-containing buffer. Collagenase digestion did not increase the yield of adenoidal cells. The mast cell content of the cell suspensions was in the range of 1–10 mast cells/10⁴ cells with an estimated mean of 1–2 mast cells/10⁴ cells, a value considerably below previous reports on adenoidal cell suspensions. The mast cell content was determined by staining with toluidine blue at low pH (to prevent interference by phagocytes). The mast cell count as assessed by alcian blue staining and by fluorescence microscopy after FITC-anti-human IgE binding was similar. Various attempts to enrich the cell suspension (i.e. by differential centrifugation, by gradient centrifugation on Ficoll or Ficoll-Hypaque and by velocity sedimentation at unit gravity) all gave negative results.     

Does the destruction of catecholaminergic neurons in newborn rats influence the modulator function of the cholinergic system?

The influence of the destruction of the catecholaminergic (CA) system on the reactions of neurons of the somatosensory zone of the cortex elicited by stimulation of the sciatic nerve, and on the features of the modulation of these reactions following the stimulation of the region of the basal nuclei (source of cholinergic innervation of the neocortex) and the microiontophoretic application of acetylcholine (ACh), was investigated in mongrel infant rats, 21–31 days of age. It was demonstrated that destruction of the CA system in newborn rats increases the reactivity of neurons somatosensory cortex to sensory stimulation, has no influence on the modulating effect of the cholinergic system, of the forebrain, and leads to intensification of the modulating influence of applied ACh [2].Translated from Zhurnal Vysshei Nervnoi Deyatel'nosti imeni I. P. Pavlova, Vol. 42, No. 5, pp. 1018–1022, September–October, 1992.     

Wertigkeit der EKG-Telefon-Telemetrie in der Erfassung symptomatischer Herzrhythmus-Störungen

Summary The ECG-telephone-transmission (TTM) was used to record an ECG-strip during a typical symptomatic period in patients complaining of symptoms possibly caused by arrhythmias (palpitations, dizziness, paroxysm tachycardia, pulse irregularities; angina and dyspnea only if other reasons could be excluded). Patients complaining of syncope only were not admitted, because of the inability to make a telephon call successfully during such a symptomatic period. The ECG was transmitted to the CCU using a frequency modulation technique. In 60% of 196 patients an ECG-TTM could be achieved during a typical symptomatic period, whereas arrhythmias as cause for the symptoms could be excluded in 51 patients (26%). The remaining 66 patients (34%) demonstrated various arrhythmias ranging from simple SVPB and PVC to total AV-block and sustained VT.TTM, an easy-to-perform and cost-effective method allowed a successful ECG registration during a symptomatic period in almost two-thirds of symptomatic patients. In these patients arrhythmias could be verified or excluded as cause of the symptoms.

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Abkürzungsverzeichnis TTM EKG-Telefon-Telemetrie - HF Herzfrequenz - SA-Block sinu-aurikulärer Block - AV-Block atrio-ventrikulärer Block - SVES supraventrikuläre Extrasystole(n) - VES ventrikuläre Extrasysteole(n) - KHK koronare Herzkrankheit - VH-Flimmern Vorhof-Flimmern - parox. paroxysmal - C.C.I.T.T. Internationale Post-Organisation - Ö.P.T. Österreichische Post- u. Telegraphen-Verwaltung - LZ-EKG Langzeit-EKG     

Obesity and non-alcoholic steatohepatitis

Obesity is the most important risk factor associated with non-alcoholic steatohepatitis, which is caused by to impaired insulin activity, overflow of portal triglycerides, and production of inflammatory cytokines; all of these are deleterious to hepatocytes. These phenomena facilitate disruptions in hepatic physiology, as observed in alcoholic hepatitis; however, consumption of this substance is absent. Non-alcoholic steatohepatitis has had a great impact due to the fact that previously, main cases of cryptogenic cirrhosis actually were attributed to this disease. Despite advances in understanding the pathophysiologic process of the disease, there is no better treatment than weight reduction (a combination of diet and exercise). In this issue, we describe the most important topics with regard to non-alcoholic steatohepatitis and the obesity-related process.     

Wie lange ergeben aufbewahrte Blut- und Knochenmarksausstriche zuverlässige zytochemische Färbungen?

Summary We tested how long unstained and unfixed films of blood and aspirated bone marrow could be kept before special cytochemical staining. To exclude influences other than time on the outcome of the reactions, all the material was taken from hematologically normal persons. A simple score was used to evaluate the results. These may be summarized as follows: in most cells Naphthol-AS-acetate-esterase first shows a progressive decline in reactivity after a delay of 6 weeks, the reaction becoming very weak after 10±1 weeks. This does not hold for monocytes, megakaryocytes and platelets, which maintain reactivity (and susceptibility to NaF) for more than three months. With PAS staining, a slight decrease in reactivity after 8±2 weeks could be observed, whereas all other stainings tested (POX, Sudan black B and Naphthol-AS-D-esterase) were unaffected even by a delay of up to 16 weeks.