Simultane Bestimmung von CA 125 im Tumorcytosol und im Serum bei Patientinnen mit Ovarialtumoren

Ohne Zusammenfassung     

Einsatz einer Mischkultur in Acetat-Fermentationen

Bacterial cultures were selected from the native flora of liquid manure in order to metabolize liquid manure substances. The mixed culture used in the growth experiments is characterized by low growth rates when maximum degradation of acetate occurs. The biomass concentration reached 2.2 g/l.     

Nasal administration of naloxone for detection of opiate dependence.

In clinical trials, nasally applied naloxone was used to identify opiate dependence in humans for the first time. Withdrawal distress was recorded, and pupillary response, pulse rate and blood pressure measured. A significant increase in withdrawal distress and pupillary dilation was observed after nasal administration of 1mg (1mg/400 microliters) naloxone in all subjects who also showed opiate-positive urine samples. In control subjects, no reaction to naloxone was observed. It may be concluded that the nasal route for naloxone administration is as effective as the parenteral route. This test is sensitive enough to identify the physically-dependent opiate user and might have a role in emergency medicine and withdrawal treatment.     

Resektion der Vena jugularis interna bei infizierter Thrombose Management einer seltenen Komplikation nach Polychemotherapie bei metastasiertem, testikul?rem Keimzelltumor

Zusammenfassung Für die Therapie bei infizierten Thrombosen der großen Halsvenen und zentralen Venen gibt es kein standardisiertes therapeutisches Vorgehen. Sowohl konservative als auch aggressive, invasive Therapiestrategien werden beschrieben. Wir präsentieren den Fall einer septischen Thrombose der rechten V. jugularis interna nach einliegendem zentralem Venenkatheter bei einem immunsupprimierten Patienten nach Polychemotherapie wegen eines metastasierten Seminoms des rechten Hodens. Nach konservativem Therapieversuch mit intravenöser antibiotischer Therapie und therapeutischer Heparinisierung wurde wegen des sich verschlechternden septischen Zustandsbildes des Patienten die Indikation zur chirurgischen Intervention gestellt. Intraoperativ war eine Thrombektomie unmöglich, sodass eine vollständige Resektion der rechten V. jugularis interna durchgeführt wurde. Der postoperative Verlauf war komplikationslos. Der histopathologische Befund zeigte eine putride Thrombophlebitis mit ausgeprägter Periphlebitis; die kulturellen Untersuchungen aus dem Wundgebiet und Blutkulturen wiesen übereinstimmend Staphylococcus aureus nach. Vor allem der immunsupprimierte Patient mit Neutropenie und Thrombopenie erfordert ein aggressives chirurgisches Vorgehen zur sicheren und schnellen Befundsanierung. Abstract There is no therapeutic standard for the treatment of septic thrombosis of the central veins. We present a case of septic thrombosis of the right internal jugular vein. The immunocompromised patient had a central venous line for polychemotherapy of metastasized seminoma of the right testis. After conservative therapy with antibiotics and therapeutic heparinization the septic status of the patient worsened rapidly and surgical intervention was planned. Intraoperatively, thrombectomy was not feasible and complete resection of the right internal jugular vein became necessary. Postoperative reconvalescence was uneventful. Histopathological findings showed purulent suppurative thrombophlebitis and marked periphlebitis, mirobiology revealed staph. aureus both in the catheter insertion site and in blood cultures. Especially in immunocompromised patients with severe granulo- and thrombocytopenia, surgery may be attributed with less danger for the patient than prolongued septicemia.     

Fusion and failure following anterior cervical plating with dynamic or rigid plates: 6-months results of a multi-centric, prospective, randomized, controlled study

Anterior cervical plate fixation is an approved surgical technique for cervical spine stabilization in the presence of anterior cervical instability. Rigid plate design with screws rigidly locked to the plate is widely used and is thought to provide a better fixation for the treated spinal segment than a dynamic design in which the screws may slide when the graft is settling. Recent biomechanical studies showed that dynamic anterior plates provide a better graft loading possibly leading to accelerated spinal fusion with a lower incidence of implant complications. This, however, was investigated in vitro and does not necessarily mean to be the case in vivo, as well. Thus, the two major aspects of this study were to compare the speed of bone fusion and the rate of implant complications using either rigid- or dynamic plates. The study design is prospective, randomized, controlled, and multi-centric, having been approved by respective ethic committees of all participating sites. One hundred and thirty-two patients were included in this study and randomly assigned to one of the two groups, both undergoing routine level-1- or level-2 anterior cervical discectomy with autograft fusion receiving either a dynamic plate with screws being locked in ap - position (ABC, Aesculap, Germany), or a rigid plate (CSLP, Synthes, Switzerland). Segmental mobility and implant complications were compared after 3- and 6 months, respectively. All measurements were performed by an independent radiologist. Mobility results after 6 months were available for 77 patients (43 ABC/34 CSLP). Mean segmental mobility for the ABC group was 1.7 mm at the time of discharge, 1.4 mm after 3 months, and 0.8 mm after 6 months. For the CSLP- group the measurements were 1.0, 1.8, and 1.7 mm, respectively. The differences of mean segmental mobility were statistically significant between both groups after 6 months (P = 0.02). Four patients of the CSLP-group demonstrated surgical hardware complications, whereas no implant complications were observed within the ABC-group (P = 0.0375). Dynamic plate designs provided a faster fusion of the cervical spine compared with rigid plate designs after prior spinal surgery. Moreover, the rate of implant complications was lower within the group of patients receiving a dynamic plate. These interim results refer to a follow-up period of 6 months after prior spinal surgery. Further investigations will be performed 2 years postoperatively.     

The feasibility of sensitization studies using fewer test animals

The possibility of reducing the number of animals in sensitization studies (maximization method) is discussed on the basis of results from 20 sensitization tests. It appears that the number of test animals in sensitization studies may be reduced to ten treated animals and five control animals without prejudice to the quality of the test.     

Drug conditioning induced by intrastriatal apomorphine administration

The present study examined (1) whether the neostriatum is involved in a drug-induced conditioned locomotor response and; (2) whether this structure participates in the development of behavioral sensitization. Moreover, the present study addressed the question whether the development of behavioral sensitization is necessary for the induction of conditioning. Rats received injections of either apomorphine (2 μg) or vehicle (solution of 0.1% ascorbate/saline) into the dorsal neostriatum daily for 7 days. These treatments were performed immediately prior to (apomorphine-paired group and vehicle group) or 30 min following (apomorphine-unpaired group) 10-min placement in an open field which served as the test environment. After a 3-day drug withdrawal period, the animals were given a 10-min non-drug vehicle test trial in the test environment. Three days later, a drug test with apomorphine was administered to the animals of the paired and unpaired treatment groups; the vehicle group again received an injection of vehicle. The analysis of locomotor activity in the open field (measured as the distance traversed) revealed that locomotor activity in the apomorphine-paired group was higher than in the other groups. There were no indications for behavioral sensitization to intrastriatal apomorphine, since the locomotor response in the apomorphine-paired group did not increase, but rather decreased with daily repeated injections of apomorphine. Furthermore, only the apomorphine-paired animals showed a higher locomotor response when tested after an intrastriatal injection of vehicle in the previously apomorphine-paired environment, which is indicative of a conditioned drug effect. These results suggest that the neostriatum is directly involved in the development of drug-induced conditioning of locomotor behavior but not in the establishment of behavioral sensitization.     

Ureteral stents — materials and new forms

Summary Three different types of polymers are currently used for self-retained ureteral stents: thermoplastic materials such as polyurethanes, and thermoset elastomers such as silicone and hydrogels. Polyurethane stents are easy to form and have high drainage capacity, whereas silicone shows the best biocompatibility but a lower drainage efficacy than the former. A mock urinary system consisting of a collecting system and a 9-F tube was used to evaluate the flow characteristics of various double-pigtail stents in cases of urinary obstruction. For simulation of an unobstructed urinary system a human urogenital system was used. Inner flow polyurethane stents showed the best drainage as compared with inner flow silicone and outer flow ESWL stents in an obstructed ureter, whereas ESWL stents maintained the best flow in an unobstructed ureter or in respect to conventional stents with obstructed sideports.