Orbital surgery – perioperative problems and results

<b>Fragestellung:</b> Orbitotomien nehmen innerhalb der Ophthalmochirurgie auf Grund der involvierten anatomischen Strukturen und des daraus resultierenden Spektrums m?glicher perioperativer Probleme eine Sonderstellung ein. Um einen überblick über die Art und H?ufigkeit intra- und postoperativer Probleme bei Orbitotomien zu erhalten, führten wir eine retrospektive Auswertung an unserer Klinik durchgeführter Orbitotomien durch. <b>Patienten und Methode:</b> Es wurden 48 Orbitotomien bei 46 Patienten berücksichtigt, die zwischen 08/1995 und 02/1998 operiert wurden. <b>Ergebnisse:</b> Schwerwiegende intraoperative Komplikationen waren mit zwei transfusionspflichtigen Blutungen und einer Liquorfistel selten. Sie wurden interdisziplin?r behandelt. Postoperativ traten vorübergehende funktionelle St?rungen mit guter Rückbildungstendenz wie Visusminderungen (35 %), Motilit?tsst?rungen mit oder ohne Doppelbildwahrnehmung (20 %) und Lidfehlstellungen auf. Ihnen liegt v. a. die postoperative ?dem- und H?matombildung zugrunde. Persistierende Funktionseinschr?nkungen waren dagegen selten (10 %). <b>Schlu?folgerung:</b> Unsere Untersuchung zeigt, da? perioperativ bei Orbitotomien v. a. vorübergehende funktionelle Einschr?nkungen auftreten, die sich rasch zurückbilden. Schwere Komplikationen sind dagegen selten, treten v. a. intraoperativ auf und k?nnen eine interdisziplin?re Therapie erfordern. </blockquote>     

Decreased phospholipase A2 activity in the brain and in platelets of patients with Alzheimer's disease

Phospholipase A<sub>2</sub> (PLA<sub>2</sub>) is a key enzyme in the metabolism of membrane phospholipids. PLA<sub>2</sub> influences the processing and secretion of the amyloid precursor protein, which give rise to the <img src="/content/f01578313026t875/xxlarge946.gif" alt="beta" align="MIDDLE" BORDER="0">-amyloid peptide, the major component of the amyloid plaque in Alzheimer's disease (AD). We investigated the PLA<sub>2</sub> activity in two samples: in post-mortem brains from 23 patients with AD and 20 non-demented elderly controls, and platelets from 16 patients with a diagnosis of probable AD, 13 healthy controls and 14 elderly patients with a major depression. In AD brains PLA<sub>2</sub> activity was significantly decreased in the parietal, and to a lesser degree in the frontal, cortex. Lower PLA<sub>2</sub> activity correlated significantly with an earlier onset of the disease, an earlier age at death and higher counts of neurofibrillary tangles and senile plaques. In platelets PLA<sub>2</sub> activity was also significantly reduced in the AD group as compared with healthy and depressed controls. The reduction of the enzyme activity in platelets correlated with an early disease onset and with the severity of cognitive impairment, indicating a relationship between abnormally low PLA<sub>2</sub> activity and a more severe form of the illness. The present results provide new evidence for a disordered phospholipid metabolism in AD brains and suggest that reduced PLA<sub>2</sub> activity may contribute to the production of amyloidogenic peptides in the disease. Further studies are needed to examine whether PLA<sub>2</sub> activity in platelets may be useful as a peripheral marker for a subgroup of patients with AD.     

Catecholamines modulate growth and differentiation of human preosteoclastic cells

Using a clonal cell line of human osteoclast precursors (FLG 29.1 cells), that after treatment with 12-<i>O</i>-tetradecanoyl phorbol 13-acetate (TPA) show many functional characteristics of osteoclasts, we demonstrated that catecholamines act as inducers of osteoclast maturation in vitro and as stimulators of osteoclast activity via the binding to <img src="/content/t36865h332124hq1/xxlarge946.gif" alt="beta" align="MIDDLE" BORDER="0"><sub>2</sub> adrenergic receptors. Scatchard analysis of<sup>125</sup>I-labelled iodocyano-pindolol to untreated (undifferentiated) or TPA-treated (differentiated) FLG 29.1 cells revealed the presence of a single high-affinity site with a<i>K</i> <sub> <i>d</i> </sub> value around 24 pM and 8 pM respectively and with superimposable binding capacity (1.18 fmol/mg protein). Catecholamines increased in a dose-dependent fashion the intracellular cyclic AMP (cAMP) accumulation in both undifferentiated and TPA-treated FLG 29.1 cells. Pretreatment of untreated and TPA-treated FLG 29.1 cells with propranolol inhibited the catecholamine effect on cAMP accumulation, while pretreatment with clonidine had no effect. Catecholamines also reduced cell proliferation, increased tartrate-resistant acid phosphatase (TRAcP) activity, interleukin 6 (IL-6) production, multinuclearity and response to salmon calcitonin (sCT) in undifferentiated FLG 29.1 cells. In differentiated FLG 29.1 cells only IL-6 release was induced by catecholamine treatment. These findings support a potential role for catecholamines in modulating osteoclast differentiation and mature osteoclast activity.     

Immunohistochemical analysis of 61 pituitary adenomas with a monoclonal antibody to the neuron-specific β-tubulin isotype

Pituitary adenomas surgically resected from 61 consecutive patients and 9 normal pituitary glands were studied by immunohistochemistry to determine the localization of the class III<img src="/content/q651t8646230w6v6/xxlarge946.gif" alt="beta" align="MIDDLE" BORDER="0">-tubulin isotype (neuron-specific) which is recognized by the monoclonal antibody TUJ1. In normal pituitary glands only a few cells were weakly immunopositive for TUJ1, whereas, in 43(73%) of 61 adenomas, more than 5% of tumor cells were immunopositive. The result may indicate that this neuron-specific <img src="/content/q651t8646230w6v6/xxlarge946.gif" alt="beta" align="MIDDLE" BORDER="0">-tubulin isotype may be either expressed de novo or enhanced under the transformation of pituitary acinar cells to tumors.Research fellow of the Department of Pathology, Kitasato University School of Medicine where the work was conducted     

Are the disparate pharmacological profiles of competitive and un-competitive NMDA antagonists due to different baseline activities of distinct glutamatergic pathways? (Hypothesis)

Summary In superfused mouse striatal slices preincubated with [<sup>3</sup>H] dopamine 25 nmol/l, the electrically (3 Hz) evoked tritium overflow was inhibited by histamine 10 <img src="/content/h051255w31541t28/xxlarge956.gif" alt="mgr" align="MIDDLE" BORDER="0">mol/l by 18%. The degree of inhibition was increased to 38% by haloperidol but not affected by (1) atropine, (2) reducing the stimulation frequency to 0.3 Hz or (3) increasing the concentration of [<sup>3</sup>H]dopamine (used for preincubation) to 100 nmol/l. The effect of histamine was mimicked by the H<sub>3</sub> agonist R-(–)-<img src="/content/h051255w31541t28/xxlarge945.gif" alt="agr" align="BASELINE" BORDER="0">-methylhistamine; it was not affected by the H<sub>1</sub> antagonist dimetindene and the H<sub>2</sub> antagonist ranitidine but abolished by the H<sub>3</sub> antagonist thioperamide. Tritium overflow evoked by Ca<sup>2+</sup> ions (introduced into Ca<sup>2+</sup>free, K<sup>+</sup>-rich medium containing tetrodotoxin) was not affected by histamine 10 <img src="/content/h051255w31541t28/xxlarge956.gif" alt="mgr" align="MIDDLE" BORDER="0">mol/l in the absence, but inhibited (by 30%) in the presence of haloperidol; the effect of histamine was abolished by thioperamide. In conclusion, the dopaminergic nerve terminals in the mouse striatum are endowed with presynaptic H<sub>3</sub> receptors. Simultaneous blockade of dopamine autoreceptors increases the extent of the H<sub>3</sub> receptor-mediated inhibition of dopamine release.     

102. Dickdarmreinigung für den Colon-Rectum-Eingriff: Schlackenfreie Kost

Zusammenfassung Ein ,steriler<img src="/content/wv86h47854808108/xxlarge8221.gif" alt="rdquo" align="MIDDLE" BORDER="0"> Darm ist mit keinem der gebräuchlichen Vorbereitungsregime zu erreichen. Ziel der Vorbereitung ist die quantitative Reduktion der Darmkeime. Qualitative Anderungen sind unerwünscht. Das kann durch alleinige mechanische Darmreinigung erreicht werden. Da bei fehlender Substratzufuhr wahrend der Vorbereitungsphase die grunderkrankungsbedingte Katabolie zunimmt, muß wahrend dieser Zeit ,kiinstlich<img src="/content/wv86h47854808108/xxlarge8221.gif" alt="rdquo" align="MIDDLE" BORDER="0"> ernährt werden. Bei Anwendung von chemisch-definierter Diät erhält der Patient ausreichend Energie und Eiweißbausteine. Der Dickdarm bleibt infolge der im Dünndarm komplett absorbierten Nahrung jedoch sauber und keimarm.</blockquote>     

Preparation of crystalline bovine liver β-glucuronidase

Summary A method is described for the preparation of pure <img src="/content/w5714432583863t0/xxlarge946.gif" alt="beta" align="MIDDLE" BORDER="0">-glucuronidase from bovine liver. The procedure includes ammonium sulfate, acetone and ethanol fractionation and a simple two-step ion exchange chromatography. The yield is acceptable and the method requires only standard laboratory equipment. The pure enzyme is easily crystallized from ammonium sulfate. Some practical applications of the pure <img src="/content/w5714432583863t0/xxlarge946.gif" alt="beta" align="MIDDLE" BORDER="0">-glucuronidase are discussed.</blockquote>     

Tetrahydronorharmane (Tetrahydro-β-carboline), a physiologically occurring compound of indole metabolism

Summary In the present paper a sensitive method is described to measure tetrahydronorharmane (THN) in the urine of man and rats as well as in the forebrain of rats. The compound is extracted into diethyl ether, separated by thin layer chromatography (TLC), acetylated with radiolabelled acetic anhydride and further isolated by two-dimensional TLC development. The existence of THN in urine of man was proven by using chromatography with different solvent systems, cocristallisation, isotope dilution technique as well as mass-spectrometry. The amount of THN in the urine varied over a wide range.With the same method it was demonstrated that THN occurs also in the forebrain of rats. The concentration increases after loading with tryptamine.The findings are discussed in view of the hypothesis that THN acts as a compound modulating neuronal mechanism.     

Phenprocoumon requirement,whole blood coagulation time,bleeding time and plasmaγ-GT in patients receiving mianserin

Summary A possible interaction between the tetracyclic antidepressant mianserin and a coumarin derivative has been investigated. Sixty-three subjects, 61 of whom required anticoagulant therapy for a variety of medical conditions, were treated for 5 consecutive weeks with phenprocoumon, in a dose adjusted to reduce the prothrombin time to 15%–25%. After an initial control period of one week, subjects were randomly treated under double-blind conditions with mianserin 3×10 mg daily or 3×20 mg daily, or with a matching placebo. The dose of mianserin was gradually increased to reach the maximum by the 6th day. Three subjects dropped out and 60 completed the trial.The dose of phenprocoumon and the prothrombin, bleeding, and coagulation times were not significantly affected by administration of mianserin. It can be concluded that there is no clinically important interaction between phenprocoumon and doses of mianserin effective in depression. Sedation was more frequent in patients taking mianserin than in those given placebo.