Diastrophische Dysplasie

The case report presents a 25-year-old woman who got pregnant twice in 1 year. Both pregnancies were terminated after ultrasound examination demonstrated limb abnormalities. Radiological and pathological examinations showed diastrophic dysplasia, a rare form of an osteochondrodysplasia with autosomal recessive inheritance. Here the histopathological findings in the cartilage and prenatal diagnosis by ultrasound are discussed.     

Untersuchungen an 1,4-Napthochinonen, 24. Mitt.: Zur Dehalogenierung von 2-/3-Halogen-1,4-naphthochinon-derivaten

1,4-Naphthoquinones, XXIV: On the Dehalogenation of 2-/3-Halogen-1,4-naphthoquinone Derivatives Bu₃SnH is an effective reagent for the debromination of 2-bromonaphthoquinones but elimination of chlorine with 1c , e.g., only proceeds at 30%. With Et₃SiH dechlorination does not occur at all. Instead, with the 5-acetoxy derivatives 1a/1d as starting materials the cyclic acetales 3a – c are formed as selectively protected juglone derivatives. The bromo derivative 3a is obtained only at temp. < 10° and even at room temp. Br-Elimination occurs with low yield of 3b . An especially suitable reagent for the debromination of 1a – b leading to the natural compounds plumbagin ( 2a ) and isoplumbagin ( 2b ) is zinc-silver couple but Cl-elimination again occurs in traces only.     

Indikationen der operativen Behandlung von Wirbelsäulenverletzungen

Now as before, a deteriorating paraplegia as well as a partial transverse lesion are absolute indications for a stabilization of spinal injuries. The operation has to be carried out within a few hours after the accident. A complete transverse lesion as well as an instable situation in the spine are relative indications for surgery. In these cases, the operation should be performed as early as possible considering the easier reposition and the possibility of an earlier beginning of rehabilitation measures. The condition of the posterior vertebral body edge, the root of the vertebral arch and the articular process of a vertebra are decisive for the stability of the spine. Acute surgery in injuries to the spine is dependent on the operability of the patient, the presence of a surgeon skilled in spinal surgery together with an appropriate staff, and the possibility to produce at any time a CT scan of the spine.     

Indikationen zur Therapie von Stenosen der A. carotis

The annual stroke risk for patients with asymptomatic stenoses of the carotid artery is around 1% in case of <70% stenosis (NASCET criteria) and 2-5% in patients with >70% stenosis. The risk of recurrent ischemic events for patients with symptomatic stenoses is much higher, around 15% during the first year. For more than 10 years, the efficacy of carotid surgery has been proven, and there is growing evidence to support surgery in case of asymptomatic stenosis. Patients with severe stenoses, male or elderly patients, and those with bilateral stenoses benefit more from surgery. Carotid artery stenting has not proven its safety or efficacy. Despite this lack of evidence, the method is used in many centers as an alternative to surgery. Especially symptomatic carotid artery stenosis should be used mainly in the setting of a randomized trial such as SPACE.     

Die palliative operative therapie pathologischer frakturen

In der Unfallchirurgischen Universitätsklinik Gießen wurden von 1971 bis 1985 97 Patienten mit pathologischen Frakturen operativ versorgt. Die palliative Operation zielte dabei auf eine Schmerzerleichterung für den Patienten, auf die Vermeidung langer Liegezeiten für den Patienten, die Wiedererlangung der Belastungsfähigkeit der unteren Extremität sowie der freien Beweglichkeit der oberen Extremität ab. Die Erhaltung oder die Wiederherstellung der allgemeinen Mobilität des Patienten im alltäglichen Leben sowie die Unterstützung der Psyche des Patienten mußte dabei ebenso berücksichtigt werden. Bei einem Primärtumor führte am häufigsten das Mammakarzinom, gefolgt vom Bronchialkarzinom, Hypernephrom, Kolonkarzinom und Plasmozytom, durch Metastasierung zu einer pathologischen Fraktur. Die Metastasen bevorzugen vor allem den proximalen Femurbereich, den Femurschaft, den Humerus und das Becken zur Absiedelung. Insgesamt verwendeten wir bei der palliativen operativen Versorgung 43 Verbundosteosynthesen, 23 Endoprothesen, 17 Resektionen, zehn Marknägel, vier Endernagelungen bzw. Bündenagelungen. In je einem Fall erfolgte die Stabilisierung des Schenkelhalses durch einen Laschennagel sowie die Stabilisierung der Wirbelsäule durch Spondylodese. In sieben weiteren Fällen wurde eine Exzision vorgenommen. Die durchschnittliche Überlebenszeit lag zwischen 24 und 52 Wochen.     

"Nucleolar organizer regions" as a factor for the prognosis of laryngeal cancer?]

The prognostic significance of silver-binding nucleolar organizer regions (AgNORs) was assessed in tissue sections of primary tumours taken from 30 patients with squamous cell carcinomas of the larynx. By means of semiautomated image analysis the AgNORs of 100 tumour cell nuclei were measured. Their number as well as their area were evaluated together with morphometrical features (obtained by automated image analysis) and histopathological and clinical data. Considering the mean number of AgNORs the multivariate discriminant analysis revealed significant differences between carcinomas of patients, who were alive of at least 3 years without local or distant recurrence and those, who had died of laryngeal cancer (p less than 0.03%). There was, however, no correlation between the AgNOR number and the DNA features. But, on the other hand, the DNA features, e.g. the 5c exceeding rate according to B?cking and the DNA index according to Atkin were found to be correlated with the tumour size (p less than 0.08%). These preliminary results indicate that the AgNOR number as well as the DNA features could be independent prognostic parameter in laryngeal squamous cell carcinoma, complementary to the staging categories.