The use of liquid latex for detecting traces of blood following thermal exposure

International Journal of Legal Medicine - In cases of crimes involving blood, the perpetrators often attempt to remove the traces they have left behind. Setting fire to the crime scene, aside from...     

Proteingebundenes Jod und D-Thyroxinumsatz bei Lebererkrankungen

Zusammenfassung 1. Das PB¹²⁷I im Serum ist hochnormal bis erhöht bei frischer akuter Hepatitis und bei aktiver Cirrhose, normal bei Fettleber und Verschlußikterus und niedrignormal bei dekompensierter Cirrhose.2. Der nach oraler Gabe von 4 mg D-Thyroxin über 48 Std gemessene Verlauf des PB¹²⁷I im Serum war bei Leberekrankungen in typischer Weise verändert. Das besonders charakteristische Abweichen vom Normalverlauf bei akuter Hepatitis, dekompensierter Cirrhose und bei Verschlußikterus erlaubt differentialdiagnostische Folgerungen.

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Summary 1. PB¹²⁷I in serum ranges from upper normal to elevated values in acute hepatitis and active liver cirrhosis, is normal in fatty liver and obstructive jaundice and shows lower normal values in decompensated cirrhosis.2. In liver disease, the course of PB¹²⁷I, measured over a period of 48 hrs after oral administration of 4 mg D-thyroxine, was found to be typically altered; characteristic deviations from the normal course in patients with acute hepatitis, decompensated cirrhosis and obstructive jaundice may facilitate diagnostic conclusions.

     

Disturbed color vision in endogenous psychoses

We examined 50 patients with endogenous depressions and 50 patients with schizophrenic psychosis. We found disturbed colour vision in 54 % of the endogenous depressions and in 72 % of the schizophrenic psychosis. We discuss the aetiopathogenic from disturbed colour vision in the endogenous psychosis.     

Long-term persistence of monoclonal B cells after cure of Helicobacter pylori infection and complete histologic remission in gastric mucosa-associated lymphoid tissue B-cell lymphoma.

PURPOSE: Cure of Helicobacter pylori infection is associated with remission induction in the majority of patients with low-grade gastric mucosa associated lymphoid tissue (MALT) lymphoma in localized stages; however, limited data exist as to whether these patients may be cured of their lymphoma. The present study was performed to investigate whether the polymerase chain reaction (PCR) for the rearranged immunoglobulin heavy chain region may be used to define "molecular" remission. PATIENTS AND METHODS: Ninety-seven patients who suffered from low-grade gastric MALT lymphoma stage I(E) were observed with central pathology and molecular biology after cure of H pylori infection. PCR was performed with the use of consensus primers for the framework regions 1, 2, and 3 and monoclonality was corroborated by sequence analysis. In selected cases, microdissection was performed to study the origin of the monoclonal B cells. RESULTS: Of the 97 patients, 77 obtained complete endoscopic and histologic remission (CR). Twenty of 44 patients with PCR monoclonality at diagnosis and with sufficient molecular follow-up displayed monoclonal bands for a median time of 20.5 months after CR (range, 0 to 50.4 months). These B cells were related to the original lymphoma clone by sequence analysis. Microdissection analysis identified basal lymphoid aggregates as the source of these monoclonal B cells. Local relapse occurred in and was observed by PCR in four patients. All four patients displayed monoclonal PCR before relapse, and three of these four showed ongoing PCR monoclonality throughout their course, indicating the persistence of malignant cells. CONCLUSION: Half of all patients with gastric MALT lymphoma show long-term PCR monoclonality up to several years after cure of H pylori infection and CR. Patients with monoclonal PCR should be observed closely, whereas long-term PCR negativity may indicate cure of the disease.     

Therapy of gastric mucosa associated lymphoid tissue lymphoma

Gastric mucosa associated lymphoid tissue （MALT） lymphoma has recently been incorporated into the World Health Organization （WHO） lymphoma classification, termed as extranodal marginal zone B-cell lymphoma of MALT-type. In about 90% of cases this lymphoma is associated with H pylori infection which has been dearly shown to play a causative role in lymphomagenesis. Although much knowledge has been gained in defining the clinical features, natural history, pathology, and molecular genetics of the disease in the last decade, the optimal treatment approach for gastric MALT lymphomas, especially locally advanced cases, is still evolving. In this review we focus on data for the therapeutic, stage dependent management of gastric MALT lymphoma. Hence, the role of eradication therapy, surgery, chemotherapy and radiotherapy is critically analyzed. Based on these data, we suggest a therapeutic algorithm that might help to better stratify patients for optimal treatment success.     

Genetic diversity of the HpyC1I restriction modification system in Helicobacter pylori

Helicobacter pylori is unique because of the unusually high number and diversity of its restriction modification (R-M) systems. HpyC1I R-M was recently characterized and contains an endonuclease which is an isoschizomer of the endonuclease BccI. This R-M is involved in adherence to gastric epithelial cells, a crucial step in bacterial pathogenesis. This observation illustrates the fact that R-M systems have other putative biological functions in addition to protecting the bacterial genome from external DNA. The genomic diversity of HpyC1I R-M was evaluated more precisely on a large collection of H. pylori strains by PCR, susceptibility to BccI digestion and sequencing. The results obtained support the mechanism of gain and loss of this R-M system in the H. pylori genome, and suggest that it is an ancestral system which gradually disappears during H. pylori evolution, following successive steps: (1) inactivation of the endonuclease gene, followed or accompanied by: (2) inactivation of the methyltransferase genes, and then: (3) definitive loss, leaving only short endonuclease remnant sequences.     

Das Verhalten des freien Thyroxins im Serum von Patienten mit Hyperthyreose unter thyreostatischer Therapie

Zusammenfassung Bei 21 Patienten mit einer diffusen dekompensierten Hyperthyreose wurden vor und unter Therapie mit Methylmercaptoimidazol das proteingebundene Jod¹²⁷ und das freie Thyroxin neben dem proteingebundenen Jod¹³¹ (nur vor Therapie) und dem Grundumsatz gemessen. Aus den Einzelwerten im Therapieverlauf wurden die Halbwertszeiten des proteingebundenen Jod¹²⁷ und des freien Thyroxins bestimmt. Nach statistischen Kriterien erwiesen sich proteingebundenes Jod¹²⁷ und freies Thyroxin in ihrer Beziehung zur Grundumsatzhöhe und in der Abhängigkeit ihrer Halbwertszeiten vom intrathyreoidalen Jodumsatz als homologe Parameter. Die Halbwertszeit des freien Thyroxins ist jedoch kürzer als die des gesamten Thyroxins. Der größere Gradient des Abfalls des freien Thyroxins ist im wesentlichen durch eine Zunahme der Gesamtbindungsvalenz der Transportproteine unter Therapie bedingt.

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Summary Studies concerning the course of PB¹²⁷ I and of free thyroxine (FT₄; AFT₄) during treatment with methylmercaptoimidazole have been carried out in 21 patients suffering from hyperthyroidism (diffuse type). Half-concentration-time data (T_50%) were obtained from frequent single measurements while MMT was administered. PB¹²⁷ I and AFT₄ proved to be homologous parameters in their resp. relation to pretreatment BMR levels and PB¹³¹ I values. Under MMI treatment, T_50%-AFT₄ (6.5d) was considerably less than T_50%-PB¹²⁷ I (9.6), which is most probably due to an increase of thyroxine binding capacity.

     

Malignant tumors of the stomach. Gastric mucosa-associated lymphoid tissue lymphoma and Helicobacter pylori

With the help of many clinical studies, the diagnosis and therapy of gastric MALT lymphoma have evolved. Major progress has been seen in this area, including improvement of biopsy diagnosis, better histologic classification, new information concerning pathogenesis, and, especially, the start of a revolution in the treatment of low-grade gastric MALT lymphomas by eradicating H. pylori. About 12 clinical studies with almost 400 patients and case reports have shown that cure of H. pylori infection is associated with complete remission in approximately 80% of patients with low-grade MALT lymphoma in an early clinical stage. To establish H. pylori eradication as the primary choice in low-grade gastric MALT lymphoma further, it is necessary to select patients before therapy who are most likely to benefit from this single treatment modality. An excellent histologic workup of obtained biopsy specimens and comprehensive clinical staging are necessary. Because of the supposition that H. pylori-related growth support may play a role only in the early stages of low-grade gastric MALT lymphoma, the importance of determining the depth of lymphoma infiltration in the gastric wall is evident. Examinations by endosonographic ultrasonography have been shown to be the most reliable method to differentiate the layers of the gastric wall and to determine the infiltration depth of lymphomas. Eradication of H. pylori has to be considered as a first-line and single treatment modality in patients with low-grade gastric MALT lymphoma in clinical stage EI1. As a therapy with fewer side effects than radiation, surgery, or chemotherapy and as a stomach-conserving treatment, eradication of H. pylori in patients with low-grade gastric MALT lymphoma should be the treatment of the choice within clinical trials because there are no long-term results available thus far. Besides pretreatment patient selection, careful follow-up with endoscopy, biopsies, and clinical staging including endoscopic ultrasonography is necessary. A 5- to 10-year follow-up is necessary before the definitive value of H. pylori eradication can be established, but long-term results are excellent thus far. There are many questions to be addressed: What are the exact mechanisms that lead to the malignant transformation of a reactive infiltrate? Why do approximately 20% of low-grade MALT lymphomas not regress after H. pylori eradication? Is there a molecular-genetic or immunologic point of no return? What is the biologic significance of the immunoglobulin rearrangement detected with PCR? What will be the 5- and 10-year relapse-free survival rates of patients suffering from low-grade MALT lymphoma treated with H. pylori eradication alone as first and only treatment? The wave of new data each year about the role of H. pylori in gastric MALT lymphoma may help many of these questions to be answered.