Hexokinase I Messenger RNA in the Rat Central Nervous System

Hexokinase I (ATP: -hexose 6-phosphotransferase, EC 2.7.1.1) is the first enzyme required in the metabolism of glucose in the central nervous system and plays a major role in regulation of the cerebral glycolytic rate. The distribution of hexokinase I mRNA was examined throughout the central nervous system of the rat by use of oligonucleotide probes and in situ hybridization histochemistry. In the rhinencephalon, strong hexokinase I mRNA labeling was demonstrated in the glomerular, mitral, internal granular, and internal plexiform layers, whereas the olfactory nerve, external plexiform, and subependymal layers and ependyma were devoid of labeling. Within the telencephalon, strong labeling was present in all layers (with the exception of the molecular layer) of the cerebral cortex, in the septum, in CA1-4 and dentate gyrus of the hippocampus, and in several amygdaloid nuclei. There was only weak labeling in the nucleus accumbens and caudate putamen. In the diencephalon, there was in general a strong labeling in the epithalamus, in several thalamic nuclei, including the anteriodorsal, anterioventral, anteriomedial, reticular, paravetricular, intermediodorsal, anteriomedial, interanteriomedial, rhomboid, reuniens, and parafascicular thalamic nuclei. Several hypothalamic regions, including the subfornical organ, the medial preoptic area, the suprachiasmatic, supraoptic, paraventricular, dorsomedial, ventromedial nuclei, and the zona incerta, were strongly labeled. In the mesencephalon, there was particularly strong labeling in the pars compacta and reticulata of the substantia nigra, central gray, and red nucleus, in the Darkschewitsch nucleus, and in the medial accessory oculomotor nucleus. In the rhombencephalon, there was strong hybridization in all raphe nuclei, pontine, tegmental, lateral parabrachial, olivary nuclei, and several cranial motor nuclei. All neurons of the locus ceruleus were heavily labeled. Very strong labeling was present in Purkinje and granular cells of the cerebellar cortex. Neurons of the medulla oblongata area postrema, nucleus tractus solitarius, reticular nucleus, nucleus cuneatus and several motor nuclei were strongly labeled. In the spinal cord, labeled cells were present in all laminae, and also neurons of the dorsal root ganglion were heavily labeled. Hexokinase I mRNA was also demonstrated in the epithelium lining the choroid plexus. In the E15 fetus, very strong labeling was seen in the liver, heart, and trigeminal ganglion, with less intense labeling in the brain and other tissues having more moderate labeling. Administration of 2% saline as drinking water resulted in a marked increase in hexokinase I mRNA in the magnocellular neurons of the supraoptic and paraventricular nuclei. In summary, the results show extensive neuronal distribution of hexokinase I mRNA with regional differences in the expression pattern.     

Cytodiagnosis in chronic laryngitis]

The cytodiagnosis is a simple noninvasive procedure which requires close cooperation between the clinician and an experienced cytologist. It enables important diagnostic and therapeutic recommendations on the basis of morphological findings. A total of 1000 smears of the larynx obtained from 430 patients with chronic laryngitis were examined. In a case- controlled study of 143 patients with chronic hyperplastic laryngitis, smokers and/or laryngeal dysplasia patients with a 9.6% risk for malignant transformation, were identified as risk groups needing cytological screening at intervals of 6 months to a year. In the cytodiagnostic evaluations the main emphasis should be placed on dysplasias and metaplasias. Performed systematically, cytologically assisted early examination of the larynx expands the diagnostic possibilities, and is a useful supplement to biopsy. In the risk group chronic hyperplastic laryngitis, cytodiagnosis can be used to screen suspicious lesions for tumors. Although it cannot replace histological examination, it is highly suitable for the early diagnosis and effective follow-up of precancerous epithelial changes of the larynx.     

Infiltration during intravenous therapy in neonates: comparison of Teflon and Vialon catheters.

Infiltration is a frequent complication of intravenous therapy using peripheral venous lines in neonatal patients. In a randomized trial of two catheter materials, Vialon (Becton Dickinson) and Teflon (DuPont), we studied 19 putative risk factors for infiltration, including 11 infusates, in 772 peripheral venous lines in patients aged 1 to 67 days. The best-fit Cox regression model identified six significant predictors of infiltration (P less than .05): catheter material, age, anatomic insertion site, hyperalimentation, and use of furosemide and dopamine. For the subsample of patients weighing less than or equal to 1500 g, a second Cox regression model identified time spent inserting the catheter and the number of insertion attempts as additional significant predictors. These multivariate models showed that Vialon catheter material reduced the risk of infiltration by 18% (95% CI, 1% to 32% reduction) in the total sample and by 35% (95% CI, 15% to 50% reduction) in the higher risk low-weight (less than or equal to 1500 g) subsample.     

Malignant histiocytosis

Summary Diagnosis of malignant histiocytosis (MH) was confirmed in 16 patients. Stage at diagnosis was I–II in nine, and III–IV in seven patients. Poor prognosis and B-symptoms were correlated to advanced stages. Bone marrow biopsy proved most useful to verify organ involvement. Scintigraphy and computerized tomography, too, detected organ involvement in some patients and were helpful for judging response to therapy. Relapses after radiotherapy were frequent. Polychemotherapy using CHOP-combination is recommended for most patients and may in stages I–II be supplemented by primary or secondary involved or extended field irradiation and in more advanced stages by mainbulk-irradiation. The value of prophylactic CNS-therapy remains controversial. Pathophysiological aspects and differential diagnosis are discussed.     

Fibrous histiocytoma: a histological and statistical analysis of 155 cases.

Various salient histological features were rated from + to +++ in a semiquantitative evaluation of a series of 155 cases of fibrous histiocytoma. Relations between individual histological features, as well as between histological findings, localisation and size of lesions, and age or sex of the patient were tested statistically. Most impressive was an inverse proportional relationship between cellular and fibrillar densities: highly cellular fibrous histiocytomas chiefly showed little fiber formation. Accordingly, cases with marked fiber formation were distinguished by low cellularity. Based on this statistically significant relation, 3 subtypes could be classified on a scale of increasing fiber formation and decreasing cellular density. The majority of cases showed medium cellularity and fibrillar density, with distinct storiform (spokewheel or "whirlygig") pattern which is compatible with typical storiform histocytoma, including clincally progressive, recurrant FH and/or "dermatofibrosarcoma protuberans". The typical patient was more frequently female than male, 40 years of age with a 0.5 to 1.0 cm size tumor node in the lower extremities located in the corium, often with beginning infiltration of the subcutaneous fat tissue.     

Malignant tumor of humerus with features of "adamantinoma" and Ewing's sarcoma

This female patient was born in 1935 and died in 1976 with a malignant bone tumor involving the proximal humerus following multiple local recurrences, axillary lymph node metastases, and pulmonary metastases. Histologically, over the course of time, there was an increase in features of an atypical Ewing's sarcoma, at the expense of findings of a typical, extra-cranial so-called adamantinoma. In contrast to another report, our case showed neither epithelial nor endothelial features on fine structural examination, but rather primitive mesenchymal cells, as is described for Ewing's sarcomas.     

70. Ileorectostomie versus ileo-anale Anastomose mit Reservoir bei Colitis ulcerosa und Adenomatosis coli

Zusammenfassung Ca. 2000 Proktomucosektomien sind in den letzten Jahren durchgeführt worden als Alternative zur Proktocolektomie, aber auch zur Ileorectostomie bei AC und CU. Bei minimaler Operationsletalität ist die Rate der Frühkomplikationen (Ileus, Anastomoseninsuffizienz, Anastomosenstenose) nicht unbeträchtlich (> 10%). Die funktionellen Ergebnisse dagegen sind nach einer Phase der Adaptation vorwiegend gut. Die nicht unerheblichen Risiken der Ileorectostomie bei AC (Entartungsrate bis 20%) und bei CU (Entzündungsrezidiv 20–30%, sekundäre Entartung um 5%) haben die Proktomucosektomie an gröeren Zentren zu einem etablierten Verfahren werden lassen.