Interdisziplin?re Leitlinien zur Diagnostik und Therapie der extrazerebralen Amyloidosen

Ohne Zusammenfassung     

Esthesioneuroblastoma in a young child. Case report

Esthesioneuroblastoma is an uncommon malignant neoplasm that arises from olfactory mucosa, often with intracranial extension.A case report of the youngest victim in the literature (2-year-old boy) is presented.     

Abdominal Stab Wounds in Children: an 18-Year Experience

Objective: Evaluation of the diagnosis, management, and the role of selective treatment in children with abdominal stab wounds. Patients and Methods: 59 children (56 male and three female) were included in the study. The patients' median age was 11.8 years (range, 5–14 years). Time between injury and admission was about 3 h. Laparotomy was performed in 44 patients (74%). Solid organ injury was detected in 32 of these patients (73%) and could not be observed in twelve (27%). 15 patients (26%) were treated conservatively, and only one (6.6%) underwent laparotomy during the follow-up. The stomach was the most frequently injured organ (ten patients), followed by the intestines (nine patients). Types of surgical treatment were as follows: primary suture in 28 patients, resection-anastomosis in three, and osteotomy in two. Results: Some prognostic factors such as presence of abdominal organ evisceration and pneumoperitoneum were not significantly correlated with intraabdominal organ injury, whereas some other risk factors such as acute abdomen on admission (p < 0.002) or abdominal clinical and hemodynamic findings (p < 0.001) showed significant correlation with intraabdominal organ injury. The relative risk (odds ratio) of developing an intraabdominal organ injury was > 2 for patients with signs of an acute abdomen on admission. Postoperative complications were observed in five patients with organ injuries. None of our patients died. Conclusions: Conservative treatment can be safely performed in most children with abdominal stab injuries. Signs of major internal hemorrhage or generalized peritonitis are an absolute indication for emergency operation for abdominal stab wounds. Peritoneal penetrations, free air on the abdominal X-ray, and omental or intestinal evisceration are poor indicators of significant organ injuries, and patients presenting these signs shold be closely followed up for developing acute abdominal symptoms. Received: November 2, 2001; revision accepted: February 15, 2002     

Therapeutic effect of adipose-derived mesenchymal stem cells on Cisplatin induced testicular damage in adult male albino rat

Infertility represents a major medical, economic, and psychological problem. Stem cells therapy for infertility has a great interest nowadays especially for cancer survivors at pre-reproductive and reproductive age.

 Thirty-two adult male albino rats were used, divided equally into four groups; Group I (Control group) received isotonic saline intraperitoneally (i.p.) as vehicle. Group II (Cisplatin-treated group) received Cisplatin (i.p.) at a single dose of 7 mg/kg, and then were sacrificed after 5 days. Group III (Stem-cell-treated group) received Cisplatin (i.p.) at a single dose of 7 mg/kg, then after 5 days received adipose-derived mesenchymal stem cells (ADMSCs) (1 × 10⁶). Cells were injected in the rete testis, then after 60 days, the animals were sacrificed. Group IV (Auto healing group) received Cisplatin (i.p.) at a single dose of 7 mg/kg, and then left for 65 days then the animals were sacrificed. Cisplatin administration resulted in degenerative changes in the testicular architecture in the form of thickened irregular BM of seminiferous tubules. The germinal epithelium showed disorganization and marked reduction in the thickness, associated with Sertoli cells preservation. Features of apoptosis assured by elevated caspase-3 expression were noticed. The interstitium showed cellular infiltration and distorted Leydig cells. Injection of (ADMSCs) resulted in great improvement of testicular architecture and increase in the testosterone level associated with strong immune reaction of the CD-44. ADMSCs are recommended as a new treatment modality for male infertility.

Abbreviation: i.p.: intraperitoneally; BM: basement membrane; ADMSCs: adipose-derived mesenchymal stem cells; WHO: World Health Organization; MSCs: mesenchymal stem cells; DMEM: Dulbecco modified eagles media; PBS: phosphate-buffered saline; FACS: fluorescence-activated cell sorting; ELISA: enzyme-linked immunosorbent assay; CP: Cisplatin; ROS: reactive oxygen species; CAT: catalase; SOD: superoxide dismutase; OS: oxidative stress; SSCs: spermatogonia stem cells; GCs: germ cells; UCMSCs: umblical cord mesenchymal stem cells; TGFb1: transforming growth factor beta-1; BMP4: Bone morphogenic protein 4; BMP8b: bone morphogenic protein 8b.     

Takayasu’s arteritis occurring under TNF blockers in a patient with spondyloarthritis: is it an association or a paradoxical effect?

Coexistence of spondyloarthritis (SpA) and Takayasu’s arteritis is not a common finding, but such cases have been discussed, particularly in the context of choice of therapy. Inhibition of inflammation by tumor necrosis factor inhibitors (TNFi) is a key aspect of the treatment of SpA and also positive effects of such treatment in concomitant large vessel vasculitis have been reported. However, TNFi is also associated with the possibility of initiating vasculitis.The present article based on a case study and the available literature is an attempt to discuss coexistence of these two diseases and the impact of treatment with biological drugs from the anti-TNF group in the course of SpA with Takayasu’s arteritis.     

Synthesis of some heterocycles of potential biological activity

A convenient method for the preparation of imidazobenzimidazole3, imidazoimidazole5, imidazotriazole6 and pyrano [2, 3-c] oxazole7 derivatives is described. This depends on interaction of 2-methyl-4-arylidene-2-oxazolin-5-ones1 with o-diamines, thiosemicarbazide and/or ethylcyanoacetate. The effect of alcoholic potassium cyanide on oxazolinone1 was studied. Antibacterial activity of the obtained products was studied.     

A large primary malignant melanoma of the female urethra

We present a case of large, primary malignant melanoma of the female urethra with poor prognosis in this case report. Malignant melanoma is one of the rare tumors of the female urethra and accounts for 0.2% of all malignant melanoma cases. Large (5.6 cm in diameter), primary malignant melanoma of the female urethra is exceedingly rare.