The location of paravertebral catheters placed using the landmark technique.

The aim of this prospective clinical study was to evaluate the location of paravertebral catheters that were placed using the classical landmark puncture technique and to correlate the distribution of contrast dye injected through the catheters with the extent of somatic block. Paravertebral catheter placement was attempted in 31 patients after video-assisted thoracic surgery. In one patient, an ultrasound-guided approach was chosen after failed catheter placement using the landmark method. A fluoroscopic examination in two planes using contrast dye was followed by injection of local anaesthetic and subsequent clinical testing of the extent of the anaesthetised area. In nine patients (29%), spread of contrast dye was not seen within the paravertebral space as intended. Misplaced catheters were in the epidural space (three patients), in the erector spinae musculature (five patients), and in the pleural space (one patient). There was also a discrepancy between the radiological findings and the observed distribution of loss of sensation. We have demonstrated an unacceptably high misplacement rate of paravertebral catheters using the landmark method. Additional research is required to compare the efficacy and safety of continuous paravertebral block using ultrasound-guided techniques or surgical inserted catheters.

[Representation of the nerves of the wing of psittacines (Amazon, gray parrot} using a digital photographic technique]. / Darstellung der Nerven am Flügel von Psittaciden (Amazone, Graupapagei) mit digitaler Phototechnik.

In four blue-fronted Amazon and five African grey parrots, the nerves innervating the muscles of the wings were carefully dissected and described. The preparation steps were recorded with a digital camera. This technique has now advanced so far that the image quality is almost the same as that of a normal camera. The pictures are stored in a computer. They can be enhanced and published via the Internet.

Solid-phase synthesis of new S-glycoamino acid building blocks.

Efficient synthesis of unprotected S-glycoamino acid building blocks in the solid phase by coupling a sugar 1-thiolate with iodine activated fluoren-9-ylmethoxycarbonyl (Fmoc) protected amino acids.

Three novel paralogs of the rodent prolactin gene family.

The prolactin (PRL) family consists of a collection of genes expressed in the uterus, placenta and anterior pituitary. These cytokines/hormones participate in the control of maternal-fetal adaptations to pregnancy. In this report, we establish the presence of three new members of the PRL family. Novel expressed sequence tags (ESTs) with homology to PRL were isolated from embryonic and placental cDNA libraries. The cDNAs were sequenced and compared with those of other members of the PRL family. The three new cDNAs were assigned to the PRL family on the basis of sequence similarities and were referred to as PRL-like protein-J (PLP-J), PRL-like protein-K (PLP-K) and PRL-like protein-M (PLP-M). Both rat and mouse PLP-J cDNAs were identified. Rat PLP-J cDNA encodes for a predicted 211 amino acid protein containing a 29 amino acid signal peptide and two putative N-linked glycosylation sites, whereas the mouse PLP-J cDNA encodes for a 212 amino acid protein containing a 29 amino acid signal peptide with a single N-linked glycosylation site. Rat and mouse PLP-J proteins share approximately 79% and 70% nucleotide and amino acid sequence identity, respectively. A full-length rat PLP-K cDNA and a partial tentative mouse PLP-K cDNA were identified. The rat PLP-K cDNA encodes for a predicted 228 amino acid protein containing a 31 amino acid signal peptide and one putative N-linked glycosylation site; the mouse PLP-M cDNA encodes for a predicted 228 amino acid protein containing a 28 amino acid signal peptide and one putative N-linked glycosylation site. Genes for PLP-J, PLP-K and PLP-M are situated at the Prl family locus on mouse chromosome 13. PLP-J was exclusively expressed in decidual tissue from both the mouse and rat. PLP-K was expressed in trophoblast cells of the chorioallantoic placenta and showed an apparent species difference. In the mouse, virtually all trophoblast lineages expressed PLP-K, whereas in the rat, PLP-K expression was restricted to the labyrinthine trophoblast cells. Mouse PLP-M expression was restricted to the junctional zone of the chorioallantoic placenta. In summary, we have identified three new members of the rodent PRL gene family that are expressed in uterine and placental structures. Future experimentation is needed to determine the specific roles of each of these ligands in the biology of pregnancy.

[Management of Werlhof disease in pregnancy complicated by diabetes mellitus type I]. / Management eines M. Werlhof in der Schwangerschaft bei gleichzeitig bestehendem Diabetes mellitus Typ I.

We report on a 25-year old female in whom idiopathic thrombozytopenic purpura and diabetes type I existed at the same time in pregnancy. In this constellation we decided to treat her with intravenous immunoglobulins for five days and delivered her by caesarean after recovery of the maternal thrombozytes. While this proved to be an effective treatment for the mother with few adverse effects we saw severely low thrombozytopenia of the child requiring intensive postnatal care. A longterm treatment with immunoglobulins for about three weeks could be a possible treatment for the fetal as well as the maternal thrombozytopenia. Reports on this question do not yet exist.

Goethe almost died of urosepsis.

In the year of 1805, Goethe almost died of urosepsis. His urological problems were not diseases arising from full health but a new variation in a life accompanied by illnesses. Some sources date the first colics he experienced to the year 1795 and others say 1805. The most dramatic period in the course of his illness was in February, when he suffered from fever of such an extent that one could speak of urosepsis. Recovery took place slowly and was accompanied by minor relapses. Nothing about this is written down in his work. On the advice of his doctors, Goethe undertook a cure in Lauchstädt in July and August. The report of his consultant, Professor Johann Christian Reil, on his problems in the field of urology remained undiscovered until 1937. Professor Reil recommended treatment with thermae carolinae, aqua calcis, soap soda crystallisata, herbae subastringentes, and uva ursi, among other measures. With increasing age, Goethe's colics disappeared. The passing of a stone has never been described. Whereas Goethe hinted about medical problem other than those reported herein, the urological problems discussed in this article were left unmentioned. Nonetheless, literature that deals with Goethe's diseases is interesting from the aspect of both the history of medicine and the history of culture.

The role of glycolipids in mediating cell adhesion: a flow chamber study.

Selectins constitute a family of proteins that mediate leukocyte tethering and rolling along the vascular endothelium by recognizing various carbohydrate ligands in response to inflammation. To test the hypothesis that multivalent binding of selectins to their ligands is the molecular basis for achieving sufficient binding forces, we have performed this flow chamber study. Selectin-containing Chinese hamster ovarial cells (CHO-E) bind and roll along a support-fixed phospholipid membrane containing a defined concentration of a synthetic Sialyl Lewisx (sLex) glycolipid ligand. Ligands are either homogeneously distributed, or arranged in defined lateral clusters, as illustrated here for the first time. The lateral glycolipid clusters which appear as recognition motifs are essential for mediating cell rolling. Furthermore, the transition from firm cell adhesion to cell rolling depends on the site density of ligands. Rolling velocity shows little dependence on shear forces within a broad range. As we found out that cells do not roll along the model membranes with homogeneous ligand distribution, our results therefore support the hypothesis of multivalent binding events. Since these investigations suggest that lipid-anchored sLex, functionally embedded in a lipid matrix, can mediate cell rolling, this study demonstrates the relationship between dynamic glycolipid binding to selectins with the hypothesis of multivalency of binding for the first time.

Characterization of the murine gene of gC1qBP, a novel cell protein that binds the globular heads of C1q, vitronectin, high molecular weight kininogen and factor XII.

gC1qBP is a novel cell protein which was found to interact with the globular heads of C1q, high mol. wt kininogen, factor XII and the heparin-binding, multimeric form of vitronectin. The protein sequence shows no homology to any protein family. This paper describes the genomic organization of mouse gC1qBP and the characterization of its 5' flanking region. The mouse gene consists of six exons separated by five introns, and its total length is approximately 6kb. Exon 1 encodes the putative signal peptide, a long stretch of 70 amino acid residues, and the first four amino acid residues found in the mature gC1qBP. Exons 2-5 encode four very hydrophilic domains, whereas exon 6 encodes a neutral domain. The amino acid sequence responsible for binding to the heparin-binding, multimeric form of vitronectin is located in exon 2. A 1kb DNA fragment upstream of the first initiation codon was sequenced, which contained four potential TATA boxes, seven CAAT boxes, six SP1 sites and various putative transcription factor-binding elements, indicating that the promoter region is in close proximity to the first exon. The mouseC1qbp gene was mapped to chromosome 11, closely linked to D11Mit4 using genomic DNAs from a (C57BL/6J x Mus spretus)F1 x Mus spretus backcross.

Ultrastructure of rat Purkinje neurons after chronic ethanol consumption and prolonged abstinence.

In the present study of nutrition control of Wistar white rats, the ultrastructure of cerebellar Purkinje cells was studied after chronic ethanol exposure and a subsequent period of prolonged abstinence: a qualitative investigation of the perikarya of Purkinje cells was performed in age-matched controls (group A) and rats alcohol-fed for 5 months and withdrawn from this diet for 3 months (group B). The results showed massive accumulation of small dense bodies as well as obvious deposition of lipofuscin in the Purkinje cells of group B. Furthermore, ring-shaped Golgi apparatus units, lamellar bodies and degenerative foci dispersed throughout the cytoplasm of the alcohol-treated animals referred to degeneration processes and neuronal cell death, the morphological characteristics and the aetiology of which are discussed.

[Development, cytoarchitecture and ultrastructure of the mesencephalic trigeminal nucleus in domestic ruminants]. / Entwicklung, Zytoarchitektonik und Feinstruktur des mesencephalen Trigeminuskerns bei Hauswiederkäuern.

The ontogenetic development and cell differentiation of the mesencephalic trigeminal nucleus (Ntm) is lightmicroscopically examined in 58 bovine embryos and fetuses ranging from 2.4 to 80 cm Crown-Rump-Length (CRL). The cytoarchitecture and fine structure in adult cattle, sheep, and goats are investigated with the aid of light- and electronmicroscopy. At 2.4 cm CRL, the proneurons of the Ntm are detectable for the first time within the ventricular zone of the alar plate, possessing one drop-like cytoplasmic protrusion, whereas at 5 cm CRL, two cell types with differing sizes appear. Up to a CRL of 11.5 cm, the nucleus shows advanced maturation processes and has reached his final position at the border of the mesencephalic central grey. From 26 cm CRL onward, three cell types, and at 34 cm CRL four cell types, are discernible based on their nissl-granule arrangement. The cytomorphological differentiation and the maturation of the cells proceeds until 56 cm CRL, at which point the topographical and cytological characteristics of the Ntm are comparable with those of adult animals. In adult cattle, sheep and goats the Ntm consists of large (40-60 microns) and scarce medium-sized (30-40 microns) neurons with round and oval shapes. Scarcer small (20-25 microns) round and medium-sized multipolar neurons occur. The Nissl bodies are scattered throughout the pericaryon of the large neurons in a dust-like pattern and in the medium-sized neurons in a grained form. Within the cytoplasmic streets, which are situated between the membranes of the rough ER, numerous neurofilaments and mitochondria are detectable. Large Golgi complexes are placed in a perinuclear position. The neurons are also characterized by some somatic spines, and by a moderate distribution of axosomatic synapses, in which axon-endings with flattened synaptic vesicles predominate.

Electrolyte equilibration of human kidneys during perfusion with HTK-solution according to Bretschneider.

Twelve surgically removed human kidneys (mainly tumor kidneys) were investigated. The investigations comprised perfusion criteria (perfusion flow, perfusion pressure, perfusion resistance, electrolyte equilibration). During perfusion of the kidneys with HTK solution, the perfusion resistance was nearly three times as high in human kidneys as in canine kidneys perfused under the same conditions in previous studies. Beside possible species differences the raised perfusion resistance may be explained by the greater trauma to the human kidneys due to the surgery, the primary ischemic stress which cannot be avoided clinically and the often nonoptimal initial diuresis. Nevertheless definitive perfusion is possible under clinical conditions although pronounced increases of perfusion resistance may occur. As indicated by the raised perfusion resistance of human kidneys under clinical conditions as compared with canine kidneys in an experimental model, electrolyte equilibration of human kidneys was protracted. For this reason, a duration of perfusion of at least 10 min is necessary in clinical application of HTK solution, i.e., longer than in animal experiments.

[Morphology and histogenesis of the colliculi rostrales in cattle]. / Morpho- und Histogenese der Colliculi rostrales beim Rind.

Based upon macroscopic and light microscopic examinations the development of the superior colliculus of bovine embryos and fetuses with crown-rump lengths (CRL) ranging from 0.8 to 90.0 cm was studied. Macroscopically, the mesencephalon can be recognized for the first time at 0.8 cm CRL, whereas the superior colliculus can be clearly differentiated in embryos of 4.5 cm CRL. The macroscopic features of this brain area have reached adult conditions at 80.0 cm CRL. The light microscopic examination reflected the beginning of layer formation at 0.8 cm CRL, which is induced by the proliferating activity of the ventricular zone. Up to 3.4 cm CRL the primordium of the tectum opticum exhibits still a trilaminate pattern (ventricular-intermediate- and marginal zone), but at 4.5 cm CRL, the formation of the specific tectal layers is marked by the origin of the stratum profundum and intermedium. With the appearance of the tenth layer named stratum opticum at 8.0 cm CRL the laminar pattern corresponds to the characteristics of adult animals.

[Fine structure of the trigeminal nerve nucleus of the domestic fowl]. / Feinstruktur der Trigeminuskerne vom Haushuhn.

The trigeminal nerve nuclei are examined light- and electron-microscopically in the adult domestic fowl. The nucleus sensibilis principalis nervi trigemini is formed by scarce, medium-sized, round-to-ovoid polygonal neurons. The Nissl bodies are concentrated around the nucleus and consist of short cisterns of the rough endoplasmic reticulum densely bordered with ribosomes. The nucleus tractus spinalis nervi trigemini extends to the first segments of the cervical cord. The rostral part of the nucleus is characterized by medium-sized polygonal neurons. Their cell bodies are densely packed with coarse Nissl bodies. Small multiforme cell types with large nuclei frequently showing two nucleoli predominate in the caudal part. The motorical main portion, nucleus motorius nervi trigemini consists of medium-sized as well as great polygonal neurons. The accessory portion, nucleus motorius dorsalis nervi trigemini, consists of medium-sized polygonal neurons. Both nuclei show the typical motoneuron cytomorphology. In the neuropil, the axodendritic synapses can be differentiated into five types. Occasionally, densely packed glial lamellae and giant mitochondria occur.

[Development and cell differentiation in the nucleus nervi hypoglossi in cows]. / Entwicklung und Zelldifferenzierung des Nucleus nervi hypoglossi beim Rind.

Based upon light- and electron-microscope examinations, the ontogenetic development of the nucleus of cranial nerve XII is documented. At 1-cm crown-rump length (CRL), the caudal pole of the nucleus nervi hypoglossi forms a uniform cell column with the cornu ventrale of the spinal cord. During this period, its caudal area shows signs of cellular degeneration. From 3.5 cm CRL onward, all nuclear groups can be identified. At 53 cm CRL, they correspond to the pattern as described in the adult brain. Electron-optically, at 2.5 cm and 3.6 cm CRL, the nucleus of cranial nerve XII exhibits a close relationship to the matrix layer which consists of elements of dark nuclei. The hypoglossus nucleus is composed of dark and light cell types. It is the latter type that represents the presumptive neuron; it shows an increased ultrastructural differentiation from 2.5 cm CRL onward.

The cytogenesis and radial migration of cranial nerve efferent neurons in the developing brain stem of the bovine.

The cytogenesis of motor neurons of the immature brain stem of the bovine has been examined by light-and electron microscopy from the periods of origin and migration of the motor neurons until their transformation into relatively mature neurons in their area of destination. Up to 2.7 cm CRL intensive cell migration occurs from the ventromedial cell column in a ventrolateral direction, leading to the formation of the definitive viscero-efferent nucleus of the facial nerve. Electron-optically these cells exhibit features of immature neurons which are extending leading processes in the direction of their destination. At 2.5 cm CRL a formation of vertical cell columns can be identified in the facial nucleus which has reached its final position. Its perikaryon areas come into contact with radial fibres. This morphological pattern marks the process of migration. An increased ultrastructural differentiation is typical for neurons which are localized in their ultimate position.

[Development and cell differentiation of the vestibulocochlear nuclei in cattle]. / Entwicklung und Zelldifferenzierung der Nuclei vestibulocochleares beim Rind.

Based upon light- and electron microscopic examinations (50 embryos ranging from 1 to 53 cm crown-rump-length, CRL) the origin of the nuclei of the cranial nerve VIII is described with special regard to neurogenesis. The ventricular matrix lateral to the sulcus limitans represents the alar plate with its sensory areas. Up to 2.7 cm CRL migrating neurons from the vestibular nuclei can be detected, the bigger neuronal elements of which are the early formed lateral vestibular nucleus. From 6.7 cm CRL onward all nuclear groups of the vestibular nerve can be identified. At 1 cm CRL the recess plate represents the primordium of the cochlear nuclear complex. Identification of the definitive nuclei is possible at 3.8 cm CRL. Subsequently from 7.6 cm CRL onward the process of lamination can be observed in the dorsal cochlear nucleus. Due to the proceeding maturation the nuclei of the cranial nerve VIII correspond at 53 cm CRL topographically and cytologically to the characteristics of adult animals. Electron microscopic examinations are documenting characteristic features of cytogenesis of sensory neurons (vestibular nucleus) during early embryonic stages (2.5 cm and 3.6 cm CRL). At 2.5 cm CRL the elements exhibiting features of migrating neurons are predominating, whereas at 3.6 cm CRL an increased differentiation is typical for neurons localized in their ultimate position. At this stage synapses can be identified for the first time.

A modified technique for nerve-sparing retroperitoneal lymph node dissection in stage II nonseminomatous germ cell tumors using intraoperative measurement of bladder neck pressure alterations following sympathetic nerve fiber electrostimulation.

We present a simplified method for nerve-sparing retroperitoneal lymph node dissection in patients with nonseminomatous testicular cancer. The sympathetic fibers involved in antegrade ejaculation are identified by intraoperative electrostimulation, resulting in an increase of bladder neck closure pressure. This increase is demonstrated by intraoperative monitoring of both the intravesical pressure and the pressure within the bladder neck by a two-channel microtip measuring catheter. 4 patients with stage I and 6 patients with stage II nonseminomatous testicular cancer were operated on with this modified technique. Ejaculation was preserved in all cases. Semen volume ranged from 2.2 to 4.0 ml. Sperm cell count ranged from 2 to 22 x 10(6)/ml with 20-50% motile spermatozoa, except for 2 of the 3 patients who initially presented with preoperative azoospermia following chemotherapy. In 1 of these 3 patients, postoperative semen analyses revealed a recovery of germ cell function demonstrated by oligoasthenozoospermia.

[Development and cell differentiation of the motor nucleus of the facial nerve of cattle]. / Entwicklung und Zelldifferenzierung des Nucleus motorius nervi facialis beim Rind.

The early development, cell-migration and cell-differentiation of the nucleus motorius nervi facialis were studied in 32 bovine embryos with a CRL of 1 to 53 cm by light microscopical techniques. The ventro-medial cell column, a transitory embryonic formation, can be regarded as the origin of the nucleus. From there migrating cells can be demonstrated up to a CRL of 2.7 cm. With 3.8 cm CRL the cells are confined to their definitive location. From 5 cm CRL onwards a subdivision into 4 subnuclei can be seen. By succeeding maturation processes the nucleus of fetuses with 53 CRL acquires the topographical and cellular appearance of mature animals. With the electron microscope the cell-differentiation of the early stages (2.5 and 3.6 cm CRL) was demonstrated. Additionally the ventro-medial cell column was studied. The vertical columnar organisation of the neurons of the nucleus facialis shows besides longitudinal orientated guiding structures the migration process which is taken place at a CRL of 2.5 cm. Synaptogenic cell contact are seen from 3.6 cm SSL. At this stage the migration of cells has come to an end.