[Osseous ligament ruptures in the ankle joint]. / Knöcherne Bandausrisse im Sprunggelenksbereich.

An osseous ligament rupture in the ankle joint can conceal a distorsion. The exact diagnosis is possible only by X-ray. The origin of those injuries is frequently twisting of the ankle by walking on smooth or uneven ground. Osseous ligament tear out injuries in the ankle joint are found frequently in defined areas of ligament-passage points and insertions of the ankle joint. Mostly the collateral ligaments are concerned.

Plasma membrane-integrated estrogen receptors in breast tissue: possible modulator molecular for intracellular hormone level.

Plasma membrane fractions from tumor specimens of 14 peri- and postmenopausal primary breast cancer patients and from non-neoplastic tissue were prepared by sucrose density sedimentation. The membranes were disintegrated by Triton X-100 and the 3H-estrogen binding capacity of membrane-derived proteins was determined. The receptor system found in the plasma membranes was mainly of low affinity and high capacity, working apparently in tandem with the high affinity and low capacity system described for the cytosol. Receptor concentrations in plasma membranes of non-neoplastic and neoplastic tissue were distributed over a wide range of values, but a significantly lowered receptor capacity was found on neoplastic tissue. An association constant, Ka = 6.35 . 10(10) M-1 was determined for neoplasma-derived membrane receptor proteins, whereas non-neoplastic tissue membrane proteins were not saturable, when incubated with up to 150 pmol 3H-estradiol. From a Scatchard plot analysis of some experiments a molar concentration of binding sites for membrane proteins, derived from breast cancer tissue, n(M) = 1.7 . 10(-12)/mg protein was extrapolated. Furthermore, ample evidence was provided by an estrogen fluorescence probe that an estrogen binding system is located within the plasma membrane. It is suggested that the estrogen binding capacity of the epithelium cell membrane, due to the phospholipid moiety, can modulate the estrogen uptake and, thus, preventing hazardous high levels of estrogens within the cytoplasm. The presented experimental data throw a new light on the use of antiestrogens in the treatment of breast cancer.

[Neurofibroma and neurofibrosarcoma in Recklinghausen's neurofibromatosis]. / Neurofibron und Neurofibrosarkom bei der Neurofibromatose von Recklinghausen.

The neurofibromatosis von Recklinghausen is a systemic disease, which can cause various different changes in the body. The case report of a female patient shows all the typical signs of neurofibromatosis von Recklinghausen. These signs are café-au-lait spots, congenital tibia pseudarthrosis, abdominal plexiform neurofibromatosis and peripherical neurofibromas with sarcomatous degeneration.

[Replacement of the choledochus with autologous vascularized gallbladder]. / Ersatz des Gallengangs mit autologer vaskularisierter Gallenblase.

Multiple experiments to replace the extrahepatic bile duct by autologous or homologous and alloplasty failed until now. The possibility to employ autologous gall bladder as replacement for the common bile duct has been examined in animal experiments. With the supposition of primary vascularization and the adaptation of the luminal proportion of the transplant to the common bile duct, it could be demonstrated that a flapped, tubular gall bladder interposition kept its epithelium and, by this way, showed no shrinkage or stenosis. The functionaal performance of this method has been confirmed by clinical, laboratory, radiological, and bacteriological, as well as micro- and macropathological experiments.

[Ten years of emergency medical service in Munich. Experiences and results]. / 10 Jahre Notarztdienst in München. Erfahrungen und Ergebnisse

The emergency ambulances of the emergency medical service in Munich have been called out on 89,748 occasions. From the point of view of the specialties involved, internist emergencies were the most frequent with more than half the calls. One fifth of the emergencies were street accidents, occupational and domestic accidents. Genuine saving of life was possible in 1.3% of the cases. Vital functions were disturbed in 10% of all emergencies. With increasing popularity, the emergency ambulance is called to every urgent medical case, because it appears for every patient with unsurpassed reliability and speed. Herein lies the dangers of misuse and decreasing efficiency of an organization originally conceived only for victims of street accidents.