[Peranal bleeding and elevated liver function tests in a 33­year-old refugee from Nigeria]. / Peranaler Blutabgang und erhöhte Leberwerte bei einem 33­jährigen Flüchtling aus Nigeria.

A 33-year-old refugee from Nigeria, who had been living in Germany for 1 year, was admitted to the hospital due to pelvic pain, peranal hemorrhage, and an unexplained increase in transaminase levels. As the liver screening tests, sonography findings, and colonoscopy were normal, a liver biopsy was performed that revealed Schistosoma mansoni worm eggs as an unexpected diagnostic finding. Serological tests for specific antibodies and parasitological egg detection in the stool confirmed the diagnosis. After only temporary response to a short-term and low-dose treatment with praziquantel, a 3-day high-dose (40 mg/kg body weight) treatment with praziquantel finally led to long-lasting symptom relief.

Globulomaxillary cysts--do they really exist?

OBJECTIVES: The so-called "globulomaxillary cyst", described as a fissural cyst, caused by entrapped epithelium between the nasal and maxillary process, is no longer considered for its own entity. Nevertheless, cystic lesions, which correspond to the previous image of globulomaxillary cysts, do still occur in daily practice. This raises the question to which entities pathological processes in this particular region actually belong to. MATERIALS AND METHODS: In a retrospective study, 17 cases (12 men and 5 women, 12-59 years old) of primarily diagnosed globulomaxillary cysts are analysed according to clinical, radiological and histological aspects, catamnestic processed and assigned to a new entity. The results are compared with the international literature and draws conclusions on the diagnostic and therapeutic procedure. RESULTS: Seven lateral periodontal cysts, four radicular cysts, two keratocystic odontogenic tumours, one adenomatoid odontogenic tumour, one periapical granuloma, one residual cyst and one undefined jaw cyst were determined. CONCLUSIONS: According to the results of our study and the data from the international literature, the entity globulomaxillary cyst is no longer justified.

Adherence of monocytes and polymorphonuclear cells to infective larvae of Strongyloides stercoralis after complement activation.

The activation of the complement system by living Strongyloides stercoralis filariform larvae and their antigenic preparation was demonstrated in vitro through both classical and alternative pathways. This activation does not require the presence of specific antibodies but promotes the adhesion of peripheral blood monocytes (MNC) and polymorphonuclear cells (PMNC) to the larval surface. Larvae, totally coated by PMNC, showed a visible loss of motility after 2 hr incubation. Ethylenediamine tetraacetic acid, in contrast to ethylene glycol-bis beta-aminoethylether N,N,N,N-tetraacetic acid, abolished the adherence activity, suggesting the involvement of the alternative pathway in this process. Deposition of complement components C1q, C3, C4, C8, and properdin on the larval surface was demonstrated by immunofluorescence assays. In addition, complement activation by the larvae was demonstrated through C3 conversion and C4 cleavage assays, both depending on the number of larvae. On the other hand, complement activation by S. stercoralis antigen was determined by factor B and C4 cleavage, as well as C3 conversion assays. Our results suggest that the complement system as a first line of defense, in association with the effector cells, plays an important role in the nonspecific immune response of the host to S. stercoralis infection, especially considering the constant parasite recycling through the host tissues.

[Leptospirosis after refurbishment of old buildings]. / Leptospirose nach Altbausanierung.

UNLABELLED: HISTORY AND DIAGNOSIS: A 30-year-old patient was hospitalised with fever and jaundice. No long-term medication was taken. The patient worked as a plumber in refurbishment projects. He presented with headaches, myalgia and arthralgia of varying location and a fever of 38.9 °C. Skin and sclerae were visibly jaundiced. His cardiovascular system was normal. Further routine examination did not reveal any additional signs. INVESTIGATIONS: Having ruled out an acute gallbladder infection or mechanical obstruction of the bile ducts by abdominal ultrasound, an infectious etiology appeared likely, alongside possible toxicological and immunological reasons. Clinical history and diagnosis led to an urgent suspicion of leptospirosis which was confirmed by IgM titer rise within five days in ELISA. TREATMENT AND COURSE: The patient was treated immediately with ceftriaxone. During his stay in the hospital, his fever, jaundice and subjective symptoms subsided. Initial pathological markers also showed a significant trend towards reversion to normal levels. The patient was discharged from the hospital without any symptoms after 16 days. CONCLUSION: Leptospirosis is a significant differential diagnosis in patients with fever, jaundice, headaches and myalgia. Clinical history can provide vital clues for diagnosing this illness. Individuals that are prone to be exposed to water contaminated with rodent urine are at heightened risk of developing the disease. Climatic conditions such as heavy rainfalls or flooding also appear to increase the risk of infection.

[Occurrence of liver cell necrosis during surgery; histological findings of specimens obtained by biopsy during laparotomy (author's transl)]. / Chirurgische granulozytäre Leberzellnekrosen und Bedeutung intraoperativer Leberbiopsien.

Liver biopsy specimens were taken in 350 patiens during laparotomy and examined histologically. In 27.7% of all cases liver cell necrosis with invasion of granulocytes could be demonstrated, however only when biopsies were taken at least 45-60 min after start of surgery. There is no clear evidence, that the occurrence of this type of necrosis depends on the method of narcosis, the age of the patient, the severity or duration of the underlying disease, on the presence of cholangitis, cholestasis or fatty infiltration of the liver. Cell necrosis occuring during surgery arises primarily in the centrolobular areas as single cell necrosis; in rare cases however confluent and extended necrotic changes may occur. Etiology, pathogenesis and significance of the lesions are discussed. The frequency of other changes of the liver diagnosed inadvertently during these investigations is discussed as well.

Pheromone receptors in Bombyx mori and Antheraea pernyi. II. Morphometric analysis.

Sensilla trichodea of the silk moths, Antheraea pernyi and Bombyx mori, were reconstructed from serial sections after freeze substitution. The volume and surface area of the different sensillar cells were calculated from the area and circumference of consecutive section profiles. A. pernyi and B. mori differ largely in the size of the sensory hair and the larger outer dendritic segments as well as in the volume of the receptor lymph within the hair, while there are only small differences regarding inner dendritic segments, receptor-cell somata, trichogen and tormogen cells and the volume of the receptor lymph below the hair base. In each sensillum the two (or three) receptor-cell somata, dendrites, and initial axonal segments differ significantly in volume and surface. The apical cell membranes of the trichogen and tormogen cells, which border the receptor-lymph cavity and which are the presumed site of electrogenic cation pumps, are deeply invaginated and enlarged by microlamellae and microvilli, so that their area is twice that of the remaining basolateral cell membrane. In contrast to mechanoreceptors, the trichogen cell is the largest auxiliary cell and has the largest apical membrane surface. The morphometric data are discussed with regard to recent electrophysiological observations.