Postoperative visual loss following dorsal root entry zone rhizotomy: A dreaded complication after a benign procedure.

Postoperative visual loss (POVL) is a rare but grave postoperative complication. It has been mainly reported in patients undergoing cardiac and spinal surgeries. Dorsal root entry zone (DREZ) is pain relieving procedure performed in patients with refractory neuropathic pain with minimal complication rate. We present a case of unilateral POVL following DREZ rhizotomy in prone position in a patient having brachial plexus neuropathy. Exact etiology of vision loss was though not clear; hypotension, use of vasopressors and hemodilution may have led to vision loss in this patient. This case report highlights the associated risk factors for development of this hazardous complication.

Infections due to Elizabethkingia meningoseptica in critically injured trauma patients: a seven-year study.

Elizabethkingia meningoseptica is an infrequent cause of hospital-acquired infections. The clinical and microbiological profiles of infections due to E. meningoseptica over a seven-year period at a Level-I trauma centre are reported in this study. Medical records of patients from whose clinical samples E. meningoseptica was isolated on more than one occasion were reviewed. A total of 21 cases were observed during the study, 16 (76.2%) of which exhibited multidrug resistance. The observed in-hospital mortality rate was 47.6%. A high index of clinical suspicion and effective detection of E. meningoseptica in clinical samples are requisite for improved clinical outcome.

Search for DNA of exogenous mouse mammary tumor virus-related virus in human breast cancer samples.

Earlier reports of a human exogenous retrovirus (HMTV) related closely to mouse mammary tumor virus (MMTV) led us to search for these viral sequences in breast cancer tissues and normal tissues. A real-time PCR was developed based on MMTV and published HMTV envelope sequences. The real-time PCR method can detect one to ten copies of MMTV target DNA. Tissue samples were collected prospectively from 18 breast cancer patients and 11 non-malignant control cases, as well as peripheral blood leukocytes from the same women. Despite the high sensitivity of the real-time PCR method used, none of the samples were positive for HMTV DNA or RNA. The absence of HMTV DNA in both breast cancer samples and controls indicates either that the concentration of putative HMTV DNA in the breast cancers was too low for detection or that it did not exist there.

Uptake of amplifiable fragments of retrotransposon DNA from the human alimentary tract.

Few attempts have been made to study the transfer of DNA from ingested food across the intestinal barrier. A low uptake of ingested DNA has been observed in mice, cattle and poultry. There have been no reports on humans so far. Maintenance of species barriers, protection against retrotransposons, optimisation of oral DNA vaccines and the fate of genetically modified foodstuffs are issues where this topic is of importance. We therefore used the high-copy-number rabbit retrotransposon RERV-H, and rabbit mitochondrial DNA, to study the transfer of DNA from ingested rabbit meat into the bloodstream of two human volunteers. A quantitative PCR was used to measure RERV-H levels in food and in the blood. Amplification with the primers selected results in the generation of a 250-bp fragment of RERV-H. Transfer across the intestinal epithelium could be demonstrated in both subjects. Levels of the fragment in the bloodstream peaked at 1-3 h after ingestion of the experimental meal. One hour after a meal of rabbit meat containing 10(14) copies of RERV-H DNA, a maximum concentration of 200 copies of RERV-H DNA per ml of peripheral blood was observed, which corresponds to the uptake of approximately 10(6) RERV-H DNA copies in 1 h. RERV-H DNA was detected in both cellular and plasma compartments. Both rabbit retrotransposon and mitochondrial DNA was taken up from the human alimentary tract. The size of the fragments detected is similar to that of SINE retrotransposons (approximately 300 bp). The fate and functionality of alimentary DNA in humans will require further study.

Calcium induced alterations in structural and functional role of phospholipids in Microsporum gypseum.

The effect of calcium on the structural and functional aspects of phospholipids in Microsporum gypseum was examined. Cells grown in presence of calcium exhibited increased content of phospholipids and enhanced synthesis of phospholipids as monitored by the incorporation of [32P] orthophosphoric acid. The rise in the levels of phospholipids was found to be due to increased synthesis of fatty acids as observed from [14C] acetate incorporation studies. The rise in the levels of phospholipids were reflected in the subcellular fractions also. Change in the phospholipid composition increased the fluidity of the membrane as is evident from fluorescence polarization studies using 1-anilinonaphthalene-8-sulfonate (ANS) and 1,6-diphenyl-1,3,5-hexatriene (DPH). The increased membrane fluidity was consistent with the enhanced uptake of [3H] proline in calcium grown cells.

Identification, localization and possible role of calmodulin like protein in phospholipid synthesis of Microsporum gypseum.

Calmodulin like protein has been identified for the first time in dermatophyte--M. gypseum (by specific radioimmunoassay). Maximum amount of this protein was present in the early and mid log phase of growth and was mainly localized in the cytosolic fraction. Cells treated or grown with calmodulin antagonists (phenothiazine and trifluoperazine) exhibited lower uptake of [14C]acetate or labelled phosphate into phospholipids. This is probably due to lower levels of calmodulin seen in these cells. Our results suggest the relationship between calmodulin levels and phospholipid synthesis in Microsporum gypseum.

Possible role of calcium in phospholipid synthesis of Microsporum gypseum.

The effect of calcium on lipid synthesis in Microsporum gypseum was examined by growing these cells in calcium supplemented (1 mM to 10 mM) medium. Maximum incorporation of [14C]acetate into total lipids and phospholipids was observed in cells grown with 6 mM calcium. This was probably due to a 3-fold increase in total calcium levels as incorporation of label was inhibited in total lipids (33%) and phospholipids (20.5%) in calcium-grown cells which were preincubated with the calcium specific chelator ethylene glycolbis (beta-aminoethyl ester) N,N,N',N',-tetracetate (EGTA). Increased incorporation of [14C]acetate into phospholipids was further supported by increase in the activity of key phospholipid biosynthetic enzymes (glycerolkinase and glycerol-3-phosphate acyltransferase) as well as the increase in phospholipid content in calcium-grown cells, which suggests a correlation between increased calcium levels and phospholipid biosynthesis in M. gypseum.

Influence of cyclic AMP on the biosynthesis of phosphatidylcholine in Microsporum gypseum.

The influence of intracellular cAMP on phosphatidylcholine biosynthesis in Microsporum gypseum has been examined using radiolabelled precursors. The incorporation of labelled choline, methionine and ethanolamine into total lipids, phospholipids and choline containing phospholipids increased in aminophylline and decreased in atropine grown cells as a result of rise and fall in cAMP levels in these cells. The enhanced uptake of labelled methionine and ethanolamine in comparison to labelled choline in choline containing phospholipids in aminophylline grown cells suggests that methylation pathway is more influenced by cAMP than CDP-choline pathway.

Further studies on the influence of aminophylline on lipids of Microsporum gypseum.

Aminophylline added to the growth medium of Microsporum gypseum for varying periods exhibited varied effects on lipid synthesis. A decreased incorporation of [14C]acetate into both lipids and phospholipids was initially observed which showed increase after 24 hr of incubation. Short-time exposure of aminophylline also resulted in decreased activity of glycerol-3-phosphate acyltransferase, the key enzyme of lipid synthesis, which, however, got stimulated on longer incubation, supporting the decreased/increased synthesis of lipids during short/long time exposure. Changes in the intracellular levels of cAMP at different time points account for the induced alterations in lipid synthesis, possibly due to formation of metabolites of aminophylline during growth of the organism.

Correlation between intracellular cAMP levels and phospholipids of Microsporum gypseum.

Atropine, a modulator of cAMP has been used to examine the relationship between phospholipids and intracellular levels of cAMP in Microsporum gypseum. A decreased phospholipid content was observed in atropine grown cells as a result of reduced levels of intracellular cAMP. This decline was caused by the inhibitory effect of atropine on adenylate cyclase. Lowered phospholipid content was supported by decreased [14C]acetate incorporation as well as reduced activities of key enzymes of phospholipid biosynthesis. In vitro supplementation of atropine in control cells also caused inhibition in lipid synthesis indicating similar effects of atropine and its metabolites. These results in conjunction with our previous report, in which enhanced levels of cAMP resulted in increased phospholipid synthesis, suggest a direct correlation between phospholipid biosynthesis and intracellular levels of cAMP in M. gypseum.

Establishing a self-perpetuating American Heart Association/Advanced Cardiac Life Support program in West Germany.

Sudden cardiac death is one of the major health problems in industrialized nations. The American Heart Association-sponsored Basic Life Support and Advanced Cardiac Life Support (ACLS) programs provide consensus training programs geared to teach local persons and health care providers the techniques of CPR and advanced life support, respectively. In April 1988, the staff of the U.S. Army Hospital Berlin conducted an ACLS provider course for German physicians. Fourteen students attended the first course; nine passed, and two did not complete the course. Two more courses have been completed. The enthusiasm expressed by the German physicians led to the nomination of one of the physicians for an associate faculty position, and plans for an instructor course of German physicians are under way.

Influence of aminophylline on the lipids in Microsporum gypseum.

The effect of aminophylline on the lipid synthesis of Microsporum gypseum has been examined. A decreased incorporation of [14C]acetate into lipids was observed when the cells were incubated for 1 h with aminophylline which was reflected in all the individual lipid fractions. However, cells grown with aminophylline in the growth medium exhibited increased levels of total phospholipids, which was probably due to a rise in intracellular cAMP as these cells exhibited 4-fold increased levels of cAMP. Decreased activity of phosphodiesterase by aminophylline accounts for the increased cAMP levels. Increased phospholipid content in aminophylline grown cells was further supported by the increased incorporation of [14C]acetate into phospholipids as well as increased activities of phospholipid biosynthetic enzymes in comparison to non-supplemented cells.

Role of vitamin K prophylaxis in newborn.

The role of Vit. K prophylaxis in preventing haemorrhagic disease of newborn has been well established for many years. Although the opinions differ on a general prophylaxis and selective prophylaxis i.e. prophylaxis only for newborn at risk. In our hospital only the selective Vit. K prophylaxis was administered to newborns during the last 20 years. We observed a marked reduction in the incidence of haemorrhagic disease of newborn, particularly after the availability of neonatal intensive care unit. This could be attributed to the effectiveness of Vit. K prophylaxis and better neonatal care and observation. Hence, the present study, reinforced by the experience of the past emphasise the efficacy and safety of Vit. K prophylaxis in the prevention of haemorrhagic disease of newborn.

[Mechanism of a genetically conditioned failure to thrive shown in a patient with ring chromosome 18]. / Mechanismus einer genetisch bedingten Gedeihstörung am Beispiel eines Patienten mit Ringchromosom 18.

The influence of genetic factors on growth is only partially understood. The assumed regulatory mechanism is an interplay of multiple genes, which are localized on various chromosomes. Numerical and unbalanced structural chromosome anomalies cause abundance or lack of genes and gene products. As a consequence the subtle, in their complexity hardly fully conceivable regulatory mechanisms for metabolism and growth of the single cells appear to be disturbed. This kind of model is supported by the occurrence of growth failure in most numerical and structural chromosome anomalies. Further evidence is the variability of the phenotype in cases of ringchromosome 18, which depends on the localization and degree of loss of chromosome material preceding ring formation: depending on the participation of one or several growth-regulating genes normal or impaired growth follows. Consequently we find some normally thrived proponents within the group of predominantly mal grown people with ringchromosome 18. Besides growth the phenotypical variability is concerned with a whole lot of body-functions and systems and virtually every case reported in the literature shows individual signs. This is also true for the patient reported in this paper, in whom we additionally describe the following hitherto not mentioned signs: rudimentary pair of first ribs, apical pulmonary hernias, submammilary dermal groove, hemangioma, meatal stenosis of the urethra, unilateral kidney aplasia, 6 lumber vertebral bodies, umbilical-, abdominal- and inguinal hernias.

[EEG changes following perinatal asphyxia]. / EEG-Veränderungen nach perinataler Asphyxie.

The EEG was studied in 46 pre-term and 43 full-term babies to evaluate its usefulness in estimating the degree of perinatal asphyxia. During the first 12 hours after a severe perinatal asphyxia isoelectric periods (IEP) of abnorm long duration are dominant in the EEG-records of pre-term and full-term babies and remain dominant in EEG-records of pre-term babies during the second 12 hour-period. During the first 12 hour-period in the EEG-records of full-term babies epileptic seizure patterns (ESP) appear sporadically, while in the second 12 hour-period they increase with respect to number and duration and often become even dominant within single records. During the second and third day of life ESP decrease in the EEG-records of full-term babies. IEP remain dominant in about 30% in the EEG-records of pre-term babies. During episodes of bradycardia with or without apnoea a three to fourfold increase of IEP is seen. Therefore an increase of number and/or duration of episodes of bradycardia does not seem to be without importance for cerebral function.