xButyagrus nabonnandii (Prosch.) Vorster (Arecaceae): a sterile and rare palm with variable morphology?

×Butyagrus nabonnandii (Prosch.) Vorster is known as mule palm due to sterility, but recently, its pollen has been successfully used in backcrosses. It was first described as an artificial cross between Syagrus romanzoffiana (Cham.) Glassman and Butia odorata (Barb.Rodr.) Noblick in 1890. It has been considered rare in nature, and its morphology has been little studied. Thus, we aimed to verify if ×B. nabonnandii is sterile by studying its morphology and seed germination from different natural populations. The hybrid was sampled in four municipalities and is new to three of these. In one of the visited cities, 20 specimens were counted. The vegetative morphology showed less variation than the reproductive. However, part of the vegetative characters differed from previous descriptions relying solely on cultivated specimens. Contrary to previous reports, our data indicate that ×Butyagrus nabonnandii is neither rare nor infertile. Seed germination rates of ×B. nabonnandii are low due to seed predation by beetle larvae and seedless fruit production, which is also observed in the genera of the parental species. Furthermore, as in its parents, the morphology of the hybrid is complex, and future anatomical and molecular approaches are important for a better delimitation and understanding of the biology of ×B. nabonnandii.

Operative treatment of subcortical metastatic tumours in the central region.

The operative treatment of subcortical metastatic tumours within the paracentral area is still under discussion. Against the background of possible new postoperative neurological deficits and of evolving new radio oncological techniques, the indication for surgery is limited only to a subgroup of patients. In this retrospective study we present the clinical results after operative treatment of metastases within the central and paracentral brain region, with an emphasis on the short-term and mid-term functional outcome. We report on 20 patients suffering from subcortical brain metastases within the primary sensorimotor area, with a median volume on MRI-scans of 8.18 cm³. Patients were admitted to our department with a progressive hemiparesis (n = 11), focal seizures (n = 6) or other unspecific symptoms (n = 3) like headache, nausea, and neuropsychological disturbances, respectively. After updated MRI- and fMRI-scanning, intensive electrophysiological testing including MEP-brain mapping and interdisciplinary tumour-board discussion of each case, those patients were evaluated for surgery. Early postoperative control was done by MRI within the first 48 h. Follow-up took place in our outpatient department, assessing clinical criteria two and 6 weeks postoperatively, followed by clinical control and MRI-scans every 3 months. In all patients, surgery was performed under general anaesthesia, cranial neuro navigation and intraoperative motor cortex stimulation. Surgery and the early postoperative course were uneventful in all cases. After a 6 months follow-up, two patients had died. The motor deficits improved in seven patients and remained unchanged in four cases. One patient suffered from a new persistent hemiparesis. A temporary paresis occurred in two cases. In five patients there was no motor deficit pre- and postoperatively. The Karnofsky Performance Status improved in ten patients 6 months after surgery. Quality of Life, measured by the FACT-Br score, improved in 12 patients and remained unchanged in one patient. With modern techniques like fMRI-guided cranial neuronavigation and intraoperative neuromonitoring including direct stimulation of the motor cortex, microsurgical resection of subcortical paracentral metastases is feasible with an acceptable risk of neurological deterioration. Even preexistent deficits can improve with positive influence on the quality of life for oncological patients, being disabled by the symptoms caused by the cerebral lesion.

[Spinal cord stimulation at the level of the conus medullaris : treatment option for therapy-resistant postoperative neuralgia of the pudendal nerve]. / "Spinal cord stimulation" in Höhe des Conus medullaris : Behandlungsoption bei therapierefraktärer postoperativer Neuralgie des N. pudendus.

Injuries of the pudendal nerve, due to a perineal tear during delivery for example, can cause significant and debilitating neurological deficits. Aconuresis and anal incontinence, as well as sensory loss of the outer genitals or even impotency in men are the well known consequences. In addition some patients suffer from a severe neuropathic pain syndrome which is resistant to conservative treatment options. Epidural spinal cord stimulation at the level of the terminal cone of the spinal cord may be a new and successful therapeutic concept in otherwise untreatable cases.

[Operative therapy for intraspinal empyema: a retrospective study of 23 patients]. / Operative Therapie intraspinaler Empyeme: Eine retrospektive Untersuchung von 23 Patienten.

OBJECTIVE: Intraspinal empyema is a rare entity in spinal surgery. This study analyses the results after operating in 23 patients. MATERIAL AND METHODS: This is a retrospective study of 23 patients suffering from intraspinal empyema treated operatively in our department. The data were obtained by analysing the patient documents including the radiological and microbiological data. RESULTS: 18 patients suffered from different neurological deficits ranging from isolated mild hypaesthesia to paraplegia (n = 3). The operation was done as a one-level (n = 13), two-level (n = 8)or three-level (n = 2) microsurgical fenestration followed by irrigation and drainage of the pus. Staphylococcus aureus was the most frequent triggering organism. After a follow-up of 7 months 1 patient had died because of septic complications. Neurological deficits improved in 14 patients but 3 patients were still disabled in their daily life. CONCLUSION: Epidural spinal empyema remains a challenge in spine surgery. Persistent neurological deficits and lethal complications make it a severe problem. Management comprises urgent surgical evacuation of the pus followed by targeted antibiotic therapy.

[Operative therapy of bacterial spondylodiscitis: a retrospective study]. / Operative Therapie der bakteriellen Spondylodiszitis: Eine retrospektive Untersuchung.

OBJECTIVE: Bacterial spondylodiscitis is a rare entity in spinal surgery. This study analyses the postoperative results of 53 patients, focusing on the history, the treatment, and the course of the disease. MATERIAL AND METHODS: This retrospective study is based on the patients' medical charts, including the laboratory and microbiological data. RESULTS: Twenty-nine patients suffered from different neurological deficits ranging from isolated mild hypaesthesia (n=1) to complete paraplegia (n=6). Depending on the affected area and the extension of the infection, surgery was done either as simple decompression in 16 cases or as decompression combined with a ventral or dorsoventral stabilization in 37 patients. Staphylococcus aureus was the most important triggering organism (n=23). After a median follow-up of 11.25 months, three patients had died, and 22 patients were still disabled because of persisting pain or neurological disturbances. CONCLUSION: Because of persistent neurological deficits and possible lethal complications, spondylodiscitis remains a severe problem. Management comprises targeted antibiotic therapy and surgery in selected cases.

[Neuralgia of the genitofemoral nerve after hernioplasty. Therapy by peripheral nerve stimulation]. / Neuralgie des N. genitofemoralis nach Hernioplastik. Therapie durch periphere Nervenstimulation.

The peripheral nerve stimulation (PNS) is an established therapy in the management of neuropathic pain. Here, we describe a case of successful epifascial stimulation in the proximity of the genitofemoral nerve, which was injured during an endoscopic hernioplasty. During the following months the patient developed an intense neuropathy of this nerve, which we now treated by permanent PNS with an 8-polar electrode. During the 1 year follow-up the patient described a pain reduction of nearly 70%. There were no adverse events until now. In conclusion, PNS is a promising procedure in the treatment of neuralgia after hernioplasty.

GABA(A)-receptor expression in glioma cells is triggered by contact with neuronal cells.

The expression of functional GABA(A)-receptors in glioma cells correlates with low malignancy of tumours and cell lines from glioma lack these receptors. Here we show that contact with neurons induces the expression of functional GABA(A)-receptors. C6 and F98 glioma cell lines were labelled by recombinant expression of enhanced green fluorescent protein injected into rat brain and studied in acute slices after two to three weeks of tumour growth. The cells responded to GABA or the specific agonist, muscimol with a current typical for GABA(A)-receptors, as studied with the patch-clamp technique. To get insight into the mechanism of GABA(A) receptor induction, the C6 or F98 cells were co-cultured with neurons, astrocytes, oligodendrocytes and microglia. Glioma cells expressed functional GABA(A) receptors within 24 h only in cultures where physical contact to neurons occurred. Activation of GABA(A)-receptors in the co-cultures attenuated glioma cell metabolism while blockade of the receptors increased metabolism. We conclude that with this form of interaction, neurons can influence tumour behaviour in the brain.