[2-year follow-up examinations (Bayley II) in infants born at <32 weeks in a German perinatal center]. / 2-Jahres-Nachuntersuchung (Bayley) sehr kleiner Frühgeborener der Jahrgänge 2004-2007: Ergebnisse und Vollständigkeitsanalyse eines Perinatalzentrums.

BACKGROUND: Since 2008, follow-up examinations at 2 years of age with the standardized Bayley II test have become obligatory in Germany for all very low birth weight infants. AIM: We already performed such examinations before 2006. Here, we compared our data and the completeness of our examinations before and after the introduction of the obligatory 2-year follow-up. PATIENTS: From 2004-2007, 372 infants <1500 g or <32 weeks were discharged alive from our center, 19 infants died during their initial hospital stay, 2 after discharge. RESULTS: 271 patients participated in the follow-up examination at age 2 years, with the proportion of participating infants increasing from 64% to 84% after the introduction of obligatory tests. 75% of infants showed a normal development, while 4% had a severe impairment (defined as being blind (1), deaf (1) or having cerebral palsy (6), the CP rate thus being 2%). 49% of infants completed the Bayley test; the mean MDI was 100.3 (SD 10.6). There were no significant qualtitative differences in test results with the introduction of the obligatory test. CONCLUSIONS: The completeness of our follow-up increased over the years. In comparison with international data we found a low rate of severely impaired, deaf or blind VLBW infants.

[Value of diffusion-weighted imaging for diagnosing vertebral metastases due to prostate cancer in comparison to other primary tumors]. / Stellenwert der Diffusionsbildgebung in der Diagnostik von Wirbelkörpermetastasen des Prostatakarzinoms im Vergleich zu anderen Primärtumoren.

PURPOSE: Several publications have reported that the apparent diffusion coefficient is generally lower in metastatically affected vertebrae. Therefore, metastases are represented in diffusion-weighted images by increased signal intensity in comparison to unaffected vertebrae. However, there were indications that metastases due to prostate cancer may differ from this. Therefore, the contrast behavior of vertebral metastases due to prostate cancer or tumors with another histology are to be systematically studied using diffusion-weighted images. The present study is intended to examine whether the two groups differed and whether possible differences depended on the degree of sclerosis. MATERIALS AND METHOD: In a retrospective study the vertebral metastases of patients with prostate cancer (n = 18) were compared to those of patients with tumors of another histology (n = 20). A steady-state free precession sequence was used for the diffusion-weighted imaging. Additionally, a T1 weighted sequence before and after administration of contrast agent as well as a fat suppressed T2 weighted sequence were performed. The contrast behavior of the metastases was evaluated for all four sequences and was compared to that of the unaffected parts of the vertebra. RESULTS: In 18 patients of the tumor group, the vertebral metastases showed positive contrast in the diffusion-weighted images, and 2 had minimally negative contrast up to - 0.04. In the prostate cancer group, the contrast was positive in 9 patients and negative in 9. 6 of the metastases with negative contrast had an osteoblastic metastasization, 1 had an osteolysis, and 1 had a normal finding in the conventional X-ray image. Between the tumor group and the prostate cancer group, the medians of the contrasts were not significantly different (p = 0.054). CONCLUSION: In general, the metastatically affected vertebrae appear hyperintense in the diffusion-weighted images. This observation is only true for some vertebral metastases due to prostate cancer. The cause for this seems to be the degree of sclerosis of the metastases. Thus, it cannot be generally deduced from the hypointensity in diffusion-weighted images that a lesion is benign.

[The amelanotic melanoma of the rectum]. / Das amelanotische Melanom des Rektums.

The amelanotic melanoma of the rectal mucosa is a very rare, difficult to discover tumor. We report on a 65-year-old female patient with an amelanotic melanoma of the rectum who underwent several transanal resections and finally, after an exact histological diagnosis,was treated by abdominoperineal excision. The present case emphasizes the necessity for an obligate histological examination of all suspicious alterations of the anorectum. Even with a very unfavourable prognosis, the amelanotic melanoma of the anorectum should be treated by radical surgical procedures to achieve a significant prolongation of life.

Appendix carcinoma invading the urinary bladder.

We report a case of an appendix carcinoma invading the urinary bladder. In contrast to other bowel tumors invading the bladder, history and symptoms were consistent with a primary bladder tumor. This is due to the unique anatomical position of the appendix where the tumor did not hinder passage of bowel contents or cause melena. Findings on physical examination as well as diagnostic imaging and transurethral resection were inconclusive. Consideration of local progression of an appendix carcinoma is an important differential diagnosis. In contrast to other vesical or extravesical T4 tumors, the appendix carcinoma offers a good chance for resection en bloc by right-sided hemicolectomy and partial cystectomy.

Ultrastructure and molecular composition of the central filament body in hydrozoan cnidocils.

The cnidocils of hydrozoan nematocytes contain modified microtubular axonemes and a cross-striated central filament body. Filament body and axonemal microtubules are interconnected by cross-bridges or are directly attached to one another. Structure and molecular composition of the central filament body was analyzed by means of electron microscopy and immunological techniques. The spindle-like, cross-striated filament body is composed of less than 4 nm thick subfibers. Each unit of its periodical striation pattern is approximately 19 nm broad and comprises subzones with different electron densities. Pure filament bodies are obtainable by a lysis of isolated cnidocils in detergent- and EDTA-containing buffers. The filament body is soluble in 5 mM dithioerythritol (DTE) or 1 M urea. Its structure is stabilized by high concentrations of Na+ or K+ (0.5 M both). Intermediate states of assembly can be induced by 1 mM DTE in lysis buffer which causes the filament bodies to spread into subfibers. CFB43, a monoclonal antibody against filament body protein reacts with a 33 kDa protein in Hydra. Like a polyclonal antibody against SF-assemblin, the protein forming cross-striated system I fibers in unicellular green algae, the antibody cross-reacts with a 36 kDa protein obtained from the unicellular organism Tetrahymena. In immunogold labeling experiments, CFB43 binds to the central filament body in Hydra and recognizes an epitope on the striated rootlets associated with the basal bodies of Tetrahymena. Our results indicate that the central filament body of hydrozoan cnidocils is composed of a protein with properties similar to those of SF-assemblin. In combination with microtubules, the filament body seems to participate in the formation of a stiff mechanical backbone within the cnidocils.

Hip joint arthrodesis utilizing anterior compression plate fixation.

Sixteen patients who had undergone hip arthrodesis utilizing an anteriorly placed compression plate were evaluated at an average of 4.5 years after surgery. The technique was designed to facilitate future conversion to a total hip arthroplasty by preserving the abductor musculature. Of the 11 patients who underwent primary fusions, 5 failed to unite (45%). Nonunion occurred in all five (100%) patients undergoing refusion for a failed surgical arthrodesis. The authors conclude that an anterior compression plate alone in patients with limited bone stock does not provide adequate fixation and predisposes the patient to failure of fixation and nonunion.

Occurrence and Distribution of RFamide-Positive Neurons Within the Polyps of Coryne sp. (Hydrozoa, Corynidae).

The neuronal network of the hydrozoan polyp Coryne sp. contains RFamide-positive neurons. Within the body column, these neurons are centralized in a basal ring and a distal field of ganglionic cells surrounding the peristome. The capitate tentacles are traversed by thick RFamide-positive neurites. Their pericarya are centralized in the knobby heads of the tentacles, forming a brightly fluorescing plaque after immunolabeling with an antibody against the RFamide sequence. Numerous dendrite-like extensions project from these cells towards the cell bodies of the nematocytes. The possible role of these dendrites in communication between adjacent nematocytes is discussed.

Mutants with substitutions for Glu171 in the catabolite activator protein (CAP) of Escherichia coli activate transcription from the lac promoter.

Single amino acid substitutions for residue Glu171 in helix E of the catabolite gene activator protein (CAP) of Escherichia coli have been reported to abolish activation of transcription without impairing binding to the CAP site of the lac promoter. The negative charge of Glu171 was proposed to transmit the activating signal from CAP to RNA polymerase. However, this idea has been challenged by later work. We set up a system to re-examine this issue. We analysed the ability of mutant CAP-E171L and CAP-E171K proteins to bind a near-consensus CAP site in vivo and found it to be diminished fourfold relative to wild type in each case. Activation of lac transcription by these mutant proteins remains the same as with wild-type CAP. Thus our results confirm that Glu171 in helix E of CAP is not involved directly in the activation of transcription. Yet CAP-E171K does not activate transcription as well as wild-type CAP under all circumstances. Possible reasons for this absence of activation are discussed.

[Intrauterine pericardial effusion. Early symptom of a primary symptomatic congenital cytomegaly]. / Intrauterin aufgetretener Perikarderguss. Frühsymptom einer primär symptomatischen kongenitalen Zytomegalie.

We report of a fetus who was ultrasonographically shown to have growth retardation, oligohydramnios and a pericardial effusion without other components of a hydrops fetalis at 28 weeks' gestation. At 29 weeks' gestation the child was born by cesarean section of pathological CTG. A congenital cytomegaly was diagnosed. The etiological role of the infection for the development of the pericardial effusion is discussed.

Frequency of urogenital tuberculosis in an unselected autopsy series from 1928 to 1949 and 1976 to 1989.

The evaluation of a total of 12,211 autopsy protocols prior to the introduction of chemotherapy (1928-1949) and in the recent years (1976-1989) had the following results: the frequency of renal tuberculosis has dropped from 2.0 to 0.6% of all autopsies in men and from 1.7 to 0.9% in women. While the frequency of miliary tuberculosis infections in general has decreased to about one fourth (from 2.7 to 0.6% of all autopsies), renal involvement in patients with miliary tuberculosis has rather increased (from 35.4 to 52.2 for men and from 37.5 to 68.0% for women). The frequency of miliary tuberculosis of the kidneys was two times higher in girls than in boys (3.8% of girls and 1.8% of boys). Tuberculosis of the renal pelvis, ureter or urinary bladder secondary to a renal tuberculous infection has decreased from 65 to 4.3% of all tuberculous infections with renal involvement in males and from 25 to 0% in females. In the second period, the frequency of genital tuberculosis has in all dropped to about one tenth.

Sequential infection of silicone metacarpophalangeal joint arthroplasties resulting from skin breakdown.

We report a case of late multiple infected metacarpophalangeal silicone implants in a patient who had had replacement arthroplasty for treatment of rheumatoid arthritis. The patient had done well for 10 years after metacarpophalangeal joint arthroplasty when an implant infection developed. Over the next 4 years the remaining three implants on her dominant extremity also became infected necessitating their removal. The origin of the infections is thought to be the result of excessive and improper usage of the hand.

Candidosis of the prostate: a rare form of endomycosis.

The third case of a culturally and histologically proven candidosis of the prostate in the world literature available to us is reported. Autopsy of a 59-year-old man with metastasizing bronchial carcinoma as predisposing primary disease revealed a local candidosis of the prostate in the left lobe of the prostate, without evidence of a Candida sepsis. Parallel and different aspects in comparison with the other two cases are described.

Distal ulnar physeal injury.

We reviewed 18 patients and two traumatic amputation specimens with injuries involving the distal ulnar physis. Type 1 growth mechanism injuries were the most common fracture pattern with premature physeal closure and ulnar shortening occurring in 55% of the patients. Other consequences included radial bowing, ulnar angulation of the distal radius, and ulnar translocation of the carpus. Most of the patients, however, were asymptomatic. Initial radiographic diagnosis of this physeal injury may be difficult because of the relatively late ossification of the distal ulnar physis. Concomitant ulnar physeal injuries must be suspected in any injury to the distal radius, especially when an ulnar metaphyseal or styloid fracture is not readily evident.

Direct evidence for the occurrence of simple microtubule organizing centers (MTOCs) and for end-to-end joining of microtubules with modified ends in the reticulopodia of Allogromia laticollaris (foraminifera).

The partial disassembly of filopodial microtubules into helical filaments, respectively the reassembly from paracrystals of exactly registered tubulin helices was recognized as a special adaptation to the highly dynamic reticulopodial movements in the foraminifer Allogromia laticollaris [4, 16]. Electron microscopic investigations of partially extracted or completely lysed filopodial strands revealed some additional adaptations to the local tubulin demands within the widely spread, rapidly changing reticulopodial networks. As probable foci for the initiation of additional microtubules from pools of tubulin during the netto growth phase, small (40 × 60 nm) cube-shaped, electron dense bodies were discovered which could act as mobile MTOCs at very distant sites from the metabolically active cell body within the reticulopodial system. The microtubule ends, proximally as well as distally to the filopodial origins, are characterized by a closed appearance because of a terminal cap which is continuous with the microtubule wall, whereas some other microtubules appear as the usual open cylinders. It is suggested that the closed ends, which occur either freely or decorated by the cube-shaped, electron dense bodies, may play a role in the de novo initiation of microtubules as well as in the transformation to the helical state or vice versa. Points of discontinuity within single longitudinally cut microtubules can be observed directly by electron microscopy and correspond to end-to-end contacts of closed MT-terminations. These junctions probably represent initial contact points of an annealing process between adjacent shorter MT-segments. Microtubule annealing occurs rapidly in vitro [14, 15] and could explain the elongation rates observed during filopodial outgrowth.

Prostatic specific antigen: immunoreactivity in urachal remnants.

Urachal remnants were obtained at autopsy from 10 males and 15 females in order to determine whether prostatic specific antigen (PSA) is present in that tissue. Immunohistochemical staining was carried out using a commercially available antibody to PSA. Four cases (three females and one male) showed focal positive reaction of PSA, predominantly in narrow glandular structures of metaplastic origin. Therefore, it cannot be excluded that PSA might occur in urachal adenocarcinomas. PSA-staining is evidently not confined exclusively to tissue originating in the prostate.

Multifocal adult rhabdomyoma. Case report and literature review.

Extracardiac adult rhabdomyoma is a rare benign tumor which occurs mostly in the head and neck region. A few cases of adult extracardiac rhabdomyoma (9 out of 69 reported) have been multifocal. We present a new case of multifocal adult rhabdomyoma which was asymptomatic. We describe histological features of adult rhabdomyoma which may provide a means for distinguishing it from other types of tumors.