[Ulceroglandular tularemia after contact with a wild boar : Risk of infection for medical personnel by aerosol inhalation during lymph node resection]. / Ulzeroglanduläre Tularämie nach Kontakt mit Wildschwein : Infektionsrisiko für medizinisches Personal durch Inhalation von Aerosolen bei Lymphknotenresektion.

This article presents a case of ulceroglandular tularemia with local lymph node manifestation in a hobby hunter. An adequate diagnosis and early treatment of tularemia is of crucial importance not only for the patient, as when a surgical intervention is necessary there are also substantial risks for medical personnel. In the diagnosis of tularemia, which is rare but with an increasing incidence in Germany, the anamnesis provides the most important clues. A surgical intervention should only be performed after adequate treatment and duration of treatment.

[Translational research and diagnostics of melanoma]. / Translationale Forschung und Diagnostik beim Melanom.

Although early stage malignant melanoma (MM) has a favorable prognosis five year survival rate is poor (<10%) in patients suffering from distant metastases. Due to molecular typing of MM recently high response rates were achieved in metastatic MM by using specific inhibitors directed against the mutated form of BRAF kinase, e.g. Vemurafinib and Dabrafinib. Therefore BRAF mutation analysis has become standard of care in advanced MM and pathologists are urged to provide a quality guaranteed molecular diagnostics. However, squamous neoplasias (e. g., keratoacanthomas) and recurrences of MM mostly within 6 months during targeted therapy point to the need of further translational research. Thus new drugs, such as MEK inhibitors, based on the MAP-kinase pathway downstream of BRAF have already effectively been used. Finally, the impact of molecular characteristics in different subtypes of MM (acral, mucosal, uveal) will be discussed with respect to their specific mutational spectrum (e.g. cKIT , NRAS , GNAQ).

[Inflammatory pseudotumour of the lung as a rare differential diagnosis of a pulmonary mass - a case report and overview of the literature]. / Inflammatorischer Pseudotumor der Lunge als seltene Differenzialdiagnose einer pulmonalen Raumforderung - ein Fallbericht mit Literaturübersicht.

The case of a 37-year-old woman with an inflammatory pseudotumour of the lung is reported. Inflammatory pseudotumour of the lung is a rare disease predominantly occurring in younger patients. Because of its rarity as well as its usually unspecific clinical and radiological presentation, this disease constantly causes diagnostic and therapeutic difficulties. The case report is followed by a short overview of the literature.

Veno-occlusive disease in a fetus caused by pyrrolizidine alkaloids of food origin.

We report the occurrence of veno-occlusive disease in a preterm neonate who was symptomatic with hepatomegaly and ascites and was delivered by caesarean section for threatening fetal asphyxia and died shortly afterwards. Post mortem examination revealed veno-occlusive disease typical for pyrrolizidine alkaloid poisoning. The content of pyrrolizidine alkaloids in the liver could be confirmed. Analysis of a herbal mixture which was used for cooking in the family revealed high amounts of the respective alkaloids clarifying the source of the poison and the causal relationship.

Bronchial artery perfusion during cardiopulmonary bypass does not prevent ischemia of the lung in piglets: assessment of bronchial artery blood flow with fluorescent microspheres.

OBJECTIVE: Blood supply of the lungs during total cardiopulmonary bypass (CPB) is limited to flow through the bronchial arteries. This study was undertaken to assess the bronchial artery blood flow during CPB with fluorescent microspheres in a piglet model. METHODS: We subjected ten piglets (mean weight 5.0+/-0.5 kg) to 120 min of normothermic, total CPB without aortic cross-clamping, followed by 60 min of post-bypass perfusion. Fluorescent microspheres were injected into the left atrium or the aortic cannula or distal to the cannula to assess bronchial artery blood flow before, during and after CPB. The reference samples were taken from the descending aorta. We compared the different sites of injection. Tissue samples of the lungs were taken before and 60 min after CPB. RESULTS: Before CPB, total bronchial artery perfusion was 43.6+/-14.1 ml/min (4.8+/-1.3% of cardiac output) as by injection distal to the aortic cannula. These values were not different when microspheres were injected into the left atrium or the aortic cannula. There was no difference in scatter or in the amount of microspheres in the reference samples among the three injections sites. During CPB, bronchial artery perfusion was significantly decreased (4.4+/-2.4 ml/min vs. 40.0+/-5.0 ml/min before CPB) and returned to baseline values 60 min after CPB. Light microscopy of the tissue samples revealed alveolar septal thickening and a decrease in alveolar surface area after 60 min of reperfusion which was associated with a decreased capacity to oxygenate blood. CONCLUSIONS: (1) Bronchial artery blood flow can quantitatively be assessed during CPB when microspheres are injected into the ascending aorta and the reference samples are taken from the descending aorta. (2) Despite adequate perfusion pressure bronchial artery blood flow is decreased substantially during CPB. (3) The decrease in blood flow and the ultrastructural changes present at the end of CPB suggest the presence of low-flow ischemia of the lung during total CPB.

Focal dermal hypoplasia (Goltz-Gorlin syndrome) associated with obstructive papillomatosis of the larynx and hypopharynx.

A 14-year-old girl with focal dermal hypoplasia (Goltz-Gorlin-syndrome) presented with dysphagia, hoarseness, inspiratory stridor, intermittent dry cough and a 10% weight loss. Endoscopy showed that these symptoms were caused by papillomatosis of the hypopharynx and the larynx. The papillomatous masses were resected subtotally by endoscopic laser treatment. Residual papillomas were left in the subglottic space but tracheotomy could be avoided. Complete clinical recovery with adequate weight gain as well as, resolution of dyspnoe and dysphagia resulted after the intervention. Histological examination did not show morphological signs of human papilloma virus as an etiological agent.

Ampullary hamartoma: A rare cause of biliary obstruction.

Tumors of the papilla of Vater are very rare. Despite advanced imaging techniques the distinction between benign and malignant tumors remains very difficult. Because most ampullary and periampullary tumors are malignant, primary management is surgical. Here we report the case of a 65-year-old man with biliary obstruction caused by an ampullary hamartoma simulating cancer. The correct diagnosis was not established until surgery.

Anaerobic degradation and transformation of p-toluidine by the sulfate-reducing bacterium Desulfobacula toluolica.

The ability of the strictly anaerobic sulfate-reducing bacterium Desulfobacula toluolica (strain Tol2) to cometabolically degrade p-toluidine (p-methylaniline) while using toluene as the primary source of carbon and energy has been studied. This organism has been shown to modify and degrade toluidine in dense cell suspensions when no other source of carbon and energy is added. The metabolism led to the formation of a variety of metabolites. From these metabolites a biphenyl-like compound as well as phenylacetic acid have been identified by means of HPLC/MS techniques. The probable conversion of p-toluidine to p-aminophenylacetic acid and phenylacetic acid as dead end products suggested that this organism initiates p-toluidine degradation by the carboxylation of the methyl group. If this could be validated in further experiments, it would be the first time that a toluidine was carboxylated at the methyl moiety by an anaerobic, sulfate-reducing bacterium.

Effect of filipin on liposomes prepared with different types of steroids.

The action of the polyene antibiotic filipin on the permeability of liposomes prepared with lecithin and several plant and other steroids was studied. The effect of filipin was found to be dependent upon the type of steroid incorporated into the membrane. The interaction of filipin with steroids was found to be related both to the functional group at the 3-position and the aliphatic chain of the steroid. Complex formation of the steroid with filipin in aqueous solutions, as detected by ultraviolet spectrophotometry, correlated with the ability of filipin to increase the permeability of the liposomes.From these results it was suggested that the action of filipin could be used as a diagnostic tool to determine the presence of different steroids in plant membranes. Differences in the sensitivity of subcellular organelles to filipin may be due to differences in the steroid composition of their membranes.

Effect of Growth Temperature on the Lipid Composition of Cyanidium caldarium: I. Class Separation of Lipids.

Cyanidium caldarium was cultured at 20 and 55 C and harvested during exponential growth phase. Comparative lipid studies on each cell type show a decrease by one-half of the total lipid in cells grown at 55 C over cells grown at 20 C. While the distribution of lipid into each of five lipid classes was not influenced by high temperature (55 C), the degree of unsaturation was greatly affected. Ratios of unsaturated to saturated fatty acids in these cells decreased 3-fold with increased temperature in the growth environment. Cells cultured at 20 C contained 30% of their fatty acids as linolenic while this fatty acid could not be detected in cells cultured at 55 C.

Effect of Growth Temperature on the Lipid Composition of Cyanidium caldarium: II. Glycolipid and Phospholipid Components.

Cyanidium caldarium was grown at 20 and 55 C and harvested during exponential growth phase. Lipids were extracted and separated by silicic acid column and thin layer chromatography. The major glycolipids were identified as mono- and digalactosyl diglyceride and sulfolipid. Major phospholipids were identified as phosphatidyl choline and phosphatidyl ethanolamine. The cells grown at 20 C contained significantly larger quantities of these glycolipids and phospholipids than cells grown at 55 C.Fatty acid analysis showed that in all cases the cells grown at 20 C contained more unsaturated fatty acids than the cells grown at 55 C. Cells grown at 55 C were shown to lack linolenic acid, in contrast to cells grown at 20 C, which contained appreciable quantities in certain lipid components. For example, monogalactosyl diglyceride had 57% of its fatty acids in the form of linolenic acid. Cells grown at 55 C were 10 to 15 C more stable to disruption by heating than cells grown at 20 C. The greater thermostability of the latter was attributed to a higher degree of saturation of their membrane fatty acids.