[Acral necrosis in metastatic ovarian carcinoma. A single episode of Moschowitz syndrome during gemcitabine chemotherapy]. / Akrale Nekrosen bei metastasiertem Ovarialkarzinom. Ausdruck eines singulären Moschkowitz-Syndroms unter Gemcitabin-Chemotherapie.

For some time now, there have been reports of acral necrosis as a paraneoplasia that may occur in association with a number of different malignant tumours. There have also been a series of reports about acral necrosis associated with chemotherapy with various cytostatics. The treatment of choice if these lesions occur is plasmapheresis. Ultimately, the occurrence of thrombotic microangiopathy (TMA) can only be prevented by close monitoring through regular laboratory controls before each new cycle of chemotherapy. In the differential diagnosis, Raynaud's syndrome should be considered as a premonitory paraneoplasia, a risk factor for the occurrence of acral necrosis in patients with a malignant tumour undergoing chemotherapy, particularly patients with ovarian carcinoma receiving gemcitabine treatment.

Dynamic ankle ultrasonography. A new imaging technique for acute ankle ligament injuries.

We have developed a noninvasive ultrasound technique that may be used to differentiate complete and incomplete acute tears of the anterior talofibular ligament. Direct visualization of the ligament will demonstrate the lesion in most cases and can be supplemented by an anterior drawer test with the ligament under direct vision. Seventeen athletes involved in sports and work that put high-demand pressure on their ankles underwent ultrasonic examination of their acute lateral ankle ligament injuries before surgical exploration. Fourteen scans demonstrating a complete lesion of the anterior talofibular ligament were confirmed at operation. Three scans were equivocal; two of these patients had incomplete lesions of their anterior talofibular ligaments and one patient had a complete tear that was not detected. We have found that the dynamic ultrasound test is a simple and reliable examination. We suggest that this technique is indicated where the extent of an acute lateral ligament injury requires further definition. Ankle ultrasonography may reduce the need for ankle arthrography.

UV susceptibility and negative phototropism of dermatophytes.

High doses of ultraviolet radiation (UVR) have well-known inhibitory effects upon dermatophytes. In the present study, the effect of repetitive low doses of UVR on mycelial growth of dermatophytes was tested. Pellets of Trichophyton rubrum, T. mentagrophytes and Microsporum canis were placed between two thin layers of Sabouraud glucose agar. Obverse, reverse or both sides of these 'sandwich' agars were irradiated for 10 days twice daily with 0.13 or 0.17 J cm-2 UVB. To simulate microaerophilic conditions, one or both agar sides were covered by transparent airtight plastic lids. In addition, T. rubrum was also grown as usual on plates of Sabouraud glucose agar without any covering, and irradiated on its obverse side twice daily with UVA (13.5 J cm-2), UVB (0.17, 0.34 or 0.69 J cm-2) or infrared light, or once only with 3.8-15.1 J cm-2 UVB. As a result, thallus diameters of all strains were found to be reduced by repetitive UVB irradiation under both aerobic and microaerophilic growth conditions. T. rubrum was unaffected by infrared irradiation, responded with an increased pigmentation to UVA (13.5 J cm-2 twice daily) and was inhibited by a single dose of 15.1 J cm-2 UVB. Negative phototropism of dermatophytes is a new observation. It may be biologically relevant as a mechanism to evade harmful doses of UVR.