[Traumatic dissection of the internal carotid artery following whiplash injury. Diagnostic workup and therapy of an often overlooked but potentially dangerous additional vascular lesion]. / Traumatische Dissektion der A. carotis interna nach HWS-Beschleunigungstrauma. Diagnostik und Therapie einer häufig übersehenen aber potenziell gefährlichen Begleitverletzung.

We report on the case of a 33-year-old male patient who was brought to the emergency room of our hospital after suffering a high-energy trauma due to an automobile accident. Besides a scaphoid fracture there were no signs of any neurological deficits. After several hours without clinical symptoms the patient developed dysarthria as the first manifestation of local cerebral ischemia based on a traumatic dissection of the internal carotid artery. Under systemic high-dose heparin therapy, fast and complete remission of all neurological disorders could be achieved. In the course of time a dissecting aneurysm developed. Temporary anticoagulation with phenprocoumon was started in the meantime and no further complications have appeared up to now. Besides presenting this absorbing case, this article highlights the diagnostic and therapeutic regime in cases of a traumatic dissection of supra-aortal arteries for rapid and adequate management of this rare but potentially dangerous complication.

Epstein-Barr virus-related dacryocystitis: a case report.

BACKGROUND AND OBJECTIVE: Acute dacryocystitis is an atypical and rare manifestation of pediatric mononucleosis still widely underdiagnosed in clinical practice. We report this rare condition and describe challenges in its diagnosis and treatment on the basis of a presented case. CASE PRESENTATION: A 6-year-old Caucasian girl without any ophthalmic history was admitted for right preseptal cellulitis requiring intravenous antibiotic therapy. During hospitalization, she developed a fluctuating lump in the nasolacrimal region which resembled an abscess, both clinically and radiologically. There was no spontaneous purulent discharge. Serology was positive for acute mononucleosis and Epstein-Barr virus-related dacryocystitis was diagnosed. Following multidisciplinary discussion, she was treated conservatively with digital lacrimal sac massages and intravenous antibiotic therapy with an excellent outcome. DISCUSSION: This rare form of Epstein-Barr virus is poorly documented in the literature, and thus barely known. As initial symptoms are nonspecific (rhinitis, fever, eyelid edema and erythema lack of purulent discharge, and moderate bilateral cervical lymphadenopathy), diagnosis is often difficult. Nevertheless, differentiating between dacryocystitis and abscess is crucial to select the appropriate treatment and avoid unnecessary, potentially harmful surgery. Conservative management of dacryocystitis appears to be the gold standard of treatment. CONCLUSION: Acute dacryocystitis in children free of ophthalmic history should raise suspicion of primary Epstein-Barr virus infection. With conservative treatment, prognosis appears to be excellent; therefore, surgery should be avoided as much as possible.

Theory of deep minima in (e,2e) measurements of triply differential cross sections.

Deep minima in He(e,2e)He+ triply differential cross sections are traced to vortices in atomic wave functions. Such vortices have been predicted earlier, but the present calculations show that they have also been observed experimentally, although not recognized as vortices. Their observation in (e,2e) measurements shows that vortices play an important role in electron correlations related to the transfer of angular momentum between incident and ejected electrons. The vortices significantly extend the list of known features that summarize the general picture of electron correlations in impact ionization.

Creating and manipulating vortices in atomic wave functions with short electric field pulses.

We demonstrate the creation of vortices in the electronic probability density of an atom subject to short electric field pulses, how these vortices evolve and can be manipulated by varying the applied pulses, and that they persist to macroscopic distances in the spectrum of ejected electrons. This opens the possibility to use practical femtosecond or shorter laser pulses to create and manipulate these vortex quasiparticles at the atomic scale and observe them in the laboratory. Within a hydrodynamic interpretation we also show, since the Schrödinger equation is a particular instance of the Navier-Stokes equations, that for compressible fluids vortices can appear spontaneously and with a certain time delay, which is not expected to occur from the conventional point of view, illustrating applicability of the present study to vortex formation more broadly.

[Marjolin's ulcer: malignant transformation of a crural ulcer due to posttraumatic chronic osteomyelitis]. / Das Marjolin-Ulkus : Maligne Transformation eines Ulcus cruris auf dem Boden einer posttraumatischen chronischen Osteomyelitis.

We report on the case of an 81-year-old female patient who developed a squamous cell carcinoma in a long-lasting therapy-resistant crural ulcer of the lower leg due to posttraumatic chronic osteomyelitis. Eventually the lower leg had to be amputated because of massive destruction of soft tissue and the tibia bone. Based on the desolate wound conditions plastic reconstruction by a pivoted muscle flap and surgical covering with mesh graft plastic was also necessary.The amputation stump had completely healed 6 months after surgery and the patient is fitted with an artificial limb ensuring independent mobility even outside the home. Up to the present there is no evidence of any tumor recurrence or progression.

Nerve growth factor (NGF) regulates adult rat cultured dorsal root ganglion neuron responses to the excitotoxin capsaicin.

An overlap between subpopulations of nerve growth factor (NGF)-responsive and capsaicin-sensitive dorsal root ganglion (DRG) sensory neurons has been suggested from a number of in vivo studies. To examine this apparent link in more detail, we compared the effects of capsaicin on adult rat DRG neurons cultured in the presence or absence of NGF. Capsaicin sensitivity was assessed histochemically by a cobalt staining method, by measuring capsaicin-induced 45Ca2+ uptake, and by electrophysiological recording of capsaicin-evoked membrane currents. When cultured with NGF, approximately 50% of these adult DRG neurons were capsaicin-sensitive, whereas adult sympathetic neurons or ganglionic nonneuronal cells were insensitive. DRG cultures grown in the absence of NGF, however, were essentially unresponsive to capsaicin. Capsaicin sensitivity could be regained fully within 4-6 days of replacement of NGF. These results indicate that, at least in vitro, NGF can modify the capsaicin sensitivity of adult DRG neurons.

Genetic exchange in African trypanosomes.

African trypanosomes are important pathogens of humans and domestic animals, but little was known, until recently, of the genetic system of these parasites. Recent results demonstrate the existence of nonobligatory genetic exchange between different stocks of T. brucei. A number of models have been put forward for the mechanism of genetic exchange, including a fusion model with subsequent random loss of chromosomes and a more conventional mendelian system.

Regulation of vesicular monoamine and glutamate transporters by vesicle-associated trimeric G proteins: new jobs for long-known signal transduction molecules.

Neurotransmitters of neurons and neuroendocrine cells are concentrated first in the cytosol and then in either small synaptic vesicles ofpresynaptic terminals or in secretory vesicles by the activity of specific transporters of the plasma and the vesicular membrane, respectively. In the central nervous system the postsynaptic response depends--amongst other parameters-on the amount of neurotransmitter stored in a given vesicle. Neurotransmitter packets (quanta) vary over a wide range which may be also due to a regulation of vesicular neurotransmitter filling. Vesicular filling is regulated by the availability of transmitter molecules in the cytoplasm, the amount of transporter molecules and an electrochemical proton-mediated gradient over the vesicular membrane. In addition, it is modulated by vesicle-associated heterotrimeric G proteins, Galphao2 and Galphaq. Galphao2 and Galphaq regulate vesicular monoamine transporter (VMAT) activities in brain and platelets, respectively. Galphao2 also regulates vesicular glutamate transporter (VGLUT) activity by changing its chloride dependence. It appears that the vesicular content activates the G protein, suggesting a signal transduction from the luminal site which might be mediated by a vesicular G protein-coupled receptor or as an alternative possibility by the transporter itself. Thus, G proteins control transmitter storage and thereby probablylink the regulation of the vesicular content to intracellular signal cascades.

Dot-blotting--a novel screening assay for antibodies in hybridoma cultures.

A novel solid phase radioimmunoassay using nitrocellulose filters, is described. The method is of particular value in screening hybridoma cultures for monoclonal antibodies against chromosomal protein. Also it permits detection of antibodies directed against epitopes stable to SDS denaturation.

Gene exchange in African trypanosomes: characterisation of a new hybrid genotype.

We describe the isolation of a hybrid Trypanosoma brucei clone following the mixed cyclical transmission of two parental clones through tsetse flies. The characterisation of this clone reveals some new facets of the process of genetic exchange in T. brucei. The inheritance of four isoenzyme loci and restriction fragment polymorphisms at two loci was interpretable in 'mendelian' genetic terms, involving meiosis either before or after the genetic exchange event. However, at a further two isoenzyme loci a deviation from mendelian behaviour was observed. Pulse field gel analysis showed that the hybrid clone possessed a new combination of intermediate size chromosomes. Examination of kinetoplast DNA variants showed uniparental kinetoplast inheritance, and with reference to previous work we conclude that the kinetoplast can be inherited from either parent. The nuclear DNA content of the hybrid clone was measured and found to be identical to the parental nuclear DNA contents. This finding, together with the inheritance of isoenzyme and RFLP markers, is discussed with respect to possible models for genetic exchange.

Gene exchange in African trypanosomes: frequency and allelic segregation.

The existence of a system of genetic exchange in Trypanosoma brucei is now established, but the frequency with which mating occurs and the mechanisms by which genes are exchanged are still unknown. This paper presents the results of a study of one pair of trypanosome stocks, which show that mating is a non-obligatory but frequent event in a life-cycle stage within the insect vector. Analysis of ten progeny clones using a total of eleven markers (iso-enzymes and DNA probes detecting restriction fragment length polymorphisms) has indicated that segregation of alleles occurs at five of these loci. The segregation patterns of a polymorphic EcoRI site in the maxi-circle of the kinetoplast DNA (kDNA) show that the progeny inherit one or other of the parental kDNA types. These results demonstrate that segregation of alleles occurs and that new combinations of alleles at different loci are generated in the progeny clones. The implications of these findings for defining the mechanism of gene exchange are discussed in relation to a simple mendelian genetic system involving meiosis and syngamy.

Neuropeptide expression in cultures of adult sensory neurons: modulation of substance P and calcitonin gene-related peptide levels by nerve growth factor.

In contrast to developing sensory neurons, the survival of adult rat dorsal root ganglion neurons in pure neuronal culture is not dependent on specific neurotrophic factors such as nerve growth factor or brain-derived neurotrophic factor [Lindsay R. M. (1988) J. Neurosci. 8, 2394-2405]. In the present study we have examined possible modulatory effects of nerve growth factor on the neuropeptide content of sub-populations of adult rat dorsal root ganglion neurons in vitro. During the first 1-2 days in culture the neuropeptides substance P and calcitonin gene-related peptide could be detected by immunofluorescence staining in cultures grown in the presence or absence of nerve growth factor, but at longer times in nerve growth factor-deprived cultures there was loss of immunoreactive staining for both peptides. In the presence of nerve growth factor, however, the percentage of substance P- and calcitonin gene-related peptide-immunoreactive neurons remained relatively constant, for at least 14 days, at levels that were similar to the percentage of such peptide-containing neurons found in sections of adult rat dorsal root ganglia. Quantitation by radioimmunoassay of the levels of substance P and calcitonin gene-related peptide in cultures grown in the presence or absence of nerve growth factor agreed with the qualitative observations obtained by immunofluorescence: 10-15-fold higher levels of substance P and calcitonin gene-related peptide were found in cultures grown with nerve growth factor for 18 days, as compared to nerve growth factor-deprived cultures. In nerve growth factor-treated cultures increased levels of substance P and calcitonin gene-related peptide were observed within 3-6 days in vitro, and further steady increases in the levels of both peptides were found up to 18 days. A low basal level of both peptides could always be detected, even in the presence of an excess of antibodies to nerve growth factor. Up-regulation of the synthesis of substance P and calcitonin gene-related peptide did not depend on nerve growth factor being present at the initiation of the cultures, as elevated levels of both peptides could be induced in cultures even after up to 10 days' prior deprivation of nerve growth factor. Removal of nerve growth factor from the cultures resulted in reduced levels of peptide within 3 days.(ABSTRACT TRUNCATED AT 400 WORDS)

Nuclear DNA content of Trypanosoma congolense.

We have measured the nuclear DNA content of the major life cycle stages of Trypanosoma congolense, in two clones of geographically distant origin. We find that nuclear DNA content in epimastigote, mammalian blood-stream and metacyclic forms is constant and that the nuclear DNA contents of the two clones were 0.1 pg and 0.09 pg, respectively.

Semiconductor laser-induced fluorescence detection in capillary electrophoresis using a cyanine dye.

Cy5, an activated carboxyl cyanine fluorophore, was characterized by capillary electrophoresis (CE) using a semiconductor laser at 652 nm to induce fluorescence. Hydrolysis of the activated Cy5 in the presence of ammonia results in the formation of a mono- and diamide and a dicarboxylic acid. A Cy5-labeled oligonucleotide M13 primer for DNA sequencing (M13mp18 template) was synthesized with a purity of better than 95%. The labeled primer was analyzed by liquid chromatography, using UV-visible detection, and by CE, monitored by laser-induced fluorescence (LIF) detection. Analysis of the Cy5-labeled oligonucleotide primer by CE-LIF in a 9% polyacrylamide gel-filled capillary indicated the purity of the major Cy5-oligonucleotide primer was greater than 90%. The detection sensitivity for Cy5-based CE-LIF detection system with a 2.5-mW red semiconductor laser is about 10(-10) M.

Famoxadone: the discovery and optimisation of a new agricultural fungicide.

Famoxadone (3-anilino-5-methyl-5-(4-phenoxyphenyl)-1,3-oxazolidine-2,4-dione), is a new agricultural fungicide recently commercialized by DuPont under the trade name Famoxate. Famoxadone is a member of a new class of oxazolidinone fungicides that demonstrate excellent control of plant pathogens in the Ascomycete, Basidiomycete, and Oomycete classes that infect grapes, cereals, tomatoes, potatoes and other crops. DuPont's entry into the oxazolidinone area resulted from the procurement of 5-methyl-5-phenyl-3-phenylamino-2-thioxo-4-oxazolidinone (1) from Professor Detlef Geffken, then at the University of Bonn. An extensive analog program was initiated immediately after the fungicidal activity of 1 was discovered through routine greenhouse testing. The discovery program in the oxazolidinone area eventually culminated in the advancement of famoxadone to commercial development in the early 1990s. The synthesis of various oxazolidinone ring systems and the development of the structure-activity relationships that led to the discovery of famoxadone are described.

Sublingual pyramidal lobe. Complications of subtotal thyroidectomy for Graves' disease.

A potential complication of subtotal thyroidectomy where a large pyramidal lobe is present is described. The pyramidal lobe normally is immobilized inferiorly by its attachment to the thyroidal isthmus. When the isthmus is removed and the pyramidal lobe is left in situ during subtotal thyroidectomy its superior attachments will allow the pyramidal lobe to become situated sublingually. This may produce gagging and nausea. To avoid the complication, it is recommended that the pyramidal lobe be removed during subtotal thyroidectomy. If the patient also is thyrotoxic, I-131 can be used to treat this complication successfully.

Anaemia in human African trypanosomiasis caused by Trypanosoma brucei rhodesiense.

OBJECTIVE: To find out if indeed anaemia is a major sign in human trypanosomiasis caused by Trypanosoma brucei rhodensiense. DESIGN: A one year cross-sectional study of all admitted and surveyed Trypanosoma brucei rhodensiense infected patients (June 2001-June 2002) SETTING: Nkhotakota District Hospital-Central Region of Malawi. RESULTS: After survey and investigations, 28 patients (16 males and 12 females) were admitted to Nkhotakota District Hospital with a parasite positive Trypanosoma brucei rhodensiense infection. Twenty four (85.7%) of them were anaemic. Their mean haemoglobin was 8.96 +/- 3.07 g/dl compared to controls that had a mean haemoglobin concentration of 12.17 +/- 1.35 g/dl (p < 0.000001, 95% CI -4.342 to -2.0785) (n = 45). None of the trypanosomiasis infected individuals had schistosomiasis or hookworms. Two patients had malaria. One of them was an 18-year-old pregnant woman with hepatosplenomegaly, who developed ante partum haemorrhage. She was jaundiced and had haemoglobin of 10 g/dl. She died after two weeks following the diagnosis and treatment. The other was a two-year-old girl who had haemoglobin of 8.4 g/dl. She also had hepatosplenomegaly. All the other patients looked well nourished with no other signs of chronic diseases. Hepatosplenomegaly was significantly related to the severity of illness (p = 0.011) but not to anaemia. CONCLUSION: Though basic, this study has shown that anaemia is indeed a complication of human Africa trypanosomiasis caused by Trypanosoma brucei rhodesiense. There is need for further investigation to investigate the type of anaemia that is caused by this disease.

[CT-findings in penetrating captive bolt injuries to the head and brain: analysis of the trauma-related CT-findings and review of the literature]. / CT-Befunde bei penetrierenden Kopfverletzungen durch Bolzenschussgeräte--Analyse der verletzungsspezifischen CT-Befunde und eine Übersicht über die relevante Literatur.

Penetrating gunshot injuries to the head and brain are rare in Germany and the rest of Western Europe. Due to the small number of cases over here no consistent diagnostic and therapeutic standards exist in this respect. Thus these kinds of injuries present a great challenge to the attending physicians. Most of these violations are a result of a suicidal attempt or an accident. Beside violations by firearms also penetrating injuries to the head and brain due to captive bolt devices, as used in slaughtery business for the "humane" killing of animals, occur from time to time. The impact on the head differs from that caused by firearms because no projectile is leaving the barrel and the used bolt, as a fix part of the device, does not remain in the affected tissue. That implies characteristic results within the radiological imaging that might be pathbreaking for the further treatment, because the origin of such a head injury is often unknown during primary care. Consequently the knowledge of these specific findings is central to the radiologist to make the appropriate diagnosis. Based on some clinical examples the trauma-related CT-findings are introduced and a short overview of the relevant literature is also given.