Strong Absorption of Hadrons with Hidden and Open Strangeness in Nuclear Matter.

We present the first observation of K^{-} and ϕ absorption within nuclear matter by means of π^{-}-induced reactions on C and W targets at an incident beam momentum of 1.7 GeV/c studied with HADES at SIS18/GSI. The double ratio (K^{-}/K^{+})_{W}/(K^{-}/K^{+})_{C} is found to be 0.319±0.009(stat)_{-0.012}^{+0.014}(syst) indicating a larger absorption of K^{-} in heavier targets as compared to lighter ones. The measured ϕ/K^{-} ratios in π^{-}+C and π^{-}+W reactions within the HADES acceptance are found to be equal to 0.55±0.04(stat)_{-0.07}^{+0.06}(syst) and to 0.63±0.06(stat)_{-0.11}^{+0.11}(syst), respectively. The similar ratios measured in the two different reactions demonstrate for the first time experimentally that the dynamics of the ϕ meson in nuclear medium is strongly coupled to the K^{-} dynamics. The large difference in the ϕ production off C and W nuclei is discussed in terms of a strong ϕN in-medium coupling. These results are relevant for the description of heavy-ion collisions and the structure of neutron stars.

[Fetal juvenile granulosa cell tumor with hermaphroditism verus - prenatal diagnosis, management and outcome]. / Fetaler juveniler Granulosazelltumor mit Hermaphroditismus verus - pränatale Diagnostik, Management und postnatales Outcome.

Fetal ovarian cysts are common during pregnancy and after delivery. Most of these cysts are simple cysts that involute during pregnancy or in the first months of life. However, complicated cyst with a heterogeneous structure and also possible and can result in various complications: rupture, hemorrhage, ascites, edema of the labia, compression of other viscera, and ovarian torsion. In this case report we describe rare diagnosis of a complicated fetal ovarian cyst with edema of the labia and moderate ascites. The neonate had ambiguous genitalia with clitoromegaly. The newborn underwent surgery with oophorectomy. During the operation a uterus with fallopian tubes was found. The pathological findings showed a juvenile granulosa cell tumor FIGO Ia. Karyotyping revealed a mosaic of 45, X/ 46, X mar (Y) in the peripheral blood as well as in the granulosa cell tumor. Because of a right side inguinal hernia, the child underwent a second surgery. Specimen taken from the abdominal gonad and the inguinal region showed testicular and dysplastic ovarian tissue. There were elevated levels of androgens in the child's peripheral blood due to the granulosa cell tumor. In summary, this case report describes a fetus with true hermaphroditism and a juvenile granulosa cell tumor diagnosed as a complicated ovarian cyst in the 32 (nd )week of pregnancy.

[A rare cause of a central bile duct stricture]. / Seltene Ursache einer zentralen Gallengangsstenose.

HISTORY AND CLINICAL FINDINGS: A 55 year old female patient was diagnosed because of painless jaundice and weight loss. She had undergone conventional cholecystectomy 15 years before. INVESTIGATIONS: Bilirubin level before ERCP and stent implantation was 287 micromol/l at maximum. A subtotal stenosis was found in the proximal common hepatic duct. Endosonographically, a mass of 14 mm diameter was seen. She was suspected of having a Klatskin tumour Bismuth type II. Tumour markers (CEA, CA19-9) were within normal ranges. TREATMENT AND COURSE: One month after stent implantation open surgery was performed suspecting a malignant tumour of the bile duct. A solid tumour at the hepatic bifurcation was resected completely. Reconstruction was performed by hepatico-jejunostomy was formed and the blind end of the jejunum was anastomosed to the gastric antrum to form an "access loop". Upon histological analysis no malignancy was found. However, a distinct fibrosis within the suspicious area was seen, formed around braided suture material. CONCLUSION: Preoperative distinction between benign and malignant bile duct stenosis can be difficult, even impossible. Thus, every resectable bile duct tumour should undergo surgery even and especially if a histological diagnosis cannot be reached preoperatively and the condition of the patient is adequate.

[A huge malignant degenerating neurofibroma of the lower leg coexistent with type 1 Recklinghausen disease]. / Monströses, maligne entartetes Neurofibrom am Unterschenkel bei Morbus Recklinghausen.

HISTORY: A 65-year-old man had noted a tumor of the right lower leg that had progressively grown over the last twenty years. He had a dyspnoea on insignificant movement and was relatively immobile because of the extent of the tumor. The tumor had been diagnosed as a Klippel-Trenaunay syndrome. INVESTIGATIONS: Laboratory investigations suggested a hypochromic and microcytic anaemia and an inflammatory constellation. The tumor had no av-fistulas on ultrasonography and angiography, but there were many pathological arteries and tumor nodes. The tumor nodes had been seen also on MRI-biopsy suggested a neurogenic sarcoma. DIAGNOSIS AND TREATMENT: Amputation of the leg was necessary. The histological diagnosis was neurofibrosarcoma with extensive necrotic areas and Recklinghausen disease. Investigation did not reveal any metastasis. Postoperatively the anaemia regressed and the patient learned to walk with a prosthesis. CONCLUSIONS: This history shows the problem of separating clearly the two hereditary diseases. Often there is a different clinical picture in everyday life. One must consider the definitely higher risk of malignant tumors of patients with neurofibromatosis. Ultrasonography is a non-invasive method that can provide morphological information on soft parts and pathology of the vessels. It facilitates the classification of such.

Functional implications of tissue factor localization to cell-cell contacts in myocardium.

Recently published studies suggest that the procoagulant receptor protein tissue factor (TF) is involved in vitro in cell adhesion and migration, via an interaction of its cytoplasmic domain with cytoskeletal proteins. Interestingly, TF is abundantly expressed in myocardium, but not in skeletal muscle. To elucidate the possible roles of TF in the myocardium, this study examined the cellular distribution of TF in relation to cytoskeletal proteins, as well as its relative amounts in different segments of premature, mature, and pathologically altered cardiac muscle. In juvenile and adult hearts, TF was predominantly detectable in the transverse part of the intercalated discs, where it co-localized with cytoskeletal proteins such as desmin and vinculin. The lowest amount of TF was observed in right atrial and the highest in left ventricular myocardium, which correlated with the number of contact sites of cardiomyocytes in these segments of the cardiac muscle. Lower levels of TF were present in structurally altered myocardium from patients with hypertension or ventricular hypertrophy. In addition, TF expression was decreased in human heart during sepsis and transiently decreased in rabbit heart in an endotoxaemia model, which indicates that a reduction in TF may contribute to cardiac failure in sepsis. The microtopography of TF at cardiomyocyte contact sites indicates that TF may play a structural role in the maintenance of cardiac muscle.

[Langerhans cell histiocytosis in the elderly]. / Langerhanszell-Histiozytose im Alter.

Disseminated Langerhans-cell-histiocytosis (LCH) is most frequent in children at the age of 1-3 years, seldomly seen in adults and extremely rare in the elderly. The clinical course may be acute, subacute or chronic, progressive or stationary. Spontaneous remissions are possible, but rare. In elderly patients often the disease is at first limited to the skin before it becomes systemic. A 73-year-old female patient with chronic stationary disease of 3.5 years duration died 4 weeks after the acute dissemination of her LCH. At the beginning, her skin and liver involvement had responded to chemotherapy with etoposide. Six months later cutaneous relapse occurred with a more disseminated pattern involving the external auditory meatus. Treatment with topical nitrogen mustard followed by thalidomide produced marked improvement. As complications an irritation after topical application of nitrogen mustard and a maculo-papular exanthem after thalidomide were noted. No further visceral involvement was documented for one year. Then the patient developed acute disseminated disease and died within four weeks. As LCH may show a highly unpredictable course with progress and spontaneous remission, the prognosis is difficult. Any therapeutical procedures should be based on the actual state of the disease as determined by careful examination of the organs most commonly involved.

Extracellular HTK perfusion and intracellular acidification in ischemic dog kidneys: a 31P NMR spectroscopic study.

PURPOSE: Bretschneider's histidine-tryptophan-ketoglutarate solution (HTK) for organ preservation is in wide clinical use. Its high buffering capacity is its major protective principle. It is assumed that renal ischemic tolerance benefits from this principle. The study was undertaken to determine the degree to which extracellular buffering influences intracellular acid load. MATERIAL AND METHODS: Canine kidneys were investigated for intracellular and extracellular pH changes during a clinically relevant period of ischemia after preperfusion with either HTK or Ringer solution (Ringer) at different temperatures. Extracellular pH (pHe) was measured with ion-sensitive electrodes. Intracellular pH (pHi) was determined with 31P NMRS. Morphologic and functional parameters were assessed in reperfusion experiments. RESULTS: After perfusion with HTK, pHe values of 7.35, 7.25, and 7.30 were determined for 5C, 20C and, normothermia, respectively. The pHe values after 150 minutes were 7.37, 6.84, and 6.76 at the temperatures indicated. The corresponding pHi values 150 minutes after HTK perfusion were 7.20, 6.79 and 6.54. After Ringer perfusion and 150 minutes at 20C and normothermia, pHi values of 6.29 and 5.92 were measured. Reperfusion experiments showed better results in the HTK group. CONCLUSIONS: Preperfusion with HTK considerably decreases ischemic acidification of extracellular and intracellular compartments at 20C and 37C, compared with Ringer. In kidneys preperfused with HTK and kept at 5C, a nearly physiologic pH was maintained during the observation period of 150 minutes and longer, HTK leads to better functional and morphologic preservation compared to Ringer.

Aluminum levels and stores in patients with total hip endoprostheses from TiAIV or TiAINb alloys.

Aluminum ranks as a potentially hazardous agent. Pathologic findings in different organs show that it can accumulate in brain, muscle, liver and bone. Therefore, we investigated whether patients with cementless total hip endoprostheses made out of titanium alloys containing aluminum are at risk. In order to determine the complete aluminum body loading in patients who have had their hip replacement for a long period of time (mean 58 months), we mobilized possible stores of aluminum with desferoxamine (DFO). Electrothermal atomic absorption spectroscopy was used to quantify the level of aluminum in serum and urine before and after DFO treatment. A serum aluminum value of 10 micrograms/l or less is internationally accepted as safe. The average serum aluminum level in this study was 14.2 micrograms/l, which is slightly above the limit, but clearly below those levels which can lead to disease (> 50 micrograms/l). No relevant storage of aluminum was found. This latter finding is more important since chronically elevated aluminum levels lead to cellular deposits, which affect the cellular biochemistry. The values before and after DFO mobilization did not differ substantially, indicating that aluminum in alloys for biomaterials can be regarded as safe as far as the risk of aluminum release in vivo is concerned. Histologic studies of bone from the bone-metal interface also showed no deposits of local aluminum release.

Distribution of different fiber types in whole cross-sections of human platysma. A histological and morphometric study.

Analysis of cryostat cross-sections of the entire platysma muscle from human autopsies revealed enzyme histochemical and morphometric differences between normal human limb and facial muscles. The mean diameter of platysma fibers was about 50% of that of normal limb muscle fibers. Fiber type diameter increased from the medial to the lateral parts of the platysma. A variability coefficient of 356 indicated great variation in fiber caliber, with many fibers of 10 microns and less. Type I fibers showed an increase in density from the medial to the lateral parts of the muscle. The arrangement of histochemical fiber types was irregular with a tendency to form fiber type groupings.