[Traumatic coronary artery dissection after blunt thoracic trauma--a case report]. / Traumatische Koronararteriendissektion nach stumpfem Thoraxtrauma--Fallbericht.

We present a case of cardiac infarction after blunt chest trauma. The 49-year-old patient suffered from severe angina and the ECG demonstrated a pattern of acute anterior wall myocardial infarction. Acute coronary angiography was performed showing complete occlusion of the left interventricular coronary artery due to dissection. An attempted revascularization by percutaneous transluminal coronary angioplasty failed and the patient was then submitted to bypass surgery. We conclude that possible heart injury should be considered in patients with blunt chest trauma to lead them to adequate therapy.

Pseudohomophone effects in lexical decision: still a challenge for current word recognition models.

Computational models that implement a serial mechanism of phonological assembly predict interactions between the size of the pseudohomophone (PsH) effect and stimulus length. Models with frequency-sensitive word representations predict baseword frequency effects. These predictions were tested in a lexical-decision task. The results showed constant PsH effects across different word lengths (in favor of parallel phonological activation) and baseword frequency effects (in favor of frequency-sensitive representations). However, the baseword frequency effect was opposite of what the models predicted. This result is most easily accommodated by models that assume an orthographic verification mechanism. The plausibility of such a mechanism was further supported by the results of 2 additional experiments investigating the effects of response speed and spelling probability (feedback consistency) on the size of the PsH effect.

[Cystic space-occupying lesion with involvement of the pelvis: unusual site of echinococcosis. Case report and surgical treatment]. / Cystische Raumforderung mit Beteiligung des Beckens: ungewöhnliche Lokalisation einer Echinokokkose. Fallbericht und chirurgische Behandlung.

A case of an unusual localization of cystic echinococcosis is presented. Initially it appeared as a retropertioneal tumor with bone involvement and the diagnosis was only recognized intraoperatively. The patient was treated by radical surgery and chemotherapy according to the guidelines of the WHO. We conclude that echinococcosis should be considered in extrahepatic cystic tumors, especially in patients from endemic areas.

Improvement of breast cancer prognostication using cell kinetic-based silver-stainable nucleolar organizer region quantification of the MIB-1 positive tumor cell compartment.

Recently, it was stated that the proliferative activity (P) of a cell population could be indirectly calculated by multiplying the MIB-1 immunopositivity and silver-stainable nucleolar organizer region (AgNOR) features extracted exclusively in MIB-1 positive (pos.) nuclei: P=MIB-1 x AgNOR(MIB-1pos.). To study the prognostic significance of this hypothesis, MIB- immunohistochemistry and AgNOR staining were applied on a series of 89 cases of breast cancer with an 8-year follow-up period. The mean MIB-1 immunopositivity (MIB-1mean) was evaluated immunohistometrically on paraffin sections using a TV image analysis system CM-2 (Hund, Wetzlar, Germany). Later, a combined MIB-1/AgNOR staining was applied and evaluated using a TV image analysis system AMBA (IBSB, Berlin, Germany). The AgNOR features of 150 randomly chosen tumor nuclei were investigated, irrespective of their MIB-1 status (AgNOR count, AgNOR area). Later, a second measurement was performed on 100 MIB-1 positive tumor nuclei exclusively (AgNOR countMIB-1pos., AgNOR areaMIB-1pos.). AgNOR count and AgNOR countMIB-1pos. showed a different data distribution [2.7+/-0.7 (mean+/-SD) vs 3.9+/-1.1; r=0.315, P=0.014]. Similar results were obtained for AgNOR area and AgNOR areaMIB-1pos. (5.1+/-2.1 microm2 vs 7.5+/-2.4 microm2; r=0.501, P<0.001). Kaplan-Meier survival curves revealed significant differences for MIB-1mean (P=0.0018) and AgNOR areaMIB-1pos. (P=0.0340). In Cox models, both parameters provided independent prognostic information. Using their combination, the P, three groups of patients with statistically different survival could be separated (P=0.0014). Thus, the combination of MIB-1-immunopositivity and AgNOR measurements in MIB-1 positive nuclei appears to be more useful in breast cancer prognosis than the exclusive application of one of the two methods. By this combined application, probably effects of tumor biology are represented more precisely.

[Tuberculous coxitis. Case report and surgical treatment]. / Coxitis tuberculosa. Fallbericht und chirurgische Behandlung.

The possibility of a specific origin of joint infection should be considered in finding the diagnosis. This is demonstrated in a case of tuberculosis of the hip treated in the Dept. of Trauma Surgery in collaboration with the Medical Dept. of the Klinikum Minden. Microbiological and imaging examinations are essential to plan and perform a combined therapy of hip arthroplasty and concommitant medical antituberculous therapy. In accordance to a literature review, this procedure proved successful for both eliminating the local infection and the functional outcome of the operation.

Rapid and prognostically valid quantification of immunohistochemical reactions by immunohistometry of the most positive tumour focus. A prospective follow-up study on breast cancer using antibodies against MIB-1, PCNA, ER, and PR.

The prognostic significance of immunohistochemical markers for cell proliferation [MIB-1, proliferating cell nuclear antigen (PCNA)] and hormone receptor analysis [oestrogen receptor (ER), progesterone receptor (PR)] was tested by means of immunohistometry in a series of 103 breast cancer patients in comparison with the lymph node status N, the tumour size T, histomorphological grading, and the biochemical ER and PR status. Immunohistochemical reactions were performed on 2 microns sections from paraffin-embedded tissue, using an indirect peroxidase method. The proportion of immunostained tumour cell nuclei was determined using a TV-image analysis system. Measurements were performed using a 20 x objective on 40 viewing fields (1.94 mm2, MIB-1 and PCNA) or 20 viewing fields (0.97 mm2, ER and PR). The mean immunopositivity of all viewing fields and the value of the most immunopositive viewing field (MIB-1max, PCNAmax, PRmax, ERmax) were calculated. The mean values and the maximal values were highly correlated (r = 0.903, P < 0.001). After 1:2:1 quantilization, 84.2 per cent of the 412 single measurements revealed mean and maximal values in the same category (P < 0.0001). For each of the four immunohistochemical markers, the prognostic significance of the maximal values was higher than that of the mean values. The highest prognostic significance was found for MIC-1max (P = 0.0002), followed by PRmax (P = 0.0046), ERmax (P = 0.0154), and PCNAmax (P = 0.0161). From the results of a Cox model, a 'prognostic index (PI)' was developed, ranging from -1 to 8: PI = 2 x N + T + MIB-1max-PRmax. The four groups of patients with PI values of < 2, 2-3, 4-5, and > 5 revealed significantly different 7.5-year survival probabilities (P < 0.0001). The simplicity of the PI makes it a clinically useful, routinely applicable, and understandable parameter in the surgical pathology of breast carcinoma.