First comprehensive screening of lipophilic organic contaminants in surface waters of the megacity Jakarta, Indonesia.

Jakarta is an Indonesian coastal megacity with over 10 million inhabitants. The rivers flowing through the city receive enormous amounts of untreated wastewaters and discharge their pollutant loads into Jakarta Bay. We utilized a screening approach to identify those site-specific compounds that represent the major contamination of the cities' water resources, and detected a total number of 71 organic contaminants in Jakarta river water samples. Especially contaminants originating from municipal wastewater discharges were detected in high concentrations, including flame retardants, personal care products and pharmaceutical drugs. A flame retardant, a synthetic fragrance and caffeine were used as marker compounds to trace the riverine transport of municipal wastewaters into Jakarta Bay. These markers are also appropriate to trace municipal wastewater discharges to other tropical coastal ecosystems. This application is in particular useful to evaluate wastewater inputs from land-based sources to habitats which are sensitive to changing water quality, like coral reefs.

[The pressure-sensitive swelling in the knee as a sign for a monoclonal gammopathy of undetermined specificity (MGUS)]. / Die druckdolente Schwellung in der Kniekehle als Wegweiser einer monoklonalen Gammopathie unklarer Spezifität (MGUS).

AL amyloidosis (AL-A) is seen in about 6-15 % of patients with multiple myeloma. In contrast, the sporadic occurrence of AL-A is a rarity. The presence of amyloid is often found in the respiratory tract followed by the lung, the eyelids, the skin and the lower urinary tract, while the presence in soft tissues or bone is rather uncommon. We here describe a 71-year-old woman who presented with a pressure-sensitive swelling in the left knee at our hospital. The clinical examination on admission showed a tumourous alteration of the popliteal soft tissues without any signs of neurological deficits. However, the range of motion (ROM) of the left knee was restricted with 0-0-100 degrees for extension and flexion. A dialysis-dependent renal insufficiency, heart insufficiency with the necessity of permanent anticoagulation and glaucoma were noted as pre-existing illnesses. Further diagnostic examinations including ultrasound and magnetic resonance imaging (MRI) of the left knee revealed a solid tumourous structure with a radiological suspicion of pigmented villonodular synovitis. A complete surgical extirpation of the tumourous structure was performed. The further performed diagnostic examinations including histological and immunohistochemical analyses showed evidence of an AL-A tumour. A monocloncal gammopathy of unknown specificity (MGUS) was detected as an origin for the AL-A. This case underscores the necessity of complete extirpation and histological and immunohistochemical analyses of any soft tissue tumour. Possible previously existing rare malignant diseases can be detected only in this way.

[Underdiagnosed disco-ligamentous lesion in the cervical spine of a paraglider]. / Übersehene disko-ligamentäre Zerreißung an der HWS bei einem Gleitschirmflieger.

INTRODUCTION: Paragliding is an increasingly popular airborne sport with numerous associated injuries. We here describe the case of an experienced paraglider who, after a fall from 15 meters, presented with an initially underdiagnosed disco-ligamentous lesion of the cervical spine. PATIENT AND METHOD: We report on a 51-year-old male paraglider, who was referred to our hospital four days after a fall from 15 meters. Initial treatment was performed in a regional hospital. The performed clinical and radiological examinations including computerized tomography showed, besides a fracture of the radius, no further abnormalities. RESULTS: The patient was discharged home four days after injury. Due to persistent pain in the cervical spine and parasthesia, the patient was referred to the practicing orthopaedic surgeon. The performed MRI and CT including the sagittal and coronal planes showed a disco-ligamentous lesion of the cervical spine. The patient was transferred immediately to our hospital for surgical treatment. The initial existing neurological symptoms resolved postoperatively and the patient was discharged home in a well condition. DISCUSSION: Injuries of the cervical are extremely rare in paragliders. Nevertheless, this case underscores the importance of adequate clinical and radiological examinations. We report the case of our patient to increase awareness among physicians and training staff working in emergency rooms.