Influence of nitrogen fertilizers on yield and antifungal bioactivity of Tulbaghia violacea L.

Tulbaghia is known to have antifungal properties that can be used in the treatment of both human and plant pathogens and is used in traditional medicine in South Africa. Increasing demands for plant material makes it necessary to cultivate this species on a large scale. Unfortunately, cultivation can lead to a reduction in the biological activity of plants making them unsuitable for use. In light of the lack of knowledge regarding the agronomic requirements of this plant, the aim of this study was to determine the effect of several rates and two forms of nitrogenous fertilizer on the yield and biological activity of Tulbaghia violacea. Plants were cultivated in sand while the basic fertilization used was the same as that of garlic (20 kg P ha(-1), 75 kg K ha(-1)), a plant from the same family, containing similar active ingredients. Nitrogen was applied once at the beginning of the trial at rates of 30, 60, 120, and 180 kg ha(-1) in the form of either nitrate or ammonium. Vegetative growth was quantified in terms of number of leaves and leaf area as well as root and leaf dry mass, while harvested material was tested for antifungal activity. The results indicated that compared with the untreated control, increasing N-rates in both the nitrate and ammonium forms increased leaf number and leaf area as well as both root and leaf dry mass. However, at a rate above 60 kg ha(-1), and especially at 180 kg ha(-1), the nitrate form stimulated growth more markedly than the ammonium form, whereas antifungal activity decreased sharply and almost linearly as the application rate was increased. Although growth was not stimulated to the same extent by the ammonium form, it increased the in-vitro antifungal activity at different levels during different times of the growing season. From an ornamental perspective, nitrate is the preferred nitrogenous form but, from a bioactivity perspective, ammonium is recommended.

Photodynamic diagnosis of breast tumours after oral application of aminolevulinic acid.

Photodynamic diagnosis is of increasing interest for diagnosis in oncology. It is based on a more intense incorporation of a fluorescent dye in tumours compared to normal tissue. As a feasibility study we investigated the effectiveness of oral application of 5-aminolevulinic acid for photodynamic diagnosis of human primary mammary tumours. The study included 16 patients with palpable breast tumours. Aminolevulinic acid was administered at a concentration of 40 mg kg(-1)bodyweight 150-420 min prior to tumourectomy. Intraoperatively blue light (405 nm) was applied to the operation site. Sections of the excised tumour and some lymph nodes were prepared and analysed with a fluorescent microscope. All primary mammary tumour tissues showed significantly higher fluorescence intensity than surrounding normal mammary tissue. Fluorescence of the mammary tumours could also be discriminated macroscopically and intraoperatively. Fluorescence intensity in nonmetastatic lymph node tissue was higher in 2 out of 3 patients than in primary tumour tissue. By photodynamic diagnosis using aminolevulinic acid we were able to reliably distinguish primary mammary tumours from normal mammary tissue microscopically and macroscopically in all our patients. We suggest that photodynamic diagnosis with aminolevulinic acid for breast tumours should be further investigated and developed for intraoperative use and may well be a simple tool for better intraoperative diagnosis and recognition of tumour margins. We hypothesize that lymph node metastasis of breast tumours will not be detectable by this method.

Lethal pulmonary hypertension in a young woman caused by unrecognized haemangiosis carcinomatosa.

A 38-year-old female is described, who was admitted with increasing respiratory distress, cough and visible blood stasis in the jugular veins. The most likely diagnosis in this young women taking oral contraceptives was pulmonary embolism, however, a ventilation-perfusion lung scan was normal. Echocardiography showed a dilated right ventricle and increased systolic pulmonary pressure. Despite administration of oxygen and intravenous heparin the patient died in circulatory collapse before further investigations could be initiated. Post-mortem examination revealed diffuse adenocarcinoma of the stomach (linitis plastica) with metastasis to local lymphnodes, lymphangiosis carcinomatosa of the liver, pancreas and spleen and tumour cell masses within the lumen of small pulmonary arteries leading to variable occlusions of the vessels. Fibrocellular intimal proliferation was found, leading to further obstruction and increased resistance to flow through the pulmonary vascular bed and to subacute cor pulmonale.

[Granulomatous tumor of the flexor tendon sheath as first manifestation of sarcoidosis]. / Granulomatöser Beugesehnenscheidentumor als Erstmanifestation einer Sarkoidose.

While osseous tumors of the phalanges are more common, soft-tissue manifestations in the hand are uncommon in patients with sarcoidosis. Our patient presented with a large but painless tumor on the palmar aspect of the right index finger limiting finger flexion. Histology of a biopsy specimen was interpreted as a granuloma of sarcoidosis. Further X-ray investigations revealed large bilateral formations in the hila of the lung interpreted as stage I sarcoidosis in an otherwise healthy individual. Tuberculosis and polyarthritis were excluded by standard tests. The tumor was then radically excised, as it was located within the flexor tendon sheath. After uneventful wound healing the patient had regained full function of his finger at six weeks follow up. Interestingly enough, a chest film at that time showed the hilar changes to have decreased as well, which is considered quite typical for this disease.

[Gastric lipoma as an unusual cause of upper gastrointestinal bleeding]. / Magenlipom als seltene Ursache einer oberen Gastrointestinalblutung.

This is a case report of a gastric lipoma causing a severe upper gastrointestinal bleeding. About 200 cases of this very rare benign gastric tumor have been reported so far. Symptoms are not characteristic, but may also mimic malignancy when occurring with bleeding, obstruction or weight loss. Malignant transformation is possible, but extremely rare. Because the tumor is situated under the submucosal layer in 90%, preoperative diagnosis by endoscopic biopsy is almost never possible. The tumor has to be treated by resection. A diagnosis by frozen section during the operation is recommended.

[Cystic lymphangioma of the mesenterial root as a rare cause of acute abdomen]. / Das cystische Lymphangiom der Mesenterialwurzel als seltene Ursache des akuten Abdomens.

Mesenteric lymphangioma is a rare, benign cystic tumor of the lymphatic system, which is commonly found in younger children and may in certain cases lead to an acute abdominal manifestation. The treatment of choice is surgical resection without damage to the blood supply of the bowel. The prognosis is generally favourable, but with increasing tumor size radical resection becomes more difficult and local recurrence more probable.

Case report 726. Enchondromatosis of the left femur and hemipelvis (Ollier's disease).

A case of Ollier's disease is demonstrated. Large osteolytic lesions in the left femur and hemipelvis visible on the roentgenograms represent enchondromas. On CT and MRI studies numerous fine translucencies are demonstrated in the surrounding bone, corresponding to multiple cartilaginous foci. These findings may be considered pathognomonic for enchondromatosis (Ollier's disease). In addition, the nature of Ollier's disease and its predilection for malignant transformation are considered. The major differential diagnostic entity in this case was probably fibrous dysplasia.

[Spontaneous remission in histiocytosis X with lung and bone involvement]. / Spontaner Rückgang einer Histiozytose X mit Lungen- und Knochenbeteiligung.

Histiocytosis X is very rare in the adult. Since the illness is frequently asymptomatic it often causes diagnostic and therapeutic problems. Up to the present, assessment of the long-term course in the adult has required individual case records. A uniform therapeutic concept does not exist. According to prevailing opinion, asymptomatic patients do not require therapy. Our case record describes the spontaneous course in a young asymptomatic patient in whom histiocytosis X, which had affected lungs and bones, healed within 16 months.

[Medroxyprogesterone acetate in adenomatous hyperplasia of the uterine endometrium. Clinical and morphologic studies on the duration and dosage of gestagen therapy]. / Medroxyprogesteronacetat bei der adenomatösen Hyperplasie des Korpusendometriums. Klinische und morphologische Untersuchungen zur Frage der Dauer und Dosierung der Gestagentherapie.

To learn how effective medroxyprogesterone-acetate is for treating adenomatous hyperplasia of the endometrium, we prescribed a controlled therapy in a randomly selected group of 60 women in whom we had diagnosed adenomatous hyperplasia histologically. The endometria of these women were histologically evaluated before therapy was started and again after three months of therapy. The greatest rate of regression was shown by the 40-59 year old women with adenomatous hyperplasia of grade I (15 of 23 patients). The regression occurred with 50 mg/day within three to eight months. For the women with adenomatous hyperplasia of grade II severity, 100 mg per day were required to obtain a similarly good result. For those with adenomatous hyperplasia of grade III severity, 150 mg per day were needed. The over 60-year old patients required higher doses of MPA over longer time periods for equally good therapeutic results. The patients younger than 40 years of age received lower doses (10-40 mg daily) to maintain or regain their fertility. Their adenomatous hyperplasias regressed with 20-40 mg of MPA daily, whereas with a daily dose of 10 mg their adenomatous hyperplasias recurred. The number of cases here, however, is too small for a statistical analysis. Summarising our results we recommend treating patients with adenomatous hyperplasias of grade I and II severity with MPA until it can be proved histologically that the hyperplasia has regressed. The daily dose needed for grade I hyperplasias is between 50 and 100 mg per day, whereas for grade II between 100 and 150 mg are needed.(ABSTRACT TRUNCATED AT 250 WORDS)

[Traumatic myocardial infarct. Report of 3 cases]. / Traumatischer Myokardinfarkt. Drei Fallberichte.

Three patients aged 52, 22 and 29 years, without known previous heart disease, sustained acute myocardial infarction due to blunt chest trauma. A 52-year-old man without a history of heart disease sustained an acute non-transmural lateral myocardial infarction following blunt chest trauma during a sledging party. No coronary arteriography was performed. The clinical course during follow-up of 3 1/2 years was uncomplicated. A 22-year-old, previously asymptomatic man developed acute transmural anteroseptal infarction after a motor-cycle accident. Seven days later he died suddenly after an uncomplicated initial course. The autopsy demonstrated a complete rupture of the proximal left anterior descending artery with periarterial hemorrhage, compression of this artery by the hemorrhage and luminal thrombosis distal to the rupture. No sign of preexisting atherosclerotic coronary disease was found. A 29-year-old man admitted to the hospital after blunt chest trauma during a football game developed an acute transmural inferior infarction with an uncomplicated clinical course. Seven months later coronary arteriography demonstrated a 40% obstructive lesion of the right coronary artery, compatible with thrombosis and subsequent recanalization.

[Exeresis in occipital neuralgia]. / Exhärese bei Okzipitalneuralgie.

31 patients, suffering from an occipital neuralgia, were treated surgically by section of the n. occipitalis major or minor. The retrospective study of these cases extends over a period of one to nine years. In 26 patients (84%) a good result was achieved initially, and 16 patients (52%) are completely free of any complaint up to the present. In five patients (16%) no improvement has occurred. In two of these five patients an epipharyngeal cancer was discovered later; in one of the patients trigeminal neuralgia was established later on. Contrary to earlier published intradural rhizotomy this operation is simple and without risk (it is performed under local anaesthesia), and in long-standing, obstinate and tormenting cases very good results can thus be achieved. The unclear aetiology of the neuralgia was observed anatomically by the atypical course of the nerves. Other methods for the treatment of occipital neuralgia were not considered here.

[Rare variant of a Turner-Ullrich syndrome]. / Seltene Variante eines Turner-Ullrich-Syndroms.

A 25-year-old patient with 45-X0-Turner syndrome exhibited at autopsy dysgenesis of the ovaries and anomalies of the phenotypus and the great blood-vessels (especially coarctation of the aorta). Also found were abnormalities of the urogenital tract, osteoporosis, spider finger, "pectus excavatum" and idiopathic medionecrosis which had led to a rupture of the ascending aorta. This combination of symptoms of Turner syndrome on the one and of Marfan syndrome on the other suggests that in our case two different syndromes coincided accidentally due to a chromosomal aberration. Also worth mentioning is an extraordinary structure of the media in the great blood vessels of the pelvic and femoral region, a texture nerve previously described in the literature.

[Decompensated liver cirrhosis caused by galactosemia in a 52-year-old man]. / Dekompensierte Leberzirrhose infolge Galaktosämie bei einem 52jährigen Mann.

A 52-year-old oligophrenic man hospitalized for esophageal hemorrhage had histologically proven liver cirrhosis and died from massive rehemorrhage. As a neonate he had survived severe jaundice, had had delayed psychomotor development and remained severely retarded. At age 15 years, bilateral cataracts had been excised and from 18 to 25 years he had had occasional grand mal seizures. The triad oligophrenia, liver cirrhosis and cataracts, prompted suspicion of galactosemia. Deficiency of galactose-1-phosphate uridyltransferase was demonstrated in blood and post mortem tissue. At autopsy, liver cirrhosis and esophageal varices were confirmed and unilateral chronic pyelonephritis, bilateral nephrolithiasis and testicular atrophy were found. There was not brain pathology. The patient appeared to be the oldest nondiagnosed galactosemic and the first male patient in whom hypogonadism was documented.