[Increasing lactate levels during treatment of diabetic ketoacidosis]. / Ansteigende Laktatwerte im Verlauf der Therapie einer diabetischen Ketoacidose.

A young woman with type 1 diabetes mellitus and severe diabetic ketoacidosis was treated in an intensive care unit according to the guidelines. Only a few hours after starting the therapy, rising lactate values were diagnosed in the arterial blood gas analysis. Since there were no indications for other reasons of lactatemia, an acute refeeding syndrome caused by the insulin therapy was suspected. Thiamine and phosphate were thus replaced. With this treatment, lactate values fell, supporting the hypothesis of lactatemia due to substrate deficiency.

[Acute liver failure following the use of ecstasy (MDMA)]. / Akutes Leberversagen nach dem Konsum von Ecstasy (MDMA).

The use of "ecstasy" (Methylenedioxymethamphetamine) as a recreational drug is increasing in europe since the 1980's. Aside intended psychological effects the use of ecstasy can be followed by symptoms of intoxication; complications include toxic hepatic damage up to acute hepatic failure. This case-report is about a 17-year old female patient who regularly used "ecstasy" over a six-month period. Two days after the last use of "ecstasy", she reported to her general practitioner with nausea, vomiting, abdominal pain and jaundice. Within 10 days the patient developed acute liver failure. With criteria for liver transplantation fulfilled she was listed for orthotopic liver transplantation of high urgency which was carried out only one day later. Histological examination of the explanted liver showed evidence for a toxic fulminant hepatitis. After transplantation the patient made a full recovery and was released from hospital on day 26 after transplantation. At the first control after six months the patient was in good physical and nutritional condition, serological parameters were normal and ultrasound examination of the transplanted liver was unremarkable. The ethiopathology of "ecstasy"-induced hepatotoxicity, which can occur dose-independently with a symptom-free period from days to weeks after ingestion is not yet fully understood. Possible mechanisms of hepatic damage include influence of MDMA on body temperature regulation, harmful effects of the substance or further components of the "ecstasy"-tablets on the liver cell or a genetic vulnerability of some individuals against amphetamines and amphetamine derivates. There are no parameters existing which could predict the course and severity of "ecstasy"-induced hepatopathy. Especially in young patients with symptoms of hepatic damage frequent controls of clinical status and relevant laboratory parameters are of great importance. Patient transfer to a specialised centre should follow as early as possible; at the latest, when coagulopathy occurs.

Arzneimittelentwicklung in der Onkologie. Status und Ausblick unter besonderer Berucksichtigung des Standortes Deutschland.

The development of oncological therapeutic agents is a complex and risky process and it is mainly pursued by research-based pharmaceutical companies. Academic and public research institutions, however, have contributed to the finding and evaluation of basic scientific knowledge, which were transferred to the industry for co-development. Since 1960 increasing regulatory demands have caused a prolonged development time and dramatical multiplication of costs. Oncological research in Germany began shortly after the end of war, when Bayer worked on the ethyleneimino compounds with agents like E39 and trenimon for therapeutical use. Early in the fifties this focus of research changed to Asta-Werke, Bielefeld (later ASTA Medica, Frankfurt) where cyclophosphamide (Endoxan, Cytoxan), ifosfamide (Holoxan, Ifex) and trofosfamide were developed as worldwide leading alkylating cytotoxic agents. The detection of mesna (Uromitexan, Mesnex) used for the organospecific detoxification of urotoxic metabolites caused a further increase of the cancerotoxic selectivity and an improved safety of oxazaophosphorine therapy. There has been ongoing research on alkylating agents (mafosfamide, glufosfamide), and new therapeutic principles like miltefosine (Miltex) or hormonal agents like cetrorelix (LHRH-antagonist) are in development.

Improved sensitivity in blue-membrane bacteriorhodopsin films.

We show that D85N/V49A, a mutant bacteriorhodopsin in which two residues, aspartate (D) at position 85 and valine (V) at position 49, have been replaced with asparagine (N) and alanine (A), respectively, has significantly improved optical properties compared with other forms of blue-membrane Bacteriorhodopsin. Absorption studies of the mutant in gels show that it forms the P(490) state at light levels that are comparable with M-state formation in wild-type films. Theoretical calculations based on Kramers-Kronig transformation of light-induced absorption data predict that the refractive index is three times larger than that of mutant D85N. Holographic measurements performed on gelatin-based films confirm that the sensitivity is improved by a factor of 50 over that of D85N.

Tuberculosis case detection in a state prison system.

OBJECTIVE: This study was designed to describe the epidemiology of tuberculosis ((TB) among inmates in the Georgia state prison system; to evaluate the effectiveness of the TB case detection methods used; to evaluate the use of contact tracing for inmate TB cases; and to determine rates of completion of therapy. METHODS: Using a standardized form, the authors abstracted data from reports to the Centers for Disease Control and Prevention, prison hospital medical charts, and county health department records for all patients with TB treated in the Georgia Department of Corrections prison system from 1991 through 1995. RESULTS: A total of 142 cases of tuberculosis were treated in the prison during five-year period. Approximately two-thirds were detected by active case finding,either at the county jail prior to transfer to the prison system (31%) or at the prison intake evaluation (37%). Routine screening procedures at entry, following Centers for Disease Control and Prevention guidelines, had a sensitivity of 96%. Contact investigations were carried out in county jails or in the community for only 25% of cases detected at entry to prison. For those released from prison still on treatment, 38% were lost to follow-up before completion of therapy. CONCLUSIONS: The Georgia prison system is doing an effective job of TB case detection and treatment among incarcerated inmates. Closer cooperation between the prison system and local health departments is needed to improve contact tracing and completion of therapy for this high risk population. Some cases detected at entry to prison appear to have been missed in the county jails

Mycobacterium fortuitum infection occurring after a punch biopsy procedure.

Mycobacterium fortuitum is a rapidly growing atypical mycobacterium frequently reported as a postsurgical wound complication from a major surgical procedure. We present a unique case of M. fortuitum infection occurring in a 4-year-old boy after a minor punch biopsy surgical procedure. As far as we know there has been no published case of M. fortuitum occurring after a punch biopsy procedure.

Holographic profilometry with a rhodium-doped barium titanate crystal and a diode laser.

We present a novel, whole-field, noncontact profilometer based on real-time, two-color contour holography. A single 30-mW laser diode was used to record a hologram in a BaTiO(3):Rh crystal, and the reconstructed image was interfered with the real-time object wave. Current modulation of the diode laser produced continuously tunable contour intervals. The resulting interferograms were processed by use of phase-shift interferometry algorithms to yield quantitative, three-dimensional measurements of the original object. We demonstrate submillimeter depth resolution and show how resolution and speed can be further improved.

Resonant holographic interferometry with ZnTe:V:Mn.

The photorefractive semiconductor ZnTe:V:Mn is investigated for use in real-time resonant holographic interferometry applications. Experimental results of two-wave and four-wave mixing with pulsed dye and cw diode lasers are presented; in addition holographic image transfer, as well as two-wavelength resonant holographic interferometry, are demonstrated. Species-specific interferograms of potassium seeded into various combustion environments are captured at video-frame rates. Calculations of the species measurement sensitivity and dynamic range are presented, and design considerations for resonant holographic interferometry systems employing photorefractive materials are outlined.

Real-time resonant holography using bacteriorhodopsin thin films.

We demonstrate real-time, two-dimensional measurement of species concentration in a turbulent flow field. The dynamics of pulsed holographic recording and decay are characterized for a 46-microm polymer film containing bacteriorhodopsin. We produced species-specific holographic interferograms of sodium vapor by simultaneously recording two holograms at different wavelengths, one tuned near a sodium absorption feature and the other tuned off resonance. An analysis of the techniques' sensitivity is presented.

Sandwich, double-reference-wave, holographic, phase-shift interferometry.

Phase-shift interferometry has provided a straightforward method for converting interferograms to phase maps. Unfortunately, some of the most powerful pulsed holographic interferometry techniquesare generally not compatible with phase-shift interferometry. One solution is to employ two reference waves, one for each of the two object waves to be interfered, that can be phase stepped during reconstruction. Practical aberration and alignment problems render this approach difficult. A simple method that employs a second hologram, sandwiched with the first, which produces the required two reference waves during reconstruction, is presented. The process compensates for both chromatic and geometric aberrations that otherwise render the phase-shift method unusable.