[Volvulus of the small intestine, a rare complication during laxative period before colonoscopy]. / Dünndarmvolvulus: eine seltene Komplikation bei der Koloskopievorbereitung.

HISTORY AND CLINICAL FINDINGS: A 69-year-old patient was hospitalized 16 h after investigation of the colon (screening colonoscopy), suffering from abdominal pain, which had started during the laxative period the day before colonoscopy. INVESTIGATIONS: Clinical and technical investigations showed signs of a peritonitis. TREATMENT AND COURSE: By laparotomy a volvulus of the small intestine was found, caused by adhesions after appendectomy years before. A resection of a part of the small intestine got necessary, there were no problems during the postoperative course. CONCLUSIONS: If pain appears during the laxative period before colonoscopy, rare complications like volvulus of the small intestine should be considered.

Tuber physiology and properties of starch from tubers of transgenic potato plants with altered plastidic adenylate transporter activity.

We showed recently that antisense plants with decreased activity of the plastidic ATP/ADP-transporter protein exhibit drastically reduced levels of starch and a decreased amylose/amylopectin ratio, whereas sense plants with increased activity of the transporter possessed more starch than wild-type plants and an increased amylose/amylopectin ratio. In this paper we investigate the effect of altered plastidic ATP/ADP-transporter protein expression on primary metabolism and granule morphology in more detail. Tuber tissues from antisense and sense plants exhibited substantially increased respiratory activity compared with the wild type. Tubers from antisense plants contained markedly increased levels of free sugars, UDP-Glc, and hexose phosphates, whereas phosphoenolpyruvate, isocitrate, ATP, ADP, AMP, UTP, UDP, and inorganic pyrophosphate levels were slightly decreased. In contrast, tubers from sense plants revealed a slight increase in adenine and uridine nucleotides and in the levels of inorganic pyrophosphate, whereas no significant changes in the levels of soluble sugars and metabolites were observed. Antisense tubers contained 50% reduced levels of ADP-Glc, whereas sense tubers contained up to 2-fold increased levels of this sole precursor for starch biosynthesis. Microscopic examination of starch grain morphology revealed that the size of starch grains from antisense tubers was substantially smaller (50%) compared with the wild type. The large starch grains from sense tubers appeared of a more angular morphology, which differed to the more ellipsoid shape of wild type grains. The results suggest a close interaction between plastidial adenylate transport and starch biosynthesis, indicating that ADP-Glc pyrophosphorylase is ATP-limited in vivo and that changes in ADP-Glc concentration determine starch yield, as well as granule morphology. Possible factors linking starch synthesis and respiration are discussed.

[Medical correspondence]. / Der ärztliche Schriftverkehr.

This paper gives a short overview of the most relevant elements of medical records. It seems important to emphasise, that writing a letter to the family doctor has more meaning than simple documentation. It is a matter of communication, involving psychological and ethical requirements. Professional discretion, the right length of the letter, as well as focusing at the real important issues are further aspects of successful records.

Simulation system SONCHES-based toxicokinetic model and data bank as a tool in biological monitoring and risk assessment.

This paper describes the use of an interactive simulation system (SONCHES) as a model and databank system. The basic model is a physiologically based toxicokinetic model (partition coefficient concept). This model takes circulation times into consideration and includes a metabolic subsystem with spot urine output. Data libraries related to the physiology of mammals, chemical substances, the external environment (exposure, physical activity, skin uptake, water intake) and real experiments allow various simulation experiments (scenarios). Scenario service and result post processing can be used to compare real experiment and simulated data (data-gathering and interpretation).

[Color Doppler echocardiography in emergency diagnosis of ventricular septal rupture after acute myocardial infarct]. / Erweiterung der kardialen Notfalldiagnostik bei Ventrikelseptumruptur nach akutem Myokardinfarkt mittels Farb-Doppler-Echokardiographie.

A 58-year-old man developed a rupture of the interventricular septum after acute posterior myocardial infarction. The two-dimensional echocardiographic features of the ruptured interventricular septum included akinesia of posterior wall, hyperkinesia of the interventricular septum and anterior wall, inferior basal septum aneurysm and visualization of the ventricular septum defect. Injection of echocardiographic contrast (Gelatin solution) into the right atrium showed a small right-to-left shunt, injection into the left ventricle (during heart catheterization) demonstrated massive crossing of echocontrast similar to the results of cineventriculography of the left ventricle. By coloured Doppler-echocardiography the left-to-right shunt could directly be visualized, as well as a diastolic right-to-left shunt. By calculation of pressure gradient using adjusted continuous wave Doppler, estimation of right ventricular pressure was possible. The results demonstrated that colour Doppler in addition to two-dimensional echocardiography has an important diagnostic role in patients with complications of myocardial infarction.

[Ultrasound-guided percutaneous one-step nephrostomy]. / Ultraschallgeführte perkutane "One-step"-Nephrostomie.

The percutaneous nephrostomy-set described is a two-piece desposable set for temporary or permanent urine drainage. Under combined sonographic and radiologic control the thin but stabilised puncture needle, used alone, offers the advantage of permitting definitive establishment of the fistula in a fast and safe manner without changing of the guide instrument and without any troublesome bouginage.

Combination of chemolysis and shock wave lithotripsy in the treatment of cystine renal calculi.

Acetylcysteine was shown to be the best agent for in vitro dissolution of cystine calculi in 4 patients. Shock wave destruction enlarged the surface area effectively and decreased the dissolution time by 50 per cent.

[Transient neurogenic bladder-emptying disorder caused by herpes genitalis following kidney transplantation]. / Vorübergehende neurogene Blasenentleerungsstörung durch Herpes genitalis nach Nierentransplantation.

We report on a case of transient neurogenic dysfunction of the urinary bladder caused by herpes genitalis in a renal transplant patient. The patient noticed a slow urinary stream 3 days after the vesicular stage of the herpes genitalis. After 9 days complete urinary retention and loss of sensation developed, necessitating the insertion of suprapubic tube. Symptoms and residual urine spontaneously disappeared after 20 days. After removal of the suprapubic tube the patient could empty his bladder completely with good stream. 45 cases of this kind have been described in the literature. the cause is a sacral meningo-radiculitis with herpes simplex virus leading to a transient neuromotoric paralysis of the bladder.