[Evaluation of testicular volume in 0- to 18-year-old boys by sonography]. / Sonographische Bestimmung der Hodenmaße im Alter von 0 bis 18 Jahren.

BACKGROUND: Reference values are necessary in clinical practice in order to correctly evaluate testicular volume and detect disorders. OBJECTIVES: The objective of this prospective cross-sectional study was to evaluate reference values for testicular volume dependent on age, height, and weight in boys aged 0-18 years. MATERIAL AND METHODS: During their inpatient stay, the testes of 174 boys, who were free of disease or therapy that might influence testicular development, were examined by sonography. High resolution ultrasound transducers ranging from 7.5-14 MHz were used for evaluation. The testicular volume was calculated by the ellipsoid formula: length • width • height • (π/6). RESULTS: The subject age ranged from 0-18 years (average 7.1 ± 5.3 years). At the age of 0-8 years, the left testicular volume (1.2 ml) was less than the right testicular volume (1.3 ml). At the age of 13 years, the testicular volume of all subjects was over 3 ml. Left testicular volume of boys aged 16.5-18 years ranged from 7 to 22 ml and the right testicular volume ranged from 6 to 22 ml. CONCLUSION: Reference value tables of testicular volume dependent on age, and for the first time dependent on weight and height in boys aged from 0-18 years were compiled. Tables of testicular length, width, and height dependent on age are provided.

Study of water adsorption and capillary bridge formation for SiO(2) nanoparticle layers by means of a combined in situ FT-IR reflection spectroscopy and QCM-D set-up.

Water adsorption and capillary bridge formation within a layer of SiO2-nanoparticles were studied in situ by means of a combination of quartz crystal microbalance (QCM-D) with dissipation analysis and Fourier transformation infrared reflection absorption spectroscopy (FT-IRRAS). FT-IR data were employed to distinguish the "ice-like" and "liquid-like" contributions and to support the analysis of the QCM-D data concerning mass change and dissipation. Combined measurements show that for SiO2-nanoparticles with a diameter of about 250 nm, the formation of two adsorbed monolayers of water as well as bulk water leads to a rather linear increase in the dissipation for relative humidity values of up to 60% which is followed by a strong increase in dissipation during the actual liquid bridge formation. Subsequently, the dissipation drops again when the relative humidity is further increased to values >90%.

Outdoor Terrestrial Model Ecosystems are suitable to detect pesticide effects on soil fauna: design and method development.

Terrestrial Model Ecosystems (TME) were developed as one higher-tier option to detect and assess effects of pesticides on soil communities in a 1 year study using lindane (gamma-HCH) as a persistent and toxic reference pesticide. TME contained intact soil cores (diameter 300 mm, height 400 mm) including indigenous soil communities of undisturbed grassland. Forty units were placed outdoors between spring 2005 and 2006. The TME experiment was designed to provide data that fulfill the requirements of the revised European regulation on plant protection products (regulation 1107/2009/EEC replacing guideline 91/414/EC) with a focus on structural endpoints such as soil organisms and their community structure in case higher-tier evaluation is triggered. The key objective was to evaluate the dynamics and stability of species-diverse microarthropod communities of undisturbed grassland over at least 1 year after application. In grassland soils, less selection pressure towards insensitive species compared to arable land was presumed. Sufficient numbers of organisms and numerous TME replicates ensured that a statistical evaluation could be performed to estimate the sensitivity of the organisms upon application of lindane applied at high rates of 7.5 and 75 kg ai/ha. The application rates resulted in nominal concentrations of 10 and 100 mg ai/kg dry soil referred to the top 5 cm soil layer of 10 TME each; 20 untreated TME served as controls and were used to study the natural dynamics and the variability of populations under field conditions. Results showed that the grassland from which the soil cores were sampled contained communities of soil organisms marked by typical diversity of improved grassland. Lindane applied at excessive rates caused clear dose-related and long-lasting effects on the communities of microarthropods. On the contrary, lumbricids, the total feeding activity (bait lamina) and the growth of plant biomass were not affected up to 1 year after application. Based on the results of this study using a toxic reference insecticide, the methodology seems to be suitable for use in the regulatory context of the assessment of pesticides once protection goals, data requirements and the conceptual framework are defined.

Case report: ectopic pancreas with pseudocyst and pseudoaneurysm formation.

Ectopic pancreas is a rare congenital anomaly. It is usually asymptomatic, or presents with non specific gastrointestinal symptoms. We describe here a case of ectopic pancreas in the gastric antrum, with pseudocyst and pseudoaneurysm formation. This entity has not been reported previously in the literature.

Haemophiliac pseudotumour: two case reports of patients with moderate haemophilia A.

We report on two patients with haemophiliac pseudotumours who did not respond to intensified factor replacement therapy. Therefore the pseudotumours had to be removed surgically in both cases.

A delayed diagnosis of an unstable os odontoideum.

We report the case of a 2-year old child from Kuwait with known history of tetraparesis from birth. Radiological evaluation including computed tomographic scan and magnetic resonance imaging confirmed an unstable orthotopic os odontoideum which was complicated by cervical myelopathy.

Intravitreal bevacizumab for the treatment of macular oedema secondary to branch retinal vein occlusion.

PURPOSE: To evaluate the effect of intravitreal bevacizumab (Avastin) injections on visual acuity (VA) and foveal retinal thickness in patients with macular oedema secondary to branch retinal vein occlusion. METHODS: A prospective, non-comparative, consecutive, interventional case series of 34 patients. Patients received repeated intravitreal injections of 1.25 mg bevacizumab. Main outcome measures were VA (Snellen charts and ETDRS) and retinal thickness (optical coherence tomography measurements) in a follow-up period of 6 months. RESULTS: Patients presented at a mean age of 69 years (range 44-86). Mean duration of symptoms was 40 weeks (range 1-300). Mean (SD) VA at baseline was 0.79 (0.39) logMAR, improving to 0.51 (0.34) logMAR at 6 months (p = 0.009). Mean number of letters on the ETDRS chart at baseline was 45.3 (19.0), improving to 60.6 (19.9) at 6 months (p = 0.003). Mean (SD) retinal thickness at baseline was 474 (120) microm, declining to 316 (41) microm at 6 months. CONCLUSION: Intravitreal injection of 1.25 mg bevacizumb appears to be an effective treatment option for branch retinal vein occlusion.

[Eyelid swelling caused by a meningioma in an 8-year-old girl. Case report and review of the diagnosis and the treatment for meningiomas in childhood and adolescence]. / Lidschwellung durch ein Meningeom bei einem 8-jährigen Mädchen: Fallbericht und Ubersicht über Meningeome im Kindes- und Jugendalter.

BACKGROUND: Tumours of the eyelid and orbit with different biological behaviour and localisation may cause eyelid swelling. Orbital meningiomas are rare, particularly in childhood and adolescence. CASE REPORT: We report the case of an 8-year-old girl with frontobasal meningioma, who was admitted to the hospital because of a one-sided upper eyelid swelling. With the example of this case, the diagnosis, treatment and aftercare of meningiomas in childhood and adolescence will be discussed. CONCLUSIONS: The treatment strategy of meningiomas in childhood requires a close interdisciplinary cooperation of ophthalmology, paediatric oncology, neurosurgery and radiotherapy. Moreover, controlled investigations should yield information about the efficiency of modern irradiation techniques or adjuvant chemotherapy in the treatment of inoperable or malignant meningiomas.

[Prolactinoma of the sphenoid sinus. Case report and literature review]. / Prolaktinom der Keilbeinhöhle. Kasuistik und Literaturübersicht.

In this case study, we report on a patient complaining of headache who, after CT and MRI, was found to have a neoplasia of the left sphenoid sinus. After a transnasal biopsy and histological examination, a prolactinoma was diagnosed. Based on this case, we discuss important aspects of tumor biology, diagnostic procedures, histology as well as differential diagnosis. Prolactinoma has to be considered as a differential diagnose in all sphenoid sinus neoplasias with close contact to the pituitary gland.

[Thrombosis of the iliac artery in a premature neonate: thrombolytic therapy using rt-PA]. / Arteria iliaca-Thrombose bei einem Frühgeborenen: Lysetherapie mit rt-PA.

Thromboembolic events in neonates are very rare. They are often associated with severe disease affecting the newborn or are secondary to central venous lines or arterial catheters. Most of the described cases of thromboses of the iliac or femoral arteries are associated with cardiac catheterisation or femoral invasive blood pressure monitoring. The relationship between single umbilical arteries and an increased incidence of structural and chromosomal anomalies is well known, but a higher rate of thromboembolic disease in infants with single umbilical arteries has not been described. Rt-PA (recombinant tissue plasminogen activator) has been successfully used in small studies and numerous case reports. To date controlled clinical trials giving guidelines for antithrombotic therapy using rt-PA are still lacking. We report the clinical course of a 700 g premature male, who was born by Caesarean section at 29 + 6 gestational weeks. On the fifth day the baby suffered from arterial thrombosis of the right pelvis axis. Antenatally a single umbilical artery was identified. Iliac arteries on the involved site appeared hypoplastic. Additionally, the prothrombin G20210A mutation was found. The patient was treated successfully using recombinant tissue plasminogen activator. In the case of a high risk of limb or organ loss due to arterial thrombosis, thrombolysis using rt-PA is justified. Appropriate rt-PA treatment has been studied for the adult but not the paediatric population. Hence, well-designed clinical trials are necessary to determine the pharmacokinetics and dynamics of thrombolytic agents in children.

Anatomic basis for a minimally invasive approach to the subtalar joint.

INTRODUCTION: An isolated arthrodesis of the talocalcaneonavicular joint is a common indication in cases of pain and post-traumatic arthroses. MATERIALS AND METHODS: Because of the high infection rate after surgery with the lateral incision, the authors decided to evaluate an alternative, minimally invasive procedure. Joint destruction was carried out via a posterolateral access after the insertion of two guidewires. For an evaluation of the risk for vessel and nerve structures, 102 ankle joint specimens preserved in formalin/alcohol were examined. Additionally, the minimally invasive access was evaluated in ten ankle joint specimens. RESULTS: Neither in the specimen nor during evaluation of the minimally invasive access could injuries of vessels or nerve structures larger than 1 mm in diameter be found. The authors did not encounter any problems when drilling open the articular surface with a destruction of 65% of the overall surface and when performing the following arthrodesis using a plug technique. Using a posterolateral, minimally invasive access between the Achilles tendon and lateral malleolus, it is possible to resect about 65% of the subtalar articular surface for arthrodesis without impact on major vessels and nerves. Postoperative complications such as sensitive and sensory failure as well as wound healing impairment at the lateral side of the foot are not to be expected when choosing the minimally invasive access. CONCLUSION: It has to be said, however, that this technique does not offer the opportunity of performing a corrective arthrodesis as the hindfoot cannot be displayed during surgery. As the result of this study was positive, clinical evaluation was started.

Application of ubiquitous computing in personal health monitoring systems.

A possibility to significantly reduce the costs of public health systems is to increasingly use information technology. The Laboratory for Information Processing Technology (ITIV) at the University of Karlsruhe is developing a personal health monitoring system, which should improve health care and at the same time reduce costs by combining micro-technological smart sensors with personalized, mobile computing systems. In this paper we present how ubiquitous computing theory can be applied in the health-care domain.

[Poly-beta-hydroxybutyric acid (PHB) films and plates in defect covering of the osseus skull in a rabbit model]. / Polyhydroxybuttersäure (PHB)-Folien und -Platten zur Defektdeckung des knöchernen Schädels im Kaninchenmodell.

BACKGROUND: Titan plates have proven a success in the operative assistance of middle face fractures for stabile osteosynthesis. Also bioresorbant materials are being used increasingly. METHOD: Films and plates made from poly-beta-hydroxybutyric acid (PHB) with two holes and bolts are tested subperiostally on the osseus skull of 15 rabbits or respectively on cut trough zygomatic arches. The test bodies and the surrounding tissue are explantated after a defined period and are clinically and histologically prepared. RESULTS: All implants healed well. There were no macroscopic or microscopic signs of inflammation. A very slow, clinically not recordable decomposition followed. A "leap" in the decomposition evidently took place between the 20th and 25th month. Only initial signs of resorbation were to be found microfocally on the surface of the implant until 20 months after implantation but no more test body could be detected after 25 months. CONCLUSION: PHB is suitable for defect covery of the osseus skull or respectively as osteosynthesis material for fractures of the visceral cranium.

Elevated levels of calcitonin gene-related peptide in aqueous humor of patients with proliferative vitreoretinopathy.

PURPOSE: To detect the levels of the sensory peptide calcitonin gene-related peptide in aqueous humor of patients with proliferative vitreoretinopathy and to compare them with those of uninflamed eyes (cataract and uncomplicated rhegmatogenous retinal detachment). MATERIALS AND METHODS: Using a highly specific and sensitive radioimmunoassay the concentration of calcitonin gene-related peptide was detected in fresh samples of aqueous humor obtained via paracentesis. Furthermore, calcitonin gene-related peptide-like immunoreactivities were characterized by high-pressure liquid chromatography. RESULTS: The mean level of calcitonin gene-related peptide was 6.11 fmol/ml in cataract controls and 14.77 fmol/ml in uncomplicated rhegmatogenous retinal detachment. In the cataract group, 9 of 18 cases were below the detection limit and in the retinal detachment group, 5 of 16. In proliferative vitreoretinopathy, the peptide averaged 76.92 fmol/ml and none of the samples was below the detection limit. High-pressure liquid chromatography revealed one major peak corresponding to synthetic calcitonin gene-related peptide. CONCLUSION: In recent studies, we found elevated levels of the sensory peptide substance P in aqueous humor of patients with proliferative vitreoretinopathy. This fact and the present result, the elevation of calcitonin gene-related peptide in aqueous humor of eyes with proliferative vitreoretinopathy, clearly point to an involvement of sensory peptides in the pathobiology of the disease. The source of the elevation is not clear, but we hypothesize that it originates from a neurogenic mechanism, i.e. an acceleration of the peptides by their enhanced release from the iris/ciliary body complex subsequent to sensitization of sensory neurons, thus representing a very interesting epiphenomenon of proliferative vitreoretinopathy. Our results constitute novel aspects in the pathophysiological concept of proliferative vitreoretinopathy and extend the knowledge about the pathobiology of the disease process.