On the efficacy of a spleenic dialysate (M 40,412) in disturbed potency (author's transl)

By means of a combined phallographic-exploratory method and using statistical classification we were able to confirm clinically the potency enhancing action of a spleenic dialysate (M 40,412, Solcosplen). The remarkable alleviation of chronic and acute disturbances of potency can be explained not only by the elevated serum testosterone levels but likewise by biochemical mechanisms of action in the target organ, as was demonstrated by a research group. The treatment of potency disorders of different genetical origins yielded as the outstanding conclusions: 1. The interdependence of dream- and erection phases, usually injured in disturbed potency, could be restored by M 40,412. 2. The effect of 40,412 was the more striking the more pronounced were the initial values. 3. A particular type of experiencing (feeling of inferiority and disturbed contact) appears to respond prevailingly well to M 40,412. Further clinical studies are suggested.     

Preoperative determination of the probability of a pulmocardiac insufficiency after resection of the lung

Pneumonectomy is endangered above all by pulmocardial insufficiency. Its probability can be calculated in advance by a simple formula and a nomogram. With the help of a special mathematical method the most important functional parameters have been investigated and the formula and nomogram have been derived. The safety of the prediction comes up to the demands of biostatistical significance.     

Diagnosis of pulmonary embolism with spiral and electron-beam CT

PURPOSE: To compare spiral (SCT) and electron-beam CT (EBT) for the diagnosis of pulmonary embolism (PE). MATERIALS AND METHODS: From June 1997 to June 1998 188 patients with suspected acute or chronic thromboembolism of the pulmonary arteries were examined. A total of 108 patients were scanned using SCT and 80 patients using EBT. On each scanner two different scan protocols were evaluated. RESULTS: PE was diagnosed in 38 patients using EBT and in 49 patients using SCT. Especially with EBT, isolated peripheral emboli could be confidently diagnosed. When EBT and SCT were compared for the analysis of peripheral pulmonary arteries, some paracardiac segmental and subsegmental vessels were significantly better analyzable with EB. Additional or diseases other than PE were diagnosed in 112 patients. Other diagnoses included bronchial carcinoma and aortic dissection. CONCLUSIONS: Advanced CT scanning techniques allow the highly accurate diagnosis of central and peripheral PE. Other potentially life-threatening underlying diseases are also readily recognized.     

Contrast hysterosonography: an efficient means of investigation in gynecology. Review of the literature

The structure of WA8242B, a potent novel inhibitor against phospholipase A2, was fully characterized by spectroscopic methods and chemical degradation. The success of total synthesis of WA8242B confirmed the structure and allowed the pharmacological study of WA8242B. The structures of WA8242A1 and A2 were also described.     

Cold preservation of the porcine pancreas with histidine-tryptophan-ketoglutarate solution

OBJECTIVES: To describe the prescribing and use of antiepileptic drug (AED) therapy in nursing facility residents. DESIGN: A retrospective, multicenter drug use evaluation. SETTING: A total of 85 nursing facilities (average size, 119 beds) in five states. PARTICIPANTS: 1132 residents of the total 10,168 residents screened were prescribed at least one AED. MEASURES: Demographic information, primary indication for AED, comorbid conditions, prescribing physician's specialty, concomitant medications, and AED dosage regimen information were collected. Laboratory tests obtained in the most recent 6 months and seizure occurrence and seizure-related diagnostic assessments made in the most recent 3 months were also recorded. RESULTS: Of 1132 residents receiving AED therapy, 892 (78.8%) were prescribed AED therapy for a seizure-related diagnosis although 86% of seizure types were unspecified. Another 215 residents (19.0%) were prescribed AEDs for nonseizure diagnoses, and 25 (2.2%) had no indication for AED therapy. AEDs most frequently prescribed were phenytoin (56.8%), carbamazepine (23.0%), phenobarbital (15.6%), and valproic acid (13.1%). For residents with a seizure diagnosis, the most frequently prescribed monotherapy agents were phenytoin (52.0%), carbamazepine (12.2%), and phenobarbitol (7.1%). Almost 25% of residents with a seizure diagnosis took a combination of AEDs; more than 50% of all combinations included phenobarbital. About 9% of residents with a seizure diagnosis had one or more documented seizures during a 3-month review period. CONCLUSION: Among the substantial percentage of residents treated with AEDs, the lack of diagnosis of seizure type has serious implications for the choice of AED therapy. Opportunities exist for prescribing physicians, consultant pharmacists, and nursing staff to improve the medical management of nursing facility residents with seizures and of others receiving AEDs.     

Scintigraphic evaluation of experimental colitis in rabbits

Scintigraphic techniques are frequently used for evaluation of inflammatory bowel disease. The radiopharmaceutical of choice is labeled leukocytes. In this study, two new agents, 111In-labeled polyethylene glycol-coated liposomes and 111In-labeled human nonspecific gamma globulin (immunoglobulin G; IgG), were compared with 111In-leukocytes in a rabbit model of colitis. METHODS: In rabbits, acute colitis was induced by colonic instillation of trinitrobenzene sulfonic acid at 25 cm from the anal sphincter. After 24 hr, 15 MBq of the radiopharmaceuticals was injected intravenously in groups of four rabbits. Twenty-four hours after injection, the animals were killed and macroscopic abnormalities were scored in seven consecutive affected colonic segments of 5 cm each (0 = normal, 1 = inflammation, 2 = ulcers). The ex vivo uptake was measured in the normal ascending colon and the affected colonic segments. The colitis index (CI, affected-to-normal colon-uptake ratio) was calculated. RESULTS: Histologically, an acute, patchy, transmural colitis was observed at the site of instillation and the distal colon. The CI of all agents in colitis lesions correlated with the severity of the abnormalities. With increasing severity, the CI for liposomes was 1.86 +/- 0.24, 4.88 +/- 0.42 and 7.42 +/- 0.54 (r2 = 0.68, p < 0.001); for leukocytes 1.77 +/- 0.32, 3.10 +/- 0.58 and 5.54 +/- 0.83 (r2 = 0.31, p < 0.01); for IgG 1.60 +/- 0.29, 2.81 +/- 0.21 and 2.65 +/- 0.21 (r2 = 0.29, p < 0.02). CONCLUSION: Indium-111-labeled-leukocytes, -IgG and -liposomes all show increased uptake in inflamed colonic tissue. Indium-111-liposomes showed the highest CI, which correlates best with the morphological abnormalities. Indium-111-leukocytes and 111In-liposomes are superior to 111In-IgG for this indication.     

Teratogenicity of 3-deoxyglucosone and diabetic embryopathy

The increased rate of embryonic dysmorphogenesis in diabetic pregnancy is correlated with the severity and duration of the concurrent hyperglycemia during early gestation. Whole embryo culture was used to investigate a possible association of hyperglycemia-induced disturbances of embryo development with tissue levels of the three alpha-oxoaldehydes: glyoxal, methylglyoxal, and 3-deoxyglucosone (3-DG). Rat embryos exposed to high glucose levels in vitro showed severe dysmorphogenesis and a 17-fold increased concentration of 3-DG compared with control embryos cultured in a low glucose concentration. Exogenous 3-DG (100 micromol/l) added to the medium of control cultures yielded an increased embryonic malformation rate and a 3-DG concentration similar to that of embryos cultured in high glucose. Addition of superoxide dismutase (SOD) to the culture medium decreased the malformation rates of embryos exposed to either high glucose or high 3-DG levels, but it did not decrease the high embryonic 3-DG concentrations caused by either agent. Our results implicate the potent glycating agent 3-DG as a teratogenic factor in diabetic embryopathy. In addition, the anti-teratogenic effect of SOD administration appears to occur downstream of 3-DG formation, suggesting that 3-DG accumulation leads to superoxide-mediated embryopathy.     

Transnasal microsurgery in children and adolescents with Cushing's disease

OBJECTIVE: Transnasal adenomectomy is the treatment of choice for Cushing's disease. We review the diagnostic peculiarities, specific surgical problems, and outcome of children and adolescents with Cushing's disease. METHODS: We report on our series of 55 consecutive children and adolescents (range, 4.2-18.9 yr [mean age, 14.4 yr]; female:male = 1.1:1.0; mean follow-up, 54.5 +/- 38.6 mo [standard deviation]) with Cushing's disease on whom we performed surgery since 1980. The indication for transsphenoidal surgery is based on endocrinological parameters and not on neuroradiological findings. RESULTS: Detection rate of the tumor site was 22% using computed tomography and 33% using magnetic resonance imaging. Only 7 of 13 interpetrosal adrenocorticotropic hormone gradients obtained during inferior petrosal sinus sampling correctly lateralized the tumor site preoperatively (53.8%). In cases of incomplete sphenoid pneumatization, adequate exposure is achieved by drilling. The tumor finding rate is 98%. The remission rate is 100% when two early subsequent operations are included. The recurrence rate for 45 primary operations with follow-up of at least 1 year is 15.5%. Seven of nine subsequent operations for recurrent hypercortisolism were successful. One patient needed three more operations until hypercortisolism subsided; one patient achieved remission after additional pituitary irradiation. The surgical morbidity was low in this series, which consisted of two cerebrospinal fluid fistulas. The incidence of hypopituitarism after primary operations (10.3%) is significantly lower than after subsequent operations (45.5%). CONCLUSION: Direct transnasal submucosal surgery for Cushing's disease is successful, and pituitary function can be preserved in most of these young patients.     

Contrast hysterosonography: indications and technic]

Contrast-enhanced sonography constitutes a new way of visualizing the uterine cavity. Indeed, real-time transcervical instillation of sterile saline inside the uterine cavity during transvaginal sonography (saline infusion sonography, SIS) allows a precise diagnosis of various intrauterine pathologies such as endometrial polyps, submucous myomas, intrauterine adhesions and various anatomical malformations. The aim of this article is to detail the technique of saline infusion sonography, its indications, contra-indications and semiology.